EdD- Dong Lijuan Revealing Nurses’ Practical Knowledge of Professional Caring: A Grounded Theory Study
Introduction This thesis concerns the diminishing nature of caring in professional nursing practice. As a practice discipline, nursing has a primary mission relating theory to practice. The aim of this study was therefore to discover what caring nurses do, why they do it, and when they do it through the lens of practical knowledge. In this way of knowledge development, practice can inform theory and therefore the curriculum 2. Methods The two main theoretical frameworks that shaped the theoretical and methodological foundation were professional caring from nursing field and practical knowledge from general teaching field 1. Using Straussian grounded theory approach to qualitative research, the main source of data was collected through semi-structured in-depth individual interviews with caring nurses in a primary care setting in Singapore. Theoretical sampling directed the recruitment strategy, data collection and analysis process, and sensitized derived concepts. Data analysis proceeded with constant comparison from open coding, axial coding to selective and theoretical coding. The main source of data was triangulated with data obtained from field observation and document review. Reflexivity was an important deliberation throughout the whole study to mitigate the influence of the researcher to this study. The ethics clearance was obtained from both the Institutional Review Board of Nanyang Technological University (IRB-2014-01-007) and Domain Specific Review Board of National Healthcare Group (2014/00223). Results The findings corroborated with the aim of grounded theory methodology, illuminating the practical knowledge of professional caring characterized by a set of reasons, understandings and actions enacted by nurses who put patients at the center of their practice. These nurses uphold shared values and beliefs of professional caring as the intrinsic motivation to initiate affective caring practice and to nurture the next generation of caring nurses. The actions, espoused by a mixture of content knowledge pertinent to nursing science, reflect the competencies of a nurse in fulfilling patients’ medical, psychosocial, mental, and emotional needs in collaboration with patients and colleagues in the often-challenging environment and emotion-laden situations. Discussion and Conclusion This research revealed five components of the practical knowledge of professional caring in the Singaporean context, namely a way of seeing, a way of being, a way of
knowing, a way of doing, and a way of becoming. Among the five components, a way of seeing emerged as the core category which delineated a nurse’ mental model of people-oriented worldview. This explained the intrinsic motive for enactment of caring practice i.e. a way of doing, which was espoused by the embodied values and beliefs in professional caring i.e. a way of being. This way of seeing promoted the relationship building in workplace where the culture nurtured caring people, caring work environment and caring community i.e. a way of becoming. Finally, a way of seeing mediates what content knowledge and competencies a nurse would choose to apply and achieve in own practice by understanding the situation and context i.e. a way of knowing. A way of being, a way of doing and a way of knowing were consistent with the literature, whilst a way of seeing and a way of becoming were the new insights harvested through this study. This study calls for attention of policy makers, educators and practitioners on repositioning professional caring at the centrality of nursing practice and education embodying a true patient centred care model. References 1. Elbaz, F. (1983). Teacher Thinking. A Study of Practical Knowledge. New York: Nichols Publishing Company. 2. Meleis, A. I. (2011). Theoretical Nursing: Development and progress (5th Ed.). Philadelphia: Lippincott Williams & Wilkins.