UNCOVERING CLINICAL KNOWLEDGE IN EXPERT PSYCHIATRIC NURSING PRACTICE (NURSING).
Contributors: University of Alabama at Birmingham.
Published: 1990
Number of pages: 181
Subjects: Health Sciences, Nursing.; Health Sciences, Mental Health.
Description: Psychiatric nursing has been defined as a specialty area of nursing which is fading away due to the failure of its members to develop a theoretical base for practice. Benner (1984) maintained there is knowledge embedded in expert practice which can be used for theory development. The purpose of this interpretive study was to uncover clinical knowledge embedded in the paradigm cases of expert psychiatric nurses. The conceptual framework for the study was based on nursing research conducted by Benner (1984), Benner and Tanner (1987), Tanner (1989), and a Skill Acquisition Model developed by Dreyfus and Dreyfus (1986). Heideggerian hermeneutics was the methodology which guided this research.

The sample consisted of 10 registered nurses, who had 5 or more years experience in a psychiatric setting and were identified as skilled clinicians by their peers. Paradigm cases obtained from the participants in unstructured interviews were audio-taped and transcribed to compose the texts for analysis. Analysis of data was based on the seven-stage process described in Diekelmann, Allen, and Tanner (1989). Because clinical knowledge emerged which was consistent with the competencies in all seven of Benner's Nursing Domains, another stage was added to the analysis to illustrate this relationship.

Three relational themes--Uncovering Danger in Psychiatric Nursing Practice, Acknowledging and Marking the Boundaries, and Reflection on Practice--emerged from the data. The major finding of the study was the constitutive pattern, the Primacy of the Nurse-Patient Relationship in Psychiatric Nursing Practice.

Recommendations for further research included the investigation of the decision-making process of nurses caring for patients experiencing danger to self or others, examination of the relationship of interpersonal boundaries to the termination phase of the nurse-patient relationship, and exploration of aspects of the nurse-patient relationship which emerged from this study: presence, trust, and reciprocity of caring. A suggestion which has implications for clinical practice was the use of small group forums for expert psychiatric nurses to exchange paradigm cases as a means of explicating and validating clinical knowledge developed through practice experience.
Notes: Source: Dissertation Abstracts International, Volume: 52-03, Section: B, page: 1355.

Thesis (D.S.N.)--UNIVERSITY OF ALABAMA AT BIRMINGHAM, 1990.

School code: 0005.