Primary nursing: autonomy or autocracy?
There has been an almost exponential increase in the number of clinical areas using primary nursing as a mode for delivering nursing care. Concurrently, the amount of written material pertaining to primary nursing has grown. In this paper, a small sample of this literature is reviewed. Most of the literature can be seen as either descriptive or as evaluative research. Many of the papers reviewed have methodological weaknesses; also the findings are equivocal about the advantages and the nature of primary nursing. A major problem appears to be that the basic tenets, beliefs and values of primary nursing have not been systematically investigated; thus attempts to evaluate primary nursing without such a philosophical analysis may be misdirected. This paper argues that such an analysis: (a) is now necessary; (b) requires a qualitative research approach to generate theory; and (c) that a grounded theory methodology is the most appropriate way to do this. A preliminary field study is briefly described and the generated data discussed.
Leach
M K
MK
ARC Epidemiology Research Unit, Medical School, Manchester University, England.
D006801:Humans; D007400:Interprofessional Relations; D007587:Job Description; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000592:standards; D009742:Nursing Theory; D011321:Primary Nursing / Q000458:organization & administration / Q000592:standards*; D017009:Professional Autonomy; D012380:Role