title: The use of metaphor in district nursing: maintaining a balance.
abstract: OBJECTIVE
  To explore with practitioners and others, their priorities for and definitions of district nursing.
  
  
  BACKGROUND
  This paper discusses whether the use of metaphor in nursing literature and research can offer particular insights about the situation and experiences of nurses.
  
  
  METHODS
  A case study approach was used to examine district nursing during a time of policy change. The study was undertaken in two stages using a range of qualitative methods of enquiry. Participants of the study were district nurses, General Practitioners (GP) and Community Nursing managers.
  
  
  RESULTS
  Qualitative data from interviews and periods of observation revealed that district nurses, and to a lesser extent General Practitioners and nurse managers used a shared group of metaphors to try and capture district nursing work. The paper suggest that this recurring group of metaphors demonstrated coherence between the language used, observed practice and accounts of how district nurses worked which provided useful insights for district nursing. The metaphoric language revealed both negative and positive dimensions of district nursing work. It illuminated the context dependent nature of district nursing work and the conflicting interests they had to accommodate. It also revealed the emotional work, skills and strategies district nurses employed in order to achieve their work.
  
  
  CONCLUSIONS
  The paper concludes that an examination of metaphoric language offers an opportunity to examine what otherwise would be tacit or even misunderstood in nursing work.
authors.affiliation: Post Registration Nursing, University of Hertfordshire, Hatfield, Hertfordshire, UK. c.m.goodman@herts.ac.uk
authors.forename: C
authors.initials: C
authors.lastname: Goodman
mesh_terms: D001291:Attitude of Health Personnel; D003152:Community Health Nursing / Q000458:organization & administration*; D004739:England; D005194:Family Practice; D006801:Humans; D019365:Metaphor; D009718:Nurse Administrators; D009936:Organizational Innovation