Independent nursing actions in cooperative care.
OBJECTIVE
To identify and describe independent nursing actions in cooperative care.


METHODS
Qualitative, descriptive, inductive study.


METHODS
The Nebraska Medical Center's Lied Transplant Center in Omaha, where lay care partners assume responsibility for acute care of transplant recipients in partnership with nurses.


METHODS
12 cooperative care nurses.


METHODS
Two focus groups, 59 narrative logs, and three follow-up interviews were tape recorded, transcribed, and content analyzed.


METHODS
Independent nursing actions in cooperative care.


RESULTS
Independent nursing actions included surveillance, teaching, coaching, fostering partnerships, providing psychosocial support, rescuing, and coordinating. Surveillance leads to problem identification that, in turn, triggers other actions. Because all nursing actions occur in the context of nurse, dyad, and healthcare team relationships, coordinating is the category of nursing action used to manage all aspects of care.


CONCLUSIONS
The nurses integrated specialized knowledge and expertise while dynamically using surveillance to identify problems that trigger nursing actions to manage signs and symptoms. Cooperative care is an example of apprenticeship or guided participation in which a community of experts (nurses) guides, supports, and challenges novices (lay individuals) to participate in skilled activities until the responsibility for the activities can be transferred to the novice.


CONCLUSIONS
Independent nursing actions identified in this study are the first step in formulating an instrument to measure "doses" (frequency and intensity) of nursing actions in cooperative care. Such an instrument is needed to evaluate interventions designed to prepare and support lay care partners.
Eilers
June
J
The Nebraska Medical Center, Omaha, USA. jeilers@nebraskamed.com
Heermann
Judith A
JA
Wilson
Margaret E
ME
Knutson
Sue
S
D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007400:Interprofessional Relations; D024802:Nurse's Role; D009732:Nursing Care / Q000592:standards; D016377:Organ Transplantation / Q000451:nursing; D010348:Patient Care Team