Understanding nursing on an acute stroke unit: perceptions of space, time and interprofessional practice.
OBJECTIVE
This paper is a report of a study conducted to uncover nurses' perceptions of the contexts of caring for acute stroke survivors.


BACKGROUND
Nurses coordinate and organize care and continue the rehabilitative role of physiotherapists, occupational therapists and social workers during evenings and at weekends. Healthcare professionals view the nursing role as essential, but are uncertain about its nature.


METHODS
Ethnographic fieldwork was carried out in 2006 on a stroke unit in Canada. Interviews with nine healthcare professionals, including nurses, complemented observations of 20 healthcare professionals during patient care, team meetings and daily interactions. Analysis methods included ethnographic coding of field notes and interview transcripts.


RESULTS
Three local domains frame how nurses understand challenges in organizing stroke care: 1) space, 2) time and 3) interprofessional practice. Structural factors force nurses to work in exceptionally close quarters. Time constraints compel them to find novel ways of providing care. Moreover, sharing of information with other members of the team enhances relationships and improves 'interprofessional collaboration'. The nurses believed that an interprofessional atmosphere is fundamental for collaborative stroke practice, despite working in a multiprofessional environment.


CONCLUSIONS
Understanding how care providers conceive of and respond to space, time and interprofessionalism has the potential to improve acute stroke care. Future research focusing on nurses and other professionals as members of interprofessional teams could help inform stroke care to enhance poststroke outcomes.
Seneviratne
Cydnee C
CC
Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada. ccsenevi@ucalgary.ca
Mather
Charles M
CM
Then
Karen L
KL
D000328:Adult; D000416:Alberta; D001291:Attitude of Health Personnel; D005260:Female; D006272:Health Facility Environment / Q000592:standards*; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D010348:Patient Care Team / Q000458:organization & administration; D036301:Qualitative Research; D011787:Quality of Health Care; D020521:Stroke / Q000451:nursing*; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016526:Workload / Q000523:psychology; D055815:Young Adult