Ethnographic Study In Nursing

Of the limited literature available, recent valuable insight is offered by an ethnographic study which explored the nurse’s role on an acute medical unit (Griffiths, 2010). The study highlighted the nurse’s focus on rapid assessment and management with the need to maintain a flow of patients from A&E through the AMU, whilst managing patients who were potentially unstable and often critically ill. In terms of the levels of patient acuity, dependency and activity, nursing patients in the AMU is very different to nursing practice in a general ward. Griffiths (2010) identified that the level of demand for acute medical hospital beds and the weight of clinical work in the AMU resulted in ‘superficial and short lived relationships between patients

There has been minimal research into the impact of time (time spent with patients) temporality (life experiences bounded by time) and tempo (speed of nursing activity), resulting in poor understanding of the impact of time upon practice. The majority of research that has been conducted is outdated and has focused on linear models of time measured by the clock and calendar. The sociologists Frankenberg (1992) and Zerubavel (1979) compare and contrast the time experiences of doctors and nurses, providing insightful portrayal of medical time, but demonstrating a poor grasp of the realities of nursing time which, when examined, is looked at from the perspective of the linear monochronic model. This portrayal of time fails to recognize the potential for chaotic and disordered nursing environments (Waterworth, 2003) which are arguably found within acute care environments such as the AMU and does not recognize that comparisons across the two disciplines are incompatible, since medical and nursing

Jennings et al. (2011) offer valuable insight from their ethnographic study conducted on a medical and surgical ward, which explored how administration of medication impacted upon nursing time. They reported that much of the nurses’ day was spent in the preparation and administration of medication and was complicated by the demands and availability of technical devices used to administer the drugs. With no clear start and finish to the essential task of administering medication, nurses adapted their practice to incorporate the constant demands of this function with the delivery of nursing care. Settings within the hospital with high volumes of admissions, high levels of activity and patient acuity such as the AMU are referred to by Jennings (2008) as turbulent, meaning that there may be sudden and unpredictable changes to the workload at any given time during a shift consequently affecting the time available to nurses to provide care. Where insufficient staff numbers are available to cope with demand, interventions may be missed, ultimately