ALL DRESSED UP AND NOWHERE TO GO: NURSING ASSESSMENT IN GERIATRIC CARE.

Description

Available from UMI in association with The British Library. The purpose of the study was to uncover the patterns and perceptions of patient assessment in geriatric care. This aim arose from an examination of theoretical literature which advocated objective and detailed assessment as a foundation for nursing care. Clinical experience and a research review had indicated, however, that this form of assessment was not apparent in geriatric care. If changes in nursing assessment were to be implemented it was apparent that current beliefs and practices would have to be examined. An inductive approach to research design and methodological development was indicated by the aims of the study. The role of the naive stranger was, however, untenable given the researcher's nursing experience. This led to the use of more structured methods, an observation checklist, a study of nursing care plans, and guided interviews, which focused and disciplined the research. These tools were developed from unstructured observation and in consultation with the nurses studied, and therefore do not represent a researcher-imposed structure. This inductive development resulted in a focus on the assessment of mobility, and also led to a comparative study between one acute and two long term care wards. The second stage was governed by the findings of the first stage which suggested that there would be differences between patterns of assessment on the two types of ward. Qualitative analysis of the data indicates that assessment is a situated activity, and that nurses conduct assessment according to their definition of the ward function. These definitions arise from their adoption of medical values of cure and discharge, and so assessment becomes a meaningless activity in long term care. This has implications, not only for changes in nursing practice, but also for attempts to develop universally applicable theories and definitions of nursing which seek to determine the domain of nursing as care.

Subjects