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A narrative case study evaluation of the role of nurse consultant in palliative care

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Publication Date
Keywords
  • Rt Nursing
Disciplines
  • Education
  • Political Science

Abstract

The role of Nurse Consultant was developed as part of government strategy to reform the National Health Service. This thesis is an evaluation of my practice in this ‘new’ role. The evaluation was undertaken in three phases. In the first phase, from an extensive qualitative data base collected from my day-to-day practice, I analysed and constructed four short stories of my practice. Told in poetic form, these short stories evocatively portray the difficulties faced in caring for people at the end of life in an acute hospital and illuminate key themes that shaped my experience in this ‘new role’. These were finding my place and being put in my place, the emotion inherent in my day-to-day practice, developing and enhancing palliative care practice, and brokering professional presence and hybridity. In the second phase, I analysed and evaluated the short stories to identify the values that influenced my nursing leadership and patient care. From these a theory of my practice was constituted. This theory was critically examined in the third phase of analysis. The theory emphasises the importance of leadership as a relational practice, through which patient care is enhanced. This practice is influenced by professional power interrelations, the meanings of palliative care within the acute Trust and the cultural divide between organisations, particularly between nursing and education and acute care and palliative care. The thesis concludes with reflections on the research process and the tension I experienced in researching my own practice in a culture where ‘evidence-based practice’ is the norm and empirical evidence is most valued. My understanding and theory of leadership portrayed in this thesis stems from a different tradition. Grounded in observation and reflection on practice, it provides a perspective on the role currently absent from the literature, especially in the field of palliative care.

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