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The work of district nurses: first assessment visits
1School of Acute and Continuing Care Nursing, Napier University, Edinburgh, UK. c.kennedy@napier,ac,uk
Journal of Advanced Nursing
|December 11, 2002
Summary
District nurses utilize a blend of theoretical and practical knowledge for patient assessments. This knowledge is context-specific and dynamically applied to manage complex patient needs effectively.
Area of Science:
- Community Health Nursing
- Nursing Practice
- Qualitative Research
Background:
- District nurses are the primary community nursing group in the UK.
- Assessing and planning patient and family needs is a core responsibility.
- Understanding the knowledge base for initial patient assessments is crucial.
Purpose of the Study:
- To investigate the knowledge district nurses require for initial assessment visits.
- To examine the link between this knowledge and their decision-making processes.
Main Methods:
- Ethnographic research design.
- Participant observation and two semi-structured interviews with 11 district nurses.
- Data collected between 1997 and 1998, with interviews conducted in two phases.
Main Results:
- District nurses employ a combination of theoretical ('knowing that') and practical ('knowing how') knowledge.
- The assessment process is reflexive and context-dependent, challenging decontextualized theoretical models.
- Knowledge application is tailored to the specific patient-nurse interaction.
Conclusions:
- Information seeking during assessment is paced according to situational uncertainty.
- Effective judgment in complex cases relies on understanding assessment as a paced process.
- This paced approach supports optimal decision-making during patient visits.