From ward-based critical care to educational curriculum 2: a focussed ethnographic case study

The earlier published literature review (Part 1) identified the limits of our current understanding of the context of ward-based critical care nursing. Critical care curriculum for acute ward nurses, which will have to develop as part of meeting the mandates for 'training' outlined in Comprehensive Critical Care [Comprehensive Critical Care: a Review of Adult Critical Care Services (2000) Department of Health], will benefit from greater understanding of the culture and context of ward-based critical care nursing. In this, Part 2, the methods and findings of a focussed ethnographic case study are presented. The study explored, in depth, the culture and context of ward-based critical care in one acute surgical ward. Seven nurses were interviewed about their experiences of caring for critically ill ward patients. The data were analysed with a view to exploring what knowledge and skills were 'compatible' with the nurses' perceived role and the 'practical applicability' and 'relative advantage' of such knowledge for these practitioners. The context of ward care was found to be busy and contradictory for the nurses. The concepts central to this study; 'compatibility', 'practical applicability' and 'relative advantage' [Communication of Innovations (1971) The Free Press] were found to be complex concepts when studied in relation to real life clinical practice.