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To have and to hold nutritional control: balancing between individual and routine care. A grounded theory study
Mona Wentzel Persenius1, Bodil Wilde-Larsson, Marie Louise Hall-Lord
1Department of Nursing, Karlstad University, Karlstad SE-651 88, Sweden. mona.persenius@kau.se
Objectives:
Gaining insight into nutritional processes can help nurses and other staff in their work. The aim was to provide a theoretical understanding of the concerns and strategies of nutritional nursing care for patients with enteral nutrition in intensive care units.
Design:
A grounded theory approach was used. Observations of patient's nutritional care and twelve interviews with eight registered nurses and four enrolled nurses were conducted.
Setting:
The study was carried out in one intensive care unit at a medium sized hospital in Sweden.
Results:
The substantive theory developed included the core category "To have and to hold nutritional control - balancing between individual care and routine care". The core category was reflected in and related to the categories "knowing the patient", "facilitating the patient's involvement", "being a nurse in a team", "having professional confidence" and "having a supportive organisation". Finding a balance between individual care and routine care was a way of enhancing the patient's well-being, security and quality of care.
Conclusion:
To have and to hold nutritional control over the patient's nutrition was found to be a balancing act between individual care and routine care. Organisation and teamwork are both challenging and supporting the provision, maintenance and development of nutritional care.
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