With and for the Patient: The Knowledges Embodied in Nurses' Practices-of-Work in Acute Care

While understanding of what nurses do is most commonly framed as using clinical decision-making in completing a range of tasks to meet the care needs of patients, other perspectives show nurses as experiential carers and/or utilising a body of professional knowledge to do this. Taking data from an ethnographic study framed in Bourdieu's theory of practice, this paper aims to extend understanding of how nurses in acute care accomplish nursing-in-practice by utilising reconnaissance, a conceptualisation of nursing practice knowledges, as a vocabulary to further analyse these data. In this new way of thinking about what nurses do, nursing-as-it-happens is shown to be not about nurses making decisions as such, but about how nurses use contextualised knowledge to activate practices that respond to what needs to be done for patient care in the context of each practice situation. Focusing attention on what nurses accomplish in their daily practices-of-work reveals nurse agency as working with and for the patient. This enables recognition of how nurses working with multiple patients on a shift can make adjustments to their practices in light of unfolding situations and, when necessary, bring each of those patients as persons to the centre of their practice.