Negotiated care--fundamental to nursing practice

This paper focuses on negotiation in nursing. It suggests that negotiation, in the form of negotiated care, is a key element of nursing practice in the many contexts in which it takes place. To support this statement the process of negotiated care is illustrated by three examples. These examples portray negotiated care as it occurs between nurse manager (or leader) and nurse clinicians, in an interdisciplinary context, and between nurses, other health practitioners and patients/relatives. These examples demonstrate that negotiation which is aimed at achieving quality patient care pervades nursing practice. Nevertheless, it is suggested that nurses often do not recognise the centrality of negotiation in their nursing practice, nor are its implications for long-held beliefs about the role of the nurse considered. This paper also suggests that the successful outcome of negotiation in the context of nursing is dependent on nurses' confidence in, and their ability to articulate their knowledge about, nursing practice. It also relies on their commitment to the therapeutic nature of nursing practice and nurses' awareness that their practice is an essential component to patient care. The specialist nature of negotiation in nursing care, and its fundamental role in the care process, suggests that negotiation in nursing is more accurately termed negotiated care.