Edinburgh Napier University

  Most nurses, when asked why they joined the profession, would state ‘to care for people’. Equally, popular discourse depicts nurses as caring and conjures up images of self-sacrifice, altruism and ‘angels’. This perspective is shared by the nursing profession and public. Certainly nursing has a philosophical tradition where care and compassion are core. Yet not all patients experience this level of nursing care. A brief examination of popular press reveals numerous reports where patients’ receive routine care versus person centred care, and at worst suffer neglect and even abuse. The media questions the caliber of nurses and accuses them of rejecting their professional and philosophical mandate to care. Yet, findings from several high profile health care scandals question this view and indicate that workplace culture, rather than personal failings profoundly impact on the quality of patient care.

This presentation explores the impact of workplace culture on nurses’ beliefs, values and care giving behaviour. Utilizing the findings from a critical ethnographic study, one aspect of the findings, notably the team culture within this group of nurses is explicated to illustrate how individual nurses are constrained to deliver task focused care even in the presence of a personal and professional philosophical stance that espouses individualised, compassionate care.

Data were collected through observing nursing practice, participant interviews and examination of clinical documents used in care planning. A critical lens was applied to data analysis to reveal taken for granted assumptions and institutions of power that functionally limited the autonomy of individual nurses and promoted task focused ways of working. Nurses experienced a constant tension between autonomous action and social construction in their nursing practice. In this study social pressure predominated and nurses prioritized the needs of the team over patients and worked in ways designed to limit their colleagues’ workload stress.