Uncovering Clinical Knowledge in Expert Psychiatric Nursing Practice

Abstract

BACKGROUND: Psychiatric nursing has been referred to as a specialty area of nursing that is fading away because of the failure of its members to develop a theoretical base for practice. Benner (1984) maintained there is knowledge embedded in expert practice that can be usedfor theory development.

OBJECTIVES: The purpose of this interpretive study was to uncover clinical knowledge embedded in the paradigm cases of expert psychiatric nurses.

STUDY DESIGN: Heideggerian bermeneutics was the method that guided the study. Analysis of data was based on the seven-stage process described in Diekelmann, Allen, and Tanner (1989).

RESULTS: Three relational themes, Uncovering Dangerousness in Psychiatric Nursing Practice, Acknowledging and Marking the Boundaries, and Reflection on Practice, emergedfrom the data. The major finding of the study was the constitutive pattern, the Primacy of the Nurse-Patient Relationship in Psychiatric Nursing Practice.

CONCLUSIONS: Embedded in the paradigm cases in this study were descriptions of theoretical knowledge being refined and extended through reflection on practice experience. Clinical knowledge consistent with competencies in all seven of Benner's nursing domains also was present in the paradigm cases.

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