Those who make a difference : nursing accounts of oncology and palliative care

Davies, Grant Thomas (1997) Those who make a difference : nursing accounts of oncology and palliative care. Masters by Research thesis, Queensland University of Technology.

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Abstract

A great many people in the community experience a range of chronic debilitating diseases that threaten their wellbeing and eventually lead to their death. The challenge for many practitioners is to provide care that is responsive to the needs of the patient, family and friends. This study seeks to examine this complex relationship and to explore the challenges, particularly the ethical challenges, faced by the practitioners in providing care that is acceptable to the individual, family and friends. The scope of this study, therefore, is upon the practices of oncology and palliative care nurses in three different organisational settings; an acute oncology ward, an acute palliative care unit and a specialist palliative care unit. An exploration of these practices is elicited by encouraging narrative accounts from the nurses working in these different care settings. The nurses were invited to explain their work as practitioners and encouraged to describe the challenges that they faced in the performance of that work. The accounts are devices for provoking reflection upon and questions about oncology and palliative care nursing practice. Therefore, these accounts should be seen as contributing to the conversation about how to care for people in these environments, not as definitive and universalistic claims about what happens in these settings. An analysis of the narratives of the participating nurses revealed many significant themes. There were also significant accounts of the quality of relationships nurses have with their surroundings which impact upon the quality of the care they provide. The key relationships mentioned by the nurses were: relating with patients; relating with family/significant others; relating with colleagues; relating with other health care professionals; relating with the institution; and relating with their profession. The significant themes, or meta-themes, to emerge from the accounts of the nurses were the types of agency encountered, the types of engagement encountered and the conditions experienced in their day to day practice. To be able to explain the significance of these accounts, the thesis provides a framework, based on previous studies of nursing practice and accounts about the nature of social and professional practices. This framework is utilised to introduce the narrative accounts of the nine nurses in Chapter 1 and to integrate and extend the findings emerging from these accounts in the final chapter. This study seeks to contribute to the discourse about the nature and quality of oncology and palliative care nursing practice. The accounts given by the nurses reveal significant aspects of the nature of oncology and palliative care nursing practice. These accounts highlight the challenges faced by these nurses and encourage careful consideration by those who are committed to and play a part in providing care for those who receive oncology and palliative care. An assumption which underpins the entire study is that an understanding of the challenges and perspectives of oncology and palliative care nurses is a crucial element in any deliberations or endeavours to improve these areas of nursing practice. A more explicit statement and a major conclusion of the study is that the responsibility for improvement in these practices, predominantly, but not exclusively, lies with the nurses themselves.

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ID Code: 35876
Item Type: QUT Thesis (Masters by Research)
Supervisor: Massey, David & Isaacs, Peter
Additional Information: Presented to the School of Humanities, Queensland University of Technology.
Keywords: Nursing ethics, Cancer Nursing, Palliative treatment, applied ethics, narrative, oncology nursing, palliative care nursing, nursing agency, nursing relationships, social practice, professional practice, thesis, masters
Institution: Queensland University of Technology
Copyright Owner: Copyright Grant Thomas Davies
Deposited On: 22 Sep 2010 13:03
Last Modified: 19 Jun 2017 23:57

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