Making meaning of nursing practices in acute care

Purpose - The purpose of this paper is to consider how meaning may be made of nursing practices by contrasting the rationalistic approach commonly used in the nursing literature with Bourdieu's theory of practice. Design/methodology/approach - The data under consideration is an account of ten to 15 minutes of a larger ethnographic study of nursing practices which asks the question: how do nurses accomplish nursing within and between patients' needs for care in the acute hospital setting? The five main sources of data were: observations of and conversations with nurse participants, as well as hospital documentation (including facility protocols and patients' notes) and the observer's field diary. These were woven together to provide an account of one nurse with one patient for a few moments of her day. Findings - Although this paper makes no attempt to speak to the rest of her workload, in these few minutes the nurse accomplishes multiple moments of nursing practice. Further, while the rationalistic approach presents the nurse as a highly skilled practitioner, Bourdieu's theory of practice not only illuminates the nurse's role as pivotal in the acute hospital setting but is also able to address the dialectical nature of the relationship between nurses' practices and the dynamics of the context. Originality/value - The use of Bourdieu's theory of practice makes possible the study of how nurses nurse "within and between" to illuminate the everyday practices of nurses.