Exploring nursing expertise: nurses talk nursing It has become increasingly important for practitioners to articulate their expertise in modern healthcare settings that demand high levels of accountability and evidence‐based practice. The material presented within this article has been interpreted drawing from discourse analysis1 to help explore the discourses that shape and influence understandings of nursing practice. What we present are extracts from four of the 35 participant nurses who applied to take part in the Royal College of Nursing Institute's Expertise (...) in Practice (pilot) Project (EPP). The material presented is used to provide a starting point for exploring how nurses talk about and construct expertise in nursing practice. The four nurse participants’ clinical practice areas cover palliative care, mental health, intensive care and fertility care. The material reveals high levels of intensity in the nurse–patient relationship, ‘maverick’ nursing practices and ongoing reflexivity. All of these aspects appear to capitalize on expertise as a ‘catalyst’ that alters treatment pathways and maximizes patient‐centred outcomes. Exploring a discourse of nursing expertise exposes the tacit situated nature of professional practice that is heterogeneous and most difficult to articulate and explain. It is proposed that expertise tends to be understood from traditional and dominant discourses of medicine, management and technology. Explaining expertise in practice exposes non‐conventional practice that in itself can be isolating and challenging to the status quo of contemporary health‐care. (shrink)

Forlagets beskrivelse: Informative, analytical and stimulating, this book examines the relationship between professional knowledge and clinical practice.Biography.

This long-awaited sequel to Benner's earlier book, From Novice to Expert, this volume further analyzes and examines the nature of clinical knowledge and judgment, using the authors' major new research study as its base. The authors interviewed and observed the practice of 130 hospital nurses, mainly in critical care, over a 6-year period, collecting hundreds of clinical narratives from which they have refined and deepened their explanation of the stages of clinical skill acquisition and the components of expert practice.

‘I’ll tell you what suits me best if you don’t mind me saying’: ‘lay participation’ in health‐careIncreasing ‘lay participation’ in healthcare has become a popular notion in recent years and is generally considered to be a good thing in both nursing and wider policy circles. Yet despite the widespread acceptance of this overall idea, there is a dearth of theorising in this area. This has resulted in a lack of conceptual clarity which has not only hamstrung the development of empirical (...) work in the field, but has also led to a tendency by both nurses and policy‐makers to assume that greater ‘lay participation’ in health will lead to a concomitant increase in lay power vis‐à‐vis health professionals. The data presented in this paper indicate that this is, at best, an over‐simplistic assumption and, at worst, an erroneous one. Drawing on sociological theories of the division of labour, I suggest that one way in which we might begin to clarify our thinking in this area is by differentiating between the ‘role’ and ‘task’ components of ‘lay participation’. I illustrate my argument with reference to two separate ethnographic studies undertaken between 1994 and 1998 in which participation at the level of the individual was examined. (shrink)

The idea that nurses should be trustworthy seems to be accepted as generally unproblematic. However, being trustworthy as a nurse is complicated because of the diverse range of expectations from patients, relatives, colleagues, managers, peers, professional bodies and the institutions within which nursing takes place. Nurses are often faced with competing demands and an action perceived by some as trustworthy can be seen by others as untrustworthy. In this article some of the reasons for the importance of being trustworthy are (...) offered together with a preliminary discussion about how being a trustworthy nurse is far from straightforward. (shrink)