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Title: A higher level of practice : community nurse practitioners at work
Author: MacDonald, Janet M.
ISNI:       0000 0001 3614 9972
Awarding Body: University of Sunderland
Current Institution: University of Sunderland
Date of Award: 2003
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Community nurse practitioners from different parts of England were researched, who worked in General Practice, minor treatment centres or with homeless people. The aim of the research was to establish whether or not they were actually nursing, and if so, identify whether they were able to achieve a 'higher level of practice' ,as articulated by the UKCC Grounded theory, the qualitative research methodology developed by Glaser and Strauss, was used as a framework for the research. Data was gathered using primary observation with some participation (five hundred and eighty-one consultations being observed in the process), and by interviewing the community nurse practitioners and their clinical managers. The data was analysed using Glaser and Strauss' constant comparative method. Three theoretical frameworks emerged from the analysis. 'Negotiation for autonomy' is the core category at the heart of the overall theoretical framework that emanated from the research data. Those community nurse practitioners who were working at a 'higher level of practice' had the ability to negotiate for autonomy with GPs and multidisciplinary staff. It was this ability that allowed them the opportunity to practice with the autonomy required to be able to hold consultations with patients with undifferentiated diagnoses, as first point of access, providing care through to discharge or referral on to others. From a category, 'combination model of care,' within the overall theoretical framework, the researcher has developed a theoretical model of care, and a framework for the process - 'HADPIPE'. This model of care (and HADPIPE) is unique, as there is no other model of care, as opposed to a model of nursing, which has been developed, certainly in the UK, from researching the practice of nurses. The third theoretical framework sets down the characteristics of those practising at a 'higher level of practice. , This research highlights the nursing oriented approach to care taken by nurse practitio~ers, counteracting the argument that they merely perform a technical role.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Nursing