Abstract: This study focussed on nursing practice in action. The research goal was to identify nursing-relevant dimensions within a person's experience of being a hospital patient undergoing elective surgery. In order to discover and conceptualize the underlying processes which are present as patients are nursed through this experience, an open question was posed – What is happening here? A qualitative research method ws the most appropriate means of discovering an answer to this question.The particular method chosen was the grounded theory approach developed by Glaser and Strauss. Data were collected in five surgical wards of a large city hospital over a period of five months. The research participants were twenty-one patients and the nurses involved in their care. Primary sources of data were interviews and the nursing records. These were augmented by field notes and accounts of observed incidents relating to the care of each patient.Using the inductive strategies of the grounded theory method, numerous descriptive concepts were generated during the data analysis. These were ordered within an integrating social process derived from anthropology. By this means a founded theory in the form of a theoretical framework – the Nursed Passage – was developed. Within this passage the patient is the passage and nursing is translated into action through the agency of the nurse.The Nursed Passage is a patterned partnership with three key elements. Firstly, the temporal element, characterised by ongoing movement and constant change, is conveyed in the sequence of phases or stages. Secondly the participative element is portrayed as a patterned relationship in which both nurses and patient are actively involved in progressing the patient through the passage. Finally, the contextual element recognises complex factors within the nursing environment which have an impact on the shape of the relationship between patient and nurse.This theoretical framework, generated from the reality of nursing as it occurs in one setting, assigns a specific shape to the encounter between nurses and patient. It identifies the contribution nursing alone can make to optimise each patient's hospital experience. In this way it both complements and facilitates the work of medical and other colleagues with whom nurses work. Thus it serves to revalue nursing in terms that can maximally utilise the registered nurse's knowledge and skill for the benefit of all concerned. Consequently, it has the potential value for nursing practice, education and research

Abstract: The question for this study arose from the observation that health care often does not match the client's self-determined needs and desires, and hence is wasted care. As a result, the study proposed to discover what elements are involved when women with dependent children make health care choices and what they want in the way of health care.The exploratory study was conducted using strategies of grounded theory. Fourteen in-depth interviews, involving eleven women, were conducted. The selection of participants and of the questions for the interviews was basef on theoretical sampling. Constant comparative analysis and integrative diagramming were used to analyse the data.The theory that emerged from the data was Bonded Caring and its two essential categories; Interconnectedness and Caring. Bonded Caring requires an intimate and ongoing relationship in which there is development of in-depth knowledge of the unique characteristics of the person(s) involved. It is characterised by a strong and enduring effective quality, and by a concern, worry and serious attention to the needs of the person(s) involved. This concern necessitates the gathering of information about the nature of the needs, and making the best possible choices concerning their management.During this research for knowledge and skills needed to carry out health care, women assess their own knowledge and experience; the level(s) of health care needed by each individual; the availability, competence and expected response of the resource person or health care consultant; the perception of risk associated with a health concern; and the family's culture and life style. The women considered these elements within a structural framework of finite material and personal resources. The women juggled the distribution of these resources in a way that allowed them to select the avenues of health care that provided the best degree of safety and protection of development within the context of their circumstances

Abstract: This study examines the practice world of twenty two registered nurses working in medical and surgical wards of an acute general hospital in New Zealand. It is argued that nursing practice is a complex, context-specific, activity and needs to be studied using methods that do not assume an objective, context-free reality.The work of Patricia Benner (1984) guided this study which utilized a qualitative research approach to enter the lived world of nursing practice. Through descriptions of work days and a sharing of clinical exemplars, an understanding of the broader context of nursing practice was gained, areas of skilled performance in nursing emerged, and the meaning of making a difference for the nurses in the study examined. The central role of mutual advice and support in facilitating significant incidents in practice was apparent.An examination of the types of experiences which challenge current practice and change it in some way provided insight into the importance of experience in developing clinical expertise and the vital role of local knowledge in facilitating practice. Nursing practice emerged as crucial to patient welfare and safety in the acute care setting