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Fleming, V. E. M. (1991). Towards nursing advocacy: a socio-political process. Ph.D. thesis, , .
Abstract: This thesis provides a reflexive critique of the power structures which constrain nursing actions in the practice setting, an abortion clinic, of the registered nurses who participated in this study. The development of abortion services, like other health services for women, has been based on a medical ideology of health which has created many ethical dilemmas for nurses. One of the most complex of these is the extent to which nurses should fulfil the role of client advocate. While the literature on nursing advocacy has been prolific, published research in this area is scant.The theoretical assumptions of critical social science, provide the basis for the methodological approach of action research adapted in this study. In depth, unstructured interviews involving exchange of dialogue amongst the participants with the researcher focused on the participants' experiences of their own nursing practice, with a view to uncoveing and removing restrasints, which had prevented them fulfililng an advocacy role. Diaries were also kept and used as supplementary research tools.The analysis of the data demonstrates the ways in which nurses interpret their own practice world as a system independent of their own actions. It shows how the shared understandings of the participants were 'ideologically frozen' and power relations inherent in the health care system are deep rooted and subtle, coming to be treated as natural by the nurses, and so denying them their own ability to make changes.It is suggested that opportunities for nurses coming together and engaging in such critically reflexive dialogue may provide a basis for future emancipation from traditional power structures. In this way effective and satisfying nursing practice dependent on emancipatory knowledge and a reinterpretation of power structures may result in an advocacy role for nurses
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Woods, M. (1997). Maintaining the nursing ethic: a grounded theory of the moral practice of experienced nurses. Ph.D. thesis, , .
Abstract: This thesis presents a study of the every-day moral decision making of experienced nurses. Eight experienced registered nurses participated in the completed research that is based on data gathered through interviews, document audit and literature review. A grounded theory approach was used to analyse the extensive data gathered for the study. This methodology generated a theoretical description involving the antecedents, processes and consequences of nursing moral decision making.Nursing practice has moral content, if not an entirely moral purpose, and moral decision making is the central component of this practice, yet the ethical aspects of nursing practice remain a comparatively recent field of study. It is therefore essential to nurses and their patients that this process is adequately studied and theorised. To date, very few studies have been undertaken in this area in New Zealand. This study aims to at least partially redress this situation by offering insights through conceptualisation and theoretical description of nursing moral decision making.The findings of the study reveal that antecedents such as personal moral development, upbringing and social experiences, contribute to a 'nursing ethic' in the moral decision making of experienced nurses. Furthermore, the study shows that the context and individual and shared perceptions of moral events influence the degree of nursing involvement in ethical situations. Finally, the study maintains that an intrinsic and persistent nursing ethic guides ethical decision making in nursing. This ethic is an undeniable phenomenon of considerable significance to nursing practice and education
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