The nursing profession comprises of various dimensions. These dimensions however have not been appreciated by the society by understanding the complexity of the nursing profession. The role of nurses has changed over times and is dynamic. To many, nursing profession is solely for physical health provision. This is not exactly the case as nurses are also involved in provision of other aspects of care such as social and spiritual care. The role of nurses as care givers is unique and needs to be appreciated. Nurses all over the world are connected by the technical skills that they posses.
These professional goes beyond the mare health care provision by the technical skills only. (Nieswiadomy, 1998 pp. 97-135) This paper is a critique of the article “Dimensions of caring: A qualitative analysis of Nurses’ Stories’’ by Sharon Hudacek. In this article Hudacek has written on a research conducted carried out in a qualitative manner to identify the dimensions of nursing profession. The research focused at analyzing the stories that were obtained from nurses around the world where analysis was done using Giorgis methodology which assisted in deducing the multidimensional and complex of the roles of nurses in provision of care.
This essay consists of two major parts in criticizing the article. The first part of the paper will criticize the significance of the research to nursing and the clinical practices in general. It will also examine the reason as to why the research was based on qualitative methodological approach. (Streubert & Carpenter, 1999 pp 67-89) In the second part of the essay, the research will be criticized in details through qualitative research critique methods. This critique will look on both the weakness and the strengths of the research based on the following components:
? Definition of the research problem ? Literature review ? The research design ? Data collection strategies ? Data analysis strategies ? Interpretation of the result finding ? Ethical consideration PART ONE Rationale for research area Nurses are entrusted in the provision of health care and are available to assist the sick in their most needy times. This unique responsibility brings about a unique relationship between the nurse and the patient. Hudacek’s article is on research about the stories of nurses in their day to day duties which are of different nature and challenging.
The nurse plays the role of a life saver yet nurses also witness their patients pass inevitably. In establishing what the nurses have to say to the public and to other professionals in their work of care giving. Hudacek collected stories from nurses from various parts of the world about the uniqueness of their job through experiences in care provision. These stories are an important base in understanding the role of nurses and appreciating the multidimensional complex essential care provided by the nurses.
The work of nurses should be acknowledged and through their stories it is easy to understand the specialty of this profession in the society. (Beanland et al. 1999 pp 57-107) Leaders in nursing stress on nurses telling on their stories to better understand the practice of nursing. It is obligatory and persuasive to share and the human experiences in daily life activities. In nursing telling stories of personal encounter with patients is a reflection on clinical practice and the essence of working at the bedside.
The essence of this research is to encourage nurses to tell there stories through written or oral means to the public and to the professionals. This is necessary in generating critical thinking and review which connects and illuminates the complexity and great inherent within the nursing profession. The narrative stories of nurses about their experiences in bedside care with their patients take the nurses back to a deep etched memory at one time in their care giving activity. This is necessary in motivating the nurses in the provision of care that constitutes more than health care provision as the research identified.
The stories enhance the relationship between nurses and their patients through touching of each others life. (Polit, & Hungler, 1997 pp 102-156) There are times when the nurse may touch the heart of a patient and make a change to their lives and the patients also may touch the life of a nurse and bring about change which improves the provision of health care and other services in the care giving practice of nurses. According to Crookes and Davies 2005, it is the story of the nurses which unfold the trusting relationships between nurses and their patients.
This research is also important in revealing of the unique nature of nursing profession which can create a good public relation. The care giving practice of nurses is special and innovative which integrates analysis, interpretation and the technical skills possessed by nurses. The research identified seven dimensions care giving in the nursing practice which helps us to appreciate the critical contribution of nurses in the society. These dimensions are as follows. ? Compassion ? Caring ? Community outreach ? Providing comfort
? Crisis intervention ? Spirituality and ? Caring the extra distance. This research assisted nurses to break the silence after many years of service which is more personal and meaningful. It has brought into light the true aspect of nursing through the written narratives they provided for this research to be able to come out with conclusive results of the various dimensions of care giving in the nursing practice. (Parahoo, 1997 pp 56-114) The research is also helpful for further research in the care giving practice of nurses.
The finding of this research are useful and can open further research studies in the field of nursing by assimilating theories and the results of this research in conducting useful research that brings the true meaning of care giving within the nursing profession as well as improving the relationship between nurses and patients in all aspects of care giving established in this very research by Hudacek. Methodological approach Research is essential in every aspect of life. In nursing various researches have been carried out in improving and demystifying the care provision in the nursing profession.
Various research methods are applied depending on the type of research and the aim of the research. Both qualitative and quantitative research methods have been widely used in research in nursing. These two methods of research can contribute to useful knowledge in nursing. In research it has become useful to use multidimensional research that includes both qualitative and quantitative research techniques. Therefore the polarization of this two research methods is no longer in existence and one cannot entirely work on its own.
In the research article by Hudacek, qualitative research was used and analysis performed through Giorgi’s methodology for existential methodology which is a qualitative research design. This research method is focused on the experiences of people in their day to day activities. (Giorgi, 1985 pp 111-142) This research allows individuals to describe their experiences. In the research by Hudacek, questionnaires were sent through mail to different individuals in different countries serving in the nursing profession. The question was not open ended question as it directed the nurse on the type of response one was required to provide.
The stories collected all were expected to tell of an experience in care giving that touched the life of the nurse or that of the patient. This is one of the weaknesses of this research methodology which uses closed ended questionnaires as it limits the nurses on telling stories about the challenges they face in providing care to their patients which also may touch their lives or change the life of the patient. However qualitative research is appropriate in the study of human behavior through experiences. It involves interactive process instead of linear.
This is essential in asking a general question which refines the intended meaning of results of the research as the research continues. The qualitative research tries to understand the whole phenomenon in the context of the research field. This is done through inductive reasoning with no preconceived ideas about the study outcomes as it involves the investigation of individual experiences of the nurses in a naturalistic setting that put meaning to the theory and practice of nursing and for further research work. (Streubert & Carpenter, 1999 pp 80-165)
The qualitative phenomenological research is common and is interested in descriptive data rather than numerical data. The phenomenological qualitative research is flexible and people centered which enhances the respondents in the research to be true to their story, that is, it increases the credibility of the data obtained through questionnaires. Considering that the nurses are emailed from a foreign country and are given a guideline question is important in producing reliable research result. Qualitative research is holistic and has continuous analysis of data to invent successive strategies.
The quantitative research however has strengths over qualitative research as it applies deductive reasoning. It offers numerical data that allows the researcher to reject or accept the data in relation to the formulated hypothesis. In the research article by Hudacek, there was no null hypothesis to guide the information collected during the research. The questionnaires sent to Australia, Argentina, United States, Slovakia, Cuba, Tekrik, Tokyo and other parts of the world including Africa may have been taken in a different way.
Considering that the different nurses come from different societies and have differing personal attributes could have brought about controversy in answering the question. This might be the reason unto why out of all the sent mails to the respondents; only two hundred were mailed back. (Burns and Grove, 2007 pp 90-198) Qualitative research fails to give an analysis of the real data. It does not break down data into meaningful conclusion. Out of the two hundred responses or stories that were received, they are not specified where they came from.
There is a possibility of the responses coming from one region or state which can not be reliable for drawing out a general conclusion. Quantitative research and analysis of data could have been applied in this research article to address such shortcomings that the article failed to consider. In quantitative research data is numerical and therefore statistical data analysis methods are deployed to come out with a information emphasizing objectivity.
In the research article by Hudacek, qualitative research has been singly used in establishing the role of nurses in health care provision in the named countries. The response obtained within twelve months time span from two hundred nurses was used to determine the heights of care giving practice of nurses. The Giorgi’s phenomenological research analysis was applied to give meaningful evaluation of the two hundred stories received. This qualitative method of data analysis used four major steps that helped in giving meaning to these stories in connection to the research topic.
(Giorgi, 1985 pp 34-102) These steps assisted in the study of data obtained and were applied as follows; ? The general reading of the narrative stories for general sense of the whole work. ? The re-reading of the narratives to filter the meaningful section ton be used in the drawing conclusive meaning to research. ? The reflection and focusing of each story to the phenomenon under investigation. ? The final synthesizing of meaning units into reliable structure of learning.
Generally the qualitative research used in this research were appropriate to the investigation of the phenomenon of care giving by nurses and helped in deducing seven dimensions of care giving by nurses who share a common technical skill despite the boundaries, race, religion, gender age and most important the level of development of the countries they live or give services in. PART TWO Problem definition Research in the field of nursing is endless and is important in filling in gaps in knowledge that is needed for care giving in nursing practice.
The purpose of a research is a clear and concise statement of a specific goal, aim or objective of the research study generated from the research problem. There are three major characteristics which a good problem should hold; ? The problem statement should clearly identify the variables under consideration. ? Should specify the group of population to be studied ? Should involve the possibility of empirical testing. The article by Hudacek the statement of the problem in the research is clearly stated in the very first paragraph of the article in the abstract.
It has also been expounded into more than just a problem by describing the methodology of research that would be applied in the research. The problem states, “The purpose of this qualitative, phenomenological study is to describe dimensions of caring as they relate to and clarify the practice of professional nursing” This definition of the research problem is descriptive of the nature of research that one expects and the purpose of carrying the research is vivid to the reader. In fact the articles abstract is a summary of every aspect of the research which puts the reader toes.
The reader also gets to know the extent at which the research goes into investigation of the problem. (DePoy, & Gitlin, 1994 pp. 58-94) The statement of this problem is clear and eliminates the possibility of ambiguity to the reader. The statement gives the summary of the article. The article puts it clear of the nurses stories obtained telling of the great experiences the nurses encounter in their day-to-day activities of health care provision. The article also explores the fact that nurses have not been telling their stories about their unique care giving practice. Literature review
In research, literature review is usually a written summary of the position of the existing knowledge on a research problem. Literature review is the use of theoretical and empirical sources to form a clear picture of what is known and what is not known in regard to the statement of the problem which gives the basis of the conducted study. In simple terms, literature review is the process by which the researcher takes account of the known knowledge about a given research topic. In the present research by Hudacek, the scope of the nursing profession in health care provision has been screened and analyzed deeply from different sources.
These sources include both secondary and primary sources. The research problem of the nurses’ silence about their daily experiences has been supported from other works. Hudacek has also used evidence of other available knowledge about the leaders in nursing encouraging nurses to give narrative stories in written form to express their day-to-day experiences in care giving practice. He uses evidence from books of various writers that the use of story telling to understand the nursing practice of care giving has been endorsed. Of all of the articles and books used are current.
The research used very recent scholarly works in the literature review which gives the research a sense of validity. (Hudacek, 2005 pp 89-153) Research design Research design is the recipe for conducting a research study and is responsible for optimizing control over factors that could get in the way with the validity of the findings. The research design controls and guides planning and implementation of a research study in order to achieve the desired results and findings. (Crookes & Davies, 2004 pp 89-130). In Hudacek research, the research design used is too weak to draw out conclusions.
The mailing of questions to nurses was not random in the first place. The names were provided from the University for the Research Group. This could have led to biasness of the respondents in writing their stories. The time span given to the respondents was quite enough in the research and amazingly only a small number of two hundred out of over thousand were received. The study design was not efficient in conducting this research and could not be valid to conclude the research. The narratives were not controlled from the place of source.
That is, there was no criterion for picking up stories for example at least ten from each state as most of them could have come from the same state. Therefore in the current research by Hudacek, the research design is generally poor. Sampling Sampling is the selection of the elements from the entire population to be studied. These elements can be people, behaviors or events among any other element that can be researched on. (Beanland et al. 1999 pp 45-123) In Hudacek article, a global database was used to provide names of nurses to be invited in the research. The participation was also voluntary.
In this non probability non purposive sampling, results are credible and fit for research study. Here the subject is not hand picked by the researcher. Data collection strategies This is the process by which information to be used in study of the research problem is gathered. The method of data collection is determined by the research method or the aim of the study. In the article by Hudacek, self report data was found appropriate. Structured self report data was collected by means of written form in stories that were mailed to the respondents. The respondents sent back the written stories via mails.
In the research study by Hudacek, the question was formed to guide the respondent on the orientation of the study by just writing a narrative story on ones experience with a patient who changed the life of the nurse. Approval was sought from the University of Scranton nursing department review board which approved the study. Data analysis strategies This is the systematic organisation and synthesis of research data. It is aimed at giving meaning to the data or information collected. In the current article Giorgi’s phenomenological methodology of data analysis was used.
The stories were read and interpreted to give meaning to the research problem using the three steps reviewed earlier in this essay. Interpretation of findings, Conclusion and Recommendations Findings of a research are the result of the analyses of the study information obtained from the research question. Conclusion on the other hand is the synthesis and explanation of the research findings. Result interpretation takes into account the objectives or goals of the study and the existing body of knowledge related to the research study.
In the research by Hudacek it was found that practice of nursing is meaningful to them and goes beyond the health care provision, i. e. , care giving practice is a multidimensional practice. From the findings seven dimensions of care in nursing practice were identified. These are, Caring, compassion, spirituality, providing comfort, crisis intervention, community outreach, and going the extra distance. (Parahoo, 1997 pp 98-134) Hudacek also encourages more research in his article on matters pertaining care provision by nurses.
The research helped in liberating nurses from the traditional restraints that may have caused them to feel unappreciated. Ethical issues Every research should be guided by ethical principles which ensure respect for person, beneficence and justice. Beneficence is entails the protection of the participant from harm which can either be psychological or physical. Ethical considerations in a research study outweigh the possibility of risks to the participants. In the research by Hudacek, ethical issues were considered in the best way. The mailing of the questions was personal and never involved a third party.
In giving information, anonymous was used to ensure that the stories were neutral and safe to be published in the article by Hudacek. Participants were not named neither did there stories were published with names of the patients. Professional code of ethics has been respected in the Hudacek research article i. e. Privacy, anonymity and confidentiality were observed during the research. (Roberts & Taylor, 2002 pp 34-69) The essay criticized the article on the dimensions of nursing: A qualitative analysis of nurses’ stories by Hudacek.
In the critique all aspects have been looked into clearly and weaknesses and strengths pinpointed during the critique. The abstract of the article defines the research problem statement and gives a summary of the whole article at a glance. The research was effective in achieving its goals all the same despite the pinpointed methodological shortcomings in the research. References Bailey, P. H. , & Tilley, S. (2002). Storytelling and the interpretation of meaning in qualitative research. Journal of Advanced Nursing, 38, 574-583 Burns, N. & Grove, K. (2007). Understanding nursing research: Building an evidence-based practice.
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Whitireia Nursing Journal, 10, 11-16 Nieswiadomy, R. (1998). Foundations of nursing research (3rd ed. ). Connecticut: Appleton & Lange. Parahoo, K. (1997). Nursing research: Principles, processes and issues. Basingstoke: Macmillan. Polit, D. & Hungler, P. (1997). Essentials of nursing research: Methods, appraisal and utilisation (4th ed. ). JB Lippincott. Roberts, K. & Taylor, B. (2002). Nursing research processes: An Australian perspective. Victoria: Nelson. Streubert, H. , & Carpenter, D. (1999). Qualitative research in nursing: Advancing the humanistic imperative (2nd ed. ). Philadelphia: Lippincott.
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