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‘Nurses whisper.’ Identities in nurses’ patient safety narratives of nurse-trainee doctors’ interactions

Samuriwo, Raymond, Bullock, Alison, Webb, Katie and Monrouxe, Lynn 2021. ‘Nurses whisper.’ Identities in nurses’ patient safety narratives of nurse-trainee doctors’ interactions. Medical Education 55 (12) , pp. 1394-1406. 10.1111/medu.14575

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Abstract

Context Nurses are integral to patient safety, but little is known about their constructions of identity in relation to their dyadic interactions with trainee doctors about patient safety and competence during the trajectory of a medical career. Aim We sought to examine how identities are constructed by experienced nurses in their narratives of patient safety encounters with trainee doctors. Methods Our qualitative study gathered narrative data through semi-structured interviews with nurses of different professional standing (n=20). Purposive sampling was used to recruit the first eight participants, with the remainder recruited through theoretical sampling. Audio recordings were transcribed verbatim and analysed inductively through a social constructionist framework and deductively using a competence framework. Results We classified seven identities that participants constructed in their narratives of dyadic interactions with trainee doctors in relation to patient safety: nurses as teacher, guardian of patient-wellbeing, provider of emotional support, provider of general support, expert advisor, navigator, and team-player. These identities related to the two key roles of nurses as educators and as practitioners. As they narrated these dyadic interactions, participants constructed identities that positioned trainee doctors in character tropes, suggesting gaps in professional competence: nurses as provider of general support was commonly narrated in the context of perceived deficits of personal or functional capabilities and nurses as team-player was mainly associated with concerns (or reassurances) around ethical capabilities. Discussion and Conclusion We shed light on the identities that experienced nurses construct in their narratives of interactions with trainee doctors to ensure patient safety, and to facilitate learning in practice about key tenets of medical competence. Nurses' work in ensuring patient safety and support trainee doctors’ professional development merits greater formal recognition and legitimation.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE)
Medicine
Publisher: Wiley
ISSN: 0308-0110
Date of First Compliant Deposit: 7 June 2021
Date of Acceptance: 27 May 2021
Last Modified: 04 Jun 2022 06:16
URI: https://orca.cardiff.ac.uk/id/eprint/141708

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