A gap between the philosophy and the practice of palliative healthcare : sociological perspectives on the practice of nurses in specialised palliative homecare
(2020) In Medicine, Health Care and Philosophy 23(1). p.141-152- Abstract
- Palliative care philosophy is based on a holistic approach to patients, but research shows that possibilities for living up to this philosophy seem limited by historical and administrative structures. From the nurse perspective, this article aims to explore nursing practice in specialised palliative homecare, and how it is influenced by organisational and cultural structures. Qualitative, semi-structured interviews with nine nurses were conducted, inspired by Bourdieu. The findings showed that nurses consolidate the doxa of medicine, including medical-professional values that configure a control-oriented, positivistic approach, supported by the organising policy for clinical practice. Hierarchically, nurses were positioned under... (More)
- Palliative care philosophy is based on a holistic approach to patients, but research shows that possibilities for living up to this philosophy seem limited by historical and administrative structures. From the nurse perspective, this article aims to explore nursing practice in specialised palliative homecare, and how it is influenced by organisational and cultural structures. Qualitative, semi-structured interviews with nine nurses were conducted, inspired by Bourdieu. The findings showed that nurses consolidate the doxa of medicine, including medical-professional values that configure a control-oriented, positivistic approach, supported by the organising policy for clinical practice. Hierarchically, nurses were positioned under doctors:medical rounds functioned as a structuring structure for their working day. They acted as medical assistants, and the prevailing
medical logic seemed to make it difficult for nurses to meet their own humanistic ideals. Only short time slots allowed
nurses to prioritise psychosocial needs of patients and relatives. Point-of-actions had high priority, added financial resources
and ensured that budgets were allocated. Weekly visits made it possible for nurses to measure, control and govern patients’
drugs and symptoms which was a necessity for their function as medical assistants. The findings challenge nurses to take
on an ethical point of view, partly to ensure that patients and their families receive good palliative care focusing on more
than medical issues and logic, and partly to strengthen the nurses’ profession in the palliative field and help them implement
palliative care philosophy in practice. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/0f4143ae-f691-4085-af2b-27040e701ecb
- author
- Glasdam, Stinne LU ; Ekstrand, Frida ; Rosberg, Maria and van der Schaaf, Ann-Margrethe
- organization
- publishing date
- 2020-03
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Specialised palliative homecare, Philosophy of palliative care, nurses, Bourdieu, Medical logic, neoliberalism
- in
- Medicine, Health Care and Philosophy
- volume
- 23
- issue
- 1
- pages
- 12 pages
- publisher
- Springer
- external identifiers
-
- scopus:85070191963
- pmid:31385188
- ISSN
- 1572-8633
- DOI
- 10.1007/s11019-019-09918-2
- language
- English
- LU publication?
- yes
- id
- 0f4143ae-f691-4085-af2b-27040e701ecb
- date added to LUP
- 2019-08-06 10:03:32
- date last changed
- 2023-10-26 10:42:40
@article{0f4143ae-f691-4085-af2b-27040e701ecb, abstract = {{Palliative care philosophy is based on a holistic approach to patients, but research shows that possibilities for living up to this philosophy seem limited by historical and administrative structures. From the nurse perspective, this article aims to explore nursing practice in specialised palliative homecare, and how it is influenced by organisational and cultural structures. Qualitative, semi-structured interviews with nine nurses were conducted, inspired by Bourdieu. The findings showed that nurses consolidate the doxa of medicine, including medical-professional values that configure a control-oriented, positivistic approach, supported by the organising policy for clinical practice. Hierarchically, nurses were positioned under doctors:medical rounds functioned as a structuring structure for their working day. They acted as medical assistants, and the prevailing<br/>medical logic seemed to make it difficult for nurses to meet their own humanistic ideals. Only short time slots allowed<br/>nurses to prioritise psychosocial needs of patients and relatives. Point-of-actions had high priority, added financial resources<br/>and ensured that budgets were allocated. Weekly visits made it possible for nurses to measure, control and govern patients’<br/>drugs and symptoms which was a necessity for their function as medical assistants. The findings challenge nurses to take<br/>on an ethical point of view, partly to ensure that patients and their families receive good palliative care focusing on more<br/>than medical issues and logic, and partly to strengthen the nurses’ profession in the palliative field and help them implement<br/>palliative care philosophy in practice.}}, author = {{Glasdam, Stinne and Ekstrand, Frida and Rosberg, Maria and van der Schaaf, Ann-Margrethe}}, issn = {{1572-8633}}, keywords = {{Specialised palliative homecare; Philosophy of palliative care; nurses; Bourdieu; Medical logic; neoliberalism}}, language = {{eng}}, number = {{1}}, pages = {{141--152}}, publisher = {{Springer}}, series = {{Medicine, Health Care and Philosophy}}, title = {{A gap between the philosophy and the practice of palliative healthcare : sociological perspectives on the practice of nurses in specialised palliative homecare}}, url = {{http://dx.doi.org/10.1007/s11019-019-09918-2}}, doi = {{10.1007/s11019-019-09918-2}}, volume = {{23}}, year = {{2020}}, }