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"Pain talk" in hospice and palliative care team meetings: An ethnography

Arber, A (2007) "Pain talk" in hospice and palliative care team meetings: An ethnography INTERNATIONAL JOURNAL OF NURSING STUDIES, 44 (6). 916 - 926. ISSN 0020-7489

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Abstract

Background: Specialist palliative care nurses have considerable expertise in pain management and this expertise can contribute to tension in the boundary between specialist nurses and non specialist doctors. Objectives: This article reports on how specialist palliative care nurses contribute to team talk about pain and the rhetorical strategies they use to develop their reputation and credibility in pain management Design and settings: This is an ethnographic study involving the collection of naturally occurring data from eight palliative care team meetings. The study is concerned with team meetings in hospice, community and hospital palliative care settings. Methods: Data was collected by audio recording eight team meetings in hospice, hospital and community palliative care settings. The data were analysed using a grounded theory approach followed by application of the tools of discourse and conversation analysis. Results: The findings indicate that specialist palliative care nurses use rhetorical strategies such as contrastive rhetoric, telling atrocity stories, veiled criticism and neutralism as a platform for building a reputation in managing pain. Furthermore they situate their expertise in pain management by direct contrast with problems related to non-specialist practice in pain management. Conclusions: The team meetings are a safe place, a collegial setting for specialist nurses to challenge non-specialist medical practice and to manage the specialist/non-specialist boundary. The findings have implications for further research related to the specialist nurse/ non-specialist doctor boundary and for education of specialist nurses and GPs.

Item Type: Article
Additional Information: NOTICE: this is the author’s version of a work that was accepted for publication in International Journal of Nursing Studies. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in International Journal of Nursing Studies, 44(6), August 2007, DOI 10.1016/j.ijnurstu.2006.04.002.
Uncontrolled Keywords: Science & Technology, Life Sciences & Biomedicine, Nursing, boundaries, community, pain, reputation, specialist palliative care, CLINICAL NURSE SPECIALISTS, NEGOTIATED ORDER, ISSUES, DISCOURSE, HEALTH
Related URLs:
Divisions: Faculty of Health and Medical Sciences > Health and Social Care
Depositing User: Anne Arber
Date Deposited: 06 Nov 2012 11:10
Last Modified: 23 Sep 2013 19:45
URI: http://epubs.surrey.ac.uk/id/eprint/732160

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