Maximizing Impact: A Grounded Theory Study of Primary Nursing Relationships in the Neonatal Intensive Care Unit
Bailey, Stephanie J
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Primary care nursing (PCN) is a common nursing care delivery system within the neonatal intensive care unit (NICU). Some studies of the effects of this form of care delivery have demonstrated positive effects for patients, families, nurses, and healthcare facilities but some reported concerning negative effects for nurses. There has been little study of the underlying relationships that develop between the primary nurse and the family which can be complex because of involvement of the parents in the NICU environment. The few extant studies of PCN relationships in the NICU are either dated or conducted in regions outside the United States. Classical Grounded Theory (CGT) was used to study relationships between NICU primary nurses and families as CGT can elucidate theories that underlie sociological processes while staying firmly grounded in the data. Eleven participants were recruited purposively and through snowball sampling methods from geographic areas spanning the US South, Southwest, and West. The researcher collected data using recorded semi-structured interviews. Transcripts were analyzed using constant comparative method, substantive and selective coding, memoing, and sorting. The participants’ main concern was revealed to be Maximizing Impact and they resolved their concern through relationships they built with NICU families through a four-phase process named Safeguarding this Family. At present, primary care nursing relies on motivated individual nurses and most patients are not matched with a primary nurse. Better understanding of primary NICU nursing could increase the implementation of PCN improving care and nurses’ experiences.