A Study Of The Introduction Of The Nursing Process In A Maternity Unit

This study provides a description of the introduction of the nursing process and an assessment of its use in a particular organization. The longitudinal study of the introduction of the nursing process (with "patient" allocation) was initiated by senior midwives at the research hospital. Midwives had become increasingly dissatisfied with their role and this study is an example of the initiatives being made by midwives to re-establish their role. Consumer dissatisfaction also suggested to the midwives that they should aim to individualize care and provide more continuity of care. The nursing process, widely introduced in general nursing, had had limited application in midwifery in the United Kingdom at the start of the project. Change was introduced into the practice of midwifery staff via a programme of in service education. Two-and-a-half years after the start of the longitudinal study a Cross-Sectional Study was undertaken to assess the extent of the changes introduced. Data was collected using a variety of research methods to provide a description of midwifery care from a number of perspectives. The data was analyzed in the context of the action framework of organizational activity (Silverman, 1972). The action of midwifery staff (midwifery care) was considered in relation to the knowledge of the nursing process held by midwives and nurses; the models of pregnancy in the wider society; the individual midwife's knowledge of and attitudes towards these areas, and the structure of the organization and relationships between different role occupants in the organization. The results of the Cross-Sectional Study indicated that although midwifery staff valued individualized care and had developed some understanding of the nursing process, care was routinized. It was concluded that the education programme aimed at the individual member of the midwifery staff produced little change in care and that such changes could only be achieved by attention to, and changes in, wider societal and organizational factors influencing midwifery care.