Abstract

Purpose: This study offers a study of how a local ward culture underpins nursing actions of Thai surgical nurses in order to account for issues such as lack of sustainability, and failure to use research, including evidence-based nursing practice. The study was conducted at a Thai surgical ward to illuminate and describe the culture of the Thai surgical nurse, including the ways in which the organizational culture influences or guides their thinking, decision-making, and actions in a patterned way.

Methods: The knowledge about how the Thai surgical nurses allocate care, and make clinical decisions in the surgical ward in the context of social relations and staff culture is constructed through an ethnographic approach based on fieldwork. A better understanding of the diversity of Thai surgical nursing practice is then enacted from a typical day in the life of the Thai surgical nurses, which consists of the realities, ritualised practices, relations, and integration both with within their group and with others.

Results: The study results represent the way that nursing organizational culture informs the practices, decision-making, and the predictions of the nurses' possible response to change. The pre- and post-operative cares allocated by the nurses of the TSW are routinised, almost ritualised, and reflect fixed assumptions about the way cares ought to be delivered, including those reflecting the lack of commitment to implementing new multimodal models of care as well as research utilization and evidence-based practice.

Conclusion: The study raises significant concerns about the status of professional nursing in Thailand in terms of professional autonomy and the status of the nurses within the Thai hospital context. The ritualised practices, task-oriented working system, and the dominance of the medical model in the Thai nursing culture further reflect the need to establish an evidence-based nursing culture to create professional identity and improve the quality of care.

Author Details

Maneewat, Khomapak, PhD, MNs, BNS, (first, honor)

Sigma Membership

Unknown

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Clinical Decision-Making, Thai Nursing Culture, Workplace Relations

Conference Name

23rd International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Brisbane, Australia

Conference Year

2012

Rights Holder

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All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

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Proxy-submission

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Nursing care practices and workplace relations in a Thai surgical ward: An exploration of clinical decision-making

Brisbane, Australia

Purpose: This study offers a study of how a local ward culture underpins nursing actions of Thai surgical nurses in order to account for issues such as lack of sustainability, and failure to use research, including evidence-based nursing practice. The study was conducted at a Thai surgical ward to illuminate and describe the culture of the Thai surgical nurse, including the ways in which the organizational culture influences or guides their thinking, decision-making, and actions in a patterned way.

Methods: The knowledge about how the Thai surgical nurses allocate care, and make clinical decisions in the surgical ward in the context of social relations and staff culture is constructed through an ethnographic approach based on fieldwork. A better understanding of the diversity of Thai surgical nursing practice is then enacted from a typical day in the life of the Thai surgical nurses, which consists of the realities, ritualised practices, relations, and integration both with within their group and with others.

Results: The study results represent the way that nursing organizational culture informs the practices, decision-making, and the predictions of the nurses' possible response to change. The pre- and post-operative cares allocated by the nurses of the TSW are routinised, almost ritualised, and reflect fixed assumptions about the way cares ought to be delivered, including those reflecting the lack of commitment to implementing new multimodal models of care as well as research utilization and evidence-based practice.

Conclusion: The study raises significant concerns about the status of professional nursing in Thailand in terms of professional autonomy and the status of the nurses within the Thai hospital context. The ritualised practices, task-oriented working system, and the dominance of the medical model in the Thai nursing culture further reflect the need to establish an evidence-based nursing culture to create professional identity and improve the quality of care.