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Opting in and opting out: a grounded theory of nursings contribution to inpatient rehabilitation

Pryor, Julie, Walker, Annette, O'Connell, Beverly and Worrall-Carter, Linda 2009, Opting in and opting out: a grounded theory of nursings contribution to inpatient rehabilitation, Clinical rehabilitation, vol. 23, no. 12, pp. 1124-1135, doi: 10.1177/0269215509343233.

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Title Opting in and opting out: a grounded theory of nursings contribution to inpatient rehabilitation
Author(s) Pryor, Julie
Walker, Annette
O'Connell, Beverly
Worrall-Carter, Linda
Journal name Clinical rehabilitation
Volume number 23
Issue number 12
Start page 1124
End page 1135
Publisher Sage Publication
Place of publication London, England
Publication date 2009-12
ISSN 0269-2155
1477-0873
Summary Aim: To develop a grounded theory of nursing’s contribution to patient rehabilitation from the perspective of nurses working in inpatient rehabilitation.

Design:
Grounded theory method, informed by the theoretical perspective of symbolic interactionism, was used to guide data collection and analysis, and the development of a grounded theory.

Setting:
Five inpatient rehabilitation units in Australia.

Participants:
Thirty-five registered and 18 enrolled nurses participated in audio-taped interviews and/or were observed during periods of their everyday practice.

Findings:
The analysis revealed a situation whereby nurses made decisions about when to ‘opt in’ and when to ‘opt out’ of inpatient rehabilitation. This occurred on two levels: with their interaction with patients and allied health professionals, and when faced with negative system issues that impacted on their ability to contribute to patient rehabilitation. The primary contribution nurses made to inpatient rehabilitation was working directly with patients, enabling them to self-care. Nurses coached patients when their decisions about ‘opting in’ and ‘opting out’ were based on assessment of the person in their particular context. In contrast, the nurses mostly distanced themselves from system-based problems, ‘opting out’ of addressing them. They did this not to make their working lives easier, but more manageable.

Conclusion:
System-based problems impacted negatively on the nurses’ ability to deliver comprehensive rehabilitation care. As a consequence, some nurses felt unable to influence the care and they withdrew professionally to make their work lives more manageable.
Language eng
DOI 10.1177/0269215509343233
Field of Research 111099 Nursing not elsewhere classified
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2009, SAGE Publications
Persistent URL http://hdl.handle.net/10536/DRO/DU:30021685

Document type: Journal Article
Collection: School of Nursing and Midwifery
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Created: Fri, 15 Jan 2010, 11:14:36 EST by Sally Morrigan

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