Balancing and compromising: nurses and patients preserving integrity of self and each other

This paper brings together the perspective of both nurses and patients of t he experience of nursing care delivery in acute care hospital settings. Ini tially, two grounded theory studies of the phenomenon of high-quality nursi ng care were conducted concurrently and in the same settings; one focussed on patients' experiences (Irurita, 1993. From person to patient: nursing ca re from the patient's perspective. Department of Nursing Research, Sir Char les Gairdner Hospital), the other on those of nurses (Williams, 1994. Unpub lished report, Department of Nursing Research Sir Charles Gairdner Hospital , Perth, Western Australia). Similarities between the findings of both stud ies led the authors, using grounded theory methods, to re-examine and compa re the findings and raw data, with additional data collected by theoretical sampling. The previous findings were integrated and extended, resulting in the development of a theory of Balancing and Compromising in response to t he shared problem of threats to integrity, especially encountered when broa der environmental and contextual conditions were unfavourable, This recipro cal process used by nurses and patients to preserve their own and each othe r's integrity involved: contributing to care - cooperating; prioritising an d rational sacrificing; justifying compromised care and lowering expectatio ns and protecting self by attracting or repelling. Both positive and negati ve outcomes resulted. (C) 2001 Elsevier Science Ltd. All rights reserved.