The structure and enactment of agency in the context of rural nursing practice
department or school: Applied Science, Faculty of
department or school: Nursing, School of
data provider: DSpace
degree campus: UBCV
creator: Buckley, Barbara Jean
issued: 2015-04-09T22:54:10Z
issued: 2015
related degree: Doctor of Philosophy - PhD
degree grantor: University of British Columbia
description: There is a growing awareness of inequities in rural healthcare in Canada and internationally. Rural nurses are embedded within complex healthcare structures, yet little attention has been paid to their experiences. These complex structures can function to both constrain and enable nurses to provide equitable, safe, and quality healthcare services to rural populations. This ethnographic study was conducted with rural nurses to explore the relationship between healthcare structures and rural nurses’ enactment of their agency. Informed by Structuration Theory (Giddens, 1984), Sewell’s (1992) notion of reciprocity, and a relational ethics lens, this research illuminates the relationship between the structures and rural nurses’ enactment of their agency in providing healthcare to rural based populations. Carspecken’s Critical Qualitative Research method (1996) was used to guide data collection during 528 hours of fieldwork and participant observations with primary nurse and allied healthcare provider participants (n=14). Additional data collected included: in-depth interviews (n=18); participant demographics; documents; and cultural commodities. Findings showed that the rural structure-nurse agent relationship was strained by urban-based policy-making. In particular, the rural practice context lacked sufficient physical and human resources to enact urban-policy directives (e.g. being unable to provide consistent primary and palliative care services). Nursing’s lack of active participation in policy decision-making has further impacted lack of policy directives toward fostering development of rural practice expertise. Key themes of: “we’re it”; “unseen complexity”; “pulling the nurse’s card”; “how many hands do you see?” and “beg forgiveness Monday morning” exemplified the disjuncture between rural and urban healthcare policy and practice. Inequities in access to healthcare services ultimately expanded rural nurses’ perceived moral obligations to include providing ad hoc …
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/52673
note: The Structure and Enactment of Agency in the Context of Rural Nursing Practice by Barbara Jean Buckley R.N., SIAST-­‐ Kelsey Institute, 1987, R.N., Recertification, Malaspina College, 2003, B.S.N., Thompson Rivers University, 2005, M.S.N., The University of British Columbia, 2007, A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in The Faculty of Graduate and Postdoctoral Studies (Nursing) The University of British Columbia (Vancouver) April 2015 © Barbara Jean Buckley, 2015 ii Abstract There is a growing awareness of inequities in rural healthcare in Canada and internationally. Rural nurses are embedded within complex healthcare structures, yet little attention has been paid to their experiences. These complex structures can function to both constrain and enable nurses to provide equitable, safe, and quality healthcare services to rural populations. This ethnographic study was conducted with rural nurses to explore the relationship between healthcare structures and rural nurses’ enactment of their agency. Informed by Structuration Theory (Giddens, 1984), Sewell’s (1992) notion of reciprocity, and a relational ethics lens, this research illuminates the relationship between the structures and rural nurses’ enactment of their agency in providing healthcare to rural based populations. Carspecken’s Critical Qualitative Research method (1996) was used to guide data collection during 528 hours of fieldwork and participant observations with primary nurse and allied healthcare provider participants (n=14). Additional data collected included: in-­‐depth interviews (n=18); participant demographics; documents; and cultural commodities. Findings showed that the rural structure-­‐nurse agent relationship was strained by urban-­‐based policy-­‐making. In particular, the rural practice context lacked sufficient physical and human resources to enact urban-­‐policy directives (e.g. being unable to provide consistent primary and pal…
has type: Thesis/Dissertation
date issued: 2015-05
is shown at: 10.14288/1.0166132
language: eng
degree discipline: Nursing
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivs 2.5 Canada
rights URI: http://creativecommons.org/licenses/by-nc-nd/2.5/ca/
scholar level: Graduate
type: Text
identifier URI: http://hdl.handle.net/2429/52673