Juggling a way of being: A grounded theory of how one group of nurses navigates tension among personal and professional values 'in the moment'

Abstract

Despite nursing’s espoused professional values of caring and social justice, some patients are stigmatized and receive discriminatory nursing care. There is a gap in existing literature about how nurses deal with the tension they experience when personal and professional values collide. The purpose of this study was to generate a substantive theory of the process that nurses use when faced with values tension in clinical practice and how this affects their behaviour. Using constructivist grounded theory methodology informed by symbolic interactionism and critical social theory, the theory of Juggling a Way of Being was co-constructed with data obtained through interviews with registered nurses (n=8) who provide frontline care in an emergency department in Atlantic Canada. The study’s findings revealed a process fraught with tension as nurse participants assimilated internal and external stressors, adjusted the patient-centered/nurse-centered lens according to their interpretation of the situation, and achieved a point of action or inaction. Implications for nursing practice and administration, education and research are discussed.