Skilled nursing practice: a qualitative study of the elements of nursing

An understanding of skilled nursing practice has implications for the identity of nursing in service delivery, and for the learning environment of the developing nurse. Here I report a qualitative study, largely reliant on ethnography, which became a journey of exploration through accounts and descriptions given by nurses in a number of different practice settings. This journey is founded in an understanding of what I have called a phenomenological and psychosocial tradition, recognising the importance of a postmodern influence, which is in tension with a scientific and behavioural tradition. The emergence of four domains of skilled nursing practice in a contextualised narrative would seem to offer justification of assumptions concerning the value of embedded knowledge and intuitive clinical judgement in nursing practice, and lay a foundation for a qualitative study of the developing nurse.