Enacting Nursing Obligations: Public Health Nurses' Theorizing in Practice by ProQuest


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									 Research and Theory for Nursing Practice: An International Journal, Vol. 23, No. 2, 2009

          Enacting Nursing Obligations:
             Public Health Nurses’
             Theorizing in Practice
                     Gweneth Hartrick Doane, RN, PhD
                      University of Victoria, British Columbia, Canada

                          Annette J. Browne, RN, PhD
                           Joanne Reimer, RN, MN
                     University of British Columbia, Vancouver, Canada

                           Martha MacLeod, RN, PhD
              University of Northern British Columbia, Prince George, Canada

                             Edna McLellan, RN, MN
              Northern Health Authority of British Columbia, Kitimat, Canada

     A recent study illustrated Public Health Nurses’ theorizing of obligation within
     their everyday practice with high priority families. As a practical (and practice)
     activity this theorizing shaped and enhanced PHN practice in complex nursing
     situations and served to affect desired outcomes for families. Using a hermeneutic
     methodology, six features were identified as central to this practical theorizing
     process: (a) being in the complexity of families’ lives, (b) responding to relational
     cues, (c) putting the primary investment in people and families, (d) working toward
     potential, (e) working the relational “in-betweens,” and (f ) reflexive inquiry. The
     findings have implications for understanding theory and theory development in
     everyday nursing practice.

     Keywords: obligation; family; theory; relational; reflexivity; ethics

         evelopment of theoretically sound nursing practice and the integral con-
         nection of practice and theory have been central foci of discussion within
         the nursing discipline over the past few decades (Tolley, 1995). As the
discipline has moved beyond the objective, realist understanding of theory, a grow-
ing emphasis on the role that practice experiences can potentially play in theory
development has emerged. Ellis (1969) first proposed the idea of practitioner as
theorist contending that “the professional practitioner must become not simply a

88                                                    © 2009 Springer Publishing Company
                                                                  DOI: 10.1891/1541-6577.23.2.88
Enacting Nursing Obligations                                                       89

user of given theory, but a developer, tester, and expander of theory. This is not
for the purpose of scholarship; it is an essential for intelligent practice” (p. 430).
More recently, Hartrick Doane and Varcoe (2005a, 2005b) have illustrated the way
in which theorizing within practice situations can simultaneously enhance nurses’
capacity for ethically responsive practice as well as further theory development
within the discipline of nursing.
   In line with the perspective of practitioner as theorist, this article describes
findings of a recent study that illustrated theorizing as a practical (and practice)
activity. Specifically we describe Public Health Nurses’ (PHNs) theorizing of nursing
obligation, the way in which theorizing of obligation—in the everyday contexts of
practice—was an inherent part of their 
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