Learning Objective #1: Describe the complex interactions among nurses, family members, and patients

Learning Objective #2: Identify factors that influence the process of collaboration for nurses, patients, and family members

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The importance of including family members in nursing care has never been greater. Evidence about the reciprocal influence between families' health status and patients' illness status emphasizes the necessity for nurses to include families in their care to achieve better patient and family outcomes. It has been widely suggested however, that numerous barriers to implementation of family theory and to the formation of collaborative relationships among nurses, patients, and family members exist in acute care hospital settings. Explanations of the nature of interactions among nurses, patients and families in acute care clinical practice are limited. Consequently, the processes underpinning family nursing care in acute care settings, represented by various perspectives, i.e., nurses, patients and families is not known. My aims are to explain: how nurses, patients, and family members in acute care hospital settings interact around the provision of nursing care; how contextual and systemic features associated with the acute care environment affect interactions; and how features of a more personal nature, e.g. beliefs, affect interactions among nurses, patients and families. My research design is qualitative. Symbolic Interactionism serves as the theoretical framework for the study. Grounded theory is my specific strategy of inquiry. Using purposive and theoretical sampling strategies, participants were recruited from medical/surgical units from three acute care community hospitals. To date my sample includes 15 nurses, 10 family members and 13 patients. I have conducted 36 interviews and 6 hours of participant observation. I used concurrent data collection and analysis and constant comparative analysis to develop my findings. My preliminary findings suggest that the relationship among nurses, patients and family members in acute care hospital settings is characterized by a process of selective collaboration, which is influenced by available time, acuity of the patient's illness, level of rapport, patient and family initiative, and reciprocal respect.