Theory and practice in the induction of five graduate nurses : a reflexive critique : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Education at Massey University

Abstract

This thesis investigates the induction of comprehensive nurses into a professional culture during their polytechnic nursing education and first year of hospital practice. It combines a critical theory approach with case study method. The ways in which social forces constrain individual and professional action are demonstrated through a critical reflexive analysis of the perceptions of five recently graduated comprehensive nurses. Each graduate was interviewed at regular intervals over a three month period. It is argued that previous studies of professional socialisation of nurses conducted within both empirico-analytic and interpretive epistemologies, have tended to objectify the day-to-day actions that students and new graduates take. While providing descriptions of the socialisation process, previous studies have not explored the reflexivity of understanding and action as well as the structural constraints of nursing education and practice. In this thesis critical social theory provides a framework in which to reveal, through empirical research, the constraining conditions of actions, and, through interpretive forms of enquiry, human perception and understanding. The reflections of the five participants in this study reveal that there are similar structural constraints in education as in hospital based nursing practice. There is, in effect, a continuity of structural constraints and this is contrasted with a disjunction between knowledge and beliefs gained through education and those apparently required in nursing practice. The graduates' perceptions are discussed and interpreted in terms of both the intended and the unintended learning states engendered by their actual experiences in the polytechnic and hospital settings. It is suggested that, at present, nursing education and practice are shaped by forms of technical control which arise from the dominant ideologies already embedded in the education and health care structures. In particular, nursing curricula are dominated by the technical linear paradigm of curri­culum design which contributes to a distorted separation of theory and practice and which obscures the process of reproduction of professional culture. It is argued that a more socially critical approach to the design of nursing curricula might begin to transform some of the structures which presently inhibit and constrain the professional choices and actions of student and graduate nurses