An autoethnographic account of changes in outpatient nursing practice

Abstract

The aim of this thesis is to explore the changes that have occurred in the outpatient nursing practice and how the changes have affected the way outpatient services have been delivered. A literature review collectively identified the changes and evolution of the hospital outpatient department with the advances in nursing practice that supported the changes. Legislation, policy making, and government reform have all contributed to changes in nursing practice. The qualitative research design for this thesis was based on autoethnography involving a written narrative describing a thirty-year career with recollections of experiences over that time.

The narrative for this thesis was analysed systematically using a general inductive thematic approach. This identified several common themes that emerged and were discussed under the sub-headings: nurse training, education and practice; technology; culture and socialisation, and patient demographics. In the subheading of nurse training, education and practice the changes that have influenced nursing career paths are identified. Changes that have been influenced by the innovation of technological advancements are discussed, and the drivers for the changes that are patient-centred on safety or quality improvement. Finally, the subheading -patient demographics has raised awareness of the different needs of the population and community I nurse in.

The goal of this research was to identify the changes that have occurred over a thirty-year nursing career, to understand the growth of the outpatient department and nursing practice within it. This has been deeply personal and insightful into how the nursing profession has evolved.