Developing a relationship with the computer in nursing practice: a grounded theory




Cross, Barbara L.

Journal Title

Journal ISSN

Volume Title



Background: Computerization and the automation of nursing practice have evolved discretely and concurrently in this local health authority. During the early years when computers were first introduced into the clinical areas, computer technology was deployed with lilLIe or no consideration of the relationship between nurses and their requirements for access to information. With limited education and training, computer adoption rates among nurses have varied and havc not yct achieved the desired level of uptake to optimize the use ofcomputer technology in nursing practice. Aim: The purposc of this grounded theory research study was to gain a theoretical understanding about how nurses' understand and manage computer integration in their clinical practice. Method: Grounded Theory methods were used to examine the data acquired through semistructured interviews of 12 RN participants, currently practicing in two acute care, tertiary hospitals. Using the constant-comparative method of analysis, all data wcre collected and analyzed concurrently. Memo-writing was used extensively throughout the data collection and analysis process to further analyze and engage with the data. Findings: The findings demonstrate that nurses experience the integration of computers in their practice with varying spccds and degrees of adoption. They all engaged in the social process identified in this thesis as "Developing a Relationship with the Computer in Nursing Practice". Conditions and contingencies such as Prior Experiences contribute 10 the nurses' ability to Synthesize Values in their practice. Synthesizing Values is a process that requires nurses to identify and acknowledge their practice values in relation to the integration of computer technology in the context of patient care. The extent to which the nurse is able to synthesize values, detcnnincs herlhis ability to realize the benefits of integrating computer technology and subsequently manage the barriers. The extent to which nurses realize benefits and manage the barriers further defines whether they, "adopt", "adapt" or "ignore" the computer technology. This process is continuous and dynamic. As the nurses engage in new experiences associated with computerization, their acknowledgment of and ability to synthesize values and thus to realize benefits and/or manage the barriers becomes that much more infonned. Ln the end, the nurse may transition from a stale of"ignoring" to a stale of ,'adopting" depending on the outcome of her or his ability 10 realize benefits and manage the barriers. Conclusions: The participants in this study illuminated the importance of the organization attending to a diverse nursing community whcn introducing computer technology in their respective practice environments. Consideration of nurses' prior experiences particularly in the areas of computer experiences, bio-medical technology experiences, leaming, organizational discourses and professional discourses, will better inform future computerization initiatives requiring computer adoption and the inclusion of related clinical information systems. The participants in this study reveal the basic social process of DEVELOPING A RELATIONSHJP WITH THE COMPUTER IN NURSING PRACTICE when confronted with computerization in their practice.



computers and health care, grounded theory, synthesizing values, computer technology, integration