The ethnography on which the thesis reports was conducted over a period of fourteen weeks in which the chief investigator was located within an urban district nursing team in the north of England. Two methods of data collection were used – observations and interviews. Observations of clinical interactions (n=62) were undertaken between older adult patients aged over 60 (n=40) and members of the nursing team (n=15). Semi-structured interviews were undertaken with staff (n=11) and patients (n=11), which covered some standardised questions about dignity and human rights, plus individualised questions from the observations.
Thematic analysis resulted in three overarching themes: dignity in relationships, dignity in caring for the body, and dignity in the home. Dignity is fluid and there are some nursing tasks in which dignity is highly fragile, which includes care of the leaky body. Dignity does not exist absolutely, but findings indicate dignity is socially (de)constructed through social interactions. Within the caring relationship, nurses and patients can create a ‘dignity encounter’, and if care within the home is managed successfully, an ‘environment of dignity’ ensues.
The study concluded that although dignity is desirable, it is highly complex and has multiple meanings, yet dignity remains core to community nursing practice. Through investigating routine and ‘mundane’ aspects of community nursing, this study showed how micro-articulations in caring relationships have macro applications in terms of dignity.
Stevens E, Price, E, Walker, L “Just because people are old, just because they're ill…” Dignity matters in district nursing”, Journal of Adult Protection, 24(1), 3-14.
Stevens E, Price E, Walker L (2021) Dressings and dignity in community nursing. British Journal of Community Nursing, Vol 26 (11), pp 526-531.
Stevens E, Price E, Walker E (2021). Making the mundane remarkable: an ethnography of the ‘dignity encounter’ in community district nursing. Ageing & Society 1–23. S0144686X21000738