Professional Socialization: A Grounded Theory of the Clinical Reasoning Processes That RNs and LPNs Use to Recognize Delirium

Delirium is an acute disorder of attention and cognition. It affects half of older adults in acute care settings and is a cause of increasing mortality and costs. Registered nurses (RNs) and licensed practical nurses (LPNs) frequently fail to recognize delirium. The goals of this research were to id...

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Bibliographic Details
Published in:Clinical nursing research 2019-03, Vol.28 (3), p.321-339
Main Authors: El Hussein, Mohamed, Hirst, Sandra, Osuji, Joseph
Format: Article
Language:English
Subjects:
Acute services
Clinical decision making
Cognition
Critical thinking
Delirium
Grounded theory
Inpatient care
Medical diagnosis
Mortality
Nurse patient relationships
Nursing
Nursing theory
Older people
Patient assessment
Professional development
Professional socialization
Qualitative research
Sampling
Social processes
Substantive theory
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Summary:Delirium is an acute disorder of attention and cognition. It affects half of older adults in acute care settings and is a cause of increasing mortality and costs. Registered nurses (RNs) and licensed practical nurses (LPNs) frequently fail to recognize delirium. The goals of this research were to identify the reasoning processes that RNs and LPNs use to recognize delirium, to compare their reasoning processes, and to generate a theory that explains their clinical reasoning processes. Theoretical sampling was employed to elicit data from 28 participants using grounded theory methodology. Theoretical coding culminated in the emergence of Professional Socialization as the substantive theory. Professional Socialization emerged from participants’ responses and was based on two social processes, specifically reasoning to uncover and reasoning to report. Professional Socialization makes explicit the similarities and variations in the clinical reasoning processes between RNs and LPNs and highlights their main concerns when interacting with delirious patients.
ISSN:1054-7738
1552-3799
DOI:10.1177/1054773817724961