Inadequate nursing care in an emergency care unit in Sweden. Lack of a holistic perspective.

The aim of this case study has been to analyze factors that hinder the provision of adequate nursing care in one emergency care unit (ECU). The research question was, What are the conditions that explain the provision of inadequate nursing care in an ECU with reported problems concerning caring attitudes? The design of the study was exploratory and interpretive within a hermeneutic tradition. Nurses were interviewed, and field notes were made from participant observations of routine work and staff meetings. An interpreted whole revealed a lack of a holistic perspective. The difficulty of these nurses in accomplishing a holistic perspective seemed to be due to overvaluation of measurable tasks, such as medical interventions, and undervaluation of nonmeasurable tasks, such as caring. As a consequence, caring interventions failed to strengthen the nurses' self-esteem in the same high degree as medical tasks.