The pursuit of excellence in nursing care: what does it mean?

This study explores the meaning of excellence in nursing care held by nurses. Qualitative data were collected from 156 undergraduate and postgraduate nurses by means of an open-ended questionnaire. Respondents were asked to reflect on practice which enabled a clear understanding of the meanings given to excellence in nursing care. In addition, details of their nursing background, level of nursing experience, and demographics were sought. Responses were content-analysed for themes by three coders. Four major themes emerged: (1) professionalism, (2) holistic care, (3) practice, (4) humanism. The fourth theme comprised three sub-themes: (a) enabling personal qualities, (b) nurse patient relationships, and (c) nurse-health team relationships. Responses revealed that professionalism constituted an all-encompassing theme subsuming all others. Findings suggested that the client is the central focus of excellent nursing care at all times. According to these respondents, nurses who deliver excellent nursing care implement nursing in a professional and competent manner, demonstrate a holistic approach to caring, possess certain personal qualities which enhance practice, and relate to patients, families, peers, hospital administrators and community members in a competent, cooperative manner. An important aspect of this study is the differential quality of responses provided by respondents, who were students enrolled in a nursing degree programme compared to respondents who were state-registered nurses and concurrently undertaking higher degree studies. The final result is suggestive of the stages of transition through which nurses pass in their quest for excellence.