The Transition to "Patienthood," the Contribution of the Nursing Assistant: A Grounded Theory Study

Abstract

The face of nursing is changing, as health-care organizations are looking to new assistant roles to support the registered nurse and potentially provide a source for apprenticeship toward registration. These developments are within a context of an existing assistant staff group, delivering much of the bedside care. Few studies have explored the dyadic relationship between nursing assistant and patient, despite the potential for their interactions to contribute to the patient experience. This study aimed to gain an understanding of patients' perceptions of the nursing assistant role using constructivist grounded theory. Constant comparison guided data collection and analysis, and 4 core categories emerged: expectation, observation, meaningful connections, and adaptation. Within these core categories, we suggest the assistant plays a part in how participants adapt from the known self to a self of patienthood and the overall patient experience. We conclude that there is a necessity to understand more fully the dyadic relationship between patients and nursing assistants.

Keywords: grounded theory; health-care assistant; nurses; nursing; nursing assistant; patient; patient experience.

Figure 1.

Stages and process of constant comparison. Adapted from Charmaz (18) and Holton (21).

Figure 2.

Model depicting the relationship between elements contributing to the patient experience through the process of adaptation.