Date of Award

Fall 2018

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Leadership and Advanced Nursing Practice

Committee Chair

Dr. Lachel Story

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Janie Butts

Committee Member 2 School

Leadership and Advanced Nursing Practice

Committee Member 3

Dr. Bonnie Harbaugh

Committee Member 3 School

Leadership and Advanced Nursing Practice

Committee Member 4

Dr. Kathleen Masters

Committee Member 4 School

Leadership and Advanced Nursing Practice

Committee Member 5

Dr. Sarah Allison


The critical ethnography research examines need prioritization culture among medical-surgical nurses. Grove, Burns, and Gray (2013) define the problem statement as an explicit identification of the research need. Literature search yields scarce ethnographic research on the nursing population as a culture-sharing group, and no qualitative research exists regarding medical-surgical nurses’ self-need prioritization. The purpose of this critical ethnography is to observe medical-surgical nursing culture, related to personal need prioritization, as reflected by behavior and dialogue.

Qualitative research methodology is appropriate where statistical data is not. Research motivation involves seeking insight and sociocultural understanding. Critical ethnography is the chosen qualitative research methodology for this study based on research gaps. Ethnography research promotes cultural awareness and highlights change potential. Participants were full-time, day-shift medical-surgical unit nurses at a large Southeastern United States hospital. Data collection consisted of field observation, individual interviews, and surveys which occurred over a two week period. All ten participants completed the Nurse Codependency Questionnaire (Allison, 2004) upon observation completion.

Findings provide visibility to self-sacrificial tendencies and self-care adaptations within the medical-surgical nursing culture. Multiple themes emerged, and the researcher identified complex self-care behaviors. Data lead to more questions and implicated further research. The goal of this research was to encourage cultural self-awareness and promote inward change. Cultural examination examines both positive attributes and limitations. Future progress, because of introspective research, may lead to a nurse meta-paradigm shift through continued scholarly reinforcement.

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