7.8.1 Nursing patients in transition: An ethnography of the role of the nurse on an acute medical admissions unit (38)

Pauline Griffiths, Senior Lecturer, School of Health Science, University of Wales Swansea, Swansea, Wales, United Kingdom p.a.griffiths@swan.ac.uk


Background & aims:

This paper discusses a recently completed doctoral study that sought to describe and explain the role of the nurse on an acute medical admissions unit (AMAU). AMAUs are found in district general hospitals in the United Kingdom and they provide a setting where acute medical emergencies are admitted and treated (Wood, 2000). However, there is a paucity of research that considers the nurse’s role in these units despite the importance of the nurse’s contribution to care provision.

Research design:

Using a reflexive ethnographic approach data were collected on one AMAU from 2002-2004 by participant observation, semi-structured interviews (n=19), and review of documentary evidence. A purposive sampling approach was utilised. Analysis was an abductive process with data collection guided by analysis in an iterative process (Mason, 2002). Full ethical approval was gained for the study.


The major claims of this study are that the role of the AMAU nurse was to manage and coordinate rapid patient transition and that this nursing role had evolved in response to the AMAU’s particular clinical and managerial demands. The findings of this study are grounded in clinical practice and data extracts are provided to support findings. Validity and relevance of the study’s findings are supported by a clear audit trail, the reflexive approach taken, and the substantive relevance of the findings.


A unique aspect of this study is the use of Wenger’s (1998) concept of community of practice to understand the locally negotiated working practices of the AMAU nurses studied. Theoretical descriptions of the role of the nurse are compared and contrasted to the reality of practice and arguments offered for an innovative understanding of the AMAU nurse’s role. This study makes a significant contribution to the limited body of knowledge regarding AMAU nursing practice.

Recommended reading list:

  • Mason, J. (2002) Qualitative researching. London. Sage Publications
  • Wenger, E. (1998) Communities of practice. Learning, meaning, and identity. Cambridge, Cambridge University Press
  • Wood, I. (2000) Medical assessment units in the West Midlands region: a nursing perspective. Accident & Emergency Nursing, 8, 196-200

Source of Funding: N/A

Amount in Funding: N/A


I am a senior lecturer in the School of Health Science, Swansea University, Wales. I have particular responsibility for curricula and research developments related to critical, emergency, and unscheduled care. I am also a registerd nurse and my clinical background is in acute medicine and neurosurgery. I have recently completed a PhD. and the paper to be presented will draw on this study.