Thomas Cox PhD, RN
I defended my dissertation in nursing: Risk induced professional caregiver despair: A unitary appreciative inquiry
on April 7, 2004.
The purpose of this research study was to expand nursing science through the collaborative investigation of registered nurses’ experiences of the effect of insurance risk transfers such as capitation contracts, managed care programs, Diagnosis Related Groups (DRG) financing mechanisms and intra-organizational insurance risk transfers, on caregiving environments, registered nurses, and their clients. A collaborative, participatory, qualitative, descriptive, exploratory design, using unitary appreciative inquiry was used to facilitate collaborative relationships with registered nurses in the development of eight appreciative profiles of their experiences of risk induced professional caregiver despair. The eight registered nurses participating in this study revealed serious problems they believe result from the impact of insurance risk transfers on workplace staffing, equipment, and material resources. The data synopsis and synthesis also enhanced the a priori theory of risk induced professional caregiver despair and expanded the science of unitary human beings in previously unexplored domains. This study reveals the impact of insurance risk transfers on bedside nurses and the care they are able to render to their clients. This study met the research objectives of understanding the experiences of these registered nurses and developing strategies to improve the situations they face in the workplace. This report sets the stage for future work to identify and describe critical features of the impact of insurance risk acceptance and resulting cost-constraints on registered nurses, nursing environments, and clients.
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