The notion of culture is central to ethnography. Culture can be defined as the “total way of life of a group, the learnt behaviour which is socially constructed and transmitted“ [11]. Individuals in a culture or subculture hold common ideas acquired through learning from other members of the group. No matter what the setting the general questions guiding ethnographic studies are the same: “What is it like to be a member of a particular culture? What are the rules guiding social behaviour?” [12].
The literature reveals a limited understanding of the nursing care provided in a HHU and of the relationships between the various members within this culture. Ethnography was chosen as the study method to help provide contextual meaning to the ways in which the people in the HHU interact and communicate. The focus of the research was the interactions between the nurses and patients, who were the major informants within the HHU.
3.3. Setting
The study was conducted in the haemodialysis unit of a large teaching hospital in Sydney, Australia. The HHU has 12 machines operating six days per week, 16 hours a day, for patients requiring haemodialysis treatments for acute or chronic renal failure.
3.4. Participants
As the study used an ethnographic method, all people attending activities in the HHU were participants in the study. The major participants were nurses and patients. Doctors, other health care workers, domestic and catering staff and patients’ carers and visitors attended the HHU for short periods during the study. There were 48 patients attending the unit for dialysis sessions three times each week. Fifteen nurses with differing levels of experience in nursing worked in the HHU either part time or full time. The unit was staffed to provide dialysis sessions for 48 patients with a usual ratio of one nurse to four patients. There are no data to compare this finding with other HHUs within the state or country.
3.5. Data collection
Ethnographic data collection involves observations, interviews and the review of relevant documents [13]. The CNC collected data over a twelve-month period. Participant observations were performed over a nine-month period for a total of 280 hours. Observations were performed on different days of the week and during different shifts in order to determine whether practices changed with