Electronic Thesis and Dissertation Repository


Doctor of Philosophy




Dr Deborah Compeau

2nd Supervisor

Dr. Nicole Haggery

Joint Supervisor


Driven by developments in technology and communication, and by social, political and economic issues, the introduction of different information systems in nursing has risen significantly in recent years. However, little is known about the understanding of these systems by the nurses who are intended to use them.

Informed by a Symbolic Interactionist approach, this research explored the experience of nurses interacting with information systems. Using grounded theory methods, the main sources of data were interviews, textual analysis and observation with nurses in three Canadian cities.

The key findings of this research are fourfold. First, the core category developed in this study is the care reality, a multi-faceted understanding of care that is central to the nursing identity, which adds a new level of understanding behaviour beyond the common attributes identified within nursing and information systems research. Second, this research identified the existence and importance of ready-to-hand and unready-to-hand information systems objects within nursing. Third, this research identified a care reality negotiation process, where each individual is continuously introduced to different care realities when they come into contact with co-workers or management who do not share the same care reality. The individual must then go through a negotiation process whereby each individual manages his or her care reality. The care reality negotiation process includes four phases: exposure, developing consciousness, sense-making and acclimatizing. Finally, the fourth result of this research was the identification of how an individual’s identity impacts on his or her understanding of information systems.

This research produces a theoretical understanding of the experiences of nurses interacting with information systems. It identified a link between an individual’s care reality and his or her behaviour toward all technology, including information systems.

The findings inform nursing research and practice, as well as contribute to the development, implementation and use of information systems in other areas of the modern healthcare system.