The process of implementing a new baby-friendly hospital initiative for nurses: a grounded theory study

Maternity nursing practice is changing across Canada with the movement toward becoming “baby friendly.” The World Health Organization (WHO) recommends the Baby-Friendly Hospital Initiative (BFHI) as a standard of care in hospitals worldwide. Very little research has been conducted with nurses to explore the impact of the initiative on nursing practice. The purpose of this study, therefore, was to examine the process of implementing the BFHI for nurses. The study was carried out using Corbin and Strauss’s method of grounded theory. Theoretical sampling was employed, which resulted in recruiting and interviewing 13 registered nurses whose area of employment included neonatal intensive care, postpartum, and labour and delivery. The data analysis revealed a central category of resisting the BFHI. All of the nurses disagreed with some of the 10 steps to becoming a baby-friendly hospital as outlined by the WHO. Participants questioned the science and safety of aspects of the BFHI. Also, participants indicated that the implementation of this program did not substantially change their nursing practice. They empathized with new mothers and anticipated being collectively reprimanded by management should they not follow the initiative. Five conditions influenced their responses to the initiative, which were (a) an awareness of a pro-breastfeeding culture, (b) imposition of the BFHI, (c) knowledge of the health benefits of breastfeeding, (d) experiential knowledge of infant feeding, and (e) the belief in the autonomy of mothers to decide about infant feeding. The identified outcomes were moral distress and division between nurses. The study findings could guide decision making concerning the implementation of the BFHI.

The tonglen experiences of individuals with established sitting meditation practices: a grounded theory study

While there is an ever expanding body of research on various forms of meditation, there is currently a relative absence of academic literature on tonglen. A form of meditation which involves both visualizations and breathing elements, during tonglen one takes in the negativity and suffering experienced by others and, in return, sends back happiness and compassion. The current study explores the tonglen meditation experiences of individuals who have established sitting meditation practices. A qualitative, grounded theory approach was used in looking at what tonglen means to participants, how they engage with the practice, why they practice tonglen, and what they perceive to be the benefits of tonglen in the context of a 28 day practice period. Based on the findings from this study, a model was developed that describes the tonglen experiences of participants.