Putting Safety in the Frame: Nurses’ Sensemaking at Work

Valerie Jean O'Keeffe, Kirrilly Rebecca Thompson, Michelle Rae Tuckey, Verna Blewett

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Current patient safety policy focuses nursing on patient care goals, often overriding nurses’ safety. Without understanding how nurses construct work health and safety (WHS), patient and nurse safety cannot be reconciled. Using ethnography, we examine social contexts of safety, studying 72 nurses across five Australian hospitals making decisions during patient encounters. In enacting safe practice, nurses used “frames” built from their contextual experiences to guide their behavior. Frames are produced by nurses, and they structure how nurses make sense of their work. Using thematic analysis, we identify four frames that inform nurses’ decisions about WHS: (a) communicating builds knowledge, (b) experiencing situations guides decisions, (c) adapting procedures streamlines work, and (d) team working promotes safe working. Nurses’ frames question current policy and practice by challenging how nurses’ safety is positioned relative to patient safety. Recognizing these frames can assist the design and implementation of effective WHS management.

Original languageEnglish
Number of pages12
JournalGlobal Qualitative Nursing Research
Publication statusPublished - 9 Jul 2015
Externally publishedYes

Bibliographical note

Creative Commons CC-BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages


  • social constructionism
  • decision making
  • naturalistic inquiry
  • nursing
  • occupational health
  • risk
  • perceptions


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