Nurses' perceptions of their role and role conflicts

Emotional Intelligence and Professional Boredom among Nursing Personnel in Greece

Occupational (professional) boredom results in low performance at work. It has been positively associated with high levels of anxiety and depression as well as premature death. However, occupational boredom has not been extensively studied among working nurses. This study aimed to investigate the relationship between emotional intelligence and occupational boredom in nurses working in both public (52.9%) and private (47.1%) health units in Greece. A cross-sectional study was conducted among a convenience sample of 189 nurses (84.7% females) with an average age of 40 years. Emotional intelligence was evaluated with the use of The Trait Emotional Intelligence Questionnaire-Short Form and Professional boredom was assessed with the use of the Boredom Proneness Scale. The majority of Nurses showed relatively high values of total Emotional Intelligence (EI), and marginally low values of overall Professional Boredom. A statistically significant negative correlation was found between the overall Professional Boredom of Nurses and the Well-being, Self-control, Emotionality and Sociability subscales of EI, as well as total EI (p < 0.001). Multiple linear regression analyses showed that the three dimensions of EI (Well-being, Self-Control and Emotionality) explained 39.0% of the variability of the total Professional Boredom of the working Nurses.

A World Apart: How Occupational Therapists, Nurses and Care Managers Perceive Each other in Acute Health Care

Multidisciplinary teamwork is one of the key processes through which care is managed in the British National Health Service. Working in a multidisciplinary team requires many skills, which include understanding not only one's own role but also that of other professionals. The aim of this paper is to provide an understanding of occupational therapists', nurses' and care managers' perceptions of each other and how these influence interprofessional relationships.

In total, nine occupational therapists, nine care managers and 19 nurses within an acute physical health care setting were interviewed using the critical incident approach. The findings revealed that the interprofessional relationships between nurses, care managers and occupational therapists were often problematic owing to role confusion and competing priorities, which influenced communication.

To prevent role ambiguity, occupational therapists must define their role clearly. It is suggested that multidisciplinary team members need continuing interprofessional education in order to understand the changing roles in the National Health Service.

[Role of nursing in physical rehabilitation]

This study reviews the literature concerning improvement of rehabilitation nurse role, suggesting paths to reach this goal and evoking a still poorly discussed area. Some questions were raised to provoke reflection and discussion. It is evident, based on the literature, that nurses have a total role in rehabilitation, however the boundaries are not clearly defined. Professional nurses must must join rehabilitation practice with permanent education, that will contribute for a more efficient and influence in processes and rehabilitation services.

Impact and determinants of nurse turnover: a pan-Canadian study

AIM

As part of a large study of nursing turnover in Canadian hospitals, the present study focuses on the impact and key determinants of nurse turnover and implications for management strategies in nursing units.

BACKGROUND

Nursing turnover is an issue of ever-increasing priority as work-related stress and job dissatisfaction are influencing nurses' intention to leave their positions.

METHODS

Data sources included the nurse survey, unit managers, medical records and human resources databases. A broad sample of hospitals was represented with nine different types of nursing units included.

RESULTS

Nurses turnover is a major problem in Canadian hospitals with a mean turnover rate of 19.9%. Higher levels of role ambiguity and role conflict were associated with higher turnover rates. Increased role conflict and higher turnover rates were associated with deteriorated mental health. Higher turnover rates were associated with lower job satisfaction. Higher turnover rate and higher level of role ambiguity were associated with an increased likelihood of medical error.

CONCLUSION

Managing turnover within nursing units is critical to high-quality patient care. A supportive practice setting in which role responsibilities are understood by all members of the caregiver team would promote nurse retention.

IMPLICATIONS FOR NURSING MANAGEMENT

Stable nurse staffing and adequate managerial support are essential to promote job satisfaction and high-quality patient care.

Preparing for practice: how well are practitioners prepared for teamwork

This article reports on the findings of a study that aimed to explore how relevant initial training is in relation to teamwork, and to explore the perceptions of newly qualified practitioners about their confidence to work as a member of a team. A cross-sectional postal survey was used to ascertain the views of nurses, social workers, occupational therapists and physiotherapists who had been qualified between six months and two years prior to the survey, and had qualified at one of three London universities. Fifty questionnaires were sent out to each professional group (a sample of 200 overall) and there was a 43% response rate. Findings revealed that respondents reported positive experiences of team working, with only one area--equality of status within teams--being highlighted as problematic. While no other area generated this level of disagreement, there were two other areas in which respondents felt unsure: cooperation within the team and conflict resolution within the team.

Nurses' perceptions of multidisciplinary team work in acute health-care

Multidisciplinary teamwork is viewed as one of the key processes through which care is managed in the British National Health Service, and yet is often viewed as one of the most problematic. Working in a multidisciplinary team requires many skills, which involves understanding not only one's own role but also the role of other professionals. The aim of this study was to explore nurses' perceptions of multidisciplinary teamwork in acute health-care. Nineteen nurses were interviewed using the critical incident approach to obtain their perceptions of multidisciplinary teamwork. Direct observation was conducted to record interactions between nurses and health-care professionals in multidisciplinary teams. In total, 14 meetings were attended in elder care and orthopaedics and seven in acute medicine. The findings of this study identified three barriers that hindered teamwork: (i) differing perceptions of teamwork; (ii) different levels of skills acquisitions to function as a team member; and (iii) the dominance of medical power that influenced interaction in teams. Thus, education establishments and nursing managers need to ensure that the acquisition of team-playing skills is an integral part of continued professional development.

Multidisciplinary perceptions of the role of nurses and healthcare assistants in rehabilitation of older adults in acute health care

AIM

This paper describes the perceptions of nurses, healthcare assistants, doctors and therapists of rehabilitation and the role of nurses and healthcare assistants on an acute older adults ward in a London teaching hospital.

BACKGROUND

The role perception, education and training and attitudes towards the older adults have been identified as barriers that have an impact upon the nurses' role within rehabilitation. However, little is known about the role of nurses and healthcare assistants in rehabilitation of older adults in acute health care.

DESIGN

Action research study.

METHOD

Twenty-four semi-structured interviews were conducted and audio recorded about healthcare professionals' understanding of rehabilitation, the type of skills needed and their perceptions of the role of nurses and healthcare assistants in rehabilitation. The interview transcripts were analysed using the thematic content analysis.

RESULTS

The findings suggest that the therapists relied on nurses and healthcare assistants for therapy carry-over. Healthcare assistants were perceived as the professional group who could deliver therapy carry-over. There was an evidence of role hierarchy as healthcare assistants perceived that they were not actively involved in decision-making or discharge planning.

CONCLUSION

This paper suggests that healthcare assistants and nurses are viewed as the professional group best placed to deliver therapy carry-over. However, whilst there is an acknowledgement of their role, there remains a reluctance to acknowledge healthcare assistants as a professional group and to involve them within decision-making and discharge planning.

RELEVANCE TO CLINICAL PRACTICE

Employers must be seen to advocate, support and implement education and training programs for healthcare assistants. However, whilst nurses and healthcare assistants have an integral role in rehabilitation, there needs to be more research into the how they are supported by therapy professionals.

Do all health and social care professionals interact equally: a study of interactions in multidisciplinary teams in the United Kingdom

Problems around deficits in interprofessional collaboration have been identified since the National Health Service (NHS) was introduced. It is within the context of the current policy focus on improving collaborative working that this study was undertaken. A direct observational study using the Bales' Interaction Process Analysis tool was carried out in two older persons teams to explore patterns of interaction in the multidisciplinary team meetings. Analysis revealed some key differences in the way in which different professions interacted. Occupational therapists, physiotherapists, social workers (SW) and nurses rarely asked for opinions and for orientation. The consultant (the individual in charge of the medical team) tended to have high rates for asking for orientation, giving opinions and giving orientation. Although some nurses did have high individual rates for the giving of orientation. The data from the research has highlighted that therapists, SWs and nurses are reluctance to voice their opinions in multidisciplinary teams and thus conformity may dominate its culture. It is suggested that therapists, SWs and nurses need to cite their opinions in teams more effectively if they are to be competent and committed patient-centred practitioners.

How Stroke Survivors and Primary Support Persons Experience Nurses in Rehabilitation

The role of nursing in rehabilitation has been studied from various perspectives. This study explored experiences with nursing care in rehabilitation from the perspective of stroke survivors and their primary support persons (PSP). The sample consisted of six stroke survivors and seven primary support persons. Through in-depth phenomenological interviews, participants related the experiences with nursing care that stood out for them. The experience was conceptualized as a two-dimensional continuum from helpful to adversarial, with none of the participants articulating a therapeutic presence from nurses. Implications for nursing are explored.

Nurses' perceptions of discharge planning in acute health care: a case study in one British teaching hospital

AIM OF THE STUDY

To provide an in-depth understanding of nurses' perceptions of the hospital discharge process in a London teaching hospital.

BACKGROUND

Discharging patients from hospital is a key component of the nurse's role in acute health care settings. It is remarkable that despite government legislation and research, which stretches back over 20 years in both Europe and North America, discharge planning remains problematic. Furthermore, it is an activity that requires collaboration between health and social care agencies. In the United Kingdom there is a new emphasis and incentive on managing acute hospital beds, which in turn results in shorter stays in hospital. In London, discharge planners face additional problems because of social, economic and environmental factors.

METHOD

Using a case study design, 19 nurses were interviewed using the critical incident approach to obtain their perceptions of the discharge process. Direct observation was conducted to record interactions between nurses and health care professionals in multidisciplinary teams. In total 14 meetings were attended in elder care and orthopaedics and 7 in acute medicine.

FINDINGS

Aspects of the discharge process were often ignored or neglected and assessments were rarely co-ordinated. The nursing ward handover was regarded as a process that hindered communication. Lack of time was reported to be the biggest barrier that affected interprofessional working and hence the co-ordination of assessments.

CONCLUSION

The findings have important implications for nurses, managers and educational establishments. It is essential that social and medical diagnoses run parallel and that accurate information is collated and communicated within the multidisciplinary team. Further research into the impact of time pressures on communication, interprofessional working and the discharge process is needed.

Nurses' perceptions of physiotherapists as rehabilitation team members

OBJECTIVE

To investigate nurses' perceptions of physiotherapists as members of the rehabilitation team. This study arose from the current emphasis that is placed on good multidisciplinary teamwork for effective rehabilitation and the awareness that different team members often have different perceptions of their respective roles within the team.

DESIGN

Semi-structured interviews, the results of which were then subject to content analysis.

SETTING AND SUBJECTS

Experienced rehabilitation nurses in two rehabilitation wards within a National Health Service Trust.

RESULTS

Nurses perceived the role of physiotherapists as being concerned with mobility and movement, and valued the therapists' knowledge and skills in these areas. They felt, however, that physiotherapists had insufficient understanding of the demands and pressures of nursing practice and lacked recognition of the nurses' professional autonomy in decision-making in rehabilitation. Nurses viewed nursing and physiotherapy as two quite distinct and different roles within rehabilitation, despite some role overlap. Physiotherapy was perceived as specific and measurable, while nursing was perceived as generalized and undefined. These perceptions extended to their views on patient-staff interactions and organizational structures. Some of the differences, such as organizational structures, created barriers to rehabilitation. Others, such as physiotherapy expertise in mobility, were valued for their contribution to rehabilitation. Areas were identified where the two professions can assist each other in professional skills.

CONCLUSION

Nurses valued the role and contribution of physiotherapists, but identified areas in which barriers existed to effective interprofessional working, particularly in relation to organizational factors and interprofessional relationships.

Neurological rehabilitation nursing: a review of the research

Neurological rehabilitation is increasingly seen as a specialist form of rehabilitation requiring specialist nursing knowledge. However, as in many areas of nursing, nurses in this field recognize that there is a need to increase their knowledge base to ensure that they provide the best and most up-to-date quality care for their patients and their families. To achieve high levels of competence, neurological rehabilitation nurses need to be aware of the existing body of research in this field so that they can make sound decisions regarding their practice and future research endeavours. This review aims to validate the existing knowledge base in this area by identifying and critically analysing research conducted in the area of neurological rehabilitation nursing during the decade 1988-1998 and by identifying any gaps and weaknesses that may be addressed by future research. Studies were included in the review if they examined an aspect of rehabilitation nursing, were concerned predominately with the neurological patient and were conducted in an in-patient setting. Research with a medical focus was not included and only research published in English was reviewed. Relevant research located examined the following areas: (1) the role of the rehabilitation nurse; (2) specific problems concerning the neurological rehabilitation patient; (3) specific nursing interventions; (4) rehabilitation nursing practice; (5) the delivery of rehabilitation programmes and team working; and (6) the family of the rehabilitation patient. The review concludes that research in this speciality remains limited both in quantity and quality. Most of the studies lack rigour and, because they were conducted at a single site, their generalizability to other clinical sites may be limited.

Developing the role of the generic healthcare support worker: phase 1 of an action research study

This paper reports on the first phase of an action research practice development project to explore, develop and evaluate the role of the generic healthcare support worker in a high dependency rehabilitation service. The project is being jointly conducted by staff from the University of Southampton, the University of Portsmouth and the Isle of Wight Healthcare NHS Trust and phase 1 is supported by a grant from the NHS Executive (South and West). The aim of phase 1 of the project is to explore the attitudes of staff towards the implementation of the role of the generic healthcare support worker, particularly regarding the practical, professional and ethico-legal problems of the role. Professional and support staff from different parts of the service were interviewed in groups and the interviews were tape recorded, transcribed and subjected to a simple thematic analysis. Four themes emerged from the data relating to the challenge to professional boundaries, being a generic worker, outcomes for service and patients and implementing the role. As an action research project, the aim was not to produce findings that are generalizable beyond the practice areas in which they were generated, but it is nevertheless hoped that the reader might be able to apply some of the conclusions to his or her own setting.

An exploratory study of nurses' perceptions of their role in neurological rehabilitation

The role of the nursing profession in the multidisciplinary specialty of neurological rehabilitation has not been clearly defined in the United Kingdom. A qualitative exploratory study was performed in a highly specialized neurological rehabilitation unit. Nine registered nurses having at least 1 year of experience in this setting were interviewed in a semistructured manner. Transcripts of the interviews were subjected to a theme analysis. Three main themes emerged in relation to the role of the nurse. The first theme referred to actions directly related to patient care. This theme included four concepts: the promotion of patient independence, routine tasks, the management of patient care, and counseling. The second theme involved the organizational issues that influence practice. Nurse opinions and views of their roles formed the third theme. The subjects' views identified skills specific to neurological rehabilitation nursing and areas for further exploration.

Viewing rehabilitation nursing like a 'magic eye' picture: clinical supervision can sharpen the focus

This article discusses the contributions of rehabilitation nurses to the interdisciplinary team process. The authors propose that the process of clinical supervision can help nurses examine client interactions in new ways, thereby enhancing their involvement in the interdisciplinary team process. An analogy to a "magic eye" picture is used to encourage nurses to examine the importance of their role within the interdisciplinary team.