Measuring the socialization of graduate and diplomate nurses using the Corwin Role Orientation Scale

Exploring the influences and use of the literature during a grounded theory study

In a grounded theory study, the literature review is delayed until the theory begins to emerge, it is then used as data. This paper will utilise my own research, a grounded theory study of transition to staff nurse as a process of disrupted continuity, to explore some of the issues stemming from this maxim. It starts by considering the debate around the delayed literature review, before illustrating the use of literature as data. In relation to this process, I have coined the terms deductive and inductive theoretical sensitivity and explain these by example. The ongoing vigilance needed to prevent use of literature becoming a distorting influence will be examined by describing the emergence of my core category. Grounded theory has been criticised for ignoring existing theories and failure to integrate the emergent theory with existing knowledge. This criticism is addressed by use of a priori theory and paradigm cases from my data set. Finally, I reverse the first issue by discussing how knowledge of emergent theory can both legitimately shape and unavoidably bias the literature review.

Professional development utilizing an oncology summer nursing internship

The aim of this study was to examine the effect of an oncology student nursing internship on role socialization and professional self-concept. This mixed-methods study utilized a convergent parallel approach that incorporated a quasi-experimental and qualitative design. Data was collected through pre and post-survey and open-ended questions. Participants were 11 baccalaureate nursing students participating in a summer oncology student nursing internship between their junior and senior years. Investigators completed a content analysis of qualitative questionnaires resulted in categories of meaning, while the Wilcoxon signed-ranks test was used to compare pre and post internship scores. Aggregated mean scores from all instruments showed an increase in professionalism, role socialization, and sense of belonging from pre to post-internship, although no differences were significant. Qualitative data showed participants refined their personal philosophy of nursing and solidified their commitment to the profession. Participants did indicate, however, that the internship, combined with weekly debriefing forums and conferences, proved to have a positive impact on the students' role socialization and sense of belonging. Despite quantitative results, there is a need for longitudinal research to confirm the effect of nursing student internships on the transition from student to professional.

Measuring student nurse professional socialisation: the development and implementation of a new instrument

The role of the clinical teacher is poorly understood, particularly the role they play in supporting the professional socialisation of student nurses. In part this lack of understanding is due to the inadequacy of existing tools to measure the phenomenon. This paper reports on the development and trial of a tool that attempts to illuminate the effects this role has on the development of the newest members of the profession. Selected results of the trial with Australian undergraduate Bachelor of Nursing students and their Clinical Teachers demonstrate that Clinical Teachers are important adjunct socialising agents particularly for mature students and students who enter the profession for altruistic reasons. Further, female Clinical Teachers indicate that they are more involved in certain aspects of student professionalisation than their male counterparts. The development of the tool followed interviews with Clinical Teachers and graduates from 2 universities. The tool trial then used a multi-site cohort study design, with N=196 students (from 3 universities) and N=58 Clinical Teachers (from 2 universities).

Supporting student nurse professionalisation: the role of the clinical teacher

This paper reports aspects of the findings from the qualitative component of a mixed methods research study that investigated the role of the Clinical Teacher in student nurse professional socialisation. Graduates and Clinical Teachers were interviewed to identify the domains where the support of a Clinical Teacher was crucial in the students' development of a professional identity. Emergent themes were clustered into seven (7) domains as follows: Professional role concept; Acculturation; Acquisition of Knowledge; Acquisition of Skill; Acquisition of Professional Values; Assimilation into the Organisation; and a seventh domain encompassing the role model attributes of Clinical Teachers. The domains are presented alongside exemplars from the interviews, in order to illustrate the importance of the support of a Clinical Teacher.

Impact of Healthy Work Environments on New Graduate Nurses’ Environmental Reality Shock

Do healthy work environments (HWEs) facilitate new graduate transition into professional practice in hospitals? Are such environments related to a decrease in Environmental Reality Shock? Experienced nurses in 17 Magnet hospitals completed the Essentials of Magnetism II© (EOMII©) instrument that measures health of unit work environments. New graduates ( N = 468) were then tracked with modified versions of the EOMII© from immediate post hire to 4, 8, and 12 months post hire to ascertain degree of Environmental Reality Shock. New graduate nurses have extremely high anticipations of unit work environments that would enable delivery of quality patient care. HWE is the most-significant variable in Environmental Reality Shock, number of related Issues and Concerns, and perceptions of quality of patient care. Suggestions of how to improve quality of unit work environments are offered.

Perspectives of Iranian male nursing students regarding the role of nursing education in developing a professional identity: a content analysis study

AIM

The purpose of the present study was to explore the perspectives of Iranian male nursing students regarding the role of nursing education in developing a professional identity.

METHODS

A qualitative design, based on the content analysis approach, was used to collect the data and analyze the perspectives of 14 Iranian male nursing students who were chosen by using a purposive sampling strategy. After the selection of the participants, semistructured interviews were held in order to collect the data.

RESULTS

During the data analysis, three main themes emerged: "reality-expectation incompatibility", "being supported by the educational system", and "nursing image rectification". The second theme consisted of two categories: "feeling trusted" and "being defended".

CONCLUSIONS

This study will be useful to nurse educators and administrators in relation to what constitutes nursing students' professional identity within the Iranian culture and context and how nursing education can play an effective role in developing their professional identity in order to devise strategies to attract male students to the nursing profession and promote their retention after graduation.

Early nursing career experience for 1994?2000 graduates from the University of Nottingham

AIM

This paper reports the views of nurses graduating from the University of Nottingham School of Nursing, UK, 1994-2000, Bachelor of Nursing (Hons) course, concerning career aspirations, progress and reflections on their qualification.

BACKGROUND

Alongside academic knowledge and practical skills, this four-year Bachelor of Nursing course aimed to develop students' critical thinking and research skills. The degree's effect on nurses' career trajectories is unknown.

METHODS

Self-completion questionnaires employing open and closed questions were sent to graduates 9 months after graduation and at intervals over the next 6 years.

RESULTS

Most respondents were confident and motivated in their nursing careers. Promotion, increased responsibility, further study, specialization and qualifications were career priorities. Recent qualifiers also focused on changing jobs, travel and working overseas.

CONCLUSION

The graduates' experience has salience for nurse managers, especially when matching graduates against post outlines within the knowledge and skills framework, considering staff skill mix, and advising graduates about their development and assisting them to find satisfaction in their nursing careers.

The theory-practice gap: impact of professional-bureaucratic work conflict on newly-qualified nurses

AIM

This paper reports the findings from a naturalistic enquiry undertaken in the United Kingdom into the extent to which the ideals and values of the preregistration nursing course are adopted by individual newly educated Registered Nurses.

BACKGROUND

Research in several countries provides consistent evidence of the existence of a theory-practice gap in nursing. Clear disparities have been demonstrated between the best practice ideals and values that are taught and those actually encountered in everyday practice. Nurse education 'Project 2000' reforms in the United Kingdom were designed, in part, to address this issue. Few studies to date have examined the impact of these reforms on newly qualified Registered Nurses' ability to translate theory into practice.

METHODS

A longitudinal study was carried out in three educational institutions in the United Kingdom from 1997 to 2000. Final year nursing students (n = 72) in three colleges of nursing completed questionnaires to elicit views on their ideals and values for practice. In-depth interviews with a purposive subsample of 26 participants (at 4-6 and 11-15 months postqualification) indicated the extent to which these ideals and values were adopted in practice. Interviews were tape-recorded, transcribed, and data were analysed using constant comparison and negative case analysis.

FINDINGS

Although new nurses emerged from their programmes with a strong set of nursing values, a number of professional and organizational factors effectively sabotaged implementation. Professional sabotage includes obeying covert rules, lack of support and poor nursing role models. Organizational sabotage includes structural and organizational constraints such as time pressures, role constraints, staff shortages and work overload.

CONCLUSION

The disparity between nursing as taught and as practised may have profound implications for the future of the profession both in the United Kingdom and internationally, in terms of morale, job satisfaction and retention. Measures to improve resources and reduce the professional-bureaucratic work conflict are discussed.

Professional Commitment in RN-BSN and Basic BSN Students

This program evaluation study compared the outcome of professional commitment in RN-BSN, full-time basic, and part-time basic nursing students using the Health Care Professional Attitude Inventory. Students' responses did not differ on a pretest during the first course of the nursing major. Posttest professional commitment scores differed significantly. Faculty reviewed student performance and considered revising the evaluation plan of the undergraduate nursing program.

Professional socialization: students becoming nurses

Usually colleges are evaluated by the quality of the knowledge and technical training offered to the students. Little attention is given to the acquisition of the values, behaviors and attitudes necessary to assume their professional role. This exploratory study aims to increase understanding of the professional socialization process that occurs at nursing schools and the results obtained through the socialization of professional values and standards. The educational experience of nursing students involves more than a body of scientific knowledge and the acquisition of abilities to provide care to patients. Questionnaires were filled out by 278 students of two public Nursing Schools in São Paulo state, 164 in school A and 114 in school B. The results indicated that some professional values, norms and behaviors are influenced by College years, studying at a College of Nursing during four years leads to a difference in values, norms and professional behavior.

The impact of role discrepancy on nurses' intention to quit their jobs

AIMS AND OBJECTIVE

The purpose of this study was to investigate the impact of role discrepancy on nurses' intention to quit their jobs.

BACKGROUND

Nurses experience role discrepancy, which refers to incompatibility between the roles nurses desire and expect to take, and the roles they actually engage in at work. However, there is a paucity of information as to how this role discrepancy affects nurses' intention to quit their jobs.

DESIGN

A correlational design was used to investigate the impact of role discrepancy on nurses' intention to quit their jobs.

METHODS

A total of 346 Australian nurses participated in this study by completing questionnaires. The results were analysed by t-test, polynomial regression and response surface analysis.

RESULTS

Nurses tended to experience role discrepancy, in particular, in decision making with hospital policies and provision of patient education. The overall results show that this role discrepancy contributes to nurses' intention to quit their jobs. Nurses' intention to quit their jobs also increased when they had a low desire to engage in nursing roles and when they only performed a few roles. When specific dimensions of nursing roles were examined, a role discrepancy in the use of nursing skills, such as participation in decision making and providing patient education and emotional support, had little impact on their turnover intention. On the contrary, a role discrepancy in task delegation practice showed a significant association with nurses' intention to leave their jobs.

CONCLUSIONS

Role discrepancy has been experienced by many nurses, and this discrepancy partially contributes to nurses' intention to quit their jobs.

RELEVANCE TO CLINICAL PRACTICE

To reduce nursing turnover, it is important to create a work environment where nurses are inspired to engage in various nursing roles and their work desires are reinforced by existing work opportunities.

Role discrepancy: is it a common problem among nurses?

AIM

This paper reports a study of nurses' perceptions of the differences between ideal and actual nursing roles, how these perceptions differ according to length of experience and the factors that might contribute to these perceived differences.

BACKGROUND

The literature suggests that nurses tend to experience role discrepancy or a mismatch between their ideal and actual roles. Although it has been assumed that experienced nurses perceive less role discrepancy than inexperienced nurses, either because the former adjust themselves to their actual practice or because they have the expertise to improve their practice, this assumption has not been tested.

METHODS

A survey design was used and the data were collected in 2003. Selected items from the Jefferson Survey of Attitudes Toward Physician-Nurse Inventory and the Staff Nurse Role Conception Inventory were administered to 216 Registered Nurses in Victoria, Australia to measure their perceptions of ideal and actual nursing roles. Data were analysed using a t-test and regression analysis.

RESULTS

Nurses with more clinical experience rated their ideal and actual nursing roles more positively than those with less experience. However, the results showed that both groups of nurses experienced the same degree of role discrepancy. Both groups perceived strong role discrepancy in the areas of organizational decision-making and provision of patient education. Experienced nurses also perceived moderate role discrepancy in developing nursing care plans and in the freedom to initiate referrals.

CONCLUSIONS

Role discrepancy cannot be resolved by having more clinical experience. While clinical experience enhances nurses' conceptions of their ideal roles, it can also lead to role discrepancy if there are organizational barriers that prevent nurses from engaging in their ideal roles. It is important to find a way whereby nurses can actualize their ideal views of practice in the current healthcare environment.

Nurses' job dissatisfaction and turnover intention: Methodological myths and an alternative approach

Job dissatisfaction and turnover are recurring themes in nursing. The current international nursing shortage has resulted in increased interest in investigating the causes of nurses' job dissatisfaction and turnover, and in developing countermeasures to address these issues. This paper involves a review of quantitative nursing studies, which investigated the causes of nurses' job dissatisfaction and turnover intention, and identifies commonly held myths that may inhibit more nurse-centered strategies from being developed. These myths are based on an assumption that a nurse-environment relationship is a one-way interaction in which nurses passively respond to their environment. The paper introduces the person-environment fit theory as an alternative framework, which challenges the assumption by suggesting it is the relationship between person and environment, rather than environmental characteristics alone, that affects nurses' occupational behavior. This theory enables nurse researchers to develop a more mutual approach involving the nurse and environment.

Sacrificing the personal to the professional: community mental health nurses

BACKGROUND

The study of stress in mental health nurses has almost always focused on factors intrinsic to their job roles and has neglected the interaction between work and home roles, which may also be a source of stress. Moreover, role theory has not provided an adequate account of either personal or occupational change, especially when this results from the experience of stress.

METHODS

Twenty community mental health nurses agreed to participate in semi-structured interviews about the stresses they experienced at work and at home. A grounded theory analysis disclosed the centrality of conflicts between work and home roles in participants' accounts and this provided the focus for subsequent detailed readings of the interview transcripts.

FINDINGS

Participants described how difficult and often demanding family situations were integrated with professional careers in a climate of rapid organizational change in the health service. As well as being an ongoing source of strain, these competing role demands were often described as leading to sudden changes for individual workers, such as periods of illness or re-evaluation of their work role. To assist in making sense of this process, the term 'punctuated equilibria' was adopted to illuminate the build-up of tension between work and domestic lives, which was described by some workers as leading to a sudden reformulation of their relationship to their work roles and employing organizations.

CONCLUSIONS AND LIMITATIONS

The study was small-scale and relied on retrospective self-reports. Nevertheless, it emphasized the importance of considering all the roles that individuals play and highlights the possibility that, even when staff are apparently coping with their roles at work and home, difficulties may be building up which could lead to a sudden period of absenteeism or disillusionment.