Remaining in the nursing profession: The relevance of strong evaluations

What school nurses strive to achieve for themselves in order to remain in practice: A qualitative study

AIM

This study aims to describe and interpret what it is school nurses strive to achieve for themselves in order to remain in practice.

DESIGN

A qualitative study with a hermeneutic approach.

METHOD

The data were collected by means of in-depth interviews with 15 Norwegian school nurses on two separate occasions and analysed using a phenomenological hermeneutic method.

RESULTS

The analysis resulted in the following themes: (1) trusting your own professional ability, (2) aspiring to appreciation and (3) accomplishing self-care. These themes were reflected in the school nurses' choices and actions and were regarded as an expression of what was of value to them as a nurse. Thus, the nurses' realizing what they strived to achieve for themselves can comprehensively be understood as a good of higher value for their remaining in nursing practice.

Does professional identity play a critical role in the choice to remain in the nursing profession?

AIM

To explore aspects of professional identity in nurses' written narratives of what is significant to their choice to remain in the profession.

DESIGN

This study used a qualitative design and was underpinned by a hermeneutical approach.

METHODS

The participants were recruited via purposive sampling procedures and included 13 nurses aged 26 to 62 years. The data were collected in the form of written narratives to initiate the nurses' reflections on the decision to remain in the profession. A thematic analysis was conducted.

RESULTS

The analysis revealed two themes: acting as a professional contributor and realigning to maintain professional belongingness. In the nurses' written narratives, these aspects of professional identity were clearly significant to their choice to remain in the profession. In a complexly interwoven way, the aspects constructed who the nurses were as professionals, and thus, professional identity seems to play a critical role in the choice to remain.

Nurses' Remaining in Everyday Nursing Practice-A Comprehensive Model

Previous theoretical and empirical models of nurses' remaining in everyday nursing practice are explained by elements such as intent to stay and desire to stay. This study provides a model that expands or expresses an increased understanding of the comprehensiveness of the issue by pointing to the qualitative worth of different desires. The aim of this study is to describe a comprehensive model of nurses' remaining in everyday nursing practice. This study was designed in three sequential stages: first, the empirical foundation of the model; second, the development of the model; and third, the description of the model. The described model is derived from a previous qualitative study's comprehensive understanding of empirical findings. That original study was based on a hermeneutical approach, the aim of which was to understand what is of significance for nurses to remain in everyday practice. The collected data consisted of qualitative interviews and qualitative follow-up interviews with 13 nurses. The research context was the primary and secondary somatic and psychiatric health service. The present comprehensive model is stated in a simple structure, which nonetheless provides a relevant framework for constituent elements of nurses' remaining in everyday practice. Horizons of identity and self-understanding have been identified as constituent elements or key concepts involved in remaining. By focusing on a deepened and broader understanding, the model highlights that remaining may be constituted through a process of identification and taking standpoints, which in turn has a potential to empower nurses to realize themselves.

Problematizing Boundaries of Care Responsibility in Caring Relationships

INTRODUCTION

Nursing care takes place within nurse-patient relationships that can be demanding. In exceptional circumstances, the relationship may be destructive, and when this happens, significant onerous demands, appeals, or challenges can arise from patients and be placed upon nurses.

AIM

The aim is to explore what can be termed boundaries of care responsibility when relationships with patients place significant destructive demands on nurses.

METHOD

Based on a hermeneutical approach, this study introduces aspects of phenomenological philosophy as described by the Danish theologian and philosopher Knud E. Løgstrup and provides examples of nurses' experiences in everyday nursing practice drawn from a Norwegian empirical study focusing on remaining in everyday nursing practice. Data in that original study consisted of qualitative interviews and qualitative follow-up interviews with 13 nurses working in somatic and psychiatric health service.

DISCUSSION

The exploration of empirical examples demonstrates that nurses consider confronting demands from patients which manifest themselves as onerous and that they have to set limits to safeguard themselves. When the nurses had to manage acting out or actions from patients by opposing what was said and done, they experienced the situation as more than very unpleasant or connected to a perversion. Significant destructive caring relationships cannot be without boundaries, and explicating boundaries are of relevance to protect nurses from onerous demands. Protecting them implies reducing a hazard, that is, that nurses carry on even when this may be unhealthy for them.

CONCLUSION

Consistently pinpointing boundaries between demands is assumed to be essential in caring relationships, as onerous or destructive demands are strongly connected to a content where boundlessness is involved. To protect both nurses and patients as valued human beings, thus raising and preserving the status of the nurse and the patient, the nature and possible detrimental effects of destructive caring relationships should be considered and examined.