Living Legacy Across the Nursing Career Spectrum: A Qualitative Study

Monday, 18 November 2019: 3:45 PM

Jennifer Graber, EdD, APRN, PMHCNS-BC
Jennifer L. Saylor, PhD, APRN, ACNS-BC
Evelyn R. Hayes, PhD, RN, MPH, FNP-BC
School of Nursing, University of Delaware, Newark, DE, USA

Introduction: Legacy can be described in a variety of ways including what one leaves behind and gives to those who follow. Sherman (2016) defines legacy as “...an investment in those who will carry the work on” (para. 1). Every interaction with friends, colleagues, students and patients provides an opportunity to build legacy. Everything a person contributes to the nursing profession helps to create an avenue for others to follow. The legacy one leaves behind helps pave the way forward impacting health locally and globally (Steinert & Macdonald, 2015). Legacies grow when there is a commitment to passion and a spirit of self-giving. Newton and Jones (2016) found that legacy can provide a purposeful insight into cultural differences. It’s important for members to understand that every action has an impact on the future of nursing, even if it seems inconsequential at the time. “Living a career of purposefulness and intentionality can sustain long-term efforts in nursing directed at making a difference to benefit the lives of others” (Hinds P.S., Britton D.R., Coleman L., Engh E., Humbel T.K., Keller S., Kelly K.P.,..., Walczak D, 2013, p. 218). The purpose of this qualitative study was to gain a deeper understanding of the influence legacy has on catalyzing the nursing profession, leadership development, and collaborative relationships.

Significance: The implications of legacy building will foster other nursing honor society chapters to focus on membership engagement and leadership development. This innovative strategy is part of an ongoing legacy program and its impact on the nursing profession and individuals will continue to unfold.

Methods: This project evolved from a previous presidential call to action regarding livacy (living legacy) development and continues with the current presidential call to action related to collaboration and catalization. The surveys were developed in an effort to determine how nurses viewed their personal legacy and how engagement has influenced personal career paths over time. This post-hoc design is a qualitative study. Qualitative data were collected via voluntary surveys that were given out over several nursing events during 2014-2017. In order to build a Nursing legacy the members of the local chapter were asked to respond to legacy building and leadership related questions. The focus is to develop future research on nursing legacy, collaborative relationships, leadership development, and the future of nursing. The members were asked to be open and respond to questions.

Nursing Impact: This work will contribute to the body of knowledge on legacy and leadership development in nursing, where there is currently a gap in the literature.

Procedures: This data was collected between 2014 and 2017 at chapter events. For example, one of these events celebrates active, inactive and potential members. This is a unique opportunity to newly form and reignite collaborative relationships and offer appreciation. Furthermore, embracing the spirit of giving is cultivated in this informal gathering. Nurses (members and non-members) who attended these chapter events were asked to anonymously respond to four open-ended questions related to legacy building and leadership development: Describe your most memorable moment in nursing? What was your most memorable patient moment? What changes do you expect in the nursing profession? What do you believe are the most important qualities of a nurse? What thoughts would you like to share with a novice, graduating nurse? In 2016, the open-ended questions focused on global health, but the root of the previous questions remained the same. In honor of the chapter’s 40th anniversary, attendees were asked to share the legacy they created since beginning their nursing careers by responding to the following questions: What positive impact have you made on the nursing profession? What contributions have you made to the Chapter since you were initiated? If you could share any advice to a new nurse beginning his/her legacy, what would it be? What are the most important qualities of a nurse?

Setting and Sampling: The surveys were distributed during various chapter events, including membership appreciation, membership induction, outreach events, and evidence based practice dinner meetingA convenience sample of 84 nurses and nursing students who attended the various events were asked to fill out the surveys. No demographic data were collected such as age, gender, race, and ethnicity. There were no risks as the data collected were part of a voluntary survey and all responses were uploaded to a secure computer and stripped of identifiers. Subjects may experience a sense of contribution to the scientific knowledge and may gain knowledge pertaining to developing a personal nursing legacy.

Analysis: The data was analyzed as aggregate and not at an individual level. No personal identifiers were used. The qualitative data was transcribed from the surveys and reviewed for errors using a double check system prior to analysis. Qualitative data was analyzed using Braun and Clarke’s six phase process for thematic analysis (Braun & Clarke, 2006). The analysis was performed by 3 researchers who reviewed the data in its entirety to gain and note general impressions looking for emerging themes. Using an iterative process, researchers analyzed the data, defining and naming themes.

Several themes emerged from the analysis of the data. These descriptors are sorted by survey question and then overarching themes. For question one (Describe your most memorable moment in nursing?) the emerging themes related to first day of clinical or work, mentoring/ role models, connecting with patients, and making a difference. Themes that emerged from question two (What was your most memorable patient moment?) related to comprehensive care, faith, and seeing patients in their best and worst moments throughout the lifespan. Question three (What changes do you expect in the nursing profession?) themes focused on technology, education, autonomy, and collaboration. Themes for question four (What thoughts would you like to share with a novice, graduating nurse?) supported descriptors of nurse qualities portrayed in question five. These themes advised the new nurse to be confident, compassionate, a life long learner, and have a balanced life. Question five (What do you believe are the most important qualities of a nurse?) had 4 main themes that emerged including caring/ compassion, honesty/ integrity, good communication skills, and patient advocacy. Overall, the main themes from all five questions related to being a caring, compassionate, and competent nurse who advocates for clients, families, and self through collaboration.

Conclusion: The implications of legacy building will foster other chapters to focus on membership engagement and leadership development. Also, this chapter initiative will lead to future research on nursing legacy. This innovative strategy is part of an ongoing legacy research program and its impact on the nursing profession and individuals will continue to unfold. Nurses can enhance their legacy through communicating an attitude of gratitude as well as collaborating and contributing time and expertise in an effort to make a difference and catalyzing the mission and vision of Sigma.