Paper: Experiences of Novice Nurses in a Public Hospital in Japan: The Effects of Culture, Tradition and Ethical Issues (19th International Nursing Research Congress Focusing on Evidence-Based Practice)

Monday, 7 July 2008: 3:15 PM

Junko Inagaki, PhD, RN, RSW , Graduate School of Medicine, Faculty of Health Science, Yamaguchi University, Ube,Yamaguchi, Japan

Sue Turale, EdD, MSt, RN, RPN, FRCNA, FACMHN , Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan

Nao Ikenaga, RN , Department of Nursing, Yamaguchi University Hospital, Ube City, Japan

Ai Uda, RN , Department of Nursing, Fukuyama City Hospital, Fukuyama City, Japan

Rieko Kimura, RN , Department of Nursing, Yamaguchi University Hospital, Ube City, Japan

Junko Sakai, RN , Department of Nursing, Yamaguchi University Hospital, Ube City, Japan

Reiko Fujisawa, MEc, RN , Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan

Misae Ito, MSN, RN, NMW , Department of Nursing, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan

Learning Objective 1: explain some unique experiences of novice nurses who work within culture bound practices in Japan.

Learning Objective 2: consider strategies to better support novice nurses in the future.

Background:

Recently in Japanese public hospitals the workload of nurses has increased significantly due to shortened length of stays; admission of patients with acute and complex conditions; implementation of electronic medical record systems; increasingly complex technology, and a rise in ethical problems. These affect the working and learning experiences of all nurses. Little is known however, about the experiences of novice nurses who begin work in such environments and sometimes leave because of pressure or work problems.

Objective:

This qualitative study explored the experiences of novice nurses to determine their needs for educative assistance and support at work, and to help retain them in the workplace.

Methods:

Tape recorded interviews were conducted with 22 novice nurses at a public hospital. The phenomenological approach of Colaizzi (1978) was used to gather and analyse data by extracting and clustering themes and meanings of these.

Results: In this small exploratory study seven themes emerged: Troubles with senior nurses; Flexibility with nursing techniques; The ideal versus the reality of practice; Relationship difficulties with patients and family; Uncertainty about be able to care; Comparing self abilities with other novice nurses; and Too tired to learn more.

Participants believed relationships with senior nurses were difficult, and were reluctant to ask for support from seniors or preceptors they did not know well, in keeping with traditional Japanese culture-bound communication practices. This caused nervousness, and a lack of confidence to do their work. Moreover, some ethical issues arose because the participants did not know the right way to act.

Conclusions: Novice nurses need more support and assertiveness training when working in busy environments. Their preceptors and senior nurses require education, and ways to consult better in future regarding such support.

Key words: novice nurse, phenomenology, Japan

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