Nurse Self-Concept Associated with Perception of Efficacy of Nurse Practice: A Narrative Analysis

Friday, 16 July 2010: 8:30 AM

Diane Randall Andrews, PhD, RN1
Joyce Burr, MSN, RN1
Angeline Bushy, PhD, RN, FAAN2
1College of Nursing, University of Central Florida, Orlando, FL
2College of Nursing, University of Central Florida, Daytona Beach, FL

Learning Objective 1: demonstrate knowledge of workplace factors which influence the manifestation of self concept in staff nurses.

Learning Objective 2: identify courses of action which may be used to support the development of an empowered self-concept.


The challenge of maintaining a stable workforce encourages analysis of nurse perceptions of the work environment.


Narrative content analysis was used to evaluate the written comments of staff nurses using methods suggested by Richards and Morse. Participants responded to the open-ended question: “Thank you for taking time to complete this survey. Please use the following space to share any additional comments.” Of 308 participants responding to an initial quantitative survey, 107 (35%) provided written comments following completion of items regarding the impact of job strain on intent to leave. 


The comments revealed that an inability to reconcile the realities of the work environment with professional standards and values; and an inability to actualize professional role expectations resulted in a sense of loss of personal and professional identity.  Nurses took it upon themselves to adjust to the circumstances presented in the work setting through self-sacrifice and compromised their own self-care out of a sense of obligation to their profession and their patients. This loss of self-concept was associated with a negative interpretation of the nurse’s ability to influence quality patient care outcomes. It was also associated with a variety of negative emotions ranging from frustration to anger. 


While further research on the influence of self-concept is indicated, this study suggests a need to incorporate self-development content into academic, transitional orientation and continuing education programs.  Recommendations include emphasis on mentoring, coaching and role modeling in order to promote effective use of coping skills and support conceptualization of the professional role as one empowered to advocate on behalf of both the nurse and the patient.  The focus on role and professional socialization, as impacted by the work experience, appears to have broad applicability for nurse leaders seeking techniques which transform the work experience of nurse employees.