The Voice of the Nurse: Facilitators and Barriers to Advancing in the Nursing Profession

Background: RN’s represent the frontline of patient defense in healthcare, and play a key role in ensuring quality.  Nurses are indispensable to patient safety through their ability to recognize, interrupt, and correct errors that are often life threatening. It is imperative that nurses participate in professional development (PD) and career advancement (CA) to gain the skills necessary to meet the changing needs of their patients. Healthcare organizations use career advancement programs to promote nurses’ participation in PD. In order to advance through the career ladder, nurses must show evidence of enhanced or new competency in their practice. Thus, CA serves as a tool that supports nursing excellence by conferring higher clinical status to those that meet the requirements. CA programs recognize, reward and retain highly competent and skilled nurses at the clinical area, thus career advancement serves as a framework that supports nurses to develop their skills for improved patient care.

 Purpose: Identify the factors influencing PD and CA in IENs and UENs.

 Methods: IENs and UENs participated in an online survey consisting of two open-ended questions asking them to discuss the positive factors and barriers that have influenced participation in PD and CA.  Responses were analyzed using a quantitative and qualitative content analysis to identify themes and sub-themes.

 Results: Although some differences emerged in the subthemes between IENs and UENs, the overall themes were similar. Positive themes identified included structural empowerment, commitment to advancement in the profession, and external support. Barrier themes were poor work environment, complacency vs. contentment and competing priorities.

 Conclusion: Both groups emphasized the importance of leadership in creating an environment where nurses can advance their careers. Nurses identified limited opportunity to advance in areas of interest as a cause for less participation, as well as in the reasons for complacency/contentment in their current positions.