Situations Among Novice Nurses and Preceptor: They Cannot be Assertive

Saturday, 26 July 2014

Eiko Suzuki, PhD
Department of nursing, International University of Health and Welfeare, Tokyo, Japan
Tomomi Azuma, PhD, RN
School of nursing, Konan women's university, koube, Japan
Akiko Maruyama, PhD
Faculty of Nursing, Kyoritsu Women's University, Tokyo, Japan
Yukiko Sato, PhD
School of Nursing, Yamagata University, Yamagata City, Japan
Miyuki Saito, PhD, RN, PHN
School of Nursing, Yamagata University, Yamagata, Japan
Atsuko Kobiyama, RN
Nursing, International University of Health and Welfare, Kodaira city in Tkyo, Japan
Yuko Takayama, RN
international medical welfare university., Tokyo, Japan

Purpose:  This study describes “the situations where novice nurses and preceptor nurses felt “I wanted to decline, but I could not do so” on the job relatively.

Methods: A self-administered questionnaire was distributed to 102 novice nurses and 52 preceptor in each workshop. Having been explained the definition of assertiveness in the questionnaire, participants were asked about the situations and reasons where they have felt: “I wanted to decline but could not do so” as “using an example at the workplace from the past year of when they felt they wanted to be assertive and could not be”. Three situations labeled, “what happened”, ”what I wanted to do”, and “what I could not do” and their reasons were extracted from the scenarios described in the questionnaire’. A content analysis based on Krippendorff's method was carried out on their described messages by focusing on the context. The situations were classified for each participant, and categorized based on the similarity of the situations.


Novice nurse’s number of valid responses was 81, and the average age was 23.7 years old. Preceptor’s number valid responses was 42, and the mean age was 33.3 years old. The situations where the participant novice nurses felt “I could not be assertive toward my seniors” yielded the following nine categories: (1) I cannot decline tasks assigned to me; (2) I cannot say anything about my senior’s unfavorable behavior; (3) I cannot say I’m confused by the unstructured instructions; (4) I cannot argue against my senior’s scolding or pointing out grievances regarding my work; (5) I cannot argue about my senior’s behavior toward me and novice nurses; (6) I cannot declare my uneasiness about the work;  (7) I cannot argue about a false accusation of errors made by my senior; (8) I cannot decline private requests; and (9) Others.The situations where the preceptor felt the following seven categories: “Nursing practice”, “Dependent behavior”, “Lack of feeling strain”, “Inappropriate language”, “Presentation of the homework”, “Appearance”, “Character of novice nurse”.


 Novice nurses were in situations where they could not decline to do something or were made to feel uneasiness about fulfilling their duties, or declining overtime work, and not being able to communicate or report necessary messages, all of which were potential situations that could contribute to medical accidents. The preceptors considered relationships with novice nurses to be important. This study made us realize the importance of assertiveness education for novice nurses. As well, it suggested the necessity to ensure the assertiveness of the whole ward by improving the assertiveness of preceptors or bosses.