Three Japanese Expert Nurses' Professional Narrative: Reflections on Their Accumulated Clinical Nursing Experiences Refining Nursing Identity

Saturday, 26 July 2014

Hiromi Kuroda, RN, MN1
Satomi Yamaguchi, RN, MN2
Sayaka Higajima, RN, BA3
Tomoko Miyashita, RN, BA4
Hideko Urata, RN, PhD1
(1)Department of Nursing, Graduate School of Biomedical Sciences, Nagasaki University, NAGASAKI, Japan
(2)Department of Nursing, Graduate School of Biomedical Sciences, Nagasaki University, NAGSAKI, Japan
(3)Nursing Dep., Nursing department of Saga university hospital, Saga, Japan
(4)Nursing Dep., Nursing department of Juntendo University Urayasu hospital, Tokyo, Japan

Purpose: Reflection on one’s own practices and experiences is a significant key for the expert nurses as it constructs intellectual and clinical competencies of nurse and it would refine their professional identity. The purpose of this study is to describe 3 Japanese expert nurses’ perceptions for nursing as their lifework profession.

Methods: Three active expert nurses, who have over 30 years of work experiences, working for a University Medical Hospital with 800 beds in Japan, were the informants of the study. The main role of the informants was day to day patient care rather than the administrative aspect of their work. The interview guide with some key questions such as 1)What do you give attention to the most when you interact with the patients? 2) What does nursing mean for you? 3) What do you wish to tell about nursing and for this to be adopted by the next generation of nurses? was distributed to the informants a few days before the semi-structured interview. The IC recorder was used and the interview was taken in each interview, and the transcripts were made after the interviews. Some categorie! s and sub-categories were extracted in inductive manner, and careful analysis was maintained by discussions and triangulation of the research team members.

Results: The three female nurses in their 50’s agreed with the study. The mean interview hour was 56 minutes, and 12 categories with 45 sub-categories and 118 codes were extracted from the transcripts. Unique categories [ ] were found as [Ideal nursing] [Importance of communication and social skills] [Nursing as the interpersonal relations with the patients] [Caring includes family of the patients] [Supporting patient with team] [Realizing a true attraction of nursing by the accumulated experiences] [Increasing the choices/options of appropriate care for the patients by considering their individuality] [not only quietly cuddling close to the patients but also providing appropriate care] [Determining to carry out care for patents’ true bene! fit] [Accumulations of both personal life and professional life fosters nurses growth] [Recognition of what is a key to maintain nursing career] [Considering own role to educate and guide  the next generation nurses into nursing]

Conclusion: Professional roles and identity of expert nurses were cultivated within their everyday practices and repetitive reflections of those actions.[Ideal nursing and] [Nursing as the interpersonal relations with the patients] were the principle ideas beyond the age and career of nurses. However, these Japanese expert nurses perceived that their professional growth was underpinned by [Accumulations of both personal life and professional life fosters nurses' professional growth]. With over 30 years of nursing experiences and tuning into in their 50s, these experts refined what and how the nursing professional is like. That was also influenced by their interactions with patients and others. In addition, [Increasi! ng the choices/options of appropriate care for the patients by considering their individuality] was perceived. The more expert nurses reflect their own practices the more they would have choices of care to be provided, and to be flexible and creative to provide care of which patients individuality is well considered. [Determining to carry out the care for patents’ true benefit] and [not only quietly cuddling close to the patients but also provide appropriate care] showed Japanese expert nurses’ specific approaches as they believe it fulfilled patients' needs. They accept their patients as they are, but at the same time they provide necessary and beneficial care for their patients with their strong faith as it fosters patients growth. They also perceived themselves as the leaders to lead the next generations as [Considering their own role to educate and guide  the next generation nurses into nursing] was shown. !

Acknowledgement: A part of this study was supported by the Research founding of the Alumni Association of Nagasaki University Department of Nursing 2012