In order to increase the number of registered nurses (RNs) choosing to pursue advanced nursing degrees, it is important to understand the many factors that may influence this decision. Commonly identified barriers include time constraints, family obligations, and financial limitations (Schwarz & Leibold, 2014). Consequently, a better understanding of the intrinsic characteristics that enable a nurse to overcome barriers and return to graduate school will provide novel information to the profession. Other less common barriers to the education of advanced practice nurses that are not well studied include oppression within the nursing culture and institutional workplace factors.
Purpose: The purpose of our research is to study the intrinsic characteristics that empower and motivate RNs to pursue higher levels of education and how the nursing culture and institutional workplace may encourage or discourage this career achievement. The data generated from our research can be used by the individual, institution, and nursing profession to increase the number of RNs returning to graduate school and functioning as APRNs thereby relieving the current provider shortage in American healthcare.
Theoretical Framework: Self-determination theory (SDT) explores the concept of goal-directed behavior in terms of internal and external motivators and personality (Deci & Ryan, 2000). The pursuit of higher education in nursing is a goal directed behavior. Paulo Freire’s model of oppression is a theory grounded in the marginalization of Brazilians by the imperialist Europeans (2000). Nurses are often perceived as an oppressed profession, due to exploitation experienced in the profession (Dong & Temple, 2011). SDT and Freire's Pedagogy of the Oppressed provide the foundational theoretical component of our research.
Methods: The research design for our project is a quantitative, descriptive correlational, cross-sectional study. In our study, we are using a self-report questionnaire to collect data from a convenience sample of registered nurses, followed by the use of statistical techniques to examine the relationships and correlations between intrinsic and extrinsic motivators among registered nurses across the educational spectrum.
In our study, we use the General Causality Orientation Scale (GCOS), created from the concepts defined in the SDT, to measure the dependent variable of intrinsic motivation among nurses (Deci & Ryan, 1985). We use the GCOS to measure the personality characteristics of nurses in order to determine if there is a statistically significant difference in causality orientation as a nurse’s level of education increases. We also utilize the Nurse Workplace Scale (NWS) in our study. This scale was created by Demarco, Roberts, Norris, and McCurry to measure behaviors in nursing that are counterproductive and associated with oppressed group behavior (2008). The healthcare profession is dominated by the medical model and for this reason, nursing is oftentimes classified as an oppressed profession (Demarco, Roberts, Norris & McCurry, 2008).
The target population for our study is registered nurses, 18 years of age and older that hold an active license from his or her respective Board of Nursing. To select participants, we utilize a convenience sampling method with a network or “snowball” effect. Using the Qualtrics online survey program, a survey was distributed online via email and social media outlets, including but not limited to Facebook, Twitter, Instagram, and Linked-In. The sample size of the study is unknown until the completion of the open survey period.
Results: The autonomous orientation predominated over the control and impersonal orientations. Oppression scores decreased as education increased. Kruskal Wallis H testing showed statistically significant differences (p < .05) between nurses’ education levels, age, and questions of the NWS. Mann-Whitney U testing showed statistically significant differences (p < .05) between financial incentives and perceived support.
Conclusion: An implication of this research is advancement of knowledge surrounding RNs’ pursuit of higher education. Our research indicates that the majority of nurses are oriented towards autonomous personality traits which may result in increased job satisfaction, improved performance, and improved competence. As education level advances, a nurse’s sense of self-confidence increases and oppressed behavior decreases. Facilities that offer financial incentive for education foster a supportive environment for nurses pursuing advanced education.