Professional education results when a professional discipline devises a system of preparing future practitioners to meet their commitments and fundamental responsibilities to society. A major aim of professional nursing education is to develop a set of values, attitudes, beliefs, knowledge, and skills supportive to their professional roles as a licensed professional registered nurse. Conceptual and theoretical frameworks that support these two research studies include Good Work in Nursing concepts, Hinshaw’s Re-Socialization in Nursing framework, and role development theories and models. The presenters of this session will compare the results of a qualitative research study on Good Work in Nursing (GWN) with traditional baccalaureate newly licensed registered nurses (NLRNs) to one that dealt with value orientation of second degree masters newly licensees.
Methods:
The GWN qualitative longitudinal study describes the perceptions of NLRNs from the point of graduation from a baccalaureate nursing program to one-year after the initial employment of professional practice. A purposive sample of 12 graduates met criteria. Each participant was interviewed for approximately one-hour at two data collection points (2012 and 2013) using a semi-structured interview protocol adapted from the GoodWork© Project. Perceptions were obtained regarding beliefs, values, goals, responsibilities, opportunities, supports, obstacles, pressures and conditions of the domain. Content analysis of verbatim transcripts and researcher triangulation were used to identify category descriptors and themes. Examples of results after one year indicated a more holistic approach to care, increase sense of responsibility not equal to scope of authority, greater sense of accountability for patient safety, and alignment with peers with similar values and practice beliefs.
As a comparative sample, the transcribed data from multiple focus groups (n=7 participants) with second degree clinical nurse leader masters graduates will be shared and compared to the GWN longitudinal study. These second degree masters’ graduates were working as NLRNs for 6-9 months. In 2016, each participant was interviewed and described their professional values and beliefs as a newly licensed second degree nurse upon exit from their institutional based orientation program. Examples of results between 6-9 months of professional practice indicated that participants focused on providing care that was comprehensive and safe. They worked to do so by gaining efficiency with skill and role and by recognizing their lack of knowledge. This acknowledgement of their knowledge deficit highlights another value of accountability. Additionally, participants shared that they asked questions and actively sought knowledge to ensure they were safe during caring episodes. Participants also discussed support systems of transition that served as safeguards to safe care. They saw these support systems, not only in their assigned preceptors or mentors, but in every nurse who interacted with them within their work environments.
Results:
The comparative results indicate retention of a core set of values and behaviors by NLRNs regardless of the educational program. Both cohort groups in their first year of professional practice reaffirmed commitment to excellence in their nursing practice with comprehensive/holistic care, accountability and ethical integrity of patient care. All participants indicated the importance of support systems and positive role models and work environments. Both traditional baccalaureate and second degree masters NLRNs also identified responsibilities and obstacles during their first year of practice. In addition, they expanded their views, values, and beliefs based primarily on unit-based activities with patients, families, peers, physicians, and nurse administrators. The end result for these participants included nurse satisfaction, greater self-confidence and engagement in the nursing profession.
Conclusions:
Nursing practice adheres to high standards regardless of the multi-contextual work environment or paradigm shift in modern health care. Influential factors in sustaining values and belief play a role in promoting good work in nursing (nursing practice deemed to be of high quality and socially responsible). Recommendations and implications for educational and institutional change will be discussed.