Acorn, Sonia
Person Preferred Name
Sonia Acorn
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Default image for the object New emergency nurses descriptions of making the transition to a more experienced emergency nurse: An interpretive descriptive study, object is lacking a thumbnail image
Content type
Digital Document
Abstract
How do new emergency nurses describe their experiences as they make the transition from being a new to becoming a more experienced emergency nurse? What are the needs of new emergency nurses as they make this transition? In this qualitative study, new emergency nurses were interviewed for the purpose of identifying what is was like to be a new nurse in the emergency department; what were their needs; what health care personnel, educators and administers could do to help them; and their intent to leave. Interpretive description was the research approach utilized in this study. Ethical approval was obtained from the University of British Columbia Behavioural Research Ethics Board and the Fraser Health Clinical Investigation Committee. Using theoretical sampling, eight new emergency nurses, from the lower mainland and Vancouver Island of British Columbia, participated in semistructured, audiotaped interviews. They had three years or less of emergency nursing practice and had completed the core courses of an emergency specialty program. The new emergency nurses felt overwhelmed and unprepared as they started their emergency practice. They encountered inconsistencies and deficiencies in their orientation programs. They encountered factors in the workplace environment that created challenges for them to practice safely and ethically. Workplace challenges included: the nursing shortage; the lack of resources; frustrations with management; the high patient acuity and volume; the challenges of attempting to meet organizational and technical changes; and the expectations of patients and patient's families. Hospital overcrowding created an environment where the nurses experienced occupational stress; mental and physical fatigue plus abuse from patients, patient families and emergency personnel. The participants did not utilized professional services to debrief stressful incidents. They described favourable relationships with emergency physicians and experienced horizontal violence from nursing colleagues. Six of the eight participants anticipated leaving the emergency department or changing their status in a year. They expressed feelings of being frustrated, stressed, overwhelmed and exhausted. The study's findings suggest implications for policy makers, nursing practice and nursing education. Further research is needed to explore the experiences of emergency nurses, the work place environment, the abuse they encounter and strategies to retain them.
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Content type
Digital Document
Abstract
Health personnel, especially nurses, are often victims of workplace violence. Unfortunately, little is known about the nurses' experience of violence. A research study was initiated to further explore the nurses' accounts of workplace violence so as to make dimensions of the nurses' experience visible and more fully understood. Interpretive description was the research methodology adopted for this study. Using theoretical sampling, ten Registered Nurses from the lower mainland and Vancouver Island, British Columbia participated in semi structured, audiotaped interviews. In this research, the nurses' experience of workplace violence emerged as a highly complex entity, deeply embedded in relationships and context. How nurses perceive the contextual factors of the organization, their immediate work environment and their individual attributes were found to play a significant role in how they respond to the phenomenon. The findings of this study suggest that organizational culture is an important determinant in managing workplace violence and that policy and administrative personnel play a pivotal role in influencing the problem. Nursing culture also influences the nurses' expectations, assumptions and actions towards violence. Participants voiced that role conflict often challenged their ability to enact acquired professional ideals and that that they routinely undertake roles in dealing with violence that are not appropriate to their level of knowledge or skill. Within the nurses' immediate work environment, bullying as well as physical and verbal abuse was commonplace. Overcrowding, long waits for service, poor environmental design and inadequate staff to patient ratios were seen as factors that increased nurses' risk. Individual factors were associated with emotional and psychological harms that nurses endured. Workplace violence affected self-concept, self-esteem, self-efficacy and the nurses' sense of control. Moral distress, self-blame, feelings of failure, loss of motivation and leaving the nursing profession were significant findings. The results of this study demonstrate a need to re-think how we can address workplace violence in nursing. Research and intervention is needed to further explore organizational policy and governing structures, the culture and climate of practice environments, and the fundamental role nursing education programs have in preparing nurses to manage workplace violence.
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