从护士长角色到护士角色的转换与适应

在从护士长角色转换为护士角色过程中,面临各种困难与困惑,当事者如能摆正心态,正确对待;积极“充电”,完善自我;学会放松;找准位置,就能淡化管理角色痕迹,强化护士角色行为,顺利度过适应期。     

Role transition from student nurse to staff nurse: Facilitating the transition period

BackgroundUndergraduate nursing programmes are designed to equip student nurses with the skills and knowledge necessary for their future work as professional nurses. Influences on the role during the transition period from student to staff nurse are unclear.PurposeThis paper explores the experience of role transition for newly-qualified nurses from an Irish perspective.MethodsA Heideggerian Hermeneutic approach was the research method adopted. Ten newly qualified nurses from one of Dublin's Academic Teaching Hospitals were interviewed. Data were analysed using Van Manen's thematic analysis. Influences on the transition period were explored in the context of Chick and Meleis's Transition Concept.FindingsNewly-qualified nurses initially felt excited upon qualification. However, professional responsibility and accountability associated with the new role were overwhelming for participants. They felt frustrated when they didn't receive adequate support during transition.ConclusionNewly-qualified nurses need support while they incorporate their knowledge into clinical practice. Hidden influences should as education levels and scope of practice should be considered before nurse educators begin to develop education programmes for undergraduate nurses.     

Role transition from staff nurse to clinical nurse specialist: a case study

? Over the last decade, nursing in the United Kingdom has witnessed a major development and expansion in the number of Clinical Nurse Specialists. ? These nurses are considered to be experts in their own specialities, have in-depth knowledge and provide a service for patients, relatives and staff. ? There is, however, a paucity of literature relating to role transition from experienced Staff Nurse to Clinical Nurse Specialist. ? Using Nicholson's (1984) model of work-role transition and Wanous' (1992) four-stage model of organizational socialization, this study explores the transition of two nurses from experienced Staff Nurses to novice Clinical Nurse Specialists.     

Research as a catalyst for change: the transition from student to Registered Nurse

This paper outlines the qualitative findings of a study exploring the transition from student to Registered Nurse and the catalytic effect of the way in which newly registered nurses are prepared for this role change. The study explored the experiences of one cohort of students undertaking the pre-registration Advanced Diploma in Nursing Studies at the University of Sheffield. Data were collected pre-qualification and post-qualification in order to compare the expectations and reality of the transition period. Two key aspects emerged, one relating to the experience of students undertaking the final module of the course and the other to preceptorship once qualified. These two areas of practice have been the focus of development following dissemination of the research findings in the local NHS Hospitals. The study suggests that the transition period remains very stressful for some nurses, because of both pre-registration educational issues and the level of support received once qualified. Careful planning of the student experience in the final year and addressing inconsistencies within the preceptorship programmes of newly qualified nurses are needed. The study is stimulating change in the local NHS hospitals, with the aim of enhancing the overall experience of student nurses and newly qualified staff alike.     

A confirmatory factor analysis of the novice nurse practitioner role transition scale

As interest in supporting new nurse practitioners' (NPs) transition to practice increases, those interested in measuring the concept will need an instrument with evidence of reliability and validity. The Novice NP Role Transition (NNPRT) Scale is the first instrument to measure the concept. The preliminary exploratory factor analysis revealed a five-factor structure: organizational alignment, mentorship, sense of purpose, perceived competence and self-confidence, and compensation. Using a cross-sectional design and data from 210 novice NPs, the purpose of this study was to confirm the NNPRT Scale's internal factor structure via confirmatory factor analysis (CFA). The sample was primarily female (97.5%), White (75.9%), and certified in primary care (53.5%). The CFA confirmed the five-factor structure, and model fit was improved by moving and omitting items (χ²[619] = 1277.799, p < 0.001; Root Mean Square Error of Approximation = 0.071 [0.066−0.077]). The final NNPRT Scale includes 37-items, and internal consistency reliability was calculated at 0.95. Convergent validity evidence was supported by a positive, significant correlation with receiving a formal orientation in the first NP position; a negative, significant correlation with turnover intention; and a lack of a relationship with years of prior registered nurse experience. The NNPRT Scale is an instrument with sound evidence of reliability and validity. The NNPRT Scale will be useful for researchers, administrators, and clinicians looking to explore factors that affect NNPRT, as well as by clinicians and administrators implementing programs to support novice NPs' transition to practice.     

Project 2000 diplomates' perceptions of their experiences of transition from student to staff nurse

? This paper presents findings from an exploratory study of the transition experiences of newly qualified Project 2000 diplomates. ? A qualitative approach was utilized involving in-depth interactive interviews with a sample of 10 staff nurses. ? The data indicate that some aspects of transition were initially difficult, but that all those interviewed were enjoying nursing. ? Similarities to the experiences of ‘traditionally prepared’ colleagues are highlighted by the use of phrases such as ‘in at the deep end’ and ‘cast adrift’, reflecting the practice environment once qualified. ? Paradoxically initial transition for Project 2000 diplomates is characterized by a lack of confidence, while their questioning approach to practice and a willingness to ask others when unsure (‘no bluffing’) suggests a high degree of confidence. ? Preceptorship in the context of a supportive environment is suggested as a model for easing the transition process. A re-evaluation of what an initial preparation course can and should achieve, and a re-assessment of the skills and knowledge expected of newly qualified nurses, are also indicated.     

The influences on and experiences of becoming nurse entrepreneurs: a Delphi study

There is little known about private practice nursing as an area of advanced practice. As more nurses take the option to develop private practice, the experiences of and influences on nurses currently in private practice might be a useful guide to the pitfalls and difficulties which might be encountered. In addition, an understanding of the experiences of and influences might assist nursing organizations and health services to provide support to nurses who play an integral part in health care delivery in the community. A research study was undertaken utilizing a two-round Delphi Technique to elicit and assess consensus on the reasons for nurses going into business and the experiences they encountered in becoming and being a nurse entrepreneur. The study instrument in round one comprised a questionnaire with statement headings inviting opinions on the influences and experiences of nurses in business. In the second round, levels of agreement were elicited from responders on collated opinions from round one, including statements formed from comments written in round one. The initial questionnaire also included closed questions to obtain a profile of nurses in private practice. Responders were 59 nurses in private practice in round one and 54 nurses in round two. The themes raised could be grouped under headings of influences, advantages/disadvantages, education/experience, skills/knowledge, characteristics and barriers. The level of agreement on the themes was reasonably high. Dissent occurred on issues of increased income, professional image and support structures. This Delphi study has identified key areas of consensus on the experiences of nurses in private practice who have extended their career into the business arena. It has also identified areas in which further work needs to be carried out to understand this work of nurse entrepreneurs.     

从不同角度分析实习护生临床角色转换影响因素

目的:研究临床实习护生角色转换的影响因素,并在此基础上提出相应对策。方法:采用自制的调查问卷分别对93名实习护生和90位临床带教老师进行调查。结果:影响实习护生角色转换的因素包括理论水平、临床操作水平、理论知识的临床应用能力、沟通能力、对护理事业的热爱程度、带教老师的带教水平、言行、患者怀疑与不信任等。其中,实习护生认为临床操作水平对其角色转换的影响因素最大,而带教老师认为沟通能力影响最大,同时,护生在对护理事业的热爱程度这一影响因素与带教老师的观点存在统计学差异。结论:只有针对不同的影响因素提出可行性的改良对策才能使护生的角色转变顺利进行。     

The transition from nursing student to practicing nurse: An integrative review of transition to practice programs

The transition from student to novice is a difficult time. Although the novice nurse is excited to start working, the nurse struggles with acclimating to a new role with new responsibilities and the need to reconcile disparities between what was taught in school and what is practiced in the real world. To lessen the impact of the transition experience, health care organizations have implemented transition-to-practice programs including orientations, preceptorships, and residencies. Despite these efforts, if the novice nurse does not find these programs helpful, there is still a risk that the transition experience will not conclude with successful results. This integrative review examined qualitative studies that explored the transition-to-practice experience of novice nurses who participated in a transition-to-practice program provided by their place of employment. Thirteen articles met the criteria for this integrative review; seven themes emerged from the commonalities in the studies: socialization, professional growth, feeling supported, transition challenges, reflections, transition shock, and feelings. Though the transition period includes unique experiences for each novice nurse, the common feelings and needs identified in these studies require nurse educators and the healthcare organizations to ensure that novice nurses are prepared and given the tools to successfully transition to professional nursing practice.     

对临床实习护生建立分值考评制度的研究

目的 探讨临床实习护生的管理。方法 对临床实习护生建立分值考评制度,对实施分值考评制度前后两组临床实习护生进行比较,并对结果进行分析。结果 建立分值考评制度后临床实习护生工作综合评价明显优于建立分值考评制度前临床实习护生。结论 对临床实习护生建立分值考评制度可促进临床实习护生的工作积极性和临床实习护生管理规范。     

Understanding and becoming – the heart of the matter in nurse education

The aim of this study was to deepen the understanding of student nurses' processes of understanding and becoming nurses. The study is phenomenological‐hermeneutic in design, comprising data from three focus group interviews in two Scandinavian countries. The process of student nurses' understanding and becoming a nurse emerged as a hermeneutical movement. A caring student–preceptor relationship and a growth‐promoting preception in a supportive and inclusive environment provide the frame within which the movement happens. The movement towards understanding and becoming is initiated as students, based on their level of knowledge, are given responsibility. In order to fulfil the responsibility imposed on them, students take their entire repertoire of knowledge into consideration. By tying these threads together, they found the basis for conscious action, and care is provided according to what the current situation requires. The experiences obtained are reflected on and integrated with earlier knowledge, which leads to enhanced understanding. Students form a new base to stand on. They show increased readiness for still more responsibility and action. This movement towards deeper understanding and becoming affects the students also ethically and deepens their ethical awareness. When one loop of understanding and becoming is closed the process continues by passing into a new loop. This movement could be described as a hermeneutical spiral consisting of interconnected loops taking the students further and deeper in their process of understanding and becoming a nurse. The student–preceptor relationship and the ethos permeating it are decisive for students' learning both epistemologically and ontologically. Responsibility is the catalyst in students' understanding and becoming both intellectually and ethically. Understanding and becoming are ongoing processes of appropriation, thus altering students both professionally and personally. Understanding and becoming can be perceived as the hearth of the matter in nurse education.