Reflection in night nursing: a phenomenographic study of municipal night duty registered nurses’ conceptions of reflection

Aim. The aim of the study was to describe nurses’ conception of reflection in their working situation. Background. To be a municipal night duty registered nurse in Sweden means to shoulder nursing care responsibility for numerous units with older people in need of care. Two night nurses share nursing care responsibility for up to 1300 people. In nursing research, reflection is an often‐mentioned phenomenon discussed with advantages and benefits within the ‘traditional fields’ of nursing (hospital context). A question to ask is, how do night nurses having an untraditional amount of nursing care responsibility conceptualise and experience reflection in their working situation? Design. A phenomenographic methodology was used. Methods. Data were collected by interviewing all nurses (n = 7) in a medium‐sized municipality bordering a metropolitan area of Sweden. Results. The nurses’ conceptions of reflection are categorised as ‘Field of applications’ (an instrument for interpreting, a strategy for handling the working situation and an approach to learning) and ‘Field of prerequisites’ (presence facilitates reflection; flexibility implies reflection; courage in thought and activity increases reflection). Conclusion. The findings reveal that reflection in the nurses’ working situation is more than an instrument for learning, understanding and encouragement for change and improvement. Reflection is conceptualised as an instrument for interpreting nursing care situations, which requires courage and is facilitated by presence and flexibility. Reflection is also conceptualised as an approach to handling, managing and coping with a sometimes impossible working situation that includes nursing responsibility for hundreds of older people and can sometimes entail difficulties and stress. Relevance to clinical practice. The findings showed that reflection has a broader use than had earlier been described. Deliberate use of reflection could mean improved nursing practice. This guides nursing managers to pay attention to the phenomenon as an instrument for nursing care improvement.     

新疆二级及以上综合医院护士职业生涯规划认知现状调查

目的调查护士职业生涯规划认知现状,为今后建立有效的职业生涯规划程序、稳定护士队伍提供依据。方法对新疆二级及以上综合医院1 298名在职护士进行问卷调查。结果护士职业生涯规划认知得分为(3.28±0.41)分,总体偏低;职业生涯规划认知得分的影响因素包括医院等级、职称、职务、学历、职业生涯规划培训、是否重症科室、婚育情况。结论应加强对护士职业生涯规划的指导与管理,提高护士对职业生涯规划的认知度,稳定护理队伍。     

Newly licensed registered nurses' perceptions of job difficulties, demands and control: individual and organizational predictors

unruh l.y. & nooney j. (2011) Journal of Nursing Management 19 , 572–584
Newly licensed registered nurses’ perceptions of job difficulties, demands and control: individual and organizational predictors Aims To determine predictors of newly licensed registered nurses’ perceptions of job difficulties, job demands and job control. Background In previous studies, new registered nurses describe their work environment as stressful, yet little is known about factors that influence these experiences. Methods We surveyed a random sample of newly licensed registered nurses in Florida. Dependent variables included indicators of job difficulty, job demand and job control. Independent variables included individual and organizational characteristics hypothesized to be related to the dependent variables. Logistic and ordinary least squares regressions were used to analyse survey data. Results Inadequate orientation, working the day shift, working a greater number of hours and caring for a higher number of patients were significantly related to a greater likelihood of perceptions of job difficulty and job demand. Less adequate orientation and a greater number of float shifts were related to a lower likelihood of perceptions of job control. Conclusions and implications Adequacy of orientation, patient load, work hours, shift work and floating are priority items that need improvement in the work environment of newly licensed registered nurses. Implications for Nursing Management The present study identified factors involved with newly licensed registered nurses’ perceptions of job difficulties, job demands and job control which will help managers redesign work settings to retain new nurses.