|Author:||Chung, Mei-yee Mimie|
|Title:||The lived experience of nurse specialists working in acute care setting|
Intensive care nursing
Hong Kong Polytechnic University -- Dissertations
Department of Management
|Pages:||v, 77 leaves : ill. ; 30 cm|
|Abstract:||Hospital Authority (HA) created a new grade Nurse Specialist (NS) in May, 1994, aiming at establishing a new clinical career path for nurses. The main roles of NS were : expert patient care, counselling, research and teaching. The impact of this change has led to some role conflict and confusion between the grades of ward manager(WM), nursing officer (NO) and nurse specialist (NS). Unclear role delineation caused nurses of these grade a lot of difficulties in performing their roles and become frustrated. It may adversely affect the organizational harmony and effectiveness. The purpose of this study was to explore the lived experience of NS working in acute care setting using a non-experimental design, and an interpretive approach. Phenomenological approach was used to study the lived experience of NS. These experiences were thought to disclose and elucidate the phenomena that were difficult to discover through quantitative methodology. Data collection through semi-structured interview using open-ended questions focused on role conflict / confusion, satisfaction, motivation, and self-actualization. Acute care setting was defined as intensive care unit, accident and emergency department, neonatal intensive care, paediatric intensive care, coronary care unit. These areas shared common characteristics which highly demanded NS to possess complexity of knowledge and skill and persistently work under tension due to the need of high accuracy. Among 23 NSs who worked in acute care setting, five NSs with one from each acute care setting were invited randomly for individual interview. Individual interviews were conducted and followed by a focused group interview which consisted of 6 NSs. These interviews were tape-recorded and then analyzed qualitatively after transcription. Themes emerged from data which led to the creation of the framework of lived experience of NSs. The level of job satisfaction and frustration was influenced by role ambiguity / conflict; lack of support; unique knowledge; and disempowerment. These factors were interrelated and they interacted to affect the level of satisfaction and frustration of NSs. Role ambiguity / conflict was due to unclear role definition, work role versus family role, work role versus professional role, and position. They felt lack of support from organization, management, peers and medical staff. Support was an important facilitator for their role implementation. Unique knowledge was a mean to maintain their expert power. It was necessary for them to have continuing education, maintaining their clinical competence and keeping up-to-date knowledge. Disempowerment was due to lack of authority, lack of autonomy, conflict in human relationship and staff resistance. The satisfaction came from ability utilization, status, recognition and respect gained from others. Frustration was due to no advancement opportunity, heavy workload, self imposed demand, expectations of the role and effectiveness of the role. NSs noticed the potential obstacles in their role development enable them to overcome it easier. Manager understood the influencing factors of NS's role development and could help to alleviate or eliminate the negative effect of these factors. Thus, NSs may work happier and more committed to their work and maintained high quality and productivity.|
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