Georgia Baptist College of Nursing of Mercer University, Atlanta, Georgia 30341, US.
J Nurs Scholarsh. 2010 Mar;42(1):83-91. doi: 10.1111/j.1547-5069.2009.01325.x.
To explain how baccalaureate-prepared acute care nurses understand, adapt to, and negotiate challenge and change in acute care settings in the context of social and structural features and consequently develop career persistence there.
Grounded theory method based on the research of Strauss and Corbin.
A research team conducted open-ended interviews with a theoretic sample of 19 new and experienced baccalaureate-prepared (BSN) nurses in the southeast United States during 2007 and 2008 until saturation was achieved. Interviews were audiotaped and transcribed verbatim. Constant comparative method was used to analyze data to three increasingly abstract levels culminating in theory emergence. A diagram was developed to better understand relationships and processes.
A central category, building professional resilience, emerged as the central social process with three core processes of verifying fit, stage setting, and optimizing the environment contributing to career persistence in acute care. Core processes include skills and practices nurses have learned to negotiate changing acute care environments while sustaining patient advocacy. Definitions, properties, and dimensions of each were established.
The study offers a systematic framework for understanding and promoting career persistence for acute care nurses. Findings broaden theories of resilience to the unique settings of acute care nursing and further extend theoretical understanding of the nursing shortage and market issues of supply and demand.
A middle range theory of professional resilience and career persistence makes visible skills and practices acute-care nurses use to weather continuous change and challenge in health care. Teachable practices can be integrated into nursing education and staff development to improve professional career longevity of experienced nurses at the bedside.
解释学士学位准备的急症护理护士如何在社会和结构特征的背景下理解、适应和协商急症护理环境中的挑战和变化，从而在该环境中发展职业持久性。
基于 Strauss 和 Corbin 研究的扎根理论方法。
一个研究小组于 2007 年至 2008 年期间，对美国东南部的 19 名新入职和有经验的学士学位准备（BSN）护士进行了开放性访谈，作为理论样本，直到达到饱和。访谈进行了录音，并逐字转录。使用恒比比较法对数据进行分析，以达到三个逐渐抽象的层次，最终出现理论。还制定了一个图表以更好地理解关系和流程。
一个核心类别“建立专业韧性”作为中心社会过程出现，其中三个核心过程，即验证适配、设定阶段和优化环境，有助于在急症护理中保持职业持久性。核心过程包括护士在维持患者权益的同时，学习到的用于协商不断变化的急症护理环境的技能和实践。每个核心过程都确定了定义、属性和维度。
该研究为理解和促进急症护理护士的职业持久性提供了一个系统框架。研究结果拓宽了韧性理论在急症护理独特环境中的应用，并进一步扩展了对护理短缺和供求市场问题的理论理解。
专业韧性和职业持久性的中程理论使人们能够看到急症护理护士在医疗保健中应对持续变化和挑战时使用的技能和实践。可教的实践可以整合到护理教育和员工发展中，以提高经验丰富的护士在床边的专业职业寿命。
