Ho Hsueh-Hua, Liu Pei-Fen, Hu Hsiao-Chen, Huang Su-Fei, Chen Hsiao-Lien
The Taipei City Nurses' Association, Taipei, Taiwan, ROC.
Hu Li Za Zhi. 2010 Dec;57(6):31-41.
The role transition process is full of stresses and challenges for nurses. Between 35-61% nurses leave their job within the first year. Past cross-sectional quantitative studies have not provided deep descriptions of either the dynamic role transition or work adaption processes of new nurses.
The purpose of this study was to understand the role transition experience of new nurses as they transitioned into clinical practice during their first three months on the job.
A qualitative approach was used. Data were collected through a semi-structured interview from 50 new nurses. Data were analyzed using category-content analysis.
Three stages were identified in the new nurse work adaption process over the first three-month period. These included (1) Understanding: New nurse knowledge and skills are insufficient to handle routine work, adapting to the role transition is difficult, feelings of anxiety emerge related to fears of incompetence, communication difficulties must be faced in the handover process, new nurses adopt feelings of attachment to their preceptors, they must work to adopt appropriate attitudes and approaches to nursing practice, and support is sought from family, teachers and friends; (2) Acclimation: Learning to care for patients independently, seeking role models, learning to adapt to night shifts, trying to identify with co-workers, and seeking support from colleagues, preceptors and head nurses; (3) Acceptance: Managing nursing work better in terms of time and organization, feeling gradual acceptance from co-workers, restoring personal enthusiasm for work, starting to consider other, non-work related matters, experiencing and appreciating the support of co-workers and head nurses. CONCLUSIONS/IMPLICATION: New nurses face a critical role transition process through their first three months on the job. Guidance and leadership from experienced nurses and multiple support systems can assist new nurses to acclimate to their role. Research results provide information for educators and administrators to better understand the adaption process of new nurses, and offer a reference for developing future strategies to improve nurse competency in handling their work.
角色转变过程对护士来说充满压力和挑战。35%至61%的护士在入职第一年就离职。以往的横断面定量研究并未深入描述新护士动态的角色转变或工作适应过程。
本研究旨在了解新护士在入职头三个月过渡到临床实践过程中的角色转变经历。
采用定性研究方法。通过对50名新护士进行半结构化访谈收集数据。采用类别内容分析法对数据进行分析。
在新护士入职头三个月的工作适应过程中确定了三个阶段。这些阶段包括：（1）理解阶段：新护士的知识和技能不足以处理日常工作，难以适应角色转变，因担心不胜任而出现焦虑情绪，在交接班过程中必须面对沟通困难，新护士对带教老师产生依恋之情，她们必须努力采取适当的护理实践态度和方法，并向家人、老师和朋友寻求支持；（2）适应阶段：学会独立护理患者，寻找榜样，学会适应夜班，试图认同同事，并向同事、带教老师和护士长寻求支持；（3）接受阶段：在时间管理和组织安排方面能更好地处理护理工作，逐渐得到同事的认可，恢复个人工作热情，开始考虑工作以外的其他事情，感受并感激同事和护士长的支持。
结论/启示：新护士在入职头三个月面临关键的角色转变过程。经验丰富的护士给予指导和引领以及多重支持系统可帮助新护士适应其角色。研究结果为教育工作者和管理人员提供信息，使其更好地理解新护士的适应过程，并为制定未来策略以提高护士工作能力提供参考。
