Chu Wen, Hsu Li-Ling
Department of Nursing, Cardinal Tien Hospital, Taipei, Taiwan.
J Emerg Nurs. 2011 Mar;37(2):126-31. doi: 10.1016/j.jen.2009.12.019. Epub 2010 Jan 15.
The emergency department is the front line in the hospital battlefield. Medical staff are frequently tested with highly complex and fast-changing clinical situations. Nurses must acquire practical knowledge in a fast-changing environment in order to provide the most appropriate form of nursing care. This study explores the process of the development of practical knowledge in emergency nurses.
This study uses a phenomenological approach and in-depth interviews and adopts Moustakas data analysis techniques. In 2007, the researcher interviewed 10 professional nurses with at least 3 years of ED experience and collected 13 interview transcripts.
Data analysis identified 4 major themes and 10 sub themes in the process of development of practical knowledge for ED nurses. The 4 major stages in the learning process are (1) matter-of-course apprenticeship, (2) stimulus-response learning, (3) work demand-oriented learning, and (4) self-reflective learning.
Upon entering the emergency department, nurses began learning by serving as apprentices to seniors. After this, they experienced the stimulus-response learning phase as they responded to stimuli in the form of pressure to grow and learn. As they gradually drifted away from the protection of seniors, they continued to learn in order to meet work demands, hold on to their jobs, and maintain a proper level of professional competence. A small number of participants entered the final stage of self-reflective learning, in which they examined their life experience by self-reflection and developed a proper nursing attitude and knowledge about holistic patient care.
急诊科是医院战场的前线。医护人员经常面临高度复杂且瞬息万变的临床情况的考验。护士必须在快速变化的环境中获取实践知识，以便提供最恰当的护理形式。本研究探讨急诊护士实践知识的发展过程。
本研究采用现象学方法和深度访谈，并采用穆斯塔卡斯数据分析技术。2007年，研究者对10名具有至少3年急诊科工作经验的专业护士进行了访谈，收集了13份访谈记录。
数据分析确定了急诊护士实践知识发展过程中的4个主要主题和10个子主题。学习过程中的4个主要阶段为：（1）理所当然的学徒期，（2）刺激-反应学习，（3）工作需求导向学习，以及（4）自我反思学习。
进入急诊科后，护士们通过向年资较高者学习开始实践。在此之后，他们经历了刺激-反应学习阶段——应对成长和学习压力形式的刺激。随着他们逐渐摆脱年资较高者的庇护，他们继续学习以满足工作需求、保住工作并维持适当的专业能力水平。少数参与者进入了自我反思学习的最后阶段，在这个阶段，他们通过自我反思审视自己的生活经历，并形成了恰当的护理态度和关于整体患者护理的知识。
