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护士所经历的非护理任务:一项描述性定性研究。

Non-nursing tasks as experienced by nurses: a descriptive qualitative study.

机构信息

Member of the Nursing Board IPASVI, Belluno, Italy.

President of the Nursing Board IPASVI, Belluno, Italy.

出版信息

Int Nurs Rev. 2019 Jun;66(2):259-268. doi: 10.1111/inr.12496. Epub 2019 Feb 12.

Abstract

BACKGROUND

Different concepts have been used to date (e.g. non-nursing tasks, organizational work) to define tasks performed by clinical nurses other than nursing care. However, the true essence of nursing work is still poorly understood mostly because nurses are lacking an appropriate lexicon to describe their practice.

AIMS

To describe non-nursing tasks as experienced by nurses, exploring antecedents and consequences as perceived in daily practice.

METHODS

A descriptive qualitative study from 2015 to 2016. A purposeful sample of nurses was approached. Semi-structured interviews were used, and content analysis was performed on audio-recorded and verbatim-transcribed interviews.

FINDINGS

A total of 22 nurses participated, the majority of whom were female (16; 72.7%) and their average age was 42.6 years. The concept of 'Non-nursing tasks' is limited in describing what nurses experience in daily practice; the concept of 'Being out of the nursing role' emerged as being fully descriptive of the nurses' experience and this can occur in two dimensions: outside and inside the role of other healthcare professions. The first dimension includes administrative work separating nurses from patients. The second dimension was reported to happen in proximity to patients but in three different directions towards professions requiring: (a) less education (e.g. healthcare assistants), (b) the same amount of education at university level (e.g. physiotherapists), and (c) higher education at university level as compared to nurses, thus performing activities expected by physicians. Antecedents of 'Being out of the nursing role' have been identified at the organizational, individual and educational levels; their consequences have been reported at the patient, professional and organizational levels.

CONCLUSION

Nurses play various non-nursing roles, below, above and in the horizontal levels, both inside and outside other healthcare professionals' role, mainly as a result of their felt moral obligation to offer the best to their patients, the organization's demand to nurses and the imprinting of nursing education.

IMPLICATIONS FOR NURSING/HEALTH POLICY: Strategies at the nursing professional and policy levels are needed aimed at (a) supporting nurses in optimizing their professional identity, (b) sharing their sense of moral obligation towards patients with other healthcare professionals, and (c) implementing models of care based on interprofessional cooperation.

摘要

背景

迄今为止,不同的概念(例如非护理任务、组织工作)被用于定义临床护士除护理以外的工作。然而,由于护士缺乏描述其实践的适当词汇,因此对护理工作的真正本质仍了解甚少。

目的

描述护士所经历的非护理任务,探索日常实践中感知到的任务的前因和后果。

方法

这是一项 2015 年至 2016 年的描述性定性研究。选择了有目的的护士样本。使用半结构化访谈,对录音和逐字转录的访谈进行内容分析。

结果

共有 22 名护士参与了研究,其中大多数是女性(16 名;72.7%),平均年龄为 42.6 岁。“非护理任务”这一概念在描述护士在日常实践中所经历的情况时具有局限性;“脱离护理角色”这一概念完全描述了护士的体验,并且可以从两个维度体现:脱离其他医疗保健专业的角色和在角色内脱离其他医疗保健专业。第一个维度包括将护士与患者分开的行政工作。第二个维度则发生在靠近患者的地方,但朝着三个不同的方向,分别涉及:(a)需要较少教育(例如医疗助理),(b)与护士接受相同大学水平的教育(例如物理治疗师),以及(c)比护士接受更高水平的大学教育,从而执行医生期望的活动。在组织、个人和教育层面已经确定了“脱离护理角色”的前因;在患者、专业人员和组织层面已经报告了其后果。

结论

护士扮演着各种非护理角色,包括低于、高于和在水平层面,以及在其他医疗保健专业人员角色内和之外,这主要是由于他们对向患者提供最佳服务的道德义务、组织对护士的需求以及护理教育的印记。

对护理/卫生政策的影响:需要在护理专业和政策层面采取策略,旨在(a)支持护士优化其专业身份,(b)与其他医疗保健专业人员分享他们对患者的道德义务感,以及(c)实施基于跨专业合作的护理模式。

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