Understanding Complex Work Environments When Novice Nurses Feel Uncomfortable or Pressured

Purpose:

The purpose of this study was to identify specific factors surrounding complex work situations that result in novice nurses feeling uncomfortable or pressured.

Significance:

Academic and service settings historically focus on clinical education. The findings from this study demonstrate the gap between education and practice for novice nurses. The nursing profession must address either reducing the identified complex situations in which novices practice or foster the skills in which to cope with the identified situations.

Design:

This was a descriptive study using focus groups. Three focus groups were conducted using a semistructured interview guide. Focus group participants were audio recorded, and interview data were transcribed verbatim.

Methods:

Three separate focus groups were held. The focus groups were lead by clinical nurse specialists with the cognitive task analysis interview technique. Conversations were guided by asking the following questions. "Think of the last time you worked." "Was there a situation where you felt uncomfortable or pressured?" Each member described their situation with probing questions from the authors. Tapes from the groups were transcribed taken by the authors during the group sessions to identify any gaps in information.

Results:

Crossed referenced with transcribed data, patterns were identified within and across the 3 groups. With discussion and consensus, an agreement was reached on a final set of patterns. Uncertainty with decision making, overwhelming and unrealistic need to complete all goals, and specific barriers to decision making were identified patterns.

Conclusions:

Novices require not only mentoring for development of proficiency in clinical skills but also mentoring for the skills to manage the complexity of their work situations that make them feel uncomfortable or pressured.

Implications for Practice:

Understanding situations in which novice nurses feel uncomfortable or pressured will lead to the development of effective interventions to support novice nurses.

Section Description

Editor's Note The 2006 NACNS Conference featured juried student abstracts. Student abstracts appear in this issue of the journal, separate from the other conference abstracts which appeared in 20(2) because student abstracts are on a delayed submission deadline. Congratulations to our students for being selected for a poster presentation and congratulations to their faculty advisors!