BackgroundProfessional autonomy is a key concept in understanding nurses’ roles in delivering patient care. Recent research exploring the role of autonomy in the nursing work environment indicated that English and American nurses had differing perceptions of autonomy. This qualitative study aimed to explore the understanding and experiences of autonomy of nurses working in England.MethodsA descriptive phenomenological analysis of data from 48 semi-structured interviews with registered nurses from two National Health Service (NHS) hospitals (purposive sample) was used to explore the concept of autonomy.ResultsSix themes were identified: working independently; working in a team; having professional skills and knowledge; involvement in autonomy; boundaries around autonomy; and developing autonomy requires support. A key finding was that nurses related autonomy to their clinical work and to the immediate work environment of their ward, rather than to a wider professional context. Nurses also perceived that autonomy could be turned off and on rather than comprising an integrated aspect of nursing.ConclusionsFindings suggest that nurses in England, as framed by the sample, had a local ward-focused view of autonomy in comparison to nurses in America, who were reported to relate autonomy to a wider involvement in hospital level committees. Findings further indicate that autonomy was practiced occasionally, rather than incorporated into practice. Findings highlight the need for nurses in England to adopt a broader perspective and actively contribute to writing hospital guidelines and policies that recognise the importance of autonomy to nurse training and practice.
Aim
To report a qualitative study of themes Registered Nurses raised spontaneously about their work environment, in a cross‐sectional survey study when responding to the Essentials of Magnetism II (EOMII) scale.
Design
Qualitative descriptive survey.
Methods
At the end of the EOMII scale, a free form text section was included asking nurses to add comments about their ward/work environment
.
Of the 247 nurses who completed the EOMII scale, 30% (
N
= 75) provided comments. Inductive content analysis was used to analyse the textual information generated.
Results
Three key themes emerged: “nurses need nurses to nurse”; working as a team and workplace environment. Participants described issues they were facing which comprised high turnover rates, inadequate staffing levels, increasing workload and high stress levels. Particular attention was drawn to the role of the ward manager in promoting a positive work environment, good teamwork and quality patient care.
Objective: To determine the eVectiveness of video role play with structured feedback in improving undergraduate communication skills and application of knowledge in genitourinary medicine. Design: A blind, randomised, controlled trial. Subjects and setting: Fourth year undergraduates attending a 5 week attachment in genitourinary medicine during 1997 at a London medical school. Intervention: A randomly selected sample group of undergraduates were filmed in the role of a doctor interviewing a patient (played by an actor) presenting with a genitourinary (GU) problem. Structured feedback by a GU physician and an educational psychologist was given a week later. The control group of undergraduates did not receive this training intervention. Outcome measures: Student performance in two stations of an objective structured clinical examination (OSCE), administered at the end of their attachment. This tested communication skills and knowledge in GU settings. Results: 132 undergraduates were assessed in the OSCE. 40 of these were in the sample group who received training using video role play with feedback and 92 were in the control group. The sample group scored significantly higher marks than the control group (p<0.001). Conclusions: Video role play with structured feedback is eVective in improving undergraduate communication skills and application of knowledge in GU medicine settings. (Sex Transm Inf 2001;77:376-380)
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