The influencing factors of clinical nurses’ problem solving dilemma: a qualitative study

Abstract

Purpose Problem solving has been defined as “a goal-directed sequence of cognitive and affective operations as well as behavioural responses to adapting to internal or external demands or challenges. Studies have shown that some nurses lack rational thinking and decision-making ability to identify patients’ health problems and make clinical judgements, and have poor cognition and response to some clinical problems, easy to fall into problem-solving dilemma. This study aimed to understand the influencing factors of clinical nurses’ problem solving dilemma, to provide a basis for developing training strategies and improving the ability of clinical nurses in problem solving. Methods A qualitative research was conducted using in-depth interviews from August 2020 to December 2020. A total of 14 participants from a tertiary hospital in Shanghai, China were recruited through purposive sampling combined with a maximum variation strategy. Data were analysed with the conventional content analysis method. Results Three themes and seven subthemes were extracted: nurse’s own factors (differences in knowledge structure and thinking, differences in professional values, poor strain capacity); improper nursing management (low sense of organizational support, contradiction between large workload and insufficient manpower allocation); patient factors (the concept of emphasizing medicine and neglecting to nurse, individual differences of patients). Conclusion The influencing factors of clinical nurses’ problem-solving dilemma are diverse. Hospital managers and nursing educators should pay attention to the problem-solving of clinical nurses, carry out a series of training and counselling of nurses by using the method of situational simulation, optimize the nursing management mode, learn to use new media technology to improve the credibility of nurses to provide guarantee for effective problem-solving of clinical nurses.

Predicting New Graduate Nurses’ Retention during Transition Using Decision Tree Methods: A Longitudinal Study

“…Unlike previous studies, our study included only new graduate nurses in the 22-29-year age range, who had worked less than a year and were still in transition. Previous studies have reported that the age of senior nursing students is negatively correlated with their learning outcomes; confdence in managing multiple patients [49] and nursing skill competency [46] decrease as age increases. Considering that confdence and competence on the learning curve are likely to grow with experience [50], we cannot confrm the efect of age on the retention of nurses.…”

“…An interesting fnding is that the participants who had confdence in clinical problem-solving when they were nursing students tended to remain in their jobs as new nurses. Problem-solving skills are a core competency of professional nurses, who need to continuously identify patients' health problems and make clinical judgments in patient care [45,46]. Nurse educators should pay attention to the problem-solving ability of new graduate nurses during the transition, optimize the new nurse orientation program, and conduct a series of training sessions using situational simulation and new media technology to improve their clinical reasoning [46].…”

Consequences of the hospital nursing research culture: Perspective of staff nurses

“…This finding is consistent with a Chinese study that showed that research-oriented cultures encourage continuous learning and enhance analytical and critical thinking abilities in newly graduated Chinese nurses [ 18 ]. In a separate study conducted in China, clinical nurses who can adapt to the changes brought about by research are more likely to make practical problems solving efforts [ 19 ]. Research-friendly workplace environments are frequently associated with greater job satisfaction, according to a study of nursing faculty members working in Canadian colleges and universities [ 20 ].…”