A Grounded theory study of the intention of nurses to leave the profession.

Objective: this study explores the process of the development of an intention to leave bedside nursing. Method: the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis. Results: according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together. Conclusion: the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them.

A Grounded theory study of the intention of nurses to leave the profession / Estudo utilizando a Teoria Fundamentada sobre a intenção das enfermeiras de abandonar sua profissão / Estudio utilizando la Teoría Fundamentada sobre la intención de las enfermeras de abandonar su profesión

ABSTRACT Objective: this study explores the process of the development of an intention to leave bedside nursing. Method: the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis. Results: according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together. Conclusion: the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them.

RESUMO Objetivo: este estudo explora o processo de desenvolvimento da intenção de deixar a enfermagem de cabeceira. Método: o processo foi estudado desde a perspectiva de 21 enfermeiras utilizando o método da Grounded Theory (Teoria Fundamentada). Os dados foram coletados utilizando entrevistas semi-estruturadas e o método comparativo constante de Corbin e Strauss se utilizou para analisar os dados. Resultados: segundo os participantes, duas categorias principais, "imagem social da enfermagem" e "cultura e estrutura de cabeceira", foram os fatores contextuais que influenciam as razões para que as enfermeiras estejam deixando o cuidado de cabeceira. A decepção com a percepção de falta de progresso ou melhora na experiência clínica cria preocupações psicossociais primárias para as participantes. A competência e o processo de autocontrole são passos dados pelas participantes. Isso associado a condições de intervenção foram os resultados da perda do compromisso profissional que as leva a deixar o cuidado de cabeceira. "O fracasso em integrar expectativas pessoais e expectativas da organização: em busca de uma saída" foi a categoria central do estudo que uniu as categorias. Conclusão: os achados deste estudo proporcionam informação útil sobre as necessidades das enfermeiras para superar as intenções de deixar o cuidado de cabeceira. A identificação deste processo pode ajudar a reconhecer os problemas emergentes e oferecer soluções para resolvê-los.

RESUMEN Objetivo: este estudio explora el proceso de desarrollo de la intención de dejar la enfermería de cuidado de cabecera. Método: el proceso fue estudiado desde la perspectiva de 21 enfermeras utilizando el método de la Grounded Theory (Teoría Fundamentada). Los datos se recogieron utilizando entrevistas semiestructuradas; para analizar los datos se utilizó el método comparativo constante de Corbin y Strauss. Resultados: según los participantes dos categorías principales ("imagen social de la enfermería" y "cultura y estructura del cuidado de cabecera ") fueron los factores contextuales que influenciaron las razones para que las enfermeras deseasen dejar el cuidado de cabecera. La decepción con una percepción de falta de progreso o mejora en la experiencia clínica causó preocupaciones psicosociales primarias en las participantes. La competencia y el proceso de autocontrol fueron considerados por las participantes, y esto asociado a las condiciones de intervención resultaron en la pérdida del compromiso profesional que las lleva a dejar el cuidado de cabecera. La categoría central del estudio que unió las categorías encontradas fue: "Fracaso para integrar las expectativas personales con expectativas de la organización: en busca de una salida". Conclusión: los hallazgos de este estudio proporcionan información útil sobre las necesidades de las enfermeras para superar las intenciones de abandonar el cuidado de cabecera. La identificación de este proceso puede ayudar a reconocer los problemas emergentes y ofrecer soluciones para resolverlos.

A qualitative exploration of facilitators and inhibitors influencing nurses' intention to leave clinical nursing / Análise Qualitativa dos Facilitadores e Inibidores que Influenciam a Intenção dos Enfermeiros de Abandonarem a Enfermagem Clínica / Análisis Cualitativo: Facilitadores e Inhibidores Influyentes Sobre Voluntad de Enfermeros Para Abandonar la Enfermería Clínica

Abstract OBJECTIVE The aim of this study was to determine the barriers and facilitators shaping the development of an intent to leave the nursing profession, from the perspective of Iran's clinical nurses. METHOD The study was completed using qualitative content analysis And included 21 Participants who were clinical nurses with a variety of work experience across a range of clinical posts. Semi-structured interviews were used to collect data and data obtained from the interviews were analyzed and interpreted utilizing a content analysis method. RESULTS During data analysis, 2 main themes, 5 categories and 12 subcategories were extracted as follows. Facilitators include: (I) spoiled identity (weak social status and violation of dignity), (II) frustration (feeling subordinate including a lack of appreciation), and (III) experience of hard labor (job stress, hard work and shift work). Inhibitors include: (I) positive management behaviors (rewards and support systems), and (II) being valuable (spiritual satisfaction, the efficient presence and professional capabilities development). CONCLUSION Based on the findings, it can be concluded that managers can prevent nurses from leaving clinical nursing by providing appropriate activities for them and increasing their motivation and satisfaction.

Resumo OBJETIVO Este estudo teve como objetivo determinar as barreiras e facilitadores que definem o desenvolvimento de uma intenção de abandonar a profissão de enfermagem, sob a perspectiva de enfermeiros clínicos do Irã. MÉTODO O estudo foi realizado através da análise de conteúdo qualitativo e incluiu 21 participantes que eram enfermeiros clínicos com vasta experiência de trabalho em uma variedade de cargos clínicos. A coleta de dados foi realizada através de entrevistas semiestruturadas, e os dados obtidos com as entrevistas foram analisados e interpretados através do método da análise de conteúdo. RESULTADOS Durante a análise dos dados, 2 temas principais, 5 categorias e 12 subcategorias foram obtidos como indicado a seguir. Os facilitadores incluem: (I) identidade debilitada (status social vulnerável e violação da dignidade), (II) frustração (sentimento de subordinação, incluindo falta de reconhecimento) e (III) experiência de trabalho árduo (estresse ocupacional, trabalho árduo e trabalho por turnos). Os inibidores incluem: (I) gestão de comportamentos positivos (recompensas e sistemas de apoio) e (II) ser útil (satisfação espiritual, eficiência e desenvolvimento de habilidades profissionais). CONCLUSÃO Com base nos achados, pode-se concluir que supervisores responsáveis podem impedir os enfermeiros de abandonarem a enfermagem clínica, delegando-lhes atividades pertinentes e aumentando sua motivação e satisfação.

Resumen OBJETIVO Estudio objetivando determinar obstáculos y facilitadores condicionantes del desarrollo de la intención de abandonar la profesión de enfermería, en la perspectiva de enfermeros clínicos de Irán. MÉTODO Se aplicó análisis cualitativo de contenidos. El estudio incluyó 21 participantes, todos ellos enfermeros clínicos con variada experiencia laboral en el campo de la enfermería clínica. Datos recolectados mediante entrevistas semiestructuradas, posteriormente analizados e interpretados por método de análisis de contenido. RESULTADOS Durante el análisis de datos fueron establecidos 2 temas principales, 5 categorías y 12 sub categorías, a saber. Los facilitadores incluyen: (I) identidad damnificada (status social debilitado y violación de la dignidad), (II) frustración (sentimiento de subordinación incluyendo falta de reconocimiento), y (III) percepción de alta carga laboral (estrés laboral, trabajo duro y turnos de trabajo). Los inhibidores incluyen: (I) comportamientos positivos de gestión (sistemas de recompensas y soporte), y (II) sentirse valorado (satisfacción espiritual, presencia eficiente y desarrollo de capacidades profesionales). CONCLUSIÓN En base a estos hallazgos, puede concluirse en que los gestores pueden prevenir el abandono de la profesión de los enfermeros clínicos brindándoles actividades apropiadas para ellos e incrementando su motivación y satisfacción.

Towards an understanding of clinical nurses challenges that leads intention to leave

Abstract Objective: Clinical nursing is the most important feature of the nursing profession and similar to the global community. The study objective was to identify and describe the challenges and why Iranian nurses leave their profession. Methods: Qualitative methods were applied to describe nursing practice challenges through in-depth and semi-structured interview of 16 Iranian nurses with 2 to 15 years of work experience in 2014 by asking: “Please tell me about your challenges at work and why nurses are leaving the nursing profession?” Obtained data were analyzed using conventional content analysis. Results: Analyzed data revealed four thematic categories as 1) unfriendly workplace, 2) lack of opportunity for professional advancement, 3) work stress, and 4) ethical issues. Conclusion: Recognizing nursing challenges in clinical setting can help faculty in academia and administrators in healthcare institutions to develop policies to reduce pitfalls and prevent attrition.

A qualitative exploration of facilitators and inhibitors influencing nurses' intention to leave clinical nursing.

OBJECTIVE: The aim of this study was to determine the barriers and facilitators shaping the development of an intent to leave the nursing profession, from the perspective of Iran's clinical nurses. METHOD: The study was completed using qualitative content analysis And included 21 Participants who were clinical nurses with a variety of work experience across a range of clinical posts. Semi-structured interviews were used to collect data and data obtained from the interviews were analyzed and interpreted utilizing a content analysis method. RESULTS: During data analysis, 2 main themes, 5 categories and 12 subcategories were extracted as follows. Facilitators include: (I) spoiled identity (weak social status and violation of dignity), (II) frustration (feeling subordinate including a lack of appreciation), and (III) experience of hard labor (job stress, hard work and shift work). Inhibitors include: (I) positive management behaviors (rewards and support systems), and (II) being valuable (spiritual satisfaction, the efficient presence and professional capabilities development). CONCLUSION: Based on the findings, it can be concluded that managers can prevent nurses from leaving clinical nursing by providing appropriate activities for them and increasing their motivation and satisfaction.