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Refining nursing practice through workplace learning: A grounded theory
Author(s) -
Jantzen Darlaine
Publication year - 2019
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.14841
Subject(s) - grounded theory , nursing , competence (human resources) , apprehension , theoretical sampling , health care , nurse education , qualitative research , nursing process , psychology , participant observation , context (archaeology) , medicine , sociology , social psychology , social science , paleontology , anthropology , economics , cognitive psychology , biology , economic growth
Aims and objectives To examine how experienced registered nurses in direct patient care learn within the constantly changing contemporary healthcare environment. The key objectives were to examine educational interactions amongst workplace, nurse and nursing practice, with a focus on the influence of context. Background Registered nurses must maintain competence throughout their careers. The related ongoing learning is triggered by external demands and nurses’ internal motivation. Experienced nurses, poised to retire, have worked through the recent tumultuous changes in health care and therefore provide insight into how they sustained excellent patient care. Design The methodology for this study was a grounded theory informed by symbolic interactionism. EQUATOR guidelines for qualitative research (COREQ) applied. Methods Data collection entailed semi‐structured interviews with experienced nurses across diverse settings and participant observation on two acute care units. Analysis of data was conducted using three‐level coding, constant comparison, theoretical sampling and extensive memoing. Results Refining nursing practice begins during nursing education and early employment. Getting grounded involves establishing key capabilities, specifically becoming self‐aware, setting high standards, cultivating healthy apprehension and seeing the whole patient picture. Three catalysts for workplace learning are mentor‐guides, workplace camaraderie and a highly functional workplace team. Refining nursing practice includes both formal and informal learning; however, significant nursing expertise is developed through puzzling and enquiring, an iterative process of learning while nursing. Conclusions Facilitating the development of capabilities for nurses’ workplace learning during nursing education and early work experiences contributes to excellent patient care. Healthcare organisations need to value and support the unique contributions of mentor‐guides in the clinical setting and promote individuals’ development of expertise by nurturing camaraderie and developing highly functional workplace teams. Relevance to clinical practice Attending to the processes and catalysts for nurses’ workplace learning will contribute to excellent patient care.