Threats to nurses' dignity and intent to leave the profession.

BACKGROUND: It is essential to pay attention to and respect the dignity of nurses to maintain them in their profession while they deliver skilled nursing care. Little is known, however, about how a sense of dignity influences the practitioner. OBJECTIVES: The purpose of this study is to describe nurses' experiences of threats to their dignity occurring within clinical settings, which generates an intention to leave clinical practice. RESEARCH DESIGN AND METHOD: The study was performed using qualitative content analysis. The participants were 21 clinical nurses with work experience who were employed across a range of clinical posts. Data obtained from the semi-structured interviews were analyzed and interpreted using a content analysis approach. Ethical considerations: The study was approved by the Ethics Committee of Tabriz University of Medical Sciences and was guided by the ethical principles of voluntary enrolment, anonymity, privacy, and confidentiality. FINDINGS: Within data analysis, three main themes and nine categories were extracted as follows: (1) lack of professional pride (physician's dominance, intangible nature of nursing, and negative attitude toward clinical nurses); (2) oppressive work environment (high workload, disrespect, discrimination, and lack of support); and (3) suppression of progressivism (lack of appreciation and attention to meritocracy). DISCUSSION: Almost all of the participants have experienced some degree of disrespect and violation of dignity. In general, attempts made by the participants to show their objection to the threats and to support and protect their dignity have not been effective and in fact made them more inclined to leave the clinical work. CONCLUSION: According to the views of nurses themselves, identification of the factors threatening nurses' dignity can be one of the appropriate solutions for the broader and deeper investigation of this phenomenon and can help promote and support nurses' dignity and their retention within the profession.

Experiences of Iranian Nurses that Intent to Leave the Clinical Nursing: a Content Analysis.

INTRODUCTION: Despite the current shortage of nurses, it is important to know the reasons nurses want to leave the clinical setting. The purpose of this study was to explore the experiences of nurses who intend to leave clinical nursing. METHODS: In a qualitative content analysis study, data obtained from 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to the Tabriz and Urmia University of Medical Sciences in Iran, selected through purposive sampling. A conventional content analysis was used for data analysis. RESULTS: Four categories and eleven subcategories emerged during data analysis. The extracted categories and sub categories consisted of (I) Entry routes into nursing (implicitly entry, targeted entry), (II) Defects in dignity (lack of professional vision toward the nurses, social status of nurses), (III) Work in non-ideal working environment (lack of support, discrimination, conflict, lack of opportunities for advancement), and (IV) Dissatisfaction with working conditions (heavy workload, lack of power, unusual working hours). CONCLUSION: The findings of this qualitative study reflect professional turnover as a complex, ongoing, multidimensional process. By identifying the factors responsible, it could be possible to retain nurses in the field.

Coping Strategies to Hinder Intention to Leave in Iranian Nurses: A Qualitative Content Analysis.

BACKGROUND: Due to the high clinical challenges, differences in coping strategies, and high workload in nurses, there is a need to develop strategies to keep them in the profession. The aim of the present study was to explore the Iranian nurses' coping strategies to deal with intention to leave. METHODS: A qualitative content analysis was used to obtain rich data. We performed 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to Tabriz and Urmia Universities of Medical Sciences in Iran, selected through purposive sampling. Constant comparative method was used for data analysis. RESULTS: Three categories and eleven subcategories emerged during data analysis. The extracted categories and sub-categories consisted of (I) Self-empowerment (practical knowledge increase, responsibility, finding identification of the nurse, balancing work and life, seek support and humanitarian interests), (II) Self-controlling (tolerance, avoidance, the routine-based performance), and (III) Pursuing opportunities for advancement and promotion (community development, planning for higher education). CONCLUSION: Nurses make attempts to individually manage problems and stressors perceived from bedside that have led them to leave the bedside; these efforts have been effective in some cases but sometimes they are ineffective due to discontinuous training and relative competence in terms of how to manage and deal with problems. It is suggested that nurses should learn strategies scientifically to meet the challenges of bedside. Through enabling and supporting behaviors and creating opportunities for growth and professional development, nursery managers can help nurses to stay and achieve improvement of the quality of cares.

The efficacy of self-care education on rehabilitation of stroke patients.

OBJECTIVE: To determine the efficacy of self-care education on rehabilitation of hemiplegic stroke patients discharged from hospital. METHODS: For this experimental study, 80 patients were randomly assigned to 2 groups at Urmia University of Medical Sciences Hospitals, Iran, in 2008. First, we recorded the demographic data, and ability performance of both groups, then self-care education was given for the experiment group. Finally, both groups were retested 45 days following the last self-care education section of the experiment group. RESULTS: The results of the study showed a significant difference between the mean acquired distinctions in different performance fields before and after education for the study group (p=0.0001). In addition, the findings showed a significant difference between the 2 groups post-test (p=0.0001). We statistically concluded by independent t test that the level of performance in the experimental group was higher than the controls (t=19.83; p=0.0001). CONCLUSION: Self-care education of stroke survivors can improve patient's performance, and change them from a dependent to an independent person.