Professional identity and competence in practice : : self-evaluation of nurses in paediatric care

Abstract: Paediatric health care is becoming increasingly high-specialised and there is a need to employ, nurses with specialist knowledge in the field. A large turnover of personnel and shortage of specially training in paediatric nursing have led to the need for employment of newly graduated nurses. How to best support these nurses to be those competent nurses that is needed have therefore been discussed. Aim: The overall aim of the study was to describe and analyse how nurses employed in paediatric care, describe the nurse profession, evaluate their professional level and attitude towards to research utilization. Study I: 18, newly graduated and newly employed nurses have described what they included in the concepts of responsibility, management of daily and rapidly changing situations and reflection. The results, analysed with qualitative content analysis, showed that nurses seemed to be fully aware of their responsibility regarding patients' well-being. The moral responsibilities, i.e. to function as the patient's "advocate" and protect patient's personal integrity, was also evident. The nurses emphasized the need for time and space for reflection, but also time to acquire the necessary knowledge for providing optimal nursing. Study II: 56 newly graduated nurses, and newly employed at two children's hospitals, have responded to the two questionnaires; Professional Self Description Form (PSDF), where nurses evaluate themselves regarding empathy, flexibility, ability to act etc (21 items in total), and Barriers Scale, a questionnaire concerning perceived barriers to research utilization (29 items in total). In the PSDF the nurses rated themselves highest in items of In the newly graduated nurses' scorings at the time for their employment, the highest scores were found in consideration (mean 4.05), ambition (mean 3.91) and sensitivity (mean 3.84). The lowest scores were found in grasp of ideas (mean 2.69), leadership (mean 2.73) and discrimination (mean 2.89), Regarding Barriers Scale the nurses perceived the highest barriers in using research results in the health care mostly related to the organisation itself (Study II). Study III: is a comparison two years after graduation between 36 nurses who received "traditional" introductory training and had worked for two years at a children's hospital (Controls), and 42 nurses who went through a one year trainee programme (Trainee). These were also compared to 35 paediatric nurses with specialist education. (Specialists). They responded to the same questionnaire as in study II. The control nurses rated themselves higher in the PSDF description of persistence (p<0.024). No other differences were found. In the Barriers Scale the specialists scored higher barriers in the affirmations pertaining to themselves as nurses, especially in that nurse is unwilling to test new ideas, that there are not enough experienced colleagues with whom to discuss research results, and that the administration does not allow implementation of research results. In conclusion Self-evaluation of professional self and barriers to research utilisation are quite similar and independent of professional experience and knowledge. How to best evaluate, support and further develop nurses in their professional role is still a question that needs an answer.