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Advancing nursing? Master's level nurses in Jordan

By Zainab A.H Zahran


The aim of the study was to examine the extent to which advanced nursing practice was evident in Jordan, with a particular focus on the contribution of Master’s level nurses to advancing practice. It also aimed at understanding the drivers for developing its roles and the factors which might facilitate or hinder their implementation. \ud The study used an ethnographic design in which qualitative and quantitative methods of data collection were used. The study comprised two stages. The first stage involved interviewing key stakeholders and surveying M-level nurses. Stage two involved interviewing and observing M-level nurses working in clinical practice in five Jordanian hospitals and interviewing the main stakeholders with whom those nurses had contact. \ud Three themes emerged from the data: understanding advanced nursing practice, becoming am M-level nurse, and being an M-level nurse. The analysis showed that there was no clear notion of advanced nursing practice in Jordan, although participants did describe a number of different elements of advanced practice. The analysis also revealed that nurses undertake Master’s degrees for professional and self-development reasons. The most frequently cited benefits from M-level education that reflected on practice were the enhancement of cognitive abilities, including critical thinking, problem solving and the questioning of practice, the use of research skills and in-service training. The area with least change was that of the development of new practical skills. The data also suggested that a change of job title or job description, after gaining a Master’s degree, reflects the movement of M-level nurses away from direct patient care to non-direct patient care. \ud Several factors were identified as facilitating or hindering the development of the role of M-level nurses in practice. These were organisational factors, professional factors, and personal attributes. The most significant factors were lack of recognition of the M-level nurse, and the subservient role of the nurse in Jordanian society.\u

Publisher: Nursing and Midwifery (Sheffield)
Year: 2009
OAI identifier: oai:etheses.whiterose.ac.uk:687

Suggested articles



  1. (1997). A conceptual framework for advanced practice: An action research project operationalising an advanced practitioner/consultant nurse role. doi
  2. (2001). A definition of advanced nursing practice. In doi
  3. (1999). A description of the roles, activities, and skills of clinical nurse specialists in the United States. doi
  4. (1999). A life on the edge: King Hussein.
  5. (1997). A literature review of advanced clinical nursing practice in the United States of America. doi
  6. (1995). A meta-analysis of nurse practitioners and nurse midwives in primary care. doi
  7. (2006). A new role for advanced practice nurses in Canada: bridging the gap in health services for rural older adults.
  8. (1991). A participant observation study of power relations between nurses and doctors in a general hospital. doi
  9. (1997). A phenomenological investigation into the role of the clinical nurse specialist. doi
  10. (2005). A reflection on the use of semi-structured interviews. doi
  11. (1992). Academic levels in nursing. doi
  12. (1998). Accessed 25/06/2009, from www.rcn.org.uk
  13. (2008). Accessing elite nurses for research: Reflections on the theoretical and practical issues of telephone interviewing. doi
  14. (2008). Advanced nursing practice update: 12 doi
  15. (2009). Advanced nursing practice: A global perspective. doi
  16. (1995). Advanced nursing practice: New ideas and new perspectives. doi
  17. (2005). Advanced nursing practice: Policy, education and role development. doi
  18. (2003). Advanced nursing practice: What is it? doi
  19. (2006). Advanced nursing practice. doi
  20. (2003). Advanced nursing practitioners in primary care settings: An exploration of the developing roles. doi
  21. (2002). Advanced practice in nursing: International perspective. doi
  22. (2004). Advanced practice nursing roles: Development, implementation and evaluation. doi
  23. (1998). Advanced practice: the 'advanced practitioner' perspective.
  24. (2004). Advancing nursing practice through postgraduate education (part two).
  25. (2001). Advisory Committee on Health Human Resources (ACHHR)
  26. (1996). American Association of Colleges of Nursing
  27. (1997). An action research study into the development of nurses as reflective practitioners.
  28. (2007). An evaluation of masters in nursing programmes in the Republic of Ireland: the impact of inputs and processes on graduate outcomes. Unpublished Ph.D thesis,
  29. (1997). An exploratory study examining the influence of translation on the validity and reliability of qualitative data in nursing research. doi
  30. (1993). An international approach to master's-level preparation for clinical nurse specialists. doi
  31. (2001). Analysing qualitative data: Examples from two studies of end-of-life care.
  32. (2005). Assessing outcomes in advanced practice nursing practice: The use of quality indicators and evidence-based practice. doi
  33. (2000). Assessing quality in qualitative research. doi
  34. (1999). Assessment of nurses' continuing education needs in Jordan.
  35. (2006). Association of Advanced Nursing Practice Educators (AANPE)
  36. (2009). Attitudes of professional Jordanian nurses toward continuing education. doi
  37. (2003). Australian nurses' perception of the impact of their postgraduate studies on their patient care activities. doi
  38. (2008). back to the bedside': Graduate level education in critical care. doi
  39. (1994). Beginning qualitative research: a philosophic and practical guide.
  40. (1997). Being a "marginal native": Dilemmas of the participant observer.
  41. (2005). Beliefs, attitudes and perceived practice among newly enrolled students at the Jordanian Ministry of Health nursing colleges and institutes in 2003. Education for Health, doi
  42. (2005). Bringing the professional challenges for nursing in Jordan to light. doi
  43. (1987). Bureaucracy. Milton Keynes:
  44. (2003). Challenges and leadership strategies for managers of nurse practitioners. doi
  45. (2003). Changes in practice at the nurse-doctor interface: using focus groups to explore the perceptions of first level nurses working in acute care setting. doi
  46. (1992). Changing the image of nursing in Jordan through effective role negotiation.
  47. (2005). Clinical career ladder for registered nurses (Arabic), JNMC, Amman-Jordan Jordanian Nursing Council.
  48. (2008). Clinical career ladder for registered nurses (Arabic). Accessed 25/06/2009, from http://www.jnc.gov.jo/english/home.htm Jordanian Nursing Council.
  49. (2003). Clinical expertise in advanced practice nursing: A Canadian perspective. doi
  50. (1997). Conceptualizing advanced nursing practice: Curriculum issues to consider in the educational preparation of advanced practice nurses in the UK. doi
  51. (2000). Conducting an interview. doi
  52. (1992). Congress of nursing practice meets.
  53. (1992). Continuing professional education for qualified nurses: A review of the literature. doi
  54. (1995). Continuing professional education: Identifying the characteristics of an effective system. doi
  55. (1995). Coping with data in ethnographic study.
  56. (2003). Creating what sort of professional? Master's level nurse education as a professionalising strategy. doi
  57. (2003). Crossing cultural boundaries: flexible approaches and nurse education. doi
  58. (1993). Culture shock. Cultural norms influencing nursing in Jordan.
  59. (2002). Definition and characteristics of nurse practitioners/advanced practice nurses. Practice issues. Accessed 25/06/2009, from http://icn-apnetwork.org
  60. (1999). Designing qualitative research (3rd Ed.).
  61. (1992). Determinants of career attainments of doctorates in nursing. doi
  62. (2008). Development of nurses with specialities: The nurse administrators' perspective. doi
  63. (2000). Diversity in nursing education-part iii. doi
  64. (2000). Do new roles contribute to job satisfaction and retention of staff in nursing and professions allied to medicine? doi
  65. (2004). Does advanced community/public health nursing practice have a future? Public Health Nursing, doi
  66. (2005). Doing qualitative research (2nd Ed.). London:
  67. (1999). Effect of gender and education on the quality of nursing work life of Jordanian nurses.
  68. (2007). Empowering front-line staff to deliver evidence-based care: the contribution of nurses in advanced practice roles. Final report submitted to the Department of Health. Sheffield:
  69. (2001). Engaging with cultures: Reflections on entering the ethnographic field. doi
  70. (1994). Establishing rigour in qualitative research: the decision trail. doi
  71. (2006). Ethnographic evidence. doi
  72. (2006). Ethnography
  73. (2000). Ethnography and health care. doi
  74. (1995). Ethnography and nursing research: A critical appraisal.
  75. (2004). Ethnography and participant observation. In doi
  76. (2003). Ethnography and reflexivity: Emotions and feelings in fieldwork. doi
  77. (2000). Ethnography in nursing research. Thousands Oak: Sage Publications. doi
  78. (1995). Ethnography: Research method or philosophy.
  79. (1998). Ethnography: step by step (2nd Ed.). doi
  80. (1996). Evaluation of the process of introducing a quality development program in a nursing department at a teaching hospital: The role of change agent. doi
  81. (2006). Evidence-based practice. In doi
  82. (2007). Experiences of a novice researcher. doi
  83. (2008). Experiencing intensive care: women‟s voices in Jordan. Unpublished PhD thesis,
  84. (1992). Expert to novice. doi
  85. (1994). Expert: a discussion of the implications of the concept as used in nursing. doi
  86. (2001). From novice to expert: Excellence and power in clinical nursing practice. doi
  87. (2000). Gender issues and nursing practice.
  88. (2009). Getting collaborative research happening in a busy clinical world, Research seminar,
  89. (2004). Hashemite Kingdom of Jordan. World Convention. Accessed 14/04/2007, from www.worldconvention.org/county.php?c==jo Holloway, I.
  90. (2004). Help to get you started- reflecting on your experiences.
  91. (2002). Higher education and socio-political transformation in Jordan, doi
  92. (2000). History and evolution of advanced nursing practice. In
  93. (1996). How can nurse teachers be more effective in practice settings? doi
  94. (1998). Identifying the practice characteristics of advanced practitioners in acute and critical care settings. doi
  95. (2007). Impact of continuing professional education on practice: The rhetoric and the reality. doi
  96. (2005). Implementation of a framework for the standard for post registration nursing. Accessed 25/06/2009, from http://www.nmcuk.org/article.aspx?ArticleID=3150&Keyword=advanced and nursing and practice.
  97. (1998). Implementing advanced practice: Identifying the factors that facilitate and inhibit the process. doi
  98. (2004). Improving accuracy of transcripts in qualitative research. doi
  99. (2003). In-depth interviews. In
  100. (2008). Influences on physiotherapists when deciding to study at master‟s level: An exploratory study. doi
  101. (2002). Insider-outsider perspectives of participant observation. doi
  102. (2001). Interpreting qualitative data: methods for analysing talk, text and interaction. doi
  103. (2001). Interviewing colleagues: Addressing the issues of perspective, inquiry and representation. doi
  104. (2007). Interviewing women: Using reflection to improve practice. doi
  105. (2006). Interviewing. In
  106. (2005). Interviewing. In I. Holloway (Ed.), Qualitative research in health care
  107. (1994). Introduction: entering the field of qualitative research.
  108. (2004). Involvement and detachment in researching sexuality: Reflections on the process of semi- structured interviewing. doi
  109. (1915). Is social work a profession?
  110. (2006). Is there a role for higher education in preparing nurses? doi
  111. (1997). Issues and opinions. A master's degree for entrylevel acnm-certified midwives: An option or necessity?
  112. (1996). Issues in qualitative research: Practical experiences in the field.
  113. (2007). Jordanian nurses' job satisfaction and intent to stay: Comparing teaching and non-teaching hospitals. doi
  114. (2006). Jordanian nurses' job satisfaction, patients' satisfaction and quality of nursing care. doi
  115. (2008). Jordanian nurses' job stressors and social support. doi
  116. (2004). Jordanian women in education: Politics, pedagogy and gender discourses. doi
  117. (2002). Laddered questions and qualitative data research interviews. doi
  118. (1999). Learning how to change: a selective analysis of literature and experience of how teams learn and organisations change. doi
  119. (1991). Life and career pathways of deans in nursing programmes. doi
  120. (2000). Managing the unmanageable? Nurse executive directors and new role developments in nursing. doi
  121. (2007). Master's level critical care nursing education: A time for review and debate. doi
  122. (1999). Measuring advanced practice nursing outcomes. doi
  123. (1995). Medical power and social knowledge (2nd ed.).
  124. (1997). Men in nursing: issues of gender segregation and hidden advantage. doi
  125. Ministry of Health Annual Statistical Book. Accessed 1/03/2009, from http://www.moh.gov.jo/MOH/Files/Publication/report 2008_.pdf.
  126. (2005). Motivation for nurses undertaking a post-registration qualification in Malaysia. doi
  127. (1998). Motivational forces affecting participation in post-registration degree courses and effects on home and work life: A qualitative study. doi
  128. (1985). Naturalistic Inquiry. doi
  129. (1993). New BJN initiative to close the theory/practice gap.
  130. (2003). New directions in midwifery education: The master's of science in midwifery degree. doi
  131. (2007). Nineteenth century handmaids or twenty-first century partners? doi
  132. (2005). Nurse job satisfaction and retention: Comparing public to private hospitals in Jordan. doi
  133. (1993). Nurses are changing not extending their roles.
  134. (2003). Nurses must start fighting for higher status as a profession.
  135. (1969). Nurses. In A. Etzioni (Ed.), The semi-professions and their organisation
  136. (2007). Nurses' experiences of continuing professional development. doi
  137. (2006). Nurses' midwives' and health visitors' perceptions of the impact of higher education on professional practice. doi
  138. (2008). Nurses' motivation for studying third level post-registration nursing programmes and the effects of studying on their personal and work lives. doi
  139. (1995). Nurses' perceptions of the impact of continuing professional education on the quality of nursing care. doi
  140. (1984). Nursing careers: Findings of a followup survey of graduates of the nursing education and administration certificate courses of the department of nursing studies, university of Edinburgh. doi
  141. (1995). Nursing faculty--an endangered species? doi
  142. (1998). Nursing in Jordan: Start, development and aspirations (Arabic). Sultan Graphics Centre for design and printing.
  143. (1958). Nursing in Jordan. doi
  144. (1985). Nursing in the Middle East: A Jordan experience.
  145. (2004). Nursing practice issues in Jordan: Studentsuggested causes and solutions.[see comment]. doi
  146. (2003). Nursing roles and levels of practice: A framework for differentiating between elementary, specialist and advancing nursing practice. doi
  147. (2000). Nursing the image: media, culture and professional identity. London and doi
  148. (2008). Nursing work in Jordan: An example of nursing work in the Middle East. doi
  149. (1995). Nursing's relationship with medicine: a critical realist ethnography.
  150. (2005). Observing method: recognizing the significance of belief, discipline, position and documentation in observational studies.
  151. (1981). On interviewing one's peers. doi
  152. (1998). Organisational context for quality: lessons from the fields of organisational development and change management.
  153. (2002). Outing" the researcher: the provenance, process, and practice of reflexivity. doi
  154. (2003). Part one: Restoring patients to health: Outcomes and indicators of advanced nursing practice in adult critical care. doi
  155. (2004). Part two: The core components of legitimate influence and the conditions that constraint or facilitate advanced nursing practice in adult critical care. doi
  156. (2000). Patient satisfaction with emergency nurse practitioners in a & e. doi
  157. (2007). Patients' preferences for nurses' gender in Jordan. doi
  158. (2000). Perception of Jordanian male nursing students about caring for children in the paediatric units after graduation. doi
  159. (2001). Perceptions and expectations of baccalaureate-prepared nurses in Jordan: Community survey. doi
  160. (1999). Physiotherapy and postgraduate study: A follow-up discussion paper. doi
  161. (1997). Physiotherapy and postgraduate study. doi
  162. (1996). Postgraduate education in nursing: A case study. doi
  163. (2004). Power: An application to the nursing image and advanced practice. doi
  164. (2000). Practical considerations in case study research: The relationship between methodology and process. doi
  165. (2008). Predictors of career commitment and job performance of Jordanian nurses. doi
  166. (1999). Predictors of job satisfaction, turnover, and burnout in female and male Jordanian nurses.
  167. (1966). Princess Muna College of nursing,
  168. (1970). Profession of Medicine: A study of sociology of applied knowledge. doi
  169. (2008). Professional and academic destination of masters in nursing graduates: A national survey. doi
  170. (2002). Professional and organisational obstacles to establishing a new specialist service in primary care: Case study of an epilepsy specialist nurse. doi
  171. (1998). Professionalisation of nursing: current issues and trends (3rd ed.).
  172. (1997). Professionalisation of nursing: development, difficulties and solutions. doi
  173. (1992). Professions and patriarchy. doi
  174. (1999). Public service reform and their impact on health sector personnel in Jordan. Accessed 25/11/2005, from www.ilo.org/public/english/dialogue/sector/papers/health/pubserv3.pdf
  175. (2006). Qualitative interviewing: Encountering ethical issues and challenges. doi
  176. (2004). Qualitative research and translation dilemmas. doi
  177. (1998). Qualitative research methods in health technology assessment: a review of the literature.
  178. (1995). Qualitative research: Reaching the parts other methods cannot reach: An introduction to qualitative methods in health and health services research. doi
  179. (2002). Qualitative researching (2nd Ed.).
  180. (1988). Quantity and quality in social research. Oxon: Unwin Hyman Ltd. doi
  181. (2008). Questionnaires. In
  182. (2000). Recognising advancing nursing practice: Evidence from two observational studies. doi
  183. (1998). Reconceptualising rigour: The case for reflexivity. doi
  184. (2001). Reflection as a transforming process: student advanced nurse practitioner' experiences on developing reflective skills as part of an MSc programme. doi
  185. (2003). Reflections of a novice researcher: How it all started. doi
  186. (2001). Reflective practice and clinical outcomes: Practitioners' views on how reflective practice has influenced their clinical practice. doi
  187. (2001). Reflective teaching and learning in the health professions. doi
  188. (2003). Reflexivity: A personal journey during data collection. doi
  189. (2006). Research and development in nursing. In
  190. (1998). Research degrees in librarianship and information science: A survey of master's and doctoral students from the department of information studies, university of Sheffield. doi
  191. (2005). Research methodology: A step by step guide for beginners. doi
  192. (2008). Researching 'at home' as an insider/outsider: Gender and culture in an ethnographic study of social work practice in an Arab society. doi
  193. (2007). Review of advanced nursing practice: The international literature and developing the generic features.[see comment]. doi
  194. (2002). Role boundaries - research nurse or clinical nurse specialist? A literature review. doi
  195. (2005). Role development and effective practice in specialist and advanced practice roles in acute hospital settings: Systematic review and meta-synthesis. doi
  196. (2005). Role development and effective practice in specialist and advanced practice roles in acute hospital settings: systematic review and metasynthesis. doi
  197. (1998). Role extension or expansion: A qualitative investigation of the perceptions of senior medical and nursing staff in an adult intensive care unit. doi
  198. (1998). Role transition from staff nurse to clinical nurse specialist: A case study. doi
  199. Royal College of Nursing (2008). Advanced nurse practitioners: an RCN guide to the advanced nurse practitioner role, competencies and programme accreditation.
  200. (2003). Self and others: The rigour and ethics of insider ethnography. In
  201. (2008). Should nurse academics engage in clinical practice? doi
  202. (2008). Snakes and ladders: Reflections of a novice researcher. doi
  203. (2008). Social selection and professional regulation for master's degrees for nurses. doi
  204. (2000). Some dilemmas of master's level nurse education. doi
  205. (1986). Speaking of ethnography. doi
  206. (1998). Specialist practice: Advancing the profession? doi
  207. (1995). Specialist practice: An educational perspective. Nursing in Critical Care,
  208. (2005). Spotlight on rural nurses: Implications for a new nursing discipline in Jordan.
  209. (2005). Status of nursing in the Arab world.
  210. (2005). Strategic health workforce progections: Jordan human resources development project, report no. 7. Accessed 11/07/2006, from http://www.Dec.Org/pdf_docs/pnade687.Pdf.
  211. (2003). Study at master's level by practicing physiotherapists. doi
  212. (2001). Teaching and researching motivation. doi
  213. (1998). The assurance of standards at Master's level: an empirical investigation. doi
  214. (1992). The clinical nurse specialist: a personal perspective. doi
  215. (1999). The contingent nature of advanced nursing practice. doi
  216. (1994). The development and implementation of lecturer practitioner roles in nursing. Unpublished DPhil thesis,
  217. (2008). The development of advanced nursing practice globally. doi
  218. (2001). The development of advanced practice roles: Implications in the international nursing community. doi
  219. (2001). The development of reflective learning in the context of health counciling and health promotionduring nurse education. doi
  220. (2007). The development of role adequacy for professional nurses in Jordan. doi
  221. (1990). The doctor-nurse game revisited. doi
  222. (1966). The doctor-nurse game. doi
  223. (1996). The effect of unit type and gender on Jordanian nurses' job satisfaction: A comparison of operating room, medical-surgical, and critical care nurses. Seminars in Preoperative Nursing,
  224. (2006). The effects of master's degree education on the role choices, role flexibility, and practice settings of clinical nurse specialists and nurse practitioners.
  225. (2000). The enigma of advanced nursing practice. Wiltshire: Quay BooksMark
  226. (1995). The evolving role of the clinical nurse specialist. doi
  227. (1999). The extended role of the nurse: The United Kingdom perspective. doi
  228. (2003). The foundation of qualitative research. In
  229. (1996). The future of Australian postgraduate critical care nursing education. doi
  230. (2004). The generic skills debate in research higher degrees. doi
  231. (2004). The globalization of the nursing workforce: Implications for education.
  232. (1999). The impact of higher education for postregistration nurses on their subsequent clinical practice: An exploration of students' views. doi
  233. (2002). The impact of part-time post-registration degrees on practice. doi
  234. (2008). The influence of a postgraduate clinical master's qualification in manual therapy on the careers of physiotherapists in the United Kingdom. doi
  235. (2005). The interview in qualitative research.
  236. (2006). The legitimate role of the medical-surgical staff nurse in Jordan: The views of patients, doctors, and nurses. Unpublished thesis.
  237. (2003). The mentor's tale: A reflexive account of semi-structured interviews. doi
  238. (2006). The motivation of nurses to participate in continuing professional education in Ireland. doi
  239. (2008). The nature and language of nursing research. In
  240. (2001). The nature of advanced practice nursing. doi
  241. (2001). The nurse specialist role in Hong Kong: Perceptions of nurse specialists, doctors and staff nurses. doi
  242. (2006). The place of experience in graduate level nursing education: A time for discussion and debate.
  243. (1996). The politics of nursing knowledge. doi
  244. (1985). The politics of nursing. doi
  245. (1994). The polity reader in gender 252 studies.
  246. (1992). The poverty of professionalisation: a critical analysis of strategies for the occupational advancement of nursing. doi
  247. (2005). The problems with interviews. doi
  248. (1996). The professional stranger (2nd ed.).
  249. (1998). The provision of individualized care in a multi-ethnic society: an ethnographic study of nursing policy and practice. Unpublished PhD thesis,
  250. (1994). The qualitative research interview. In
  251. (2006). The quantitative-qualitative continuum. In
  252. (1998). The relationship between work status congruency and the job attitudes of full-time and part-time Canadian and Jordanian nurses. doi
  253. (1994). The report of the post registration education and practice project (Prep). London: UKCC UNRWA
  254. (1998). The Royal Hashemite Court. Accessed14/04/200, from http://www.kinghussein.gov.jo/jo_information.html
  255. (1999). The use of brief written educational material to promote reflection amongst trained nurses: a pilot study. doi
  256. (1998). The use of clinical logs to improve nursing students' metacognition: a pilot study. doi
  257. (1994). The use of depth interviewing with vulnerable subjects: Lessons from a research study of parents with learning difficulties. doi
  258. (2000). The use of reflection in a palliative care programme: A quantitative study of reflective skills over an academic year. doi
  259. (2002). To get a better job or do the job better: Motivations of registered general nurses to participate in post-registration degrees. doi
  260. (1998). Transferable skills, marketability and lifelong learning: The particular case of postgraduate research students. doi
  261. (1995). Uncharted territory: Masters preparation as a foundation for nurse clinicians. doi
  262. (2005). Understanding the nursing workforce: A longitudinal study of Australian nurses six years after graduate study.
  263. (2009). Uses of a research diary: learning reflectively, developing understanding and establishing transparency. doi
  264. (2006). Using observation. In
  265. (2005). Using qualitative interviews in cam research: A guide to study design, data collection and data analysis. doi
  266. (2005). Using reflective writing within research. doi
  267. (1998). Views of health promotion among primary health care nurses and midwives in Jordan. Health Care for doi
  268. (1992). What's wrong with ethnography? doi
  269. (2001). Whither nursing? Discourses underlying the attribution of master's level performance in nursing. doi
  270. (1995). Why do nurses agree to take on doctors' roles?
  271. (1969). Women and bureaucracy in the semi-professions. In A. Etzioni (Ed.), The semi-professions and their organisation
  272. (2006). Work related post-traumatic stress as described by Jordanian emergency nurses. doi

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