2 research outputs found
Registered nurses' perceptions and experiences of autonomy: a descriptive phenomenological study
Background Professional autonomy is a key concept in understanding nurses’ roles in delivering patient care. Recent research exploring the role of autonomy in the nursing work environment indicated that English and American nurses had differing perceptions of autonomy. This qualitative study aimed to explore the understanding and experiences of autonomy of nurses working in England. Methods A descriptive phenomenological analysis of data from 48 semi-structured interviews with registered nurses from two National Health Service (NHS) hospitals (purposive sample) was used to explore the concept of autonomy. Results Six themes were identified: working independently; working in a team; having professional skills and knowledge; involvement in autonomy; boundaries around autonomy; and developing autonomy requires support. A key finding was that nurses related autonomy to their clinical work and to the immediate work environment of their ward, rather than to a wider professional context. Nurses also perceived that autonomy could be turned off and on rather than comprising an integrated aspect of nursing. Conclusions Findings suggest that nurses in England, as framed by the sample, had a local ward-focused view of autonomy in comparison to nurses in America, who were reported to relate autonomy to a wider involvement in hospital level committees. Findings further indicate that autonomy was practiced occasionally, rather than incorporated into practice. Findings highlight the need for nurses in England to adopt a broader perspective and actively contribute to writing hospital guidelines and policies that recognise the importance of autonomy to nurse training and practice
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Exploring the nursing work environment in England using the essentials of magnetism II scale: a mixed methods sequential explanatory study
Introduction and background
The Essentials of Magnetism II Scale (EOMII) developed in the US to measure nursing work environments (NWEs) has not yet been used in England.
Aims
To evaluate the structure of the EOMII Scale, and to describe the impact of different aspects of the NWE on nurse-assessed care quality (NACQ) using data from nurses working in England
Methods
A mixed-methods sequential explanatory design was utilised. First, in a cross-sectional survey study, 247 RNs in 29 wards in two NHS hospitals completed the EOMII and a single item measuring NACQ in 2012. Principal Component Analysis (PCA) was used to evaluate the structure of the EOMII. Correlation and regression analyses were used to describe relationships between factors and NACQ. Second, comments made by nurses on questionnaires were analysed. Third, a purposive sample of 48 RNs were recruited to explore their understanding of the concept of autonomy, using short-structured interviews.
Results
PCA identified a solution with explanatory variance of 45.25%. Forty items loaded on five factors: ward manager support, working as a team, concern for patients, organisational autonomy, and constraints on nursing practice. In correlation analysis, each of the factors was significantly associated with NACQ (p < .001). In a hierarchical multiple regression analysis, four factors were associated with NACQ. Only one factor, organisational autonomy, was not a significant predictor (β=.02, t = .24, ns) of NACQ. Analysis of the interviews revealed that nurses in this sample did not relate autonomy to involvements in managerial/higher level decisions, but limited their discussions to decision-making at the ward team level.
Conclusion
Results suggest that EOMII does measure important aspects of NWE and that each of the factors identified is related to NACQ. Analysis of qualitative data suggests several hypotheses about differences in the meaning of autonomy that could be tested in future research