Vilma Žydžiūnaitė HAL - 2005:05, pp. 270. HAL/Sektionen för hälsa, 2006.
Crucial point for the research, which is tied together by these research questions: What is the lived experience of nurse’s role mission in nursing care? What is the meaning for nurses of their role mission in nursing care practice? What kind of issues the nurses refer to nurse’s role mission in nursing care and what does it mean for them?
Aims. The overall aim: To illuminate and substantiate the nurses’ lived experience of their role mission in nursing care practice. The specific aims: study I - To find out and substantiate the overlaps and differences between the nurse’s role and mission and in study II - To unfold the meaning of nurses’ lived experience of their role mission in nursing care practice
Method. Data selection / collection: in study I were formed the specific criterions and in study II it was performed the qualitative interview. Data analysis: in study I it was used the matrix method and in study II – phenomenological hermeneutics. Sample: In the study have participated 10 registered nurses practitioners who work in primary, secondary and tertiary level health care organizations.
Results. Study I results highlighted the overlaps, which connect the role and mission are the following: >expressional part; >interaction between patient and nurse; >working in a team; >caring and helping processes are contexts; >orientations are to individuals, families, groups; >main realization level is cognitive; >dependence on personal nurse’s qualities; >based on integration of theory and practice; >dependent on organizational needs and infrastructure; >key activity is attached to educational area. Differences between the role and mission are those: a) Nurse’s self – expression in mission performance is attached to spiritual and cognitive levels through commitment to mission goal without active interventions. In role performance here are integrated two parts – physical (doing with patients) and psychological and spiritual (being with patients). b) In mission performance various phenomenons are related to mono – direction (nurse – patient interaction). In nurse’s role performance the interactions are oriented to multi – directions (e.g., nurse – nurse, nurse – patient, nurse – student etc. interactions). c) Nurse’s mission in one situation could be only one. The nurse could realize several subroles in one situation. d) Only nurse’s role is related to philosophy of a concrete ward. e) Mission is an outcome of personal calling. Even through role performance the nurse experiences calling. f) Role enactment empowers the nurse to reflect and have insights. Mission does not empower the nurse for reflecting. g) Nurse’s role is associated with highest quality of specialist’s education. This aspect is not actualized in mission performance. Study II results illuminated the following empirical facts: a) Exceptionally nurse’s role performance allows the nurse to ‘survive’ with concrete experiences in nursing care practice. b) Permanent connection between the role and mission first and foremost exists in cognitive level (nurse’s thinking, perceiving). c) Role experience and its performance is contextual. The mission is experienced through expression of nurse’s caring and dignity. d) In mission performance is important internal nurse’s motives and in role performance key aspect is only formal her / his commitment. e) In mission is urgent nurse’s being feeling one’s part deeply and in role performance is accentuated even compulsory functions. f) In mission performance the nurse’s calmness and caring is not accentuated as key aspects as they are in role performance. g) Nurse’s internal self – empowerment, ability to be in dignity in all situations and experience of professional satisfaction allows experience the mission in nursing care context with the orientation exceptionally to profession. h) In mission experience is urgent nurse’s devotion and in role experience – satisfaction, limitations and dependence. i) Nurse’s motivation to act for organization forms premises to experience the role in organizational context. f) Nurse’s competence allows her / him to experience the role in full value through collaboration with other specialists.
• The nurse’s role and mission in nursing care practice are experienced in complex with the dimensions (orientations) to patient, patient family, nurse’s self, activity, nursing profession, colleagues nurses and other specialists, organization, physician and society. Nurse’s role mission meaning is experienced through the following aspects (those are illuminated by adequate themes / overlaps between the role and mission content): being in communion, permanent experiencing, feeling one’s part deeply, devotion, being able to influence (the patient and his / her family, activity, and colleagues nurses), being reflective, being in dignity, commitment, nurse’s competence, being caring, self – empowerment and satisfaction.
• The experience of nurse’s role mission meaning in nursing care practice is:
• Limited by nurse’s being in broken dignity, having depersonalized standpoint to patient, being negligent with the patient and not performing the professional obligation.
• Dependent on changes, personal nurse’s perception, competence, and family ‘roots’, context, formed activity aims and personal standpoints to activity.
• Influenced by patient’s age and his / her response to performed nurse’s activity, being counseling and empowered and patient’s experiences, nurse’s permanent learning, acquired education, practical experience and being interested in novelties.
• The meaning of nurse’s role mission is experienced in nursing care practice by five levels – personality, cognitive, spiritual, and psychological and activity. The meaning of nurse’s role mission is experienced in nursing care practice through practical, managerial, cognitive, social and educational activities.