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A Study of the Lived Experiences of Newly Licensed Nurses by Lynn M

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A Study of the Lived Experiences of Newly Licensed Nurses by Lynn M A Study of the Lived Experiences of Newly Licensed Nurses by Lynn M. Derickson A dissertation submitted to the faculty of Wilmington University in partial fulfillment of the requirements for the degree of Doctor of Education in Innovation and Leadership in Higher Education Wilmington University November 2011 Copyright Page ii A Study of the Lived Experiences of Newly Licensed Nurses By Lynn Derickson I certify that I have read this dissertation and that in my opinion it meets the academic and professional standards required by Wilmington University as a dissertation for the degree of Doctor of Education in Innovation and Leadership. Pamela M. Curtiss, Ph.D., Chairperson of Dissertation Committee Susan Luparell, Ph.D., Member of Dissertation Committee Michael S. Czarkowski, Ed.D., Member of Dissertation Committee John C. Gray, Ed.D, Professor and Dean College of Education iii Dedication This work is dedicated to my husband, my best friend and my greatest supporter. You have been with me through all of my frustrations, encouraging me, loving me unconditionally. Now is our time. To my girls, Heather and Andrea, who do not remember a time in their lives when I wasn’t involved in some educational endeavor, I love you both. Please remember that learning changes your life. And to my grandsons, my ‘boys’, I love you--all five of you! It is also dedicated to all the nurses out there who have ever been victims of incivility. My hope is that this will help us to no longer ‘eat our young’. iv Acknowledgements I wish to acknowledge my committee, Dr. Pam Curtiss, Dr. Susan Luparell, and Dr. Michael Czarkowski. Please accept my deepest appreciation for all of your guidance, support and encouragement. Thank you, Pam, for encouraging me to “think more deeply” and for all your encouragement. To Susan, thank you for giving me the courage to follow my passion. To Dr. Czarkowski (“Dr. Mike”), thank you for your support throughout this program. I wish to thank my participants, who were kind enough to share their stories and without whose help this would not have been possible, “Thank You” from the bottom of my heart. I wish to thank the members of Cohort 18, who have made this journey unique and interesting. Thank you for accepting me and for your encouraging words when I needed them. Thanks to my colleagues at work for keeping me on track, when I would have taken a break. To my family for all your love and unwavering support, and for making me feel like I can do anything, and to God for giving me such blessings and a profession that I love and enjoy. And lastly (but most importantly) to my parents, Bill and Shirley McKenzie, you taught me to pursue my dreams. Now on to the next…! v Abstract A qualitative study of newly licensed nurses within their first five years of practice, this study looked at twelve participants’ receptions into the nursing workforce, and their intent to stay or leave their first nursing positions were examined. Factors influencing their perceived satisfaction in their first nursing jobs were found to be reception by other nurses and doctors, perceived support from management, and their perceptions of preceptors/mentors. From this study a grounded theory emerged. From that theory, A Model for Promoting Newly Licensed Nurse Success was developed that includes: zero-tolerance in the organization for incivility, a formal preceptor/mentoring program that incorporates Benner’s skill acquisition model (2001), and formal leadership training for all levels that also incorporates Benner’s model (2001). vi Table of Contents Dedication ................................................................................................................................. iv Acknowledgements.................................................................................................................... v Abstract ..................................................................................................................................... vi Table of Contents ..................................................................................................................... vii List of Tables ............................................................................................................................. xi List of Figures ........................................................................................................................... xii Chapter I .................................................................................................................................... 1 Introduction .............................................................................................................................. 1 Background of the Study ....................................................................................................... 1 The Purpose of the Study .................................................................................................... 10 Need for the Study .............................................................................................................. 10 Research Questions ............................................................................................................ 12 Definition of Terms ............................................................................................................. 12 Incivility. .......................................................................................................................... 12 License............................................................................................................................. 12 New nursing graduate. .................................................................................................... 13 Nursing code of ethics. ................................................................................................... 13 Nursing education. .......................................................................................................... 13 Nursing Practice. ............................................................................................................. 13 Nursing shortage. ............................................................................................................ 13 Practice registered nursing. ............................................................................................ 13 Registered Nurse (RN). .................................................................................................... 14 Overview ............................................................................................................................. 14 Chapter II ................................................................................................................................. 15 Literature Review .................................................................................................................... 15 Inclusion Criteria ................................................................................................................. 16 Nursing ................................................................................................................................ 17 vii Changes over the past 50 years. ..................................................................................... 21 Nursing Education ............................................................................................................... 23 Nursing Shortage ................................................................................................................ 26 Theoretical Framework ....................................................................................................... 28 Oppression Theory .............................................................................................................. 28 Incivility in Nursing .............................................................................................................. 32 Administrative Support ....................................................................................................... 34 Preceptors and Mentors ..................................................................................................... 37 Professionalism ................................................................................................................... 39 Facilities of Excellence and Magnetism .............................................................................. 42 Conclusion ........................................................................................................................... 43 Chapter III ................................................................................................................................ 44 Methodology ........................................................................................................................... 44 Introduction ........................................................................................................................ 44 Choosing a Research Design ............................................................................................... 45 Risk Benefit Analysis ........................................................................................................... 49 Sampling and Participants .................................................................................................. 49 Data Collection Procedures/Sources .................................................................................
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