Ekström and Idvall qualitative study

Ekström and Idvall qualitative study

Introduction

In 2015, Ekström and Idvall conducted a qualitative study to examine the experiences of a registered nurse who was newly qualified in a leadership position in a care team within a ward. The study was informed by the notion that nurses’ leadership qualities are a reflection of the quality of care they provide to patients under their supervision. The study recruited 12 participants composed of 1 male nurse and 11 female nurses. All were newly qualified and were between 23 and 43years old. They were enrolled from one of four wards: neurological, medical, surgical, and rheumatic wards based in a university teaching hospital. Data was collected through one on one interviews and the feedbacks transcribed. Based on their findings, the lack of experience contributed to poor delegating and prioritizing among newly qualified nurses. Using a qualitative approach allowed the researchers to develop a detailed understanding of the feelings and thoughts expressed by the partakers concerning the transition period. The method also enabled the researchers to eliminate generalisation of findings given that partakers were enrolled from different wards, which facilitated the exploration of various experiences.

Also worth noting is that the participants had varying degrees of experience, depending on the length of being in a leadership role. Thus, the researchers were able to investigate the competency of leadership skills of NQNs from the start to the completion of their changeover period. The small size sample could be a weakness for the study in generalising the findings. However, it can be argued that this was remedied by the in-depth interviews conducted by the researchers. Moreover, a detailed analysis with a larger population size would have been complicated, thereby affecting accurate analysis (Parahoo, 2014). Before each interview, the researchers dedicated about 30-70 minutes for bonding. The technique increases participant confidence, openness, and honesty, which in turn improved the conformability and credibility of the study result (Taylor and Francis, 2013). According to the researchers’ conclusion, newly qualified nurses need to be furnished with the right support necessary to develop their leadership and clinical skills (Ekström and Idvall (2015).

In their 2010 study, Potter et al. carried out a qualitative descriptive research, which determined that effective communication was crucial for efficient delegation practices. In particular, it was determined that proper delegation significantly relied on clear, concise, and comprehensive communication. Also, the research revealed that communication was supported by the effective and timely sharing of crucial information that enables the team to expect a demanding workload. A vital revelation was also that the communication style fosters teamwork, which is critical for successful delegation. The article identified conflicts arising from factors such as personality, work ethic, age, role, and management were due to delegation. In this context, the findings showed that conflict commonly arose when there was poor communication and breakdown of teamwork between the nurse and delegates. Age occasioned conflict in situations where the delegates were older than the newly qualified nurse. Case in point, younger newly qualified nurses found it difficult to delegate duties to older nursing assistances due to resistance from the latter, which caused conflict. Primarily, the researchers determined that the newly qualified nurse used poor communication style when dealing with senior nursing assistances.

Consistently, the study emphasised another communication concern associated with work ethics in causing conflicts. Essentially, the researchers described work ethic as a set of principles founded on the initiative, diligence, and hard work (Potter et al. 2010). Conflicts arose from the perception that ‘over-delegation’ was a sign of lethargy in addition to the fact that nurses showed reluctance when asked to help. Suffices it to say, both the delegates and the qualified nurse valued willingness to demonstrate resourcefulness and adherence to a strong work ethic. Undoubtedly, this research provides valuable insights into the concept of delegation, given its extensive discussion on the potential factors that may affect smooth delegation.

Moreover, the study has more credibility in that the researchers used appropriate methodologies as well as data collection techniques like in-depth group interviews. Another advantage of using group interviews is that it creates room for discussion among participants concerning questions raised by the authors. Furthermore, group interviews eliminate common problems associated with individual interviews, such as participants feeling intimidated by interviewers. This is because, in group interviews, responses by participants evoke peer conversation on work practices. Correspondingly, through group interviews, researchers generate information in a manner that allows participants to raise questions about each other hence creating an opportunity for them to re-examine their perceptions of an experience.

Using a similar approach, Gravlin and Bittner (2010), examined the role of attitude as a barrier to a smooth delegation in a quantitative study. The results portrayed that the attitude of nursing assistant alongside other causes such as knowledge and competence affected successful delegation. The study also revealed that effective delegation was hindered, where individuals belonging to the same nursing group had conflicting attitudes. Potentially, this can be attributed to the fact that people have diverse backgrounds, which means that their values are determined by factors such as culture, age, religion, ethnicity, political affiliation, and many others. Moreover, effective delegation can also be affected by distrust between the care assistant and the nurse. As such, nurses need to develop trust since they are expected to deal with the implications of errors given their accountability for the task (NMC 2015).

The study also associated poor delegation with a working environment characterised with unclear reporting structures and job descriptions. The absence of clear definitions of roles was also linked to poor delegation. It can, therefore, be said that establishing well-defined roles reduces conflicts significantly that often arise during delegation. Potter et al. (2010) also observed this where they contended that the primary cause of disputes between care assistants and nurses was the perception that the care assistants’ role was similar to that of the NQN save for circumstances involving the provision of medication. In other words, care assistants were unaware of clinical decision-making on the part of the nurse and patient care management duties. In sum, attitude is a common obstacle for effective delegation, and some of the critical causes of attitude among nurses include conflicts arising from the age gap, role confusion, work ethic, personality, and rebellion. Overall, the data collection method of the study is its key strength as it was carried out as semi-structured interviews. Possible ethical concerns were also addressed as the researchers obtained the participants’ consent.

Additionally, the interviews were carried out in a conference room, thus adding more privacy and possibly the ability of the participants to provide information confidently. Conversely, only thirteen participants were recruited for the study, which is quite a small population size. In short, it may be inaccurate to generalise the findings of this study.

Finally, in different qualitative research, Bjerknes and Bjørk (2012) implemented an ethnographic approach where they used interviews, observations, and scrutiny of documents on the changeover from being a student of nursing to an NQN. Using purposive/convenience sampling, the researchers recruited and interviewed thirteen female nurses of Norwegian descent in their mid-twenties. According to their findings, the newly graduated nurse found the transition journey challenging, given that most of the senior nursing professionals treated them with contempt when leading a team. As a result, most of the graduate nurses felt discouraged and out of place, which gradually affected their confidence when it came to performing their duties. At the same time, this lack of confidence also prevented them from raising the issues. Ultimately, many of the graduate nurses found themselves stressed at work all the time because they felt hated by some of the established professionals. Pointedly, among the multidisciplinary team, some members completely ignored the graduate nurses and were mostly uncommunicative. Not only do such poor practices create toxic work environments, but they also lead to adverse healthcare outcomes. Since participants were specially selected for this research, the findings may not be applicable in other settings, such as in a different age/ gender group population. Despite this limitation, the use of diverse data collection methods encompassing interviews, observations, and document scrutiny reinforces the credibility and reliability of the entire project.

References