NRS 433 Rough Draft Quantitative Research Critique and Ethical Considerations
Bullying among nurses is one of the workplace problems that is experienced in health. Evidence has shown that of all the cases of bullying in healthcare, more than 50% of them are reported by the nurses. New nurses are often the victims of bullying from other nurses due to their powerlessness in their organizations. Besides, female nurses are more likely to be bullied when compared to the male nurses. Bullying is associated with significant adverse outcomes. They include decline in productivity and quality of nursing care, increased risk of depression and intent of nurses to leave their jobs. As a result, it is important that responsive interventions be adopted to address this issue affecting newly employed nurses in healthcare settings. Consequently, this research paper is a critical appraisal of two research articles that were used to perform problem identification and development of PICOT statement.
The studies by Barchard et al., (2017) and Roter (2016) were selected for this critique. The study by Roter (2016) sought to investigate the experiences of registered nurses with dysfunctional leadership in a hospital setting. According to the author, dysfunctional leadership contributes to organizational issues that include bullying and workplace violence. However, she notes that few studies have explored the experiences of nurses in hospitals characterized by dysfunctional leadership. This research is significant to nursing because it provides insights into the negative effects of dysfunctional leadership to health organizations. It also provides insights into the ways in which the consequences of dysfunctional leadership can be averted in nursing and healthcare. as a result, it increases the need for the use of evidence-based leadership styles in nursing practice to promote health and wellbeing of the nurses. The research question in this research was not stated explicitly. However, it can be deduced from its aim that the question was, what are the experiences of registered nurses who have been exposed to dysfunctional leadership in hospital setting? The article will support my PICOT statement in two ways. Firstly, it will show that organizations have competencies to address the effects of dysfunctional leadership such as bullying and violence. Secondly, the article recognizes employee development as a way of addressing the challenges of dysfunctional leadership. Training is one of these strategies, hence, its application to my PICOT statement.
The research by Barchard et al., (2017) sought to explore the understanding of nurses about the concept of courage. According to the authors, nurses often experience situations that they perceive to be contrary to their expectations. As a result, it is important to explore the manner in which they are committed to expressing themselves to others in the workplace. The article is significant to nursing since it explored the concept of courage among nurses and ways it influences their practice. It also provides insights into the manner in which nurses can utilize the concept to lead change in their organizations. The research question for this research was not stated. However, it supports the nurse practice issue that was chosen by strengthening the need for the provision of opportunities to nurses that improve their courage to face their uncomfortable situations.
How the Articles will be Used to Answer
The articles will answer the PICOT question in a number of ways. Firstly, it will demonstrate that bullying among nurses is a vice that can be prevented with the creation of awareness among them. The awareness is important in promoting the desired behavioral change in the nurses. As a result, the rate of bullying of new nurses is expected to decline. The articles will also be used to provide insight into the effectiveness of interventions that raise awareness about the effects of bullying in the workplace. The articles have demonstrated that the use of organizational support systems such as training is effective in building the desired assertiveness among the new nurses. Consequently, the articles will make it evident that bullying of new nurses can be prevented by providing training opportunities to nurses about it. The articles selected for the review did not explore directly the use of training to address the issue of bullying among nurses. However, the researchers recommended its use to increase the ability of the nurses to address the issue in their clinical practice. The anticipated outcomes for my PICOT question are varied. They include the increase in the level of awareness among the nurses on the effects of bullying and ways of addressing it. It will result in the reduction in the rates of bullying in the organization. The outcomes of the selected articles in this review compare with the anticipated outcomes in this project by showing that awareness programs are effective in reducing the rates of bullying. They show that organizational leadership is important in informing the need for the adoption of interventions that eliminate bullying in the workplace.
Methods of Study
The research by Roter (2016) utilized phenomenology approach of inquiry. According to Holloway (2017), this approach aims at
investigating the experiences of the participants. The researcher obtains data from the participants and uses it to come up with universal meanings of their experiences. The method is premised on the assumption that every person has unique experiences, which have different meaning from the others. Therefore, the experience should be explored on individual basis to understand it better and its influence on the subjective assessment of a situation by the participant. One of the advantages of this method is that it provides in-depth understanding of a phenomenon under investigation. However, it is associated with disadvantage of poor reliability and validity due to its subjective nature.
The research by Barchard et al. (2017) utilized the grounded theory approach. According to Harvey (2015), this approach focuses on the use of collected and analyzed data to come up with a theory. It allows for the uncovering of the behaviors and social relationships of groups. One of the benefits of this approach is that it does not make assumptions on human behavior. Instead, researchers adopt a neutral view of the social contexts influencing human behavior. However, it has the disadvantage of failing to recognize the manner in which the researcher is embedded in the investigation. Therefore, the role of the researcher is not recognized.
Results of the Studies
The studies revealed that the leadership approach utilized in an organization influences the behaviors of the staffs. Accordingly, dysfunctional leadership increased the risk of undesired organizational behaviors such as bullying and violence. However, support systems such as the provision of training opportunities to the nurses increase their level of awareness about these behaviors, hence, the prevention of bullying (Yoder-Wise, 2019). The study outcomes also revealed that nurses are aware of the concept of courage. However, their ability to utilize it in responding to uncomfortable situations by taking risks and speaking out can be improved by raising their level of awareness through interventions such as training of the staffs.
Implications to Nursing Practice
The results of the selected articles demonstrate that bullying among nurses is a behavior that occurs due organizational influences such as infective leadership styles and low level of situational awareness among them. The articles have also shown that organizational behaviors such as bullying have adverse effects on healthcare providers, patients, and quality of care. Therefore, it is important that interventions that raise the level of awareness of the nurses concerning peer bullying are embraced. The right leadership should be embraced to promote the creation of safe environments for the new nurses. The organizations should create support systems that encourage nurses to speak up their experiences, thereby, their wellbeing.
Scientific researches should be conducted with a consideration of ethics for them to demonstrate the desired rigor. One of the ethical considerations in research is seeking informed consent. It is essential that researchers obtain consent from the participants prior to conducting their studies. Informed consent implies that the participants have been informed about the research and its associated implications (Boswell & Cannon, 2020). The other research ethic that is important when undertaking scientific studies is privacy. Researchers are tasked with the responsibility of ensuring that the identity of the study participants is not revealed. This eliminates the possibility of victimization of the participants due to their participation in the research. Researchers promote this principle by ensuring anonymity of the study participants (Scott, 2017). The ethical principles of informed consent and privacy have been taken into consideration in the selected articles for this critique. As shown by the authors, the participants gave their informed consent prior to participating in the research. The participation was also voluntary. The authors also did not reveal the identities of the study participants. The participants were assigned codes to identify them. Therefore, the studies were conducted with a consideration of research ethics.
Barchard, F., Sixsmith, J., Neill, S., & Meurier, C. (2017). 6Cs and ten commitments: nurses’ understanding and use of courage. Nursing Management, 23(10).
Boswell, C., & In Cannon, S. (2020). Introduction to nursing research: Incorporating evidence-based practice. Burlington, MA: Jones & Bartlett Learning.
Harvey, M. (2015). Research methods for nurses and midwives: Theory and practice. Sage.
Holloway, I. (2017). Qualitative research in nursing and healthcare. Chichester, England: Wiley Blackwell.
Roter, A. B. (2016). A phenomenological study: Understanding registered nurses experiences related to dysfunctional leadership in a hospital setting. Journal of Organizational Psychology, 16(1).
Scott, P. A. (2017). Key concepts and issues in nursing ethics. Cham, Switzerland: Springer.
Yoder-Wise, P. S. (2019). Leading and managing in nursing. New York, NY: Mosby.
As noted above, nursing shortage is a critical issue that affects the safety and quality of care given to patients (Bittner & Bechtel, 2017). Nursing shortage is an issue that affects most of the healthcare organizations in America in the modern world. The American Association of Colleges of Nursing (AACN) reports that the shortage of nurses in the US is anticipated to rise in the next decade due to the aging of the Baby Boomers. The aging of the Baby Boomers will also imply the increased need for care demands, hence, overburdening the already burden healthcare system due to nursing shortage (Marć et al., 2019). Shortage of nurses in the US is also attributed to the low capacity of nursing schools that do not produce new nurses to meet the increasing demands (Sokhanvar et al., 2018).
Authors have explored the issue of shortage of nurses in their studies. One of the studies that examined the issue of nursing shortage is the one conducted by (Halter, Boiko, et al., 2017). Halter et al., (2017) identified in their study that nursing turnover is a critical factor contributing to the shortage of nurses being experienced in America today. As a result, the aim of their research was to investigate the determinants as well as consequences of staff turnover among adult nurses. The research question that guided their investigation was; what are the determinants and consequences of adult nursing staff turnover? Halter, Pelone et al., (2017) conducted another study to examine evidence-based interventions that can be used to address the issue of nursing shortage by reducing adult nursing turnover. The authors recognized the fact that nursing shortage is preventable by implementing practical interventions that aim at its contributing factors. Therefore, the research question that guided the authors was; what interventions can be embraced to reduce adult nursing turnover?
How do these two articles support the nurse practice issue you chose?
The articles by Halter, Pelone, et al. (2017) and Halter, Boiko, et al. (2017) answers the PICOT question for my project in a number of ways. Firstly, the article by Halter, Boiko, et al., (2017) answers the PICOT question by providing insights into the determinants of factors that contribute to shortage of nurses and its consequences. The information obtained from the article provides information about the severity and magnitude of the problem of nursing shortage, hence, increasing the need for the exploration of interventions to address the problem. The article by Halter, Pelone, et al., (2017) answers the PICOT question by providing evidence-based interventions that can be adopted to address the issue of nursing shortage. The article examines broad interventions that are applicable to health organizations in addressing the issue of nursing shortage. The article by Halter, Pelone, et al., (2017) provided interventions that are similar to those proposed in my PICOT question. The interventions include the adoption of teamwork approaches in nursing, effective leadership styles, preceptor-based programs, needs-based orientation programs, use of residency programs and expanding the training capacity of nursing education institutions. The two articles used previous studies with a mix of comparison groups comprising of nurses, nursing students, and healthcare leaders and managers. As a result, the comparison groups vary from those in my PICOT question.
Method of Study:
The studies by Halter, Pelone, et al., (2017) and Halter, Boiko, et al., (2017) were quantitative systematic reviews. The authors reviewed evidences from previous quantitative studies that examined the factors contributing to nursing shortage, including turnover by adult nurses. The quantitative systematic reviews that the authors performed are associated with a number of benefits as well as limitations. The benefits include the fact that they provide highly reliable and accurate data, addresses specific questions or hypothesis, and guides the identification of best practices in nursing. The method is however associated with limitations such as the lack of use of human subjects, using studies with bias, and presenting findings that may not be generalizable to a larger population.
Results of Study
The study Halter, Boiko, et al., (2017) found that the determinants of turnover in adult nursing that contribute to nursing shortage include nurse stress and job dissatisfaction, managerial style, and factors that relate to the supervision methods that organizations utilize. The study further showed that that the consequences of nursing turnover and shortage include significant economic costs incurred by health organizations and patients alongside the decline in safety and quality of care. The study by Halter, Pelone, et al., (2017) showed that a number of interventions can be embraced in practice to increase retention of adult nurses as a way of addressing the issue of nursing shortage. The authors found that some of the effective interventions that can be embraced include the adoption of effective leadership styles, teamwork approaches, transformational nursing models, preceptor programs, and residency and new gradate internship programs, and establishment of need-based programs for the nurses.
The findings presented in the selected articles have considerable implications to nursing practice. The findings translate into the need for health organizations to identify effective practices that can be adopted to minimize turnover among nurses. The findings also translate into the need for the adoption of effective leadership styles that promote the development of the employees. The findings in the articles also raise the need for the creation of effective organizational cultures. The organizational culture should strengthen teamwork, use of effective leadership styles and the recognition of the diverse needs of the staffs in the organization. Overall, the findings increase the need for the adoption of transformational practices in nursing practice to promote the needs of nurses, hence, reducing nursing turnover and shortage.
One of the anticipated outcomes of my PICOT question is the identification of factors that contribute to nursing shortage in the US. It is anticipated that through the analysis of the various sources of data and intervention outcomes, nurses will be able to identify and understand the factors that contribute to shortage of nurses in the state. The other anticipated outcome of the PICOT question is the determination of the effectiveness of the intervention in addressing the issue of nursing shortage. The intervention will be examined to determine whether it minimized the factors contributing to nursing shortage or not. The outcomes of the selected articles compare to my anticipated outcomes. Firstly, the outcomes of the selected articles identified individual and organizational determinants of nursing shortage and turnover that may relate to the anticipated outcomes of the PICOT question. Secondly, the outcomes of the chosen articles showed that transformation of organizational processes contribute to improved retention of nurses, hence, reduction of nursing shortage. The anticipated outcome of the project is to increase the retention of nurses in health organizations, hence, the similarity with the outcomes of the selected articles.
Overall, nursing shortage is a critical issue that threatens the safety and quality of nursing care. Nursing shortage is attributed to a number of factors such as high rate of adult nurses’ turnover, limited training capacity of nursing institutions, and elderly nurses that are retiring. Nurse leaders and managers have a role to play in addressing the issue of nursing shortage in the US. Therefore, the consideration of evidence-based interventions is recommended to promote the effective management of the issue in practice.
Bittner, N. P., & Bechtel, C. F. (2017). Identifying and Describing Nurse Faculty Workload Issues: A Looming Faculty Shortage. Nursing Education Perspectives, 38(4), 171–176. https://doi.org/10.1097/01.NEP.0000000000000178
Halter, M., Boiko, O., Pelone, F., Beighton, C., Harris, R., Gale, J., Gourlay, S., & Drennan, V. (2017). The determinants and consequences of adult nursing staff turnover: A systematic review of systematic reviews. BMC Health Services Research, 17. https://doi.org/10.1186/s12913-017-2707-0
Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., Gourlay, S., & Drennan, V. (2017). Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews. The Open Nursing Journal, 11, 108–123. https://doi.org/10.2174/1874434601711010108
Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage – a prospect of global and local policies. International Nursing Review, 66(1), 9–16. https://doi.org/10.1111/inr.12473
Sokhanvar, M., Kakemam, E., Chegini, Z., & Sarbakhsh, P. (2018). Hospital nurses’ job security and turnover intention and factors contributing to their turnover intention: A cross-Sectional study. Nursing and Midwifery Studies, 7(3), 133. https://doi.org/10.4103/2322-1488.235640
Topic 5 DQ 2
Aug 22-26, 2022
According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interactions with patients. How do you see this being applied in your workplace? In addition, how can you strive to make spirituality and self-care a practice for your patients as well as yourself? How does this practice align with the Christian worldview?
Aug 26, 2022, 11:40 PM
Replies to Justina Aguilar
Nurses use EBP to provide patients with safe, quality care and to improve outcomes. When developing EBP, one is looking at research already conducted (Helbig, 2018). My employer uses EBP for hospital-wide wide patient care. For example, I work on a GI floor. Our patients receive new ileostomy or colostomy placements regularly. However, EBP shows enhanced recovery is better than traditional recovery methods. We encourage our patients to ambulate within 4 hours post-op, intake 500mls within 8 hours post-op, and start patients off on a regular diet. Most patients are educated before surgery.
Workplace spirituality in nursing is mostly defined and researched from the individual viewpoint. The definition includes dimensions of inner life, meaningful work, interconnectedness, transcendence, and alignment between values (Pirkola et al., 2016). A sense of community and meaningful work are the most important dimensions of workplace spirituality in health care.
My goal is to view every shift as 12 hours to make a difference in my patients’ lives. Not just the medical part of the tasking and the critical thinking that comes naturally. But to give my patients the TLC they need in this, their hardest hour. They are down, ill, alone at night. I develop a rapport with them and make sure they are as comfortable as possible. I help them get clean, and pain-free (if possible), meet needs, tidy the room, clarify the night’s plan of care, and expectations from me, and make sure the patient and I are on the same page as far as the doctor’s plan. This may be reiterating the day Ds notes. I offer prayer if appropriate. I always offer a warm blanket, fan, and/or aromatherapy. I do my best to give holistic care and treat each patient with the utmost dignity and respect.
Selfcare is a personal struggle, to be honest. I do need to prioritize “me” time more than I do. I truly feel guilty not spending my extra time with my family since I’m so tired with the night shift and school all the time. I try and use any extra time to be with my family. I want to start going for 30-minute walks daily. It’s been a personal goal for a while.
When it comes to my Christian worldview, I try to treat others the way I want to be treated. It’s a simple rule, but it works for my personal and professional life. I try every day to be a better human than the day before. I am not a perfect mom, wife, sister, daughter, best friend, student, nurse, tia, or daughter-in-law, but I do my best. I do have a personal relationship with my savior. I know where I’m going when my earthly days are done. I’m confident with my actions on earth. I do my best, that’s all we can do.
Helbig, J. (2018). Nursing research: Understanding methods for best practice. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1
Pirkola, H., Rantakokko, P., & Suhonen, M. (2016). Workplace spirituality in health care: an integrated review of the literature. Journal of nursing management, 24(7), 859–868. https://doi.org/10.1111/jonm.12398
replied toJustina Aguilar
Aug 27, 2022, 5:47 PM
- Replies to Justina Aguilar
In everyday nursing practice, nurses are encouraged to incorporate and utilize evident base practice in their day to day nursing care. Evidence-based practice is using scientific evidence to determine best practice. Evidence based practice is real and very effective. Look at the rule of hand washing, which is the most effective way to eradicate germs. Evidence based practice if followed as recommended. It really works in nursing practice.
- Kadija Tejan-deen
replied toJustina Aguilar
Aug 27, 2022, 10:30 PM
Replies to Justina Aguilar
Good post. The process of making decisions regarding patient care that are founded on the most compelling evidence obtained through carefully planned and executed clinical research, as well as the clinical experience and preferences of the individual patient, is referred to as “evidence-based practice.” This process is referred to by the term “evidence-based practice.” Numerous studies have shown that providing patients with care that is based on evidence can improve the overall quality of care that is provided, reduce the number of medical problems that patients experience, and lower the overall costs associated with providing medical care by as much as 30 percent (Rosendal et al., 2022).
Rosendal, K. A., Lehn, S., & Overgaard, D. (2022). Body care of older people in different institutionalized settings: A systematic mapping review of international nursing research from a Scandinavian perspective. Nursing Inquiry, e12503.