| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 91 === The purpose of this research is via the noviced nurses’ points of views to understand their subjective of the first year working experience, the condition of how they adjusted and the ways they chose to fit in the clinical environment, and to explore the impact of the first year clinical nursing experience on the graduated nurses. This research adopts purposive sample which focus on 20 new graduated nurses employed in one medical center at Taipei. In-deep, individual interview were undertaken according to a semi-structural instruction and the data were analyzed by qualitative content analysis developed by Shin (1997).
The informants were between the ages of 22 to 27 (mean = 24), they are all unmarried, and only one male included. Their working period span from 8 months to 20 months (mean=14.3), education background include 11 college graduated and nine vocational school certificated, all of them achieved bachelor degree. The period of orientation and supernumerary status span from 0 to 4 weeks long (mean=2.05). In terms of working units, nine of them are located at general wards (internal & surgery department), eight at special unit (emergency department, operation room and intensive care unit), one at obstetric and two at pediatrics.
The finding results show that satisfied experience of the first year survivor is derived from others’ positive feedback to their nursing professionalism and the improvement of clinical nursing service. In positive feedback that mentioned above, nine of informants come from patients and their family, only one is from senior nurse. As to which formatted graduated nurses’ satisfied experiences are being supported, nursing professionalism, up growth in both working experience and communication skill. And being supported is the most occurred reason. Consequently, it will lead to assertion toward the value of their life as well as their nursing career. Needless to say it influences the possession of positive vision toward future nursing career.
The unsatisfied experiences are personal health impaired, lacking of positive feedback for their clinical performance & up growth, being deficient in professional confidence, unsatisfied their clinical performance and worried about potential medical confrontations. The reasons of unsatisfied experience are derived from inadequate prepared nursing professional capability and clinical experience, lack harmony interpersonal relationship, overwhelming workload, and lack sufficient support from others. In the deficiency of professional ability and preparedness, lacking hands-on experience is the upmost one. Overwhelming workload is mainly talked about trivial things are too many to handle. As for the lacking supportive feedback, it is referred to not enough emotional support. The unsatisfied experience leads to lower quality of life, personal professional development encounter bottleneck, lower quality in clinical service and identification for nursing professionalism. Eventually, there is no vision toward future nursing career.
The stages of adaptation to nursing work for graduated nurse in their first year can be put into three stages: re-learning & preparing stage, respite stage and finally, the career re-identification stage. Mission of the first stage is to gain control over job, the second stage is to master job as well as to gain balance of it, and the third is to re-assure the certainty toward nursing professionalism. Different missions in every stage have different coping strategy accordingly. In this research, there are 80% of informants decided to leave their job, only 20%, that is 5 people, decided to stay.
Based on the nature of graduated nurse’s clinical experiences, the results will be discussed in below: special character of individual nursing subjective working experience, further analysis on the factors which influence the individual’s satisfaction status, the character of individual’s adaptation toward nursing, and the potential risk in nursing education. Eventually, base on the finding and results of this research, there are implications in this study for clinical nursing, nursing school education and nursing research.
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