三個月內新進護理人員感受護理臨床工作之壓力與因應經驗

Perceived Stress and Coping Strategies of Newly Graduated Nurses

馮明珠(Ming-Chu Feng) ； 陳幼梅(Yao-Mei Chen) ； 吳玲琨(Lin-Kun Wu) ； 吳鈴珠(Ling-Chu Wu)

《護理暨健康照護研究》 7卷2期 (2011/06) Pp. 98-107

https://doi.org/10.6225/JNHR.7.2.98

摘要

背景　應屆畢業生帶著有限的專業知識與實習經驗，進入壓力及變化大的醫療工作，期間的角色轉變與適應充滿著壓力與挑戰，此為量性研究難以深入描述。
目的　以描述性現象學研究法探討新進護理人員的壓力及調適經驗。
方法　以深度訪談法收集資料，對象為南部某醫學中心三個月內新進護理人員。以Colaizzi之資料分析法進行分析。
結果　新進護理人員的壓力：⑴角色轉換責任重，自我要求難達成；⑵臨床業務變化大，拼命加班無止息；⑶學姊超乎想像兇，環境樣樣得適應；⑷做錯事如觸天條，遭到誤解難說明；⑸難以融入感孤獨，缺乏支持身心疲。調適策略：⑴不同的困難，抒發管道有差異；⑵不期待別人，改變自我較實在；⑶犯錯後更小心，努力學習向前看；⑷成就與鼓勵，渡過試用期難關。
結論／實務應用　新進護理人員承受多重壓力，也發展出各自的適應方法，醫院的護理主管若能建立臨床輔導員制度，提供持續性支持將有助於新進人員度過試用階段。此外，更應加強新進人員的在職訓練課程以協助其建立專業能力，將有助於提升其自信心，進而促進其留任意願。

關鍵字

新進護理人員 ； 壓力 ； 因應

並列摘要

Background: With insufficient professional knowledge and limited clinical experience, recently graduated nurses entering stressful and fast changing medical environments often find role transition and adaptation highly challenging. Their stress and coping strategies are difficult to capture using quantitative studies.
Purpose: The present study used a descriptive phenomenological design to investigate perceived stresses faced by recently graduated staff nurses and related coping strategies.
Methods: Data was collected using several interviews and analyzed using the Colaizzi's phenomenological method. Participants were recruited from a medical center in southern Taiwan. Ten recently graduated staff nurses still in their three-month probation period were interviewed individually.
Results: Findings showed newly graduated nurse stressors as (1) lack of confidence in being able to successfully transition into their new roles and in being able to develop clinical competency and professionalism, (2) lack of control over practice and work overload, (3) unfriendly senior staff, (4) accusations and misunderstandings after making mistakes, and (5) sense of isolation and burnout due to insufficient support from colleagues. Coping strategies for newly-graduated nurses included (1) applying various stress-releasing methods, (2) trying to make personal changes rather than trying to change others, (3) being more cautious when undertaking unfamiliar tasks, and (4) focusing their attentions on direct patient care, which offered a higher probability of reward through patient-given encouragement and gratitude that enhanced subjects' sense of accomplishment.
Conclusions/Implications for nursing management: Recently graduated nurses face relatively high levels of work stress for which they develop coping strategies. Previous research suggests the beneficial effects of clinical counselor and administrative support on helping novice nurses overcome premature career burnout. This study described the lived experiences of junior staff nurses during their initial probation period. Findings suggest that the nurse executives in acute care hospitals should develop counseling programs for junior nurses during probation. Furthermore, on-the-job-training focusing on competency development should be strengthened to facilitate retention.

並列關鍵字

newly graduated nurses ； stress ； coping strategies