Assignment On Refining Nursing Practice Through Workplace Learning

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Refining nursing practice through workplace learning
Refining nursing practice through workplace learning:
A grounded theory

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Refining nursing practice through workplace learning
Abstract
The point of this investigation is to evaluate research utilizing the grounded hypothesis
for analyzing encounters enrolled medical caretakers working in direct contact with the
patients learn and modify their consideration as indicated by contemporary needs and
disclosures. The current circumstance of the medicinal services industry is exceptionally
imbalanced. The quantity of patients and care searchers are rising consistently. Be that
as it may, there is no comparative ascent among the specialist organizations and their
frameworks or assets. Thus, the weight upon the consideration suppliers is mounting as
they need to represent an ever-increasing number of patients. The learning is important
and activated by the rising requests and slanted harmony between consideration
suppliers and care searchers.

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Refining nursing practice through workplace learning
Introduction
The aim of this study is to critique a research using the grounded theory for examining
experiences registered nurses working in direct contact with the patients learn and
revise their care according to the contemporary needs and discoveries. The aim of the
research was to identify how the nurses interacted with their workplace and their
profession and how it affected their way of providing care to patients. It is a given
necessity that the registered nurses maintain their competencies and efficiency
throughout their career (Lima et al. 2016). However, the next level has been added to
the necessity where the nurses are also required to improve themselves and learn as
they work. The learning is necessary and triggered by the rising demands and skewed
balance between care providers and care seekers.
Literature review
The present situation of the healthcare industry is highly imbalanced. The number of
patients and care seekers are rising steadily. However, there is similar rise among the
service providers and their systems or resources. As a result, the pressure upon the
care providers is mounting as they have to account for more and more patients. This
puts forward an issue where the care providers are put in stressful situations, where
they have to work longer periods without a break and be accountable for patient
information and care (Glen, 2017). This not only undermines the type of care provided
but also the health of the nurses (Baek, & Jang, 2016). As a result, the burnout rate
among the nurses is exceptionally high. Also, tired, stressed out care providers are
unable to maintain a safe workplace that is free from health hazards for the patients as
well as themselves.
In order to be able to put up with these demands and growing changes in the industry
the nurses need to be able to include learning and adaptability as a significant skill in
their profession (Dahl, Dewing, Mekki, Håland & Øye 2018).
They have committed to provide the best care and practice to the patients. And the only
way to keep up to their commitment is learning and implementing it in their practice. The
research is also focused on finding out how some nurses are able to adapt while others
keep on struggling or are hesitant to the idea itself.
The literature review of the research draws upon the writings of many researchers and
intellectuals to assert the idea that maintaining their competency is a way to maintain
their professionalism in the field (Newton, Henderson, Joly & Greaves, 2015). The
needs for change and learning is pointed out in the research to be necessitated
because of the continuous advancement of technologies, treatments, medications and
care procedures. These changes when implemented make the prognosis of a disease
of complication better and make the recovery of a patient quicker. Also, the
technologies used for imaging purposes and for surgical needs have improved which
makes it easy to provide an accurate diagnosis of the issue. Another reason is that

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Refining nursing practice through workplace learning
healthcare organizations have reviewed the practice methods of nurses and the way
they interact with the patients (Faithfull-Byrne et al. 2017). They are working to provide
for a more patient-centric model of healthcare delivery that positions the patient as a
partner and not as a subordinate. This needs the nurses to be more competent and
aware of the needs or opinions of their patients and base their treatment delivery upon
it. The third reason is how the systems in the healthcare industry have changed to make
it match the efficiencies in private sectors (Flott & Linden, 2016). Many concepts like the
managerialism and neoliberalism have been introduced to enhance the care provided
by the positioning managers who are responsible for the service aspects. As a result,
the healthcare industry has been the premise of some path changing inventions that
have revolutionized how the nurses provided care.
Methodology
The research was based on a grounded theory research design where a data is
collected methodically in order to create a balanced and practically viable theory.
Grounded theory was thought to be the most suited approach for this study as it was
found to be the best for exploring the career and competencies learnt by the nurses
throughout their practice. The research question on which the research was based on
how well the nurses use their best practice when caring for the patients? It is to be
noted that their practice is a combination of their academic training and what they have
learned through their care practice. The next research question delved into how the
workplace environment allowed them to learn and inculcate their learning into their
practice (Hegenbarth et al. 2015). The role and nature of the workplace environment is
key to the understanding of nurse competencies.
Approval for ethics for conducting a research interview with the nurses was gained from
the university and the health authority. The care units were also intimated about the
nature and purpose of the research (Kyndt, Vermeire & Cabus, 2016).
Data collection strategies
Data was collected through primary qualitative research tools. The candidates for the
interview were nurses who had worked in a healthcare institution at a position where
they were required to directly care for the patient for five to ten years. The nurses were
selected from diverse settings and departments from two acute care hospitals (Miotto,
Wang, Wang, Jiang, & Dudley, 2017). Data has been collected from 17 nurses who
were interviewed. The nurses had 119 hours of service. The research was conducted
by two units who were responsible for observing the conduction of the interviews and
interpreting, presenting the information. The nurses were included from various
backgrounds including surgical, maternal health, home and community care as well as
paediatric nurses. The participants were chosen among their peers through the
exclusion criteria (Faust, Hagiwara, Hong, Lih & Acharya, 2018). Nurses who had less
than 10 years of practice were excluded. In order to be included the nurses needed to

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Refining nursing practice through workplace learning
be experienced, have a role which allowed them to be in direct contact with the patients
and be renowned for their professionalism and efficiency. Nursing competency included
aspects like being all ware of the needs and condition of the patient, maintaining the
research documents and being knowledgeable and responsible for the health of the
patient. They are also needed to show skills like adeptness, decision-making skills and
implementation of care techniques in their practice.
Data analysis and results
A unique thing in this study is the use of participants from various areas of healthcare
and the criteria for choosing the participants through well devised inclusion criteria.
More than half the participants had more than 20 years of participants and one of them
had more than 40 years. In order to analyses and draw inferences from the collected
data grounded theory was used. First and second level of coding was used for coding
procedures and for comparing the data. It was seen that refining the care practice of the
nurses meant that they need to earn through both formal and informal sources
(Patterson et al. 2017). The role of the workplace was to provide three distinct stimuli for
learning. The first role of the workplace was to trigger the nurses to learn more even if
they are competent. The second role is to demand more from the nurses because of the
increasing workload, the third role is to support the nurses as they learn and provide an
area to implement their learning as well. These aspects act as the catalyst in refining
nurse practices and need to be present if the nurses are to learn throughout their career
(Saylor & Graber, 2016). However, these aspects are only situational demands for a
perfect workplace. There needs to be a mentor guided working system where the
nurses are able to approach their mentors for learning and can also learn from an
informal camaraderie. The nurses had made it clear that these were some of the more
essential requirements for promoting learning in their practice. However, it was not
limited to these aspects only. The internal will and motivation also play an important
role. They have agreed that within the profession, it is easy to feel stressed and burned
out. Personal motivation is necessary to keep one’s head above the work and be able to
balance out work and normal life activities (Price & Reichert, 2017).
Discussion
From the interview information it was understood how learning and implementation can
be made into a habit or a skill to improve the competencies of nurses through their
practice. The basic start for learning was to be grounded during the nursing education.
The students needed to understand the nature of the profession be equipped with the
right attitude at that stage (Pool, Poell, Berings & Cate, 2015). The learning that is
conducted during the course of active practice has its base in what was learnt during
the nursing education. The nurses need to be trained from the start to be aware of the
quality of their care and be able to set, maintain a high standard of care in their personal
practice. They are needed to be self-aware so that they are their own critiques and see

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Refining nursing practice through workplace learning
the actual value of the care they provide. The value of their care refers to the greater
whole picture of two their actions are responsible for the recovery of the patient. They
need to have a healthy habit of apprehension through which they are urged to double
check their actions so that there is no scope for a mistake (Winslow et al. 2016).
Throughout this research there are several mentions of the word trigger, it refers to a
stimulus that poses as a need that requires the nursing professional to undergo
learning. Another need for learning is more personal and it is a need for continuous
development and advancement in the field of one’s work. Certain triggers are stimulated
from the needs of the patient or a difficulty faced when interacting with the patient. As a
result, the nurses are forced to develop another skill that could make their task easier
and allow them to provide better care. The nurses also agreed that a change in their
department or their workplace environment was a great trigger that caused them to gain
a skill.
The nurses during their educational training are intimidated that their profession is one
where change is a constant. However, the speed of change is a significant
characteristic. In case of slow changes, the nurses do not have to seek a source of
training as they have the time to adapt to the change by themselves. In case of rapid
changes, like the ones noted in the technological advances and use of new machines,
nurses may need to be formally trained to be able to adapt to these changes.
Limitation
The research has various limitations like the way it defines the triggers and situations
that necessitates change is not comprehensive. It acknowledges that the nature of
triggers is different for different people but there is no conclusive understanding for
creating an environment that will be equally effective for all the nurses. Also, the
research only included nurses who have experience of at least 10 years and are known
for their work. The lesser known nurses who may or may not provide high quality care
and nurses who are not yet experiences have been excluded. An inference can be
drawn from this exclusion criteria that process of learning while being profession is only
a skill relevant for a small group of nurses.
Conclusion
Excellence is an aspect that is desirable in every work sphere. In nursing the quest for
excellence is not stagnant and as a result the nurses have to learn even during practice.
Since, the environment in a healthcare professional has several triggers that requires
nurses to learn a skill to adapt themselves better and provide better service. It is
necessary to create a workplace environment where the nurses are supported in their
learning. The research argues for a mentor trainer relationship to build among the
nurses. Through these relationships’ nurses would be guided towards better learning
and work practices.

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Refining nursing practice through workplace learning
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