皇帝的新衣？医护人员对两家英国国民健康服务医院护理助理角色的看法：定性访谈研究

IF 3.1 Q1 NURSING International Journal of Nursing Studies Advances Pub Date : 2024-06-06 DOI:10.1016/j.ijnsa.2024.100211

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引用次数: 0

摘要

背景英国于 2017 年引入护理助理这一专业 "衔接 "角色，旨在缓解长期的人员短缺问题，促进医护助理的职业发展，并释放注册护士以提供更复杂的护理服务。关于英国独立监管机构--护理与助产委员会（Nursing & Midwifery Council）所描述的护理助理角色的身份和目的与在实践中遇到的期望、义务和团队动力之间的一致性，现有证据有限。对逐字记录进行归纳编码。我们采用了适合 Excel 使用的框架分析方法，以帮助确定交叉主题。我们使用《定性研究报告标准》核对表来报告本研究。他们的经验很少反映护理助理角色在实践中的政策愿景。几位参与者将护理助理比作 "皇帝的新衣 "的寓言故事，在这个故事中，人们的期望与现实是背道而驰的。在这一总主题下，确定了四个分主题：(结论：政策议程中对护理助理角色身份的想象与实际情况之间存在差异。有必要为护理助理提供更多受到保护的、定义明确的培训、明确的角色界限以及便捷的职业发展途径。此外，还必须继续在组织和政策层面开展坦诚对话，以正确认识护理助理的挑战和机遇！英国国家医疗服务系统（NHS）急症医院新护理助理角色的经验和观点 @CarolynSpring3.

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‘The Emperor's new clothes?’ Healthcare professionals’ perceptions of the nursing associate role in two UK National Health Service hospitals: A qualitative interview study

Background

The introduction of nursing associates in England in 2017 as a professional ‘bridging’ role aimed to mitigate chronic staffing shortages, enable career progression of healthcare assistants and release registered nurses to provide more complex care. Limited evidence exists about the alignment between the identity and purpose of nursing associate roles described by the UK independent regulator, the Nursing & Midwifery Council, and the expectations, obligations, and team dynamics encountered in practice.

Purpose

Investigate the perceptions of nursing associate roles through the views and experiences of role holders, registered nurses, and healthcare assistants.

Setting

Two British National Health Service (NHS) Hospital Trusts in London, England (UK).

Methods

For this registered service evaluation, data were collected via in-person, semi-structured interviews. Verbatim transcripts were coded inductively. An adapted framework analysis method, suitable for use with Excel, was applied to support the identification of cross cutting themes. We used the Standards for Reporting Qualitative Research checklist for reporting this study.

Results

Eleven registered nurses, five nursing associates, and five healthcare assistants participated. Their experiences seldom reflected the policy vision of the nursing associate role in practice. Several participants likened the nursing associate role to the fable of the ‘Emperor's New Clothes’ in which expectations and reality diverge. With this over-arching theme, four sub-themes were identified: (1) preparedness of organisational infrastructure to support this role; (2) credibility of the role in practice; (3) perceived organisational “blindness” to the ambiguities of the role and (4) increasing task orientation and segmentation in care delivery.

Conclusion

There is a discrepancy between the identity of the nursing associate role as imagined in the policy agenda and its reality in practice. There is a need for more protected and well-defined training, clear role boundaries, and accessible career progression pathways for nursing associates. Moreover, honest dialogue at an organisational and policy level must continue, so that the challenges and opportunities of the nursing associate role are properly realised.