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중환자실 간호사의 임상 적응 경험

Experience of Clinical Adaptation among Nurses in Intensive Care Unit

  • 투고 : 2023.08.26
  • 심사 : 2023.12.27
  • 발행 : 2024.02.28

초록

Purpose : This study aimed to explore and describe intensive care unit (ICU) nurses' experience of clinical adaptation. Methods : The participants were 14 ICU nurses with more than two years of working experience in the ICU. Data were collected through in-depth individual interviews conducted between July and October 2021. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using the Strauss and Corbin method. Results : A total of 79 concepts, 37 subcategories, and 16 categories were identified through open coding. Axial coding based on the paradigm model revealed that the central phenomenon was "The harsh adversity faced in the nursing field where life and death are determined" and the core category was "Enduring the adversity of caring for critically ill patients and achieving self-realization." ICU nurses' clinical adaptation process was explained in five phases: "confrontation period," "turbulent period," "seeking period," "struggling period," and "stabilized period." The five phases that affect interventional conditions were "Support from reliable people," "Recognition of administrative and financial support." Conclusion : This study provided novel insights for a comprehensive understanding of ICU nurses' clinical adaptation processes. Furthermore, the findings are expected to be used as basic data to develop multifaceted strategies to help ICU nurses' adaptation to critical care.

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참고문헌

  1. Hospital Nurses Association. 2020 Survey on the status of hospital nursing staff placement [Internet]. Seoul: Hospital Nurses Association; 2023 [cited 2021 Oct 01]. Available from: https://khna.or.kr/home/pds/utilities.php
  2. Hospital Nurses Association. 2022 Survey on the status of hospital nursing staff placement [Internet]. Seoul: Hospital Nurses Association; 2023 [cited 2023 Nov 12]. Available from: https://khna.or.kr/home/pds/utilities.php
  3. Lee JH, Song YS. Predictive factors of turnover intention among intensive care unit nurses. Journal of Korean Clinical Nursing Research. 2018;24(3):347-55. https://doi.org/10.22650/JKCNR.2018.24.3.347
  4. Lee JH, Song YS. Mixed method research investigating turnover intension with ICU nurses. Journal of Korean Academy of Fundamentals of Nursing 2020;27(2):153-63. https://doi.org/10.7739/jkafn.2020.27.2.153
  5. You JE, Lee EN. Reasons, incidences, and influencing factors of work interruptions in intensive care unit nurses. Journal of Muscle and Joint Health. 2020;27(3):247-54. https://doi.org/10.5953/JMJH.2020.27.3.247
  6. Jakimowicz S, Perry L. A concept analysis of patient-centred nursing in the intensive care unit. Journal of Advanced Nursing. 2015;71(7):1499-517. https://doi.org/10.1111/jan.12644
  7. Hong JY, Kim SN, Ju MJ, Sohn SK. The experience of male nurses working in intensive care units. Journal of Korean Clinical Nursing Research. 2020;26(3):352-64. http://dol.org/10.22650/JKCNR.2020.26.3.352
  8. Bruyneel A, Bouckaert N, Detollenaere J, Kohn L, Pirson M, Sermeus W, et al. Association of burnout and intention-to-leave the profession with work environment: a nationwide cross-sectional study among Belgian intensive care nurses after two years of pandemic. International Journal of Nursing Studies. 2023;137:104385. https://doi.org/10.1016/j.ijnurstu.2022.104385
  9. Jang MS, Kim SJ. Person-centered relational care experienced by critical care nurses: An interpretative phenomenological analysis study. Journal of Korean Academy of Nursing. 2019;49(4):423-36. https://doi.org/10.4040/jkan.2019.49.4.423
  10. Turan N. An investigation of the effects of an anger management psychoeducation programme on psychological resilience and affect of intensive care nurses. Intensive and Critical Care Nursing. 2021;62:102915. https://doi.org/10.1016/j.iccn.2020.102915
  11. Jackson J, Vandall-Walker V, Vanderspank-Wright B, Wishart P, Moore SL. Burnout and resilience in critical care nurses: a grounded theory of managing exposure. Intensive and Critical Care Nursing. 2018;48:28-35. https://doi.org/10.1016/j.iccn.2018.07.002
  12. Won YH, Kang JY. Intensive care unit nurse's communication experience. Korean Journal of Adult Nursing. 2014;26(3):352-61. https://doi.org/10.7475/kjan.2014.26.3.352
  13. Kim KM, Lee EN, Kim MJ. The moderating effect of supervisor's support in relation to violence experience between co-workers and organizational commitment of nurses working in special departments of a hospital. Korean Academy of Nursing Administration. 2020;26(4):400-8. https://doi.org/10.11111/jkana.2020.26.4.400
  14. Fulbrook P, Albarran JW, Baktoft B, Sidebottom B. A survey of European intensive care nurses' knowledge levels. International Journal of Nursing Studies. 2012;49(2):191-200. https://doi.org/10.1016/j.ijnurstu.2011.06.001
  15. Guilhermino MC, Inder KJ, Sundin D, Kuzmiuk L. Education of ICU nurses regarding invasive mechanical ventilation: Findings from a cross-sectional survey. Australian Critical Care. 2014;27(3):126-32. https://doi.org/10.1016/j.aucc.2013.10.064
  16. Celik Aysegul R, Oznur UY, Asiye A. Evidence-based practices for preventing ventilator-associated pneumonia in intensive care nursing: knowledge and practice. International Journal of Caring Sciences. 2020;13(3):1794-8.
  17. Oren B, Cuvadar A. The effectiveness of training for peripheral venous catheter application in intensive care units of a university hospital. International Journal of Caring Sciences. 2020;13(1):163-170.
  18. El Khamali R, Mouaci A, Valera S, Cano-Chervel M, Pinglis C, Sanz C, et al. Effects of a multimodal program including simulation on job strain among nurses working in intensive care units: a randomized clinical trial. Jama. 2018;320(19):1988-97. https://doi.org/10.1001/jama.2018.14284
  19. Kelly LA, Johnson KL, Bay RC, Todd M. Key elements of the critical care work environment associated with burnout and compassion satisfaction. American Journal of Critical Care. 2021;30(2):113-20. https://doi.org/10.4037/ajcc2021775
  20. Kim SR, No MJ, Moon KE, Choi HJ, Park Y, Lee NJ, et al. Intensive care unit nurses' death perception, end of life stress and end of life nursing attitudes. Journal of Korean Clinical Nursing Research. 2018;24(2):255-62. https://doi.org/10.22650/JKCNR.2018.24.2.255
  21. Jin YE, Lee YM, Park HJ. Impact of role conflict, nursing organizational culture, and nurse-physician collaboration on job embeddedness of intensive care unit nurses. Journal of Korean Critical Care Nursing. 2023;16(1):15-27. https://doi.org/10.34250/jkccn.2023.16.1.15
  22. Cranley LA, Doran DM, Tourangeau AE, Kushniruk A, Nagle L. Recognizing and responding to uncertainty: a grounded theory of nurses' uncertainty. Worldviews on Evidence-Based Nursing. 2012;9(3):149-58. https://doi.org/10.1111/j.1741-6787.2011.00237.x
  23. Welch TD, Carter M. Expertise among critical care nurses: a grounded theory study. Intensive and Critical Care Nursing. 2020;57:102796. https://doi.org/10.1016/j.iccn.2019.102796
  24. Lee JY, Lee YM, Jang JI. Intensive care nurses' experiences of death of patients with DNR orders. Journal of Hospice and Palliative Care. 2017;20(2):122-30. https://doi.org/10.14475/kjhpc.2017.20.2.122
  25. Lee MS, Lee EO, Jang EH, Jo GJ, Choi JS, Lee KS, et al. Expertise in ICU nursing : A qualitative approach. Journal of Korean Academy of Nursing 2000;30(5):1230-42. https://doi.org/10.4040/jkan.2000.30.5.1230
  26. Strauss AL, Corbin JM. Basics of qualitative research: techniques and procedures for developing grounded theory. 2nd ed. Thousand Oaks, CA: Sage Publications; 1998.
  27. Corbin JM, Strauss AL. Basics of qualitative research: techniques and procedures for developing grounded theory. 3rd ed. Thousand Oaks, CA: Sage Publications; 2008.
  28. Benner, P. Using the dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice and education. Bulletin of Science, Technology Society. 2004;24(3):188-99. https://doi.org/10.1177/0270467604265061
  29. Corbin JM, Strauss A. Basics of qualitative research: techniques and procedures for developing grounded theory. 4th ed. Thousand Oaks, CA: Sage Publications; 2014.
  30. Lincoln YS, Guba EG. Naturalistic inquiry. Newbury Park, CA: Sage Publications; 1985. p. 289-331.
  31. Lee JH, Song YS. Nurses' experiences of the COVID19 crisis. Journal of Korean Academy of Nursing. 2021;51(6):689-702. https://doi.org/10.4040/jkan.21160
  32. Kwak SY, Lee BS. Role adaptation process of hospice nurses. Journal of Korean Academy of Nursing Administration. 2018;24(2):149-90. https://doi.org/10.11111/jkana.2018.24.2.149
  33. Park MO, Yang EJ, Lee MM, Cho SH, Shim MY, Lee SH. The nurse staffing in intensive care units based on nursing care needs: A multicenter study. Journal of Korean Critical Care Nursing. 2021;14(2):1-11. https://doi.org/10.34250/jkccn.2021.14.2.1
  34. Kang JH, Lee YM, Lee HJ. Effect of the awareness of a good death and perceptions of life-sustaining treatment decisions on attitudes of intensive care nurses toward terminal care. Journal of Korean Critical Care Nursing. 2019;12(2):39-49. https://doi.org/10.34250/jkccn.2019.12.2.39
  35. Wright RR, Mohr CD, Sinclair RR. Conflict on the treatment floor: an investigation of interpersonal conflict experienced by nurses. Journal of Research in Nursing. 2014;19(1):26-37. https://doi.org/10.1177/1744987113485577
  36. Jung SH. A ground theory on occurrence and persistence of Tae-um among nurses on the nursing unit environment [dissertation]. Seoul: Seoul university: 2018.
  37. Amestoy SC, Backes, VM, Thofehrn MB, Martini JG, Meirelles BH, Trindade LD. Conflict management: challenges experienced by nurse-leaders in the hospital environment. Revista Gaucha De Enfermagem. 2014;35(2):79-85. https://doi.org/10.1590/1983-1447.2014.02.40155
  38. Tae YS, Kwon SH, Lee YS. The job experience of oncology nurse specialists. Asian Oncology Nursing. 2014;14(4):236-48. https://doi.org/10.5388/aon.2014.14.4.236
  39. Kwon HJ, Kim YJ, Lee KS. Career female nurses' professional experiences: coordinating. A Collection Of Women's Studies. 2014;31(1):33-62. https://doi.org/10.18341/wsr.2014.31.1.33
  40. Almost J, Doran DM, Mcgillis Hall L, Spence Laschinger HK. Antecedents and consequences of intra-group conflict among nurses. Journal of Nursing Management. 2010;18(8):981-92. https://doi.org/10.1111/j.1365-2834.2010.01154.x
  41. Kang SY. The process of overcoming the professional burnout of clinical nurses. The Journal of Korean Nursing Administration Academic Society. 2013;19(3):427-36. https://doi.org/10.11111/jkana.2013.19.3.427
  42. Lee MH, Park HS, Ha JH. Adjusting process of nurses to an oriental medical unit. Korean Journal of Adult Nursing. 2017;6(29):615-25. https://doi.org/10.7475/kjan.2017.29.6.615
  43. Park EJ, Kim CM, Lim SJ. Role transition from clinical nurse to case manager for medical-aid beneficiaries: taking root in a barren land. Journal of Korean Academy of Nursing, 2012;42(2):149-60. https://doi.org/10.4040/jkan.2012.42.2.149