Critique of a Qualitative Ethnographic Study of New Nurses Working in the Hospital

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Qualitative research is essential to nursing evidence- based practice as in a quantitative study. Qualitative studies focus more on the interpretation of the individual as related to the research analysis than on the experimental statistics data of the problem identified (Creswell, J. W.

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& Creswell, J. D., 2018). The nursing field must utilize the qualitative research study as well as quantitative studies in helping to improve nursing care, patient outcomes, and seek further knowledge to change nursing habits for improved results. This qualitative critique offers a systematized analysis of the research article titled “Entry into Nursing: An Ethnographic Study of Newly Qualified Nurses Taking on the Nursing Role in a Hospital Setting (Bjerknes & Bjerk, 2012).

Critique of Writing Style, Title, and Abstract

The writing style of the article was plainly written and use of verbiage and grammatical mistakes is not detected. The article is also arranged appropriately and well organized in the dispersal of material. The researchers of the article meet degree qualifications in this field of research.

According to Ritchie, Lewis, Nicholls, & Ormston (2013), a qualitative study that focuses on the theory of Ethnography should produce a title that shows the study conducted of immersion into a culture or community. The title chosen by the Bjerknes & Bj??rk (2012) follows the above stated criteria of new nurses in the hospital setting. The title is made clear of what the researchers wanted to investigate while also maintaining precise and definite information about the study being conducted.

The abstract was not titled as such; thus, leading readers toward the possibility of overlooking the paragraph and thinking it is information about the authors and location of the study. However, it does provide the offer a strong summary of the research, including the research question, trial sample size, methodology, results, and suggestions of future improvements to the problem at hand. The abstract goes into clear detail when discussing the sample group size of thirteen new nurses, the methods used to conduct the study, and the results the author found with the study. For the reader, this clear clarification of the study helps to recognize what researchers are presenting. A limitation found in the abstract was there were no keywords for the reader to identify with which could lead to inaccurate searches in the future for similar studies.

Critique of Statement of the Phenomenon of Interest and Purpose of the Study

Qualitative studies differ from quantitative studies when addressing the problem in a research study. Qualitative studies problem, or termed phenomena, is more individualized and subjective to the reader (Creswell, J. W. & Creswell, J. D., 2018). In the article by Bjerknes & Bj??rk (2012), the phenomena of interest are stated in two separate locations. First, when discussing in the introduction about the new graduate nurse starting the role of nursing, the researchers state that the challenges of starting in this new nursing role for student role is what stimulated the researchers to perform the study. This phenomenon is then addressed again in the background of the study as the research question by asking a focused question about the new nurse experience in starting anew role. By stating the phenomena twice, the researchers enforce the importance of the study and the result outcomes for future improvement of incorporating new nurses into the hospital setting; making this method a strength of the study. The research question and phenomenon of interest are clearly linked and work well for researchers.

Critique of Literature Review and Theoretical Framework

The literature review performed by the researchers was connected to the philosophical underpinnings of the article by showing that other researchers have found commonalities as well as differences with the research undertaken for this article. The review of literature did fulfill the aims of the researchers. A strength of the literature review of the article was that the researchers were able to use articles to support the claim of new nurses needing more support and mentoring than they are receiving in the hospital setting. Another strength seen was that the researchers were also able to find articles that contradicted the experience perceived by the new nurses of this study. This literature review helps to show the unbiased nature of the article and improve validity. A weakness seen by the reader is that some of the literature reviewed and cited was more than ten years old and in the nursing field changes are always occurring. These changes lead to older information being inaccurate or out-of-date for nursing research and research studies. Twenty-three of the referenced literature reviews were more than ten years old. This is out of the forty-two references listed. This makes for some question of reliability of the literature review and why the researchers chose articles more than ten years in the past.

The theoretical framework used for this study was the ethnography approach. The intention of the ethnography approach is to recognize the social realm of the individuals being analyzed through absorption in their population to yield comprehensive images of their culture

and views (Ritchie et al., 2013). The researchers adequately described this framework by discussing the method of observation in the research process of the study. This framework was also appropriate for this study because of the qualitative nature of the study and the interpretive aspect of the study.

Critique of Methodology and Philosophical Underpinnings

Bjerknes & Bj??rk (2012), did not clearly state to this reader the philosophical underpinnings, or foundation, of the study, and it had to be read a few times to gather the information needed to discuss the foundation. The philosophical approach of the study is working closely with the individual nurses to identify problems related to starting in the nursing role. I found it very difficult to understand the philosophical underpinnings addressed, and so I do not believe the authors approach was successful. The philosophical approach chosen, after much research on the article, was appropriate for this study because it is a more one-on-one approach to understanding the complications and advantages of being a new nurse. The research was conducted by a single individual who was also the primary author of the study. This be a strength because the author did not work in the facility being study, and she could gather all the information needed and kept in one place until time for review and results identification. This can also be a limitation because the author/researcher is an experienced nurse who could have a bias toward asking certain questions to receive an answer. Both strengths and weaknesses were addressed be the researchers in the article.

Sample

The sample method of meetings held on both units of the hospital being observed, and written information given out to new nurses on the floor was identified in the article. The sample size of thirteen participants was also included. The sample size is a strength here because the researcher designated to this study can spend more feasible time with each individual and not get overwhelmed with the research of the study. The researchers of the article state that the study was completed out of convenience; however, the authors also state the importance of using the convenience sample method in this study. The sampling convenience method was appropriate for this study because the researchers needed to have the criteria of the sample met. This criterion was stated as a new nurse for three months when the study was started (Bjerknes & Bj??rk (2012). The participants were suitable for the study because of the three month experience requirement and the new graduate nurse requirement. The demographics of the individuals was given. There were limitations in the demographics of this study because the study contained females only with a mean age of 25 (Bjerknes & Bj??rk, 2012). This is a limitation because older individuals who are new graduate nurses and male new graduate nurses could provide a distinct perspective for researchers.

Ethical Considerations

Ethical considerations are of extreme importance in a qualitative study because these considerations relate to the individual and how they are feeling throughout the study. The researchers did an excellent job of informing the contributors about the disposition of the research and getting informed consent. Another strength to the study was that individuals were made aware that they could quit working with the study at any time of their choosing if they did not feel comfortable any longer. Autonomy and confidentiality were guaranteed to the individuals and maintained by having an outside researcher with no affiliation to the hospital to conduct the study. This outside researcher also helps keep the individual identities and individuals from harm. Ethical permission was given by the hospital ethics committee prior to the study.

Data Collection/Data Analysis

Researchers conducted observations, interviews, reflection notes from the individuals who participated in the study, and observational notes post-observation were used in the data collection. These strategies were used to analyze the data. The analysis of the data was completed corresponding to data collection. This led to the strength of data recorded or observed not being forgotten or left out of the study. The focal analysis was then completed after a year of study in the field. A limitation to the study was that no method of data analysis was identified. The researchers do point out that they used the philosophies of analyzing copious data on limited informants, but there is not a clear explanation of what this description means (Bjerknes & Bj??rk, 2012). Outside experts were used in the collection of data and the data analysis portion of the study. This is a strength in keeping with the non-biased nature of research. The participants were consulted to establish validity of the information provided which is a key aspect in qualitative research (Ritchie et al., 2013). This gives strength to the study because it follows the credibility, transferability, dependability, and confirmability of the article (Creswell, J. W. & Creswell, J. D., 2018). The data analysis process was started with open-ended questions; these questions became more specific as the data collection progressed (Bjerknes & Bj??rk, 2012). This is a strength and a weakness of the study. First is a strength because it can help researchers determine what the individual nurse goes through on a daily and shift-by-shift basis. Conversely, it is a weakness because the questions asked could be more geared toward what the researcher deems appropriate leading to a bias in the study. Data saturation was not mentioned, but to the reader it could not be perceived; this is because the participants were chosen on a convenience based form. The researchers in this article did not discuss any quantitative matters, so no quantities were needed or provided.

Rigor

The rigor, or trustworthiness of an article is important in a qualitative study to maintain validity and reliability (Creswell, J. W. & Creswell, J.D., 2018). The researchers of the critiqued study did discuss in detail how rigor was assured. The researchers do this by providing a section of trustworthiness of the study where they include credibility, dependability, and confirmability (Bjerknes & Bj??rk, 2012). These researchers discussed in detail that credibility was achieved by the encouragement of sharing and analyzing others notes, dependability by appropriate claims and references in the article being read, and confirmability by documenting the findings so they can be used and confirmed in other studies (Bjerknes & Bj??rk, 2012). In this section of the article the researchers gained several strengths by directly stating how the above three rigors were maintained. The authors show transferability to the reader by addressing the issue of new nurse graduate situations on the floor in a way that the reader can understand and relate to. Goodness was met by the article maintaining a direct approach to the study at hand and the researcher remaining non-biased throughout the study. Some weaknesses to the rigor include only one researcher completing the data, the flow in which the data was collected, and the change in questions as the study developed according to the individual being studied.

Critique of Findings and Discussion

Bjerknes & Bj??rk (2012), present the findings of the study in a unique way of a narrative format of what two nurses experienced throughout a four hour period, which was the designated time for the research to observe the individual, on two different units in the hospital. The researchers used these findings as collaborative approach to all thirteen participants. For this study, the researchers presented the findings appropriately, so the reader could gather what the new nurse was feeling on the floor at an exact moment on the unit. This format gives a huge strength to the study because it gives the reader the sense and emotions of the nurse, so they can feel the transferability of the study and relate to the new nurse. A weakness to this presentation is that not all the participants would have experienced the exact same interactions that the two nurses who were discussed experienced. The original purpose of the study has been adequately addressed in the findings and again in the discussion of the study showing how new nurses take on the role of a nurse, and the opportunities and limitations given to them (Bjerknes & Bj??rk, 2012). In the discussion paragraph of the study, the researchers return to literature review and the findings of the study to show the stress and feelings of accomplishment for new nurses. By bringing the literature review back into the discussion, the researchers give more confirmability and goodness to the article. This leads the report to return to what is already known about the phenomenon of new graduate nurses in the nursing role.

Critique of Conclusions and Recommendations

The researchers identify the importance of the study and implication of the findings in the conclusion paragraph of the paper. Bjerknes & Bj??rk (2012) present both the enthusiasm of new nurses and the want for care for their patients, and the limitations presented of deficiency of assistance mentorship and time restrictions that nurses experience during the shift. This gives a strength to the study to show the reader that there are opportunities for change and improvement in the nursing role for new nurses. Another strength is the fact that changes and improvements are can be made on a unit by unit basis to help improve experiences. The recommendations for further studies was given at the end of the conclusion, however, it shows a weakness in the study by not offering ways to improve the new nurse experiences on the floor. The recommendations should have offered solutions as well as further studies to improve outcomes.

References

The references for this study did were all accurately referenced in the study and on the reference page. Although they were cited appropriately, the reader had to keep checking down at the references to understand which refence was being alluded to because the authors used numbers only instead of including names as well. This style was a weakness to the reader because it took away the time to engross in the study to check the reference list. Another weakness in the references were that some references were over ten to twenty years old. In the healthcare population, references should go back no more than five to ten years unless citing a direct theory because the knowledge of the healthcare field is in an ever-changing and growing state.

Summary

The writing style flowed well, and the title was appropriate for the study. Although the abstract was not clearly identified, it did give all the components necessary for the reader to understand what the study is about and what the findings of the study were. The statement of the phenomenon interest was clearly identified, and the purpose of the study followed the phenomena well. The literature review was well placed in the beginning and end of the article to provide the reader with an understanding of the importance of the study. Although the literature review was well laid out, some references were old and could be a weakness in the study. The theoretical framework was clearly identified as ethnography and was followed well throughout the remainder of the study. The philosophical underpinnings were hard to distinguish and left the reader having to read the article multiple times to understand what the methodology was following. This led to huge gaps in the readers perspective of the importance of the study. The sample size and ethical considerations were visibly acknowledged by the authors and explained as to the importance of the study. The data collection and analysis were explained; however, the weaknesses of the study were most evident in this area. The limitation of possible bias was shown to possibly occur, and the participants critiques of other nurses could lead to further bias by knowledge of the other nurse. The rigor of the article was stated plainly in a dedicated paragraph, so the reader could understand the trustworthiness of the article. Although transferability was not stated in this paragraph, three of the other assets of rigor were stated, giving the article a strong rigor quality. The findings were presented in a unique way that did give pure description of the new nurse transition into the nursing role. The article provided abundant information from other articles and the findings of this article. Even though some of the references were older than ten to twenty years, they were helpful and supported the article well. This is a respected aspect of all research articles. Generally, the study can be suggested as a significant reading for new nurses entering the nursing role, as well as older nurses mentoring new nurses on the floor.

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