Organizational Barriers to Professional Development for Nurses
Existing research supports the notion that nurses poses an ongoing drive to acquire knowledge placing value on their own professional development and that healthcare organization play a role in hindering achieving professional development goals. This qualitative survey research study explores the perception of nurse regarding organizational barriers, correlating the findings with demographic statistics and professional goals. The cross-sectional survey was delivered via the AllNurses.com platform, resulting in a participant selection process that produced a varied, nationally representative sample population of registered nurse.
This study identifies time and financial limitations as the most prevalent perceived organizational barriers to professional development. It further concluded that nurses place high value on professional development and take on some of the challenges in mitigating financial and time related barriers to achieving their professional development goals. This study reiterated the findings in existing research that nurses perceive that leaders and administrators provide adequate support to their professional development endeavors. Nursing leaders and educator must develop programs that further mitigate these factors in order to maintain a relevant, well-educated nursing workforce that delivers quality and safe patient care. Existing professional development programs are deemed to be relevant in content to nursing practice, indicating a continued need for attention to the relevancy of programs. Despite the value this article adds to the general nursing knowledge, further research is needed to explore the perception of nurse regarding organizational barrier.
Chapter 1: Introduction to the Problem
As the nursing profession and the entire healthcare environment continues to evolve and expand into new territories, it is crucial for nurses to maintain an up to date set of skills and knowledge base (Hallin & Danielson, 2008). Whether achieved through continued organizational support or by individual endeavors, professional development of the nurse must be a primary focus and an ongoing effort (Torstad & Bjork, 2007). The benefits of professional development programs have been documented extensively. The most compelling benefit comes in the form of improved patient outcomes (Spilsbury & Meyer, 2001). Patient outcomes have been dramatically improved when a better educated nursing workforce exists. Improved professional development opportunities for nurses have also been shown to drastically decrease turn-over rates, increase retention rates. These enhancements all ultimately lead to an improved utilization of resources and financial outcome for the healthcare institutions (Pine & Tart, 2007).
Professional development has also been found to contribute to the individual development of nurses. It has been shown to improve the self-esteem and confidence of nurses, leading to better patient care (hln & Segesten, 1998). Furthermore, professional development empowers nurses and contributes to increase job-satisfaction and organizational commitment (Kuokkanen, Leino-Kilpi, Katajisto, 2003). A feeling of belonging was reported by nurses that participated in professional development programs (Stanley & Simmons, 2011). Structured development activities have been shown to provide nurses with positive experiences and affect the attitude and job energy of nurses (Jantzen, 2008).
In choosing to further explore this topic, there were expectations to discover elements that nursing administrators could readily address and improve the participations of staff in professional development activities. In a cost conscious environment, identifying perceptions that can be altered by efficiently addressing apparent shortcomings, nursing administrators are able to improve staff morale, loyalty and ultimately patient outcomes.
Nurses today have numerous barriers and various attitudes towards continuing education and professional development (Munro, 2008). Increasing awareness of these barriers and developing ways to overcome them, as well as develop new ways of delivering knowledge to nurses that bypass those immutable barriers may provide an increased success in achieving the required ongoing professional development needed to continue making nurses relevant in today's healthcare environment (Anderson, 2011). It is imperative that nursing administrator and educators identify these barriers and craft professional development opportunities that mitigate these shortcomings (Yoder & Terhorst, 2012). There have been well-defined links identified between support of leadership for professional development and job attitudes of nurses (Robinson, 2008).
Existing literature has identified some factors that negatively affect the pursuit of professional development in nurses. Personal barriers, limitations of time and availability have been identified. Cultural diversity of the nursing workforce has been found to impact professional development (Davis, Davis, Williams, 2010). Kyrkjeb & Hanestad suggest that personal improvement projects as a tool to improve knowledge and drive the desire to pursuit professional development (2003). Farrell & Rose have identified that adopting new technologies in nursing education could be conducive to better professional development (2008). Organization professional development units have also been shown to eliminate some of the barriers to professional development (Happell, 2008), however this practice is not prevalent in the United States. Access to and awareness of the already existing programs and opportunities has proven to be an area of improvement for organizations. Current programs and resources are not well publicized and nurses are often not well aware their existence (Younger, 2010).
Identifying those perceived barriers to professional development, that are placed by organizations and their processes, will provide administrator and educators with the knowledge needed to identify successful programs and create more relevant delivery systems for the professional development needs of the changing nursing workforce.
As the need for nurses to adapt to the ever-changing healthcare environment persists, professional development plays an important role in the relevancy of the nursing profession. In the quest for continued professional development there exist barriers placed by family life, state and federal policy and organizations alike (Cheng-I, Meei-Ling, Shu-Jen, Wei-Herng, Fu-Jin, 2004). It is important for organizations to become partners in the professional development of nurses instead of contributing to the problem. With only 62% of states requiring continuing education credits and imperfect audit methodologies (ANA, 2011), the responsibility for continued development falls onto the individual nurse. Existing research shows the need for developing delivery methods that are relevant to the needs of the changing population and nursing workforce alike (Bradly & Benedict, 2010), however those delivery methods may be prove difficult to reach nurses when hindered by organizational barriers as well. As organizations themselves face the struggle of a changing healthcare environment, shifting population paradigm and socio-economic climate "benefits" such as staff development opportunities have joined the likes of pension funds and retiree health coverage on the proverbial chopping block (Salisbury, 2008). It is also possible that declining retention rates have contributed to the elimination of some professional development opportunities, as cope with lost investments in human capital. Whatever the reasons, organizations are contributing to the problem rather than partnering up to create a better educated, more knowledgeable nursing workforce. Nurse have demonstrated a perceived unrealistic expectation on the part of healthcare organizations that the professional development of nurses, should happen with minimal participation from those organizations (Joyce & Cowman, 2007).
The possible causes for the problem stated can be multi-faceted. The lack of funding for professional development programs for cash-strapped health care organizations is a perpetual issue (Salisbury, 2008). Nurses, as mature learners, have to delicately balance work-life, personal life and education (Tennant & Field, 2004). As a result of that complex balancing act education often takes a back seat with obstacles placed by organizations further hindering the process. Furthermore the vastly diverse workforce possesses greatly differing motivating factors to purse post-registration education (Joyce & Cowman, 2007). When considering professional development programs, there is often a discrepancy in the goals and expectations of nurses and employers (Munro, 2008). The lack of evidence as to what nurses perceive as organizational barriers contributes to that expectations disconnect.
Rationale and Significance of the Study.
This projects sets out to identify some of those barriers in which institutions play a direct role, in order to provide nursing and healthcare leaders with the knowledge and tools necessary to mitigate those deficiencies. This includes deficiencies in deliver methods, flaws in compensation models and content related inadequacies. Research shows that adequate professional development programs contribute to increased job satisfaction of nurses (Hallin & Danielson, 2008). This study will provide administrators and educators with insights into the perceived barriers that they themselves, as leaders, contribute to. By arming nursing leadership with the knowledge of perceived barriers, better, more efficient programs can be developed, that strengthen the relationship between the individual and the organization. This may lead not only to a more knowledgeable workforce, but may also lead to increased retention rates by creating added value, an often well received concept in the age of value based purchasing. The study also sets out to provide a basis for further research to identify the best ways to mitigate those identified failings within organizational approach to professional development.
The study addresses the following question: "What barriers do nurses perceive as being placed by organization to achieving their professional development and continuing education goals?"
The researcher acknowledges the existence of barrier to professional development of nurses. The researcher expected barriers placed by organizations to be identified and mitigating strategies developed. The researcher also expected to identify further correlations between professional goals, demographics and experience of surveyed nurses and perceived barriers placed by organizations.
Definition of Terms.
Organizational Barriers: limitations placed on professional nurses by institutions and healthcare organizations (Bostrom, A. M., Kajermo, K. N., Nordstrom, G., Wallin, L., 2008).
The ever-changing nature of the healthcare environment dictates the need for a continually developing nursing workforce. At the same time the changing economic realities provide nursing administrators and educators with the challenge of financial stewardship and a vastly diverse workforce (Lambert, 2012). The need to develop efficient professional development programs and eliminate wasteful programs is paramount to the success of institutions and the nursing professions. Identifying the attitudes and perceptions of nurses towards those programs will enable administrators and educators to address those challenges.
Chapter 2: Literature Review
The benefits of a better educated nursing workforce have been well documented in influencing patient outcomes and adding relevance to the nursing profession (Hallin & Danielson, 2008). The existence of perceived barriers to professional development have also been identified and documented. However the role of organizations in placing as well as mitigating such barriers has yet to be fully explored.
Increasing the education level of the nursing workforce is a priority of national organizations such as the American Association of Colleges of Nursing (AACN), the Institute of Medicine (IOM) and the American Nurses Association (ANA). While the Institute of Medicine has recommends that 80% of the nursing workforce be baccalaureate prepared, only 50% of nurses have achieved this level of education (AACN, 2012). Research has directly linked positive patient outcomes to higher professional development and education of nurses (Altman, 2012). Improved patient safety, lower rates of medical errors as well as fewer disciplinary actions have all been correlated to a better educated workforce (Altman, 2012). Better patient education, improved pain management, improved peri-operative results and health promotions have also resulted from nurses participating in professional development programs (Spilsbury & Meyer, 2001).
Despite these findings a great majority of nurses feel that they require further training in task they perform routinely (Robinson, 2008). Nursing leaders have not always been able to recognize the benefits of professional development programs, however when these merits were recognized, improved relations between leaders and staff have emerged (Torstad & Bjork, 2007). The scarce availability of educational opportunities has also been identified as a barrier to the development of nurses.
Self-perceived barriers to professional development of nursing leaders have been identified as being varied (Fealy, McNamara, Casey, Geraghty, Butler, Halligan, Treacy, Johnson, 2011), underlining the necessity to identify more global factors. Fealy et al. also indicate that lack of representation and influence at the interdisciplinary level contribute to the perceived barriers to development of nurses (2011).
However the attitude of non-baccalaureate prepared nurses towards achieving higher levels of education needs improvement. The professional self-perception of nurses has been identified as declining with experience, contributing to a decline in pursuit of professional development (Bjorkstrom, Athlin, Johansson, 2008). An ignorance on the part of these nurses as to the clear benefits of achieving formal higher standards of education exists (Altman, 2012). Discovering the attitudes towards both formal and informal professional development of clinical nurses may lead to key elements to promote such activities. Research shows these activities leading to improved work attitudes and performance (Johnson, Hong, Groth, Parker, 2010). The views of clinical nurses towards professional development has been studied, but is limited to specialties that may create particular variations. While mental health nurses "favored in-house locally based sessions targeting patient-related skills enhancement" (Cleary, Horsfall, O'Hara-Aarons, Jackson, Hunt, 2011), still only a plurality of nurses expressed plans to purse professional development, far away from the IOM suggested 80%.
When approaching the subject of continued professional development, there is also a detachment between healthcare organization and nurses (Munro, 2008). While organizations and nurses may disagree as to who should be responsible for the cost of professional development, the benefits of properly structured professional development programs are "not only gains in competency by individuals, but also shared knowledge in the organization" (Bjork, 2009). Regardless of who picks up the tab for these programs, a further part in the delivering relevant professional development programs to nurses has been identified: the changing trends in education and distance learning (McCoy, 2009). Delivery of education to nurses that is relevant and engaging is a focus of the ANA's 2010 Nursing Professional Development Scope and Standards of Practice (Anderson, 2011). This creates a best practices framework that can be used to create professional development programs that encourage positive attitudes and may dissuade professional development skeptics. Cohesive and pertinent education programs can "promote higher education for nurses, and support the increasing needs for advanced practice nurses across the country" (Gormley & Glazer, 2012). Research also suggests that providing nurses with continued, relevant professional development opportunities leads to a more satisfied workforce (Hallin & Danielson, 2008). As nurses develop their practice a supportive environment from administrators and educators is essential for further development and professional growth (Jantzen, 2008).
Delivery methods of professional development courses and programs have been proven to be essential for the participation in and success of professional development programs (AACN, 2012). Adapting the delivery methods to the changing nursing workforce has proven effective. Utilizing emerging technologies to deliver content and programs has shown beneficial (Farrell & Rose, 2008). The existence of work-based programs have proven to be an active and engaging way to promote professional development (Stanley & Simmons, 2011). Unit based development activities have also been shown to be a valuable resource and add to the knowledge base of nurses (Tennant & Field, 2004). Casey & Egan identified that professional development activities delivered and presented in relevant format to the practicing nurse can contribute to the personal development of professional nurses (2010). Research has also identified lapses in informing nurses about existing resources and opportunities for continued professional and personal development (Younger, 2010). The development of innovative practices in delivery of programs can lead to more cost effective ways of educating healthcare professionals (Houston, Munoz, Bradham, 2011). Professional development programs that will contribute to the life-long, behavior forming learning as well as employ instructional design will prove the most effective (Yoder & Terhorst, 2012).
While attitudes towards as well as needs for professional development of nursing leaders has been extensively researched, there is scarce such relevant data for clinical nurses. Studies have identified shortcomings in nursing leaders that greatly relate to formal education and professional development more so than clinical skills and practice (Gould, Kelly, Goldstone, Maidwell, 2001). Following professional development programs for nursing leaders, improvements have been noted in vitals areas of leadership competency "leading to the development of self-awareness, leadership and subsequently care practices" (Boomer & McCormack, 2010). Deficiencies of clinical nurses in regards to professional development needs have been identified however these may prove obsolete due to the rapidly changing healthcare environment and nursing workforce in the United States. With the shortcoming of clinical nurse and developing professional identified, development programs addressing these issues could prove beneficial not only to nursing leaders but also to clinical nurses. However the attitudes of clinical nurses, in the American workforce, towards professional development both formal, informal, national and organization based must be first identified.
In summary, the continued accumulation of nursing knowledge and professional development is essential to the relevance of the professional nurse and is encouraged by relevant national organizations. The need for efficiently delivering relevant content to professional nurses, is a continued struggle in a perpetually changing healthcare environment and workforce (Hunter, 2010). Furthermore, professional development programs need to be rooted in practical design, contribute to the nurse's continued desire to learn and continuously evaluated for relevancy and effectiveness (Yoder & Terhorst, 2012). While some factors influencing the effectiveness of the existing programs are known exploring the organizational barriers placed on professional nurses and benefit the profession.
Chapter 3: Methodology
This chapter addresses the methodology used in this study to identify perceived organizational barriers by practicing registered nurses. It includes information regarding the setting in which the research was conducted, the design of the study, the participants, research procedures and tools, data collection and analysis procedures, as well as measures taken to maximize the protection of human subjects.
The research took place online, with the survey being accessible to participants on the device of their choosing. The survey was made available as a post/topic on the website AllNurses.com in the "Nursing Student" section, the "Academic Nursing Research Participation Requests" subsection (http://allnurses.com/academic-nursing-research). The setting in which the survey was taken has been left to the latitude of the participant. Depending on the device used, the survey was available both as desktop and mobile version, as made available by the utilized platform.
Participants were selected with the help of the AllNurses.com website. This forum allowed for national selection of participants. The study was open to any licensed Registered Nurse in the United States. Demographic data was collected at the time of delivery of survey and included in the study. Information such as age, gender, education background, practice experience & practice setting was collected. Each participant was asked to complete an Informed Consent. Participation in this study was completely voluntary.
The study design is quantitative in nature, structured as a cross-sectional survey. This allowed the researcher to begin understanding the nature of organizational barriers as perceived by nurses (Gay, Mills, & Airasian, 2009, p. 176). The study also contains elements of correlational research. It is looking to identify possible relationships between perceived attitudes, barriers and demographic and educational characteristics. The sampling methodology is purposive with snowballing elements, by encouraging participants to promote taking the survey to registered nurses that may not be accessed by the delivery methods. The use of this research design was chosen due to the importance of surveys in exploring persecutions of participants (Gay, Mills, & Airasian, 2009, p. 176). This allowed the researcher to identify the perceptions of registered nurses opposite to organizational barriers.
Description of Instruments or Tools.
The survey consists of 5 demographic items and 11 items used to identify the participant's educational and professional development goals. The survey will also contain 7 Likert-type questions meant to assess the perceptions of organizational barriers by participants. It is a 5 point scale, denoting opinions as "Strongly Agree" (5), "Agree" (4), "Neutral" (3), "Disagree" (2), and "Strongly Disagree" (1). There are also 11 identified barriers that participants will select as either being perceived to be a barrier or not being perceived to be a barrier.
The readability of the survey tool was tested to ensure that it is appropriate for the subject population. The Flesch-Kincaid Reading Ease test and Flesch-Kincaid Grade Level test was applied to the survey tool as well as the Informed Consent required. Determining the readability of the survey and its items enabled the researcher to determine whether the survey and Informed Consent are appropriate for the population it is intended to survey. This allowed the researcher to determine how easily the information is to read (Fry, 2002). Since this study is aimed at registered nurses, an adult college level or below readability of the survey was satisfactory. The use of these readability tests ensured the reliability of the study as applicable to the greater nursing population.
The demographic data obtained was compared to nationally available data to confirm reliability of the surveyed sample population. Inferential analysis was utilized in analyzing this demographic data. The one sample t-test was performed for these data sets using existing data that is representative of the national nursing work force. Demographic items that were related to national averages include the education level of participants. Inferential validity on this item eliminated the possibility of errors due to a lesser or better educated population sample. Inferential validity resulted from comparing the size of the organization to national averages reduced the likelihood of perception due to resources available due to the size of the organization. By looking at the level of experience the subject possess compared to national averages the researcher was able to reduce the likelihood of errors occurring from a mismatch in subject experience. The use of the one sample t-test ensured the validity of the study as referring to the greater nursing population.
Data Collection and Integrity.
Data collection was done through the aforementioned procedures. The survey was available for a period of 3 calendar days. A total of 33 responses were received. Quality assurance and quality control are essential to maintaining data integrity and preserving scientific validity of the study (Most, Craddick, Crawford, Redican, Rhodes, Rukenbrod, & Laws, 2003). Quality assurance was maintained by employing an automated method of response collection. By using an online format, responses did not have to be transcribed from a paper form into a digital format, therefore avoiding errors, and creating a standard path for data aggregation. The researcher was the only participant in the data collection, manipulation and analysis process. This helped avoid any breakdown in communication and possible errors that can occur in studies where a team approach is employed. Deviation from the original data collection protocol is unlikely due the single researcher approach and adherence to an automated data collection platform.
Quality control was a high priority in maintaining the integrity of data collected. Thorough inspection of data sets resulted from the collection platform as well as careful processing of data into the SPSS and Excel formats was paramount. Automating the export of data allowed for more reliable transcribing than manually entering data. Random cell testing of SPSS values and labels ensured proper coding of data into SPSS.
The researcher was the sole person with access to the data collected and individual responses were kept strictly confidential. Results were solely reported on aggregated data
The data collected was manipulated and analyzed with the aid of two computer programs: Microsoft Excel 2013 ("Excel" or "*.xlsx") and IBM SPSS Statistics Version 21 ("SPSS" or "*.sav") (IBM Corp, 2012). The raw data resulted from the survey platform was exported to *.xlsx format and manipulated to formats valid in *.sav format. The SPSS program was utilized for correlational and descriptive statistical calculations for the appropriate data resulted. Descriptive analysis such as mean and standard deviation were be calculated. Description of the population, their professional development goals and perceived barriers were analyzed. Correlational analysis in the form of computing the correlation factor was execute. Due to the ordinal nature of the data collected Spearman's rank correlation coefficient ("Spearman's Rho" or "rs") was employed. Variables resulted from the Likert scale questions, demographic, career goal and perceived barriers were compared to identify relevant correlations. Correlation was considered significant at the 0.01 and the 0.05 level for 2-tailed analysis.
Human Subject Protection.
All participants were required to complete an Informed Consent and the voluntary participation in the study is emphasized. Data collection was performed on "https" servers, providing encrypted transmission of data between the participant's terminal and the servers where the data is stored. A Study Approval Letter was obtained prior to any data collection activities. This was obtained from AllNurses.com, Inc. for conducting data collection on the company's platform. Institutional Review Board approval for the study was obtained from Western Governors University prior to any data collection activities. The researches has completed the National Institutes of Health (NIH) online Protection of Human Subjects training program prior to any research activities.
This study aims to answer the stated research question without infringing on the right of human participants. Correlational elements lent relevance to the cross-sectional survey design of this study. Participant selection avoided ethical conflicts and demographic data provided relevance to the findings. The Flesch-Kincaid Reading Ease test, the Flesch-Kincaid Grade Level test, as well as the one sample t-test applied to three different demographic data sets were employed to support the validity and reliability of the survey tool utilizes in data collection. The analysis of data provided insights to answering the states research question and contributed to the overall nursing knowledge.
Chapter 4: Data Analysis
The purpose of this study was to identify organizational barriers as perceived by registered nurses in the United States. Following the data collection process, the obtained data was aggregated and tested for reliability and validity. The results were analyzed and elaborated upon as necessary. Data regarding the reliability and validity of the study and study tools are presented first followed by demographic data regarding the sample population. The findings regarding the professional goals of the population are then presented. Finally the data findings related to attitudes toward professional development and perceived organizational barriers are put forth.
Reliability and Validity.
The readability of the informed consent as well as the survey tool was analyzed using the Flesch-Kincaid Reading Ease test and the Flesch-Kincaid Grade Level test. The informed consent scored 38.3 on the Flesch-Kincaid Reading Ease test and 10.7 on the Flesch-Kincaid Grade Level test. This means that the informed consent has an average grade level of about 12 and should be easily understood by 17 to 18 year old children. The survey tool scored 68 on the Flesch-Kincaid Reading Ease test and 5.7 on the Flesch-Kincaid Grade Level test. This means that the survey tool has an average grade level of about 7 and should be easily understood by 12 to 13 year old children. Given that this study targeted register nurse, these findings grant validity to the survey tool utilized and to the study.
In order to test the reliability of the sample utilized, the education level, experience and size of place of employment were tested to national averages. Table 1 displays descriptive data regarding the sample population as well as the results of inferential statistical tests performed on this data. Means of the national nursing population was obtained from data available from the Bureau of Labor and Statistics (USBLS, 2013) and Salary.com (2013). A total of 33 participants were included in the study (n=33). At an Alpha lever (α) of 0.05 the Critical t-value was determined to be 1.694. The Education and Experience demographic data resulted in a t-value of 1.065 and 1.059 respectively, confirming the relevance of the sample population as representative of the national nursing populations. When looking at the Size of Organization sample data, the t-value was only relevant to the national nursing population at an α-level of 0.035, where the critical t-value was 1.875 (See Table 1 for details).
Demographic information regarding the sample population is presented in Table 2. Demographic data of the sample revealed that 51.5% of participants held an Associate's Degree in Nursing (ASN), 45.5% of participants held a Bachelor's Degree in Nursing (BSN), while only 3% of participants held a Master's Degree in
Nursing (MSN). The majority of participants (n = 25, 75.8%) were between the ages of 25 and 45, while 7 participants were 46 years of age or older and only 1 participant was between 18 and 24 years of age. The plurality of participants (n = 13, 39.4%) were relative novices in the nursing field, having been practicing nursing for less than two years. 33.3% of participants were practicing nursing between 3 and 5 years, while 27.3% of participants had been practicing nursing for over 5 years. The majority of participants (n = 19, 57.6%) worked in organization that employed between 500 and 6,000 people. 27.3% of participants (n = 9) worked in organization that employed more than 6,000 people while the reaming 15.1% (n = 5) worked in organizations employed less than 500 people. 87.9% of participants (n = 29) held staff nursing positions while 12.1% (n = 4) held nursing leadership positions.
In order to indicate professional drive, participants were also asked to indicate what they thought the position they would hold in the next five years would be. 33.3% of participants (n = 11) indicated they would hold the same position as they currently do. 21.2% (n = 7) indicated they would change specialties, but hold the same position as the current one. The remaining 45.5% indicated a professional advancement either in the leadership track (n = 3. 9.1%) or the clinical track (n = 12, 36.4%).
Participants were also asked to indicate short and long term professional goals. 70.6% (n = 12) of those participants who indicated only possessing and Associate's Degree in Nursing indicated they will pursue a Bachelor's Degree in Nursing. 36.4% of all participants (n = 12) indicated their desire to pursue a Master's Degree in Nursing, while only 3% of all participants (n = 12) indicated their desire to pursue a Doctoral Degree in Nursing. 57.6% of participant indicated the accumulation of nursing knowledge as a professional goal while only 36.4% (n = 12) indicated the desire to acquire or maintain a specialty certification such as Certification for Critical Care Nurse (CCRN) or Certified Emergency Nurse (CEN). Those participants who indicated the accumulation of nursing knowledge as a professional development goal were also more likely to pursue a specialty certification (r = .521, p = < .002).
Statements regarding perceived organizational barriers and attitudes towards professional development were scored on a five point Likert scale, as per Table 4. The summary of responses is shown in Chart 1. A vast majority of participants (n = 31, 93.9%) stated that they consider professional important. Those participants were also more likely to attend professional development activities on their own time and money within the organization (r = .595, p = < .000) as well as outside their healthcare organization (r = .448, p = < .009). When asked about attending paid and unpaid educational opportunities within their organizations, 81.8% (n = 27) indicated their likelihood to attend paid opportunities, while only about half that amount (n = 14, 42.4%) were likely to attend unpaid opportunities. The amount of participants that indicated they were not likely to attend unpaid opportunities offered by their healthcare organizations were equal to those who indicated they were likely to take advantage of those opportunities (n = 14, 42.4%), while 15.2% (n = 5) indicated a neutral position on the issue.
A majority of participants indicated that they feel they receive support in both their professional (n = 21, 63.6%) and personal development (n = 18, 54.5%) form their organizations. Those participants who indicated perceived support for professional and personal development were also more likely to attend unpaid opportunities offered by their healthcare organization (r = .473, p = < .005 and r = .433, p = < .012, respectively). While a majority of participants (n = 15, 45.5%) indicated their perception of support from organizations in their professional development goals, a close 42.4% indicated the opposite (n = 14), with 12.1% (n = 4) having a neutral position on the matter. There was also a significant correlation between those who indicated lack of support from organization in professional development and those participants more likely to attend outside professional development at their own cost (r = .480, p = < .005). Several barriers to professional development that were tested during the study were identified according to Table 3. Twelve organizational barriers to professional development were presented in the survey tool and participants were asked to identify them as perceived barriers or not, as per Table 3. The result to this part of the study are detailed in Chart 2. A common element seemed to emerge when participants were asked about barriers to professional development. Time constraints such as long hours (n = 18, 54.5%) and inconvenient scheduling for the participants (n = 17, 51.5%) were indicated as barriers to professional development. There was a sense among participants that professional development programs offered by their organizations were sufficiently abundant. However the perception that more unpaid versus paid professional development programs exists was prevalent (n = 24, 72.7% unpaid opportunities versus n = 17, 51.5% paid opportunities). The study also revealed that existing professional development programs are perceived as adequate in relevancy (n = 29, 87.9%), content (n = 26, 78.8%) and delivery method (n = 27, 81.8%) by the participants.
Research Question Answers.
The study set out to explore the barriers nurses perceive as being placed by the healthcare organizations they belong to. In the course of the study it has become apparent that the most common barrier is related to time and scheduling of these professional development programs as well as the compensation model associated with them. Participants with ambitious short and long term professional goals were more likely to overlook the compensation issue when offered professional development
Chapter 5: Discussion and Conclusions
This section will present the implication, limitations and recommendation that this project sets forth. It will show how the results of this study can address the research question as well as the nursing profession and what it will add to the knowledge base. This section ill further present the limitations the study faced as well as possible mitigating factors. Finally this section will present recommendation for actions, future studies and analysis.
The study identified the driven nature of nurses, affirming their desire to advance professional, both clinically and on the administrative front. The study also underlines the desire of nurses to acquire continued nursing knowledge. Therefore nursing leaders must develop programs that keep valuable employees engaged and stimulated, risking the loss of valuable human capital to organizations that support professional advancement and continued intellectual development.
The study also identified that nurses who desire to acquire more nursing knowledge are more likely to purses a nursing specialty certification. This indicates a willingness to personally take on the challenge of mitigating some of the financial and time barriers to professional development. Targeting those nurses to participate in programs that promote acquiring specialty nursing certification could lead to increased patient safety when care is delivered better educated nurse.
The study also identified that nurses perceive existing professional development programs as adequate in content, delivery methods and relevance to their practice. This indicates the responsiveness of nursing leaders and educators in developing such relevant programs. A continued effort in the development of pertinent professional development programs is paramount to improving the education of the nursing workforce and safety and quality of care delivered.
The study identified the perception of lacking compensated professional development programs. Participants with this perception were also more likely to participate professional development opportunities at their own expense. This indicates the perception of an increased financial burden for professional development of nurses.
It was further identified that nurses perceive a disconnect between the time professional development programs are offered and their availability. Given the continued nature of nursing care, this could imply the lack of programs that fit the schedule of nurse on non-traditional schedules as well as evening and night shifts.
The study was limited by the 33 participants and their perceptions of the items explored. Despite the reliability and validity tests performed on the survey tool and sample population, inherit flaws in the readability tests as well as inferential testing can alter the results as applicable to the greater nursing population.
The cross sectional nature of this study does not factor in possible changes in perception of the sample population as result of the ongoing nature of the organizations of which they are a part and the healthcare environment.
The study also presents limitations in the barriers surveyed. A limited number of previously identified barriers were explored, failing to include other organizational barriers nurses may perceive.
Time also presented as a limitation to this study. The time allowed for gathering response was limited to three days. The ability to extend the window to a more extensive timeframe may have produced a greater number of participants and may have mitigated the limitation placed by the cross sectional nature of this study.
1)__ Nursing leaders and educators should develop professional development programs that address the scheduling of nurses. Providing scheduling of programs for non-traditional shifts should be explored.
2)__ Nursing leaders should explore ways to provide more compensated professional programs to nurse.
3)__ The development of programs that support acquiring professional specialty certification (such as CCRN, CEN or others) will appeal to those nurses that are interesting in the continued accumulation of nursing knowledge.
4)__ Nursing leaders and educators should continue the development and delivery of relevant professional development programs, that keep nurses motivated, interested and contribute to the delivery of safe patient care.
5)__ Nursing leaders should continue to encourage and support professional development of nurses and acquiring of bachelors, graduate and post-graduate degrees to meet NIH recommended goals.
6__ Explore the perception of scheduling conflicts regarding professional development programs and explore the possible implication of availability around the clock for day and night shift nurses.
7)__ Perform the same study at a different point in time allowing for cross sectional comparison of finding.
8)__ Perform a similar study with longitudinal designs, allowing for an ongoing analysis of perceptions regarding organizational barriers.
Nurses poses an ongoing drive to acquire knowledge placing value on their own professional development. In their quest for professional development, nurses often encounter time and financial limitations. Nursing leaders and educator must develop programs that mitigate these factors in order to maintain a well-educated nursing workforce that delivers quality and safe patient care. Existing professional development programs are deemed to be relevant in content to nursing practice, indicating a continued need for attention to the relevancy of programs. Despite the addition to the general nursing knowledge this article brings, further research is needed to explore the perception of nurse regarding organizational barriers.Last edit by Joe V on Jan 12, '15
Mr. B. Daniel Budusan offers a combined 10 year of managerial, professional and nursing experience, currently practicing emergency nursing specializing in trauma, stroke and emergency critical care. He holds a Master's Degree in Nursing, Emergency Nurse Certification and is a member of the Emergency Nurses Association. Mr. Budusan is actively involved in shared governance with significant contribution to customer service, trauma and critical acre improvement and training programs demonstrating solid leadership abilities and great professional versatility. He is a savvy consumer of technology and a perpetual learner seeking continued opportunities for growth. Study Website: https://sites.google.com/site/organizationalbarriers
From 'Marietta, GA'; 33 Years Old; Joined Oct '09; Posts: 4; Likes: 4.Aug 11, '13 by liebling5Congratulations on completing your Capstone! Mine will have some overlaps with yours. Specifically, I will address your Recommendation #1.Aug 11, '13 by dan83Thank you. I'm glad I was on point with the recommendations and that other thought about that.
Good luck with yours.Aug 12, '13 by LadyFree28, BSN, RNAwesome! Great sources too.
My research proposal was actually a pilot study regarding this.
I wonder if one day our papers can be used in the nursing world...
Kudos to you!Aug 14, '13 by nurseprnRNAnother limitation of the study is that you cannot be sure that the respondents are who they say they are. It's also a pretty small sample size. If you intended to limit your sample to people working only in hospitals, perhaps I read it too fast to see that you said that. Many nonhospitalhave different policies (I find them to be more liberal generally), and many nurses work in other settings.
If >80% would attend paid continuing ed (which did you mean, paid work time, or reimbursed for cost of offering, or free offering at the place of employment?) and >40% if unpaid, then it would appear that price (or payment, or whatever your term means) is a nonfactor for a fairly large number of people.
Surveys are often presented as "research" but it's comparatively low-level. Great paper for an undergraduate (though you want to fix a lot of those typos).
Thanks very much for sharing your work!
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