Introduction
New graduate nursing, as a profession, entails high stress levels. This phenomenon is evident in ERs since nursing graduates move from a structured environment to an unruly one. A new move comes in unexpectedly, and it’s so rapid that a new nurse has no options other than to adjust their activities within a short period – when dealing with an extremely high speed of events around them when facing threatening cries.
This study examines stress experienced by beginner RNs who have recently left college and are currently employed at ERs. The study seeks to investigate how these nurses cope with the inevitable stressors they encounter in their work and to assess the efficacy of specialized anti-stress therapeutic measures developed for this purpose. In this regard, the study will take a mixed method approach, which combines quantitative research offering measurable statistics about the stress levels and effect of interventions, alongside qualitative research, which explores these nurses’ personal stories, perceptions, and coping strategies. This integrative approach seeks to comprehend stress at a greater degree towards improved interventions on stress management within this vital healthcare area.
Mixed Methods Research Overview
Qualitative and quantitative approaches merge in mixed methods research, as emphasized by Creswell and Plano Clark (2011). Merging these two methods is beneficial because each has advantages that compensate for the shortcomings of the other. The quantitative approach offers general information on subjects through numerical values and objectivity. On the other hand, qualitative research, which is more exploratory, provides depth and insight.
According to Lund (2012), mixed methods research presents several challenges. This process is not straightforward, as it requires competence in qualitative and quantitative methods, which are time-consuming and need highly skilled methodological integrity. Such disparate data collection approaches pose problems, particularly in keeping uniformity and reliability between the differing data sources. Such an integration requires striking the right balance to ensure that blending qualitative and quantitative data only adds value to the research and does not dissipate it. Designing mixed methods study is also naturally more involved than single method one; it requires keenness, carefulness, and precision in every process step. However, these studies ought to have well-defined research objectives and a carefully considered methodology to handle the complexity of this approach effectively. The complexity above highlights the need for a detailed research plan, clear objectives, and thorough mixed-methods research techniques.
Proposed Quantitative Study
Study Goal and PICO Question
This quantitative study aims to critically evaluate the effects of specialized training programs on reducing stress levels in new graduate RNs working in ERs. This study is important because it seeks solutions to make it easy for new emergency room (ER) RNs to adjust within the busy ER. The study design follows a PICO scheme, which gives it rigor and ensures all relevant information is directed towards that question.
The PICO question underpinning this study is: “To what extent are a comprehensive training program for a new graduate RN vs. the standard onboarding procedures in an ER setting associated with a lower level of perceived stress?” This query analyzes the differences between an extensive training plan and customary entrance procedures among freshly graduated registered nurses. The study considers individual perceived stress levels as its main focus, thereby giving a real-life perspective of the interventions from the eyes of the new RNS. Adopting this approach will enable deeper appreciation regarding the stress experienced by nurses working in the ER and the benefits of specific training programs for new nurse graduates.
Literature Search Strategy
To support the suggested study using substantial ground information, an extensive literature review was accomplished by exploring some medical and nurse databases such as PubMed, Canal, and PsycINFO. The search was specifically designed to yield the most current articles at present. The selected keywords for the search were strategically chosen to align closely with the study’s focus: An in-depth internet search using keywords such as “stress,” “new graduate nurses,” “emergency room,” and “training programs” was done.
There was, however, a strategic maximum of the parameters’ search terms to recently published (five recent) RCTs. This decision entailed ensuring that the analysis included only up-to-date and well-documented results from RCTs as key clinical research components. The time constraint was introduced in the past five years to apply the data to modern nursing approaches and current healthcare institutions.
Fifteen randomized controlled trials were found through the search method, making it successful (Chopra et al., 2020). Subsequently, each of these studies was examined to establish their relevance to the issues considered in this research. Each study was evaluated concerning the methodologies used, the participants involved, the interventions reviewed, and the outcomes assessed.
This was done to select only those studies that could help understand the effect of training programs on stress levels among new graduate RNs in ER setups. Such a systematic approach to the literature review is a very important basis for the suggested research because it gives a clear overview of the current state of knowledge in this field.
Quantitative Study Design
Stress is operationalized via the PSS, an established, widely used scale for measuring stress levels within healthcare research. The subject recruitment targets new graduate RNs who have served in most hospitals in the ER department for up to twelve months. The inclusion criteria comprise ER Nurses in their first year, while the exclusion criteria entail seasoned ER Nurses and nursing assistants going through other stress management processes. Data collection consists of administering the questionnaires and using two teams, each comprising three.
This crucial study informed the current research design by Smith et al. (2018), using the PSS to measure changes in stress scores among healthcare service providers after undergoing a structured intervention program. This will be discussed later in this chapter. The results presented in this study constitute an important step toward better understanding the possible effects of training interventions on pressure, stress, and well-being in the workplace.
Proposed Qualitative Study
Study Purpose and Methodology
This qualitative dimension is important in making a detailed interpretation of the type of stress that new GRNs go through in ER situations (Chaturvedi et al., 2021). While quantitative studies aim to measure actual results or outcomes, I wanted to address the subjective perspectives of the involved nurses with a qualitative approach to provide further insight into factors contributing to stress management among them.
Multiple purposes of the qualitative study. It seeks to interpret the stress levels among new graduates as perceived by them in this work-life setting. It also looks for ways such nurses cope with stress, thus enhancing knowledge on mitigating this menace. In addition, the study will examine how the work environment influences the mental well-being of these young graduates, focusing on particular elements in work that cause their stress.
This qualitative research comprises purposive sampling meant to recruit about 20 female nurse responders from different genders, ethnicities, and hospital types. This aims to broaden the scope of personal experiences and perceptions to increase the depth, relevance, and reliability of the information gathered. Thus, like with the quantitative components, the study uses the same mirror strategy to ensure coherence. More so, this approach allows one to understand how stress affects new graduate RNs in the E. This approach further supports the quotative conclusions and highlights the issues that can only be understood with qualitative research.
Data Collection
Qualitative data for the study will be obtained using in-depth, semi-structured interviews (Madhuri et al., 2022). The interview will elicit personal responses towards work-related stress from the respondents. Two primary questions guiding these interviews are: “Can you narrate one ER moment that brought out high stress in you as a new graduate nurse?” or “How do you cope with stress in the ER setting?” There are some of the aspects included in the interviewing guide, detailed in Table 1 on the last page of this paper
This qualitative study is motivated by Johnson et al. (2019), who studied nursing stressors and possible ways of coping with them. The information provided in this study contributes to the design of an interview guide and assists us in understanding nurses’ subjectivity to stress at work.
Integration of Quantitative and Qualitative Studies
Mixed Methods Study Design
Therefore, this study will use a convective-parallel mixed methods design based on Creswell & Plano Clark (2011). A mixed method with a parallel independent-to-combined method is required, wherein qualitative and quantitative research strands are conducted simultaneously. Subsequently, an analysis involving synthesis takes place at a later stage. Using this approach, quantitative and qualitative data are used concurrently, facilitating a holistic comprehension of the stress the new graduate RNs undergo in emergency room settings.
The mixed method design for the study draws inspiration from Whitman-Price EDM3 and the works of Shorten & Smith (2017). these references build a robust foundation for properly combining quantitative and qualitative methods in nursing research. This study will be led by an interdisciplinary group comprising qualitative methods experts, quantitative research specialists, and ER nurses’ practicing experts to provide an all-inclusive research approach.
Discussion and Justification
Key Findings from Literature Review
Specifically, a study by Smith et al. (2018) and a literature review show that structured training programs might reduce stress in healthcare workers. The results of this part support the selection of the comprehensive training program as an intervention in the quantitative aspect of this research. There was adequate proof indicating that effective training and support package significantly reduces stress levels in a new graduate RN practicing within an extreme-pressure environment such as the Emergency Room (ER).
Potential Impact of the Study
This study’s findings are set to greatly impact the nursing domain, particularly regarding nurse education and ER administration (Alsyouf et al., 2022). they listed 1. In the current society, women play an essential role in every aspect. The study could further inform policy and practice aimed at helping new graduate nurses make a smoother transition into the workforce by identifying effective interventions for stress management and those specific stressors particular to nursing in emergency care department settings. The findings could also improve patient services through a prepared, mentally alert, and stable nursing workforce that can manage pressure well.
Conclusion
Qualitative research should be employed to measure stress levels among novice nurses in the emergency department. At the same time, intervention studies should be utilized to explain different strategies geared towards alleviating stress among the same cohort. Using a convergent parallel mixed method approach, the study aims to provide a holistic understanding of the phenomenon involving both quantitative depth and qualitative richness. As discussed above, the findings will greatly assist in improving the experience of new graduate RNs entering the emergency department, affecting the quality of care offered, the health of the nursing workforce, and patients’ welfare.
Reference
Alsyouf, A., Ishak, A. K., Lutfi, A., Alhazmi, F. N., & Al-Okaily, M. (2022). The Role of Personality and Top Management Support in Continuance Intention to Use Electronic Health Record Systems among Nurses. International Journal of Environmental Research and Public Health, 19(17), 11125. https://doi.org/10.3390/ijerph191711125
Chaturvedi, P., Anna Johanna Wiese, Arindam Ghatak, Lenka Záveská Drábková, Weckwerth, W., & Honys, D. (2021). Heat stress response mechanisms in pollen development. New Phytologist, 231(2), 571–585. https://doi.org/10.1111/nph.17380
Chopra, S., Malhotra, A., Ranjan, P., Vikram, N. K., Sarkar, S., Siddhu, A., Kumari, A., Kaloiya, G. S., & Kumar, A. (2020). Predictors of successful weight loss outcomes amongst obese individuals undergoing lifestyle interventions: A systematic review. Obesity Reviews. https://doi.org/10.1111/obr.13148
Mashuri, S., Sarib, M., Rasak, A., & Alhabsyi, F. (2022). Semi-structured Interview: A Methodological Reflection on the Development of a Qualitative Research Instrument in Educational Studies Ruslin. IOSR Journal of Research & Method in Education, 12(1), 22–29. https://doi.org/10.9790/7388-1201052229
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