Explaining why nurses remain in or leave bedside nursing: a critical ethnography

Area of Science:

• Nursing Research
• Qualitative Research
• Critical Ethnography

Background:

• Previous research on nurses' job satisfaction and turnover primarily focused on work environments.
• Limited insight exists into the personal and professional factors influencing nurses' decisions to leave bedside nursing.
• This study addresses the gap by exploring individual and professional influences on nurses' career decisions.

Purpose of the Study:

• To apply critical ethnography to understand nurses' decisions regarding bedside nursing retention or departure.
• To detail the researcher's positioning and reflexivity within the critical ethnography framework.
• To explore how issues of fairness and equity impact nurses' employment decisions.

Main Methods:

• A critical theoretical perspective guided the examination of employment decisions.
• Data collected from 31 nurses in a pediatric intensive care unit (PICU) through semi-structured interviews and unobtrusive observation.
• Employed critical ethnography to challenge assumptions and explore complex interactions.

Main Results:

• Critical ethnography provided a framework to challenge assumptions about nurses' job retention and departure.
• The study identified fairness and equity as significant factors influencing nurses' decisions.
• Researcher reflexivity and attention to power dynamics were crucial for data interpretation.

Conclusions:

• Critical ethnography is a powerful methodology for investigating complex nursing environments like PICUs.
• Researchers using this approach must be aware of power dynamics, their own positionality, and practice reflexivity.
• Navigating the insider position, acknowledging and challenging assumptions, and addressing power relationships were key challenges.