Role transformation of special care unit nurses: a comparative study

To investigate whether special care unit nurses have characteristics different from nurses who work in nonintensive care settings and whether SCU nurses make more effective role transformations than non-SCU nurses, this posthoc descriptive study utilized data from 213 new graduate nurses in their first jobs in eight medical centers across the United States. The 213 nurses were a subsample of 307 new graduate nurses in a parent study that tested effect of a bicultural orientation program in role transformation. The nurses in the subsample worked in one of four nursing areas: medical--surgical, medical--surgical specialty, parent--child, and SCU. They were pretested at six weeks of employment regarding their: professional, bureaucratic, and service role conceptions; total role deprivation; professional, bureaucratic, and bicultural role behavior; self-esteem; and degree of self-actualization. SCU nurses had significantly higher self-actualization scores initially than medical--surgical nurses. Posttesting at nine months of employment included all of the above variables plus measures of empathy and change-agent activity. Performance ratings and resignations were examined at one year of employment. Analyses of variance of the difference scores and posttest-only scores showed no significant differences by type of unit except for self-actualization. To examine the relationship between the degree of specialization and the variables under study, units were rank ordered according to degree of specialization. Nurses working on units which required the most specialization had significantly higher increases in bicultural scores and self-esteem and trends toward higher increases in bureaucratic role conception and higher performance ratings. However, SCU nurses also had the most decrease in professional role conception scores, least increase in self-actualization scores, least amount of empathy with co-workers, and least amount of effective change-agent activity--all undesirable occurrences.