Challenges of nurses' professional behaviour change process

The aim of the study was to complement a project consisting of a planned modification of nurses' professional activities, which showed that nurses did not adopt a problem-solving approach to care after a specific in-service training. The aim of the study was to gain a better understanding of the 'meanings' that a group of nurses assigned to daily work, and how they perceived the changed situation. The main findings were that the nurses felt they had a limited degree of control over nursing care, a dependence on physicians, and consequently, used defensive strategies. The meaning assigned to nursing care was thus a series of pre-determined routines, though the nurses wished to increase the extent of interaction with patients. The study highlights the conflict between professional values and work values, as well as the gap between 'espoused theories' and 'theories in use'. It is suggested that the process of change with regard to the nurses' professional behaviour, at unit level, is mediated by intrapersonal as well as by interpersonal factors such as the nurse's role and the nurse-physician relationship.