MN504 Qualitative Critique

Please use the below Qualitative Critique Completion Form to complete your critique of quantitative research. Type in your responses under EACH section. If your opinion is that the research article does not address or infer an answer to a particular section, then you must so state and JUSTIFY your statement.

IMPORTANT:

• Do not leave any section blank!
• Do not provide a “yes” or “no” answer without an explanation. You must justify all your responses.
• ALL responses must be written in YOUR OWN WORDS. Do NOT use quotes.
• You must submit the full article in PDF form. Critiques submitted without the PDF will not be accepted.
• Save your file as YourName_QualitativeCritique.doc and upload to the unit Dropbox.

STUDENT NAME

Full and Complete Reference for the Article

Note: You must submit the full article in PDF form. Critiques submitted without the PDF will not be accepted.

Problem

What is the problem the study was conducted to address?

The study was meant to seek answers to the question as to why Registered Nurses leave the nursing field as soon as they start working in the nursing industry.

Why is the problem an important one for nursing to study?

The problem is important because the nursing study needs redress and the redress needs to prescribed to the exact accuracy and perfection.  The study will help iron out any of the issues found to impact the nursing industry negatively.

Study Purpose

What is the purpose of the study?

The purpose of the study was to identify the factors influencing the decision of Registered Nurses to leave clinical nursing practice soon after they join the practice.

Research Questions

What are the research question(s)?

The research questions are:

1. What does the term bedside nursing mean to you?
2. How do you define the role of the bedside or clinical nurse?
3. Can you explain the relationship that existed between you as the RN and your patients?
4. Can you talk about the reasons or a situation that may have brought you to the decision to leave bedside nursing?
5. Can you think of a situation that exemplifies the relationships that you had with your co-workers while providing direct patient care?
6. Have you found career fulfillment in your current position?
7. Can you describe what you would require to return to the practice of clinical nursing?
8. Why did you decide to participate in this research?
9. Is there anything else you would like to share with me?

Are the questions stated broadly enough for a qualitative study? Explain WHY.

The questions are not one hundred percent fit for such a qualitative study. They need further clarification for the respondent to be exact. For instance, non-of the questions asks why the respondent left the nursing field as a whole, leave alone bedside nursing.

Study Design

What specific qualitative method is used?

A phenomenological research design was used to provide an in-depth understanding of nurses’ decisions to leave clinical practice. This method is Interpretive hermeneutic, with its intent to give meaning to the experience.

Provide a clear description of the qualitative method utilized (utilize your text or another source to do this – provide citation)

In this method,data is obtained by personal, in-depth, semi structured or unstructured interviews.  The interviews are typically long, and the researcher may have several interview sessions with each participant.  Because of the heavy reliance on this single method of data collection, it is important for the researcher to be skilled at interviewing.  The interviews are tape-recorded for analysis; Participants are selected because they have lived the experiences being investigated, are willing to share their thoughts about the experiences, and can articulate their conscious experiences (Hennink, Hutter and Bialey, 2010).  Often the participants are from a single site but multi-sites are not uncommon.  Typically, between 5 and 25 individuals are interviewed phenomenological research problem focuses on what is essential for the meaning of the event, episode, or interaction.  It also focuses on understanding the participants’ voice.  The problem can be stated directly or less directly.  Usually there is a single, central question in the research.  Several sub questions are used to orient the researcher in collecting data and framing the results.

In what way is the method used an appropriate one for this study? Clearly justify your answer.

The method is appropriate in the sense that it is intensive to the extent of double checking the accuracy of data collected. It is also the most specific and explanatory in terms of research. 

Philosophical/Theoretical Framework Basis for the Study (Determine from Literature – this does not refer to the methodology.)

Identify the philosophical/theoretical basis of the study.

The basis of this study is to explain why the Nursing practice keeps on deficient of personnel yet there is continuous recruitment of Registered nurses in the United States of America. The nursing sector has a deficit of about half a million nurses and the ones in the practice keep leaving. Reasons behind this exodus from the sector are the basis of this study (Keele, 2010). Actually the study believes there is something wrong with the practice and seeks to what is wrong in this field. Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care given the national move toward healthcare reform. The American Association of Colleges of Nursing (AACN) is working with schools, policy makers, nursing organizations, and the media to bring attention to this healthcare concern. AACN is leveraging its resources to shape legislation, identify strategies, and form collaborations to address the shortage (Holloway and Wheeler, 2013). This alone explains the reasoning that apart from recruiting and encouraging more nurses into the industry, those already in the industry need to there first

Describe/discuss the references cited to support the philosophical or theoretical approach used.

  According to the Bureau of Labor Statistics’ Employment Projections 2010-2020 released in February 2012, the Registered Nursing workforce is the top occupation in terms of job growth through 2020. It is expected that the number of employed nurses will grow from 2.74 million in 2010 to 3.45 million in 2020, an increase of 712,000 or 26% (Holloway & Wheeler, 2013). The projections further explain the need for 495,500 replacements in the nursing workforce bringing the total number of job opening for nurses due to growth and replacements to 1.2 million by 2020. 

 According to the “United States Registered Nurse Workforce Report Card and Shortage Forecast” published in the January 2012 issue of the American Journal of Medical Quality, a shortage of  registered nurses is projected to spread across the country between 2009 and 2030.  In this state-by-state analysis, the authors forecast the RN shortage to be most intense in the South and the West. 

Is the philosophical or theoretical basis of the study clearly linked with the study assumptions, data collection procedures and analytical and interpretative approach. How? If not, describe what is missing.

                              Much of the philosophical study is in line with the study assumptions. For instance the study assumptions were that the exodus could be due to among other reasons, sub-optimal working conditions and stress. In the end the two were confirmed by the study. How one assumption did not clearly come out, that of economic benefits.

How is the framework related to the body of knowledge in nursing?

The framework explains what has been seen in the nursing sector and ignored for sometime. It is related to the body of knowledge of nursing in that the body has its own knowledge of the why there are such migrations. A greater percentage of this knowledge ends up being the real reasons. The link is felt from the perspective that the body is actually in touch with what is happening in nursing. This is a qualitative case study in which an interpretative narrative approach is adopted. Qualitative case study has been defined as a research methodology grounded in an interpretive, constructivist paradigm (Guest & McQueen, 2008). Case studies often contain narratives that approach the complexities and contradictions of real life and can be used for exploring, describing, and understanding a phenomenon in its context. An intensive investigation of cases can provide contextual knowledge of real-life phenomena that would be unobtainable with a population-based approach. Case-centered research can add knowledge of how people experience career transitions and construct new career identities.

Review of the Related Literature

Are the articles relevant with previous studies and theories described? Justify your response.

 The articles are relevant. There is shortage in the nursing practice. That is the proposition of the articles. The theories also confirm the same and go ahead to explain why. Registered nurses are opting out of the nursing field and the sector is still in need. Statistics favor the theories and the article proposition. There are reasons (already enumerated above).

Are the references current? What are the number of sources within past 10 years? What is the number of sources within past five years?

The references are current. Three are within the past ten years and two are within five years.

Describe the current knowledge about the research problem.

The current knowledge the nursing situation is that the U.S. is projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows. Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care given the national move toward healthcare reform. The American Association of Colleges of Nursing (AACN) is working with schools, policy makers, nursing organizations, and the media to bring attention to this healthcare concern. AACN is leveraging its resources to shape legislation, identify strategies, and form collaborations to address the shortage. The use of the qualitative case study method made it possible to examine nurses’ career turnover as an ongoing and multidimensional process, in which several causes consequently impacted on the final decision to leave the nursing profession. Narrative career interviews are a feasible way of collecting data regarding career transition processes. In-depth narrative stories can provide unique real-life contextual knowledge of nurses’ experiences when living through these kinds of career transitions.

Specify the gap in the literature that justifies the need for the research.

 Given the complex nature of nurse turnover, a qualitative, in-depth approach is essential, alongside with quantitative studies, for a sound development of the nurse turnover research. The literature report that there is a dire need of more than half a million nurses and the few that are available are on the move is reason enough to carry out a research.

Subjects and Setting

Describe the subjects and the setting.

Subject recruitment was done through the snowballing technique. Currently practicing RNs at various hospitals in the southeastern United States were contacted by the primary investigator and asked if they knew nurses no longer in clinical practice. The email described the study, and asked for these nurses’ help in recruiting potential participants. Telephone contact was made with each potential participant prior to the interview process to ensure study criteria were met. All recruitment was done over the telephone. An effort was made to not limit recruitment to one hospital, but to contact all known non-practicing RNs who might be willing to participate in the study. After providing a brief description of the proposed study, the investigator determined a mutually convenient time and location for the interview.  The setting was a place appropriate for the subject and the interviewer. Many at times an agreement was the consensus of the setting. Phone calls and email communication were the first one to create contact.

In what way is the method of obtaining subjects appropriate? Justify your answer.

It ensures surety of meeting the subjects and also ensures the subjects are the ones needed for the information sought after. The subjects and the interviewer create kind of a labor that enables them meet again in case the first meeting ends up giving erroneous information . Clarity of the earlier information is very necessary 

In what way is the size of the sample used adequate? Justify your answer.

The sample size is adequate enough. It is a non-probability sampling, to identify the primary participants. The selected the sample based on the judgment and the purpose of the research. No chance taking and the time taken is well accounted for.

In what way was the setting in which data were collected an appropriate one for this study? Why? Justify your answer.

The setting made it easy to note the information gathered. It also made it easier to rectify any mistakes made earlier as there is an audiotaped record. The notes can be amended and the audiotape can be re-listened to for cleaning purposes.

Indicate the type of consent obtained and institutional review board approval.

Institutional review board approval was the consent obtained.

In what way were the steps taken to protect the rights of subjects adequate?

Participants were given the opportunity to meet again with the researcher to clarify any issues they deemed important. This ensured that the participants were never quoted wrongly inn the final draft.  Participants also received copies of their transcripts to review for accuracy (Hennink, Hutter & Bailey, 2010).

Data Collection Procedure and Appropriateness of Data Analysis Methods

Identify the data collection procedures used and provide a description of how the data was collected.

 The data was collected from a sample of ten participants. The participants were given time to respond to e-mails and were also engaged in phone calls for a briefing before a face-to-face meeting to tell what they are already aware of.

In what way were the data collection procedures used consistent with the purpose of the qualitative approach selected? Clearly justify your answer.

 Consistency was upheld in that the pre-conditions set for a participant were not changed and the participants had to proof they were registered nurses. No where did the procedure change and the participants attested to the same procedure. The number was good to allow time for the whole thing to take place well.

Define data saturation.

Data Saturation is the point at which data collection can cease. This is a point of closure arrived at when the information that is being shared with the researcher becomes repetitive and contains no new ideas.

What evidence is there that data saturation was achieved? Describe fully.

When speaking of the reasons for leaving the nursing practice, all the participants mention unfriendly workplace. On record Tina and Tony give an overview to what they were going. It is conclusive enough that conditions at the work place were not friendly.  All participants from the initial sample agree to these. This is a saturated data (Watzlawik & Born, 2007).

Specific Data Analysis Procedures Used

Identify the qualitative data analysis procedures used to examine the data

The qualitative data analysis procedures used in examining the data are:

1. Typology
2. Taxonomy
3. Grounded Theory (Constant Comparison)
4. Induction
5. Matrix/Logical Analysis
6. Quantitative/Quasi-Statistics
7. Event (Frame) Analysis
8. Metaphorical Analysis
   
   

Define the qualitative data analysis procedures used.

 Typology:   Creation of a system of classification, list of (mutually exclusive) categories.

Taxonomy:  Essentially a typology with multiple levels of concepts.

Grounded Theory (Constant Comparison): Coding of documents, categories saturate when no new codes (quotes?!) are added to them; core/axial categories emerge.

Induction: Form hypothesis about event, then compare to similar event to verify/falsify/modify hypothesis. Eventually central/general hypothesis will emerge.

Quantitative/Quasi-Statistics: Count numbers of events/mentionings, mainly used to support categories.

Event (Frame) Analysis: Identify specific boundaries (start,end) of events, then event phases.

Metaphorical Analysis: Develop specific metaphors for event, also by asking participants for spontaneous metaphors/comparisons

In what way(s) are the data analysis procedures appropriate for the data collected? Clearly justify your answer.

All these ways are appropriate to give the picture of reasoning as to why the study was necessary. For instance, the typology procedure helps tell which group among the men and women; in terms of gender was the most affected in the election from nursing to other professions,   quantitative procedure helped come up with the figures in terms of percentages and numbers of those affected by a given reason or issue of concern. Boundaries were set in the span of sample size and setting; this conforms to event/frame analysis procedure.

In what way(s) are the data analysis procedures consistent with the qualitative method used? Clearly justify your answer.

None of the procedures goes out of the research question. All of the procedures are targeting an answer as to why; bringing in the aspect of how many Registered Nurses have been lost because the particular quality in question hence the quantitative aspect. It really answers the whole idea of why and how did it happen, to who and who among other aspects.

Evidence of Auditability/Decision Trail/Member checks

Define decision trail.

It is a strategy that will allow another researcher, using the same data, to follow the logic of the original researcher. In other words, the decision trail provides an audit trail and will allow replication of the original findings when the data is reexamined.

Was a decision trail developed? Was it reported in sufficient detail? Clearly justify your answer.

Initially the researcher mentions three reasons as to why the exodus from nursing could be happening. The three include economic benefits and the first two found out by the current research. The initial facts could be from an initial or first research done some where and conform to a decision trail. However the trail is not sufficient as it does not mention the research from where they were got.

Specific Results Obtained

In YOUR OWN WORDS, what are the outcomes of the study? What did the study reveal? Provide a DETAILED response of at least ONE FULL PARAGRAPH as this is worth 8 points!

 The study was successful in unearthing the reasons behind the exodus of Registered Nurses from the nursing field to other fields. The study found that there are three major things that drive especially new Registered Nurses away: unfriendly workplace, emotional distress related to patient care and fatigue and exhaustion (Holloway & Wheeler, 2013). The study goes ahead and explains these reasons in detail. For instance the participants mention reports evidenced by nurses reporting sexual harassment; verbal or physical abuse from co-workers, managers, or physicians in the workplace; and/or consistent lack of support from other Registered Nurses.  Emotional distress related to the patient care, was recognized when nurses report conflicts they felt regarding patient care decisions, mostly ignoring the patients (Holloway & Wheeler, 2013). Finally, fatigue and exhaustion is revealed characterized by the frequent comments regarding overwhelming emotional and physical exhaustion.

Strengths and Limitations

What are two major strengths of the scientific merit of this study? (This does NOT refer to outcomes of the study). Address credibility and conformability.

 The first strength of this study is that it is interpretative: the study manages to interpret all aspects posed to the researchers and tell the benefit or effect they will have on the field of study. It gets facts and digests them fully and as often needed goes beyond to oversee the effect of the collected fact. Secondly, the study is exhaustive and qualitative: it does not finish at the collection of the reasons but also goes on to verify with the same participant at least twice to confirm that is what was the aim of the response and if there was a mistake, the participant can rectify.

What are two major limitations of the scientific merit of this study?

The first limitation is the sample size: however much the sample size might be fully exhausted, the magnitude of the sample is not very reasons of all the Registered Nurses who have left. A sample size of ten is not all exhaustive.  The second limitation is that the study is time consuming: for a specific participant, an arrangement to meet is made; the meeting takes place and then there is or is subsequent meetings to verify the information given. The exercise is long and can be expensive.

To what extent are the study findings valid? Justify your answer.

The study findings are valid to a very large extent. The theories held before are proved right to a large extent and the reasoning of the participants and researchers involved tell the same thin in the end. There is a reason. When asked for the reason, the participant gives the researchers’ gausses.

Implications/Recommendations

How did the researcher generalize the findings? Where in nursing can the results be applied?

The researcher acknowledges that with increasing medical technology demands, increased acuity of patients, and the complex phenomena of the nursing shortage, retaining experienced nursing staff at the bedside is of utmost importance (Aiken et al, 2002). Medical surgical nurses may benefit from recognition that perceptions of the workplace appear to cause some RNs to leave nursing.

What did the researchers say the relevance of the data was? Describe the researchers’ interpretation of the findings.

The researcher says exploring the concepts of the study in more detail is necessary and will benefit every nurse, every patient, and every family, and ultimately improve quality of care.

What suggestions for further study were identified?

Further study suggestions are; the reason as to why some registered nurses consider abuse acceptable in clinical practice and exploration of the power differential among registered nurses, its relation to perceptions of vertical indifference, and its ultimate impact on nursing turnover or intent.

Is the description of the study sufficiently clear for replication? Why or why not?

The description is clearly sufficient for replication because the participants were well vetted and gave first hand verified information.

REFLECTION

Reflect on your newly developed understanding of QUALITATIVE research. What has this experience meant to you? How will this make a difference in your practice of nursing? This is a personal reflection and should have some depth (at least two full paragraphs). Please respond in reference to understanding qualitative methodology and not the specific focus of the research study.

Qualitative research has come to me as a very clear and most effective way of getting information in its factual form. The sample does not have to be very big to give the clearest of the findings and the research does not have to be a surprise to the participants or subjects in that case (Guest & McQueen, 2008). This study has provided broad conceptualizations of why things are done the way they are done. Exploring these concepts in more detail is necessary and will benefit every nurse, every patient, and every family, and ultimately improve quality of care.

The study has also imparted the knowledge of the expected findings as key to keeping focus in research. Subjects can be wrong and when they are, prior information helps give them a clue of expectations and their responsibility or responsibilities for that matter. The study teaches that mistakes can be made the first time but that does not mean they cannot be rectified the second time.

What has the experience of reading and critiquing a qualitative study meant to you? How will understanding and using qualitative research findings make a difference in your practice of nursing?

It is a nice insightful experience that tells how to reconfirm facts; even when the theories are favorable to the research.

How will understanding and using qualitative research findings make a difference in your practice of nursing?

The findings are encouraging in that the issues that are spoken about are real. However, they can also be averted to the practice of nursing more friendly and admirable. Exploring these findings in more detail is necessary and will benefit every practicing nurse like me, every patient, and every family, and ultimately improve quality of conditions in the practice and environment of nursing.

References

Guest, G & McQueen, K. (2008). Handbook for team-based qualitative research. New York: Cengage Learning.

Hennink, M., Hutter, I & Bailey, A (2010). Qualitative Research Methods. New York: SAGE.

Holloway, I & Wheeler, S (2013). Qualitative Research in Nursing and Healthcare. Boston: John Wiley & Sons.

Keele, R. (2010). Nursing Research and Evidence based practice. London: Jones & Bratlett.

Watzlawik, M & Born, A (2007). Capturing Identity: Quantitative and Qualitative Methods. Washington: University of America Press.

REFERENCES

Please list at least FIVE references (APA) used to inform your responses to the questions. Be sure you have properly cited the references with your answers.