The role of the registered nurse in Taiwanese nursing homes : a grounded theory study

Abstract

The global trend towards an ageing population presents challenges for

health-care professionals, including registered nurses (RNs). In Taiwan,

health care policies relating to the aged and to gerontological nursing are still

in the early stages of development. Integral to this development is the

evolving definition of the clinical role of RNs who make a major contribution

to aged care. Using data from in-depth interviews of 29 RNs working across

eight nursing homes, this grounded theory study examines the factors that

shape the care work of RNs in long-term aged care in Taiwan.

The objectives of this study were to:

* examine the work-experience perceptions of RNs employed in nursing

homes in Taiwan

* explore the factors that influence the delivery of nursing care to the

aged by RNs

* explain the events that constitute nursing practices in aged care

provision that have an effect on the roles of RNs, and

* develop a theoretical proposition that can guide future nursing practice

in aged care.

Grounded theory and symbolic interactionism are the complementary

methodologies selected to underpin this study. The perspective of grounded

theory allows for a critical investigation of the social processes that are

integral in shaping the perspectives of RNs who work in Taiwanese nursing homes. The application of the theory of symbolic interactionism facilitates an

exploration of the roles of RNs in this context and of the different meanings

for individuals in the various situations they confront. Organizational factors

and interactions that shape the role of RNs in the working environment of

aged care are highlighted in the interaction between the data and the theory.

The core category that emerged from the study was searching for an identity.

This core process reflects ambivalence in the perceptions of RNs in

describing and explaining the nursing role in Taiwanese nursing homes. Five

categories that bring some greater understanding of this ambivalence are:

coming to know, doing anything and everything, negotiating the work role,

dealing with the system, and learning by being there.

The specific intention of this study was to extend our understanding of

nursing work and the delivery of care to older people in nursing homes in

Taiwan. The findings of this study will contribute to the development of an

educational framework that may be applied to improve nursing practices in

nursing homes. These findings also have the potential to make a positive

contribution to aged health care policy-making in Taiwan.