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Critical Appraisal Of Journal

I. Introduction A nurses career is not only professionally challenging but also puts great demand on physical and mental resources to cope up with the continuously changing environment within a healthcare setting. A nurse practitioner is expected to comply with the orders of the physician meticulously and flawlessly as well as take appropriate decisions on her own according to the ever changing situation in a patient care setting. Expectations from a nurse are enormous, especially from the patients perspective. This requires discipline, punctuality; evidence based and informed decision making capability, as well as thorough professional competence in terms of theoretical and practical skills. In fact a nurse has to play the role of a physician, counselor, pharmacist, family member and psychologist all rolled into one at the same time while dealing with her patients. No doubt, this requires a high level of competence which can easily break a normal person. Issues such as satisfaction with ones career, ability to cope up with personal and professional challenges and the question whether the nursing profession allows one to lead a happy, fulfilling life, which is the ultimate human goal, therefore need to be addressed. Nemcek (2007) attempted to address these particular issues precisely in their quantitative studies respectively. The former has followed a thorough and well designed approach to evaluate the three facets of life of a nursing practitioner identified by her, which she labels as the ability to promote self nurturance, satisfaction with life in general and career in particular. She has conducted a quantitative study to arrive at a statistically significant inference, which might serve to indicate the relationship between the three aspects she has identified as vital in nursing practice. The framework for analysis of a research article must identify what problem is being addressed, the purpose for research in the problem area, and a gist of previous and current research on an aspect in order to arrive at a sensible and statistically valid conclusion. The theoretical framework and hypothesis should be clearly stated and the sample size selected for the study should be adequate to provide a valid result. Both studies have satisfied these criteria within the limits imposed by the apparently small sample sizes. II. Critical Appraisal Journal Tittle: Registered Nurses Self-Nurturance and Life and Career Satisfaction Nemcek, 2007 who is an Assistant Professor at the Decker School of Nursing at Binghamton, NY and an experienced registered nurse herself, has conducted a descriptive correlational study by designing questionnaire based measures of self nurturance and life and career satisfaction, which were administered to 136 shortlisted registered nurses, believing that if these measures related in any way to each other, could contribute towards improving the mental health and safety among nurses. II.1 On Tittle

The title of the paper is succinct and self explanatory though it does not portray that the relationship between the three aspects enumerated is the focus of the study. II.2 On Abstract The abstract is a succinct summarization of the intention behind the research and explains the salient points of the inference obtained as a result. Building upon the current necessity for promotion of a healthy, safe and satisfied workforce in the nursing profession due to paucity of professionals, the author has cited previous work on such aspects which have identified self-nurturance which she explains to be a holistic nourishment of body, mind and spirit in an endeavor to promote personal growth as one of the primary factors contributing to satisfaction.

II.3 On Introduction and Literature reference In her introductory paragraph, she has stressed upon the necessity of an occupational health nurse to employ self nurturance strategies to inculcate a feeling of satisfaction among her employees. She feels that such strategies should involve regular programs aimed at teaching and assisting nurses to modify personal lifestyle behaviors and their work environment in order to lead more fulfilling lives. She has opined that thoroughly satisfied nursing professionals can deliver better healthcare services to the public which can serve to relieve them of undue stress and ultimate burnout, which are forcing younger nurses in particular to opt out from the profession altogether in the current era, resulting in serious shortages. The author has thoroughly researched what self nurturance actually means and its implications on normal human being as well as nursing professionals in an effort to lay down the background for her proposed study. Building upon her own definition of the term published in an earlier paper, she has eulogized the benefits of happiness and satisfaction in general life for success in any professional pursuit. She has cited numerous studies done on people from diverse backgrounds such as students, single parents and old women which prove that satisfaction with ones working environment and the ability to exert professional control translates into more meaningful work performance. In fact, the author insists that self nurturance is an entity in itself whose regular practice enables one to achieve better work outcomes. She has pointedly referred to just one study about the effects of self nurturance in nurses which she felt was reason enough for exploration into this area. Past quantitative studies on this aspect had mainly concentrated on finding the differences self nurturance exerts between normal and psychologically perturbed subjects. The author believes that a positive correlation between self nurturance with help and well being has firmly been established and this needs to be probed in those involved in the nursing profession as well. II.4 On Methodology The author has approached the subject of her inquiry with a thoroughly researched methodological design in which she conducted a pilot study initially to ascertain the appropriateness of her design on 6 volunteer nurses selected from a

private university. This was followed by the actual study conducted on 136 volunteer nurses who were recruited through an online advertisement. Adequate provisions were made by the author to obtain institutional approval and informed consent in both pilot and the actual study. This seems to be an appropriate sample size at this stage as it eliminates variation due to institutional differences and also makes the volunteers to be adequately prepared for the type of questionnaires they are going to be subjected to. Although a larger sample size could have been more indicative of the results but as this study was the first effort of its kind, the novelty of the idea compensates for the small sample size. Moreover, an already accepted descriptive, correlational statistical design was chosen by the author, which is appropriate for this kind of study. The questionnaires were carefully planned to yield pertinent data as far as the motives for the desired ends are concerned. SPSS is the most common statistical software employed these days for analysis of various kinds of data with assured accuracy due to dependence on computers rather than manual calculations. The statistical instruments included MSNS (Modified Self Nurturance Scale; 53 items) from a pre-established design, SWLS (Satisfaction With Life Scale; 5 items) and NCSS (Nursing Career Satisfaction Scale; 3 items) with response scales of 1-7 ranging from Strongly Agree to Strongly Disagree, which suggests that, a lot of data must have been generated for the statistical analysis. The author has described all instruments in detail as far as their historical origin and validity for this particular study are concerned. In identical studies done in the past, correlations were found to be within permissible limits of consistency as well as accuracy required to form valid inferences.

II.5 On Result and Discussion The results have been depicted in easily comprehensible tabulated forms which describe the demographic details of the participants, mean values obtained for the three instruments under study and the correlational attributes within the three. The age range of the participants in the study is fairly wide and represents inexperienced as well as experienced nurses. Errors due to sex or demographic variations seem to be minimal as most respondents were female and White. Expectedly the statistical analysis revealed no significant variation between demographics and self nurturance or life and career satisfaction scales. Mean scores of all parameters under study revealed scores of 3.5, 4.9 and 4.7 for MSNS, SWLS and NCSS respectively with permissible levels of standard deviation. Extremely significant correlation was established between MSNS and SWLS, MSNS and NCSS, and SWLS and NCSS. The results are more representative of the younger lot of the white, female participants as majority of them (42%) belonged to the category which had a work experience ranging from 1-10 years. The MSNS score of 3.5 obtained in this study has been claimed by the author to consistent with data obtained from normal or well individuals in past studies. The SWLS score also compared well with that from well persons at 4.87. In short, all instruments studied by the author showed a statistically significant positive

relationship with each other leading the author to conclude that self-nurturance, career satisfaction, and life satisfaction were positively correlated with each other (Nemcek, 2007). The variables which could have affected the results of this study and can be considered dependant include age variations, differences values of life due to individual perception, ethnic and cultural backgrounds, educational level, job setting, home environment and personal circumstances. The independent variable was the same profession of the participants. The author has later described how a highly structured and organized environment as in Magnet Hospitals can impact overall satisfaction in a nursing practitioner in a positive manner. Greater autonomy and participation in administrative decisions in such locations facilitates career satisfaction which has a direct impact on satisfaction in life in general and promotes self nurturance. Implications for occupational nurses in particular have been discussed as the author believes that they are the pertinent link in inculcating self nurturance tendencies affecting career and life satisfaction of the employees working under their guidance. II.6 The limitation of study The limitations of this study, as admitted by the author herself are the inability of correlation based studies to provide evidence for causality, and the sample being a convenience sample as participants were aware of the motives of the study. This suggests that the study should involve a predictive design i.e. measures of the same construct should be measured sometimes in the future and the similar sets of data are compared for ascertaining validity. III. Conclusion The articles analyzed above stress upon the importance of self care in nursing practitioners which has assumed greater significance in recent years due to reduced workforce and the high attention span required in the workplace. Excess work does not allow a nurse to stop and think about caring for self though she is expected to care for others. This has resulted in situations where some practitioners contemplate withdrawing from the profession altogether or suffer burnouts which are extremely damaging physically as well as emotionally. The article is a quantitative analysis of the relationship between self nurturance, life and career satisfaction which have been found to be positively correlated with each other (Nemcek, 2007). Both articles not only suggest further research in this aspect but also offer suggestions to future nursing leaders to incorporate self care and self nurturance into their professional sphere for optimum growth and satisfaction with nursing as a career.

References Nemcek, M. A. (2007). Registered Nurses Self-Nurturance and Life and Career Satisfaction, American Association of Occupational Health Nurses Journal, 55(8), 305-310.