The fate of ideals and values : experiences of newly qualified nurses
Recent changes in nurse education in the UK (UKCC 1986) have emphasised particular values in nursing, such as individualised, holistic and research and evidence based care. However, the extent to which these values and ideals have been adopted by students and qualified nurses has not been explored, nor the extent to which they can be implemented in practice. This study is a longitudinal, naturalistic enquiry into the fate of the ideals and values of newly qualified nurses. At the end of their course students in three colleges of nursing were asked, via questionnaires (n=86), to describe their ideals for practice. Questionnaires and in-depth interviews (at 4-6 months and 11-15 months post qualification) were the methods used with a purposive sub sample of twenty-six participants, who were followed from the end of their Dip HE Adult nursing courses to up to three years post qualification (second questionnaire after 3 years). Interviews were tape-recorded, transcribed, and data were analysed using constant comparison and negative case analysis. The study found that the diplomates emerged from their courses with a cogent set of high ideals. The fate of these ideals in practice was dominated by two key forces: professional and organisational sabotage. Three groups emerged in the findings: sustained, compromised and crushed idealists. The key to the retention or otherwise of their ideals and values was the practice environment, together with diplomates' own strategies for maintaining ideals and motivation. Particularly important in the practice environment were support, role models and staff attitudes, and the adequacy of resources, especially staffing and skill mix issues. It is suggested that educational, policy and social changes have sharpened the professional-bureaucratic conflict in nursing, and that individual nurses are often caught in the middle of this conflict, with deleterious consequences for both individuals and for the nursing profession.