Nursing Experience in Iran

Abstract

Abstract: Introduction: Difficulties of clarifying the nature of the nursing profession and the limits of its scope of practice are common in many countries. The debate over what actually constitutes nursing has raged fiercely for years Nursing as a paradigmatic concept has different meanings in different cultures. The milieu in which nurses work as well as the socio-cultural, context all a and all the contributing factors such as public image, self image , social values and norms are regarded as very important in development of the nursing profession and to identifying the nurses identity, skill and expertise. Indeed any efforts to define nursing socio-culturally can contribute to a development of nursing profession and can also contribute to improve knowledge in understanding the process of professional socialization. The purpose of this qualitative phenomenological study was to shed light the Iranian nurses' lived experiences of nursing and the perception held by them concerning their profession and clinical experiences. Henceforth, this study presents nursing perspective of Iranian nurses in comparison to a western paradigm (Sweden). It also discusses some of the socio -cultural viewpoints around such experience. Methods: The data were initially collected through series of face to face and/or group semi-structured interviews with 24 employed nurses in Iran and 6 RNs in Sweden, and continued by asking 168 Iranian nurses to write narratives about their experiences of nursing. The additional documents about caring and nursing as well as some related photographs and researcher field notes were used as complementary sources of data. The data were then analyzed by utilizing Benner's interpretive phenomenological method and 4 different main themes as well as 4 different subthemes emerged vital for Iranian nursing experiences. The four main themes emerged in this study were: Altruism, nursing and difficulties experienced, burnout and “weak professional identity”. The four subthemes emerged in this study were: routine oriented nursing practice, humanistic (not religious necessarily) approach to nursing work, marriage problems due to poor socio-cultural position of nurses in society and poor public image about nursing and finally difficulties with doing the primary basic nursing cares like change sheets and giving bedpan. Results: The findings show that the nurses are severely dissatisfied with their work and this dissatisfaction could be explained by relating it to a state of “burnout”. Significant aspects expressed by them that could be explained as “burnout” were as follows: poor working conditions, work environmental problems, dissatisfaction with the content of nursing practice and socio-cultural difficulties. Despite these severe difficulties the study showed that there was also an altruistic approach involved in the nurses' professional work and this motivated them to their work as an intrinsically value. nurses were in general not satisfied, conversely, the negative experiences m them seriously consider leaving nursing. the caring concept did not also defined clearly in the Iranian nursing system They considered caring as merely doing some nursing services/tasks for patients and in this way nursing and caring were similar meanings for them. The whole interpretation in analysis the nurses' narratives showed nursing experiences by emphasizing the “weak professional identity”. In fact their everyday difficulties related to their work settings and unsatisfied content of nursing work and also all problems related to the poor socio-cultural position in society and continuously burnout moved them to a state of “weak professional identity”. The results can be considered as a basis for a number of implications for nursing management and education to ensure changes, which improve nursing status effectively in Iran. A holistic approach is necessary to integrate these implications into a nursing system, both in practice and education, in order to improve conditions that facilitate a higher development of nursing in Iran