Professional Nursing value, Problem Solving Ability

and Career Identity Among Nurse Interns

Protocol of Thesis

Submitted for Partial Fulfillment of the Requirements for the Master Degree
in Nursing Science.
(Administration of Nursing)
By
Ahlam Mahmoud Mohammed Khater
(B.Sc. Nursing, Zagazig University)

Supervisors

Dr. Maha Abdeen Abdeen

Assist. Professor of Nursing
administration Faculty of Nursing
Zagazig University

Dr. Nora Mahdy Attia

Lecturer of Nursing Administration
Faculty of Nursing
Zagazig University

Faculty of Nursing

Zagazig

University 2023

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 Introduction
Nurse interns are bachelor nursing college students who have started
the role transition from student’s role to practitioner nurse via involvement
in the internship training program. One of the mechanisms utilized and
applied to assist new graduate nurses in the clinical setting is the internship
program, which is available by most hospitals in different formats. During
the last year of under graduate under the supervision of clinical teacher in
teaching hospital, the time last 12 months. The internship is a critical stage,
while the nurse interns are new and they are as obvious materials. It is actual
chance that in enables in nurse interns in developing clinical competence and
conducting professional activities and finally forming an objective career
identity. (Panda , 2021)

Nurse interns aim to become professional nurses who can call on their
own abilities to take care of patients in clinical fields. To become
professional nurses, nurse interns must have a clear understanding of their
capacities and a commitment to their career interests in the nursing
profession. they start to develop their career identity in nursing college and
continue to cultivate it throughout. (Cruess et al., 2019; Fitzgerald, 2020).

Professional nursing values are standards for action established by

practitioners and professional group to provide a framework for evaluating
beliefs and attitudes that influence behavior. The use of professional values
in nursing practice helps to increase the quality of patients care. In addition
to increase nurse interns satisfaction, retention and commitment to the
organization. During clinical training they found themselves not have
enough experience to cope with a highly dynamic and intense clinical

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environment. A well-developed value system helping nurse interns to find
solutions for ethical dilemmas in the problem solving ability and decision
making process. Professional values guide nursing student action, interaction
with others, judgment, rationalization, and choices. When nurse interns
faced with problems, they reflect on their personal and professional values to
solve problem and make appropriate decision. (Shammari, 2017)
Problem solving ability is the process of actively and skillfully
conceptualizing, applying, analyzing, synthesizing, and/or evaluating
information gathered from, or generated by, observation, experience,
reflection, reasoning, or communication, as a guide to belief and action,
Effective problem solving skills based on sound knowledge are expected
from professional nurses. (Mao A et al, 2020)
Problem solving process, which requires creative thinking, is at the
heart of nursing practices. For nurse interns to have adequate problem-
solving skills when they start working as nurses, must be integrated
theoretical knowledge with practice throughout their education, they must be
encouraged to think critically of the circumstances faced and must be
provided to them with an education that promotes critical thinking,
(Patterson, 2019).
career identity conceptualized as having a clear sense of one’s goals,
interests, and talents, is an essential factor in career decision making can be
thought of as the overall measure and process of career development
However, it also consists of interest, values, beliefs, and attitudes. Further,
career identity can be thought of as a process, where one obtains pertinent
information, explores, selects, and tries different occupations in a revolving
process until he or she settles upon a career. (Landis TT et al ,2020)

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 career identity empowers nurse interns in the workplace and functions
their role effectively and reflects how nurses perceive the nursing profession
and it is based on attributes, characteristics, beliefs, values, and experiences
in carrying out professional roles to achieve a sense of identity in a job In
addition, career identity is the result of nursing education institutions and
includes decision-making elements for selecting a future career (Mao A et
al, 2020)

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 Significance of the study
Fostering career identity in nursing education, practice, and regulation
is an example of an evidence-based intervention that may transform
workplaces into environments that support nurse interns well-being,prevent
burnout, fatigue, mental and physical stress, moral distress, and moral injury
and promote work satisfaction and retention . (Mao A et al, 2020)
In a health setting, career identity serves a great importance. It defines
practice boundaries and assists in limiting role confusion particularly in
multidisciplinary teams .nurse interns with a strong career identity are more
motivated to work in nursing and show a higher retention rate. There fore ,
it is important to explore the career identity of nurse interns. (Panda, 2021)
A lack of career identity clarity has been found to have a significant
impact on a profession’s perceived value and on a nurse interns confidence
in advocating for their professional opinions. These difficulties also
influence in their confidence to instill appropriate professional knowledge
and values and problem solving ability level . Further, an unclear career
identity can lead to larger issues within a profession in which practice
become less paradigm-specific and increasingly focused on roles that ‘fill
gaps’ of other profession. ( Sundberg K ,2017)
Although, there are some studies done about professional nursing
value, problem solving ability and career identity but most of these studies
focus more on clinical nurses’ career identity Codsi MP et al.,( 2021), ,
there are limited studies nationally and internationally done to assess
professional nursing value, problem solving ability and career identity
among nurse interns. Likewise there no studies carried out in the Faculty of
Nursing, Zagazig University to assess professional nursing value, problem
solving ability and career identity among nurse interns, so it is crucial to
conduct this study to investigate this relation and benefit from implications.

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 Aim of the study
The aim of this study is to:
Assess Professional Nursing value, Problem Solving Ability and Career
Identity Among Nurse Interns

This will be achieved through the following objectives:

1. Measure professional nursing value level of nurse interns .
2. Assess problem solving ability level of nurse interns .
3. measures the degree of nurse interns idea about their goals, interests,
sense of self, and strengths of career identity.

Research questions:
1. What is the level of professional nursing values among nurse
interns?
2. What is the level of problem solving ability among nurse interns ?
3. What is the degree of nurse interns idea about their goals, interests
, sense of self, and strengths of career identity?

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 Subjects and Methods
Subjects and methods of the study will be consisted of four main
designs as follows: technical, operational, administrative and statistical
designs.
1) Technical design:
The technical design of this study will include a description of the
research design, the research setting, the subject, and tools of data collection.
Research design:
Descriptive design will be conducted to achieve the aim of the study.
Setting:
This study will be conducted at Zagazig University Hospitals , Al-
sharqia Governorate , Egypt, which include two sectors involving six
teaching hospitals, namely; the Emergency sector includes four hospitals and
El-Salam sector includes two Hospitals.
Subjects:
All nurse interns at Zagazig University Hospitals from academic year
2022/2023. The sample size will be calculated according to number of
nurse interns in this academic year.
Tools of data collection:
Tool I: Professional Nursing Value scale:
This tool was developed by Yeun et al (2005) to measure
Professional Nursing Value level and it consists of two parts are:
Part (1): Personal characteristics sheet for nurse interns to collect data
about their age, gender, nursing major selection motive , hospital name .
Part (2) it consist of 29 items grouped under five domains

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namely: self-concept of the profession (nine items), social awareness (eight
items), nursing professionalism (five items), roles of nursing service (four
items), and nursing originality (three items). The response of nurse interns to
the scale was on a five point likert scale ranged from (1) not at all to(5)
very much.
Tool II: Problem Solving Ability Inventory
This tool was developed by Lee et al (2008) to assess problem solving
ability level. The scale comprises 30 items, grouped under five domins
namely: clarifying the problem, seeking a solution, decision-making,
applying the solution, and evaluation and reflection. All of them had( 6 item)
.Each item is rated on a five-point Likert scale from 1 (“very rarely”) to 5
(“very frequently”).
Tool III : My Vocational Situation MVS.
This tool was developed by Holland, Daiger, et al (1980) to measures
the degree to which nurse interns has a clear and persistent idea about their
goals, interests, sense of self, and strengths. It consists of 18 items . Items
are answered with dichotomous responses of true or false and modified by
researcher to be rate on a four point likert scale from 1(strongly disagree) to
4(strongly agree) .
2) Operational design:
Pilot study:
A pilot study will be carried out on10% of the study subjects to test
tool clarity and any necessary modification will be done and these subjects
will be excluded from study sample.

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Validity:
Tools of data collection will be tested for clarity, relevance,
applicability, comprehensiveness, understanding, and easy for
implementation by experts in the field.
3) Administrative design:
To carry out the study in the selected setting, an official approval for
the collection of the data will be obtained by using the proper channel of
communication.
Ethical consideration:
Informal oral consent will be obtained from nurses that will be
included in the study sample after verbal explanation with each subject of
the nature and the aim of the study. They will be given an opportunity to
refuse or to participate; the study could not pursue any negative
consequences for the subjects. They will be reassured that any information
collected will be used exclusively for research purpose and will be
confidentially treated
4) Statistical design:
Data will be collected, analyzed, organized, and tabulated by using
appropriate statistical methods according to the obtained result
Discussion:
Discussion of the results will be done based on current related
literatures.
Conclusion and recommendation:
They will be derived from the discussion and result

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 References
Al Shammari F., Grande R., Vicencio D. and Al Mutairi S. (2017)
Nurses’ professional values on patient care provisions and
decisions. Journal of Nursing Education and Practice.; 7(.9):78-84.

Landis TT, Severtsen BM, Shaw MR, Holliday CE, (2020): editors.
Professional identity and hospital‐ based registered nurses: A
phenomenological study. Nursing forum: Wiley Online Library.

Cruess, S. R., Cruess, R. L., & Steinert, Y. (2019). Supporting the

development of a professional identity: General principles.
Medical Teacher, 41(6), 641–649 Codsi MP, Karazivan P, Rouly
G, Leclaire M, Boivin A. Changing relationships: how does
patient involvement transform professional identity? An
ethnographic study. BMJ Open. 2021;11(7):e045520

Codsi MP, Karazivan P, Rouly G, Leclaire M, Boivin A. (2021):

Changing relationships: how does patient involvement transform
professional identity? An ethnographic study. BMJ Open.;
11(7):e045520

Mao A, Lu S-e, Lin Y, He M. A (2020): scoping review on the

influencing factors and development process of professional
identity among nursing students and nurses. Journal of
Professional Nursing. 2020.

Fitzgerald, A. (2020). Professional identity: A concept analysis. Nursing

Forum, 55(3), 447–472. https://doi.org/10.1111/nuf.12450

10
Foster, R. (2021). Fostering nurses’ professional identity. Nursing
Management, 52(6), 56

Lee, W.-S.; Park, S.-H.; Choi, E.-Y.(2008): Development of a Korean

problem solving process inventory for adults. J. Korean Acad.
Fundam. Nurs. 2008, 15, 548–557

Mao, A., Wang, J., Zhang, Y., Cheong, P. L., Van, I. K., & Tam, H. L.
(2020). Factors influencing recruitment and retention of male
nurses in Macau and mainland China: A collaborative, qualitative
study. BMC Nursing, 19(1), 104

Panda S, Dash M, John J, Rath K, Debata A, Swain D, et al. (2021):

Challenges faced by student nurses and midwives in clinical
learning environment - A systematic review and meta-synthesis.
Nurse Educ Today.

Patterson R. (2019): 7 Ways to Improve Your Critical Thinking Skills.

https://collegeinfogeek.com/improvecritical-thinking-skills/25
June 2020 at 8pm

Holland, J. L., Daiger, D. C., & Power, P. G. (1980). My Vocational

Situation: Description of an experimental diagnostic form for the
selection of vocational assistance. Palo Alto, CA: Consulting
Psychologists Press

Sundberg K, Josephson A, Reeves S, Nordquist J. (2017): An

explorative study of the professional identity of undergraduate
medical education leaders. BMC Medical Education;17

11
The Essentials of Baccalaureate Education for Professional Nursing
Practice.2016. http://www.aacn.nche.edu/education-
resources/BaccEssentials08.pdf. Accessed 20 Oct 2016.

Yeun, E.J.; Kwon, Y.M.; Ahn, O.H. (2005): Development of a nursing

professional values scale. J. Korean Acad. Nurs, 35, 1091–1100

Yilmaz A.A., Ilce A., Cicek S.C., Yuzden G.E., Yigit U. (2017): The
effect of a career activity on the students’ perception of the
nursing profession and their career plan: A single-group
experimental study. Nurse Educ. Today; 39:176–180

Yamane, T. (1967): Statistic: An introductory analysis, (2 nd Ed.), New

York: Harper and Row

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