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Post-basic baccalaureate nursing education : the nurses' experience Hoopfer, Donna L. 1988

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POST-BASIC BACCALAUREATE NURSING EDUCATION THE NURSES' EXPERIENCE By Donna L. Hoopfer B.Sc.N., The U n i v e r s i t y of Alberta, 1979 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF EDUCATION i n THE FACULTY OF GRADUATE STUDIES (Department of Adult Education) We accept t h i s thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA October 1988 Donna Leigh Hoopfer, 1988 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of CAuraJusr^ The University of British Columbia Vancouver, Canada Date <QrJ , 2 ) , /W DE-6 (2/88) ABSTRACT The purpose of t h i s study was to understand the meaning of the post-basic baccalaurate nursing education experience through the nurses' eyes. Ten nurses described the experience during t h e i r f i r s t year of being e n r o l l e d as a f u l l time student at one Canadian u n i v e r s i t y . Twenty two sessions were completed which were composed of three sessions with each of the f i r s t s i x nurses and one session with each of the remaining four nurses. The researcher kept notes regarding the sessions which added to the descriptions of the experiences. Thematic analysis of the data suggests that the experience i s a journey that i s embarked on to s a t i s f y a personal need of accomplishment and the degree, i t s e l f , i s seen as a possible means to the nurse's future. The experience took the form of a journey and f o r the informants i t was the f u l f i l l m e n t of a long standing dream to attend u n i v e r s i t y . The v i s i o n of the experience included the nurse's expectations f o r the experience and f o r t h e i r own performance i n the experience. The experience was a game of s u r v i v a l . The nurses were constantly t r y i n g to incorporate the u n i v e r s i t y experience into t h e i r l i v e s . The worth of the experience was questioned and remained i n question throughout the study. The nurses remained hopeful that the experience would be worthwhile i n helping them accomplish t h e i r goal of being able to make a difference i n the future. Signature of the Supervising Professor i i TABLE OF CONTENTS CHAPTER PAGE I. THE BEGINNING 1 Introduction 1 Background of the Problem 1 Purpose of the Study 2 Research Question 2 Assumptions 3 Relevance of the Study To Nursing and Education .... 3 Organization of the Thesis 4 I I . LITERATURE REVIEW 6 Experiencing a Change 6 Nurses as Adult Learners 8 The Educators Views on Post-Basic Baccalaureate Nursing Education 10 The E f f e c t s of the Experience on the Nurses 12 Beginning Insights into the Meaning of the Experience 13 Summary 14 II I . PHENOMENOLOGICAL INQUIRY 16 The Study Sample 17 Obtaining Informant Nurses 18 The Informant Nurses 19 External V a l i d i t y 21 Data C o l l e c t i o n 21 i i i CHAPTER PAGE Thematic Analysis 26 Categories of Analysis 28 Coding R e l i a b i l i t y 29 IV. A JOURNEY 30 F u l f i l l m e n t of a Dream 30 An Accomplishment 31 The V i s i o n 32 Hope for the Future 33 A Means to the Future 35 A Game of Survival 37 Being Threatened 38 Limited Freedom to Learn 43 Achievement i s Personal 45 Getting Through I t 48 Being Helped Up or Being Brought Down 55 A Question of Worth 62 An Opening 63 A Broadening 65 Confirming B e l i e f s 67 Weighing the Factors 68 Too Far From R e a l i t y 69 Being Confined by Practice 72 Remaining Uncertainty 73 i v CHAPTER PAGE Summary 74 V. THE END AS A BEGINNING 76 The Journey 76 Concluding Thoughts 89 Implications of the Study f o r Nursing and Education 91 Informants' Comments about the Study 93 References 95 Appendix A Project Information and Reply Form 99 Appendix B P a r t i c i p a n t Consent Form 100 Appendix C P a r t i c i p a n t Information Form 101 Appendix D Pool of Interview Questions 102 v L I S T OF FIGURES FIGURE PAGE C h a r t 1 I n t e r v i e w S c h e d u l e Showing P r o g r e s s o f I n f o r m a n t I n t e r v i e w s by Weeks o f the S t u d y . . . . 23 v i ACKNOWLEDGEMENTS This study was made possible through the commitment and support of many i n d i v i d u a l s . I wish to thank a l l of the committee members, Dr. James Thornton, Dr. Peggy Anne F i e l d , Dr. Marion A l l e n , and Dr. Gordon Selman. Thank you to Dr. James Thornton from the Un i v e r s i t y of B r i t i s h Columbia f o r acting as my supervisor. I e s p e c i a l l y wish to thank Dr. Peggy Anne F i e l d and Dr. Marion A l l e n from the Un i v e r s i t y of Albe r t a f o r t h e i r immense commitment that enabled the implementation and completion of th i s study. I am indebted to a l l the post-basic nurses who p a r t i c i p a t e d i n the study. I wish to thank a l l of the nurses who were w i l l i n g to p a r t i c i p a t e and a l l the nurses who shared t h e i r i n t e r e s t i n the study. I wish to thank Dr. Jeannette MacPhail, Dr. Marilyn Wood, and a l l my nursing colleagues and peers at the Un i v e r s i t y of Albe r t a who bel i e v e d i n the value of the study. I would l i k e to thank the Alberta Foundation of Nursing Research f o r t h e i r support. Their words of encouragement and the Student Bursary were greatly appreciated. Thank you to my family,friends, and colleagues who believe i n me and provide undying support. My f i n a l and most important thank you i s to my husband Ken: "Thank you for a l l of the hugs and the cups of tea. Thank you for being my editor, and e s p e c i a l l y f o r being you and encouraging me to be me... I love you!" v i i DEDICATION To the nurses who have been part my career To the nurses who w i l l advance our profession v i i i 1 CHAPTER I THE BEGINNING Introduction The impetus f o r the study comes from my personal experience as a post-basic nurse learner and as a nurse educator who has observed and talked with many post-basic nurse learners and educators over the past ten years. The question of what i s the meaning of the post-basic baccalaureate nursing education experience, from the learners' perspective, has not been addressed i n the l i t e r a t u r e . I t i s important to know the meaning nurses place on the post-basic baccalaureate education experience because t h e i r experience can influence how they view nursing, how they act p r o f e s s i o n a l l y and how they function i n t h e i r personal l i v e s . Understanding the nurses' perceptions of the experience could provide information that could a s s i s t educators with i n s t r u c t i o n as well as programming. Background of the Problem Educators know how they want the nurse learner to perceive the nursing education experience but are the learners perceiving the experience i n the way hoped for by the educators? The l i t e r a t u r e i ndicates that many nurses returning to school are f r u s t r a t e d and d i s i l l u s i o n e d with t h e i r e a r l i e r nursing education experiences. The 2 question s t i l l remains, what i s the meaning of the experience f o r the nurse? People can be involved i n experiences that generate a v a r i e t y of f e e l i n g s , however feeli n g s do not explain what the experience means to the i n d i v i d u a l . An experience can i n i t i a t e f e e l i n g s of sadness and s t i l l be viewed as a p o s i t i v e and rewarding experience. Post-basic baccalaureate nursing education i s seen as preparing nurses to act as change agents i n advancing the nursing profession. Understanding the nurses' perception of t h i s educational experience could provide insi g h t s into how the experience influences the nurses' views of the nursing profession and personal perceptions of being a nurse. Purpose of the Study The purpose of t h i s study was to understand the meaning of the post-basic baccalaureate nursing education experience through the nurses' eyes, so educators would have an increased means by which to plan and f a c i l i t a t e nursing education. In t h i s study the learners' perceived world was investigated i n order to provide educators with a view of the learners' r e a l i t y . Diploma nurses w i l l be able to u t i l i z e the study information to increase t h e i r understanding of the experience so they can have an increased basis from which to prepare for and f a c i l i t a t e t h e i r own education. Research Question The study question was: "What i s the meaning of the post-basic 3 baccalaureate nursing education experience from the learner's perspective as i t was being experienced?" Assumptions Three basic assumptions were made: 1. The nurses would describe t h e i r experiences as accurately as they could remember. 2. The nurses would describe t h e i r experiences based on t h e i r perceptions. 3. Human beings seek to f i n d an understanding or r e s o l u t i o n i n a l l l i f e experiences. Relevance of the Study to Nursing and Education Studies have demonstrated that nurses who return to do post-basic baccalaureate nursing often become d i s i l l u s i o n e d with nursing and experience a decrease i n self-esteem (Downing & Macmillan, 1987; Schipiour, 1981; Sands, 1987). Mabbett's (1987) findings suggest that frequently nurses become f r u s t r a t e d with nursing and leave the profession or have decreased enthusiasm for t h e i r work r e l a t e d to the ideals of education not being accepted into c l i n i c a l nursing p r a c t i c e . The nursing profession and the health care community have had increasing concern regarding nurses not returning to c l i n i c a l nursing or not returning to nursing at a l l following completion of t h e i r post basic baccalaureate degree i n nursing. We might ask what d i d t h i s educational experience mean to the nurse? Did the experience a f f e c t 4 the nurses views of nursing and of themselves as nurses? Might i n s i g h t s into nursing and nursing education be gained by l i s t e n i n g to the nurses describe t h e i r post-basic educational experience? Another concern voiced by the nursing profession i s that often nurses do not end up p r a c t i c i n g what they have been taught i n an education program. The question here i s what has been learned? Nurse educators have stated t h e i r b e l i e f s on the content and structure of post basic baccalaureate nursing education, now i t i s time to hear from nurses i n post-basic nursing educational programs what the l i v e d experience was l i k e f o r them. Phenomenological research methodology was used i n t h i s study i n order to obtain the nurses s t o r i e s about t h e i r experience i n obtaining a baccalaureate nursing degree. Nurses i n the study had already completed a nursing diploma and had been employed as nurses. The s t o r i e s might provide the nursing profession and i n p a r t i c u l a r , nurse educators, with valuable insi g h t s into the p r o v i s i o n of p r o f e s s i o n a l adult education as i t i s u n l i k e l y the nurses would write or publish t h e i r own personal story to provide such an understanding of t h i s experience. Organization of the Thesis This chapter has focused on the background of the problem, the statement of the problem, the research question, the assumptions of the study, and the relevance of the study to nursing education and the 5 nursing profession. Chapter II includes a review of the l i t e r a t u r e r e l a t e d to perceptions and c h a r a c t e r i s t i c s of post-basic baccalaureate nursing education. Chapter III outlines the process of phenomenological inquiry used i n the study. Chapter IV outlines the composite d e s c r i p t i o n of the experience as described by the informants. Chapter V contains the summary and discussions of the research data from chapter IV, the conclusions, the implications of the study f o r nursing and education, and the informants comments about the study. 6 CHAPTER II LITERATURE REVIEW Experiencing a Change Attending u n i v e r s i t y as an adult learner i s a " s i t u a t i o n a l change" that can a f f e c t an i n d i v i d u a l ' s personal development (Stevenson, 1985, p.65) and f o r nurses, t h e i r p r o f e s s i o n a l development i n nursing ( S u l l i v a n , 1984; Woolley, 1978). Stress i s a common re a c t i o n to changes that occur within a person's physical and s o c i a l environment and has the p o t e n t i a l f o r contributing to an i l l n e s s state at any age (p.114). Cohen and Lazarus (1980) demonstrated that stress i s appraised i n terms of perceived threat, l o s s , or challenge depending on how the i n d i v i d u a l perceives the present experience, not what the objective c h a r a c t e r i s t i c s are of the s i t u a t i o n . Therefore, i t i s the perception of an experience not the actual occurrence of an experience that i n i t i a t e s the feeli n g s of stress. What may be s t r e s s f u l f o r one person may not be s t r e s s f u l f o r another. Epstein (1973) suggested that s e l f concept i s learned and the s e l f has the fundamental purpose to maintain a balance f o r i t s e l f (p.414). Epstein also suggested that emotions are a means to understanding how a person perceives an event. He has found that negative emotions occur when a person i s engaged i n an event that i n t e r f e r e s with how the person views themselves or when the event i s a threat to the person's concept of s e l f (Epstein, 1973, p.411). 7 Epstein suggested that a person with an extensive " s e l f theory" has the a b i l i t y to cope with a wide v a r i e t y of s i t u a t i o n s , while a person with a narrow s e l f theory experiences l i f e i n a more "black and white" fashion and i s c h a r a c t e r i s t i c a l l y more repressed and r i g i d , and stress i s a co n t r i b u t i n g factor that influences the person to behave i n a narrow fashion (Epstein, 1973, p. 408) Felkner (1974) supported Epstein's (1973) view that i n d i v i d u a l s act i n ways that are consistent with how they view themselves. When a person f e e l s threatened the person's b e l i e f i n t h e i r s e l f i s r e s t r i c t e d which reduces one's a b i l i t y to cope with the new s i t u a t i o n . Felkner suggests that each person that comes into another person's l i f e has the p o t e n t i a l of becoming a " s i g n i f i c a n t person" i n the personal development of that i n d i v i d u a l (p. 39). Continued threats to the s e l f can r e s u l t i n a further c o n s t r i c t e d view of the s e l f and a reduced a b i l i t y of the i n d i v i d u a l to cope with other l i f e s i t u a t i o n s that are being experienced by the person. According to Epstein an i n d i v i d u a l can be at r i s k of becoming overwhelmed with anxiety and diso r g a n i z a t i o n i f too many threatening s i t u a t i o n s are occurring when the i n d i v i d u a l i s not able to assimilate a l l the incoming data e f f e c t i v e l y . Festinger (1957) proposed that a condition of cognitive dissonance r e s u l t s when a person f e e l s there i s a c o n f l i c t between how they are and how they wish to be. When dissonance occurs the person i s motivated to reduce the c o n f l i c t unless the dissonance becomes too overpowering. 8 N u r s e s a s A d u l t L e a r n e r s Learning i s described p s y c h o l o g i c a l l y as a process of need-meeting and g o a l - s t r i v i n g by the learners. This i s to say that i n d i v i d u a l s are motivated to engage i n learning to the extent that they f e e l a need to learn and perceive a personal goal that learning w i l l help to achieve; and they w i l l invest t h e i r energy i n making use of a v a i l a b l e resources ( i n c l u d i n g teachers and readings) to the extent that they perceive them as being relevant to t h e i r needs and goals. The q u a l i t y and amount of learning i s influenced by the q u a l i t y and amount of i n t e r a c t i o n between the learner and t h e i r environment and by the educative potency of the environment. (Knowles 1980, p. 56) Nurses return to school to engage i n learning based on personal incentives, motives and perceptions that the learning experience w i l l have personal value and worth and be applicable i n one's l i f e (Dolphin and Holtzclaw, 1983). Epp (1986), Hammer and Tufts (1985), Erickson (1983), and Shane (1983) i d e n t i f i e d a v a r i e t y of i n t r i n s i c and e x t r i n s i c motivating factors for nurses returning to school which included (a) desire, (b) career advancement, and (c) maintaining a present employment p o s i t i o n . Arms (1985) and Jackson (1984) suggested that nurses returning f o r a baccalaureate degree i n nursing have s p e c i a l needs as adult learners. Nurses are not a t y p i c a l adult learners when compared with Knowles'(1980) d e s c r i p t i o n of the adult learner. Nurses often 9 continue working while attending classes and they have a s e l f s u f f i c i e n c y view that i n h i b i t s them from asking for help (Downing and Macmillan, 1987; S u l l i v a n , 1984; Jackson, 1984). Nurses are often performing multiple role s with high s e l f performance expectations while t r y i n g to deal with fee l i n g s of inadequacy and a fear of f a i l u r e i n the added learner r o l e . Stevenson (1984) suggested that i n adulthood, learning i s experienced as a constant s h i f t i n g of p r i o r i t i e s between a l l the i n d i v i d u a l ' s r o l e s and s o c i a l commitments. S u l l i v a n suggests f e e l i n g s of inadequacy and fear of f a i l u r e can engulf a l l of the i n d i v i d u a l ' s roles when the learner does not a l t e r s e l f performance expectation to accommodate the learner r o l e . Recent research investigated 'burnout' i n nursing and why nurses leave nursing, with the hope of providing the nursing profession with an understanding of these occurrences (Green, 1987; Mabbett, 1987; Wilson, 1987). Wilson suggested three reasons why nurses leave the profe s s i o n (a) lack of career advancement, (b) lack of acknowledgement, and (c) lack of control and decision making. Thus, Green and Wilson both suggested that nurses reach some kind of crossroads at age f o r t y because few nurses remain doing bedside nursing a f t e r t h i s age. Wilson suggested that nurses now have more opportunity to branch out into other careers away from nursing and away from bedside nursing than they d i d p r i o r to the 1960's. Other pr e d i c t i o n s f or why nurses leave nursing are (a) they are not committed to nursing, (b) i t i s d i f f i c u l t to keep up with a l l the new technology, and (c) degree programs are not meeting the needs of the 10 adult nurse learners (Green, 1987). Mabbett (1987) suggested that nurses become 'burned out' because the ideals of nursing they were taught i n t h e i r educational program are not p r a c t i c e d i n t h e i r employment s e t t i n g , r e s u l t i n g i n negative s e l f perceptions and a lack of enthusiasm for t h e i r work. Mabbett proposed that nurses who stay energetic i n nursing demonstrate c h a r a c t e r i s t i c q u a l i t i e s and that i f the profession could promote the i n t e g r a t i o n of these q u a l i t i e s within the nurses then more nurses might stay i n nursing and would be there to promote the profession. The Educators Views on Post-Basic Baccalaureate Nursing Education Nursing educators view post-basic baccalaureate nursing education as a r e s o c i a l i z a t i o n process, however, there are two d i s t i n c t views on how t h i s process occurs. Woolley (1978) views r e s o c i a l i z a t i o n as r o l e development, a change from being a technical nurse to a p r o f e s s i o n a l nurse. S u l l i v a n (1984) suggested that r e s o c i a l i z a t i o n involves taking on a new r o l e and does not agree that r e s o c i a l i z a t i o n i s development of the previous nursing r o l e . There i s evidence that behaviors that are expected of nurses who pursue post-basic baccalaureate nursing education are never demonstrated by the graduate (Muzio and OHashi, 1979). This outcome has l e d some educators to look into i n s t r u c t i o n a l approaches that f a c i l i t a t e the r e s o c i a l i z a t i o n process to promote p r a c t i c e of expected behaviors. Some educators suggested that the educator's b e l i e f s 11 and values about the learner and approaches with the learner are main factors that influence the r e s o c i a l i z a t i o n process (Wallhead, 1986; Arms, 1985; Betz, 1985; S u l l i v a n , 1984; Schipiour, 1981; Knowles, 1980). S u l l i v a n stated that teaching must be d i f f e r e n t f o r the nurse returning f o r a degree when compared with the teaching approaches used f o r students entering the generic baccalaureate nursing degree programs. Woolley (1978) and S u l l i v a n suggested that r e s o c i a l i z a t i o n i s i n h i b i t e d i n post-basic baccalaureate nursing programs p o s t u l a t i n g that previous learning may be the factor that i s preventing the learner's a b i l i t y to learn new material. Knowles agrees that adults often have d i f f i c u l t y learning new material but emphasized that the educator's r o l e i s to f a c i l i t a t e the learner to i n t e r n a l i z e new ideas along with o l d ideas. A second view regarding i n s t r u c t i o n a l approaches f o r r e s o c i a l i z a t i o n i s that courses, i n the nursing program, should be offer e d that address the r e s o c i a l i z a t i o n process. The courses would a s s i s t the learners to understand the r e s o c i a l i z a t i o n process and develop s k i l l s i n working through the process (Woolley, 1984; Ericksen, 1983). Queen (1984) suggested that r e s o c i a l i z a t i o n should be more than j u s t courses, i t should be a curriculum thread that i s interwoven within each course, i f i t i s believed that r e s o c i a l i z a t i o n i s an aim of post-basic baccalaureate nursing education. Blatchley and Stephan (1985) investigated many post-basic baccalaureate nursing programs i n order to f i n d out what i n s t r u c t i o n a l techniques were the most b e n e f i c i a l i n helping the nurse make the 1 2 t r a n s i t i o n into baccalaureate education and into the r o l e of a pro f e s s i o n a l nurse. They found that many approaches were being used but none had been evaluated. They concluded that r e s o c i a l i z a t i o n was being approached through t r i a l and error implementation of educational techniques. The E f f e c t s of the Experience on the Nurses What happens to nurses who return to school f o r a baccalaureate degree i n nursing has been described by Shane (1983) as a "returning to school syndrome" ( p . l ) . The syndrome i s outlined as having stages that most nurses go through, including the general f e e l i n g s that accompany each stage. The feeli n g s that nurses experience while pursing t h e i r baccalaureate i n nursing are described as being those of f r u s t r a t i o n , lack of s e l f esteem, i n f e r i o r i t y , i n a b i l i t y to compete, and anger (Downing and Macmillan, 1987; Sands, 1987; Shane, 1983; Schipiour, 1981). Boone and Rakoczy (1986) concurred with Shane (1983) that a frequent comment by the nurses about the learning experience i s that t h e i r previous experience (education and nursing employment) was not recognized as valuable by the educational system or by some of the educators. Knowles (1980) suggested that when recognition i s not received f o r previous education and experience, adult learners often f e e l r e j e cted which negatively a f f e c t s t h e i r a b i l i t y to le a r n and impedes t h e i r development of a p o s i t i v e s e l f - i d e n t i t y . Knowles 13 postulated that adults derive t h e i r s e l f i d e n t i t y from t h e i r experiences. Beginning Insights into the Meaning of the Experience No documented studies that investigated the meaning of the post basic baccalaureate nursing education experience, from the nurses' perspective, were found i n the l i t e r a t u r e . H i l l s m i t h (1975), Portnoy (1980), and Sabina (1985) provided a glimpse into the meaning of the experience by sharing comments by nurses that were involved i n the educational experience. H i l l s m i t h (1975) described the nurses as "grudgingly admitting to gaining a broader nursing background while they s t i l l h e l d on to o l d l o y a l t i e s and values"(p. 101). H i l l s m i t h interpreted the nurses experience as being one of "accepting the baccalaureate i n t e l l e c t u a l l y but not emotionally"(p.101). She suggested that these f e e l i n g s stem from the nurses f r u s t r a t i o n of not being viewed any d i f f e r e n t l y than a diploma nurse when they returned to c l i n i c a l bedside nursing following the program. Sabina (1985) discussed the educational experience with two nurses, one had j u s t completed the program and one was i n the f i r s t year of the program. The nurses both reported that the experience was d i f f e r e n t from what they had expected and they had to re-evaluate the experience within the context of t h e i r whole l i f e , i n order to reset r e a l i s t i c goals and personal performance expectations for a l l aspects 14 of t h e i r l i v e s while attending u n i v e r s i t y . The need f o r support from colleagues and family was described by both the nurses as important. One of the nurses f e l t the experience was causing some ma r i t a l stress and that divorce was i n the future. The motivating f a c t o r to come to u n i v e r s i t y was described by one of the nurses as coming "from within" (Sabina, p.32). Both of the nurses f e l t that they would have l i k e d to have known more about the experience i n a r e a l i s t i c sense so they could have been more prepared on ways to approach the whole experience. They both f e l t that there was no one av a i l a b l e to t a l k to about entering the program or about problems when i n the program. They both emphasized the importance of seeking out assistance from a professor or a colleague i n order to survive. Portnoy (1980) provided a retrospective d e s c r i p t i o n of the experiences students taking her course reported about t h e i r t r a n s i t i o n to a baccalaureate nurse r o l e . The nurses had fe e l i n g s of " s i l e n t anger, compliance, and stated they would do what ever they had to do to get through the program" (p. 114). A main descriptor of the experience was "emotional turmoil" (p. 114). Summary The experience of attending u n i v e r s i t y i s viewed as a change that has the p o t e n t i a l of influ e n c i n g a person's s e l f concept. A person's a b i l i t y to cope with the new s i t u a t i o n i s influenced by t h e i r previous coping a b i l i t i e s and the perception of the new s i t u a t i o n . The experience can become overpowering when i t i s perceived as being an 15 unmanageable threat to the person. Nurses and other adults return f o r further schooling based on s i m i l a r goals and needs. A concern for nursing i s the waste of scarce educational resources when nurses return for post-baccalaureate studies and then chose to leave nursing or do not implement the material they have been taught and hopefully learned. Nurse educators have suggested that post-basic baccalaureate nursing education i s a r e s o c i a l i z a t i o n process but there are two views regarding what i s involved i n the process. There are also many suggestions regarding i n s t r u c t i o n a l approaches that could be used to f a c i l i t a t e the process but none of them have been comprehensively evaluated. Numerous authors have described the c h a r a c t e r i s t i c s of nurses who return for baccalaureate education, and t h i s information has been used i n program planning. Other authors have described the reactions of nurses to attending a u n i v e r s i t y baccalaureate program. No documented studies that investigated the meaning of the post-basic baccalaureate nursing experience from the nurses' perspective, however, were found i n the l i t e r a t u r e . The present study was developed to gain an understanding of t h i s educational experience and how i t a f f e c t e d the nurses personally and p r o f e s s i o n a l l y . 16 CHAPTER III PHENOMENOLOGICAL INQUIRY The nurses' experience i n post-basic baccalaureate nursing education can best be described by the nurses who are ' l i v i n g the experience' ( B a r r i t t 1984, Van Manen 1984, O i l e r 1982). O i l e r was r e f e r r i n g to nurses understanding t h e i r patients more f u l l y when she said: "The nursing profession advocates the i n d i v i d u a l as author of hi s own world; definer of h i s own r e a l i t y " (p. 178). I t Can therefore be accepted that the post-basic baccalaureate nursing students should be the authors of t h e i r world and can best describe t h e i r own r e a l i t y . Van Manen (1984) stated, "phenomenological research i s the study of ' l i v e d experience', i t i s seeking to understand the very nature of a phenomenon" (p. 1). Van Manen suggested that phenomenological research seeks to understand the "essence" of the experience so others can gain i n s i g h t into that aspect of l i f e (p. 1). Phenomenology does not investigate why something occurs, i t i s a searching to understand what the experience was l i k e so others can gain an appreciation f o r what that l i v e d experience was l i k e f o r the person l i v i n g the experience and to understand what the e s s e n t i a l elements are that make the experience what i t was (Van Manen; Kwant, 1963). Only the person who l i v e s the experience knows what the experience i s l i k e and can describe the experience f o r others to understand ( O i l e r , 1982). 17 The Study Sample The study population was nurses taking nursing courses during the f i r s t year of f u l l time on-campus study for a two year post-basic baccalaureate nursing degree program. Purposive volunteer sampling was used to s e l e c t the nurses for the study. The f i r s t 10 nurses who were w i l l i n g and able to t a l k about t h e i r experiences became the informants for the study. The term informants w i l l be used through out the document when r e f e r r i n g to these post-basic baccalaureate nursing students who p a r t i c i p a t e d i n the study. The de c i s i o n to l i m i t the study sample siz e to a minimum of ten subjects was an a r b i t r a r y decision made by the researcher and the research consultant. The consultant has had extensive experience with q u a l i t a t i v e research and from experience believed that ten subjects would be a s u f f i c i e n t number to generate the data required f or t h i s study. Denzin (1978) suggested that the sample siz e cannot be predetermined i n phenomenological research because the s i z e i s dependent on the nature of the data c o l l e c t e d . With t h i s i n mind the researcher contacted a l l the nurses who volunteered f o r the study and asked the ones that were not the i n i t i a l ten, i f they would be w i l l i n g to p a r t i c i p a t e i n the study i f a f t e r the i n i t i a l interviews i t was seen as necessary to expand the sample s i z e . External v a l i d i t y i n not a goal of q u a l i t a t i v e research ( F i e l d and Morse, 1985). The study goal was to i d e n t i f y the meaning nurses a t t r i b u t e to the post-basic baccalaureate nursing education experience. Sandelowski (1986) suggested the goal of phenomenological 1 8 research i s to describe the ' l i v e d experience' and to " e s t a b l i s h the p o s i t i o n of a l l subjects i n r e l a t i o n to the group, of which they are members, and to e s t a b l i s h the meaning of the s l i c e s of l i f e " ( p . 32). In q u a l i t a t i v e research any subject that belongs to the population being studied i s considered to be representative of the t o t a l population (Denzin, 1978). Obtaining Informant Nurses Permission to conduct the study was obtained from the Faculty of Nursing E t h i c a l Review Committee and the Faculty of Nursing Executive Committee at the u n i v e r s i t y where the study was conducted. The study was explained to nursing professors teaching f i r s t year post-basic baccalaureate nursing courses. Consent, from the professors, was obtained f o r the researcher to explain the study to the nurses during t h e i r scheduled cl a s s time f o r the purpose of obtaining study p a r t i c i p a n t s . The purpose and conduct of the study was explained to e l i g i b l e f i r s t year post-basic baccalaureate nurses, who were attending cl a s s on the days the study was presented. Between 80-90 students were present to hear about the study. The students were provided with a short w r i t t e n d e s c r i p t i o n of the key aspects of the study at the end of the c l a s s overview (see Appendix A). Included with the written d e s c r i p t i o n was a tear o f f section they were to f i l l out i f they wished to p a r t i c i p a t e or would l i k e further information about the study. I t was stressed that there would be a maximum time commitment 19 of f i v e hours needed for interviews should they volunteer as an informant. This included a maximum of four one hour interview sessions and one hour f or getting to and from the sessions. They were informed that i f they d i d i n i t i a l l y decide to p a r t i c i p a t e they could withdraw from the study at anytime. I t was stressed that c o n f i d e n t i a l i t y of a l l study information would be maintained; t h e i r permission f o r the use of a tape recorder was included i n the consent to p a r t i c i p a t e document (see Appendix B) and was re-explained to p o t e n t i a l informants when they met with the researcher to discuss the proposed study i n more d e t a i l . At that time they signed the o f f i c i a l consent to p a r t i c i p a t e form. The nurses who became informants i n the study received a copy of the consent form that restated, i n d e t a i l , key aspects of the study (see Appendix B). A l l the informants had the choice of s e l e c t i n g t h e i r own pseudonym that was used to insure t h e i r anonymity on a l l t r a n s c r i p t i o n s and preserved c o n f i d e n t i a l i t y of data. The Informant Nurses A l l informants were female, t h e i r ages ranged from 23 to 46 years of age, with the average age being 32.5 years. The length of time since they completed t h e i r diploma i n nursing ranged from one to 20 years, with the average being 8.5 years. The informants had a l l completed a diploma i n nursing from a college or h o s p i t a l based nursing program and were reg i s t e r e d nurses i n the province where the study was conducted. Seven of the informants were married and three 20 were s i n g l e . One married informant was widowed and had remarried while another became separated during the study. Three of the informants had taken continuing education courses following t h e i r nursing diploma while one of the three had completed a Baccalaureate i n A r t s . One of the informants had started the generic Baccalaureate i n Nursing program but l e f t before completing the program, and obtained the nursing diploma from a two year College program. Eight of the ten informants had been c l a s s i f i e d as 'special students', taking courses that would be cre d i t e d to t h e i r baccalaureate i n nursing before entering the post-basic baccalaureate program as f u l l time students. Seven of the informants were c l i n i c a l bedside nurses, s i x remained working on a casual basis and one was working part time. One of the informants was employed i n a casual nursing p o s i t i o n but worked only two s h i f t s less than f u l l time and c a r r i e d three nursing courses. This load was deemed as excessive by the informant. One of the informants was on educational study leave from a community nursing administrative p o s i t i o n . Two of the informants were not employed immediately p r i o r to attending u n i v e r s i t y and remained unemployed during the time of the study. The ten informants were i d e n t i f i e d using the following pseudonyms and numbers: (1) THESNIF, (2) SUZIE, (3) VICTORIA, (4) MANDY, (5) MAC, (6) CAROLYN, (7) MISS Z, (8) SKI, (9) CARMEN, and (10) RUTH. These names w i l l be used through the report. The f i r s t s i x informants were interviewed three times and the l a s t four informants were interviewed once during the study. 21 External V a l i d i t y Guba and L i n c o l n (1981) suggested that one way of dealing with the issue of external v a l i d i t y i n q u a l i t a t i v e research i s evaluating i f the study findings ' f i t ' with members of the study population that d i d not p a r t i c i p a t e i n the study. The researcher had planned to have four of the volunteers that d i d not p a r t i c i p a t e i n the study, read the study findings and provide feedback. This d i d not take place due to time r e s t r i c t i o n s . The researcher did v a l i d a t e the themes with the ten p a r t i c i p a n t s . Data C o l l e c t i o n Seventeen nurses contacted the researcher i n d i c a t i n g t h e i r willingness to p a r t i c i p a t e i n the study. The researcher contacted a l l of the volunteers by telephone and thanked them f o r t h e i r i n t e r e s t i n the study. At t h i s time appointments were made with the f i r s t s i x informants and the remaining volunteers were t o l d they might not be used i n the study. A l l of the volunteers had one or two questions on which they wanted further c l a r i f i c a t i o n , and a l l seventeen volunteers remained w i l l i n g to be included i n the study as needed. The interview sessions with the f i r s t s i x informants began within seven days of the i n i t i a l presentation of the study. The interviewing schedule was completed i n two groups, with three informants being i n each of the i n i t i a l two groups. The f i r s t three informants were interviewed before the second group were interviewed. This allowed 22 data to be c o l l e c t e d and analysis started so the researcher could begin to see emerging themes and would be prepared to ask c l a r i f y i n g questions or request further descriptions, from the informants, should the themes become evident during the interviews with the remaining informants. The sessions with the f i n a l four informants: MISS Z, SKI, CARMEN, and RUTH, began i n the same way as with the f i r s t s i x informants. The researcher had improved on using communication techniques to the extent that a f t e r f o r t y - f i v e minutes the informants stated that they had shared the essence of a l l t h e i r experiences. During the remaining f i f t e e n minutes of the session the researcher asked s p e c i f i c questions for the purposes of exploring i n greater depth experiences that were i n keeping with the emerging themes from interviews with the f i r s t s i x informants. Interview session number three was conducted with the f i r s t s i x informants i n order to discover any new themes from experiences they had since the previous session, and to c l a r i f y themes that were emerging from the data. This f i n a l session also allowed f o r the researcher to obtain feedback on the research technique and obtain suggestions on ways to improve the research approach. The i n i t i a l interview sessions (weeks 1, 2 and 6) were arranged by telephone and subsequent sessions were arranged at the end of each interview session. This process minimized telephone contact for the Chart 1 Interview Schedule Showing Progress of Informant  Interviews by Weeks of the Study Time i n Weeks Interview session F i r s t Second Th i r d 1 4 2 5 3 6 Informants n 4 5 6 7 8 9 10 1 2 3 4 5 6 informants. Each of the i n i t i a l sessions began with the informant completing the P a r t i c i p a n t Consent Form (see Appendix B ) and then completing the P a r t i c i p a n t Information Form (see Appendix C ) . The Pa r t i c i p a n t Information Form contained demographic information and informant r a t i n g of what p r i o r i t y the educational experience held i n 24 the informant's l i f e . The r a t i n g of the educational experience was compared with the verbal response to the same question that was asked during the second interview, which a s s i s t e d i n v a l i d a t i n g the verbal responses of the informant. The interviews were conducted i n a private o f f i c e i n the b u i l d i n g that housed the Faculty of Nursing at the U n i v e r s i t y . The researcher and informant sat facing each other with no obstructions between them, and the tape recorder was set to the side, between the two i n d i v i d u a l s . The informant was facing a window that had a scene of trees and another b u i l d i n g with no people being v i s i b l e which helped i n reducing unnecessary d i s t r a c t i o n s . The informant was given the choice of using a chair with coasters or a stationary chair. This choice was given to allow the informant some sense of c o n t r o l over the s i t u a t i o n . The tape recorder was started during the " s e t t l i n g i n " conversation i n order to reduce anxiety from obviously s t a r t i n g the recorder when the informant began sharing experiences. A l l of the i n i t i a l interviews (weeks 1, 2 and 6) began with the researcher explaining the purpose of the study and asking the informant the following (minor v a r i a t i o n s were used with the essence remaining the same): What I would l i k e you to do i s share with me what i t has been l i k e f o r you to come to u n i v e r s i t y to take your post-basic nursing education. This i s not to be an evaluation of the program i t i s meant to help me understand what t h i s experience has meant to you as a person and as a nurse. You can s t a r t anywhere you wish. 25 A l l of the informants began the sessions by wanting to provide the researcher with some personal background about themselves. This was given so the researcher would have some context i n which to understand the nurse's experience. Each of the sessions was tape recorded and notes were kept by the researcher regarding impressions about the sessions and how i t was conducted i n order to improve on subsequent sessions. The informants were encouraged during the interview to share what ever they wanted about t h e i r experience. Paraphrasing and verbal encouragers were used to help the informant share during the interview sessions. When the informant was unsure what to t a l k about, the researcher used the Pool of Interview Questions (see Appendix D) to give some d i r e c t i o n to the informant. One question was asked of a l l the p a r t i c i p a n t s that was not i n the i n i t i a l Pool of Interview Questions. The question was formulated a f t e r the s i x i n i t i a l interviews (weeks 1 and 2). The informants had been sharing what t h e i r expectations were before coming to u n i v e r s i t y and t h e i r experience while attending u n i v e r s i t y , so i t seemed appropriate to discuss i f they had expectations for when they l e f t u n i v e r s i t y . The question was "What w i l l you take with you from t h i s experience that might be h e l p f u l to you when you leave the un i v e r s i t y " ? The researcher informed the informants when the one hour period fo r the interview session had elapsed. A l l but two of the sessions went longer than the one hour as informants wanted to stay and share more. None of the sessions l a s t e d longer than two hours and the 26 majority ended a f t e r an ad d i t i o n a l f i f t e e n minutes. Informants #7 to #10 were only interviewed once. The researcher and research consultant f e l t no new themes were emerging when data were compared with that of the f i r s t s i x subjects. The descriptions given by these l a t t e r informants served to support and c l a r i f y the themes that had already emerged. The interview sessions f o r informants #7 to #10 occurred following the second interview with the f i r s t s i x informants (see Chart 1, p.23) Tape recordings f o r each session were transcribed by the researcher as finances were l i m i t e d . Thematic Analysis I t i s l i v e d experience that we are attempting to describe and l i v e d experience cannot be captured i n conceptual abstractions. Phenomenological themes are more l i k e knots i n the webs of our experiences, around which c e r t a i n l i v e d experiences are spun and thus experienced as meaningful wholes. (Van Manen 1984, p, 20) Thematic analysis must be thorough enough to enable the experience to be described as i t i s l i v e d (Van Manen, 1984). Royce's thematic analysis uses a process of reduction to search f o r consistency among the many descriptions, u n t i l the descriptions are reduced into basic groups. Royce's thematic analysis requires looking for commonalities while at the same time looking f o r the descriptions that would c r i t i c i z e or negate the proposed theme (Goicoechea, 1975). Thematic analysis was conducted on a l l of the 22 interview sessions. The tr a n s c r i p t s from a l l of the interview sessions were reviewed over and over and over by the researcher. The i n i t i a l 27 analysis phase concluded when the verbal responses of the informants, which pertained to t h e i r perceptions of t h e i r experiences i n the post-basic baccalaureate nursing education experience during the f i r s t year as f u l l time students, were i d e n t i f i e d and hi g h l i g h t e d within the context of the t o t a l t r a n s c r i p t i o n . The researcher then reread the hig h l i g h t e d text descriptions and coded each d e s c r i p t i o n into an i n d i v i d u a l u n i t f o r further analysis. Themes were beginning to emerge at t h i s point i n the analysis. The t o t a l text was then reread l i n e by l i n e and analyzed as a cross check for the previous theme analysis (Van Manen, 1984; B a r r i t t , 1984). Thematic units were developed, a u n i t was eit h e r a word, a few words, a phrase, a sentence, or a serie s of sentences r e f e r r i n g to one perception of the educational experience. The end of one u n i t occurred when the informant's d e s c r i p t i o n of one thought ended and another began. The coded units were then sorted into u n i t groupings. This was made possible because the coded units of the t r a n s c r i p t s were put on f i l e cards carrying the informant's pseudonym and the number of the interview. A l l of the coded descriptions f o r each u n i t were then reviewed to i d e n t i f y commonalities. The f i n a l step of the thematic analysis included reviewing a l l of the t r a n s c r i p t s i n l i g h t of the proposed themes i n order to f i n d a d e s c r i p t i o n that might negate the theme. Some themes were adjusted to describe the experience more f u l l y while some themes were v a l i d a t e d and a few were negated. At t h i s point the thematic analysis ended. Three categories of analysis emerged with each u n i t of analysis f i t t i n g within one of the 28 categories of analysis. Categories of Analysis The three categories of analysis that became evident during the analysis were: the S e l f , the U n i v e r s i t y Educational System, and the S o c i a l Network. Themes and subthemes emerged from the u n i t s of an a l y s i s . The S e l f The S e l f r e f e r s to the nurse's perceptions of themselves as a human being i n t h e i r many s o c i e t a l r o l e s . This category included a l l the descriptions of how the nurses thought they should perform i n a l l t h e i r r o l e s and how they expected the u n i v e r s i t y program to help them perform i n t h e i r many r o l e s . The U n i v e r s i t y Educational System The U n i v e r s i t y Educational System refe r s to the nurse's perceptions of personal experiences with d i f f e r e n t aspects of The System. Elements of The System were; course content, learning experiences (eg.papers, exams, professors, p r o j e c t s ) , and u n i v e r s i t y bureaucracy (eg. admission, c l e r i c a l s t a f f , u n i v e r s i t y functioning). The S o c i a l Network The S o c i a l Network refe r s to the nurse's perceptions of i n d i v i d u a l ' s behaviors, that af f e c t e d the nurses thoughts and f e e l i n g s . The i n d i v i d u a l s included i n the nurses s o c i a l network were: other nurses who were also taking t h e i r nursing degree i n the post basic baccalaureate program, working nurses they had contact with when 29 deciding to attend u n i v e r s i t y and while attending u n i v e r s i t y , and family and f r i e n d s . Coding R e l i a b i l i t y R e l i a b i l i t y i s a concern of a l l researchers. When research methods are r e l i a b l e there i s less chance of measurement err o r and more support for the v a l i d i t y of the findings (Glaser and Strauss, 1964). For q u a l i t a t i v e research Guba and L i n c o l n (1980) suggested that a u d i t a b i l i t y i s the c r i t e r i o n that i s equal to the quantitative c r i t e r i a of r e l i a b i l i t y . A u d i t a b i l i t y i s achieved when another researcher a r r i v e s at the same or comparable findings given the same study data s i t u a t i o n and perspective as the o r i g i n a l researcher. Funds were not a v a i l a b l e to have another researcher analyze a l l of the study material. The consultant to the study independently reviewed and analyzed four of the t r a n s c r i p t s . The consultant and researcher discussed each other's analysis and found there was agreement between them on theme i d e n t i f i c a t i o n . 30 CHAPTER IV A JOURNEY This chapter presents descriptions of the nurses experience i n post-basic baccalaureate nursing education. The presentation i s i n the form of a composite d e s c r i p t i o n of the experience as described by the majority of the nurses. This chapter does not include any discussion of the descriptions. They are presented i n t h i s d e s c r i p t i v e manner i n order to provide the essence of the experience without researcher i n t e r p r e t a t i o n . The following i s the composite d e s c r i p t i o n of ten nurses' experience i n t h e i r f i r s t year of f u l l time study of a two year post basic baccalaureate nursing education. " I t i s l i k e a tunnel" CARMEN ra i s e d her hands up and placed them l i k e b l i n d e r s on a horse, as she continued she slowly moved her hands s t r a i g h t ahead. "You keep going s t r a i g h t ahead with not too many d i s t r a c t i o n s . I do see a l i g h t at the end, but i t i s n ' t the b r i g h t e s t l i g h t . The b r i g h t e s t l i g h t i s the one for A p r i l . I hope next year w i l l be le s s l i k e a tunnel". CARMEN said i n one cl a s s the students drew pictures of t h e i r f e e l i n g s and some drew tunnels while others drew mountains, but for CARMEN the journey was l i k e going through a tunnel. F u l f i l l m e n t of a Dream Where the journey began for a l l of the nurses i s uncertain but 31 a l l of the nurses d i d "dream" about attending u n i v e r s i t y "someday." THESNIF smiled as she remembered her dream s t a r t i n g i n high school. "Attending u n i v e r s i t y was something I had always dreamed about, i t was something I had always wanted to do." F u l f i l l m e n t of the dream had taken a long time f o r MANDY, now she was f o r t y - s i x years young,"behind everything I have done has been the thought that I would l i k e to go to u n i v e r s i t y . " She was very thoughtful and then continued as i f she was t a l k i n g to h e r s e l f , "I could put o f f doing i t for the r e s t of my l i f e but then I would be sorry." An Accomplishment Coming to u n i v e r s i t y was the f u l f i l l m e n t of a dream and was deemed as "an accomplishment" by a l l of the nurses. MAC was very c e r t a i n as she said, "I wanted to go back f o r myself." For SUZIE the accomplishment was very personal because of what coming to u n i v e r s i t y meant to her, "I put u n i v e r s i t y way up there on a pedestal and somehow being able to go was a measure of personal worth... i t i s being looked up to and valued." For MISS Z a u n i v e r s i t y degree was "more to show" for one's s e l f as compared to j u s t having a nursing diploma. She also wanted to do the degree "by h e r s e l f " before she had a husband or c h i l d r e n . VICTORIA was very animated and spoke with excitement as she described what coming to u n i v e r s i t y meant to her, "I remember the f i r s t week being here on campus i t f e l t good getting on the bus and coming. I t i s an accomplishment, I count i t as one of my successes." THESNIF didn't know i f she could achieve her dream of a u n i v e r s i t y 32 education. As she started r e c a l l i n g what a teacher back i n high school t o l d her about her a b i l i t y to attend u n i v e r s i t y a knowing smile developed, "I remember coming to the open house at the u n i v e r s i t y , as a high school student, and my teacher saying to me: 'Why are you taking two days o f f school, y o u ' l l never get there.' THESNIF now had a b i g smile on her face as she added how she would love to go up to that teacher now and say, "See, I made i t . " The V i s i o n The nurses a l l had expectations of what coming to u n i v e r s i t y would be l i k e . Eight of the nurses had never been to u n i v e r s i t y before. CARMEN had gone back to u n i v e r s i t y and received one baccalaureate degree, while RUTH had started her nursing education at a u n i v e r s i t y but l e f t the program and pursued a nursing diploma at a community college. Expectations were based on t h e i r b e l i e f s of what the experience should be l i k e which was influenced by personal ideas of u n i v e r s i t y education, previous educational experiences, and rumors from people who had and did not have any u n i v e r s i t y experience. A l l of the nurses found there were elements to the experience that were inconsistent with t h e i r preconceived expectations. CARMEN expected that doing her nursing degree would be s i m i l a r to doing the previous degree. She thought she would have time to "synthesize" material she was learning and that the time commitment for studying would be i n keeping with a " f u l l time job." These 33 expectations of what i t would be l i k e were projected from what she had hoped the experience would have been l i k e : I wish I had more time to synthesize... I don't honestly think that education should be l i k e a f u l l time job and i t i s more than a f u l l time job. Descriptions from friends and colleagues provided many mental images of what the experience would be l i k e . SKI smiled as she remembered work colleagues t e l l i n g her "not to bother" g e t t i n g her degree because she would f i n d the experience "hair r a i s i n g . " SKI laughed and then as i f to q u a l i f y her colleagues comments she said, "you see I'm considered a b i t of a red neck. They never thought I would l a s t i n here." THESNIF described the rumors she heard as being "horror s t o r i e s " that she had not experienced "yet." She sighed and sounded tentative as she added, "knock on wood." VICTORIA was t o l d by a work colleague that the experience would be "dog eat dog" and "people step over you and on you." VICTORIA'S voice developed a tone of s e l f c e r t a i n t y as she said, " i t doesn't have to be that way." She was very o p t i m i s t i c about attending u n i v e r s i t y as i t was such a dream come true and was seen as a necessity i n f u l f i l l i n g her dream of continuing her education. The v i s i o n also included how the experience would b e n e f i t the nurse personally and p r o f e s s i o n a l l y . Hope f o r the Future When the nurses talked about t h e i r reasons for pursuing a degree t h e i r comments always included the reference to "hope" and wanting to 34 "make a d i f f e r e n c e " or to "changing things" i n the future. CARMEN sa i d i t most eloquently for a l l the nurses when she s a i d why she wanted the degree, "I wanted career advancement, no r e a l l y what I wanted was j u s t more feel i n g s of accomplishment." Then she added, "It ' s a future orientated decision." SKI hoped the degree would help her learn more about nursing and would provide her with more insi g h t into what was "out there" for her i n nursing: I r e a l l y didn't know what I wanted or where I wanted to go with my career. I l i k e education experiences- not always the formal kind, but I l i k e learning. I r e a l l y wanted to learn more about nursing. I wanted to know more of how nursing worked. I wanted to see what was out there and I wanted to gain an o v e r a l l perspective on nursing. I f e l t I was getting very tunnel v i s i o n e d from working i n the ICU for s i x years. When the nurses talked about what they hoped would happen i n t h e i r future they a l l q u a l i f i e d t h e i r hope with an experience from the past they d i d not want to have repeated i n t h e i r future. CARMEN sounded very dejected as she described how working as a bedside nurse had become very f r u s t r a t i n g f or her, "There i s never the time to be cr e a t i v e and make any improvements and i f you d i d think of better ways then...they weren't c a r r i e d through or sometimes even looked at." She sat back i n her chair and sounded very defeated when she added, "I f e l t l i k e a work horse." She then sat up i n her chair and seemed to gain energy and enthusiasm as she talked about her hopes for the future: I wish I had the power to change that. I f there was someway I could change that part of nursing to u t i l i z e nurses better and to make i t a more f u l f i l l i n g experience. I f you could use the p o t e n t i a l rather than j u s t using them as a work force i t would be worthwhile a l l around. 35 CARMEN added that another reason for wanting to get the nursing degree; she wanted more f l e x i b i l i t y i n her nursing career because she saw i n her future that bedside nursing would be too p h y s i c a l l y demanding, so having the degree would hopefully allow her to stay i n nursing: I am f i n d i n g that as I get a l i t t l e b i t older that i t i s a l i t t l e b i t harder to take the p h y s i c a l demands of h o s p i t a l nursing, and I can't t o l e r a t e night working anymore. I t i s j u s t p h y s i c a l l y very hard and I thought when I am f o r t y I don't think I want to , be doing bedside nursing. I wanted to get my nursing degree so I could have a b i t more f l e x i b i l i t y with my future, more challenge for my future. VICTORIA'S v i s i o n of the degree r e l a t e d to how the experience would "enhance" her nursing p r a c t i c e : I thought i t would help me to improve i n my p r a c t i c e . I thought i t would give me more s k i l l s and knowledge. A Means to the Future The v i s i o n of what the future would be was not c l e a r to the nurses. The nursing degree was seen by a l l the nurses as a "means to the future" but i t was uncertain what d i r e c t i o n might be opened up by taking the degree. MAC was very guarded as she said, "Maybe i t w i l l be a stepping stone ( i n a nursing career) or maybe i t won't be the r i g h t thing, but at l e a s t I ' l l have a degree so I can go into a d i f f e r e n t f i e l d . " For these nurses going back to school was considered "a r i s k . " THESNIF and RUTH both smiled a f t e r c a l l i n g i t a r i s k and added, "but i t was a "calculated r i s k . " When MANDY described going back to school as a r i s k she paused, sat up s t r a i g h t i n her chair and i n a very 36 c e r t a i n tone of voice said, "But i t i s also a chance to open some doors that have been closed because of not having my degree." MANDY along with eight of the others were considering pursuing a career within or outside of the nursing profession. Q u i e t l y CARMEN said, " I t ' s a means to the future for me. I hear the nursing degree i s more important to get i f I want to do a Master's, so I have to get good marks, I have to perform." MANDY and CAROLYN, both i n t h e i r f o r t i e s , were unsure i f they wanted to have a career i n nursing but saw nursing as "the quickest way to get a degree", so they could "get on with what they wanted to do." MANDY hes i t a t e d as she talked about getting the degree so she could leave nursing. She was very quiet and sounded w i s t f u l when she said: I thought i t might open up things i n nursing for me. Maybe I would f i n d there was a place for me. Also i f I had my degree I could bounce o f f into another area that required a degree for entrance. I thought i t could be an open door into nursing or i t could allow me to step r i g h t out of the f i e l d . I decided to do my nursing degree because i f I went to another Faculty I would be s t a r t i n g at the bottom of the ladder and so I thought t h i s would be my best choice. CAROLYN was planning on doing Master's studies i n order to achieve her career aspirations and she was not c e r t a i n i f she could take the courses she wanted within a Master's of Nursing program. I f she could not achieve her aspirations through the nursing f a c u l t y , she was planning to "go another route." Six of the nurses experienced fe e l i n g s of disappointment because t h e i r marks were not of the standing they f e l t would be acceptable to continue on into further studies. MISS Z had decided part way into 37 the degree that the degree could be a means to a future i n another d i s c i p l i n e but found that she could not keep up a high average because she was not w i l l i n g to excessively compromise the other aspects of her l i f e i n order to get the marks needed to enter another f a c u l t y . She became very disappointed and d i s i l l u s i o n e d as one of the doors i n her future seemed to be c l o s i n g i n front of her, " I t i s very discouraging to me because I can not keep my average up... because of the workload I am expected to put i n for j u s t three nursing courses... I have chosen to f i n i s h my nursing." She gave a b i g sigh, paused as she gazed out the window and then went on very q u i e t l y , " I might as well have some degree and I know i t won't be Law." A Game of Surv i v a l When the nurses talked about t h e i r experience at u n i v e r s i t y t h e i r voice tone always conveyed a sense of disappointment or anger coupled with an undertone of uncertainty: . . . i t ' s threatening ...you are always t r y i n g to figure i t out ...you never know for sure ...everyone expects you to know the way ...I don't t r u s t any of them ...there as so many discrepancies and inconsistencies ... i t i s a game . . . i t i s j u s t a t r i c k ... i t i s brainwashing Six of the nurses summed up t h e i r experience as being one of s u r v i v a l . CARMEN sat back i n her chair at the end of the interview and paused. She looked as though she was having many thoughts going through her mind as her f a c i a l expressions changed from smiles to frowns, from stern s t a r i n g eyes to eyes that were looking into the 38 past or future. She then said, "There can be simultaneous demands making i t d i f f i c u l t to cope but I have survived" she paused gave a sigh and then added, "so f a r . " SUZIE sounded defeated i n her attempt to have her expectations of the experience s a t i s f i e d : I used to t r y and f i t the ideals with r e a l i t y , but i t i s j u s t impossible. Now i t i s t r y i n g to pass the course by t r y i n g to f i n d out what i t i s they want you to put on the paper. Trying to f i n d out what answer they think i s r i g h t . I t has become a game. I am s o c i a l i z e d into the system. I don't care what I l e a r n anymore, I j u s t want to pass and that makes me very angry and r e s e n t f u l . . . I am j u s t too beaten to even be mad. There was only so long that I could f i g h t the discrepancies and I have given up...there i s nothing I can do to change the system. For SKI the game of s u r v i v a l also pertained to having the degree so she could survive i n her future. She saw the degree as being her "only option" i n f u l f i l l i n g her dream "at t h i s time." SKI squirmed s l i g h t l y i n her chair as she talked about beginning f u l l time studies, "Three days into the degree and I knew I had made a mistake." She made a nervous laugh and went on, "But I stuck with i t because i n a way i t i s the only option at t h i s time." Being Threatened When the nurses started t a l k i n g about beginning t h e i r u n i v e r s i t y experience they a l l made comments that i t was "scary" or " f r i g h t e n i n g " because "you j u s t didn't know what to expect." A l l of the nurses viewed some aspects of the experience as a threat. CARMEN who already had a u n i v e r s i t y degree said, "There was a l o t of fear of the unknown" when she started. CARMEN sai d very s o f t l y , " I t i s threatening, i t r e a l l y has been a threatening experience." 39 The nurses were threatened by any experience that d i d not meet t h e i r expectations. The main expectations were: a b i l i t y to perform within the u n i v e r s i t y system, associations with professors, associations with colleagues. A l l of the nurses experienced " s t r e s s " at t r y i n g to integrate u n i v e r s i t y requirements into t h e i r l i f e . They a l l experienced f r u s t r a t i o n i n not being able to achieve t h e i r preconceived expectations for themselves i n t h e i r u n i v e r s i t y experience. Being Threatened by the Un i v e r s i t y System CARMEN talked about the workload as being a threat, "I didn't know i f I was going to be able to handle the workload." CARMEN sounded overwhelmed as she r e f l e c t e d back on beginning the degree, " I t was degrading"; CARMEN paused and gave a heavy sigh, "I don't remember the f i r s t degree having as much work as t h i s nursing degree. The f i r s t term r e a l l y lowered my s e l f esteem. I didn't think I would be able to do i t . " MISS Z looked as i f she was t r y i n g to protect h e r s e l f as she moved to s i t almost i n the corner of her chair and cuddled her arms about h e r s e l f as she compared her diploma education to the degree experience: This experience i s r e a l l y d i f f e r e n t from the diploma program. There you have one exam at the end of one whole nursing course. Here, you take more courses, have more exams and are r e a l l y f r a z z l e d . CARMEN f e l t threatened by the f e e l i n g that at u n i v e r s i t y "you have to compete." She described i t as "a very seductive pattern", she paused for only a moment and then as she continued the speed of her 40 voice quickened, " I t makes me want to run away f a s t " , then the speed of her voice slowed as she continued, "The tension can b u i l d and snowball and j u s t get to be too much." CARMEN saw the expectations being "imposed upon her" from others as well as from h e r s e l f . MISS Z found there were inconsistencies i n course workloads between f a c u l t i e s and t h i s made i t very d i f f i c u l t to make r e a l i s t i c plans for i n t e g r a t i n g u n i v e r s i t y into one's l i f e : I l i k e the nursing courses but they are too much work compared to what i s expected i n other f a c u l t y ' s courses. When I was doing my e l e c t i v e s I took three courses and worked more than f u l l time and I could do i t . Now I am taking three nursing courses and working almost f u l l time and I can barely survive. There should be more consistency, otherwise you never know what to expect or how to plan. SUZIE's voice was stern and defensive as she i n s i s t e d , "I am not going to be molded and changed, not who I am." She described h e r s e l f as being a piece of clay with " c h a r a c t e r i s t i c s of i t ' s own" and the u n i v e r s i t y system as the pottery, " t r y i n g to shape the clay": I am not going to be molded and changed, not who I am. The professors, the courses and the learning experience, they are t r y i n g to shape me...I'm i n the u n i v e r s i t y where I am being cooked...But when I am done, I j u s t might not be quite the shape they intended. I w i l l only l e t them shape me as f a r as I want to be shaped. Being Threatened by Professors A l l of the nurses had at l e a s t one experience, with a nursing professor, that was deemed as a threat to t h e i r s e l f concept of being a "good nurse." SKI's body tensed and she became v i s i b l y a gitated as she r e f l e c t e d on her fee l i n g s about some of the experiences she had with her professors: 41 I was r e a l l y f r u s t r a t e d i n the very beginning because of the attit u d e s of some of the professors. I got the impression that you are not a "good nurse" unless you have the degree. I had worked f or s i x years and was considered to be a very good nurse. I found some of the professor's attitudes very i n s u l t i n g and degrading. SKI paused f o r a moment, gave a sigh and then continued i n a dejected tone of voice as she slouched into her chair: I f I had never nursed before I would never have had any perceptions of myself and I wouldn't have been offended by any of the professor's comments and I wouldn't have had to go through that. The nurses also had experiences with professors that made the nurses question t h e i r a b i l i t y to learn. THESNIF spoke passionately as she described how she f e l t t r i c k e d by a professor and how t h i s experience influenced the remainder of the semester: Face to face we were supposedly being boosted, "go r i g h t ahead put your ideas down", but i t was marked on format not content. I was so angry and f e l t so undermined, so d i s c r e d i t e d f o r my thought. I r e a l l y f e l t t r i c k e d . . . i t permeated a l l my other courses because I was spending so much emotional energy t r y i n g to deal with the whole experience. MISS Z talked about inconsistencies between professors which was not r i g h t as i t caused a l o t of personal f r u s t r a t i o n : There are a l o t of inconsistencies within the same course and I don't think that i s r i g h t . Each professor had d i f f e r e n t expectations f o r the assignment which was r e a l l y f r u s t r a t i n g . MISS Z shook her head as she talked about how nursing professors expect her to be as committed to nursing as they were and that they didn't understand there are other courses that also need some attenti o n : You know what my main observation i s about the nursing professors...nursing i s t h e i r whole l i f e . . . t h e y think i t should be as important to me as i t i s to them, well i t i s not and 42 they can't understand that. They are j u s t too nursie, i t i s almost unhealthy, unnatural, i t i s weird. (MISS Z gave a small quiet sad sounding laugh). They don't seem to understand that we have other courses to do too. Being Threatened by Colleagues A l l of the nurses stated they knew nurses and u n i v e r s i t y graduates that viewed t h e i r education as b e n e f i c i a l . During our times together the nurses only talked i n d e t a i l about nurses and graduates who were not s a t i s f i e d with t h e i r education. MISS Z decided she had to stay away from people who had done t h e i r nursing degree because t h e i r comments scared her. She sounded frightened as she clenched her hands and seemed to p u l l into the chair: The g i r l s who have done t h e i r degree r e a l l y intimidate me because they say things l i k e : Oh, you have her now! She i s the worst you have so much work to do and i t i s the hardest course. They a l l say i t i s so h o r r i b l e and I get scared. MISS Z paused f o r a moment, her shoulders seemed to sink down to her waist and her face became quite solemn as she continued by sharing a conversation she had had with a nurse who had gone back and got her degree: "She said: Just you wait, y o u ' l l come down o f f your baccalaureate cloud and r e a l i z e i t doesn't mean anything." MISS Z was quiet for a long time as she lowered her head and looked down into her lap. The nurses were also threatened by the idea that they were not as good as some of t h e i r colleagues. MISS Z sounded so disappointed as she shared how she viewed her a b i l i t y i n w r i t i n g papers compared with other students. She ended her comments with a heavy sigh: I always f e e l l i k e I am not doing a good enough job. I read other people's papers and they come up with such i n t e l l i g e n t a n a l y s i s . 43 Limited Freedom to Learn The nurses had come back to u n i v e r s i t y i n order to learn what they wanted to know about nursing for t h e i r career . A l l of the nurses experienced " l i m i t e d freedom to learn" what they had wanted to learn during t h e i r u n i v e r s i t y experience. Two areas the nurses commented on regarding " l i m i t e d freedom to learn" were: l i m i t e d choice to l e a r n what they wanted to learn, and l i m i t e d freedom to l e a r n to the l e v e l of s a t i s f a c t i o n they desired because of there being too much work for the time that was a v a i l a b l e . MANDY wanted to be able to learn material that was i n l i n e with helping her achieve her learning and career goals. She wished she could have more con t r o l of what she could l e a r n instead of having "to conform" to what others wanted her to learn: I t wasn't what I expected and i t wasn't i n l i n e with where I am planning to go i n my nursing career. I want to d i r e c t my energies i n areas that are i n t e r e s t i n g to me. I think there should be more options for learning instead of having to conform to what they want. VICTORIA and the other nurses f e l t that they were only "scratching the surface" of a l l the material and eight of the nurses stated that they would prefer to have more depth i n a few areas versus keeping the amount of the material and only "scratching the surface of i t a l l . " CARMEN was f e e l i n g " s t r e s s " because there was "less freedom to learn" the material she wanted to learn and there wasn't the freedom to l e a r n the material to the depth she wanted to learn. CARMEN f e l t the freedom to learn was being compromised because there was not enough time to l e a r n the amount of material that what was s a i d to be 44 "required": I would never ever neglect how important the learning part f e e l s to me and that i s why I am f i n d i n g i t hard t h i s time because I love learning and I am not sure about the learning part here, i t i s r e a l l y squished. The freedom to learn, ya that's i t , there i s a l o t le s s freedom to learn than what I had expected. The content i s n ' t tough, i t i s the amount and not having the time to integrate i t the way you would l i k e to. There i s a l o t of depth i n the course material and that i s why I wish I had time to f i n d i t a l l . I wasn't expecting t h i s sort of s t r e s s . The message I seem to get i s that there are things that need to be processed and then regurgitated instead of being able to take the fact s i n digest them and come out with what they mean to me. SKI sounded very f r u s t r a t e d as she r e l a t e d her f e e l i n g s of not having enough time to tr y and "decipher" the material, "Some of i t i s very broad and very flowery and unless you have a l o t of time to s i t there and decipher i t and digest i t and take i t apart and put i t together, i t i s a waste of time." CARMEN described the experience as "a commitment f or every hour", and she found the experience "very inescapable." When the nurses were given an opportunity to make a choice i n t h e i r learning they r e a l l y f e l t there r e a l l y wasn't a choice. MISS Z shared her fe e l i n g s of one s i t u a t i o n where there was a c o n f l i c t i n u n i v e r s i t y timetables, "The professor s a i d you w i l l have to make a choice between what class you w i l l attend." MISS Z sounded exasperated as she continued, "Well I am i n no p o s i t i o n to choose which i s the most important because I need to go to both." She paused fo r a moment, looked down into her lap and when she ra i s e d her head she looked so small and vulnerable as she said, "I f e l t caught." MAC and SUZIE talked about wanting to take c e r t a i n courses but couldn't because of timetable c o n f l i c t s with t h e i r nursing courses. 45 MAC sounded very disappointed, "They say you have a choice but r e a l l y you don't. You j u s t have to take something that f i t s and hopefully i t i s something that you might f i n d i n t e r e s t i n g . " Achievement i s Personal When the nurses talked about learning t h e i r comments r e l a t e d to wanting to learn and achieve to t h e i r standards. They s a i d things l i k e : . . .1 l i k e to do my best ...I l i k e to learn everything I can while I have the opportunity . . . i f I don't get done what I f e e l i s required, I have f a i l e d . . . i t i s hard when you can't even get the minimum required done to your standards . . . i t i s how I would f e e l inside i f I d i d not succeed...that would be that hardest part. When VICTORIA spoke of achievement she talked a f f e c t i o n a t e l y of wanting to l e a r n more about nursing so she could " o f f e r more" to her patients, "The more I have to o f f e r my patients the better I f e e l . " For CARMEN being able to complete a larger than expected amount of assignments was viewed as an achievement that gave her some confidence that she could "get through the r e s t " of the degree: W i l l I be able to get s i x papers done i n one term. But when you did i t was, "Well I guess I can get through the r e s t . You have already put a quarter of the time i n . " MISS Z was not getting the highest marks she f e l t she could get but they were the highest marks she could get "and s t i l l survive", and so f o r her that was "an accomplishment." CARMEN sai d she had a "general fear of f a i l u r e . " She f e l t that she must obtain high marks or she "would not be accepted" by others. 46 She r e a l i z e d that her f e e l i n g were "emotional" and not " l o g i c a l " but high achievement was very important to her sense of being accepted by others. CARMEN was obtaining top marks but s t i l l remained concerned about how others viewed her: I l i k e others to have a high opinion of me. I f I do lousy on an exam or paper you think, "what i s that person going to think." You get a funny perspective on things being here. You think that person i s going to think r e a l l y poorly of me i f I make a s p e l l i n g mistake, or i f t h i s paper i s stinkopooh (nervous laugh). This i s n ' t a l o g i c a l f e e l i n g t h i s i s an emotional f e e l i n g but I belie v e the opinion of others i s pinned on my performance here. I t ' s a f e e l i n g l i k e I won't be accepted i f I don't do w e l l . SKI believed that what she learned and was able to "take away" from the experience was more than what her marks showed because as she At papers I am a wash out...My w r i t i n g s k i l l s are not that good and being out of school f o r f i v e years made my w r i t i n g s k i l l s even slo p p i e r . . . i n charting i t i s j u s t one word period...you come here and they expect to write these huge papers. Well I am better than I was. I f only they could see how much better I am. When the nurses talked about evaluation of t h e i r learning t h e i r comments always captured the thought that marks were "not a true measure of learning." SKI sounded very disappointed when she talked about a mark she had received, " i t didn't r e f l e c t what I had learned." A l l of the nurses negated marks as being important unless they were coming back for more schooling. Marks were negated because, ...they r e a l l y don't measure what I have learned. ...the exams are written very poorly ...exam answers can sometimes be so ambiguous ...poor marks are a sign of a poor exam SKI along with a l l the other nurses f e l t " the emphasis has to be taken o f f the marks and the exams because they don't measure what you 47 learn anyway." The nurses d i d not equate marks with any measure of learning, "learning i s not so much what marks I get." Learning was equated with what they would do with the material i n p r a c t i c e not with being able to write an exam or a paper, "Marks are not as important, i t i s what you learn." CARMEN'S long d i s s e r t a t i o n captured a l l the nurses' i n d i v i d u a l comments about how evaluations were not seen as measuring learning: I t r y to minimize the importance of marks because I think the marks are not a very accurate way of describing anything at a l l . L o g i c a l l y I t r y so hard to remember what I think about marks and I r e a l l y d i s l i k e the grading systems because of the pressure i t puts on me. I t puts a l o t of a r t i f i c i a l s u p e r f i c i a l pressure on. I t i s l i k e saying your worth i n a number, or how you have done i n a course i n a number and i t doesn't take the broader look at what you have learned. I t often does not show my learning. I t shows I d i d better on one t e s t than on another. Often the course that I f e e l I am learning a l o t i n and keeping up i n and i n t e r e s t e d i n and have a l l the things that should give you a good mark but i t doesn't c o r r e l a t e with the mark I get. In other courses you w i l l write an exam a f t e r g iving up on studying but you do marvelously on the exam" (nervous laugh). Then i n a more serious tone CARMEN said, " I f i n d there are a l o t of discrepancies because marks from papers may show some learning but they also measure how well you can write and a r t i c u l a t e thoughts. They also measure what you already know. Exams are so s i t u a t i o n a l . They are one day and often once you understand the profs s t y l e of questioning you can respond more appropriately. A l l of the nurses found evaluation very "int i m i d a t i n g " and would tr y to get through one evaluation technique and t r y to improve t h e i r mark with the evaluation technique that was not as intimidating. MISS Z found doing papers was r e a l l y i n t i m i d a t i n g so she would t r y to cope with these fee l i n g s by getting everything she could from the professor and then t r y i n g to improve her mark on the exams: Papers r e a l l y intimidate me so I go to the professor and f i n d out exactly what they want me to do and do that to the best of my a b i l i t y . I don't do any extra, j u s t what i s expected and I t r y 48 to do better on the exams. I hate papers!. CARMEN was very calm as she talked about how she made adjustments to her approach i n w r i t i n g papers s p e c i f i c to professor preference: There are times when I have known I shouldn't write something i n a paper because i t won't be accepted well but that depends on the prof. You pick that up from l i s t e n i n g i n cl a s s sometimes you can t e l l they have a very s p e c i f i c idea about things. You j u s t know f o r some: I better make t h i s r e a l l y s t r a i g h t forward and not t r y any new discoveries, I better j u s t s t i c k to the main s t u f f , whereas other times I can expand. I have never t o t a l l y p r o s t i t u t e d my papers to pander to a prof, I have never had a s i t u a t i o n that severe." CARMEN paused, her voice tone became f i l l e d with nervous anxiety, "Ghee that would be a t e r r i b l e s i t u a t i o n to be i n . " SKI dealt with evaluation that she f e l t was i n c o r r e c t by "keeping her mouth shut." She described the approach as being used f o r " s u r v i v a l " i n completing the degree. As she talked about her f e e l i n g s she slouched i n the chair and her head f e l l s l i g h t l y backward and she sighed: I f someone gives you a bad mark you are stuck with i t . . . I j u s t want to complete t h i s and get my piece of paper, take what I have learned and go on with my l i f e . I f I get a lower mark than I f e e l I deserve I j u s t shut my mouth and t r y to improve, j u s t as long as I pass. I know that i s a lousy a t t i t u d e and I don't l i k e i t but that i s sort of s u r v i v a l . Getting Through I t The nurse's voice took on a tone of wonder, searching and exhaustion when they talked about t h e i r a b i l i t i e s i n "getting through" the experience: ...I don't know i f I can make i t through ...I have no time for myself . . . i f I can j u s t make i t t i l l Christmas ...sometimes i t i s more than you can take ...sometimes i t was a question of being able to f i t i t a l l i n When they experienced a threat they f e l t they only had two 49 choices. They could e i t h e r "get through" the experience or "leave" the experience. The nurses helped themselves through the experience by using t h e i r own personal resources which required making personal adjustments and compromises. THESNIF sounded r e l i e v e d at how she was adjusting to f i t t i n g u n i v e r s i t y into her l i f e , "Sometimes i t was a question of being able to f i t everything i n but I knew I could do the courses i f everything else was OK...I protected myself pretty w ell when I star t e d . " A l l of the nurses used short term goals and some form of reward to help "get through i t " ( t h e program). CARMEN's recipe f o r getting through i t was by "making i t one goal at a time." RUTH sounded reassured as she said, "I had to learn to set my own goals and not f e e l g u i l t y that I wasn't doing what I thought I should be doing compared to what the other students were doing." Five of the nurses described using rewards to help them get through i t . MISS Z saw being able to take e l e c t i v e s that she wanted as a reward f o r taking the nursing courses that she considered "a burden." She got a l i f t i n her voice, her eyes widened and she looked excited as she added, "I can hardly wait u n t i l I get these nursing courses over with so I can look through the calendar and f i n d an e l e c t i v e that I can r e a l l y get my teeth i n t o . " MAC's and RUTH's reward f o r study long hours during the week was having "some time" to be with t h e i r husband. Making Adjustments A l l of the nurses found that they had to make some personal 50 adjustments i n order to attend u n i v e r s i t y . The two main areas of t h e i r personal l i v e s that had to be adjusted, with attending u n i v e r s i t y , were no longer having the same amount of time or money to do things they enjoyed and, sometimes, valued dearly i n t h e i r personal l i f e . A l l of the nurses found, to d i f f e r i n g degrees, that they were "putting l i f e on hold." As SKI began to t a l k about how attending u n i v e r s i t y was a f f e c t i n g her l i f e s t y l e , she s h i f t e d her s i t t i n g posture to be more s t r a i g h t and r i g i d and her tone of voice became quite firm, "You get used to having money and a l i f e s t y l e , you get used to your own time. Before I came back to school I went s k i i n g f i v e times a year." SKI relaxed her posture and gave a somewhat s a r c a s t i c laugh, "I haven't gone since I started u n i v e r s i t y . I t r e a l l y l i m i t s you." She sat up s t r a i g h t again and became firm i n her voice again, " I t has been putting things on hold" and then she slumped i n her chair and s a i d very q u i e t l y , "But g i v i n g them up for the time being." MANDY noticed most the reduction of time she had to be a mother and t h i s required her to make adjustments i n how she approached her mother r o l e : I am not on top of t h e i r every move and now I r e a l l y have to screen out what i s important because I don't have the time to be with them or to get on them. I get s t r a i g h t to the point now because there i s n ' t the time to be going around i n c i r c l e s . THESNIF described how she had " l i v e d and breathed" a course she was taking and her husband didn't know " i f they would make i t " should the year end up that way. CAROLYN'S husband sometimes said, "I miss 51 you" when she had to "put extra time i n around exam and paper time." The nurses also had to make adjustments to how they approached learning at the u n i v e r s i t y compared to t h e i r previous educational experiences. THESNIF sounded so annoyed, at h e r s e l f , f o r the adjustments she had to make for studying, "Everything had to be quiet, no radio, no husband i n the house, nothing...I even had to put the dog outside because of her snorting." MANDY also sounded annoyed with her a b i l i t y to learn t h i s time: I have to make i t part of me now, absorb it . . . B e f o r e I could read i t and l i s t e n and i t would be there, but now I have to concentrate so much more to get i t i n . . . i t i s so d i f f e r e n t t h i s time. Eight of the nurses found t h e i r previous educational experience was not helping them to deal with u n i v e r s i t y education. The nurses talked about how much "other learning" they had to do, that was i n add i t i o n to learning the content. The other learning was described as having to lea r n "the system." CARMEN described how she had learned how to write papers and study during her previous u n i v e r s i t y experience so she had "less learning to do" t h i s time and " a i l of that r e a l l y helped" her to deal with the workload t h i s time around. Even though CARMEN had attended u n i v e r s i t y before, she found that approaching the second u n i v e r s i t y degree the same as the f i r s t degree wasn't working so she had to "learn to look at learning d i f f e r e n t l y " t h i s time and found she was s t a r t i n g to "adapt." VICTORIA was using a learning technique that had worked f o r her i n her diploma nursing program. VICTORIA had a study partner within 52 the f i r s t two weeks of s t a r t i n g u n i v e r s i t y , "I knew that I wanted a study partner because you can learn more e a s i l y so I decided to approach one of the other students and we became study partners." Having to Compromise Making personal l i f e adjustments to attend u n i v e r s i t y turned into having to make personal compromises when u n i v e r s i t y demands exceeded what had been outlined and anticipated by the nurses. The nurses became "upset" and "angry" at "the system" for "imposing u n r e a l i s t i c workload demands." The d i f f i c u l t y for the nurses was that they had done preplanning to f i t u n i v e r s i t y into t h e i r l i f e and when extra demands entered into the game compromises had to be made. CARMEN compromised her personal l i f e i n order to meet her educational goals: I have found that I have had to compromise i n other parts of my l i f e i n ways that I am not pleased with. I haven't been able to keep up with any s o c i a l i z i n g with friends and I f i n d i t hard to have the time to work on handling the stress of the s i t u a t i o n . I haven't r e a l l y been doing much to manage my health, that's for sure. MISS Z made a decision of how much she would compromise her personal l i f e i n order to attend u n i v e r s i t y . She sounded so dejected and defeated as she very q u i e t l y said, "I w i l l never be an 'A' student because other aspects of my l i f e are too important to me to j u s t immerse myself into the books." SKI was very concerned that some of her colleagues were not understanding they could not get maybe the highest marks "because of t h e i r s i t u a t i o n . " She was very sincere and emphatic as she said: 53 A l o t of g i r l s are only taking two courses so they can make eights and nines. I t sort of makes the re s t of the g i r l s f e e l dumb. But hey, they are taking four or f i v e courses, working part time and have a family... they do need to be reassured they are not any dumber than anyone else, i t i s j u s t t h e i r s i t u a t i o n . Seven of the nurses were working ei t h e r casual or part time i n order to finance attending u n i v e r s i t y and l i v i n g . MISS Z was working almost f u l l time hours while taking three nursing courses. She sat very s t r a i g h t i n the chair and had a stern expression as she described how her basic " s u r v i v a l " was being compromised while she was attending u n i v e r s i t y : " I t i s a very b i g s t r a i n for myself ( f i n a n c i a l l y ) . I didn't stop working and that i s a b i g s t r a i n too. Most of the f a c u l t y members have said: Why are you working?" MISS Z sat forward i n the chair and the volume of her voice increased, "Because no one i s paying my b i l l s ! " MISS Z's tone of voice became s l i g h t l y s a r c a s t i c as she continued: "Then they say: 'You should get your p r i o r i t i e s s t r a i g h t ! ' " Her voice tone now became very s o f t and she sat back i n the chair, "I am get t i n g my degree and that i s nice but i t i s not the most important thing i n my l i f e . The most important thing i n my l i f e i s b a s i c a l l y my s u r v i v a l , my well-being, my health and these don't go together with taking my degree. MISS Z saw that she had no choice put to make the personal compromise. She sounded very dejected as her shoulders slouched and her smile disappeared: I guess I am putting nursing, no I am putting t h i s degree program above my personal l i f e r i g h t now. I have made my choice but I f e e l I have no choice. I j u s t f i t i t a l l i n . . . I w i l l do what ever I have to, to get through. That i s n ' t a very p o s i t i v e a t t i t u d e , I know but "I have never been t h i s p e s s i m i s t i c about anything i n my whole l i f e . " Her body posture took on a very 54 guarded and tense appearance even though a smile formed on her face. When I s a i d to her, you are smiling even though you f e e l that way and she said, "but I am not smiling on the i n s i d e . " MAC was not doing c l i n i c a l bedside nursing as much as she had hoped she could because studying and f i e l d projects were "taking more time" than she had expected. One month she found she d i d have to work because she needed new glasses and as she sighed and shook her head she said, "we j u s t didn't have the money i n our budget so I had to work." For SUZIE the personal compromise came when t h e i r car "died" and she had to make a decision of what she would compromise: I f I continue then I ' l l have to work more hours and I won't be able to spend as much time on my studies as I would l i k e to. I f I drop a few of my courses i t w i l l take longer and I don't think my family could handle that and i f I quit altogether I w i l l be l e t t i n g my dream die and I w i l l be r e a l l y disappointed. One of SKI's compromises that she had to deal with i n attending u n i v e r s i t y was i n l o s i n g some of her previous s k i l l s . She was very calm as she talked about l o s i n g some "technology s k i l l s " but sounded disappointed at l o s i n g her "people s k i l l s . " SKI laughed as she explained why she was l o s i n g her people s k i l l s , "I think with attending u n i v e r s i t y i t i s hard to be receptive to others when you are f r i e d y o urself"! When the nurses were not able to adjust to the stress of the s i t u a t i o n they f e l t "defeated." They f e l t they should be able to cope with the stress of t h i s s i t u a t i o n because they coped s u c c e s s f u l l y i n nursing s i t u a t i o n s that they considered as s t r e s s f u l . CARMEN f e l t she was not being able to cope with the stress she was experiencing which was upsetting as she could u s u a l l y cope with 55 " s t r e s s f u l s i t u a t i o n s " : Usually i n s t r e s s f u l s i t u a t i o n s I've been able to adapt l i k e water running o f f a duck's back and I can cope with the things that are causing me stress but t h i s time the stress and the pressures are h i t t i n g me very very hard and I don't f e e l l i k e I am dealing with them that well yet. MISS Z had one experience where she f e l t i f she would have added one more item to her personal performance menu she would have had a nervous breakdown: I was s e t t i n g up my timetable with assistance of one of the professors. She s a i d I had to take t h i s c e r t a i n course i n t h i s term and I s a i d I can not take four courses and she s a i d well you w i l l have to and I said, (MISS Z's voice became very stern and her speech was very slow and staccato) " L i s t e n to me. I can not take i t t h i s semester or else, I w i l l have a nervous breakdown." Being Helped Up or Being Brought Down When the nurses talked about "getting through" the experience they talked thankfully of "being supported and encouraged" by family, fr i e n d s , colleagues and professors. Almost i n the same breath t h e i r smiles disappeared and they spoke with disappointed surprise that at times turned to resentment at how they could be "brought down" by professors and colleagues. Sometimes the nurses found that colleagues provided "no support" for getting through the experience. The nurses always talked about t h e i r f a m i l i e s as "helping me through" and they "couldn't have done i t without t h e i r family support." MAC said, "I would have f e l t very alone without my husband's support" and VICTORIA thought having no support would be l i k e "being alone on an i s l a n d . " A l l of the nurses were pleasantly "surprised" at how much support 56 t h e i r f a m i l i e s gave. MAC's "surprise" i n her husband's support was i n i t i a t e d by h i s willingness to relocate to another c i t y i n order for her to attend u n i v e r s i t y , "I j u s t couldn't believe how supportive he was...I didn't r e a l l y expect that." MANDY was happy that her husband remained supportive even a f t e r a l l the "bad s t u f f " they thought could happen, as a r e s u l t of her attending u n i v e r s i t y , d i d happen. CARMEN'S support for getting through the experience came from her boyfriend i n the capacity of "encouragement" and "some esteem r e b u i l d i n g . " She smiled and crossed her arms t i g h t l y i n front of her as she said, "When I am p a r t i c u l a r l y stressed there i s always a hug." MISS Z r e f l e c t e d on how she was f e e l i n g so discouraged and how her family and friends helped her, when a l l of a sudden she sat up s t r a i g h t i n the chair, leaned forward with an expression that made you think she had made an i n c r e d i b l e discover: I have a brother who was l i v i n g with me and we are very close. When he was here I never f e l t t h i s f r u s t r a t i o n . He moved away fo r a year. That could have something to do with i t , I don't have someone there a l l the time to say you are doing f i n e don't worry. And your family can say things that nobody else can. The nurses found that friends and work colleagues were more supportive i f they had attended u n i v e r s i t y . THESNIF talked a p p r e c i a t i v e l y of her friends, "they know what I am going through... they can understand." MISS Z s a i d that her work colleagues who had not attended u n i v e r s i t y "couldn't give" her any support because "they haven't been there." SKI's head moved up and down as she talked about the " p o s i t i v e " aspects of having friends go back to school at the same time as she 57 came back to u n i v e r s i t y . Her head them moved from side to side as she talked about the "negative" aspects of doing studies at the same time, "We tend to support each other but we can also b r i n g each other down, but f o r the most part i t i s p o s i t i v e . " The nurses a l l found the professor made "a r e a l d i f f e r e n c e " to the learning experience. SKI found: "There are some professors you can challenge with your ideas and some you can not." There was yearning i n her voice as she talked about how she could challenge her in s t r u c t o r s i n the diploma program. The professors approach i s what made the differe n c e i n making the experience a "learning experience or an evaluation experience." SKI described the dif f e r e n c e having a supportive i n s t r u c t o r was having on her a b i l i t y to learn: "The professors make a very large difference. The professor t h i s term i s making a l l the difference. I t i s not a case of I am going to f a i l or I am going to drop out, i t i s : What do I do to get a better mark. The good professors give you options and give them ea r l y so you have a chance to reach your goal." SKI smiled as she said, "This term I have a chance on these l a s t weeks to p u l l up my boots and get my act together and go for i t . . . l a s t term I didn't f i n d out I was having a problem u n t i l the very end and that didn't give me any chance." A l l of the nurses found that some professors approached them as adults while others approached them l i k e c h i l d r e n . The nurses spoke with a tone of appreciation when they were treated l i k e adults. They spoke with disappointment and surprise when they were treated l i k e c h i l d r e n . CAROLYN and MANDY both made reference to "I shouldn't have 58 to take t h i s at my age" [Remember they were both i n t h e i r f o r t i e s ] . MAC, SUZIE and MISS Z "couldn't believe they would t r e a t us that way" and sounded so surprised when they said, "they must have gone back to school as adults." MAC sounded very upset, the clenching of her f i s t s added to the tension i n the a i r as she r e l i v e d her experiences: Some in s t r u c t o r s t r e a t you l i k e adults. They r e a l i z e that you are there for y o u r s e l f and you w i l l get the p r o j e c t done. You have other r e s p o n s i b i l i t i e s and they know that. I f we don't get i t done we are only l e t t i n g ourselves down. In other classes i t i s , "you should have been prepared for t h i s " they j u s t l i k e to reprimand you l i k e you are a c h i l d . SKI sounded disappointed as she talked about some of the nursing professors, "There i s n ' t a comrade f e e l i n g with the professors. There i s n ' t a f e e l i n g l i k e , here i s a helping hand up." SUZIE described the professors as e i t h e r "giving a helping hand up or being able to crush you." CARMEN concurred with SUZIE: Some of them are r e a l l y supportive and encouraging. They are there to help you to meet your goal while others j u s t are there to evaluate you and they w i l l decide i f you have met your goal or not. CARMEN continued sharing d i f f e r e n t experiences where she wished the professor had been more supportive, then she stopped and gazed out the window as i f she were deep i n thought. She started nodding her head very slowly up and down as i f to say, yes that i s r i g h t . With the nodding came the statement, " I t i s very s t r e s s f u l and your s e l f esteem i s being threatened by the new s i t u a t i o n and by the heavy workload" CARMEN stopped for a few moments, she gave out a heavy sigh and then her breathing became very deep and each exhale caused her shoulders to sink lower and lower. Her faced looked l i k e i t was being drained of 59 a l l energy as she w i s t f u l l y said, "Sometimes you need the encouragement on your strengths." SKI and four other nurses had to deal with a professor's approach that seemed to zap a l l of t h e i r energy. The experience required them to take energy that was ear marked for learning and put that energy i n dealing with the "inner turmoil" that r e s u l t e d from i n t e r n a l i z a t i o n of the professor's approach. SKI was very stern as she talked about how she had gotten the impression that a nursing professor was t e l l i n g SKI that she was not a good nurse. Even though SKI i n t e l l e c t u a l l y negated what the professor was saying she could not negate her emotional f e e l i n g . The emotional feel i n g s were overpowering SKI's a b i l i t y to lear n i n a l l of her courses and as she sa i d i t put her i n a "bad frame of mind" about the nursing degree and i t required her to use so much "emotional energy" to deal with the s i t u a t i o n : I t put me i n a bad frame of mind. I t made i t so I had to do a l o t of mind work, a l o t of back tracking [ s i c ] . I t made i t hard to l i s t e n to her i n c l a s s . I had to say to myself: "I'm going to get as much out of t h i s as I can. I t doesn't mean I have to swallow the whole p i l l , I ' l l j u s t t r y to get the best out of i t . " I t took a l o t of hard work and a l o t of energy. I had to spend so much emotional energy...I shouldn't have been made to f e e l so uncomfortable. I had to use so much emotional energy to t r y and get the knowledge. I t was going through a bunch of head games. THESNIF sounded f r u s t r a t e d and disappointed with how a professor's approach could influence u t i l i z a t i o n of personal energy f o r learning: . . . i t i s t h e i r intonation. What they are r e a l l y saying i s , 'don't question anything I have to say because we don't have time f o r that'. That makes i t r e a l l y a r e a l struggle...you f e e l l i k e you are up against i t a l l the time...you have to work harder to even t r y to lea r n because you have to get by t h e i r approach. 60 MISS Z made a wish of how she would l i k e professors to give her encouragement to help her through: You know what would be nice? I f once i n a while a prof would j u s t say to you: 'You know you are doing OK', rather than w r i t i n g a l l these comments, t h i s i s wrong, t h i s i s wrong, t h i s i s wrong! I f once i n a while somebody would say that was good, maybe i t wasn't a nine but that was a good point, rather than always bringing you down. The nurses a l l found some u n i v e r s i t y students as "giving support." MISS Z talked about how she "gathered f i v e or s i x friends"(nurses) at u n i v e r s i t y and how they were " t r y i n g to help each other through": I have gathered f i v e or s i x friends here and we are j u s t t r y i n g to help each other get through t h i s program. They are very supportive. We go for lunch once a week and one w i l l s t a r t by saying: 'I have not cleaned my house i n a month', and another one w i l l say,'my kids have not had clean sheets i n four months' and they say,'I am so glad that I am not the only one that can't get i t a l l together'. We are more of a support group. I don't think I could continue without t h e i r support. I know now that I am not the only one who can't get i t a l l together. MANDY gave a sigh of r e l i e f as she talked about how much support she obtained from the nurses i n the program. She described her previous encounters with nurses as "non-supportive" and "back stabbing." A smile came on her face and she relaxed into the chairs as she explained: I have r e a l l y never had p o s i t i v e r e l a t i o n s h i p s with nurses when I was working... Here i t i s d i f f e r e n t . The nurses here are not l i k e the ones out there. We can discuss things, they are f r i e n d l y and they are supportive. I have learned a l o t from them and i t i s nice to get t h e i r perspective on issues. I t i s nice being around them here. MAC and three of the nurses gained support f o r continuing i n the program through "being i n s p i r e d " by other nurses i n the program. MAC 61 sounded as i f she was encouraging h e r s e l f when she talked about the i n s p i r a t i o n she gained from the other students: ...you see t h i s mother with three kids...and she's doing i t . You think, " i f she can do i t I should be able to."..you see someone 40 or 50 years o l d and you think, " I f they can so can I."..that r e a l l y i n s p i r e s me. A l l the nurses found at l e a s t one colleague at the u n i v e r s i t y that was not supportive of the nurse's s i t u a t i o n . For MISS Z the non-support came i n comments from other colleagues about her l e v e l of achievement. MISS Z sat back i n the chair and as she voice took on a tone of regret her head began to move from side to say as i f to say, they don't understand: Some say I don't know how you can be happy with a s i x , but those people don't work, a l l they do i s go to school. A l o t of them have husbands who are bringing i n an income and I don't have that. I have to work. Losing Support The eight nurses who had been working before attending u n i v e r s i t y a l l f e l t they had " l o s t " some personal support and were "looked at d i f f e r e n t l y " by t h e i r work colleagues. SKI found working as a f l o a t nurse, while attending u n i v e r s i t y , was a disadvantage because she "no longer got support" from the people with whom she worked. RUTH and MISS Z described s i t u a t i o n s where they were at r i s k of l o s i n g personal support from t h e i r diploma nursing friends as they did not understand the time commitment involved i n attending u n i v e r s i t y . RUTH sounded annoyed that her nursing diploma friends expected her to keep i n touch with them to the same degree as she d i d when she 62 was working: They don't understand that i t i s not l i k e doing our diploma. They think j u s t because I am not i n cl a s s that I have time to get together. They don't r e a l i z e the amount of time I have to spend studying and doing papers i n the l i b r a r y . They j u s t don't understand. MISS Z sounded f r u s t r a t e d as she described her diploma nursing friends as "getting upset" with her because "I never c a l l . . . I am never at home so obviously I don't value t h e i r f r i e n d s h i p . " She sat up s t r a i g h t i n the chair and s a i d emphatically, "That i s n ' t true. I j u s t don't have time." MAC's voice was quiet and guarded as she talked about how she t r i e d not to lose the support of her diploma work colleagues: There are bad f e e l i n g s , mixed feel i n g s about having a degree... I couldn't t e l l them I was coming back for me because they wouldn't understand...I didn't want to rock the boat...I didn't want to lose t h e i r respect...so I t o l d them I had at l e a s t 20-30 years l e f t i n nursing and I had to keep up with the flow. A Question of Worth When the nurses talked about what they were learning i n the experience there was v i s i b l e excitement and e x h i l a r a t i o n along with v i s i b l e dejection and f r u s t r a t i o n . They described t h e i r experience with what they were learning as: "an opening", "a broadening", "a confirmation of t h e i r b e l i e f s . " They described the material they were learning as " i n t e r e s t i n g " but too much of the content was "too f a r from r e a l i t y . " The nurses' view of r e a l i t y was what would be possible to implement i n t h e i r " l i f e t i m e . " I t appeared from the data that the nurses asked two questions about the worth of the learning experiences. 63 An Opening The f i r s t question of worth was, what i s the s i g n i f i c a n c e of the learning experiences? The nurses found the learning experiences were s i g n i f i c a n t i n "opening" t h e i r "eyes" and "thoughts" to issues that pertained "to everyday l i v i n g " as well as being opened to see nursing as they had never seen i t before. A l l of the nurses talked about d i f f e r e n t aspects of the learning experience which helped them "to see" t h e i r a b i l i t i e s and enabled them to have a sense of confidence i n themselves as people. SUZIE sounded thankful for how the u n i v e r s i t y had opened her to the world and to h e r s e l f , " I t has opened my eyes to see a broader perspective of the world...I won't be a f r a i d to t r y new things." MANDY was t a l k i n g about her l i f e and she paused for a moment and then s a i d s o f t l y and with an a i r of s a t i s f a c t i o n , "University i s helping me unravel some of the things i n my l i f e . I am coming to c e r t a i n r e a l i z a t i o n s about myself." She then went on to t a l k about those r e a l i z a t i o n s and how a course she was taking was helping her to "look i n t o " her l i f e and postulate some answers. MISS Z described how having to cope with the program had "opened up" how she viewed h e r s e l f and helped her to gain more s e l f confidence i n her a b i l i t i e s as a person: I was always confident i n myself but now being here and having to cope with a l l of t h i s has opened up that part of how I view myself. I guess you don't r e a l i z e the resources you have u n t i l you are forced to do something. THESNIF found i t " e x c i t i n g " to see what she was learning 64 happened i n "everyday l i f e " : One of the biggest rewards i s f i n d i n g trends and patterns i n everyday l i f e that are outlined i n the theory. I was l i s t e n i n g to the radio and i t r e a l l y seemed to apply... I thought ya that i s e x c i t i n g to show up! The nurses were also experiencing being opened i n t h e i r nursing r o l e . VICTORIA sounded so exhilarated as she smiled and moved her head up and down slowly, " I t has increased my sense of r e s p o n s i b i l i t y with my p a t i e n t s . " THESNIF's face held a s a t i s f i e d smile when she spoke of being opened to more opportunities i n nursing, "There are so many more opportunities than I had thought." The nurses were also f i n d i n g what they were learning was opening them to see nursing l i k e they had never seen i t before. For SKI, the problems i n nursing started to become v i s i b l e . SKI relaxed i n the chair and rested her head i n her hand. She sounded as i f she was very f a r away and her gaze only added to the distance that she was p l a c i n g between her body and her thoughts, " I am beginning to see why there i s so much dissension i n nursing, why there are so many c o n f l i c t s . " She was so quiet and distant that no comment could have brought her back. RUTH sounded so s a t i s f i e d with "seeing the whole grey area of nursing open up" for her. MISS Z sat back i n the chair and her shoulders began to sink as she shared how learning more about nursing was a f f e c t i n g her: I t has given me more in s i g h t into nursing but i t has made me much more discouraged about nursing. I was so much happier when I didn't know a l l the problems i n nursing. Now that I am taking t h i s degree, and seeing a l l of t h i s , I j u s t don't think any type of nursing w i l l give me a r e a l sense of job s a t i s f a c t i o n . I do regret s t a r t i n g my degree because i t j u s t i s n ' t worth i t . I 65 won't make nursing my career, not now. I j u s t wasn't exposed to these nursing issues i n my diploma. A Broadening The nurses f e l t t h e i r views of nursing were being "broadened" and "expanded." SKI saw the experience as giving her a "broader perspective" of nursing and she f e l t that was "very valuable." MISS Z found that hearing the " d i f f e r e n t views of students i n other f a c u l t i e s " helped her to "expand" her understanding of d i f f e r e n t issues. SKI found doing her c l i n i c a l practicum i n an area that she has never worked i n allowed her "to see" the d i f f e r e n t and valuable perspective of the nurses who worked i n that area. A l l of the nurses placed value i n learning what nursing " r e a l l y i s " from l i s t e n i n g to t h e i r colleagues. They f e l t they "expanded t h e i r view" of what nursing i s because of the v a r i e t y of backgrounds of t h e i r nursing colleagues. SKI sat back and smiled, "I have learned a l o t from them." MAC sounded pleased and excited as she said, "I never knew nursing encompassed so many things." SKI guessed she had gotten "tunnel visioned" working i n the h o s p i t a l f o r the past s i x years and THESNIF was exhilarated because seeing the expanse of nursing made her f e e l l i k e she "could stay i n nursing now" and she didn't have to be "a physician's handmaiden" and SUZIE saw she was "only a physician's a s s i s t a n t before" and now she wanted to "be on the patient's t u r f . " VICTORIA described how she saw the degree a f f e c t i n g her views of nursing, "To me nursing i s caring but the degree of caring i s going to change for me now. I didn't have the whole concept 66 of the things I was doing before. The degree has expanded that, i t w i l l enhance my p r a c t i c e . . . i t i s going to enhance my contributions." A l l of the nurses experienced a broadening of nursing knowledge into "what nursing could be" and they a l l "hoped" that "someday" nurses could p r a c t i c e the " i d e a l . " Coming to u n i v e r s i t y r e s u l t e d i n MISS Z seeing "two parts to nursing", "One i s out there i n p r a c t i c e and one i s from i n here, i n the 'ivory tower'. Hopefully they can become one, so then we could become focused toward the same thing." CARMEN spoke with c e r t a i n t y when she said, " I t has given me a b e t t e r understanding of things and also some good sound knowledge." A l l of the nurses found that they were learning to question a l l aspects of nursing and they were learning the "whys" behind a l o t of the things they j u s t d i d automatically before. THESNIF's eyes brightened and a smile appeared, "What I am learning i s to question everything." The broadening also encompassed views about u n i v e r s i t y education. SUZIE sounded disappointed and angry as she said, " I t i s n ' t the be a l l and end a l l of education...I shouldn't have put i t way up there on a pedestal...but I now have a better understanding of how to manipulate the system." SKI found that attending u n i v e r s i t y was "giving" her "some i n s i g h t s " into why professors are not as supportive as they could be: I think the professors are asked to do too many things: research, teaching, counsellors, and scholars. Like no one can have that many hats and be good at a l l of them. I t i s u n f a i r to them and i n turn i t i s u n f a i r to us. I think a l o t of the profs are burnt out too. 67 Four of the seven married nurses f e l t that t h e i r husbands were sharing i n some of the learning and were "coming with" them versus "being l e f t behind" or "growing apart." THESNIF's eyes widened and a l i f t e d tone came to her voice as she talked about the personal broadening she was seeing i n her husband that she a t t r i b u t e d to her attendance at u n i v e r s i t y , "I know he has a broader focus now and I take c r e d i t f or that." Confirming B e l i e f s B e l i e f s about personal a b i l i t y and nursing were confirmed by attending u n i v e r s i t y and taking nursing courses. SUZIE sa i d with s e l f - c e r t a i n t y , "The experience has confirmed my confidence , i t has tested what I thought was true about myself." SKI sounded happy and r e l i e v e d when she talked about what she was learning. As she continued sharing how she f e l t , she moved to s i t up s t r a i g h t e r i n the chair. I t looked l i k e d she was being pumped up: I t i s confirming and strengthening a l o t of f e e l i n g I already had about nursing. Often i n the h o s p i t a l you are put i n uncomfortable s i t u a t i o n s . Now I can go out there and say, I'm not the only one who f e e l s t h i s way. I already knew that but now I have theories behind me. I t has been good i n that way. I t has also confirmed the things I have looked negatively on too. I had a l o t of problems with the way administration and organizations were but one of my sociology courses i s pointing out that my f e e l i n g s are a r e a l i t y . You now know those things that you thought were not p o s i t i v e are indeed there and that they are not p o s i t i v e . I t shows you what you thought were problems are indeed problems. THESNIF sounded exhilarated when she said, "I knew there was more to nursing than j u s t following orders...It i s confirming and re a f f i r m i n g what I thought was true." 68 W e i g h i n g t h e F a c t o r s The second question of worth the nurses asked was: Is the learning i n l i n e with helping me to achieve my personal goals to the l e v e l that i s worth the personal s a c r i f i c e ? Nine of the nurses questioned i f they should continue with the baccalaureate i n the f i r s t four months of t h e i r f u l l time studies. Five o f the nurses s a i d they would have quit but they had "come to f a r already" and they "might as well have a degree" a f t e r t h e i r name. MISS Z s a i d she couldn't quit because she had over h a l f of her c r e d i t s completed. She sounded very w i s t f u l about being able to quit because the workload was more than she believed to be r e a l i s t i c f o r one person to handle: I would l i k e to quit but I can't quit at t h i s point, I have gone t h i s f a r . I know I shouldn't quit. I t i s j u s t the end i s not i n sight yet and they ask too much, i t i s j u s t too much for one person to do. CARMEN thought about leaving the program at mid-terms and then decided to wait u n t i l the end of term to make a decision: I thought about leaving the program around mid-terms, l a s t term (which was the f i r s t semester as a f u l l time student). I decided that i f I f e l t that I hadn't made some sort of progress f o r a l l the bustle and f l u r r y by Christmas that I would leave. I t was weighing those two things to decide i f doing the degree was worthwhile. CARMEN's voice became serious: I t i s so product orientated, you are always supposed to be producing, producing, and you are always supposed to be busy. I appreciate a slower pace where you can notice everything... maybe we need to be busy and learn a l l these facts maybe by learning more you r e t a i n more but I don't know. I t i s j u s t a question I have: 'Are we r e a l l y learning'! MANDY came into the program questioning whether she should do her 69 degree i n nursing or i n another area. She was s t i l l asking that question and s t i l l sounded puzzled during our l a s t time together, "I am not sure about nursing I am s t i l l turning i t over, and over, l i k e a Rubik's Cube." As she paused a questioning furrow developed on her brow, "I am t r y i n g to see what i s i n i t for me, i f I should stay." Her voice took on a tone of defense, "Maybe that i s s e l f i s h but there must be something i n a l l of t h i s f or me, i t has to have a purpose." THESNIF sounded thankful that the material she was learning was " r e i n f o r c i n g " what her supervisor was helping her to learn on the job. She sounded so happy and a smile appeared when she added, "Now I can stay i n nursing." Too Far from R e a l i t y Eight of the nurses viewed portions of nursing theory as being "too f a r from r e a l i t y . " The material was viewed as being too fa r from r e a l i t y because they believed that they would never apply the material i n t h e i r l i f e t i m e . This f r u s t r a t e d the nurses because they f e l t i f they learned material that might be u s e f u l i n t h e i r l i f e t i m e then they would acquire more depth and not j u s t "skim the surface of everything." They didn't mind the learning experiences i t was j u s t that there was so much to learn and "having to l e a r n material that y o u ' l l never use" was described by SUZIE as being "a waste of time and energy." SKI was v i s i b l y upset as she talked about how she f e l t about what she was learning. She moved from side to side i n her chair and the 70 volume of her voiced increased as she spoke: During the program there were times I f e l t l i k e I wanted to get out of the program. A l o t of i t was the discrepancy between r e a l i t y and theory. The theory i s nice but i n a large part i t i s so f a r from what r e a l i t y i s and I know what the r e a l i t y i s . They give you the global view i n the theories but they don't give the r e a l i t y " ! As SKI continued to t a l k about r e a l i t y and ideals she described two nursing experiences to back up her statement about what she was learning, "They keep t e l l i n g us how management supports the nurses, well, i n r e a l i t y that i s not quite true"! MISS Z had a tone of t o t a l f r u s t r a t i o n and disappointment i n her voice when she was t a l k i n g about how i t was great to l e a r n the course material but what she wanted was "more" of the material to be " r e a l i s t i c " f o r her to be able to apply i n the h o s p i t a l : I am learning so much more than I'11 ever be able to put into actual p r a c t i c e . I f I d i d t r y and use i t I would be t o l d to quit wasting my time... The learning part i s good, but when I am learning so much that I w i l l never be able to p r a c t i c e , I become fr u s t r a t e d . I f I w i l l never be able to use i t , why should I learn i t ? MISS Z s a i d her advice to nurses about whether they should come back for t h e i r degree would be, " I f they are not going to nurse for the r e s t of t h e i r l i v e s , i t i s n ' t worth i t to take the degree." A l l of the nurses found some element of t h e i r nursing assignments " u n r e a l i s t i c " because what they were suppose to learn was "not being p r a c t i c e d " i n r e a l i t y . MANDY sounded so f r u s t r a t e d as she talked about the difference she saw between theory and p r a c t i c e , "We are suppose to apply a l l of t h i s i n our practicum and you don't see i t being practiced...by your preceptor so you j u s t wonder about i t a l l . " 7 1 SUZIE was v i s i b l y upset when she talked about the professors a p p l i c a t i o n of theory, "They don't use the same p r i n c i p l e s that they teach." MISS Z's voice was very emphatic and her tone r a i s e d as she shared her f e e l i n g s about a nursing course assignment: The assessment they want us to do with one family i s extremely u n r e a l i s t i c . The f i e l d guide I have does not do that kind of assessment. She has one piece of paper for s i x to ten v i s i t s , yet I have two v i s i t s and I have documented twenty-four pages, that i s u n r e a l i s t i c . The assignments are not r e a l i s t i c to what i s r e a l l y going on i n the nursing world. A l l of the nurses talked about at l e a s t one of t h e i r professors as being " u n r e a l i s t i c . " What was u n r e a l i s t i c was t h e i r " a t t i t u d e . " SUZIE and MISS Z agreed that i t would be "wonderful i f most of t h e i r goals could be achieved but I don't think they w i l l . . . They are t r y i n g to do too much at once." MISS Z wished nursing could be what the professors s a i d " i t should be", " I t might be i n the future but not i n my l i f e time and that i s very sad because these women, these profs, a l l the people i n nursing throughout Canada are t r y i n g so hard." A l l of the nurses experienced some sense of personal worth from attending u n i v e r s i t y . MANDY shared how attending u n i v e r s i t y had increased her children's f e e l i n g s of respect for her and that the experience was helping her to "withdraw" from her c h i l d r e n without f e e l i n g g u i l t y : I think they respect me more. The other day my youngest surprised me, I t o l d them I had studying to do so they had to do more of the chores, she s a i d 'now you know what i t f e e l s l i k e ' and she gave me a nice warm smile. Maybe i t i s easier because they see we have something i n common. There are rough times too but parts of i t are better. I think u n i v e r s i t y has been a crutch f o r me to withdraw from them a b i t and not f e e l g u i l t y , anyway I f e e l good about that. 72 MANDY had a b i g smile on her face and sounding r e a l l y s a t i s f i e d as she talked about how her attending u n i v e r s i t y was i n f l u e n c i n g her son to work harder at school: He i s l i s t e n i n g to everything I say. He would l i k e to go to u n i v e r s i t y so I think he i s lapping up everything. He i s r e a l l y h i t t i n g the books too because he sees how d i f f i c u l t i t can be and he sure hears that enough from me. Being Confined by Practice The c l i n i c a l bedside nurses f e l t that they were not able to put the majority of what they were learning into immediate nursing p r a c t i c e . When the nurses talked about t h i s experience t h e i r comments included, "I've given up", " I t j u s t doesn't work i n r e a l i t y " , and "I can't go back to being confined l i k e I was before." MISS Z was solemn as she talked about how she had "given up t r y i n g to integrate things into ( c l i n i c a l ) p r a c t i c e . . . a t work." She gave a large sigh and seemed to melt into her chair. She looked l i k e a l i t t l e g i r l t r y i n g to get away from something and then very q u i e t l y she said, "I hope that I do help some. I hope my courses have done some good." MAC sounded tentative and hesitant as she talked about how she had changed her approach to patient care from what she had been learning, "I decided to t r y i t and everyone looked at me l i k e , why are you doing that." MISS Z was t o l d by a nursing supervisor "that she was out of her bounds as a nurse," that was enough f o r MISS Z to state, "The theory j u s t doesn't work i n p r a c t i c e . CARMEN viewed what she was learning as " r e q u i r i n g a l o t of changes i n the future...and i t i s n ' t going to be easy." 73 MISS Z sounded wishful as she talked about how she would l i k e nursing to be: I would l i k e to do things on the ward but I can't. They j u s t don't l i s t e n to me because I am a nurse and I'm not supposed to know those things and i t w i l l be a long time before medicine recognizes nurses' a b i l i t i e s . SUZIE wanted to be able to implement what she was learning. She sounded disappointed and uncertain about being able to go back to bedside nursing: You learn the i d e a l and when you go back out of school you l e a r n that l i f e i s not the i d e a l you have been taught...the h o s p i t a l i s too f a r removed from the i d e a l , and the i d e a l has become very important to me. I don't think I could t o l e r a t e that amount of inconsistency now...there must be some place that i s c l o s e r to the i d e a l than the h o s p i t a l . SKI f e l t she had a s o l u t i o n to being "confined" by nursing p r a c t i c e . She was very sincere and hopeful as she said, " I f the professors r e l a t e d the content to more of the r e a l i t y of nursing i n a l l aspects of p r a c t i c e them maybe more of the nurses would see how the theory could be put into p r a c t i c e and thereby provide us with a means f o r f e e l i n g more ' s a t i s f i e d ' with nursing." Remaining Uncertainty The nurses a l l entered the program with the idea that the program would provide them with a means to the future. They a l l remained "hopeful" that t h e i r pursuit of the degree would be "worthwhile" and not be "a waste of time." Each one of the nurses were at d i f f e r e n t stages of questioning the worth of the nursing degree for t h e i r envisioned future. SKI gazed into the distance and was s o f t spoken as she talked 74 about her future a f t e r the degree, "I don't know i f i t w i l l help, I think i t w i l l i n the long run". Then she became more determined i n he voice tone and sat up s t r a i g h t i n the chair, "But I know when I f i n i s h I w i l l need to get a l o t of s k i l l s that are s t i l l out there before i t i s going to give me the be a l l and end a l l job, i f there i s one." MISS Z set her jaw and her voice was very emphatic: Getting my degree w i l l mean absolutely nothing to my nursing. I t might mean a d i f f e r e n t job but those kinds of jobs i n nursing would take me farther away from what I f e e l i s r e a l nursing, which i s working on the ward. I wish the diploma had never been invented and everybody had t h e i r degree. CARMEN'S voice was quiet and she looked thoughtful and sounded hopeful as she talked about the worth of the degree: I am sure i t w i l l be worthwhile because there was a great need for a change. I weighed a l o t of options and when you do that you l e a r n a l o t about yourself and what you r e a l l y want to do. r e a l l y l i k e people and I r e a l l y l i k e nursing. I think i t w i l l b worthwhile a f t e r i t i s over, but r i g h t now I can't say. Summary Attending u n i v e r s i t y was a journey that had been a dream from an undetermined o r i g i n . Being able to attend u n i v e r s i t y was considered personal accomplishment because the informants believed people who attended u n i v e r s i t y were revered by society. The journey of attending u n i v e r s i t y as a nurse i n the pursuit of a baccalaureate degree began with v i s i o n s of the experience as being means of bringing hope to one's future. Thoughts about the journey r e s u l t e d i n v i s i o n s of what the experience would be l i k e , to begin 75 developing. V i s i o n s about the experience developed r e l a t e d to: (a) what would be gained by going on the journey, (b) how would one be treated on the journey, and (c) how successful would one be i n completing the journey. Travel plans were made with the idea that minor adjustments might have to be made along the way. T r i p contingencies had been developed should the journey not be what was expected or not be achievable at t h i s point i n time. The journey began with a fear of the unknown but with a nervous excitement that t h i s journey could be a means to the future. During the journey eyes and thoughts were being opened, views were being broadened, personal b e l i e f s and nursing profession b e l i e f s were being confirmed. As the journey unfolded i t became a game of s u r v i v a l . A l l along the journey there were threatening events which l i m i t e d freedom to explore and learn to one's personal s a t i s f a c t i o n . The journey started to require a d d i t i o n a l personal adjustments. When adjustments were no longer s u f f i c i e n t , undesirable compromises had to be made i n order to complete the journey. The question of whether the journey was going to be worth the personal s a c r i f i c e s demanded an answer. I t seemed impossible to turn back. To qui t could mean c l o s i n g a door to a future that might be opened by completing the journey. But was there going to be enough energy l e f t to continue? There was so much to see and learn. A l l of i t was i n t e r e s t i n g but i f the journey took on a route that was more r e a l i s t i c , maybe completion could be possible without such personal turmoil. Even though uncertainty remained, undying hope kept the journey a l i v e . 76 CHAPTER V THE END AS A BEGINNING This chapter i s presented i n four sections. The f i r s t s e c t i o n of the chapter includes the analysis and discussion of the themes that emerged from the informants descriptions of t h e i r experiences during the post-basic baccalaureate nursing education experience. The discussion includes the commonalities and diff e r e n c e s between t h i s study and the r e l a t e d documented l i t e r a t u r e . The second s e c t i o n of the chapter outlines the concluding thoughts of the researcher which focuses on issues the researcher believes should be addressed by educators involved i n post-basic baccalaureate nursing education. The t h i r d s e c t i o n of the chapter outlines the implications of the study for both nursing and u n i v e r s i t y education. This s e c t i o n includes issues that nursing, nursing education and the u n i v e r s i t y educational system need to address i n order to increase the p o t e n t i a l contributions of adult learners. The f i n a l s e c t i o n summarizes why the informants p a r t i c i p a t e d i n the study and how they f e l t about the research approach. The Journey F u l f i l l m e n t of a Dream Coming to u n i v e r s i t y was a f u l f i l l m e n t of a dream f o r the nurses. Chapman (1986) found that attending u n i v e r s i t y had been "a long 77 standing desire" f o r the informants and was considered a personal accomplishment. The nurses a l l questioned t h e i r a b i l i t y to achieve at u n i v e r s i t y and since they valued a u n i v e r s i t y education there i s a suggestion that they questioned t h e i r own worth. I t i s postulated that one reason the nurses had not attended u n i v e r s i t y f o r t h e i r diploma could be r e l a t e d to a lack of confidence i n being able to achieve at u n i v e r s i t y . This i s supported by the f a c t that eight of the ten nurses d i d pre-course work toward to the post-basic baccalaureate degree before entering the program f u l l - t i m e . The nurses made comments that the pre-course work gave them confidence that they could pass u n i v e r s i t y courses. The researcher has heard t h i s comment by numerous post-basic students who have, l i k e Chapman's informants, "tested the waters" before jumping i n . The nurses agreed with THESNIF's comment that: "Attending u n i v e r s i t y was a r i s k , but i t was a c a l c u l a t e d r i s k . " The V i s i o n The nurses engaged i n learning for the same reasons Knowles (1980) has c i t e d most adults engage i n learning: "They f e e l a need to l e a r n and perceive a personal goal that learning w i l l help to achieve"(p.56). The need for the nurses was the need f o r personal "accomplishment" and the goal was obtaining "a means to the future" by having a degree. The nurses were motivated to come back to school from the 78 i n t r i n s i c f a c t o r of d e s i r i n g an increased sense of personal "accomplishment" i n t h e i r future. One of Sabina's (1985) informants described the desire f o r attending u n i v e r s i t y as coming from "within." Career advancement was seen as possible with the degree, but the reason f o r wanting career advancement was because i t was envisioned that career advancement would enable the nurse to be i n a p o s i t i o n of "power" to f a c i l i t a t e "change" and "make a di f f e r e n c e " i n the future. Previous nursing research has i d e n t i f i e d many motivating factors f o r pursuing a degree such as: career advancement, maintaining present employment, and desire (Epp,1986; Hammer and Tufts, 1985; Erickson, 1983; Shane, 1983). This research study suggests that the informant nurses were motivated by one i n t r i n s i c need: personal accomplishment. Chapman found that the informants i n h i s study were also i n search of personal accomplishment as attending u n i v e r s i t y was seen as providing: (a) enlightenment, (b) i n t e l l e c t u a l enrichment,(c) personal enhancement, and (d) academic v a l i d a t i o n . A major stimulus f o r returning to school was some d i s s a t i s f a c t i o n with t h e i r current l i f e which mostly revolved around personal d i s s a t i s f a c t i o n with employment challenges and opportunities to make a dif f e r e n c e . Findings from Chapman's (1986) study also demonstrated that d i s s a t i s f a c t i o n i n l i f e was a key factor i n pursuing a u n i v e r s i t y education. The nurses f e l t that the u n i v e r s i t y degree was t h e i r only option at t h i s time for what they wanted i n t h e i r future. The nursing degree was the quickest route because i t required two years compared to four years i f the nurses had sought a degree outside the Faculty of Nursing. Some informant nurses saw the nursing degree as the only 7 9 option since they were planning on continuing i n nursing and stated they d i d not want to be l e f t behind when a baccalaureate became the only entry route into the profession. Eight of the nurses wanted to keep the door open for continuing studies i n the future. Chapman's informants saw a degree as t h e i r only choice for career opportunities. From l i s t e n i n g to the nurses experiences the researcher strongly believes that the need for increasing one's sense of accomplishment i n one's l i f e was the motivating f a c t o r d r i v i n g a l l of the nurses to pursue and get through the baccalaureate program. None of the nurses had a d e f i n i t e career goal that was being pursued; however a l l were looking to a future of personal and p r o f e s s i o n a l accomplishment. A l l of the nurses had a v i s i o n of what the experience of attending u n i v e r s i t y would be l i k e . The nurses d i d preplanning to t r y and make adjustments to t h e i r l i v e s [personal journey] so that they could incorporate attending u n i v e r s i t y [professional journey]. The nurses were d i f f e r e n t than the adults i n Chapman's study who thought u n i v e r s i t y could be absorbed into t h e i r l i f e . A problem for the nurses was that complete preplanning was impossible because they d i d not know a l l the p a r t i c u l a r s f o r planning the experience. Eight of the nurses took courses toward the degree before attending u n i v e r s i t y f u l l time i n order to reduce the course load from f i v e to three or four courses and to see i f they could do i t . Seven of the nurses planned on having to continue working to meet f i n a n c i a l requirements, so pre-course work was undertaken i n order to see i f and how they could accommodate u n i v e r s i t y into t h e i r e x i s t i n g l i f e . The data 80 suggests that each of the nurses personal l i f e s i t u a t i o n was d i f f e r e n t . For some there was more room for adjustments to be made along the way while for others attending u n i v e r s i t y was almost impossible as they had few resources l e f t when the experience required more time than what was anticipated. For these nurses adjustment resources were used almost immediately upon entering f u l l time u n i v e r s i t y status. They began making compromises as the experiences required more time than had been expected. I t was at t h i s point that coping ended and s u r v i v a l began. Although eight of the nurses had done courses p r i o r to attending u n i v e r s i t y as a f u l l time student, they found inconsistencies between workloads for courses with the same c r e d i t value which made preplanning almost impossible. Chapman's (1986) adult informants f e l t that attending u n i v e r s i t y could be absorbed into t h e i r present l i f e . A Game of Sur v i v a l The nurses found that t h e i r a b i l i t y to complete a u n i v e r s i t y education was threatened by having to deal with the u n i v e r s i t y system. The nurses had to learn the system which required a l o t of time and energy and t h e i r f r u s t r a t i o n with the system res u l t e d i n f e e l i n g s of "inner turmoil." Chapman (1986) found that informants were not w i l l i n g to accept the u n i v e r s i t y system during t h e i r f i r s t u n i v e r s i t y experience while they more w i l l i n g to accept i t during the second experience. Chapman postulated that t h i s r e s u l t e d because the informants viewed the second u n i v e r s i t y experience as being t h e i r only 81 career choice option. Three of the nurses were w i l l i n g to accept the u n i v e r s i t y system and deal with i t . Two of the nurses had previous u n i v e r s i t y experience; one of the nurses had taught courses at the u n i v e r s i t y and had c h i l d r e n i n u n i v e r s i t y . Three nurses made comments that they didn't l i k e the system but they knew they couldn't change i t . The remaining seven nurses described being angry and at times r e s e n t f u l toward the u n i v e r s i t y system. Chapman found the informants had negative f e e l i n g s that stemmed from "the conventional i n s t i t u t i o n a l pedagogical" demands of the u n i v e r s i t y system. The nurses had a general fear of f a i l u r e and questioned t h e i r a b i l i t y to make i t through the experience. A l l of the nurses made reference to t h e i r s e l f esteem being lowered during the experience. S u l l i v a n (1984) suggested that feelings of f a i l u r e and inadequacy are the r e s u l t of the person's i n a b i l i t y to a l t e r self-performance expectations to accommodate the learner r o l e . Chapman (1986) found the informants developed overwhelming g u i l t f e e l i n g s about not being able to meet t h e i r personal expectations of themselves wi t h i n t h e i r family. In this, present study the nurses used a l l t h e i r known personal resources i n order to plan for the u n i v e r s i t y system. The study data suggest that the nurses d i d not have enough information to do adequate preplanning or to do ongoing planning while i n the program. The major element of attending u n i v e r s i t y that was not a n t i c i p a t e d f u l l y was what the nurses c a l l e d "learning the system." The study data suggests that excessive personal energy was channeled toward having to deal with the system. The nurses then had to compromise energy e s s e n t i a l 82 for either l e a r n i n g a c t i v i t e s or for l i v i n g . The personal reactions of the nurses to the u n i v e r s i t y experience were emotional, included pleasant surprise when things were b e t t e r than envisioned, and turned to r e g r e t f u l d i s i l l u s i o n m e n t when the experience d i d not meet t h e i r expectation. The informants i n Portnoy's (1980) cla s s described feelings of "emotion turmoil" during t h e i r degree experience. The nurses found t h e i r self-concept of being a good nurse and having the a b i l i t y to achieve was threatened by the professor's educational approach and by the system as a whole. Their s e l f -concept was threatened because they received l i t t l e acknowledgement and recognition for t h e i r a b i l i t i e s as adults or t h e i r p r o f e s s i o n a l experience as nurses. These comments were the most common comments made by nurse learners about how they f e l t they were treated by t h e i r nursing professors. The emotions, displayed by the nurses as they r e l i v e d experiences with some of t h e i r professors, are i n keeping with Epstein's (1973) view that a threat to a person's concept of s e l f r e s u l t s i n negative emotions. The nurses also found they were using emotional energy to t r y and deal with t h e i r f e e l i n g s of unmet expectations. The nurses i n a b i l i t y to manage t h e i r emotional energy, has been explained by Felkner (1974) as the r e s u l t of too many threats to the person's concept of s e l f thereby the person becomes at r i s k for becoming overwhelmed, disorganized, and unable to cope with the s i t u a t i o n . F r u s t r a t i o n , anger, e x h i l a r a t i o n , and resentment were a l l emotions documented by previous authors regarding the reactions of 83 nurses who have gone back to school (Downing and Macmillan, 1987; Sands, 1987; Sabina, 1985; Shane, 1983; Schipiour, 1981; Portnoy, 1980; H i l l s m i t h , 1975). Three nurses v o l u n t a r i l y shared t h e i r reactions to reading material they were given r e l a t i n g to Shane's (1983) "returning to school syndrome." The nurses were given the material a f t e r they had shared t h e i r f r u s t r a t i o n s with the learning experiences with a nursing professor. The nurses f e l t there was some tru t h to Shanes's d e s c r i p t i o n of the "returning to school syndrome", however they f e l t i t lacked describing the personal aspects of the experience. The nurses f e l t that Shane's stages were being assumed to be the explanation for why they were f e e l i n g upset or depressed which re s u l t e d i n f e e l i n g s of resent and anger toward the professor. The nurses f e l t they had l i m i t e d freedom to l e a r n the content i n the depth they wanted because of the breadth of the content and the time l i m i t a t i o n s . Some f e l t they were not free to l e a r n content they would have l i k e d to pursue and, therefore, f e l t that learning was being imposed upon them. A l l of the nurses came to u n i v e r s i t y with an idea of what would constitute achievement. They i n i t i a l l y saw "marks" as being an i n d i c a t o r of achievement but a l l of them came to the point where they decided marks were not an i n d i c a t o r of t h e i r personal learning. The nurses a l l believed that they were learning much more than t h e i r marks indicated, and so marks were negated as a true measure of learning. The marks became an i n d i c a t o r of knowing how to write a multiple choice exam or being able to put down on paper what the professor 84 wanted to hear. Marks were seen as being required i n order to go on to further education which res u l t e d i n considerable emotional upset for the nurses who could not put the time into t h e i r studies because of t h e i r l i f e s i t u a t i o n . At t h i s point the nurses started evaluating the whole u n i v e r s i t y experience and t r i e d to understand why they could not achieve t h e i r expectations. They also saw inconsistencies i n workloads between nursing and e l e c t i v e courses. The nurses used the c r e d i t a l l o c a t i o n as guidelines for a n t i c i p a t i n g how much time they would have to a l l o c a t e to a course. The nurses viewed evaluation as not demonstrating t h e i r learning. Festinger (1957) would have described t h i s s i t u a t i o n as causing "dissonance" between how the nurses perceived others viewed t h e i r performance and how they wished to be viewed as performing. The nurses had to make adjustments and sometimes compromises i n order to get through the experience. Sabina's (1985) informants found they also had to make readjustments to t h e i r expectations of the learning experience. Compromises made during the program were seen as being r e l a t e d to the system re q u i r i n g more time than was r e a l i s t i c . The nurses found they were always s h i f t i n g p r i o r i t i e s i n order to accommodate the u n i v e r s i t y experience into t h e i r l i v e s . Stevenson (1984) found s h i f t i n g p r i o r i t i e s between the adult learner's many roles was a common behavior of adult learners. Seven of the nurses rated family as having a higher p r i o r i t y than attending u n i v e r s i t y . The remaining three rated the experience as having equal p r i o r i t y with family. I f a choice had to be made between the u n i v e r s i t y and t h e i r 85 family, the nurses'choice would be t h e i r family. The nurses f e l t caught when they saw the u n i v e r s i t y degree as t h e i r only option at t h i s time. They had already invested a l o t of time and money into the experience, so q u i t t i n g was desirable but not an acceptable choice. Chapman's (1986) findings suggested that the family wanted to maintain an e x i s t i n g economic l i f e s t y l e and not regress. Four of the married nurses i n the present study f e l t more secure when they were able to l i v e on only t h e i r husband's salary. One of the nurses s a i d she would not have st a r t e d the program i f she had not received a scholarship, while the remaining nine nurses f e l t that t h e i r standard of l i v i n g was reduced by returning to school. Seven of the nurses were working i n some capacity i n order to help meet t h e i r f i n a n c i a l commitments. The nurses found the professors made a r e a l d i f f e r e n c e to the learning experience. The learning experiences with the professors i n t h i s study o f f e r s support for nursing authors who have stated that the professor's b e l i e f s about and approaches with the learner have a large influence on the r e s o c i a l i z a t i o n process. The descriptions from the nurses suggest that they expand t h e i r roles as nurses, which supports Woolley's (1978) view of the r e s o c i a l i z a t i o n process i n baccalaureate degree education. The nurses commented that the degree does not make them better nurses but does expand t h e i r views of nursing and opens them up to see nursing l i k e they have never seen i t before. This suggests support for the expectation that the baccalaureate takes the nurse from a technical nurse to a p r o f e s s i o n a l nurse. The nurses d i d not appear to take on a new nursing role but they assumed a r o l e as a 86 continuous learner. By coming to the u n i v e r s i t y they were s o c i a l i z e d into the u n i v e r s i t y system which includes the u n i v e r s i t y system of pr o f e s s i o n a l nursing. The nurses f e l t that family, friends, colleagues and professors provided assistance i n getting through the u n i v e r s i t y experience, while some professors and colleagues threatened achievement of the dream. Friends and colleagues without u n i v e r s i t y education, f o r nine of the nurses, were not as supportive as those who had u n i v e r s i t y experience. This required that the nurse used coping behaviors, l i k e avoidance, to reduce the chance of having any threatening contacts. The nurses coped with non-supportive comments by disregarding the comments and by no longer discussing the experience openly. The nurses f e l t that dealing with non-supportive s i t u a t i o n s required expenditure of energy that they would rather put toward learning, but they could not put aside t h e i r emotions t o t a l l y . They sensed a los s of support from previous work colleagues because of attending u n i v e r s i t y f o r a nursing degree. The nurses were in s p i r e d by t h e i r contacts with the other nursing students who had d i f f e r e n t nursing backgrounds. These contacts were i n s p i r i n g because the students could hear the e x p e r i e n t i a l v a r i a t i o n s i n nursing and begin to understand the r e a l i t y of d i f f e r e n t s i t u a t i o n s f i r s t hand, versus only learning through readings. E x p e r i e n t i a l learning was h i g h l y valued by the nurses. 87 A Question of Worth The nurses found that the experience helped them appreciate t h e i r own a b i l i t i e s which helped them gain confidence i n t h e i r personal resources. The nurses found the course content i n the degree program heightened t h e i r awareness about nursing and s o c i e t a l issues and helped them to s t a r t seeing the expanse of nursing. The broadening encompassed looking at the whole of the nursing profession which helped the nurses see the issues facing nursing and see the "whys" behind nursing actions and issues. Four of the seven married nurses f e l t that t h e i r husbands shared i n t h e i r learning. The nurses found themselves discussing issues they had never discussed with t h e i r husband's who they f e l t were "coming with" them during the experience. They were both able to understand each other better. The nurses f e l t t h i s new understanding with t h e i r spouse was an unexpected b e n e f i t of pursuing a u n i v e r s i t y education. The nurses found attending u n i v e r s i t y broadened t h e i r views on u n i v e r s i t y education. Chapman's (1986) informants and the nurses i n t h i s study a l l gained great s a t i s f a c t i o n i n learning material that was personally meaningful. For the nurses t h i s was material they could use i n t h e i r nursing p r a c t i c e or use i n t h e i r personal l i v e s . The experience r e s u l t e d i n confirmation of many b e l i e f s [ p o s i t i v e and negative] about themselves and about nursing. The nurses weighed the value of t h e i r learning against the personal compromises and s a c r i f i c e s they made i n order to determine i f the nursing degree was worthwhile. Five of the nurses considered 88 leaving the program. One considered switching f a c u l t i e s because she was disappointed i n what was being taught. One nurse sought more co n t r o l over her program of studies and surveyed possible f a c u l t i e s that would be f l e x i b l e so she could meet her learning needs. Two wanted to q u i t but knew they wouldn't because they had come to f a r . One informant i n Chapman's (1986) study switched f a c u l t i e s because of being disappointed i n the learning opportunities. The switch made i t possible to set a more personal program of studies which r e s u l t e d i n p o s i t i v e f e e l i n g s about the u n i v e r s i t y learning experience. The nurses found that too much of the learning material was too f a r from r e a l i t y to be applicable i n t h e i r l i f e t i m e . Mabbett (1987) suggested that i f t h i s f e e l i n g i s affirmed when the nurses leave an educational program that the nurses are at r i s k of becoming "burned out" and could r e s u l t i n them leaving the profession. One of the nurses i n the present study was t a l k i n g about leaving the profession because of not being able to implement changes that would make the profession the i d e a l that was being taught at u n i v e r s i t y . The nurses found that t h e i r current experience with c l i n i c a l bedside nursing d i d not allow them to p r a c t i c e what they were learning i n the u n i v e r s i t y degree program. The data suggest that when peers and colleagues, i n the work place, were not supportive of implementing new ideas the nurses would ei t h e r see that the material was u n r e a l i s t i c f or p r a c t i c e or that p r a c t i c e needed extensive changes i n order to be considered as the future working environment. Three of the seven nurses who were working as c l i n i c a l beside nurses p r i o r to 89 entering the program had envisioned going back to bedside nursing following the degree. Within s i x months of attending u n i v e r s i t y they decided they would only go back to c l i n i c a l bedside nursing u n t i l they found an employment p o s i t i o n that would f i t with t h e i r expanded view of nursing. The data suggest that the nurses wanted to make a differ e n c e i n the future. I f the nursing p o s i t i o n was envisioned as not allowing for the goal to be achieved, then the p o s i t i o n was not appropriate i n t h e i r future. The nurses remained uncertain about the worth of the degree during t h e i r f i r s t year of f u l l time studies at the u n i v e r s i t y . The researcher believes the question of worth w i l l remain unanswered u n t i l the nurses have the opportunity to see i f the degree becomes "a means" to "make a d i f f e r e n c e " and gain more fe e l i n g s of personal and p r o f e s s i o n a l "accomplishment." Concluding Thoughts I t i s the researcher's b e l i e f that the key f a c t o r i n f l u e n c i n g the meaning of the degree experience i s the f r u s t r a t i o n i n dealing with the u n i v e r s i t y system. The nurses "believed" t h e i r v i s i o n of what attending u n i v e r s i t y would be l i k e . They prepared themselves to the best of t h e i r a b i l i t y , using previous experience and what they were t o l d by people they considered knowledgeable about u n i v e r s i t y education. The nurses trusted the experts view of the u n i v e r s i t y system and believed the system was there to help them reach t h e i r goal. The nurses became very emotional and angry when the u n i v e r s i t y 90 system was seen as changing from being h e l p f u l to being a b a r r i e r . The nurses f e l t they had no c o n t r o l over the system so they had to l e a r n the system and work within i t . This required considerable energy that brought up the question, "Is i t worth i t ? " . The question remained unanswered but p e r s i s t e d as the nurses used a l l t h e i r resources i n making adjustments to t h e i r pre-planned expectations and then had to make compromises. The nurses had four choices: (a) maintain t h e i r l e v e l of personal achievement expectations and s a c r i f i c e t h e i r support network, (b) reduce personal achievement expectations and s a c r i f i c e some of the support network, (c) lower personal achievement expectations and not s a c r i f i c e the support network, and l a s t l y (d) withdraw from the program. What option the nurses chose r e l a t e d to t h e i r personal s i t u a t i o n and was a very d i f f i c u l t d e c i s i o n for each of them. They wanted to l e a r n and do t h e i r best which was i n t r i n s i c a l l y important to an experience they viewed as "means" to t h e i r future. Not meeting t h e i r own performance expectation was seen as personal f a i l u r e even though they were passing courses. Not being able to meet personal performance expectations because the system required more than they believed to be r e a l i s t i c was defeating, p a r t i c u l a r l y when some of the nurses saw doors i n t h e i r future being closed that were i n i t i a l l y seen as being open. The researcher believes that the nurses valued the content they were learning and were opened up, broadened, and gained confidence i n themselves as people and nurses. The d i f f i c u l t y f o r the nurses was not being able to see how the material they were learning could be 91 used i n t h e i r l i f e t i m e or how i t f i t t e d i n with t h e i r perceived r e a l i t y of nursing. I t i s the researchers b e l i e f that the professor's approach with the learner when presenting issues and views has the p o t e n t i a l f o r e i t h e r encouraging the learner to expand and consider d i f f e r e n t ideas or can r e s u l t i n the learner r e s i s t i n g and negating ideas or issues presented by the professor. The researcher believes that i f u n i v e r s i t y educators could reduce the amount of energy needed to manage the u n i v e r s i t y system learners would have more energy to learn content and f e e l more s a t i s f i e d with the experience. I f nursing education and p r a c t i c e could become, as one of the nurses said, more u n i f i e d and focused, then the nursing profession could reap the rewards of nurses wanting to improve i t s future. Implications of the Study f o r Nursing and Education Insights gained from t h i s study suggest that nurses seek challenges and opportunities to increase t h e i r f e e l i n g s of personal accomplishment. When the nurses f e l t that t h e i r present employment could no longer s a t i s f y t h e i r need for accomplishment, a l t e r n a t i v e career avenues were considered f o r meeting that need. The choices were e i t h e r to pursue a career i n nursing that could be more challenging or pursue a career outside of nursing that could be more rewarding. The data suggest, i f an employer or the profession wants to maintain i t ' s experienced people, there must be opportunities f o r the nurse to be involved i n professional a c t i v i t i e s that meet t h e i r 92 need for personal accomplishment and t h e i r goal of being able to make a di f f e r e n c e . The data suggest that post-basic baccalaureate nursing education should include educational approaches that promote the development of strategies and a b i l i t y for p a r t i c i p a t i o n i n cr e a t i n g change. The study data and the material from nursing authors (Green, 1987; Mabbett, 1987; Schipiour, 1981; Muzio and OHashi, 1979; H i l l s m i t h , 1975) suggest nursing educators and p r a c t i t i o n e r s develop c o l l a b o r a t i v e i n t e g r a t i o n of learning experiences that would allow the learners to see t h e i r learning experiences as r e a l i s t i c and worthwhile. The findings support the perspectives of other authors (Wallhead, 1986; Arms, 1985; Betz, 1985; S u l l i v a n , 1984; Schipiour, 1981; Knowles, 1980) who have suggested that nursing educators should c a r e f u l l y evaluate t h e i r b e l i e f s and attitudes about adult learners, and t h e i r i n s t r u c t i o n a l approaches i f they wish to p o s i t i v e l y a f f e c t the r e s o c i a l i z a t i o n of nurses. A d d i t i o n a l studies should be conducted to evaluate learner reaction and achievements to v a r i e d educational approaches i n post-basic baccalaureate nursing programs. Based on the findings adult learners need ongoing assistance to deal with or adjust to the u n i v e r s i t y system. Nursing f a c u l t i e s need to implement and evaluate the effectiveness of such assistance. The findings support previous authors (Woolley, 1984; Ericksen, 1983) who have suggested that nurses need to develop an understanding of the r e s o c i a l i z a t i o n process they are involved i n , along with developing 93 s k i l l s i n working through the process. The data suggest that learner assistance should be ongoing as previously suggested by Queen (1984). The informants i n the study as i n other studies (Sabina, 1985) stated they were not comfortable i n seeking out assistance. Three of the nurses suggested having "open sessions" between f a c u l t y and students so there could be a sharing of information throughout the program. I t was suggested the sharing should include: information about the program, suggestions on how to get through the program, and dis c u s s i o n of personal f e e l i n g s experienced throughout the program. Informants' Comments about the Study A l l ten informants i n the study remained and completed a l l the interviews. They were very w i l l i n g to share t h e i r experiences and on no occasion d i d an informant refuse to share t h e i r experiences. At the end of the t h i r d interview with the f i r s t s i x informants the researcher asked f o r comments on how they f e l t about how the study was conducted and t h e i r f e e l i n g s about being involved. A l l of the informants stated they f e l t that the interview approach was most appropriate f o r t h i s topic. They stated they would not have p a r t i c i p a t e d i f they had been required to complete a questionnaire or write the story of t h e i r experiences. They a l l believed that i n d i v i d u a l l y taping t h e i r comments without the researcher being present would not have been possible or acceptable. They thought i t was important to have the researcher there to c l a r i f y questions and to 94 provide words of encouragement, as then they f e l t whatever was s a i d was "OK." One of the informants commented that she f e l t the researcher l i s t e n e d and accepted whatever was s a i d without g i v i n g any sense of judging the informant. Just to have someone l i s t e n to what they were going through was believed to be a kind of "therapy" i n dealing with the educational experience. They were p o s i t i v e that a questionnaire would not have allowed them to describe what the experience was l i k e f o r them. A l l of the informants s a i d they p a r t i c i p a t e d i n the study because they saw the study as a way they could contribute i n "making a d i f f e r e n c e " i n u n i v e r s i t y baccalaureate nursing education. SUZIE captured the groups comments as she looked d i r e c t l y into the researchers eyes and s i n c e r e l y said: I hope your study can help make some changes because I know I can't and I guess that i s why I came because t h i s i s one way, a possible way of making some sort of impact somewhere and maybe changing things. A l l of the informants thanked the researcher for caring enough to f i n d out what the experience was l i k e f o r them and they wanted to know how to access the findings of the study. References Arms, D., Chenevey, B. , Karrer, C , & Rumpler C. (1985). A Nurse Baccalaureate Degree Program i n Nursing f o r Adult Students. Nurse Educator. 10(4), 31-35. B a r r i t t , L.S., Beekman, T., Bleeker, H., & Mulderij, K. (1983). A Handbook for Phenomenological Research i n  Education. Michigan: U n i v e r s i t y of Michigan School of Education. Betz, C.L. (1985). Students i n T r a n s i t i o n : Imitators of Role Models. Journal of Nursing Education. 24, 301-303. Blatchley, M.E., & Stephan, E. (1985). RN Students i n Generic Programs: What do we do with them? Journal of Nursing Education. 24, 306-308. Boone, M., & Rakoczy, M. (1986). Lakehead University's RN Baccalaureate Program. The Canadian Nurse. 82(10), 31-35. Byrnes, A. (1986). Bridging the Gap Between Humanism and Behaviorism i n Nursing Education. Journal of Nursing  Education. 25, 304-305. Chapman, D.E. (1986). An Interpretive Study of the Circumstances of Married Mature-aged Undergraduate U n i v e r s i t y Students. Unpublished doctural d i s s e r t a t i o n , U n i v e r s i t y of Alberta, Edmonton, Alberta. Chenitz W.C., & Swanson J.M. (1986). From Practice to  Grounded Theory. Q u a l i t a t i v e Research i n Nursing. C a l i f o r n i a : Addison-Wesley Publishing Company. Cohen, F., & Lazarus, R. (1980). Coping with the stresses of i l l n e s s . In G.C. Stone, F. Cohen , N. Adler, and Associates, Health Psychology A Handbook. San Francisco: Jossey Bass. Cragg, C., & Cairns, B. (1987). Strained Relations: Degree and Diploma Nurses i n the Workplace. The Canadian Nurse. 83(5), 19-20. DeBack, V., &Mentkowski, M. (1986). Does the Baccalaureate Make a Difference? D i f f e r e n t i a t i n g Nurse Performance by Education Experience. Journal of Nursing Education. 25, 275-284. 96 Denzin, N.K. (1978). The Research A r t A T h e o r e t i c a l  Introduction to S o c i o l o g i c a l Methods (2nd ed.). New York: McGraw-Hill. Dolphin, P., & Holtsclaw, B. (1983). Continuing Education  i n Nursing Strategies f o r L i f e l o n g Learning. V i r g i n i a : Reston Publishing Company Incorporated. Downing, J . , & MacMillan, K. (1987). The Post-Basic Baccalaureate Degree: The Value and the Process. AARN  Newsletter. 43(6), 26-27. Epp, J . (1986). Achieving Health for A l l : A Framework f o r  Health Promotion. Ottawa: Health and Welfare Canada, Supply and Services. Epstein, S. (1973). The S e l f Concept R e v i s i t e d or a Theory of a Theory. American Psychologist. 28, 404-416. Erickson, H. (1983). Coping with New Systems. Journal of  Nursing Education. 22. 132-135. Felkner, D. (1974). Building P o s i t i v e S e l f Concepts. Minnesota: Burgess Publishing Company. F i e l d , P.A., & Morse, J . (1985). Nursing Research The  A p p l i c a t i o n of Q u a l i t a t i v e Approaches. London: Croom Helm. Glaser, B., & Strauss, A. (1964). The Discovery of Grounded  Theory. New York: Alkine Publishing Company. Goicoechea, D. (1975). Royce and Reductions. In H. Spiegelberg (Ed.), Phenomenological Perspectives. Netherlands: Martinus N i j h o f f . Green, E. (1987). The Age Drain. The Canadian Nurse. 83(3), 24-26. Guba, E.G., & Lincoln, Y.S. (1981). E f f e c t i v e Evaluation. San Francisco: Jossey Bass. Hammer, R., & Tufts, M. (1985). Nursing's S e l f Image Nursing's R e s p o n s i b i l i t y . Journal of Nursing Education. 24, 280-283. H i l l s m i t h , K. (1978). From RN to BSN: Student Perceptions. Nursing Outlook. 26(2), 98-102. Hogstel, M., & Sayner, N. (1986). Nursing Research an  Introduction. New York: McGraw-Hill Book Company. 97 Hurt, G., Crawford, T., & Hicks, B. (1985). RN to BN: B u i l d i n g on Education Experience. The Canadian Nurse. 81(5), 22-25. Jackson, M. (1984). Entry C h a r a c t e r i s t i c s of Post-RN Students: Implications f or the Future. The Canadian  Nurse. 80(7), 20-25. King, E. (1983). Humanistic Education: Theory and Teaching Strategies. Nurse Educator. 8(4), 39-45. Knowles, M. (1980). The Modern Practice of Adult Education  From Pedagogy to Andragogy (rev. ed.). Chicago: Associated Press. Kwant, R. (1963). The Phenomenlogical Philosophy of Merleau-Ponty. Pittsburgh: Duquesne Un i v e r s i t y Press. Mabbett, P. (1987). From Burned Out to Turned On. The  Canadian Nurse. 83(3), 15-19. Munhall, P.L., & O i l e r , C.J. (Eds. ). (1986). Nursing  Research A Q u a l i t a t i v e Perspective. Connecticut: Appleton-Century-Crofts. Muzio, L.G., & OHashi, J.P. (1979). The RN Student Unique C h a r a c t e r i s t i c s , Unique Needs. Nursing Outlook. 27, 528-532. O i l e r , C. (1982). The Phenomenological Approach i n Nursing Research. Nursing Research. 31(3), 178-181. Portnoy, F. (1980). RN Students Analyze Their Experiences. Nursing Outlook. 28, 112-115. Queen, P.S. (1984). R e s o c i a l i z i n g the Degree Seeking RN: A Curriculum Thread. Journal of Nursing Education. 23. 351-353. Sabina, D. (1985). What are the needs of the mature RN student. The Canadian Nurse. 8(5), 32-33. Sandelowski, M. (1986). The Problem of Rigor i n Q u a l i t a t i v e Research. Advances i n Nursing Sciences. 8(3), 27-37. Sands, A. (1987). Access to Post-Basic Baccalaureate Education i n Nursing. AARN Newsletter. 43(4), 18. Schipiour, P. (1981). The Guided Study Learning Approach: One Student's Perspective. Nurse Educator. 6(3), 30. Shane, D.L. (1983). Returning to School A Guide f o r Nurses New Jersey: Pr e n t i c e - H a l l Incorporated. Smith, S., & Reeves, N. (1984). Returning to School? Energy Management. RNABC New. 16(1), 14-15. Stevenson, J . (1984). Adulthood: A Promising Focus f o r Future Research. In H. Werley and J . F i t z p a t r i c k (Ed.), Annual Review of Nursing Research (pp. 55-74). New York Springer Publishing Company. S u l l i v a n , E. (1984). The Registered Nurse Baccalaureate Student: Differences at Entry; Differences at E x i t . Journal of Nursing Education. 23(7), 302-303. Taylor, S. (1983). Adjustment to Threatening Events A Theory of Cognitive Adaptation. American Psychologist. 38, 1161-1173. Van Manen, M. (1984). Doing Phenomenological Research and  Writing: An Introduction. (Department of Secondary Education Monograph No. 7). Edmonton, Alberta: U n i v e r s i t y of Alberta, Faculty of Education. Wallhead, E. (1986). Developmental C r i s i s : Helping Student Grow. Nurse Educator. 11(3), 19-22. Wilson, J . (1987). Why Nurses Leave Nursing. The Canadian  Nurse. 83(3), 20-23. Witter, B., & Casey, A. (1987). Teleconferencing. The  Canadian Nurse. 83(5), 22-25. Woolley, A.S. (1978). From RN to BSN: Faculty Perceptions. Nursing Outlook. 26(2), 103-108. Woolley, A. (1984). The Bridge Course T r a n s i t i o n of Professional P r a c t i c e . Nurse Educator. 9(4), 15-19. 101 A p p e n d i x C Pa r t i c i p a n t Information I would appreciate the following information. The data i s needed so proper analysis of the data and comparisons can be made with previous research information. THANKYOU. Pseudonym Age Gender: F or M A. U n i v e r s i t y Status: part-time or f u l l - t i m e , other B. Present Employment: f u l l - t i m e , part-time, casual, o the r . employment p o s i t i o n : . C. Post Secondary Education: Year Completed 1. Nursing diploma 2. C e r t i f i c a t e program(s) 3. Baccalaureate (other than nursing) D. Are you si n g l e , married, divorced, widowed? E. What p r i o r i t y does t h i s education experience have i n r e l a t i o n to your l i f e a c t i v i t i e s and roles? ( please c i r c l e ) Highest Moderate Lowest 1 2 3 4 5 F. What l i f e a c t i v i t i e s and roles have higher or equal p r i o r i t y with t h i s education experience? 1. Higher p r i o r i t y : 2. Equal p r i o r i t y : 102 A p p e n d i x D Pool of Interview Questions A. How has t h i s experience, of post-basic baccalaureate nursing education, been compared to what you expected? 1. Have you been learning what you expected? 2. Have the courses been what you expected? 3. What has been your experience with your professors? 4. How have you been treated by other nursing students? 5. What has i t been l i k e to get back to studying and w r i t i n g papers? B. What experiences have been the most f r u s t r a t i n g f o r you? 1. Why have these experiences been f r u s t r a t i n g ? 2. What has going through these experiences meant to you? C. What experiences have been the most rewarding to you? 1. Why have these experiences been so rewarding? 2. What has going through these experiences meant to you? D. What has occurred i n your l i f e since you sta r t e d the post-basic program? 1. What adjustments have you made i n your l i f e to make time f o r your studies? 2. Have there been any unexpected events that have happened since you started the program. I f so, how have you dealt with them and what has t h i s meant to you? 3. How have you incorporated returning to school into your l i f e ? 4. What has returning to school meant to you personally? 5. What have you had to give up to return to school? 6. Has returning f o r your baccalaureate been worth i t to you? In what way? E. What does pursuing your baccalaureate degree mean to you? 1. How has taking the program affected your views on the nursing professsion? 2. How has taking the program affected your views on nursing education? 3. How has taking the program affected you personally? 4. Why d i d you decide to take your baccalaureate degree? 5. Would you recommend other nurses to take the baccalaureate program? Why? What are you f i n d i n g out about yourself that you d i d not r e a l i z e before? 1. What do you l i k e about yourself? 2. What do you want to change i n yourself? 3. Has coming back to school affected how you perceive y o u r s e l f ? I f so how? 

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