UBC Theses and Dissertations

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UBC Theses and Dissertations

Role conceptions of baccalaureate nursing graduates Way, Sandra Lee 1981

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ROLE CONCEPTIONS OF BACCALAUREATE NURSING GRADUATES by SANDRA L E E WAY B.S.N., T h e U n i v e r s i t y o f B r i t i s h C o l u m b i a , 1975  A T H E S I S SUBMITTED IN P A R T I A L F U L F I L M E N T OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF S C I E N C E IN NURSING in THE FACULTY OF GRADUATE S T U D I E S (School o f Nursing)  We a c c e p t t h i s t h e s i s a s c o n f o r m i n g to the r e q u i r e d s t a n d a r d  THE U N I V E R S I T Y OF B R I T I S H COLUMBIA A p r i l 1981  c ) S a n d r a L e e Way, 1981  In p r e s e n t i n g  t h i s t h e s i s i n p a r t i a l f u l f i l m e n t o f the  requirements f o r an advanced degree a t the U n i v e r s i t y o f B r i t i s h Columbia, I agree t h a t t h e L i b r a r y s h a l l make it  f r e e l y a v a i l a b l e f o r reference  and study.  I further  agree t h a t p e r m i s s i o n f o r e x t e n s i v e copying o f t h i s t h e s i s f o r s c h o l a r l y purposes may be granted by t h e head o f my department o r by h i s o r h e r r e p r e s e n t a t i v e s . understood t h a t  copying o r p u b l i c a t i o n o f t h i s t h e s i s  f o r f i n a n c i a l gain  s h a l l n o t be allowed without my w r i t t e n  permission.  Department o f  ///£//r/>/rts?  The U n i v e r s i t y o f B r i t i s h 2075 Wesbrook P l a c e Vancouver, Canada V6T 1W5 Date  T-,T?_£  10 /-7Q \.  It i s  Columbia  Abstract Role c o n f l i c t experienced i n the t r a n s i t i o n from t h e e d u c a t i o n a l i n s t i t u t i o n t o t h e w o r k o r g a n i z a t i o n c a n be u n d e r s t o o d through t h e study o f r o l e c o n c e p t i o n s ; where i n c o n s i s t e n c y between i d e a l r o l e conceptions and a c t u a l e x p e r i e n c e i s termed r o l e d e p r i v a t i o n .  This  s t u d y i s a d e s c r i p t i v e s u r v e y o f t h e r o l e c o n c e p t i o n s o f t h e 1980 b a c c a l a u r e a t e graduates o f The U n i v e r s i t y o f B r i t i s h Columbia School o f Nursing.  Role c o n c e p t i o n s were measured by t h e Nursing Role Conception  S c a l e ( C o r w i n , 1 9 6 0 ) one m o n t h p r i o r t o g r a d u a t i o n (N=77) a n d s i x m o n t h s f o l l o w i n g g r a d u a t i o n f o r t h o s e employed i n a h o s p i t a l s e t t i n g (N=37). In a d d i t i o n , c o m p l e t i o n o f t h e Work E x p e r i e n c e Q u e s t i o n n a i r e p r o v i d e d d a t a t o d e s c r i b e t h e e m p l o y m e n t s t a t u s o f t h e s e g r a d u a t e s (N=62) s i x months f o l l o w i n g g r a d u a t i o n . R e s u l t s o f t h i s study a r e presented i n terms o f b u r e a u c r a t i c , p r o f e s s i o n a l and s e r v i c e r o l e c o n c e p t i o n and r o l e d e p r i v a t i o n s c o r e s . The f i n d i n g s a r e a l s o a n a l y z e d f o r two s u b - g r o u p s o f g r a d u a t e s ;  those  who c o m p l e t e d f o u r y e a r s o f u n i v e r s i t y n u r s i n g e d u c a t i o n ( U B C - 4 ) a n d t h o s e who e n t e r e d a s r e g i s t e r e d n u r s e s a n d c o m p l e t e d t h e l a s t two y e a r s of t h e program (UBC-2). importance.  This study reveals three f i n d i n g s o f major  The f i r s t i s t h e absence o f d i f f e r e n c e s i n t h e r o l e  c o n c e p t i o n s c o r e s o f UBC-2 a n d UBC-4 g r o u p s o f b a c c a l a u r e a t e g r a d u a t e s , despite differences i n educational process.  T h e s e c o n d i s t h a t t h e mean  b u r e a u c r a t i c r o l e d e p r i v a t i o n s c o r e r e m a i n e d c o n s t a n t f o r UBC-2 g r a d u a t e s b u t d e c r e a s e d s i g n i f i c a n t l y f o r t h e UBC-4 g r a d u a t e s o v e r t h e s i x m o n t h post-graduation period.  T h e t h i r d f i n d i n g i s an o b s e r v e d  ii  significant  d e c r e a s e i n s e r v i c e r o l e d e p r i v a t i o n s c o r e s o v e r the s i x month p e r i following graduation.  The i m p o r t a n t i m p l i c a t i o n s o f t h e s e  findings  n u r s i n g e d u c a t i o n , n u r s i n g s e r v i c e and p a t i e n t c a r e d e l i v e r y a r e a d d r e s s e d and s u g g e s t i o n s f o r f u r t h e r s t u d y a r e p r e s e n t e d .  i ii  T A B L E OF CONTENTS Page i i  ABSTRACT L I S T OF T A B L E S  vi  L I S T OF FIGURES  vii  ACKNOWLEDGEMENTS  vi i i  CHAPTER .1. INTRODUCTION Problem  .  1  .  4  Purpose o f the Study  4  D e f i n i t i o n o f Terms  5  Assumptions  .-  6  Limitations  6  I I . REVIEW OF THE L I T E R A T U R E I.  8  T h e o r e t i c a l Framework  8  Role Theory  8  Role A c q u i s i t i o n  10  Role C o n f l i c t  . .  Types o f Role C o n f l i c t II.  13 14  N u r s i n g S t u d i e s R e l a t e d t o t h e P r o b l e m U n d e r S t u d y 16  Summary  22  I I I . METHODOLOGY  26  Research Design  26  Instruments  27  Nursing Role Conception S c a l e  27  Work E x p e r i e n c e Q u e s t i o n n a i r e  28  Sample  .-. . .  Procedure f o r Data C o l l e c t i o n iv  28 29  T A B L E OF CONTENTS Page CHAPTER IV. PRESENTATION AND DISCUSSION OF FINDINGS  31  Scoring o f Nursing Role Conception Scale  31  R e l i a b i l i t y o f Nursing Role Conception Scale ....  33  Role Conception  33  Role D e p r i v a t i o n  41  Work P r o f i l e  47  V. SUMMARY, CONCLUSIONS, I M P L I C A T I O N S AND RECOMMENDATIONS FOR FURTHER STUDY  56  Conclusions  60  Implications  61  Recommendations f o r F u r t h e r Study  62  BIBLIOGRAPHY  64  APPENDIX A  68  APPENDIX B  79  APPENDIX C  83  APPENDIX D  85  APPENDIX E  87  APPENDIX F  89  v  L I S T OF T A B L E S page TABLE I  S i g n i f i c a n c e o f D i f f e r e n c e B e t w e e n Mean R o l e Conception Scores o f Baccalaureate Graduates M e a s u r e d One M o n t h P r i o r t o G r a d u a t i o n (T-j) and S i x Months F o l l o w i n g G r a d u a t i o n ( T )  35  S i g n i f i c a n c e o f D i f f e r e n c e s B e t w e e n Mean R o l e C o n c e p t i o n S c o r e s f o r Two G r o u p s o f B a c c a l a u r e a t e S t u d e n t s (N = 76) One M o n t h Prior to Graduation . . .  38  S i g n i f i c a n c e o f D i f f e r e n c e s B e t w e e n Mean R o l e C o n c e p t i o n S c o r e s f o r Two G r o u p s o f B a c c a l a u r e a t e G r a d u a t e s (.N_ = 3 7 ) S i x M o n t h s Following Graduation  39  S i g n i f i c a n c e o f D i f f e r e n c e s B e t w e e n Mean R o l e Deprivation Scores o f Baccalaureate Graduates M e a s u r e d One M o n t h P r i o r t o G r a d u a t i o n ( T ^ ) . and S i x M o n t h s F o l l o w i n g G r a d u a t i o n (1^)  42  2  TABLE I I  TABLE I I I  T A B L E IV  TABLE V  S i g n i f i c a n c e o f D i f f e r e n c e s B e t w e e n Mean R o l e D e p r i v a t i o n S c o r e s f o r Two G r o u p s o f B a c c a l a u r e a t e S t u d e n t s (N = 7 6 ) One M o n t h Prior to Graduation  T A B L E VI  45  S i g n i f i c a n c e o f D i f f e r e n c e s B e t w e e n Mean R o l e D e p r i v a t i o n S c o r e s f o r Two G r o u p s o f B a c c a l a u r e a t e G r a d u a t e s ' ( N = 37) S i x Months Following Graduation  TABLE V I I  46  Number o f P o s i t i o n s by L e n g t h o f E m p l o y m e n t a n d T y p e o f Work O r g a n i z a t i o n H e l d by B a c c a l a u r e a t e Graduates as Reported S i x Months F o l l o w i n g  TABLE V I I I  Graduation  50  P o s i t i o n T i t l e s o f Those Baccalaureate Graduates (N_ = 3 6 ) E m p l o y e d i n t h e H o s p i t a l S e t t i n g S i x Months F o l l o w i n g G r a d u a t i o n  53  vi  L I S T OF FIGURES page FIGURE 1  FIGURE 2  Employment S t a t u s o f B a c c a l a u r e a t e Graduates (N = 6 2 ) S i x M o n t h s F o l l o w i n g G r a d u a t i o n . . . .  48  C u r r e n t Employment S e t t i n g s o f B a c c a l a u r e a t e G r a d u a t e s (N^ = 5 7 ) S i x M o n t h s F o l l o w i n g Graduation  51  vi i  ACKNOWLEDGEMENTS The a u t h o r w i s h e s t o a c k n o w l e d g e review p r o v i d e d by t h e s i s committee  t h e guidance and c r i t i c a l  members D r . M a r i l y n W i l l m a n ,  chairman, and S h e i l a Stanton i n t h e development research project.  and completion o f t h i s  I n a d d i t i o n , t h e e n c o u r a g e m e n t a n d h e l p o f f e r e d by  Dr. G a r y J o h n s o n a n d D r . Mark S t a r r i n t h e u s e o f t h e c o m p u t e r  i s very  much a p p r e c i a t e d . G r a t e f u l l y acknowledged  i s the valuable contribution of the  1980 c l a s s o f b a c c a l a u r e a t e g r a d u a t e s f r o m T h e U n i v e r s i t y o f B r i t i s h Columbia School o f Nursing.  T h e i r high level o f p a r t i c i p a t i o n and  w i l l i n g n e s s t o complete research instruments p r i o r t o and f o l l o w i n g g r a d u a t i o n made t h i s s t u d y p o s s i b l e . My m o s t h e a r t f e l t t h a n k s i s e x p r e s s e d t o my f a m i l y a n d f r i e n d s f o r t h e i r ongoing support and understanding. and f o r c a r i n g .  vi i i  Thank y o u f o r l i s t e n i n g  CHAPTER I INTRODUCTION R e a l i t y shock i s a term used t o d e s c r i b e t h e e x p e r i e n c e encountered  as p e o p l e l e a v e t h e e d u c a t i o n a l system and e n t e r t h e work  o r g a n i z a t i o n ( H a l l , 1976;  Kramer, 1974).  H a l l (1976) r e l a t e s t h a t these  p e o p l e " t e n d t o e x p e r i e n c e unmet e x p e c t a t i o n s , s u r p r i s e , d i s i l l u s i o n m e n t , a n x i e t y , and o t h e r f e e l i n g s o f n o t being f u l l y p r e p a r e d f o r t h e day-today a c t i v i t i e s a n d p r o b l e m s  o f t h e work e n v i r o n m e n t "  (pp. 37-38).  T h e s e o b s e r v a t i o n s f o c u s a t t e n t i o n on r o l e t h e o r y a n d t h e process o f r o l e a c q u i s i t i o n . Within the stages o f s o c i a l i z a t i o n the r o l e incumbent  f i r s t a c q u i r e s s k i l l s , knowledge and r o l e e x p e c t a t i o n s  through  the e d u c a t i o n a l p r o c e s s ; then a d j u s t s t o t h e e x p e c t a t i o n s o f o t h e r s and o n - t h e - j o b d e m a n d s ; a n d l a s t l y i m p o s e s h i s / h e r own d e f i n i t i o n s on t h e role occupied, negotiating the r o l e to f i t the expectations o f others with h i s / h e r own p r e f e r e n c e s [ B r i e f , A l d a g , Van S e l l a n d M e l o n e , 1 9 7 9 , p . 1 6 1 ) . G r a d u a t i o n f r o m an e d u c a t i o n a l i n s t i t u t i o n i s a t i m e o f s t a t u s passage as i t r e f l e c t s changes i n t h e r o l e from s t u d e n t Formation o f r o l e conceptions r e s u l t s from placement  to-worker.  of self with respect  to o t h e r s ; such t h a t r o l e c o n c e p t i o n s r e p r e s e n t the r o l e e x p e c t a t i o n s h e l d b y an i n d i v i d u a l a t a s p e c i f i e d t i m e .  Role conceptions a r e expected  to change as a r e s u l t o f t h e passage from t h e e d u c a t i o n a l environment the work environment,  and a r e a p o t e n t i a l source o f c o n f l i c t f o r the  1  to  2 i n d i v i d u a l when r o l e e x p e c t a t i o n s a r e i n c o m p a t i b l e w i t h t h o s e h e l d by the s e l f or others. Many o c c u p a t i o n a l g r o u p s h a v e o b s e r v e d t h e r o l e c o n f l i c t e x p e r i e n c e d by p r o f e s s i o n a l s e n t e r i n g w o r k o r g a n i z a t i o n s ( H a l l , K r a m e r , 1974;  S c h e i n , 1968;  Sorensen  and S o r e n s e n ,  1974).  Organizations  h a v e o b s e r v e d a d e c r e a s e i n new g r a d u a t e m o t i v a t i o n o v e r t i m e  and a t r e n d  t o w a r d i n c r e a s e d m i g r a t i o n o f s t a f f ( S c h e i n , 1968, pp. 2 7 - 2 8 ) . d i s s a t i s f a c t i o n and r o l e c o n f l i c t h a v e b e e n c i t e d as p r i m a r y  Job reasons  u n d e r l y i n g p o s t g r a d u a t e e x o d u s f r o m n u r s i n g ( K r a m e r and B a k e r , pp.  1976;  1971,  15-30). S t u d y o f r o l e c o n f l i c t i n n u r s i n g has f o c u s s e d on t h e p r o c e s s  o f r o l e a c q u i s i t i o n and t h e m e a s u r e m e n t o f r o l e c o n c e p t i o n s a n d r o l e behaviours 1971;  ( B r i e f e t a l , 1979;  K r a m e r , 1966,  1974;  C o r w i n , 1960;  P i e t a , 1976).  F a r h a n g M e h r , 1973;  Corwin  Johnson,  (1960) p e r c e i v e d nurses  to c o n c e i v e t h e i r r o l e s i n t h r e e ways; b u r e a u c r a t i c , p r o f e s s i o n a l and s e r v i c e (p. x x i i ) .  T h e s e r o l e c o n c e p t i o n s a r e d e s c r i b e d as r e f l e c t i n g  l o y a l t i e s t o the h o s p i t a l and h o s p i t a l a d m i n i s t r a t i o n ; t o the n u r s i n g profession; andto  the p s y c h o l o g i c a l w e l f a r e of the p a t i e n t , r e s p e c t i v e l y  ( C o r w i n , 1960, pp. 1 6 2 - 1 6 3 ) .  Within these three r o l e conceptions,  the  p r o f e s s i o n a l a n d b u r e a u c r a t i c h a v e m o s t o f t e n b e e n o b s e r v e d t o be i n c o m p a t i b l e and t o c o n f r o n t t h e n u r s e w i t h p o t e n t i a l d i l e m m a s ( K r a m e r , 1974, p. 5 3 ) .  The i n c o m p a t i b i l i t y o f r o l e c o n c e p t i o n s  reflects  d i s c r e p a n c i e s i n e x p e c t a t i o n s which r e s u l t s i n r o l e c o n f l i c t f o r the nurse. R o l e d i s c r e p a n c y has b e e n shown t o be s i g n i f i c a n t l y g r e a t e r f o r b a c c a l a u r e a t e g r a d u a t e s t h a n f o r d i p l o m a , o r a s s o c i a t e d e g r e e (two y e a r college) graduates  ( C o r w i n , 1960;  K r a m e r , 1966,  1974).  3 The c o n f l i c t o f r o l e c o n c e p t i o n s employed i n o r g a n i z a t i o n s  h e l d by  professionals  r e f l e c t s differences inherent in professional  and b u r e a u c r a t i c o r i e n t a t i o n s t o w a r d w o r k and t a s k p e r f o r m a n c e ( B r i e f e t a l . , 1979;  C o r w i n , 1960;  Sorensen, 1974).  J o h n s o n , 1971;  K r a m e r , 1974;  Sorensen  and  In n u r s i n g , t h e h o s p i t a l e m p l o y m e n t s e t t i n g i s t h e  only  o r g a n i z a t i o n w h i c h has b e e n s t u d i e d , and i t d e m o n s t r a t e s a d h e r e n c e t o bureaucratic p r i n c i p l e s of organization.  T h i s f o c u s i s r e l e v a n t f o r an  understanding  by n u r s e s  of the c o n f l i c t experienced  system where nurses that of nurses (92.9  are p r i m a r i l y employed.  as i t i s t h e h o s p i t a l  S t a t i s t i c s f o r 1977  show  r e g i s t e r e d f o r p r a c t i c e i n C a n a d a , 1 1 3 , 3 4 4 o u t o f 143,388  percent) were employed i n h o s p i t a l s ; i n B r i t i s h Columbia the f i g u r e s  w e r e 10,961 o u t o f 13,355 (82.0  percent)  ( S t a t i s t i c s C a n a d a , 1980,  p.  22).  Thus, the nature of r o l e c o n f l i c t i s f e l t to have s i g n i f i c a n t i m p l i c a t i o n s f o r t h e p r a c t i c e o f n u r s i n g , and n u r s i n g n e e d s t o d i r e c t s p e c i f i c a t t e n t i o n t o the observed e n t e r i n g the h o s p i t a l Nursing  d i f f i c u l t i e s f o r new  graduates  organization.  service administrators  are concerned with  the  c o n s e q u e n c e s o f r o l e c o n f l i c t f o r i n d i v i d u a l n u r s e f u n c t i o n i n g , and d e l i v e r y o f n u r s i n g c a r e t o p a t i e n t s ( K r a m e r , 1976, Educators  pp.  106-107).  committed to the p r e p a r a t i o n of p r o f e s s i o n a l nurses  baccalarueate  the  at the  l e v e l a r e c o n c e r n e d w i t h t h i s t i m e o f t r a n s i t i o n and  the  consequences of r o l e c o n f l i c t f o r which they are i n c r e a s i n g l y held accountable education  ( K r a m e r , 1976,  pp. 1 0 6 - 1 0 7 ) .  are i n t e r e s t e d i n understanding  B o t h n u r s i n g s e r v i c e and the r o l e conceptions  g r a d u a t e s and t h e i r i m p l i c a t i o n s f o r r o l e c o n f l i c t .  of  nursing new  4  Much o f t h e . r e s e a r c h r e l a t e d t o n u r s i n g r o l e s h a s b e e n conducted  i n t h e U n i t e d S t a t e s and r e f l e c t s t h e e d u c a t i o n a l and work  organizations of that country. U n i v e r s i t y o f B r i t i s h Columbia  The o n l y Canadian  study i d e n t i f i e d i s a  Master's t h e s i s which s t u d i e d  determinant  f a c t o r s i n v o l v e d i n t h e d e v e l o p m e n t o f r o l e b e h a v i o u r s f o r t h e 1976 g r a d u a t e s o f The U n i v e r s i t y o f B r i t i s h Columbia (Farhang Mehr,  b a c c a l a u r e a t e program  1977).  In summary, r o l e c o n f l i c t i n n u r s i n g c a n be s t u d i e d f r o m t h e perspective of role conceptions.  In view o f e v i d e n c e l i n k i n g j o b  d i s s a t i s f a c t i o n a n d m i g r a t i o n o f new g r a d u a t e s t o r o l e c o n f l i c t , i t i s important f o r both n u r s i n g e d u c a t i o n and n u r s i n g s e r v i c e a d m i n i s t r a t i o n t o u n d e r s t a n d t h i s phenomenon i n o r d e r t o h e l p g r a d u a t e s d u r i n g t h e t i m e of t r a n s i t i o n .  The l a c k o f s t u d i e s w i t h i n t h e Canadian e d u c a t i o n a l and  health system i s a stimulus f o r i n v e s t i g a t i o n o f these Comparison  concerns.  o f f i n d i n g s c a n t h e n be made t o t h o s e o b s e r v e d i n A m e r i c a n  studies.  Problem What a r e t h e r o l e c o n c e p t i o n s o f T h e U n i v e r s i t y o f B r i t i s h Columbia  B a c c a l a u r e a t e graduates p r i o r t o u n i v e r s i t y g r a d u a t i o n , and i n  t h e i r work e x p e r i e n c e a f t e r g r a d u a t i o n ?  Purpose o f the Study The p u r p o s e o f t h i s s t u d y i s t o a n s w e r t h e f o l l o w i n g q u e s t i o n s : 1. ' What a r e t h e b u r e a u c r a t i c , p r o f e s s i o n a l a n d s e r v i c e r o l e c o n c e p t i o n s o f T h e U n i v e r s i t y o f B r i t i s h C o l u m b i a (UBC)  5 b a c c a l a u r e a t e s t u d e n t s m e a s u r e d one m o n t h p r i o r t o u n i v e r s i t y graduation? 2.  What a r e t h e b u r e a u c r a t i c , p r o f e s s i o n a l a n d s e r v i c e r o l e d e p r i v a t i o n s o f UBC b a c c a l a u r e a t e s t u d e n t s m e a s u r e d one m o n t h prior to u n i v e r s i t y graduation?  3.  What a r e t h e b u r e a u c r a t i c , p r o f e s s i o n a l and s e r v i c e r o l e c o n c e p t i o n s o f t h e same UBC b a c c a l a u r e a t e g r a d u a t e s when e m p l o y e d i n a h o s p i t a l s e t t i n g and m e a s u r e d s i x m o n t h s following graduation?  4.  What a r e t h e b u r e a u c r a t i c , p r o f e s s i o n a l and s e r v i c e r o l e d e p r i v a t i o n s o f t h e same UBC b a c c a l a u r e a t e g r a d u a t e s when e m p l o y e d i n a h o s p i t a l s e t t i n g and m e a s u r e d s i x m o n t h s following graduation?  5.  A r e t h e r e d i f f e r e n c e s i n r o l e c o n c e p t i o n and r o l e d e p r i v a t i o n s c o r e s o f UBC-4 a n d UBC-2 b a c c a l a u r e a t e g r a d u a t e s ?  6.  What a r e t h e d i f f e r e n c e s b e t w e e n t h e r o l e c o n c e p t i o n and r o l e d e p r i v a t i o n s c o r e s o f t h e UBC b a c c a l a u r e a t e g r a d u a t e s when m e a s u r e d one month p r i o r t o u n i v e r s i t y g r a d u a t i o n , a n d , . f o r t h o s e e m p l o y e d i n a h o s p i t a l s e t t i n g , when m e a s u r e d a g a i n s i x months f o l l o w i n g g r a d u a t i o n ?  7.  What a r e t h e t y p e s o f w o r k o r g a n i z a t i o n s e n t e r e d by baccalaureate graduates f o l l o w i n g graduation?  8.  I s t h e r e a r e l a t i o n s h i p b e t w e e n t h e r o l e c o n c e p t i o n s o f UBC b a c c a l a u r e a t e g r a d u a t e s m e a s u r e d one m o n t h p r i o r t o g r a d u a t i o n , and t h e t y p e o f w o r k o r g a n i z a t i o n i n w h i c h t h e y a r e e m p l o y e d s i x months f o l l o w i n g g r a d u a t i o n ?  UBC  D e f i n i t i o n o f Terms ROLE:  A set of expectations r e f l e c t i n g i n t e r n a l i z e d needs, a t t i t u d e s and v a l u e s a b o u t how a p e r s o n i n a g i v e n p o s i t i o n i n a p a r t i c u l a r s o c i a l s y s t e m s h o u l d a c t r e l a t i v e t o how t h e i n d i v i d u a l i n a r e c i p r o c a l p o s i t i o n should a c t . Each r o l e i s a s s o c i a t e d w i t h l e a r n e d b e h a v i o u r s t h a t have v a l u e f o r the s o c i a l system.  ROLE CONCEPTION: " t h e images o f t h e r i g h t s and o b l i g a t i o n s w h i c h a p e r s o n p e r c e i v e s t o be a s s o c i a t e d w i t h h i s p o s i t i o n , ...: 1) t h e y p r o v i d e e x p e c t a t i o n s w h i c h g u i d e c o n d u c t — t h e y i n d i c a t e the a p p r o p r i a t e behaviour f o r p a r t i c u l a r s i t u a t i o n s , a n d 2) t h e s e g u i d e s g e n e r a t e a t t i t u d e s — p e r s o n a l p r e d i s p o s i t i o n s t o a c t " ( C o r w i n a n d T a v e s , 1962, p. 223)s. In t h i s s t u d y , r o l e c o n c e p t i o n s w e r e m e a s u r e d by t h e N u r s i n g R o l e C o n c e p t i o n S c a l e d e v e l o p e d by C o r w i n ( 1 9 6 0 ) .  6 B u r e a u c r a t i c Role Conception: " r e f e r s t o the a d m i n i s t r a t i v e r u l e s and r e g u l a t i o n s w h i c h d e s c r i b e t h e n u r s e ' s j o b i n a s p e c i f i c hospital; i t suggests primary loyalty to the hospital a d m i n i s t r a t i o n " ( C o r w i n , 1961, p. 7 2 ) . P r o f e s s i o n a l Role Conception: " r e f e r s t o the occupational p r i n c i p l e s which transcend the l o c a t i o n o f a s p e c i f i c h o s p i t a l " (Corwin, 1961, p. 7 2 ) ; " i m p l i e s l o y a l t y t o t h e a b s t r a c t p r o f e s s i o n a l s t a n d a r d s which a r e s a n c t i o n e d by t h e p r o f e s s i o n " ( C o r w i n , 1960, p. 1 6 3 ) . S e r v i c e R o l e C o n c e p t i o n : " r e f e r s t o n u r s i n g c o n c e i v e d as a s e n t i m e n t a l c a l l i n g and suggests primary d e v o t i o n t o t h e p a t i e n t a s a p e r s o n " ( C o r w i n , 1 9 6 1 , p. 7 2 ) ; " i m p l i e s l o y a l t y to t h e p a t i e n t and i n p a r t i c u l a r , t o p a t i e n t s ' p s y c h o l o g i c a l w e l f a r e " ( C o r w i n , 1960, p. 1 6 3 ) . ROLE D E P R I V A T I O N : " i n c o n s i s t e n c y b e t w e e n a p e r s o n ' s i d e a l r o l e c o n c e p t i o n s and h i s consequent a c t u a l e x p e r i e n c e " (Corwin, 1960, p p . 2 0 8 - 2 0 9 ) . F o r t h i s s t u d y , an i n d e x o f r o l e d e p r i v a t i o n was d e t e r m i n e d u s i n g C o r w i n ' s ( 1 9 6 0 ) N u r s i n g Role Conception S c a l e , with computation o f a d i f f e r e n c e score from the respondent's p e r c e p t i o n o f the ideal s i t u a t i o n compared t o h e r p e r c e p t i o n o f t h e a c t u a l s i t u a t i o n (p. 2 0 9 ) . The t o t a l r o l e d e p r i v a t i o n f o r e a c h s c a l e i s a sum o f t h e d i f f e r e n c e s noted f o r each item. UBC-4:  UBC b a c c a l a u r e a t e n u r s e g r a d u a t e who c o m p l e t e d f o u r y e a r s o f u n i v e r s i t y n u r s i n g s t u d y f o r a B.S.N, d e g r e e .  UBC-2:  UBC b a c c a l a u r e a t e n u r s e g r a d u a t e who e n t e r e d T h e U n i v e r s i t y of B r i t i s h Columbia School o f Nursing with r e g i s t e r e d nurse c e r t i f i c a t i o n , a n d c o m p l e t e d two y e a r s o f u n i v e r s i t y s t u d y f o r a B.S.N, d e g r e e .  Assumptions I t was a s s u m e d t h a t c a l c u l a t i o n o f r o l e d e p r i v a t i o n f r o m measurements r e l a t e d t o p e r c e p t i o n o f t h e i d e a l n u r s i n g s i t u a t i o n and p e r c e p t i o n o f t h e a c t u a l n u r s i n g s i t u a t i o n p r o v i d e d an a d e q u a t e m e a s u r e o f t h e r o l e d i s c r e p a n c y e x p e r i e n c e d by t h e i n d i v i d u a l .  7 Limitations Limitations to this study relate to the f o l l o w i n g : S a m p l e — T h e s a m p l e was l i m i t e d t o t h e p o p u l a t i o n o f f o u r t h y e a r s t u d e n t s a v a i l a b l e i n The U n i v e r s i t y o f B r i t i s h Columbia School o f N u r s i n g d u r i n g the s c h o o l y e a r 1979-1980 and r e s u l t s a r e n o t g e n e r a l i z a b l e beyond  this  population. Instrument—The  N u r s i n g R o l e C o n c e p t i o n S c a l e was d e v e l o p e d by C o r w i n i n  1960 i n an A m e r i c a n differences.  s e t t i n g a n d r e s p o n s e s may r e f l e c t t i m e a n d p o p u l a t i o n  F u r t h e r , the h y p o t h e t i c a l s i t u a t i o n s i n the Nursing Role  C o n c e p t i o n S c a l e r e f l e c t h o s p i t a l work o r i e n t a t i o n , which l i m i t e d t h e second c o m p l e t i o n o f the S c a l e t o graduates employed setting.  in a hospital  CHAPTER I I REVIEW OF THE L I T E R A T U R E The a i m o f t h i s l i t e r a t u r e r e v i e w i s t o e x p l o r e t h e t h e o r e t i c a l p e r s p e c t i v e o f r o l e t h e o r y as a background  f o r study o f the r o l e  c o n c e p t i o n s o f b a c c a l a u r e a t e nurses p r i o r t o u n i v e r s i t y g r a d u a t i o n , and i n t h e i r work e x p e r i e n c e a f t e r g r a d u a t i o n . P r e s e n t e d i n two p a r t s , t h i s r e v i e w w i l l f i r s t e x p l o r e t h e concept o f r o l e and t h e process o f r o l e a c q u i s i t i o n t o determine t h e nature o f r o l e c o n f l i c t c o n f r o n t i n g i n d i v i d u a l s i n t r a n s i t i o n from the e d u c a t i o n a l system t o t h e work o r g a n i z a t i o n .  The second p a r t o f t h i s  review presents n u r s i n g s t u d i e s r e l a t e d t o t h e problem under  I. Role  study.  T h e o r e t i c a l Framework  Theory S t u d y o f o r g a n i z a t i o n a l b e h a v i o u r i s i n c r e a s i n g l y f o c u s s e d on  human p e r f o r m a n c e ,  a n d t h e i s s u e o f i n t e g r a t i n g t h e o r i e s o f human  p e r s o n a l i t y with, o r g a n i z a t i o n a l t h e o r y .  V i e w i n g an o r g a n i z a t i o n a s a  s o c i a l s y s t e m , t h e c o n c e p t o f r o l e i s p r o p o s e d a s " t h e m a j o r means f o r l i n k i n g the i n d i v i d u a l and o r g a n i z a t i o n a l l e v e l s o f research and theory; i t i s a t once t h e b u i l d i n g b l o c k o f s o c i a l systems t h e r e q u i r e m e n t s w i t h which, s u c h s y s t e m s  8  and t h e summation o f  c o n f r o n t t h e i r members a s  '  9  i n d i v i d u a l s " ( K a t z and K a h n , 1966, operationalize  p. 1 9 7 ) .  Role i s thus seen to  t h e m e r g i n g o f s o c i a l and i n d i v i d u a l phenomena  within  the systems framework. R o l e c a n be d e f i n e d  as a t i t l e d e s i g n a t i n g  or p o s i t i o n with s o c i a l l y sanctioned  c l a s s i f i c a t i o n s of  r e f l e c t i n g i n t e r n a l i z e d n e e d s , a t t i t u d e s and v a l u e s . associated  with learned  a particular  status  expectations  Each r o l e i s  b e h a v i o u r s t h a t have v a l u e f o r the s o c i a l system  and r e f l e c t s an i n t e r a c t i v e p r o c e s s b e t w e e n t h a t r o l e p o s i t i o n  reciprocal  w i t h o t h e r p o s i t i o n s i n t h e s o c i a l s y s t e m ( B i d d l e and T h o m a s , 1 9 6 6 ) . Merton (1966) d e f i n e s  r o l e s e t as " T h a t c o m p l e m e n t o f .role  relationships  w h i c h p e r s o n s h a v e by v i r t u e o f o c c u p y i n g a p a r t i c u l a r s o c i a l (p. 282).  F o r e x a m p l e , i n a s i n g l e s t a t u s p o s i t i o n a n u r s e has a r o l e  set r e l a t i n g nurse to p a t i e n t , colleagues, hospital administration, described  status"  and p r o f e s s i o n a l  supervisor,  physicians,  organizations.  The  latter  are  as r o l e s e t members, and t h e y h e l p t o d e f i n e a p a r t i c u l a r r o l e  and e x p e c t e d r o l e b e h a v i o u r s , c o m m u n i c a t i n g t h e s e p e r c e p t i o n s expectations  t o t h e f o c a l p e r s o n ( B r u c k , 1970,  these expectations,  p. 8 ) .  r o l e s e t members can be d e s c r i b e d  and  In c o m m u n i c a t i n g as r o l e s e n d e r s ,  and t h e i r a t t e m p t s t o i n f l u e n c e t h e f o c a l p e r s o n a r e a c t s o f r o l e p r e s s u r e ( K a h n , W o l f e , Q u i n n , S n o e k , and R o s e n t h a l , 1964, role there i s a received and c o g n i t i o n  role that represents  p. 1 5 ) .  the i n d i v i d u a l ' s  of the message sent, which then i n f l u e n c e s  b e h a v i o u r (Kahn e t a l , 1964,  p. 1 6 ) .  i n t e r n a l i z e d n e e d s and e x p e c t a t i o n s  For every  sent  perception  subsequent  The n a t u r e o f r o l e p o s i t i o n w i t h a l l o w s f o r e a c h p e r s o n t o be a r o l e  s e n d e r f o r h i m s e l f , w h i c h f u r t h e r m o t i v a t e s and d i r e c t s r o l e b e h a v i o u r .  10 The i n t e r a c t i v e p r o c e s s b e t w e e n r o l e s e n d e r s a n d t h e f o c a l p e r s o n , has b e e n ' d e s c r i b e d by Kahn e t a l ( 1 9 6 4 ) as t h e r o l e e p i s o d e ( p . 2 6 ) . The t o t a l p a t t e r n o f e x p e c t a t i o n s and p r e s s u r e s i n t h e r o l e e p i s o d e d e t e r m i n e t h e p o t e n t i a l f o r c o n f l i c t i n t h e s i t u a t i o n (Kahn e t a l , 1964, P. 2 7 ) . S u p e r i m p o s e d on t h i s e p i s o d e a r e o r g a n i z a t i o n a l f a c t o r s , p e r s o n a l i t y f a c t o r s and i n t e r p e r s o n a l r e l a t i o n s ( K a h n e t a l , 1964, pp. 3 1 - 3 3 ) .  Kahn e t a l ( 1 9 6 4 ) s t a t e t h a t :  The p r o p e r t i e s and t r a i t s m a k i n g up t h e o r g a n i z a t i o n , t h e p e r s o n , and s o c i a l r e l a t i o n s h i p s a r e f o r t h e m o s t p a r t a b s t r a c t i o n s and g e n e r a l i z a t i o n s b a s e d upon r e c u r r e n t e v e n t s and b e h a v i o u r s S u c h r e p e t i t i o n s and p a t t e r n s o f b e h a v i o u r s and e v e n t s p r o v i d e a b a s i s f o r u n d e r s t a n d i n g e a c h new e v e n t , ( p . 3 1 ) . The i n p u t o f o r g a n i z a t i o n a l f a c t o r s t o t h e r o l e e x p e c t a t i o n s o f r o l e s e n d e r s i l l u s t r a t e s t h a t t h e e x p e c t a t i o n s o f members i n a r o l e s e t a r e d e t e r m i n e d i n l a r g e p a r t by t h e o r g a n i z a t i o n a l c o n t e x t .  Personality  f a c t o r s and i n t e r p e r s o n a l r e l a t i o n s h a v e i n f l u e n c e on t h e r e c e i v e d r o l e o f t h e f o c a l p e r s o n , and as w e l l on t h e e x p e c t a t i o n s o f t h e r o l e s e n d e r s . T h e s e i n f l u e n c e s may c h a n g e as t h e y a r e a f f e c t e d by t h e f o c a l  person's  role behaviour or coping responses to experiences of c o n f l i c t or ambiguity.  Role A c q u i s i t i o n A p e r s o n ' s r o l e b e h a v i o u r s w i l l be f u r t h e r i n f l u e n c e d by t h e s t a g e he/she i s a t i n the process of r o l e a c q u i s i t i o n .  The s t a g e s o f r o l e  s o c i a l i z a t i o n r e f e r r e d to i n Chapter I r e f l e c t i n g the educational process, o n - t h e - j o b e x p e r i e n c e , and p e r s o n a l m a n a g e m e n t o f t h e e x p e c t a t i o n s o f b o t h , h a v e b e e n m o r e f u l l y d e s c r i b e d by T h o r n t o n and N a r d i ( 1 9 7 5 , pp. 8 7 0 - 8 8 1 ) .  11 The f i r s t o r a n t i c i p a t o r y s t a g e o f r o l e a c q u i s i t i o n i s concerned with the p e r i o d p r i o r to a c t u a l incumbency i n a s o c i a l p o s i t i o n ( T h o r n t o n a n d N a r d i , 1975, p. 8 7 4 ) .  Included i n t h i s time i s the  e d u c a t i o n a l p r o c e s s as a c o n t r i b u t o r o f i n f o r m a t i o n r e g a r d i n g t h e r o l e . T h i s s t a g e i s c h a r a c t e r i z e d by t h e f o r m a t i o n o f i n c o m p l e t e  role  c o n c e p t i o n s , w i t h i d e a l i z e d e x p e c t a t i o n s o f what enactment o f the r o l e " s h o u l d " i n v o l v e ( T h o r n t o n and N a r d i , 1975, pp. 8 7 4 - 8 7 5 ) .  In t h i s  way  " a n t i c i p a t i o n may n o t be c o n g r u e n t w i t h w h a t w i l l a c t u a l l y be e x p e r i e n c e d " ( T h o r n t o n and N a r d i , 1975, p. 8 7 5 ) . O n - t h e - j o b r o l e a c q u i s i t i o n i s c o m p r i s e d o f f o r m a l and i n f o r m a l stages.  In t h e f o r m a l s t a g e t h e r o l e i n c u m b e n t i s i n t h e s o c i a l p o s i t i o n  and t h u s has an i n s i d e p e r s p e c t i v e .  During t h i s stage the i n d i v i d u a l i s  confronted with the f o r m a l i z e d expectations of the o r g a n i z a t i o n w r i t t e n o r s t a t e d e x p l i c i t l y i n j o b d e s c r i p t i o n s and o r g a n i z a t i o n h a n d b o o k s ( T h o r n t o n and N a r d i , 1975, p. 8 7 6 ) .  The f o r m a l i z e d e x p e c t a t i o n s i n d i c a t e  t h e " m u s t s " o f e x p e c t e d b e h a v i o u r and a b i l i t i e s ( T h o r n t o n and N a r d i , P. 8 7 7 ) .  By c o n t r a s t , t h e i n f o r m a l s t a g e r e f l e c t s t h e u n o f f i c i a l  or  i n f o r m a l e x p e c t a t i o n s o f ways o f d o i n g t h i n g s ( T h o r n t o n and N a r d i , p. 8 7 8 ) .  1975,  1975,  C o r r e s p o n d i n g t o t h e " s h o u l d s " and " m u s t s " o f t h e p r e v i o u s  s t a g e s , a r e t h e "mays" o f t h i s s t a g e .  The i n f o r m a l s t a g e r e f l e c t s t h e  a t t i t u d e s , e m o t i o n s , and v a l u e s o f r o l e s e t members, and t h e r e i s l e s s c o n s e n s u s among t h e v a r i o u s e x p e c t a t i o n s t h a n e n c o u n t e r e d i n t h e p r i o r stages.  T h i s s t a g e d e m o n s t r a t e s the i n f l u e n c e o f "back s t a g e r e a l i t y "  w h i c h has b e e n o b s e r v e d by K r a m e r ( 1 9 7 4 ) i n t h e s o c i a l i z a t i o n o f n u r s e s i n t h e work e n v i r o n m e n t (pp. 144-147).  12 Last i n the process of r o l e a c q u i s i t i o n i s the personal  stage.  In t h i s s t a g e i n d i v i d u a l s i m p o s e t h e i r own e x p e c t a t i o n s a n d c o n c e p t i o n s on r o l e s , s u c h t h a t r o l e e x p e c t a t i o n s a r e m o d i f i e d a c c o r d i n g t o t h e i r own u n i q u e p e r s o n a l i t i e s ( T h o r n t o n a n d N a r d i , 1 9 7 5 , p. 8 8 0 ) .  The  d e v e l o p m e n t o f t h e p e r s o n a l s t a g e i s v e r y much d e p e n d e n t on t h e expectations encountered stages.  i n t h e a n t i c i p a t o r y , f o r m a l , and i n f o r m a l  Thornton and Nardi (1975) note t h a t , u n l e s s p e r s o n a l  conceptions  a nd n e e d s c a n be r e c o n c i l e d w i t h t h e demands o f t h e s i t u a t i o n , i n c o n g r u e n c e between s e l f and r o l e r e s u l t s i n p e r f u n c t o r y r o l e enactment a nd p r o b l e m s i n s o c i a l a n d p s y c h o l o g i c a l a d j u s t m e n t ( p . 8 8 1 ) . S t u d i e s r e l a t e d t o t h e p r o c e s s o f r o l e a c q u i s i t i o n have demonstrated the r e l a t i v e importance  of various stages.  Ondrack  (1975)  s t u d i e d s o c i a l i z a t i o n i n p r o f e s s i o n a l s c h o o l s and c o n c l u d e d t h a t t h e d e g r e e o f s o c i a l i z a t i o n among s t u d e n t s v a r i e d d i r e c t l y w i t h t h e d e g r e e o f a t t i t u d e and v a l u e c o n s i s t e n c y i n t h e i r e d u c a t i o n a l program (p. 9 7 ) . The a n t i c i p a t o r y o r e d u c a t i o n a l p h a s e was shown t o be i m p o r t a n t i n a s t u d y by M i l l e r a n d W a g e r (.1971), who r e p o r t e d t h a t t h e l e n g t h a n d t y p e o f e d u c a t i o n , b u t n o t t h e l e n g t h o f e m p l o y m e n t , was r e l a t e d t o t h e t y p e of r o l e o r i e n t a t i o n adopted (p. 161).  The dynamics o f t h e i n f o r m a l s t a g e  h a v e b e e n s u p p o r t e d by K r a m e r ( 1 9 7 4 ) i n t h e r e p o r t e d o b s e r v a t i o n s o f a back s t a g e r e a l i t y where s t u d e n t s have d i f f i c u l t i e s w i t h p e r c e p t i o n o f the v a r i e t y o f e x p e c t a t i o n s encountered  (pp. 144-147).  F u r t h e r , Kramer  and Schmalenberg (1978) c a u t i o n t h a t " i t i s q u i t e p o s s i b l e t h a t t h e k i n d o f s i t u a t i o n a l a d a p t a t i o n s t h e new w o r k e r makes on h e r f i r s t j o b w i l l s e t the p a t t e r n f o r t h e r e m a i n d e r o f h e r work c a r e e r " ( p . 2 ) .  The m i g r a t i o n  o f w o r k e r s o u t o f p r o f e s s i o n s may be an i n d i c a t i o n t h a t some i n d i v i d u a l s  13 do n o t a c h i e v e t h e p e r s o n a l r e s o l u t i o n o f e x p e c t a t i o n s f o r a s o c i a l p o s i t i o n ( K r a m e r and B a k e r , 1971;  Schein,  1968).  Role C o n f l i c t In p r e s e n t a t i o n o f t h e r o l e e p i s o d e and t h e p r o c e s s o f r o l e a c q u i s i t i o n r e f e r e n c e s w e r e made t o t h e p o t e n t i a l f o r r o l e c o n f l i c t . ; R o l e c o n f l i c t o c c u r s when i n d i v i d u a l s a r e r e q u i r e d t o p l a y a r o l e c o n f l i c t s w i t h t h e i r v a l u e systems  o r t o p l a y two o r more r o l e s  which which  c o n f l i c t w i t h e a c h o t h e r (Van S e l l , B r i e f and S c h u l e r , i n p r e s s , p. 1 ) . Role c o n f l i c t r e s u l t s i n p s y c h o l o g i c a l c o n f l i c t f o r the i n d i v i d u a l  which  i n f l u e n c e s h i s p r e s e n t and f u t u r e b e h a v i o u r and o b s e r v a b l e p e r f o r m a n c e an o r g a n i z a t i o n .  in  W i t h i n t h e r o l e e p i s o d e , Kahn e t a l ( 1 9 6 4 ) , h a v e  i d e n t i f i e d four types of role c o n f l i c t : 1)  intra-sender conflict—where different prescriptions  proscriptions 2)  f r o m a s i n g l e member o f t h e r o l e s e t may  incompatible;  i n t e r - s e n d e r c o h f l i c t - - w h e r e p r e s s u r e s f r o m one r o l e  o p p o s e p r e s s u r e s f r o m one o r m o r e o t h e r 3)  be  and  sender  senders;  i n t e r - r o l e c o n f l i c t — w h e r e role pressures associated with  m e m b e r s h i p i n one o r g a n i z a t i o n c o n f l i c t w i t h p r e s s u r e s s t e m m i n g memberships i n o t h e r groups; 4)  and  person-role conf1ict--when  v a l u e s (pp.  from  role requirements  violate  moral  19-20).  W i t h i n t h e s e t y p e s o f c o n f l i c t t h e f i r s t two r e l a t e t o c o n f l i c t i n g e x p e c t a t i o n s i n t h e r o l e s e n t m e s s a g e s , and t h e l a t t e r two t o r o l e received messages, f o r behaviour t h a t c o n f l i c t s with i n t e r n a l i z e d or expectations r e l a t i v e to others i n the r o l e s e t .  values  14 A lack of information role ambiguity, and r e c e i v e d . expectations  regarding  role expectations  which contributes to confusion  results in  i n the r o l e messages sent  F o r r o l e p e r f o r m a n c e , t h e i n d i v i d u a l n e e d s t o know w h a t a r e h e l d by members o f h i s r o l e s e t ; w h a t a c t i v i t i e s w i l l  f u l f i l l r e s p o n s i b i l t i e s o f h i s p o s i t i o n ; and t h e p o t e n t i a l c o n s e q u e n c e s of r o l e performance or non-performance f o r himself, his r o l e senders, the o r g a n i z a t i o n  (Kahn e t a l . , pp.  and  19-20).  In s u p p o r t o f t h e o u t l i n e d t h e o r e t i c a l t y p e s o f r o l e c o n f l i c t are f i n d i n g s of e m p i r i c a l  studies.  Types of Role C o n f l i c t Professional-bureaucratic  c o n f l i c t r e f l e c t s the c o n f l i c t i n g  o r i e n t a t i o n s o f t h e i n d i v i d u a l v e r s u s t h e o r g a n i z a t i o n and has  received  a considerable  K r a m e r and  degree of study  S c h m a l e n b e r g , 1978; Sorenson, 1974).  ( J o h n s o n , 1971;  M i l l e r and W a g e r , 1971;  K r a m e r , 1974; S c o t t , 1966;  Sorenson  and  S c o t t (.1966) o u t l i n e d f o u r p a r t i c u l a r a r e a s o f c o n f l i c t :  1) t h e p r o f e s s i o n a l ' s r e s i s t a n c e t o b u r e a u c r a t i c r u l e s ; 2) t h e professional's r e j e c t i o n of bureaucratic standards; 3) t h e p r o f e s s i o n a l ' s r e s i s t a n c e t o b u r e a u c r a t i c s u p e r v i s i o n ; and 4) t h e p r o f e s s i o n a l ' s c o n d i t i o n a l l o y a l t y t o t h e b u r e a u c r a c y , ( p , 269) This r e l a t e s to the s o c i a l i z a t i o n experience  o f p r o f e s s i o n a l s who  are  t r a i n e d w i t h c o m p l e x s k i l l s and s p e c i a l k n o w l e d g e and i n t e r n a l c o n t r o l m e c h a n i s m s f o r w o r k p e r f o r m a n c e ( S c o t t , 1966,  p. 2 6 8 ) .  The r u l e s ,  and s u p e r v i s i o n r e f l e c t i n g a b u r e a u c r a t i c o r i e n t a t i o n e m p h a s i z e t h e task a u t h o r i t a r i a n system o f work p e r f o r m a n c e which c o n f l i c t s w i t h a u t o n o m o u s w h o l e - t a s k o r i e n t a t i o n o f p r o f e s s i o n a l s ( K r a m e r and 1978,  p. 3 ) .  standards partthe  Schmalenberg,  This c o n f l i c t i n o r i e n t a t i o n s r e f l e c t s the s o c i a l i z a t i o n  15 experience  and d i f f i c u l t i e s e n c o u n t e r e d  i n managing p r o f e s s i o n a l  values  and e x p e c t a t i o n s w i t h b u r e a u c r a t i c r u l e s and r e g u l a t i o n s f o r a c o n s o l i d a t e d personal  identity.  P r o f e s s i o n a l - b u r e a u c r a t i c c o n f l i c t encompasses the  r a n g e o f r o l e c o n f l i c t t y p e s d e s c r i b e d by Kahn e t a l . (.1964). t h a t the r o l e incumbent i s a r o l e sender,  Remembering  t h e m e s s a g e s s e n t and  received  by r o l e s e t members a r e i n f l u e n c e d by p r o f e s s i o n a l o r  bureaucratic  o r i e n t a t i o n and t h i s p r e s e n t s p o t e n t i a l f o r c o n f l i c t .  Professional-  b u r e a u c r a t i c c o n f l i c t has b e e n r e p o r t e d f o r b u s i n e s s s c h o o l (Schein, 1968); f o r p u b l i c accountants  graduates  i n large firms (Sorensen  S o r e n s e n , 1 9 7 4 ) ; and f o r n u r s e s e m p l o y e d i n h o s p i t a l s e t t i n g s 1960;  K r a m e r , 1966,  of role conceptions have attempted  1974;  K r a m e r and S c h m a l e n b e r g , 1 9 7 8 ) .  Measurements  t o d e t e r m i n e the degree t o which such c o n c e p t i o n s These measures of discrepancy  the degree of c o n f l i c t experienced t o an u n d e r s t a n d i n g  in role expectations  are  have r e f l e c t e d and  contributed  o f t h e r e a l i t y s h o c k phenomenon ( K r a m e r , 1 9 7 4 ) .  K r a m e r and S c h m a l e n b e r g ( 1 9 7 8 ) h a v e f o r m u l a t e d  1)  (Corwin,  r e f l e c t i n g p r o f e s s i o n a l and b u r e a u c r a t i c o r i e n t a t i o n s  inoperative in practice.  of nurse  and  additional  types  conflict:  M e a n s - g o a l s c o n f l i c t s a r i s e when one d o e s n o t h a v e t h e means t o  achieve a goal, p a r t i c u l a r l y '"people  changing  1  g o a l s " (p. 61).  This i s  an e x a m p l e o f a p e r s o n - r o l e c o n f l i c t w h e r e i n d i v i d u a l v a l u e s a s k more o f a r o l e than i s p o s s i b l e . 2)  P e r s o n a l - c o m p e t e n c y gap c o n f l i c t a r i s e s f r o m a l a c k o f k n o w l e d g e o r  s k i l l s ; and an i n a b i l i t y t o m e e t o n e ' s own e x p e c t a t i o n s  f o r performance  (p. 62).  T h i s i s a g a i n an e x a m p l e o f p e r s o n - r o l e c o n f l i c t , w i t h  generated  f r o m an i n a b i l i t y t o m e e t t h e r o l e e x p e c t a t i o n s  tension  of s e l f .  16 3)  D i f f e r e n t i a l s e l f - o t h e r r o l e expectation c o n f l i c t s are generated  differences in i n d i v i d u a l s ' conceptions of appropriate behaviour W h i l e e x a m p l e s c a n be o f d o c t o r - n u r s e , p a t i e n t - n u r s e , o r  by  (p. 62).  nurse-nurse,  expectation c o n f l i c t s , they represent i n t e r - s e n d e r c o n f l i c t s i n t h a t the p r e s s u r e s f r o m r o l e s e n d e r s c o n f l i c t w i t h t h o s e o f r o l e s e n t by t h e s e l f . 4)  Expressive-instrumental  c o n f l i c t a r i s e s when t h e r e i s an  p e r s o n a l d i l e m m a i n how t o m e e t c o n f l i c t i n g n e e d s ( p . 6 3 ) .  intraCategorized  as i n t r a - s e n d e r c o n f l i c t , t h i s r e p r e s e n t s an i n d i v i d u a l ' s d i f f i c u l t y i n m e e t i n g b o t h t h e p r e s c r i p t i o n s and p r o s c r i p t i o n s deemed a p p r o p r i a t e . 5)  C o m p e t i n g r o l e s c o n f l i c t o c c u r s when t h e n u r s e r o l e i n t e r f e r e s w i t h  o t h e r r o l e s f o r t h e i n d i v i d u a l (.p. 63).. accounts f o r the pressures  In t h i s c a s e , i n t e r - r o l e c o n f l i c t  experienced.  In summary, v a r i o u s o b s e r v e d c o n f l i c t s t h a t h a v e b e e n r e p o r t e d i n e m p i r i c a l s t u d i e s c a n be c l a s s i f i e d w i t h i n t h e f o u r t y p e s o f r o l e c o n f l i c t o u t l i n e d by Kahn e t a l ( 1 9 6 4 ) .  This lends support to the  t h e o r e t i c a l p e r s p e c t i v e of r o l e c o n f l i c t w i t h i n the r o l e episode.  II.  Nursing S t u d i e s Related to the Problem Under Study N u r s i n g s t u d i e s h a v e c o n s i d e r e d a number o f q u e s t i o n s r e l a t e d  t o r o l e c o n c e p t i o n s and r o l e  behaviour.  One o f t h e f i r s t s t u d i e s t o d e s c r i b e t h e r o l e c o n f u s i o n c o n f l i c t i n n u r s i n g was  t h a t o f B e n n e a n d B e n n i s i n 1959.  and  Studying  90  nurses working i n o u t - p a t i e n t departments of seven h o s p i t a l s i n the Boston a r e a , they found t h a t nurses' images o f n u r s i n g d i f f e r e d from  the  r e a l i t i e s o f t h e w o r k s i t u a t i o n . In i d e n t i f y i n g c o n f l i c t s i t u a t i o n s f o r  17 the n u r s e , t h e y s p e c i f i e d r o l e d e p r i v a t i o n as the d i f f e r e n c e between p e r c e p t i o n o f t h e i d e a l s i t u a t i o n a n d p e r c e p t i o n o f t h e s i t u a t i o n as i t actually exists. C o r w i n ' s 1960 s t u d y p r o p o s e d t h e h y p o t h e s i s t h a t " t h e f o r m a t i o n and d i s i l l u s i o n m e n t w i t h r o l e c o n c e p t i o n s i s a f a c t o r i n f l u e n c i n g m o b i l i t y i n t h e p r o f e s s i o n " ( p . x x i ) . He d e v e l o p e d t h e N u r s i n g  Role  C o n c e p t i o n S c a l e c o m p r i s e d o f 22 h y p o t h e t i c a l s i t u a t i o n s t o m e a s u r e r o l e c o n c e p t i o n s o f n u r s e s ( C o r w i n , 1960, C h a p t e r I V ) .  He t h e n c o m p a r e d t h e  r o l e c o n c e p t i o n s o f s t u d e n t s a n d g r a d u a t e s f r o m d i p l o m a and d e g r e e His  programs.  s a m p l e c o n s i s t e d o f 296 s t u d e n t and g r a d u a t e n u r s e s f r o m f o u r s c h o o l s  of n u r s i n g and seven h o s p i t a l s i n a m i d w e s t e r n c i t y i n t h e U n i t e d S t a t e s . The c o m p a r i s o n s  made b e t w e e n s t u d e n t and g r a d u a t e n u r s e s w e r e b a s e d on  c r o s s - s e c t i o n a l d a t a ( C o r w i n , i 9 6 0 , pp. 2 3 5 - 3 1 5 ) .  The s t u d e n t n u r s e s w e r e  o b s e r v e d t o h a v e s i g n i f i c a n t l y h i g h e r p r o f e s s i o n a l and s e r v i c e r o l e c o n c e p t i o n s t h a n t h e g r a d u a t e n u r s e s , w i t h no s i g n i f i c a n t d i f f e r e n c e i n bureaucratic role conception.  W h i l e the g r a d u a t e and s t u d e n t n u r s e s d i d  n o t show a s i g n i f i c a n t d i f f e r e n c e f o r b u r e a u c r a t i c r o l e c o n c e p t i o n , students from the diploma program h e l d s i g n i f i c a n t l y h i g h e r b u r e a u c r a t i c r o l e conceptions than students from the b a c c a l a u r e a t e program.  In  c o m p a r i n g s t u d e n t s and g r a d u a t e s o f d i p l o m a n u r s i n g p r o g r a m s , t h e r e was  a  g r a d u a l d e c l i n e i n p r o f e s s i o n a l r o l e , c o n c e p t i o n and a s i m i l a r d e c l i n e i n s e r v i c e r o l e c o n c e p t i o n o v e r e x t e n d e d w o r k p e r i o d s a f t e r an i n i t i a l i n -the f i r s t few y e a r s o f n u r s i n g .  A s i m i l a r comparison  increase  o f s t u d e n t s and  graduates o f b a c c a l a u r e a t e programs i n d i c a t e d a gradual r i s e i n both b u r e a u c r a t i c and p r o f e s s i o n a l r o l e c o n c e p t i o n s and a c o n s i s t e n t d e c r e a s e in the s e r v i c e r o l e conceptions.  His f i n d i n g s demonstrated  t h a t the r o l e  18 conceptions  h e l d by g r a d u a t e n u r s e s  p r o g r a m and t h a t n u r s e s  v a r i e d with the type of b a s i c  perceived discrepancies  in r o l e enactment,  p a r t i c u l a r l y r e l a t e d t o p r o f e s s i o n a l and b u r e a u c r a t i c  role  concpetions.  Those holding high b u r e a u c r a t i c combined with high p r o f e s s i o n a l perceived greater discrepancies organization.  Baccalaureate  role conceptions  graduates were found to hold high  more f r e q u e n t l y t h a n d i d d i p l o m a g r a d u a t e s .  baccalaureate  conception  orientations  than those with o t h e r s t y l e s o f r o l e professional While  diploma graduates modified t h e i r professional role conceptions graduation,  nursing  graduates maintained  after  the p r o f e s s i o n a l  role  while a l s o i n c r e a s i n g t h e i r a l l e g i a n c e to the bureaucracy.  a published  review of h i s f i n d i n g s , Corwin (1961) i n d i c a t e d t h a t  In  career  a s p i r a t i o n s f o r promotion or p o s i t i o n s o u t s i d e the h o s p i t a l were f e l t to be a m e t h o d f o r r e s o l v i n g t h e d i l e m m a a r i s i n g when t h e i d e a l i s n o t v a l i d a t e d i n e x i s t i n g p r a c t i c e Cpp,  82-85),  C o r w i n and T a v e s 09.62) u s e d a s i m i l a r f r a m e o f r e f e r e n c e that of the study d e s c r i b e d above. conceptions  to  They examined the type of r o l e  h e l d and t h e r o l e d e p r i v a t i o n e x p e r i e n c e d  by n u r s e s  from  d i f f e r e n t types of educational  p r o g r a m s and i n d i f f e r e n t s t a g e s o f t h e i r  careers.  whether r o l e deprivations would i n f l u e n c e  They a l s o questioned  career aspirations. nurses p.  Data were obtained  by q u e s t i o n n a i r e s  and 17 j u n i o r and s e n i o r n u r s i n g s t u d e n t s  227).  I t was  concluded  that degree students  f r o m 124  staff  ( C o r w i n and T a v e s , develop  a stronger  1962, profess-  i o n a l o r i e n t a t i o n and l e s s l o y a l t y t o t h e h o s p i t a l s o t h a t a f t e r b e c o m i n g s t a f f nurses  a sense of d e p r i v a t i o n of the p r o f e s s i o n a l r o l e occurs  the hureaucracy  o f h o s p i t a l employment.  found to d i r e c t career ambitions  Professional role conception  o u t s i d e of the h o s p i t a l toward  within was  non-nursing  19 or other types of careers; bureaucratic r o l e conception decreased  ambition  to leave h o s p i t a l n u r s i n g f o r t e a c h i n g , sometimes i n c r e a s i n g h o s p i t a l promotion a s p i r a t i o n s . B o t h t h e C o r w i n and C o r w i n and T a v e s s t u d i e s d e m o n s t r a t e d  that  b a c c a l a u r e a t e g r a d u a t e s a r e more s u s c e p t i b l e t o r o l e d e p r i v a t i o n than diploma graduates because role  t h e y d e v e l o p and m a i n t a i n h i g h e r p r o f e s s i o n a l  conceptions. U s i n g t h e N u r s i n g R o l e C o n c e p t i o n S c a l e d e v e l o p e d by  Corwin  (1960), Kramer (1966) conducted a l o n g i t u d i n a l study to determine e f f e c t s of exposure  to employing  and r o l e d e p r i v a t i o n o f n e o p h y t e  the  b u r e a u c r a c i e s on t h e r o l e c o n c e p t i o n s c o l l e g i a t e nurses.  Her s a m p l e was  79  n u r s e g r a d u a t e s , d i v i d e d i n t o a s t u d y g r o u p o f 59 and a c o n t r o l g r o u p  of  2 0 , f r o m t h e 1965 g r a d u a t i n g c l a s s e s o f t h r e e C a l i f o r n i a c o l l e g e p r o g r a m s . A l l 79 g r a d u a t e s c o m p l e t e d  t h e N u r s i n g R o l e C o n c e p t i o n S c a l e one month  b e f o r e g r a d u a t i n g and a f t e r t h r e e months o f employment,the s t u d y o f 59 was r e t e s t e d a n d i n t e r v i e w e d .  group  A f t e r s i x months o f employment a l l  79 s u b j e c t s w e r e r e t e s t e d and i n t e r v i e w e d ( K r a m e r , 1966, p. 2 5 ) .  Kramer's  (1966) r e s u l t s i n d i c a t e d a s i g n i f i c a n t i n c r e a s e i n b u r e a u c r a t i c r o l e conception a f t e r exposure  to the employing  o r g a n i z a t i o n and a c o n t i n u a l  drop i n the p r o f e s s i o n a l r o l e c o n c e p t i o n d u r i n g the f i r s t s i x months a f t e r employment (pp. 77-78).  T h e r e was a s i g n i f i c a n t i n c r e a s e i n r o l e  d e p r i v a t i o n d u r i n g the f i r s t t h r e e months o f employment.  Subjects with  h i g h p r o f e s s i o n a l a n d h i g h b u r e a u c r a t i c r o l e o r i e n t a t i o n s had t h e h i g h e s t r o l e d e p r i v a t i o n s c o r e s when c o m p a r e d t o s u b j e c t s w i t h o t h e r o f b u r e a u c r a t i c a n d p r o f e s s i o n a l o r i e n t a t i o n ( K r a m e r , 1966, high simultaneous  combinations p. 7 7 ) .  Thus,  l o y a l t y t o b o t h s y s t e m s was a s s o c i a t e d w i t h r o l e c o n f l i c t .  20 K r a m e r ( 1 9 6 6 ) f u r t h e r n o t e d t h a t " s u b j e c t s who  left nursing practice,  c h a n g e d j o b s b e c a u s e o f d i s s a t i s f a c t i o n , o r r e t u r n e d t o s c h o o l , show s i g n i f i c a n t l y g r e a t e r r o l e d e p r i v a t i o n s c o r e s t h a n s u b j e c t s who i n t h e same j o b f o r s i x m o n t h s " ( p . 7 7 ) .  remain  K r a m e r ( 1 9 7 4 ) f o l l o w e d up on  t h i s s a m p l e by m a i l two y e a r s l a t e r w i t h an 80 p e r c e n t r e t u r n r a t e ( p . 2 3 ) . The s i g n i f i c a n t f i n d i n g was t h a t t h e r e was an e v e n f u r t h e r d e c r e a s e i n p r o f e s s i o n a l r o l e c o n c e p t i o n a t t h a t time (Kramer,  1974, p. 2 3 ) .  K r a m e r and B a k e r ( 1 9 7 1 ) l o o k e d a t t h e p r o b l e m o f e x o d u s f r o m n u r s i n g and f o u n d t h a t t h e r e a s o n s g i v e n r e l a t e d t o p r o f e s s i o n a l b u r e a u c r a t i c c o n f l i c t (pp. 15-30).  A n a t i o n w i d e s a m p l e o f 200  b a c c a l a u r e a t e g r a d u a t e s was s e l e c t e d f r o m a p o p u l a t i o n o f b a c c a l a u r e a t e g r a d u a t e s w o r k i n g i n m e d i c a l c e n t r e h o s p i t a l s . T h e r e was e v i d e n c e d a l a c k o f w o r k s a t i s f a c t i o n among t h e g r a d u a t e s and a 29 p e r c e n t rate.  'dropout'  The m a j o r i t y o f d r o p o u t s had h i g h p r o f e s s i o n a l r o l e c o n c e p t i o n s  ( K r a m e r and B a k e r , 1971, pp.  15-30).  In a f u r t h e r s t u d y o f t h e r e l a t i o n s h i p o f r o l e c o n c e p t i o n s , r o l e d e p r i v a t i o n and i n t e g r a t i v e r o l e b e h a v i o u r s , K r a m e r ( 1 9 7 4 ) s t u d i e d t h r e e c l a s s e s o f s t u d e n t s i n the g e n e r i c program a t the U n i v e r s i t y o f C a l i f o r n i a S c h o o l o f N u r s i n g , San F r a n c i s c o ( p . 5 7 ) .  Instruments used i n  t h i s s t u d y w e r e t h e N u r s i n g R o l e C o n c e p t i o n S c a l e d e v e l o p e d by  Corwin  ( 1 9 6 0 ) and t h e K r a m e r R o l e B e h a v i o u r S c a l e s d e v e l o p e d by K r a m e r ( 1 9 7 4 ) to study i n t e g r a t i v e role behaviours.  The 1968 g r a d u a t i n g c l a s s  c o n s t i t u t e d a c o n t r o l g r o u p and t h e 1969 a n d 1970 c l a s s e s w e r e t h e experimental  g r o u p s t h a t had an " a n t i c i p a t o r y s o c i a l i z a t i o n "  added t o t h e i r r e g u l a r n u r s i n g program  ( K r a m e r , 1974, p . - 5 7 ) .  a n t i c i p a t o r y s o c i a l i z a t i o n p r o g r a m was d e s i g n e d t o a i d i n r o l e  program This  21 t r a n s f o r m a t i o n and t o l e s s e n r e a l i t y shock.  Testing of students included  r o l e c o n c e p t i o n m e a s u r e m e n t on e n t r a n c e t o t h e S c h o o l o f N u r s i n g , a g a i n a b o u t one m o n t h p r i o r t o g r a d u a t i o n .  The K r a m e r R o l e  and  Behaviour  S c a l e s m e a s u r e d i n t e g r a t i v e r o l e b e h a v i o u r 11 t o 13 m o n t h s a f t e r e m p l o y m e n t and a g a i n 23 t o 26 m o n t h s a f t e r e m p l o y m e n t .  Kramer (1974)  reports t h a t the a n t i c i p a t o r y s o c i a l i z a t i o n program: was e f f e c t i v e i n r a i s i n g p e r c e i v e d r o l e d e p r i v a t i o n w h i l e i n s c h o o l , d e c r e a s i n g r o l e d e p r i v a t i o n upon e m p l o y m e n t , i n c r e a s i n g the l e n g t h of time t h a t nurses remained i n t h e i r i n i t i a l jobs and i n n u r s i n g s e r v i c e , a n d h e l p i n g n u r s e s t o d e v e l o p i n t e g r a t i v e r o l e s t r a t e g i e s u s e f u l i n managing c o n f l i c t , (p. 134). M o s t r e c e n t l y K r a m e r and S c h m a l e n b e r g  (.1978) h a v e d e v e l o p e d  a  B i c u l t u r a l T r a i n i n g P r o g r a m (BTP) t o a i d i n r o l e t r a n s f o r m a t i o n f o r new graduates employed i n the h o s p i t a l s e t t i n g (pp. 1-47).  They continue to  use t h e N u r s i n g R o l e C o n c e p t i o n S c a l e d e v e l o p e d by C o r w i n , t o m e a s u r e r o l e d e p r i v a t i o n t r a n s l a t e d i n t o degree of r e a l i t y  shock.  In 1976, P i e t a c o n d u c t e d a s t u d y t o c o m p a r e t h e r o l e c o n c e p t i o n s o f n u r s i n g s t u d e n t s and f a c u l t y from t h r e e t y p e s o f n u r s i n g programs w i t h those o f head n u r s e s . d e v e l o p e d by C o r w i n ( P i e t a , 1976,  She m o d i f i e d t h e N u r s i n g R o l e C o n c e p t i o n  Scale  ( I 9 6 0 ) , t o a s c a l e w i t h 34 h y p o t h e t i c a l s i t u a t i o n s  pp. 6 7 - 7 2 ) .  Her f i n d i n g s r e v e a l e d a d i f f e r e n c e between  p e r c e p t i o n s o f w h a t s h o u l d he p r a c t i c e d and w h a t was p r a c t i c e d .  Each o f  t h e t h r e e s t u d e n t g r o u p s , t h e a s s o c i a t e d e g r e e and b a c c a l a u r e a t e  degree  f a c u l t y g r o u p s and t h e h e a d n u r s e g r o u p had t h e g r e a t e s t r o l e d i s c r e p a n c y f o r t h e s e r v i c e r o l e c o n c e p t i o n , w h i l e t h e d i p l o m a f a c u l t y g r o u p had g r e a t e s t r o l e discrepancy f o r the p r o f e s s i o n a l r o l e conception.  the  All  g r o u p s had t h e l e a s t r o l e d i s c r e p a n c y f o r t h e b u r e a u c r a t i c r o l e c o n c e p t i o n . W i t h i n g r o u p s t h e b a c c a l a u r e a t e , f a c u l t y g r o u p had t h e g r e a t e s t r o l e  22  d i s c r e p a n c y f o r a l l t h r e e r o l e c o n c e p t i o n s and t h e b a c c a l a u r e a t e s t u d e n t s had t h e g r e a t e s t r o l e d i s c r e p a n c i e s w i t h i n t h e s t u d e n t g r o u p s f o r t h e t h r e e r o l e c o n c e p t i o n s ( P i e t a , 1976, pp. 1 3 9 - 1 4 0 ) . From a n o t h e r p e r s p e c t i v e , t h e r e l a t i o n s h i p b e t w e e n a n t i c i p a t o r y s o c i a l i z a t i o n and r o l e s t r e s s among n u r s e s was s t u d i e d by B r i e f , A l d a g , V a n . S e l l , and M e l o n e [ 1 9 7 9 ) .  The 157 r e s p o n d e n t s w e r e r a n d o m l y s a m p l e d  f r o m 3,400 r e g i s t e r e d n u r s e s i n t h e S t a t e o f Iowa i n 1975, who s e l e c t i o n c r i t e r i a f o r i n c l u s i o n i n the study.  met  They were graduates  d i p l o m a , a s s o c i a t e d e g r e e , and b a c c a l a u r e a t e p r o g r a m s .  The  of  results  i n d i c a t e d t h a t the e d u c a t i o n a l program does not i n f l u e n c e the a c t i v i t i e s p e r f o r m e d by t h e g e n e r a l d u t y n u r s e ; t h a t n u r s e s w i t h b a c c a l a u r e a t e e d u c a t i o n e x p e r i e n c e more r o l e s t r e s s t h a n n u r s e s w i t h d i p l o m a e d u c a t i o n ; t h a t r o l e s t r e s s i n n e g a t i v e l y c o r r e l a t e d w i t h j o b s a t i s f a c t i o n ; and t h a t o n - t h e - j o b t e n u r e does not m i t i g a t e the impact o f a n t i c i p a t o r y s o c i a l i z a t i o n on r o l e s t r e s s ( B r i e f e t a l , 1979, pp. 1 6 3 - 1 6 4 ) .  Role s t r e s s i n t h i s study  was c o n s i d e r e d t o e n c o m p a s s r o l e c o n f l i c t and r o l e a m b i g u i t y , and t h e f i n d i n g s r e i n f o r c e d the r e l a t i o n s h i p of educational p r e p a r a t i o n to the degree of r o l e s t r e s s experienced.  The f i n d i n g s e m p h a s i z e t h a t t h e  a n t i c i p a t o r y s o c i a l i z a t i o n o f t h e e d u c a t i o n a l e x p e r i e n c e has m o r e e f f e c t on r o l e s t r e s s t h a n do l a t e r o n - t h e - j o b e x p e r i e n c e s .  F u r t h e r , i t was  that the p r o f e s s i o n a l o r i e n t a t i o n of baccalaureate graduates  felt  conflicted  w i t h the o r g a n i z a t i o n o f d u t i e s i n h o s p i t a l employment, s u p p o r t i n g t h a t professional-bureaucratic c o n f l i c t contributes to role s t r e s s .  Summary Within the l i t e r a t u r e reviewed, r o l e theory p r o v i d e s a back-  23  g r o u n d f r o m w h i c h r o l e b e h a v i o u r c a n be u n d e r s t o o d .  The r o l e  designates the r o l e r e l a t i o n s h i p s f o r each s o c i a l p o s i t i o n . episode provides received  The  role  a model f r o m w h i c h to a n a l y z e the messages s e n t  and t h e p o t e n t i a l c o n f l i c t f o r r o l e e n a c t m e n t .  the i n t e r r e l a t e d n e s s organizational  set  This i l l u s t r a t e s  of individual role behaviour within  context.  and  the  The p r o c e s s o f r o l e a c q u i s i t i o n d e s c r i b e s  s t a g e s an i n d i v i d u a l p a s s e s t h r o u g h f o r p e r s o n a l demands and e x p e c t a t i o n s .  resolution of role  As w e l l , i t p r o v i d e s  an u n d e r s t a n d i n g o f  p o t e n t i a l f o r c o n f l i c t w i t h the i d e a l "shoulds" of the educational the a c t u a l  "musts" of the o r g a n i z a t i o n ,  i n t e r p r e t e d by r o l e s e n d e r s w i t h i n  the  cognitions,  i d e n t i t y and,  as s u c h , r e f l e c t t h e  of the They are  Role conceptions are influenced  r o l e s e t members.  Role discrepancy  conceptions are inoperative  r e f l e c t s the degree to which r o l e  an u n d e r s t a n d i n g o f  r o l e c o n f l i c t f o r t h a t i n d i v i d u a l i n the r o l e e p i s o d e .  as b u r e a u c r a t i c , the e d u c a t i o n a l  professional  personal  role  the  It further  r e f l e c t s t h e s o c i a l i z a t i o n e x p e r i e n c e o f t h a t i n d i v i d u a l and  have d e f i n e d  the  A study of r o l e conceptions  of the f o c a l person provides  C o r w i n and o t h e r s  the  i n p r a c t i c e and s e r v e s as a m e a s u r e o f  d i f f i c u l t i e s encountered in achieving  closely  by t h e r o l e p r e s s u r e s o f  r o l e c o n f l i c t e x p e r i e n c e d by t h e i n d i v i d u a l . from the p e r s p e c t i v e  role  expectations,  v a l u e s and a n t i c i p a t e d m a n o e u v e r s and r e s p o n s e s o f  individual.  process,  organization.  h e l d by an i n d i v i d u a l a t a s p e c i f i e d t i m e .  bound t o p e r s o n a l  the  and t h e m e t h o d s o r "mays"  Role c o n c e p t i o n s are the i n t e r n a l r e p r e s e n t a t i o n expectations  the  the  resolution.  r o l e c o n c e p t i o n s h e l d by n u r s e s  and s e r v i c e .  These r o l e conceptions r e f l e c t  s o c i a l i z a t i o n o f t h e g r a d u a t e and a r e o b s e r v e d t o c h a n g e  24  on e x p o s u r e  to h o s p i t a l employment.  The b a c c a l a u r e a t e g r a d u a t e , f o r  example, holds a high p r o f e s s i o n a l r o l e conception a t g r a d u a t i o n , which i s o b s e r v e d t o d e c r e a s e i n the f i r s t s i x months o f h o s p i t a l employment. On t h e o t h e r h a n d , t h e b u r e a u c r a t i c r o l e c o n c e p t i o n i s h e l d a t a l e v e l a t g r a d u a t i o n , but i n c r e a s e s with, exposure  lower  to h o s p i t a l employment.  Role d e p r i v a t i o n , o r the d i f f e r e n c e between p e r c e p t i o n s o f the i d e a l s i t u a t i o n a n d t h e s i t u a t i o n as i t a c t u a l l y e x i s t s , i s u s e d as a m e a s u r e of r o l e c o n f l i c t .  The s i m u l t a n e o u s  h o l d i n g o f h i g h p r o f e s s i o n a l and  high  bureaucratic r o l e conceptions i s observed to contribute to greater r o l e d e p r i v a t i o n and r o l e c o n f l i c t than o t h e r c o m b i n a t i o n s  of role conceptions.  T h i s i s f e l t t o be r e l a t e d t o t h e a n t i t h e t i c a l n a t u r e o f l o y a l t i e s t o p r o f e s s i o n a l and b u r e a u c r a t i c s y s t e m s .  R o l e d e p r i v a t i o n i s r e p o r t e d t o be  g r e a t e r f o r b a c c a l a u r e a t e graduates than f o r graduates of diploma  or  a s s o c i a t e degree p r o g r a m s , and i s r e l a t e d t o the h o l d i n g o f h i g h professional role conceptions that c o n f l i c t with increased bureaucratic r o l e c o n c e p t i o n s on e x p o s u r e s t u d y s u b j e c t s who school who  to h o s p i t a l employment.  The  baccalaureate  l e f t n u r s i n g p r a c t i c e , changed jobs or r e t u r n e d to  were o b s e r v e d to have g r e a t e r r o l e d e p r i v a t i o n s c o r e s than  remained  i n t h e same j o b f o r s i x m o n t h s .  Study i n the broader  those area  of r o l e s t r e s s i n d i c a t e s t h a t the e d u c a t i o n a l p r e p a r a t i o n of nurses i s r e l a t e d t o t h e d e g r e e o f r o l e s t r e s s e x p e r i e n c e d and t h a t t h e s o c i a l i z a t i o n e x p e r i e n c e o f t h e e d u c a t i o n a l p r o g r a m has m o r e e f f e c t on r o l e s t r e s s t h a n l a t e r , on-the-job experiences.  B a c c a l a u r e a t e graduates were observed  experience g r e a t e r r o l e s t r e s s than diploma graduates. also negatively correlated witfi job s a t i s f a c t i o n .  to  R o l e s t r e s s was  25  These f i n d i n g s support the t h e o r y o f r o l e s o c i a l i z a t i o n and s e r v e t o f o c u s c o n c e r n on r o l e c o n f l i c t a s an e x p l a n a t i o n f o r t h e observed j o b m i g r a t i o n and j o b d i s s a t i s f a c t i o n o f b a c c a l a u r e a t e g r a d u a t e s . The c u r r e n t s t u d y i s i n r e s p o n s e t o t h e s e f i n d i n g s and r e f l e c t s a need t o s t u d y t h e r o l e c o n c e p t i o n s o f b a c c a l a u r e a t e g r a d u a t e s a t The U n i v e r s i t y o f B r i t i s h C o l u m b i a , t o d e t e r m i n e how f i n d i n g s w i t h t h i s s a m p l e c o m p a r e t o t h o s e b a s e d on s t u d i e s i n A m e r i c a n  s e t t i n g s . I t i s also designed to  compare t h e outcome o f t h e r o l e s o c i a l i z a t i o n p r o c e s s f o r t h e p r o d u c t s o f two d i f f e r e n t e d u c a t i o n a l p a t t e r n s .  The i n c l u s i o n o f a work p r o f i l e o f  g r a d u a t e s s i x months f o l l o w i n g g r a d u a t i o n w i l l r e f l e c t e x p o s u r e t o h o s p i t a l s and o t h e r employment o r g a n i z a t i o n s w i t h i n t h e p r o v i n c i a l h e a l t h care  system.  CHAPTER I I I METHODOLOGY T h i s s t u d y was a d e s c r i p t i v e s u r v e y o f t h e r o l e c o n c e p t i o n s h e l d by a c o n v e n i e n c e s a m p l e o f The U n i v e r s i t y o f B r i t i s h C o l u m b i a b a c c a l a u r e a t e g r a d u a t e s p r i o r t o g r a d u a t i o n and d u r i n g t h e i r w o r k e x p e r i e n c e s i x months f o l l o w i n g g r a d u a t i o n . of t h i s study were:  and 2) t h e t y p e o f w o r k e x p e r i e n c e  s e l e c t e d by t h e b a c c a l a u r e a t e g r a d u a t e .  (bureaucratic,  variables  1) t h e e d u c a t i o n a l p r o g r a m o f t h e b a c c a l a u r e a t e  g r a d u a t e s , w h e t h e r UBC-4 o r UBC-2;  v a r i a b l e s were:  The i n d e p e n d e n t  The c o r r e s p o n d i n g d e p e n d e n t  1) t h e r o l e c o n c e p t i o n and r o l e d e p r i v a t i o n  scores  p r o f e s s i o n a l , and s e r v i c e ) m e a s u r e d one m o n t h p r i o r t o  g r a d u a t i o n and s i x m o n t h s a f t e r g r a d u a t i o n i f e m p l o y e d i n a h o s p i t a l setting;  and 2) t h e s u r v e y d e s c r i p t i o n o f t h e w o r k e x p e r i e n c e s o f t h e  b a c c a l a u r e a t e g r a d u a t e s s i x months a f t e r g r a d u a t i o n .  Research  Design  The s t u d y was d e s i g n e d a s a l o n g i t u d i n a l p a n e l s t u d y  (Polit  a n d H u n g l e r , 1978, p. 2 6 6 ) , w i t h m e a s u r e m e n t o f r o l e c o n c e p t i o n s u s i n g t h e N u r s i n g R o l e C o n c e p t i o n S c a l e ( s e e A p p e n d i x A) one month p r i o r t o g r a d u a t i o n and f o r t h e same s u b j e c t s ( i f e m p l o y e d i n a h o s p i t a l s i x months a f t e r g r a d u a t i o n .  setting)  The Work E x p e r i e n c e Q u e s t i o n n a i r e ( s e e  A p p e n d i x B) was d e s i g n e d t o p r o v i d e f o l l o w - u p d a t a i n d i c a t i n g s u b s e q u e n t  26  27 e m p l o y m e n t o f g r a d u a t e s and t o d i s t i n g u i s h t h o s e s u b j e c t s who c o n s t i t u t e d the panel f o r r e p e a t measurement o f r o l e c o n c e p t i o n s .  :  This type of  l o n g i t u d i n a l study allowed f o r c o l l e c t i o n o f i n f o r m a t i o n from which to c o n s i d e r p a t t e r n s o f change i n r o l e c o n c e p t i o n . The s t u d y o f t h e d y n a m i c s ' o f a v a r i a b l e o v e r t i m e w i t h t h e same s u b j e c t s a l l o w e d e a c h s u b j e c t t o be h e r own c o n t r o l , w h i c h  minimized  t h e d i f f e r e n c e s o f e x t r a n e o u s v a r i a b l e s and s t r e n g t h e n e d t h e i n t e r n a l v a l i d i t y o f t h i s s t u d y ( P o l i t and H u n g l e r , 1978, pp. 2 5 8 - 2 6 7 ) .  Instruments Nursing Role Conception Seale The N u r s i n g R o l e C o n c e p t i o n S c a l e ( C o r w i n , 1960) was s e l e c t e d f o r measurement o f r o l e c o n c e p t i o n s .  T h i s S c a l e i s c o m p o s e d o f 22  hypothetical hospital nursing situations representing bureaucratic, p r o f e s s i o n a l and s e r v i c e o r i e n t a t i o n s .  E a c h s i t u a t i o n i s f o l l o w e d by a  L i k e r t - t y p e f i v e - p o i n t r a t i n g scale. (.Strongly agree t o S t r o n g l y d i s a g r e e ) . Respondents are asked to i n d i c a t e ; r e p r e s e n t s how n u r s i n g s h o u l d b e ;  a) t h e e x t e n t t o which, each s i t u a t i o n and b) the. e x t e n t t o w h i c h  s i t u a t i o n r e p r e s e n t s what i s a c t u a l l y o b s e r v e d i n n u r s i n g .  each  C o r w i n (.1960)  d e s c r i b e s d e v e l o p m e n t o f t h e S c a l e and a p r e t e s t w i t h . 150. n u r s e s , h e a d n u r s e s , s t u d e n t n u r s e s , and l i c e n s e d p r a c t i c a l n u r s e s , t h e r e s u l t s o f which were a n a l y z e d f o r i n t e r n a l c o n s i s t e n c y t o determine  reliability  ( p p , 2 1 1 - 2 1 3 and A p p e n d i x I I I ) , C o n t e n t v a l i d i t y was d e t e r m i n e d  through  a t t e n t i o n t o r e s p o n d e n t comments and e x a m i n a t i o n o f t h e S c a l e by  two  p r a c t i c i n g n u r s e s ( C o r w i n , I 9 6 0 , pp, 2 1 3 - 2 1 7 ) .  In u t i l i z i n g  this  28 i n s t r u m e n t , K r a m e r ( 1 9 6 6 ) t e s t e d f o r c o n s t r u c t v a l i d i t y u s i n g t h e "known g r o u p s " m e t h o d f o r t h e r o l e c o n c e p t i o n s c a l e s and v a l i d a t i o n i n t e r m s o f b e h a v i o u r a l c r i t e r i a f o r t h e r o l e d e p r i v a t i o n s c a l e s ( p . 32 a n d D and E ) .  Appendices  F o r b o t h , r e s u l t s were i n the p r e d i c t e d d i r e c t i o n . Kramer and  Schmalenberg (1978) have c o n t i n u e d to use the N u r s i n g Role  Conception  S c a l e w i t h d i f f e r e n t p o p u l a t i o n s and s e t t i n g s and m a i n t a i n t h a t " a t t h i s t i m e , t h e r e i s no b e t t e r p a p e r - p e n c i l t e s t o f r e a l i t y s h o c k a v a i l a b l e " (p. 6 ) .  T h i s S c a l e has b e e n f u r t h e r u s e d i n n u r s i n g r e s e a r c h a s o u t l i n e d  by Ward and F e t l e r ( 1 9 7 9 , p.  Work E x p e r i e n c e  415).  Questionnaire  The q u e s t i o n n a i r e r e g a r d i n g w o r k e x p e r i e n c e a f t e r g r a d u a t i o n was d e s i g n e d by t h e i n v e s t i g a t o r t o c o l l e c t d a t a r e l a t e d t o t h e e m p l o y m e n t s t a t u s a n d w o r k s e t t i n g s o f The U n i v e r s i t y o f B r i t i s h baccalaureate graduates  s i x months a f t e r g r a d u a t i o n .  This questionnaire  was s u b j e c t e d t o t h r e e c r i t i c a l r e v i e w s by n u r s i n g f a c u l t y and students i n a seminar s e t t i n g with subsequent f i n a l review comprised graduate nursing  Columbia  graduate  r e v i s i o n each time.  The  i n p u t f r o m f o u r n u r s i n g f a c u l t y members and s i x  students.  Sample The p o p u l a t i o n f o r t h i s s t u d y c o n s i s t e d o f t h e 120 s t u d e n t s i n t h e 1980 g r a d u a t i n g c l a s s f r o m The U n i v e r s i t y o f B r i t i s h C o l u m b i a  School  of Nursing, the only f o u r - y e a r baccalaureate n u r s i n g program i n the province.  S t u d e n t s g r a d u a t i n g f r o m t h i s p r o g r a m had e i t h e r  completed  29 f o u r y e a r s o f u n i v e r s i t y study o r e n t e r e d as r e g i s t e r e d nurses (from a h o s p i t a l d i p l o m a o r t w o - y e a r c o l l e g e program) and completed two y e a r s o f u n i v e r s i t y study.  Both groups o f graduates r e c e i v e t h e degree o f B a c h e l o r  of Science i n Nursing.  This population thus r e f l e c t s graduates with a  d i f f e r e n c e i n e d u c a t i o n a l p r o g r a m , d e f i n e d a s UBC-4 a n d UBC-2. A c o n v e n i e n c e s a m p l e f r o m t h i s p o p u l a t i o n was o b t a i n e d by a p p r o a c h i n g s t u d e n t s i n a r e g u l a r l y h e l d c l a s s i n t h e i r l a s t week o f formal i n s t r u c t i o n i n March, 1980.  O f t h e .85 q u e s t i o n n a i r e s d i s t r i b u t e d ,  77 w e r e c o m p l e t e d a n d t h e s u b j e c t s who r e s p o n d e d f o r m t h e c o n v e n i e n c e sample f o r t h e study.  Procedure F o r Data  Collection  The i n s t r u c t o r i n t r o d u c e d t h e i n v e s t i g a t o r a n d t h e n l e f t t h e room.  The i n v e s t i g a t o r p r e s e n t e d t h e purpose o f t h e s t u d y and r e q u e s t e d  student p a r t i c i p a t i o n .  T h i s r e q u e s t was f r o m a p r e p a r e d t e x t ( s e e  A p p e n d i x C) w h i c h was a t t a c h e d t o t h e N u r s i n g R o l e C o n c e p t i o n S c a l e a n d d i s t r i b u t e d t o t h e s t u d e n t s b y two g r a d u a t e s t u d e n t c o l l e a g u e s o f t h e investigator. t o c o m p l e t e an  Those w i l l i n g t o p a r t i c i p a t e i n t h e study were r e q u e s t e d a t t a c h e d m a i l i n g a d d r e s s f o r m ( s e e A p p e n d i x D) f o r  f u t u r e c o n t a c t and t o respond t o t h e Nursing Role Conception S c a l e .  Of  t h e 77 r e s p o n d e n t s who c o m p l e t e d t h e N u r s i n g R o l e C o n c e p t i o n S c a l e , 75 completed the m a i l i n g address form f o r follow-up c o n t a c t .  The Nursing  R o l e C o n c e p t i o n S c a l e a n d Work E x p e r i e n c e Q u e s t i o n n a i r e w e r e m a i l e d o u t t o t h e 75 r e s p o n d e n t s i n l a t e O c t o b e r , 1 9 8 0 , a p p r o x i m a t e l y s i x m o n t h s after graduation.  I n c l u d e d w i t h t h e s e i n s t r u m e n t s was a c o v e r i n g l e t t e r  i n v i t i n g and e x p l a i n i n g c o n t i n u e d p a r t i c i p a t i o n ( s e e Appendix E ) . A l l  30  p a r t i c i p a n t s w e r e r e q u e s t e d t o c o m p l e t e t h e Work E x p e r i e n c e Q u e s t i o n n a i r e , l a b e l l e d PART A , a n d t h o s e n u r s e s e m p l o y e d  i n a h o s p i t a l s e t t i n g were  r e q u e s t e d t o c o m p l e t e t h e N u r s i n g R o l e C o n c e p t i o n S c a l e , l a b e l l e d PART B, as w e l l . return.  A s t a m p e d , s e l f - a d d r e s s e d e n v e l o p e was i n c l u d e d f o r i n s t r u m e n t A r e m i n d e r was s e n t i n m i d - N o v e m b e r t o t h o s e p a r t i c i p a n t s n o t  y e t heard from (see Appendix  F f o r copy o f l e t t e r ) .  Responses  were  r e c e i v e d f r o m 62 o f t h e o r i g i n a l p a r t i c i p a n t s , a r e t u r n r a t e o f 82 p e r c e n t . T h i s completed t h e c o l l e c t i o n o f d a t a , which were then s c o r e d and e n t e r e d i n t o computer analysis to follow.  coded,  f i l e s by t h e i n v e s t i g a t o r f o r t h e d a t a  CHAPTER IV PRESENTATION AND DISCUSSION OF FINDINGS As o u t l i n e d i n C h a p t e r I I I , d a t a w e r e o b t a i n e d  through  c o m p l e t i o n o f t h e N u r s i n g R o l e C o n c e p t i o n S c a l e one month p r i o r t o g r a d u a t i o n and' a g a i n s i x m o n t h s f o l l o w i n g g r a d u a t i o n f o r t h o s e b a c c a l a u r e a t e graduates employed i n h o s p i t a l s e t t i n g s . t h e Work E x p e r i e n c e Q u e s t i o n n a i r e was c o m p l e t e d following graduation.  In a d d i t i o n ,  by r e s p o n d e n t s  s i x months  T h e d a t a c o l l e c t e d i n t h i s s t u d y w e r e s c o r e d by  t h e i n v e s t i g a t o r a n d a n a l y z e d by c o m p u t e r . ^  S c o r i n g o f Nursing Role Conception  Scale  In c o m p l e t i n g t h e N u r s i n g R o l e C o n c e p t i o n S c a l e  respondents  i n d i c a t e d r e s p o n s e s t o t h e 22 h y p o t h e t i c a l s i t u a t i o n s on a L i k e r t s c a l e . Score v a l u e s were a s s i g n e d u s i n g a f i v e p o i n t s c a l e , 5 = S t r o n g l y Agree through 1 = S t r o n g l y Disagree.  This resulted i n three r o l e conception  and t h r e e r o l e d e p r i v a t i o n s c o r e s f o r e a c h r e s p o n d e n t ,  corresponding to  the b u r e a u c r a t i c , p r o f e s s i o n a l and s e r v i c e items o f the S c a l e .  The U n i v e r s i t y o f B r i t i s h C o l u m b i a S t a t i s t i c a l P a c k a g e f o r t h e S o c i a l S c i e n c e s , V e r s i o n 7.01, ( U n d e r M T S ) , ( K i t a , 1 9 7 8 ) was u s e d f o r c o m p u t e r analysis o f data.  31  32 The i n v e s t i g a t o r t r e a t e d b l a n k r e s p o n s e s a n d t h o s e w h e r e comments w e r e made w i t h o u t a d e f i n i t e c h e c k t o i n d i c a t e r e s p o n s e a s m i s s i n g d a t a , c o d e d a s a 9. in s t a t i s t i c a l analysis.  M i s s i n g data v a r i a b l e s were then e x c l u d e d  Thus, c a l c u l a t i o n o f respondent r o l e conception  and r o l e d e p r i v a t i o n s c o r e s was b a s e d o n l y on t h e number o f i t e m s f o r which t h e r e were r e s p o n s e s .  A t the f i r s t time o f a d m i n i s t r a t i o n with  77 r e s p o n d e n t s , t h e r e w e r e 14 r e s p o n s e s c o d e d a s m i s s i n g .  These could  be t r a c e d t o s i x r e s p o n d e n t s , o n e o f whom c o n t r i b u t e d 6 o f t h e 14 m i s s i n g responses.  Item a n a l y s i s o f responses i n d i c a t e d t h a t t h e m i s s i n g  r e s p o n s e s w e r e g e n e r a l l y f o r d i f f e r e n t i t e m s , w i t h a maximum o f two m i s s i n g r e s p o n s e s f o r e a c h o f two S c a l e i t e m s .  A t the second time o f  S c a l e a d m i n i s t r a t i o n s i x m o n t h s f o l l o w i n g g r a d u a t i o n t h e r e w e r e 37 r e s p o n d e n t s a n d s i x m i s s i n g r e s p o n s e s o v e r a l l , w h i c h c o u l d be a t t r i b u t e d to f o u r respondents.  C o m p a r i s o n o f m i s s i n g r e s p o n s e s f o r t h e two t i m e s  of S c a l e a d m i n i s t r a t i o n i n d i c a t e d t h a t d i f f e r e n t respondents were i n v o l v e d at t h e s e t i m e s , and w i t h one e x c e p t i o n , t h a t t h e m i s s i n g r e s p o n s e s were related to d i f f e r e n t Scale items.  The l a c k o f p a t t e r n i n m i s s i n g  r e s p o n s e s c a n p e r h a p s be a t t r i b u t e d t o i n d i v i d u a l d i f f i c u l t i e s w i t h t h e q u e s t i o n f o r m a t a n d t h e o v e r a l l l e n g t h o f t h e S c a l e (Ward a n d F e t l e r , 1979, p. 4 1 5 ) . Following examination of individual response patterns, the i n v e s t i g a t o r determined the r e l i a b i l i t y o f the instrument with t h i s sample, and t h e n a n a l y z e d g r o u p d a t a f o r r o l e c o n c e p t i o n a n d r o l e d e p r i v a t i o n scores.  T h i s was f o l l o w e d b y a n a l y s i s o f t h e w o r k p r o f i l e of.  b a c c a l a u r e a t e g r a d u a t e s s i x months f o l l o w i n g g r a d u a t i o n , and i t s r e l a t i o n ship to the role conceptions held prior to graduation.  33 R e l i a b i l i t y of Nursing Role Conception  Scale  In a d o p t i o n o f t h e N u r s i n g R o l e C o n c e p t i o n S c a l e d e s i g n e d Corwin  by  ( 1 9 6 0 ) , i t was r e c o g n i z e d t h a t t h e r e s p o n s e s i n t h i s s t u d y c o u l d  r e f l e c t t i m e and p o p u l a t i o n d i f f e r e n c e s . C o r w i n a n a l y z e d f o r i n t e r n a l consistency to determine  r e l i a b i l i t y i n c o n s t r u c t i o n of the Nursing  Role C o n c e p t i o n S c a l e (pp. 211-213 and Appendix  I I I ) . However, w h i l e  o t h e r s h a v e u s e d t h e S c a l e i n n u r s i n g r e s e a r c h , n o n e h a v e r e p o r t e d on i t s r e l i a b i l i t y (Ward and F e t l e r , 1979, p.  415).  P o l i t and H u n g l e r ( 1 9 7 8 ) d e s c r i b e v a r i o u s m e t h o d s u s e d t o determine  i n s t r u m e n t r e l i a b i l i t y and d e s c r i b e t h e c o e f f i c i e n t a l p h a a s  "perhaps the s i n g l e most u s e f u l index o f r e l i a b i l i t y a v a i l a b l e " (p. 430). Using Cronbach's  alpha to determine  the r e l i a b i l i t y of the Nursing  C o n c e p t i o n S c a l e w i t h t h i s s a m p l e a t The U n i v e r s i t y o f B r i t i s h r e s u l t e d i n a c o e f f i c i e n t a l p h a o f 0.51 i s no  ( K i t a , 1978, p. 2 0 8 ) .  Columbia While  s t a n d a r d f o r what a r e l i a b i l i t y c o e f f i c i e n t s h o u l d be, P o l i t  H u n g l e r (.1978) recommend a c o e f f i c i e n t o f 0.70 group-level comparisons  (p. 432).  o r 0.60  Role  there and  as s u f f i c i e n t f o r  However, i t i s r e c o g n i z e d t h a t "the  r e l i a b i l i t y o f a m e a s u r e i s p a r t l y a f u n c t i o n o f i t s l e n g t h o r number o f i t e m s " ( P o l i t and H u n g l e r , 1978,  p. 4 3 3 ) .  t o t h e low r e l i a b i l i t y c o e f f i c i e n t may [22 i t e m s ) a n d t h e s a m p l e s i z e o f 77  Role  Possible contributing factors  have been the l e n g t h o f the S c a l e respondents.  Conception  The b u r e a u c r a t i c , p r o f e s s i o n a l and s e r v i c e r o l e c o n c e p t i o n s w e r e m e a s u r e d f o r b a c c a l a u r e a t e g r a d u a t e s one m o n t h p r i o r t o g r a d u a t i o n  34 (N=77) a n d s i x m o n t h s f o l l o w i n g g r a d u a t i o n ( N = 3 7 ) .  The b u r e a u c r a t i c r o l e  c o n c e p t i o n s c o r e may r a n g e f r o m 6 t o 30 a n d t h e p r o f e s s i o n a l a n d s e r v i c e r o l e conception s c o r e s , from 8 t o 40. second time o f Scale completion^  O f t h e 37 r e s p o n d e n t s  36 w e r e b a c c a l a u r e a t e  at the  graduates  c u r r e n t l y employed i n h o s p i t a l s e t t i n g s and t h e a d d i t i o n a l graduate had been employed i n a h o s p i t a l s e t t i n g u n t i l j u s t p r i o r t o S c a l e  completion,  w i t h no o t h e r i n t e r v e n i n g e m p l o y m e n t . The mean r o l e c o n c e p t i o n s o f t h e b a c c a l a u r e a t e  graduates  ( t o t a l N=77; h o s p i t a l e m p l o y e d N=37) m e a s u r e d p r i o r t o a n d f o l l o w i n g g r a d u a t i o n a r e p r e s e n t e d i n T a b l e I . T h e mean b u r e a u c r a t i c , p r o f e s s i o n a l and s e r v i c e r o l e c o n c e p t i o n s c o r e s r e f l e c t l o y a l t i e s t o t h e h o s p i t a l and a d m i n i s t r a t i v e r u l e s , t o t h e n u r s i n g p r o f e s s i o n , and t o t h e p s y c h o l o g i c a l w e l f a r e o f t h e p a t i e n t , r e s p e c t i v e l y . T h e r e i s no n u m e r i c a l o f what r e p r e s e n t s a h i g h o r low r o l e c o n c e p t i o n s c o r e .  definition  Corwin  Cl960)  s t a t e d t h a t a " h i g h mean i n d i c a t e s h i g h r o l e c o n c e p t i o n s c a l e s c o r e " ( p . 2 3 7 ) . R e f e r r i n g t o t h e r a n g e p o s s i b l e f o r e a c h s c o r e ( a maximum o f 30 f o r t h e b u r e a u c r a t i c , a n d a maximum o f 40 f o r t h e p r o f e s s i o n a l a n d s e r v i c e s c o r e s ) , the p r o f e s s i o n a l and s e r v i c e r o l e conceptions a r e o b s e r v e d t o be h e l d a t a h i g h e r l e v e l t h a n t h e b u r e a u c r a t i c r o l e conception.  T h i s p a t t e r n i s s i m i l a r t o t h o s e o b s e r v e d b y C o r w i n (.1960)  and K r a m e r ( 1 9 6 6 , 1 9 7 4 ) f o r b a c c a l a u r e a t e g r a d u a t e s .  Baccalaureate  programs emphasize p r o f e s s i o n a l and p a t i e n t c e n t e r e d g o a l s , w i t h l e s s l o y a l t y t o b u r e a u c r a t i c p r i n c i p l e s and v a l u e s .  In t h i s s t u d y , r o l e  c o n c e p t i o n s w e r e o b s e r v e d t o be r e l a t i v e l y s t a b l e o v e r t i m e .  The s l i g h t  decrease i n t h e b u r e a u c r a t i c r o l e conception and s l i g h t i n c r e a s e s i n p r o f e s s i o n a l and s e r v i c e r o l e conceptions over t h e six-month not s i g n i f i c a n t .  p e r i o d were  35  TABLE I S i g n i f i c a n c e o f D i f f e r e n c e s B e t w e e n Mean R o l e C o n c e p t i o n S c o r e s o f B a c c a l a u r e a t e G r a d u a t e s M e a s u r e d One M o n t h P r i o r t o G r a d u a t i o n ( T ^ ) and S i x M o n t h s F o l l o w i n g G r a d u a t i o n ( T ) 9  Role Conception  Bureaucratic  Professional  Service  a  d f = 36  Time  IN  M  SD  T  l  77  17.104  3.102  T  l  37  16.892  2.951  T  2  37  15.838  3.387  T  l  77  29.818  3.564  T  l  37  29.460  3.202  T  2  37  29.703  3.332  T  l  77  28.818  3.047  T  l  37  29.189  2.271  T  2  37  29.865  2.820  t  a  36 T h e s e f i n d i n g s c a n be c o m p a r e d w i t h t h o s e o f K r a m e r ( 1 9 7 4 ) f o r a s i m i l a r b a c c a l a u r e a t e g r o u p who w e r e a d m i n i s t e r e d t h e N u r s i n g C o n c e p t i o n S c a l e i n 1970 of B r i t i s h Columbia  (p. 106).  Role  P r i o r t o g r a d u a t i o n , The U n i v e r s i t y  b a c c a l a u r e a t e group  (N=37) had mean b u r e a u c r a t i c ,  p r o f e s s i o n a l and s e r v i c e r o l e c o n c e p t i o n s c o r e s o f 1 6 . 8 9 , 2 9 . 4 6 and r e s p e c t i v e l y ; c o m p a r e d i n t h e same o r d e r t o K r a m e r ' s b a c c a l a u r e a t e (N=59) s c o r e s o f 1 7 . 3 9 , 3 1 . 1 3 , and 29.12  ( 1 9 7 4 , p. 1 0 6 ) .  While  29.19 group  the  p r o f e s s i o n a l r o l e c o n c e p t i o n s c o r e o f K r a m e r ' s g r o u p was n o t i c e a b l y h i g h e r , the l e v e l s o f r o l e c o n c e p t i o n scores a t g r a d u a t i o n were of a s i m i l a r magnitude.  H o w e v e r , on e x p o s u r e  to employment, f o r which  Kramer  r e p o r t e d a f t e r one y e a r o f e m p l o y m e n t , h e r g r o u p had i n c r e a s e d i t s b u r e a u c r a t i c r o l e c o n c e p t i o n and d e c r e a s e d p r o f e s s i o n a l a n d - s e r v i c e r o l e c o n c e p t i o n s ( 1 9 7 4 , p. 1 0 6 ) .  T h i s d i r e c t i o n o f c h a n g e was  observed  p r e v i o u s l y by K r a m e r ( 1 9 6 6 ) a n d f e l t t o r e l a t e t o t h e b u r e a u c r a t i c p r o f e s s i o n a l c o n f l i c t o f h o s p i t a l employment.  Exposure  to bureaucratic  r u l e s a n d r e g u l a t i o n s and p a r t - t a s k d e s i g n a t i o n o f d u t i e s was f e l t t o c a u s e an i n c r e a s e i n t h e b u r e a u c r a t i c r o l e c o n c e p t i o n , w h i l e t h e p r o f e s s i o n a l r o l e conception decreased with the r e a l i t i e s of p r a c t i c e . W h i l e t h e c h a n g e s i n mean r o l e c o n c e p t i o n s c o r e s f o l l o w i n g h o s p i t a l employment  w e r e n o t s i g n i f i c a n t f o r The U n i v e r s i t y o f B r i t i s h  baccalaureate graduates, the d i r e c t i o n of the observed changes o p p o s i t e t o t h a t r e p o r t e d by K r a m e r ( 1 9 7 4 ) .  Columbia was  This s t a b i l i t y of role  c o n c e p t i o n s w i t h an i n d i c a t i o n f o r c h a n g e i n t h e o p p o s i t e d i r e c t i o n t o K r a m e r ' s f i n d i n g s m i g h t i n d i c a t e t h a t The U n i v e r s i t y o f B r i t i s h  Columbia  b a c c a l a u r e a t e graduates were s o c i a l i z e d t o r e f l e c t a g r e a t e r degree l o y a l t y t o b u r e a u c r a t i c p r i n c i p l e s . As w e l l , e x p o s u r e  to h o s p i t a l  e m p l o y m e n t was s u p p o r t i v e o f t h e p r o f e s s i o n a l and s e r v i c e v a l u e s ; f o r  of  37 p r a c t i c e l e a r n e d i n t h e i r e d u c a t i o n a l program. o f t h e i n c r e a s e d emphasis  T h i s m i g h t be a r e f l e c t i o n  on p r o f e s s i o n a l a n d p a t i e n t c e n t e r e d n u r s i n g  care o f the l a s t ten years. The r o l e c o n c e p t i o n s o f T h e U n i v e r s i t y o f B r i t i s h b a c c a l a u r e a t e graduates were a l s o examined  Columbia  f o r d i f f e r e n c e s between  groups.  The UBC-4 g r o u p c o m p l e t e d f o u r y e a r s o f n u r s i n g a t T h e U n i v e r s i t y o f B r i t i s h C o l u m b i a , w h i l e t h e UBC-2 g r o u p e n t e r e d t h e p r o g r a m  as r e g i s t e r e d  n u r s e s a n d c o m p l e t e d t h e l a s t two y e a r s o f t h e n u r s i n g p r o g r a m w i t h t h e f i r s t group.  The d i f f e r e n c e s i n r o l e c o n c e p t i o n s between these  groups  one m o n t h p r i o r t o g r a d u a t i o n a n d s i x m o n t h s f o l l o w i n g g r a d u a t i o n a r e presented i n Tables II and I I I . T h e r e w e r e no s i g n i f i c a n t d i f f e r e n c e s i n t h e r o l e c o n c e p t i o n s o f t h e s e two g r o u p s a t t h e t i m e s o f m e a s u r e m e n t b e f o r e a n d a f t e r g r a d u a t i o n . T h i s was a somewhat s u r p r i s i n g f i n d i n g i n v i e w o f t h e o r i e s o f r o l e acquisition.  W i t h i n t h e s t a g e s o f r o l e s o c i a l i z a t i o n d e s c r i b e d by T h o r n t o n  and N a r d i ( 1 9 7 5 ) , t h e s e two g r o u p s d i f f e r e d b o t h i n t e r m s o f e d u c a t i o n a l process and on-the-job e x p e r i e n c e .  As t h e r e a d e r w i l l r e c a l l , t h e  UBC-2 g r o u p r e c e i v e d t h e i r b a s i c n u r s i n g e d u c a t i o n i n a n o t h e r s e t t i n g a n d members o f t e n h a d w o r k e d a s r e g i s t e r e d n u r s e s p r i o r t o o r c o n c u r r e n t w i t h t h e two a d d i t i o n a l y e a r s o f n u r s i n g a t T h e U n i v e r s i t y o f B r i t i s h  Columbia.  The e d u c a t i o n a l p r o c e s s c o n t r i b u t e s i n f o r m a t i o n r e g a r d i n g r o l e , w i t h t h i s s t a g e o f r o l e s o c i a l i z a t i o n c h a r a c t e r i z e d by t h e f o r m a t i o n o f i n c o m p l e t e role conceptions.  Incumbents a r e then c o n f r o n t e d w i t h  on-the-job  e x p e c t a t i o n s a n d m o d i f i c a t i o n s o f t h e two r e s u l t i n p e r s o n a l r o l e c o n c e p t i o n s (Thornton and N a r d i , 1975).  The r e s u l t s o f t h i s study  would  i n d i c a t e t h a t e i t h e r t h e r e g i s t e r e d n u r s e s e n t e r e d t h e l a s t two y e a r s o f  38  TABLE I I S i g n i f i c a n c e o f D i f f e r e n c e s B e t w e e n Mean R o l e C o n c e p t i o n S c o r e s f o r Two G r o u p s o f B a c c a l a u r e a t e S t u d e n t s (H = 76) One M o n t h P r i o r t o G r a d u a t i o n  Role Conception  Group  N  M  Bureaucratic  UBC-2  35  16.657  2.754  UBC-4  41  17.415  3.369  UBC-2  35  29.943  4.022  UBC-4  41  29.932  3.217  UBC-2  35  28.971  3.120  UBC-4  41  28.732  3.042  Professional  Service  Note.  SD  JN = 76 a s o n e r e s p o n d e n t o f t o t a l s a m p l e d i d n o t i n d i c a t e program o f study a  d f = 74  t  a  •1.06  0.25  0.34  39.  TABLE I I I S i g n i f i c a n c e o f D i f f e r e n c e s B e t w e e n Mean R o l e C o n c e p t i o n S c o r e s f o r Two G r o u p s o f B a c c a l a u r e a t e G r a d u a t e s (N^ = 3 7 ) S i x M o n t h s F o l l o w i n g G r a d u a t i o n  Role Conception  Group  N  M  Bureaucratic  UBC-2  14  15.500  3.568  UBC-4  23  16.044  3.337  UBC-2  14  29.929  3.751  UBC-4  23  29.565  3.131  UBC-2  14  29.571  2.441  UBC-4  23  30.044  3.067  Professional  Service  a  d f = 35  SD  t  a  •0.47  0.32  -0.49  40 the b a c c a l a u r e a t e program w i t h r o l e c o n c e p t i o n s s i m i l a r t o those h e l d a t t h e t i m e o f g r a d u a t i o n , o r t h e two y e a r s i n t h e S c h o o l o f N u r s i n g a t The U n i v e r s i t y o f B r i t i s h Columbia  r e s u l t e d i n t h e same r o l e o r i e n t a t i o n s as  those from f o u r y e a r s o f the program.  A l s o , the r e a c t i o n of the r o l e  c o n c e p t i o n s o f t h e UBC-2 g r o u p on e x p o s u r e t o h o s p i t a l e m p l o y m e n t w e r e o f a s i m i l a r n a t u r e t o t h o s e o f t h e UBC-4 g r o u p .  The a b s e n c e o f d i f f e r e n c e s  b e t w e e n t h e two g r o u p s may be r e f l e c t i v e o f a c h i e v e m e n t out f o r the b a c c a l a u r e a t e program 1980, p. 5 7 ) .  of the goals s e t  (The U n i v e r s i t y o f B r i t i s h  Columbia,  The p h i l o s o p h y o f t h e S c h o o l o f N u r s i n g w o u l d be e x p e c t e d  t o d i r e c t t h e n u r s i n g e d u c a t i o n o f b a c c a l a u r e a t e s t u d e n t s and t o be r e f l e c t e d i n the b e l i e f s of baccalaureate graduates.  The r e s u l t s o f t h i s  study i n d i c a t e that i n d o c t r i n a t i o n with these nursing b e l i e f s i s e q u a l l y p o s s i b l e f o r r e g i s t e r e d n u r s e s e n t e r i n g i n t o t h e l a s t two y e a r s o f t h e b a c c a l a u r e a t e p r o g r a m and f o r g r a d u a t e s o f t h e f o u r y e a r p r o g r a m .  This  f i n d i n g i s f u r t h e r s u p p o r t i v e of the i n t e g r a t i v e approach to baccalaureate e d u c a t i o n t a k e n a t The U n i v e r s i t y o f B r i t i s h C o l u m b i a .  While there are  some 28 u n i v e r s i t y n u r s i n g p r o g r a m s o f f e r e d f o r r e g i s t e r e d n u r s e s i n C a n a d a ( " U n i v e r s i t y P r o g r a m s f o r RN's", 1980, p. 3 6 ) , The U n i v e r s i t y o f B r i t i s h C o l u m b i a o f f e r s t h e o n l y known i n t e g r a t e d p r o g r a m w h e r e r e g i s t e r e d n u r s e s c o m p l e t e t h e l a s t two y e a r s o f t h e p r o g r a m w i t h t h o s e t a k i n g t h e f o u r y e a r program.  The U n i v e r s i t y o f B r i t i s h C o l u m b i a ' s  b e l i e f that the goals of  t h e b a c c a l a u r e a t e p r o g r a m c a n be a t t a i n e d by b o t h g r o u p s o f s t u d e n t s i n an i n t e g r a t e d b a c c a l a u r e a t e p r o g r a m w o u l d a p p e a r t o be s u p p o r t e d by t h e r o l e c o n c e p t i o n s o f t h e 1980 b a c c a l a u r e a t e g r a d u a t e s m e a s u r e d p r i o r t o g r a d u a t i o n and f o l l o w i n g e x p o s u r e t o h o s p i t a l e m p l o y m e n t .  41 Role  Deprivation  The r o l e d e p r i v a t i o n s c o r e s o f b a c c a l a u r e a t e  graduates were  d e t e r m i n e d by c a l c u l a t i n g t h e d i f f e r e n c e s i n t h e r e s p o n d e n t ' s  perception  of the i d e a l n u r s i n g s i t u a t i o n compared to h i s / h e r p e r c e p t i o n a c t u a l s i t u a t i o n f o r i t e m s on t h e N u r s i n g  Role Conception  of  the  Scale.  These  b u r e a u c r a t i c , p r o f e s s i o n a l and s e r v i c e r o l e d e p r i v a t i o n s c o r e s w e r e m e a s u r e d one month p r i o r t o g r a d u a t i o n graduation  and s i x m o n t h s f o l l o w i n g  f o r r e s p o n d e n t s e m p l o y e d i n h o s p i t a l s e t t i n g s as  for role conception to graduation Bureaucratic  measurement.  described  T h i s r e s u l t e d i n 77 r e s p o n d e n t s p r i o r  and 37 r e s p o n d e n t s s i x m o n t h s f o l l o w i n g r o l e d e p r i v a t i o n s c o r e s may  graduation.  r a n g e f r o m 0 t o 24  and  p r o f e s s i o n a l and s e r v i c e r o l e d e p r i v a t i o n s c o r e s f r o m 0 t o 32.  The mean  r o l e d e p r i v a t i o n s c o r e s as m e a s u r e d one month p r i o r t o g r a d u a t i o n s i x months f o l l o w i n g g r a d u a t i o n Given  are presented  graduates.  and a c t u a l e x p e r i e n c e  p r o f e s s i o n a l v a l u e s and e x p e c t a t i o n s .  the  h i g h e s t f o r t h i s sample of  T h i s i n d i c a t e s t h a t the g r e a t e s t  between i d e a l r o l e c o n c e p t i o n  conceptions  IV.  the ranges p o s s i b l e f o r r o l e d e p r i v a t i o n s c o r e s ,  p r o f e s s i o n a l r o l e d e p r i v a t i o n s c o r e was baccalaureate  in Table  and  was  inconsistency  in the area  of  T h i s c a n be r e l a t e d t o t h e r o l e  p r e v i o u s l y d e s c r i b e d and t h e h i g h p r o f e s s i o n a l o r i e n t a t i o n  of t h i s group of baccalaureate  graduates (see Table I ) .  deprivation is a manifestation  of the p r o f e s s i o n a l - b u r e a u c r a t i c  d e s c r i b e d by o t h e r s S c h m a l e n b e r g , 1978; Sorenson, 1974).  ( J o h n s o n , 19.71;  K r a m e r , 1966,  M i l l e r and W a g e r , 1971; Professional education  1974;  Such r o l e conflict  K r a m e r and  S c o t t , 1966;  with complex s k i l l s  Sorenson and  and  42  T A B L E IV S i g n i f i c a n c e o f D i f f e r e n c e s B e t w e e n Mean R o l e D e p r i v a t i o n S c o r e s o f B a c c a l a u r e a t e G r a d u a t e s M e a s u r e d One M o n t h P r i o r t o G r a d u a t i o n ( T ^ ) and S i x M o n t h s F o l l o w i n g G r a d u a t i o n ( T ) 9  Role  Deprivation  Bureaucratic  Professional  Service  a  d f = 36  Time  N  M  SD  T  l  77  7.922  3.444  T  l  37  7.973  3.201  T  2  37  6.622  3.443  T  l  77  13.481  4.819  T  l  37  13.730  5.064  T  2  37  11.865  5.116  T  l  77  10.688  4.247  T  l  37  11.595  4.561  T  2  37  8.351  4.957  43 k n o w l e d g e t o p e r f o r m i n an a u t o n o m o u s m a n n e r c o n f l i c t s w i t h t h e b u r e a u c r a t i c o r i e n t a t i o n o f a p a r t - t a s k a u t h o r i t a r i a n system o f work performance.  T h e s e g r a d u a t e s i n d i c a t e d by t h e i r r o l e d e p r i v a t i o n s c o r e s  at g r a d u a t i o n t h a t they p e r c e i v e d t h i s c o n f l i c t between p r o f e s s i o n a l i d e a l s and a c t u a l p r a c t i c e .  The r o l e d e p r i v a t i o n s c o r e s o b s e r v e d o v e r  t i m e and e x p o s u r e t o h o s p i t a l e m p l o y m e n t d e c r e a s e d i n a l l a r e a s , a l t h o u g h t o a s i g n i f i c a n t d e g r e e o n l y f o r s e r v i c e r o l e d e p r i v a t i o n . I t w o u l d seem t h a t i n t h e a c t u a l employment s e t t i n g s i x months f o l l o w i n g g r a d u a t i o n the baccalaureate graduates perceived less i n c o n s i s t e n c y i n meeting t h e i r ideal role conceptions.  While the r o l e c o n c e p t i o n s were not observed to change  s i g n i f i c a n t l y over t h i s time, the graduates' perception of t h e i r a b i l i t y to meet t h e i r i d e a l r o l e c o n c e p t i o n s l e s s e n e d t h e r o l e d e p r i v a t i o n .  The  s i g n i f i c a n t decrease in s e r v i c e role d e p r i v a t i o n suggests that graduates p e r c e i v e d t h e m s e l v e s b e t t e r a b l e t o meet p a t i e n t needs i n the employment s e t t i n g t h a n t h e y had a t g r a d u a t i o n . perception  The r e a s o n s f o r t h i s c h a n g e i n  c a n n o t be i d e n t i f i e d t h r o u g h t h e d a t a a v a i l a b l e f r o m t h i s  study. T h e s e f i n d i n g s w e r e s i m i l a r t o t h o s e r e p o r t e d by K r a m e r ( 1 9 7 4 ) f o r a group o f b a c c a l a u r e a t e graduates C o n c e p t i o n S c a l e i n 1970 ( p . 1 0 6 ) .  who c o m p l e t e d t h e N u r s i n g R o l e  While she o b s e r v e d the g r a d u a t e s o v e r  one y e a r o f e m p l o y m e n t , s h e n o t e d t h e same p a t t e r n o f d e c r e a s e i n r o l e d e p r i v a t i o n s c o r e s w i t h the s e r v i c e r o l e d e p r i v a t i o n showing the l a r g e s t d e c r e a s e ( K r a m e r , 1974, pp. 1 0 6 - 1 0 7 ) .  She n o t e d t h a t t h e i r s e r v i c e r o l e  c o n c e p t i o n s w e r e s i m i l a r l y s t a b l e , and s t a t e d : T h i s means t h a t w h i l e t h e i r c o n c e p t o f t h e n u r s e r o l e w i t h r e g a r d t o d e v o t i o n and l o y a l t y t o the p a t i e n t remained r e l a t i v e l y u n c h a n g e d f r o m g r a d u a t i o n t o one y e a r a f t e r employment, these nurses found c o n d i t i o n s i n a c t u a l p r a c t i c e more c o n s o n a n t w i t h t h e i r s e r v i c e r o l e c o n c e p t i o n t h a n t h e y had a t g r a d u a t i o n , ( p . 1 0 7 ) .  44 The r o l e d e p r i v a t i o n s c o r e s r e p o r t e d f o r T h e U n i v e r s i t y o f B r i t i s h Columbia baccalaureate  graduates were a l s o examined f o r  d i f f e r e n c e s b e t w e e n g r o u p s , t h a t i s UBC-2 a n d UBC-4 g r a d u a t e s .  The r o l e  d e p r i v a t i o n s c o r e s as measured one month p r i o r t o g r a d u a t i o n a r e presented  i n T a b l e V and those measured s i x months f o l l o w i n g  are presented  graduation  i n Table VI.  The r o l e d e p r i v a t i o n s c o r e s o f t h e s e two g r o u p s w e r e n o t s i g n i f i c a n t l y d i f f e r e n t p r i o r to graduation, graduation,  and s i x months f o l l o w i n g  they d i f f e r e d s i g n i f i c a n t l y only f o r bureaucratic  deprivation.  role  C o m p a r i s o n o f t h e two t a b l e s i l l u s t r a t e s t h a t t h e b u r e a u -  c r a t i c r o l e d e p r i v a t i o n s c o r e remained c o n s t a n t over t h e s i x months f o r t h e UBC-2 g r o u p b u t d e c r e a s e d  f o r t h e UBC-4 g r o u p , w h i c h a c c o u n t e d f o r t h e  s i g n i f i c a n t d i f f e r e n c e between groups noted a t t h a t time.  This finding  can p e r h a p s be u n d e r s t o o d i n t e r m s o f t h e d i f f e r e n c e s i n r o l e s o c i a l i z a t i o n previously discussed. not d i f f e r , previous prepared  While the r o l e conceptions on-the-job  experiences  o f t h e UBC-2 g r o u p may h a v e  them t o h o l d more r e a l i s t i c e x p e c t a t i o n s  bureaucratic  role conceptions  h e l d by b o t h g r o u p s d i d  f o r congruence between  and actual p r a c t i c e .  T h e UBC-4 g r o u p  p e r c e i v e d g r e a t e r i n c o n s i s t e n c y between b u r e a u c r a t i c experience graduation.  p r i o r to graduation  l o y a l t i e s and actual  than they d i d s i x months f o l l o w i n g  In terms o f p r o f e s s i o n a l - b u r e a u c r a t i c  c o n f l i c t , i t w o u l d seem  t h a t UBC-4 g r a d u a t e s w e r e b e t t e r a b l e t o m e e t t h e b u r e a u c r a t i c demands o f h o s p i t a l e m p l o y m e n t t h a n was p e r c e i v e d a t g r a d u a t i o n . educational  p r o c e s s was r e s p o n s i b l e f o r t e a c h i n g b e h a v i o u r s  to t h i s adjustment. entered  Perhaps again, the  I t i s also recognized  that  contributed  t h a t UBC-2 g r a d u a t e s may h a v e  h o s p i t a l employment a t d i f f e r e n t l e v e l s i n t h e h o s p i t a l  hierarchy  45  TABLE V S i g n i f i c a n c e o f D i f f e r e n c e s B e t w e e n Mean R o l e D e p r i v a t i o n S c o r e s f o r Two G r o u p s o f B a c c a l a u r e a t e S t u d e n t s (N^ = 76) One M o n t h P r i o r t o G r a d u a t i o n  Role D e p r i v a t i o n  Group  N  Bureaucratic  UBC-2  35  8.314  3.787  UBC-4  41  7.707  3.092  UBC-2  35  13.943  4.537  UBC-4  41  13.195  5.085  UBC-2  35  10.229  4.609  UBC-4  41  11.293  3.710  Professional  Service  Note.  M  SD  t  a  0.77  0.67  •1.11  N_ = 76 a s o n e r e s p o n d e n t o f t o t a l s a m p l e d i d n o t i n d i c a t e program o f study a  d f = 74  46  T A B L E VI S i g n i f i c a n c e o f D i f f e r e n c e s B e t w e e n Mean R o l e D e p r i v a t i o n S c o r e s f o r Two G r o u p s o f B a c c a l a u r e a t e G r a d u a t e s (N^ = 3 7 ) S i x M o n t h s F o l l o w i n g G r a d u a t i o n  Role D e p r i v a t i o n  Group  N  Bureaucratic  UBC-2  14  8.071  2.921  UBC-4  23  5.739  3.493  UBC-2  14  13.571  4.450  UBC-4  23  10.826  5.306  UBC-2  14  9.643  3.734  UBC-4  23  7.565  5.501  Professional  Service  a  d f = 35  *p_  <.05  M  SD  t  a  * 2.09  1.62  1.25  47 t h a n UBC-4 g r a d u a t e s and t h u s e x p e r i e n c e d more d i f f i c u l t y i n a c h i e v i n g t h e i r b u r e a u c r a t i c r o l e c o n c e p t i o n s , which r e s u l t e d i n t h e i r c o n s t a n t bureaucratic role deprivation scores over  time.  Work P r o f i l e I n f o r m a t i o n t o d e s c r i b e t h e work p r o f i l e o f b a c c a l a u r e a t e g r a d u a t e s f o l l o w i n g g r a d u a t i o n was c o m p i l e d f r o m r e s p o n s e s t o t h e Work Experience Questionnaire completed t h e 62 r e s p o n d e n t s who at that time.  completed  s i x months; f o l l o w i n g g r a d u a t i o n .  Of  t h i s Q u e s t i o n n a i r e , f i v e were unemployed  W i t h i n t h e g r o u p o f f i v e g r a d u a t e s who w e r e u n e m p l o y e d ,  two w e r e i n E u r o p e and p r o v i d e d no  work h i s t o r y s i n c e g r a d u a t i o n , w h i l e  t h e o t h e r t h r e e had b e e n e m p l o y e d s i n c e g r a d u a t i o n a n d w e r e c u r r e n t l y s e e k i n g employment. F o r t h o s e g r a d u a t e s c u r r e n t l y e m p l o y e d i t was o f a d d i t i o n a l i n t e r e s t t o l e a r n o f t h o s e who  had h e l d two and t h r e e p o s i t i o n s s i n c e  g r a d u a t i o n , as i l l u s t r a t e d i n F i g u r e 1, In a s i m i l a r s t u d y o f 79 b a c c a l a u r e a t e g r a d u a t e s , K r a m e r (.1966) r e p o r t e d t h a t 33 p e r c e n t had c h a n g e d j o b s o n c e I n s i x m o n t h s ( p . 4 2 ) , F o r The U n i v e r s i t y o f B r i t i s h C o l u m b i a  baccalaureate graduates  this  p a t t e r n o f work e x p e r i e n c e seemed r e l a t e d i n p a r t t o the t i m i n g o f g r a d u a t i o n and employment f o r t h r e e t o f o u r months i n v a r i o u s : s e t t i n g s as summer r e l i e f , f o l l o w e d by movement i n t o p e r m a n e n t p o s i t i o n s . was a l s o a s h o r t a g e o f n u r s e s i n t h e p r o v i n c e o f B r i t i s h  There  Columbia  c o n c u r r e n t w i t h t h i s s t u d y , w h i c h may h a v e c o n t r i b u t e d t o a more f l e x i b l e e m p l o y m e n t m a r k e t f o r t h o s e who w i s h e d t o c h a n g e p o s i t i o n s . The number  48  FIGURE 1 Employment S t a t u s o f B a c c a l a u r e a t e Graduates Following Graduation  Initial Position ii 47.03 %  (N_ = 6 2 ) S i x M o n t h s  N = 29 Currently Employed  Second Position  Third Position Other  41.70  %i  3 22?,,  8.06 %  IN = 26 N= 2 N = 5  ICurrently Unemployed  49 o f p o s i t i o n s h e l d by t h e b a c c a l a u r e a t e g r a d u a t e s a s r e p o r t e d s i x m o n t h s f o l l o w i n g g r a d u a t i o n i s p r e s e n t e d i n T a b l e V I I , c a t e g o r i z e d by t h e l e n g t h o f employment i n t h e p o s i t i o n and t h e type o f work o r g a n i z a t i o n . The 88 p o s i t i o n s r e p r e s e n t t h o s e o f t h e 57 g r a d u a t e s c u r r e n t l y e m p l o y e d , t h e p o s i t i o n s o f t h e t h r e e g r a d u a t e s who w h i l e c u r r e n t l y u n e m p l o y e d h a d b e e n e m p l o y e d s i n c e g r a d u a t i o n a n d t h e a d d i t i o n a l p o s i t i o n s o f 28 g r a d u a t e s who h a d b e e n e m p l o y e d i n more t h a t o n e p o s i t i o n s i n c e g r a d u a t i o n . The t y p e s o f w o r k o r g a n i z a t i o n s i n d i c a t e d w e r e H o s p i t a l , Community H e a l t h A g e n c y , B u s i n e s s / I n d u s t r y , E d u c a t i o n a l I n s t i t u t i o n a n d Other.  Those employed i n the Other c l a s s i f i c a t i o n s p e c i f i e d the  Association f o r the Mentally Retarded, the Registered P s y c h i a t r i c Nurses' A s s o c i a t i o n , d r o p - i n c e n t r e s , a r e c r e a t i o n c e n t r e and a v o l u n t e e r agency as t h e i r employment s e t t i n g s . The range i n l e n g t h o f employment from l e s s than one month t o s i x months f u r t h e r i l l u s t r a t e s t h e v a r i a b i l i t y o f work e x p e r i e n c e f o r t h e s e g r a d u a t e s i n t h e f i r s t s i x m o n t h s f o l l o w i n g graduation. W h i l e t h e h o s p i t a l s e t t i n g a c c o u n t e d f o r 50 o u t o f t h e 88 (47.27  p e r c e n t ) p o s i t i o n s h e l d b y t h e b a c c a l a u r e a t e g r a d u a t e s a t some  time i n t h e f i r s t s i x months f o l l o w i n g g r a d u a t i o n , a l o o k a t t h e e m p l o y m e n t s e t t i n g s o f t h e b a c c a l a u r e a t e g r a d u a t e s who w e r e c u r r e n t l y e m p l o y e d (N=57) p r e s e n t s a c l e a r e r p i c t u r e o f t h e d i s p e r s i o n o f g r a d u a t e s t o w o r k o r g a n i z a t i o n s a t one p o i n t i n t i m e ,  A summary o f t h e w o r k  o r g a n i z a t i o n s o f c u r r e n t e m p l o y m e n t f o r t h e s e 57 b a c c a l a u r e a t e  graduates  i s p r e s e n t e d i n F i g u r e 2, The h o s p i t a l c a n t h u s be s e e n t o be t h e e m p l o y e r f o r t h e g r e a t e s t number o f b a c c a l a u r e a t e g r a d u a t e s , f o l l o w e d b y c o m m u n i t y h e a l t h  50  TABLE V I I Number o f P o s i t i o n s by L e n g t h o f E m p l o y m e n t a n d T y p e o f Work O r g a n i z a t i o n H e l d by B a c c a l a u r e a t e G r a d u a t e s a s R e p o r t e d S i x M o n t h s F o l l o w i n g G r a d u a t i o n  Type o f Work O r g a n i z a t i o n  Position Totals  Number o f P o s i t i o n s by Length o f Employment i n Months  N_  <1  1  Hospital  50  1  6  13  8  5  10  7  Community  24  3  2  4  5  6  3  1  Business/Industry  2  -  -  -  -  -  2  -  Educational  5  -  Other  7  1  1 2  2  1 1  2  1  1  -  1  1  51  FIGURE 2 C u r r e n t Employment S e t t i n g s o f B a c c a l a u r e a t e Graduates S i x Months F o l l o w i n g  8  "5  (N_ = 5 7 )  Graduation  50  3  2 O  2  40  30  3  o  u u O CQ  0)  _Q  20  10 N = 13  E  N = l N = 10  3 z  Work  Organizations  I UBC-2  Baccalaureate graduates  Mmvj  UBC-4  Baccalaureate graduates  52 a g e n c i e s , w i t h o n l y a s m a l l number i n e d u c a t i o n a l a n d o t h e r s e t t i n g s , combined.  T h e b r e a k d o w n o f e m p l o y m e n t f o r UBC-2 a n d UBC-4  graduates  i n d i c a t e s t h a t t h e g r e a t e s t number f o r b o t h g r o u p s was e m p l o y e d i n t h e h o s p i t a l s e t t i n g . T h e UBC-2 g r o u p r e p r e s e n t s a g r e a t e r p r o p o r t i o n o f those b a c c a l a u r e a t e graduates employed i n community h e a l t h a g e n c i e s and o t h e r s e t t i n g s , as w e l l as t h e t o t a l o f those employed i n e d u c a t i o n a l institutions. W i t h i n t h e s e work o r g a n i z a t i o n s t h e b a c c a l a u r e a t e  graduates  w e r e a s k e d t o i n d i c a t e t h e i r p o s i t i o n t i t l e s on t h e Work E x p e r i e n c e Questionnaire.  T h e g r e a t e s t v a r i e t y o f p o s i t i o n t i t l e s was i n t h e h o s p i t a l  s e t t i n g as i n d i c a t e d i n T a b l e V I I I .  The p o s i t i o n s o f s u p e r v i s o r , head  n u r s e / a s s i s t a n t h e a d n u r s e , a n d i n s t r u c t o r w e r e f i l l e d b y UBC-2  graduates,  which p o s s i b l y r e f l e c t e d work e x p e r i e n c e p r i o r t o b a c c a l a u r e a t e  education.  The g e n e r a l d u t y p o s i t i o n s w e r e f i l l e d b y both. UBC-2 a n d UBC-4 g r a d u a t e s , w i t h t h e m a j o r i t y b e i n g UBC-4 g r a d u a t e s . s p e c i a l i s t was a UBC-4 g r a d u a t e .  The one r e p o r t e d c l i n i c a l  nurse  Those employed i n community h e a l t h  a g e n c i e s were a l l t i t l e d community h e a l t h n u r s e , w i t h one g r a d u a t e more s p e c i f i c a l l y a community mental  health nurse.  T h e two b a c c a l a u r e a t e  graduates employed i n e d u c a t i o n a l i n s t i t u t i o n s were i n s t r u c t o r s , and t h e t h r e e i n o t h e r s e t t i n g s were a s u p e r v i s o r with, t h e A s s o c i a t i o n f o r t h e M e n t a l l y R e t a r d e d , an  independent  nurse p r a c t i t i o n e r i n a r e c r e a t i o n  c e n t r e , and a c h i l d care worker i n a d r o p - i n c e n t r e . F o l l o w i n g f r o m t h e summary o f t h e w o r k o r g a n i z a t i o n s , i n w h i c h b a c c a l a u r e a t e g r a d u a t e s were employed s i x months f o l l o w i n g g r a d u a t i o n , the i n v e s t i g a t o r attempted  t o determine  i f t h e r e was a r e l a t i o n s h i p  between t h e r o l e c o n c e p t i o n s o f The U n i v e r s i t y o f B r i t i s h . Columbia  53  TABLE V I I I P o s i t i o n T i t l e s o f T h o s e B a c c a l a u r e a t e G r a d u a t e s {H = 3 6 ) E m p l o y e d i n t h e H o s p i t a l S e t t i n g S i x Months F o l l o w i n g  Graduation  Baccalaureate Graduates Position Titles  UBC-2  UBC-4  General Duty Nurse  6  22  Instructor  4  0  Supervisor  2  0  Head N u r s e / A s s i s t a n c e Head N u r s e  1  0  C l i n i c a l Nurse S p e c i a l i s t  0  1  13  23  TOTAL  54 b a c c a l a u r e a t e g r a d u a t e s as m e a s u r e d one m o n t h p r i o r t o g r a d u a t i o n ,  and  the t y p e o f work o r g a n i z a t i o n i n which they were employed s i x months following graduation.  One-way a n a l y s i s o f v a r i a n c e was u s e d t o e x a m i n e  the r e l a t i o n s h i p between the r o l e c o n c e p t i o n s measured p r i o r t o g r a d u a t i o n and t h e e m p l o y m e n t o f g r a d u a t e s i n h o s p i t a l and c o m m u n i t y h e a l t h s e t t i n g s s i x months f o l l o w i n g g r a d u a t i o n . (N=2)  Those employed i n e d u c a t i o n a l  institutions  and o t h e r s e t t i n g s (.N=3) w e r e e x c l u d e d f r o m s t a t i s t i c a l a n a l y s i s  because o f the s m a l l numbers i n each group.  Separate examination  of the  r o l e c o n c e p t i o n means f o r t h o s e g r o u p s was c o n s i d e r e d m o r e a p p r o p r i a t e . The one-way a n a l y s i s o f v a r i a n c e f o r t h o s e e m p l o y e d i n t h e h o s p i t a l and c o m m u n i t y h e a l t h s e t t i n g s was n o t s i g n i f i c a n t f o r t h e b u r e a u c r a t i c o r p r o f e s s i o n a l r o l e c o n c e p t i o n s , b u t was ( f ( 1 , 5 0 ) = 4.03,  significant  £ = .05) f o r t h e s e r v i c e r o l e c o n c e p t i o n h e l d by  graduates p r i o r to graduation.  The mean s e r v i c e r o l e c o n c e p t i o n  those  scores  o f g r a d u a t e s who w e r e l a t e r e m p l o y e d I n t h e h o s p i t a l (29.0.6) w e r e h i g h e r than those o f graduates l a t e r employed i n community h e a l t h s e t t i n g s , (,27.44), a f i n d i n g w h i c h may  i n d i c a t e l o y a l t i e s to d i r e c t p a t i e n t care  t h a t d i r e c t e d graduates to choose h o s p i t a l employment.  However, t h i s  d i f f e r e n c e m i g h t a l s o be t h e r e s u l t o f t h e e m p l o y m e n t a v a i l a b l e and h o s p i t a l s as employers  o f t h e m a j o r i t y o f g r a d u a t e s had a g r e a t e r  thus chance  f o r i n c l u s i o n o f t h o s e w i t h h i g h e r mean s e r v i c e r o l e c o n c e p t i o n s c o r e s . G r e a t e r n u m b e r s i n a v a r i e t y o f e m p l o y m e n t s e t t i n g s w o u l d a l l o w f o r more comprehensive  analysis of this question.  The mean r o l e c o n c e p t i o n  s c o r e s as measured p r i o r t o  graduation f o r those graduates employed i n e d u c a t i o n a l i n s t i t u t i o n s  (N=2)  w e r e f o u n d t o be s i m i l a r t o t h o s e h e l d by t h e t o t a l g r o u p e m p l o y e d s i x  55 m o n t h s f o l l o w i n g g r a d u a t i o n (N=57).  T h e means f o r b u r e a u c r a t i c ,  p r o f e s s i o n a l a n d s e r v i c e r o l e c o n c e p t i o n s w e r e 1 6 . 0 0 , 20.00 a n d 2 8 . 5 0 r e s p e c t i v e l y ; c o m p a r e d i n t h e same o r d e r t o t o t a l g r o u p means o f 1 7 . 3 2 , 29.83 a n d 2 8 . 7 9 .  T h e s m a l l number i n t h i s g r o u p a n d t h e s i m i l a r i t y o f  mean r o l e c o n c e p t i o n s c o r e s t o t h o s e o f t h e t o t a l g r o u p g i v e no i n d i c a t i o n o f a r e l a t i o n s h i p between r o l e c o n c e p t i o n s h e l d p r i o r t o g r a d u a t i o n and l a t e r employment i n e d u c a t i o n a l  institutions.  T h e b a c c a l a u r e a t e g r a d u a t e s i n o t h e r e m p l o y m e n t s e t t i n g s (N=3) showed g r e a t e r d i f f e r e n c e s f r o m t h e t o t a l g r o u p means ( N = 5 7 ) .  Their role  c o n c e p t i o n means f o r b u r e a u c r a t i c , p r o f e s s i o n a l a n d s e r v i c e r o l e c o n c e p t i o n s w e r e 1 9 . 0 0 , 36.33 a n d 33.00 r e s p e c t i v e l y ; . c o m p a r e d i n t h e same o r d e r w i t h t o t a l g r o u p means o f 1 7 . 3 1 , 29,83 a n d 2 8 . 7 9 .  Both the  p r o f e s s i o n a l a n d s e r v i c e r o l e c o n c e p t i o n means f o r t h i s g r o u p o f t h r e e g r a d u a t e s w e r e much h i g h e r t h a n t h o s e o f t h e t o t a l g r o u p .  Perhaps  these  differences i n r o l e conceptions indicated l o y a l t i e s to the nursing p r o f e s s i o n and p a t i e n t c a r e t h a t d i r e c t e d such graduates t o seek  employment  o u t s i d e t h e t r a d i t i o n a l n u r s i n g employment s e t t i n g s upon g r a d u a t i o n . H o w e v e r , t h e number o f g r a d u a t e s was t o o s m a l l f o r a n y d e f i n i t i v e interpretation. Attempts  t o determine a r e l a t i o n s h i p between t h e r o l e c o n c e p t i o n s  h e l d p r i o r t o g r a d u a t i o n and t h e employment s e t t i n g s o f graduates  observed  a f t e r g r a d u a t i o n w e r e l i m i t e d by t h e s m a l l numbers i n some s e t t i n g s , a n d r e s u l t e d i n no d e f i n i t i v e c o n c l u s i o n s . In t h e n e x t c h a p t e r a summary o f t h e f i n d i n g s f r o m t h i s s t u d y i s presented.  T h e s e f i n d i n g s , f o r m t h e b a s i s f r o m w h i c h t o draw t h e m a j o r  c o n c l u s i o n s and i m p l i c a t i o n s o f t h i s s t u d y and from which recommendations f o r f u r t h e r study are proposed.  CHAPTER V SUMMARY, CONCLUSIONS, I M P L I C A T I O N S  AND  RECOMMENDATIONS FOR FURTHER STUDY The o b s e r v a t i o n t h a t b a c c a l a u r e a t e g r a d u a t e s d i f f i c u l t i e s in adjustment  t o the work e n v i r o n m e n t  experience  upon g r a d u a t i o n  f o c u s s e d a t t e n t i o n on t h e phenomenon l a b e l l e d r e a l i t y  has  shock.  W i t h i n a t h e o r e t i c a l f r a m e w o r k b a s e d on r o l e t h e o r y , t h e c o n c e p t o f r o l e and t h e p r o c e s s o f r o l e a c q u i s i t i o n f o r m e d a b a s i s f o r the study of the r o l e c o n f l i c t c o n f r o n t i n g i n d i v i d u a l s i n t r a n s i t i o n from the e d u c a t i o n a l system t o the work o r g a n i z a t i o n .  Role  conceptions  w h i c h r e p r e s e n t t h e r o l e e x p e c t a t i o n s h e l d by an i n d i v i d u a l a t a s p e c i f i e d time are expected to change w i t h i n t h i s p e r i o d of t r a n s i t i o n . The r o l e c o n f l i c t i n n u r s i n g has b e e n s t u d i e d f r o m t h e p e r s p e c t i v e o f role conceptions.  Such study i s i m p o r t a n t to p r o v i d e i n f o r m a t i o n f o r  n u r s i n g e d u c a t i o n and n u r s i n g s e r v i c e as a b a s e f r o m w h i c h t o h e l p graduates d u r i n g t h i s time of r o l e t r a n s i t i o n .  The l a c k o f s t u d i e s  w i t h i n t h e C a n a d i a n e d u c a t i o n a l and h e a l t h s y s t e m was a s t i m u l u s f o r i n v e s t i g a t i o n o f t h e s e c o n c e r n s a t The U n i v e r s i t y o f B r i t i s h  Columbia.  T h i s s t u d y was a d e s c r i p t i v e s u r v e y o f t h e r o l e c o n c e p t i o n s h e l d by t h e 1980 b a c c a l a u r e a t e g r a d u a t e s o f The U n i v e r s i t y o f B r i t i s h Columbia  School of Nursing.  R o l e c o n c e p t i o n s w e r e m e a s u r e d by t h e  N u r s i n g R o l e C o n c e p t i o n S c a l e one m o n t h p r i o r t o g r a d u a t i o n ( N = 7 7 ) , and 56  57  s i x months f o l l o w i n g g r a d u a t i o n f o r t h o s e employed i n a h o s p i t a l s e t t i n g (N=37).  I n a d d i t i o n , c o m p l e t i o n o f t h e Work E x p e r i e n c e  Questionnaire  produced data t o d e s c r i b e t h e employment s t a t u s o f graduates  (N=62) s i x  months f o l l o w i n g g r a d u a t i o n .  Conception  Completion  o f the Nursing Role  S c a l e r e s u l t e d i n b u r e a u c r a t i c , p r o f e s s i o n a l and s e r v i c e r o l e c o n c e p t i o n scores which r e f l e c t e d l o y a l t i e s t o t h e h o s p i t a l and a d m i n i s t r a t i v e r u l e s , t o t h e n u r s i n g p r o f e s s i o n and t o t h e p a t i e n t ' s w e l f a r e , respectively.  Role d e p r i v a t i o n scores which r e f l e c t e d p e r c e i v e d  i n c o n s i s t e n c i e s betweem t h e i d e a l s o f t h e r o l e c o n c e p t i o n s a n d o b s e r v a t i o n s of a c t u a l p r a c t i c e were s i m i l a r l y c a l c u l a t e d f o r t h e b u r e a u c r a t i c , p r o f e s s i o n a l and s e r v i c e items o f t h e S c a l e . The r e l i a b i l i t y  o f the Nursing Role Conception Scale with  t h i s sample a t The U n i v e r s i t y o f B r i t i s h Columbia  was f o u n d t o h a v e a  c o e f f i c i e n t a l p h a o f 0.51 w h i c h was l o w e r t h a n h o p e d f o r a n d r a i s e d t h e question o f whether t h i s Scale i s c o n s i s t e n t l y measuring  the bureaucratic,  p r o f e s s i o n a l and s e r v i c e r o l e conceptions t h a t i t i s designed t o measure. The r o l e c o n c e p t i o n s o f T h e U n i v e r s i t y o f B r i t i s h b a c c a l a u r e a t e n u r s i n g graduates remained  Columbia  f a i r l y s t a b l e from the time o f  measurement p r i o r t o g r a d u a t i o n and f o l l o w i n g g r a d u a t i o n . d i r e c t i o n o f c h a n g e i n r o l e c o n c e p t i o n s on e x p o s u r e  While the  t o h o s p i t a l employment  was n o t s i g n i f i c a n t , i t was i n t h e o p p o s i t e d i r e c t i o n t o t h a t r e p o r t e d by K r a m e r ( 1 9 7 4 ) .  T h e r e was a s l i g h t d e c r e a s e i n t h e mean b u r e a u c r a t i c  r o l e c o n c e p t i o n s c o r e a n d a s l i g h t i n c r e a s e i n t h e mean p r o f e s s i o n a l and s e r v i c e r o l e c o n c e p t i o n s c o r e s o f T h e U n i v e r s i t y o f B r i t i s h Columbia  b a c c a l a u r e a t e g r a d u a t e s , w h i l e K r a m e r n o t e d an i n c r e a s e i n  t h e mean b u r e a u c r a t i c r o l e c o n c e p t i o n s c o r e a n d a d e c r e a s e i n mean  58  p r o f e s s i o n a l and s e r v i c e r o l e conception questions  scores.  This finding raises  regarding the possible influences of difference i n s o c i a l i z a t i o n  and t h e e f f e c t s o f i n c r e a s e d e m p h a s i s o n p r o f e s s i o n a l a n d p a t i e n t c e n t e r e d n u r s i n g c a ^ e which have o c c u r r e d d u r i n g t h e l a s t t e n y e a r s . The r o l e c o n c e p t i o n s  o f t h e t o t a l group were examined f o r  d i f f e r e n c e s b e t w e e n t h e UBC-2 a n d UBC-4 g r a d u a t e s , entered the baccalaureate  the former  program as r e g i s t e r e d nurses  l a s t two y e a r s o f t h e p r o g r a m .  having  and completed t h e  T h e r e w e r e no s i g n i f i c a n t d i f f e r e n c e s  b e t w e e n t h e s e two g r o u p s , w h i c h was s u r p r i s i n g t o t h e i n v e s t i g a t o r i n view o f the d i f f e r e n c e s i n r o l e s o c i a l i z a t i o n , p a r t i c u l a r l y educational process  and on-the-job  experience.  supportive o f t h e School taken t o baccalaureate  T h i s f i n d i n g was f e l t t o be  o f Nursing education  philosophy  and t h e i n t e g r a t e d  o f r e g i s t e r e d nurses  approach  a t The U n i v e r s i t y o f  B r i t i s h Columbia. The r o l e d e p r i v a t i o n s c o r e s r e v e a l e d p r o f e s s i o n a l d e p r i v a t i o n t o be g r e a t e s t , w h i c h c o u l d be e x p e c t e d  role  from the p r o f e s s i o n -  b u r e a u c r a t i c c o n f l i c t w h i c h r e s u l t s when p r o f e s s i o n a l v a l u e s o f autonomous w h o l e - t a s k performance a r e c o n f r o n t e d w i t h t h e p a r t - t a s k a u t h o r i t a r i a n o r i e n t a t i o n s t o work o f t h e b u r e a u c r a t i c d e p r i v a t i o n s c o r e s were observed graduation, deprivation.  although  t o have decreased  system.  The r o l e  s i x months f o l l o w i n g  t h e d i f f e r e n c e was s i g n i f i c a n t o n l y f o r s e r v i c e r o l e  This suggests  t h a t g r a d u a t e s p e r c e i v e d t h e m s e l v e s t o be  b e t t e r a b l e t o m e e t p a t i e n t n e e d s when i n t h e e m p l o y m e n t s e t t i n g t h a n had a t g r a d u a t i o n .  These f i n d i n g s f o r r o l e d e p r i v a t i o n scores  t h o s e r e p o r t e d by K r a m e r ( 1 9 7 4 ) f o r a s i m i l a r b a c c a l a u r e a t e b e e n e m p l o y e d f o r one y e a r .  they  support  g r o u p who h a d  Mean r o l e d e p r i v a t i o n s c o r e s w e r e a l s o  59 e x a m i n e d f o r d i f f e r e n c e s b e t w e e n g r o u p s o f UBC-2 a n d UBC-4 g r a d u a t e s . The o n l y s i g n i f i c a n t d i f f e r e n c e was f o r t h e b u r e a u c r a t i c r o l e d e p r i v a t i o n s c o r e measured s i x months f o l l o w i n g g r a d u a t i o n . d e p r i v a t i o n s c o r e o f t h e UBC-2 g r o u p r e m a i n e d  The b u r e a u c r a t i c r o l e  constant over time while  t h e UBC-4 g r o u p s c o r e d e c r e a s e d , w h i c h a c c o u n t e d f o r t h e s i g n i f i c a n t difference.  T h i s d i f f e r e n c e was f e l t t o r e l a t e a g a i n t o t h e d i f f e r e n c e  in r o l e s o c i a l i z a t i o n f o r these groups.  From p r e v i o u s e x p e r i e n c e s t h e  UBC-2 g r o u p m i g h t h a v e h e l d m o r e c o n g r u e n t e x p e c t a t i o n s b e t w e e n b u r e a u c r a t i c r o l e c o n c e p t i o n s and a c t u a l p r a c t i c e , and were a l s o l i k e l y t o e n t e r t h e h o s p i t a l o r g a n i z a t i o n a t l e v e l s w h e r e t h e y w e r e more i n v o l v e d with t h e r u l e s and r e g u l a t i o n s o f t h e o r g a n i z a t i o n . e x p e r i e n c e s o f t h e UBC-4 g r o u p p e r h a p s p r e p a r e d t h e s e  The e d u c a t i o n a l baccalaureate  graduates t o expect g r e a t e r i n c o n s i s t e n c y between b u r e a u c r a t i c r o l e conceptions and a c t u a l p r a c t i c e than they a c t u a l l y experienced. A work p r o f i l e o f t h e s e b a c c a l a u r e a t e g r a d u a t e s 41.7 p e r c e n t o f t h e 62 r e s p o n d e n t s  indicated that  h a d h e l d more t h a n o n e j o b s i n c e  g r a d u a t i o n , a s c o m p a r e d t o a 33 p e r c e n t f i g u r e r e p o r t e d b y K r a m e r ( 1 9 6 6 ) f o r a six-month  period following graduation.  T h i s c o u l d have been  a f f e c t e d by t h e t i m i n g o f g r a d u a t i o n a n d t h e r e a d y a v a i l a b i l i t y o f summer r e l i e f p o s i t i o n s p r i o r t o p e r m a n e n t e m p l o y m e n t , o r by t h e m a r k e t c o n d i t i o n s f o r nurses which f a c i l i t a t e d j o b changes. The m a j o r e m p l o y e r s  o f t h e graduates were h o s p i t a l s (63 p e r c e n t )  and c o m m u n i t y h e a l t h a g e n c i e s ( 2 8 p e r c e n t ) .  Those b a c c a l a u r e a t e  graduates employed i n h o s p i t a l s and community h e a l t h a g e n c i e s h e l d s i g n i f i c a n t l y d i f f e r e n t service role conception scores p r i o r to g r a d u a t i o n , a s shown b y t h e r e s u l t s o f a one-way a n a l y s i s o f v a r i a n c e .  60  Conclusions The r e s u l t s o f t h i s s t u d y h a v e r e v e a l e d t h r e e f i n d i n g s o f major  importance. The f i r s t m a j o r f i n d i n g was t h e a b s e n c e  of differences i n the  r o l e c o n c e p t i o n s c o r e s o f UBC-2 a n d UBC-4 g r o u p s o f b a c c a l a u r e a t e graduates, despite differences i n educational process.  T h e UBC-2 g r o u p  had r e c e i v e d t h e i r b a s i c r e g i s t e r e d n u r s e e d u c a t i o n p r i o r t o e n t r y t o the b a c c a l a u r e a t e program and had had on-the-job e x p e r i e n c e s , w h i l e t h e UBC-4 g r o u p h a d c o m p l e t e d  f o u r years i n t h e nursing program.  Nevertheless,  t h e i r r o l e c o n c e p t i o n s c o r e s i n d i c a t e d they were r e p r e s e n t a t i v e o f t h e same p o p u l a t i o n . Columbia  T h i s f i n d i n g l e n d s credence t o The U n i v e r s i t y o f B r i t i s h  School o f Nursing p h i l o s o p h y o f b a c c a l a u r e a t e education and t h e  goals s e t o u t f o r t h e baccalaureate program.  Further, i t suggests  that  r e g i s t e r e d n u r s e s c a n be i n t e g r a t e d i n t o a b a c c a l a u r e a t e p r o g r a m a n d achieve t h e goals as s e t o u t , n o t r e q u i r i n g s e p a r a t e e d u c a t i o n as i s t h e p r a c t i c e i n most Canadian  baccalaureate programs.  The s e c o n d f i n d i n g , t h a t t h e b u r e a u c r a t i c r o l e d e p r i v a t i o n scores remained  c o n s t a n t f o r UBC-2 g r a d u a t e s b u t s i g n i f i c a n t l y  decreased  f o r t h e UBC-4 g r a d u a t e s o v e r t h e s i x m o n t h p o s t - g r a d u a t i o n p e r i o d , i n d i c a t e s t h a t t h e UBC-2 g r o u p h e l d m o r e c o n g r u e n t e x p e c t a t i o n s o f t h e difficulties, i n achieving bureaucratic loyalties within actual practice t h a n d i d t h e UBC-4 g r o u p .  T h i s i s f e l t t o be t h e r e s u l t o f the. UBC-2  group's p r e v i o u s o n - t h e - j o b e x p e r i e n c e s , with, t h e b a c c a l a u r e a t e program h a v i n g s o c i a l i z e d UBC-4 g r a d u a t e s t o be more p r e p a r e d f o r d i f f i c u l t y i n t h i s a r e a t h a n was r e q u i r e d .  The s i g n i f i c a n t decrease i n b u r e a u c r a t i c  r o l e d e p r i v a t i o n f o r t h e UBC-4 g r o u p i n d i c a t e s t h a t t h e y p e r c e i v e d t h e m -  61 s e l v e s t o be b e t t e r a b l e t o m e e t t h e b u r e a u c r a t i c demands o f h o s p i t a l e m p l o y m e n t when i n t h a t s i t u a t i o n t h a n a t g r a d u a t i o n . The t h i r d f i n d i n g was t h e o b s e r v e d s i g n i f i c a n t d i f f e r e n c e i n s e r v i c e r o l e d e p r i v a t i o n o v e r t h e s i x month p e r i o d .  While the s e r v i c e  r o l e conceptions remained c o n s t a n t , the graduates a p p a r e n t l y found t h a t c o n d i t i o n s i n the h o s p i t a l r e s u l t e d i n l e s s d i s c r e p a n c y between i d e a l s o f l o y a l t y t o p a t i e n t c a r e and w e l f a r e than t h o s e p e r c e i v e d i n a c t u a l practice at graduation.  Implications These f i n d i n g s have important implicatn'ons f o r n u r s i n g e d u c a t i o n , n u r s i n g s e r v i c e and p a t i e n t c a r e d e l i v e r y , r e s p e c t i v e l y . The a b s e n c e o f d i f f e r e n c e s i n r o l e c o n c e p t i o n s o f UBC-2 and UBC-4 g r a d u a t e s o f t h e b a c c a l a u r e a t e p r o g r a m a t The U n i v e r s i t y o f B r i t i s h Columbia i n d i c a t e t h a t the I n t e g r a t e d b a c c a l a u r e a t e program r e s u l t e d i n t h e same b e l i e f s a n d e x p e c t a t i o n s f o r n u r s i n g a t g r a d u a t i o n a n d s i x months f o l l o w i n g .  T h i s I n f o r m a t i o n I s e x p e c t e d t o be h e l p f u l t o n u r s i n g  e d u c a t o r s as t h e y e n d e a v o r t o p l a n and I m p l e m e n t c u r r i c u l a f o r g r e a t e r numbers o f b a c c a l a u r e a t e g r a d u a t e s .  I t f o c u s s e s a t t e n t i o n on t h e  two y e a r s o f b a c c a l a u r e a t e e d u c a t i o n as i n f l u e n c i n g t h e b e l i e f s values held at graduation.  last  and  The s e c o n d f i n d i n g t h a t b u r e a u c r a t i c r o l e  d e p r i v a t i o n r e m a i n e d c o n s t a n t f o r UBC-2 g r a d u a t e s and d e c r e a s e d f o r UBC-4 graduates, s i x months f o l l o w i n g g r a d u a t i o n would f u r t h e r s u p p o r t benefits of Integrated baccalaureate education.  the  The i n t e g r a t i o n o f  r e g i s t e r e d n u r s e s I n t h e f o u r y e a r b a c c a l a u r e a t e p r o g r a m may  contribute  62 to the b e n e f i t of a l l graduates with sharing of experiences observations  of practice.  The l a t t e r f i n d i n g a l s o has i m p l i c a t i o n s  nursing service administration discrepancy  i n the b u r e a u c r a t i c  i n t h a t the UBC-4 group p e r c e i v e d  T h i s c o u l d mean t h a t t h e  t o and a c c e p t a n c e o f t h e r u l e s a n d r e g u l a t i o n s o f t h e s y s t e m w e r e n o t as d i f f i c u l t as a n t i c i p a t e d .  less  adjustment  bureaucratic  T h i s w o u l d be w e l c o m e news  s e r v i c e and s h o u l d e n c o u r a g e o n g o i n g d i a l o g u e  s e r v i c e and n u r s i n g e d u c a t i o n  for  r o l e a r e a when i n v o l v e d i n a c t u a l  employment i n the h o s p i t a l s e t t i n g .  to nursing  and  between  nursing  to l e s s e n the r o l e d e p r i v a t i o n noted at  graduation. L a s t l y , the f i n d i n g that there i s a s i g n i f i c a n t decrease i n s e r v i c e r o l e d e p r i v a t i o n o v e r t h e s i x m o n t h p e r i o d has i m p l i c a t i o n s p a t i e n t c a r e d e l i v e r y and t h e g o a l s o f b o t h n u r s i n g e d u c a t i o n service administration.  and  That g r a d u a t e s found the p r a c t i c e o f  for nursing  nursing  more c o n s o n a n t w i t h t h e i r b e l i e f s a b o u t p a t i e n t c a r e and w e l f a r e when i n t h e h o s p i t a l s e t t i n g s i x months, f o l l o w i n g g r a d u a t i o n  indicates  patient care i s indeed valued within health care s e t t i n g s . the mutual goals of n u r s i n g education to a l l a y p u b l i c concerns regarding  and n u r s i n g  patient  This  that supports  s e r v i c e and m i g h t  help  care.  Recommendations f o r F u r t h e r  Study  B a s e d on t h e f i n d i n g s o f t h i s s t u d y , t h e i n v e s t i g a t o r w o u l d recommend f u r t h e r r e s e a r c h , t o e x a m i n e t h e 1.  The  r e l i a b i l i t y o f the Nursing  C o r w i n i n 1960  following:  R o l e C o n c e p t i o n S c a l e d e v e l o p e d by  with a l a r g e r sample of baccalaureate  graduates.  63 2.  The r o l e c o n c e p t i o n s o f b a c c a l a u r e a t e g r a d u a t e s e m p l o y e d i n s e t t i n g s  other than the h o s p i t a l , r e q u i r i n g a d a p t a t i o n of the Nursing Role Conception Scale. 3.  The r o l e c o n c e p t i o n s o f r e g i s t e r e d n u r s e s on e n t r y t o T h e  University  o f B r i t i s h C o l u m b i a S c h o o l o f N u r s i n g , and a g a i n on g r a d u a t i o n . 4.  The r o l e c o n c e p t i o n s o f g r a d u a t e s f r o m a v a r i e t y o f b a c c a l a u r e a t e  n u r s i n g p r o g r a m s i n C a n a d a and e m p l o y e d i n a v a r i e t y o f w o r k s e t t i n g s . 5.  The e f f e c t s o f d i f f e r e n c e s i n r o l e s o c i a l i z a t i o n on t h e r o l e  conceptions of baccalaureate graduates.  64 BIBLIOGRAPHY Benne, Kenneth, and B e n n i s , Warren. Role Confusion and C o n f l i c t Within N u r s i n g , American J o u r n a l o f N u r s i n g , 1959, L I X ( 2 ) , 196-198; LIX ( 3 ) , 380-383. B i d d l e , B . J . , and Thomas, E . J . R o l e T h e o r y : Concepts and R e s e a r c h , New Y o r k : J o h n W i l e y a n d S o n s , I n c . , 1 9 6 6 . B r i e f , A r t h u r P., A l d a g , Ramon J . , V a n S e l l , M a r y , a n d M e l o n e , N a n c y . A n t i c i p a t o r y S o c i a l i z a t i o n a n d R o l e S t r e s s Among R e g i s t e r e d N u r s e s , J o u r n a l o f H e a l t h and S o c i a l B e h a v i o r , June 1979, 20, 161-166. B r i n k , P . J . , a n d Wood, M . J . North S c i t u a t e , Mass.:  Basic Steps i n Planning Nursing Research, Duxbury P r e s s , 1978.  B r o w n , B.W., a n d H o l l a n d e r , M. S t a t i s t i c s - A B i o m e d i c a l I n t r o d u c t i o n . New Y o r k : J o h n W i l e y a n d S o n s , I n c . , 1 9 7 7 . Bruck, A r l e n e . O r g a n i z a t i o n a l Role Behavior. f o r Canada, 1970.  Ottawa:  Queen's P r i n t e r  C o r w i n , R o n a l d G. R o l e C o n c e p t i o n a n d M o b i l i t y A s p i r a t i o n : A s t u d y i n the f o r m a t i o n and t r a n s f o r m a t i o n o f b u r e a u c r a t i c , p r o f e s s i o n a l , and humanitarian nursing i d e n t i t i e s , Unpublished Doctoral Dissertation, U n i v e r s i t y o f M i n n e s o t a , 1960. C o r w i n , R o n a l d G. R o l e C o n c e p t i o n a n d C a r e e r A s p i r a t i o n s : A S t u d y o f I d e n t i t y i n N u r s i n g , S o c i o l o g i c a l Q u a r t e r l y , 1 9 6 1 , 2_, 6 9 - 8 6 . C o r w i n , R o n a l d G. T h e P r o f e s s i o n a l E m p l o y e e : A S t u d y o f C o n f l i c t i n N u r s i n g R o l e s , i n Mark A b r a h a m s o n ( E d . ) , . T h e P r o f e s s i o n a l i n t h e O r g a n i z a t i o n . C h i c a g o : Rand M c N a l l y P u b l i s h i n g C o . , 1 9 6 7 , pp. 9 3 - 1 0 2 . C o r w i n , R o n a l d G., a n d T a v e s , M a r v i n J . Some C o n c o m i t a n t s o f B u r e a u c r a t i c and P r o f e s s i o n a l C o n c e p t i o n s o f t h e N u r s e R o l e , N u r s i n g R e s e a r c h , 1962, J ! , 2 2 3 - 2 2 5 . F a r h a n g M e h r , M. S e l e c t i o n o f N u r s e ' s R o l e B e h a v i o u r s a n d I d e n t i f i c a t i o n o f D e t e r m i n a n t F a c t o r s i n Development o f Such R o l e s . U n p u b l i s h e d Master's T h e s i s , The U n i v e r s i t y o f B r i t i s h Columbia, 1977. Graen, George. Role-Making P r o c e s s e s W i t h i n Complex O r g a n i z a t i o n s , i n M.D. D u n n e t t e ( E d . ) , H a n d b o o k o f I n d u s t r i a l O r g a n i z a t i o n a l P s y c h o l o g y . C h i c a g o : Rand M c N a l l y C o l l e g e P u b l i s h i n g C o . , 1976, p p . 1201-1245.. H a l l , D o u g l a s T. P o t e n t i a l F o r C a r e e r G r o w t h , 1971, 3 4 , 1 8 - 3 0 .  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A C o m p a r i s o n o f R o l e C o n c e p t i o n s Among N u r s i n g S t u d e n t s and F a c u l t y from A s s o c i a t e Degree, B a c c a l a u r e a t e Degree, a n d D i p l o m a N u r s i n g P r o g r a m s . a n d Head N u r s e s , U n p u b l i s h e d D o c t o r a l D i s s e r t a t i o n , S t a t e U n i v e r s i t y o f New Y o r k , a t A l b a n y , 1976. P o l i t , D e n i s e F., a n d H u n g l e r , B e r n a d e t t e P. N u r s i n g R e s e a r c h : a n d M e t h o d s , P h i l a d e l p h i a : J . B . L i p p i n c o t t Company, 1978.  Principles  P u b l i c a t i o n Manual o f t h e A m e r i c a n P s y c h o l o g i c a l A s s o c i a t i o n , S e c o n d E d i t i o n , B a l t i m o r e , M a r y l a n d : P r i d e m a r k P r e s s , 1979. S a r b i n , T.R. R o l e T h e o r y , i n G. L i n d z e y ( E d . ) , Handbook o f S o c i a l P s y c h o l o g y , V o l . 1 , R e a d i n g , M a s s : A d d i s o n W e s l e y , 1954. S c h e i n , E d g a r , The F i r s t J o b D i l e m m a , pp. 2 7 - 3 7 .  Psychology Today,  March  1968,  S c h m a l e n b e r g , C l a u d i a and Kramer, M a r l e n e . B i c u l t u r a l T r a i n i n g A C o s t E f f e c t i v e P r o g r a m , The J o u r n a l o f N u r s i n g A d m i n i s t r a t i o n , D e c e m b e r 1979, pp. 1 0 - 1 6 . S c h u l e r , R a n d a l l S. R o l e C o n f l i c t a n d A m b i g u i t y as a F u n c t i o n o f t h e Task - S t r u c t u r e - Technology I n t e r a c t i o n . O r g a n i z a t i o n a l B e h a v i o r a n d Human P e r f o r m a n c e . 1977, 20, 6 6 - 7 4 .  67 BIBLIOGRAPHY - c o n t i n u e d S c h u l e r , R a n d a l l S. A R o l e P e r c e p t i o n T r a n s a c t i o n a l P r o c e s s M o d e l f o r O r g a n i z a t i o n a l Communication - Outcome R e l a t i o n s h i p s , O r g a n i z a t i o n a l B e h a v i o r , a n d Human P e r f o r m a n c e , 1 9 7 9 , 23_, 268-291 . S c o t t , W. R i c h a r d . P r o f e s s i o n a l s i n B u r e a u c r a c i e s - A r e a s o f C o n f l i c t , In Howard M. V o l l m e r a n d D o n a l d L. M i l l s ( E d s . ) , P r o f e s s i o n a l i z a t i o n . E n g l e w o o d C l i f f s , New J e r s e y : P r e n t i c e - H a l l , I n c . , 1 9 6 6 , pp. 2 6 4 - 2 7 5 . S o r e n s e n , James E. a n d S o r e n s e n , Thomas L. T h e C o n f l i c t o f P r o f e s s i o n a l s in Bureaucratic Organizations, Administrative Science Quarterly, 1974, 5 9 , 3 8 - 4 2 . S t a t i s t i c s Canada, Nursing i n Canada 1978, Ottawa: The M i n i s t e r o f Supply and S e r v i c e s Canada, J u l y 1980. T h o r n t o n , R u s s e l l , a n d N a r d i , P e t e r M. T h e D y n a m i c s o f R o l e A c q u s i t i o n , American J o u r n a l o f S o c i o l o g y , 1975, 8 0 ( 4 ) , 870-885. The U n i v e r s i t y o f B r i t i s h C o l u m b i a 6 6 t h S e s s i o n 1980-1981 C a l e n d a r , V a n c o u v e r , B.C.: T h e U n i v e r s i t y o f B r i t i s h C o l u m b i a , 1 9 8 0 , p p . 5 6 - 5 9 . U n i v e r s i t y P r o g r a m s f o r RN's, pp. 3 6 - 3 9 .  The Canadian  Nurse,  January  1980, 76(1),  Van S e l l , M a r y , B r i e f , A r t h u r P., a n d S c h u l e r , R a n d a l l , S. R o l e C o n f l i c t and Role A m b i g u i t y : I n t e g r a t i o n o f t h e L i t e r a t u r e a n d D i r e c t i o n s f o r Future Research, Human R e l a t i o n s , i n p r e s s , 1 9 8 0 . Wandelt, Mabel. Guide f o r the Beginning Researcher, New Y o r k : Appleton-Century-Crofts Educational D i v i s i o n , Meredith Corporation, 1970. Ward, M . J . , a n d F e t l e r , M.E. I n s t r u m e n t s f o r U s e i n N u r s i n g E d u c a t i o n Research. Boulder, Colorado: Western I n t e r s t a t e Commission f o r H i g h e r E d u c a t i o n , 1979.  68  APPENDIX A  NURSING ROLE CONCEPTION S C A L E  69 Code  NURSING ROLE CONCEPTION S C A L E * Instructions T h i s c o n s i s t s o f a l i s t o f 22 h y p o t h e t i c a l s i t u a t i o n s i n w h i c h nurse might f i n d h e r s e l f .  a  You a r e a s k e d t o i n d i c a t e b o t h : (A)  t h e e x t e n t t o w h i c h y o u t h i n k t h e s i t u a t i o n s h o u l d be t h e ideal for nursing.  (B)  the e x t e n t t o which you have o b s e r v e d the s i t u a t i o n i n your h o s p i t a l .  N o t i c e t h a t two ( 2 ) q u e s t i o n s m u s t be a n s w e r e d f o r e a c h s i t u a t i o n . C o n s i d e r t h e q u e s t i o n s o f w h a t o u g h t t o be t h e c a s e and w h a t i s r e a l l y t h e c a s e s e p a r a t e l y ; t r y n o t t o l e t y o u r a n s w e r t o one q u e s t i o n i n f l u e n c e y o u r a n s w e r t o t h e o t h e r q u e s t i o n . G i v e y o u r o p i n i o n s ; t h e r e a r e no 'wrong' answers. I n d i c a t e the degree to which you agree o r d i s a g r e e w i t h the statement by c h e c k i n g one o f t h e a l t e r n a t i v e a n s w e r s , r a n g i n g f r o m : STRONGLY AGREE, AGREE, UNDECIDED, D I S A G R E E , and STRONGLY DISAGREE. STRONGLY AGREE i n d i c a t e s t h a t y o u a g r e e w i t h t h e s t a t e m e n t a l m o s t no e x c e p t i o n s  with  AGREE i n d i c a t e s t h a t y o u a g r e e w i t h t h e s t a t e m e n t w i t h some e x c e p t i o n s UNDECIDED i n d i c a t e s t h a t y o u c o u l d e i t h e r ' a g r e e ' o r ' d i s a g r e e ' w i t h : t h e s t a t e m e n t w i t h a b o u t an e q u a l number o f e x c e p t i o n s in e i t h e r case. DISAGREE i n d i c a t e s t h a t y o u d i s a g r e e w i t h t h e s t a t e m e n t w i t h some exceptions STRONGLY DISAGREE i n d i c a t e s t h a t y o u d i s a g r e e w i t h t h e s t a t e m e n t a l m o s t no e x c e p t i o n s  Note.  From W a r d , M.J., and F e t l e r , M.E. I n s t r u m e n t s f o r Use i n Nursing Education Research. Boulder, Colorado: Western I n t e r s t a t e C o m m i s s i o n f o r H i g h e r E d u c a t i o n , 1979, pp. 4 1 7 - 4 2 4 . C o p y r i g h t 1960 by R o n a l d G. C o r w i n . R e p r i n t e d by p e r m i s s i o n .  with  70  STRONGLY DISAGREE-  DISAGREE  •UNDECIDED  AGREE  STRONGLY ' AGREE  H e r e i s an e x a m p l e :  Some g r a d u a t e n u r s e s i n New Y o r k h o s p i t a l s b e l i e v e t h a t d o c t o r s a r e more p r o f e s s i o n a l than nurses. A.  On t h e b a s i s o f t h e f a c t s g r a d u a t e nurses should b e l i e v e doctors are more p r o f e s s i o n a l .  B.  G r a d u a t e n u r s e s a t my h o s p i t a l a c t u a l l y do b e l i e v e t h a t d o c t o r s a r e more p r o f e s s i o n a l .  /  ', I;  V  Suppose t h a t , almost without e x c e p t i o n , you agree t h a t nurses should r e g a r d d o c t o r s a r e m o r e p r o f e s s i o n a l . T h e n c h e c k ( S) t h e f i r s t c o l u m n (STRONGLY AGREE) f o r q u e s t i o n A. S u p p o s e t h a t , w i t h some e x c e p t i o n s , y o u d i s a g r e e t h a t n u r s e s i n y o u h o s p i t a l do b e l i e v e t h a t d o c t o r s a r e more p r o f e s s i o n a l . T h e n c h e c k ( </) c o l u m n f o u r ( D I S A G R E E ) a f t e r q u e s t i o n B. Be s u r e y o u p l a c e a c h e c k mark ( ^ )  a f t e r both questions  A a n d B.  71  b u r e a u c r a t i c Items 1.  2.  3.  One g r a d u a t e n u r s e , who i s an o t h e r w i s e e x c e l l e n t nurse except t h a t she i s f r e q u e n t l y l a t e f o r work, i s n o t being c o n s i d e r e d f o r promotion, even though she seems t o g e t t h e i m p o r t a n t w o r k d o n e . A.  Do y o u t h i n k t h i s i s t h e way i t s h o u l d be i n n u r s i n g ?  B.  _Is t h i s t h e way t h i n g s a r e a t y o u r hospital?  A head n u r s e a t one h o s p i t a l i n s i s t s t h a t t h e r u l e s be f o l l o w e d i n d e t a i l a t a l l t i m e s , e v e n i f some o f them do seem impractical. A.  Do y o u t h i n k t h i s i s t h e way h e a d nurses and s u p e r v i s o r s s h o u l d a c t ?  B.  ls_ t h i s t h e way h e a d n u r s e s a n d supervisors at your hospital actually do a c t when t h e o c c a s i o n a r i s e s ?  A graduate s t a f f nurse observes another graduate s t a f f nurse, licensed p r a c t i c a l n u r s e , o r a i d e who h a s w o r k e d i n t h e h o s p i t a l f o r months, v i o l a t i n g a very important h o s p i t a l r u l e o r p o l i c y and mentions i t t o t h e head nurse o r supervisor. A.  Do y o u t h i n k t h a t t h i s i s w h a t graduate nurses s h o u l d do?  B.  Ls t h i s w h a t g r a d u a t e n u r s e s a t y o u r h o s p i t a l a c t u a l l y do when t h e occasion arises?  Q LU Q  CD Z O  LU LU  \— 00  CD <£  LU. CU. CD  LU ai CD CO  72  CD ^ O CC I— CO  When a s u p e r v i s o r a t o n e h o s p i t a l c o n s i d e r s a g r a d u a t e f o r promotion, one o f t h e most: important f a c t o r s i s the length o f e x p e r i e n c e on t h e j o b . A.  Do y o u t h i n k t h i s i s w h a t s u p e r v i s o r s s h o u l d r e g a r d as important?  B.  J_s t h i s w h a t s u p e r v i s o r s a t y o u r h o s p i t a l a c t u a l l y d_o r e g a r d a s important?  In t a l k i n g t o a c q u a i n t a n c e s who a r e n ' t i n n u r s i n g , a graduate nurse gives her o p i n i o n s about things she d i s a g r e e s with in the h o s p i t a l .  6.  A.  Do y o u t h i n k t h i s i s w h a t nurses s h o u l d do?  graduate  B.  Ls t h i s w h a t g r a d u a t e n u r s e s a t y o u r h o s p i t a l a c t u a l l y ck) when t h e occasion arises?  A g r a d u a t e n u r s e i s i n f l u e n c e d m a i n l y by the o p i n i o n s o f h o s p i t a l a u t h o r i t i e s and d o c t o r s when s h e c o n s i d e r s w h a t t r u l y "good" n u r s i n g i s . A.  Do y o u t h i n k t h i s i s w h a t g r a d u a t e nurses should consider i n forming their opinions?  B.  Is_ t h i s w h a t g r a d u a t e n u r s e s a t y o u r hospital actually d£ consider in forming t h e i r opinions?  Q UJ Q LU LU CC CD  <c  i—I  UJ CD  CJ UJ Q  ZD  UJ Q; CD <C CO i—I Q  CD Z  CC CD  Q:  OO  00  Q  o  <c  h- i-t  73  >CD  1Z.  o  Q LU  i  l—i  LU LU  cc cc I— CD  00 <t  Professional 7.  8.  9.  Items  One g r a d u a t e n u r s e t r i e s t o p u t h e r s t a n d a r d s and i d e a l s about good n u r s i n g i n t o p r a c t i c e even i f h o s p i t a l r u l e s and procedures prohibit i t . A.  Do y o u t h i n k t h a t t h i s i s w h a t g r a d u a t e n u r s e s s h o u l d do?  B.  Ls t h i s w h a t g r a d u a t e n u r s e s a t y o u r h o s p i t a l a c t u a l l y do when t h e occasion arises?  One g r a d u a t e n u r s e d o e s n o t do a n y t h i n g w h i c h s h e i s t o l d t o do u n l e s s s h e i s s a t i s f i e d that i t i s best f o r the welfare of the patient. A.  Do y o u t h i n k t h a t t h i s i s w h a t g r a d u a t e n u r s e s s h o u l d do?  B.  Is t h i s w h a t g r a d u a t e n u r s e s a t y o u r h o s p i t a l a c t u a l y do when t h e occasion arises?  A l l graduate nurses i n a hospital are a c t i v e members i n p r o f e s s i o n a l n u r s i n g a s s o c i a t i o n s , a t t e n d i n g most c o n f e r e n c e s and m e e t i n g s o f t h e a s s o c i a t i o n . A.  Do y o u t h i n k t h i s s h o u l d be t r u e o f a l l nurses?  B.  J s t h i s true o f nurses a t your hospital?  LU  CC  CD  <  o  LU Q  LU LU  CC  CD <C CO  CD  CC  C£  CO  z: CD o <c  il— ICO  >-H  Q  74  Q LU Q i—i  >_i CD  O  CC I—  10.  11.  12.  A l l graduate nurses i n a hospital spend, on t h e a v e r a g e , a t l e a s t s i x h o u r s a week r e a d i n g p r o f e s s i o n a l j o u r n a l s and t a k i n g refresher courses. A.  Do y o u t h i n k t h i s s h o u l d be t r u e o f all nurses?  B.  Is_ t h i s t r u e o f n u r s e s a t y o u r h o s p i t a l ?.  Some n u r s e s t r y t o l i v e up t o w h a t t h e y think are the standards of their p r o f e s s i o n , e v e n i f o t h e r n u r s e s on t h e w a r d o r s u p e r v i s o r s d o n ' t seem t o l i k e i t . A.  Do y o u t h i n k t h i s i s w h a t graduate nurses s h o u l d do?  B.  Is_ t h i s w h a t g r a d u a t e n u r s e s a t y o u r h o s p i t a l a c t u a l l y do when t h e occasion arises?  Some g r a d u a t e n u r s e s b e l i e v e t h a t t h e y c a n get along very well without a l o t of formal e d u c a t i o n , such as r e q u i r e d f o r a B.S., M.S., o r M.A. c o l l e g e d e g r e e . A.  Do y o u t h i n k t h a t t h i s i s w h a t graduate nurses should believe?  B.  _Is_ t h i s w h a t g r a d u a t e n u r s e s a t y o u r hospital actually d£ believe?  LU LU  CC  CD  CJ UJ CD  Q  CC  CD < OO  CD  CC  I—  OO 1-1  s: CD o < oo  Q  75  >CD  O  cc  I—  Q LU  i LU LU  cc  CD  00 <c  13.  14.  A t some h o s p i t a l s when a g r a d u a t e n u r s e i s c o n s i d e r e d f o r p r o m o t i o n , one o f t h e m o s t i m p o r t a n t f a c t o r s c o n s i d e r e d by t h e s u p e r v i s o r i s h e r k n o w l e d g e o f , and a b i l i t y to use, judgment about n u r s i n g care procedures. A.  Do y o u t h i n k t h i s i s w h a t s u p e r v i s o r s s h o u l d r e g a r d as i m p o r t a n t ?  B.  J_s t h i s w h a t s u p e r v i s o r s a t y o u r h o s p i t a l a c t u a l l y do r e g a r d as important?  Some h o s p i t a l s t r y t o h i r e o n l y g r a d u a t e n u r s e s who t o o k t h e i r t r a i n i n g i n c o l l e g e s and u n i v e r s i t i e s w h i c h a r e e q u i p p e d t o teach the b a s i c t h e o r e t i c a l knowledge o f nursing science. A.  Do y o u t h i n k t h i s i s t h e way i t s h o u l d be i n n u r s i n g ?  B.  ls_ t h i s t h e way t h i n g s a r e a t y o u r hospital?  S e r v i c e Items 15.  A t one h o s p i t a l g r a d u a t e n u r s e s s p e n d m o r e t i m e a t b e d s i d e n u r s i n g t h a n any o t h e r nursing task. A.  Do y o u t h i n k t h i s i s t h e way i t s h o u l d be i n n u r s i n g ?  B.  _Is_ t h i s t h e way hospital?  things are at your  LU LU CC CD  o I—I  o  LU Q  CC CD <C OO  76  Q UJ Q  >__i CD Z O  CC  CC  CO  <c  I—  16.  17.  18.  Head n u r s e s a n d d o c t o r s a t one h o s p i t a l allow the graduate nurse to t e l l p a t i e n t s as much a b o u t t h e i r p h y s i c a l a n d e m o t i o n a l c o n d i t i o n as t h e n u r s e t h i n k s i s b e s t f o r the p a t i e n t . A.  Do y o u t h i n k t h i s i s t h e way i t s h o u l d be i n n u r s i n g ?  B.  J_s t h i s t h e way t h i n g s a r e a t y o u r hospital?  A d o c t o r o r d e r s a p a t i e n t t o s i t up i n a w h e e l - c h a i r twice a day, but a graduate n u r s e b e l i e v e s t h a t he i s n o t e m o t i o n a l l y ready t o s i t up; t h e d o c t o r r e s p e c t s h e r o p i n i o n and changes the treatment. A.  Do y o u t h i n k t h i s i s t h e way i t s h o u l d be i n n u r s i n g ?  B.  ls_ t h i s t h e way t h i n g s a r e a t y o u r hospital?  D o c t o r s and head nurses a t t h e h o s p i t a l r e s p e c t a n d r e w a r d n u r s e s who s p e n d t i m e t a l k i n g w i t h p a t i e n t s i n an a t t e m p t t o understand the h o s i l i t i e s , f e a r , and d o u b t s w h i c h may e f f e c t t h e p a t i e n t ' s recovery. A.  Do y o u t h i n k t h i s i s w h a t d o c t o r s a n d h e a d n u r s e s s h o u l d r e g a r d as important?  B.  _Is t h i s w h a t d o c t o r s a n d h e a d n u r s e s a t y o u r h o s p i t a l a c t u a l l y do r e g a r d as i m p o r t a n t ?  LU LU CD  UJ UJ  oi CD  CC CD  <c CO  s: o o;  oi CD < oo  OO  Q  CD  i—  I-I  77  CD  O  LU LU  I— CO  CD =C  •ZL cc  19.  A graduate nurse b e l i e v e s that a p a t i e n t o u g h t t o be r e f e r r e d t o a p s y c h o l o g i s t o r a p u b l i c h e a l t h nurse and t r i e s t o c o n v i n c e t h e d o c t o r o f t h i s , e v e n t h o u g h he i s doubtful. A.-  Do y o u t h i n k t h i s i s w h a t g r a d u a t e n u r s e s s h o u l d do? Is t h i s what g r a d u a t e n u r s e s a t y o u r h o s p i t a l a c t u a l l y do when t h e occasion arises?  20.  21.  A t one h o s p i t a l t h e n u r s e ' s a b i l i t y t o u n d e r s t a n d the p s y c h o l o g i c a l and s o c i a l f a c t o r s i n the p a t i e n t ' s background i s r e g a r d e d a s more i m p o r t a n t t h a n h e r knowledge o f such o t h e r n u r s i n g s k i l l s as how t o g i v e e n e m a s , I V s , o r how t o c h a r t accurately. A.  Do y o u t h i n k t h i s i s t h e way i t s h o u l d be i n n u r s i n g ?  B.  Is_ t h i s t h e way t h i n g s a r e a t y o u r hospital?  Some g r a d u a t e n u r s e s b e l i e v e t h a t t h e p r o f e s s i o n a l n u r s e s who s h o u l d be r e w a r d e d m o s t h i g h l y a r e t h e o n e s who r e g a r d n u r s i n g as a c a l l i n g i n which one's r e l i g i o u s b e l i e f s c a n be p u t i n t o p r a c t i c e . A.  Do y o u t h i n k t h a t t h i s i s w h a t graduate nurses should believe?  B.  _Is_ t h i s w h a t g r a d u a t e n u r s e s a t y o u r h o s p i t a l a c t u a l l y do b e l i e v e ?  Q LU Q  cc  I—1  CD  CJ LU Q  cc  CD < CO  CD Z O Qi  C£ CD < CO  I  l-H  CO  Q  22.  A t some h o s p i t a l s t h e g r a d u a t e n u r s e s who a r e m o s t s u c c e s s f u l a r e t h e o n e s who a r e r e a l i s t i c and p r a c t i c a l about t h e i r j o b s , r a t h e r t h a n t h e o n e s who a t t e m p t t o l i v e according t o i d e a l i s t i c p r i n c i p l e s about s e r v i n g humanity. A.  Do y o u t h i n k t h i s i s t h e way i t s h o u l d be i n n u r s i n g ?  B.  J_s t h i s t h e way t h i n g s a r e a t y o u r hospital?  STRONGLY DISAGREE  DISAGREE  UNDECIDED  AGREE  STRONGLY AGREE  78  79  APPENDIX B  WORK E X P E R I E N C E QUESTIONNAIRE  80  Code The U n i v e r s i t y o f B r i t i s h  Colubmia  School o f Nursing Master's Thesis S t u d y — S a n d r a  Way  Q u e s t i o n n a i r e R e g a r d i n g Work E x p e r i e n c e A f t e r G r a d u a t i o n f r o m UBC Please check o r f i l l - i n t h e a p p r o p r i a t e response as i n d i c a t e d : 1.  Are you p r e s e n t l y employed? yes  Those answering  P l e a s e do not write in this section  no no, complete o n l y SECTION I  Those a n s w e r i n g y e s , b e g i n a t SECTION I I SECTION I 2.  A r e y o u s e e k i n g employment?  3.  Have y o u b e e n e m p l o y e d i n a n y s e t t i n g s i n c e g r a d u a t i n g f r o m UBC?  4.  yes  yes  no  no  I f y o u a n s w e r e d y e s t o q u e s t i o n 3, i n d i c a t e d a t e s o f employment  to d / m / y  , and type o f employing d / m / y  Hospital Community H e a l t h Agency Business/Industry Physician's Office Educational I n s t i t u t i o n Other (Please Specify)  agency.  81  P l e a s e do not write in this section  SECTION I I — 5.  M o s t r e c e n t d a t e o f commencement a t y o u r  present  p l a c e o f employment d / m / y 6.  What i s t h e t i t l e o f y o u r p o s i t i o n ? Supervisor/Assistant Supervisor Clinical  Specialist  H e a d N u r s e / A s s i s t a n t Head N u r s e General D u t y / S t a f f Nurse Community H e a l t h N u r s e Instructor/Professor Other (Please Specify) Please check t h e type o f employing Hospital Community H e a l t h Agency Business/Industry Physician's Office Educational  Institution  Other (Please Specify)  agency.  82 S i n c e g r a d u a t i n g f r o m UBC,  i f you have been employed i n p o s i t i o n s  other  than y o u r p r e s e n t p o s i t i o n , p l e a s e c o n t i n u e w i t h SECTION I I I  P l e a s e do not w r i t e in this section  SECTION I I I 8.  P l e a s e g i v e dates o f employment i n a d d i t i o n a l s i n c e g r a d u a t i n g f r o m UBC type of employing  d/m/y  d/m/y  to  to  to  specify  agency.  Dates  d/m/y  ( n o t c u r r e n t ) , and  settings  Type o f Agency  d/m/y  d/m/y  d/m/y  83  APPENDIX C  84  The U n i v e r s i t y o f B r i t i s h C o l u m b i a Master's Thesis  School o f Nursing  Study  Role Conceptions o f Baccalaureate My name i s S a n d r a Way.  Nurses  I am a s t u d e n t i n t h e g r a d u a t e  i n n u r s i n g a t The U n i v e r s i t y o f B r i t i s h Columbia.  program  I am i n t e r e s t e d i n  l e a r n i n g a b o u t how UBC b a c c a l a u r e a t e n u r s e s p e r c e i v e t h e i r r o l e s a s n u r s e s p r i o r t o u n i v e r s i t y g r a d u a t i o n , a n d when e m p l o y e d i n t h e i r nursing job following graduation.  first  As w e l l , I would l i k e t o d e t e r m i n e  t h e w o r k s e t t i n g s i n w h i c h UBC b a c c a l a u r e a t e g r a d u a t e s a r e e m p l o y e d following graduation. To o b t a i n t h i s i n f o r m a t i o n I r e q u e s t y o u r p a r t i c i p a t i o n t o complete  t h e a t t a c h e d q u e s t i o n n a i r e , form, and a f u r t h e r q u e s t i o n n a i r e  w h i c h w o u l d be m a i l e d t o y o u f o r c o m p l e t i o n l a t e r i n t h e f a l l o f 1 9 8 0 . It i s expected that completion o f the described questionnaire w i l l 30 m i n u t e s .  take  R e s p o n s e s t o t h e s e q u e s t i o n n a i r e s w i l l be c o n s i d e r e d  confidential.  A l l d a t a w i l l be c o d e d i n t o t a b l e s w i t h an a s s i g n e d  number, a n d o r i g i n a l d a t a d e s t r o y e d , s o t h a t r e s p o n s e s r e m a i n P a r t i c i p a t i o n i n t h i s s t u d y i s i n no way a s s o c i a t e d w i t h  anonymous.  course  r e q u i r e m e n t s , a n d y o u may w i t h d r a w f r o m t h i s s t u d y a t a n y t i m e . q u e s t i o n n a i r e i s completed  I f the  i t w i l l be a s s u m e d t h a t c o n s e n t h a s b e e n  given f o r p a r t i c i p a t i o n i n this  study.  If you are w i l l i n g to p a r t i c i p a t e i n this study, please 1)  t h e attached m a i l i n g address form f o r f u t u r e c o n t a c t , and  2)  the attached questionnaire.  complete:  85  APPENDIX D  86  M a i l i n g A d d r e s s Form f o r F o l l o w - U p  Questionnaire  Please print:  Name  Mailing Address  City  Postal  Code  P l e a s e check one: Program o f Nursing  Study:  UBC-4 -- C o m p l e t e d  four years o f u n i v e r s i t y nursing study  a t The U n i v e r s i t y o f B r i t i s h UBC-2 —  Columbia  E n t e r e d UBC S c h o o l o f N u r s i n g w i t h R.N., c o m p l e t e d two y e a r s o f u n i v e r s i t y s t u d y  and  87  APPENDIX E  89  APPENDIX F  

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