The Process of Role Acceptance among Female Nurses: A Case Study of Imam Khomeini Hospital, Khalkhal, Iran

Following their graduation and when accepting their professional role, nursing students enter an environment which involves conditions and values that are relatively different compared to the atmosphere at universities while sensing a large gap in this regard. Subsequently, novice nurses cannot become properly adapted to these conditions as a result of the present contradictions between expectations and the reality of such a work place. The present study was conducted in line with explaining the process of accepting the role of nursing as well as its facilitating and preventive factors through the view of nurses.



One of the factors that is influential in increasing work efficiency is congruence between an occupation and the individual’s expectations. As a result, job conflict or contradiction is an organizational variable that negatively affects the individual’s job performance. A number of different factors result in conflicts such as individual or characteristic issues, system failure, organizational relations, problems related to the organizational structure, lack of resources, facilities and weak management. The present study was conducted using the qualitative method, the grounded theory, and the lived experience approach along with the views of 15 nurses obtained through semi-structured in-depth interviews. There are various definitions and interpretations regarding this theory which can simultaneously be regarded as a method. Considered as the founders of this theory, Glaser and Strauss believe that this is a constant comparative analysis method based upon the idea of the possibility of the formation of a theory of social sciences according to systematic data, derived from the social context, and an orderly and logical means of data collection and analysis so as to obtain a theoretical framework. The qualitative method allows researchers to take a close look at the data through which they are able to obtain the analytical and conceptual aspects. The total population of the study included 122 nurses (113 official and contractual nurses and 9 interns) currently working at Imam Khomeini hospital in Khalkhal, Iran, with a minimum of 1-year working experience. The number of subjects in qualitative studies cannot be predicted at the beginning. The sample population is indicated using the collected data and its analysis; and sampling is continued until data reaches saturation. Subsequently, 15 nurses at this hospital were interviewed based on data saturation. In this study, the participants were initially selected purposefully and then chosen based on constant comparative analysis of data, emergence of conceptual classes during data analysis, and in accordance with the requirements of the study in a theoretical manner. The process of selecting the participants continued until conceptual and theoretical saturation was reached. After each interview was conducted, the researcher would write down the data and compare it to the previous interview. Then, similar data was integrated and placed in a group; for each class, a title was selected which was representative of the codes placed within that class. This process was repeated in subsequent interviews where the appeared codes at each interview were compared and contrasted with the previous interview code; in case of finding similarities or disparities, they would be placed in previously-formed classes or a new class, respectively. The analysis of interviews conducted with the participants on the experiences of nurses regarding the process of accepting the nursing role resulted in the extraction of four stages including: Motivation, Obstruction, Rethinking and Role Correction, and Adaptation.

Accepting the nursing role is a process which involves shifting from a balanced state, passing through an unstable state and gaining a new balanced state, in which at least two aspects (the nurse and the atmosphere) are taken into account for novice nurses. Role acceptance is a process-oriented phenomenon which leads to the engagement of individuals as a response to change. Furthermore, as a stressful experience and a period of stress, doubt, fear, and conflicts and a process formed in response to change, this process entails a complex set of responses to the new role which involves an invisible, hidden, difficult, challenging, hard, stressful, and complicated nature through a period of instability, vulnerability, and inevitability. This process includes aspects such as change, difference, and engagement. Some would go through such a period fast, while others would take slower steps by tolerating various problems and shortcomings. In this period, nurses are engaged in restoring their roles and changing their characteristic structures. In addition to identifying the features of the role acceptance process, this analysis also revealed motivation, obstruction, rethinking and role correction, and adaptation as well as facilitating factors and barriers against successful shifts. During the process of role acceptance, nurses may suffer from numerous undesirable emotions, particularly a sense of insecurity, instability, and obstruction due to their lack of sufficient practical skills, inconsistency between the hospital’s environment and nurses’ expectations, and new requirements which are consequences of the status quo; nurses would then be involved with role correction by reforming and rethinking their roles and performances, mitigating the present instability and adapting to their work place. Accordingly, they would become a part of treatment process, playing their clinical roles, accepting hospital and work place norms, and cooperating with medical teams. Consequently, an understanding of the features of this process results in the elevation of the position, significance, and application of this notion within the nursing profession, particularly for novice nurses; it could also be employed as a tool to conduct more examinations and research as well as expanding the body of knowledge revolving around this profession.