Data Collection Tools

Interview Schedule

There were two different interview schedules; one for NHS nurse managers including ward managers (Appendix XII); and one for recently qualified nurses (Appendix XIII).

The interview schedule for NHS nurse managers including ward managers was composed of two parts. The first part consisted of six questions (Q1-Q6) that probed their perceptions, opinions, concerns and issues related to government policies regarding nursing workforce planning. The second part focused on about their perceptions and opinions about ‘FS’ and ‘ECCFs’. Questions (Q7-Q8) were about their expectations and

Part 1 Scotland perceptions of ‘FS’ and ‘ECCFs’. The next two questions (Q9-Q10) aimed to probe the responses and changes due to these two programmes. The following question (Q11) was about their concerns and issues related to ‘FS’ and ‘ECCFs’ and their perceptions of key factors in achieving the goal of these initiatives (Q12). The last questions (Q13-Q14) explored more about the programme and asked for their comment on these matters.

The interview schedule for recently qualified nurses was composed of two parts. The first part probed their experiences of being a recently qualified nurse (Q1-Q5) while the second part was aimed at their experience of being involved in ‘FS’ and/or ‘ECCFs’ (Q6-Q15). The last questions were about their concerns or recommendations for other recent qualified nurses.

Construction of the Questionnaire

In this study, a specially designed questionnaire (Appendix XVI) was applied to examine the impact of government policies related to recently qualified nurses; ‘FS’ and ‘ECCFs’ on the nursing workforce at local level with critical care nurses and to provide a general view of the nursing practice environment in Scotland. The questionnaire included participant demographics and three further sections: in relation to change in their work place; in relation to experiences as a recently qualified nurse; and in relation to their working environment.

The first part of the questionnaire was about demographic data. Participants were asked to tick the most appropriate box for each question e.g. gender, work experience, length of registration and educational background. The questionnaire then filtered participants to a) those who had been registered for 24 months or less (recently qualified nurses) and b) those who had been registered more than 24 months. For those who had been registered for 24 months or less, they were asked to complete Sections 2 and 3. For those who have been registered for more than 24 months, they were asked to complete Sections 1 and 3.

In Section 1, perceptions of workplace change were measured by using the POWCS (Perception of Workplace Change Schedule) (3.8.1) (Nolan et al., 1998; Schofield et al., 2005). The original POWCS has 15 items in three sub-scales; Pressure, Concerns, and Strength. The researcher gained written approval from the original author and used the modified POWCS which was used in the previous international study with 16 items (Schofield et al., 2005) (see 3.8.1). The researcher gained permission to use this tool from

Part 1 Scotland Nolan36

. Minor changes were made to further understanding; for example ‘workplace change’ became ‘things have changed in relation to your work’. Participants were asked to tick the best reflective statement from five options; ‘Decreased a lot’, ‘Decreased a little’, ‘Stayed about the same’, ‘Increased a little’, ‘Increased a lot’. At the end of Section 1, participants were asked how much they were aware of government policies related to their area of clinical practice in terms of health policy and nursing workforce planning. Finally, participants were asked about their involvement in the ‘Early Clinical Career Fellowship’ and ‘FS’ programmes or projects targeted at recently qualified nurses.

Section 2 was designed only for recently qualified nurses to complete. In this section, experiences of being recently qualified were explored. A part of this section was developed by the researcher based on the results taken from a report by the Japanese Nursing Association (JNA, 2005). The JNA asked a range of questions but for the purposes of this study only two questions were used: ‘What kind of factors make it difficult for recently qualified nurses to familiarize themselves into clinical practice’; and ‘What are the reasons for recently qualified nurses to signal their intention to leave their current job’. There were 27 different answers for these two questions. Therefore the researcher grouped these 27 answers into 12 different factors. These 12 factors included for example, ‘lack of knowledge about essential nursing care’ and ‘negative feelings towards job and working environment’. The factors were then translated from Japanese into English and discussed with her supervisor regarding their equivalence. Additionally the content of Section 2, that is the translated English and original Japanese were compared by bilinguals. Back translation was carried out on the entire questionnaire [English to Japanese] and was deemed appropriate.

In Section 2, participants were asked to tick the most appropriate box for each factor. The options for the answers were ‘A great deal’, ‘Very much’, ‘to some degree’, ‘a little’, and ‘Not at all’. There were also three open-ended questions. The first asked if there were any other factors that made it difficult for them to familiarise themselves into clinical practice. The second one asked them to identify the factors that made it easy for them to familiarize themselves into clinical practice. The last one asked them to describe the organisational support they had had since they started working. Participants were also asked how satisfied with ‘FS’, ‘ECCFs’, and their experience of being a recently qualified nurse.

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Part 1 Scotland Section 3 was designed for all registered nurses to complete. In this section, their perceptions of the hospital nursing practice environment were measured with the PES- NWI (Practice Environment Scale-Nursing Working Index). The PES-NWI was adapted from the published paper for the purpose of this study (Lake, 2002). The original tool was developed in the USA. Because there were organizational, political and cultural differences between hospitals in the USA and UK, several changes were made in specific words for clearer understanding with British English under the advice of supervisor (e.g. ‘administration’ to ‘hospital’, ‘A chief nursing officer’ to ‘Division’s Nursing Lead’, ‘supervisors’ to ‘managers’.) In addition, several statements were rephrased to provide a clearer understanding of statement after discussion with the supervisor. For example, ‘collaboration between nurses and physicians’ was rephrased to ‘We have collaboration between nurses and physicians’ and ‘Adequate support services allow me to spend time with my patients’ rephrased to ‘Our hospital believes that it is important for me to spend time with my patients’. Initially, the PES-NWI had 31 items to measure the hospital nursing practice environment in 5 subscales (Nurse Participation in Hospital Affairs, Nursing Foundations for Quality of Care; Nurse Manager Ability, Leadership, and Support of Nurses; Staffing and Resource Adequacy; Collegial Nurse-Physician Relations). However, one item, ‘Use of nursing diagnosis’, was omitted after the discussion with supervisor because it was concluded that this item does not measure the nursing practice environment in the UK and it was also omitted from another study (Aiken et al., 2008). Participants were asked to scale from 1-4 (‘strongly agree’, ‘somewhat agree’, ‘somewhat disagree’ and ‘strongly disagree’), to express their level of agreement to the statements. At the end of this section, participants were asked their intention to leave their current job and nursing with five different options; ‘Never’, ‘Occasionally in the last 12 months’, ‘Sometimes every month’, ‘Sometimes every week’, ‘Every day’.