조기 이직 신규간호사의 태움 경험

Abstract

The purpose of this study was to explore the experience of bullying described by newly graduated nurses who left their nursing jobs. A qualitative research methodology was adopted. Eleven newly graduated nurses who left nursing were recruited using a convenient sampling method. Data were collected through individual in-depth interviews with open-ended questions from November 27, 2018 to April 17, 2019. The collected data were analyzed using a content analysis method. The findings are as follows. 1. The experience of bullying among newly graduated nurses who left their jobs within one year of becoming nurses was classified into five themes and 14 categories. The five themes are: ‘confused with the emotional and inconsistent training received from senior nurses’, ‘awkward position of newly graduated nurses due to strict hierarchical working environment’, ‘being physically and psychologically exhausted’, ‘finding every possible way to escape from the bullying’, and ‘not being able to see myself growing as a professional nurses at current workplace, leaving for a new career path. 2. The experience of newly graduated nurses of having been bulled and who left their jobs are as follows. Research participants expressed their opinions that the training they received by their senior nurses was emotionally driven and inconsistent. Senior nurses provided the newly graduated nurses with little information during their busy work hours while requesting them to immediately take on the new tasks taught. When there were mistakes made by newly graduated nurses, senior nurses were often said to have bullied newly graduated nurses by treating them as if the latter were insignificant or by yelling at them. Research participants, in particular responded that they could not express their own opinion due to the strictly hierarchical working relationship. In addition, newly graduated nurses felt disappointed for not receiving support from senior nurses. Opportunities to apply for rotational posts or duties, as well as overtime pay, were often not granted to newly graduated nurses and irrational practices were often endured by newly graduated nurses in the strict and controlled work environment. Newly graduated nurses expressed their views that the tasks given to them were menial and increased their work burden, making them physically and psychologically exhausted. Too much of a work load made them desire a break and often made them feel as if their physiological needs were not met, especially when they were unable to go to the restroom when they wanted to or when they had no choice but to skip meals due to time constraints. Moreover, they felt psychologically bullied due to the coldness of senior nurses. Humiliating insults made them sad, while being reprimanded via abusive language made them felt resentful and distressed. Newly graduated nurses felt pain when their performance was pointed out as not up to par as it made them emotionally upset. Newly graduated nurses often study hard to adapt to a challenging and unfamiliar environment, take notes on new tasks and work processes, and their areas of improvement. They try to reduce mistakes by taking notes. They were also active in harnessing a working relationship with the staff at the clinic and participated in extracurricular activities to escape from bullying. Also, the participants responded that they had been friendly and acted with charm to bond better with senior nurses and took on a positive attitude to help other members taking care of the ward. On the other hand, newly graduated nurses thought they could do better as time passed, as they believed that the current difficulties were due to not being familiar with the new tasks. Once they became more skilled at the tasks, they had higher expectations of themselves to perform better in their job, and perhaps even better than the senior nurses someday. They tried to forget about and endure their difficulties through seeking consolation by posting their thoughts on social media, receiving comments from others on their posts and chatting with their co-workers. Newly graduated nurses asked for help from chief nurses but often the chief nurses responded as if the situation was due to the lack of competency on the part of the newly graduated nurses, which leads to bullying. In other cases, the chief nurses would just comforted them with words by saying that things get better over time and did not offer any concrete help. Newly graduated nurses witnessed that even senior nurses suffered from workplace bullying and that they were unable to escape it. They observed that the bullying was passed down from them to newly graduated nurses, and the motive to be reliant upon someone would lead to another form of bullying, which they described as painful experience in a human relationship. Also, newly graduated nurses felt fear that they themselves would change negatively over time in the busy work environment, and also felt unhappiness working as a nurse. They experienced inner conflicts as to their identity as a nurse and worried about never improving. Newly graduated nurses left their jobs due to repetitive bullying as it seemed unlikely that the situation would improve and chose to quit the job for more psychological stability. Also, they expressed an intention to move after realizing the reality and decided to put their efforts towards doing better as they broadened their horizons. From these findings, it is evident that the bullying experience of newly graduated nurses had a negative impact on their adaptation to their tasks and to their professional growth. Preventing bullying which is targeted at newly graduated nurses is regarded as a challenging issue from the perspective of each individual. It is therefore suggested that practical measures be put in place by the organization, as well as intervention strategies to address this issue. The findings of this study is meaningful in that it provides data on possible ways to develop systematic mediating programs for an improved work environment for nurses.;본 연구는 조기 이직한 신규간호사가 간호 현장에서 체험한‘태움’의 의미를 파악하고 그들의 태움 경험을 이해하여, 이를 근거로 문제해결을 위한 조직적 차원의 체계적인 중재 전략의 필요성 제시 및 간호환경 개선을 위한 프로그램 개발의 기초자료를 제공하고자 시도되었다. 연구방법은 질적 연구방법을 사용하였으며, 자료 수집을 위해서 온라인 간호사 커뮤니티에 공고하여 대상자를 모집하였고 심층면담을 이용하였다. 연구 참여자는 간호사 면허를 취득한 후 첫 근무지인 의료기관에서 태움으로 인해 1년 이내에 이직한 신규간호사 11명이었다. 자료 수집은 2018년 11월 27일부터 2019년 4월 17일까지 비구조적이고 개방적인 질문을 통해 평균 80분 동안 개별 면담을 실시하였다. 수집된 자료는 내용 분석 방법을 이용하여 분석하였고 결과는 다음과 같다. 1. 연구 결과 조기 이직한 신규간호사의 태움 경험은 5개의 주제와 14개의 범주로 도출되었다. 5개의 주제는 ‘선임의 감정적이고 일관성 없는 신규교육에 혼란스러움’, ‘엄격한 위계질서에 설 곳이 없음’, ‘신체적 ․ 심리적으로 지쳐감’, ‘태움에서 벗어나기 위해 다양한 방법을 시도함’, ‘전문직 간호사로서 미래가 그려지지 않아 새로운 길을 찾아 떠남’이였다. 2. 조기 이직한 신규간호사의 태움 경험을 종합적으로 기술하면 다음과 같다. 연구 참여자들은 선임으로부터 받는 교육을 감정적이고 일관성 없는 교육으로 표현하였다. 참여자들은 미숙한 부분에 대한 가르침 과정에서 선임들로부터의 배움을 감정적 가르침으로 느꼈다. 바쁜 업무 환경에서 한번 알려준 내용을 한 번에 스펀지처럼 흡수하길 원했으며, 업무 미숙 시에는 신규간호사를 투명인간 취급을 하여 주눅들게 하였다. 또한 연구 참여자들은 선임마다 다른 교육 지침으로 일에 대한 기준을 세울 수 없어 혼란스러웠다고 하였다. 연구 참여자들은 위계적이고 경직된 분위기의 병동에서는 연차 간의 서열 관계가 분명하여 정당한 이유가 있어도 반대의견을 개진하기 어려웠으며, 존중받지 못하고 있다고 생각하였다. 특히, 경직된 상하 관계에 놓여있는 프리셉터 앞에서 업무 수행이 긴장되고 역량을 발휘하기 어려워하였다. 로테이션 신청, 시간 외 수당 신청, 근무 신청 등에서 신규간호사라는 이유로 배제되는 불합리함을 감수해야 했다. 연구 참여자들은 모든 것이 서툴고 버거운 상황에서 신체적, 심리적으로 지쳐갔다고 표현하였다. 버거운 업무로 인해 휴식의 간절함을 느꼈고, 근무 중 식사를 거르거나 화장실을 못 갈 정도로 일에 치여 생리적 욕구 해결에 어려움을 호소하였다. 또한 선임의 냉랭한 표정에 심리적 위협을 느끼고 주눅이 들며, 공개적인 장소에서 이루어지는 질책과 폭언에 인격적인 모욕감을 느꼈다. 연구 참여자들은 힘들고 낯선 환경에서 적응하기 위해 다양한 방법을 시도하였다. 업무에 대한 복습을 더 철저히 하며 업무 실수를 줄이기 위해 노력하였다. 병동 구성원과의 관계, 간호업무 외에 적극적으로 참여함으로써 선임과의 관계를 쌓고 태움에서 벗어나기 위해 노력하였다. 한편 연구 참여자들은 태움이 이루어지는 상황이 자신의 업무 미숙으로 생각하고 시간이 지나면 좋아질 것이라 믿으며 무조건 참고 버티려고 노력하였다. 심리적인 어려움을 개인 SNS와 동기들과의 소통으로 위로를 받아 어려움을 잊고자 노력하였다. 연구 참여자들은 수간호사에게 도움을 요청하였지만, 직접적으로 도움을 받지는 못했다. 연구 참여자들은 한 번 태움의 타깃이 되면 사직할 때까지 태움에서 벗어나기 힘들고, 연차가 올라가도 태움이 지속된다고 하였다. 태움의 피해자가 시간이 지나고 가해자가 되는 태움의 대물림 현상을 목격하였고, 의지하고 싶은 동기도 태움의 가해자가 되는 모습을 보고 고통스러운 인간관계 경험으로 표현하였다. 전문직으로서 간호 정체성이 흔들리는 갈등을 경험하였고, 나아지지 않는 간호사 처우에 대해 걱정하는 표현을 하였다. 연구 참여자들은 개선될 여지가 없이 반복되는 태움에 계속 일하기를 포기하였다. 참여자들은 건강한 환경에서 개인의 전문직으로서 발전과 함께 간호대상자에게 더 좋은 간호를 제공하고자 간호사로서 재취업에 대한 의지를 표현하였다. 이상의 연구 결과 간호 현장에서 조기 이직을 한 신규간호사의 태움 경험은 간호사 개인 뿐 아니라 간호업무와 간호전문직 정체성에 부정적인 요인으로 작용하였음을 이해하였다. 신규간호사에 대한 태움은 개인적 차원에서 해결하기 어려운 부분임을 인식하여 조직적 차원에서 해결하려는 실질적 노력과 체계적인 중재 전략의 필요성을 제시하고 간호환경 개선을 위한 프로그램 개발을 위한 자료로 본 연구결과가 활용이 가능하다는 데 의의가 있다.