The Registered Practical Nurse (RPN) Role in an Academic Acute Care Hospital: A Mixed Method Study of the Barriers and Facilitators to Practice
Bibliographic record
Abstract
Background . Registered Practical Nurses (RPNs) are considered a critical component of high functioning nursing and interprofessional care teams. Therefore, it is important to ensure that RPNs feel valued within their roles within acute care settings. High acute care demands in tandem with unsupported workplace environments can lead to increased levels of job dissatisfaction, burnout, and ultimately impact retention. Identifying and examining the barriers and facilitators that enable RPNs to be optimally equipped within acute care are critical towards ensuring success in their role. In this study, we explore the experiences of RPNs and perspectives of nurse leaders on RPN integration into an acute care setting. Methods . A mixed method study among RPNs ( n = 10) and nurse leaders ( n = 10) was conducted. This included administration of the Assessment for Collaborative Environments (ACE‐15) tool to measure interprofessional integration, collaboration, and teamwork. Semi‐structured interviews were also held with all participants to explore both the lived experiences of RPNs in the acute care environment and the perspectives of nurse leaders who had supported the onboarding and integration of RPNs. Results . Our inductive content analysis identified 5 themes: preintegration process, nursing team dynamics, RPN role clarity, challenges to RPN integration, and benefits to RPN integration. ACE‐15 data showed no significant differences in the level of teamness and internal disagreement between RPNs and nurse leaders (t (17) = 0.37 and p = 4.60). RPNs reporting a higher level of teamness described a more positive integration experience than those who reported a lower level of teamness. Conclusion . The integration of a new role to existing teams brings both benefits and challenges which are experienced uniquely by RPNs and nurse leaders. Nurse leaders can utilize findings of this study to better prepare their staff and units for the integration of new roles into their models of care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".