title: Is anybody listening? A qualitative study of nurses' reflections on practice.
abstract: OBJECTIVE
  To explore nurses' perceptions of the reality of practice based on data from the Nurses and Midwives e-cohort Study which examined the workforce characteristics, work-life balance and health of nurses.
  
  
  BACKGROUND
  Recruitment and retention of the nursing workforce is of international concern as demands increase due to demographic changes, political pressure and community expectations, in a climate of economic constraint.
  
  
  METHODS
  Qualitative analysis of data from a cohort of Australian, New Zealand and UK nurses.
  
  
  METHODS
  Of the 7604 participants in the electronic cohort, 1909 provided qualitative comments of which 162 related to nursing practice; thematic analysis resulted in four high order themes. The analytical discussion is structured around 'care' as the organising construct.
  
  
  RESULTS
  Four themes emerged: 'embodied care' which discusses the impact of work on the nurse's physical and emotional health; 'quantity/quality care' which addresses increasing pressures of work and ability to provide quality care; 'organisational (non)care' raising the seeming lack of support from management; and '(un)collegial/self care' where bullying and professional relationships were raised.
  
  
  CONCLUSIONS
  Issues raised by participants have been discussed in the nursing literature for several years yet nurses still experience these negative aspects of nursing. It appears there is a significant gap between what is known about the practice environment, recommendations for change and change occurring: the management equivalent of the theory-practice gap, resulting in nurses intending to leave the profession.
  
  
  CONCLUSIONS
  Research demonstrates that a well-qualified, stable nursing workforce improves quality of health care and health outcomes. Changing the work environment and fostering a positive workplace culture seems fundamental to supporting the retention of nurses, that this is not occurring in some areas in the current climate is a concern for the profession and those responsible for the provision of care.
authors.affiliation: Massey University, Wellington, New Zealand. a.d.huntington@massey.ac.nz
authors.forename: Annette
authors.initials: A
authors.lastname: Huntington
authors.forename: Jean
authors.initials: J
authors.lastname: Gilmour
authors.forename: Anthony
authors.initials: A
authors.lastname: Tuckett
authors.forename: Stephen
authors.initials: S
authors.lastname: Neville
authors.forename: Denise
authors.initials: D
authors.lastname: Wilson
authors.forename: Catherine
authors.initials: C
authors.lastname: Turner
mesh_terms: D001315:Australia; D015331:Cohort Studies; D006801:Humans; D009520:New Zealand; D009726:Nurses / Q000523:psychology*; D006113:United Kingdom