The role of physical design and informal communication

In their study of the factors that influence the learning ability of nurses, White
et al. (1998) found that learning from peers facilitated integration of knowledge into
nursing practice. Information from focus group interviews revealed that peers were
perceived to be “unofficial resources” who provided education “on an as-needed basis
– informal learning.” Ready accessibility of information from colleagues who were on
the floor was crucial. One nurse summarized by saying: “…the easier the access, the
easier the learning.” In an ethnographic study designed to investigate how nurses
learn, Hunter, Spence, McKenna, and Iedema (2008) found that the orientation of new
staff included informal, incidental, interpersonal, and interactive forms of learning.
On-the-job learning took the form of role modeling where nurses who were skilled at
performing certain procedures supported those who were unaccustomed to the
practices. Less-experienced nurses called on their more experienced peers for advice,
and this practice mediated the overwhelming feeling that resulted from being in such
an intense learning environment.
We can summarize the literature reviewed up to this point with the following
broad statements:
• Work-induced stress in nurses significantly contributes to high rates of
nurse turnover, which exacerbates the current national nursing
shortage.
• In the transition from the role of a student to the role of an RN,
graduate nurses experience tremendous amounts of stress largely due to
a perceived lack of knowledge and skill that is required to function
independently in the clinical environment.
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