A Phenomenological Study on the Experiences of Nursing Home Nurses

A Phenomenological Study on the Experiences of Nursing Home Nurses | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Phenomenological Study on the Experiences of Nursing Home Nurses Nilay ERCAN ŞAHİN, Mücahide ÖNER This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5973903/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 01 Jul, 2025 Read the published version in BMC Nursing → Version 1 posted 8 You are reading this latest preprint version Abstract Backgorund: The nursing home is a multifaceted environment where residents, many of whom have multiple chronic conditions, typically spend their final years receiving care. Being a nurse in a nursing home is a challenging and multifaceted role that demands a range of skills. The study aimed to explore the experiences of nursing home nurses, with the aim of gaining a deeper understanding of what it means to be a nurse in a nursing home, both professionally and personally. Methods: Seventeen nurses working in nursing homes in Ankara, Turkey were recruited between June and Agust 2024 for a descriptive phenomenological study. Data were collected through in-depth face-to-face interviews and analyzed using thematic analysis. The study was reported according to the Consolidated Criteria for Reporting Qualitative Research Checklist. Findings: Six themes emerged from descriptive analysis “Transformation”, “Wish to Die Before Experiencing Aging”, “Needs and Shortcomings in Older Adults Care”, “Communication Challenges”, “Struggles with Professional Fulfillment”, “Perspectives on Aging in Residential Care”. Conclusions: This study demonstrates that working with older adults in nursing homes can be highly stressful for nurses, potentially leading to negative effects on their professional and personal experiences. experiences nurse nursing home qualitative research Figures Figure 1 Figure 2 Background A rising older population, along with a higher incidence of dementia and other chronic illnesses, is leading to increased demand for nursing home care [ 1 ]. The nursing home is a multifaceted environment where residents, many of whom have multiple chronic conditions, typically spend their final years receiving care. Being a nurse in a nursing home is a challenging and multifaceted role that demands a range of skills [ 2 ]. The nurses must be skilled at identifying, reflecting on, and addressing practical, medical, and ethical challenges that come up throughout the day. Their responsibilities are diverse, encompassing assessment, health promotion, risk management, and end-of-life care [ 3 ]. These responsibilities of nurses are recognized as key factors affecting their decision to remain in their current roles within the facility [ 4 ]. Upon reviewing the literature, numerous studies focus on nurses working in nursing homes or long-term care facilities. These studies often examine topics such as job satisfaction, workload, burnout, and the roles and responsibilities of nurses in elderly care. According to these studies results, the work environment in nursing homes is often challenging due to high patient-to-nurse ratios and the emotional toll of caregiving. These challenges can lead to role ambiguity and job dissatisfaction, which in turn negatively impact the quality of care provided [ 2 , 5 – 10 ]. Moreover, the literature highlights that nursing home nurses often struggle to provide essential care due to limited time or resources, resulting in a higher prevalence of missed care and impacting the quality of care provided and the health outcomes of residents [ 5 , 11 – 15 ]. This issue is especially critical for residents with complex, long-term medical needs, where insufficient care can lead to worsened health outcomes and a decrease in quality of life. Furthermore, studies frequently address the psychological resilience of nurses working in these settings, their work-life balance, and stress management. Nurses working in nursing homes often experience high levels of stress due to the demanding nature of the job, emotional exhaustion, and the difficulty in balancing personal and professional lives. The lack of adequate support systems, such as peer networks or mental health services, can exacerbate these stressors, leading to burnout and increased turnover rates [ 9 , 16 – 20 ]. Additionally, it was noted that working conditions, job satisfaction, burnout, nurse characteristics, relationships with residents, and work relationships significantly contribute to turnover, which remains a persistent challenge in nursing homes settings. Factors such as poor management, lack of professional development opportunities, and inadequate compensation are cited as critical contributors to nurse turnover. This turnover not only affects the continuity of care but also exacerbates staffing shortages, further increasing the burden on the remaining staff [ 4 , 12 , 21 ]. In addition, older adult care services are more vulnerable to turnover than hospitals, and many nurses preferred working in hospitals over nursing homes [ 22 ]. These studies provided insight into the challenges faced by nurses in these environments and the strategies they use to cope with these challenges. The literature offers extensive findings on various factors related to nurses' work in nursing homes and their professional roles. Moreover, the literature includes many qualitative studies on nursing home nurses' experiences related to resident relationships[ 23 ], training needs [ 24 ], emergency transfers [ 25 ], nursing care [ 26 – 28 ], ethical challenge [ 29 , 30 ]. However, no study has been found that specifically explores how the experiences of nursing home nurses working with older adults impact them and their profession. This gap is significant, as understanding the emotional, ethical, and professional challenges faced by these nurses is crucial for improving the quality of care provided to older adults. Thus, this study will address this gap by providing in-depth insights focused on the lived experiences of nursing home nurses caring for older adults. It is anticipated that revealing the experiences of nurses in elderly care, a demographic of increasing importance in the aging world, will offer valuable guidance on priorities at the levels of education, practice, research, and policy for nurses. Methods Study Design This study utilized a descriptive phenomenological approach to examine how the experiences of nursing home nurses working with older adults affect them and their profession. In this study, a descriptive phenomenological approach based on the philosophical foundations of Edmund Husserl was adopted to reveal the subjective meanings of nurses’ lived experiences. This approach aims to describe the essence of individuals’ experiences by bracketing the researcher’s preconceptions [ 31 ]. The Consolidated Criteria for Reporting Qualitative Research checklist was used to ensure quality reporting in the study [ 32 ]. Participant The research was conducted with nurses working in nursing homes in Ankara, Turkey. To gain a deep and comprehensive understanding of a complex experience, this study utilized purposive sampling, a non-probability sampling method, and participants were reached through the snowball sampling technique. The inclusion criteria required participants to have at least one year of experience in a nursing home and a willingness to participate voluntarily. The first interview was conducted with a nursing home nurse known to the second author, and subsequent participants were selected based on the recommendations of the interviewed nurses. This approach facilitated access to nurses working in different nursing homes in Ankara. The sample consisted of nurses working in both public and private nursing homes, with varying levels of education and years of experience, to achieve data triangulation. Twenty-six nurses were recruited through snowball sampling; however, after being informed about the study, seven declined to participate. Data Collection The interviews were conducted between January and February 2024. Data were collected through open-ended, semistructured interviews guided by an interview protocol (Fig. 1). Prior to each interview, participants provided informed consent and completed a demographic form capturing details such as educational background, total nursing experience, and years of experience in nursing homes. Using the semistructured guide, participants engaged in a single, in-depth, face-to-face interview lasting approximately 35–40 minutes, which was audio-recorded. The interviews were conducted in Turkish by the principal investigator, a female associate professor with a PhD in public health nursing, in a quiet and private room at the nursing home to ensure confidentiality. Field notes were also recorded during or immediately after the interviews. Data collection and analysis were carried out simultaneously, and sampling was stopped when data repetition occurred and data saturation was achieved. Therefore, the interviews were concluded after the 17th interview. The transcripts were provided to the nurses for their feedback. Data Analysis The audio-recorded, semistructured, in-depth individual interviews were transcribed verbatim by the second author, with the first author meticulously crosschecking the transcripts for accuracy. The interviews were organized, and the data were coded using the MAXQDA software. The seven-step analysis method developed by Colaizzi [ 33 ] was used to analyze the data. In the first step, the recordings were listened to repeatedly by the researchers. In the second step, the researchers analyzed the interviews one by one. In the third step, initial codes were created. In the fourth step, the first codes were organized as themes. In the fifth step, themes and sub-themes were formed. In the sixth step, the researchers defined the themes and sub-themes broadly. In the last step, participant statements describing the phenomenon were determined. Finally, the main themes and their associated subthemes were identified, representing the key content of the interviews. Written notes and observations made during data collection were compared with the data from group discussions, ensuring the study's findings were validated and corroborated. Trustworthiness To demonstrate the reliability of the study, the confirmability, reliability, and transferability strategies proposed by Guba and Lincoln [ 34 ] were utilized. In this context, no changes were made to the participants' quotations to ensure confirmability, and all notes, transcripts, and data collection tools were kept for re-examination. To ensure reliability, both researchers were involved in the data analysis and interpretation process. To ensure transferability, detailed information about the semi-structured interview form, participant characteristics, sampling method, and research method was provided. Ethical considerations Ethical approval was obtained from the Bitlis Eren University Ethics Committee (number E.3893, date: 7 July 2023). All participants were informed verbally and in writing before the interview and verbal and written informed consent was obtained from the participants. The study was conducted by ethical standards and the Declaration of Helsinki. Results Among the study participants, 13 were female and 4 were male, with ages ranging from 24 to 44 years and nursing experience in nursing homes ranging from 1.5 to 15 years (Table 1 ). The descriptive analysis of nursing home nurses’ experiences identified six themes “Transformation”, “Wish to Die Before Experiencing Aging”, “Needs and Shortcomings in Older Adults Care”, “Communication Challenges”, “Struggles with Professional Fulfillment”, “Perspectives on Aging in Residential Care” (Fig. 2 ). Table 1 Characteristic of participants Participants Educational Level Nursing home Years of nursing experience Years of nursing experience in nursing home 1 Undergraduate Private 3 1.5 2 High school Public 11 9 3 Undergraduate Private 6 4 4 High school Public 8 1.5 5 High school Public 5 3 6 Master Private 2 2 7 High school Public 9 5 8 High school Private 2 2 9 High school Public 14 11 10 Undergraduate Public 13 3 11 Undergraduate Public 18 10 12 Undergraduate Private 6 6 13 Undergraduate Public 13 10 14 High school Public 6 5 15 High school Public 11 7 16 Undergraduate Public 2 2 17 Master Private 17 15 Theme 1. Transformation This theme examines how nurses transform as they care for the nursing home residents. All nurses reported changes in their perceptions of aging, outlook on life, and views on death. Interacting with older adults resulted in significant transformations and growth in the participants' perspectives on life. Subtheme 1.1.Transformation in Life Outlook Nurses indicated that work experience led to a life with fewer expectations and less dreaming. The participants stated the following: "…. For example, I have been here for three years. Sometimes, there are dreams that we have; this is true for everyone, after working here, I have begun to view things a bit more realistically. People often live as if nothing will happen to them and direct all their dreams accordingly. However, after my time here, I can say that it has led me to a life with fewer expectations... " (P5) "I’ve come to realize that you shouldn’t really dream too much about life here. Reaching high positions doesn’t mean much, and no matter how many people are around me, I sometimes think that in 10 or 15 years, or maybe at the end of life, I’ll die alone or end up being alone." . (P8) Subtheme 1. 2. Transformation in Views on Aging Participants expressed that their emotional attachment to old age has weakened, that the perception of older people has changed over time, and that aging is perceived as a frightening process. While the participants' thoughts on aging are transformed with the impact of their experiences, factors such as emotional distance, fear, and efforts to understand come to the fore in this process. " When you start aging, in my opinion, as you get older, you fall back from the stage of a 10-year-old child. For example, if a person starts aging at the age of 70, he/she is 10 years old for me, when he/she turns 80, he/she is 5 years old for me, and when he/she turns 90, he/she is 3 years old, and this changes when chronic diseases are added to this ." (P1) " When I reflect on aging from my own perspective, I realize it has been a frightening process for me. I didn’t fully understand its implications before. The elderly figures I knew, like my grandparents, appeared to be just two people in the larger picture of old age, but now I see that their lives represent a much deeper and more complex experience ." (P6) Theme 2. Wish to Die Before Experiencing Aging Participants expressed the anxiety and sense of helplessness caused by the physical and mental challenges of old age. Old age was associated with powerlessness and dependency. “At the moment, I see old age as a disease, and I wish to die before I grow old. I believe that old age brings a great deal of helplessness.” (P4) "Honestly, I’d like to live until I’m around 60 and not see any more than that. I mean, while I’m still healthy and able to take care of myself. After elderly people are admitted here, they find themselves in situations where strangers are changing their diapers or helping them with baths—people they’ve never met before. I think these are important things, and when empathy is in place, it becomes a challenging situation. I hope I die before reaching that point. " (P7) Theme 3. Needs and Shortcomings in Older Adults Care In this theme, it was stated that there are deficiencies and difficulties encountered in the health services and care of older adults due to the deficiencies in their education processes and the autonomy of nurses. Subtheme 3.1. Educational Needs Participants reported that they were not trained or educated enough to effectively support the physical and mental health of the older adults. The participants stated the following: "The older adults are a very different group. For instance, I think diseases affecting them should be explained in more depth. Reflecting on my education, I don’t believe the older adults are adequately addressed. I consider myself insufficient in terms of knowledge about older adults health. " (P5) "We have learned about the treatment of diseases in the elderly, but we have not received training on how to approach them psychologically. " (P13) "When I was at university, we focused intensely on theoretical lessons. Here, I observe and learn things more practically. I believe there is potential for further development in practical training." (P16) Subtheme 3.2. Physician Shortage Participants noted that while the health and illness conditions of older adults are often complex and multifaceted, nursing homes lack on-site doctors. Consequently, they explained that even minor health issues require referring older adults to the hospital. Additionally, the dependence on doctors as a profession has created significant challenges. The participants stated the following: "It would be much better if there were doctor services available for the individuals here. There is a significant gap in terms of having doctors. Therefore, since we often carry out treatments based on a doctor's request, there are places where we fall short, and we constantly have to consult others." (P5) " We don’t have a doctor here, so as nurses, we can’t make decisions or implement many things on our own. For even the simplest issues, we have to start a hospital process, especially for elderly patients. However, if there were a doctor, everything would progress much more quickly. I think things like urinary tract infections or fungal infections could be resolved much more easily ." (P10) Theme 4. Communication Challenges All of the nurses mentioned that communicating with the older adults is challenging, but that they manage to cope with the situation in one way or another. While some compared it to the mother-child relationship, others noted that communication varies from person to person. Participants made the following statements: " You can’t help but feel frustrated, but I always try to take the high road. It may seem like you’re giving them too much leeway, but there’s nothing else you can do. They’re elderly, and we’re here to care for them. They are our elders, and as such, we must respect them. " (P1) " I always try to approach things positively. I try to understand them most of the time. Sometimes, they can be difficult or act out. They may shout, yell, and use offensive language, but I always have to take a step back, both because of their age and the fact that they are elderly." (P11) “…..That person is with you until they pass away and needs you constantly. It’s like the relationship between a mother and child at home, requiring unlimited care and attention. The same applies here ." (P12) Theme 5. Struggles with Professional Fulfillment Nurses stated that working with the same older adults in the nursing home leads to monotony, that everything they will do is predetermined from the morning, and that this routine decreases their motivation and professional fulfillment. " I also can’t adapt; I want a bit more intensity, a bit more excitement. This place dulls us professionally because the work we do is always the same. " (P2) " I see this place as one where a person feels more fulfilled on a moral level, but becomes dull in a professional sense . " (P11) " From a professional perspective, if I were working in a hospital, I would have a much more dynamic professional life. This place is very stable. When I come in the morning, unless there is an emergency, I already know what I will be doing; my day from morning to evening is planned. This situation makes me feel insufficient in terms of professional fulfillment . " (P1) Theme 6. Perspectives on Aging in Residential Care As a result of their emotional and social experiences in the nursing home, the nurses shared different perspectives on life in the facility and expressed how they perceive the nursing home, as well as their willingness or reluctance to stay in this environment. Subtheme 6.1. Willingness to Live in a Nursing Home The nurses stated that the nursing home has many positive features such as health care services, cleanliness, food, socialization and activities and expressed that they or their relatives could live here. " I would like to live here because cleanliness is maintained. The food is served ready for you. In my opinion, the nursing home is actually like a hotel concept for the elderly. For example, when an elderly person feels unwell, they go to the nearby hospital, receive their treatment, and come back. They don’t have to wait for anything or be told what to do. I think it’s nice; I would like to stay in a nursing home. " (P6) " I’m thinking about living here. I tell my family that it’s really fun. Because after a while, older people start staying home and don’t go out. They don’t do any activities or anything. I think it’s possible to live here because these places have activities and programs designed for them" (P3) Subtheme 6.2. Reluctance to Live in a Nursing Home Although the nurses acknowledge that the conditions in the nursing home are good, they do not want to live there because it contradicts the cultural values of society and evokes negative emotions psychologically. " Yes, it’s a nice environment. They can socialize and chat with each other, but maybe because of the prejudices we all have, just hearing the name of this place can make people feel suffocated." (P7) "The care they provide is very good, and it’s a social environment. But inevitably, there’s a feeling of abandonment among the elderly, whether they have family or not. That’s why I wouldn’t want to stay here." (P13) " This place makes me feel very lonely too. I wouldn’t want to stay here because it feels like a student dorm. Everything here feels cold to me. Even though we take care of the elderly one-on-one, we don’t hug or kiss them, for example. So, I wouldn’t want to stay. " (P9) Discussion The objective of this study was to explore how the experiences of nursing home nurses working with older adults influence their professional practice and personal well-being. The findings indicate that such experiences indeed have a profound and lasting impact on nurses, shaping both their professional and personal lives. Through thematic analysis, six key themes emerged, offering deeper insights into this phenomenon. It was notable that when nurses shared their experiences of working in nursing homes, they focused more on the negative aspects. Under the theme of transformation, nurses' perspectives on life and aging changed due to their work in nursing homes. Through their experiences in nursing homes, nurses began to view life more realistically and developed negative feelings toward aging. Similar findings were reported in a study conducted to explore the perceptions and experiences of registered nurses in the aged care sector, where nurses developed negative attitudes towards older people [ 35 ]. This phenomenon may also be related to nurses' ageist stereotypes. Notably, the healthcare field and its professionals, especially those employed in residential aged care, are more likely to display stronger negative ageist stereotypes compared to the general population [ 35 , 36 ]. Another significant finding is that nurses expressed a desire to die before reaching old age. Their experiences working in nursing homes led them to believe that aging brings numerous negative conditions, such as physical and mental health problems, dependency, and frailty. As a result, they preferred the idea of passing away before experiencing old age. This theme actually highlights how deeply and negatively working with older adults affects nurses. It could be said that many experiences nurses have with older adults lead them to the thought of dying before aging or experiencing the negative aspects of old age. Under the theme of "Needs and Shortcomings in Older Adults Care," it has been identified that nurses require further education and there is a need for more doctors. Nurses stated that they felt a lack of training while working in nursing homes. They emphasized that the education they received regarding older adults care was insufficient, particularly in understanding and providing psychological support to older adults. This finding highlights the significance of education that incorporates both clinical skills and the emotional and psychological aspects of caring for older adults. Addressing these emotional and psychological dimensions goes beyond the technicalities of medical treatment; it also requires the ability to provide empathetic and compassionate support to individuals facing various challenges related to their health, aging, and life circumstances [ 37 ]. Thus, nurses working with older adults need comprehensive training that equips them with the specialized skills required to navigate the unique challenges of aged care. [ 35 ]. Additionally, nurses mentioned that the absence of a permanent doctor in the facility often put them in challenging situations and contributed to feelings of inadequacy. Similarly, a study highlighted that nursing homes frequently face limited access to doctors and a shortage of qualified nurses. Consequently, the working conditions for nurses in these facilities can be especially challenging. [ 22 ]. Nurses have emphasized communication issues with older adults based on their experiences working in nursing homes. They have sometimes likened communication with them to the relationship between a mother and child, and have highlighted that they try to maintain communication by always adopting a gentle approach. It has been revealed that, without this approach, communication can become untenable. Similarly, in a study, nurses have mentioned the communication barriers they experienced with older adults [ 35 ]. Based on nurses' professional experiences working in nursing homes, it has been revealed that the nursing home environment is perceived as stagnant in terms of professional development. Due to working with the same older adults individuals on a daily basis, everything that needs to be done becomes routine, and working in such an environment eventually leads to professional dissatisfaction after a certain period of time. Nurses believe that the resources and care provided in nursing homes cannot be replicated at home, which leads them to view living in a nursing home as a viable option. On the other hand, most of nurses are opposed to the idea of living in a nursing home in the future. They feel that their cultural values are not compatible with the concept of a nursing home and believe that such facilities do not adequately address the psychological needs of older adults. In Turkish society, there are negative judgments towards nursing homes. It is believed that those living in nursing homes have been abandoned or that their family ties are weak. Even though older adults individuals living in nursing homes express great satisfaction with the services provided, studies have shown that they associate the process of moving into a nursing home with the value placed on them by their children and close relatives, revealing their own negative perceptions of nursing homes [ 38 , 39 ]. Although nurses believe that the services they provide are good and that the living conditions in nursing homes are satisfactory, it is thought that they are influenced by the culture of the society in which they grew up. Limitations There is a limitation to consider when interpreting the results. The study's sample predominantly consisted of female nurses; however, since gender was not a primary focus of the study, no specific information is provided on this aspect. Conclusion This study demonstrates that working with older adults in nursing homes can be highly stressful for nurses, potentially leading to negative effects on their professional development and personal experiences. Highlighting these experiences is an essential step in tackling and resolving them. Implication for nursing practice The findings can be used as a foundation for developing a healthy work environment for nurses working in nursing homes. Improved working conditions for nursing home nurses can positively impact both their professional and personal well-being. The current findings also provide valuable insights for managers on how to improve the work environment for nurses in nursing homes, based on factors such as demand, control, and support. Moreover, potential strategies include education programs to enhance nurses' competencies in older adult care, the development of innovative care models that prioritize person-centered care, and the provision of psychosocial support. Furthermore, further research is needed to explore opportunities for improving the experiences of nurses working in nursing home environments. Declarations Ethical consideration Ethical approval was obtained from the Bitlis ERUniversity Ethics Committee (number E.3893, date: 7 July 2023). All participants were informed verbally and in writing before the interview and verbal and written informed consent was obtained from the participants. The study was conducted by ethical standards and the Declaration of Helsinki. Conflict of interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding sources This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Data Availability: Data is available on request from the authors. Consent to publish declaration : not applicable Acknowledgements None. Author contributions Study design: NEŞ, MÖ Data collection: NEŞ Data analysis: NEŞ, MÖ Study supervision: NEŞ Manuscript writing: NEŞ, MÖ Critical revisions for important intellectual content: NEŞ, MÖ References UN, The growing need for long-term care assumptions and realities. 2016, United Nations. pp. 1–7. Cooper E, et al. Priorities for the professional development of registered nurses in nursing homes: a Delphi study. Age Ageing. 2017;46(1):39–45. Kiljunen O, et al. Competence for older people nursing in care and nursing homes: An integrative review. Int J Older People Nurs. 2017;12(3):e12146. McGilton KS, et al. Determinants of regulated nurses' intention to stay in long-term care homes. 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Gerontological nursing: A holistic approach to the care of older people. Elsevier Health Sciences; 2020. Şenol D, Erdem S. YAŞLILIK VE YAŞLI KADINLARDA HUZUREVİ ALGISI: NİTEL BİR ÇALIŞMA. Kırıkkale Üniversitesi Sosyal Bilimler Dergisi. 2017;7(2):31–50. İNCE ADC. HUZUREVİ KÖŞESİNE ATILMAK YA DA ÖLÜMÜN BİR ADIM ÖNCESİ: YAŞLI BİREYLERİN HUZUREVİNİ TERCİH ETME NEDENLERİ VE HUZUREVİNE YÖNELİK ALGILARI. SOCIAL SCIENCES STUDIES JOURNAL (SSSJournal), 2024. 7(78): pp. 769–78. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 01 Jul, 2025 Read the published version in BMC Nursing → Version 1 posted Editorial decision: Accepted 09 May, 2025 Reviews received at journal 08 May, 2025 Reviews received at journal 05 May, 2025 Reviewers agreed at journal 05 May, 2025 Reviewers agreed at journal 28 Apr, 2025 Reviewers invited by journal 25 Apr, 2025 Submission checks completed at journal 23 Apr, 2025 First submitted to journal 19 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5973903","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":448889107,"identity":"abbb46eb-ac05-4256-945b-8eed5b4a5ab6","order_by":0,"name":"Nilay ERCAN ŞAHİN","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABJElEQVRIie3Rz0rDMBzA8cRAevnVPUCZfYWEwspAu1exFOpV8DJQZkdgp7JzBR+iV2+BQL0Iuwq7DAaePAwGY6CoycThn3Z4FMz30pDmE0KCkM32FyMk23wZQXj++QfOGgneEhKYAdAtIQ3mgyBEvV+R0MHDJaCBHzpudX56ER30fFHNFuiwXcpWtaghXYGFB0jxG7GfTosqCYDSE16gNCglIUUNYQpnmkhcKuhMgco4p9Axm8SG1B1ME/GkD9Yz5Axe5GVOWyvvGb3uIiO9J4kNIe5IHgMFcw9yJ+leM5VoEnjuOOF5lYY8Z0lwpd5v/QeZKHX/2B8clZM7voRV5DtCPczW/ag9vh3O64hpD9jXCbp5psaX1OH1twnavNZms9n+Y29VA1ouzoV47gAAAABJRU5ErkJggg==","orcid":"","institution":"Hacettepe University","correspondingAuthor":true,"prefix":"","firstName":"Nilay","middleName":"ERCAN","lastName":"ŞAHİN","suffix":""},{"id":448889110,"identity":"04958cf8-e805-4b48-a29d-77fdf42e2dbd","order_by":1,"name":"Mücahide ÖNER","email":"","orcid":"","institution":"Bitlis Eren University","correspondingAuthor":false,"prefix":"","firstName":"Mücahide","middleName":"","lastName":"ÖNER","suffix":""}],"badges":[],"createdAt":"2025-02-06 13:23:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5973903/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5973903/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12912-025-03192-9","type":"published","date":"2025-07-01T15:58:42+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":81821574,"identity":"0c3db814-4d02-4428-b49a-81bc1edeae46","added_by":"auto","created_at":"2025-05-02 11:25:05","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":29380,"visible":true,"origin":"","legend":"\u003cp\u003eContents of semi-structured interview guide\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5973903/v1/d164de740131492fcc3a7582.png"},{"id":81821575,"identity":"cd1035e5-dbda-4e9e-a518-2f72f3340342","added_by":"auto","created_at":"2025-05-02 11:25:05","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":81041,"visible":true,"origin":"","legend":"\u003cp\u003eThemes and subthemes\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-5973903/v1/0c6d8dadd625fe301e31345d.png"},{"id":86181035,"identity":"151fc07a-4267-4a14-8810-1db0d3f692bc","added_by":"auto","created_at":"2025-07-07 16:23:10","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":904681,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5973903/v1/1b921e41-65b1-494b-b545-311d4a1ba441.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A Phenomenological Study on the Experiences of Nursing Home Nurses","fulltext":[{"header":"Background","content":"\u003cp\u003eA rising older population, along with a higher incidence of dementia and other chronic illnesses, is leading to increased demand for nursing home care [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The nursing home is a multifaceted environment where residents, many of whom have multiple chronic conditions, typically spend their final years receiving care. Being a nurse in a nursing home is a challenging and multifaceted role that demands a range of skills [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The nurses must be skilled at identifying, reflecting on, and addressing practical, medical, and ethical challenges that come up throughout the day. Their responsibilities are diverse, encompassing assessment, health promotion, risk management, and end-of-life care [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. These responsibilities of nurses are recognized as key factors affecting their decision to remain in their current roles within the facility [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eUpon reviewing the literature, numerous studies focus on nurses working in nursing homes or long-term care facilities. These studies often examine topics such as job satisfaction, workload, burnout, and the roles and responsibilities of nurses in elderly care. According to these studies results, the work environment in nursing homes is often challenging due to high patient-to-nurse ratios and the emotional toll of caregiving. These challenges can lead to role ambiguity and job dissatisfaction, which in turn negatively impact the quality of care provided\u003c/p\u003e \u003cp\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Moreover, the literature highlights that nursing home nurses often struggle to provide essential care due to limited time or resources, resulting in a higher prevalence of missed care and impacting the quality of care provided and the health outcomes of residents [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan additionalcitationids=\"CR12 CR13 CR14\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. This issue is especially critical for residents with complex, long-term medical needs, where insufficient care can lead to worsened health outcomes and a decrease in quality of life. Furthermore, studies frequently address the psychological resilience of nurses working in these settings, their work-life balance, and stress management. Nurses working in nursing homes often experience high levels of stress due to the demanding nature of the job, emotional exhaustion, and the difficulty in balancing personal and professional lives. The lack of adequate support systems, such as peer networks or mental health services, can exacerbate these stressors, leading to burnout and increased turnover rates [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR17 CR18 CR19\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Additionally, it was noted that working conditions, job satisfaction, burnout, nurse characteristics, relationships with residents, and work relationships significantly contribute to turnover, which remains a persistent challenge in nursing homes settings. Factors such as poor management, lack of professional development opportunities, and inadequate compensation are cited as critical contributors to nurse turnover. This turnover not only affects the continuity of care but also exacerbates staffing shortages, further increasing the burden on the remaining staff [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. In addition, older adult care services are more vulnerable to turnover than hospitals, and many nurses preferred working in hospitals over nursing homes [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. These studies provided insight into the challenges faced by nurses in these environments and the strategies they use to cope with these challenges.\u003c/p\u003e \u003cp\u003eThe literature offers extensive findings on various factors related to nurses' work in nursing homes and their professional roles. Moreover, the literature includes many qualitative studies on nursing home nurses' experiences related to resident relationships[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], training needs [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], emergency transfers [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], nursing care [\u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], ethical challenge [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. However, no study has been found that specifically explores how the experiences of nursing home nurses working with older adults impact them and their profession. This gap is significant, as understanding the emotional, ethical, and professional challenges faced by these nurses is crucial for improving the quality of care provided to older adults. Thus, this study will address this gap by providing in-depth insights focused on the lived experiences of nursing home nurses caring for older adults. It is anticipated that revealing the experiences of nurses in elderly care, a demographic of increasing importance in the aging world, will offer valuable guidance on priorities at the levels of education, practice, research, and policy for nurses.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n\u003ch2\u003eStudy Design\u003c/h2\u003e\n\u003cp\u003eThis study utilized a descriptive phenomenological approach to examine how the experiences of nursing home nurses working with older adults affect them and their profession. In this study, a descriptive phenomenological approach based on the philosophical foundations of Edmund Husserl was adopted to reveal the subjective meanings of nurses\u0026rsquo; lived experiences. This approach aims to describe the essence of individuals\u0026rsquo; experiences by bracketing the researcher\u0026rsquo;s preconceptions [\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e]. The Consolidated Criteria for Reporting Qualitative Research checklist was used to ensure quality reporting in the study [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eParticipant\u003c/h3\u003e\n\u003cp\u003eThe research was conducted with nurses working in nursing homes in Ankara, Turkey. To gain a deep and comprehensive understanding of a complex experience, this study utilized purposive sampling, a non-probability sampling method, and participants were reached through the snowball sampling technique. The inclusion criteria required participants to have at least one year of experience in a nursing home and a willingness to participate voluntarily. The first interview was conducted with a nursing home nurse known to the second author, and subsequent participants were selected based on\u003c/p\u003e\n\u003cp\u003ethe recommendations of the interviewed nurses. This approach facilitated access to nurses working in different nursing homes in Ankara. The sample consisted of nurses working in both public and private nursing homes, with varying levels of education and years of experience, to achieve data triangulation. Twenty-six nurses were recruited through snowball sampling; however, after being informed about the study, seven declined to participate.\u003c/p\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eThe interviews were conducted between January and February 2024. Data were collected through open-ended, semistructured interviews guided by an interview protocol (Fig.\u0026nbsp;1). Prior to each interview, participants provided informed consent and completed a demographic form capturing details such as educational background, total nursing experience, and years of experience in nursing homes. Using the semistructured guide, participants engaged in a single, in-depth, face-to-face interview lasting approximately 35\u0026ndash;40 minutes, which was audio-recorded. The interviews were conducted in Turkish by the principal investigator, a female associate professor with a PhD in public health nursing, in a quiet and private room at the nursing home to ensure confidentiality. Field notes were also recorded during or immediately after the interviews.\u003c/p\u003e\n\u003cp\u003eData collection and analysis were carried out simultaneously, and sampling was stopped when data repetition occurred and data saturation was achieved. Therefore, the interviews were concluded after the 17th interview. The transcripts were provided to the nurses for their feedback.\u003c/p\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n\u003ch2\u003eData Analysis\u003c/h2\u003e\n\u003cp\u003eThe audio-recorded, semistructured, in-depth individual interviews were transcribed verbatim by the second author, with the first author meticulously crosschecking the transcripts for accuracy. The interviews were organized, and the data were coded using the MAXQDA software. The seven-step analysis method developed by Colaizzi [\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e] was used to analyze the data. In the first step, the recordings were listened to repeatedly by the researchers. In the\u003c/p\u003e\n\u003cp\u003esecond step, the researchers analyzed the interviews one by one. In the third step, initial codes were created. In the fourth step, the first codes were organized as themes. In the fifth step, themes and sub-themes were formed. In the sixth step, the researchers defined the themes and sub-themes broadly. In the last step, participant statements describing the phenomenon were determined. Finally, the main themes and their associated subthemes were identified, representing the key content of the interviews. Written notes and observations made during data collection were compared with the data from group discussions, ensuring the study's findings were validated and corroborated.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eTrustworthiness\u003c/h3\u003e\n\u003cp\u003eTo demonstrate the reliability of the study, the confirmability, reliability, and transferability strategies proposed by Guba and Lincoln [\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e] were utilized. In this context, no changes were made to the participants' quotations to ensure confirmability, and all notes, transcripts, and data collection tools were kept for re-examination. To ensure reliability, both researchers were involved in the data analysis and interpretation process. To ensure transferability, detailed information about the semi-structured interview form, participant characteristics, sampling method, and research method was provided.\u003c/p\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n\u003ch2\u003eEthical considerations\u003c/h2\u003e\n\u003cp\u003eEthical approval\u0026nbsp;was obtained from the Bitlis Eren University Ethics Committee (number E.3893, date: 7 July 2023). All participants were informed verbally and in writing before the interview and verbal and written informed consent was obtained from the participants. The study was conducted by ethical standards and the Declaration of Helsinki.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eAmong the study participants, 13 were female and 4 were male, with ages ranging from 24 to 44 years and nursing experience in nursing homes ranging from 1.5 to 15 years (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). The descriptive analysis of nursing home nurses\u0026rsquo; experiences identified six themes \u0026ldquo;Transformation\u0026rdquo;, \u0026ldquo;Wish to Die Before Experiencing Aging\u0026rdquo;, \u0026ldquo;Needs and Shortcomings in Older Adults Care\u0026rdquo;, \u0026ldquo;Communication Challenges\u0026rdquo;, \u0026ldquo;Struggles with Professional Fulfillment\u0026rdquo;, \u0026ldquo;Perspectives on Aging in Residential Care\u0026rdquo; (Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eCharacteristic of participants\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eParticipants\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eEducational Level\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNursing home\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eYears of nursing experience\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eYears of nursing experience in nursing home\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePublic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePublic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePublic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMaster\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePublic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e9\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePublic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePublic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePublic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e12\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e13\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePublic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePublic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePublic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePublic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e17\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMaster\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eTheme 1. Transformation\u003c/h3\u003e\n\u003cp\u003eThis theme examines how nurses transform as they care for the nursing home residents. All nurses reported changes in their perceptions of aging, outlook on life, and views on death. Interacting with older adults resulted in significant transformations and growth in the participants\u0026apos; perspectives on life.\u003c/p\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003eSubtheme 1.1.Transformation in Life Outlook\u003c/h2\u003e\n \u003cp\u003eNurses indicated that work experience led to a life with fewer expectations and less dreaming. The participants stated the following:\u003c/p\u003e\n \u003cp\u003e\u0026quot;\u0026hellip;.\u003cem\u003eFor example, I have been here for three years. Sometimes, there are dreams that we have; this is true for everyone, after working here, I have begun to view things a bit more realistically. People often live as if nothing will happen to them and direct all their dreams accordingly. However, after my time here, I can say that it has led me to a life with fewer expectations...\u003c/em\u003e\u0026quot; (P5)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026quot;I\u0026rsquo;ve come to realize that you shouldn\u0026rsquo;t really dream too much about life here. Reaching high positions doesn\u0026rsquo;t mean much, and no matter how many people are around me, I sometimes think that in 10 or 15 years, or maybe at the end of life, I\u0026rsquo;ll die alone or end up being alone.\u0026quot;\u003c/em\u003e.\u003c/p\u003e\n \u003cp\u003e(P8)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e\n \u003ch2\u003eSubtheme 1. 2. Transformation in Views on Aging\u003c/h2\u003e\n \u003cp\u003eParticipants expressed that their emotional attachment to old age has weakened, that the perception of older people has changed over time, and that aging is perceived as a frightening process. While the participants\u0026apos; thoughts on aging are transformed with the impact of their experiences, factors such as emotional distance, fear, and efforts to understand come to the fore in this process.\u003c/p\u003e\n \u003cp\u003e\u0026quot;\u003cem\u003eWhen you start aging, in my opinion, as you get older, you fall back from the stage of a 10-year-old child. For example, if a person starts aging at the age of 70, he/she is 10 years old for me, when he/she turns 80, he/she is 5 years old for me, and when he/she turns 90, he/she is 3 years old, and this changes when chronic diseases are added to this\u003c/em\u003e.\u0026quot; (P1)\u003c/p\u003e\n \u003cp\u003e\u0026quot;\u003cem\u003eWhen I reflect on aging from my own perspective, I realize it has been a frightening process for me. I didn\u0026rsquo;t fully understand its implications before. The elderly figures I knew, like my grandparents, appeared to be just two people in the larger picture of old age, but now I see that their lives represent a much deeper and more complex experience\u003c/em\u003e.\u0026quot; (P6)\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\n \u003ch2\u003eTheme 2. Wish to Die Before Experiencing Aging\u003c/h2\u003e\n \u003cp\u003eParticipants expressed the anxiety and sense of helplessness caused by the physical and mental challenges of old age. Old age was associated with powerlessness and dependency.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;At the moment, I see old age as a disease, and I wish to die before I grow old. I believe that old age brings a great deal of helplessness.\u0026rdquo;\u003c/em\u003e (P4)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026quot;Honestly, I\u0026rsquo;d like to live until I\u0026rsquo;m around 60 and not see any more than that. I mean, while I\u0026rsquo;m still healthy and able to take care of myself. After elderly people are admitted here, they find themselves in situations where strangers are changing their diapers or helping them with baths\u0026mdash;people they\u0026rsquo;ve never met before. I think these are important things, and when empathy is in place, it becomes a challenging situation. I hope I die before reaching that point.\u003c/em\u003e\u0026quot; (P7)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\n \u003ch2\u003eTheme 3. Needs and Shortcomings in Older Adults Care\u003c/h2\u003e\n \u003cp\u003eIn this theme, it was stated that there are deficiencies and difficulties encountered in the health services and care of older adults due to the deficiencies in their education processes and the autonomy of nurses.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\n \u003ch2\u003eSubtheme 3.1. Educational Needs\u003c/h2\u003e\n \u003cp\u003eParticipants reported that they were not trained or educated enough to effectively support the physical and mental health of the older adults. The participants stated the following:\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026quot;The older adults are a very different group. For instance, I think diseases affecting them should be explained in more depth. Reflecting on my education, I don\u0026rsquo;t believe the older adults are adequately addressed. I consider myself insufficient in terms of knowledge about older adults health. \u0026quot;\u003c/em\u003e (P5)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026quot;We have learned about the treatment of diseases in the elderly, but we have not received training on how to approach them psychologically. \u0026quot;\u003c/em\u003e (P13)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026quot;When I was at university, we focused intensely on theoretical lessons. Here, I observe and learn things more practically. I believe there is potential for further development in practical training.\u0026quot;\u003c/em\u003e (P16)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\n \u003ch2\u003eSubtheme 3.2. Physician Shortage\u003c/h2\u003e\n \u003cp\u003eParticipants noted that while the health and illness conditions of older adults are often complex and multifaceted, nursing homes lack on-site doctors. Consequently, they explained that even minor health issues require referring older adults to the hospital. Additionally, the dependence on doctors as a profession has created significant challenges. The participants stated the following:\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026quot;It would be much better if there were doctor services available for the individuals here. There is a significant gap in terms of having doctors. Therefore, since we often carry out treatments based on a doctor\u0026apos;s request, there are places where we fall short, and we constantly have to consult others.\u0026quot;\u003c/em\u003e (P5)\u003c/p\u003e\n \u003cp\u003e\u0026quot; \u003cem\u003eWe don\u0026rsquo;t have a doctor here, so as nurses, we can\u0026rsquo;t make decisions or implement many things on our own. For even the simplest issues, we have to start a hospital process, especially for elderly patients. However, if there were a doctor, everything would progress much more quickly. I think things like urinary tract infections or fungal infections could be resolved much more easily\u003c/em\u003e.\u0026quot; (P10)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\n \u003ch2\u003eTheme 4. Communication Challenges\u003c/h2\u003e\n \u003cp\u003eAll of the nurses mentioned that communicating with the older adults is challenging, but that they manage to cope with the situation in one way or another. While some compared it to the mother-child relationship, others noted that communication varies from person to person. Participants made the following statements:\u003c/p\u003e\n \u003cp\u003e\u0026quot;\u003cem\u003eYou can\u0026rsquo;t help but feel frustrated, but I always try to take the high road. It may seem like you\u0026rsquo;re giving them too much leeway, but there\u0026rsquo;s nothing else you can do. They\u0026rsquo;re elderly, and we\u0026rsquo;re here to care for them. They are our elders, and as such, we must respect them.\u003c/em\u003e \u0026quot; (P1)\u003c/p\u003e\n \u003cp\u003e\u0026quot;\u003cem\u003eI always try to approach things positively. I try to understand them most of the time. Sometimes, they can be difficult or act out. They may shout, yell, and use offensive language, but I always have to take a step back, both because of their age and the fact that they are elderly.\u0026quot;\u003c/em\u003e (P11)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;\u0026hellip;..That person is with you until they pass away and needs you constantly. It\u0026rsquo;s like the relationship between a mother and child at home, requiring unlimited care and attention. The same applies here\u003c/em\u003e.\u0026quot; (P12)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\n \u003ch2\u003e\u003cstrong\u003eTheme 5. Struggles with Professional Fulfillment\u003c/strong\u003e\u003c/h2\u003e\n \u003cp\u003eNurses stated that working with the same older adults in the nursing home leads to monotony, that everything they will do is predetermined from the morning, and that this routine decreases their motivation and professional fulfillment.\u003c/p\u003e\n \u003cp\u003e\u0026quot; \u003cem\u003eI also can\u0026rsquo;t adapt; I want a bit more intensity, a bit more excitement. This place dulls us professionally because the work we do is always the same.\u003c/em\u003e\u0026quot; (P2)\u003c/p\u003e\n \u003cp\u003e\u0026quot; \u003cem\u003eI see this place as one where a person feels more fulfilled on a moral level, but becomes dull in a professional sense\u003c/em\u003e. \u0026quot; (P11)\u003c/p\u003e\n \u003cp\u003e\u0026quot;\u003cem\u003eFrom a professional perspective, if I were working in a hospital, I would have a much more dynamic professional life. This place is very stable. When I come in the morning, unless there is an emergency, I already know what I will be doing; my day from morning to evening is planned. This situation makes me feel insufficient in terms of professional fulfillment\u003c/em\u003e. \u0026quot; (P1)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\n \u003ch2\u003eTheme 6. Perspectives on Aging in Residential Care\u003c/h2\u003e\n \u003cp\u003eAs a result of their emotional and social experiences in the nursing home, the nurses shared different perspectives on life in the facility and expressed how they perceive the nursing home, as well as their willingness or reluctance to stay in this environment.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\n \u003ch2\u003eSubtheme 6.1. Willingness to Live in a Nursing Home\u003c/h2\u003e\n \u003cp\u003eThe nurses stated that the nursing home has many positive features such as health care services, cleanliness, food, socialization and activities and expressed that they or their relatives could live here.\u003c/p\u003e\n \u003cp\u003e\u0026quot;\u003cem\u003eI would like to live here because cleanliness is maintained. The food is served ready for you. In my opinion, the nursing home is actually like a hotel concept for the elderly. For example, when an elderly person feels unwell, they go to the nearby hospital, receive their treatment, and come back. They don\u0026rsquo;t have to wait for anything or be told what to do. I think it\u0026rsquo;s nice; I would like to stay in a nursing home.\u003c/em\u003e \u0026quot; (P6)\u003c/p\u003e\n \u003cp\u003e\u0026quot;\u003cem\u003eI\u0026rsquo;m thinking about living here. I tell my family that it\u0026rsquo;s really fun. Because after a while, older people start staying home and don\u0026rsquo;t go out. They don\u0026rsquo;t do any activities or anything. I think it\u0026rsquo;s possible to live here because these places have activities and programs designed for them\u0026quot;\u003c/em\u003e (P3)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\n \u003ch2\u003eSubtheme 6.2. Reluctance to Live in a Nursing Home\u003c/h2\u003e\n \u003cp\u003eAlthough the nurses acknowledge that the conditions in the nursing home are good, they do not want to live there because it contradicts the cultural values of society and evokes negative emotions psychologically.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026quot; Yes, it\u0026rsquo;s a nice environment. They can socialize and chat with each other, but maybe because of the prejudices we all have, just hearing the name of this place can make people feel suffocated.\u0026quot;\u003c/em\u003e (P7)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026quot;The care they provide is very good, and it\u0026rsquo;s a social environment. But inevitably, there\u0026rsquo;s a feeling of abandonment among the elderly, whether they have family or not. That\u0026rsquo;s why I wouldn\u0026rsquo;t want to stay here.\u0026quot;\u003c/em\u003e (P13)\u003c/p\u003e\n \u003cp\u003e\u0026quot; \u003cem\u003eThis place makes me feel very lonely too. I wouldn\u0026rsquo;t want to stay here because it feels like a student dorm. Everything here feels cold to me. Even though we take care of the elderly one-on-one, we don\u0026rsquo;t hug or kiss them, for example. So, I wouldn\u0026rsquo;t want to stay.\u003c/em\u003e \u0026quot; (P9)\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe objective of this study was to explore how the experiences of nursing home nurses working with older adults influence their professional practice and personal well-being. The findings indicate that such experiences indeed have a profound and lasting impact on nurses, shaping both their professional and personal lives. Through thematic analysis, six key themes emerged, offering deeper insights into this phenomenon.\u003c/p\u003e \u003cp\u003eIt was notable that when nurses shared their experiences of working in nursing homes, they focused more on the negative aspects. Under the theme of transformation, nurses' perspectives on life and aging changed due to their work in nursing homes. Through their experiences in nursing homes, nurses began to view life more realistically and developed negative feelings toward aging. Similar findings were reported in a study conducted to explore the perceptions and experiences of registered nurses in the aged care sector, where nurses developed negative attitudes towards older people [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. This phenomenon may also be related to nurses' ageist stereotypes. Notably, the healthcare field and its professionals, especially those employed in residential aged care, are more likely to display stronger negative ageist stereotypes compared to the general population [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAnother significant finding is that nurses expressed a desire to die before reaching old age. Their experiences working in nursing homes led them to believe that aging brings numerous negative conditions, such as physical and mental health problems, dependency, and frailty. As a result, they preferred the idea of passing away before experiencing old age. This theme actually highlights how deeply and negatively working with older adults affects nurses. It could be said that many experiences nurses have with older adults lead them to the thought of dying before aging or experiencing the negative aspects of old age.\u003c/p\u003e \u003cp\u003eUnder the theme of \"Needs and Shortcomings in Older Adults Care,\" it has been identified that nurses require further education and there is a need for more doctors. Nurses stated that they felt a lack of training while working in nursing homes. They emphasized that the education they received regarding older adults care was insufficient, particularly in understanding and providing psychological support to older adults. This finding highlights the significance of education that incorporates both clinical skills and the emotional and psychological aspects of caring for older adults. Addressing these emotional and psychological dimensions goes beyond the technicalities of medical treatment; it also requires the ability to provide empathetic and compassionate support to individuals facing various challenges related to their health, aging, and life circumstances [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Thus, nurses working with older adults need comprehensive training that equips them with the specialized skills required to navigate the unique challenges of aged care. [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Additionally, nurses mentioned that the absence of a permanent doctor in the facility often put them in challenging situations and contributed to feelings of inadequacy. Similarly, a study highlighted that nursing homes frequently face limited access to doctors and a shortage of qualified nurses. Consequently, the working conditions for nurses in these facilities can be especially challenging. [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eNurses have emphasized communication issues with older adults based on their experiences working in nursing homes. They have sometimes likened communication with them to the relationship between a mother and child, and have highlighted that they try to maintain communication by always adopting a gentle approach. It has been revealed that, without this approach, communication can become untenable. Similarly, in a study, nurses have mentioned the communication barriers they experienced with older adults [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBased on nurses' professional experiences working in nursing homes, it has been revealed that the nursing home environment is perceived as stagnant in terms of professional development. Due to working with the same older adults individuals on a daily basis, everything that needs to be done becomes routine, and working in such an environment eventually leads to professional dissatisfaction after a certain period of time.\u003c/p\u003e \u003cp\u003eNurses believe that the resources and care provided in nursing homes cannot be replicated at home, which leads them to view living in a nursing home as a viable option. On the other hand, most of nurses are opposed to the idea of living in a nursing home in the future. They feel that their cultural values are not compatible with the concept of a nursing home and believe that such facilities do not adequately address the psychological needs of older adults. In Turkish society, there are negative judgments towards nursing homes. It is believed that those living in nursing homes have been abandoned or that their family ties are weak. Even though older adults individuals living in nursing homes express great satisfaction with the services provided, studies have shown that they associate the process of moving into a nursing home with the value placed on them by their children and close relatives, revealing their own negative perceptions of nursing homes [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. Although nurses believe that the services they provide are good and that the living conditions in nursing homes are satisfactory, it is thought that they are influenced by the culture of the society in which they grew up.\u003c/p\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThere is a limitation to consider when interpreting the results. The study's sample predominantly consisted of female nurses; however, since gender was not a primary focus of the study, no specific information is provided on this aspect.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study demonstrates that working with older adults in nursing homes can be highly stressful for nurses, potentially leading to negative effects on their professional development and personal experiences. Highlighting these experiences is an essential step in tackling and resolving them.\u003c/p\u003e \u003cdiv id=\"Sec26\" class=\"Section2\"\u003e \u003ch2\u003eImplication for nursing practice\u003c/h2\u003e \u003cp\u003eThe findings can be used as a foundation for developing a healthy work environment for nurses working in nursing homes. Improved working conditions for nursing home nurses can positively impact both their professional and personal well-being. The current findings also provide valuable insights for managers on how to improve the work environment for nurses in nursing homes, based on factors such as demand, control, and support. Moreover, potential strategies include education programs to enhance nurses' competencies in older adult care, the development of innovative care models that prioritize person-centered care, and the provision of psychosocial support. Furthermore, further research is needed to explore opportunities for improving the experiences of nurses working in nursing home environments.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical consideration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Bitlis ERUniversity Ethics Committee (number E.3893, date: 7 July 2023). All participants were informed verbally and in writing before the interview and verbal and written informed consent was obtained from the participants. The study was conducted by ethical standards and the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding sources\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability:\u0026nbsp;\u003c/strong\u003eData is available on request from the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publish declaration\u003c/strong\u003e: not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudy design: NEŞ, MÖ\u003cbr\u003eData collection: NEŞ\u003cbr\u003eData analysis: NEŞ, MÖ\u003cbr\u003eStudy supervision: NEŞ\u003cbr\u003eManuscript writing: NEŞ, MÖ\u003cbr\u003eCritical revisions for important intellectual content: NEŞ, MÖ\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eUN, The growing need for long-term care assumptions and realities. 2016, United Nations. pp. 1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCooper E, et al. 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Nursing home nurses' perceptions of emergency transfers from nursing homes to hospital: a review of qualitative studies using systematic methods. Geriatr Nurs. 2015;36(6):423\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNasu K, Konno R, Fukahori H. End-of‐life nursing care practice in long‐term care settings for older adults: A qualitative systematic review. Int J Nurs Pract. 2020;26(2):e12771.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGonella S, et al. A qualitative study of nurses\u0026rsquo; perspective about the impact of end-of‐life communication on the goal of end‐of‐life care in nursing home. Scand J Caring Sci. 2021;35(2):502\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHov R, Athlin E, Hedelin B. Being a nurse in nursing home for patients on the edge of life. Scand J Caring Sci. 2009;23(4):651\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJia Y, et al. Nurses\u0026rsquo; ethical challenges caring for people with COVID-19: a qualitative study. Nurs Ethics. 2021;28(1):33\u0026ndash;45.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArjama A-L, Suhonen R, Kangasniemi M. Ethical issues in long-term care settings: Care workers\u0026rsquo; lived experiences. Nurs Ethics. 2024;31(2\u0026ndash;3):213\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChristensen M, Welch A, Barr J. Husserlian descriptive phenomenology: A review of intentionality, reduction and the natural attitude. J Nurs Educ Pract. 2017;7(8):113\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMorrow R, Rodriguez A, King N. Colaizzi\u0026rsquo;s descriptive phenomenological method. Psychol. 2015;28(8):643\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuba EG, Lincoln YS. Epistemological and methodological bases of naturalistic inquiry. Ectj. 1982;30(4):233\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSun YJ et al. \u003cem\u003eRegistered nurses' perceptions and experience of working in aged care: A qualitative approach.\u003c/em\u003e Nursing Open, 2024. 11(1): p. e2060.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCrutzen C, et al. Does caring lead to stigmatisation? The perception of older people among healthcare professionals and the general population: A cross-sectional study. Int J Older People Nurs. 2022;17(5):e12457.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVafeas C, Slatyer S. Gerontological nursing: A holistic approach to the care of older people. Elsevier Health Sciences; 2020.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eŞenol D, Erdem S. YAŞLILIK VE YAŞLI KADINLARDA HUZUREVİ ALGISI: NİTEL BİR \u0026Ccedil;ALIŞMA. Kırıkkale \u0026Uuml;niversitesi Sosyal Bilimler Dergisi. 2017;7(2):31\u0026ndash;50.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eİNCE ADC. \u003cem\u003eHUZUREVİ K\u0026Ouml;ŞESİNE ATILMAK YA DA \u0026Ouml;L\u0026Uuml;M\u0026Uuml;N BİR ADIM \u0026Ouml;NCESİ: YAŞLI BİREYLERİN HUZUREVİNİ TERCİH ETME NEDENLERİ VE HUZUREVİNE Y\u0026Ouml;NELİK ALGILARI.\u003c/em\u003e SOCIAL SCIENCES STUDIES JOURNAL (SSSJournal), 2024. 7(78): pp. 769\u0026ndash;78.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"experiences, nurse, nursing home, qualitative research","lastPublishedDoi":"10.21203/rs.3.rs-5973903/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5973903/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackgorund: \u003c/strong\u003eThe nursing home is a multifaceted environment where residents, many of whom have multiple chronic conditions, typically spend their final years receiving care. Being a nurse in a nursing home is a challenging and multifaceted role that demands a range of skills. The study aimed to explore the experiences of nursing home nurses, with the aim of gaining a deeper understanding of what it means to be a nurse in a nursing home, both professionally and personally.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eSeventeen nurses working in nursing homes in Ankara, Turkey were recruited between June and Agust 2024 for a descriptive phenomenological study. \u0026nbsp;Data were collected through in-depth face-to-face interviews and analyzed using thematic analysis. The study was reported according to the Consolidated Criteria for Reporting Qualitative Research Checklist.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFindings: \u003c/strong\u003eSix themes emerged from descriptive analysis “Transformation”, “Wish to Die Before Experiencing Aging”, “Needs and Shortcomings in Older Adults Care”, “Communication Challenges”, “Struggles with Professional Fulfillment”, “Perspectives on Aging in Residential Care”.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eThis study demonstrates that working with older adults in nursing homes can be highly stressful for nurses, potentially leading to negative effects on their professional and personal experiences.\u003c/p\u003e","manuscriptTitle":"A Phenomenological Study on the Experiences of Nursing Home Nurses","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-02 11:25:00","doi":"10.21203/rs.3.rs-5973903/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Accepted","date":"2025-05-09T05:45:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-08T12:47:14+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-06T02:10:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"222111161381941880231270034917180337547","date":"2025-05-05T14:53:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"257553288139906108074307401708778625959","date":"2025-04-28T07:02:17+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-25T17:28:53+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-24T03:06:05+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-04-19T21:31:28+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6b8823ea-e989-4020-afff-7a4358fb2eca","owner":[],"postedDate":"May 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-07T16:21:14+00:00","versionOfRecord":{"articleIdentity":"rs-5973903","link":"https://doi.org/10.1186/s12912-025-03192-9","journal":{"identity":"bmc-nursing","isVorOnly":false,"title":"BMC Nursing"},"publishedOn":"2025-07-01 15:58:42","publishedOnDateReadable":"July 1st, 2025"},"versionCreatedAt":"2025-05-02 11:25:00","video":"","vorDoi":"10.1186/s12912-025-03192-9","vorDoiUrl":"https://doi.org/10.1186/s12912-025-03192-9","workflowStages":[]},"version":"v1","identity":"rs-5973903","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5973903","identity":"rs-5973903","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}