Experiences of Iranian Nurses in Employing Nurse Assistants: A Descriptive Phenomenological Study

Abstract

Background: The integration of nursing assistants into care delivery systems presents considerable challenges for healthcare teams, particularly in upholding care standards and preserving professional boundaries. These challenges are especially evident for nurses, whose lived experiences have not been sufficiently explored. Given their central role in patient care, this descriptive phenomenological study investigates the experiences of nurses and the challenges they encounter when working with nursing assistants. Materials and Methods: This qualitative study was conducted from August 12, 2023 to January 11, 2023 at a hospital in Lorestan Province, Iran. A descriptive phenomenological design was applied, and 14 nurses were recruited through purposive sampling. Data collection involved semi‑structured, in‑depth interviews, and analysis was performed using Colaizzi’s seven‑step method. MAXQDA software facilitated data management. Results: The study involved 14 nurses, with a mean (SD) age of 35.86 (3.89) years. Their experiences with nursing assistants were categorized into five overarching themes: reactions to their presence, diminished professional value, dilemmas of role and identity, attitudinal and interactional conflicts, and perceived injustice. These were further divided into 19 subthemes. Conclusions: The presence of nurse assistants in clinical environments introduces both advantages and challenges. Despite reported benefits, participants voiced concerns about role ambiguity, absence of legal accountability, and adverse effects on the professional identity of nurses. The findings highlight the importance of clear job descriptions and structured training programs. These insights may inform targeted educational initiatives and support policy reforms to address nursing workforce shortages, thereby improving service quality and optimizing healthcare team performance.