Predictors of new graduate nurses' health over the first 4 years of practice

Job satisfaction, professional competence, and self-efficacy: a multicenter cross-sectional study among registered nurses in Sweden and Norway

BACKGROUND

Healthcare organizations worldwide face persistent challenges relating to turnover and intention to leave the nursing profession among registered nurses. Factors contributing to their retention and well-being at work include high job satisfaction, professional competence, and self-efficacy. Few multicenter studies have investigated these factors in relation to work experience in a Nordic context. Therefore, this study aimed to investigate job satisfaction, professional competence, and self-efficacy among registered nurses.

METHODS

This multicenter cross-sectional study survey was part of a larger overarching Swedish-Norwegian project, and was conducted among registered nurses (n = 1137) in September 2021. The participants worked in a variety of health care units, e.g., hospital units, primary health care, and home care. Data was subjected to descriptive and comparative statistical analysis; chi-square test, one-way between-groups analysis of variance (ANOVA) and Kruskal-Wallis test.

RESULTS

The findings show that job satisfaction is reported as lowest in registered nurses with medium-term work experience as compared to newly qualified and long-term work-experienced registered nurses. Professional competence and self-efficacy are reported as higher among registered nurses with long-term work experience as compared to those with medium-term work experience and newly qualified registered nurses. However, the participants reported their professional competence as highest in relation to the same factor - "Value-based nursing care" - regardless of their work experience.

CONCLUSIONS AND IMPLICATIONS

This study underscores the need for continuous support and professional development for registered nurses throughout their careers. Proactive support for newly qualified nurses may improve job satisfaction as they progress to being registered nurses with medium-term work experience. Tailored interventions to address the distinct needs of both newly qualified and medium-term work-experienced registered nurses are crucial for nurturing a sustainable nursing workforce.

Nursing Students' Resilience and Intent to Work at the Bedside

AIM

The primary purpose of this study was to explore relationships between self-efficacy, peer support, coping style, intent to work at the bedside, and resilience in nursing students.

BACKGROUND

Resilience correlates with one-year retention at the bedside. Retention of bedside nurses improves patient outcomes.

METHOD

A quantitative, correlational design determined relationships between variables. Surveys were completed by 205 participants. Surveys included a program type list, intent to work at the bedside items, the Brief Cope Scale, the General Self-Efficacy Scale, the Peer Group Caring Interaction Scale.

RESULTS

Significant relationships were found between resilience and self-efficacy, resilience and coping style, and peer support and approach coping style. Half of the respondents intended to work at the bedside for two years after graduation. Self-efficacy and avoidance coping were resilience predictors.

CONCLUSION

To support resilience, educators should facilitate students' development of self-efficacy and approach coping style.

Commitment and efforts to maintain mentoring: Nurse managers' perceptions of structuring mentoring provision for new nurses in a hospital setting

AIM

The aim of the present study was to describe nurse managers' perceptions of the provision of mentoring for newly graduated registered nurses (NGRNs) and its contribution to the work environment in a hospital setting.

BACKGROUND

Nurse managers are responsible for the work environment and for supporting the staff's professional development, which includes giving NGRNs organizational support during their introduction to the workplace. Mentorship is one common way to provide support, but there is a lack of knowledge about how nurse managers view this support.

DESIGN/METHOD

This was a qualitative descriptive study, using a semi-structured interview guide. Fifteen individual interviews with nurse managers were performed in hospital settings. The interview transcripts were analysed using qualitative content analysis. The COREQ guidelines and checklist were used.

RESULTS

The results describe the nurse managers' perceptions of the provision of mentoring in three themes: Ensuring and sustaining mentoring for new nurses' needs is a struggle in the harsh reality of healthcare, Identifying mentors who are willing and possess the necessary competence for the assignment and Promoting a secure and attractive workplace by mentoring new nurses.

CONCLUSIONS

Our study confirms that nurse managers are important in the provision of mentoring for NGRNs' learning and professional development. Mentoring has a positive spillover effect on the entire unit as a sustainable approach to securing and improving the work environment. Our study also identifies challenges for nurse managers to structure mentoring provision.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

This study highlights the importance of investment in mentoring for the NGRNs' professional development and for patient care. Support is needed from the top level of the organization, but how mentoring should be structured and facilitated needs to be investigated further.

Perspectives of Chinese New Nurses Regarding Successful Transition: A Qualitative Study

BACKGROUND

Transition issues have been discussed for many decades, yet little is known about successful transition expectations in the context of Chinese culture.

PURPOSE

This article was designed to describe the expectations of newly graduated nurses in China regarding successful transition.

METHODS

A qualitative, descriptive study design was employed, and a purposive sampling method was used to recruit interviewees. All of the one-to-one conversations were held in a quiet room to ensure privacy. All of the interviews were transcribed and then analyzed using thematic analysis.

RESULTS

Nineteen new nurses were recruited from seven tertiary hospitals and participated in the in-depth interview process. Transition success, that is, "professional metamorphosis," was revealed through the four themes of "being competent in nursing work," "establishing a professional identity," "establishing comfortable interpersonal relationships," and "achieving balance between work and life."

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Chinese new nurses expect their successful transition to achieve a professional metamorphosis in many aspects. A successful transition is not only a journey of professionalization but also a process of socialization. New nurses expect to achieve both maturity in their work and wisdom in life. The results of this study provide a greater understanding of transition issues in the context of Chinese culture. Thus, support and strategies cannot be limited to interventions designed to improve working competence but should be individualized to help new nurses achieve a smooth transition.

Registered nurses' psychological capital: A scoping review

AIMS

The aim was to examine the extent and scope of empirical research concerning registered nurses' psychological capital.

BACKGROUND

In a time of global nursing shortage, identifying variables that could positively contribute to the retention of the nursing workforce is essential. Prior research has shown that psychological capital correlates positively with employees' better performance and well-being.

DESIGN

A scoping review.

DATA SOURCES

A systematic literature search was conducted in the following databases: PubMed, CINAHL, PsycINFO, Web of Science and Scopus covering the period from 1 January 2005 to 7 May 2023.

REVIEW METHODS

The JBI methodological guidance for scoping reviews was followed. The results were summarized narratively.

RESULTS

A total of 111 studies reported in 114 peer-reviewed articles were included. Studies were carried out across 20 countries, with the majority from China (45), Australia (nine), Pakistan (nine), Canada (eight), South Korea (eight) and the United States (eight). A positive correlation was found between registered nurses' psychological capital and desirable work-related outcomes, such as work engagement, commitment and retention intention.

CONCLUSION

A comprehensive overview of research evidence suggests that psychological capital is associated with many positive work-related outcomes and might therefore be a valuable resource for reducing nurse turnover.

Predictive factors of sleep quality and burnout in nurses working in transplant units during the COVID-19 lockdown - A cross-sectional study

Background: There is minimal information regarding sleep disturbance and burnout during COVID-19 in nurses working within haematology-oncology and hematopoietic stem cell transplantation (HSCT) settings.Aim: To identify socio-demographic and professional factors that predicted burnout and sleep disturbance during COVID-19 in nurses working in HSCT settings.Design/Methods: Data were collected using the Maslach Burnout Inventory and the Pittsburgh Sleep Quality Index. Descriptive statistics and linear regression examined relationships.Results: 308 responses were received. Nurses working in outpatient settings had greater emotional exhaustion (Rpartial = -0.12, n = 308, p = 0.03). Negative predictors for quality of sleep were transplant programme setting (Rpartial = -0.19, n = 308, p < 0.01) and years working in HSCT (Rpartial = -0.17, n = 308, p < 0.01). Other relationships were found on univariate analysis.Conclusion: Institutions must offer programmes for nurses to develop sleep strategies, self-care, and work-related stress management.

Let's Hang On! Ramping Up Nurse Resident Retention Strategies After the Pandemic

The nurse residency program (NRP) was developed as a recruitment strategy for new graduate registered nurses (NGRNs). The 2020 COVID-19 pandemic impacted health care in many ways, including causing a decline in NGRN retention rates. Post-pandemic, the NRP needed to incorporate strategies that would promote nursing retention. Effective collaboration and innovative strategies were found to be key elements in promoting successful NGRN retention. [J Contin Educ Nurs. 2023;54(6):245-247.].

Success factors in adaptation of newly graduated nurses: a scoping review

BACKGROUND

Difficulties in adapting to the workplace can affect newly graduated nurses' transition. Such nurses must adapt quickly, as it can affect their future career prospects. Therefore, this review aimed to identify the success factors that promote newly graduated nurses' effective transition and adaptation.

METHODS

The Joanna Briggs Institute scoping reviews methodology was used. Data were extracted from MEDLINE, Scopus, EBSCOhost, and Web of Science publications published between 2011 and 2020. A total of 23 articles were included in this review, which comprised qualitative, quantitative, and mixed methods primary research studies focusing on the contributing factors that aided newly graduated nurses' adaptation to the work environment during their transition period. Key emerging themes were identified with thematic analysis.

RESULTS

Three main themes were identified: (1) organisational contribution (social development, organisational culture, work characteristics, work readiness, work commitment, professional role), (2) personality traits (self-embodiment, personality masking, being proactive and confident), and (3) academic institutions (pre-entry knowledge and role of nursing faculty). Newly graduated nurses' adaptation should begin during nursing education, be supported by the workplace organisation, and driven by the nurse's personality. We determined that that the role of nursing education in aiding the provision of the required knowledge and actual clinical experiences to students profoundly affected developing nurses' self-confidence levels in delivering nursing care effectively. Additionally, a warm environment supported nurses emotionally and physically.

CONCLUSIONS

While organisations and educational institutions have undertaken numerous efforts to ensure that newly graduated nurses are adequately supported, the nurse's personality and values are also equally important to ease adaptation during the transition process. Academic and workplace programs designed for newly graduated nurses should apply and emphasise this knowledge to develop and strengthen their personalities and values, especially to increase confidence and promote proactive values that facilitate newly graduated nurses' rapid and effective adaptation to their new employment.

Legacy Letters Written by Oncology Nurse Residents: Post Hoc Poetic Inquiry

BACKGROUND

A qualitative analysis of Legacy Letters written by oncology nurse residents to future nurse residents on what they wish they knew and what they learned at the end of their 1-year residency program showed four themes. This article presents a poetic inquiry of select themes/subthemes, providing a new perspective on the findings.

METHOD

Post hoc poetic inquiry of select subthemes/themes from a previously conducted qualitative nursing research study on nurse residents' Legacy Letters was conducted using a collective participant voice approach.

RESULTS

Three poems were created. A sample quote by an oncology nurse resident and an explanation of the relationship of the poem to the Legacy Letters are provided.

CONCLUSION

These poems represent a larger theme of resilience. Learning from mistakes, dealing with emotions, and providing self-care embody the experience and adaptation of the oncology nurse residents to this year of transition from graduation to professional practice. [J Contin Educ Nurs. 2023;54(3):117-120.].

Novice nurses and factors that influence job adaptation after incorporation into the world of work

Abstract Objective To analyze the factors that influence the job adaptation of hospital nursing, during the transition period of graduates as a health workforce in their new stage. Method An exploratory, cross-sectional study, involving 100 graduate nurses as a workforce of hospital units. The collection was carried out with a questionnaire on the web platform in the period November 2020 - August 2021. The analysis was carried out using descriptive statistics. Results There was a predominance of women, single, aged between 23 and 32, licensed and operational, working between 19 months and 2 years. Regarding the factors, three most influential were identified, corresponding to: Autonomy; Psychological; Staff. Conclusions and implications for practice The adaptation of nursing staff in the hospital presents difficulties in the transition period; the internal factors of the professional, whether acquired through practices or developed during life, and the training of employers have influence. For improvement, it would be essential that the induction protocols guarantee the adaptation of the novice and that the employee training programs evaluate the effectiveness of the nursing staff in the hospital, until the achievement of the adaptation of nursing to the hospital.

Enfermeiros novatos e os fatores que influenciam a adaptação ao trabalho após a incorporação ao mundo laboral

Resumo Objetivo Analisar os fatores que influenciam a adaptação ao trabalho da enfermagem hospitalar durante o período de transição dos egressos como força de trabalho em saúde em sua nova etapa. Método Estudo exploratório, transversal, que envolveu 100 enfermeiros graduados como força de trabalho de unidades hospitalares. A coleta foi realizada com um questionário na plataforma web no período de novembro de 2020 a agosto de 2021. A análise foi realizada por meio de estatística descritiva. Resultados Houve predomínio de mulheres, solteiras, com idade entre 23 e 32 anos, licenciadas e operacionais, trabalhando entre 19 meses e 2 anos. Em relação aos fatores, foram identificados três mais influentes: Autonomia; Psicológico; Funcionários. Conclusões e implicações para a prática A adaptação da equipe de enfermagem no hospital apresenta dificuldades no período de transição; os fatores internos do profissional, sejam adquiridos por meio de práticas ou desenvolvidos ao longo da vida, e a formação dos empregadores influenciam. Para melhoria, seria fundamental que os protocolos de indução garantissem a adaptação do novato e que os programas de treinamento de funcionários avaliassem a efetividade da equipe de enfermagem no hospital, até a realização da adaptação da enfermagem ao hospital.

Frequency and Outcomes of Workplace Incivility in Healthcare: A Scoping Review of the Literature

AIMS

To evaluate the frequency and outcomes of workplace incivility in healthcare for nursing management.

BACKGROUND

Incivility in the workplace is a significant problem that is important to nurse managers, as it goes directly against the fundamental values and ethics of providing high-quality care to patients. The Joint Commission (2021) and the American Nurses Credentialing Center have called on healthcare organizations to identify and intervene in the problem of workplace incivility.

EVALUATION

Studies included in this scoping review were those that measured and analyzed the frequency and outcomes of workplace incivility in healthcare. Four databases were searched, and 28 articles were reviewed. Evaluation was based on general quality, including study characteristics, instruments, and statistical analyses.

KEY ISSUES

Studies used a quasi-experimental design, and most focused on the Registered Nurse population. The Workplace Incivility Scale was the most commonly used instrument to measure workplace incivility frequency. The most frequently studied work-related outcomes were burnout, satisfaction, and turnover.

CONCLUSIONS

Although the frequency of workplace incivility in healthcare is not clear, its consequences are substantial. Multiple studies have revealed significant relationships between workplace incivility and work-related outcomes that are important to nurse managers. Research is needed on non-nursing healthcare professionals, and validation studies are needed on instruments used to measure workplace incivility frequency.

IMPLICATIONS FOR NURSING MANAGEMENT

The findings of this review can help nurse managers better understand the phenomenon, frequency, and impact of workplace incivility in the healthcare setting and move toward addressing the problem of workplace incivility among nurses and other healthcare professionals.

Exploring facilitators and barriers for successful transition among new Saudi graduate nurses: A qualitative study

AIM

This study aims at exploring Saudi newly graduated nurses' perspectives on the facilitators and barriers for successful transition from being a student to being a nurse.

DESIGN

A phenomenological qualitative methodology was employed.

METHODS

Focus group discussions were carried out among 35 Saudi nurses at one major university hospital in Saudi Arabia.

RESULTS

Under the theme of barriers to transition three main subthemes emerged, namely "Fear of making medical errors," "Intense Workload and Expectations," "Bullying and lack of support," while under the facilitators of transition the subthemes which emerged were "Supportive preceptor," "Training workshops," "Need for transition programs." This research found that formal and informal techniques for strengthening institutional variables and improving individual factors are critical for new graduate nurses' effective transition into professional responsibilities.

Effects of Mindfulness Meditation on Doctors' Mindfulness, Patient Safety Culture, Patient Safety Competency and Adverse Event

Objective: This study investigated the effects of mindfulness meditation on doctors’ mindfulness, patient safety culture, patient safety competency, and adverse events. Methods: We recruited 91 doctors from a hospital in China and randomized them to mindfulness meditation group (n = 46) and a waiting control group (n = 45). The mindfulness meditation group underwent an 8-week mindfulness meditation intervention, while the control group underwent no intervention. We measured four main variables (mindfulness, patient safety culture, patient safety competency, and adverse event) before and after the mindfulness meditation intervention. Results: In the experimental group, mindfulness, patient safety culture and patient safety competency were significantly higher compared with those of the control group. In the control group, there were no significant differences in any of the three variables between the pre-test and post-test. Adverse events in the experimental group were significantly lower than in the control group. Conclusions: The intervention of mindfulness meditation significantly improved the level of mindfulness, patient safety culture and patient safety competency. During the mindfulness meditation intervention, the rate of adverse events in the meditation group was also significantly lower than in the control group. As a simple and effective intervention, mindfulness meditation plays a positive role in improving patient safety and has certain promotional value.

A comprehensive dataset describing nurse's emotions, perceived stressors and coping mechanisms during the first surge of the COVID-19 pandemic

A comprehensive and validated questionnaire modified from previous epidemics [1,2] was distributed to frontline HCWs at high risk for COVID-19 at our community-based teaching hospital, the epicenter of the pandemic in our state. Results of the full analysis were previously reported [3] indicating that our nursing staff were more likely to report feelings of stress, emotional exhaustion and fatigue compared to physicians and other health professionals. We highlight the pandemic's specific impact on nurses’ emotions, perceived stressors and effective coping mechanisms used during the first surge of COVID-19.

The influence of subjective well-being on mental health in nursing students: the role of student cynicism

Previous studies have reported high rates of poor mental health among nursing students, but few studies focused on the internal pathway of mental health. This cross-sectional study was conducted at a vocational medical school and investigated 384 nursing students. Symptom Check List-90, Index of Well-Being Scale and Cynical Attitudes Toward College Scale were used to test mental health, subjective well-being (SWB) and cynicism of nursing students, respectively. Academic cynicism, social cynicism and institutional cynicism were negatively related to mental health. SWB not only directly had positive effect on mental health, but had an indirect effect on mental health through academic cynicism, social cynicism and institutional cynicism.

Proceed With Caution: Integrating Newly Graduated Nurses Into an Emergency Department

Virtually, no published research is available on the relationship between employing newly graduated nurses (NGNs) in the emergency department (ED) and the advancing of nursing practice and the optimization of patient care outcomes. Traditionally, nurses hired into these practice areas have required advanced skills in clinical assessment and experience with a variety of situations that were assumed to offer them a framework by which they could recognize and respond to potentially life-threatening changes in a patient's status. This qualitative study explored the issues of integrating NGNs into the ED. Findings clearly established the challenges to integrating NGNs into this practice context. The intersection of variables included a low level of clinical predictability accompanied by high acuity; an increased level of practitioner autonomy combined with high levels of risk when applying decision making to patient outcomes; and the potential for devolution of professional identity in the face of highly intense, morally conflicted, and socially nuanced care situations.

Health-promoting and -impeding aspects of using peer-learning during clinical practice education: A qualitative study

AIM

The aim of the present study was to elucidate health-promoting and -impeding aspects of peer-learning by examining nursing students' descriptions of learning together as peers, and how this might interact with their health.

BACKGROUND

Peer-learning is a useful strategy for teaching and learning in nursing students' clinical practice education. In the research, benefits such as improved cooperation and increased self-confidence have been described and labelled as health-promoting.

DESIGN

A qualitative descriptive approach METHOD: Thirteen first-year nursing students aged 22-45 years, who had completed their first clinical practice education on a medical or surgical hospital ward, participated in one-on-one semi-structured interviews. The interviews were analyzed using qualitative content analysis.

RESULT

Working as a pair was primarily described as positive, as the peers felt basic support from each other, even though they described negative experiences that limited their own development and challenged their patience.

CONCLUSION

Peer-learning as a model for supervision in clinical practice incorporates valuable health-promoting aspects, as the students felt safe, supported, increased self-confidence, and participation. The interaction between peers helped them grow as human beings, and the mutual support the peers felt was a vital health-promoting aspect that limited the impact of the described health-impeding aspects, which included sometimes finding peer-learning trying, stressful and irritating.

Transition to Practice for New Nurse Graduates: Barriers and Mitigating Strategies

Inadequate transition to practice increases stress for new health care providers and threatens employment longevity. This integrative review aimed to synthesize the evidence on transition process for newly graduated registered nurses and advanced practice nurses in hospital settings and to identify enablers/barriers and mitigating strategies. Two databases were systematically searched for articles that described the process, strategies, participant perceptions, and implications of role transition with a final yield of 23 articles. Synthesis of the evidence revealed three major themes: (a) achieving competence for safe practice, (b) addressing stress during transition, and (c) reducing turnover. Emotional support for new graduates was instrumental to achieving clinical competence. Role transition adaptation was linked to anxiety, while emotional health was positively associated with retention. Developing best practices that address skill proficiency, attending to the emotional needs of new nurse graduates, and providing structured transition programs to improve clinical competence are the strategies of choice.

Burnout and distress among nurses in a cardiovascular centre of a quaternary hospital network: a cross-sectional survey

BACKGROUND

Burnout and distress have a negative impact on nurses and the treatment they provide. Our aim was to measure the prevalence of burnout and distress among nurses in a cardiovascular centre at 2 quaternary referral hospitals in Canada, and compare these outcomes to those for nurses at academic health science centres (AHSCs) in the United States.

METHODS

We conducted a survey of nurses practising in a cardiovascular centre at 2 quaternary referral hospitals in Toronto, Ontario, between Nov. 27, 2018, and Jan. 31, 2019. The survey tool included the Well-Being Index (WBI), which measures fatigue, depression, burnout, anxiety or stress, mental and physical quality of life, work-life integration, meaning in work and distress; a score of 2 or higher on the WBI indicated high distress. We also evaluated nurses' perception of the adequacy of staffing levels and of fair treatment in the workplace, and satisfaction with the electronic health record. We carried out standard univariate statistical comparisons using the χ², Fisher exact or Kruskal-Wallis test as appropriate to perform univariate comparisons in the sample of respondents. We assessed the relation between a WBI score of 2 or higher and demographic characteristics. We compared univariate associations among WBI data for nurses at AHSCs in the US who completed the WBI to responses from our participants.

RESULTS

The response rate to the survey was 49.1% (242/493). Of the 242 respondents, 188 (77.7%) reported burnout in the previous month; 189 (78.1%) had a WBI score of 2 or higher, and 132 (54.5%) had a score of 4 or higher (indicative of severe distress). Ordinal multivariable analysis showed that lower WBI scores were associated with satisfaction with staffing levels (odds ratio [OR] 0.33, 95% confidence interval [CI] 0.16-0.69) and the perception of fair treatment in the workplace (OR 0.41, 95% CI 0.23-0.74). Higher proportions of our respondents than nurses at AHSCs in the US reported burnout (77.7% v. 60.5%, p < 0.001) and had a WBI score of 2 or higher (78.1% v. 57.0%) or 4 or higher (54.5% v. 32.0%) (both p < 0.001).

INTERPRETATION

Although levels of burnout and distress were high among nurses, their perceptions of adequate staffing and fair treatment were associated with lower distress. Addressing inadequate staffing and unfair treatment may decrease burnout and other dimensions of distress among nurses, and improve their work experience and patient outcomes.

Burnout and distress among allied health care professionals in a cardiovascular centre of a quaternary hospital network: a cross-sectional survey

BACKGROUND

Burnout and distress negatively affect the well-being of health care professionals and the treatment they provide. Our aim was to measure the prevalence of burnout and distress among allied health care staff at a cardiovascular centre of a quaternary hospital network in Canada, and compare outcomes to those for nonphysician employees in the United States.

METHODS

We conducted a survey of allied health care staff, including physical, respiratory and occupational therapists, pharmacists, social workers, dietitians and speech-language pathologists, in a cardiovascular centre at 2 quaternary referral hospitals in Toronto, Ontario, between Nov. 27, 2018, and Jan. 31, 2019. The survey tool included the Well-Being Index (WBI), which measures fatigue, depression, burnout, anxiety or stress, quality of life, work-life integration, meaning in work and overall distress; a score of 2 or higher indicated high distress. We carried out standard univariate statistical comparisons using the χ², Fisher exact or Kruskal-Wallis test as appropriate to perform univariate comparisons in the sample of respondents. We assessed the relation between a WBI score of 2 or higher and demographic characteristics. We compared univariate associations among WBI data for nonphysician employees in the US who completed the WBI to responses from our participants.

RESULTS

The response rate to the survey was 86% (45/52). Thirty-three respondents (73%) reported experiencing burnout in the previous month, and 31 (69%) reported emotional problems. Compared to respondents who perceived fair treatment in the workplace, those who perceived unfair treatment (20 [44%]) were more likely to report emotional problems (17 [85%] v. 13 [54%], p = 0.05), to worry that work was hardening them emotionally (15 [75%] v. 8 [33%], p = 0.008), and to feel down, depressed or hopeless (12 [60%] v. 4 [17%], p = 0.005). Twenty-five respondents (56%) and 13 respondents (29%) reported WBI scores consistent with high (≥ 2) or severe (≥ 5) distress, respectively. Respondents were more likely to have a high WBI score if they perceived unfair treatment or inadequate staffing levels. Our respondents had a higher prevalence of burnout (73.3% v. 53.6%, p = 0.008) and a higher average WBI score (2.6 [SD 2.8] v. 1.7 [SD 2.6], p = 0.05) than 9096 nonphysician employees in the US.

INTERPRETATION

The prevalence of burnout, emotional problems and distress was high among allied health care staff. Fair treatment in the workplace and adequate staffing may lower distress levels and improve the work experience of these health care professionals.

New graduate nurses' coping with death and the relationship with death self-efficacy and death anxiety: A multicentre cross-sectional study

AIMS

To examine new graduate nurses' perceptions of competency on coping with dying and death and the relationship with death self-efficacy and death anxiety.

DESIGN

A multicentre, cross-sectional study.

METHODS

Three hundred and forty new graduate nurses from five metropolitan hospitals were recruited between August-November 2018. Participants completed the Coping with Death Scale, Death Self-efficacy Scale, and Death Anxiety Scale.

RESULTS

Two hundred and ninety-eight new graduate nurses responded to the survey. The mean score of coping with death and death self-efficacy was 120.11 (SD 24.59), 259.11 (SD 57.70) respectively. 88.9% feared a painful death, 81.5% were particularly afraid of getting cancer, and 80.2% were afraid of death. There was a positive relationship between coping with death and death self-efficacy, a negative relationship between coping with death and death anxiety and a negative correlation between death self-efficacy and death anxiety. Five variables, including death self-efficacy, three dimensions of death anxiety including emotion, cognition with life and death and stress and distress and religion in total accounted for 46.9% of the variance of coping with death.

CONCLUSION

New graduate nurses are at a disadvantage in terms of death self-efficacy, less well prepared in coping with death and are more anxious about death.

IMPACT

It is imperative for educational institutions to support new graduate nurses with pre-licensure learning related to patient death issues and care. Organizations are also strongly advised to support new graduate nurses to cope with patient death through development of culturally sensitive interventions and guidelines, which may in turn assist with decreasing new graduate nurses' risk of burnout and increasing their longevity in the profession.

New Registered Nurse Transition to the Workforce and Intention to Leave: Testing a Theoretical Model

BACKGROUND

The transition of new nurses into practice has been identified as challenging, and new nurses report having intentions to leave (ITL) jobs. Concerns of ITL are worrisome for the nursing profession, especially when faced with the need to replace an aging nursing workforce and to maintain quality patient care.

PURPOSE

Guided by components of Meleis et al.'s mid-range transition theory, the purpose of this study was to test a theoretical model linking transition and ITL, as well as the personal, community and societal conditions of transition.

METHODS

A predictive, non-experimental design using cross-sectional data was employed. Ontario registered nurses, who had graduated within two years, were randomly selected to complete a mailed questionnaire in 2015 (N = 217). Structural equation modeling was undertaken to test the model.

RESULTS

The new nurses reported a relatively positive transition; yet, 44% of the respondents indicated leaving their first job, and 1% departed the nursing profession. A revised model of the constructs showed a more adequate fit with the data, but overall, the hypothesized model was not supported and methodological validity of tools questioned. From the modeling, lower role stress led to a positive transition.

CONCLUSIONS

Given organizational and governmental investments in orientation and transition programs, challenges in measuring transition and ITL requires additional research. Our findings highlight the value of organizations supporting new nurses by reducing role stress through reasonable workloads and expectations, which in turn contributes to a positive transition.

Consequences of early career nurse burnout: A prospective long-term follow-up on cognitive functions, depressive symptoms, and insomnia

BACKGROUND

Burnout is common among nurses and midwives. We examined whether an early career episode of burnout has long-term consequences on; a) cognitive functions, b) symptoms of depression, and/or c) insomnia for nurses a decade after graduation.

METHODS

Symptoms of burnout were investigated in an observational longitudinal study of three national cohorts of registered nurses (RNs). Nursing students were recruited from all 26 of Sweden's nursing programs. Burnout was subsequently measured through annual assessment over the first three years post graduation, with one long-term follow-up 11-15 years after graduation. A total of 2474 nurses (62%) consented to participate at follow-up. Burnout was measured using items from the Oldenburg Burnout Inventory, cognitive function by a study specific instrument, depressive symptoms by the Major Depression Inventory, and sleep problems using items from the Karolinska Sleep Questionnaire. We used logistic regression to identify factors associated with consequences of early career burnout, adjusting for concurrent levels at follow up.

FINDINGS

The prevalence of nurses reporting high levels of burnout symptoms at least one of the first three years of working life was 299 (12·3%). High levels of burnout symptoms in early working life were significantly related to more frequent symptoms of cognitive dysfunction, depression, and impaired sleep a decade later when taking current burnout levels into account. After controlling for both current symptoms of burnout and the other outcome variables, nurses with early career burnout still reported more frequent problems with cognitive functions and sleep but not depression.

INTERPRETATION

The results of this study show that the detrimental processes caused by overwhelming or chronic stress start early on in nurses' careers and thus preventive efforts should preferably be introduced early on (e.g. as part of nursing education and onboarding programs).

FUNDING

AFA Insurance Grant [number 150284].

An Exploratory Study of the Influence of Perceived Organizational Support, Coworker Social Support, the Nursing Practice Environment, and Nurse Demographics on Burnout in Palliative Care Nurses

Burnout, a condition characterized by emotional exhaustion, depersonalization, and decreased personal accomplishment, has been studied in many disciplines in health care, including nursing, medicine, and social work. The purpose of this study was to examine the relationship between perceived organizational support, coworker social support, the nursing practice environment, and nurse demographics (age, years of nursing experience, education level, marital status, and sex) on burnout in a national sample of palliative care nurses. The study aims were (1) to examine the relationship between perceived organizational support, coworker social support, and nursing practice environment on burnout in palliative care nurses; (2) to examine the relationship between age, years of nursing experience, education level, marital status, and sex on burnout in palliative care nurses; and (3) to examine potential moderators (perceived organizational support and coworker social support) on the relationship between demographic characteristics and palliative care nurse burnout. A convenience sample of 73 Hospice and Palliative Nurses Association registered nurses who were bedside caregivers was recruited from Hospice and Palliative Nurses Association's membership. Data were analyzed using Pearson correlation and regression modeling. Findings indicated palliative care nurses had moderate to high levels of burnout. There was a negative correlation between burnout and perceived organizational support, and between burnout and coworker social support. The nursing practice environment of palliative care nurses was favorable; perceived organizational support and coworker social support were not moderators for demographics of age and years of experience and their relationship to burnout.

A survey of clinical competence of new nurses working in emergency department in Iran: A descriptive, cross-sectional study

Aims

This article reports on a study investigating the self‐assessed clinical competence of new nurses working in emergency departments.

Design

A quantitative approach using descriptive cross‐sectional survey design was employed.

Methods

The clinical competency of the participants was assessed using the Competency Inventory for Registered Nurse questionnaire, which contains the seven dimensions of clinical care, leadership, interpersonal relations, legal/ethical, professional development, teaching/coaching and critical thinking/research aptitude. Data from 115 new nurses employed in emergency departments of nine selected university hospitals in the northwest of Iran were collected by the Competency Inventory for Registered Nurse (CIRN) from December 2018–May 2019 and analysed.

Results

The mean clinical competency for the total scale was 155.7 (SD 32.9), indicating a moderate competency. The most highly self‐rated competency was legal/ethical practice, and the least rated was critical thinking–research aptitude.