Good nurse-nurse collaboration implies high job satisfaction: A structural equation modelling approach

How can strategies based on performance measurement and feedback support changes in nursing practice? A theoretical reflection drawing on Habermas' social perspective

Strategies based on performance measurement and feedback are commonly used to support quality improvement among nurses. These strategies require practice change, which, for nurses, rely to a large extent on their capacity to coordinate with each other effectively. However, the levers for coordinated action are difficult to mobilize. This discussion paper offers a theoretical reflection on the challenges related to coordinating nurses' actions in the context of practice changes initiated by performance measurement and feedback strategies. We explore how Jürgen Habermas' theory of Communicative Action may shed light on the issues underlying nurses' collective actions and self-determination in practice change and the implications for the design of strategies based on performance measurement and feedback. Based on this theory, we propose differences between communicative and functional coordination according to the nature of the actions and the purposes involved. The domains of action underlying these coordination processes, which Habermas referred to as the lifeworld and the system, are then used to draw a parallel with aspects of nursing practice. Further exploration of these concepts allows us to consider the tensions between the demands of the system and the self-determination of nurses within their practice.

Job satisfaction in nursing: A qualitative inquiry into novice and experienced nurses' perspectives

AIM

To explore factors associated with job satisfaction between novice and experienced nurses.

BACKGROUND

Job satisfaction is crucial for better quality of patient care and nurses' job engagement in clinical setting. However, job dissatisfaction is commonly reported from clinical nurses leading to poorer patient outcomes and high turnover rate. Job satisfaction at different professional stages may have different expectations. Knowledge about factors influencing job satisfaction of junior and senior nurses is inadequate.

DESIGN

A phenomenological study was conducted using face-to-face individual interviews.

METHOD

Semi-structured interviews were conducted and audio-recorded. The Herzberg's Two-Factor Theory was used to understand the phenomena. Purposeful sampling was used to select eligible nurse participants who were working in hospital settings.

RESULTS

Eight participants, consisting of four junior and four senior nurses, with clinical experience ranging from 1 to more than 25 years, were selected in this study. Four main themes related to job satisfaction were identified: "supportive working environment," "autonomy in practice," "professional training for competence enhancement," and "heavy workload and insufficient manpower." These themes highlighted the common aspects that contribute to job satisfaction among nurses according to the Herzberg's Two-Factor Theory.

CONCLUSION

The findings of this study contribute to our understanding of the factors that influence job satisfaction among both novice and experienced nurses. While four themes highlighting common aspects of their needs have been identified, it is important to acknowledge that novice and experienced nurses may have their own unique perspectives within these aspects. According to Herzberg's Two-Factor Theory, job satisfaction factors can be complex and diverse. To enhance job satisfaction among nurses, hospital policymakers and senior management should be attentive to identify factors that have an impact on job satisfaction of nurses at different stages of their clinical experience. Developing a strategic plan to meet the needs of nurses based on their experience levels should take into consideration the disparities in work environment and responsibilities, ultimately job satisfaction can be improved, leading to better overall patient care.

Peer Collaborative Clinical Decision Making in Nursing Simulation: A Theoretical Framework

BACKGROUND

Collaboration and decision making among nursing students are essential competencies in nursing education. However, how students collaborate and make decisions in simulation is a complex phenomenon and not well understood. This study aimed to develop a framework that describes peer collaborative clinical decision making (PCCDM) among nursing students in simulation.

METHOD

Charmaz's constructivist grounded theory method was used. The sample included 32 participants (16 dyads) from two nursing programs.

RESULTS

The PCCDM framework described three interrelated functional domains (cognition, behavior, and emotion) experienced through three interrelated processes (awareness, communication, and regulation), alternating between individual and collaborative spaces and changing across time according to the simulation's acuity levels.

CONCLUSION

The PCCDM framework provides a model that reflects how these processes unfold over time in simulations, which can be applied in nursing simulation, classroom, and clinical settings that require students to make collaborative decisions. [J Nurs Educ. 2024;63(7):435-443.].

Nurse-to-Nurse Collaboration: A Scoping Review

OBJECTIVE

To map predictors and outcome of collaboration between nurses, outcomes of a good collaboration, and the tools developed to evaluate nurse-nurse collaboration.

BACKGROUND

Collaboration between nurses is an intraprofessional relationship between coworkers that is expressed through shared objectives, authority, and a decisional process. Studies on collaboration between nurses are very limited.

METHODS

A scoping review was conducted through 4 databases.

RESULTS

Eighteen studies were included. Nurses with higher levels of collaboration are more satisfied with their work and report less of an intention to leave their job. Greater collaboration among nurses resulted in a decrease of patient falling, hospital-acquired pressure ulcers, and a better care. Three tools have been developed to evaluate nurse-nurse collaboration: the Nurse-Nurse Collaboration Scale, the Nurse-Nurse Collaboration Behavior Scale, and the Nurse-Nurse Collaboration Between Sector.

CONCLUSIONS

Further studies should be conducted to fully understand the issue of collaboration between nurses and the factors connected to it.

Mediating effects of workgroup processes on the relationship between nurse turnover and nurse outcomes in hospitals

Background

Nurse turnover is often considered to be an outcome, and few studies have investigated its consequences in nursing care. The underlying mechanism of the nurse turnover-nurse outcome relationship has not been empirically investigated. Therefore, this study examines workgroup processes and nurse outcomes as the consequences of nurse turnover and the mediating effect of workgroup processes on the nurse turnover-nurse outcomes relationship.

Methods

A cross-sectional design was adopted to investigate the data collected from 264 staff nurses. Furthermore, six-month turnover rates, workgroup processes (nurse-nurse collaboration, team cohesion), and nurse outcomes (job satisfaction, intent to leave) were utilized in the multivariate regression models.

Results

Overall, 53 (24.4%) nurses had worked in nursing units with a zero six-month turnover rate. The average mean six-month turnover rate was 15.5%. Nurse turnover adversely affected nurses' job satisfaction and several subscales of team cohesion including task cohesion and social cohesion. Team cohesion partially mediated the relationship between nurse turnover and job satisfaction.

Conclusion

Nurse turnover decreased job satisfaction and team cohesion, and team cohesion partially mediated the nurse turnover-nurse outcomes relationship. These findings provide evidence supporting the significant adverse effects of nurse turnover and suggest the potential role of workgroup processes in explaining the underlying mechanism of the relationship between nurse turnover and nurse outcomes.

Implications for nursing and health policy

Healthcare organizations must create a positive work environment to reduce nurse turnover. Further, states and countries should try to develop and establish nursing and health policies to prevent turnover.

Registered nurses' experience of care for adult patients with a temporary tracheostomy at general hospital wards. A phenomenological-hermeneutic explorative study

BACKGROUND

Caring for adult patients with a temporary tracheostomy in general wards can be challenging and complex. Little research has explored registered nurses' experiences with caring for these groups of patients.

OBJECTIVES

This study sought to interpret and describe registered nurses' lived experiences of caring for adult patients with a tracheostomy in general wards.

RESEARCH DESIGN/METHODOLOGY

Six registered nurses were interviewed in this study. The interviews were analysed to gain comprehensive knowledge about caring for adult patients with a temporary tracheostomy. The interviews were transcribed, analysed, and interpreted by using Gadameŕs philosophical hermeneutics and Kvale and Brinkmann's three steps of understanding.

SETTING

Three different wards medical, surgical, and neurological of a teaching hospital in Norway.

FINDINGS

Three themes emerged from data analysis. These included experiencing clinically challenging patients, a lack of clinical support from the intensive care nurses, and a lack of professional confidence.

CONCLUSION

This study highlighted the challenges surrounding the care of an adult patient with a tracheostomy in the general wards. Identifying these challenges would lead to further improvement in registered nurses' experiences and, in turn, in the quality of competent care for adult patients with a tracheostomy in the general ward.

IMPLICATIONS FOR CLINICAL PRACTICE

Understanding the registered nurses' experiences will assist the head nurses in planning and providing relevant information and education to provide safe and holistic patient care. Adequate support from intensive care unit nurses and professional development are required to ensure high-quality care. This study recommends that healthcare managers focus on establishing step-down units to improve patient outcomes, especially for high-risk patients and to increase the competencies of registered nurses in caring for adult patients with a tracheostomy as a whole person.

The Effect of Nurses' Professionalism Attitudes on Nurse-Nurse Collaboration in a City Hospital in Turkey: A Cross-Sectional Study

Background: Professionalism in nursing plays a key role in establishing collaboration between nurses. Collaboration between nurses increases the quality of patient care and reduces medical errors. Aim: This study aimed to determine the effect of nurses' professionalism attitudes on nurse-nurse collaboration. Methods: This study adopted a descriptive and cross-sectional design. The sample consisted of 409 nurses in public hospitals in Kayseri, Turkey. Data were collected using a socio-demographic characteristics questionnaire, the Occupational Professional Attitude Inventory, and the Nurse-Nurse Collaboration Scale. Results: Nurses had high professionalism but low nurse-nurse collaboration. There was a weak positive correlation between professionalism and nurse-nurse collaboration. It was determined that professionalism affects nurse-nurse collaboration at low level. Conclusion: Nurses had high levels of professionalism but low levels of collaboration. However, professionalism was weakly associated with collaboration, and nurses' attitudes toward professionalism had little effect on nurse-nurse collaboration. Executive nurses should organize training to help nurses develop professionalism and collaboration skills. In addition, for collaboration, all nurses must have at least a bachelor's degree education.

The relationship between nurse-nurse collaboration and work readiness among new graduate nurses

BACKGROUND

Communication and collaboration with colleagues are crucial for new graduate nurses (NGNs) because of the adaptation to both the healthcare system and professional role. Therefore, working units with effective collaboration among nurses may increase new graduates' work readiness.

AIM

This study aimed to determine the relationship between the perceptions of nurse-nurse collaboration and the work readiness level among NGNs.

METHODOLOGY

This descriptive, cross-sectional study was carried out with 198 NGNs in four private hospitals affiliated with a university. A self-administered questionnaire, including a personal information form, the Nurse-Nurse Collaboration Scale, and Work Readiness Scale, was used to collect data. Data analysis was performed using descriptive tests, and Spearman's rank correlation coefficients.

RESULTS

NGNs had moderate perceptions of nurse-nurse collaboration, with a median score of 2.46 (2.23-2.88) out of 4. Work readiness among NGNs was moderate, with a median score of 304 (270-332) out of 460. There was a statistically significant correlation between nurse-nurse collaboration and work readiness (r_s  = 0.26; p < .001).

CONCLUSION

The results of this study demonstrated that improving nurse-nurse collaboration is an effective way to increase work readiness among NGNs.

A qualitative exploration of nurse-physician collaboration in intensive care units

BACKGROUND

Effective nurse-physician collaboration is associated with superior patient outcomes and improved job satisfaction for both nurses and physicians.

OBJECTIVES

This qualitative study explored factors that contribute to nurse-physician collaboration in critical care. Using a qualitative descriptive design, in-depth interviews were conducted with intensive care unit physicians and nurses. Four physicians and six nurses were interviewed between November 2018 and February 2019. Using an iterative process, data analysis occurred after each interview and Lincoln & Guba's Trustworthiness criteria was used to establish validity.

RESULTS

The importance of effective collaboration was emphasized by all nurses and physicians who participated in this study. All participants emphasized the importance of communication and linked effective collaboration to better patient outcomes. Nurses valued respect while physicians stressed the importance of relationships. Both nurses and physicians identified multidisciplinary rounds as the best mechanism for collaboration. Collaboration was also linked to both nurse and physician job satisfaction.

CONCLUSION

Effective nurse-physician collaboration is essential to a healthy work environment and optimal patient outcomes. Collaboration improves with the implementation of multidisciplinary rounds. This is the first study to examine this relationship using a qualitative approach. Regardless of health system, both nurses and physicians value effective collaboration. Efforts should be made to invest in activities to improve this relationship.

IMPACT

Intenisve care units with effective collaboration are associated with superior patient outcomes. This study used an intimate approach to examine nurses' and physicians' perceptions on collaboration which provided candid and provoking opinions.

The cross-cultural adaptation and validation of the Nurse-Nurse Collaboration Scale in Italy

BACKGROUND AND AIM

Collaboration between colleagues is an essential element of clinical nursing care because it helps to ensure patient safety. This study aimed to evaluate the psychometric properties of the XXX version of the Nurse-Nurse Collaboration Scale (NNCS). The secondary goal of this study was to assess the degree of collaboration between nurses in Italy.

METHODS

First, the cultural adaptation of the NNCS tool was performed. The face and content validity of the tool were assessed through the involvement of nursing experts. To test construct validity, a descriptive cross-sectional study was conducted on a sample of 362 nurses.

RESULTS

The Italian version of the NNCS was composed of 23 items distributed across five domains. The five-dimensional model showed an adequate model goodness of fit (RMSEA=0.075, CFI=0.883, SRMR=0.072). The NNCS dimension with the highest average score was Professionalism (M=3.10 ± 0.45), while Conflict Management (M=2.14 ± 0.47) exhibited the lowest score.

CONCLUSIONS

The Italian version of the NNCS is a valid and reliable tool. More effort should be made to ensure the proper management of conflicts in healthcare environments.

Nurse-nurse collaboration and performance among nurses in intensive care units

BACKGROUND

An essential element for offering high-quality care in the intensive care units (ICUs) is the intraprofessional collaboration among nurses, which facilitates the exchange of knowledge and information and hence improves performance. More research is needed to understand the relationship between the nurse-nurse collaboration and job performance in the ICUs due to the multidimensionality of both concepts, the complexity of the ICU environment, and the lack of studies.

AIM

To examine the relationship between nurse-nurse collaboration and self-perceived nurse performance among Jordanian nurses in ICUs.

DESIGN

Descriptive, correlational cross-sectional design was used.

METHODS

Data were collected through an online survey including the demographic questionnaire, the nurse-nurse collaboration scale, and six-dimensions scale for nursing performance.

RESULTS

In total, 155 critical care nurses participated (response rate = 46.97%). Self-perceived job performance was significantly associated with gender (t = -3.189, P = .002), age (r = -0.301, P < .01), workplace (F = 28.20, P = .001), the type of ICU (F = 17.70, P = .001), and the number of assigned patients (r = 0.407, P < .01). Among all nurse-nurse collaboration subscales, only the conflict management subscale was an independent significant predictor of self-perceived nursing performance (t = 3.06, B = 3.066, P = .003).

CONCLUSIONS

Effective conflict management is associated with better nurse performance, which could ultimately improve patient care in ICUs.

RELEVANCE TO CLINICAL PRACTICE

Conflict resolution is an important dimension of optimal nurse-nurse collaboration and has an important effect on nursing performance. Nurses and nurse managers in ICUs need to attend workshops and training programs in conflict management.

The Relationship Between Emotional Intelligence and Nurse-Nurse Collaboration

PURPOSE

The purpose of this study was to examine the relationship between emotional intelligence and nurse-nurse collaboration among registered nurses in Jordan.

DESIGN

This study used a cross-sectional, quantitative survey design to query 342 nurses who worked in two hospitals in Jordan.

METHODS

We used Arabic versions of valid, reliable instruments to measure emotional intelligence and nurse-nurse communication.

FINDINGS

A total of 311 questionnaires were returned (91% response rate). Nurses' emotional intelligence was positively and significantly correlated with the nurse-nurse collaboration subscales. The results also indicated a statistically significant mean difference in communication subscale scores by gender and nursing unit.

CONCLUSIONS

The present study demonstrated that nurse-nurse collaboration is linked to benefits for nurses in terms of improved job satisfaction, better nurse retention, improved quality of patient care, and enhanced healthcare efficiency and productivity. This suggests that improving nurse-nurse collaboration may have spillover effects of benefits, not only for nurses but for patients, organizations, and the overall healthcare system.

CLINICAL RELEVANCE

Building an environment that encourages collaboration among nurses can greatly impact the performance of nurses and its benefit to nurses. Encouraging employees to participate in activities and to collaborate in making this an integral part of their evaluation will contribute to improving the teamwork in patient care.

Flourishing at work: Nurses' motivation through daily communication - An ethnographic approach

Shortage and turnover of registered nurses are worldwide challenges, and work motivation is one factor in retaining staff in the healthcare sector. The aim of this study was to explore registered nurses' motivation expressed in daily communication, using the basic needs in self‐determination theory as a framework. A secondary analysis of ethnographic data, collected through participant observations, informal interviews during observations, and individual interviews, was used. A total sample of all registered nurses employed at a hospital unit in Sweden (n = 10) participated. The data were analyzed thematically through the lens of the basic needs in self‐determination theory: autonomy, competence, and relatedness. Self‐regulation of learning, the possibilities to discuss work‐related challenges with colleagues, and having registered nurses lead dialogues with physicians were factors connected to autonomy. Having a registered nurse and physician solve problems together was a factor connected to competence. A sense of belonging and security in a permissive climate between registered nurses was connected to relatedness. This paper has implications for increased awareness of the three basic motivational needs, which could be used in the development of attractive workplaces.

Nursing leadership styles and their impact on intensive care unit quality measures: An integrative review

AIM

To examine the impact of nursing leadership styles on intensive care unit quality measures.

BACKGROUND

Evidence on the impact of leadership styles has direct implications for building and strengthening leadership behaviours that foster quality nursing care in intensive care units.

EVALUATION

An integrative review approach was adopted. Databases including the Cumulative Index of Nursing and Allied Health Literature, PubMed, Scopus, ProQuest, Google Scholar and the Cochrane Library were searched.

KEY ISSUES(S)

Out of 253 identified studies, seven were included in the review. Leadership styles in intensive care units include transformational, considerate, exemplary, trusted and absentee leadership. Active nurse leaders who share a common vision, and advocate for their staff are perceived as more effective than those who exhibit absentee characteristics. Structural measures influenced by leadership styles include productivity and morale of nursing staff. Outcome measures such as staff outcomes (intent to stay, job satisfaction), medication errors and periventricular/intraventricular haemorrhage in neonatal intensive care units have a positive relational effect with nursing leadership style.

CONCLUSIONS

The findings highlight the link between nursing leadership styles on structural and outcome measures in intensive care units. The current literature lacks studies highlighting the impact of nursing leadership styles on process measures in intensive care units.

IMPLICATIONS FOR NURSING MANAGEMENT

Transformational, considerate, exemplary leadership practices, and trusted leadership styles when used by nurse leaders guarantee higher quality of nursing care in intensive care units. Therefore, modern leadership styles need to be supported by health care organisations and education.