Effective leadership, teamwork and mentoring – Essential elements in promoting generational cohesion in the nursing workforce and retaining nurses

Using Innovation in Credentialing to Foster Meaningful Transitions to Practice and Support Continuing Professional Development

Certification within specialized areas in nursing has long been an avenue by which nurses demonstrate competence and dedication toward professional development. Because of innovation within the credentialing arena, certification also can serve as an avenue that supports nursing professional development practitioners who are assisting nurses transitioning into new roles or new practices. [J Contin Educ Nurs. 2023;54(9):413-420.].

What interventions and programmes are available to support older nurses in the workplace? A literature review of available evidence

BACKGROUND

High exit rates, stalling entry rates, population ageing, and, most recently, the COVID-19 pandemic have placed significant strain on the world's nursing workforce. Both developed and developing countries face similar predicaments. Evidence-based programmes to support older nurses in the workplace are urgently needed to ensure the sustainability of a career in nursing for this group of healthcare professionals.

OBJECTIVES

To scope and synthesise available evidence on evaluated programmes and interventions implemented to support the ageing nursing workforce's health, wellbeing, and retention.

DESIGN

A literature review of available evidence using a systematic approach.

METHOD

Medline, Scopus, PsycINFO and CINAHL were searched for relevant peer-reviewed evidence. Data from the peer-reviewed literature were extracted separately into purpose designed-extraction spreadsheets. Information relevant to study design, intervention design, outcome constructs, intervention outcomes, and barriers and enablers to intervention success were collected. The protocol for this review was registered in PROSPERO [CRD42021274491].

RESULTS

Eighteen published studies were included in this review. We identified a range of interventions and programmes that have been implemented to support older nurses, which included flexible and reduced work arrangements, mentoring programmes, exercise and lifestyle interventions, continued professional development and purpose-designed remote retreats. We found limited evidence of evaluated outcomes from workplace support interventions that addresses the actual challenges faced by ageing nurses as reported in previous literature reviews. Interventions that were designed to promote a sense of purpose at work resulted in positive outcomes and appeared to more directly address the stated needs of older nurses. Holistic programmes and interventions that could potentially promote both physical well-being and psychological well-being required a broader, whole-of-organisation approach rather than more piecemeal interventions addressing individual physical and mental health concerns. Interventions which acknowledged older nurses' clinical expertise and experience (e.g., mentoring programmes) were linked to positive outcomes.

CONCLUSION

Future intervention efforts should acknowledge and balance intervention participation opportunities against existing everyday workload constraints faced by older nurses. Our review suggests the need for further intervention studies assessing specific outcomes such as psychological and emotional health, as well as interventions that more directly address the most pressing concerns that ageing nurses report at personal and organisational levels. A paradigm shift in productivity measurement in clinical nursing work is required in order to increase the value placed on the unique contribution of older nurses working clinically, particularly in sharing their acquired knowledge, skill, and expertise.

TouchPoint: Undergraduate Senior Immersion Activity

BACKGROUND

TouchPoint is an innovative approach to traditional clinical postconferences for prelicensure BSN students in an immersion experience. The aim of TouchPoint was to build relationships between faculty and students in an unscripted method of deep, meaningful, reflective sharing.

METHODS

TouchPoint sessions were a synthesis of stories told by nursing students. These sessions addressed relationships among patient, nurse, and families, and the importance of inter- and intraprofessional relationships. Faculty facilitators guided discussions.

RESULTS

TouchPoint sessions promoted psychological safety, built resiliency, and enhanced student awareness. The safe space created and opened a structured discussion of sensitive topics such as death, dying, gossip, loss, unsupported nursing staff, joy, and happiness, and the supportive nature of nurse mentors throughout these positive and negative experiences.

CONCLUSIONS

TouchPoint's success was in strengthening resilience practices for students by sharing lived experiences and adhering to an environment of trust, respect, and support.

Inspirational Leadership and Innovative Communication in Sustainable Organizations: A Mediating Role of Mutual Trust

The possibility of accomplishing sustainable objectives is largely connected to the management and flourishing of an organizational system which keeps human capital engaged and committed. Our study investigated the association of inspirational leadership and innovative communication with employee engagement and commitment under the lens of leader member exchange theory. Specifically, we emphasized the mediating role of mutual trust in connection to social sustainability facets. A survey of data from employees in the manufacturing sector of Yunnan, China was utilized to test the hypothesized model. The study findings reported a significant association and came to the conclusion that a leader’s inspirational behavior coupled with innovative communication is a significant predictor of engagement and commitment in socially sustainable organizations. Moreover, mutual trust significantly mediated the relationship of innovative communication and inspirational leadership with employee engagement and commitment reaching the social perspective of sustainability. The current study added to the literature of sustainable organization by pointing out the social dimensions of sustainability.

Increasing Registered Nurse Retention Using Mentors in Critical Care Services

Recruiting and training 1 newly hired registered nurse can cost thousands of dollars. With a high percentage of these newly hired nurses leaving their first place of employment within their first year, the financial implications may be enormous. It is imperative that health care facilities invest in recruiting and retention programs that retain high-quality nurses. Mentorship programs in retaining and easing the transition to practice for new graduate nurses, re-entry nurses, and nurses new to a specialty area are critical in nurse retention. Discussion in this study includes the effect of implementing a mentor program into the critical care services area of a 325-bed not-for-profit community hospital in northern Indiana. Based on this study, nurses with a mentor were retained at a 25% higher rate than those not mentored. Implementation of a mentor program reduced the training cost to the facility and increased retention and morale.

Newly Graduated Swedish Nurses' Inadequacy in Developing Professional Competence

BACKGROUND

The learning process for student and recently graduated nurses during their transition to professional nursing is stressful and challenging. The aim of this study was to describe recent graduates' experiences of developing professional competence in their basic nursing program and during their first year.

METHOD

A qualitative descriptive design with an inductive approach based on interviews with 11 nurses, with a qualitative content analysis.

RESULTS

Recently graduated nurses experience shortages and struggle to develop their professional competence. They find that reflection is a fundamental tool in the process of professional competence development. The competence gap is not between theoretical and practical knowledge, but rather between the university and health care organizations.

CONCLUSION

Focusing on the intertwining of theoretical and practical knowledge can bridge the gap between these two organizations and create a foundation for lifelong learning of professional competence. Creating opportunities for reflection is central to the learning process. [J Contin Educ Nurs. 2020;51(2):65-74.].

The Turkish version of the Nursing Teamwork Survey: A validity and reliability study

AIM

This study aimed to test the validity and reliability of the Turkish version of the Nursing Teamwork Survey, which was developed to measure the concept of nursing teamwork.

METHOD

Performed as a methodological study with a cross-sectional design, the study included 486 bedside nurses in three different types of hospitals in Istanbul. The data were collected using the Nursing Teamwork Survey between October and December 2018. The scale includes five subscales and 33 items. The data were analysed using SPSS 22.0 and LISREL 8.7.

RESULTS

Nurses' mean age was 29.82 (SD = 7.33). The content validity index of the scale was 0.94. Confirmatory factor analysis conducted on the original form showed that all items fell within the subscales of the original scale and that their factor loads were between 0.48 and 0.91. Following factor analysis, the factor structure of the original scale was valid; however, suggested modifications were applied to improve the results. The obtained goodness-of-fit indices were close to the excellent range according to literature. Cronbach's alpha was 0.95 for the scale.

CONCLUSION

The scale is a valid and reliable tool for measuring teamwork among nurses.

Nurses' expectations about the succession of leaders in the hospital context

Objective:

to analyze the expectation of nurses about the succession of leaders in the hospital context.

Method:

a descriptive and exploratory study of a qualitative approach carried out with 36 nurses from a public university hospital selected using the snowball technique. The data collection was done through semi-structured interviews that were recorded and analyzed based on the assumptions of the Content Analysis technique, Thematic modality. Ethical criteria were adequately met.

Results:

the reports comprised two central categories, “Who Will Take My Place?” and “Potential and Openness to Plan the Succession of Leadership in Nursing,” the latter being divided into two subcategories: “Nursing leadership in the hospital five years from now” and “Strengths for the implementation of a leadership succession plan”.

Conclusion:

from the results, positive aspects of the diagnosis of the leadership profile in the institution that favor the development of succession planning were verified. In addition, it was possible to perceive the necessity of the development of this planning in the hospital and its importance for the succession of leadership in Nursing. In this context, this study presents itself with an innovative character for exposing a theme that aims to potentiate the future of Nursing.

Challenges in municipality healthcare services-The nurse leaders' perspective

AIM

To examine perceptions of key challenges that nursing leadership face when organizing healthcare services in the municipality.

DESIGN

A qualitative study involving community nurse leaders (N = 9) in two focus group interviews.

METHODS

The material has been processed and interpreted in accordance with the phenomenological-hermeneutical tradition, and this process was inspired by Graneheim and Lundman.

RESULTS

Three themes were identified in this study: (a) Tension between organizing the daily work and future challenges; (b) Challenges with recruiting enough registered nurse (RNs) in municipal healthcare services; and (c) Competence development plan-a strategic tool for nursing leadership. The municipal healthcare services need a better knowledge base with better knowledge of both the content and quality of services, organization, leadership and management, thus improving new forms of work and professional approaches.

A study of deficiencies in teamwork skills among Jordan caregivers

Purpose

The purpose of this paper is to present the deficiencies in teamwork skills at Jordan hospitals as seen by team members. The study aims to identify training needs to improve teamwork-related soft skills of caregivers to enhance staff satisfaction and improve quality of care. Moreover, the paper provides a methodology to identify the training needs in any healthcare workplace by repeating the same questionnaire.

Design/methodology/approach

A self-administrated questionnaire was designed to study deficiencies in teamwork and team leadership at Jordan hospitals as seen by team members. Surveyed care providers included physicians, nursing and anesthesiologists operating in emergency departments, surgical operating rooms and intensive care units from various hospitals.

Findings

With a response rate of 78.8 percent, statistical analysis of collected data of opposing staff members revealed low levels of satisfaction (40.7-48 percent opposing), lack of awareness on the impact of teamwork on quality of care (15.6-22.1 percent opposing), low levels of involvement of top management (27.1-57.3 percent opposing), lack of training (52.5-69.8 percent opposing), lack of leadership skills (29.8-60 percent opposing), lack of communication (22.3-62.1 percent opposing), lack of employee involvement (37.6-50.8 percent opposing) and lack of collaboration among team members (28.6-50 percent opposing). Among the many, results illustrate the need for improving leadership skills of team leaders, improving communication and involving team members in decision making.

Originality/value

Several studies investigated relationships between teamwork skills and quality of care in many countries. To the authors’ knowledge, no local study investigated the deficiencies of teamwork skills among Jordan caregivers and its impact on quality of care. The study provides the ground for management at Jordan hospitals and to healthcare academic departments to tailor training courses to improve teamwork skills of caregivers. Data of this study are collected from the society who is working in the field of healthcare. As the results of this are produced from a real data, it is expected that applying the recommendations will impact the society positively by enhancing the patients’ satisfaction.

HUMAN RESOURCES AND INNOVATIVE BEHAVIOUR: IMPROVING NURSING PERFORMANCE

This study examines, using the social exchange theory, the mediating effect of employees’ perception of wellbeing on the relationship between two human resource (HR) management factors (satisfaction with teamwork and satisfaction with training opportunities) and innovative behaviour of nurses working in Australian public and private hospitals. Current nurse shortages and limited budgets have increased the need for hospitals to improve their efficiency and cost-effectiveness. It is proposed that fostering innovative behaviour is one way that hospitals can improve the efficiency and effectiveness of nurses. A cross-sectional self-report survey was completed by 220 nurses working within Australian hospitals. The results show that an employee’s perception of their wellbeing completely mediated the relationship between satisfaction with training opportunities and their innovative behaviour and partially mediated the relationship between satisfaction with teamwork and innovative behaviour. The findings shed new light on how HR management factors can foster innovative behaviour. The results raise new implications for managers seeking to stimulate innovative behaviour, highlighting the importance of cultivating an organisational environment conducive to positive perceptions of wellbeing.

Perianesthesia Nurses Are My Second Family: A Qualitative Descriptive Study

PURPOSE

Identify the perceptions of perianesthesia nurses regarding behaviors that promote or detract from sustaining a safe, efficient, and satisfying work environment.

DESIGN

Two focus groups and seven individual interviews (n=14) were conducted exploring the perceptions regarding team behavior of registered nurses in one pediatric perianesthesia unit.

METHODS

Qualitative descriptive data collection, inductive content analysis.

FINDINGS

Nurses described a responsive, engaged health care team whose leadership is available and directive when needed, as creating an effective, satisfying work environment. Primary themes that emerged were Leadership Sets the Tone, Playing Fair, No One Gets Hurt, and Why We Stay. This nursing team acknowledged that inattentive, distracted team members cause frustration, work inequities, and care delays, potentially undermining patient safety.

CONCLUSIONS

Results demonstrate the need to create and sustain consistently respectful perianesthesia work cultures. Research focusing on unit specific approaches to work distribution, communication, leadership, and technology use is needed.

The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses' turnover intention and patient satisfaction

BACKGROUND

Nurses' voluntary turnover is a worrying global phenomenon which affects service quality. Retaining nursing staff within a hospital is important to eliminate the negative influence of voluntary turnover on the quality of care and organisation costs.

OBJECTIVES

This research helps explain nurses' voluntary turnover by analysing the role of self-efficacy, agentic capacities, job satisfaction, and work engagement on hospital turnover intention, and to study the relationships between these variables and patient satisfaction.

SETTING AND PARTICIPANTS

This study gathered data from 194 nurses and 181 patients from 22 inpatient wards at two hospitals in southern Italy.

RESULTS

Correlation analysis revealed that job satisfaction, work engagement, self-efficacy and agentic capacities were positively interrelated and negatively correlated with turnover intention. Path analysis showed that self-efficacy, some agentic capacities (anticipation and self-regulation), job satisfaction, and work engagement had direct or indirect effects on nurses' turnover intention, and that job satisfaction exerted a stronger effect on turnover intention. Also, patient satisfaction was positively correlated with nurses' job satisfaction, work engagement, self-efficacy, self-regulation and anticipation and negatively correlated with nurses' turnover intention.

CONCLUSION

Results highlighted the importance of implementing actions (for example through feedforward methodology and the goal setting technique) to improve self-efficacy, self-regulation skill, work engagement and job satisfaction in order to reduce nurses' turnover intention and increase patient satisfaction with nursing care.

Retirement planning and work-related variables in Chinese older nurses: A cross-sectional study

AIM

To explore the situation of older nurses approaching retirement with regard to their retirement planning, and the relationship of their retirement planning behaviour with the job environment and job satisfaction under their current employment arrangements and other work-related variables.

BACKGROUND

Nurse shortage has become a global phenomenon that can be alleviated by retaining older nurses in service. The Chinese government proposed the "Incremental Delay Retirement Age Policy." However, older nurses face delayed retirement but lack retirement plans.

METHOD

A cross-sectional questionnaire survey was conducted among a convenience sample of older retiring nurses (n = 152; 84.92% response rate) recruited from every department of four large general hospitals in Changchun, Jilin Province from June to August 2016.

RESULT

The majority of the respondents presented poor retirement planning (n = 122, 80.3%). The independent variables of information exchange with patients, teamwork and personal growth and development explained approximately 16.6% of the variance in retirement planning. Nurse-patient communication and personal growth and development can promote retirement planning, but teamwork is negatively related to retirement planning.

CONCLUSION

Retirement planning by Chinese older nurses is related to certain work-related variables. However, many other work-related variables were not associated with retirement planning and require further research. Overall, Chinese older retiring nurses must improve their retirement planning practices.

Increasing Registered Nurse Retention Using Mentors in Critical Care Services

Recruiting and training 1 newly hired registered nurse can cost thousands of dollars. With a high percentage of these newly hired nurses leaving their first place of employment within their first year, the financial implications may be enormous. It is imperative that health care facilities invest in recruiting and retention programs that retain high-quality nurses. Mentorship programs in retaining and easing the transition to practice for new graduate nurses, re-entry nurses, and nurses new to a specialty area are critical in nurse retention. Discussion in this study includes the effect of implementing a mentor program into the critical care services area of a 325-bed not-for-profit community hospital in northern Indiana. Based on this study, nurses with a mentor were retained at a 25% higher rate than those not mentored. Implementation of a mentor program reduced the training cost to the facility and increased retention and morale.

Mentoring: uma vivência de humanização e desenvolvimento no curso médico

Programas de Tutoria, por meio de uma relação próxima junto aos alunos, oferecem suporte e, também, um ambiente de reflexão para uma formação profissional segundo as Diretrizes Curriculares Nacionais para os Cursos de Graduação em Medicina. O objetivo foi compreender a experiência vivida por alunos de Medicina na atividade de Tutoria da Universidade Federal de Minas Gerais (UFMG), Brasil. Pesquisa documental com análise fenomenológica dos relatórios produzidos pelos alunos. Os elementos experienciais revelaram três conjuntos temáticos: 1 O contexto da tutoria; 2 O vivido na tutoria; 3 A avaliação da experiência. A relação de tutoria mostrou contribuir tanto no enfrentamento das vicissitudes da formação quanto no exercício de habilidades como: a escuta, a aceitação e a comunicação, fundamentais para a boa atuação do médico. Revelando interseções entre as ações de suporte ao estudante e as demandas de formação em áreas humanísticas no currículo médico.

Intention to leave the workplace among nurses working with cancer patients in acute care hospitals in Sweden

PURPOSE

To examine associations between perceived leadership and intention to leave the workplace due to job dissatisfaction among registered nurses (RNs) who care for patients with cancer. We also examine intention to leave in relation to proportion of cancer patients, length of time in practice, perceived adequacy of cancer care education, and burnout.

METHODS AND SAMPLE

The data originated from the Swedish component of RN4CAST, based on a survey of RNs working with in-patient care in all acute care hospitals in Sweden. The 7412 RNs reporting ≥10% patients with cancer on their unit were included in this analysis. Data were collected on perceptions of work environment, burnout, future employment intentions, and demographic characteristics. Additional questions related to cancer care.

KEY RESULTS

About 1/3 of all RNs intended to leave their workplace within the next year. Intention to leave was more prevalent among RNs reporting less favourable perceptions of leadership, who had worked ≤ two years as RN, who reported having inadequate cancer care education, and with higher burnout scores. Associations between leadership and intention to leave were stronger among RNs in the profession > two years, who reported having adequate cancer care education, and with lower burnout scores.

CONCLUSIONS

Perception of leadership is strongly associated with intention to leave among RNs in both specialized and general cancer care. This suggests a crucial area for improvement in order to reduce turnover rates.