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

The Phenotype of a Bone Marrow Transplant Nurse: Survival of the Fittest

There is a need for proficient nursing practice in specialized critical care settings, such as a pediatric Bone Marrow Transplant (BMT) Unit. The staffing crisis continues to be problematic for areas around the country. Nursing tenure has been positively correlated with improving patient outcomes and confidence in giving care, so efforts must be made to retain pediatric BMT nurses. The purpose of this study was to investigate factors of resilience and how it pertains to the retention of pediatric BMT nurses through (1) Understanding current BMT nursing turnover and trend why nurses are leaving; (2) Measure resilience throughout BMT nursing cohort, covering all tenure of nurses; and (3) Interview senior nurses within the cohort to identify themes relating to retention and resilience using grounded theory methodology. This research was carried out in the Bone Marrow Transplant (BMT) Unit at Cincinnati Children's Hospital Medical Center (CCHMC). The study spanned from 2014 to 2019, during which researchers gathered extensive data to evaluate the turnover risk among BMT nurses. A detailed follow-up was conducted in 2019 to further assess this risk. To measure resilience levels, a group of 115 nurses in the unit completed the Connor Davidson Resilience Scale (CD-RISC). Additionally, in-depth interviews were conducted with 9 senior nurses in the cohort, continuing until theoretical saturation was reached, ensuring a comprehensive understanding of the factors influencing nurse turnover in the unit. Researchers looked retrospectively at nursing turnover from 2014 to 2019. Investigators determined the risk of new nurses leaving was between 22 and 24 months (HR 0.025). Further, follow-up was conducted for data points between 2019-present time, which showed a drastic change in the hazard rate curvature. However, the risk remained relatively the same at 22 to 24 months (HR 0.03). There was no statistical significance found between CD-RISC results and age (P = .465), gender (P = .725), working experience (P = .15), or education (P = .14). Through a constant comparative process, several themes were identified as positive, negative, and ambiguous contributions to the retention of nurses. The risk of nurses leaving after 2 years decreases significantly; therefore, we determined that a nurse with a commitment to pediatric BMT occurs with 2 years' experience. Although our initial hypothesis was that senior nurses had greater resilience than less tenured nurses, there was no statistical significance as the effect of resilience is small. However, we identified several additional factors pertinent to the pediatric BMT field which may be associated with nursing retention.

The association of patient safety culture with intent to leave among Jordanian nurses: a cross-sectional study

BACKGROUND

The existence of patient safety culture is crucial for healthcare providers' retention, particularly for nurses. Patient safety culture is getting more attention from healthcare organizations worldwide, and Jordan is no exception. Nurses' satisfaction and retention are paramount to providing safe, high-quality patient care.

PURPOSE

To investigate the relationship between patient safety culture and intent to leave among Jordanian nurses.

METHODS

A descriptive cross-sectional design was used. A sample of 220 nurses was selected through convenience sampling from one governmental and one private hospital in Amman. The patient safety culture survey and anticipated turnover scale were used to collect data. Descriptive statistics and Pearson r correlation were used to answer the research questions.

RESULTS

The findings showed that nurses had 49.2% positive scores for patient safety. Teamwork (65.3%) and handoff and exchange of information (62% each) had the highest scores, while staffing and workplace (38.1%) and response to error (26.6%) had the lowest. Moreover, nurses had strong intentions to leave their jobs (M = 3.98). A moderately significant but not highly negative relationship existed between patient safety culture and intent to leave (r = -0.32, p = 0.015).

CONCLUSIONS

There are opportunities to improve patient safety culture, satisfaction, and nurse retention in Jordanian hospitals by implementing several recommendations, such as ensuring better staffing patterns and increasing staff motivation by utilizing various available methods.

Global Oncology Nursing Recruitment and Retention: A SWOT Analysis

OBJECTIVES

This article documents the current status of global recruitment and retention of oncology nurses. A strengths, weaknesses, opportunities, and threats model was used to identify internal-to-nursing recruitment and retention factors/influences and external opportunities and threats as well as strategies and initiatives to improve the current situation.

DATA SOURCES

Data sources include published and grey literature from around the world.

CONCLUSION

Despite the increasing cancer burden threatening public health worldwide, recruitment and retention of oncology nurses remains challenging. Nursing strengths include action by oncology nursing associations, prelicensure nurse recruitment and preceptorships, and models of hospital shared governance. Nursing weaknesses include nurse bullying, practice models that curtail clinical nurses' autonomy, and hierarchical and inflexible nursing leadership. External to nursing are opportunities exemplified by international partnerships in oncology care and international oncology conferences for networking and learning. Examples of external threats are a lack of oncology nursing faculty, disrespectful media portrayal of nurses, community misconceptions about cancer curability, and hazards of cancer nursing.

IMPLICATIONS FOR NURSING PRACTICE

Governments and hospital authorities wishing to successfully address cancer control must strategically plan for the recruitment and retention of an adequate nursing workforce. Opportunities such as government recognition of oncology specialty training, shared governance, continuing specialized education, advanced practice nursing roles and career paths, and participation in national cancer control planning will increase and sustain a critical oncology nursing workforce.

The future of cancer nursing in Europe: Addressing professional issues in education, research, policy and practice

Cancer nursing has evolved to meet the demands of rising cancer incidence, newer and more complex treatment options, and the emergence of specialist roles supporting patients from pre-diagnosis, through treatment, survivorship and end of life care. Nurses are involved in direct and in-direct care of people at risk of, and living with and after cancer in diverse contexts. As a result, nurses are positioned to have a significant influence on the processes and outcomes of cancer care, through education, research, policy, practice and leadership. However, nursing and cancer care face challenges, arising from workforce shortages, under-investment in services and under-representation in decision-making. This paper discusses the evolution of cancer nursing across education, policy, research, profession and practice, and sets an agenda for innovation and disruption across these domains to ensure sustainability of cancer care services and care for people living with and after cancer. We argue for the continued advancement of cancer nursing with critical focus on identifying and addressing inequities in role recognition and access to specialist cancer nursing education throughout Europe. Partnership, exchange of learning, and co-design will be central to progressing education, evidence and policy to support future growth in the cancer nursing workforce and embed cancer nurses in research and policy setting at local, national and international levels.

The personality of newly graduated and employed nurses: Temperament and character profiles of Swedish nurses

Background

One of the challenges of the 21st century is the high turnover rate in the nursing profession due to burnout and mental illness. From a biopsychosocial perspective, an individual's personality is an important vulnerability-resilience factor that comprises four temperament traits (i.e., a person's emotional reactions) and three character traits (i.e., self-regulation systems). Indeed, different personality profiles are associated to different coping strategies and health outcomes.

Objective

We investigated and mapped the temperament and character of Swedish newly graduated and employed nurses' in relation to the Swedish general population and an age-matched sub-sample.

Design

In this cross-sectional study, nurses self-reported their personality (Temperament and Character Inventory) at the beginning of their employment.

Setting

The data collection was conducted at a hospital in the South of Sweden.

Participants

A total of 118 newly graduated and employed nurses (Mage = 25.95±5.58) and 1,564 individuals from the Swedish general population participated in the study.

Methods

We calculated T-scores and percentiles for all seven personality dimensions using the Swedish norms (N = 1,564). The profiles were calculated by combining high/low percentiles scores in three temperament dimensions (Novelty Seeking: N/n, Harm Avoidance: H/h, and Reward Dependence: R/r) and in the three character dimensions (Self-Directedness: S/s, Cooperativeness: C/c and Self-Transcendence: T/t).

Results

Regarding T-scores, the nurses reported moderately lower Novelty Seeking (> 0.5 SD), slightly higher Harm-Avoidance (about 0.5 SD), moderately higher Persistence (> 0.5 SD) and Reward Dependence (> 0.5 SD), and extremely lower Self-Directedness (> 1 SD). The prevalence of the most common temperament profiles among the nurses (Swedish general population in brackets) were: 39.80% [10.90%] Cautious (nHR), 21.20% [10.90] Reliable (nhR), and 15.30% [16.50%] Methodical (nHr). The prevalence of the most common character profiles among the nurses were: 31.40% [4.90%] Dependent (sCt), 25.40% [14.40%] Apathetic (sct), and 19.50% [8.80%] Moody (sCT).

Conclusions

The analyses of the personality profiles showed that Low Novelty Seeking (79%), high Harm Avoidance (65%) high Reward Dependence (80%), low Self-Directedness (95%), and low Self-Transcendence (60%) were more prevalent among the newly graduated and employed nurses. This may partially explain newly graduated nurses' difficulties at work and high turnover rate. After all, a well-developed character is of special importance when working with patients with serious and terminal illness or under large global crises, such as the current pandemic. Hence, both education at universities and development at work need to be person-centered to reduce stress levels and promote positive self-regulation strategies.

Factors Influencing Pediatric Hematology/Oncology Nurse Retention: A Scoping Review

Background: Nursing staff retention is an ongoing concern within pediatric hematology/oncology settings globally. Work-related stressors cause emotional burden, psychological distress, and burnout to which nurses respond by leaving their workplace. Consequently, workplace culture and functionality are negatively impacted, quality of care reduces, and potential harm to patients increases. This paper aims to identify the "most" influencing factors for intention to leave among pediatric hematology/oncology nurses. Methods: A systematic search was undertaken on 29 July 2021 across five electronic databases, Cumulative Index to Nursing and Allied Health Literature, Joanna Briggs Institute, MEDLINE, PubMed, and Web of Science, using MeSH and keywords related to pediatric hematology/oncology nurse retention. Results: The initial search yielded 283 articles. Following abstract and full-text review, nine articles met inclusion criteria. Across all studies, strong links between health service organizational factors (e.g., unit acuity and time constraints), clinician demographics (e.g., age, education, experience, and coping mechanisms), and nursing retention within pediatric hematology/oncology settings were observed. Direct patient care and long-term relationships with pediatric hematology/oncology patients were identified as the most frequent and intense stressors, while also presenting the most rewarding aspect of the nurse's work. Discussion: Clinician burnout and retention were found to be complex and multifaceted organizational and individual issues, which most importantly evolved from accumulative exposure to specialty-specific stressors. Interventions to prevent clinician burnout and improve staff retention, therefore, need to comprise individual and organizational level strategies specific to the healthcare context.

Prevalence and predictors of burnout and work-life balance within the haematology cancer nursing workforce

PURPOSE

The effects of burnout can have serious consequence for individual nurse's, patients and healthcare organisations. The aim of this study was to assess prevalence and predictors of burnout and work-life balance amongst haemato-oncology nurses.

METHODS

This study employed a cross-sectional survey design. Haematology cancer nurses attending a 2-day conference in Ireland, during Oct 2019 were recruited. Anonymised data were collected on: 1) socio-demographics and occupational variables, 2) burnout using Maslach Burnout Inventory and 3) satisfaction with work-life balance.

RESULTS

There was an 80.4% survey completion rate (n = 78 of 97). One-third of haemato-oncology nurses reported high levels of emotional exhaustion, with an additional 46% experiencing moderate levels. Despite this, 64% of nurses highlighted a moderate or high level of personal accomplishment. Demographics such as <40yrs old, unmarried, working ≥25hrs per week and having 6-10 years' experience in haemato-oncology, all showed trends towards increased burnout, although none reached statistical significance. Over half (58%) surveyed were dissatisfied with their work-life balance. Nurses with dependent children had statistically significant poorer work-life balance scores. In addition, one-third reported they did not receive adequate support or reasonable adjustments from their organisation, with inpatient nurses finding this particularly challenging.

RELEVANCE TO CLINICAL PRACTICE

Taking into consideration the high levels of burnout, healthcare organisations should have a responsibility to teach approaches of stress management, self-care and foster resilience within their workforce. Oncology nurses with dependent children, working in in-patient settings, have identified a need for greater flexibility with working conditions, to improve work-life balance.

Occupational stressors in oncology nurses: A qualitative descriptive study

AIM AND OBJECTIVES

The present study aims at exploring oncology nurses' perceptions regarding work-related stressors.

BACKGROUND

Oncology nurses work in an environment with a high degree of stress, which can negatively affect their health. There is limited research on work-related stressors from the oncology nurses' perspective.

DESIGN

Qualitative descriptive study.

METHODS

Fifty-two oncology nurses were selected purposefully from eight cancer treatment centres in different cities of Iran. Data were collected through semi-structured interviews and analysed using conventional content analysis. The COREQ checklist was used to document the report of the study.

RESULTS

The extracted contents were classified into four main categories. The first category involved personal ability with two subcategories (person-job fit and psychological competencies). The second category included physical environment arrangements with two subcategories (physical working conditions and equipment and facilities). The third category involved psychosocial safety in the workplace with four subcategories (creating a safe work environment, overcoming the challenges of providing care to cancer patients, work/life balance and social recognition of the nursing status). The fourth category holds an organisational context with four subcategories (organisational support, interpersonal relations, justice at work and human resources).

CONCLUSION

It is necessary to find measures attenuating work-related stresses in oncology nurses. These measures should be in line with developing personal abilities in nurses and creating a safe environment in terms of optimising physical, psychosocial and organisational conditions. It is also important to develop programmes protecting the oncology nurses' occupational health.

RELEVANCE TO CLINICAL PRACTICE

The results of this study can help improve nursing work conditions, attenuate work-related stresses in nurses and introduce efficient interventions reducing occupational stressors.

Occupational stress, job satisfaction, and intent to leave: nurses working on front lines during COVID-19 pandemic in Zagazig City, Egypt

During epidemics, the medical working environment is highly stressful especially for the nurses. The purpose of this study was to assess occupational stress, job satisfaction, and intent to leave among nurses dealing with suspected COVID-19 patients. A comparative cross-sectional study was conducted among 210 nurses from Zagazig Fever Hospital (ZFH) which is one of COVID-19 Triage Hospitals (Group I) versus 210 nurses from Zagazig General Hospital (ZGH) (Group II) which is neither triage nor isolation hospital; dealing only with suspected COVID-19 patients in emergency at Sharkia Governorate, Egypt, from 10th to 24th of April 2020. Assessment was done through online questionnaire formed of the Expanded Nursing Stress Scale, the McCloskey/Mueller Satisfaction Scale, and questionnaire assessing specific COVID-19-associated stressors and nurses' intent to leave. Three quarters of nurses (75.2%) in ZFH had high stress level versus 60.5% in ZGH. Workload (98.6%), dealing with death and dying (96.7%), personal demands and fears (95.7%), employing strict biosecurity measures (95.2%), and stigma (90.5%) represented the highest priority stressors in ZFH, while exposure to infection risk (97.6%) was the stressor of highest priority among ZGH according to Pareto analysis. More than half of nurses (51.0%) in ZFH reported low satisfaction level versus 41.9% in ZGH. Only 4.8% of nurses in ZFH definitely had no intent to leave their present job. Type of hospital and its related workload were the most significant predictor of all the studied outcomes.

Salutary factors and hospital work environments: a qualitative descriptive study of nurses in Sweden

BACKGROUND

Extensive research describes how nurses experience their work environment. The conditions are described as stressful and dissatisfying with nurses intending to leave their workplace. Knowledge about the personal perception regarding why nurses consider leaving the hospital workplace is limited. The purpose of this study was to understand why hospital nurses remain in their workplace, which facilitates their continuation in the profession.

OBJECTIVE

The objective was to explore and describe factors explaining why hospital nurses remain in the workplace.

METHODS

This was a descriptive qualitative study with a purposive sample of hospital nurses in Sweden. The salutogenic theory was the basis for the interview guide and the semi-structured questions. Individual interviews were conducted in a hospital in western Sweden. Content analysis was performed to organize the coded data according to the sense of coherence.

RESULTS

Data saturation was achieved with 12 interviews. Within the three themes of coherence (comprehensibility, manageability, and meaningfulness), ten subthemes were categorized from the data as follows: job satisfaction and fun at work, acknowledgement and productivity, togetherness and team security, manageable workload, variable work and challenging situations, workplace and personal space balance, collaboration and supportive leadership, valued role and good work, commitment and involvement, and pride in the professional role.

CONCLUSIONS

The main findings of this study have shown the critical importance of being in a meaningful, comprehensible and manageable work context that supports nurses in maintaining their professional identity.

Factors contributing to burnout and work-life balance in adult oncology nursing: An integrative review

PURPOSE

Occupational stress and burnout are highlighted as the most prevalent workplace issues for adult oncology nurses. With today's global nursing workforce shortage; coupled with oncology being an inherently challenging and complex speciality, this clearly indicates the need to understand factors that contribute to burnout in adult oncology nurses and improve work-life balance. The aim of this integrative review is to synthesis the evidence on burnout and work-life balance for adult oncology nurses.

METHOD

A systematic search of four databases (CINAHL, Ovid Medline, PsycINFO and Scopus), identified 17 quantitative and three mixed-method studies. Studies were critically appraised using the Mixed Methods Appraisal Tool. Following data extraction, a qualitative evidence synthesis utilising an inductive approach was adopted to better understand influential factors, generating analytical themes.

RESULTS

One study had a specific focus on what ameliorates work-life balance for oncology nurses; depicting an area that warrants further study. All studies reported on burnout, of which six analytical themes were further categorised into two broad themes, namely: (1) 'Inability to thrive': struggling with workplace burnout due to organisational challenges and (2) 'Personal perspectives influencing burnout', for adult oncology nurses. Burnout was influenced by multiple oncology-specific factors due to quantitative workload demands and disease acuity. Workplace culture, shift in additional hours being worked remotely and personal characteristics of the nurse, also influenced susceptibility for the development of burnout in oncology nurses.

CONCLUSION

Confronting burnout and promoting wellness are the shared responsibility of both individual adult oncology nurses and their organisations to build resilience and help sustain and build workforce capacity.

The organisational context of nursing practice in hospitals in China and its relationship with quality of care, and patient and nurse outcomes: A mixed-methods review

BACKGROUND

Achieving high-quality care and retention of nurses are major concerns for nurse leaders in hospitals. The organisational context is theorised to influence the quality of care and patient and nurse outcomes. This review focuses on China where the healthcare system is different from most Western countries in terms of government healthcare expenditure, public health insurance and healthcare delivery system.

OBJECTIVES

To explore the organisational context of nursing practice in hospitals in China and its relationship with quality of care, patient outcomes (patient adverse events, safety and satisfaction) and nurse outcomes (burnout, job satisfaction and intention to leave).

DESIGN

A mixed-methods review.

DATA SOURCES

The electronic databases PubMed, EMBASE, CINAHL, PsycINFO and China Academic Journals Database were used.

METHODS

This review was conducted using the SALSA (Search, Appraisal, Synthesis and Analysis) framework. Quality assessment was conducted using the Joanna Briggs Institute (JBI) critical appraisal checklists for cross-sectional studies and qualitative research. A narrative synthesis was conducted and was supported by tabulation of study data. The PRISMA guidelines were used for this review.

RESULTS

Twenty-three articles met the inclusion criteria and were retrieved, analysed and synthesised. This review supports the link between organisational context, quality of care, and patient and nurse outcomes in the Chinese healthcare system. Aspects of organisational context warrant attention including nurse staffing levels, the shortage of nurses, a lack of nurse participation in hospital affairs and support for the professional development of nurses.

CONCLUSIONS

The findings suggest that tailored interventions are needed to improve the organisational context of nursing practice in Chinese hospitals and, in particular, to address the nurse workforce issues and organisational leadership and support. The unique policy context of the Chinese healthcare system should be considered when developing these interventions.

RELEVANCE TO CLINICAL PRACTICE

Recognising the importance of the organisational context, it is imperative that nurse leaders make every effort to legislate for safe nurse staffing and to establish a caring culture to improve quality of care and nurse and patient outcomes.

Sustaining factors, rewards, and challenges for psychologists providing clinical care in psycho-oncology

OBJECTIVE

Many who choose to work in oncology manage an ongoing tension-the work is rewarding, yet simultaneously challenging. Given the need for psychosocial professionals to provide treatment for the increasing number of cancer survivors in our aging society, it is important to consider what helps and hinders professionals in their work. Therefore, this study sought to understand the work experiences of psychologists working in psycho-oncology, specifically clarifying the rewards and challenges they experience as a result of their occupation.

METHODS

Twenty psychologists with oncology work experience in the United States completed semi-structured interviews; data were analyzed using the Consensual Qualitative Research method.

RESULTS

In this paper, findings are presented for two of the domains that emerged from the data. In the domain of Sustaining Factors and Rewards, six themes were identified: (a) making a difference, (b) personal impact of the work on psychologists' lives and personal enrichment, (c) sense of purpose and fit with the work, (d) important relationships, (e) unique aspects of psycho-oncology, and (f) benefits derived from the workplace. In the domain of Challenges, five themes were identified: (a) job-related challenges, (b) emotional intensity, (c) financial challenges, (d) ambiguity in professional roles and psycho-oncology, and (e) ethical dilemmas.

CONCLUSION

Psychologists employed in psycho-oncology found great meaning and purpose in their jobs, but also struggled with challenges related to the work and their workplaces. These findings can lead to better training, supervision, retention initiatives, and administrative policies to support productive employees.

Between a rock and a hard place: Registered nurses' accounts of their work situation in cancer care in Swedish acute care hospitals

PURPOSE

Hospital organizational features related to registered nurses' (RNs') practice environment are often studied using quantitative measures. These are however unable to capture nuances of experiences of the practice environment from the perspective of individual RNs. The aim of this study is therefore to investigate individual RNs' experiences of their work situation in cancer care in Swedish acute care hospitals.

METHODS

This study is based on a qualitative framework analysis of data derived from an open-ended question by 200 RNs working in specialized or general cancer care hospital units, who responded to the Swedish RN4CAST survey on nurse work environment. Antonovsky's salutogenic concepts "meaningfulness", "comprehensibility", and "manageability" were applied post-analysis to support interpretation of results.

RESULTS

RNs describe a tension between expectations to uphold safe, high quality care, and working in an environment where they are unable to influence conditions for care delivery. A lacking sense of agency, on individual and collective levels, points to organizational factors impeding RNs' use of their competence in clinical decision-making and in governing practice within their professional scope.

CONCLUSIONS

RNs in this study appear to experience work situations which, while often described as meaningful, generally appear neither comprehensible nor manageable. The lack of an individual and collective sense of agency found here could potentially erode RNs' sense of meaningfulness and readiness to invest in their work.

Nurses' intention to leave their job and associated factors in Bahir Dar, Amhara Region, Ethiopia, 2017

BACKGROUND

Intention to leave is an employee's plan of tendency to leave the current working institute to find an alternative job in the near future. Even though nurses are the backbone of patient caring, there was no study done on intention to leave their job in North West Ethiopia. Therefore, the aim of this study was to assess nurses' intention to leave their job and associated factors in Bahir Dar, North West Ethiopia, 2017.

METHODS

An institutional-based cross-sectional study was conducted from 1st March to 30th March 2017. After proportional sample size allocation, 210 participants were selected by simple random sampling method. Data were collected by using a self-administered structured questionnaire. Statistical Package for Social Science version 23.0 was used to enter, clean, code and analyze the collected data. The association between independent and dependent variables was assessed by using bivariable and multivariable logistic regression model. Factors that had statistically significant association with the dependent variable (P < 0.05) were identified as significant in the multivariable logistic regression analysis.

RESULT

From a total of 210 nurses, 191 of them were participating in this study making a response rate of 90.95%. From all nurses, 64.4%of them were employed in the hospital. In this study, nurses' overall intention to leave their job was 64.9% (95% CI: [57.6, 71.2]). Nurses' intention to leave their job was determined by disagree in recognition (AOR = 4.83; 95%CI: [1.73, 13.50]), and work itself (AOR = 31.30; 95%CI: [7.16, 136.78]).

CONCLUSION

Nurses' intention to leave their job in the current study was high. The contributing factors for this problem were disagree in recognition at work and work itself. Hence, we recommended that hospital and health center managers should maintain recognition at work and work itself to retain nurses.

Analysis of the work environment and intention of perioperative nurses to quit work

OBJECTIVE

to investigate how the perioperative work environment affects work dissatisfaction, professional exhaustion and the perception of the quality of care about the intention of abandoning the work of perioperative nurses.

METHOD

cross-sectional study with 130 nurses working in the surgical area of a high-tech Spanish public university hospital. The scale of the nursing practice environment, Maslach's exhaustion inventory, the questions about job satisfaction, the perception of the care quality and intention to abandon work to collect data were used. Descriptive, inferential and logistic regression statistics were made.

RESULTS

in general, 20% of perioperative nurses would want to quit their work. The dimension of the work environment of staff and resources, dissatisfaction and emotional exhaustion in nurses were factors that indicated the intention of perioperative nurses to abandon work.

CONCLUSION

the implementation of strategies for the retention of perioperative nurses should be considered, improving the factors that indicate how the work environment, especially the allocation of personnel and resources, dissatisfaction and emotional exhaustion. Creating positive work environments based on magnetic values can be a key strategy.

Redistribution of salary or professional recognition? The difficult construction of a profession, the Peruvian nursing

The study presents the current profile of Peruvian nursing, its professional construction and its dilemmas, emphasizing its socio-cultural features. To this end, an extensive literature was reviewed, interviewing nurses in key positions and analyzing secondary source data. This study keeps its distance from other studies on health care professions as a workforce, to analyze the low social legitimacy of the nursing profession despite being the great operator of health care services in Peru. This resulting psychological overload, additionally to the work overload is reflected in job dissatisfaction, stress, burnout, intention of changing careers, and a strong desire to migrate. As a result, Peruvian nursing has opted for three alternatives: a) resilience, which means to adapt to this unfavorable situation; b) abandoning the profession, or leaving the country; and c) reaction, which gathers all manifestations of the profession against abandonment, informality, and mediocrity. In conclusion, the biggest challenge of professions given low social value is the recognition and not only the salary redistribution. This significant challenge for Peruvian nursing does not mainly relate to legal professionalization, but professionalism, which must result in greater legitimacy and autonomy.

Relationship between personality traits and burnout in oncology nurses

INTRODUCTION

Nurses burnout is a serious problem which can affect their health, the quality of patient care, and health institutions. Personality traits affect level of nurse burnout, and burnout characteristics vary depending on nurses' personality traits. The present study assessed burnout levels in order to determine stages of burnout in oncology nurses and to analyze the relationship between burnout and demographic characteristics and personality traits.

METHODOLOGY

This is a cross-sectional study performed on 106 oncology nurses working in Baghaei Hospital affiliated to Ahvaz Jundishapur University of Medical Sciences in Iran. The main personality traits were assessed using the NEO Five-Factor Inventory (NEO-FFI) and anxiety and depression employing a clinical educational questionnaire. The Maslach Burnout Inventory (MBI) was utilized to determine burnout levels, the t-test to compare the means, and Pearson correlation to evaluate correlations between personality traits and the different dimensions of the MBI.

FINDINGS

About 32.1% of the oncology nurses present in this study were in the most severe phase of burnout. Depersonalization and emotional exhaustion had a significant positive correlation with anxiety and depression, whereas personal accomplishment had a negative correlation with anxiety and depression.

CONCLUSION

A significant number of the oncology nurses experienced the most severe stage of burnout. Given the effects of personality traits on burnout dimensions, they should be taken into account to prevent the burnout syndrome.

The level of sense of coherence among Swedish nursing staff

AIM

To explore the level of sense of coherence among Swedish nursing staff.

DESIGN

An explorative quantitative study design was adopted using a short form for measuring sense of coherence.

METHODS

Data were collected in January 2018 from nurses working in full-time positions at two hospitals in Western Sweden. A total of 93 nurses completed the 13 item questionnaire measuring sense of coherence. Descriptive statistics were applied to obtain means and standard deviations. Spearman's rank correlation was used to describe strength of association between sense of coherence and socio-demographic categories. Between-group differences were defined using the nonparametric tests of Mann Whitney U test and Kruskal-Wallis test.

RESULTS

The internal consistency of the SOC-13 was low. An inter-item-correlation test indicated that two items decreased the internal consistency of the scale. The level of the three dimensions of sense of coherence varied; manageability was weakest and decreased the total sense of coherence. The meaningfulness dimension was as strongest.

CONCLUSION

On a national level, nurses reported weaker sense of coherence (SOC) than the general population, but stronger in an international comparison of nurses. They found their work difficult to manage, but meaningful.

IMPACT

On a national level, the nurses reported weaker SOC than the general population, but stronger in an international comparison of nurses. Findings from this study will have an impact on how nurses can manage work related stress in terms of sense of coherence. There will also be an impact on nurses' well-being, which in a long run benefits patients.

Nurse Burnout Revisited: A Comparison of Computational Methods

BACKGROUND AND PURPOSE

To examine computational measures of job-related burnout to determine the best computation to estimate job satisfaction and intent to leave in Brazilian nursing professionals.

METHODS

Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used assess burnout in 452 hospital-based nursing professionals. Adjusted logistic regression models were fit using different computations of burnout to estimate outcomes of interest.

RESULTS

Total mean score of burnout subscales was the best estimate of job satisfaction (Cox-Snell R² = 0.312; Nagelkerke R² = 0.450) and intent to leave (Cox-Snell R² = 0.156; Nagelkerke R² = 0.300), as was high emotional exhaustion (Cox-Snell R² = 0.219; Nagelkerke R² = 0.316).

CONCLUSION

We have provided evidence that different computations of data from the Portuguese (Brazil) MBI-HSS can be used in to estimate the effect of job-related burnout on nurse outcomes.

Burnout Precursors in Oncology Nurses: A Preliminary Cross-Sectional Study with a Systemic Organizational Analysis

Burnout negatively affects nurses’ health and performance. Healthcare managers have an ethical duty to create healthy organizations that reduce burnout, especially within critical settings such as oncology. The aim of this study was twofold: (1) to measure the presence of nurses’ burnout to formulate organizational strategies to prevent the syndrome onset, and (2) to evaluate the effect of recent organizational changes on the burnout phenomenon. A descriptive, cross-sectional design supported by a systemic organizational analysis was conducted in a Swiss Oncology Institute in 2013. Of 103 nurses working in the Institute, 52 (51.4%) completed the Burnout Potential Inventory (BPI) questionnaire. Data were analyzed using descriptive statistics and Mann–Whitney and Kruskal–Wallis tests. Burnout risk levels were low to moderate. Only 2 nurses out of the 52 showed moderate burnout risk levels. Inpatient nurses showed a higher risk of burnout than outpatient nurses, particularly due to ambiguity and feelings of powerlessness. Nurses with post-basic education showed a higher risk when considering poor teamwork values and ambiguity in the workplace. Poor middle-management was found to negatively influence worker wellbeing. The working environment set by management resulted in low burnout risk levels. Managers must carefully select middle-management because inappropriate leadership might promote the onset of burnout.

Work-related stress, burnout, and related sociodemographic factors among nurses: Implications for administrators, research, and policy

This study examined work-related stress and burnout symptoms with respect to related sociodemographic factors among nurses in Nigeria.A representative sample of nurses (N = 393) was randomly selected from hospitals in Southeast Nigeria to take part in this cross-sectional, correlational study from June to December 2017. Participants received questionnaires by mail, which measured work stress and burnout symptoms, respectively. Data collected were analyzed using bivariate correlations and multiple regression analyses.Among the sociodemographic factors investigated, sex was significantly correlated with work-related stress. The sociodemographic factors were not significantly associated with burnout symptoms. Stepwise multiple regression procedure produced a model that contained four sociodemographic factors and explained 4.5% of the variance in nurses' work stress scores and 0.8% of the variance in nurses' burnout scores. Age, work environment, and work experience did not make significant contributions to the prediction of work-related stress among the nurses. Finally, sex, age, work environment, and work experience did not make significant contributions to the prediction of burnout among the nurses.Nurses' sociodemographic factors, which included sex, age, work environment and work experience accounted for only a small proportion of variance in nurses' work stress and burnout in Southeast Nigeria. The study also furthers our awareness that sex is significantly linked to work-related stress among the nurses in Southeast Nigeria. Thus, the implications of the study for administrators, research, and policy were discussed.

Relationship between authentic leadership and nurses' intent to leave: The mediating role of work environment and burnout

AIM

The aim of this study was to explore the mediating effects of work environment and burnout on the relationship between authentic leadership and the intention of nurses to leave their job.

BACKGROUND

Authentic leadership can contribute to a good work environment. Burnout is a critical factor that affects nurses‧ intent to leave. The mediating roles of work environment and burnout on the relationship between authentic leadership and intent to leave is unclear.

METHODS

A cross-sectional design was used, and 946 nurses from three different levels of hospital (medical center, regional, and district), defined in terms of the number of beds and type of medical care provided, responded to four self-report questionnaires.

RESULTS

Work environment and burnout mediated the effect of authentic leadership on intent to leave among nurses. The mediating effects of burnout on authentic leadership was present both for junior (β = 0.073) and senior (β = 0.081) nurses.

CONCLUSION

Authentic leadership can affect nurses‧ intent to leave but the work environment and burnout are important mediators of this influence.

IMPLICATIONS FOR NURSING MANAGEMENT

Administrators should adopt authentic leadership practices and make efforts to improve the work environment and decrease burnout in order to decrease nurses‧ intent to leave.

Nursing work environment, value congruence and their relationships with nurses' work outcomes

AIMS

To explore the relationships between work environment, value congruence and nurses' work outcomes; as well as to test the moderating effects of value congruence.

BACKGROUND

A poor nursing work environment in most of mainland China has negatively influenced nurses' job satisfaction, burnout and turnover intention. New insights such as improving nurses' value congruence should be proposed to better foster nurses.

METHODS

Cross-sectional data were selected from the Chinese Nurses' Environment of Work Status study. In total, 19149 valid samples were collected. Hierarchical regression analyses and simple slope analyses were performed.

RESULTS

The correlation coefficients of the variables were all significant (p < .01) and in the expected direction. Value congruence moderated the relationship between nursing work environment and burnout (emotional exhaustion: β = 0.106, p < .01; depersonalization: β = 0.111, p < .01).

CONCLUSIONS

Nursing work environment and value congruence were positively related to job satisfaction, and negatively related to burnout and turnover intention. The adverse impact of poor work environment on nurses' burnout can be buffered if nurses' value congruence is compatible with that of the organisation.

IMPLICATIONS FOR NURSING MANAGEMENT

Except for improving the organisational characteristics, value congruence is a useful concept that managers can leverage to improve positive outcomes for both the organisation and its nurses.

Health, workforce characteristics, quality of life and intention to leave: The 'Fit for the Future' survey of Australian nurses and midwives

AIM

To examine the quality of life of nurses and midwives in New South Wales, Australia and compare values with those of the Australian general population; to determine the influence of workforce, health and work life characteristics on quality of life and its effect on workforce intention to leave.

BACKGROUND

Few studies have examined nurses' and midwives' quality of life and little is known of its effects on workforce longevity.

DESIGN

This was a cross-sectional survey conducted in 2014-2015.

METHOD

The "Fit for the Future" electronic survey, delivered to nurses and midwives, examined demographic, work and health-related factors, which were compared with Australian general population normative values for physical and mental components of quality of life (the Short Form-12). Univariate and multivariate logistic regression models assessed associations with workforce intention to leave.

RESULT

Physical and mental component scores, calculated for 4,592 nurses and midwives, revealed significantly higher physical but lower mental component scores than the general population. Physical component scores decreased with increasing age; higher scores were seen in nurses with better health indices and behaviours. Mental well-being scores increased with increasing age; in nurses who reported job satisfaction, no work injury, sleep problems or frequent pain and non-smokers. The odds of intention to leave decreased with increasing mental well-being.

CONCLUSION

Managers and decision-makers should heed study recommendations to implement health promotion strategies for nurses and midwives, aiming to improve mental health, specifically to promote workforce retention.

The relationship between job satisfaction, work stress, work-family conflict, and turnover intention among physicians in Guangdong, China: a cross-sectional study

OBJECTIVE

To investigate the relationship between job satisfaction, work stress, work-family conflict and turnover intention, and explore factors associated with turnover intention, among physicians in Guangdong Province, China.

METHODS

From August to October 2013, physicians completed questionnaires and scales with regard to their job satisfaction, work stress, work-family conflict, and turnover intention. Binary logistic regression and structural equation modelling (SEM) were used in data analysis.

RESULTS

A total of 3963 physicians were approached, with 3563 completing the questionnaire. The mean score of the overall perception of turnover intention of physicians who worked in Guangdong was 2.71 on a scale ranging from 1 to 6. Hours worked per week, working in an urban/rural area, type of institution, and age significantly impacted on turnover intention. Turnover intention was directly and negatively related to job satisfaction, and it was directly, indirectly and positively related to work stress and work-family conflict.

CONCLUSION

Job satisfaction, work stress, work-family conflict, hours worked per week, working in an urban/rural area, types of institution and age are influencing factors of turnover intention. Reducing working hours, raising salary, providing more opportunities for career development and training, supporting and encouraging physicians by senior managers could potentially contribute to the reduction in turnover intention.

Nurses' practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country, multilevel study

BACKGROUND

Nursing turnover is a major issue for health care managers, notably during the global nursing workforce shortage. Despite the often hierarchical structure of the data used in nursing studies, few studies have investigated the impact of the work environment on intention to leave using multilevel techniques. Also, differences between intentions to leave the current workplace or to leave the profession entirely have rarely been studied.

OBJECTIVE

The aim of the current study was to investigate how aspects of the nurse practice environment and satisfaction with work schedule flexibility measured at different organisational levels influenced the intention to leave the profession or the workplace due to dissatisfaction.

DESIGN

Multilevel models were fitted using survey data from the RN4CAST project, which has a multi-country, multilevel, cross-sectional design. The data analysed here are based on a sample of 23,076 registered nurses from 2020 units in 384 hospitals in 10 European countries (overall response rate: 59.4%). Four levels were available for analyses: country, hospital, unit, and individual registered nurse. Practice environment and satisfaction with schedule flexibility were aggregated and studied at the unit level. Gender, experience as registered nurse, full vs. part-time work, as well as individual deviance from unit mean in practice environment and satisfaction with work schedule flexibility, were included at the individual level. Both intention to leave the profession and the hospital due to dissatisfaction were studied.

RESULTS

Regarding intention to leave current workplace, there is variability at both country (6.9%) and unit (6.9%) level. However, for intention to leave the profession we found less variability at the country (4.6%) and unit level (3.9%). Intention to leave the workplace was strongly related to unit level variables. Additionally, individual characteristics and deviance from unit mean regarding practice environment and satisfaction with schedule flexibility were related to both outcomes. Major limitations of the study are its cross-sectional design and the fact that only turnover intention due to dissatisfaction was studied.

CONCLUSIONS

We conclude that measures aiming to improve the practice environment and schedule flexibility would be a promising approach towards increased retention of registered nurses in both their current workplaces and the nursing profession as a whole and thus a way to counteract the nursing shortage across European countries.