New Graduate Nurses’ Readiness to Practise: A Narrative Literature Review

The relationship between practical skills confidence and readiness for transition to practice among nursing internship students: Exploring the mediating role of preceptorship

BACKGROUND

The transition from nursing student to practitioner can be a difficult and stressful period marked by a lack of confidence and practical skills. To bridge this theory-practice gap and ensure successful integration into the workforce, preceptorship programs are essential. By providing experienced mentors and role models, preceptors can equip new nurses with the necessary skills, boost their confidence, and ultimately contribute to a smoother transition and a more prepared nursing workforce.

AIM

Examine the relationship between practical skills confidence and readiness for transition to practice among nursing internship students through exploring the mediating role of preceptorship.

DESIGN

This was a descriptive correlational study.

PARTICIPANTS

A convenience sample of 100 internship nursing students from College of Nursing at a selected governmental University in Riyadh were included in the study.

METHODS

The study participants responded to an electronic Casey-Fink Graduate Nurse Experience Survey validated survey. Descriptive and inferential statistics were used to explore results and examine the relationships between study variables.

RESULTS

About half of the study sample (53 %) had low level of perception regarding the role transition experience with a mean score of 3.01 ± 0.39. As well as more than two thirds of the participated internship nursing students (62 %) had a moderate level of perception regarding the preceptorship role with a mean score of 3.13 ± 0.57. Furthermore, more than half of the study participants (57 %) had high confidence in their practical skills with a mean score of 2.12 ± 0.48. In addition, the study results verified that there was a highly significant correlation between the internship nursing students' practical skills confidence, their readiness for transition to practice and role of preceptorship (P < 0.001). According to the SEM, internship nursing students' perception regarding preceptorship role accounted for 98 % of the variance in internship nursing students transition to practice and 88 % of the variance in their confidence level of their practical skills.

CONCLUSION

Internship nursing students' perception regarding the role of preceptorship regarding is an important predictor of the success of their transition to practice and it affect on improving their confidence level of their practical skills.

Nursing faculty perceptions of entry to nursing practice competencies expected at day one of hire: A statewide study

BACKGROUND

No universal nursing education framework exists aligning competency expectations of new-to-practice nurses graduating from the varying prelicensure academic degree programs.

PURPOSE

This study aimed to identify a set of core competencies expected of all prelicensure nursing programs in Maryland, including associate degree (ADN), entry-level bachelor of science nursing degree (BSN), and master of science entry into nursing (MSN Entry) programs.

METHOD

A mixed-method approach was used to identify necessary competencies, including a survey consisting of 109 outcome statements and a series of focus groups with faculty representatives from the prelicensure degree programs.

FINDINGS

Unexpected findings showed few differences between ADN, BSN, and MSN Entry nursing program faculty perceptions regarding their program graduates' ability to meet the expected competencies. Faculty were not surprised that few differences emerged. Barriers like overloaded curricula, the necessity of prioritizing teaching specific components of nursing content for NCLEX, and competing priorities were faculty concerns.

CONCLUSIONS

A comprehensive examination of all BSN and MSN entry knowledge not included in the NCLEX-RN is suggested for students, nurse residents, and professional nurses, delineating entry-level and ongoing minimal core competencies expected of a competent professional nurse. Results support the development of a competency-based education framework to clearly communicate learning and performance expectations among the varying degree programs.

Lived experiences of international nursing students regarding the studying challenges: a phenomenology study

OBJECTIVES

This study explores and describes the lived experiences of international nursing students regarding studying challenges.

METHODS

This is a qualitative descriptive phenomenological study. Participants were undergraduate international nursing students who were purposively selected. The data were collected through semi-structured interviews with 11 students until data saturation was reached. Data were analyzed using a seven-step Colaizzi method.

RESULTS

After analyzing the data four main themes with fourteen sub-themes were extracted. The main themes of the study were "estrangement and confusion in an unfamiliar environment," "new self in a new situation," "inconsistent educational structure," and "communication as a multidimensional challenge."

CONCLUSIONS

The results of this study indicate the need for effective interventions to transform and improve the learning environment for international nursing students. Creating a specialized curriculum and recruiting experienced professors and mentors to teach international students, to instruct nursing students in practical environments, are vital solutions. It is advisable to provide preliminary courses for international students to familiarize them with the culture and specific issues in the destination country. It is also recommended that international campuses in universities worldwide review and revise the educational curriculum to help international nursing students better manage the educational and cultural issues that they face when studying abroad and provide care for patients.

How Does the Proportion of Child-Specific Content of Pre-Registration Nursing Programmes in Higher Education Institutions Impact Upon Newly Qualified Registered Nurses' Perceptions of Preparedness to Care for Children, Young People, and Their Families? A Narrative Review Protocol

This paper presents a narrative review protocol to explore how the proportion of child-specific content of pre-registration programmes in universities impact upon newly qualified nurses' perceptions of preparedness to care for children, young people (CYP), and their families. The preparation and education to become a nurse who cares for children and young people differs from country to country. Providers of pre-registration nurse education offer routes into nursing from diploma to degree and in some countries post-graduate routes. The United Kingdom offers pre-registration programmes leading to qualifying as a children's nurse whereas programmes in countries such as the USA and Canada lead to a professional registration as a registered nurse with postgraduate study to specialize in areas such as pediatrics. The role of pre-registration nursing programmes is to facilitate preparedness for practice. Preparation for practice can include theoretical teaching and practice learning through simulation and face-to-face experience with countries requiring different numbers of practice hours to be completed. Although practice hours are central to nursing education, there is limited evidence on the impact and portion of child-specific content, including clinical learning in preparation of newly qualified nurses to care for CYP and their families. A preliminary search of Prospero, CINAHL, Medline and Cochrane Database indicates that there are no current or in progress reviews identified. The Population of interest, Exposure of interest, and Outcome framework were used to define the research question and inform the eligibility criteria. The review will consider different research designs if related to the research question. The search strategy will conform to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for systematic reviews. Two independent reviewers will be involved in the screening progress to determine the final studies for inclusion. Eligible studies will be assessed for methodological quality using the Joanna Briggs Institute critical appraisal tools. Extraction of study characteristics and data related to the research question will be extracted into a predefined table. Data synthesis will be conducted using a descriptive analytical approach to summarize extracted data.

Exploring the effectiveness of the Career Guidance and Counseling Program on the perceived readiness for the job market: a lived experience among nursing students

Background

The current workforce demands that nursing graduates possess the necessary skills and knowledge to perform in complex clinical and professional environments. Career guidance can potentially improve students' job readiness by increasing their confidence in career pursuits, simplifying career decisions, and helping them address decision-making challenges.

Methods

This phenomenological study aimed to explore nursing students and interns' perspectives on the effectiveness of the Career Guidance and Counseling Program (CGCP) and its impact on their readiness for the job market through their lived experiences while participating in the program. Data were collected through in-depth semi-structured interviews with a purposive sample of 28 Saudi university students and continued until data saturation was reached. Thematic analysis was used for the data analysis.

Results

Seven themes emerged: personal experiences with the CGCP, the program's importance, effectiveness, benefits, strengths, and weaknesses, and recommendations for improvement. Overall, participants expressed gratitude for the CGCP and believed that it would positively impact their future career success. They also felt that the program provided them opportunities to share ideas, information, and concerns, thereby improving their career decision-making and adaptability.

Conclusion

The results show that CGCP positively affected participants' lives by providing support, guidance, and resources for informed career decision-making, developing essential career-related skills, and navigating career transitions. These findings have practical implications for nursing colleges implementing similar programs for better integration into the curriculum and for the continuity of such vital programs to help students. Future studies should explore this topic in different colleges and specialties.

Introduction of a Registered Undergraduate Student of Nursing workforce: A qualitative study of student and registered nurses

AIM

To explore the benefits and challenges of a recently introduced Registered Undergraduate Student of Nursing workforce from the perspective of Nurses and Registered Undergraduate Students of Nursing, in a major metropolitan hospital in Australia in 2020.

DESIGN

A qualitative descriptive study was undertaken using individual interviews and focus groups.

METHODS

Purposively selected employed Registered Undergraduate Students of Nursing and nurses who worked with them were interviewed, using a semi-structured format. Recordings were transcribed and coded using NVivo software. Reflexive thematic analysis using an inductive approach was undertaken.

RESULTS

Four major themes were revealed: (i) Navigating the programme, (ii) Belonging and integration; (iii) Patient care; and (iv) Continuing Development. Initial challenges were common, often related to clarifying the scope of practice for the new role. Ongoing issues were associated with gaps in understanding the role and lack of integration into the team. Mostly, nurses and Registered Undergraduate Students of Nursing built positive, professional relationships. Nurses valued the Registered Undergraduate Student of Nursing knowledge and skill level, reporting improved workload and work experiences when the Registered Undergraduate Student of Nursing was on shift. Nurses believed that the Registered Undergraduate Students of Nursing enhanced patient care. Registered Undergraduate Students of Nursing described positive, therapeutic relationships with patients. Registered Undergraduate Student of Nursing employment provided opportunities for new learning, leading to increased efficiency and confidence on clinical placement.

CONCLUSIONS

This employment model benefited the Registered Undergraduate Students of Nursing and nurses who worked with them. In the absence of adequate training and support, challenges remained unresolved and negatively impacted the experience for nurses. In addition to university-level education and clinical placement, the employment model can create a third space for student learning via on-the-job training. The study supports the ongoing employment of student nurses through the Registered Undergraduate Student of Nursing model.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Impact This study contributes to the very small body of literature investigating Registered Undergraduate Student of Nursing workforces in Australian hospitals. It is the first to explore the experiences of both nurses and students working together in a major metropolitan setting and also the first in the context of the COVID-19 pandemic. This study reflected a mostly positive experience for Registered Undergraduate Student of Nursing and the nurses who worked with them and highlighted the importance of adequate oversight and support in the implementation and maintenance of a Registered Undergraduate Student of Nursing workforce. Employed Registered Undergraduate Students of Nursing reported improved confidence, skills, and felt like they started clinical placement at an advantage, ready to step up and learn the Registered Nurse scope of practice. In addition to university-level education and clinical placement, this employment model creates a third space for learning via on-the-job training.

REPORTING METHOD

COREQ guidelines were followed in the reporting of this study.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Competency-Based Education in RN to BSN Programs

BACKGROUND

The call for nursing education reform has never been louder. National organizations recognize the urgent need to prepare nursing students to practice competently, moving away from traditional teaching and curricula and to competency-based education (CBE) strategies to prepare future nurses for independent clinical practice.

PROBLEM

The 2021 American Association of Colleges of Nursing Essentials do not account for the competencies achieved in registered nurse (RN) associate degree and diploma programs. This presents a challenge for RN to bachelor of science in nursing (BSN) program administrators and faculty when designing curricula to meet the new Essentials .

APPROACH

The Essentials crosswalk created by the National RN-Baccalaureate Faculty Forum serves as a foundational guide for the development of the template models discussed in this article.

CONCLUSION

This article provides a template of instructional models for implementing CBE in RN to BSN programs.

Remediation in clinical practice for student nurses - A scoping review

BACKGROUND

Clinical practice provides an opportunity for undergraduate nursing students to develop the professional attitudes, knowledge and skills required for the delivery of safe competent care. Some students, however, are challenged to consolidate learning in clinical practice and are therefore at risk of failing courses or programmes. Supporting these students requires remediation strategies specific to clinical practice. This is challenging, however, as remediation approaches frequently centre on supporting students in theoretical components of courses/programmes, rather than clinical practice.

OBJECTIVES

A scoping review was conducted to explore and summarise literature in undergraduate nurse education related to remediation support for clinical practice.

METHODS

The research question was developed using the Population/Concept/Context model. Following the identification of keywords, five databases (CINHAL Plus, MEDLINE, ProQuest, Scopus and Informit) were searched. Abstracts and full-text articles were independently screened by two authors. Data from included studies was extracted and then thematically analysed.

RESULTS

Twenty papers met inclusion/exclusion criteria (five literature reviews, one concept analysis, six commentary papers and eight original research studies). Research studies used qualitative, quantitative, or mixed methods research designs. Populations included nurse academics, mentors/preceptors, health professional students (including nursing students) and nursing students exclusively. Three themes were identified: pre-placement remediation strategies; on-placement remediation strategies and post-placement remediation strategies. All authors highlighted the importance of remediation for at-risk students in clinical practice.

CONCLUSIONS

This review identified several remediation strategies that may support undergraduate nursing students in clinical practice. Few, however, were well-defined or rigorously evaluated, highlighting the need for additional research on nursing student remediation in clinical practice. A partnership-based approach to remediation that engages students, educators, and healthcare providers and is underpinned by clear processes may be of further benefit to nursing students in clinical practice.

Systematic Review on Characteristics and Effects of Leadership Development Interventions for Nursing Students

BACKGROUND

Effective nursing leadership improves health care quality, patient well-being, and nursing staff outcomes. Newly graduated nurses face challenges in transitioning into leadership roles. Thus, examining the leadership development interventions for nursing students is critical.

PURPOSE

This systematic review examined the characteristics and effectiveness of leadership development interventions designed for and implemented with undergraduate nursing students.

METHODS

A comprehensive search covered Scopus, CINAHL Ultimate, ScienceDirect, MEDLINE, WOS Core Collection, Journals@Ovid, JSTOR Journals, and ERIC databases. Included studies were assessed using the Mixed Methods Appraisal Tool.

RESULTS

The final review comprised 19 studies showcasing positive impacts on leadership development. The interventions varied in leadership approach, design and content, structure, qualifications, student involvement, and outcomes.

CONCLUSIONS

Leadership development interventions are effective in enhancing nursing students' leadership. Nevertheless, future interventions should prioritize well-structured content, and studies must incorporate robust methodologies.

The impact of comprehensive licensure review on nursing students' clinical competence, self-efficacy, and work readiness

This study aims to assess the effectiveness of comprehensive licensure reviews and adaptive quizzing assignments on nursing students' clinical competence, self-efficacy, and work readiness-an under-researched topic. Additionally, it seeks to explore the mediating effect of self-efficacy in the relationship between students' clinical competence and work readiness. A quasi-experimental (pre- and post-test), single-group design was employed. The study was conducted in a public university in Saudi Arabia and included a total of 293 senior nursing students in their last year of the bachelor program. An intervention was developed based on the blueprints of the Saudi Nursing Licensing Exam and NCLEX-RN and consisted of a weekly 3-h synchronous comprehensive licensure review bundled with 23 adaptive quizzing assignments over 15 weeks. Data were collected prior to and after the intervention using three scales: clinical competence, self-efficacy, and work readiness. The mean scores of clinical competence, self-efficacy, and two subscales of work readiness (work competence and social intelligence) increased significantly post-intervention. Self-efficacy (β = 0.353, p < 0.001) and clinical competence (β = 0.251, p < 0.001) influenced work readiness (F [5, 226] = 21.03, p < 0.001) and accounted for 31.8% of the explained variability in work readiness. In the mediation analysis, clinical competence had a significant and indirect effect on work readiness through self-efficacy (B = 0.464, p < 0.001, 95% CI 0.250 to 0.699). The proportion of mediation indicated that 37.2% of the total effect of clinical competence on work readiness was due to the indirect effect of self-efficacy. Comprehensive licensure review and adaptive quizzing assignments improve students' perceptions of clinical competence and self-efficacy. Such interventions could ease the transition of senior nursing students to clinical practice.

A Healthcare-Academic Practice Partnership Program to Promote Student Nurse Readiness for Work

Highly skilled new graduate nurses must be better prepared to face the clinical and professional challenges in today's healthcare environment. Compounding these challenges are the growing resignations of clinical faculty and experienced clinical nurses. Innovative programs are needed to bridge the knowledge-practice gap with opportunities to create pipelines to aid the future nursing workforce. A multihospital health system partnered with a local college of nursing to develop a Nursing Student Pipeline Program, which allows nursing students to perform select nursing tasks as employees of the health system. Fifty-six students have been hired to participate in the pilot program. Of the students eligible for hire and who completed the program, 24 are current employees with the healthcare system. Students, preceptors, and managers report the benefits of this program, including that participating in the program supports increasing readiness for practice upon graduation.

Thai novice nurses' lived experiences and perspectives of breastfeeding and human milk in the Neonatal Intensive Care Unit (NICU)

BACKGROUND

Breastfeeding and human milk have well-documented health benefits for newborn infants, particularly those who are sick. However, breastfeeding rates and human milk feeding among infants in neonatal intensive units (NICU) in Thailand are still low; thus, breastfeeding promotion and support are required for Thai mothers of premature infants. Newly graduated nurses can play a critical role within the healthcare support system and can have a significant impact on improving breastfeeding practices in the NICU. The objective of this study was to investigate the lived experiences and perspectives of Thai novice nurses on supporting breastfeeding and human milk feeding in the NICU.

METHODS

The study was conducted between March 2021 and May 2022 at three medical centers in the central region of Thailand. This study employed a descriptive phenomenological approach to explore Thai novice nurses' experiences and perspectives on breastfeeding. Purposive sampling was used to invite Thai novice nurses who have work experience in providing breastfeeding support to NICU mothers and their infants to participate in online interviews using a video conference platform (Zoom). Semi-structured questions were used to interview study participants in their native language. Data were analyzed using Colaizzi's method of data analysis to identify emergent themes. Member checks, peer debriefing, and self-reflection were applied to ensure the validity and trustworthiness of the study results. Back-translation was also used as a quality and accuracy assurance.

RESULTS

A total of thirteen novice nurses agreed to participate in the study. All were female, and their ages ranged from 21 to 24 years old at the time of the interview. The researchers identified five major themes related to the overall study objectives and research questions. They are: positive attitude toward breastfeeding and human milk, facing breastfeeding challenges at work, self-confidence rooted in experience, professional skill needs, and requiring further support.

CONCLUSIONS

Our results suggest that breastfeeding education plays a vital role in encouraging new nurses to provide breastfeeding support to mothers of preterm infants. Establishing breastfeeding support training and innovative learning strategies can be crucial in developing appropriate breastfeeding practice guidelines and policies to support Thai breastfeeding mothers in the NICU.

Culture of patient care among international nursing students: a focused ethnographic study

BACKGROUND

This study was conducted to describe and explain the culture of patient care in international nursing students.

METHODS

This qualitative study was conducted using focused ethnography. Participants (n = 21) were purposefully selected from non-Iranian international students and their nursing instructors. Data collection included semi-structured interviews, and field-note taking. Data were analyzed with the Roper and Shapira inductive approach of ethnographic content analysis.

RESULTS

The cultural model of the study included the acquisition of cultural competence through acceptance of differences and finding commonalities. Subcategories were: "avoiding cultural bias", "trying to be on the path of adaptation", "appealing to the support and companionship of colleagues", "coping with culture shock", "acculturation", "getting help from cultural intelligence", "cultural empathy", and "language and communication enhancement".

CONCLUSION

Cultural competence is teachable. The pattern of formation is through accepting differences and searching for commonalities. Suggestions for promoting the culture of care among international students include effective use of peer groups and teaching different national ethnicities and cultures.

New Graduate Nurse Transition into Rural Home: A Case Study

The global shortage of nurses and high attrition rates for newly graduated nurses along with the shifting demand for home care has created a critical need for retention strategies that address the specific challenges of rural settings. The effectiveness of structured transition or mentoring programs are primarily studied in acute care settings, making it difficult to translate to the unique context of rural home care nursing. The complexities of the independent nature of home care nursing practice and limited resources to address transition shock make it difficult to successfully transition newly graduated nurses to rural home care. A case study supports mentorship facilitation as a readily available, effective strategy that can overcome the challenges of rural home care settings. A comparative analysis will link Duchscher's (2008) transition shock theory to mentorship as an effective strategy for supporting NGNs' transition in home care nursing. Recommendations offer rural care leaders practical strategies bundled with mentorship to optimize the successful transition and retention of newly graduated nurses in their workplaces.

Engaging Clinical Partners in Curricular Initiatives to Improve Practice Readiness

BACKGROUND

The release of the American Association of Colleges of Nursing's updated Essentials creates an opportunity for nursing programs and clinical partners to collaborate on strengthening curricula and improving new graduate practice readiness. This scoping literature review examined published models for collaborating with clinical partners on curricular initiatives to guide this process.

METHOD

Three electronic databases were searched for peer-reviewed articles describing models for collaborating with clinical partners when revising nursing curricula to improve practice readiness. The final sample included seven articles representing five models developed for prelicensure undergraduate education.

RESULTS

Themes identified among the models were creating a shared mission, leadership support and involvement, representative committees with regular meetings, clear role expectations, collaboratively determining concepts and competencies, and developing training and resources for consistent implementation of changes.

CONCLUSION

These themes provide recommendations for engaging clinical partners in the process of integrating the new Essentials in curricula and improving graduates' practice readiness. [J Nurs Educ. 2023;62(12):706-710.].

Cognitive and Noncognitive Factors Influencing Nursing Students' Academic Success: Structural Equation Model Analysis

AIM

The study aim was to identify and explore relationships among cognitive and noncognitive factors that may contribute to prelicensure baccalaureate nursing students' academic success across their program of study.

BACKGROUND

Nurse educators are challenged to improve students' academic success. With limited evidence, cognitive and noncognitive factors have been identified in the literature as potential factors that influence academic success and may support students' readiness for practice as new graduate nurses.

METHOD

Data sets from 1,937 BSN students at multiple campuses were analyzed using an exploratory design and structural equation modeling.

CONCLUSION

Six factors were conceptualized as contributing equally to the initial cognitive model. The final noncognitive model, with deletion of two factors, yielded the best fit for the four-factor model. Cognitive and noncognitive factors were not significantly correlated. This study provides a beginning understanding of cognitive and noncognitive factors associated with academic success that may support readiness for practice.

Nursing Informatics Competency and Self-Efficacy in Clinical Practice among Nurses in Palestinian Hospitals

This study purposed to determine the levels of nursing informatics competency and self-efficacy in clinical practice and influencing factors on self-efficacy among Palestinian nurses in hospitals. A descriptive-correlational design was adopted. The nurses who worked in the North West Bank of Palestine (N = 331) were recruited. The data were collected using the Self-Assessment of Nursing Informatics Competencies Scale (SANICS) which consists of 30 items rated on a 5-point Likert scale, ranging from 1(not competent) to 5 (expert), and scored by calculating the mean as follows: novice/low (1.00-2.59), beginner/moderate (2.60-3.39), and competent/high (3.40-5.00); and the New General Self-Efficacy Scale (NGSE) that consists of eight items rated on a 5-point Likert scale, ranging from 1(strongly disagree) to 5(strongly agree) and scored according to the average of the scale, whereas the average of > 3 indicated high self-efficacy, and ≤ 3 reflected low self-efficacy. The data were collected during the period from September to November 2020. Findings showed that the total mean score for the nursing informatics competency scale was 2.9 (SD = 0.7), which indicated that the nurses had a moderate level of nursing informatics competency. The average score for the self-efficacy scale was 3.5 (SD = 0.8), which reflected that nurses had high self-efficacy. Self-efficacy in clinical practice increased with age and with nursing informatics competency. Thus, it is necessary to enhance nurses' informatics competency by developing continuous educational programs about this technology for nurses and engaging nurses in such programs to enhance their competencies in this system.

Umbrella review: Newly graduated nurses' experiences of providing direct care in hospital settings

AIM

To summarize existing research syntheses reporting newly graduated registered nurses' experiences of providing direct care in hospital settings.

DESIGN

Umbrella review.

DATA SOURCES

An extensive search of all relevant databases was conducted for research syntheses. Initial key terms included "new* nurse", "nursing care" and "hospital setting" in combination with index terms to find relevant literature.

METHODS

Critical appraisal, data extraction and summary were performed independently by two reviewers according to the Joanna Briggs Institute guidelines for undertaking umbrella reviews.

RESULTS

Nine research syntheses published between 2010 and 2019 and representing 173 studies were included following critical appraisal. The evidence was summarized in narrative form with supporting tables. Twenty-six sub-branches and seven main-branches were organized in a coding tree showing the structure of three overlapping themes: "Feeling a lack of competency", "Sense of emotional distress" and "In need of support".

CONCLUSIONS

Evidence demonstrates that newly graduated registered nurses' experiences of a lack of competency, emotional distress and need for support emerged as essential requirements for the provision of competent and safe direct care for the patient.

IMPACT

Newly graduated registered nurses face multiple challenges in the transition from student nurse to practicing nurse. Unmet expectations of being a newly graduated nurse might lead to low levels of job satisfaction, high attrition rates or missed nursing care. Nurse educators, leaders and policy makers should be mindful that newly graduated registered nurses' perceptions of professional and personal identity and degree of support influences newly graduated registered nurses' direct care provision.

Validating an Instrument for Measuring Newly Graduated Nurses' Adaptation

A long-established approach, Confirmatory Factor Analysis (CFA) is used to validate measurement models of latent constructs. Employing CFA can be useful for assessing the validity and reliability of such models. The study adapted previous instruments and modified them to suit the current setting. The new measurement model is termed NENA-q. Exploratory factor analysis (EFA) revealed the instruments of the NENA-q model formed a construct of the second order with four dimensions, namely organizational contribution (OC), academic institution contribution (AIC), personality traits (PT), and newly employed nurses' adaptation (NENA). Researchers administered the questionnaires to a sample of 496 newly employed nurses working in hospitals under the Ministry of Health (MOH) for the confirmation of the extracted dimensions. The study performed a two-step CFA procedure to validate NENA-q since the model involves higher-order constructs. The first step was individual CFA, while the second step was pooled CFA. The validation procedure through confirmatory factor analysis (CFA) found the model achieved the threshold of construct validity through fitness index assessment. The model also achieved convergent validity when all average variance extracted (AVE) exceeded the threshold value of greater than 0.5. The assessment of the composite reliability (CR) value indicates all CR values exceeded the threshold value of 0.6, which indicates the construct achieved composite reliability. Overall, the NENA-q model consisting of the OC construct, AIC construct, PT construct, and NENA construct for CFA has met the fitness indexes and passed the measurements of the AVE, CR, and normality test. Once the measurement models have been validated through CFA procedure, the researcher can assemble these constructs into structural model and estimate the required parameter through structural equation modelling (SEM) procedure.

"We are really starving for respect and support," the struggle of Iranian nurses in adhering to professional values: A qualitative study

AIMS

To investigate nurses' experiences of adhering to professional values in clinical settings.

DESIGN

A qualitative study with a conventional content analysis approach.

METHODS

This study was conducted from January 2021 to March 2022. Semi-structured interviews were conducted with 12 nurses working in different wards of five public and private hospitals in West Azerbaijan of Iran. Data were analysed using the conventional content analysis approach proposed by Graneheim and Lundman (Nurse education today, 24, 2004, 105) RESULTS: "Barriers to nurses' professional values" emerged as the main category of Iranian nurses' experiences in adhering to professional values. Three subcategories of barriers were revealed: "nurses' challenges," "professional suppressors" and "poor working conditions."

CONCLUSION

Barriers in clinical settings can overshadow nurses' professional performance and disrupt their adherence to professional values. Nursing managers must pay attention to nurses' challenges, their professional suppressors and poor working condition to help them promote their professional performance in clinical settings. Thus, nursing managers should not neglect the continuous education of nurses to assist them in increasing their clinical skills by holding practical and theoretical workshops. Improving the working conditions and clinical atmosphere by recruiting a capable workforce and applying psychological and financial support for nurses are essential to increase the quality of nursing care.

The Importance of Graduate Education for Nursing Care

Graduate nursing education faces various challenges linked to research products that must be innovative and have an impact on social well-being. Knowledge transfer is a complex multidimensional process requiring multiple mechanisms, methods, and measurements to be considered in graduate training. Educational institutions must have a support infrastructure and be responsible for preparing interdisciplinary syllabi, coordinating management strategies to address student learning, and providing an environment for harmonized communication among those interested in problem-solving.

Self-Reported Clinical Practice Skill Readiness of Final Year Nursing Students Studying in Bengaluru, Karnataka: An Institutional-Based Cross-Sectional Study

Introduction In recent few years, the production of nurses in both the public and private sectors has been growing rapidly to fill up the gap of health care staff. As there is a lack of data available on clinical practice readiness among final year nursing students in India, the question remains of how nursing students see themselves and what qualities and areas interest them are of great importance.

Objectives This study was conducted to determine the clinical practice skill readiness among final year nursing students and also to explore the factors that show the significant difference with clinical practice skill readiness level.

Methodology A nonexperimental institutional-based cross-sectional online survey was conducted from October 15 to November 15, 2020 using a simple random sampling technique. A total of 200 final year nursing students have participated in the study through the self-structured and prevalidated comprehensive nursing competencies questionnaire (CNCQ). Data was collected through Google Form and exported to SPSS version 20.0 for further analysis. To compare the nursing competencies score with selected demographic characteristics, a one-way analysis of variance and an unpaired t-test were applied at a 95% confidence interval (CI). The post hoc test was used to check for multiple comparisons.

Results Results of the study revealed that the overall CNCQ mean score of basic nursing skills were reasonably high (39.08 ± 13.27) compared with advanced nursing care skills (13.03 ± 5.28). A significant difference (p < 0.05) was observed in overall clinical posting duration in both basic (p < 0.004) and advanced (p < 0.001) nursing skills with selected demographic variables. There is also a significant difference found in the overall level of qualification (p < 0.004) in basic nursing skills. It was observed that in basic nursing care skills half of the year clinical posting (minimum 6 months) duration had a significant difference with the improved performance skills (p < 0.005) (0.57; 95% CI 0.14–1.00). Whereas the results also show that, the advanced nursing skills will be greatly improved if the nursing students get an opportunity to practice in different specialty areas for at least 2 months (p < 0.013) (0.62; 95% CI 0.11–1.14) or half of the year (p < 0.001) (0.95; 95% CI 0.34–1.56). This result shows a clear indication of how important clinical posting for nursing students is.

Conclusion Our data suggested that the final year nursing students are losing ground in clinical practice readiness and competency. The result also shows that the clinical competency score will greatly improve in both basic and advanced nursing skills if the students are exposed to the clinical areas at least for a few months. Our findings will support the stakeholders, authorities of nursing colleges, and policymakers to make a significant decision to enhance the clinical practice among final year nursing students.

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

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

The Effect of Managerial and Leadership Training and Simulation on Senior Nursing Students’ Career Planning and Self-Efficacy

Introduction

Enhancing nursing students’ professional knowledge and integrating simulation and clinical training into students’ education may affect their career planning and development.

Objectives

This study aimed to explore how managerial and leadership training and simulation affect career planning knowledge, career choice, and self-efficacy among senior nursing students. Additionally, it explored how students perceived the training they received.

Methods

This study employed a mixed methods design for collecting quantitative and qualitative data about the training. A quasi-experimental design using a pretest and posttest with a convenience sample of senior nursing students ( N = 80) at a Saudi nursing college guided the quantitative part. Nursing students were introduced to a managerial and leadership training and simulation intervention focused on career knowledge. The career planning questionnaire and a self-efficacy scale were used to collect quantitative data before and after the intervention, and the open-ended questions were used for qualitative data about the training they received. For the quantitative data, we used descriptive and inferential statistics, and for the qualitative data, we used content analysis.

Results

After the training sessions, nursing students’ career planning knowledge and self-efficacy scores were considerably enhanced, with a significant difference and positive associations ( p < .001). Four themes were driven from the qualitative analysis: student engagement, experiential learning and reflection, the teacher's role as facilitator, and teamwork.

Conclusions

Knowledge and preparedness are essential elements for career planning and development. Nursing curricula should provide students with ongoing educational opportunities to help them enhance their career planning and self-efficacy. As well, nurse managers play an important role in shaping the career paths of senior undergraduates and internship nurses. Career counseling sessions and career activities can be scheduled frequently before graduation and during the internship year, which is essential for prelicensure and orientation.

Envisioning Nursing Education for a Post-COVID-19 World: Qualitative Findings From the Frontline

BACKGROUND

This study sought to qualitatively describe the implications of coronavirus disease 2019 (COVID-19) on nursing education and provide recommendations for curricular changes expressed by frontline nurses practicing during the first wave of the pandemic.

METHOD

Nurses throughout the United States (N = 100) completed the study protocol. The study sample was diverse and included White (37%), Black (20%), Latinx (20%), Asian (14%), multiracial (7%), and Native American (2%) participants; the sample also included transgender and nonbinary nurses (2%). Thematic network analysis was used to determine the implications of COVID-19 for nursing education.

RESULTS

Findings included four distinct themes: teamwork and communication, flexibility and critical thinking, leadership and using your voice, and advocacy and policy.

CONCLUSION

Shifting nursing education curriculum to focus on these key attributes will help better prepare new nurses to be adaptable in practice settings, thereby improving nursing care, clinical outcomes, and the well-being of the communities that nurses serve. [J Nurs Educ. 2021;60(12):668-673.].

Nursing student experiences in turmoil: A year of the pandemic and social strife during final clinical rotations

Background

The duration and magnitude of the coronavirus (COVID-19) posed unique challenges for nursing students, whose education was altered because of the pandemic.

Purpose

To explore the perceptions and experiences of nursing students whose clinical rotations were abruptly interrupted by COVID-19's initial surge in the United States.

Methods

This qualitative study was conducted at a midwestern, academic medical center to elicit senior nursing students' experiences. An online survey was administered with eight open-ended questions asking about: initial impressions of the pandemic; experiences of being a senior nursing student; sources of stress and coping mechanisms; preparing to work as a registered nurse; and views on the nursing profession.

Results

Among the 26 students who completed the survey, the majority were female (92%), aged 28 ∓ 4.1 years. A total of 18 subcategories emerged with four main themes identified as: a) breakdown of normal systems, b) feeling alone and the inability to escape, c) protective factors/adaptability, and d) role identify and formation.

Conclusions

Findings indicate students implemented a variety of strategies while adapting to the abrupt interruption of in-person clinical rotations, mandated restrictions, and social unrest. The cascading themes illustrate the enormity of sudden changes and their significant impact on daily life.

Graduate nurse views on patient safety: Navigating challenging workplace interactions with senior clinical nurses

AIM AND OBJECTIVE

To explore and understand the negative experiences of graduate nurses' interaction with senior nurses and the implications for safe patient care.

BACKGROUND

Patient safety is dependent on the nursing care they receive. Working in environments where there is reduced collegial support and increased emotional distress, increases the likelihood of nurses making errors that may negatively impact on patient outcomes. Insights drawn from graduate nurses' negative interactions with senior nurses may provide an understanding of the impact of nurse-to-nurse interactions on patient safety outcomes.

METHODS

A qualitative exploratory descriptive design was used. A purposive sample of 18 graduate registered nurses participated in this study. Semi-structured interviews were conducted, audio-recorded and transcribed verbatim. Data were thematically analysed. The COREQ checklist was followed.

RESULTS

The overarching theme, 'Navigating workplace challenges' was identified with two sub-themes: Processing unsupportive nurse behaviour and responding to nurse deviations from best practice. Common deviations in practice included erosion of safe medication practice, wound care and non-compliance with universal precautions. Graduate nurses also observed unsafe workplace practice, however, were hesitant to speak up due to fear of retribution. Unsupportive behaviours impacted on their critical thinking ability, follow-up interactions with other nurses and subsequent delivery of patient care.

CONCLUSION

Quality and safety strategies should not ignore and/or overlook the impact of interpersonal relationships on patient safety and risk. Strategies for delivering evidence-based, safe and quality care to patients go beyond the establishment of standards and technically focussed management strategies.

RELEVANCE TO CLINICAL PRACTICE

It is vital to examine the quality of working relationships between all levels of healthcare professionals including graduate nurses and their supervisors to ensure supportive behaviours prevail in advancing delivery of quality care within the practice environment. The study alludes to the fact that disruptive workplace behaviours are more hierarchical than horizontal (i.e., graduate nurse-to-graduate nurse).