How organisational commitment influences nurses' intention to stay in nursing throughout their career

"It was a reflection of myself, that i was weak": The impact of depression on the sense of self - An interpretive phenomenological analysis

The World Health Organisation states that more than 350 million people experience depression globally. The phenomenological changes in individuals experiencing depression are profound Phenomenological research can further researchers' and clinicians' understanding of this experience. This study aimed to gain a phenomenological understanding of how individuals with depression understood and made sense of their experiences. A methodology of interpretative phenomenological analysis was adopted. In-depth semi-structured interviews explored the lived experience of depression for eight individuals. Data were analysed into the superordinate theme Broken Self - Transforming the Self. The superordinate theme developed from the subordinate themes of 'unknown self, loss of self and one's identity', 'desperate for a way out', and thirdly, 'conflict with self and what's known', which related directly to how individuals made sense of their experience of depression. These research findings highlight the human implications of the experience of depression and the limitations of viewing depression from a biological or medical model lens. Understanding the human impact is essential for the effective, holistic practice of mental health nursing.

Investigating the impact of temporary nurses on permanent nurses' commitment via perceptions of illegitimate tasks: A cross-sectional study

AIMS

To explore illegitimate tasks as a potential mechanism that links permanent nurses' perceived exposure to temporary nurses to lower levels of affective organizational commitment.

DESIGN

A time-lagged cross-sectional survey study.

METHODS

Survey data from N = 239 permanent nurses in the German-speaking part of Switzerland were analysed via Structural Equation Models.

RESULTS

The study revealed a negative relationship between permanent nurses' perceived exposure to temporary nurses and their level of organizational commitment that was mediated by perceptions of unreasonable and unnecessary tasks.

CONCLUSION

Healthcare institutions increasingly depend on temporary nurses to fill staffing vacancies. Our data suggest that the deployment of temporary nurses may have adverse effects on permanent nurses' affective organizational commitment via perceptions of illegitimate tasks.

IMPACT

Our quantitative survey study provides a novel, theory-driven understanding of how perceived exposure to temporary nurses may impact work-related attitudes of permanent nurses.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Our findings suggest that the clinical community should limit permanent nurses' exposure to temporary nursing staff to protect their commitment. If this is not possible, we encourage strategies to counteract associated feelings of illegitimacy, for example, by showing appreciation for permanent nurses' willingness to take over responsibility for temporary nurses.

REPORTING METHOD

The study adheres to the STROBE reporting guidelines for cross-sectional studies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Organisational and leadership skills towards healthy workplaces: an interview study with registered nurses in Sweden

BACKGROUND

According to shortage of registered nurses, organisational and leadership aspects grounded in person-centrered approach, are highlighted to ensure high quality of care. Therefore, it is interesting to develop knowledge regarding registered nurses working environment.

AIM

The aim of the study was to investigate registered nurses' reason to end their employment at a university hospital setting (internal medicine, emergency department).

METHOD

Qualitative content analysis with an inductive methodological approach was used to analyse registered nurses' experiences regarding their former employment. Inclusion criteria; all nurses (n = 55) who ended employment during one year (first of July 2020-30th of June 2021) were invited, and 38 semi-structured interviews were conducted.

RESULTS

Three categories were identified: Limited organisational support, Lack of visible leadership, and Limited healthy working environment, followed by six subcategories: Longing for organisational support, Being a tile in a box, Need for professional relationship, Limitation of supportive leadership, Imbalance of work versus personal life, and Ethical stress.

CONCLUSION

To improve registered nurses working environment and commitment to work, balance between time at work and personal life is significant. Therefore, organisational support and leadership skills grounded in a person-centred approach are crucial to develop a healthy working environment. A person-centred leadership could improve collaboration and shared decision-making in partnership with those involved, managers, nurses, and team members.

Instruments for assessing health workers' burnout during the COVID-19 pandemic: a scoping review

BACKGROUND

During the COVID-19 pandemic, health workers' workload is increasing, with the risk of burnout. Several instruments for assessing burnout have been developed since the concept was coined in the 1970s. It is important to map and describe the application of burnout instruments for health workers in the current COVID-19 pandemic situation.

AIMS

This article aimed to map and describe what instruments are used and variations of their application to research burnout in health workers during the COVID-19 pandemic.

METHODS

This scoping review searched articles systematically through 7 databases (PubMed, Clinical Key, Scopus, EBSCOhost, APA PsycINFO, Science Direct, and Wiley Online Library). Articles were screened and analyzed following the Arksey and O'Malley framework.

RESULTS

From 507 results, 31 peer-reviewed articles were selected. These studies involved 33,879 participants from various health professions. Generally, the research instrument is still dominated by Maslach Burnout Inventory. Applications of burnout measurements vary widely because there is no consensus on the concept of burnout assessment.

CONCLUSION

Inconsistency in burnout-measuring tools can be seen as providing flexibility and alternatives, but at the same time, it is a gap that challenges researchers to develop more comprehensive instruments, especially for the burnout phenomenon in health workers during the COVID-19 pandemic.

The Moderating Role of Psychological Safety in the Relationship between Job Embeddedness, Organizational Commitment, and Retention Intention among Home Care Attendants in Taiwan

As Taiwan's population ages, the need for long-term care, such as home care, is increasing due to improved medical services and longer life expectancy; however, the current coverage rate for home care services is only 50%, highlighting the importance of retaining home care workers. This study applies job embeddedness, organizational commitment, and psychological safety as variables to explore the retention intention of Taiwan's home care workers. A questionnaire survey was distributed among home care workers using convenience sampling, resulting in 547 collected questionnaires, of which 458 were valid. Data analysis was conducted with SPSS 22.0 and AMOS 22.0, and a structural equation model (SEM) was used to test the hypotheses. Our findings suggest that job embeddedness has a positive impact on organizational commitment (γ = 0.649, γ = 0.607, and γ = 0.628; p < 0.001) and retention intention (γ = 0.253, γ = 0.242, γ = 0.271; p < 0.001), similar to organizational commitment (γ = 0.721, p < 0.001). Additionally, organizational commitment mediates job embeddedness and retention intention, while psychological safety moderated organizational commitment and retention intention (β = 0.639; p < 0.001). This study aims to provide information for the development of more effective human resource policies and contribute to practical advancements in the home care service environment and management structure of home care organizations. By analyzing and exploring the main factors contributing to home care workers' retention intention, we hope to enhance the overall benefits of home service organizations and the industry.

The Mediating Role of Work Satisfaction in the Relationship between Organizational Communication Satisfaction and Organizational Commitment of Healthcare Professionals: A Cross-Sectional Study

The factors that influence the organizational commitment of healthcare professionals, particularly organizational communication and work satisfaction, are essential for all healthcare organizations. This is particularly important for those who are under the pressure of high demand, economic constraints, and staff shortages. This study examined the relationship between organizational communication satisfaction and organizational commitment among healthcare professionals and the mediating role of work satisfaction in the relationship. A validated self-administered questionnaire and a universal sampling approach were used to conduct a cross-sectional survey of 235 healthcare professionals in the Gaza Strip, Palestine. The data were analyzed using SPSS version 25 and SmartPLS software to perform partial least squares structural equation modeling (PLS-SEM). A STROBE checklist was used to report the results. The results show a significant positive correlation between all measured variables. Work satisfaction partially mediates the relationship between organizational communication satisfaction and organizational commitment. The results of the PLS-SEM analyses suggest that communication satisfaction and work satisfaction account for 61% of the variation in organizational commitment. This study reveals that work satisfaction and communication satisfaction are imperative to building a sense of commitment in healthcare professionals. These results reinforce the existing evidence on the factors that influence the organizational commitment of healthcare professionals. Strategies to better shape internal communication practices and improve the work environment through regular feedback to healthcare professionals are essential to strengthening their organizational commitment.

Moral Distress Scores of Nurses Working in Intensive Care Units for Adults Using Corley's Scale: A Systematic Review

BACKGROUND

No systematic review in the literature has analyzed the intensity and frequency of moral distress among ICU nurses. No study seems to have mapped the leading personal and professional characteristics associated with high levels of moral distress. This systematic review aimed to describe the intensity and frequency of moral distress experienced by nurses in ICUs, as assessed by Corley's instruments on moral distress (the Moral Distress Scale and the Moral Distress Scale-Revised). Additionally, this systematic review aimed to summarize the correlates of moral distress.

METHODS

A systematic search and review were performed using the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), the National Library of Medicine (MEDLINE/PubMed), and Psychological Abstracts Information Services (PsycINFO). The review methodology followed PRISMA guidelines. The quality assessment of the included studies was conducted using the Newcastle-Ottawa Scale.

RESULTS

Findings showed a moderate level of moral distress among nurses working in ICUs. The findings of this systematic review confirm that there are a lot of triggers of moral distress related to patient-level factors, unit/team-level factors, or system-level causes. Beyond the triggers of moral distress, this systematic review showed some correlates of moral distress: those nurses working in ICUs with less work experience and those who are younger, female, and intend to leave their jobs have higher levels of moral distress. This systematic review's findings show a positive correlation between professional autonomy, empowerment, and moral distress scores. Additionally, nurses who feel supported by head nurses report lower moral distress scores.

CONCLUSIONS

This review could help better identify which professionals are at a higher risk of experiencing moral distress, allowing the early detection of those at risk of moral distress, and giving the organization some tools to implement preventive strategies.

Testing a model of Thai nurses' intent to stay in employment

AIM

To test the causal model of intent to stay in employment of nurses in regional medical centers.

BACKGROUND

Effectiveness and quality of nursing care are determined by an adequate number of nursing staff; however, there is an ongoing challenge of nursing shortage. Improving nurses' intention to remain in employment is an effective way to address the problem of nursing shortage.

METHODS

This study employed a cross-sectional design. The sample was 1224 registered nurses from nine regional medical centers across Thailand, selected using multistage random sampling. Data were collected between January and July 2019 and analyzed with structural equation modeling.

RESULTS AND DISCUSSION

The final model could explain 40.3% of the variance in intent to stay. Transformational leadership, coworker support, professional autonomy, opportunities for promotion, marital status, and job satisfaction positively affected intent to stay, while burnout negatively affected intent to stay. This indicates that seven factors that should be considered by nurse managers in developing a framework for constructing interventions to increase nurses' intention to continue working in their organization.

IMPLICATION FOR NURSING AND NURSING POLICY

Nurse managers should strengthen the intent to stay of nurses by providing consultations, building a positive work atmosphere, and encouraging nurse leaders to apply transformational leadership behaviors to the organizational administration. Policymakers should consider enacting policies and regulations for nurses' benefits, such as allocating civil servant positions to temporary nursing staff, expanding the framework of career advancement to a senior professional position, and considering salary and overtime pay, to increase nurses' intent to stay in an organization.

Nurses are leaving the nursing profession: A finding from the willingness of the nurses to stay in the nursing profession among nurses working in selected public hospitals of Wollega Zones, Oromia, Ethiopia

Background:

The willingness of nurses to stay in nursing profession is nurses stay in the nursing profession without having intention to shift their works to other professions. In healthcare systems, nurses are currently leaving their work. To give quality of health, nurses have to stay in their work. The aim of this study was to find the willingness of the nurses to stay in the nursing profession and associated factors.

Methods:

An institution-based cross-sectional study was employed among nurses in selected hospitals. After checking for completeness, the data were interred into Epi Data version 3 and exported to Stata SE version 14 for analysis. Then, the descriptive statistics were computed. To find association, logistic regression was computed. Covariates from binary logistic regression were a candidate for multivariate logistic regression at p-value ⩽ 0.25. Variables in the final model were selected by the stepwise backward selection procedure. In the end, variables with a p-value ⩽ 0.05 were considered as statistically significant.

Results:

In this study, 349 nurses have participated with a 100% response rate and more than half of the participants were male 188 (53.87%). The proportion of nurses who have the willingness to stay in the nursing proportion is 54.44% (95% confidence interval = 0.491, 0.59). Getting relatively high salary (adjusted odd ratio = 1.81 (95% confidence interval = 1.05, 3.11)), no presence of support among colleagues (adjusted odd ratio = 0.10 (95% confidence interval = 0.05, 0.22)), not having participation in training (adjusted odd ratio = 0.49 (95% confidence interval = 028, 0.86)), having relative low experience in nursing profession that is less than 6 years (adjusted odd ratio = 0.46 (95% confidence interval = 0.26, 1.81)), having good autonomy in the nursing profession (adjusted odd ratio = 0.41 (95% confidence interval = 0.23, 0.70)), and having a good sense of self-calling for the nursing profession among nurses (adjusted odd ratio = 2.85 (95% confidence interval = 1.64, 4.97)) are the factors related with willingness of the nurses to stay in the nursing profession.

Conclusion and recommendation:

To bring development in the nursing profession, it is a must to staying experienced nurses in the nursing profession. Therefore, to increase the willingness of nurses in the nursing profession, it is better to increase the salary of nurses, giving frequent training for the nurses, initiate the nurses to support one another, and encourage the nurses to have sense of self-calling for nursing profession. This is accomplished if there is a harmonious relationship between the governments, nurses, and other stakeholders in the healthcare delivery system.

The COVID-19 Pandemic and Professional Nursing Practice in the Context of Hospitals

The COVID-19 pandemic has imposed challenges to health systems and institutions, which had to quickly create conditions to meet the growing health needs of the population. Thus, this study aimed to assess the impact of COVID-19 on professional nursing practice environments and to identify the variables that affected their quality. Quantitative, observational study, conducted in 16 Portuguese hospitals, with 1575 nurses. Data were collected using a questionnaire and participants responded to two different moments in time: the pre-pandemic period and after the fourth critical period of COVID-19. The pandemic had a positive impact on the Structure and Outcome components, and a negative trend in the Process component. The variables associated with the qualification of the components and their dimensions were predominantly: work context, the exercise of functions in areas of assistance to COVID-19 patients, length of professional experience and length of experience in the service. The investment in professional practice environments impacted the improvement of organizational factors, supporting the development of nurses' work towards the quality of care. However, it is necessary to invest in nurses' participation, involvement and professional qualifications, which are aspects strongly dependent on the institutions' management strategies.

Improving Interprofessional Teamwork in Plastic Surgery: A Novel Approach to Microsurgical Skills Training

Shared mental models between surgeons and nurses allow them to effectively communicate and react to intraoperative complications. Microsurgery poses unique challenges that include the use of an operating microscope, fine instruments, and a restricted view of the operative field. We designed and delivered a microsurgical skills session for surgical nurses consisting of an introduction to the operating microscope and 3 practical stations involving increasingly complex motor tasks designed to highlight the importance of instrument handling and improve awareness of microsurgical challenges. Consultant plastic surgeons acted as scrub persons to add an element of role-reversal. All participants enjoyed the training session and felt that it improved their understanding of microsurgery and was relevant and helpful to their day-to-day role. All attendees reported that they would partake in similar sessions in the future. Our work suggests that role-reversal and skills-based education and training are valuable tools in improving multidisciplinary collaboration during microsurgery. Increasing shared knowledge of complex procedures encourages effective teamwork and communication, which leads to improved efficiency and better patient care. Our study is a first step toward development of a standardized microsurgical skills course for plastic surgical nurses and has broader implications for interprofessional education across all surgical specialties.

Coronavirus Disease 2019 Immediately Increases Burnout Symptoms in ICU Professionals: A Longitudinal Cohort Study

OBJECTIVES

ICU professionals are at risk of developing burnout due to coronavirus disease 2019. This study assesses the prevalence and incidence of burnout symptoms and moral distress in ICU professionals before and during the coronavirus disease 2019 crisis.

DESIGN

This is a longitudinal open cohort study.

SETTING

Five ICUs based in a single university medical center plus another adult ICU based on a separate teaching hospital in the Netherlands.

SUBJECTS

All ICU professionals were sent a baseline survey in October-December 2019 (252 respondents, response rate: 53%), and a follow-up survey was sent in May-June 2020 (233 respondents, response rate: 50%).

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Burnout symptoms and moral distress measured with the Maslach Burnout Inventory and the Moral Distress Scale, respectively. The prevalence of burnout symptoms was 23.0% before coronavirus disease 2019 and 36.1% at postpeak time, with higher rates in nurses (38.0%) than in physicians (28.6%). Reversely, the incidence rate of new burnout cases among physicians was higher (26.7%) than nurses (21.9%). Higher prevalence of burnout symptoms was observed in the postpeak coronavirus disease 2019 period (odds ratio, 1.83; 95% CI, 1.32-2.53), for nurses (odds ratio, 1.77; 95% CI, 1.03-3.04), for professionals working overtime (odds ratio 2.11; 95% CI, 1.48-3.02), and for professionals directly engaged with care for coronavirus disease 2019 patients (odds ratio, 1.87; 95% CI, 1.35-2.60). Physicians were more likely than nurses to develop burnout symptoms due to coronavirus disease 2019 (odds ratio, 3.56; 95% CI, 1.06-12.21).

CONCLUSIONS

This study shows that overburdening of ICU professionals during an extended period of time leads to symptoms of burnout. Working long hours and under conditions of scarcity of staff, time, and resources comes at the price of ICU professionals' mental health.