The relationship between task mastery, role clarity, social acceptance, and stress: An intensive longitudinal study with a sample of newly registered nurses

'We are expected to be problem solvers'-Paramedics' performance expectations through the lens of organizational socialization: An interview study

AIM

To explore Finnish paramedics' perceptions of work-related performance expectations in relation to work experience, and understand how organizational socialization contributes to understanding paramedics' performance expectations.

DESIGN

A qualitative design with a deductive-inductive approach utilizing a social constructivist framework. The organizational socialization framework by Wanberg was used as the theoretical basis.

METHODS

Data were collected between May and August 2023, using group and individual interviews of newly graduated (n = 9) and experienced paramedics (n = 13). Participants were recruited via social media channels. Data were first analyzed deductively, according to constructs of the organizational socialization framework (role clarity, task mastery, and social acceptance), then inductively, using codes not utilized in the deductive phase.

DATA SOURCES

Interviewed Finnish paramedics (N = 22), both newly graduated paramedics (n = 9) and experienced paramedics (n = 13). The interviews were performed remotely and then transcribed into text.

RESULTS

Our findings showed comparable performance expectations between newly graduated and experienced paramedics, mismatches in role clarity of paramedic work, challenges in both learning and upholding professional competence, and difficulties of social acceptance into the paramedic community. There were variations in how expectations were perceived between groups, indicating that experience might partly affect how paramedics identify and manage performance expectations. The organizational socialization framework enables the contextualization of these performance expectations.

CONCLUSIONS AND IMPLICATIONS

Paramedic work involves challenges to upholding clinical competence, aligning to a professional role, and social integration into the professional community. Our research contributes to understanding how paramedics perceive these challenges as performance expectations in different stages of their careers and how they could be managed utilizing a framework for organizational socialization. The socialization of paramedics into the workforce needs to account for these performance expectations, especially considering the changing paradigm of paramedic work, role, and societal expectations.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Commitment and efforts to maintain mentoring: Nurse managers' perceptions of structuring mentoring provision for new nurses in a hospital setting

AIM

The aim of the present study was to describe nurse managers' perceptions of the provision of mentoring for newly graduated registered nurses (NGRNs) and its contribution to the work environment in a hospital setting.

BACKGROUND

Nurse managers are responsible for the work environment and for supporting the staff's professional development, which includes giving NGRNs organizational support during their introduction to the workplace. Mentorship is one common way to provide support, but there is a lack of knowledge about how nurse managers view this support.

DESIGN/METHOD

This was a qualitative descriptive study, using a semi-structured interview guide. Fifteen individual interviews with nurse managers were performed in hospital settings. The interview transcripts were analysed using qualitative content analysis. The COREQ guidelines and checklist were used.

RESULTS

The results describe the nurse managers' perceptions of the provision of mentoring in three themes: Ensuring and sustaining mentoring for new nurses' needs is a struggle in the harsh reality of healthcare, Identifying mentors who are willing and possess the necessary competence for the assignment and Promoting a secure and attractive workplace by mentoring new nurses.

CONCLUSIONS

Our study confirms that nurse managers are important in the provision of mentoring for NGRNs' learning and professional development. Mentoring has a positive spillover effect on the entire unit as a sustainable approach to securing and improving the work environment. Our study also identifies challenges for nurse managers to structure mentoring provision.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

This study highlights the importance of investment in mentoring for the NGRNs' professional development and for patient care. Support is needed from the top level of the organization, but how mentoring should be structured and facilitated needs to be investigated further.

The relationship between medical staff burnout and subjective wellbeing: the chain mediating role of psychological capital and perceived social support

Background

Medical staff play a crucial role in delivering healthcare services, especially during epidemics of infectious diseases such as coronavirus disease 2019 (COVID-19). However, there is a growing issue of burnout and low wellbeing among this group. While it is widely recognized that burnout has a negative impact on subjective wellbeing, the exact relationship between the two is not yet completely understood. The purpose of this study is to explore the chain mediating role of psychological capital and perceived social support between burnout and subjective wellbeing among medical staff.

Methods

Using the convenient sampling method, 604 medical staff were selected for a cross-sectional study. All participants completed a self-report questionnaire that collected demographic information, as well as data from the Maslach Burnout Inventory-Human Services Survey, General Wellbeing Schedule, Psychological Capital Questionnaire, and Perceived Social Support Scale. SPSS 27.0 and SPSS PROCESS macro were used for data analysis.

Results

There was a significant correlation between burnout, psychological capital, perceived social support, and subjective wellbeing (p < 0.01). Burnout not only has a direct negative impact on the subjective wellbeing of medical staff (effect: -0.2045; Bootstrap 95%CI: -0.2506, -0.1583), but also exerts an indirect influence on subjective wellbeing through three pathways: the independent mediating effect of psychological capital (effect: -0.0481; Bootstrap 95%CI: -0.0876, -0.0109), the independent mediating effect of perceived social support (effect: -0.0092; Bootstrap 95%CI: -0.0203, -0.0003), and the chained mediating effect of psychological capital and perceived social support (effect: -0.0092; Bootstrap 95%CI: -0.0183, -0.0019).

Conclusion

High burnout in medical staff can impair the level of psychological capital, leading to diminished perceived social support and ultimately reduced subjective wellbeing. The findings of this study contribute to understanding the potential pathways between burnout and subjective wellbeing and provide preliminary data support for developing strategies to improve the mental health of medical staff.

Sleep, mental health and physical health in new shift workers transitioning to shift work: Systematic review and meta-analysis

This systematic review and meta-analysis (PROSPERO registration CRD42022309827) aimed to describe how shift work impacts new workers' sleep, mental health, and physical health during the transition to shift work and to consolidate information regarding predictors of shift work tolerance (SWT) during this transition period. Inclusion criteria included: new shift workers; sleep, mental health, or physical health outcomes; prospective study design with the first timepoint assessing workers within three months of starting shift work; and written in English. Searches from six databases returned 12,172 articles as of August 2023. The final sample included 48 papers. Publication quality and risk of bias was assessed using the critical appraisal skills program. Forty-five studies investigated longitudinal changes in sleep, mental health, or physical health outcomes and 29 studies investigated predictors of SWT (i.e., better sleep, mental and physical health). Sleep and mental health outcomes worsened following the onset of shift work, while physical health did not significantly change. Pre-shift work mental health, sleep, and work characteristics predicted SWT later in workers' careers. Shift work adversely impacts new workers' sleep and mental health early in their career, and interventions before beginning shift work are needed to promote better SWT.

Implementation of an Enculturation Toolkit for New Nurses During Unit Onboarding

OBJECTIVE

This quality improvement project targeted an enculturation gap among new nurses by assembling and piloting an Enculturation Toolkit.

BACKGROUND

Enculturation of new nurses contributes to engagement, performance, sense of belonging, and retention. During the COVID-19 pandemic, orientation was shortened, virtual, and asynchronous, creating a gap in enculturation.

METHODS

New nurses and their preceptors were surveyed at baseline, 2 to 3 months, and 4 to 5 months to measure engagement and enculturation using the Meaning and Joy in Work Questionnaire (MJWQ) and questions about the history and values of the organization.

RESULTS

Initial MJWQ responses were high and sustained throughout the study period. Participants demonstrated increased knowledge of the organization's mission statement and logo. New nurses rated the toolkit activities favorably, with an average score of 4.6 out of 5.

CONCLUSIONS

An Enculturation Toolkit was effective in improving knowledge about the organization and sustaining engagement and belonging.

The impact of transition programs on well-being, experiences of work environment and turnover intentionamong early career hospital nurses

BACKGROUND

Transition programs for newly graduated nurses in hospital settings are reported to provide learning opportunities, strengthening confidence, workplace integration and skills, retention and job satisfaction. Still, our knowledge of long-term effects is scarce and few studies have used control groups.

OBJECTIVE

To explore the long-term impact of having attended a transition program on the nurses' experiences of the first years of practice. More specifically, ideology-infused psychological contract, ethical stress, perceived organizational support, job satisfaction, opportunities for learning, and intention to stay in the nursing profession, were explored as outcome variables.

METHODS

A questionnaire survey was carried out among registered nurses from November 2019 to January 2020, with a 54% response rate. The analysis was based on 149 nurses who had attended a transition program, and 72 who had not attended. The nurses had seniority between one and three years. Independent samples t-test were used to investigate differences between the groups.

RESULTS

The two groups showed small and non-significant differences in the outcome variables. However, regarding the frequency of ethical value conflicts induced by insufficient resources, as well as experiences of ethical value conflict distress, the group of nurses who had attended a transition program showed statistically significantly higher mean values, although the effect sizes were small.

CONCLUSION

Newly graduated nurses need more than transition programs and skills training to progress in their nursing role and develop competence, increase job satisfaction, and reduce stress. Achieving these goals requires a long-term supportive learning environment that is integrated into everyday work.

Struggling in the dehumanized world of COVID-An exploratory mixed-methods study of frontline healthcare workers' experiences

AIM

To explore healthcare workers' experiences of the changed caring reality during the COVID-19 pandemic in Sweden.

DESIGN

An online fully mixed-methods design.

METHODS

A web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021, analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting.

RESULTS

Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy.

CONCLUSIONS

Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

SUMMARY

The pandemic outbreak exposed frontline healthcare workers to unparallelled stress shown as negative for their mental health in several meta-analyses and systematic reviews. In-depth understanding on experiences and how symptoms of post-traumatic stress disorder relate to coping mechanisms have been scarcely explored. This study contributes to understanding on healthcare workers' experiences and the relation between lower sense of coherence and increased risk of developing symptoms of post-traumatic stress disorder.

IMPLICATIONS FOR PRACTICE/POLICY

This study might guide how to prepare for resilience in future emergencies.

Gaining acceptance, insight and ability to act: A process evaluation of a preventive stress intervention as part of a transition-to-practice programme for newly graduated nurses

AIM

To investigate how NGNs perceived and applied an intervention for preventing stress-related ill health embedded in a transition-to-practice programme when entering their professional life.

DESIGN

A qualitative exploratory descriptive design was selected for this study to gain insights and perspectives on the adoption and utilization of the intervention.

METHODS

In this qualitative methodology process evaluation, semi-structured and audio-recorded interviews were conducted with a sample of 49 nurses. Data were collected between December 2016 and July 2017, and were sorted in NVivo 12 Plus, followed by thematic analysis.

RESULTS

The analysis resulted in three change processes stimulated by the intervention: (a) Building acceptance of being new; (b) Gaining insight into professional development and health and (c) Practical steps for skills development, healthy habits and better-organized work. In addition to the three themes, barriers that hindered the progression of the processes were also described. Each process influenced the development of the others by stimulating a deeper understanding, motivation to change and courage to act. Several barriers were identified, including the use of cognitively demanding intervention tools, fatigue, high work demands, inconvenient work hours and a hostile social climate on the ward.

CONCLUSION

This process evaluation showed that newly graduated nurses used knowledge from the intervention and adopted new behaviours largely in accordance with how the intervention was intended to work.

IMPACT

When entering a new profession, it is crucial to receive a well-thought-out, structured and targeted introduction to the new professional role, tasks and work group. Nurses stated that the intervention increased their understanding of the role as new nurses and their insight into how to develop skills that promoted better functioning and recovery. The intervention also stimulated the development of new health behaviour and some new learning strategies.

Psychosocial work characteristics and sleep quality among early career registered nurses: a cross-sectional latent profile analysis

BACKGROUND

Individual psychosocial work characteristics have been associated with health and well-being of registered nurses. However, it is yet to be determined whether different types of psychosocial work characteristics form patterned profiles and how these profiles are associated with the health and well-being. The purpose of this study was to identify latent psychosocial work characteristic profiles, including procedural, interactional and distributive justice, job demand and job control, and examine whether the profiles are associated with sleep quality among early career registered nurses.

METHODS

We conducted a cross-sectional study comprising 632 early career registered nurses. Data were collected between November and December 2018 using an electronic survey with internationally validated measures including the Organizational Justice Scale, the Nurse Stress Index Scale, the Job Content Questionnaire, and the Sleep Problems Questionnaire. Latent profile analysis was used to identify groups with similar psychosocial work characteristic profiles. Multinomial and linear regression analyses were used to examine the association between latent work characteristics profiles and sleep quality.

RESULTS

Analysis yielded four profiles. The profiles were named based on the descriptions of classes as high strain/low justice, medium strain/high justice, medium strain/medium justice, and low strain/high justice. The low strain/high justice profile group (p = < 0.001) and the medium strain/high justice profile group (p = 0.002) had statistically significantly better sleep quality compared to the high strain/low justice profile group.

CONCLUSIONS

High procedural and interactional justice may alleviate strain in early career registered nurses and protect them against sleep problems. Promoting organizational justice in early career stages seems an efficient way to enhance registered nurses' well-being and sleep quality.

Nurses' perception of identity, practice and support needed in primary care: A descriptive qualitative study

AIMS

To explore how primary care registered nurses (PCRNs) describe their professional identity, their perception of their practice, and the support they need to effectively perform the responsibilities of their role.

DESIGN

A qualitative descriptive design using inductive content analysis.

METHODS

Semi-structured interviews were conducted with registered nurses (n = 14) working in primary care settings in the United States between June 2018 and December 2020. Inductive content analysis was used and comprised three phases: preparation, organizing, and reporting. COREQ reporting guidelines were used.

RESULTS

Three categories were discovered related to PCRN identity and practice: Wearing Multiple Hats, Practicing Within Bounds and Change is a Part of Practice. There were also three categories for support needed: Entering In, Ongoing Support and Making it a Better Place. Within each category, subcategories were identified.

CONCLUSION

Primary care registered nurses have a unique professional identity and practice. When entering the setting, nurses must acquire the skills and knowledge to ask the right questions and navigate the system to meet the diverse and complex needs of their patients. PCRNs recognize change is a part of practice and have ideas and visions for what the role of PCRNs could be.

IMPLICATIONS FOR PROFESSION

Recognizing the unique identity and practice of PCRNs is necessary to create an environment that leverages their skills and knowledge.

IMPACT

We identified key elements of PCRN identity and practice and the support necessary to meet their needs. Healthcare organizations must ensure nurses new to the practice setting receive training and support for their unique and essential role. Additionally, leaders must partner with nurses to enhance nursing practice and achieve optimal patient outcomes.

REPORTING METHOD

Adherence to COREQ guidelines were maintained.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Development and validation of experienced work-integrated learning instrument (E-WIL) using a sample of newly graduated registered nurses - A confirmatory factor analysis

INTRODUCTION

Research indicates that newly graduated registered nurses struggle to develop practical skills and clinical understanding and to adapt to their professional role. To ensure quality of care and support new nurses, it is vital that this learning is elucidated and evaluated. Aim The aim was to develop and evaluate the psychometric properties of an instrument assessing work-integrated learning for newly graduated registered nurses, the Experienced Work-Integrated Learning (E-WIL) instrument.

METHOD

The study utilized the methodology of a survey and a cross-sectional research design. The sample consisted of newly graduated registered nurses (n = 221) working at hospitals in western Sweden. The E-WIL instrument was validated using confirmatory factor analysis (CFA).

RESULTS

The majority of the study participants were female, the average age was 28 years, and participants had an average of five months' experience in the profession. The results confirmed the construct validity of the global latent variable E-WIL, "Transforming previous notions and new contextual knowledge into practical meaning," including six dimensions representing work-integrated learning. The factor loadings between the final 29 indicators and the six factors ranged from 0.30 to 0.89, and between the latent factor and the six factors from 0.64 to 0.79. The indices of fit indicated satisfactory goodness-of-fit and good reliability in five dimensions with values ranging from α = 0.70 to 0.81, except for one dimension showing a slightly lower reliability, α = 0.63, due to the low item number. Confirmatory factor analysis also confirmed two second-order latent variables, "Personal mastering of professional roles" with 18 indicators, and "Adapting to organisational requirements" with 11 indicators. Both showed satisfactory goodness-of-fit, and factor loading between indicators and the latent variables ranged from 0.44 to 0.90 and from 0.37 to 0.81, respectively.

CONCLUSION

The validity of the E-WIL instrument was confirmed. All three latent variables could be measured in their entirety, and all dimensions could be used separately for the assessment of work-integrated learning. The E-WIL instrument could be useful for healthcare organisations when the goal is to assess aspects of newly graduated registered nurses' learning and professional development.

Role Clarity and Interprofessional Colleagues in Psychological Safety: A Faculty Reflection

SUMMARY STATEMENT

Psychological safety in high-fidelity simulation-based experiences ensures that learners feel safe with new experiences in the service of learning. This article is a faculty reflection on breaches in the psychological safety among nursing students in 2 independent, high-fidelity simulation-based experience studies that were conducted in 2019. Demonstrated breaches in psychological safety included fear and anxiety in the sole provider role in multiple-patient simulations and incivility directed toward nursing students in a primary nurse role in interprofessional simulations. This article adds to the growing literature on psychological safety by sharing important lessons learned regarding role clarity and interprofessional colleagues, proposing recommendations, and providing suggestions for future research on psychological safety.

Success factors in adaptation of newly graduated nurses: a scoping review

BACKGROUND

Difficulties in adapting to the workplace can affect newly graduated nurses' transition. Such nurses must adapt quickly, as it can affect their future career prospects. Therefore, this review aimed to identify the success factors that promote newly graduated nurses' effective transition and adaptation.

METHODS

The Joanna Briggs Institute scoping reviews methodology was used. Data were extracted from MEDLINE, Scopus, EBSCOhost, and Web of Science publications published between 2011 and 2020. A total of 23 articles were included in this review, which comprised qualitative, quantitative, and mixed methods primary research studies focusing on the contributing factors that aided newly graduated nurses' adaptation to the work environment during their transition period. Key emerging themes were identified with thematic analysis.

RESULTS

Three main themes were identified: (1) organisational contribution (social development, organisational culture, work characteristics, work readiness, work commitment, professional role), (2) personality traits (self-embodiment, personality masking, being proactive and confident), and (3) academic institutions (pre-entry knowledge and role of nursing faculty). Newly graduated nurses' adaptation should begin during nursing education, be supported by the workplace organisation, and driven by the nurse's personality. We determined that that the role of nursing education in aiding the provision of the required knowledge and actual clinical experiences to students profoundly affected developing nurses' self-confidence levels in delivering nursing care effectively. Additionally, a warm environment supported nurses emotionally and physically.

CONCLUSIONS

While organisations and educational institutions have undertaken numerous efforts to ensure that newly graduated nurses are adequately supported, the nurse's personality and values are also equally important to ease adaptation during the transition process. Academic and workplace programs designed for newly graduated nurses should apply and emphasise this knowledge to develop and strengthen their personalities and values, especially to increase confidence and promote proactive values that facilitate newly graduated nurses' rapid and effective adaptation to their new employment.

New Nurses' Perceptions on Transition to Practice: A Thematic Analysis

BACKGROUND

New nurses' transition to the workforce is often described as challenging and stressful. Concerns over this transition to practice are well documented, with the hypothesis that transition experiences influence the retention of new nurses in the workforce and profession.

METHODS

In a cross-sectional survey (N = 217) to assess new nurse transition in the province of Ontario, Canada, an open-ended item was included to solicit specific examples of the transition experience. The comments underwent thematic analysis to identify the facilitators and barriers of transition to practice for new nurses.

RESULTS

Comments were provided by 196 respondents. Three facilitator themes (supportive teams; feeling accepted, confident, and prepared; new graduate guarantee) and four barrier themes (feeling unprepared; discouraging realities and unsupportive cultures; lacking confidence/feeling unsure; false hope) to new nurse transition emerged.

CONCLUSIONS

Concerns of nursing shortages are heightened in the current COVID-19 pandemic, reinforcing the priority of retaining new nurses in the workforce. The reported themes offer insight into the contribution of a supportive work environment to new nurses' transition. The recommendations focus on aspects of supportive environments and educational strategies, including final practicums, to assist nursing students' development of self-efficacy and preparation for the workplace.

Caring through barriers-Newly graduated registered nurses' lived experiences in emergency departments during the COVID-19 pandemic

AIM

To illuminate the meaning of newly graduated registered nurses' experiences of caring for patients in emergency departments during the COVID-19 pandemic.

DESIGN

A phenomenological hermeneutical study guided by Lindseth and Norberg.

METHODS

In-depth one-on-one interviews with 14 nurses from five hospitals were conducted from March to November 2020 and analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) were used as the reporting guideline.

RESULTS

The findings comprise one main theme Caring through barriers and three themes with sub-themes. In the first theme, having intention to care, participants revealed their dedication to care for patients during the pandemic despite extensive stress, little experience and skills. The second theme, with tied hands in human suffering, illuminates experiences of being disconnected from the patient, overwhelmed by responsibility and unable to relieve suffering. The third theme, feeling inadequate, reveals experiences of lack of support and doubts meaning less space to develop into the nurse one wants to be.

CONCLUSION

Findings reveal a new understanding of new nurses' experiences during times of crisis. The essence of caring in the emergency department during the pandemic can be explained as mediated through spatial, temporal and emotional barriers preventing new nurses from providing holistic care.

IMPACT

The results may be used as anticipatory guidance for new nurses and inform targeted support interventions to support new nurses entering the profession in crisis conditions.

PUBLIC CONTRIBUTION

This study involved new nurses in semi-structured interviews.

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.

Transitioning to Independent Nursing Practice during COVID-19: A Mixed Methods Study

The COVID-19 pandemic presented challenges to onboard and support new graduate nurses (NGNs). This study sought to explore the perceptions of nurses entering clinical practice during the COVID-19 pandemic. Using mixed methods, we investigated the experiences of NGNs entering the field during the pandemic and how a nurse residency program (NRP) adapted to meet their needs. Newly graduated nurses entering practice in November 2019 described their transition through nurse experience surveys and focus group discussions. Results from the quantitative data reported on compassion satisfaction, burnout, and exposure to secondary traumatic stress. The qualitative data mirrored these findings with the discovery of the following five themes: transitioning through an NRP, impact to nursing care, value of coworkers, coping, and professional growth. These findings illustrate the need to better support future practice transitions in times of disruption and change.

Body image and compulsive exercise: are there associations with depression among university students?

PURPOSE

Mental health problems among university students have been reported to be significantly increasing and suggested to be associated with college drop-out. Body dissatisfaction and compulsive exercise are both constructs relevant for mental health problems in general and eating disorders in particular. This study examined associations between body dissatisfaction, compulsive exercise and self-reported symptoms of depression among Swedish university students.

METHODS

Participants (n = 4262) are students in an ongoing cohort study, and data from the baseline assessment were used. Four linear regression models were built to explore the associations between body dissatisfaction, compulsive weight control exercise and depressive symptoms.

RESULTS

Our findings showed that females reported higher levels of body dissatisfaction than males. Body dissatisfaction and compulsive exercise were associated with self-reported symptoms of depression in this non-clinical population. Results showed that compulsive exercise was negatively associated with reported symptoms of depression, while body dissatisfaction was positively associated with symptoms of depression.

CONCLUSION

In line with previous research, there was a gender difference in body dissatisfaction where females displayed higher levels of dissatisfaction than males.  Body dissatisfaction was  positively associated with reported symptoms of depression, suggesting support of previous research indicating body dissatisfaction to increase mental health problems. Compulsive exercise was negatively associated with symptoms of depression suggesting a behavior negatively reinforced, supporting both constructs to be of interest for reported symptoms of depression in a non-clinical population of Swedish university students.

LEVEL OF EVIDENCE

III, cohort study.

TRIAL REGISTRATION

http://clinicaltrials.gov/ID : NCT04465435.

Examining resilience: the role of creativity-oriented high-performance work practices and role clarity

Purpose

The paper aims to highlight the understated role of creativity in R&D organizations by exploring the effect of creativity-oriented high-performance work practices (CHPWPs) on resilience. The moderator effect of role clarity (RC) on the association between CHPWPs and resilience is examined.

Design/methodology/approach

The study proposes a simple moderation model to understand the relationship, and specifically hierarchical regression analysis (SPSS 22.0) and SPSS PROCESS Macro has been used to test the hypotheses.

Findings

Findings revealed that the implementation of CHPWPs would significantly improve resilience. The benefits of CHPWPs on resilience get compromised as the organizations lay stress on higher levels of RC.

Practical implications

Indian R&D organizations must emphasize upon enhancing resilience through a set of CHPWPs. Rather than laying greater stress on RC, these organizations should build a creative climate characterized by experimentation, freedom and a free flow of ideas.

Originality/value

The current study makes a valuable contribution by highlighting the importance of creativity and resilience in organizations. Although conceptual studies highlight the importance of creativity in R&D organizations, this has been was greatly neglected. The current study adds value to the existing literature by deepening the authors’ understanding of the role of CHPWPs in enhancing resilience, the latter being a subject of huge focus of organizations during the pandemic.

The Importance of Effective Organizational Socialization for Preventing Stress, Strain, and Early Career Burnout: An Intensive Longitudinal Study of New Professionals

Burnout was originally conceptualized based on experiences of new professionals. Role clarity, task mastery, and social acceptance are recognized as key resources enabling new professionals' management of the challenges of the new profession. However, relations between these resources and stress, strain, and burnout have not yet been thoroughly investigated at professional entry. Increased understanding of these relations could have implications for strategies to prevent burnout. The aim of the study was to investigate within- and between-individual effects over the first months and relations to burnout at one-year post-entry. Data (n = 322) was collected weekly over the first 13 weeks and again 9 months later. Relationships were modelled using a multilevel regression model and correlation analysis. Results showed that on weeks when participants experienced higher role clarity, task mastery, and social acceptance, they reported significantly less stress, and that participants who experienced higher levels of the resources in general, reported significantly less strain. Levels of the resources at three months were related to symptoms of burnout at 12 months. The study findings provide support of the role of task mastery, role clarity, and social acceptance as resources buffering the impact of demands at professional entry on experiences of stress, strain, and burnout.

Battling extraordinary situations and conflicting emotions-A qualitative study of being a newly graduated Registered Nurse in the emergency department during the COVID-19 pandemic

Aim

To describe newly graduated registered nurses’ (NGRNs’) experiences of encountering stress in emergency departments (EDs) during the COVID‐19 pandemic.

Design

A qualitative descriptive study.

Methods

Data from 14 in‐depth interviews with NGRNs working in an ED for 3‐36 months after graduation was analysed by the means of qualitative content analysis as described by Graneheim and Lundman. Interviews were conducted from March to November 2020 covering the first two waves of the pandemic.

Results

Data revealed three categories and nine subcategories comprised in the theme Battling extraordinary situations and conflicting emotions. Empowered by acknowledging themselves as important caregivers during the pandemic NGRNs struggle against limitations and exert themselves beyond their known limit. External stressors due to work overload in combination with understaffing force NGRNs into the role of the experienced nurse prematurely and internal stressors derives from part taking in less qualitative care.

Social support and job satisfaction in nursing staff: Understanding the link through role ambiguity

AIM

This study aimed to analyze the mediator effect of role ambiguity between social support from supervisor and colleagues and job satisfaction in Portuguese nursing staff.

BACKGROUND

Few studies have analyzed the processes through which social support increases job satisfaction in the nursing context.

DESIGN

A cross-sectional design using questionnaires.

METHOD

A total of 124 registered nurses and 130 certified nursing assistants participated in the study. Mediation analysis was performed by calculating Percentile confidence intervals (10,000 resamples).

RESULTS

Mediation analysis revealed a partial mediation between social support and job satisfaction through role ambiguity. The direct effect was greater in the case of supervisor support.

CONCLUSIONS

Social support is a crucial resource in the nursing work context with a beneficial effect on well-being (e.g. reducing role stress) and job satisfaction. Implications for Nursing Management Managers of hospitals and health units can establish the organizational bases to facilitate this process, considering the importance of the role of the supervisors and colleagues in the provision of high levels of instrumental and socio-emotional support.

Sustainable UNiversity Life (SUN) study: protocol for a prospective cohort study of modifiable risk and prognostic factors for mental health problems and musculoskeletal pain among university students

INTRODUCTION

Mental health problems and musculoskeletal pain are common health problems among young adults including students. Little is known about the aetiology and prognosis of these problems in university students. We aim to determine the role of personal, sociodemographic, academic and environmental factors for risk and prognosis of symptoms of depression, anxiety and stress as well as musculoskeletal pain in university students. The constructs that will be studied are based on the biopsychosocial model and psychopathology associated with disabling pain. This model acknowledges illness to consist of interrelated mechanisms categorised into biological, psychological, environmental and social cues.

METHODS AND ANALYSIS

This cohort study aims to recruit around 5000 Swedish full-time students. Data will be collected using five online surveys during one academic year. A subgroup (n=1851) of the cohort, recruited before the COVID-19 pandemic, receive weekly text messages with three short questions assessing mood, worry and pain, sent through the web-based platform SMS-track . Statistical analyses will include Kaplan-Meier estimates, Cox regression analyses, multinomial logistic regression analyses and generalised estimating equations. We will assess effect measure modification when relevant and conduct sensitivity analyses to assess the impact of lost to follow-up.

PROTOCOL AMENDMENTS

Due to opportunity and timing of the study, with relevance to the outbreak of the COVID-19 pandemic, this study further aims to address mental health problems, musculoskeletal pain and lifestyle in university students before and during the pandemic.

ETHICS AND DISSEMINATION

The Sustainable UNiversity Life study was approved by the Swedish ethics authority (2019-03276; 2020-01449). Results will be disseminated through peer-reviewed research papers, reports, research conferences, student theses and stakeholder communications.

TRIAL REGISTRATION NUMBER

NCT04465435.

A first remotely-delivered guided brief intervention to reduce intrusive memories of psychological trauma for healthcare staff working during the ongoing COVID-19 pandemic: Study protocol for a randomised controlled trial

Addressing the mental health needs of healthcare staff exposed to psychologically traumatic events at work during the COVID-19 pandemic is a pressing global priority. We need to swiftly develop interventions to target the psychological consequences (e.g., persistent intrusive memories of trauma). Interventions for healthcare staff must be brief, flexible, fitted around the reality and demands of working life under the pandemic, and repeatable during ongoing/further trauma exposure. Intervention delivery during the pandemic should be remote to mitigate risk of infection; e.g., here using a blend of digitalized self-administered materials (e.g., video instructions) and guided (remote) support from a researcher. This parallel groups, two-arm, randomised controlled trial (RCT) with healthcare staff working during the COVID-19 pandemic is the first evaluation of whether a digitalized form of a brief cognitive task intervention, which is remotely-delivered (guided), reduces intrusive memories. Healthcare staff who experience intrusive memories of work-related traumatic event(s) during the COVID-19 pandemic (≥2 in the week before inclusion) will be randomly allocated (1:1) to receive either the cognitive task intervention or an active (attention placebo) control, and followed up at 1-week, 1-month, 3-months, and 6-months post-intervention. The primary outcome will be the number of intrusive memories reported during Week 5; secondary and other outcomes include the number of intrusive memories reported during Week 1, and other intrusive symptoms. Findings will inform further development and dissemination of a brief cognitive task intervention to target intrusive memories.

Heart rate variability and heart rate monitoring of nurses using PPG and ECG signals during working condition: A pilot study

The use of wearable photoplethysmography (PPG) technology for estimating heart rate (HR) and HR variability (HRV) in the health care system is gaining attention in recent years. However, the performance of these devices remains questionable in their ability to collect data in real working conditions for long-term monitoring. The present study aimed to examine the data collected from nurses during working hours by PPG and electrocardiography (ECG) devices. Twenty-two nurses underwent a 60-minute work protocol during the normal working conditions while wearing a PPG device and an ECG device. HR, low-frequency component (LF) and high-frequency component (HF), LF/HF ratio, and percent LF distribution in total spectral power, and steps were examined. Pearson's correlation analysis and Bland-Altman method was performed to examine the relationships between the two devices based on HR and HRV indices. The results found strong positive correlations between HR estimates of both devices, and moderate correlations between LF/HF ratio and percent LF indices estimates, respectively. Moreover, the Bland-Altman analysis showed a small mean bias in general between the captured data of both devices. This pilot study suggested that the PPG device appears to demonstrate good overall reliability in measuring HR, LF/HF ratio, and percent LF. A further large-scale study is required to investigate the feasibility and practicality for HR and HRV analysis in nurses during real working conditions using PPG devices.

Basic Psychological Needs in the Work Context: A Systematic Literature Review of Diary Studies

According to the self-determination theory, individuals' basic psychological needs for autonomy, competence, and relatedness should be satisfied for optimal psychological growth. The satisfaction of these needs seems to vary due to changes in a person's social context, and the outcomes of the satisfaction of these needs also vary along with the needs. Despite several studies investigating daily and weekly variations in need satisfaction and its correlates, no systematic investigation exists. This study aimed to conduct a narrative synthesis of existing quantitative diary studies of basic psychological needs in the work context. We specifically aimed to evaluate if psychological need satisfaction varies daily and weekly and judge whether they vary more daily or weekly. Additionally, we also aimed to review the literature regarding the relations between daily or weekly variations in need satisfaction and its assumed antecedents and outcomes. We included peer-reviewed articles in English that measured work-related basic psychological needs using a quantitative diary study design. Database searching (Web of Science, ScienceDirect, EBSCOhost, and Scopus) led to the extraction of 2 251 records by February 2020. Duplicates were removed, the remaining records were screened (n = 820), and 30 articles were assessed using eligibility criteria. Two authors individually conducted the screening and eligibility processes to manage selection bias. In total, 21 articles were included in the final review. The review indicated that basic psychological need satisfaction showed considerable within-person variation and was more dynamic daily (compared to weekly). Job demands, job resources, organisational resources, and individual characteristics appeared to associate with these variations. The organisational context seemed to matter the most for need satisfaction. Variations in need satisfaction were also related to employee well-being, performance, and motivation. Despite the small number of published studies (particularly for weekly studies), our results indicate that researchers should pay attention to within-person variations in need satisfaction. Measuring daily need satisfaction could be prioritised. Different antecedents and outcomes seem to be associated with different needs. Thus, when needs are viewed as distinct constructs instead of unidimensional ones, one can derive greater insights. The study is funded by the National Research Foundation.

Technostress and Employee Performance Nexus During COVID-19: Training and Creative Self-Efficacy as Moderators

Technostress, a stressor, has implications for employee’s psychological states; however, flexibility like work from home can have positive outcomes, especially for instructors who have to teach and ensure social distance during COVID-19. The present study examined the relationship of technostress and employee performance while taking training and creative self-efficacy as boundary conditions. A sample of 222 university instructors, who worked from home or hybrid (home and workplace) during COVID-19 lockdown, was selected from Pakistan. The responses were recorded using a closed-ended questionnaire. Stepwise linear regression and PROCESS Macro by Hayes (2013) was used to analyze the data. It was revealed that technostress, instead of having adverse effects, had a positive effect on employee’s performance and both training and one’s creative self-efficacy significantly moderated the relationship. As the main finding, it was revealed that the employees continued to perform well despite the prevalence of technostress. The training and one’s creative self-efficacy were useful to control the technostress and maintain the performance of instructors during COVID-19. The university administrators and employees must take technology as a positive tool for performance. The training, along with creative self-efficacy, adds to the working capacity of employees and enhances their performance.

The information system stress, informatics competence and well-being of newly graduated and experienced nurses: a cross-sectional study

BACKGROUND

The use of information systems takes up a significant amount of nurses' daily working time. Increased use of the systems requires nurses to have adequate competence in nursing informatics and is known to be a potential source of stress. However, little is known about the role of nursing informatics competence and stress related to information systems (SRIS) in the well-being of nurses. Moreover, the potential impact of nurses' career stage on this matter is unknown. This study examined whether SRIS and nursing informatics competence are associated with stress and psychological distress in newly graduated nurses (NGNs) and experienced nurses.

METHODS

A cross-sectional study was conducted in Finland between October and December 2018. The participants were NGNs (n = 712) with less than two years of work experience and experienced nurses (n = 1226) with more than two years of work experience. The associations of nursing informatics and SRIS with nurses' stress and psychological distress were analyzed with linear regression analysis. Analyses were conducted separately for NGNs and experienced nurses. Models were adjusted for age, gender, and work environment.

RESULTS

SRIS was associated with stress / psychological distress for both NGNs (β = 0.26 p < 0.001 / β = 0.22 p < 0.001) and experienced nurses (β = 0.21 p < 0.001/ β = 0.12 p < 0.001). Higher nursing informatics competence was associated with lower stress (β = 0.20 p < 0.001) and psychological distress (β = 0.16 p < 0.001) in NGNs, but not among experienced nurses.

CONCLUSIONS

SRIS appears to be an equal source of stress and distress for nurses who are starting their careers and for more experienced nurses, who are also likely to be more experienced users of information systems. However, informatics competence played a more important role among NGNs and a lack of adequate competence seems to add to the strain that is already known to be high in the early stages of a career. It would be important for educational institutions to invest in nursing informatics so that new nurses entering the workforce have sufficient skills to work in increasingly digital health care.

New graduate nurse wellbeing, work wellbeing and mental health: A quantitative systematic review

BACKGROUND

The contribution of work to positive mental health is increasingly apparent. Transition into the workplace causes a range of stressors for new graduate nurses who experience both psychological wellbeing and illbeing in their first year of practice.

OBJECTIVE

To determine published prevalence, predictors, barriers and enablers of new graduate registered nurse wellbeing, work wellbeing and mental health.

DESIGN

Systematic review of quantitative research.

DATA SOURCES

Databases included Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, Medical Literature Analysis and Retrieval System Online and Psychological Information. Quantitative and mixed-methods studies were considered for inclusion if published in English from 2009 to 2019 reporting primary data analysis including new graduate nurses' wellbeing, work wellbeing and mental health.

REVIEW METHODS

Quantitative studies were systematically identified then screened and appraised against pre-determined inclusion criteria. Analysis was conducted by grouping according to analytical methods and results reported as a narrative synthesis.

RESULTS

Thirty-four studies were included. The quality of the evidence was variable with just a quarter of the studies being assessed as meeting the quality criteria on all nine measures. For the new graduate nurses prevalence of wellbeing, levels of resilience, optimism, and hope were found to be high. For work wellbeing, most reported higher job satisfaction by 12-months. For work illbeing, levels of burnout were moderately high, predominantly in terms of emotional exhaustion, and stress was initially high, particularly in terms of workload, but decreased over time. For the predictors, job satisfaction was positively predicted by structural empowerment and career satisfaction, and negatively predicted by co-worker incivility, supervisor incivility and emotional exhaustion. For work illbeing, stress was a positive predictor for intent to leave. Stress reductions were associated with momentary levels of high task mastery, social acceptance and role clarity.

CONCLUSIONS

For new graduate nurses, levels of emotional exhaustion, workload and stress were moderately high to high initially, decreasing over time as the graduate nurses' job satisfaction increased. Most studies focused on the nurses' intent to resign or stay and both psychological capital and work engagement positively predicted intent to stay whereas work stress positively predicted intent to resign. Resilience and group cohesion moderated the negative effects of some variables, thus may be potential enablers of work wellbeing. The standards of research reporting or design were generally sub-optimal according to quality indicators. Systematic review registration number: (CRD42020148812).

Safety outcomes for incident responders operating on high speed roads: An analysis of the relationship with behaviour, motivation and role clarity

High-speed roads present a considerable level of risk for frontline workers operating in these environments. To optimise safety, prevention activities need to target the key skills required to mitigate risk. The aim of this research was to explore the behavioural (compliance, participation, voice), motivational (safety motivation) and work demand (role clarity) factors that influence safety outcomes for incident responders working on high-speed roads. Safety outcomes included secondary incidents and near misses with passing vehicles. A total of 295 complete survey responses were received from six emergency service and incident response agencies in one Australian state. Data were analysed using structural equation modelling. The results showed that higher levels of safety voice, safety motivation and, role clarity were significantly associated with safer self-reported safety outcomes after controlling for the number of incidents attended. The findings from this study will be used to guide the development of a training program to improve the cognitive, behavioural and perceptual skills of incident responders operating on high-speed roads. Some insight into the structure and format of this program is provided.

Self-Efficacy, Psychological Flexibility, and Basic Needs Satisfaction Make a Difference: Recently Graduated Psychologists at Increased or Decreased Risk for Future Health Issues

The transition from university to working life appears a critical period impacting human service workers’ long-term health. More research is needed on how psychological factors affect the risk. We aimed to investigate how subgroups, based on self-efficacy, psychological flexibility, and basic psychological needs satisfaction ratings, differed on self-rated health, wellbeing, and intention to leave. A postal survey was sent to 1,077 recently graduated psychologists in Sweden (≤3 years from graduation), response rate 57.5%, and final sample 532 (75% women and 23% men). A hierarchical cluster analysis resulted in a satisfactory eight-cluster solution. We identified two at-risk subgroups, displaying the lowest scores on health and wellbeing, and one potential low-risk subgroup with the highest ratings on said variables. The “Low risk?” group rated high on all three psychological constructs, a positive transition to working life, a work environment where resources balanced relatively high emotional demands, good health, and wellbeing. Almost the complete opposite ratings characterized the potential risk groups. “Quitting?” scored significantly higher than “Getting sick?” on self-efficacy and psychological flexibility as well as actively seeking new employment and reporting daily thoughts on leaving the profession. We suggest that a combination of low self-efficacy and psychological flexibility could increase the risk of individuals staying despite suboptimal working conditions. With combined higher self-efficacy and psychological flexibility, individuals in similar circumstances appear more inclined to quit. We conclude that the ways recently graduated psychologists rate their self-efficacy, psychological flexibility, and basic needs satisfaction appear to be reflected in their self-rated health and wellbeing.

Newly graduated nurses' socialisation resulting in limiting inquiry and one-sided use of knowledge sources-An ethnographic study

AIM

To explore how the socialisation into the clinical setting and interaction between newly graduated nurses and experienced nurses influences the new graduates' use of knowledge sources.

BACKGROUND

Newly graduated nurses' use of knowledge sources in decision-making has been subject to an increased interest in relation to evidence-based practice. Despite interventions to strengthen nurses' competencies required for making reflective clinical decisions within an evidence-based practice, studies highlight that new graduates only draw on knowledge from research, patients and other components within evidence-based practice to a limited extent. Research exploring new graduates' use of knowledge sources calls attention to the experienced nurses' decisive role as a valued knowledge source. The new graduates' process of socialisation and their interaction with the experienced nurse raises further questions.

METHODS

Ethnography using participant-observation and individual semi-structured interviews of nine newly graduated nurses from a University Hospital in Denmark. Data were collected in 2014. The study adheres to COREQ.

RESULTS

Two main structures were found: "Striving for acknowledgment" and "Unintentionally suppressed inquiry."

CONCLUSIONS

New graduates are socialised into limiting their inquiry on clinical practice and unintentionally being restricted to using the experienced nurse as predominant knowledge source. Depending on how the experienced nurse responds to the role as predominant knowledge source, they could either limit or nurture the new graduates' inquiry into practice and thus the variety of knowledge sources used in clinical decision-making. Limited inquiry into the complexity of nursing practice indirectly excludes the use of a variety of knowledge sources, which are fundamental to an evidence-based practice.

RELEVANCE

If clinical practice wishes to benefit from the newly graduated nurses' inquiring approach and skills within evidence-based practice, clinical practice will have to greet the nurses with a supportive culture where questioning practice is seen as a strength rather than a sign of insecurity and incompetence.

The Relationship Between Authentic Leadership, Psychological Empowerment, Role Clarity, and Work Engagement: Evidence From South Africa

Employees in the mining sector are faced with a demanding work environment due to external challenges impacting on the organization. Optimizing their engagement is vital in weathering a demanding environment. The aim of this study was to (a) position authentic leadership (AL) and psychological empowerment (PE) as enablers of work engagement (WE); (b) to investigate the processes (i.e., PE) through which AL exerts its effect on WE, and (c) to determine whether contextual factors [i.e., role clarity (RC)] influenced this process. A cross-sectional research design was employed to collect data from 236 employees employed by a coal-mining organization within South Africa. The AL inventory, PE questionnaire, measures of role conflict and ambiguity questionnaire, and UWES-9 was administered to collect data. A moderated-mediation investigation was employed to test the hypotheses. Results supported the value of AL to enhance WE, both directly and indirectly via PE. Results also concluded that AL exerts its influence on WE through PE, regardless of employees’ levels of RC. AL literature is limited, not only in the South African context but also in the mining sector. The study not only extends AL literature by investigating its outcomes in a South African mining organization, but it also does so by investigating the boundary conditions under which AL exerts its influence. The boundaries (i.e., moderation) within which leadership-subordinate relationships (i.e. mediation) function are often neglected in favor of simplified investigations of mediation processes only.

Exploring the link between structural empowerment and job satisfaction through the mediating effect of role stress: A cross-sectional questionnaire study

BACKGROUND

Role stress (ambiguity and conflict) is a major psychosocial risk at work negatively associated with job satisfaction in the nursing context. According to Kanter's empowerment theory, high levels of structural empowerment reduce role stress, so role ambiguity and conflict could be potential mediators of the relationship between empowerment and job satisfaction.

OBJECTIVE

The aim of this study was to analyze the relationships between structural empowerment, role stress (ambiguity and conflict), and job satisfaction, assuming the mediating role of role stress on the relationship between structural empowerment and job satisfaction.

DESIGN

A cross-sectional design was utilized, using questionnaires for data collection and convenience sampling.

SETTING(S)

Private health care organizations in southern Portugal.

PARTICIPANTS

One hundred and twenty-four registered nurses (sample 1) and one hundred and thirty certified nursing assistants (sample 2) completed self-report measures of structural empowerment, role stress, and job satisfaction.

METHODS

Mediation analysis was performed using linear regression models and the bootstrapping method. Bias-Corrected confidence intervals (95%) were calculated for the study of direct and indirect effects.

RESULTS

In both samples, structural empowerment, role ambiguity, and role conflict were significant predictors of job satisfaction. Both ambiguity and role conflict partially mediated the effect of structural empowerment on job satisfaction. The effect mediated by ambiguity was greater than the effect mediated by role conflict in both registered nurses and certified nursing assistants.

CONCLUSIONS

Two processes could explain the effect of structural empowerment on job satisfaction in the nursing context: a direct effect generating experiences and perceptions of power in professionals; and an indirect effect reducing role stress levels in the workplace. The creation of empowering workplaces which clarify work roles and functions of nursing staff should be a priority issue for health managers and nurse executives.

Social support, role clarity and job satisfaction: a successful combination for nurses

AIM

To analyse the moderating effect of role clarity on the relationship between social support (supervisor and colleagues) and job satisfaction.

BACKGROUND

The social support of supervisors and co-workers and the clarity of roles are important antecedents of job satisfaction. According to the Conservation of Resources theory, the interaction of the instrumental nature of role clarity and social support would result in higher levels of job satisfaction in nursing.

METHODS

Through a convenience sample, a final sample of 191 participants (64.92% registered nurses, 35.08% nursing assistants) was obtained from a private hospital complex in Portugal. Hierarchical linear regression models were carried out to check the moderating function of role clarity.

RESULTS

Regression models showed the moderating effect of role clarity. Nursing staff with high social support from their supervisors and peers showed higher scores in job satisfaction when role clarity was high.

CONCLUSION

An adequate description of roles, through clear and detailed information regarding expected functions, responsibilities and behaviour, allows the effect of social support from supervisors and co-workers on job satisfaction to be stronger.

IMPLICATIONS FOR NURSING PRACTICE

Strategies such as defining responsibilities, setting clear expectations and role analysis allow a reduction in sources of uncertainty in jobs. Training in communication and feedback skills would improve the social support given by supervisors and colleagues.

IMPLICATIONS FOR NURSING POLICY

Hospital boards and nurse managers should be aware of the importance of clarifying roles, responsibilities, and functions of each professional category and hierarchical level for the provision of adequate quality of care.

Nurse Students' Thoughts on a Sustainable Professional Life as Nurses: A Qualitative Study

INTRODUCTION

In a global context of an increasing and aging population, along with environmental changes, nurses play an important role in relieving suffering among vulnerable people and groups in society. Sustainability in nursing contributes to sustainable development through providing an environment that is not detrimental to/protects present and future generations' opportunities for good health. There is a global shortage of nurses, and it has been shown that, locally, every fifth newly graduated nurse considers leaving their new profession five years after graduation. The aim was to describe how nursing students' thought about a sustainable professional life as nurses before their graduation.

MATERIALS AND METHODS

A qualitative design with a written data set was used, and a thematic analysis was performed. One hundred five students (80 women and 25 men) in semester six out of six of the nursing education program participated.

RESULTS

The analysis resulted in three themes: 1) to have an ethical foundation that guides the individual nurse in protecting the nursing care and developing the nursing care for their patients; 2) to be in a listening, reflexive and supportive workplace enabling a professional nurse to continuously grow and learn and 3) to be a proud professional nurse with integrity, not risking with their own health or personal professional development.

CONCLUSION

The nursing students describe their thoughts on the requirements for having a sustainable professional life as nurses as having a strong inner ethical compass to help guide, protect and develop the nursing care for the patients. In addition, it requires a workplace with a reflexive and supporting culture. However, the nursing students also put their own health and the opportunities for professional growth at the top of their priorities, and if these conditions are lacking, they will switch to another workplace.

Job Burnout on Subjective Well-Being Among Chinese Female Doctors: The Moderating Role of Perceived Social Support

All doctors face challenges and pressures that can lead to job burnout. The dual pressures of work and family make female doctors less happy and more likely to experience burnout, but few studies have focused on female doctors. In this study we explore the influence of job burnout on female clinical doctors' subjective wellbeing and the moderating role of perceived social support. A casual comparative study design was used for this research. Three self-reporting scales (Maslach Burnout Inventory, Perceived Social Support Scale and Subjective Wellbeing Scale) were distributed to participants, who were selected through random sampling. Participants consisted of 120 female and 120 male doctors from a hospital of Yantai City. Female doctors scored significantly higher than male doctors in the emotional exhaustion dimension (p < 0.01), and female doctors' subjective wellbeing was lower than that of male doctors (p < 0.01). The three dimensions of job burnout and subjective wellbeing exhibited significant negative correlations, and a positive relationship was found between perceived social support and subjective wellbeing in female doctors (p < 0.01). Perceived social support, especially from family, played a moderating role between emotional exhaustion and subjective wellbeing, and the moderating effect was significant (p < 0.01). A significant difference was observed between male and female doctors; female doctors experienced more emotional exhaustion and lower subjective wellbeing than male doctors. Improving perceived social support could reduce burnout and enhance subjective wellbeing.

A Stress Relief App Intervention for Newly Employed Nursing Staff: Quasi-Experimental Design

Background

Most newly employed nurses have limited practical experience, lack problem-solving abilities, and have low resistance to stress, and therefore often opt to resign from the nursing profession.

Objective

This study aimed to assess the effectiveness of a stress relief app (SR_APP) to monitor the stress levels of newly employed nurses.

Methods

We conducted a quasi-experiment to assess changes in stress levels of newly employed nurses at a case hospital, in which the experimental group used the SR_APP and the control group did not. In-depth interviews were conducted to reveal insights regarding their stress. The app usage experiences of experimental group members were assessed via a questionnaire.

Results

All the participants appreciated the experiment and were interested to know more about managing their stress. The experimental group members showed significant differences in heart rate variability scores before and after using the SR_APP, and they reported high levels of intention to use and satisfaction with regard to the SR_APP.

Conclusions

The SR_APP can be effective in helping newly employed nurses to manage their stress.

Analysis of the Risk and Protective Roles of Work-Related and Individual Variables in Burnout Syndrome in Nurses

Aims: Burnout syndrome is a phenomenon that is becoming ever more widespread, especially in workers such as nurses who have heavy workloads and time pressures. The progression of burnout syndrome has been shown to be related to both individual and work-related variables. The objective of this study is to examine the risk and protective roles played by work-related and personal variables, both sociodemographic and psychological, in the development of burnout in nurses. Method: The sample was composed of 1236 nurses aged between 21 and 57 years, with a mean age of 31.50 years (SD = 6.18). Women accounted for 84.5% (n = 1044), and the remaining 15.5% (n = 192) were men. Exploratory tests were performed to understand the relationships between burnout and other variables, and a binary logistic regression was conducted to understand the roles of these variables in the incidence of this syndrome. Lastly, a regression tree was constructed. Results: The results show that the sociodemographic variables examined are not related to the level of burnout in nurses. However, certain work-related variables, such as spending more time with colleagues and patients and reporting good-quality relationships, exhibit a negative relationship with the occurrence of burnout. Of the psychological variables, the stress factors conflict-social acceptance and irritability-tension-fatigue, as well as informative communication, are shown to be risk factors for the appearance of burnout in nurses. In contrast, the communication skills factor, empathy, and energy-joy exert a protective function. Conclusion: Identifying the variables that influence the occurrence of burnout syndrome and understanding the manner in which they exert their influence are key elements in the development of effective prevention and intervention of burnout in nursing.

Problems with task mastery, social acceptance, and role clarity explain nurses' symptoms of burnout during the first professional years: A longitudinal study

BACKGROUND

Symptoms of burnout among new professionals is a well-recognized problem but there is a lack of prevention programs. Effective interventions are based on an understanding of the processes that contribute to the development of a problem and suggest how it may be addressed.

OBJECTIVE

Using the framework of organizational socialization, the objective of this study was to investigate if development of the socialization processes role clarity, social acceptance, and task mastery affects development of symptoms of burnout among new professionals and may specifically be targeted in transition-to-practice programs to prevent symptoms of burnout from occurring. We conducted this investigation by examining the relations between role clarity, social acceptance, task mastery, and symptoms of burnout the first year after professional entry, as well as the relations between changes in the socialization processes and changes in symptoms of burnout during the first three years following professional entry in a sample of new nurses.

METHOD

Relationships between the socialization processes and symptoms of burnout were modeled using a linear latent growth model and data from a nationally representative sample of 1210 new registered nurses.

RESULTS

Role clarity, social acceptance, and task mastery were related to symptoms of burnout cross-sectionally and longitudinally. Task mastery was the most important explanatory variable.

CONCLUSIONS

The results suggest that an intervention designed to support the development of the socialization processes may be effective in preventing symptoms of burnout among new nurses. Interventions targeting role clarity, social acceptance, and task mastery during the first professional year may be expected to have effects during the following years as well, extending the value and importance of such interventions.