Work readiness of graduate nurses and the impact on job satisfaction, work engagement and intention to remain

Relationship between leadership and work readiness in a cohort of new head nurses in China: A cross-sectional study

To identify the relationship between leadership and work readiness in a cohort of new head nurses in China. This cross-sectional study enrolled 225 newly appointed head nurses in public tertiary hospitals in China, which were selected using convenience sampling. Data were collected using online questionnaires that included a sociodemographic characteristics form, the Nursing Managers Leadership Scale (NMLS), and the New Nurse Leaders' Job Readiness Scale (NNLJRS). IBM SPSS v.25 was used for statistical analysis. The overall mean scores of NMLS (100.50 ± 17.64) and NNLJRS (111.90 ± 15.84) of the 225 new nurse leaders were at moderate levels. The results of the Pearson correlation analysis and the hierarchical regression analysis further indicated that there was a significant positive correlation between leadership and work readiness of new head nurses (r = 0.85, P < .001), as well as charisma (β = 0.19, P < .01), affinity (β = 0.18, P < .01), coordination ability (β = 0.32, P < .01), and motivational ability (β = 0.21, P < .01) in leadership were found to be positively associated with work readiness. This study found that the leadership and work readiness of the new head nurses still needed improvement. A significant relationship was found between these 2 variables, and charisma, affinity, coordination ability, and motivational ability in the leadership ability of the new head nurses facilitated the level of work readiness. Nursing administration should create a leadership development series program focusing on the development of charisma, affinity, coordination ability, and motivational ability to support the work readiness of new nurse managers and help them with role transition.

Work engagement among nurses in the context of the COVID-19 pandemic: A systematic review

BACKGROUND

Despite nurses receiving education on how to respond during crises, the stress and demands arising from unprecedented situations, such as the COVID-19 pandemic, may affect their work engagement.

AIM

To appraise and synthesize studies examining work engagement among nurses in the context of the COVID-19 pandemic.

METHODS

It is a systematic review in which three databases were searched. Critical appraisal tools and PRISMA guidelines were used. Content analysis was performed.

ETHICAL CONSIDERATIONS

Ethical approval was not required for this systematic review.

FINDINGS

A total of 21 studies were included. The results were classified into three categories: (1) levels and meanings of work engagement, (2) the relationship of work engagement with various factors, and (3) measures to enhance work engagement.

CONCLUSION

The review revealed that nurses' work engagement varied from moderate to high. Factors such as education level and work schedule flexibility influenced their engagement. Positive associations were found between work engagement and job satisfaction, intention to stay, and organizational support, while stress and workload showed negative relationships. The crucial role of health policymakers, hospital administrators, and nurse managers in acting ethically, creating favorable working conditions and fostering nurses' work engagement was emphasized.

The effect of work readiness on work well-being for newly graduated nurses: The mediating role of emotional labor and psychological capital

OBJECTIVE

To investigate the relationship between work readiness and work well-being for newly graduated nurses and the mediating role of emotional labor and psychological capital in this relationship.

METHODS

A cross-sectional survey was conducted in mainland China. A total of 478 newly graduated nurses completed the Work Readiness Scale, Emotional Labour Scale, Psychological Capital Questionnaire, and Work Well-being Scale. Descriptive statistical methods, Pearson correlation analysis, and a structural equation model were used to analyze the available data.

RESULTS

Newly graduated nurses' work readiness was significantly positively correlated with work well-being (r = 0.21, p < 0.01), deep acting (r = 0.11, p < 0.05), and psychological capital (r = 0.18, p < 0.01). Emotional labor and psychological capital partially mediated the relationship between work readiness and work well-being. Additionally, emotional labor and psychological capital had a chain-mediating effect on the association.

CONCLUSIONS AND CLINICAL RELEVANCE

Work readiness not only affects newly graduated nurses' work well-being directly but also indirectly through emotional labor and psychological capital. These results provide theoretical support and guidance for the study and improvement of newly graduated nurses' work well-being and emphasize the importance of intervention measures to improve work readiness and psychological capital and the adoption of deep-acting emotional-labor strategies.

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

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

The effectiveness of learning strategies for the development of Emotional Intelligence in undergraduate nursing students: A systematic review protocol

AIM

This protocol proposes a systematic review to identify and disclose learning strategies and evaluation tools to improve Emotion Intelligence (EI) in undergraduate nursing students.

BACKGROUND

EI improves the ability to manage emotions and their consequences. Management of emotions is fundamental in nursing both at inter- and intra-professional levels, and with the patients and their family carers.

DESIGN

Systematic review protocol of effectiveness based on the Joanna Briggs Institute (JBI) guidelines.

REVIEW METHODS

All articles based on educational programmes and/or activities to develop EI in nursing curricula will be included in the review. It will analyse the principle EI attributes and outcomes such as burnout, intention to leave and problem-solving skills. Based on the review question, seven databases will be searched: MEDLINE, The Cochrane Library, SCOPUS, CINAHL, EMBASE, PsycINFO and ERIC. Also, grey literature (Google Scholar and Open Gray) will be searched. Since no similar systematic reviews are present in the literature, no time limits will be set. To establish the quality of studies JBI tools will be used. When appropriate, we will meta-analyse prevalence and incidence estimates or we will meta-synthesize themes and findings.

EXPECTED RESULTS

This systematic review is expected to provide an overview of educational and training methods, pedagogical strategies and evaluation tools to address EI in nursing and provide high-quality care to patients and their families. Results of the review will support nursing educators and leaders in implementing teaching and learning strategies to improve the Emotional Intelligence of undergraduate nursing students.

CONCLUSIONS

Mastering emotions is fundamental for nurses. Implementing education courses based on EI according to the best training methods and pedagogical strategies could become key for nursing curricula. Moreover, after the review, it will be possible to identify the best training methods and pedagogical strategies for implementing continuing professional development (CPD) courses in EI in the courses of following graduation.

The associations among nurse work engagement, job satisfaction, quality of care, and intent to leave: A national survey in the United States

Objectives

Employee work engagement, job satisfaction, quality of care, and intent to leave are critical indicators for healthcare organizational performance. This study aimed to analyze the current state of nurses' work engagement and its factors to examine the associations among nurses' work engagement, job satisfaction, quality of care, and intent to leave in the United States (US).

Methods

This is a quantitative descriptive cross-section design. Data were collected online from the US registered nurses from March to September 2022. Measures comprised the Utrecht Work Engagement Scale, the demographics, and questions regarding job satisfaction, perceived quality of care, and intent to leave.

Results

Nine hundred nurses participated in the online survey. Among the participants, 79.2% reported holding a specialty certification, 59.4% scored high/very high on job satisfaction, 82.2% expressed high/very high on the perceived quality of nursing care, and 28.4% conveyed likely/very likely to leave in the following year. Nurses' work engagement was positively associated with nurses' job satisfaction and their perceived quality of care but negatively associated with intent to leave. More certified nurses reported high or very high job satisfaction than non-certified nurses. As for demographics, the linear regression analysis showed that nurses who were older, identified as White, and held doctorate degrees reported higher levels of work engagement in comparison to their counterparts.

Conclusions

This study shows that nurses' work engagement is associated with their job satisfaction, perceived quality of care, and intent to leave. Nurses' work engagement in this study is lower than in other studies, especially before the COVID-19 pandemic, which may indicate a possible association with the COVID-19 impact. Because nurses' work engagement is significantly associated with job satisfaction, nurse leaders need to find ways to promote nurses' job satisfaction and retention.

Nurse manager support of graduate nurse development of work readiness: An integrative review

AIM

To systematically review relevant literature to identify how Nurse Managers support graduate nurse work readiness.

BACKGROUND

Graduate nurses face many difficulties when transitioning from student to qualified nurse. Nurse managers establish workplace culture through leadership styles, yet little is known about how they can best support graduate nurses to transition to professional practice in the acute hospital environment.

DESIGN

A five-step, systematic integrative review reported in accordance with the PRISMA 2020 Checklist.

METHODS

The steps of the review method included (1) problem identification, (2) literature search, (3) data evaluation and quality appraisal, (4) data extraction and analysis and (5) presentation. Analysis used the Framework method and was guided by theory of graduate nurse work readiness and the Theoretical Domains Framework.

DATA SOURCES

MEDLINE COMPLETE, Cumulative Index to Nursing and Allied Health (CINAHL) Complete, ERIC and PSYCINFO searched in December 2020.

RESULTS

Studies eligible for inclusion (N = 40) represented research from 15 countries; most (67.5%, n = 27) used a qualitative design, 22.5% (n = 9) were quantitative and 10% (n = 4) used mixed methods. Three themes related to the social constructs and local area work environments influenced by nurse managers emerged: supporting people, supportive environment and supporting learning.

CONCLUSION

The review identified a lack of robust evidence about the effectiveness of specific nurse manager-led strategies to support development of graduate work readiness. However, the findings provide a framework to guide nurse managers in supporting graduate nurses and provide a foundation for further research about nurse manager roles in developing graduate work readiness.

IMPLICATIONS FOR THE PROFESSION OR PATIENT CARE

Previous research has described poor transition of graduate nurses as responsible for increased workplace errors, decreased job satisfaction and high rates of attrition. Exploring the role of nurse managers in graduate nurse transition is essential to ensure quality patient care and a sustainable workforce.

IMPACT

What Problem Did the Study Address? Graduate nurses face many difficulties when transitioning from student to qualified nurse. Nurse managers establish workplace culture through leadership styles, yet little is known about how they can best support graduate nurses to transition to professional practice in the acute hospital environment. What Were the Main Findings? High rates of attrition are attributed to poor support during the initial transition phase of graduate nurses. Nurse managers can impact transition by providing a supportive environment, support learning and by providing a team of supportive people. Where and on whom will the research have an impact? The research will have an impact on graduate nurses and nurse managers.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution (integrative review exploring existing literature). This integrative review was registered with PROSPERO (CRD42021213142).

Mediating effects of core competence between the transition shock and work readiness of newly graduated nurses in cancer hospitals: A cross-sectional study

BACKGROUND

Newly graduated nurses face a dilemma of transitioning from student to clinical nurse roles, resulting in a low level of work readiness. The special professional environment of oncology hospitals requires newly graduated nurses to have specialized and novel theoretical knowledge and nursing skills. Therefore, they are constantly expected to develop better core competence. However, whether the core competence of newly graduated nurses mediates the relationship between transition shock and work readiness has not been investigated.

OBJECTIVE

This study examined the relationship among transition shock, core competence, and work readiness of newly graduated nurses in cancer hospitals.

DESIGN

A descriptive, cross-sectional study design.

SETTING

This study was conducted at a tertiary cancer hospital in Beijing.

PARTICIPATIONS

A convenience sample of 188 newly graduated nurses was studied from July to August 2022.

METHODS

Sociodemographic data and Transition Shock Scale for Newly Graduated Nurses, Work Readiness Scale for Newly Graduated Nurses, and Core Competence Scale scores were collected using the online Questionnaire Star support platform. Pearson correlation and multiple regression analysis were applied using the Statistical Package for the Social Sciences version 24 to test the relationship among transition shock, core competencies, and work readiness. The Analysis of Moment Structures version 24.0 software was used to construct structural equation models. This report followed the Strengthening the Reporting of Observational studies in Epidemiology checklist.

RESULTS

The transition shock of newly graduated nurses was negatively correlated with work readiness and core competence, whereas core competence was positively correlated with work readiness. Core competence partially mediated the effect between transition shock and work readiness, accounting for 19 % of the total effect.

CONCLUSION

Core competence is the mediating variable between transition shock and work readiness of newly graduated nurses in oncology hospitals. During the transition period of newly graduated nurses, clinical nursing managers and teachers should pay attention to cultivating the core competence of newly graduated nurses to improve their work readiness.

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.

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.

Graduate nurses' capability upon entering the workforce: An integrative review

OBJECTIVES

To clarify capability for work readiness in newly graduated registered nurses as viewed from the perspective of clinicians in practice, educators in tertiary institutions, and graduates.

DESIGN

Integrative review.

DATA SOURCES

Databases searched for peer-reviewed studies included PubMed, MEDLINE, ERIC, Campbell collaboration, Google Scholar, and Cochrane databases.

REVIEW METHODS

Pragmatism informed this integrative review. The five-stage method described by Whittemore and Knafl was used to enable rigorous examination of the expected capability of graduate nurses. A comprehensive database search was conducted using PRISMA guidelines. Eighteen articles were appraised and analysed for this review. The capability concept was used as a framework for analysis.

RESULTS

Eighteen articles met the inclusion criteria. Findings revealed that although there is no definition for graduate nurses' work readiness, there is a common theme. Graduate nurses are expected to have broad theoretical knowledge (knowing) along with practical knowledge (doing). They are also expected to demonstrate integrity, honesty, respect, compassion, and a moral compass. A list of personal attributes and organisational acumen was also reflective of graduate readiness upon entering the workforce and identified as necessary capabilities for graduates.

CONCLUSIONS

A picture of the perfect employee is illustrated in the definition of work readiness by the participants of the original studies. Yet there is a lack of stakeholder consensus on the capabilities expected from a graduate nurse.

Nurses' assessed self-efficacy levels to medical asepsis and their relation to structural empowerment, work engagement and work-related stress

BACKGROUND

Nurses' working conditions are important for their well-being at work and for their ability to provide patients with safe care. Self-efficacy can influence employees' behaviour at work. Therefore, it is valuable to study self-efficacy levels to medical asepsis in relation to working conditions.

OBJECTIVE

To investigate the relationship between nurses' assessed self-efficacy levels to medical asepsis in care situations and structural empowerment, work engagement and work-related stress.

METHODS

A cross-sectional study with a correlational design was conducted. A total of 417 registered nurses and licensed practical nurses at surgical and orthopaedic units responded to a questionnaire containing: the Infection Prevention Appraisal Scale, the Conditions of Work Effectiveness Questionnaire-II, the Utrecht Work Engagement Scale-9 and the Health & Safety Executive Management Standards Indicator Tool. Correlational analyses and group comparisons were performed.

RESULTS

The nurses rated high levels of self-efficacy to medical asepsis in care situations. The correlational analyses revealed that correlation coefficients between structural empowerment, work engagement, work-related stress and self-efficacy to medical asepsis were 0.254-0.268. Significant differences in self-efficacy were found in the grouped working conditions.

CONCLUSIONS

This study revealed that nurses rated high self-efficacy levels to medical asepsis and, to some extent, this seemed related to structural empowerment, work engagement and work-related stress. This valuable knowledge could enable improvements at the managerial and organisational levels, benefiting both nurses and patients in the long run.

Does the economic crisis contribute to the burnout and engagement of Spanish nurses?

The national and European economic crisis has caused significant changes in the National Health System in Spain, among others a considerable deterioration in the working conditions of nursing professionals. The aim of this study was to analyse whether the economic crisis situation influenced the burnout and engagement of Spanish nursing professionals. The research design was a transversal study based on descriptive and inferential statistical analysis. Because the variable "economic crisis" is not susceptible to direct experimental manipulation, to explore its possible influence on the burnout and engagement of nursing staff, we use an indirect strategy of "priming". That is, we presented a group of participants with news about how the economic crisis was affecting healthcare personnel, in order to facilitate their cognitive accessibility, while another control group did not read any news. The participants were 66 nursing professionals from two public hospitals in the north of Spain completed various questionnaires that allowed information to be collected on the factors of interest in the study. The work experience of the participants contributes significantly to their burnout levels. The economic crisis situation helps to explain the burnout of Spanish nurses, but not their engagement levels.

Explaining Novice Nurses’ Experience of Weak Professional Confidence: A Qualitative Study

Introduction

The majority of newly graduated nurses are not prepared to work at the bedside; therefore, they may not have the appropriate self-confidence.

Objective(s)

The present qualitative study aimed to explain the novice nurses’ experience of weak professional confidence.

Design

This qualitative study was performed using a content analysis method.

Methods

Content analysis was utilized to identify themes from interview transcripts. They were included in the study by purposeful sampling. Participants were interviewed through face-to-face and unstructured interviews. All data were recorded, transcribed, and analyzed based on the Graneheim and Lundman method.

Results

Thirteen nurses participated in interviews. After data collection, all interviews were implemented and reviewed and the categories and subcategories were extracted. Three main categories containing turbulence in working life, unpleasant interactions, and lack of knowledge were extracted.

Conclusion

According to the study findings, most novice nurses experienced turbulence in their working life, unpleasant interactions, and a lack of knowledge that affected their self-confidence. Therefore, educational and support programs are suggested to improve novice nurses’ professional confidence.

Relevance to Clinical Practice

According to the results of the study, the lack of self-confidence in novice nurses reduces the quality of care. Therefore, taking into account the experiences of the participants, nursing education managers should plan in such a way as to improve the self-confidence of the graduates. In addition, novice nurses need to be supported by their managers and colleagues to develop their professional confidence to provide more effective care.

Student Employment Models for Undergraduate Nurses and Midwives in Australia: A Scoping Review

Introduction

Evidence has shown that throughout their undergraduate years, many nursing and midwifery students obtain paid employment in a wide variety of clinical and non-clinical positions. Across Australia, inconsistencies exist in the models of clinical employment available to these student groups. Previous Australian studies have described the employment of undergraduate nursing and midwifery students in regulated and unregulated clinical roles. No studies have reported on the various regulated roles available to both student nurses and midwives in Australia. The purpose of this scoping review is to identify and synthesize evidence related to nursing and/or midwifery students employed in regulated and unregulated clinical roles in Australia.

Methods

This scoping review utilized published recommendations for data screening, abstraction, and synthesis. One of the authors, a librarian, undertook systematic searches in CINAHL Complete (1937-present), Emcare on Ovid (1995-present), Scopus (1969-present), and Ovid MEDLINE(R) (including Epub Ahead of Print, In-Process, and In-Data-Review & Other Non-Indexed Citations, 1946-present). The initial searches were completed in April 2019 and repeated in March 2021 and May 2022 to identify any new literature. Manual searching of reference lists in the included papers was also undertaken, together with selected organizational websites. The extracted data included the lead author, date, title, study design, study sample and location, and key findings.

Results

From the 53 items retrieved, 23 peer-reviewed studies met the inclusion criteria and were included in the review. All items were published between 2011 and 2022. Only four of the studies focused upon student midwives. Undergraduate nursing and midwifery students in Australia obtain paid employment in a variety of regulated and unregulated clinical roles.

Conclusion

The literature reported here demonstrates that there are differing models, nomenclature, educational requirements, and pay scales in place for student employment in clinical roles across Australian states and territories.

A Longitudinal Study of the Impact of Personal and Professional Resources on Nurses' Work Engagement: A Comparison of Early-Career and Mid-Later-Career Nurses

To predict and ensure a healthy and high-performing nursing workforce, it is necessary to identify the antecedents that promote work engagement, especially among early-career nurses. To date no study has focused on this. This longitudinal survey, administered to 1204 nurses working in seven general hospitals with 200 or more beds in four prefectures in Japan at two different times in 2019, aims to examine the causal relationship between the personal and professional resources for nurses to work vigorously (PPR-N) and work engagement among nurses in the early stages of their careers, considering time as a key mediating factor. The analysis of structural equation modeling using the cross-lagged effect model supported that PPR-N had significant and positive effects on work engagement after 3 months among early-career nurses with less than 10 years of nursing experience. The PPR-N is a reliable antecedent of work engagement, which is typical of early-career nurses. These results may be provided guidance for managers in overseeing the work environment to ensure a thriving sustainable nursing workforce.

Does Burnout Decrease With Teacher Professional Identity Among Teachers in China?

In China, burnout is common among kindergarten, primary, and secondary school teachers. Previous studies have demonstrated that professional identity positively affects the prevention of burnout among teachers. However, studies on the mediating mechanisms behind and the moderating factors affecting this relationship remain scarce. In this study, the mediating role of work engagement as well as the moderating roles of self-efficacy and perceived organizational support in these relationships was examined. A total of 3,147 kindergarten, primary, and secondary school teachers completed self-reported questionnaires. SPSS 21.0 was used to conduct data analyses, and ordinary least square (OLS) regression was used to conduct mediation and moderation analyses. Results found that the relationship between teacher professional identity and burnout was partially mediated by work engagement. Through work engagement, teacher professional identity had the biggest predictive effects on burnout when the scores for self-efficacy and perceived organizational support were high. Implications for preventing burnout among teachers in the future were provided.

Three good things: Promote work-life balance, reduce burnout, enhance reflection among newly licensed RNs

AIMS

This study assessed the feasibility of delivering three good things (3GTs) practice as part of professional nurse residency program, measured the degree to which it influenced work-life balance, resilience, and burnout, and explored what newly licensed nurses (NLRNs) identified as good things.

BACKGROUND

Burnout occurs in response to chronic work-related emotional and interpersonal stress, negatively impacting nurses and patients. However, research shows that 3GT practice can increase positive emotions, enhance resilience, and reduce burnout.

METHODS

In this study, 3GT was introduced to a convenience sample of 115 NLRNs during their professional residency program. For 14 days, participants received daily 3GT prompts. Individualized survey links were sent via SMS message at baseline, postsurvey (T1), and 6 months (T2). Survey data were collected about work-life balance, burnout, and resilience, and text data from participants' daily 3GT notations from March through November 2021.

RESULTS

Seventy-one participants were recruited. T1 survey results indicated significant improvements in survey measures but only emotional recovery improvement was sustained at T2. Burnout was the only variable that correlated to participants' number of 3GT days practice. Simple joys, reflections about work, self-care activities, and relationships were major identified themes.

CONCLUSIONS

The results demonstrate the generalizability, value, and feasibility of implementing a web-based 3GT intervention in a nurse residency program. Additional benefits may be those gained by the reflection that is prompted, thereby facilitating professional development among NLRNs.

Counterintuitive consequences of COVID-19 on healthcare workers: A meta-analysis of the relationship between work engagement and job satisfaction

Background

Studies conducted in the health sector have determined a positive relationship between job satisfaction and work engagement. However, this paper reveals that this relationship turns into a negative or non-significant relationship during the COVID-19 pandemic. We explore the reasons for inconsistency in research findings in this critical period through a meta-analysis.

Methods

This study was conducted according to the PRISMA guidelines and PICO framework. Online databases including Web of Science, Scopus, PubMed, ProQuest, Google Scholar, and additional records from other databases were searched without any time limitation, and all studies published in English that reported the correlation between work engagement and job satisfaction were included in the analysis. In total, 36 individual correlation coefficients were synthesized. R statistical language was used to analyze the data.

Result

A total of 36 studies with a sample size of 16,087 were synthesized. The overall effect size was found as r = 0.57 (95% CI [0.50-0.64]). While the moderating effect of national culture was not statistically significant, presence of COVID-19 as the significant moderator explained 37.08% of effect size heterogeneity. Such that the presence of COVID-19 has transformed the positive relationship between work engagement and job satisfaction into a negative but statistically non-significant relationship.

Conclusion

This study empirically challenges the existing assumptions about the positive link between work engagement and job satisfaction. The results of the research can be a guide for managers and policymakers. Specifically, based on these results, different mechanisms can be put in place to support work engagement and, in turn, job satisfaction in the COVID-19 process.

A systematic review and meta-analytical synthesis of the relationship between work engagement and job satisfaction in nurses

PURPOSE

This study aimed to clarify the mixed conclusions regarding work engagement and job satisfaction in the nursing research literature by conducting a systematic review and meta-analysis.

DESIGN AND METHODS

This meta-analytic review synthesized 15 independent studies published between 2007 and 2021.

FINDINGS

An overall effect size of random-effect model was calculated as r = 0.47 (k = 15, N = 3,818, 95% confidence interval [0.43;0.51]). Data collection method and presence of control variable, as significant moderators, accounted for 43.6% and 43.8%, respectively, of the effect size heterogeneity.

PRACTICE IMPLICATIONS

While the positive relationship between work engagement and job satisfaction was higher in studies using the face-to-face data collection method, it was lower in studies using the control variable in their research models.

Work Readiness of Newly Licensed RNs

OBJECTIVE

The aim of this study was to examine the work readiness of newly licensed RNs (NLRNs) based on demographics, education, and work experiences.

BACKGROUND

Work readiness is the extent to which new graduates possess qualities and competencies associated with workplace success. Work readiness of NLRNs complements their clinical knowledge and skills and has been shown to predict job satisfaction and work engagement.

METHODS

Two hundred ninety-seven NLRNs participating in the nurse residency program of a health system in the southeast region of the United States were surveyed using the Work Readiness Scale-Graduate Nurse.

RESULTS

Scores on all readiness dimensions were high. Analysis revealed unexpected differences in readiness dimensions based on race, nursing degree, and completion of a nurse externship program.

CONCLUSIONS

Work readiness adds to our understanding of factors that can affect the transition of NLRNs into the work setting. Further research is needed to understand how work readiness develops over time, factors that predict work readiness, and its relationship to NLRN retention and other outcomes.

The relationship between nurse-nurse collaboration and work readiness among new graduate nurses

BACKGROUND

Communication and collaboration with colleagues are crucial for new graduate nurses (NGNs) because of the adaptation to both the healthcare system and professional role. Therefore, working units with effective collaboration among nurses may increase new graduates' work readiness.

AIM

This study aimed to determine the relationship between the perceptions of nurse-nurse collaboration and the work readiness level among NGNs.

METHODOLOGY

This descriptive, cross-sectional study was carried out with 198 NGNs in four private hospitals affiliated with a university. A self-administered questionnaire, including a personal information form, the Nurse-Nurse Collaboration Scale, and Work Readiness Scale, was used to collect data. Data analysis was performed using descriptive tests, and Spearman's rank correlation coefficients.

RESULTS

NGNs had moderate perceptions of nurse-nurse collaboration, with a median score of 2.46 (2.23-2.88) out of 4. Work readiness among NGNs was moderate, with a median score of 304 (270-332) out of 460. There was a statistically significant correlation between nurse-nurse collaboration and work readiness (r_s  = 0.26; p < .001).

CONCLUSION

The results of this study demonstrated that improving nurse-nurse collaboration is an effective way to increase work readiness among NGNs.

Work Readiness: Its Determinants and Association with Work-related Outcomes among New Graduate Nurses

AIMS

This study aimed to identify determinants of work readiness and to assess the influences of work readiness on work-related outcomes in graduate nurses.

BACKGROUND

Higher work readiness facilitates smoother role transitions of new graduate nurses. However, determinants of work readiness had not been fully examined. In addition, the relationships between work readiness and work-related outcomes, such as coping self-efficacy and occupational commitment, are also crucial but had not been assessed.

METHODS

We recruited 794 graduate nurses and assessed their work readiness before working as nurses. After they commenced their work, we assessed their occupational commitment, coping self-efficacy, and intention to remain. All assessments were conducted online.

RESULTS

There were 728 (92%) female respondents. The mean scores and standard deviation (SD) of work readiness, coping self-efficacy, occupational commitment, and intention to remain were 261.51 (SD: 45.40), 30.30 (SD: 6.13), 81.65 (SD: 11.56), and 11.01 (SD: 2.36), respectively. Based on a regression analysis, determinants of work readiness were positive school climate, student leadership experience, nursing as the primary choice of discipline, and perceived influences of COVID-19 on the honorability of being a nurse and the willingness to be a nurse (p < 0.001). Moreover, after adjusted by all demographics and characteristics variables, higher work readiness would result in higher coping self-efficacy (estimated coefficient = 0.06, p < 0.001), occupational commitment (estimated coefficient = 0.06, p < 0.001), and intention to remain (estimated coefficient = 0.01, p = 0.002).

CONCLUSION

Work readiness is a composite concept affected by psychosocial and environmental factors, which can predict new graduate nurses' future self-efficacy, occupational commitment, and intention to remain.

IMPLICATIONS FOR NURSING MANAGEMENT

The management of new graduate nurses when they begin to work could target their work readiness. Transition programs that consider our identified determinants can be provided to those who show lower work readiness.

Not too little, not too much: supervisor perceptions of work-readiness of speech-language pathology graduates

The work-readiness skills and attributes that facilitate healthcare graduates to succeed in their new workplaces are not well defined. In particular, the perspectives of supervisors of graduates in the diverse hospital and community settings of healthcare practice are not well represented in research about work-readiness. Interview data from a case study of twenty-nine supervisors of speech-language pathology graduates was thematically analysed, using Boundary Critique Theory to interpret how the supervisors' understanding of graduate work-readiness was bounded within their understanding of their own system, needs and work environment. The four themes captured the skills that the supervisors perceived as critical for graduate work-readiness: Independence; Attitude; Teamwork; and Learning. A tension was identified within these themes, as supervisors' understanding of work-readiness was bounded by an expectation that graduates are able to moderate how they transfer and apply their graduate skills in their workplace according to the complexity of client needs and the workplace setting. This study increases the visibility of the supervisors' boundaries around what are and are not considered to be work-ready skills, attributes and expectations of a work ready speech-language pathology graduate. This knowledge can be used to facilitate speech-language pathology graduates to successfully transfer, apply and expand these skills as they transition to work, and may be useful for other health professions to explore.

A peer learning intervention in workplace introduction - managers' and new graduates' perspectives

Background

Evaluation of a complex intervention are often described as being diminished by difficulties regarding acceptability, compliance, delivery of the intervention, recruitment and retention. Research of peer learning for nursing students have found several positive benefits while studies of peer learning for newly graduated nurses are lacking. This study aimed (1) to investigate the study process in terms of (a) first-line managers’ perspectives on the intervention study, the difficulties they face and how they handle these and (b) new graduates’ fidelity to the intervention and (2) to examine the effect of the peer learning intervention in workplace introduction for newly graduated nurses.

Methods

A mixed-methods approach using semi-structured interviews with eight managers, repeated checklist for fidelity and questionnaires conducted with 35 new graduates from June 2015 and January 2018, whereof 21 in the intervention group. The peer learning intervention’s central elements included pairs of new graduates starting their workplace introduction at the same time, working the same shift and sharing responsibility for a group of patients for 3 weeks. The intervention also included 3 months of regular peer reflection.

Results

Managers offered mostly positive descriptions of using peer learning during workplace introduction. The intervention fidelity was generally good. Because of recruitment problems and thereby small sample size, it was difficult to draw conclusions about peer learning effects and, thus, the study hypothesis could either be accepted or rejected. Thereby, the study should be regarded as a pilot.

Conclusions

The present study found positive experiences of, from managers, and fidelity to the peer learning intervention; regarding the experimental design, there were lessons learned.

Trial registration

Before starting data collection, a trial registration was registered at (Trial ID ISRCTN14737280).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00791-0.

Final clinical practicum shapes the transition experience and occupational commitment of newly graduated nurses in Europe-A longitudinal study

Aims

The aim of the study was to examine the association between the characteristics of a nursing student’s final clinical practicum and the success of transition of newly graduated nurses (NGNs) in six European countries.

Design

A longitudinal design with two data collections points (pre‐ and post‐graduate).

Methods

The data were collected with an online survey between May 2018 and April 2020 from graduating nursing students (n = 1796) in Finland, Germany, Iceland, Ireland, Lithuania and Spain. Altogether, 642 NGNs responded to the second questionnaire 1 year after graduation. Logistic and linear regression analyses were used to examine the associations between five clinical practicum characteristics and three indicators for the success of transition (ease of transition, turnover intentions and occupational commitment). Models were adjusted for demographic and background/workplace factors and professional competence.

Results

Several associations were observed between the different clinical practicum characteristics and the indicators for a successful transition. Good pedagogical atmosphere and good supervisory relationship were associated with higher likelihood of an easy transition. Good leadership style of the ward manager, good premises of nursing care on the ward and a good supervisory relationship were associated with higher occupational commitment. No consistent association with turnover intention was found.

Conclusion

Having a good final clinical practicum before graduation can contribute to an easier transition experience for newly NGNs and strengthen their commitment to the nursing profession.

Impact

This study adds to the limited existing knowledge about the importance of final clinical practicums in shaping the transition process and occupational commitment of NGNs. Investing in creating a good final practicum experience could help healthcare organizations engage new nursing professionals and thus alleviate the existing shortage of nurses.

Work readiness in rehabilitation medicine: a qualitative exploration and framework

Background/aims

The skills and attributes that facilitate the transition from student to professional (also known as work readiness) have not been fully explored in rehabilitation medicine. The aim of this study was to develop a model of work readiness for new rehabilitation medicine professionals that allows for a successful transition to the workplace.

Methods

A qualitative approach was used to explore the perspectives of 26 clinicians, regulators and employers about work readiness in rehabilitation disciplines. Transcripts were coded and analysed using content analysis methods.

Results

At the core of work readiness for rehabilitation medicine professionals were three complex endeavours that were framed as professional challenges. Each endeavour integrated one or more foundational skills and could improve context-bound applied skills.

Conclusions

Work readiness in rehabilitation requires active and ongoing commitment from students, post-secondary programmes and employers.

Developing work readiness in graduate nurses undertaking transition to practice programs: An integrative review

OBJECTIVE

Investigate the strategies used to support graduate transition-to-practice, and how they align with the four domains of work readiness: work competence; personal work characteristics; organisational acumen; and social intelligence.

DESIGN

Integrative review with narrative synthesis.

DATA SOURCES

Databases searched in 2019 included Medline, CINAHL, PsychINFO, Embase via EBSCO, ERIC and MIDIRS. Grey literature was obtained through Proquest Dissertations and Thesis Global, and Trove.

REVIEW METHODS

The 5-step method included: 1) Independent title and abstract review; 2) discussion of conflicting findings after title and abstract review; 3) independent full text review; 4) discussion of conflicting findings after full text review; and 5) quality evaluation using the Mixed Methods Appraisal Tool. Twenty eligible studies were analyzed and synthesized using the framework method informed by four domains of Graduate Work Readiness.

RESULTS

Of the 24 strategies identified, most (n = 20) supported graduate development across two or more work readiness domains. Structured education (n = 14) and preceptorship (n = 13) were most often used, and findings related to development of graduate work competence (n = 17) were most often measured. All four domains of work readiness were seldom addressed, with social intelligence a common gap.

CONCLUSIONS

This review provides two important considerations for graduate nurse programs. First, a combination of strategies is required to address all four domains of work readiness. Second, there is a need to tailor strategies, and their implementation, to the context of the organisation and clinical workplace.

'Young saplings on fire' newly graduated nurses in the COVID-19 pandemic: A qualitative study

Aim

To explore the experiences of newly graduated nurses during the pandemic.

Background

Newly graduated nurses were employed during the pandemic by several countries to meet the increasing demand for healthcare services.

Methods

A descriptive qualitative study with thematic analysis. The study was conducted with 14 newly graduated nurses.

Results

Themes were systematized into four variables of the system research organization model, and a total of 12 themes were identified. Nurses, who started to work in the beginning months of the pandemic, faced several difficulties in their transition period, including the difficulties of starting employment and the effects of the pandemic on both society and health systems.

Conclusions

During the pandemic, newly graduated nurses faced various difficulties in transition processes, difficulties in starting the employment process and the effects of the pandemic on both society and health systems. In order to reduce these effects, regulations are needed at all stages of the health system.

Implications for Nursing Management

It is the responsibility of health system policymakers, hospital managers, nurse managers and senior nurses to ensure that newly graduated nurses endure these pandemic conditions, which are quite challenging even for senior nurses, without any damage, and continue in the profession.

New graduate nurses' satisfaction, adaptation and intention to leave in their first year: A descriptive study

AIM

To determine the factors affecting the professional and institutional satisfaction of new graduate nurses in their first year of work, their adaptation process and their intentions of leaving the nursing profession.

BACKGROUND

The number of new graduates has been increasing in the global labour force, yet a significant proportion of them have left their profession. The first year in the nursing profession is particularly stressful and challenging for new graduate nurses.

METHODS

The study was conducted at four hospitals with 428 new graduate nurses who were in the first years of their careers.

RESULTS

The nurses' mean score, out of ten, was 5.52 points for job satisfaction and 5.16 points for satisfaction with their institution. Of them, 47.7% had difficulties adapting to nursing, and 53.5% had issues adapting to their jobs. Of them, 42.5% had considered leaving nursing, and 50.9% planned to leave their institutions.

CONCLUSIONS

New graduates that perceive high workload, poor communication with patients and families or team members or inadequate skills and knowledge are more likely to consider turnover or leaving the profession.

IMPLICATION FOR NURSING MANAGEMENT

New graduates suggested that better cooperation and teamwork, participation in decisions, consideration of requests for placement in a specific department, fair distribution of duties and shifts and in-unit professional development opportunities would all improve the work environment and decrease risk of turnover.

Clinical competence in nursing: A hybrid concept analysis

BACKGROUND

Clinical competence (CC) is central issue in nursing. There are some controversies about this concept that needs further investigation. The present study was conducted to analyze the concept of clinical competence in nursing.

METHODS

This concept analysis was conducted using the three-phase hybrid model. In the theoretical phase, the Science Direct, PubMed, CINAHL, ProQuest, Scopus, Web of Science, SID, Iranmedex, and Magiran databases were searched to retrieve articles published from 2000 to 2020. Forty two eligible articles were included and analyzed. In the fieldwork phase, semi-structured interviews were held with eighteen university lecturers, clinical instructors, students, and hospital nurses and the data were analyzed through conventional content analysis. In the final analytic phase, the findings of the first and the second phases were combined.

RESULTS

The majority of literature defined CC in nursing as a combination of knowledge, and skills, and attitudes that is consistent with those of the fieldwork phase. Most participants in fieldwork stated that gaining CC is a process that is achieved over time through practice and repetition and increasing experience. A nurse needs to acquire personal, social and professional competencies during the study and work period. The CC has antecedents of efficient education, and organizational support. It also has consequences for patients and nurses such as satisfaction, and quality care.

CONCLUSION

CC is a continuous process of obtaining knowledge, values, and attitudes, and skills such as critical thinking skills that brings creativity and innovation in nursing practice.

The relationship between the undergraduate clinical learning environment and work readiness in new graduate nurses: A pre-post survey study

BACKGROUND

Due to projected nurse shortages, it is necessary that undergraduate programs optimise work readiness outcomes in new graduate nurses. Research that quantitatively evaluates characteristics of clinical nursing programs that predict increased work readiness is required.

OBJECTIVES

To explore the relationship between the undergraduate clinical learning environment and nurse perceptions of work readiness prior to and following, commencement as a new graduate nurse.

DESIGN

A pre-post follow-up study. Undergraduates were surveyed at the end of their Bachelor's degree (baseline) and at 8-10 weeks after commencement as a graduate nurse (Time 1).

SETTING

A multi-site, metropolitan private hospital in Victoria, Australia.

PARTICIPANTS

Nursing graduates who completed a university fellowship program (n = 26), or were undertaking their graduate year and had completed placement blocks within (n = 18) or outside (n = 31) the healthcare organisation.

METHODS

Participants self-completed the Clinical Learning Environment Inventory (CLEI) and Work Readiness Scale for Graduate Nurses (WRS-GN) at baseline and Time 1. Multiple regression analyses were performed.

RESULTS

CLEI scores significantly predicted work readiness outcomes (all p-values<.05), accounting for 16-36% and 17-28% of the variance of WRS-GN scores at baseline and Time 1, respectively. After adjusting for clustering due to clinical placement groups, CLEI Individualisation (p = .023) and Valuing Nurses Work (p = .01) predicted improved Time 1 WRS-GN Organisational Acumen. CLEI Innovative and Adaptive Culture scores predicted poorer Time 1 Organisational Acumen (p = .001).

CONCLUSIONS

Learning environments that offered high levels of individualised attention and valued nurses' work appeared to facilitate post-graduation engagement and identification with nursing practice. However, highly innovative and adaptive education may detract from optimal work readiness. Findings revealed that while important, the clinical learning environment only accounted for a small-to-moderate degree of nursing graduates' work readiness. To facilitate robust evidence-based improvement of clinical nursing education, future research should attempt to empirically establish the value of additional facilitators of work readiness.

New graduate nurses' clinical competence: A mixed methods systematic review

AIM

To appraise and synthesize evidence of empirical studies reporting assessment of new graduate nurses' clinical competence in clinical settings.

DESIGN

Mixed methods systematic review.

DATA SOURCES

The search strategy included keywords relevant to: new graduate nurse; clinical competence; and competence assessment. The searched literature databases included CINAHL, MEDLINE, Embase, PsycINFO and Web of Science. The search was limited to full-text papers in English or French, published between 2010 -September 2019.

REVIEW METHODS

Inclusion criteria were: 1) empirical studies; 2) detailed method and complete results sections; 3) competence assessment in clinical settings; and 4) new graduate nurses (≤24 months). Two independent reviewers screened eligible papers, extracted data and used the Mixed Methods Appraisal Tool framework for quality appraisal. Divergences were solved through discussion.

RESULTS

About 42 papers were included in this review: quantitative (N = 31), qualitative (N = 7) and mixed methods (N = 4). Findings suggest that new graduate nurses exhibit a good or adequate level of competence. Longitudinal studies show a significant increase in competence from 0-6 months, but findings are inconsistent from 6-12 months.

CONCLUSION

There are a multitude of quantitative tools available to measure clinical competence. This suggests a need for a review of their rigor.

IMPACT

No recent reviews comprehensively synthesized the findings from new graduate nurses' clinical competence. This review has found that new graduate nurses' competence has been mostly assessed as good, despite the expectation that they should be more competent. Longitudinal studies did not always show a significant increase in competence. These findings can help nurse educators in providing more support to new graduate nurses throughout the transition period or design improved transition programme. This review also identified quantitative tools and qualitative methods that can be used for competence assessment.

New Graduate Registered Nurses and the Spectrum of Comfort in Clinical Practice

The comfort zone is where a person consistently performs his or her role in an affective state devoid of anxiety and without a feeling of risk. This study challenges the notion of a singular comfort zone and suggests that a spectrum of comfort is a more accurate reflection of the new graduate experience. A grounded theory methodology was used to identify and explain the spectrum of comfort considerations helpful to nine new graduates amid their transition to professional practice. Emerging from the data were themes that encompassed both the positive and negative regions of the spectrum of comfort. Negative themes were: Feeling Abandoned, Sometimes I Get Frightened, and Feeling Betrayed-Catching Hold. The more positive themes were: Moderation of Emotions, and Letting Go. Each of these themes requires an appropriate response from new graduates and experienced staff. The spectrum of comfort model and practical considerations of support could accomplish this. [J Contin Educ Nurs. 2019;50(12):563-571.].

Transition shock and newly graduated nurses' job outcomes and select patient outcomes: A cross-sectional study

AIM

This study examined transition shock experiences in newly graduated nurses as well as its relative influence on job outcomes (job satisfaction, stress and burnout, and intent to leave their organisation) and select patient outcomes (missed care, adverse events and perceived quality of care).

BACKGROUND

Transition shock is a reality common among newly graduated nurses and has been considered an issue relevant to nursing administrators. To date, the mechanism by which transition shock perception is linked with nurse and patient outcomes remains unexplored.

METHODS

A descriptive, cross-sectional design was used. One hundred seventy-six newly graduated nurses (nurses with <1 year of work experience) were included in the study. Data were collected using seven standardized scales.

RESULTS

Hospital classification (e.g., being employed in a government-owned hospital) (β = 0.255; p = .001) predicted transition shock. Overall, newly graduated nurses reported greatest challenges with regard to their expectations of the actual work environment (mean = 2.60, standard deviation = 0.42) and in balancing their professional and personal lives (mean = 2.51, standard deviation = 0.35). Higher levels of reality shock were associated with adverse patient events (β = 0.821; p = .001).

CONCLUSION

New graduates experience great challenges in balancing their professional and personal lives. Ensuring work-life balance and work readiness in newly graduated nurses may potentially reduce the occurrence of missed nursing care and adverse events.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can adequately support newly graduated nurses' transition through the implementation of empirically based transition programmes. By providing flexible work arrangement, reasonable workload, adequate nurse staffing, limited mandatory overtime and self-scheduling, nurse managers can effectively assist newly graduated nurses in attaining work-life balance.

Psychometric properties assessment of Chinese version of work readiness scale for graduate nurses (WRS-GN) and associated factors of work readiness: Two cross-sectional studies

BACKGROUND

Lower work readiness is tied to anxiety, high turnover and nurse transition failure. An assessment of work readiness is necessary. To date, no relative scale exists in China. Thus, a work readiness related scale is urgently needed.

OBJECTIVES

To assess the psychometric properties of the scale, and look into the status of Chinese graduate nurse work readiness and factors associated with work readiness.

DESIGN, SETTINGS, AND PARTICIPANTS

Both psychometric assessment and associated factors are designed with cross-sectional studies. 832 and 435 graduate nurses were recruited in the above two studies, respectively.

METHODS

Brislin's transition model was utilized for the transition process, and a six-expert panel and preliminary survey were conducted for face validity and testing the transition version respectively. Exploratory factor analysis, confirmatory factor analysis, internal consistency reliability and test-retest reliability were applied for reliability and validity testing. Additionally, a linear regression method was carried out for analyzing influencing factors of work readiness of graduate nurses across China.

RESULTS

A 37-item Chinese version scale was proven to have great psychometric qualities. Five factors were extracted by exploratory factor analysis, which can explain 68.637% of the total variance. Furthermore, the confirmatory factor analysis demonstrates the fit indices of a five factors mode: X²/df = 1.769, RMSEA = 0.067, NFI = 0.859, RFI = 0.839, IFI = 0.934, CFI = 0.933, TLI = 0.923. Intra-class correlation coefficient, Cronbach's α and Guttman Split-half were 0.805, 0.960 and 0.903, respectively. Interpersonal relationships, leadership experience, scholarship, work experience and willingness to be nurses were associated with the potential to achieve higher work readiness.

CONCLUSION

The Chinese version of WRS-GN with good validity and reliability can be utilized for assessment of work readiness. Besides, improving work readiness of graduate nurses based on above five associated factors, educators and hospital managers could help graduate nurses having a smooth transition for a stable nursing workforce.

Effects of organisational justice, work engagement and nurses' perception of care quality on turnover intention among newly licensed registered nurses: A structural equation modelling approach

AIMS AND OBJECTIVES

To investigate turnover intention among newly licensed registered nurses and to clarify the impact pathways of organisational justice, work engagement and nurses' perception of care quality on turnover intention.

BACKGROUND

Nurse shortage is an ongoing and urgent issue worldwide, in which nurse turnover could exacerbate the situation. Newly licensed registered nurses will become the main nursing workforce in the future; however, previous studies have not revealed the specific reasons underlying their turnover intentions.

DESIGN

A descriptive cross-sectional design.

METHODS

A total of 569 newly licensed registered nurses undertaking direct care were recruited from thirteen hospitals from October to November 2018 across Beijing, China. Based on the job demands-resources model, we advanced a hypothetical model, linking the paths between organisational justice, work engagement, nurses' perception of care quality and turnover intention. Structural equation modelling was used to examine the hypothetical model. The study adhered to the STROBE statement for observational studies.

RESULTS

In total, 22.3% of newly licensed registered nurses had a high turnover intention. The final model had an acceptable fit and could explain 58% of the variance in turnover intention. The organisational justice was directly related to high work engagement, great nurses' perception of care quality and low turnover intention. Additionally, organisational justice also had indirect effects on great nurses' perception of care quality and low turnover intention, which were partially mediated by work engagement. However, the effect of nurses' perception of care quality on turnover intention was not significant.

CONCLUSION

The improvement of organisational justice could enhance work engagement, and nurses' perception of care quality, and reduce turnover intention, which is crucial to improving care quality and addressing the shortage of nurses.

RELEVANCE TO CLINICAL PRACTICE

This study provides evidence for policymakers and hospital administrators to take targeted measures to enhance work engagement, foster high-quality care and create better defences against losing nurses.

Investigating The Implementation of a Collaborative Learning in Practice Model of Nurse Education in a Community Placement Cluster: A Qualitative Study

Background:

Attracting new graduate nurses to work in the community is problematic, and this has contributed to shortages in this sector in the United Kingdom and internationally. This paper reports the findings of a pilot study to implement Collaborative Learning in Practice in one region of the United Kingdom, which was intended to increase placement capacity, introduce students to this sector, and accelerate their learning and development of key skills and behaviors.

Study Aim:

To investigate the views of student nurses and the staff supporting them on placement about their experiences of implementing Collaborative Learning in Practice.

Methods:

We conducted four focus group interviews between winter 2018 and spring 2019, with 31 staff and students in two English counties in the South West of England. These were transcribed and analysed using the Framework Method; themes were discussed and agreed by the research team.

Results:

Three themes emerged: Peer support, which concerned the benefits of being in placement with other students; Developing and learning, which was about the acquisition of skills including leadership; and Organisation, which related to issues and concerns involved in the preparation and daily management of the collaborative learning in practice experience.

Conclusion:

Some positive aspects were reported, particularly in relation to hospice and General Practice Nursing placements. Most clear was the supportive potential for peer learning fostered by Collaborative Learning in Practice. Less positive aspects were the potential for horizontal violence and some aspects of nursing home experiences. We believe more work needs to be done to make nursing homes an attractive option for students and new graduates, and regarding visual materials for pre-placement preparation.

Final clinical practicum, transition experience and turnover intentions among newly graduated nurses: A cross sectional study

BACKGROUND

The shortage of nurses is a global issue, and turnover rates are especially high for newly graduated nurses. The transition from student to nurse is often described as challenging, and the final clinical practicum before graduation is suggested to be important in preparing graduating students for the transition. However, little is known about the actual relationships between the final clinical practicum, transition and turnover intentions.

OBJECTIVES

To examine whether the final clinical practicum experience is associated with the transition experience and turnover intentions of newly graduated nurses, and whether the transition experience mediates the potential relationship between the practicum and turnover intentions.

DESIGN

Cross-sectional survey study.

SETTINGS

The study was carried out in Finland (October-December 2018).

PARTICIPANTS

Registered nurses graduated within the past two years (n = 712).

METHODS

A new survey instrument with five subscales was developed for measuring the final clinical practicum experience. Transition experience was measured on four scales that demonstrated the emotional, physical, socio-developmental and intellectual domains of the transition: Psychological distress, sleep quality, role conflict/ambiguity, perception of transition and educational preparation. Turnover intentions from job and profession were asked about with two questions. Structural equation modelling was used to explore the associations between the variables. The models were adjusted for multiple potential confounders.

RESULTS

Final clinical practicum experience was associated with all domains of the transition experience and turnover intentions. The association between the practicum and turnover intentions was partly mediated by the emotional (psychological distress) and socio-developmental (role conflict and ambiguity) domains of the transition.

CONCLUSIONS

Our findings provide new evidence about the associations between the specific final clinical practicum dimensions and turnover intentions and the specific mechanisms linking this association. These results highlight the importance of final clinical practicums and suggest targets for improving nurses' transition processes during their first years in practice.

Exploring opportunities for embedding graduate attributes in a first-year undergraduate anatomy course for allied health students

BACKGROUND

There is a growing discontent within the health care industry regarding the state of preparedness of graduates to adequately function in a dynamic work environment. It is therefore required of higher education institutions to equip graduates with skills beyond disciplinary expertise, which would allow them to function optimally in work environments. This study presents a team dissection project that incorporates graduate attributes in an undergraduate first-year anatomy course for the medical orthotics and prosthetics program.

METHOD

Focus group interviews with students (n = 23) were used to demonstrate the achievement of graduate attributes by aligning student perceptions of the dissection project with graduate attributes and indicators thereof.

RESULTS

Students were positive about the effectiveness of the dissection project in enforcing anatomical knowledge; ensuring active engagement with human material; enhancing communication skills and teamwork; and increasing sensitivity towards cultural diversity. These views related largely to those graduate attributes which engage students towards becoming active and reflective learners; creative thinkers; independent and collaborative workers; effective communicators; and culturally and socially aware citizens. Areas of dissatisfaction included challenges with the use of technology for the video preparation; repetition of presentations and large dissection teams.

CONCLUSION

There is an emerging view that graduate attributes be integrated as early as possible into program curricula so as to become intrinsic in a student's academic and professional development. Through the expansion of a dissection project forming part of a subject taught very early on in a program's curriculum, the integration of graduate attributes and discipline-specific competencies are highlighted.