Evolving career choice narratives of new graduate nurses

Career decisions and aspirations of early-career nurses: Insights from a qualitative interpretative description study

AIM

To explore the career decisions and aspirations of early-career registered nurses in New Brunswick, Canada.

DESIGN

A qualitative study using an interpretive description approach was conducted.

METHODS

Semi-structured one-on-one interviews were conducted with a purposive sample of nurses (n = 22) currently working in New Brunswick, Canada, with up to 5 years of experience from February to April 2022.

RESULTS

Participants described diverse career paths and aspirations. Personal factors affecting these included the desire for meaningful work, career satisfaction, work-life balance, spending time with family, working in a preferred location, and finances. Professionally, working conditions were the dominant factor influencing early-career nurses' career decisions and aspirations. Participants described how short staffing, safety, support, and scheduling influenced their day-to-day work, mental and physical health, job and career satisfaction, and intent to leave.

CONCLUSION

The findings highlighted the abundant and diverse career opportunities available to nurses early in their careers. Early-career nurses are interested in finding nursing positions with a high degree of person-job fit and value opportunities for ongoing professional education and growth.

IMPACT

This study in New Brunswick, Canada, explores early-career nurses' career decisions and aspirations during nursing shortages and the pandemic, emphasizing the importance of person-job fit. Recommendations include improving working conditions and career pathways to enhance the sustainability of the nursing profession.

REPORTING METHOD

Standards for Reporting Qualitative Research (SRQR).

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Supporting each other towards independence: A narrative analysis of first-year nursing students' collaborative process

Collaboration for nursing is a core competence and therefore educational interventions are essentials for collaborative skills. To identify such interventions, we carried out a study to understand nursing students' collaborative process. A narrative inquiry method was used to explore the collaborative process of first-year undergraduate nursing students. The analysis was conducted on field notes from 70 h of observation of 87 nursing students' collaboration during skills lab activities. It also included transcriptions of four focus group discussions with 11 students. The results are presented as a sequential process of (1) navigating in unfamiliar territory, (2) navigating together to cope, and (3) navigating together towards independency and the future nursing profession. We identified a transition from teacher-led assistance and guidance to student interdependency and reciprocal learning, ending with student-led assistance supporting independency. In line with Vygotsky's theory of zone of proximal development, different scaffolding interventions are needed depending on where the students are in the collaborative process.

Exploring career choices of specialist nurse students: Their decision-making motives. A qualitative study

AIMS

To explore Registered Nurses' motives to undergo specialist training and to choose a particular speciality.

DESIGN

A descriptive qualitative interview study.

METHODS

Semi-structured interviews were conducted during 2021 with 20 Swedish specialist nurse students from different specialisation areas. Qualitative content analysis was used. The COREQ checklist was used to report the study.

RESULTS

Specialist nurse students' motivations for further training were divided into three main categories with two sub-categories each. The main categories were 'toward new challenges and conditions in work life', 'contributions to the development and higher competencies in health care' and 'personal work and life experiences as ground for choice'.

CONCLUSION

Our study demonstrates the importance of motivating factors in the career choices of Specialist nurse students, such as personal challenges, desirable working conditions, career growth opportunities and personal experiences in the career choices. Creating a supportive work environment that helps to prioritise work-life balance and offers the development of new skills might help retain nurses.

NO PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution was used. However, if more nurses would choose to undergo specialist training, especially in areas facing significant shortages, it would most likely lead to improved health-related outcomes for patients or populations.

Motivations and expectations of generation Z nursing students: A post-pandemic career choice qualitative analysis

BACKGROUND

The global nursing shortage is a growing concern so recruiting and retaining Generation Z (Gen Z) students is vital to the sustainability of the profession.

PURPOSE

To explore the perceptions and expectations of first-year nursing students regarding the nursing profession, its working conditions, and how these factors influenced their career choices.

METHOD

Descriptive qualitative research design, employing an interpretive research approach and content analysis conducted following Graneheim & Lundman's method. Our study involved 105 Generation Z nursing degree students enrolled in first year at the Mar Nursing School in Barcelona, Spain in 2021. Data collection included voluntary written narratives about their career choice and questionnaires of demographic information and their healthcare experiences.

RESULTS

It became evident that Generation Z students' perceptions and expectations of nursing don't align with the actual professional experience. This mismatch could lead to disillusionment and attrition among these students.

CONCLUSIONS

Several factors (economic, aspirational, perception of nursing during the COVID-19, or gender) influence new students' career choice. These factors shape their expectations and often do not match actual working conditions in nursing. Educational institutions must prepare students by transferring cross-cutting competencies to effectively meet these challenges and avoid potential dropout from the profession.

Reasons for choosing and completing nursing studies among incoming and outgoing students: A qualitative study

BACKGROUND

The shortage of nurses is causing instability and crisis in health systems and will continue. The WHO reinforced the importance of recruiting and retaining new students. Authors of various studies recommend the need to identify and understand the reasons for pursuing a nursing degree.

OBJECTIVES

To determine students' preference for nursing studies and to identify the reasons for choosing, continuing, and completing a bachelor's degree in nursing.

DESIGN

Qualitative, descriptive study.

PARTICIPANTS

106 nursing students at the University of Huelva (Spain) participated during their first year (2017) and final year (2021) of the nursing degree.

METHODS

This study was conducted with the same group of students in two phases. Data were collected in writing in a document with open-ended questions and no maximum wordcount. The responses were analysed using content analysis.

RESULTS

A total of 76.4 % of participants stated that nursing had been their first choice. The main reasons for choosing a nursing degree were associated with fulfilment, and a desire to help others and interact with them. The reasons for completing their studies were primarily related to an interest in providing professional care, showing a deeper and more concrete knowledge of nursing care work.

CONCLUSION

For most participants, nursing was their first choice due to a strong intrinsic motivation related to self-satisfaction in helping others. The reasons for completing this degree had extrinsic motivations linked to nursing activity in hospital. Areas such as management, teaching, or research were not interesting to our students. Knowing the causes of this lack of interest could help us attract them to these areas.

Insights into the millennial generation of nurses

Recommendations for developing and retaining younger workers.

Factors associated with new nurses' career choice as advanced practice nurses: Implications for managing organizational turnover

PURPOSE

Staff nurse turnover is a costly problem for healthcare managers, which has been extensively studied. Now, managers are facing a new challenge attributed to nurses leaving their current positions to become advanced practice nurses. We aimed to identify factors associated with new nurses' career choice as advanced practice nurses.

METHODS

We used descriptive comparative design to analyze data from 946 nurses who reported working as new staff nurses in 2006 and 10 years later reported working as advanced practice nurses.

RESULTS

We add to the topic of nurses' turnover by identifying the factors associated with nurses leaving their jobs to become advanced practice nurses. The factors include being younger, not married, enrolled into a formal education program, and having a bachelor's degree at entry into nursing practice.

CONCLUSIONS

To better manage staff nurse turnover due to nurses becoming advanced practice nurses, managers should monitor educational policy trends on bachelor's entry into practice, new nurses' enrollment status into formal education program upon hire, and new nurses' demographics.

Associated factors of professional identity among nursing undergraduates during COVID-19: A cross-sectional study

Objectives

Professional identity plays an important role in the long-term development of nurses, and it will change when public health emergency occurs. The objective of this study is to investigate the factors associated with the professional identity of nursing undergraduates in the epidemic of COVID-19.

Methods

A cross-sectional survey design with convenience sampling was used. A total of 3,875 nursing undergraduates were recruited from seven universities across China from March to April 2020. A general information questionnaire was used to collect students’ information, and the Professional Identity Questionnaire for Nurse Students was used to survey their professional identity during the early and later stages of the first wave of the COVID-19 epidemic.

Results

The score of professional identity in the later stage (59.49 ± 12.41) was higher than that in the early stage (56.96 ± 12.61). The stepwise regression indicated that several factors were associated with professional identity, including gender, residential area, major, impact of the epidemic on intention to work after graduation, reasons for choosing nursing major and students’ scores of professional identity in early stage.

Conclusions

Nursing educators can utilize the positive impact of responding to public health emergencies to increase the professional identity of students. Meanwhile, educators should give those students with lower professional identity more targeted education to cultivate their professional identity after the occurrence of public health emergencies.

A longitudinal, narrative study of professional socialisation among health students

PURPOSE

Interprofessional collaboration (IPC) among health professionals is well-recognised to enhance care delivery and patient outcomes. Emerging evidence suggests that the early socialisation of students in health professional programmes to teamwork may have a positive impact on their future as collaborative practitioners. With a purpose of contributing to growing evidence on the processes of professional identity construction, and to explore how early expectations and perceptions of IPC develop during professional socialisation and pre-licensure education, our study examined the early professional socialisation experiences among five groups of health professional students.

METHOD

A qualitative, narrative approach was used to examine early professional socialisation among five programmes of health professional students (dentistry, medicine, nursing, pharmacy, physiotherapy) at an Atlantic Canadian University. In March and October 2016, students participated in interviews after first term (n = 44) and first year of study (n = 39). Interviews focused on participants' professional identify formation, as well as their perceptions and experiences of IPC. The authors analysed interview transcripts using narrative analysis.

RESULTS

Findings identify that despite the espoused importance of IPC within health professional training, students have a limited understanding of their professional roles and are largely focused on developing a uniprofessional, vs. interprofessional identity. Clinical experiences, role models and exposure to teamwork are critical to contextualise collaborative practice and enhance the development of an interprofessional identity.

CONCLUSIONS

Findings can be used to guide the development of curricula that promote interprofessional identity development and IPC during early professional socialisation.

Final-year undergraduate nursing students' perceptions of general practice nursing: A qualitative study

AIM

To explore final-year nursing students' perceptions of general practice nursing.

BACKGROUND

The need for general practice nurses has increased due to growing demands for health care in the community. This demand is exacerbated by a shortage in the general practice nursing workforce. Understanding final-year nursing students' perceptions of general practice nursing is important as these may influence career choices.

DESIGN

Qualitative descriptive study within a mixed methods project.

METHODS

Telephone interviews were conducted with sixteen final-year nursing students. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Reporting follows the COREQ checklist.

RESULTS

Perceptions of general practice nursing varied between participants and related to three main themes; ways of working; a broad role to meet diverse health needs; and relationships with patients. General practice nurses were seen to have stable and collaborative working relationships, with their role ranging from supporting general practitioners to being autonomous professionals. The nurse's broad role was associated with diverse presentations and was considered interesting and challenging. Participants perceived that general practice nurses had more time to spend with patients, and this helped establish trust, and facilitated patient-centred care.

CONCLUSION

Participants' perceptions of general practice nursing varied, with some students recognising the diversity of the role and others perceiving it as limited. These views were often impacted by others experiences rather than personal experience. These variations underscore the need for students to receive greater exposure to general practice nursing. Review of undergraduate curricula to increase focus on preparing nursing students to work in general practice may help shape students' interest to seek employment in this setting.

RELEVANCE TO CLINICAL PRACTICE

Students perceptions of a clinical setting can influence their career decisions. Understanding these perceptions can inform clinicians and managers and highlight areas that may need to be addressed to promote career opportunities.

Retaining Generation Y Nurses: Preferred Characteristics of Their Nurse Managers

OBJECTIVE

The purpose of this study was to describe generation Y nurses' perceptions of their nurse managers' servant leadership characteristics as well as the relationship between these characteristics and intent to stay on the job.

BACKGROUND

To attract and retain generation Y nurses, organizational leaders need to develop an understanding of this generation's perspectives around workplace loyalty and commitment.

METHOD

This study had a quantitative correlational research design. The Servant Leadership Survey (SLS) measured 116 generation Y nurses' perception of their manager's use of servant leadership.

RESULTS

Generation Y nurses' most positively rated servant leadership characteristic of their managers was accountability; the lowest was forgiveness. Significant positive relationships were found between the overall SLS score and intent to stay and between the SLS dimensions of standing back, empowerment, authenticity, humility, and stewardship, and intent to stay on the job.

CONCLUSIONS

Generation Y nurses are seeking characteristics in their nurse managers that will attract them to stay on the job; if these characteristics are lacking, they may leave.

Becoming a good nurse - Socialisation of newly employed nurses into the oncological clinic

AIM AND OBJECTIVES

To explore newly employed nurses' socialisation in the process of introduction into an oncological clinic from the perspectives of unit managers and newly employed nurses.

BACKGROUND

There are managerial challenges in retaining nurses at workplaces. The way in which nurses are socialised into their work is important for their job satisfaction and retainment.

METHOD

Qualitative, semi-structured interviews with seven nurses and two unit managers, and written introductory material. Thematic analyses were made, inspired by Goffman's concepts of social interaction, back stage, front stage and roles. SRQR checklist was used.

RESULTS

Unit managers created the framework for socialising newly employed nurses through written introductory guidelines and assignments of supervisors as mainstream role models. Newly employed nurses were socialised gradually through mirroring their supervisors in their role as nurse. Front stage, patients often functioned as objects for newly employed nurses' training. Back stage, patients often functioned as communication objects for all professionals. Newly employed nurses, who also demand roles such as transformer, boss, coordinator, prompter and friend, were socialised into the role of assistant to the doctor. Medical rounds functioned as a socialisator in this process.

CONCLUSION

The allocated supervisors were role models in socialising newly employed nurses into an oncological clinic and its culture. Nurses were socialised into an understanding of care as a biomedical orientation, in which medicine had a higher value than care in the existing knowledge hierarchy at the oncological clinic. This might have implications for who applies for and stays in the job.

RELEVANCE TO CLINICAL PRACTICE

Increased awareness of the importance of socialisation of nurses into the clinic during the introduction process. Re-thinking nurses' independent functions and patient perspectives in introduction of newly employed nurses to maintain and develop nursing as an independent profession.

Teaching and assessment strategies for nursing self-care competencies in Ontario's nursing education programs

In Canada, nurses comprise half the healthcare employment sector, yet comparably, they are twice as likely to experience absenteeism due to occupational burnout. This issue is pronounced for entry-level nurses. The College of Nurses of Ontario (CNO) mandates professional practice standards and entry-level practice competencies; notably, these documents lack explicit performance expectations linked to nursing self-care. This lack of acknowledgment is reflected in what is known, which is little, about how self-care competencies are taught and assessed in nursing education programs. From a Program Director perspective, this study examined the strategies used to teach and assess self-care competencies in Ontario's nursing education programs. Survey results (n = 8), reported intention-action gaps highest (i.e., there is a need for increased teaching), in self-care competencies not mandated by the CNO (i.e., relationship, emotional, and spiritual self-care), whereas competencies mandated by the CNO (i.e., professionalism), were rated higher in relative teaching than importance. Given that self-care strategies (e.g. maintaining healthy interpersonal relationships and engaging in spiritual growth and mindfulness) have shown to be protective factors against workload stress, burnout, and job attrition, regulatory colleges need to consider mandating these self-care competencies within their professional practice standards and entry-level registered nurse practice guidelines.