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Lim E, Tate R, Sewell A, Higham K, Ferraz K, Harban K, Murdock J, Delahunty S. Consumers' Experiences of Comprehensive-Prepared Graduate Nurses and Their Nursing Care in Acute Mental Health Settings. Issues Ment Health Nurs 2024; 45:617-623. [PMID: 38593452 DOI: 10.1080/01612840.2024.2330571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Pre-registration nursing education has long moved away from preparing nurses with mental health specialisation to nurses with comprehensive knowledge and skills. However, the consumers' experiences of comprehensive-prepared nurses and their nursing care has not been widely explored. This paper reports on a study with consumers to explore their experiences with comprehensive-prepared graduate nurses and the nursing care that they provide in acute mental health settings. An exploratory qualitative study using semi-structured interviews was chosen as the research method. Purposeful sampling recruited 12 consumers and data saturation was achieved. Braun and Clarke's method of thematic analysis was used to analyse the collected data and three themes emerged. The themes are: (i) You got what it takes to be a mental health nurse, (ii) Slow down and spend quality time with us, and (iii) Read in between the lines when we share our negative lived experiences. The findings are useful for identifying strategies to develop evidence-based nursing education for comprehensive-prepared graduate nurses to improve the consumers' experiences of their nursing care.
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Affiliation(s)
- Eric Lim
- School of Nursing, Curtin University, Perth, Australia
| | - Rebecca Tate
- Service 5, Fremantle Hospital, Palmyra DC, Australia
| | - Amy Sewell
- Service 5, Fremantle Hospital, Palmyra DC, Australia
| | - Kezia Higham
- School of Nursing, Curtin University, Perth, Australia
| | - Kristina Ferraz
- Nursing Education, Fiona Stanley Fremantle Hospitals Group, Murdoch, Australia
| | - Kathryn Harban
- Nursing Education, Fremantle Hospital and Health Service, Palmyra DC, Australia
| | - Jane Murdock
- Service 5, Fremantle Hospital, Palmyra DC, Australia
| | - Sharon Delahunty
- Service 5, Fiona Stanley Fremantle Hospitals Group, Murdoch, Australia
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Cadorette JH, McCurry MK, Letourneau RM, Viveiros JD. Competence and Confidence With Quality and Safety Education for Nurses Competencies by Newly Licensed Registered Nurses. J Nurses Prof Dev 2024; 40:133-138. [PMID: 38598739 DOI: 10.1097/nnd.0000000000001045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Understanding newly licensed registered nurses' perceived confidence in the Quality and Safety Education for Nurses (QSEN) competency domains and corresponding knowledge, skills, and attitudes will help inform clinical leaders to develop successful transition-to-practice programs. Newly licensed registered nurses and prelicensure nursing students had confidence in their understanding of QSEN competencies as they began their transition to practice. Online learning and virtual practicums were effective for attaining QSEN competencies, offering support for using these interventions in academic settings and transition-to-practice programs.
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Wang J, Xu Y, Zhang W, Guo Z, Zhang W, Zhang Y, Ma W. Transition status and influencing factors of newly graduated nurses: A descriptive survey design. Nurse Educ Pract 2024; 77:103992. [PMID: 38744095 DOI: 10.1016/j.nepr.2024.103992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/17/2024] [Accepted: 05/03/2024] [Indexed: 05/16/2024]
Abstract
AIMS To assess the transition status of newly graduated nurses in China and identify its influencing factors. BACKGROUND Newly graduated nurses are the indispensable part of nursing human resource. The successful transition of into clinical work is crucial for their future career development. However, the transition status of new nurses in China remains inadequately explored. DESIGN A descriptive survey design was employed in this study. METHODS From October 2022 to January 2023, 1261 newly graduated nurses were surveyed online with the Transition Status Scale for Newly Graduated Nurses. Description statistical analysis was adopted to evaluate the transition status of new nurses. Independent-samples t-test, Analysis of Variance and Multiple Regression Analysis was used to explore the influencing factors of the transition status. RESULTS The total mean score of Transition Status Scale for Newly Graduated Nurses was 4.00 (SD=0.61). Competence for nursing work (Mean=4.20; SD=0.57) was rated the highest among the five dimensions of the scale, while the dimension of balance between work and life (Mean=3.65; SD=0.89) was rated the lowest. Mentored by senior nurses, night shift, attribute of working hospital, educational background, interned in the same department, tertiary general hospital, reasons for choosing nursing and working time can affect the transition status of new nurses, accounting for 17.9% of the variance in transition status (R²= 0.179, P<0.001). CONCLUSION The transition status of newly graduated nurses in China is at a relatively high level, especially in the dimension of competence for nursing work. However, newly graduated nurses are in a relatively poor status of work-life balance. Nurse educators and managers need to pay more attention to the transitional training of highly educated nursing talents and the optimization of clinical transition training programs to prevent talent loss. Experienced tutors should be allocated to provide guidance for newly graduated nurses.
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Affiliation(s)
- Jia Wang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yutong Xu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wanting Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zihan Guo
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuying Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weiguang Ma
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Rababah J, Al-Hammouri MM, Awawdeh A. The association between undergraduate nursing students' health literacy and bullying and cyberbullying victimization. J Prof Nurs 2024; 52:15-20. [PMID: 38777521 DOI: 10.1016/j.profnurs.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Bullying and cyberbullying victimization are common among undergraduate nursing students. However, evidence regarding health literacy association with bullying and cyberbullying victimization is lacking. PURPOSE To investigate the association between health literacy and bullying and cyberbullying victimization in undergraduate nursing students. METHODS A cross-sectional design was used with a sample of undergraduate nursing students (N = 397). The students completed three data collection scales (Forms of Peer Victimization Scale, Florence Cyberbullying-Cybervictimization Scales, and Health Literacy Questionnaire) and a demographics questionnaire. Data analysis was performed using cluster analysis and independent samples t-test. RESULTS The mean age of students was 20.93 (SD = 2.16). Cluster analysis revealed that there were two clusters; undergraduate nursing students in cluster 1 had lower scores on health literacy and higher scores on bullying and cyberbullying victimization. The t-test results showed that undergraduate nursing students with a history of bullying victimization had lower scores on health literacy scales than those who reported no exposure to bullying victimization (p < .05). The largest mean difference was found in the "social support for health" scale. CONCLUSION The findings of this study provide evidence that health literacy is a key determinant of mitigating bullying and cyberbullying victimization in undergraduate nursing students.
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Affiliation(s)
- Jehad Rababah
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan.
| | | | - Ayat Awawdeh
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Ding Y, Tang H, Zhang Y, Peng Q, Dong W, Lu G, Chen C. The effect of work readiness on work well-being for newly graduated nurses: The mediating role of emotional labor and psychological capital. J Nurs Scholarsh 2024. [PMID: 38654402 DOI: 10.1111/jnu.12976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 04/25/2024]
Abstract
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.
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Affiliation(s)
- Yueming Ding
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Haishan Tang
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Yiming Zhang
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Qianwen Peng
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Wanglin Dong
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Guangli Lu
- Institute of Business Administration, School of Business, Henan University, Kaifeng, Henan, China
| | - Chaoran Chen
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, China
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Ma W, Xu Y, Liu Y, Liang T, Ma F. Perspectives of Chinese New Nurses Regarding Successful Transition: A Qualitative Study. J Nurs Res 2024; 32:e321. [PMID: 38506572 DOI: 10.1097/jnr.0000000000000607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Transition issues have been discussed for many decades, yet little is known about successful transition expectations in the context of Chinese culture. PURPOSE This article was designed to describe the expectations of newly graduated nurses in China regarding successful transition. METHODS A qualitative, descriptive study design was employed, and a purposive sampling method was used to recruit interviewees. All of the one-to-one conversations were held in a quiet room to ensure privacy. All of the interviews were transcribed and then analyzed using thematic analysis. RESULTS Nineteen new nurses were recruited from seven tertiary hospitals and participated in the in-depth interview process. Transition success, that is, "professional metamorphosis," was revealed through the four themes of "being competent in nursing work," "establishing a professional identity," "establishing comfortable interpersonal relationships," and "achieving balance between work and life." CONCLUSIONS/IMPLICATIONS FOR PRACTICE Chinese new nurses expect their successful transition to achieve a professional metamorphosis in many aspects. A successful transition is not only a journey of professionalization but also a process of socialization. New nurses expect to achieve both maturity in their work and wisdom in life. The results of this study provide a greater understanding of transition issues in the context of Chinese culture. Thus, support and strategies cannot be limited to interventions designed to improve working competence but should be individualized to help new nurses achieve a smooth transition.
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Affiliation(s)
- Weiguang Ma
- PhD, RN, Professor, School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Yutong Xu
- BSN, RN, Master Student, School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Yuanfei Liu
- MSN, RN, Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Zhejiang University, China
| | - Tao Liang
- PhD, RN, Professor, School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Fang Ma
- PhD, RN, Associate Professor, Nursing Department, The First Affiliated Hospital of Kunming Medical University, China
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Ma W, Dai Z, Liang T, Zhang H, Liu Y. The transition issue among new nurses in China: A mediation model analysis. Int Nurs Rev 2024; 71:108-114. [PMID: 37392463 DOI: 10.1111/inr.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 06/01/2023] [Indexed: 07/03/2023]
Abstract
AIM To explore the impact and interrelated pathway of work environment, career adaptability, and social support on the transition process and outcomes among new nurses. BACKGROUND The transition issue affecting new nurses has been discussed for many decades. However, the exact interplay of various factors influencing the transition process and outcomes needs further exploration. METHODS A cross-sectional, descriptive survey design was employed, and a convenient sample of 1628 new nurses from 22 tertiary hospitals in China was surveyed between November 2018 and October 2019. Mediation model analysis was used to analyze the data, and the STROBE checklist was used to report the study. FINDINGS The transition status mediated the effects of work environment, career adaptability and social support, and had a significantly positive influence on their intention to remain and job satisfaction. Among the influencing factors, the work environment had the most significant positive impact on both the intention to remain and job satisfaction. CONCLUSION Work environment was found to be the most significant factor affecting both the transition status and outcomes of new nurses. The transition status played an important mediating role between the influencing factors and the transition outcomes, whereas career adaptability was found to mediate the impact of social support and work environment in the transition process. IMPLICATIONS FOR NURSING AND NURSING POLICIES The results underscore the critical role of the work environment and demonstrate the mediating effects of transition status and career adaptability in the transition process of new nurses. Therefore, dynamic evaluation of the transition status should serve as the foundation for developing targeted supportive interventions. Such interventions should also focus on enhancing career adaptability and fostering a supportive work environment to facilitate the transition of new nurses.
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Affiliation(s)
- Weiguang Ma
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhenwei Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tao Liang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huan Zhang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yitao Liu
- Department of Internal Medicine, Peking Union Medical College Hospital, Beijing, China
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Generous L. New Graduate Nurse Transition into Rural Home: A Case Study. Home Healthc Now 2024; 42:96-102. [PMID: 38437043 DOI: 10.1097/nhh.0000000000001241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
The global shortage of nurses and high attrition rates for newly graduated nurses along with the shifting demand for home care has created a critical need for retention strategies that address the specific challenges of rural settings. The effectiveness of structured transition or mentoring programs are primarily studied in acute care settings, making it difficult to translate to the unique context of rural home care nursing. The complexities of the independent nature of home care nursing practice and limited resources to address transition shock make it difficult to successfully transition newly graduated nurses to rural home care. A case study supports mentorship facilitation as a readily available, effective strategy that can overcome the challenges of rural home care settings. A comparative analysis will link Duchscher's (2008) transition shock theory to mentorship as an effective strategy for supporting NGNs' transition in home care nursing. Recommendations offer rural care leaders practical strategies bundled with mentorship to optimize the successful transition and retention of newly graduated nurses in their workplaces.
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Affiliation(s)
- Laurie Generous
- Laurie Generous MN, BScN, RN, is a Clinical Nurse Specialist, Island Health, Victoria, British Columbia
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Cockerell KL, Sawyer BR, Webb PJ, Roney JK. Teaching a standardized communication method to facilitate transition to practice. Nurs Manag (Harrow) 2024; 55:48-54. [PMID: 38170889 DOI: 10.1097/nmg.0000000000000082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
- Kimber L Cockerell
- In Lubbock, Tex., Kimber L. Cockerell and Brandi R. Sawyer are assistant professors and Paula J. Webb is an associate professor at Texas Tech University Health Sciences Center School of Nursing, and Jamie K. Roney is the Texas regional research coordinator at Covenant Health
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Li G, Wu Y, Asghar A, Zhong Y. New nurses' turnover intention and clinical belonging, based on latent class analysis (LCA). Nurs Open 2024; 11:e2077. [PMID: 38268244 PMCID: PMC10747407 DOI: 10.1002/nop2.2077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 06/09/2023] [Accepted: 11/30/2023] [Indexed: 01/26/2024] Open
Abstract
AIM To identify potential categories of clinical belonging among new nurses and explore the relationship between different categories and turnover intention. DESIGN A cross sectional study. METHOD A cross sectional study was conducted among 348 new nurses from tertiary hospitals in Hainan and Guangdong provinces. A general data questionnaire, clinical belonging scale and turnover intention scale were used for examination. Further, the potential categories were used to analyse the categories of clinical belonging, and latent class analysis was utilized to analyse the relationship between different categories of clinical belonging and turnover intention. RESULTS The clinical sense of belonging of new nurses were divided into three groups namely C1, C2 and C3. The C1: poor clinical sense of belonging (8.7%), C2: moderate clinical sense of belonging (57.9%) and C3: rich clinical sense of belonging (33.4%). The risk of the turnover intention of new nurses with 'poor clinical sense of belonging' was 0.62 times that of new nurses with 'rich clinical sense of belonging' (OR = 0.62, p < 0.01), which was 0.24 times that of 'moderate clinical sense of belonging' (OR = 0.24, p < 0.01), the risk of the turnover intention of new nurses with 'moderate clinical sense of belonging' was 0.13 times that of new nurses with 'rich clinical sense of belonging'(OR = 0. 13, p < 0.01). CONCLUSIONS The results of our study revealed that in order to enhance the new nurses' sense of belonging, support was most crucial when they were first encountering difficulties. To reduce turnover intention, more structured learning opportunities are also required to maximize learning for newly graduated nurses with various nursing degrees. PATIENT OR PUBLIC CONTRIBUTION There are no patient or public contributions in this study.
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Affiliation(s)
- Guomin Li
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian)ShenzhenChina
| | - Yue‐Ting Wu
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian)ShenzhenChina
- The Fourth Affiliated Hospital of Dali UniversityChuxiongYunnanChina
| | - Ali Asghar
- School of Food and DrugShenzhen Polytechnic UniversityShenzhenChina
| | - Yinqin Zhong
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian)ShenzhenChina
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Yao L, Chen J, Zhao Q, Bai D, Li Y, Xiao M, Du Y, Liu L. Level and influencing factors of transition shock among new nurses in China: A multicenter cross-sectional study. Health Sci Rep 2023; 6:e1758. [PMID: 38111741 PMCID: PMC10726909 DOI: 10.1002/hsr2.1758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/31/2023] [Accepted: 11/26/2023] [Indexed: 12/20/2023] Open
Abstract
Background and Aims New nurses are an important part of nursing teams. The failure of new nurses to successfully transition seriously affects personal career development and nursing work quality, and important influencing factors deserve the attention of nursing managers. At present, multicenter, large-sample investigations of transition shock among new nurses are lacking in China. This study aims to investigate the current level and influencing factors of transition shock among new nurses in China. Methods We conducted a multicenter, cross-sectional study with 3414 new nurses from 16 provinces in 7 regions in China from October 22, 2021, to November 8, 2021. We used the snowball sampling method and an online questionnaire produced by the researchers to collect data; the questionnaire included questions on demographic information, a transition shock scale for new nurses and open-ended questions. Data were analyzed using SPSS version 24. Results The effective response rate of this study was 97.89%, with 3342 effective participants from 189 hospitals in China, most of whom were female (94.88%). The study showed that the transition shock of new nurses in China was at a moderate level, with pre-job anxiety, unsatisfactory welfare treatment, resignation intention, adverse events, poor sleep quality, 1 or fewer exercise sessions per week, inability to balance work and life, and gluttony negatively affecting the transition shock of new nurses in China. Psychological shock was the strongest among the four dimensions of transition shock. Conclusions The transition shock of new nurses, especially their psychological shock, deserves more attention from international society. Nursing managers should continue to take supportive measures to intervene in the factors influencing transition shock, with the aim of reducing the level of transition for new nurses, promoting their personal thriving, improving the quality of nursing work and increasing the retention rate of nurses.
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Affiliation(s)
- Lili Yao
- Department of Rehabilitation MedicineThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Jie Chen
- Department of orthopaedicsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Qinghua Zhao
- Department of NursingThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Dingqun Bai
- Department of Rehabilitation MedicineThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yuerong Li
- Department of AnesthesiologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Mingzhao Xiao
- Department of UrologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yanhui Du
- Department of Rehabilitation MedicineThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Ling Liu
- Department of Rehabilitation MedicineThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- Department of NursingThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
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Savitsky B, Shvartsur R, Findling Y, Ereli A, Hendel T. Components of professional satisfaction among novice nurses. Isr J Health Policy Res 2023; 12:35. [PMID: 37990260 PMCID: PMC10664554 DOI: 10.1186/s13584-023-00584-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND In Israel there are only 6.53 nurses per 1000 citizens, compared to 8.8 nurses per 1000 citizens in the OECD countries. The nursing shortage is even more severe in peripheral areas, especially in southern Israel. Nurses` professional satisfaction is crucial for preserving the nursing workforce. This study aimed to assess job satisfaction among novice nurses and identify components of professional satisfaction. METHODS Cross-sectional study of 216 novice nurses who graduated in 2018-2022 and were approached ten months after graduation. Job satisfaction components were constructed using factor analysis. RESULTS Professional satisfaction was based mainly on the intrinsic characteristics of the occupation related to personal accomplishment and organizational culture. In a multivariable model, a one-point increase in mean satisfaction with the training period during studies in the nursing department was associated with a more than a three-fold elevation in the odds for high and very high professional satisfaction (OR 3.0, 95% CI 1.7-5.1). Odds for high and very high professional satisfaction were more than four-fold and two-fold higher among graduates who rated their level of control over work schedule as high and medium vs. low (OR 4.2, 95% CI 1.0-16.7 and OR 2.8, 95% CI 1.2-6.3, respectively). Work-life balance without disturbance to daily life by work was found significantly associated with higher odds for high and very high satisfaction. Nurses who plan to continue professional development, i.e., an advanced professional course or Master's degree, had significantly higher mean professional satisfaction scales than others (4.2 vs. 3.7, p = .009 and 4.2 vs. 3.9, p < .001, respectively). CONCLUSION The most important components of professional satisfaction among novice nurses are self-accomplishment, which was built from work-related challenges, interest and variety of tasks, personal growth and development, and the possibility of contributing to patients` care and organizational culture, which was built from relationships with co-workers. Persons who manage nurses should cultivate an atmosphere of support and guidance, provide new nurses with interesting work tasks, and increase their ability to control their work schedule. Young nurses should be encouraged to continue their professional and academic education.
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Affiliation(s)
- Bella Savitsky
- Department of Nursing, School of Health Sciences, Ashkelon Academic College, Yitzhak Ben Tzvi 12, 78211, Ashkelon, Israel.
| | - Rachel Shvartsur
- Department of Nursing, School of Health Sciences, Ashkelon Academic College, Yitzhak Ben Tzvi 12, 78211, Ashkelon, Israel
| | - Yifat Findling
- Department of Nursing, School of Health Sciences, Ashkelon Academic College, Yitzhak Ben Tzvi 12, 78211, Ashkelon, Israel
| | - Anat Ereli
- Department of Nursing, School of Health Sciences, Ashkelon Academic College, Yitzhak Ben Tzvi 12, 78211, Ashkelon, Israel
| | - Tova Hendel
- Department of Nursing, School of Health Sciences, Ashkelon Academic College, Yitzhak Ben Tzvi 12, 78211, Ashkelon, Israel
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Li Y, Chi K, Li W, Sun X, Li Y. Relationship between transition shock and humanistic practice ability among Chinese newly graduated nurses: Mediating effect of organizational socialization. Nurse Educ Pract 2023; 73:103842. [PMID: 37984161 DOI: 10.1016/j.nepr.2023.103842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Humanistic practice ability serves as an indispensable skills that newly graduated nurses strive to develop. Yet, there is a dearth of knowledge regarding the role of organizational socialization in mediating the association between transition shock and humanistic practice ability in Chinese newly graduated nurses. AIM To breakdown the association between humanistic practice ability and transition shock among Chinese newly graduated nurses, with a simultaneous concentration on the mediating effect of organizational socialization in the association. DESIGN Utilizing a descriptive cross-sectional study design, this research aimed to provide a comprehensive overview of the variables being examined. METHODS A web-based survey was completed by 417 newly graduated nurses from three general public hospitals in Shandong Province, eastern China from February to March 2023. Three questionnaires were administered: the Nurse Humanistic Practice Ability Scale (NHPAS), the Organizational Socialization Questionnaire(OSQ) and the Transition shock of Newly Graduated Nurses Scale (TSNGNS). The IBM SPSS 22.0, AMOS 22.0 and GraphPad Prism 9.0.0 was applied for figure preparation and statistical analyses. RESULTS Findings indicated a significant statistical association among organizational socialization, transition shock and humanities practicing ability. A significant negative correlation was uncovered between OrS and TrS (r=-0.468, p<0.001), significant and negative correlation (r = -0.412, p < 0.001) was unmasked between the TrS and the HPA,whereas a significant positive correlation was observed between OrS and HPA (r=0.641, p<0.001). Moreover, in the mediation models, organizational socialization was identified as a partial mediating role in the association between transition shock and humanities practicing ability (indirect effect -0.324, p<0.001; direct effect -0.100, p =0.026; total effect -0.424, p =0.001). CONCLUSION/IMPLICATIONS FOR PRACTICE TrS has a significantly negative influence on HPA among newly graduated nurses, and OrS partially mediating the negative effect of TrS on HPA. Nursing managers and nursing educators can reduce the adverse consequences resulted from TrS through enhancing the benefits of organizational socialization programs and eventually improve the level of HPA of newly graduated nurses.
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Affiliation(s)
- Yufeng Li
- Department of Orthopaedics, Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital), Qingdao 266001, China
| | - Kun Chi
- Department of Nursing, Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital), Qingdao 266001, China
| | - Wenjiao Li
- Department of Nursing, Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital), Qingdao 266001, China
| | - Xiujie Sun
- Department of Nursing, Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital), Qingdao 266001, China.
| | - Yun Li
- Department of Orthopaedics, Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital), Qingdao 266001, China.
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14
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Ni J, Zhang J, Wang Y, Li D, Chen C. Relationship between career maturity, psychological separation, and occupational self-efficacy of postgraduates: moderating effect of registered residence type. BMC Psychol 2023; 11:246. [PMID: 37858276 PMCID: PMC10588217 DOI: 10.1186/s40359-023-01261-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/24/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND With the slowdown of economic growth and the increasing pressure of employment competition worldwide during the normalized epidemic prevention and control, the job-hunting intention and behavior of college graduates deserve in-depth study. This study explores the relationship between the career maturity, psychological separation and occupational self-efficacy of postgraduates, and provides a theoretical basis for improving their career maturity. METHODS A questionnaire survey was carried out on postgraduates with 584 valid data in China by using the Career Maturity Scale, Psychological Separation Scale and the Occupational Self-efficacy Scale. A structural equation model and bias-corrected self-sampling method were adopted to explore their relationship. The moderating effect of registered residence type was tested. RESULTS The results show that: (1) The higher the level of psychological separation of postgraduates, the higher their career maturity. (2) Occupational self-efficacy plays a mediating role in the process of psychological separation promoting career maturity. (3) The registered residence type moderates the latter half of the mediating process of psychological separation, occupational self-efficacy, and career maturity. Moreover, occupational self-efficacy plays a more significant role in promoting the career maturity of postgraduates with rural registered residence. CONCLUSIONS This study reveals the relationship between the career maturity, psychological separation and occupational self-efficacy of postgraduates. At the same time, it also verifies the mediating role of occupational self-efficacy and the moderating role of registered residence type. The result is helpful for postgraduates to understand the level of their career maturity and improve their career decision-making level and career development ability.
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Affiliation(s)
- Jianchao Ni
- Institute of Education & School of Aerospace Engineering, Xiamen University, Xiamen, 361005, Fujian, China
| | - Jiawen Zhang
- Silliman University, 6200, Dumaguete City, Negros Oriental, Philippines.
- Xiamen Institute of Software Technology, Xiamen, 361024, Fujian, China.
| | - Yumei Wang
- Institute of Education, Xiamen University, Xiamen, 361005, Fujian, China.
| | - Dongchen Li
- National Immigration Administration, Beijing, 100741, China
| | - Chunmei Chen
- Teachers College, Jimei University, Xiamen, Fujian, 361021, China
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Manik MJ, Callaway P. The implementation of Tanner's Clinical Judgment Model and the Indonesian version of the Lasater Clinical Judgment Rubric in the clinical setting. Appl Nurs Res 2023; 73:151725. [PMID: 37722793 DOI: 10.1016/j.apnr.2023.151725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/20/2023] [Accepted: 08/01/2023] [Indexed: 09/20/2023]
Abstract
A critical component for nurses to provide safe and quality care with strong patient outcomes is clinical judgment. This study aimed to identify the difference in the clinical judgment score in newly graduated nurses by implementing Tanner's Clinical Judgment Model. This study followed an experimental design with a pretest-posttest and involved thirty-two newly graduated nurses from three private hospitals in Indonesia. The intervention group had a scheduled post-conference with their preceptors using Tanner's Clinical Judgment Model's guidelines with high-level, open-ended questions for two consecutive weeks. Independent samples t-test was used to compare pre-and post-test scores utilizing the valid and reliable Indonesia version of the Lasater Clinical Judgment Rubric. There was no significant difference between the pre-test results of the intervention and control groups, with a significance value of 0.647. The results indicated a significant difference in the mean clinical judgment scores between the intervention and control groups after two weeks of intervention, where the intervention group's scores were higher than the control group's with a significance value of <0.001 with a mean difference of 6.75 and CI of 95 % (4.18-9.31). Tanner's Clinical Judgment Model showed a significant impact in increasing clinical judgment scores. The Indonesia version of the Lasater Clinical Judgment Rubric is a valuable tool for assessing and evaluating the development of clinical judgment and provides detailed targeted areas needing improvement. Preceptors and nursing leaders in the clinical setting should continue to use this model and tools to assist newly graduated nurses in developing clinical judgment skills during their transition period.
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Affiliation(s)
| | - Penny Callaway
- Division of Doctoral Nursing, Indiana Wesleyan University, Marion, Indiana, United States of America
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16
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Chargualaf KA, Bourgault A, Torkildson C, Graham-Clark C, Nunez S, Barile LT, DelaCruz F'L, Reeher D, Eversole T, Edwards G, Nichols M. Retaining new graduate nurses: Lessons learned from the COVID-19 pandemic. Nurs Manag (Harrow) 2023; 54:26-34. [PMID: 37647557 DOI: 10.1097/nmg.0000000000000049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- Katie A Chargualaf
- Katie A. Chargualaf is an associate professor at the University of South Carolina Aiken in Aiken, S.C.; Anna Bourgault is an assistant professor of nursing at the University of Connecticut in Storrs, Conn.; Christy Torkildson is the director of the MSN-Public Health Nursing program at Grand Canyon University in Phoenix, Ariz.; Cheri Graham-Clark is a director of quality in San Diego, Calif.; Susan Nunez is an adjunct faculty member at Azusa Pacific University in Azusa, Calif; Lisa T. Barile is a clinical nurse specialist, clinical educator, and health coach in Los Angeles, Calif.; Flordelis 'Lisa' DelaCruz is an NP at Community Health Centers of America in Salida, Calif.; Dana Reeher is an urgent care NP and an adjunct professor at Carlow University in Pittsburgh, Pa.; Tammy Eversole is an adjunct nursing instructor at Pima Medical Institute in Tucson, Ariz.; Grace Edwards is a nursing instructor at Chamberlain University in Sacramento, Calif.; and Michelle Nichols is an associate professor at Medical University of South Carolina in Charleston, S.C
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17
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Salt E, Jackman K, O'Brien AV. Evaluation of Staffordshire, Stoke on Trent Allied Health Professionals preceptorship programmes: a mixed method UK study. BMC MEDICAL EDUCATION 2023; 23:591. [PMID: 37605120 PMCID: PMC10441690 DOI: 10.1186/s12909-023-04515-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 07/17/2023] [Indexed: 08/23/2023]
Abstract
AIM This study aimed to evaluate current preceptorship provision across AHP professions in the Staffordshire, Stoke on Trent (SSOT) region of England to improve consistency, share and optimise best practice. BACKGROUND Preceptorship, defined as a period of structured transition from newly qualified to an independent practitioner, is thought to improve recruitment and retention of staff and ultimately improve patient care. During the COVID pandemic, SSOT recognised the potential for graduates to lack confidence having had reduced clinical exposure as pre-registration students, and so a likely increased need to support newly qualified staff, and to evaluate existing AHP preceptorship provision. METHODS An explanatory sequential mixed methods design, utilising a cross sectional survey questionnaire and two subsequent focus groups, explored existing AHP preceptorship in SSOT in 2021. Following ethical approval respondents were recruited via professional networks who completed an online survey questionnaire. Two subsequent focus groups enabled an in-depth exploration of survey results. Descriptive statistics summarised survey data and thematic analysis was used to describe focus group findings. RESULTS SSOT AHPs (n = 217; 26% preceptees; 47% preceptors) participated in the survey questionnaire and 17 AHPs in the focus groups. 57% of preceptees rated existing preceptorship programmes to be "somewhat, or not effective". Preceptors reported feeling unprepared for their role. Both preceptees and preceptors reported that, post pandemic, most existing programs required revisions to be fit for purpose. Ten pragmatic summary recommendations were made. CONCLUSIONS Allied Health Professions Preceptorship in SSOT was found to be inconsistent, poorly understood and inadequate. Revisions to preceptorship programs across Staffordshire and Stoke on Trent NHS Trusts have been instigated to reflect changes in AHP practice since the COVID pandemic.
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Affiliation(s)
- E Salt
- University Hospitals of Derby and Burton NHS Foundation Trust, Burton-On-Trent, UK.
- School of Allied Health Professions, Keele University, Newcastle, UK.
- Staffordshire and Stoke On Trent (SSOT) Allied Health Professionals (AHP), Staffordshire, UK.
| | - K Jackman
- Staffordshire and Stoke On Trent (SSOT) Allied Health Professionals (AHP), Staffordshire, UK
- Midlands Partnership Foundation Trust, Staffordshire, UK
| | - A V O'Brien
- School of Allied Health Professions, Keele University, Newcastle, UK
- Staffordshire and Stoke On Trent (SSOT) Allied Health Professionals (AHP), Staffordshire, UK
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18
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Koskinen S, Brugnolli A, Fuster-Linares P, Hourican S, Istomina N, Leino-Kilpi H, Löyttyniemi E, Nemcová J, Meyer G, De Oliveira CS, Palese A, Rua M, Salminen L, Sveinsdóttir H, Visiers-Jiménez L, Zeleníková R, Kajander-Unkuri S. A successful nursing education promotes newly graduated nurses' job satisfaction one year after graduation: a cross-sectional multi-country study. BMC Nurs 2023; 22:269. [PMID: 37580681 PMCID: PMC10424405 DOI: 10.1186/s12912-023-01438-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/08/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Job satisfaction is a key factor for the successful transition of newly graduated nurses (NGNs) and for retaining NGNs in their workplaces. However, there is limited evidence of the relationship between satisfaction regarding the nursing education program and NGNs' job satisfaction in the first year after graduation. Therefore, this study aims to examine the association of the nursing education related factors and NGNs' job satisfaction. METHODS A cross-sectional study design with the utilization of data collected from the same respondents one year earlier as educational factors was applied. The data were collected from NGNs (n = 557) in 10 European countries using an electronic survey between February 2019 and September 2020, and analyzed in detail for four countries (n = 417). Job satisfaction was measured with three questions: satisfaction with current job, quality of care in the workplace, and nursing profession. Nursing education related factors were satisfaction with nursing education program, level of study achievements, nursing as the 1st study choice, intention to stay in nursing, and generic nursing competence. The data were analyzed statistically using logistic regression. RESULTS Most of the NGNs in the 10 countries were satisfied with their current job (88.3%), the quality of care (86.4%) and nursing profession (83.8%). Finnish, German, Lithuanian and Spanish NGNs' satisfaction with the nursing education program at graduation was statistically significantly associated with their job satisfaction, i.e., satisfaction with their current job, the quality of care, and the nursing profession. Moreover, NGNs who had fairly often or very often intention to stay in nursing at graduation were more satisfied with their current job, with the quality of care, and with the nursing profession compared with NGNs who had never or fairly seldom intention to stay in nursing at graduation. CONCLUSIONS Nursing education plays a significant role in NGNs' job satisfaction one year after graduation, indicating the importance to start career planning already during nursing education. Both nursing education providers and healthcare organizations could plan in close collaboration a transition program for NGNs to ease the transition phase and thus increase the NGNs' job satisfaction and ultimately the high-quality care of the patients.
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Affiliation(s)
- Sanna Koskinen
- Department of Nursing Science, University of Turku, 20014 Turku, Finland
| | - Anna Brugnolli
- Azienda Per I Servizi Sanitari Provinciali, University of Verona, 38123 Trento, Italy
| | - Pilar Fuster-Linares
- Department of Nursing, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - Susan Hourican
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin 9, Ireland
| | - Natalja Istomina
- Institute of Health Sciences, Vilnius University, 01513 Vilnius, Lithuania
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, 20014 Turku, Finland
- Turku University Hospital, 20521 Turku, Finland
| | - Eliisa Löyttyniemi
- Turku University Hospital, 20521 Turku, Finland
- Department of Biostatistics, University of Turku, 20014 Turku, Finland
| | - Jana Nemcová
- Department of Nursing Science, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Gabriele Meyer
- Institute of Health and Nursing Science, Martin Luther University Halle-Wittenberg, 06108 Halle (Saale), Germany
| | - Célia Simão De Oliveira
- Department of Fundamentals of Nursing, Lisbon School of Nursing—ESEL (Escola Superior de Enfermagem de Lisboa), 1600-096 Lisbon, Portugal
| | - Alvisa Palese
- Department of Medicine, Udine University, 33100 Udine, Italy
| | - Marília Rua
- School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Leena Salminen
- Department of Nursing Science, University of Turku, 20014 Turku, Finland
- Turku University Hospital, 20521 Turku, Finland
| | | | - Laura Visiers-Jiménez
- Department of Health Sciences, School of Nursing and Physiotherapy, Universidad Pontificia de Comillas, San Juan de Dios, Fundación San Juan de Dios, Alberto Aguilera, 23, 28015 Madrid, Spain
| | - Renáta Zeleníková
- Department of Nursing and Midwifery, University of Ostrava, 70103 Ostrava, Czech Republic
| | - Satu Kajander-Unkuri
- Department of Nursing Science, University of Turku, 20014 Turku, Finland
- Diaconia University of Applied Sciences, 00580 Helsinki, Finland
| | - on behalf of the ProCompNurse Consortium and the COMPEUnurse Consortium
- Department of Nursing Science, University of Turku, 20014 Turku, Finland
- Azienda Per I Servizi Sanitari Provinciali, University of Verona, 38123 Trento, Italy
- Department of Nursing, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin 9, Ireland
- Institute of Health Sciences, Vilnius University, 01513 Vilnius, Lithuania
- Turku University Hospital, 20521 Turku, Finland
- Department of Biostatistics, University of Turku, 20014 Turku, Finland
- Department of Nursing Science, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
- Institute of Health and Nursing Science, Martin Luther University Halle-Wittenberg, 06108 Halle (Saale), Germany
- Department of Fundamentals of Nursing, Lisbon School of Nursing—ESEL (Escola Superior de Enfermagem de Lisboa), 1600-096 Lisbon, Portugal
- Department of Medicine, Udine University, 33100 Udine, Italy
- School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
- Faculty of Nursing, University of Iceland, 07 Reykjavík, Iceland
- Department of Health Sciences, School of Nursing and Physiotherapy, Universidad Pontificia de Comillas, San Juan de Dios, Fundación San Juan de Dios, Alberto Aguilera, 23, 28015 Madrid, Spain
- Department of Nursing and Midwifery, University of Ostrava, 70103 Ostrava, Czech Republic
- Diaconia University of Applied Sciences, 00580 Helsinki, Finland
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Gregg M, Wakisaka T, Hayashi C. Senior nurses' expectations and support of new graduate nurses' adjustment in hospitals: A qualitative descriptive study. Heliyon 2023; 9:e18681. [PMID: 37576313 PMCID: PMC10412768 DOI: 10.1016/j.heliyon.2023.e18681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 06/26/2023] [Accepted: 07/25/2023] [Indexed: 08/15/2023] Open
Abstract
Aim This study aimed to identify senior nurses' expectations and support of new graduate nurses' adjustment to their work environment. Background New graduate nurses have difficulties in adjusting to their work environment because they are not well prepared for clinical nursing practice upon graduation. Hospitals support their adjustment to their work environment through residency/transition programs. Although such support exists, new graduate nurses are expected to learn the expected behavior and attitude themselves. Thus, identifying senior nurses' expectations and support of new graduate nurses' adjustment may facilitate smooth adjustment to the work environment. Design This was a qualitative descriptive study. Methods Fourteen nurses who teach new graduate nurses in Japanese hospitals were interviewed face-to-face individually. The data were analyzed using qualitative inductive content analysis, which was coded and sorted to identify categories. Results Regarding senior nurses' expectations of new graduate nurses' adjustment, six categories emerged: trying to fit in with people in their ward, behaving by following the unspoken rules of their ward, having attitudes compatible with learning, addressing their situations using their initiative, showing a willingness to learn, and obtaining necessary information by themselves. Senior nurses' support of new graduate nurses' adjustment consisted of four categories: watching over and speaking to them, trying to create a good working environment, encouraging them to have attitudes compatible with learning, and teaching them how to learn. Conclusions Senior nurses need to understand and express what they expect from new graduate nurses at the stage of hospital adjustment. If senior nurses understand their expectations for adjustment, they can help new graduate nurses effectively. Furthermore, understanding the expectations of senior nurses may facilitate new graduate nurses' adjustment. These findings may contribute to good working relationships between senior and new graduate nurses.
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Affiliation(s)
- Misuzu Gregg
- Kobe City College of Nursing, 3-4 Gakuen Nishi-machi, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2103, Japan
| | - Toyomi Wakisaka
- Konan Women's University, 6-2-23 Morikita-machi, Higashinada-ku, Kobe-shi, Hyogo-ken, 658-0001, Japan
| | - Chifuyu Hayashi
- Kobe City College of Nursing, 3-4 Gakuen Nishi-machi, Nishi-ku, Kobe-shi, Hyogo-ken, 651-2103, Japan
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Randall PS, De Gagne JC, Lee E, Slack J, Lee Y, Ledbetter L. The experience of resilience in newly graduated nurses: A qualitative metasynthesis. Nurse Educ Pract 2023; 70:103681. [PMID: 37331028 DOI: 10.1016/j.nepr.2023.103681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023]
Abstract
AIM The aim of the present study was to understand the experiences and perceptions of newly graduated nurses in relation to resilience by providing an interpretive synthesis of the existing qualitative literature on this topic. BACKGROUND Resilience in newly graduated nurses has been associated with increased satisfaction and decreased turnover. As the experience of resilience is unique to each individual, qualitative studies are well suited to explore this concept, yet the existing data is heterogenous. DESIGN A qualitative metasynthesis was conducted using a meta-ethnographic approach. METHODS The search was performed using PubMed, CINAHL, Embase, PsycINFO, ProQuest Dissertations and Theses Global for the English literature and NDSL, KCI, RISS, KISS and DBpia for the Korean literature. The JBI Critical Appraisal Checklist for Qualitative Research was used to assess the quality of studies. An a priori protocol was created and registered on the Open Science Framework (Randall & De Gagne, 2022). RESULTS The final review included seven articles published between 2008 and 2021. Three main themes were identified: (1) internal experience of resilience; (2) external sources of resilience; and (3) building resilience over time. Subthemes were also identified. CONCLUSIONS This study indicates that resilience can be developed over time during the period of transition from student nurse to professional nurse and is impacted by personal and organizational influences. The promotion of resilience presents considerations and opportunities for health care leaders and administrators.
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Affiliation(s)
- Paige S Randall
- Duke University School of Nursing, Durham, NC, United States.
| | | | - Eunhee Lee
- Hallym University School of Nursing/Research Institute of Nursing Science, Chuncheon, Gangwon-do, the Republic of Korea
| | - Julia Slack
- Duke University School of Nursing, Durham, NC, United States
| | - Youran Lee
- Duke University School of Nursing, Durham, NC, United States
| | - Leila Ledbetter
- Research & Education Librarian at Duke University Medical Center Library & Archives, Durham, NC, United States
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21
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Öcalan S, Kovanci MS, Uslu-Sahan F, Ozdemir L. First death experiences of newly graduated nurses: A qualitative phenomenological study. DEATH STUDIES 2023; 48:303-311. [PMID: 37296532 DOI: 10.1080/07481187.2023.2219648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Newly graduated nurses typically face death for the first time during the transition to their professional careers. This encounter can cause nurses to experience compelling emotions and make it difficult for them to manage and cope with the process of adaptation to the profession and the death process of the patient. This study aims to retrospectively examine and reveal the first death experiences of newly graduated nurses (N = 15) using a retrospective phenomenological method. Analysis of the responses of the newly graduated nurses revealed three themes: first encounter with death, nothing is like before, and support need. Newly graduated nurses realized that their first death experiences change their perspectives on life and profession and that nursing touches human life.
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Affiliation(s)
- Sinem Öcalan
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey
| | - Mustafa Sabri Kovanci
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey
| | - Fatma Uslu-Sahan
- Faculty of Nursing, Department of Obstetrics and Gynecologic Nursing, Hacettepe University, Ankara, Turkey
| | - Leyla Ozdemir
- Faculty of Nursing, Medical Nursing Department, Hacettepe University, Ankara, Turkey
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22
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Su Q, Wu Y, Yun B, Zhang H, She D, Han L. The mediating effect of clinical teaching behavior on transition shock and career identity among new nurses: A cross-sectional study. NURSE EDUCATION TODAY 2023; 125:105780. [PMID: 36963229 DOI: 10.1016/j.nedt.2023.105780] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 02/13/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND New nurse attrition is a worldwide problem. Because of the gap between theory and practice in their work, new nurses may experience transition shock, which can have a negative impact on their career identity. Clinical teaching behavior is an important component in reducing the impact of new nurse transition, stabilizing the hospital nursing workforce, and cultivating high-quality nursing talents. OBJECTIVES Based on the New Nurse Transition Model, to explore the mediating role of clinical teaching behavior in the relationship between transition shock and career identity in the new nurse population of Gansu Province. DESIGN A cross-sectional study. SETTING Seventeen hospitals in Gansu province of China. PARTICIPANTS A total of 1684 new nurses (1590 female and 94 male) were recruited from seventeen hospitals in Gansu province. METHODS Three questionnaires include: The Clinical Teaching Behavior Inventory (CTBI-23), the Transition shock of Newly Graduated Nurses Scale (TSNGNS), and the Nurse's Career Identity Scale (NCIS). Structural equation modeling was used to deal with the relationships among clinical teaching behavior, transition shock, and career identity. RESULTS Transition shock was found to be negatively related to both career identity and clinical teaching behavior, with clinical teaching behavior mediates the relationship between transition shock and career identity. CONCLUSIONS The clinical teaching behavior of the teaching staff plays a role in mediating the relationship between new nurses' sense of career identity and transition shock. Accordingly, the teaching behavior of clinical teaching should be improved and the quality of clinical teaching behavior should be improved to increase the career identity of new nurses and reduce the turnover rate of new nurses.
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Affiliation(s)
- Qian Su
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China; Nursing Department, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China; School of Nursing, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Yuhan Wu
- School of Nursing, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Bei Yun
- School of Nursing, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Hongyan Zhang
- Nursing Department, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
| | - Dongli She
- Nursing Department, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
| | - Lin Han
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China; Nursing Department, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China; School of Nursing, Lanzhou University, Lanzhou 730000, Gansu Province, China.
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23
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See ECW, Koh SSL, Baladram S, Shorey S. Role transition of newly graduated nurses from nursing students to registered nurses: A qualitative systematic review. NURSE EDUCATION TODAY 2023; 121:105702. [PMID: 36577288 DOI: 10.1016/j.nedt.2022.105702] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The transition experience of newly graduated registered nurses is highly stressful and associated with high attrition rates. OBJECTIVES AND DESIGN This qualitative systematic review aims to consolidate the available evidence on the experiences of newly graduated registered nurses' role transition from nursing students to registered nurses. DATA SOURCES English language research published between 2010 and 2022 was searched using PubMed, CINAHL, Scopus, Embase, PsycInfo and ProQuest Dissertations and Thesis databases. REVIEW METHODS Data were extracted using a data extraction form and appraised using the Critical Appraisal Skills Programme (CASP) tool for published studies or the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist for unpublished studies or grey literature, respectively. RESULTS The review included 25 studies and the meta-synthesis identified four themes: (a) Knowledge deficit, (b) Overwhelming clinical practise, (c) Importance of workplace support, and (d) Meaning of "being a nurse". CONCLUSIONS Newly graduated registered nurses experienced facing knowledge deficits in the clinical setting and felt overwhelmed with work, especially for newly graduated registered nurses during the Covid-19 pandemic. Support from colleagues was invaluable, and they wished for better support through standardised transition programs. Despite nursing being mentally and physically exhausting, many newly graduated registered nurses regarded their profession satisfying and meaningful, however some eventually resigned. Understanding the transition experiences of newly graduated registered nurses can provide valuable insights on how to facilitate their transition and in turn decrease attrition rates, and ensure safe care for the patients and that public healthcare needs are met.
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Affiliation(s)
- Esther Cai Wah See
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
| | - Serena Siew Lin Koh
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
| | - Sara Baladram
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
| | - Shefaly Shorey
- Alice Lee Centre of Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
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Ren L, Kim H. Serial multiple mediation of psychological empowerment and job burnout in the relationship between workplace bullying and turnover intention among Chinese novice nurses. Nurs Open 2023; 10:3687-3695. [PMID: 36683355 PMCID: PMC10170934 DOI: 10.1002/nop2.1621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/02/2022] [Accepted: 01/13/2023] [Indexed: 01/24/2023] Open
Abstract
AIM This study aimed to examine the direct and indirect effects of workplace bullying on turnover intention using the serial multiple mediators of psychological empowerment and job burnout. DESIGN A cross-sectional study was conducted. METHODS A convenience sample of 506 novice nurses from five Triple A hospitals in China's S province from November 2020 to February 2021 and were evaluated using online questionnaires on workplace bullying, psychological empowerment, job burnout, and turnover intention. RESULTS The prevalence of turnover intention was 51.9%. In the serial multiple mediator model, workplace bullying had a direct effect (c = 0.452, p < 0.001) and indirect effect (c' = 0.229, p < 0.001) on turnover intention through the serial multiple mediators of psychological empowerment (B = -0.093, p = 0.020) and job burnout (B = 0.127, p < 0.001); hence, the proposed model explained the total variance of 32.2% in turnover intention. PATIENT OR PUBLIC CONTRIBUTION Nursing managers should use effective measures for strengthening the psychological empowerment to minimize novice nurse burnout and turnover intention resulting from workplace bullying.
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Affiliation(s)
- Liping Ren
- College of Nursing, Weifang Medical University, Weifang, China.,College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Hyunli Kim
- College of Nursing, Chungnam National University, Daejeon, South Korea
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Wray J, Calzolari M, Gammone M, Aleo G, Catania G, Zanini M, Sasso L, Bagnasco A. The potential benefits of legacy mentoring for newly qualified nurses. Nurse Educ Pract 2023; 66:103511. [PMID: 36434921 DOI: 10.1016/j.nepr.2022.103511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jane Wray
- Faculty of Health Sciences, University of Hull, Hull HU6 7RX, UK.
| | - Michela Calzolari
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
| | - Mariarosaria Gammone
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy; S.I.T.R.A, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via G. Celoria, 11, 20133 Milan, Italy.
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy; Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
| | - Annamaria Bagnasco
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
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Hoffmann M, Schwarz CM, Schwappach D, Banfi C, Palli C, Sendlhofer G. Speaking up about patient safety concerns: view of nursing students. BMC Health Serv Res 2022; 22:1547. [PMID: 36536431 PMCID: PMC9761031 DOI: 10.1186/s12913-022-08935-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND "Speaking up" is considered an important patient safety behaviour. The main idea is to voice patient safety concerns; however, several studies revealed that the organisational culture can be obstructive. In previous studies, we already identified barriers for doctors, nurses and medical students. In the current study, we explore how nursing students use "speaking up" during their internship in an academic teaching hospital. METHODS Between 2019 and 2020, 212 nursing students were invited to take part in the survey. The validated Speaking Up about Patient Safety Questionnaire (SUPS-Q) was used to assess speaking up behaviours in nursing students. The SUPS-Q consisted of three behaviour related scales (11 items), three culture related scales (11 items), a question regarding barriers to speak up as well as a clinical vignette assessing a hypothetical speaking up situation. RESULTS In total, 118 nursing students took part in the survey (response rate: 56%). Most of them noticed specific safety concerns, observed errors or rule violations. The vignette was seen as very realistic and harmful to the patient. However, the majority responded that they did not speak up and remained silent. They reported a rather discouraging environment and high levels of resignation towards speaking up. However, more advanced students were less likely to speak up than less advanced students (p = 0.027). Most relevant barriers were fear of negative reaction (64%), reaction not predictable (62%) and ineffectiveness (42%). CONCLUSIONS Survey results of nursing students imply that speaking-up behaviours and remaining silent are common behaviours and coexist in the same individual. The clinical vignette and barriers to speaking up revealed that a hierarchical system does not support speaking-up behaviours. Organizational development is needed to foster professional teamwork, support attentive listening, encourage critical thinking, and problem-solving skills.
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Affiliation(s)
- Magdalena Hoffmann
- grid.411580.90000 0000 9937 5566Executive Department for Quality and Risk Management, University Hospital Graz, Auenbruggerplatz 1, 8036 Graz, Austria ,grid.11598.340000 0000 8988 2476Research Unit for Safety and Sustainability in Healthcare, c/o Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 2, 8036 Graz, Austria ,grid.11598.340000 0000 8988 2476Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Christine Maria Schwarz
- grid.411580.90000 0000 9937 5566Executive Department for Quality and Risk Management, University Hospital Graz, Auenbruggerplatz 1, 8036 Graz, Austria ,grid.11598.340000 0000 8988 2476Research Unit for Safety and Sustainability in Healthcare, c/o Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 2, 8036 Graz, Austria
| | - David Schwappach
- grid.5734.50000 0001 0726 5157Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Chiara Banfi
- grid.11598.340000 0000 8988 2476Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Auenbruggerplatz 2, 8036 Graz, Austria
| | - Christoph Palli
- grid.452085.e0000 0004 0522 0045Institute of Health Care and Nursing, University of Applied Sciences FH Joanneum, Alte Poststrasse 149, 8020 Graz, Austria
| | - Gerald Sendlhofer
- grid.411580.90000 0000 9937 5566Executive Department for Quality and Risk Management, University Hospital Graz, Auenbruggerplatz 1, 8036 Graz, Austria ,grid.11598.340000 0000 8988 2476Research Unit for Safety and Sustainability in Healthcare, c/o Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 2, 8036 Graz, Austria
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Joseph B, Jacob S, Lam L, Rahman MA. Factors influencing the transition and retention of mental health nurses during the initial years of practice: Scoping review. J Nurs Manag 2022; 30:4274-4284. [PMID: 36336824 PMCID: PMC10100461 DOI: 10.1111/jonm.13882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/03/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022]
Abstract
AIM This review aims to identify the factors influencing the transition and retention of mental health nurses during the initial years of practice, recognize gaps in the literature and propose evidence-based strategies. BACKGROUND Mental health is a challenging specialty; recruitment, transition and retention of mental health nurses are known issues of concern. EVALUATION The present study undertakes a scoping review to identify factors influencing the transition and retention of mental health nurses during the initial years of practice and the gaps in that research domain. A literature search was conducted using electronic databases. To gain an understanding of the topic of interest, the review of the literature extended from 2000 to 2022. KEY ISSUES Existing evidence focuses on specific perspectives of transition. There is limited literature on factors influencing transition and retention among mental health nurses. Findings suggested that personal and professional factors could influence the transition and retention of mental health nurses during the initial years of practice. The main themes identified were personal attributes and professional factors with a number of subthemes. CONCLUSION The scoping review identified only a few studies, which showed personal and professional factors related to the transition and retention of mental health nurses at the early stages of their career. IMPLICATIONS FOR NURSING MANAGEMENT Potential benefits of effective transition and support with the understanding of factors influencing transition and retention of early career mental health nurses will enhance staff morale, sustainability of the workforce and better patient outcomes. Additionally, a few recommendations for nurse managers and leaders to improve transitional experiences and retention of early career nurses are highlighted.
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Affiliation(s)
- Bindu Joseph
- Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
| | - Sini Jacob
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Louisa Lam
- Graduate Studies, Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
| | - Muhammad Aziz Rahman
- Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
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Factors that influence continuing professional development over a nursing career: A scoping review. Nurse Educ Pract 2022; 65:103481. [DOI: 10.1016/j.nepr.2022.103481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022]
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Beauvais AM, Vittner D, Phillips KE, Burrows K, Corcoran K, Saracino KH, Kazer M. Ready, Set, Start: Mentoring Graduating Nursing Students During a Pandemic. Nurs Educ Perspect 2022; 43:E53-E55. [PMID: 36315885 DOI: 10.1097/01.nep.0000000000001040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Nurses are graduating from educational programs and entering health care systems at a time of great turmoil because of the COVID-19 pandemic. To support the transition to practice, nursing faculty implemented a postgraduation mentorship program (START). This exploratory study sought to describe the faculty mentor and new graduate mentee experience. Related variables (NCLEX pass rates, perceived stress, and professional quality of life) are provided to contextualize the results. The research is significant given the burden the pandemic places on the health care system, which may limit the resources available to new graduate nurses.
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Affiliation(s)
- Audrey Marie Beauvais
- About the Authors The authors are faculty at the Egan School of Nursing and Health Studies, Fairfield University, Fairfield, Connecticut. Audrey M. Beauvais, DNP, MSN, MBA, RN, is associate dean and associate professor. Dorothy Vittner, PhD, RN, CHPE, is assistant professor. Kathyrn E. Phillips, PhD, ANP-BC, is associate professor. Karen Burrows, DNP, MAHSM, RN, CHSE, C-EFM, is assistant professor of the practice. Karen Corcoran, DNP, APRN, PMHNP-BC, is assistant dean graduate studies and visiting professor. Katherine H. Saracino, MSN, RN, CWOCN, CHSE, is instructor of the practice. Meredith Kazer, PhD, APRN-BC, FAAN, is dean and professor. The authors are grateful to their colleagues on the mentoring team: Hilary Bartholomay, Susan Bartos, Cynthia Bautista, Laura Conklin, Christa Esposito, Sally Gerard, Danielle Hall, Eileen O'Shea, Gina Petersen, Rose Iannino-Renz, Linda Roney, and Pamela Barnwell-Sanders. For more information, contact Dr. Beauvais at
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Development and Psychometric Evaluation of a Japanese Version of Newly Graduated Nurses’ Difficulties with End-of-Life Care for Cancer Patients (NDEC Scale). NURSING REPORTS 2022; 12:637-647. [PMID: 36135982 PMCID: PMC9503130 DOI: 10.3390/nursrep12030063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/20/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: End-of-life care (EoL care) for cancer patients is stressful for nurses and can easily lead to burnout. Newly graduated nurses (NGNs) have a particularly difficult time, but no scale or inventory has been designed to evaluate their difficulties. This study developed and tested the reliability and validity of a scale to measure NGNs’ difficulties with EoL care for cancer patients (NDEC scale). (2) Methods: This study population consisted of 1000 NGNs and 1000 nurses with at least five years of clinical experience (GNs) that were working in hospitals in Japan. The initial scale consisted of six factors and 28 items. The reliability and validity of the scale were tested. (3) Results: A total of 171 NGNs and 194 GNs responded to the survey. The scale consisted of five factors and 25 items with the factors including “Feeling painful”, “Can’t deal with patients and their families”, “Don’t know the answer”, “Cannot afford”, and “Being afraid of death”. The criteria validity, known population validity, and internal consistency were confirmed. (4) Conclusions: The scale was validated to have a certain level of reliability and validity. The NDEC scale is expected to be used for self-care for NGNs and as an effectiveness indicator for educational programs.
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Tarhan M, Doğan P, Kürklü A. The relationship between nurse-nurse collaboration and work readiness among new graduate nurses. Nurs Forum 2022; 57:1104-1110. [PMID: 36036181 DOI: 10.1111/nuf.12795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022]
Abstract
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 (rs = 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.
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Affiliation(s)
- Merve Tarhan
- Deparmant of Nursing, Faculty of Health Science, Medipol University, Istanbul, Turkey
| | - Pınar Doğan
- Deparmant of Nursing, Faculty of Health Science, Medipol University, Istanbul, Turkey
| | - Ahu Kürklü
- Deparmant of Nursing, Faculty of Health Science, Bahcesehir University, Istanbul, Turkey
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Alsalamah Y, Fawaz M. Exploring facilitators and barriers for successful transition among new Saudi graduate nurses: A qualitative study. Nurs Open 2022; 10:278-286. [PMID: 35891593 PMCID: PMC9748113 DOI: 10.1002/nop2.1302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 01/04/2023] Open
Abstract
AIM This study aims at exploring Saudi newly graduated nurses' perspectives on the facilitators and barriers for successful transition from being a student to being a nurse. DESIGN A phenomenological qualitative methodology was employed. METHODS Focus group discussions were carried out among 35 Saudi nurses at one major university hospital in Saudi Arabia. RESULTS Under the theme of barriers to transition three main subthemes emerged, namely "Fear of making medical errors," "Intense Workload and Expectations," "Bullying and lack of support," while under the facilitators of transition the subthemes which emerged were "Supportive preceptor," "Training workshops," "Need for transition programs." This research found that formal and informal techniques for strengthening institutional variables and improving individual factors are critical for new graduate nurses' effective transition into professional responsibilities.
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Affiliation(s)
- Yasir Alsalamah
- Department of Nursing EducationQassim University Medical City, Qassim UniversityBuraydahSaudi Arabia,Department of NursingBuraydah Mental HospitalBuraydahAl‐QassimSaudi Arabia
| | - Mirna Fawaz
- Faculty of Health SciencesBeirut Arab UniversityBeirutLebanon
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Smith CJ, DesRoches SL, Street NW, Hyatt J. New graduate registered nurses: Risk mitigation strategies to ensure safety and successful transition to practice. J Healthc Risk Manag 2022; 42:24-30. [PMID: 35687512 DOI: 10.1002/jhrm.21514] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/24/2022] [Accepted: 05/02/2022] [Indexed: 11/07/2022]
Abstract
The COVID-19 pandemic has impacted traditional pathways for new graduate registered nurses (NGRN's) transition to practice. In response to stay at home emergency orders in 2020, NGRN's experienced changes in pre-licensure curriculum, clinical practicums, NCLEX testing, and licensure, all which influence preparedness for professional practice. The adverse impact on education and clinical training extends to all nursing students who attended higher education institutions of learning during 2020 to present and is a significant consideration with new graduates over the long-term, whom will be caring for patients in healthcare settings. Well before this pandemic, literature identified that NGRN's were predisposed to knowledge-practice gaps and lacked situational awareness. Recent nursing research emerging from the pandemic reveals a potentiating negative impact of the abbreviated pre-licensure experiences on patient safety in the clinical setting. In the current healthcare environment, it is preemptive for healthcare institutions and schools of nursing to work cohesively to ensure patient safety through an increased emphasis on evidence-based approaches to reduce patient harm and mitigate harm when it does occur. Further, in response to the increased demand for nurses by healthcare organizations, considerations for safety, risk management, and ethical care must be considered during the transition to practice for NGRN's.
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Affiliation(s)
- Carla Jean Smith
- School of Nursing, MCPHS University, Manchester, New Hampshire, USA
| | | | | | - Josh Hyatt
- Risk Management & Analytics Department, Coverys, Boston, Massachusetts, USA
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Graduating Nursing Students’ Empowerment and Related Factors: Comparative Study in Six European Countries. Healthcare (Basel) 2022; 10:healthcare10050754. [PMID: 35627891 PMCID: PMC9140337 DOI: 10.3390/healthcare10050754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 11/17/2022] Open
Abstract
New nurses are needed in healthcare. To meet the role expectations of a registered nurse, nursing students must feel empowered at graduation. However, there are only a few studies focusing on nursing students’ empowerment. This study aims to describe and analyze graduating nursing students’ level of empowerment in six European countries and potential related factors. A comparative and cross-sectional study was performed in the Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain with graduating nursing students (n = 1746) using the Essential Elements of Nurse Empowerment scale. Potentially related factors included age, gender, a previous degree in health care, work experience in health care, graduation to first-choice profession, intention to leave the nursing profession, level of study achievements, satisfaction with the current nursing programme, clinical practicums, theoretical education, and generic competence measured with the Nurse Competence Scale. The data were analysed statistically. Graduating nursing students’ self-assessed level of empowerment was moderate, with statistical differences between countries. Those with high empowerment had no intention to leave the nursing profession, had a higher level of study achievements, and a higher self-assessed generic competence level. The results suggest that empowerment needs to be enhanced during nursing education. Further research is needed to understand the development of empowerment during the early years of a nursing career.
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Yaghmaei S, Raiesdana N, Nobahar M. Novice nurses' experiences from teamwork in the emergency department: A qualitative content analysis. Int Emerg Nurs 2022; 61:101116. [PMID: 35074714 DOI: 10.1016/j.ienj.2021.101116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/10/2021] [Accepted: 11/23/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIM Teamwork is assumed crucial in nursing. Nevertheless, nursing shortages in medical centers have thus far compelled nurse managers to use novice nurses. The present study aimd to explaining the challenges and experiences of novice nurses regarding teamwork in emergency departments. MATERIALS AND METHODS Using qualitative content analysis, 11 novice nurses working at emergency department, participated in this study. Data were collected with semi structured interview and analyzed by Graneheim and Lundman. RESULTS The data analysis led to the emergence of four themes of "essential teamwork skills development", "contradictory relationships between team members", "unpleasant feelings and experiences", and, "personal growth and maturation during teamwork". CONCLUSION Fostering different personal aspects as prerequisites for teamwork, novice nurses will be able to deal with unpleasant feelings and experiences as well as contradictory relationships between team members in an effective manner. This challenging experience will thus give rise to personal growth and maturation during teamwork among them in emergency department.
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Affiliation(s)
- Safura Yaghmaei
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Nayyereh Raiesdana
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran; School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran.
| | - Monir Nobahar
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran; School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran; Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
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Tsai S, McClanahan R. Smoothing the Way Into School Nursing Practice. NASN Sch Nurse 2022; 37:199-205. [PMID: 35168440 DOI: 10.1177/1942602x221077236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Role transition can be a struggle for new or seasoned nurses moving into the specialty of school. School nursing, a specialized field that entails a scope of practice and competencies very different from other settings, is not taught in many primary nursing education programs. New nurses may find themselves unprepared for their role without a proper orientation, causing them to feel anxious and not ready to care for students properly, leading to attrition. This article describes the barriers and facilitators to smooth role transition and provides evidence-based orientation strategies for new school nurses.
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Affiliation(s)
- Stacey Tsai
- School Nurse, Long Beach Unified School District, Long Beach, CA
| | - Rachel McClanahan
- Associate Professor, California State University, Fullerton, Fullerton, CA
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Pålsson Y, Engström M, Swenne CL, Mårtensson G. A peer learning intervention in workplace introduction - managers' and new graduates' perspectives. BMC Nurs 2022; 21:12. [PMID: 34983518 PMCID: PMC8725265 DOI: 10.1186/s12912-021-00791-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Ylva Pålsson
- Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden. .,Department of Public Health and Caring Sciences, Uppsala University, Box 564, 751 22, Uppsala, Sweden.
| | - Maria Engström
- Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden
| | - Christine Leo Swenne
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, 751 22, Uppsala, Sweden
| | - Gunilla Mårtensson
- Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Box 564, 751 22, Uppsala, Sweden
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Chao LF, Guo SE, Xiao X, Luo YY, Wang J. A Profile of Novice and Senior Nurses' Communication Patterns during the Transition to Practice Period: An Application of the Roter Interaction Analysis System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10688. [PMID: 34682434 PMCID: PMC8535576 DOI: 10.3390/ijerph182010688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 12/03/2022]
Abstract
Novice nurses' successful transition to practice is impacted by their interactions with senior nurses. Ensuring that novice nurses are adequately supported during their transition to practice has wide-ranging and significant implications. The aim of this study is to explore the communication patterns between novice and senior nurses by applying an interaction analysis technique. Trimonthly onboarding evaluations between novice and senior nurses were recorded. The Roter Interaction Analysis System was adapted and deployed to identify communication patterns. In total, twenty-two interactions were analyzed. Senior nurses spoke more (64.5%). Task-focused exchange was predominant amongst senior (79.7%) and novice (59.5%) nurses. Senior nurses' talk was concentrated in clusters of information-giving (45%) and advice or instructions (17.2%), while emotional expression (1.4%) and social talk (0.4%) were rare. Novice nurses' talk was concentrated in clusters-information giving (57%) and positive talk (39.5%). The communication patterns between senior and novice nurses during the onboarding period indicate aspects of novice nurse transition that could be addressed, such as encouraging novice nurses to use these interactions to communicate more, or emphasizing the importance of social talk. These insights can be used to inform mentorship and preceptorship training to ensure that senior nurses are able to adequately support novice nurses through all parts of the transition to practice period.
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Affiliation(s)
- Li-Fen Chao
- Clinical Competency Center, Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan City 33303, Taiwan; (L.-F.C.); (X.X.)
- Department of Emergency Medicine, Chang Gung Memorial Hospital Linkou Branch, Taoyuan City 33305, Taiwan
| | - Su-Er Guo
- Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology, Chiayi County 613016, Taiwan;
- Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi County 613016, Taiwan
- Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi County 613016, Taiwan
- Department of Safety Health and Environmental Engineering, Ming Chi University of Technology, New Taipei 243303, Taiwan
| | - Xaviera Xiao
- Clinical Competency Center, Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan City 33303, Taiwan; (L.-F.C.); (X.X.)
| | - Yueh-Yun Luo
- Department of Nursing, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 600566, Taiwan
| | - Jeng Wang
- Clinical Competency Center, Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan City 33303, Taiwan; (L.-F.C.); (X.X.)
- Department of Nursing, Chang Gung Memorial Hospital, Linkuo Branch, Taoyuan City 33305, Taiwan
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Kennedy J, Astroth KM, Woith WM, Novotny NL, Jenkins SH. New nurse graduates and rapidly changing clinical situations: the role of expert critical care nurse mentors. Int J Nurs Educ Scholarsh 2021; 18:ijnes-2020-0131. [PMID: 34570967 DOI: 10.1515/ijnes-2020-0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 09/14/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES New nurse graduates may be prone to instances of failure to rescue. Mentoring programs may be an opportunity to assist them with clinical decision making in situations of patient decline. We explored the experiences of new nurse graduates and expert nurses after participation in a mentoring program. METHODS In this exploratory-descriptive study, five seasoned nurses were paired with five new nurse graduates. After four months, the new nurse graduates were interviewed, and the expert nurses participated in a focus group. RESULTS Themes emerged for the new nurse graduates: 1) importance of the charge nurse, 2) differences in practice areas, and 3) supportive healthcare teams. The focus group revealed three themes: 1) remembering what it was like, 2) desiring to help, and 3) having confidence in their preparation as mentors. CONCLUSIONS New nurse graduates relied on charge nurses for assistance. Therefore, it is imperative that charge nurses receive adequate support.
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Coventry TH, Russell KP. Clinical sympathy - A mixed method study of the relationship between the clinical nurse educator and the graduate nurse. Nurse Educ Pract 2021; 55:103150. [PMID: 34293705 DOI: 10.1016/j.nepr.2021.103150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
AIM/OBJECTIVE This paper sought to investigate the influence of the supernumerary clinical nurse educator role on the newly qualified graduate nurses' professional development and successful transition to competent and confident practitioners in the acute care hospital environment. BACKGROUND The novice nurses learning in the inpatient clinical environment is affected by increasing patient acuity, complex conditions and organisational expectations. The supernumerary clinical nurse educator is uniquely positioned to prioritise these nurses' education through protected and available time to support adaption in the workplace culture and retention in the organisation. DESIGN A convergent mixed methods design was used to investigate the relationship between the supernumerary clinical nurse educator role through the opinions and experiences of the graduate nurse. METHODS Data were collected in February - July 2015 from graduate nurses from three hospital sites in a healthcare organisation in Western Australia. The research used online questionnaires (n = 39) and face to face interviews (n = 10). Analysis of quantitative data used descriptive statistics and qualitative data used thematic analysis. RESULTS Four main themes were identified. These were: acknowledges new and challenging experiences, available to provide constructive responses, sympathises with anxiety and missing in action. CONCLUSION The graduate registered nurses perceived that clinical sympathy provided by the clinical nurse educator was essential to their new role of frontline nurses influencing their delivery of quality patient care and as a practical solution to champion the graduate nurses' longevity in the future nursing workforce.
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Affiliation(s)
- Tracey H Coventry
- School of Medicine, University of Notre Dame Australia, Henry Street, Fremantle 6160, Western Australia, Australia.
| | - Kylie P Russell
- School of Medicine, University of Notre Dame Australia, Henry Street, Fremantle 6160, Western Australia, Australia
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Determining the Impact of Best Fit for Newly Licensed Nurses. J Nurses Prof Dev 2021; 38:E27-E31. [PMID: 34138803 PMCID: PMC9060931 DOI: 10.1097/nnd.0000000000000763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Preparing new nursing graduates for independent practice as soon as safely possible is vital for both efficient and effective patient care. The alignment between a nurse’s personality and specialty practice area may impact orientation length, as nurses who are better suited to their job role may adapt more quickly. The current study revealed that nurses hired into a specialty practice area with a higher job fit demonstrates a significant reduction in orientation time.
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Sahay A, Willis E. Graduate nurse views on patient safety: Navigating challenging workplace interactions with senior clinical nurses. J Clin Nurs 2021; 31:240-249. [PMID: 34114276 DOI: 10.1111/jocn.15902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 11/30/2022]
Abstract
AIM AND OBJECTIVE To explore and understand the negative experiences of graduate nurses' interaction with senior nurses and the implications for safe patient care. BACKGROUND Patient safety is dependent on the nursing care they receive. Working in environments where there is reduced collegial support and increased emotional distress, increases the likelihood of nurses making errors that may negatively impact on patient outcomes. Insights drawn from graduate nurses' negative interactions with senior nurses may provide an understanding of the impact of nurse-to-nurse interactions on patient safety outcomes. METHODS A qualitative exploratory descriptive design was used. A purposive sample of 18 graduate registered nurses participated in this study. Semi-structured interviews were conducted, audio-recorded and transcribed verbatim. Data were thematically analysed. The COREQ checklist was followed. RESULTS The overarching theme, 'Navigating workplace challenges' was identified with two sub-themes: Processing unsupportive nurse behaviour and responding to nurse deviations from best practice. Common deviations in practice included erosion of safe medication practice, wound care and non-compliance with universal precautions. Graduate nurses also observed unsafe workplace practice, however, were hesitant to speak up due to fear of retribution. Unsupportive behaviours impacted on their critical thinking ability, follow-up interactions with other nurses and subsequent delivery of patient care. CONCLUSION Quality and safety strategies should not ignore and/or overlook the impact of interpersonal relationships on patient safety and risk. Strategies for delivering evidence-based, safe and quality care to patients go beyond the establishment of standards and technically focussed management strategies. RELEVANCE TO CLINICAL PRACTICE It is vital to examine the quality of working relationships between all levels of healthcare professionals including graduate nurses and their supervisors to ensure supportive behaviours prevail in advancing delivery of quality care within the practice environment. The study alludes to the fact that disruptive workplace behaviours are more hierarchical than horizontal (i.e., graduate nurse-to-graduate nurse).
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Affiliation(s)
- Ashlyn Sahay
- School of Nursing Midwifery and Social Sciences, Central Queensland University, Mackay, Australia
| | - Eileen Willis
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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