The relationship between work environment and career success among nurses with a master's or doctoral degree: A national cross-sectional study

Insights from defining nurses' career success: An integrative review

AIMS

To review the literature and identify factors that make sense of and influence nurses' career success. We sought to provide insights into achieving nurses' career success.

DESIGN

An integrative review conducted in May 2022 using Whittemore and Knafl's methodology of integrative review.

METHODS

The databases searched were PubMed, Web of Science, Scopus, and CINAHL. Search criteria included the keywords "nurs*" and "career success" in the title and abstract. The quality of the reviewed papers was assessed using the JBI Critical Appraisal Tool for cross-sectional studies and qualitative research. We extracted five types of information from quantitative studies: the definition of career success, factors of career success instruments, reliability or validity of career success instruments, and factors influencing nursing career success. Furthermore, we extracted two types of information from qualitative studies: themes that imply career success and factors that influence nurses' career success. Primary data were categorized into two perspectives: (1) what nurses' career success means and (2) what influences nurses' career success. Categorized data were unified into similar contents. Themes were developed from unified subgroups.

RESULTS

Fourteen studies were included in the analysis. Seven themes were integrated into the factors that make sense of nurses' career success: satisfaction, positive attitude towards work, quality work in nursing, continuation of career and professional development, positive interaction at work, person-organization fit, and enrichment of an individual's life. Three themes were integrated into the factors influencing nursing career success: personal resources, positive behavior toward nursing work and research, and job resources and environment.

NO PATIENT OR PUBLIC CONTRIBUTION

Patients or members of the public were not involved in this review.

Mediating effects of social support, mental health between stress overload, fatigue and turnover intention among operating theatre nurses

BACKGROUND

The high rate of nurses turnover and nursing staff shortage have been an ongoing concern issue and a challenge for global health systems. To explore the turnover intention among operating theatre nurses, and to test the hypothetical model for estimating the effects of stress overload and fatigue between social support, mental health and turnover intention.

DESIGN

a multi-center and cross-sectional online survey.

METHODS

This study was conducted from October 2020 to March 2021 comprised 1060 operating theatre nurses from 76 Chinese hospitals. The descriptive analysis, independent sample t test and one-way analysis of variance and Spearman correlation analysis were used to explore the relationships among variables by the SPSS software, and stepwise multiple linear regression analysis was utilized to identify influencing factors of turnover intention and its dimensions among operating theatre nurses. A structural equation model was analyzed by the AMOS software.

RESULTS

Social support, mental health, stress overload and fatigue were important predictors of turnover intention among operating theatre nurses. Besides, stress overload positively affected fatigue, mental health and turnover intention; fatigue negatively affected social support, however, fatigue positively affected mental health; social support negatively affected mental health and turnover intention; mental health positively affected turnover intention. Moreover, social support, mental health mediated between stress overload, fatigue and turnover intention among operating theatre nurses.

CONCLUSION

Social support, mental health mediated between stress overload, fatigue and turnover intention among operating theatre nurses.

Factors that affect career success of nurses who practice in assisted reproductive technology

to examine the relationship between career success and work environment of nurses who practice in assisted reproductive technology and to identify factors that affect career success. a cross-sectional study conducted in 53 fertility centres in 26 provinces in mainland China. Data were collected using a demographic data questionnaire, a specialised nursing competence questionnaire, the Career-Success Scale, and the Nursing Work Environment Scale. Descriptive and inferential statistics were applied. 597 assisted reproductive technology nurses participated in our survey, and 555 valid questionnaires were collected. Theoverall mean scores for career success and work environment were 3.75 [standard deviation (SD) = 1.01] and 3.42 (SD = 0.77) respectively. There was a strong positive correlation between career success and work environment (r = 0.742, p < 0.01). Multiple regression showed that attending academic conferences, psychological care, professional development, support and care, salary, and welfare were significant factors that influence career success. attending academic conferences, psychological care, and work environment are positively related to career success. Administrators should consider ways to address these factors.

Factors that affect career success of nurses who practice in assisted reproductive technology

to examine the relationship between career success and work environment of nurses who practice in assisted reproductive technology and to identify factors that affect career success. a cross-sectional study conducted in 53 fertility centres in 26 provinces in mainland China. Data were collected using a demographic data questionnaire, a specialised nursing competence questionnaire, the Career-Success Scale, and the Nursing Work Environment Scale. Descriptive and inferential statistics were applied. 597 assisted reproductive technology nurses participated in our survey, and 555 valid questionnaires were collected. Theoverall mean scores for career success and work environment were 3.75 [standard deviation (SD) = 1.01] and 3.42 (SD = 0.77) respectively. There was a strong positive correlation between career success and work environment (r = 0.742, p < 0.01). Multiple regression showed that attending academic conferences, psychological care, professional development, support and care, salary, and welfare were significant factors that influence career success. attending academic conferences, psychological care, and work environment are positively related to career success. Administrators should consider ways to address these factors.

Psychosocial factors associated with career success among nurses: A latent profile analysis

AIM

In this study, a person-centred approach was used to analyse career success profiles and explore the associated psychosocial factors among nurses.

DESIGN

A cross-sectional study was conducted from 15 April to 15 October 2019.

METHODS

A total of 1155 registered Chinese nurses were recruited from two general hospitals using convenience sampling. Participants completed a printed questionnaire, including the Maslach Burnout Inventory, Stress of Conscience Questionnaire, Practice Environment Scale, and Career Success Scale. Latent profile analysis and multinomial logistic regression were performed. The data were analysed with Mplus 8.3 and SPSS version 26.0.

RESULTS

Three latent profiles of career success were identified: high, moderate and low. Nurses with lower educational levels, more years of work experience, lower emotional exhaustion, higher personal achievement, lower stress of conscience and higher participation in hospital affairs were more likely to have higher career success than the other profiles.

CONCLUSIONS

Burnout, stress of conscience, practice environment, educational level and years of work experience were associated with career success among nurses. Targeting interventions may help enhance nurses' career success. Future research should combine subjective and objective indicators (salary, title and so on) to assess career success and explore other determinants for formulating interventions to enhance nurses' career success.

IMPACT

The heterogeneity and psychosocial factors associated with nurses' career success provide valuable evidence for the formulation of individualized interventions. Nursing managers should understand the importance of career success, develop interventions to reduce nurses' burnout and stress of conscience, and improve the practice environment to enhance their career success.

NO PATIENT OR PUBLIC CONTRIBUTIONS

This study was designed to examine the psychosocial factors associated with nurses' career success. The study was not conducted using suggestions from the patient groups or the public.

Exploring the relationship between lateral violence and nursing professionalism through the mediating effect of professional identity: A cross‐sectional questionnaire study

AIM

This study aimed to investigate the prevalence of lateral violence (LV) experienced by nursing students during their internship, explore the difference between professional identity and professionalism among nursing students who had or had not experienced LV and analyse the mediating effect of professional identity on the relationship between LV and professionalism.

DESIGN

A cross-sectional survey was used.

METHODS

An online anonymous survey was distributed to nursing students (N = 298) in Jiangsu province, China from June to July 2021. The questionnaire consisted of sections on lateral violence, professional identity and nursing professionalism.

RESULTS

Approximately 49.7% of the nursing students experienced LV behaviour during the internship period. Students who experienced LV had lower professional identity and professionalism than those who did not. Among the students, LV was negatively correlated with professional identity (r = -0.333, p < 0.001) and professionalism (r = -0.418, p < 0.001). The relationship effect of LV on nursing professionalism was partly mediated by professional identity.

CONCLUSION

Nearly half of the nursing students suffered from LV in the workplace, and this condition remarkably influenced nursing professionalism through professional identity. Both quantitative and qualitative studies are needed to investigate the factors that influence LV development in detail.

Status of core competencies of wound, ostomy and continence nurses and their influence on career success: a cross-sectional study

OBJECTIVES

The wound, ostomy and continence nursing practice has its own scope and standards, and each standard requires relevant competency. However, the core competencies of wound, ostomy and continence nurses that contribute to the career success are poorly known. To identify associations between career success and core competencies of wound, ostomy and continence nurses in China.

DESIGN

A cross-sectional survey with a convenience sample.

SETTING

Participants were recruited from 108 hospitals in 28 provinces.

PARTICIPANTS

A total of 123 wound, ostomy and continence nurses were surveyed.

MEASURES

Career success, core competencies and demographic characteristics of wound, ostomy and continence nurses, were measured in this study.

METHODS

A survey was distributed to 123 wound, ostomy and continence nurses were recruited from 108 hospitals in 28 provinces. Multivariate logistic regression was undertaken to explore associations between career success outcomes and core competency scores of wound ostomy and continence nurses and their demographic characteristics.

RESULTS

The career success and core competency of wound, ostomy and continence nurses were both above average. Nurses who had higher total scores of core competency were more likely to have higher career success, including total score (OR=4.90), career satisfaction (OR=5.58) and perceived internal (OR=4.55)/external (OR=3.42) organisation competitiveness. Higher competency in interpersonal communication (OR=7.70) and more time for wound care per month (OR=8.80) predicted higher career satisfaction. Additionally, nurses with higher professional development were more likely to score higher in perceived internal organisation competitiveness of career success (OR=4.36) and the overall career success (OR=5.96).

CONCLUSIONS

The career success and core competency of the wound, ostomy and continence nurses in China were at an above average level. The associations between career success and core competency of the wound, ostomy and continence nurses were positive, suggesting that competency enhancement could improve nurses' career success.

Factors influencing career success of clinical nurses in northwestern China based on Kaleidoscope Career Model: Structural equation model

AIM

To explore the relationships among self-efficacy, information literacy, social support and career success of clinical nurses and identify factors influencing clinical nurses' career success in northwestern China.

BACKGROUND

Understanding the influencing factors of career success is important for the professional development of nurses and the improvement of clinical nursing quality. Many influencing factors of career success have been identified, but there is no large-scale research on the relationships among self-efficacy, information literacy, social support and career success of clinical nurses based on Kaleidoscope Career Model. Studies examining the association of the four factors remain limited.

METHODS

A total of 3011 clinical nurses from 30 hospitals in northwestern China were selected in the cross-sectional survey, and the response rate was 94.71%. The clinical nurses completed the online self-report questionnaires including self-efficacy, information literacy, social support rating scale and career success scale. The data were analysed by SPSS23.0 statistical software using t test, analysis of variance, Pearson's correlation and multiple linear regression. Structural equation model (SEM) was used to analyse the influencing factors of career success using Mplus 8.3.

RESULTS

The career success of clinical nurses in northwestern China was at a medium level. The linear multivariate regression analysis showed that self-efficacy (β = .513), social support (β = .230), information support (β = .106), information consciousness (β = -.097), information knowledge (β = .067), information ethics (β = -.053), hospital grade (β = .118), marital status (β = -.071) and age (β = -.037) entered regression equation of clinical nurses' career success (all P < .05). SEM results showed that the career success was negatively correlated with demographic characteristics and positively correlated with social support and self-efficacy.

CONCLUSION

Demographic characteristics, self-efficacy, social support and information literacy are the influencing factors of nurses' career success, which should be considered in the process of promoting nurses' career success.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers need to acknowledge the significance of nurses' career success both for the realization of their own value and for the improvement of clinical nursing quality. They should encourage nurses to enhance self-efficacy and render more social support through incentive policies and foster nurses' information literacy through information technology training so as to improve their career success.

Mediating role of career self-efficacy between clinical learning environment and professional identity in nursing students

AIMS

To explore whether the clinical learning environment (CLE) has an indirect effect on professional identity through the mediation of career self-efficacy (CSE) in nursing students.

BACKGROUND

The shortage of nurses has become a universal problem worldwide. Improving nurses' professional identity is considered an effective way to reduce the turnover rate of nurses. However, little is known about the relationship between the CLE, CSE and professional identity.

DESIGN

An observational, questionnaire-based, cross-sectional study.

METHODS

A web-based survey was completed by 212 undergraduate nursing students from June to August 2018. Measures included Chinese translations of the CLE, the Career Self-Efficacy Scale, and the Professional Identity Scale.

RESULTS

Both the CLE (r = 0.552, p < 0.01) and CSE (r = 0.868, p < 0.01) correlated positively with professional identity. The indirect effect of the CLE on professional identity through CSE was positive (β = 0.342, p < 0.05) and the effect was 77.2%.

CONCLUSIONS

A better CLE and higher scores in CSE were associated with professional identity in nursing students, and a better CLE had an indirect effect on the professional identity of students through CSE.

Newly graduated nurses' perceptions of work environment: A cross-sectional study in China

AIM

To assess the attitudes of newly graduated nurses in China toward their work environment and identify the factors affecting their perception.

BACKGROUND

Newly graduated nurses are the primary supply to cover the nursing shortage, but their stressful transition into clinical work has contributed to high turnover for decades. Although serving as a source of stress, the work environment can also be a source of support for new nurses.

METHODS

A total of 2361 new nurses at 31 tertiary hospitals in 20 provinces were surveyed from June to November 2018, using the Chinese version of the Practice Environment Scale-Nursing Work Index. Basic information and their perception about work environment were collected.

RESULTS

New nurses rated their work environment with an overall score of 84.67 (12.85). Multiple linear regression identified that education level, monthly income, hospital type and location, participation (or not) in standardized training programmes and having (or not) a mentor/preceptor were factors significantly associated with their perception of the work environment.

CONCLUSION

The perception of newly graduated nurses in China was mainly positive overall. Nursing managers may take full advantage of factors affecting the perception of work environment to support newly graduated nurses better, to help their retention and transition.

SUMMARY STATEMENT

What is already known about the topic? Newly graduated nurses experience transition shock at the beginning of their work. Supportive work environments can help successful transition. What this paper adds? Newly graduated nurses are not fully supported in their work environment. Staffing and resource inadequacy were the poorest environmental factors. Residency programmes had the most impact on the perceptions of newly graduated nurses about their work environment.

IMPLICATIONS FOR NURSING PRACTICE

These results can guide nursing managers to support the newly graduated nurses better in their transition process, thus helping retention of nursing human resource.

Antecedents and Outcomes of Nurses' Subjective Career Success: A Path Analysis

PURPOSE

This study aimed to test the hypothesis model showing the relationship between nurses' individual and working characteristics, nursing work environment, subjective career success, job satisfaction, intent to leave, and professional commitment.

DESIGN AND METHODS

A cross-sectional and correlational design was utilized for the study. The study sample consisted of 604 nurses working in four hospitals in Istanbul, Turkey. Data were collected using the Nurse Information Form, Subjective Career Success Inventory, Practice Work Environment Scale of the Nursing Work Index, Job Satisfaction Global Item, Intent to Leave Subscale, and Professional Commitment Scale. Data were analyzed using descriptive and correlation analysis, and the hypothesis model was tested using structural equation modeling.

FINDINGS

The hypothesis model that was established to test the antecedents and outcomes of subjective career success in nurses was acceptable and had a good fit. Having a master's degree, work schedule with rotating shifts (negative), good individual income, participation in hospital affairs, staffing and resource adequacy, and nurse-physician relations were significantly associated with the subjective career success of nurses. Subjective career success had a positive effect on job satisfaction and professional commitment and a negative significant effect on intent to leave in nurses.

CONCLUSIONS

This study revealed that human capital, objective career success, and some characteristics of the nursing work environment were significantly associated with nurses' subjective career success, and that increased subjective career success produced positive professional and organizational outcomes.

CLINICAL RELEVANCE

The results of this study, which revealed the antecedents and outcomes of nurses' career success, should be taken into consideration by managers who wish to retain a qualified nursing workforce.

Impact of innovative education on the professionalism of undergraduate nursing students in China

AIM

To explore the relationships among innovative atmosphere, innovative behavior, professional self-efficacy, professional identity, and professionalism of undergraduate nursing students in China.

BACKGROUND

In lieu of the global shortage of nurses and low professional willingness of nursing students, innovative qualities are closely related to the professionalism of nurses.

METHODS

The participants of this cross-sectional study consisted of 320 nursing students recruited from the Nursing College of a comprehensive university in Jiangsu Province, China who voluntarily completed an anonymous questionnaire from May to October 2019. Structural equation modeling analyses were performed.

RESULTS

There was a positive correlation between all hypothetical pairwise variables (r = 0.496-0.795, p < 0.01). The final research model fits well. The results revealed that innovation atmosphere had a positive effect on innovative behavior and innovative behavior could affect nursing professionalism through self-efficacy and identity.

CONCLUSION

Innovative education plays a very important role in the professionalism of undergraduate nursing students. Nursing educators can promote the development of professionalism in future nurses by fostering innovative behaviors.

Self-Identity and Career Success of Nurses in Infectious Disease Department: The Chain-Mediating Effects of Cognitive Emotion Regulation and Social Support

There has been some research conducted regarding nurses’ career success aimed at exploring its influencing factors, but there is no research on the mechanism of self-identity on the career success of infection control nurses. In order to further explore the formation mechanism of career success of nurses, we conducted our study using the Kaleidoscope Career Model to explore the chain-mediating effects of cognitive emotion regulation and social support between self-identity and career success. Five hundred forty-seven infection control nurses from nine different hospitals participated in the study and completed questionnaires on the self-identity, cognitive emotion regulation, social support, and career success scales. The results from structural equation modeling reveal that self-identity has a positive effect on positive emotion regulation and social support and a negative impact on negative emotion regulation. Positive (negative) emotion regulation has a positive (negative) effect on social support. All antecedents have a positive impact on career success except negative emotion regulation, which has a negative one. Bootstrap analysis shows that the relationship between self-identity and career success is partially mediated by the chain of cognitive emotion regulation and social support. Overall, our research sheds light on the mechanism of self-identity on career success of nurses. Theoretical and practical implications are discussed.

Development and psychometric testing of the career success in Nursing Scale

AIM

To develop and test the psychometric properties of an instrument assessing career success in nurses.

BACKGROUND

Despite the importance of achieving success in nursing, to date, this construct has been measured using unidimensional or generic scales not fully reflecting career success as perceived by nurses.

METHODS

This scale development study used a large sample of nurses across 10 hospitals in Tabriz, Iran. Items were generated based on existing literature and previous, research team-led, qualitative study, followed by testing content and face validity of the items. Exploratory factor analysis (N = 530 nurses) then assessed the underlying structure of the scale, and reliability was tested using Cronbach's alpha and a 2-week test-retest correlation.

FINDINGS

From the initial 73 items, fourteen rated by experts as 'not relevant' and seven with poor face validity were deleted. Exploratory factor analysis further identified 13 poor items. The final 39-item solution extracted four robust career success factors: expected career progress, providing quality care, effective self-regulation, and person-organization fit. Cronbach's alpha and test-retest correlation showed excellent reliability.

CONCLUSION

This multidimensional nursing-specific scale with very good psychometric properties is suitable for individual/group-based decisions.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

This instrument can assess current perceptions of career success in nurses, so work resources can be allocated to improve policies, services and training programmes to meet career aspirations of nurses and objectives of the organization. Having a robust scale of career success will enable future research in the field of career success as specific to nursing in a clinical setting.