Role discrepancy: is it a common problem among nurses?

The impact of clinical nurses' perception of hospital ethical climates on their organizational citizenship behavior: A cross-sectional questionnaire survey

BACKGROUND

As the main force in the development of healthcare, nurses have the longest contact time with patients in clinical practice, their perception of the hospital ethical climates affecting nurses' attitudes and related ethical issues. hospital ethical climates have become an essential environmental factor for nurses to make and implement ethical decisions.

OBJECTIVE

This study aims to investigate the current status of nurses' perception of the hospital ethical climates and the nurses' organizational citizenship behavior, exploring the impact of the nurse's perception of the hospital ethical climates on the nurses' organizational citizenship behavior.

METHODS

A cross-sectional survey adopted, random sampling and cluster sampling were used to select 624 nurses from August 2019 to February 2020. The hospital ethical climate scale and organizational citizenship behavior scale were used as the questionnaire. The data was analyzed by SPSS 21.0 software. On-the-job clinical nurses who had been employed in the hospital for more than 1 year were eligible. Nurses who were administratively punished by the hospital or health administrative authorities were excluded.

RESULTS

The average scores of hospital ethical climates were 4.30 (standard deviation: 0.44), with organizational citizenship behavior 4.42 (standard deviation: 0.42). The correlation coefficient between nurses' perception of hospital ethical climates and organizational citizenship behavior was 0.359 (P < .01). Nurses' perception of the relationship between managers, patients and nurses could explain 23.1% of altruistic toward colleagues; Nurses' perception of the relationship between nurses, hospital, doctors could explain 21.2% of organizational identification. Nurses' perception of the relationship between hospital, nurses and doctors could explain 12.3% of conscientiousness; Nurses' perception of the relationship between managers, doctors could explain 7.6% of interpersonal harmony. Nurses' perception of the relationship between managers, nurses and doctors could explain 6.6% of protection company resources.

CONCLUSION

There is a correlation between nurses' perceptions of hospital ethical climate and organizational citizenship behavior, nurses' perceptions of hospital ethical climate influencing nurses' organizational citizenship behavior in different ways. Managers should focus on the changes of nurses' perception of hospital ethical climates, to promote the nurse to make more beneficial behavior to the organization.

Professionalism in the era of accountability: Role discrepancy and responses among teachers in the Netherlands

The roles and identities of professionals have undergone significant transformation in an ever-globalising world shaped by neoliberal values. In the field of education, standardisation and outcome-based quality measures have become the norm. Teachers are held accountable through their students' results, with their work subject to ongoing surveillance (performance-based accountability). This has changed the nature of teachers' tasks, and what it means to be a "good teacher". Based on 20 teacher interviews across six primary schools in the Netherlands, this study examines teachers' practices and beliefs, asking: do they experience role discrepancy? What responses do we see as a result? And, what does this reveal about teachers' sense of professionalism today? Findings show that all teachers experience the pressure of high workloads and the need to prioritise tasks. Whereas a small minority of respondents understand performative tasks as having a crucial function of supporting student learning and achievement, others experienced a discrepancy between these performative tasks and the tasks they believed to be at the heart of good teaching. Confronted with this, teachers responded in different ways; either incorporating all tasks into their schedule, or feeling forced to choose between them. Beyond this, findings indicate that teachers' understandings of key aspects of the profession, such as autonomy, are changing in response to the policy environment. This supports conceptualisations of professions and professionalism as not only "being changed by" external reform, but changing from within.

Non-nursing tasks as experienced by nursing students: Findings from a phenomenological interpretative study

BACKGROUND

During their clinical learning experience, students are exposed to the nursing profession as a powerful structural reality, experiencing the so-called professional socialisation, a process recognised as the basis of professional identity. Inside this process, students progressively acknowledge their professional identity as being composed of several competencies and, among these, also non-nursing tasks.

OBJECTIVES

To explore non-nursing tasks in the context of nursing students' clinical learning experiences.

DESIGN

An interpretative phenomenological study design was performed and carried out in 2016. The COnsolidated criteria for REporting Qualitative (COREQ) research principles were used in reporting study methods and findings.

SETTING

Two Italian Bachelor of Nursing degree programmes located in Northern Italy.

PARTICIPANTS

Students attending their nursing programmes who a) had successfully passed one or more theoretical examinations; b) had one or more clinical learning experiences in varied contexts (e.g. hospital, community); c) were attending the 1st, 2nd or 3rd year, and d) were willing to participate, were interviewed with an open-ended, face-to-face, audio-recorded interview.

METHODS

A thematic analysis was performed.

RESULTS

Participating students (n = 18) were between 20 and 25 years old and were attending the 1st to the 3rd (and final) academic year. Non-nursing tasks were experienced by them according to three main themes: a) "Being out of the scope of the learning experience," b) "Being forced by external and internal forces," and c) "Dealing with mixed outcomes by looking for a compromise." All students have reported learning to perform non-nursing tasks by shadowing clinical nurses and also practising these tasks by themselves. Internal and external forces prompted students to perform non-nursing tasks, which were recognised as having positive, negative, and neutral effects on themselves and on their learning outcomes.

CONCLUSIONS

Non-nursing tasks are acquired since the beginning of the clinical experience, thus shaping the nursing students' professional identity. At the undergraduate nursing level, strategies should be implemented to prevent the phenomena that a) threaten the acquisition of more complex nursing competences expected by patients and society, and b) shape future generations to be flexible and to perform different tasks, included those below their role.

Does value congruence between nurses and supervisors effect job satisfaction and turnover?

AIM

The purpose of this study was to examine the relationship of congruency of leadership support and value of patient outcomes between nurses and nurse managers and nurses' job satisfaction and turnover intent.

BACKGROUND

Turnover most often has a negative effect on an organization. Leadership support and patient outcomes have been identified as important factors, but congruency has not been studied in great detail.

METHOD(S)

This quantitative non-experimental study included registered nurses (92) and nurse managers (21) in five non-magnet hospitals in the United States.

RESULTS

Value congruence on leadership support was correlated with job satisfaction: Satisfaction in Nursing Scale (SINs)-Workload Barriers (r = 0.327, Administrative Support r = 0.544 and Collegiality = 0.920, P < 0.05). Value congruence and leadership support (Leadership Practices Inventory, LPI) was negatively correlated with turnover intent (r = 0.317, P < 0.05). When all variables were combined a correlation of Value of Patient Outcomes (VOPOS) and the Anticipated Turnover Scale (ATS) (r = 0.099, P > 0.05) was noted.

CONCLUSION

Value congruence of leadership support is related to job satisfaction and may be a factor in turnover intent.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse Administrators can use these results to develop policies to address the turnover especially in the area of leadership support.

Providing a children's palliative care service in the community through fixed-term grants: the staff perspective

BACKGROUND

Children's palliative care services have recently been awarded fixed-term grants, aimed at improving the provision of care for children with life-limiting conditions in the community. We report findings of a qualitative study to investigate the experience of a cohort of community children's nurses from teams involved in setting up or extending community-based children's palliative care services. The purpose of the study was to identify factors that affect service delivery, from the staff perspective, and to suggest ways of promoting their sustainable development.

METHODS

Semi-structured telephone interviews were conducted with 21 nurses from 12 different teams providing palliative care for children at home and in hospices. Participants were questioned about the services they provided and their own roles in that provision. NVIVO qualitative data analysis software was used to explore themes arising from the transcribed recorded interviews.

FINDINGS

Key findings were the importance of physical location in facilitating multidisciplinary communication, the importance of defining role boundaries between existing and new providers of children's palliative care, and the potentially detrimental impact of insecure funding on referral patterns and recruitment to posts. Staff named the opportunity to offer direct 'hands-on' care to families, access to work-based support and networking opportunities as important factors in helping them cope with the stresses involved in managing finite resources and the emotional challenges of their work.

CONCLUSIONS

The maintenance of a mixed caseload with a significant proportion of direct care, provision of ongoing support and clearly defined roles are recommended as means of bolstering the ability of staff to develop their services. The deliberate locating of services to enhance communication between staff and guidance on the preparation of funding applications may further contribute to the sustainability of these services.