Generational diversity: what nurse managers need to know

Bridging the generational gap between nurses and nurse managers: a qualitative study from Qatar

BACKGROUND

The nursing workforce comprises multiple generations, each with unique values, beliefs, and expectations that can influence communication, work ethic, and professional relationships. In Qatar, the generational gap between nurses and nurse managers poses challenges to effective communication and teamwork, impacting job satisfaction and patient outcomes.

AIM

This study investigates the generational gap between nurses and nurse managers in Qatar, aiming to identify strategies to enhance collaboration and create a positive work environment.

METHODS

A qualitative research design was used, involving semi-structured interviews with 20 participants, including frontline nurses and senior nurse managers. Participants were purposively sampled to represent different generations. Data were collected through face-to-face and virtual interviews, then transcribed and thematically analyzed.

FINDINGS

Four key themes emerged: Optimizing the Work Environment: Older generations preferred transformational and situational leadership, while younger nurses valued respect, teamwork, accountability, and professionalism. Strengthening Work Atmosphere through Communication and values: Older nurses favored face-to-face communication, while younger nurses preferred digital tools. Cultivating Respect and Empathy: Younger nurses emphasized fairness in assignments and promotions, while older nurses focused on empathy and understanding. Dynamic Enhancement of Healthcare Systems: Younger nurses were more adaptable to technology and professional development, while older nurses prioritized clinical care and patient outcomes.

CONCLUSION

The study reveals significant generational differences in leadership preferences, communication styles, and adaptability to technology. Addressing these gaps through effective leadership, ongoing education, and open communication can improve job satisfaction and patient care.

Using Innovation in Credentialing to Foster Meaningful Transitions to Practice and Support Continuing Professional Development

Certification within specialized areas in nursing has long been an avenue by which nurses demonstrate competence and dedication toward professional development. Because of innovation within the credentialing arena, certification also can serve as an avenue that supports nursing professional development practitioners who are assisting nurses transitioning into new roles or new practices. [J Contin Educ Nurs. 2023;54(9):413-420.].

Nursing Leadership Roles and Its Influence on the Millennial Psychiatric Nurses' Job Satisfaction and Intent to Leave

BACKGROUND

There is an increasing need for millennial psychiatric nurses in health care. Nurses' levels of satisfaction with their manager's leadership styles are critical to their remaining in the profession.

AIM

To explore the relationship between the roles of nursing leadership and their influence on the millennial psychiatric nurse's level of job satisfaction and intent to leave.

METHOD

Eighty-three psychiatric registered nurses between the ages of 22 and 37 with 6 months or more experience completed a Managerial Skills and Job Satisfaction Survey questionnaire.

RESULTS

The millennial psychiatric nurse who perceived their managers to display the roles in being a mentor (M = 24.95, SD = 2.81), director (M = 23.08, SD = 2.55), and monitor (M = 22.71, SD = 2.51) had higher job satisfaction and would be less likely to leave the specialty, current position, and organization.

CONCLUSION

The study revealed that nursing leaders need to focus on strengthening the monitor and mentor roles and work on changing from having a coordinator role to the director role.

Multi-Generational Perspectives on the Competencies Required of First-Line Nurse Managers: A Phenomenological Study

First-line nurse managers play an integral role in ensuring team and organizational effectiveness and quality of care. They are facing increasing challenges arising from the need to lead a generation-diverse workforce. Further research that examines multi-generational perspectives on the competencies of first-line nurse managers is warranted. This paper aimed to elucidate multi-generational perspectives on the competencies required of first-line nurse managers based on their lived experiences and perceptions, as well as those of frontline nurses. A descriptive phenomenological approach was adopted. A total of 48 informants were invited to individual semi-structured interviews to share their perspectives on the competencies required of first-line nurse managers. Findings were analyzed using Van Kaam's controlled explication method. Four themes that described four areas of competency were generated: (1) advocating for the interests of the staff, (2) allocating resources effectively, (3) building cohesive teams, and (4) embracing change and quality. The findings indicated that there were significant discrepancies among the different generations of informants in terms of their degree of commitment to work, preferred modes of team communication and collaboration, and perspectives on the role and function and preferred leadership styles of first-line nurse managers. This study fell short in examining the experiences of Generation Z nurses, and the findings are subject to further validation by larger samples. However, this study has implications for hospital administrators, nurse educators, and managers, encouraging them to rethink the notion of management competencies to develop effective strategies for leading a multi-generational workforce.

Effect of Operating Room Personnel Generation on Perceptions and Responses to Surgeon Behavior

BACKGROUND

Little is known regarding the impact of operating room (OR) personnel generation on their perceptions to various surgeon behaviors. We aimed to characterize these relationships by evaluating their responses to 5 realistic intraoperative scenarios.

METHODS

Operating room personnel were asked to assess surgeon OR behavior across a standardized set of 5 scenarios via an online survey. For each scenario, respondents were asked to identify the behavior as either acceptable, unacceptable but would ignore, unacceptable and would confront the surgeon, or unacceptable and would report to management. Chi-squared analyses were used to compare responses to surgeon behavior with respondent generation.

RESULTS

There were 3101 respondents, of which 41% of respondents were baby boomers (n = 1280), 31% were generation (Gen) X (n = 955), and 28% were Gen Y (n = 866). Overall, when compared to Gen X or Gen Y, baby boomers were significantly more likely to find surgeon behaviors of impatience (P < .001), being late for a case (P < .001), swearing in the OR (P < .001), and shouting with a bleeding patient (P = .001) to be inappropriate and would talk to the surgeon. Alternatively, Gen Y respondents were more likely to find fault with surgeon behaviors that deviate from rules and regulations, such as forgetting a time-out (P = .001), when compared to baby boomers and Gen X respondents.

DISCUSSION

Results of our study demonstrate that OR personnel generation affects their perceptions and response to surgeon behavior. Understanding these tendencies can guide efforts to improve OR interactions among team members.

Nurses' generational stereotypes and self-stereotypes: a cognitive study

PURPOSE

The present research offers insights into the generational stereotypical beliefs that different generations of nurses hold about the own and the other generations and the implications on the work floor.

DESIGN/METHODOLOGY/APPROACH

This cross-sectional, exploratory study employs a cognitive mapping approach known as the repertory grid. The sample consisted of 15 Generation Y, 15 Generation X and 15 Baby Boomer nurses.

FINDINGS

Beliefs of nurses about their own and the other generations direct social categorization and generational stereotypes of the in-group and out groups. These stereotypes mold nurses' beliefs and attitudes towards their coworkers and are enacted leading to self-fulfilling prophecies. Especially Generation Y and Baby Boomer nurses are negatively stereotyped and have their ways to deal with these negative stereotypes.

PRACTICAL IMPLICATIONS

Nurses and their managers who hold generational stereotypes may unknowingly create cliques within an organization and adopt behaviors and expectations based on generational (self-) stereotypes. The author offers noteworthy insights for fostering intergenerational synergies amongst nurses, which are important since the level of interdependent relations amongst nurses required to provide care.

ORIGINALITY/VALUE

The present study moves away from the research about the typical characteristics of nurses across the generational workforce. Instead, mental models about how different generations of nurses construe their coworkers belonging to different generations including their own generation are drawn. Employing the repertory grid technique (RGT), an established method for uncovering people's personal and collective belief systems, the present study shows how generational stereotyping and self-stereotyping among nurses belonging to varying generational cohorts occurs and debates its implications.

Age stereotypes towards younger and older colleagues in registered nurses and supervisors in a university hospital: A generic qualitative study

AIM

This study aimed to identify and compare age stereotypes of registered nurses and supervisors in clinical inpatient settings.

DESIGN

Generic qualitative study using half-standardized interviews.

METHOD

Nineteen face-to-face interviews and five focus groups (N = 50) were conducted with nurses of varying levels at a hospital of maximum medical care in Germany between August and November 2018 and were subjected to structured qualitative content analysis.

RESULTS

Reflecting the ageing process and cooperation in mixed-age teams, nursing staff and supervisors defined similar age stereotypes towards older and younger nurses reminiscent of common generational labels 'Baby Boomers' and Generations X. Their evaluation created an inconsistent and contradictory pattern differing to the respective work context and goals. Age stereotypes were described as both potentially beneficial and detrimental for the individual and the cooperation in the team. If a successfully implemented diversity management focuses age stereotypes, negative assumptions can be reduced and cooperation in mixed-age teams can be considered beneficial.

CONCLUSION

Diversity management as measures against age stereotypes and for mutual acceptance and understanding should include staff from various hierarchical levels of the inpatient setting.

Nurses and the acceptance of innovations in technology-intensive contexts: the need for tailored management strategies

Background

Several technological innovations have been introduced in healthcare over the years, and their implementation proved crucial in addressing challenges of modern health. Healthcare workers have frequently been called upon to become familiar with technological innovations that pervade every aspect of their profession, changing their working schedule, habits, and daily actions.

Purpose

An in-depth analysis of the paths towards the acceptance and use of technology may facilitate the crafting and adoption of specific personnel policies taking into consideration definite levers, which appear to be different in relation to the age of nurses.

Approach

The strength of this study is the application of UTAUT model to analyse the acceptance of innovations by nurses in technology-intensive healthcare contexts. Multidimensional Item Response Theory is applied to identify the main dimensions characterizing the UTAUT model. Paths are tested through two stage regression models and validated using a SEM covariance analysis.

Results

The age is a moderator for the social influence: social influence, or peer opinion, matters more for young nurse.

Conclusion

The use of MIRT to identify the most important items for each construct of UTAUT model and an in-depth path analysis helps to identify which factors should be considered a leverage to foster nurses’ acceptance and intention to use new technologies (o technology-intensive devices).

Practical implications

Young nurses may benefit from the structuring of shifts with the most passionate colleagues (thus exploiting the social influence), the participation in ad hoc training courses (thus exploiting the facilitating conditions), while other nurses could benefit from policies that rely on the stressing of the perception of their expectations or the downsizing of their expectancy of the effort in using new technologies.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06628-5.

The Relationship Between Emotional Intelligence and Nurse-Nurse Collaboration

PURPOSE

The purpose of this study was to examine the relationship between emotional intelligence and nurse-nurse collaboration among registered nurses in Jordan.

DESIGN

This study used a cross-sectional, quantitative survey design to query 342 nurses who worked in two hospitals in Jordan.

METHODS

We used Arabic versions of valid, reliable instruments to measure emotional intelligence and nurse-nurse communication.

FINDINGS

A total of 311 questionnaires were returned (91% response rate). Nurses' emotional intelligence was positively and significantly correlated with the nurse-nurse collaboration subscales. The results also indicated a statistically significant mean difference in communication subscale scores by gender and nursing unit.

CONCLUSIONS

The present study demonstrated that nurse-nurse collaboration is linked to benefits for nurses in terms of improved job satisfaction, better nurse retention, improved quality of patient care, and enhanced healthcare efficiency and productivity. This suggests that improving nurse-nurse collaboration may have spillover effects of benefits, not only for nurses but for patients, organizations, and the overall healthcare system.

CLINICAL RELEVANCE

Building an environment that encourages collaboration among nurses can greatly impact the performance of nurses and its benefit to nurses. Encouraging employees to participate in activities and to collaborate in making this an integral part of their evaluation will contribute to improving the teamwork in patient care.

Communication Strategies and Our Learners

Communication is vital in healthcare to facilitate the best patient care at all times. During the COVID-19 pandemic, communication has become increasingly crucial, including devising innovative, novel, and effective ways to exchange information in graduate medical education, multidisciplinary teams, and patient care, all which affect our learners. This article will provide a comprehensive review of generational characteristics, including communication preferences. Effective communication strategies and communication challenges with learners (millennial generation) will be discussed in detail.

Testing a Model of Speaking up in Nursing

BACKGROUND

Speaking up is using one's voice to alert those in authority of concerns. Failure to speak up leads to moral distress; speaking up leads to moral courage.

OBJECTIVE

The purpose of this study was to explore the influences of organizational culture, personal culture, and workforce generation on speaking-up behaviors among RNs.

METHODS

We distributed a cross-sectional electronic survey to several thousand RNs, resulting in 303 usable surveys.

RESULTS

Organizational culture was a strong predictor of speaking-up behaviors; speaking up partially mediated the relationship between organizational culture and moral distress but was not a mediator between organizational culture and moral courage. Workforce generation did not explain speaking up.

CONCLUSIONS

The role of organizational culture supports efforts toward healthy work environments. Because not speaking up is related to moral distress, efforts must be escalated to empower nurses to use their voices.

Student nurses' ethical views on responses to the severe acute respiratory syndrome outbreak

BACKGROUND

Fifteen years have passed since the outbreak of severe acute respiratory syndrome in Hong Kong. At that time, there were reports of heroic acts among professionals who cared for these patients, whose bravery and professionalism were highly praised. However, there are concerns about changes in new generation of nursing professionals.

OBJECTIVE

We aimed to examine the attitude of nursing students, should they be faced with severe acute respiratory syndrome patients during their future work.

RESEARCH DESIGN

A questionnaire survey was carried out to examine the attitude among final-year nursing students to three ethical areas, namely, duty of care, resource allocation, and collateral damage.

ETHICAL CONSIDERATIONS

This study was carried out in accordance with the requirements and recommendations of the Central Research and Ethics Committee, School of Health Sciences at Caritas Institute of Higher Education.

FINDINGS

Complete responses from 102 subjects were analyzed. The overwhelming majority (96.1%) did not agree to participate in the intubation of severe acute respiratory syndrome patients if protective measures, that is, N95 mask and gown, were not available. If there were insufficient N95 masks for all the medical, nursing, and allied health workers in the hospital (resource allocation), 37.3% felt that the distribution of N95 masks should be by casting lot, while the rest disagreed. When asked about collateral damage, more than three-quarters (77.5%) said that severe acute respiratory syndrome patients should be admitted to intensive care unit. There was sex difference in nursing students' attitude toward severe acute respiratory syndrome care during pregnancy and influence of age in understanding intensive care unit care for these patients. Interestingly, 94.1% felt that there should be a separate intensive care unit for severe acute respiratory syndrome patients.

CONCLUSION

As infection control practice and isolation facilities improved over the years, relevant knowledge and nursing ethical issues related to infectious diseases should become part of nursing education and training programs, especially in preparation for outbreaks of infectious diseases or distress.

Detriments of a Self-Sacrificing Nursing Culture on Recruitment and Retention: A Qualitative Descriptive Study

AIM

To investigate the presence and impact of self-sacrifice within the nursing profession.

BACKGROUND

Evidence suggests the existence of a culture of self-sacrifice within nursing, but its potential detriments to the profession have not been explored.

DESIGN

A qualitative descriptive approach was used.

METHODS

Semistructured interviews were conducted with 10 practicing nurses to explore the existence and potential implications of a self-sacrificing culture within nursing.

RESULTS

All participants reported self-sacrifice within the nursing profession as the result of the prevailing stereotypical image of the "ideal nurse," leading to job dissatisfaction, presenteeism, and burnout. Younger nurses reported being less willing to self-sacrifice and consequently felt unsupported by management and senior staff, resulting in job dissatisfaction and intent to leave their job.

CONCLUSION

A culture of self-sacrifice within the nursing profession may lead to job dissatisfaction, presenteeism, burnout, and retention problems, especially for younger nurses. A self-sacrificing image of nursing may also deter potential recruits from exploring a career in the profession.

Research, Technology, Education & Scholarship in the Fourth Industrial Revolution [4IR] : Influences in Nursing and the Health Sciences

The Fourth Industrial Revolution (4IR) generated considerable interests among scholars, informaticists and educational leaders around the globe. This industry shift brings with it exciting opportunities and inevitable challengesto various industries and professional practices including the health sciences. The purpose of the article is to illuminate the influences of the Fourth Industrial Revolution on the research,education and technology on Nursing and the Health Sciences. This article is organized as follows : the historical developments in the evolution of nursing images, industries and technologies in healthcare praxis, juxtaposing of current and impending trends and their impact on education, research and scholarship, and education in the healthcare sector. This article concludes with shared insights on several creative and proactive solutions in preparing for, creating new technologies, and mitigating the effects of the upcoming revolution. J. Med. Invest. 66 : 3-7, February, 2019.

Attitudes about work engagement of different generations-A cross-sectional study with nurses and supervisors

AIM

This study investigated whether generation Y nurses (1981-1995) adopt a different attitude about work than generation X caregivers (1966-1980) and baby boomers (1956-1965).

BACKGROUND

Employees' positive attitude to work engagement is a competitive factor for clinics. In age-diverse team structures, possible different attitudes can lead to conflicts.

METHODS

As part of a quantitative, descriptive, cross-sectional study with the survey instrument AVEM-44, health and nursing staff, as well as nursing directors and ward administrators, were interviewed.

RESULTS

A total of N = 992 individuals (n = 312 nursing directors, n = 259 ward administrators and n = 421 nurses) were included in the study. Nurses and executives viewed generation Y as being less willing to give oneself out and as attaching less importance to work than generation X and the baby boomers. On the other hand, professional ambition was more important to generation Y than the older generations.

CONCLUSIONS

Transformational leadership behaviour represents an approach to guide employees of different generations individually and to harmonize different attitudes.

IMPLICATIONS FOR NURSE MANAGEMENT

To lead employees transformationally, it is necessary to know generation-specific differences concerning attitudes towards work.

Nurses' Generational Differences Related to Workplace and Leadership in Two European Countries

A cross-sectional study was conducted with a convenience sample (N = 3,093) of Finnish and Italian registered nurses to identify differences related to generation, country, gender, and educational level in their perceptions and opinions about workplace-related dimensions of nursing and their managers' leadership practices. The Multidimensional Nursing Generations Questionnaire (MNGQ) and two subscales of the Transformational Leadership Scale (TLS), "Feedback and Rewards" and "Professional Development," were used as survey tools. Data were analyzed with descriptive and inferential statistics. Statistically significant (p < .05) generational and country differences emerged in the MNGQ components "Conflicts between generations," "Patient safety view," "Relationships between generations," "Working as a multigenerational team," "Orientation to change," "Intention to leave," and "Flexibility and availability." Generational and country differences also emerged for the two TLS subscales. Generational differences existed between registered nurses of different generations and countries, and should be considered in leading multigenerational nurses' workforces.

Perceptions on nurse-nurse collaboration among registered nurses in Finland and Norway

BACKGROUND

Intraprofessional collaboration necessitates understanding and knowledge on how nurses perceive each other and what factors promote good collaboration. The relationship between nurse-nurse collaboration has been explored relatively little, though intraprofessional collaboration is an essential factor for a healthy work environment.

AIM

This study explores the Finnish and the Norwegian nurses' perceptions of nurse-nurse collaboration in nursing care and factors associated with those perceptions.

DESIGN

A cross-sectional quantitative study design.

METHODS

In 2015, data were collected from 406 Finnish and Norwegian RNs in two acute-care hospitals, by employing the Dougherty and Larson's Nurse-Nurse Collaboration Scale (NNCS). Descriptive statistics, cross-tabulations, Pearson's chi-Square tests and multivariate anova were used for analysis. Ethical approval for this study was obtained from ethics committees in both countries.

RESULTS

Findings indicated that the perception of nurse-nurse collaboration was good in both countries. However, significant inter-country differences were found in the collaboration subscales. Compared with their Finnish counterparts, Norwegian nurses awarded higher scores to conflict management, communication, shared process, coordination and professionalism. The results suggest that nurse characteristics, such as main working time and total work experience, were related to the perception of collaboration.

CONCLUSION

The subscales with the highest scores in both countries were professionalism, shared process and communication. Factors such as conflict management and coordination are areas which should be emphasised to achieve good collaboration between nurses. Here, nurse leaders play an important part in assessing and improving RN-RN collaboration.

Genetic counselor workforce generational diversity: Millennials to Baby Boomers

There are currently three generations of individuals that make up the genetic counselor workforce: Baby-Boomers, Generation X, and Millennials. These generations are presumed to be shaped by the historical, cultural, and social events that occurred during critical developmental periods. Understanding the underlying perceptions and viewpoints of genetic counselors regarding the multigenerational workforce may facilitate successful working relationships as well as recognition of the perceived unique characteristics that each generation offers. An online survey was distributed to practicing genetics counselors (GC) and genetic counseling students through the National Society of Genetic Counselors and the American Board of Genetic Counseling to elicit opinions about the perceived characteristics or skills of genetic counselors in each generation. Respondents (n = 407, estimated 10% response) preferentially assigned certain traits or skills to specific generations including their own. Findings suggest GC Baby Boomers were least likely to be described as "comfortable with phone or skype counseling" (p < 0.0001), Millennial GC, were least often assigned the term "Strong respect for authority" (p < 0.0005) and Generation X GC were most likely to be described as "Does not ask for feedback" (p < 0.05). These research findings demonstrate that GC perceive that their colleagues from every generation have unique attributes to bring to the profession and these attributes match those typically described in the U.S. literature about non-GC cohorts.

Exploring Japanese nurses' perceptions of the relevance and use of assertive communication in healthcare: A qualitative study informed by the Theory of Planned Behaviour

BACKGROUND

The hierarchical nature of healthcare environments presents a key risk factor for effective interprofessional communication. Power differentials evident in traditional healthcare cultures can make it difficult for healthcare professionals to raise concerns and be assertive when they have concerns about patient safety. This issue is of particular concern in Japan where inherent cultural and social norms discourage assertive communication.

AIM

The aim of this study was to (a) explore nurses' perceptions of the relevance and use of assertive communication in Japanese healthcare environments; and (b) identify the factors that facilitate or impede assertive communication by Japanese nurses.

DESIGN

A belief elicitation qualitative study informed by the Theory of Planned Behaviour was conducted and reported according to the COnsolidated criteria for REporting Qualitative research.

SETTINGS AND PARTICIPANTS

Twenty-three practicing Japanese registered nurses were recruited by snowball sampling from October 2016 to January 2017.

METHODS

Individual face-to-face semi-structured interviews were conducted and transcribed in Japanese and then translated into English. Two researchers independently conducted a directed content analysis informed by the Theory of Planned Behaviour. Participants' responses were labelled in order of frequency for behavioural beliefs about the consequences of assertive communication, sources of social pressure, and factors that facilitate or impede assertive communication in Japanese healthcare environments.

FINDINGS

Although person-centred care and patient advocacy were core values for many of the participants, strict hierarchies, age-based seniority, and concerns about offending a colleague or causing team disharmony impeded their use of assertive communication. Novice nurses were particularly reluctant to speak up because of their perception of having limited knowledge and experience.

CONCLUSION

This study identified Japanese nurses' behavioural, normative, and control beliefs in relation to assertive communication. The findings will be used to inform the development of a culturally appropriate assertiveness communication training program for Japanese nurses and nursing students.

Intergenerational differences in the personal and professional values of nurses

OBJECTIVES:

This study was conducted descriptively for the purpose of determining the differences in the personal and professional values of nurses according to their generation.

METHODS:

The study was planned according to the descriptive research method. The population of the research consisted of nurses carrying out their duties in Istanbul, and the sample consisted of 718 nurses. The number of nurses to be included in the sample was determined by stratified sampling, and the nurses to be included in the sample were determined through random sampling. The data were collected using an information form, the Value Preferences Scale, Professional Value Order of Priority Scale, and the Nurses' Professional Values Scale.

ETHICAL CONSIDERATIONS:

Ethics committee approval for the study was received from the Ethics Committee Presidency of the I.U. Cerrahpasa Medical Faculty of Clinical Studies. The study began after the participants were informed that they could decide to withdraw from the study at any time during the data collection process. In order to use the Nurses Professional Values Scale, written permission was received from Nuray Sahin Orak.

FINDINGS:

The primary value preference is social value for nurses from the Baby Boomers generation, Y and Z generations, and political value for nurses from X generation. It is the nurses from every generation who prioritized human dignity among professional values, which is follow by activation and responsibility. It is determined that a great majority of nurses from the Baby Boomers generation, X, Y, and Z generations prioritized human dignity among professional values, which was followed by the values of equality, justice, and freedom.

CONCLUSION:

These results indicate that nurses from all generations agree on the professional values required by their profession and thus carry out their duties in accordance with the ethical principles and the values of their profession.

Perianesthesia Nurses Are My Second Family: A Qualitative Descriptive Study

PURPOSE

Identify the perceptions of perianesthesia nurses regarding behaviors that promote or detract from sustaining a safe, efficient, and satisfying work environment.

DESIGN

Two focus groups and seven individual interviews (n=14) were conducted exploring the perceptions regarding team behavior of registered nurses in one pediatric perianesthesia unit.

METHODS

Qualitative descriptive data collection, inductive content analysis.

FINDINGS

Nurses described a responsive, engaged health care team whose leadership is available and directive when needed, as creating an effective, satisfying work environment. Primary themes that emerged were Leadership Sets the Tone, Playing Fair, No One Gets Hurt, and Why We Stay. This nursing team acknowledged that inattentive, distracted team members cause frustration, work inequities, and care delays, potentially undermining patient safety.

CONCLUSIONS

Results demonstrate the need to create and sustain consistently respectful perianesthesia work cultures. Research focusing on unit specific approaches to work distribution, communication, leadership, and technology use is needed.

Exploring generational cohort work satisfaction in hospital nurses

Purpose

Although extensive research exists regarding job satisfaction, many previous studies used a more restrictive, quantitative methodology. The purpose of this qualitative study is to capture the perceptions of hospital nurses within generational cohorts regarding their work satisfaction.

Design/methodology/approach

A preliminary qualitative, phenomenological study design explored hospital nurses’ work satisfaction within generational cohorts – Baby Boomers (1946-1964), Generation X (1965-1980) and Millennials (1981-2000). A South Florida hospital provided the venue for the research. In all, 15 full-time staff nurses, segmented into generational cohorts, participated in personal interviews to determine themes related to seven established factors of work satisfaction: pay, autonomy, task requirements, administration, doctor–nurse relationship, interaction and professional status.

Findings

An analysis of the transcribed interviews confirmed the importance of the seven factors of job satisfaction. Similarities and differences between the generational cohorts related to a combination of stages of life and generational attributes.

Practical implications

The results of any qualitative research relate only to the specific venue studied and are not generalizable. However, the information gleaned from this study is transferable and other organizations are encouraged to conduct their own research and compare the results.

Originality/value

This study is unique, as the seven factors from an extensively used and highly respected quantitative research instrument were applied as the basis for this qualitative inquiry into generational cohort job satisfaction in a hospital setting.

Graduate nurses' evaluation of mentorship: Development of a new tool

AIM

Develop and test an instrument to measure graduate-nurses' perceptions of a structured mentorship program.

BACKGROUND

New graduate nurses may experience difficulties in the transition from student to practitioner. Mentoring is commonly used to support graduates. However, there is a lack of published tools measuring graduate nurses' perceptions of mentorship. As mentoring is resource intensive, development and testing of a validated tool are important to assist in determining program effectiveness.

METHODS

A pretest-posttest interventional design was used. Following a critical review of literature and content experts' input, the 10-item National University Hospital Mentorship Evaluation (NUH ME) instrument was tested with a convenience sample of 83 graduate nurses. Psychometric tests included internal reliability, stability, content validity, and factor analysis. Changed scores were evaluated using paired samples t-test.

RESULTS

Seventy-three graduates (88%) out of a possible 83 completed the pre-and post-program survey. Internal reliability was excellent with a Cronbach's alpha of 0.92. Test-retest reliability was stable over time (ICC=0.81). Exploratory factor analysis supported a 1-factor solution explaining 58.2% of variance. Paired samples t-test showed statistical significance between the pre- and post-program scores (p<0.001).

CONCLUSIONS

The NUH-ME measure was found to be valid and reliable. Confirmatory Factor Analysis of the tool with different groups of nursing graduates is required. Mentorship programs can be an effective recruitment and retention strategy, but are also resource intensive. Measuring new graduates' perceptions of mentoring contributes to program relevance in addressing their personal, professional and clinical skill development needs. As mentoring engages a diverse range of mentors, feedback through measurement may also positively alter organizational learning culture.

Speaking up: factors and issues in nurses advocating for patients when patients are in jeopardy

Although speaking up to protect patients is a key ethical and moral mandate for nurses, silence still prevails in many situations. On the basis of concepts of safety culture, generational theory, personal cultural literature, advocacy theory, oppressed group theory, and moral distress theory, the author conducted a literature review and offers a new theoretical framework. The proposed theory identifies primary factors of speaking up: generational, personal culture, and organizational.

Investigation of nurses’ intention to leave: a study of a sample of UK nurses

Purpose

– The purpose of this paper is to provide an evaluation of the key antecedents of leave intention demonstrated by nurses employed in UK National Health Service (NHS).

Design/methodology/approach

– Survey assessment of a sample of 433 nurses employed within the NHS was undertaken, potential relationships relating to both affective commitment and leave intention and work-place experiences assessed through leader-member exchange (LMX) and perceived organisational support (POS) have been evaluated quantitatively, using confirmatory factor analysis (CFA) and structural equations modelling (SEM).

Findings

– The study indicates that both LMX and POS act as direct antecedents to nurses’ leave intention. Additionally, both LMX and POS in combination, significantly effect employees’ affective commitment, the latter further impacting on employee leave intention. This would suggest that both LMX and POS have a significant role to play in employee leave intention that is partially mediated by affective commitment, further analysis confirming this to be the case.

Research limitations/implications

– The sample of nurses is large in absolute terms, permitting the CFA/SEM analysis undertaken, although the data represented only two NHS trusts, hence generalisation across the NHS should be done so cautiously. Various other drivers of leave intention, personal and organisational, have not been assessed here.

Practical implications

– The implications of these results are that to safeguard nurse retention, appropriate line manager engagement is crucial, but this requires organisational support that is recognised by the employees, especially to enhance their levels of affective commitment.

Originality/value

– This is given by providing NHS-based assessment of the role of both POS and LMX in the realisation of both affective commitment and desire to remain with their current organisations amongst members of the UK nursing profession.

Professional values, job satisfaction, career development, and intent to stay

BACKGROUND

Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from $44,380 - $63,400 per nurse-an estimated $4.21 to $6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future.

RESEARCH OBJECTIVE

The purpose of the study was to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system.

RESEARCH DESIGN

A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system.

FINDINGS

Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention.

DISCUSSION

Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future.

CONCLUSION

Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities.

Conflict management style of Jordanian nurse managers and its relationship to staff nurses' intent to stay

AIM

To explore the relationship between conflict management styles used by nurse managers and intent to stay of staff nurses.

BACKGROUND

Nursing shortages require managers to focus on the retention of staff nurses. Understanding the relationship between conflict management styles of nurse managers and intent to stay of staff nurses is one strategy to retain nurses in the workforce.

METHODS

A cross-sectional descriptive quantitative study was carried out in Jordan. The Rahim organization conflict inventory II (ROCI II) was completed by 42 nurse managers and the intent to stay scale was completed by 320 staff nurses from four hospitals in Jordan. The anova analysis was carried out.

RESULTS

An integrative style was the first choice for nurse managers and the last choice was a dominating style. The overall level of intent to stay for nurses was moderate. Nurses tend to keep their current job for 2-3 years. There was a negative relationship between the dominating style as a conflict management style and the intent to stay for nurses.

CONCLUSION

The findings of the present study support the claim that leadership practices affect the staff nurses' intent to stay and the quality of care.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can improve the intent to stay for staff nurses if they use the appropriate conflict management styles.

Do nurses wish to continue working for the UK National Health Service? A comparative study of three generations of nurses

AIM

To identify the combination of variables that explain nurses' continuation intention in the UK National Health Service. This alternative arena has permitted the replication of a private sector Australian study.

BACKGROUND

This study provides understanding about the issues that affect nurse retention in a sector where employee attrition is a key challenge, further exacerbated by an ageing workforce.

DESIGN

A quantitative study based on a self-completion survey questionnaire completed in 2010.

METHODS

Nurses employed in two UK National Health Service Foundation Trusts were surveyed and assessed using seven work-related constructs and various demographics including age generation. Through correlation, multiple regression and stepwise regression analysis, the potential combined effect of various explanatory variables on continuation intention was assessed, across the entire nursing cohort and in three age-generation groups.

RESULTS

Three variables act in combination to explain continuation intention: work-family conflict, work attachment and importance of work to the individual. This combination of significant explanatory variables was consistent across the three generations of nursing employee. Work attachment was identified as the strongest marginal predictor of continuation intention.

CONCLUSION

Work orientation has a greater impact on continuation intention compared with employer-directed interventions such as leader-member exchange, teamwork and autonomy. UK nurses are homogeneous across the three age-generations regarding explanation of continuation intention, with the significant explanatory measures being recognizably narrower in their focus and more greatly concentrated on the individual. This suggests that differentiated approaches to retention should perhaps not be pursued in this sectoral context.

Calling for collaboration: piloting smartphones to discover differences between users and devices

BACKGROUND

Healthcare technologies and patient care have evolved rapidly. Healthcare communication techniques and technologies have lagged.

PURPOSES

This pilot study was conducted at Duke University Hospital to investigate the benefits of using smartphones among healthcare team members to promote efficient and effective patient care.

METHODS

This study used a pre-post implementation survey with an educational intervention. Teams (physicians, patient resource managers, physician assistants, and nurses) from medicine and surgery were randomly assigned a smartphone. A validated 28-question survey was used to assess user experience (7-point Likert scale, with 7 indicating more reliable, strongly agree, and faster). Participants were encouraged to attend focus groups to provide feedback on survey content and overall experience. Facilitators used guiding questions and transcripts were used for qualitative analysis.

RESULTS

Eighty-nine matched pre- and postsurveys were analyzed. Postimplementation data results declined for a majority of items, although remained favorable. This suggests the reality of smartphone use did not live up to expectations but was still considered an improvement over the current paging system. Differences by device and user were found, such as the iPhone being easier to use and the BlackBerry more professional; nonphysicians were more concerned about training and the sterility of the device. Themes elicited from focus groups included challenges of the current paging system, text message content, device ease of use and utility, service coverage, and professionalism.

CONCLUSIONS

Participants in this study recognized the benefit of using smartphones to reach team members in a timely and convenient manner while having access to beneficial applications. Lessons were learned for future implementations with more favorable experiences for participants. Perhaps most striking was the shared acknowledgment that the current system doesn't work well and an understanding of why.