Reflection: an educational strategy to develop emotionally-competent nurse leaders

Undergraduate nursing student's attitudes to learning during clinical practice in different semesters when using a conceptual learning model grounded in a caritative caring perspective - A cross-sectional study

AIM

To describe undergraduate nursing students' attitudes to learning during clinical practice in different semesters when using the conceptual learning model, Model for Improvements in Learning Outcomes (MILO) grounded in a caritative caring perspective.

BACKGROUND

With the intention to support interlinking between theory and praxis and offer understanding and structure to facilitate learning, MILO, theoretically grounded in hermeneutics and a caritative caring perspective based on ethical values, was implemented. MILO consists of four contextual concepts (peer learning, co-clinical teachers, student-centred and student-active supervision) and four intrapersonal concepts (nursing, a reflective approach, a critical approach, quality and safety).

METHODS

A descriptive comparative quantitative study design was applied at a Swedish university, 3 hospitals and 13 municipalities in one county. Cross-sectional data collected via a questionnaire developed to assess attitudes to learning related to MILO's contextual and intrapersonal concepts and their applications were used.

RESULTS

209 students in semester 3, 4 and 6 participated in 6 different clinical practice courses. In comparison, intrapersonal concepts, that is, the student's own characteristics and abilities were viewed to be of greater value for learning than contextual, that is, organisational-related concepts in all semesters. Understanding the needs of others and reflective learning were rated to be of major importance. Students in semester 3 valued the use of the applications the highest. To be supervised in pairs was rated the lowest in semester 6. Some of the concepts and their applications were to great extent not applied.

CONCLUSIONS

In all semesters, fundamentals in caritative caring and characteristics and abilities related to the individual student were rated to be of greater importance for learning than environmental support. Providing students opportunities to develop independency seems essential. Use of a learning model such as MILO is dependent on a bearing of a caritative caring culture and a shared understanding between all involved in student learning during clinical practice.

The Impact of a Psychoeducational Group Program on the Mental Well-Being of Unit-Based Nurse Leaders: A Randomized Controlled Trial

This randomized controlled trial examined the impact of a psychoeducational group program on the mental well-being of unit-based nurse leaders, specifically nurse managers and assistant nurse managers. The program was developed around the themes of resilience, insight, self-compassion, and empowerment to fight burnout and enhance purposeful adaptive coping to reduce distress and improve mental wellbeing. The sample included 77 unit-based nurse leaders. Outcomes included post-traumatic growth, resilience, insight, self-compassion, empowerment, perceived stress, burnout, and job satisfaction. Paired samples t-tests and repeated measures ANOVA tests were conducted to compare outcomes at baseline to the follow-up timepoints of endpoint, one-month follow-up, three-month follow-up, and six-month follow-up. The intervention group participants showed significant improvement in post-traumatic growth between baseline and all follow-up timepoints compared to the waitlist control group. Among intervention group participants, there were also significant improvements in self-reflection and insight, self-compassion, psychological empowerment, and compassion satisfaction, as well as significant reductions in perceived stress, burnout, and secondary traumatic stress. This study extends existing evidence that this psychoeducational group program can be an effective intervention for improving and protecting mental wellbeing. Among nurse leaders, it can reduce stress and burnout and improve post-traumatic growth, self-reflection and insight, self-compassion, psychological empowerment, and compassion satisfaction.

Supporting newly qualified nurses to develop their leadership skills

Leadership is not expected solely of managers. At any stage of their career, nurses are expected to be able to demonstrate leadership in their day-to-day role. However, newly qualified nurses, who often experience a challenging transition from nursing student to registered nurse, may lack the confidence to demonstrate leadership. Nurse managers can support junior nurses to develop their leadership skills, notably through training, mentoring, reflection and action learning. By guiding newly qualified nurses in the use of different leadership approaches, experienced nurses can contribute to enhancing the quality of patient care. This article discusses how nurse managers can support newly qualified nurses to develop their leadership skills.

Fostering collaborative learning and leadership through near-peer mentorship among undergraduate nursing students

BACKGROUND

Innovative teaching strategies in nursing education are essential with increasing enrollment. Collaborative learning and leadership (CLL) activities encourage near-peer learning through mentorship between senior-level and novice students while supporting teaching ratios in lab and clinical. In this study, senior nursing students' perceptions and performance during CLL activities were explored.

METHODS

Final-semester senior students participated in CLL activities and were evaluated on their leadership and engagement. Grading rubric results were summarized using descriptive statistics. Thematic analysis of students' post-CLL reflections supported common themes.

RESULTS

Students' average scores (97.53%) confirm students were prepared and engaged in CLL activities. Senior students enjoyed "building confidence" through these activities, with a consistent theme of "becoming a leader," noted in reflections.

CONCLUSION

Near-peer learning activities assisted senior students in development of leadership and communication skills, preparing them for nursing practice. Recommendations include developing instructions for varied CLL activities and exploring faculty perspectives regarding this experience.

Shaping the Nursing Profession Postpandemic Through Reconstructed Leadership Practices

Responding to and navigating the COVID-19 pandemic were demanding and all-consuming for executive nurse leaders. Long-term pandemic challenges will continue and therefore it is important for nurse leaders to develop their reflective practice to increase role competency, gain wisdom, and advance the profession. The complex postpandemic world requires nurse leaders to show up differently, stop ineffective practices, continue best practices, and implement new ideas to improve performance and outcomes. This article offers a framework for leadership reflection, through role negotiation technique, to identify lessons from the lived nurse executive experience of the COVID-19 pandemic. Specific focus is placed on communication, teamwork, professional governance, posttraumatic growth, gratitude, diversity/equity/inclusion, and social determinants of health. These concepts, along with specific tactics, will help leaders set priorities, aid nursing leadership practice, identify meaningful goals and desired outcomes, and effectively lead to advance the nursing profession postpandemic.

Nursing students' conceptions of competence and the learning processes that support the development of competence: a phenomenographic study

The development of competence among student nurses is important to nurse educators, nursing regulatory bodies, employers and patients. Several teaching and learning strategies support the development of competence among student nurses, but the level of competence at the point of graduation remains below expected standards. Therefore, more research is needed to find strategies that can enhance the development of competence among students. The study explored students' conceptions of competence and the learning processes that support the development of competence in nursing practice. Gaining an understanding of learning and competence from the student's perspective can improve our current understanding of the development of competence. Utilising a phenomenographic approach, in-depth interviews and focus group discussions were conducted among purposively sampled groups of nursing students. The analysis of data was managed through ATLAS. ti 8.1 and followed the process of familiarisation, condensation, comparison, grouping, articulating labelling and contrasting of excerpts to generate the students' conceptions of learning. Five categories of description emerged and showed that the development of competence involves students increasing their understanding of what competence is, hence changing their learning strategies to meet the level of competence, as they understood it. In order of hierarchy from the lowest, the categories of description were: competence is understood as task completion; competence is understood as passing assessments /satisfying facilitators; competence is understood as applying theory to practice; competence is understood as performance of nursing according to clinical standards/guidelines; and competence is understood as performance that yields positive health outcomes.

Model for Improvements in Learning Outcomes (MILO): Development of a conceptual model grounded in caritative caring aimed to facilitate undergraduate nursing students' learning during clinical practice (Part 1)

AIM

The aim was to describe the development of a caritative caring conceptual model aimed to facilitate undergraduate nursing students' learning during clinical practice.

DESIGN

An explorative design was used.

METHODS

The Delphi method with a panel of 12 experts together with a literature search with a systematic approach were used and data were analysed according to content analysis.

RESULTS

The Model for Improvements in Learning Outcomes (MILO) consists of eight core concepts divided into four intrapersonal concepts (nursing, a reflective approach, a critical approach, quality and safety) and four contextual concepts (peer learning, co-clinical teachers, student-centred and student-active supervision, a good learning environment). MILO is grounded in the theory of caritative caring with a hermeneutic approach and the understanding of caring and learning as parallel processes. Tools such as reflection, structure and guiding pm are used to intertwine caring, nursing, pathophysiology and medicine.

CONCLUSIONS

MILO intertwines didactics with concepts important for nursing students' learning with a foundation in caritative caring and may facilitate undergraduate nursing students' learning in clinical practice.

The value of intentional self-care practices: The effects of mindfulness on improving job satisfaction, teamwork, and workplace environments

BACKGROUND

Burnout rates among nurses have detrimental impact on job satisfaction, teamwork, and patient care. This costs millions of dollars in the healthcare system and challenges nurse leaders to address in order to keep up with the healthcare demands. Furthermore, burnout is especially relevant in our current healthcare climate, as frontline nurses have increased workload and multiple psychosocial stressors during the coronavirus disease (COVID-19) pandemic (Sultana, Sharma, Hossain, Bhattacharya, & Purohit, 2019). Literature also suggests that mindful self-care practices need to be reinforced in order to impact burnout long term (Chamorro-Premuzic & Lusk, 2017). Project7 Mindfulness Pledge© is an accessible and voluntary mindfulness tool that nurses can utilize in their individual practice to reduce burnout and does not require significant time commitment.

OBJECTIVE

To evaluate the effectiveness of intentional self-care practices on nurse burnout and workplace environment by measuring job satisfaction and teamwork among nurses.

METHODS

Comparisons between inpatient units on data from the National Database of Nursing Quality Indicators (NDNQI) with the Practice Environment Scale (PES), specifically on job enjoyment and teamwork, were done utilizing ANOVA.

RESULTS

Results show that nurses in an inpatient unit that implemented Project7 has significantly higher job satisfaction as compared to units that did not implement Project7.

CONCLUSIONS

This suggests that this tool provides an effective and accessible mindfulness framework managers and directors can utilize to improve job satisfaction, teamwork, and thereby reduce burnout to create healthier work environments.

Emotional intelligence and authentic leadership among Saudi nursing leaders in the Kingdom of Saudi Arabia

BACKGROUND

Previous studies have found that emotional intelligence has a remarkable influence on authentic leadership. However, the conceivable relationship between emotional intelligence and authentic leadership was unclear, as were the hypothetical bases used in previous studies.

PURPOSE

To determine the correlation between emotional intelligence and authentic leadership of the nursing leaders and the socio-demographic characteristics by which emotional intelligence and authentic leadership vary.

METHODS

Data derived from 152 of the distributed 180 questionnaires were analyzed (84.44% response rate). Nurse leaders in the academy of the Kingdom of Saudi Arabia were assessed from April to July of 2019. t-Tests were used to test gender differences, while the Analysis of variance (ANOVA) tests were employed for age, position, and years of experience. The relationship between the emotional intelligence and authentic leadership scores was analyzed using Pearson's correlation coefficients (bivariate r). The relationships of the four dimensions in the emotional intelligence construct and overall emotional intelligence were assessed using multiple regression analysis and simple linear regression analysis.

RESULTS

Age and years of experience significantly and positively related to emotional intelligence, whereas gender, age, and years of experience in the current position (p = 0.026) were significant regarding authentic leadership. The emotional intelligence total score strongly and positively related to authentic leadership. The regression results on the four emotional intelligence dimensions indicated that the extent of using emotions had the strongest influence on authentic leadership (B = 0.99) followed by appraisal of one's emotions (B = 0.70) and appraisal of others' emotions (B = 0.69). The simple regression analysis indicated that, for every one-point increase in total emotional intelligence score, authentic leadership score increased by 0.086.

CONCLUSION

Age and years of experience were significant factors explaining variation in emotional intelligence, whereas gender, age, and years of experience in the current position were significant for explaining variation in authentic leadership. Using emotions was the strongest influence on authentic leadership, and the emotional intelligence dimension measuring regulation of emotion had no significant influence on authentic leadership.

Developing Authentic Leadership Voice: Novice Faculty Experience

AIM

The aim of this study was to determine the perceptions of 14 novice nurse faculty of a 20-month experiential leadership academy on the leadership development.

BACKGROUND

Managing the complexities of nursing faculty roles requires significant leadership skills that often are hard won. Evidence suggests that leadership preparation to prepare nursing faculty through guided mentoring can enhance faculty recruitment, satisfaction, and retention.

METHOD

Participants completed open-ended questions about their experiences in Sigma Theta Tau International's Nurse Faculty Leadership Academy.

RESULTS

Data analysis revealed a meta-theme of "Finding Authentic Leadership Voice." Four subthemes emerged to shape the meta-theme: Identifying Inner Strengths and Areas for Improvement, Increasing Self-Confidence and Self-Awareness, Increasing Focus on Others, and Clarifying Aspirations for a Leadership Future.

CONCLUSION

Reflecting on their experiences, participants recognized changes in their leadership roles as they found an authentic voice that helped them persist and thrive amid the complexities of their faculty roles.

The Trojan War inside nursing: an exploration of compassion, emotional labour, coping and reflection

Compassionate care is fundamental to nursing. However, when delivering compassionate care, the expected emotional state may not always spontaneously arise, risking a dissonance between authentic and displayed emotions. Nurses may therefore be required to engage in some form of emotional regulation strategy, to conform with assumed professional rules on emotional display. In both the dissonance and emotional regulation, there are risks on which nurses need to reflect. In this article, the end of the Trojan War as depicted in Homer's The Iliad and Virgil's The Aeneid is used as an allegory to illustrate the dangers and advantages of using response- or antecedent-focused strategies for emotional regulation. Response-focused strategies are reactive in nature-they could build resilience over time but may leave students and newly qualified nurses feeling exposed. An 'emotional curriculum' to include emotional intelligence in nurse education could equip the students with a more proactive approach to developing resilience rather than defensive practice. Using a narrative as an allegory may help to explore the application of these concepts in nursing practice.

Using seminars as a teaching method in undergraduate nurse education

This article explores the use of seminars as a teaching method in undergraduate nurse education. Using the backdrop of a year 1 learning unit, grounded in the 6Cs, entitled person-centred practice, the format of the seminars is described in detail. It argues that engaging in a variety of student-centred activities helps students to become informed, self-motivated and curious learners. It identifies that using seminars as a teaching method helps to ensure that students understand and learn what they need to know by using a variety of learning approaches to support them in their personal and academic growth. These include discussion, groupwork, independent learning, the use of technology and building self-confidence, problem-solving approaches and reflection techniques. While being mindful of the higher order skills required to develop and manage seminars, the author uses the concept of constructive alignment to demonstrate development of the seminar approach from curriculum design, teaching, learning, assessment and evaluation.

An integrative review on conflict management styles among nursing professionals: implications for nursing management

AIM

To critically appraise and synthesize empirical studies that examined conflict-management styles used by nursing professionals when dealing with conflict.

BACKGROUND

Conflict is an organisational issue not new to the nursing profession. Despite the increasing research interest on this topic, no studies had been conducted to appraise and summarize evidence that examined conflict-management styles in nursing professionals.

METHOD

An integrative review method was used to analyse the findings. The primary databases used to access articles published from 2000 onwards were CINAHL, Medline, Psych Info, ERIC, Embase and SCOPUS. The search words and MeSH terms included: conflict, management, nursing, nurse manager, nurse, style, and strategy.

RESULTS

Twenty-five studies met the inclusion criteria. Integration was the most frequent style employed by nursing professionals when dealing and managing conflict, followed by accommodation. Avoiding and competing were found to be the least frequently used styles. Mixed and conflicting results were obtained when nurses' demographic variables were considered. Studies are needed to examine how organisational and interpersonal factors influence nurses' choice of style for handling conflicts.

CONCLUSION

Findings demonstrated that nursing professionals used constructive/positive conflict management approaches rather than destructive/negative conflict management approaches.

IMPLICATIONS FOR NURSING MANAGEMENT

This integrative review provided up-to-date evidence that is useful when formulating interventions to equip nurses with positive conflict-management styles necessary to mitigate and manage conflict. Such interventions may include: structured training on conflict management, team building, and conflict coaching activities, continuing professional development, reflective exercises, simulation, and role playing.

Enabling relational leadership in primary healthcare settings: lessons from the DIALHS collaboration

Strong management and leadership competencies have been identified as critical in enhancing health system performance. While the need for strong health system leadership has been raised, an important undertaking for health policy and systems researchers is to generate lessons about how to support leadership development (LD), particularly within the crisis-prone, resource poor contexts that are characteristic of Low- and Middle-Income health systems. As part of the broader DIALHS (District Innovation and Action Learning for Health Systems Development) collaboration, this article reflects on 5 years of action learning and engagement around leadership and LD within primary healthcare (PHC) services. Working in one sub-district in Cape Town, we co-created LD processes with managers from nine PHC facilities and with the six members of the sub-district management team. Within this article, we seek to provide insights into how leadership is currently practiced and to highlight lessons about whether and how our approach to LD enabled a strengthening of leadership within this setting. Findings suggest that the sub-district is located within a hierarchical governance context, with performance monitored through the use of multiple accountability mechanisms including standard operating procedures, facility audits and target setting processes. This context presents an important constraint to the development of a more distributed, relational leadership. While our data suggest that gains in leadership were emerging, our experience is of a system struggling to shift from a hierarchical to a more relational understanding of how to enable improvements in performance, and to implement these changes in practice.

How should medical schools prepare medical students for leading the NHS?

Background

Good medical leadership is vital for the delivery of high-quality patient care; however, medical education in the UK has failed to adequately reflect this. While traditional training programmes focus predominantly on preparing students to be good clinicians, they fail to prepare students to be equally good leaders.

Aims

Prepared for, and subsequently winning, the FMLM Medical Student Essay Prize, this paper looks to offer practical recommendations for the design of an undergraduate curriculum that will help prepare students for leading the National Health Service (NHS).

Methods

Using the four core behaviours outlined in The Leadership and Management Standards for Medical Professionals and the Medical Leadership Competency Framework, this paper derives four themes and four practical methods that can be used to integrate leadership into the undergraduate medicine programme.

Results

There are four key themes of leadership that must be addressed within a medical leadership programme: self, team, system and responsibility. In line with these themes, four recommendations were designed: (1) self- introduce self-reflection portfolios supplemented by goal-setting exercises. (2) Team—supplement clinical placements with leadership placements which offer opportunities to shadow NHS leaders. Additionally, extend ‘Objective Structured Clinical Examinations’ to include leadership assessment stations for appraising student leadership progress. (3) Design an e-learning tool that addresses wider strategic and political issues affecting the health service. (4) Responsibility—offer service improvement projects and service auditing opportunities during placements.

Conclusion

These recommendations offer medical schools realistic ways to integrate medical leadership into the curriculum, thus helping them prepare students to lead the NHS.

Pondering practice: Enhancing the art of reflection

AIMS AND OBJECTIVES

The aim of this study was to describe the effect that immersive simulation experiences and guided reflection can have on the undergraduate nurses' understanding of how stressful environments impact their emotions, performance and ability to implement safe administration of medications.

BACKGROUND

Patient safety can be jeopardised if nurses are unsure of how to appropriately manage and respond to interruptions. Medication administration errors are a major patient safety issue and often occur as a consequence of ineffective interruption management. The skills associated with medication administration are most often taught to, and performed by, undergraduate nurses in a controlled environment. However, the clinical environment in which nurses are expected to administer medications is often highly stressed and nurses are frequently interrupted.

DESIGN/METHODS

This study used role-play simulation and written reflections to facilitate deeper levels of student self-awareness. A qualitative approach was taken to explore students' understanding of the effects of interruptions on their ability to undertake safe medication administration. Convenience sampling of second-year undergraduate nursing students enrolled in a medical-surgical subject was used in this study. Data were obtained from 451:528 (85.42%) of those students and analysed using thematic analysis.

RESULTS

Students reported increasing consciousness and the importance of reflection for evaluating performance and gaining self-awareness. They described self-awareness, effective communication, compassion and empathy as significant factors in facilitating self-efficacy and improved patient care outcomes.

CONCLUSIONS

Following a role-play simulation experience, student nurses reported new knowledge and skill acquisition related to patient safety, and new awareness of the need for empathetic and compassionate care during medication administration. Practicing medication administration in realistic settings adds to current strategies that aim to reduce medication errors by allowing students to reflect on and in practice and develop strategies to ensure patient safety.

RELEVANCE TO CLINICAL PRACTICE

Experiencing clinical scenarios within the safety of simulated environments, offers undergraduate student nurses an opportunity to reflect on practice to provide safer, more empathetic and compassionate care for patients in the future.

Leading nurses: emotional intelligence and leadership development effectiveness

Purpose

The purpose of this paper is to examine the effectiveness of an emotional intelligence (EI) and leadership development education program involving 20 nurse leaders at nursing homes. Also, it investigates the relationship between EI and transformational leadership.

Design/methodology/approach

Three research questions are posed. Correlation analysis and t-tests were conducted to answer the questions posed.

Findings

The findings of this paper indicate that the EI educational development was effective, while the personal leadership development was not. The data also showed a positive significant relationship between EI and transformational leadership.

Research limitations/implications

This paper is limited by the small sample size; thus, a causal relationship between EI and leadership could not be investigated. Additionally, the sample was not randomly selected because of the commitment needed from the participants. Furthermore, the paper was focused on nurse leaders in nursing homes, so it may not be generalizable to other populations.

Practical implications

With the increasing need for nursing home facilities and the limited training generally provided to nurses who move into managerial roles in these facilities, it is critical for organizations to understand the effectiveness of educational programs that exist. Moreover, the findings of this paper may provide information that would be useful to others who wish to develop EI and/or leadership education for nurses.

Originality/value

While much research exists on EI and transformational leadership, little of this research focuses on nurses in nursing home facilities. Thus, this paper fills a gap in the literature.

Developing Professional Practice and Ethics Engagement: A Leadership Model

Nurse leaders are responsible for a practice environment that fosters safe, quality patient outcomes through excellence in nursing practice. This article describes a reflective practice intervention in the Cardiac Intensive Care Unit of an urban academic medical center led by the unit nursing director and the hospital's nurse ethicist. The twice monthly case-based discussions, called "Nursing Practice and Ethics Rounds," were attended by staff and unit managers (nurse director, assistant nurse director, and clinical educator) and were facilitated by the nurse ethicist. The purpose of this descriptive qualitative study was to identify nurses' perceptions of the rounds on individual practice, unit practice, and the practice of their peers. Two focus groups were conducted with nurses who attended 3 or more sessions. Staff reported that they felt valued; experienced a decrease in moral distress; and improved empathy with patients, families, and other staff members after the intervention. They also reported better understanding of ethical issues and language to better talk about them. The presence of nurse leaders was valued as affirming the importance of practice development and of witnessing the experience of staff nurses. Finally, the process of reflection was valued for the opportunity it provided to process emotional and intellectual aspects of challenging cases.

Addressing ethical concerns arising in nursing and midwifery students' reflective assignments

BACKGROUND

Written reflections on practice are frequently requirements of nursing curricula. They are widely accepted as necessary for improving critical thinking and problem-solving skills. Faculty, are expected to review reflections and provide feedback that helps professional development and facilitates good practice. It is less clear what the actions of nurse educators should be when ethical infractions are revealed in the narratives.

OBJECTIVES

We had two aims: 1) To combine insights from a literature review of empirical and theoretical research related to responding to ethical issues revealed in student reflections with our experiences reviewing the reflections of undergraduate nursing and midwifery students, and 2) to construct and analyze a hybrid case from these insights in order to develop guidelines for nurse educators.

RESEARCH DESIGN

A literature review was conducted using CINAHL, MEDLINE, PsycINFO, SocINDEX and ERIC databases and pertinent key words. A hybrid case was constructed of commonly encountered ethical issues using insights from the literature review and the authors' experiences. The case was analyzed by combining Beauchamp and Childress' principlist approach with Campbell and McCarthy's ethical decision-making tool (Table 1). Participants and Research Context: No human participants Findings: A gap in the literature exists related to addressing ethical issues revealed in student practice reflections. However, a combination of insights from the literature and the authors' experiences facilitated the development of a hybrid case. Subsequent case analysis facilitated the development of a series of guidelines that can be utilized to address a range of issues commonly emerging in the reflections of nursing students during practice experiences.

DISCUSSION

A number of recommendations and guidelines are provided to enable the safeguarding of students and staff and support them in practicing ethically.

CONCLUSION

Structured ethical analysis of a constructed hybrid reflection of commonly revealed ethical issues was useful in developing guidelines for educators.

A job demands-resources approach to presenteeism

Purpose

Utilising the job demands-resources (JD-R) model, the purpose of this paper is to examine how aspects of the psychosocial work environment (namely, job demands and resources) are associated with presenteeism, and in particular, whether they are indirectly related via burnout and work engagement.

Design/methodology/approach

A cross-sectional survey of 980 working Australians measured the relationships between job demands (i.e. workplace bullying, time pressure and work-family conflict), resources (i.e. leadership and social support), burnout, work engagement and presenteeism. Path analysis was used to test the proposed hypotheses whilst controlling for participant demographics (i.e. sex, age, work level, duration and education).

Findings

Higher job demands (workplace bullying, time pressure, and work-family conflict) and lower job resources (leadership only) were found to be indirectly related to presenteeism via increased burnout. While increased job resources (leadership and social support) were indirectly related to presenteeism via improved work engagement.

Practical implications

The findings are consistent with the JD-R model, and suggest that presenteeism may arise from the strain and burnout associated with overcoming excessive job demands as well as the reduced work engagement and higher burnout provoked by a lack of resources in the workplace. Intervention programmes could therefore focus on teaching employees how to better manage job demands as well as promoting the resources available at work as an innovative way to address the issue of rising presenteeism.

Originality/value

This study is important as it is one of the first to examine the theoretical underpinnings of the relationship between presenteeism and its antecedents.

Enhancing critical thinking in clinical practice: implications for critical and acute care nurses

The complexity of patients in the critical and acute care settings requires that nurses be skilled in early recognition and management of rapid changes in patient condition. The interpretation and response to these events can greatly impact patient outcomes. Nurses caring for these complex patients are expected to use astute critical thinking in their decision making. The purposes of this article were to explore the concept of critical thinking and provide practical strategies to enhance critical thinking in the critical and acute care environment.

Developing resilience: Stories from novice nurse academics

BACKGROUND

It is acknowledged that novice nurse academics face many challenges on commencement of their new role. Most are recruited from the clinical arena, with little understanding of the academic triumvirate of teaching, research and service. They struggle with role expectation and experience feelings of isolation and anxiety.

AIM

The aim of this paper is to report on an exploration of 14 new nurse academics from two major nursing education institutions as they utilised and developed resilience building strategies.

METHOD

The paper is drawn from a qualitative study that sought to see the world through the eyes of the participants through storytelling. Data was collected using semi-structured, conversational style interviews. Interviews were audio recorded and revealed themes that captured resilience strategies.

RESULTS

These themes were: Developing supportive collegial relationships; Embracing positivity; and Reflection and transformative growth. The first theme, developing supportive relationships, provides insight into the mentoring process and the relationships developed with peers and colleagues. The second theme, embracing positivity, describes the factors that assisted them to face the adversity and challenges in the new role. The final theme, reflection and transformative growth, demonstrated participants' reflecting on difficult situations and demonstrating the ability to learn from the experiences and move forward.

CONCLUSIONS

The strategies utilised by the participants in this study were key factors in the development of resilience which assisted in the transition from clinical nurse to academic. These strategies were often tacit and it is imperative that in a time of acute nurse academic shortages where retention is paramount, that employing organisations support employees and contribute to resilience development. Education on resilience building strategies is fundamental for all new academics and is essential in the transition from clinical nurse to academic.

Managing and mitigating conflict in healthcare teams: an integrative review

AIM

To review empirical studies examining antecedents (sources, causes, predictors) in the management and mitigation of interpersonal conflict.

BACKGROUND

Providing quality care requires positive, collaborative working relationships among healthcare team members. In today's increasingly stress-laden work environments, such relationships can be threatened by interpersonal conflict. Identifying the underlying causes of conflict and choice of conflict management style will help practitioners, leaders and managers build an organizational culture that fosters collegiality and create the best possible environment to engage in effective conflict management.

DESIGN

Integrative literature review.

DATA SOURCES

CINAHL, MEDLINE, PsycINFO, Proquest ABI/Inform, Cochrane Library and Joanne Briggs Institute Library were searched for empirical studies published between 2002-May 2014.

REVIEW METHODS

The review was informed by the approach of Whittemore and Knafl. Findings were extracted, critically examined and grouped into themes.

RESULTS

Forty-four papers met the inclusion criteria. Several antecedents influence conflict and choice of conflict management style including individual characteristics, contextual factors and interpersonal conditions. Sources most frequently identified include lack of emotional intelligence, certain personality traits, poor work environment, role ambiguity, lack of support and poor communication. Very few published interventions were found.

CONCLUSION

By synthesizing the knowledge and identifying antecedents, this review offers evidence to support recommendations on managing and mitigating conflict. As inevitable as conflict is, it is the responsibility of everyone to increase their own awareness, accountability and active participation in understanding conflict and minimizing it. Future research should investigate the testing of interventions to minimize these antecedents and, subsequently, reduce conflict.

Nurse Middle Managers' Dispositions of Habitus: A Bourdieusian Analysis of Supporting Role Behaviors in Dutch and American Hospitals

A Magnet-related program has been recently adopted in the Netherlands. Support for staff nurses from nurse middle managers (NMMs) is a key component of such a program. A Bourdieusian ethnographic organizational case study in 4 hospitals in the Netherlands and the United States (Magnet, Magnet-related, and non-Magnet) was conducted to explore NMMs' supporting role behavior. Bourdieus concepts of habitus, field, and capital guided the analysis. Eight dispositions constitute NMMs habitus. A caring, clinical, and scientific disposition enhances NMMs' capital in particular organizations-as-fields. Further research is necessary to link Magnet (-related) program characteristics to various configurations of dispositions of NMMs habitus.

[A socioconstructivist and humanistic approach to continuing education nurses caring for people with complex needs]

In order to care for persons with complex needs, such as those living with a chronic illness and at risk for complications when hospitalized, nurses must possess multiple sorts of knowledge and skills. After a description of the prevalent schools of thought in pedagogy, the case is made for the use of narrative pedagogy - an educational approach based on nursing science research and congruent with the socio-constructivist and humanist schools of thought?in continuing professional development for nurses. Through the sharing of lived experiences from nurses, care recipients and their families, this educational approach fosters active listening, interpretation, questioning, and perspectival openness. It was tested with nurses caring for hospitalized older persons at risk of presenting signs of acute confusional state and found to be promising. Consequently, it is hoped that educators responsible for the continuing education of nurses in clinical settings will explore this novel educational option in order to adjust their teaching to the knowledge and experience of nurses and to the changing needs of care recipients.

Nurse managers' strategies for feeling less drained by their work: an action research and reflection project for developing emotional intelligence

AIMS

To raise nurse managers' critical awareness of practice problems; uncover practice constraints and improve work effectiveness.

BACKGROUND

Nurse management requires skills and knowledge, underscored by emotional intelligence. The research improved participants' practice and personal insights.

METHODS

Purposive sampling targeted nurse managers interested in improving their practice. Three experienced female nurse managers met fortnightly in a group, for 1 hour, for 10 meetings. The methods included: writing and sharing de-identified journal reflections; critically analysing practice stories; identifying a thematic concern; generating action strategies; and instituting and revising the action plan.

RESULTS

Phase One resulted in the identification of the issue of 'being drained by the intensity of nurse managers' work'. The participants adopted five strategies: debriefing problematic situations; deflecting multiple requests; diffusing issues; naming dysfunctional behaviours; and regrouping. In Phase Two, participants implemented and revised the action plan strategies, which resulted in them feeling less drained by their work.

CONCLUSIONS

Strategies can lessen nurse managers' sense of personal depletion. However, strategies cannot guarantee success every time because the emotional intelligence is integral to nurse management.

IMPLICATIONS FOR NURSING MANAGEMENT

Action research and reflection assist nurse managers to improve their practice and develop their emotional intelligence.

The emotional intelligence of a group of critical-care nurses in South Africa

Critical-care nurses often look after three or more critically-ill patients during a shift. The workload and emotional stress can lead to disharmony between the nurse’s body, mind and spirit. Nurses with a high emotional intelligence have less emotional exhaustion and psychosomatic symptoms; they enjoy better emotional health; gain more satisfaction from their actions (both at work and at home); and have improved relationships with colleagues at work. The question arises: what is the emotional intelligence of critical-care nurses? A quantitative survey was conducted. The target population was registered nurses working in critical-care units who attended the Critical Care Congress 2009 (N = 380). Data were collected with the use of the Trait Emotional Intelligence Short Form and analysed using the Statistical Package for the Social Sciences software. The sample (n = 220) was mainly a mature, female and professionally-experienced group of registered nurses. They held a variety of job descriptions within various critical-care units. Statistics indicated that the standard deviations were small and no aberrant aspects such as demographics skewed the findings. The conclusion was made that registered nurses who are older and that have more experience in critical care appear to have a higher range of emotional intelligence.Kritiekesorg-verpleegkundiges verpleeg dikwels drie of meer pasiënte wat kritiek siek is, tydens een skof. Die werkslading kan tot emosionele spanning ly wat ’n wanbalans tussen die liggaam, siel en gees van die verpleegkundiges laat ontstaan. Verpleekundiges met ’n hoë emosionele intelligensie ondervind minder emosionele uitbranding en psigosomatiese symptome. Hulle toon ’n beter emosionele gesondheid, ervaar meer werks- en tuisbevrediging en het beter verhoudings met hulle kollegas. The vraag wat ontstaan is ‘wat is die emosionel intelligensie van kritieksorg-verpleegkundiges?’ Die toeganglike populasie (N = 380) was geregistreerde verpleegkundiges wat tans in die kritiek sorgeenhede werksaam was en die Critical Care Congress in 2009 bygewoon het. Die data is deur die gebruikmaking van die ‘Trait Emotional Intelligence Short Form’ vraelys ingesamel. Die data is statisties met behulp van die SPSS ontleed. Die populasie (n = 220) was hoofsaaklik n groepe volwasse, vroulike en professioneel ervare verpleegkundiges. Hulle het ’n verskeidenheid van posbeskrywing in die kritieke-sorgeenhede beklee. Die statistieke het ’n minimale standaardafwyking aangetoon. Die gevolgtrekking van die studie is dat geregistreede verpleegkundiges wat ouer en meer ervaring in kritieke sorgverpleging het, ’n hoër vlak van emosionele intelligensie het.

Students in the perioperative learning environment and emotional support

This article examines the responsibilities of perioperative practitioners and students faced with the potentially emotional, stressful and occasionally distressing events of the perioperative clinical placement. It examines emotional growth and reflective learning. Specifically, it looks at the responsibilities of practitioners and students faced with the challenges of an unpredictable perioperative environment. Solutions and strategies for mentors/supervising practitioners supporting the student in the perioperative placement are offered, together with tips for emotional care.

Bearing witness: to promote therapeutic effectiveness

This article describes an innovative educational approach to developing soft skills that underpin therapeutic effectiveness and are critical for safe patient care. Called Bearing Witness, it derived from 10 years of partnering with residents of a low-income neighborhood to provide undergraduate nursing students with wellness-focused interviewing experiences that were paradoxically real and simulated.

'Things you can't learn from books': teaching recovery from a lived experience perspective

Mental health policy in Australia is committed to the development of recovery-focused services and facilitating consumer participation in all aspects of mental health service delivery. Negative attitudes of mental health professionals have been identified as a major barrier to achieving these goals. Although the education of health professionals has been identified as a major strategy, there is limited evidence to suggest that consumers are actively involved in this education process. The aim of this qualitative study was to evaluate students' views and opinions at having been taught 'recovery in mental health nursing' by a person with a lived experience of significant mental health challenges. In-depth interviews were held with 12 students. Two main themes were identified: (i) 'looking through fresh eyes' - what it means to have a mental illness; and (ii) 'it's all about the teaching'. The experience was perceived positively; students referred to the impact made on their attitudes and self-awareness, and their ability to appreciate the impact of mental illness on the individual person. Being taught by a person with lived experience was considered integral to the process. This innovative approach could enhance consumer participation and recovery-focused care.

Reflective components in undergraduate mental health nursing curricula: some issues for consideration

After reflective practice took nursing by storm 20 years ago it is timely to re-examine its influence and implementation on undergraduate teaching. Elements of reflection in relation to learning, matters that affect students and teachers in the classroom and on clinical placements, are reiterated. Interpersonal ethical concerns and issues associated with students' emotional responses to the situations on which they reflect also are considered. We have identified a number of elements that must be considered from both the student's and educator's perspectives to ensure safe and appropriate reflection activities are used in mental health-specific or non-specific undergraduate nursing subjects.

Learning concepts of cinenurducation: an integrative review

BACKGROUND

Cinenurducation is the use of films in both didactic and clinical nursing education. Although films are already used as instructional aids in nursing education, few studies have been made that demonstrate the learning concepts that can be attributed to this particular teaching strategy.

AIM

The purpose of this paper is to describe the learning concepts of cinenurducation and its conceptual metaphor based on a review of literature.

METHOD

The databases CINAHL, MEDLINE, PsychINFO, ERIC, EBSCO, ProQuest Library Journal, and Scopus databases were searched for articles. Fifteen peer-reviewed articles were selected through title and abstract screening from "films in nursing" related articles found in internationally published articles in English from the past 20 years.

RESULT

Four common concepts emerged that relate to cinenurducation: (a) student-centered, (b) experiential, (c) reflective, and (d) problem-solving learning. Current literature corroborates cinenurducation as an effective teaching strategy with its learning activities in nursing education.

CONCLUSION

Future studies may include instructional guides of sample films that could be practically used in various domains to teach nursing competencies, as well as in the development of evaluation criteria and standards to assess students' learning outcomes.

O. Miedo a la muerte y su relación con la inteligencia emocional de estudiantes de enfermería de Concepción

OBJETIVO: Conocer el miedo a la muerte y su relación con la inteligencia emocional y otras variables en estudiantes de enfermería de los últimos años de estudio. MÉTODOS: Estudio descriptivo y correlacional. Los estudiantes (n=188) respondieron a un cuestionario sobre: características socioculturales; Escalas de Miedo a la Muerte y de Inteligencia Emocional. RESULTADOS: Se obtuvo un promedio medio-alto en miedo a la muerte (3,35). La percepción emocional se correlacionó positivamente con miedo a la muerte, mientras que la comprensión y la regulación emocional se correlacionaron negativamente con el miedo a la muerte. Las puntuaciones más altas de miedo a la muerte se asociaron con el sexo femenino, con los niveles inferiores de los cursos y con la percepción de menor preparación académica en el tema. CONCLUSIONES: Los niveles altos de inteligencia emocional, se asociaron con menos miedo a la muerte, lo que evidencia la necesidad de desarrollar en los estudiantes habilidades emocionales frente a situaciones trascendentales y desconocidas, como son la muerte y el proceso de morir.

Emotional intelligence: its relationship to stress, coping, well-being and professional performance in nursing students

Emotional intelligence (EI) has been highlighted as an important theoretical and practical construct. It has the potential to enable individuals to cope better and experience less stress thus contributing to a healthy and stable workforce. The study aimed to explore the EI of nursing students (n=130, 52.0%) and its relationship to perceived stress, coping strategies, subjective well-being, perceived nursing competency and academic performance. Students were on the adult pathway of a nursing diploma or degree programme in one Higher Education Institution (HEI) in the United Kingdom (UK). A prospective correlational survey design was adopted. Three methods of data collection were used: i) A self-report questionnaire; ii) an audit of students' academic performance; and iii) mapping of EI teaching in the curricula. Emotional intelligence was positively related to well-being (p<0.05), problem-focused coping (p<0.05) and perceived nursing competency (p<0.05), and negatively related to perceived stress (p<0.05). The findings suggest that increased feelings of control and emotional competence assist nursing students to adopt active and effective coping strategies when dealing with stress, which in turn enhances their subjective well-being. This study highlights the potential value of facilitating the EI of students of nursing and other healthcare professions.

Valuation and handling of dialogue in leadership: a grounded theory study in Swedish hospitals

PURPOSE

Leadership can positively affect the work environment and health. Communication and dialogue are an important part in leadership. Studies of how dialogue is valued and handled in first-line leadership have not so far been found. The aim of this study is to develop a theoretical understanding of how first-line leaders at hospitals in western Sweden value and handle dialogue in the organisation.

DESIGN/METHODOLOGY/APPROACH

The study design was explorative and based on grounded theory. Data collection consisted of interviews and observations. A total of 11 first-line leaders at two hospitals in western Sweden were chosen as informants, and for four of them observation was also used.

FINDINGS

One core category emerged in the analysis: leaders' communicative actions, which could be strategically or understanding-oriented, and experienced as equal or unequal and performed equitably or inequitably, within a power relationship. Four different types of communicativeactions emerged: collaborative, nurturing, controlling, and confrontational. Leaders had strategies for creating arenas and relationships for dialogue, but dialogue could be constrained by external circumstances or ignorance of the frameworks needed to conduct and accomplish dialogue.

PRACTICAL IMPLICATIONS

First-line leaders should be offered guidance in understanding the consequences of consciously choosing and strengthening the communication component in leadership.

ORIGINALITY/VALUE

The positive valuation of dialogue was not always manifest in practical action. One significant consequence of not using dialogue was that information with impact on organisational efficiency and finances was communicated upwards in the management system.