Professionalism: the major factor influencing job satisfaction among Korean and Chinese nurses

Factors influencing the development of nursing professionalism: a descriptive qualitative study

BACKGROUND

The shortage of nurses threatens the entire healthcare system, and nursing professionalism can improve nurse retention and enhance the quality of care. However, nursing professionalism is dynamic, and the factors influencing its development are not fully understood.

METHODS

A qualitative descriptive study was conducted. Using maximum variation and purposive sampling, 14 southern and northern China participants were recruited. Semi-structured interviews were conducted from May 2022 to August 2023 in face-to-face conversations in offices in the workplace or via voice calls. The interviews were transcribed verbatim and analyzed via thematic analysis.

RESULTS

Three main themes emerged: (1) nourishment factors: promoting early sprouting; (2) growth factors: the power of self-activation and overcoming challenges; and (3) rootedness factors: stability and upward momentum. Participants described the early acquisition of nursing professionalism as derived from personality traits, family upbringing, and school professional education, promoting the growth of nursing professionalism through self-activation and overcoming challenges, and maintaining the stable and upward development of nursing professionalism through an upward atmosphere and external motivation.

CONCLUSION

We revealed the dynamic factors that influence the development of nursing professionalism, including "nourishment factors", "growth factors", and "rootedness factors". Our findings provide a foundation for future development of nursing professionalism cultivation strategies. Nursing administrators can guide the development of nurses' professionalism from many angles according to the stage they are in, and the development of professionalism deserves more attention. In the future, we can no longer consider the development of nursing professionalism solely as the responsibility of individual nurses; the power of families, organizations, and society is indispensable to jointly promoting nursing professionalism among nurses.

Factors Associated with Nursing Professionalism: Insights from Tertiary Care Center in India

BACKGROUND

Professionalism among nurses plays a critical role in ensuring patient safety and quality care and involves delivering competent, safe, and ethical care while also working with clients, families, communities, and healthcare teams.

AIMS AND OBJECTIVES

To assess the level of nursing professionalism and the factors affecting professionalism among nurses working at a tertiary care center in India.

METHODS

A descriptive cross-sectional study was conducted from October 2022 to March 2023 using a total enumeration sampling technique. Following institutional ethics committee approval, standardized tools were administered consisting of Nursing Professionalism Scale and socio-demographic, personal, and organizational characteristics.

RESULTS

A total of 270 nurses participated, with a response rate of 93.7%. The mean age of the participants was 27.33 ± 2.75 years, with the majority being female (82.6%) and belonged to the age group of 23-27 years (59.6%). More than half of the nurses exhibited high professionalism (53%), with the highest and lowest median scores for professional responsibility (29.0) and valuing human beings (13.0) respectively. Multivariate regression analysis demonstrated that, compared with their counterparts, nurses with a graduate nursing qualification (AOR = 4.77, 95% CI = 1.16-19.68), up-to-date training (AOR = 4.13, 95% CI = 1.88-9.06), and adequate career opportunity (AOR = 33.91, 95% CI = 14.48-79.39) had significant associations with high nursing professionalism.

CONCLUSION/IMPLICATIONS FOR PRACTICE

The majority of the nurses had high professionalism, particularly in the domains of professional responsibility and management. Hospitals and healthcare institutions can use these findings to develop policies and prioritize opportunities for nurses to attend conferences and workshops to enhance their professional values, ultimately leading to improved patient care outcomes.

PATIENT AND PUBLIC CONTRIBUTION

No patient or public contribution.

Effects of nursing professionalism and self-efficacy on job embeddedness in nurses

Purpose

This study aimed to investigate the effects of nursing professionalism on job embeddedness to stay in hospital nurses.

Methods

This cross-sectional survey recruited 438 nurses working at four general hospitals and three small to medium hospitals in K province, South Korea. Data were collected from June 10 to September 10, 2022 using structured questionnaires and then analyzed with IBM SPSS Statistics for Windows, version 25.0.

Results

The scores, out of 5.0, were 3.30 for nursing professionalism, 3.73 for self-efficacy, and 3.15 for job embeddedness. The three variables were different according to participants' general characteristics. The correlation between self-efficacy and nursing professionalism had a positive correlation to job embeddedness. Nursing professionalism had a mediating effect on the relation between self-efficacy and job embeddedness. Self-efficacy exerted an influence on organizational commitment through the mediating effect of nursing professionalism and is expected to lay the foundation for the promotion of job embeddedness.

Conclusion

To increase nurses' job embeddedness, nursing and hospital managers must develop and implement programs that help improve nurses' self-efficacy and nursing professionalism to adjust well in their organization.

The Influence of Gender Equity in Nursing Education Programs on Nurse Job Satisfaction

(1) Background: One of the strategies to overcome the shortage of nurses is to minimize gender inequity in nursing culture, starting from the undergraduate education program. Although the number of men entering the nursing profession has increased over the years, the portion of male nurses remains low, particularly in Asian countries. Only a few studies have been conducted to identify gender inequity in nursing, and most of these studies used qualitative study design. Therefore, it is necessary to quantitatively identify gender equity in nursing education and the influence it has on nurse job satisfaction. (2) Methods: A total of 165 male nurses participated in this study. Validated questionnaires were used to assess gender equity in nursing education programs, nurse job satisfaction, nurse job esteem, and nursing professional pride. (3) Results: The mean score of gender equity in nursing programs was 62.6, showing a positive correlation with nurse job satisfaction, nurse job esteem, and nursing professional pride. Gender equity positively predicted nurse job esteem. (4) Conclusions: The gender equity in nursing education programs has positive predictive effects on the factors that influence male nurse job satisfaction. In order to increase nurse job retention, educators should incorporate strategies to minimize gender inequity.

Narrative medicine as a teaching strategy for nursing students to developing professionalism, empathy and humanistic caring ability: a randomized controlled trial

BACKGROUND

Narrative medicine has become a solution to cultivate medical students' ability of empathy and humanistic care. However, the role of narrative medicine is lacking in the study of professionalism. The aim of this study was to analyze the effects of narrative medical theory learning and narrative writing on professionalism, empathy and humanistic care ability of nursing students.

METHODS

This cluster randomized controlled trial was conducted between June 2021 and June 2022 in two universities in Jiangsu, China. The participants of this study were 85 nursing students who were randomly divided into the intervention group (n = 43) or the control group (n = 42). Participants in the intervention group were trained in narrative medical theory learning and narrative writing based on a Web-based platform, while those in the control group were not. Self-report questionnaires of professionalism, empathy and humanistic care ability were used before and after intervention.

RESULTS

The results showed that the professionalism score of the intervention group was (68.7 ± 6.8 vs. 64.5 ± 7.5; P = 0.005), empathy (99.4 ± 15.7 vs. 92.2 ± 14.6; P = 0.014) and humanistic care ability (127.6 ± 20.0 vs. 113.3 ± 18.8; P = 0.004) were better than the control group.

CONCLUSION

The results of this quantitative study suggest that narrative medical theory education and narrative writing based on the network platform can promote the development of professionalism, empathy and humanistic care ability of nursing undergraduates.

Level of Professionalism and Associated Factors Among Nurses Working in South Wollo Zone Public Hospitals, Northeastern Ethiopia, 2022

Introduction

Nurses are the frontline force for patient care, and nursing professionalism is a key tool for quality of care. Nursing professionalism and its characteristics should be defined in accordance with the current system.

Objective

To determine the level of professionalism in nursing and its associated factors in the South Wollo Public Hospital, Northeast Ethiopia.

Methods

A multicenter hospital-based cross-sectional study design was used in South Wollo Zone Public Hospitals from March to April 2022, with 357 nurses selected using a simple random sampling method. Data were collected using a pretested questionnaire, then entered and analyzed using EpiData 4.7 and SPSS 26. Finally, predictors of nursing professionalism were identified using a multivariate logistic regression.

Result

Of the 350 respondents, 179 (51.1%) were women and 171 (48.9%) were men, with 68.6% displaying high levels of professionalism. Being women (adjusted odds ratio [AOR] = 2.93, 95% CI [1.718, 5.000]), having a positive self-image (AOR = 2.96, 95% CI [1.421, 6.205]), having a good organizational culture (AOR = 3.16, 95% CI [1.587, 6.302]), being a member of the nursing association (AOR = 1.95, 95% CI [1.137, 3.367]), and nurses who were satisfied with their job were significantly associated with nursing professionalism.

Conclusion

In this study, the level of nursing professionalism was encouraging but needed more effort. Furthermore, sex, self-image, organizational culture, nursing association membership, and job satisfaction were positive predictors of nursing professionalism. As a result, hospital administrations consider factors that maintain a pleasant institutional working environment to foster a positive self-image and increase job satisfaction.

The Development of Family Medicine Identity Scale

Aim: It is to put a scale into the use of the academic community which measures how well the doctors can interiorize the features concerning family practice the training of family practice specialization in our country, by developing a family practice identity scale that is peculiar to Turkey. Methods: Our research is the study of developing a scale. A 5-point Likert scale is generated by creating the questionnaire and then the aforementioned scale is studied to verify the validation and reliability in Turkey. The scale has been performed on 351 people who work as academicians, specialists and residents in the field of family practice. Results: During the analyses, while the first four factors whose eigenvalues are the highest are kept fixed, the questions from the other factors are distributed according to their content similarities. As a result, forty-six questions is obtained. Kaiser-Meyer-Olkin value conformity assessment the result was obtained at a very good level (KMO: 0.940) and Cronbach's alpha value was calculated as 0.952. The sub-scales are named by the contents of the questions: Patient-doctor communication, professional satisfaction, the scope of the working area and comprehensive approach, and biopsychosocial approach. It has been concluded that the scale is a valid and reliable questionnaire in Turkey after these advanced statistical analyses. Conclusion: "The Scale of Family Practice Identification" is developed successfully. With the aforementioned scale, by observing the professional progress of residents, the doctors that have an occupational identity and sense of belonging can be trained for the community of family practice. Keywords: family practice, reliability and validity, scales

Why do Social Workers Leave? A Moderated Mediation of Professionalism, Job Satisfaction, and Managerialism

Turnover has been a serious concern to social service organizations. A lack of committed social workers is a risk to organizational performance and service quality. Therefore, it is vital to better understand the leaving process of social work practitioners. The study constructed a moderated mediation model to examine the mediating role of job satisfaction between employees' professionalism and turnover intention and the moderating role of the perceived level of managerialism in the context of social work organizations. A total of 667 participants from Guangzhou, Shenzhen, and Shanghai in China were recruited to complete the survey. Results presented that job satisfaction plays a full mediation role in the relationship between professionalism and turnover intention. In addition, the positive relationship between professionalism and job satisfaction, as well as the negative relationship between professionalism and turnover intention were moderated by managerialism. The findings enrich knowledge about turnover among social workers in the context of China and inspire to foster professionalism among service workers to improve job satisfaction and alleviate turnover intention and actual turnover as well as to apply management techniques and structures properly to strengthen the effect of professionalism on promoting job satisfaction and on preventing turnover intention.

Impact role stress on turnover intentions of Pakistan's healthcare workers: Mediating and moderating role of organizational cynicism and self-efficacy

Nurses make up most of the global healthcare system, thus justifying their significance in the respective industry. The healthcare profession is amongst the very few careers that are attributed to a very high level of stress and imbalanced work-life equilibrium. Over past decades, the said nature of work has been observed to coerce countless nurses to leave their respective organizations. Considering this, the current study primarily evaluates the impact of role stressors on the turnover intentions of nurses employed in the healthcare industry of Pakistan. Secondly, the study examines the mediatory role of organizational cynicism between the role stressors and turnover intentions to explain the escalating trend of nurses intending to leave the industry. Lastly, it assesses the moderating role of self-efficacy between the organizational cynicism and the intended turnover of a nurse, to gauge the amount of variation self-efficacy can cause to mitigate the negative attitudes of employed individuals. The current study was conducted in the twin metropolitans of Pakistan i.e., Rawalpindi and Islamabad. A total of 394 responses were statistically evaluated using SmartPLS 3.0. The results of the current study indicated a significant impact of role stressors on the turnover intentions of nurses. Also, organizational cynicism was observed as a significant mediator between role stressors and turnover intentions. Further, self-efficacy as well was observed as a significant moderator between organizational cynicism and the intent of healthcare workers to leave the organization. The present study addressed the conceptual research gap by exploring the direct cumulative effect of role stress (role ambiguity, role conflict, role stressors, work-family conflict) in developing the intents of professionals to quit their employing organizations, the mediatory role of organizational cynicism, and the moderation effect of self-efficacy between the undertaken variables. While in terms of abridging the contextual research gap, the current study evaluated the proposed research model within the healthcare sector of Pakistan. The findings of the current study commended the management personnel of the healthcare industry to provide the nurses with healthy professional environments to work in, as well as catering to their professional and personal expectations to a better extent. Hence, increasing the ownership of an individual depicted towards his/her employing organization.

Study of Nightingale's nursing professionalism: a survey of nurses and nursing students in China

Background

Nursing professionalism is highly significant to the development of nursing. Florence Nightingale was the founder and leader of modern nursing, and Nightingale’s nursing professionalism has a significant impact on nursing in China and all over the world. In the new era, a new understanding of Nightingale’s nursing professionalism should be developed, and its positive role in nursing reshaped.

Methods

A total of 1,557 nurses and nursing students from 27 provincial administrative regions of China were surveyed using a customized questionnaire. Their recognitions of Nightingale’s nursing professionalism were evaluated based on scores, and statistical differences between and within the groups were analyzed using an Analysis of Variance (ANOVA). The elements of Nightingale’s nursing professionalism were extracted by the exploratory factor method and a principal component analysis.

Results

The Cronbach’s α of the questionnaire was 0.965, and the two groups did not differ significantly (p > 0.05). Based on the standard that the cumulative contribution rate of common factor should be > 85%, three common factors of Nightingale’s nursing professionalism, including professional emotion, professional ability and professional ethics, were extracted based on the Scree plot.

Conclusions

This study aimed to explore the connotation of Nightingale’s nursing professionalism. Our survey indicates that Nightingale’s nursing professionalism is highly recognized by nurses and nursing students in China. Its connotation includes professional emotion, ability and ethics. Nursing education and nursing management should fully utilize the leading role of Nightingale and guide the professional behaviors of nurses to be consistent with Nightingale’s nursing professionalism, thus, improving the degree of nurse professionalism.

Redefining the concept of professionalism in nursing: an integrative review

Objective

In today's world with sweeping changes, nurses are responsible for providing high-quality and cost-benefit care, which would almost be impossible unless they achieve their high professional status. To date, no precise and comprehensive definition of professionalism in nursing has been evidently proposed. In fact, many of the previously proposed definitions are either complicated or ambiguous. Moreover, there is no consensus in the literature on an exhaustive definition for “a professional nurse.” The present study aimed to illustrate the concept of professionalism in nursing and identify its defining characteristics.

Methods

In this study, concept analysis was conducted using Whittemore et al.'s method for the integrated review. A comprehensive search of electronic, scientific databases including Eric, PubMed, Scopus, Web of Science, EBSCO, PsychoINFO, Embass, MagIran, IranDoc, SID, and IRANMEDEX was carried out using the keywords such as professionalism, professional behavior, nursing professionalism (NP), professional attribute, and nursing.

Results

In the present study, a comprehensive search of 11 electronic databases retrieved 5738 articles. Then, 2837 duplicate articles were removed by endnote (version 8). Based on a preliminary examination of the titles and abstracts as well as the inclusion and exclusion criteria, 1517 articles were excluded. In addition, 137 articles were removed for scientific reasons. Finally, 52 articles in English and Persian were selected. Content analysis of the articles revealed four major themes, namely, individual prerequisite, professional prerequisite, appropriate structure, and socio-individual factors.

Conclusions

Professionalism in nursing is a major, multidimensional concept according to the literature that included individual prerequisites, professional prerequisites, appropriate structures, and socio-individual factors. In fact, professionalism in nursing comprises a wide range of personal characteristics, self-regulation, professional values, striving to acquire and enhance professional expertise, professional interactions, social, professional, and legal responsibility, and creation of a sense of belonging, and professional development.

Effects of the Resilience of Nurses in Long-Term Care Hospitals during on Job Stress COVID-19 Pandemic: Mediating Effects of Nursing Professionalism

Purpose: To investigate nursing professionalism as a mediating factor in the relationship between resilience and job stress levels for nurses working in long-term care hospitals during the COVID-19 pandemic. Methods: A cross-sectional survey was conducted from January to March 2021 in seven long-term care hospitals in the Seoul metropolitan area to measure resilience, nursing professionalism, and job stress among nurses. Simple and multiple regression analyses along with the Sobel test were performed to verify the mediating effect of nursing professionalism. Results: Data from 200 nurses were included in the final analysis. Results showed that individual and occupational characteristics could lead to differences in nurses’ resilience, job stress levels, and nursing professionalism. Nursing professionalism had a significant mediating effect on the relationship between resilience and job stress levels. The effect of resilience on job stress levels was significant (β = −0.16, p = 0.024). After controlling for nursing professionalism, the effect declined and was not statistically significant (β = −0.09, p = 0.251). Conclusion: There is a need to increase individual resilience and nursing professionalism through intervention programs and policy proposals to manage job stress among long-term care hospital nurses during the COVID-19 pandemic.

The symptoms and factors associated with post-traumatic stress disorder for burns nurses: a cross-sectional study from Guangdong province in China

BACKGROUND

The symptoms of post-traumatic stress disorder (PTSD) among medical staff has become a significant issue. Environments related to burns are highly stressful for nurses and can lead to PTSD, thus affecting their mental health. It is vital to consider that the quality of burns care, and the outcomes of such treatments, may be threatened if nurses experience PTSD. We evaluated PTSD symptoms in burns nurses and explored the correlations between demographic characteristics, work-related characteristics, professional identity, turnover intention, and PTSD symptoms.

METHODS

This was a cross-sectional study involving 273 nurses working in burns unit from Guangdong, China, between July and August 2019. Nurses were recruited from 30 hospitals and completed three validated psychological questionnaires: Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C), Professional Identity Scale for Nurses (PIS), and Turnover Intention Questionnaire (TIQ). We also collated information relating to socio-demographic and work-related characteristics.

RESULTS

The cut-off point for the PCL-C was defined as 38 points; 17.22% (n=47) of participants scored higher than or equal to 38. The PCL-C score was negatively correlated with professional identity level (P < 0.01) and positively correlated with turnover intention (P < 0.01). The workplace, mean monthly income, experience of workplace violence, and professional identity level, were important factors and all associated with the severity of PTSD.

CONCLUSION

PTSD symptoms were common in burns nurses. Attention should be paid to the mental wellbeing of these staff. Screening processes need to be initiated to identify individuals suffering from PTSD and take appropriate early interventional action.

Does professional identity play a critical role in the choice to remain in the nursing profession?

AIM

To explore aspects of professional identity in nurses' written narratives of what is significant to their choice to remain in the profession.

DESIGN

This study used a qualitative design and was underpinned by a hermeneutical approach.

METHODS

The participants were recruited via purposive sampling procedures and included 13 nurses aged 26 to 62 years. The data were collected in the form of written narratives to initiate the nurses' reflections on the decision to remain in the profession. A thematic analysis was conducted.

RESULTS

The analysis revealed two themes: acting as a professional contributor and realigning to maintain professional belongingness. In the nurses' written narratives, these aspects of professional identity were clearly significant to their choice to remain in the profession. In a complexly interwoven way, the aspects constructed who the nurses were as professionals, and thus, professional identity seems to play a critical role in the choice to remain.

Examination of evidence-based nursing attitudes and the relationship with professional self-concept in nurses working in a psychiatric hospital

PURPOSE

The study was carried out with nurses working in a psychiatric clinic to examine their attitudes toward evidence-based practices and levels of professional self-concept.

DESIGN AND METHODS

This study was carried out using a descriptive and correlational search design. We used a Personal Information Form developed by the authors and Evidence-Based Nursing Attitude Scale (EBNAS) and Professional Self-Concept Scale for Clinical Nurses (PSCSCN) to obtain data. Percentages and averages, and the Pearson correlation coefficient was used for data analysis.

FINDINGS

The mean scores of the total and subdimensions of EBNAS and PSCSCN were high for the participating nurses. A positive relationship was found between EBNAS and PSCSCN.

PRACTICE IMPLICATIONS

The positive attitude of the nurses toward evidence-based nursing is related to their high professional self-concept.

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

AIM

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

The demographic predictors of job satisfaction among the nurses of a major public hospital in KSA

OBJECTIVE

Nurses play fundamental roles in the delivery of health care services. Nurses' job satisfaction levels can have profound impacts on the quality of the care that they provide to patients. Accordingly, this study aimed to examine nurses' levels of job satisfaction and the impact of key demographic variables on this variable.

METHODS

Between April and May 2019, a quantitative cross-sectional descriptive study was conducted in a major public hospital in KSA. The Minnesota Satisfaction Questionnaire short form was completed by a sample of 382 nurses who had been recruited using systematic random sampling. The data were entered into Statistical Package for Social Sciences (SPSS) spreadsheets and analysed using SPSS version 22. Demographic differences in mean satisfaction scores were examined using independent-samples t-test and analysis of variance. Finally, multiple linear regression analysis was conducted.

RESULTS

Out of a total of 382 nurses who were invited to participate in this study, 337 responded (response rate = 88%), and almost 85% of them were Saudi nationals. Overall, 48% of the participants were satisfied, and only 22% of them were dissatisfied with their jobs. The participants were more satisfied with intrinsic than with extrinsic factors of a job.

CONCLUSION

Most nurses reported moderate levels of overall job satisfaction. Greater job satisfaction was related to demographic factors such as sex (i.e. male), nationalilty (i.e. Saudi), and age (i.e. older). Job satisfaction was negatively correlated with higher salary. Age and salary predicted the outcome variable. Health care authorities should take more efforts to increase the job satisfaction of nurses in KSA.

A Web-based Survey of Marital Quality and Job Satisfaction among Chinese Nurses

PURPOSE

This study aimed to use a web-based survey to investigate the correlation between job satisfaction and marital quality and to identify the association of demographics with job satisfaction and marital quality.

METHODS

Married nurses (N = 2,296) completed the questionnaires. Correlations and linear regression analyses were carried out.

RESULTS

Both marital quality and job satisfaction were relatively low. Additionally, marital quality was positively correlated with job satisfaction. Age, marital status (in years) and average daily hours spent with spouse had positive impact on job satisfaction. Multiple linear regression analyses showed that age, monthly income, average daily hours spent with spouse and marital quality were positively associated with job satisfaction.

CONCLUSION

Because of the shifts nurses working, there is little time for nurses to spend with their spouses and family. It is recommended that hospital leaders could provide more flexibility with nurses' shift choices so nurses can arrange their work-life balance better. Other considerations like reducing workload and reducing working hours should be promoted as options. Nurse managers could offer counseling services including strategies to cope with the balance between work and life. This effort could improve job satisfaction and reduce the rate of turnover of nurses.

The effects of amplitude and stability of circadian rhythm and occupational stress on burnout syndrome and job dissatisfaction among irregular shift working nurses

AIM

To investigate the relation between the circadian rhythm amplitude and stability, and occupational stress with burnout syndrome and job dissatisfaction among shift working nurses.

BACKGROUND

Irregular shift working nurses are prone to burnout syndrome (BS) and job dissatisfaction (JD). circadian rhythm difference and occupational stress might be effective in causing burnout syndrome and dissatisfaction.

DESIGN

In total, 684 nurses who worked in four teaching hospitals were selected by stratified random sampling in a cross-sectional design based on STROBE guidelines.

METHODS

The data were collected by the Circadian Type Inventory, Job Content Questionnaire, Minnesota Satisfaction Questionnaire and the Maslach Burnout Inventory. Multiple linear regression, one-way ANOVA and independent t test were used for statistical analysis by SPSS v24.

RESULTS

About 15% of the nurses suffered from high levels of burnout syndrome. Psychological demand (β = 0.022, CI 95% = 0.003-0.047 and β = 0.016, CI 95% = 0.001-0.032) and workplace support (β = -0.043, CI 95% = -0.097-0.003 and β = -0.025, CI 95% = -0.046-0.006) were significant predictors of BS and JD. Male nurses reported lower BS and higher JD compared to female nurses. Irregular shift working schedule was also related to a significantly higher odd of BS (p = 0.009) and JD (p = 0.011). Nurses classified as languid experienced significantly more BS and JD than vigorous nurses.

CONCLUSION

This study shows that BS and JD were strongly associated with psychological demand and workplace support; and vigorous nurses were less prone to BS and JD, and were more suitable for irregular shift work.

RELEVANCE TO CLINICAL PRACTICE

In order to reduce burnout syndrome and job dissatisfaction among irregular shift working nurses, we need to identify the effect of risk factors such as individual differences on the circadian rhythm and job demand which can affect nurses who work in irregular schedules.

English-to-Spanish Translation of the Nijmegen Professionalism Scale

BACKGROUND AND PURPOSE

The aim of this investigation was to perform the cross-cultural and linguistic translation and adaptation of the Nijmegen Professionalism Scale for Spanish nursing. Originally designed by Tromp et al. (2010) for its use by general practitioners, the new Spanish version of this tool assesses professional commitment, allowing for the comparison, prevention, association, and longitudinal monitoring of commitment among nursing professionals.

METHODS

The linguistic translation from English to Spanish was performed using the translation-back-translation method; the process of cross-cultural adaptation to the Spanish nursing context was carried out following the recommendations given by a panel of experts comprised of 24 practicing nurses with different professional backgrounds. The data for the feasibility study were collected between December 2015 and January 2016.

RESULTS

The original English version of the instrument contains 106 items and was originally developed for assessing professional behavior of general practitioner trainees; the new version, with a significant reduction in the initial number of items, comprises 49 items and is now ready for pilot testing and validation in our context.

IMPLICATIONS FOR PRACTICE

The Nijmegen Professionalism Scale in its Spanish version will act not only as a tool for measuring professional commitment among Spanish nurses but also as a motivational resource and means for reflection which will, in turn, increase the quality of the care provided by these professionals.

Psychometric evaluation of the Chinese version of the Snizek-revised Hall's Professionalism Inventory Scale

Objective

This study was performed to assess the reliability and validity of the Chinese version of the Snizek-revised Hall’s Professionalism Inventory Scale (C-SR-HPIS).

Methods

Exploratory factor analysis and confirmatory factor analysis were used to evaluate the construct validity of the C-SR-HPIS. The average variance extracted (AVE) and square root of the AVE were calculated and correlation analyses were performed to test the convergent validity and discriminant validity, respectively. Cronbach’s alpha (α) coefficient was used to test the internal consistency reliability.

Results

Data for 355 clinical nurses in mainland China were collected. Five factors were extracted, accounting for 58.86% of the total explained variance, and 20 items were selected for the C-SR-HPIS. The confirmatory factor analysis suggested good fitness of the modified model. The AVE was acceptable for convergent validity. The square roots of the AVE of the five factors were larger than their correlation coefficients with other factors, showing suitable discriminant validity. Cronbach’s α coefficient of internal consistency reliability of the overall scale was 0.76, indicating good reliability of the scale.

Conclusions

This study demonstrated good reliability and validity of the C-SR-HPIS and provides a quantitative tool for the assessment of nursing professionalism in China.

THE EFFECT OF WORK-FAMILY CONFLICT AND JOB INSECURITY ON INNOVATIVE BEHAVIOUR OF KOREAN WORKERS: THE MEDIATING ROLE OF ORGANISATIONAL COMMITMENT AND JOB SATISFACTION

South Korea is becoming an advanced economy based on continuous innovative organisational efforts. Job stressors have been identified in the literature as a major hindrance to many positive organisational behaviours. We predict that job insecurity and work–family conflict will have a negative effect on innovative behaviour with mediators of job satisfaction and organisational commitment. Results from structural equation models provided support for this study. From a practical perspective, the significant negative relationships between job stressors and innovative behaviour imply the need to reduce work–family conflict and feelings of job insecurity in Korean companies in order to foster innovation.

The Level of Professionalism of Nurses Working in a Hospital in Turkey

INTRODUCTION

Professionalism is characterized by the degree of dedication displayed by individuals regarding the values and behavioral attributes of a specific career identity. Professionalism indicates attitudes that represent high levels of identification with and commitment to a specific profession. In the process of the professional development of nursing, various factors affect these obstacles which may impede the professional development of nurses and their professional behaviors. This study was carried out with the aim of determining the professional behavior of nurses in a hospital in Turkey.

METHODS

In this descriptive exploratory study a total of 89 nurses working in a public hospital in northwestern of Turkey were participated. Data were collected using a demographic questionnaire and Behavioral Inventory Form for Professionalism in Nursing (BIPN).

RESULTS

The result showed that mean scores on the BIPN were 5.07 (3.47). The areas with the highest levels of professional behavior were competence and continuing education 1.88 (0.34). The professionalism levels for nurses were the lowest in the areas of autonomy 0.06 (0.34), publication 0.10 (0.25), and research 0.25 (0.60). There was a statistically significant difference between the total BIPN scores and the education levels of the nurses and the working of nurses.

CONCLUSION

The professional behavior of nurses is at a low level. Since the arrangement of the nurses' working conditions affects their professional behaviors; therefore, development in the field of professional behaviors in nursing must be assessed and supported to increase the quality of patient care.

Enabling professional development in mental health nursing: the role of clinical leadership

Clinical leadership is acknowledged as important to the nursing profession. While studies continue to identify its significance in contributing to positive outcomes for consumers, the role that clinical leadership has in enabling and supporting professional development in mental health nursing is poorly understood. This study utilized a grounded theory methodology to explore the characteristics clinicians consider important for clinical leadership and its significance for mental health nursing in day-to-day clinical practice. Individual face-to-face, semi-structured interviews were conducted with nurses working in mental health settings. Participants described the important role that clinical leaders play in enabling professional development of others through role modelling and clinical teaching. They describe how nurses, whom they perceive as clinical leaders, use role modelling and clinical teaching to influence the professional development of nursing staff and undergraduate nursing students. Attributes such as professionalism and honesty were seen, by participants, as enablers for clinical leaders in effectively and positively supporting the professional development of junior staff and undergraduate nurses in mental health nursing. This paper examines clinical leadership from the perspective of mental health nurses delivering care, and highlights the important role of clinical leaders in supporting professional development in mental health nursing.

Job satisfaction and intent to leave among psychiatric nurses: closed versus open wards

PURPOSE

The aim of this study was to investigate: (a) the association between socio-demographic variables, job satisfaction and intent to leave among hospital psychiatric nurses, and (b) the differences in the above between psychiatric nurses working on closed and open wards.

PROCEDURES

After receiving ethical approval, a convenience sample of 52 (70% of total nursing staff) was drawn from psychiatric nurses in a large Israeli psychiatric hospital (95% response rate). The sample completed anonymously a self-administered structured questionnaire.

MAIN FINDINGS

A negative correlation was found between job satisfaction and intent to leave and between age, all categories of seniority, and intent to leave. Closed-ward nurses reported a higher intent to leave psychiatric nursing. Nurses under 35 reported a significantly higher intent to leave psychiatric nursing than nurses over 35. Job satisfaction was significantly higher among full-time nurses than part-time.

PRINCIPAL CONCLUSIONS

Psychiatric hospitals need to pay attention to all factors associated with workers' readiness to leave. Given the widespread shortage of nurses, it is especially important that they address the relatively low job satisfaction of both younger and part-time nurses, and the particular stresses that closed-ward nurses work under.

Family nursing hospital training and the outcome on job demands, control and support

The purpose of this study was to evaluate the impact of a family systems nursing hospital training educational program (ETI program) on nurses' and midwives' perception of job demands, control, and/or support. Of the nurses and midwives who were working in the Women's and Children's Services Division at The National University Hospital in Iceland, 479 participated in the study on three time periods from 2009 to 2011. Scores for the characteristics of job demands and job control were created to categorize participants into four job types (Karasek and Theorell, 1990). These four job types are high strain (high demand, low control), passive (low demand, low control), low strain (low demand, high control), and active (high demand, high control). However, when the data were evaluated based on the proportion of job characteristics as reported by the nurses and the midwives, no significant difference was found over time (2009 to 2011) (χ(2)=5.203, p=.518). However, based on the results from the independent t-tests at time 1, a significant difference was found amongst the high strain job group regarding perceived support from administrators and colleagues among the nurses and midwives who had taken the ETI program compared to those who had not taken the program (χ(2)=2.218, p=.034). This indicates that the health care professionals who characterized their job to be of high demand but with low control evaluated the support from their administrators and colleagues to be significantly higher if they had taken the ETI program than did the nurses and midwives who did not take the ETI program. These findings are promising because they might, in the long run, increase the nurses' and midwives' autonomy and control over their own work.

The impact of psychological empowerment and organizational commitment on Chinese nurses' job satisfaction

Background: Research findings have shown that job satisfaction of Chinese nurses is at a low level. Limited studies have focused on the impact of psychological empowerment and organizational commitment on job satisfaction of Chinese nurses. Aims: The aim of this study is to describe job satisfaction, psychological empowerment and organizational commitment of Chinese nurses and to explore the impact of psychological empowerment and organizational commitment on the nurses' job satisfaction. Methods: A total of 726 nurses were recruited in a convenience sample from 10 tertiary hospitals. Data were collected using four questionnaires including Job Satisfaction Survey, Psychological Empowerment Scale, Organizational Commitment Scale and Demographic Questionnaire. Descriptive analysis, correlation and stepwise multiple regression were used for data analysis. Results: Nurses' job satisfaction, psychological empowerment, and organizational commitment were identified at moderate levels. Nurses' job satisfaction and psychological empowerment were significantly different in terms of age and length of service; nurse job satisfaction varied with respect to marital status. Findings further indicated that nurse job satisfaction was positively correlated with psychological empowerment and organizational commitment. Psychological empowerment, organizational commitment, and marital status were significant predicting factors of nurse job satisfaction. Conclusions: This study provides evidence to help nursing managers and health policy-makers to develop intervention programs aimed at enhancing nurse job satisfaction and retaining nurses.

Relationship between job satisfaction, professional identity and intention to leave the profession among nurses in Turkey

AIMS

The purpose of this study is to investigate the relationship between job satisfaction, professional identity and intention to leave the profession among nurses in Turkey.

BACKGROUND

Although there are many studies on job satisfaction among nurses in Turkey, there is a gap in the literature in relation to professional identity, particularly for intentions to leave the profession.

METHOD

This cross-sectional, descriptive and correlational study was conducted with 2122 nurses from Turkey.

RESULTS

A positive and significant correlation was determined between the nurses' job satisfaction and professional identities. It was found that 15.5% of the nurses intended to leave their profession. Intention to leave the profession was greater among the nurses with inadequate professional identity development and low job satisfaction.

CONCLUSION

Professional identity is a factor affecting job satisfaction. Both professional identity and job satisfaction are important factors affecting nurses' intention leaving the profession.

IMPLICATIONS FOR NURSING MANAGEMENT

Given that professional identity and job satisfaction affect intention to leave the profession and professional identity affects job satisfaction, nurse managers who are mainly responsible for the quality of nursing care should develop strategies that support nurses' professional identity and increase their job satisfaction if they are to prevent nurses from leaving the profession.

Job satisfaction of Malaysian registered nurses: a qualitative study

BACKGROUND

Job satisfaction is an important factor in health care settings. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care. However, there have not been any studies exploring the job satisfaction of Malaysian nurses.

AIM

The main purpose of this qualitative descriptive study was to explore the factors related to feelings of job satisfaction as well as job dissatisfaction experienced by registered nurses in Malaysia.

METHOD

A convenient sample of 46 Malaysian nurses recruited from a large hospital (number of beds = 895) participated in the study. A total of seven focus group discussions were conducted with nurses from surgical, medical and critical care wards. A semi-structured interview guide was used to facilitate the interviews, which were audio-recorded, transcribed verbatim and checked. The transcripts were used as data and were analysed using a thematic approach.

FINDING

The study identified three main themes that influenced job satisfaction: (1) nurses' personal values and beliefs; (2) work environment factors and (3) motivation factors. Concerning the nurses' personal values and beliefs, the ability to help people made the nurses felt honoured and happy, which indirectly contributed to job satisfaction. For work environment factors, team cohesion, benefit and reward, working conditions play an important role in the nurses' job satisfaction. Motivation factors, namely, professional development and clinical autonomy contributed to job satisfaction.

CONCLUSION

It is important for nurse leaders to provide more rewards, comfortable work environments and to understand issues that affect nurses' job satisfaction.

RELEVANCE TO CLINICAL PRACTICE

Our findings highlight the importance of factors that can improve nurses' job satisfaction. The study provides basic information for hospital administrators in planning effective and efficient policies to improve nursing job satisfaction in order to increase the quality of patient care and decrease nursing turnover.

Job satisfaction and turnover intention among Jordanian nurses in psychiatric units

Psychiatric nursing has been identified as a stressful occupation, and this stress could affect individuals' health, well-being, and job satisfaction. The stress of nurses might also affect the organization in terms of absenteeism and quality of care. The purpose of this study was to examine the relationship between job satisfaction and turnover intention among Jordanian nurses in the psychiatric units of the Jordanian National Mental Health Center. A descriptive, correlational, cross-sectional design was used. Nurses were asked to complete a demographic data sheet and questionnaires regarding job satisfaction and turnover intention. Of the 179 questionnaires distributed, 154 were completed, with an 86% response rate. The results revealed a statistically-significant negative relationship between job satisfaction and turnover intention. The findings of the study are consistent with previous research regarding the negative relationship between job satisfaction and turnover intention. The findings provide new information about Jordanian nurses who work in government hospital psychiatric services.

Structurational divergence theory as explanation for troublesome outcomes in nursing communication

Structurational divergence (SD) theory captures negative communication cycles resulting from interpenetration of incompatible meaning structures. It is estimated that 12-15% of practicing nurses suffer from a problematic level of SD. With a sample of 713 nurses (57 departments) in a large hospital, this study tests a model positing SD as a root explanation of nursing job satisfaction and turnover. A number of variables long presumed to be explanations for job satisfaction and turnover were hypothesized as mediators between SD and those outcomes. Path analysis showed support for burnout, role conflict, bullying, and organizational identification as useful mediators, explaining 68% of the variance in job satisfaction, and 45% in intentions to leave. The study also explores relationships between SD and hospital quality indicators. SD is a concern because it powerfully explains a number of poor outcomes and provides an underlying explanation for a number of factors that predict job satisfaction and turnover.

A cross sectional study on factors influencing professionalism in nursing among nurses in Mekelle Public Hospitals, North Ethiopia, 2012

BACKGROUND

Professionalism is defined as the conceptualization of obligations, attributes, interactions, attitudes, and role behaviors required of professionals in relationship to individual clients and to society as a whole. Professionalism attributes include knowledge, spirit of inquiry, accountability, autonomy, advocacy, innovation and visionary, collaboration and collegiality, and ethics. The study assessed level and attributes of professionalism in nursing in Mekelle, Tigray, Ethiopia.

METHODS

Institutional based cross sectional study supplemented by qualitative design was employed. Self administered semi structured questionnaire developed from RANO guideline was used. The FGD guideline was developed from different literatures. Data was analyzed using SPSS 16.0. Descriptive statistics and significance was checked at p < 0.05. Professionalism was measured using ANOVA. Qualitative of data were analyzed using coding technique. Written informed consent was obtained from the nurses and confidentiality was assured for all the information provide.

RESULTS

The mean scores for the nurses in Mekelle public hospitals on the professionalism were 140.50, knowledge (25.06), followed by ethics (25.00). The attitudes of respondents on professionalism were at high, moderate, low and very low level. Pearson product-moment correlation analysis revealed small yet significant associations among several professionalism attributes and characteristics of nurses in Mekelle Public hospitals. Age of respondents and work experience were significantly correlated with total professionalism. Work setting in Mekelle hospital was significantly associated with professionalism. Depending on FGD, the major factors were workload, had no vision, FMOH did not focused nursing as a profession, Weakness of the Ethiopian Nursing Association, lack of life insurance as well as the Health professionals and society's views of the profession.

CONCLUSION

Nurses with longer years of experience and the older respondents had significantly related with professionalism. Nurses who join professional organizations had high score on professionalism; and nurses working in Military Hospital had high score of professionalism.

Systematic review on the relationship between the nursing shortage and job satisfaction, stress and burnout levels among nurses in oncology/haematology settings

AIM

To establish the best available evidence regarding the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings.

METHODS

Electronic databases (CINAHL, Medline, Scopus, ScienceDirect, PsycInfo, PsycArticles, Web of Science, The Cochrane Library, Proquest and Mednar) were searched using a three-step strategy in order to identify published and unpublished studies conducted between 1990 and 2010. Grey literature was excluded in the review. The identified studies were evaluated using standardised critical appraisal instruments from the Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). A total of seven descriptive and descriptive-correlational studies published in English were included and data were presented in a narrative summary.

RESULTS

Findings revealed a positive bidirectional relationship between the nursing shortage and oncology registered nurses' (RNs') job dissatisfaction, stress and burnout. The extent of the job dissatisfaction, stress and burnout experienced by the oncology RNs and their perception of staffing inadequacy differed according to their demography and work settings. Particularly, nurses who had higher qualifications and positions, who worked full-time and who worked in inpatient settings and non-Magnet hospitals were more likely to attribute staffing inadequacy as one of the main contributing factors for their job dissatisfaction, stress and burnout. This led to a rise in the number of oncology RNs leaving the speciality.

CONCLUSION

Within the constraints of the study and the few quality papers available, it appears that oncology RNs who worked in substandard staffing units often express job dissatisfaction, stress and burnout, which prompt them to seek new employment out of the oncology specialty. This entails a pressing need for organisations to ensure sufficient staffing in oncology/haematology settings, in order to ensure that quality patient care is provided. Limited studies that examine the relationship between the nursing shortage and oncology RNs' stress and burnout have been conducted. Also, no studies in the Asian context have previously been conducted.

IMPLICATIONS FOR PRACTICE

Organizations need to customize their strategies for the recruitment and retention of oncology nurses. The strategies should take into consideration the specific demographic characteristics of oncology nurses or those of work settings that are experiencing staffing inadequacy and negative nursing outcomes. The strategies should also aim to replicate features of other institutions that are attractive to oncology nurses, and also include training that help oncology nurses better manage their emotions.

IMPLICATIONS FOR RESEARCH

Future research needs to examine the relationship between the nursing shortage and oncology nurses' job satisfaction, stress and burnout in bone marrow transplant units, paediatric oncology settings and Asian oncology settings. The characteristics of oncology nurses or workplaces that are more likely to experience negative nursing outcomes due the nursing shortage should also be identified.

Impact of professionalism in nursing on in-hospital bedside monitoring practice

AIM

This article reports a study exploring nursing practice of monitoring in-hospital patients including intra- and interprofessional communication and collaboration.

BACKGROUND

Sub-optimal care in general in-hospital wards may lead to admission for intensive care, cardiac arrest, or sudden death. Reasons may include infrequent measurements of vital parameters, insufficient knowledge of their predictive values, and/or sub-optimal use of Medical Emergency Teams. This study was designed to improve understanding of nursing practice and to identify changes required to support nursing staff in improving standards of clinical monitoring practice and patient safety in general in-hospital wards.

DESIGN

The study was designed as a qualitative descriptive clinical study, based on method triangulation including structured individual observations and semi-structured individual interviews.

METHODS

In the spring of 2009, structured observations and semi-structured interviews of 13 nurses were carried out at a university hospital in Copenhagen, Denmark. The observational notes and interview transcriptions were analysed using content analysis.

RESULTS

One theme (Professionalism influences nursing monitoring practice) and two sub-themes (Knowledge and skills and Involvement in clinical practice through reflections) were identified. Three categories (Decision-making, Sharing of knowledge, and Intra- and interprofessional interaction) were found to be associated with the theme, the sub-themes, and with each other.

CONCLUSION

Clinical monitoring practice varies considerably between nurses with different individual levels of professionalism. Future initiatives to improve patient safety by further developing professionalism among nurses need to embrace individual and organizational attributes to strengthen their practice of in-hospital patient monitoring and management.

The influence of the professionalism behaviour of nurses working in health institutions on job satisfaction

This study was carried out with the aim of determining the effect of the professional behaviour of nurses on their job satisfaction. The sample of the study included 531 nurses working in university, state and private hospitals in Turkey. Data were collected using two questionnaires which included the demographic characteristics of nurses, a Behavioral Inventory Form for Professionalism in Nursing (BIPN) and the Minnesota Satisfaction Questionnaire. The results from the BIPN showed that the mean score of nurses was low. The mean score of job satisfaction was at a medium level. The relationship between job satisfaction and professionalism was found to be statistically significant and in the positive direction. Based on this result, in order to increase job satisfaction, increasing the performance of arrangements directed towards the development of professional behaviour that is found within the scope of the professionalism scale is recommended.

Is nursing a profession in Turkey?

Nursing has been a dynamic process since the existence of humanity on Earth. As a part of this process, whether nursing is an occupation or a profession has been a long-lasting question. There exist different sets of criteria and schemes of classification that are used to define professions. In this article the authors inquire into the professionalism of nursing in Turkey in view of the criteria for nursing professionalism first set by B. K. Miller et al. (1993).

A systematic review on the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings

BACKGROUND

Nursing shortage is a global issue that which affects oncology nursing. Oncology nurses are more prone to experience job dissatisfaction, stress and burnout when they work in units with poor staffing. There is thus a need for greater understanding of the relationship between the nursing shortage and nursing outcomes in oncology/haematology settings.

OBJECTIVES

This review aimed to establish the best available evidence concerning the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings; and to make recommendations for practice and future research.

INCLUSION CRITERIA

Types of participants: This review considered studies that included oncology registered nurses (RNs) who were more than 18 years of age and worked in either inpatient or outpatient oncology/haematology wards or units for the adult or paediatric patients.Types of intervention: This review considered studies that evaluated the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings.Types of outcomes: This review included studies that measured job satisfaction, stress and burnout levels using different outcomes measures. Job satisfaction was determined by the Measure of Job Satisfaction scale, the Misener Nurse Practitioner Job Satisfaction Scale and the Likert scale, stress by the Pediatric Oncology Nurse Stressor Questionnaire and burnout by the Maslash Burnout Inventory scale.Types of studies: This review included descriptive/descriptive-correlational studies which were published in English.

SEARCH STRATEGY

The search strategy sought to identify published and unpublished studies conducted between 1990 and 2010. Using a three-step search strategy, the following databases were accessed: CINAHL, Medline, Scopus, ScienceDirect, PsycInfo, PsycArticles, Web of Science, The Cochrane Library, Proquest and Mednar.

ASSESSMENT OF METHODOLOGICAL QUALITY

Two independent reviewers assessed each paper for methodological validity prior to inclusion in the review using standardised critical appraisal instruments from the Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Disagreements were resolved through discussion, or with a third reviewer.

DATA COLLECTION/EXTRACTION

Data were extracted using standardised data extraction tool adapted from the JBI-MAStARI. Data synthesisDue to the heterogeneous nature of the included papers, a meta-analysis was not possible. Hence, a narrative summary was presented for the studies.

RESULTS

This review encompassed seven descriptive/descriptive-correlational studies. Findings revealed a positive bidirectional relationship between the nursing shortage and oncology nurses' job dissatisfaction, stress and burnout. In addition, the extent of oncology nurses' job dissatisfaction, stress and burnout, and their perception of staffing inadequacy also differed according to nurses' demography and work settings.

CONCLUSIONS

The nursing shortage, coupled with an increasing number of patients diagnosed with cancer, entail a pressing need for organisations to ensure sufficient staffing in oncology/haematology settings, in order to provide quality patient care. This then requires interventions that target both the recruitment and retention of nurses.

IMPLICATIONS FOR PRACTICE

Organisations need to customise their strategies for the recruitment and retention of oncology nurses. The strategies should take into considerations the specific demographic characteristics of oncology nurses or characteristics of work settings that are experiencing staffing inadequacy and negative nursing outcomes. The strategies should also aim to replicate features of other institutions that are attractive to oncology nurses; and also include training that help oncology nurses better manage their emotions.

IMPLICATIONS FOR RESEARCH

Future research need to examine the relationship between the nursing shortage and oncology nurses' job satisfaction, stress and burnout in bone marrow transplant units, paediatric oncology settings and also Asian oncology settings. Characteristics of oncology nurses or workplaces that are more likely to experience negative nursing outcomes due the nursing shortage should also be identified.