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Woodward KF, Willgerodt M, Walsh E, Johnson S. Answering the call: Experiences of nurses of color during COVID-19. Nurs Inq 2024:e12647. [PMID: 38853419 DOI: 10.1111/nin.12647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 04/29/2024] [Accepted: 05/07/2024] [Indexed: 06/11/2024]
Abstract
In the years following the COVID-19 pandemic, issues such as high job demands, burnout, and turnover continue to influence the nursing workforce, with heavier impacts to marginalized groups. Understanding the work and life contexts of nurses of color can help guide strategies for workplace equity and meaningful support. This qualitative study explored the experiences of nurses of color in the United States during the pandemic, focusing on feelings about the profession and job decisions. The overarching theme was "answering the call," with subthemes of "COVID shone a light," "being consumed by COVID," and "is it worth it?" Participants shared how their racial identities shaped their perceptions and job decisions in positive and negative ways, noting how racism impacted many facets of their work and added to the stressors felt in the workplace and the community. Findings provide insight into the underrepresented perspectives of nurses of color and suggest strategies to eliminate racism in nursing.
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Affiliation(s)
- Kyla F Woodward
- Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA
| | - Mayumi Willgerodt
- Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA
| | - Elaine Walsh
- Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA
| | - Susan Johnson
- Nursing and Healthcare Leadership, University of Washington, Tacoma, Washington, USA
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2
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Ulusoy N, Nienhaus A, Brzoska P. [Immigrant nurses' experiences of discrimination by patients and nursing home residents: a narrative review]. Pflege 2024. [PMID: 38450503 DOI: 10.1024/1012-5302/a000984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Immigrant nurses' experiences of discrimination by patients and nursing home residents: a narrative review Abstract: Background and aim: Immigrant nurses are filling the shortage of skilled workers in many countries. Studies suggest that they may face discrimination in their destination countries. This paper aims to provide an overview of the experiences of immigrant nurses with regard to discrimination in their interactions with patients. Methods: A systematic literature review was performed by searching the databases PubMed and CINAHL. Additional articles were identified through a search in Google Scholar and by reviewing reference lists. Studies published between 1/2013 and 3/2023 were included. Results: The literature search yielded 103 studies, 18 of which were included in the narrative review. The review showed that immigrant nurses may experience discrimination in the form of rejection, questioning of their qualifications, unequal treatment, derogatory remarks, threats, as well as violence from patients. Discrimination is based on their ethnicity, country of origin, external characteristics, language, and accent. Conclusions: Overall, available data is insufficient. The results of this review can serve as a basis for further studies and help managers and policy makers to better understand discrimination against immigrant care workers, to develop strategies to support them and to implement appropriate prevention measures.
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Affiliation(s)
- Nazan Ulusoy
- Competenzzentrum Epidemiologie und Versorgungsforschung bei Pflegeberufen (CVcare), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Deutschland
| | - Albert Nienhaus
- Competenzzentrum Epidemiologie und Versorgungsforschung bei Pflegeberufen (CVcare), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Deutschland
- Abteilung Arbeitsmedizin, Gefahrstoffe und Gesundheitswissenschaften (AGG), Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW), Hamburg, Deutschland
| | - Patrick Brzoska
- Lehrstuhl für Versorgungsforschung, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Deutschland
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Dunkley D. Outsiders Within: The Lived Experience of Being Black and Female When Becoming a Nurse Executive. Nurs Adm Q 2024; 48:E1-E13. [PMID: 38079300 DOI: 10.1097/naq.0000000000000622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Few Black nurses occupy positions of leadership, and even fewer Black female nurses advance to careers as nurse executives. The purpose of this 2018 study was to explore the lived experience of being Black and female when becoming a nurse executive, specifically the nuances of being both a racial and gender minority. Using a hermeneutic phenomenological method, this study explored the experiences of a purposive sample of 10 Black female nurse executives through semistructured telephone interviews. van Manen's approach and Collins' Black feminist thought as the theoretical framework guided data analysis. Three themes emerged: (a) living in a constant state of readiness; (b) embracing the responsibility beyond the job description; and (c) overcoming. Participants testified of the psychological dynamics of Black womanness, and the burdens of the intersectionality of race, gender, and class discrimination, while managing the complexities and rigors of a thriving career. Discussing the results of this research will help leaders in nursing, health care, and related professions to understand further the experiences of Black female nurse executives, which will inform efforts to (a) increase minority representation in positions of nursing leadership and (b) improve health equity.
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Affiliation(s)
- Daihnia Dunkley
- Graduate Entry Pre-Specialty in Nursing (GEPN) & Masters of Science Programs, Yale School of Nursing, Orange, Connecticut
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Caballero AE, ElSayed NA, Golden SH, Bannuru RR, Gregg B. Implicit or Unconscious Bias in Diabetes Care. Clin Diabetes 2023; 42:308-313. [PMID: 38694247 PMCID: PMC11060613 DOI: 10.2337/cd23-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
"Implicit bias," also called "unconscious bias," refers to associations outside of conscious awareness that adversely affect one's perception of a person or group. Awareness of implicit bias has been increasing in the realm of diabetes care. Here, the authors highlight several types of unconscious bias on the part of clinicians and patients, including biases based on race, ethnicity, and obesity. They discuss how these biases can negatively affect patient-centered clinical interactions and diabetes care delivery, and they recommend implementation of evidence-based interventions and other health system policy approaches to reduce the potential impact of such biases in health care settings.
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Affiliation(s)
| | - Nuha A. ElSayed
- Harvard Medical School, Boston, MA
- American Diabetes Association, Arlington, VA
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Zulfiqar SH, Ryan N, Berkery E, Odonnell C, Purtil H, O’Malley B. Talent management of international nurses in healthcare settings: A systematic review. PLoS One 2023; 18:e0293828. [PMID: 37930991 PMCID: PMC10627454 DOI: 10.1371/journal.pone.0293828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023] Open
Abstract
AIM To identify and systematically review current scholarship on talent management of international nurses in healthcare organizations. BACKGROUND As nurse shortages persistently pose challenges for healthcare organizations globally, one of the primary strategies employed to address these shortages is employment of international nurses. To date little has been done to systematically review and collate contemporary research on talent management of this strategically important cohort. Talent management is a holistic construct that can support healthcare organizations to attract, develop, motivate, and retain talented employees to drive organizational performance. This systematic review isolates, appraises and collates available evidence on talent management practices for international nurses. STUDY DESIGN Systematic literature review. DATA SOURCES Searches of PubMed, EBSCO and Scopus were made covering literature from 2012-2022. REVIEW METHODS This study followed Cochrane protocol for Systematic Reviews and key search terms were developed in consultation with University of Limerick library. As a key aim of the review was to provide evidence for the development of effective talent management practices, only peer-reviewed academic papers and empirical studies were included. Initial articles screening was conducted by two reviewers and full articles review was conducted by the entire research team. Findings were combined in a data extraction template for further analysis. RESULTS This review includes 62 articles thematically analysed under the headings recruitment and selection, retention and turnover, career progression, professional development, discrimination and racism, culture and communication. CONCLUSION No articles were found that directly address talent management for international nurses. Although there are studies that address aspects of talent management independently, more research is required on talent management as a holistic process for international nurses to inform evidence-based practice. IMPACT This research emphasizes the importance of talent management for retention of international nurses in healthcare settings. It provides a knowledge base for healthcare organisations to enhance employee retention and ensure quality care for patients, as well as setting the foundation for future studies in this area.
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Affiliation(s)
- Sidra Hareem Zulfiqar
- Department of Work and Employment Studies, Kemmy Business School, University of Limerick, Limerick, Ireland
| | - Nuala Ryan
- Department of Management and Marketing, Kemmy Business School, University of Limerick, Limerick, Ireland
| | - Elaine Berkery
- Department of Management and Marketing, Kemmy Business School, University of Limerick, Limerick, Ireland
| | - Claire Odonnell
- Department of Nursing Studies and Midwifery, School of Medicine, University of Limerick, Limerick, Ireland
| | - Helen Purtil
- Department of Mathematics and Statistics, Science and Engineering, University of Limerick, Limerick, Ireland
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Schmidt S, Lörzing R, Jahn J, Andersch-Rupprecht C, Emmert M, Nagel E. [Specific Workloads among Employees with a Migration Background in Nursing and Geriatric Care: A Systematic Review]. DAS GESUNDHEITSWESEN 2023; 85:1027-1036. [PMID: 36543260 PMCID: PMC11248394 DOI: 10.1055/a-1966-0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Multimorbidity, increasing numbers of chronically ill patients and demographic change are leading to increased care costs in Germany with an increasing shortage of staff in skilled nursing and geriatric care. In this context, more and more caregivers with a migration background of the 1st generation (PmMH) are being recruited and integrated into existing (corporate) cultures. This represents an important starting point for a permanent and needs-based supply landscape. THE AIM OF THE STUDY The aim of the study was to identify and analyze the specific stresses of PmMH at the workplace in nursing and geriatric care MATERIAL AND METHODS: A systematic literature search was carried out in relevant specialist databases (Pubmed, PsychInfo, Web of Science, Cochrane), supplemented by an extended snowball and hand search. This was followed by a descriptive presentation of the results of the study content, which in a subsequent step was iteratively brought together and consolidated into thematic categories by several people. RESULTS A total of 15 publications were identified as relevant and included in the analysis. Specific, migration-associated stress factors could be identified. In particular, the categories: "Discrimination and racism", "Language and communication problems" and "Cultural adjustment" characterized the (collaborative) work in nursing and care for the elderly and led to additional stress for employees and patients. DISCUSSION The present review article identified and summarized specific burdens of PmMH. At this point it can be assumed that these affect both PmMH and patients. So far, operational concepts do not seem to be able to adequately solve the challenges, so that effective, sustainable approaches have to be found. The extent to which the specificed stress factors only affect PmMH is not considered in this context, so that further research is needed.
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Affiliation(s)
- Sebastian Schmidt
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth, Germany
| | - Romina Lörzing
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth, Germany
| | - Jennifer Jahn
- Bayreuther Akademie für Gesundheitswissenschaften, Bayreuth, Germany
| | | | - Martin Emmert
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth, Germany
- Bayerisches Krebsregister, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Erlangen, Germany
| | - Eckhard Nagel
- Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth, Germany
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Green CA. Racism as a Public Health Issue for Nurses of Color in Clinical and Academic Settings: Ten Nurses Tell Their Stories. Nurs Educ Perspect 2023; 44:279-284. [PMID: 37594419 DOI: 10.1097/01.nep.0000000000001184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
AIM The aim of this study was to bring awareness to how racism and discrimination, accompanied by bullying and incivility, negatively impact the health of nurses of color. BACKGROUND Racism and discrimination encountered in the daily lives of nurses of color present risk for psychological and physiological damage to their health. Repeated exposure to racism and discrimination leads to cumulative stress that may pose a negative impact on the health status of affected nurses. METHODS Phenomenology served as the methodology for this research study. The principal investigator transcribed and coded data from 10 nurse participants. RESULTS Data illustrate a pattern of nurses of color experiencing discrimination and racism, with racism being a potential public health issue. Their stories may empower others to make positive, productive decisions and persevere. CONCLUSION Long-term exposure to racism and its related potential effects on nurses' health presents a grave concern for nurses of color.
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Affiliation(s)
- Cheryl Ann Green
- About the Author Cheryl Ann Green, PhD, DNP, RN, LCSW, CNE, is DNP chair and committee member, Abilene Christian University, Abilene, Texas.For more information, contact her at
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Bayuo J, Abboah-Offei M, Duodu PA, Salifu Y. A meta-synthesis of the transitioning experiences and career progression of migrant African nurses. BMC Nurs 2023; 22:104. [PMID: 37024886 PMCID: PMC10079157 DOI: 10.1186/s12912-023-01273-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/27/2023] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION With the rise in global migration, hospitals and health systems in developed countries are looking to supplement their workforces with migrant nurses who have been reported to feel devalued, underutilized with experience of deskilling and unmet expectations as they transitioned. Despite the plethora of literature reporting on the experiences of internationally trained nurses, only limited work has been done regarding understanding the experiences of Migrant African nurses. Thus, this study sought to synthesize existing qualitative studies to develop in-depth understanding of the transitioning experiences of migrant African nurses, their career progression and to highlight existing gaps to guide future studies as well as inform policies. METHOD A meta-synthesis was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Enhancing transparency in reporting the synthesis of qualitative research statement. A pre-planned search strategy was developed guided by the SPIDER tool for qualitative synthesis searching EMBASE via OVID, CINAHL via EBSCO, PubMed, Web of Science, and PsychINFO databases. We included published studies that 1) focused on migrant African nurses, 2) employed a qualitative design and 3) reported in English. RESULTS The search yielded 139 studies of which nine studies met the inclusion criteria and included in final synthesis. Three themes with corresponding subthemes emerged from data synthesis: 1) Navigating reality shock (a. Navigating a new culture, b. Survival strategies and support amidst the shock); 2) Discrimination and limited opportunities for promotion (a. Prejudices and preference for White over Black, b. Lack of recognition and limited opportunities for a workplace promotion); and 3) Finding one's feet (a. Standing up for oneself and looking beyond discrimination, b. Experiencing growth). CONCLUSION Transitioning to a new setting can be a challenging experience for migrant African nurses warranting the availability of a tailor-made adaptation or orientation programme. Though African nurses may experience discrimination and prejudices as part of their transition, they consider their situation to be better off compared to back home. Therefore, clear transitioning policies which focus on career pathways are required by hiring institutions, and migrant nurses should be proactive in taking active roles in pushing their career ahead, instead of maintaining a culture of silence.
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Affiliation(s)
- Jonathan Bayuo
- Department of Nursing and Midwifery, Presbyterian University, Kwahu East, Ghana.
| | - Mary Abboah-Offei
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Precious Adade Duodu
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, England, UK
| | - Yakubu Salifu
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Naegle MA, Kelly LA, Embree JL, Valentine N, Sharp D, Grinspun D, Hines-Martin VP, Crawford CL, Rosa WE. American Academy of Nursing consensus recommendations to advance system level change for nurse well-being. Nurs Outlook 2023; 71:101917. [PMID: 36736029 PMCID: PMC9889942 DOI: 10.1016/j.outlook.2023.101917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/08/2022] [Accepted: 12/31/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic has required close examination of workforce-related stressors that over decades have contributed to widespread burnout, negative health outcomes, including mental health outcomes, and the loss of the well-educated professionals who are the future of the nursing profession. In the United States and globally, evidence points to factors known to diminish well-being, including inequities, issues of minority status, persistent discrimination, and demanding work environments. The American Academy of Nursing (AAN), dedicated to organizational excellence, nursing leadership and evidence-based policy, develops statements reflecting its mission and those of its nursing affiliates and corporate member, The American Nurses Association. Within nursing, despite the efforts of its members toward advancement, professional fulfillment is often constrained by the systems in which nurses practice and workplace factors over which they have little control. Action by key organizations to initiate changes at systems levels in workplace safety, to increase professional mobility, and propel policies that increase access to health care resources could improve nurse well-being. This paper proposes recommendations from the AAN Expert Panels on Building Health Care System Excellence, Psychiatric Mental Health and Substance Use, and Global Health Expert Panels for the American Academy of Nursing to leverage related policy in the arenas of government and professional/healthcare organizations. Transforming health care work environments and advancing nurse well-being and equity can be accomplished through key, innovative policy changes. These will be achieved through collaboration among associations, organizations, nonprofit groups, and with the public and the media.
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Affiliation(s)
- Madeline A Naegle
- Psychiatric Mental Health and Substance Use Expert Panel, New York, NY.
| | - Lesly A Kelly
- Building Health Care Systems Excellence Expert Panel
| | | | | | - Daryl Sharp
- Psychiatric Mental Health and Substance Use Expert Panel, New York, NY
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10
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Bokek-Cohen Y. Does racism toward nurses increase as treatment invasiveness rises? Nurs Inq 2023:e12547. [PMID: 36755498 DOI: 10.1111/nin.12547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 02/10/2023]
Abstract
One of the unspoken issues in public discourse in most countries is the racism of patients toward nurses who originate from a different ethnic group than theirs. The aim of the present study is to examine whether patients' racism toward nurses increases as the invasiveness of treatment rises. This study was conducted in Israel, a highly conflictual society where Jews and Arabs live together and meet in the same health facilities. Despite the tension and sometimes animosity caused by the political situation, members of each group regularly encounter members of the other group during the provision of health-care, both as patients and as medical and nursing staff. A study questionnaire which presented nine nursing treatments of diverse levels of invasiveness was filled out by Arab and Jewish participants. They were asked to convey their preference for an Arab or a Jewish nurse for each treatment. Results of Logistic Regression Analyses reveal that in both sectors, racism toward nurses increases as the treatment invasiveness rises. These findings are discussed in light of the concept of social distance, and serve as an empirical basis for several proposed practical recommendations for eradicating racism against nurses.
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Affiliation(s)
- Ya'arit Bokek-Cohen
- Department of Behavioral Sciences, Israel Academic College of Ramat-Gan, Ramat Gan, Israel.,School of Nursing, The Academic College of Tel-Aviv-Jaffa, Tel Aviv, Israel
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Parke R, Bates S, Carey M, Cavadino A, Ferguson A, Hammond N, Joyce F, Kirby S, Moeke-Maxwell T, Nona F, Mason K. Bullying, discrimination, and sexual harassment among intensive care unit nurses in Australia and New Zealand: An online survey. Aust Crit Care 2023; 36:10-18. [PMID: 36210282 DOI: 10.1016/j.aucc.2022.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Bullying, discrimination, and sexual harassment are significant problems within healthcare organisations but are often under-reported. Consequences of these behaviours within a healthcare setting are wide ranging, affecting workplace environments, personal well-being, and patient care and leading to increased staff turnover and quality of patient care and outcomes. Whilst there has been some work undertaken in the general nursing workforce, there is a dearth of evidence regarding the extent and impact of these behaviours on the nursing workforce in intensive care units (ICUs) in Australia and New Zealand. OBJECTIVE We aimed to determine self-reported occurrences of bullying, discrimination, and sexual harassment amongst ICU nurses in Australia and New Zealand. METHODS A prospective, cross-sectional, online survey of ICU nurses in Australia and New Zealand was undertaken in May-June 2021, distributed through formal colleges, societies, and social media. Questions included demographics and three separate sections addressing bullying, sexual harassment, and discrimination. RESULTS In 679 survey responses, the overall reported occurrences of bullying, discrimination, and sexual harassment in the last 12 months were 57.1%, 32.6%, and 1.9%, respectively. Perpetrators of bullying were predominantly nurses (59.6%, with 57.9% being ICU nurses); perpetrators of discrimination were nurses (51.7%, with 49.3% being ICU nurses); and perpetrators of sexual harassment were patients (34.6%). Respondents most commonly (66%) did not report these behaviours as they did not feel confident that the issue would be resolved or addressed. CONCLUSIONS Determining the true extent of bullying, discrimination, and sexual harassment behaviours within the ICU nursing community in Australia and New Zealand is difficult; however, it is clear a problem exists. These behaviours require recognition, reporting, and an effective resolution, rather than normalisation within healthcare professions and workplace settings in order to support and retain ICU nursing staff.
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Affiliation(s)
- Rachael Parke
- School of Nursing, The University of Auckland, Auckland, New Zealand; Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, New Zealand, Auckland, New Zealand.
| | - Samantha Bates
- Dept of Intensive Care, Anaesthesia, Pain & Perioperative Medicine, Western Health, Melbourne, Australia; Centre for Integrated Critical Care, Melbourne Medical School, The University of Melbourne, Victoria, Australia
| | - Melissa Carey
- School of Nursing, The University of Auckland, Auckland, New Zealand; School of Nursing, University of Southern Queensland, Australia
| | - Alana Cavadino
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Adele Ferguson
- ICU/ED, Bay of Plenty District Health Board, New Zealand
| | - Naomi Hammond
- Critical Care Division, The George Institute for Global Health and UNSW Sydney, Sydney, NSW, Australia; Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Fiona Joyce
- Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, New Zealand, Auckland, New Zealand
| | - Steve Kirby
- Critical Care Complex, Middlemore Hospital, Auckland, New Zealand
| | | | - Francis Nona
- School of Public Health, The University of Queensland, Australia
| | - Kathleen Mason
- School of Nursing, The University of Auckland, Auckland, New Zealand
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Mercado M, Wachter K, Schuster RC, Mathis CM, Johnson E, Davis OI, Johnson-Agbakwu CE. A cross-sectional analysis of factors associated with stress, burnout and turnover intention among healthcare workers during the COVID-19 pandemic in the United States. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2690-e2701. [PMID: 35037346 DOI: 10.1111/hsc.13712] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 12/11/2021] [Accepted: 12/23/2021] [Indexed: 05/07/2023]
Abstract
In 2020, healthcare workers faced the COVID-19 pandemic amidst other salient sociopolitical stressors. This study, therefore, set out to examine associations between personal, work-related and contextual factors and three outcomes - stress, burnout and turnover intention - at a critical juncture in the pandemic. In December 2020, we recruited a broad array of healthcare workers (n = 985) in a public safety net healthcare system serving socially and economically marginalised communities in the Southwest region of the United States using a cross-sectional online survey. The results indicated that more health problems were associated with higher stress and burnout symptoms. While seeking emotional support and using drugs or alcohol to cope were associated with higher stress, a positive social outlook was associated with lower stress. Lower quality of work-life was associated with higher burnout symptoms and turnover intention. Negative effects of the pandemic on wellbeing and higher number of COVID-19-related concerns were associated with higher stress and burnout symptoms. Contrary to the original hypotheses, self-care was not associated with any of the three outcomes, and effects of the political climate and issues of racism on wellbeing were not associated with stress, burnout or turnover intention. However, identifying as a Person of Colour was associated with higher stress, as well as lower burnout. The findings on worker health, social outlook, quality of work-life and race/ethnicity, in particular, suggest a critical need for healthcare systems to address the wellbeing of workers through equitable organisational policy and practice.
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Affiliation(s)
- Micaela Mercado
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
- Watts College, School of Social Work, Arizona State University, Phoenix, Arizona, USA
| | - Karin Wachter
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
- Watts College, School of Social Work, Arizona State University, Phoenix, Arizona, USA
| | - Roseanne C Schuster
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
- School of Human Evolution & Social Change, Arizona State University, Tempe, Arizona, USA
| | - Cherra M Mathis
- Watts College, School of Social Work, Arizona State University, Phoenix, Arizona, USA
| | - Emma Johnson
- School of Human Evolution & Social Change, Arizona State University, Tempe, Arizona, USA
- Barretts Honors College, Arizona State University, Tempe, Arizona, USA
| | - Olga Idriss Davis
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
- Barretts Honors College, Arizona State University, Tempe, Arizona, USA
- Hugh Downs School of Human Communication, Arizona State University, Tempe, Arizona, USA
| | - Crista E Johnson-Agbakwu
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
- Department of Obstetrics & Gynecology and Women's Health, Refugee Women's Health Clinic, Valleywise Health, Phoenix, Arizona, USA
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13
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Dahl K, Nortvedt L, Schrøder J, Bjørnnes AK. Internationally educated nurses and resilience: A systematic literature review. Int Nurs Rev 2022; 69:405-415. [PMID: 35868023 PMCID: PMC9545834 DOI: 10.1111/inr.12787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
Abstract
Aim To synthesize knowledge extracted from the literature about protecting factors and challenges to resilience, among migrant nurses, and specifically how knowledge synthesized through the process of the literature review is relevant to nursing and health policy. Background How nurses, in general, face challenges is well documented and is often linked to the concept of resilience; however, there seems to be a lack of systematic knowledge synthesis focusing on the resilience of internationally educated nurses following migration. Method The review was guided by the PRISMA guidelines, and a systematic search of peer‐reviewed qualitative and mixed‐method articles reporting empirical research was performed in the MEDLINE, CINAHL, PsycINFO and Academic Search Ultimate databases. Methodological rigour was assessed by the Joanna Briggs’ checklist, and a structured theme‐based ecological framework, inspired by Ungar's model of resilience, was chosen. Results Following critical appraisal, 37 studies were included that identified both challenges and individual, contextual and structural protective factors in host countries and are linked to resilience. Discussion Resilience of internationally educated nurses depends on a combination of individual and contextual protective factors, with the major emphasis being placed on individual protective factors. It is crucial to consider resilience in ensuring that internationally educated nurses’ experience is appreciated, as this is necessary if nurses are to deliver the best possible health service while integrating into their host country. Implication for nursing and health policy Authorities, managers in clinical practice and education, trade unions and nurses in general should be aware of the coping strategies, the strengths and supportive factors that can promote resilience and be aware of the challenges that undermine resilience and negatively impact internationally educated nurses’ practice and social interactions.
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Affiliation(s)
- Kari Dahl
- Oslo Met, Oslo Metropolitan University, Oslo, Norway
| | - Line Nortvedt
- Oslo Met, Oslo Metropolitan University, Oslo, Norway
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14
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Vaismoradi M, Fredriksen Moe C, Ursin G, Ingstad K. Looking through racism in the nurse-patient relationship from the lens of culturally congruent care: A scoping review. J Adv Nurs 2022; 78:2665-2677. [PMID: 35441739 PMCID: PMC9544978 DOI: 10.1111/jan.15267] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/19/2022] [Accepted: 04/05/2022] [Indexed: 02/06/2023]
Abstract
AIM This review aimed to identify the nature of racism in the nurse-patient relationship and summarize international research findings about it. DESIGN A scoping review of the international literature. DATA SOURCES The search process encompassed three main online databases of PubMed (including MEDLINE), Scopus and Embase, from 2009 until 2021. REVIEW METHODS The scoping review was informed by the Levac et al.'s framework to map the research phenomenon and summarize current empirical research findings. Also, the review findings were reflected in the three-dimensional puzzle model of culturally congruent care in the discussion section. RESULTS The search process led to retrieving 149 articles, of which 10 studies were entered into data analysis and reporting results. They had variations in the research methodology and the context of the nurse-patient relationship. The thematical analysis of the studies' findings led to the development of three categories as follows: bilateral ignition of racism, hidden and manifest consequences of racism and encountering strategies. CONCLUSION Racism threatens patients' and nurses' dignity in the healthcare system. There is a need to develop a framework of action based on the principles of culturally congruent care to eradicate racism from the nurse-patient relationship in the globalized context of healthcare. IMPACT Racism in the nurse-patient relationship has remained a relatively unexplored area of the nursing literature. It hinders efforts to meet patients' and families' needs and increases their dissatisfaction with nursing care. Also, racism from patients towards nurses causes emotional trauma and enhances job-related stress among nurses. Further research should be conducted on this culturally variant phenomenon. Also, the participation of patients and nurses should be sought to prohibit racism in healthcare settings.
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Affiliation(s)
| | | | - Gøril Ursin
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Kari Ingstad
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
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15
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De Sousa I, Varcoe C. Centering Black feminist thought in nursing praxis. Nurs Inq 2021; 29:e12473. [PMID: 34820943 PMCID: PMC9286449 DOI: 10.1111/nin.12473] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 12/24/2022]
Abstract
Femininity and whiteness dominate Western nursing, silencing ontologies and epistemologies that do not align with these dominant norms while perpetuating systemic racism and discrimination in nursing practice, education, research, nursing activism, and sociopolitical structures. We propose Black feminist thought as a praxis to decenter, deconstruct, and unseat these ideologies and systems of power. Drawing from the work of past and present Black feminist scholars, we examine the ontological and epistemological perspectives of Black feminist thought. These include (i) the uniqueness and particular experiences of people, (ii) the acceptance of ontological and epistemological pluralism of truths and ways of knowing, and (iii) the mandate for equity in the health, social, political, and environmental structures of society. By focusing our attention on lived experiences and voices of those systematically excluded in nursing practice, education, research, and society, Black feminist thought offers an anticolonial, antiracist, and antidiscriminatory foundation for more effectively upholding nursing's disciplinary mandate for social justice and equity.
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Affiliation(s)
- Ismalia De Sousa
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Colleen Varcoe
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
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16
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Maglalang DD, Katigbak C, Gómez MAL, Sorensen G, Hopcia K, Hashimoto DM, Pandey S, Takeuchi DT, Sabbath EL. Workplace Discrimination and Short Sleep Among Healthcare Workers: The Buffering Effect of People-Oriented Culture. J Occup Environ Med 2021; 63:857-864. [PMID: 34597282 PMCID: PMC8486916 DOI: 10.1097/jom.0000000000002246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Examine the association of discrimination and short sleep and the buffering effect of people-oriented culture in the workplace among nurses and patient care associates. METHODS Used a mixed-methods design from the 2018 Boston Hospital Workers Health Study (N = 845) and semi-structured interviews among nurse directors (N = 16). RESULTS We found that people-oriented culture reduced the odds of short sleep and slightly attenuated the association of discrimination and short sleep. People-oriented culture did not buffer the effects of discrimination on short sleep. Qualitative findings showed that discrimination occurred between co-workers in relation to their job titles and existing support in the workplace does not address discrimination. CONCLUSIONS Healthcare industries need to implement specific programs and services aimed at addressing discrimination which can potentially improve health outcomes among workers.
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Affiliation(s)
- Dale Dagar Maglalang
- Stanford Prevention Research Center, Stanford University, School of Medicine, Stanford, California, USA
| | - Carina Katigbak
- Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - María Andrée López Gómez
- Department of Sociology, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada
| | - Glorian Sorensen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Karen Hopcia
- Workplace Health and Wellbeing, Partners HealthCare System, Boston, Massachusetts, USA
| | - Dean M. Hashimoto
- Workplace Health and Wellbeing, Partners HealthCare System, Boston, Massachusetts, USA
- Boston College Law School, Newton Centre, Massachusetts, USA
| | - Shanta Pandey
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, USA
| | - David T. Takeuchi
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Erika L. Sabbath
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, USA
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17
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Högstedt D, Engström M, Eriksson E, Jansson I. Nurses' experiences of a recertification process involving a series of examinations to obtain a nursing license in a new country. J Adv Nurs 2021; 77:4876-4886. [PMID: 34582044 DOI: 10.1111/jan.15054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/16/2021] [Accepted: 09/16/2021] [Indexed: 02/05/2023]
Abstract
AIM To examine internationally educated nurses' (IENs') experiences of the recertification process when undergoing a series of examinations to test their nursing knowledge and skills and, thereby, obtain a Swedish nursing license. DESIGN A qualitative study with a descriptive design. METHODS A convenience sample of 15 IENs at the end of the recertification process was included. Data were collected using semi-structured telephone interviews between September 2019 and January 2021 and analysed using qualitative content analysis. RESULTS Conducting the recertification process to obtain a Swedish nursing license was challenging in many ways, and the nurses described a rollercoaster of emotions during the process: frustration, loneliness, stress and anxiety, but also happiness, pride and relief. The process was, for some, so demanding they almost gave up, and support was, therefore crucial for the nurses. However, many times, they had to struggle to find out where they could turn for help or guidance. CONCLUSION The nurses found the formal support during the recertification process to be inadequate and inaccessible. For this reason, and to decrease the risk of nurses dropping out and instead taking unlicensed jobs, there is a need to develop and introduce more supportive structures and to make the existing support and information more accessible for the nurses. IMPACT This study highlights the importance of offering accessible support during a demanding and challenging recertification process. These findings can help policymakers develop and introduce supportive structures in the process of recertification for IENs.
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Affiliation(s)
- Denice Högstedt
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Maria Engström
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Elisabet Eriksson
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Inger Jansson
- Institute of Health and Care Sciences, University of Gothenburg, Göteborg, Sweden
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18
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Kritsotakis G, Gkorezis P, Andreadaki E, Theodoropoulou M, Grigoriou G, Alvizou A, Kostagiolas P, Ratsika N. Nursing practice environment and employee silence about patient safety: The mediating role of professional discrimination experienced by nurses. J Adv Nurs 2021; 78:434-445. [PMID: 34337760 DOI: 10.1111/jan.14994] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 05/18/2021] [Accepted: 07/20/2021] [Indexed: 12/29/2022]
Abstract
AIMS To examine the associations between nurse work environment with nurses' silence about patient safety and the mediating effects of professional discrimination experienced by nurses. DESIGN Multicentre cross-sectional study. METHODS Between January and April 2019, 607 nurses and nursing assistants from seven hospitals in Greece assessed their clinical environment using the 'Practice Environment Scale of the Nursing Work Index Revised-PES-NWIR', and the silence about patient safety. The 'Experiences of Discrimination Index' was adapted to specifically address experienced discrimination based on the nursing profession. The PROCESS macros for SPSS were used to examine the above associations. FINDINGS Better nurse practice environment, with the exception of 'staffing and resource adequacy' dimension, was directly associated with less experienced professional discrimination, and directly and indirectly associated with less silence about patient safety, through the mediating role of professional discrimination experienced by nurses. CONCLUSIONS Silence about patient safety is dependent on the clinical work environment and may be a response of nurses to discrimination in the work context. Both an improvement in the nurse work environment and a decrease in professional discrimination would minimize silence about patient safety. IMPACT On many occasions, nurses are directly or indirectly discouraged from voicing their concerns about patient safety or are ignored when they do, leading to employee silence and decreasing the standard of care (Alingh et al., BMJ Quality & Safety, 2019, 28, 39; Pope, Journal of Change Management, 2019, 19, 45). Nurses' work-related determinants for silence are not clearly understood in the patient safety context. A favourably evaluated nurse practice environment is associated with less experienced professional discrimination and less silence about patient safety. To minimize silence about patient safety, both the nurse work environment and the experienced professional discrimination should be taken into consideration by nurse and healthcare managers.
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Affiliation(s)
- George Kritsotakis
- Department of Bussiness Administration & Tourism, Hellenic Mediterranean University, Crete, Greece.,School of Social Sciences, Hellenic Open University, Patras, Greece
| | - Panagiotis Gkorezis
- School of Social Sciences, Hellenic Open University, Patras, Greece.,Faculty of Economics and Political Sciences, Aristotle University of Thessaloniki, Thesaloniki, Greece
| | - Eirini Andreadaki
- School of Social Sciences, Hellenic Open University, Patras, Greece.,Aghios Nikolaos General Hospital, Crete, Greece
| | | | | | | | - Petros Kostagiolas
- School of Social Sciences, Hellenic Open University, Patras, Greece.,Department of Archives, Library Science and Museology, School of Information Science and Informatics, Ionian University, Kerkyra, Greece
| | - Nikoleta Ratsika
- Department of Social Work, Hellenic Mediterranean University, Crete, Greece
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19
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Tuffour I. It is like 'judging a book by its cover': An exploration of the lived experiences of Black African mental health nurses in England. Nurs Inq 2021; 29:e12436. [PMID: 34124816 DOI: 10.1111/nin.12436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 12/01/2022]
Abstract
The aim of this paper was to explore the experiences of perceived prejudices faced in England by Black African mental health nurses. Purposive sampling was used to identify five nurses from sub-Saharan Africa. They were interviewed using face-to-face semi-structured interviews. Data were analysed using interpretative phenomenological analysis (IPA). The findings were reported under two superordinate themes: Judging a book by its cover and opportunities. The findings showed that Black African nurses experience deep-rooted discrimination and marginalisation. Aside from that, because of their ethnicity and the fact that they speak English as a second language, they face discrimination and have difficulty achieving leadership roles. These findings provide key stakeholders, such as nursing trade unions and professional associations, as well as NHS employers, with the opportunity to act to counter hegemony in the NHS and recognise that discriminatory and racially related barriers hinder Black African nurses from reaching their full professional potential.
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20
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Carthon JMB, Travers JL, Hounshell D, Udoeyo I, Chittams J. Disparities in Nurse Job Dissatisfaction and Intent to Leave: Implications for Retaining a Diverse Workforce. J Nurs Adm 2021; 51:310-317. [PMID: 33989239 PMCID: PMC8137650 DOI: 10.1097/nna.0000000000001019] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine if Black nurses are more likely to report job dissatisfaction and whether factors related to dissatisfaction influence differences in intent to leave. BACKGROUND Minority nurses report higher job dissatisfaction and intent to leave, yet little is known about factors associated with these differences in community settings. METHOD Cross-sectional analysis of 11 778 nurses working in community-based settings was conducted. Logistic regression was used to estimate the association among race, job satisfaction, and intent to leave. RESULTS Black nurses were more likely to report job dissatisfaction and intent to leave. Black nurses' intent to leave decreased in adjusted models that accounted for dissatisfaction with aspects of their jobs including salary, advancement opportunities, autonomy, and tuition benefits. CONCLUSION Nurse administrators may find opportunities to decrease intent to leave among Black nurses through focused efforts to target areas of dissatisfaction.
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Affiliation(s)
- J Margo Brooks Carthon
- Author Affiliations: Associate Professor (Dr Carthon), University of Pennsylvania School of Nursing, Philadelphia; Assistant Professor (Dr Travers), New York University Rory Meyers College of Nursing, New York; and Research Assistant (Ms Hounshell), Statistician (Ms Udoeyo), and Senior Biostatistician (Mr Chittams), University of Pennsylvania, Philadelphia
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21
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Celebi Cakiroglu O, Baykal U. Development and psychometric properties of the attitude scale towards female workers in the healthcare settings. J Adv Nurs 2021; 77:3238-3253. [PMID: 33855737 DOI: 10.1111/jan.14859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 02/11/2021] [Accepted: 03/30/2021] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to develop a new instrument to evaluate healthcare professionals' attitudes towards female workers in the healthcare settings-the Attitude Scale Towards Female Workers (ASTFW)-and test its psychometric properties. DESIGN This is a scale development study. METHOD A three-phase structure was used: (1) creating the item pool, (2) preliminarily evaluating items and (3) refining the scale and evaluating psychometric properties. The scale's content validity, construct validity, internal consistency and temporal stability were evaluated according to the scale development guidelines. The scale's psychometric properties were tested with 1,635 healthcare professionals working in six different hospitals. The data were collected between November 2018 and July 2019. RESULTS The scale items were obtained from face-to-face, semi-structured, in-depth individual interviews with the healthcare professionals. The scale's content validity index was 0.96. According to exploratory factor analysis, the scale consisted of 30 items and five subdimensions; the subdimensions were found to explain 54.48% of the total variance. Fit indices obtained with confirmatory factor analysis were at acceptable and good levels. The scale was found to have high internal consistency and temporal stability. CONCLUSION The ASTFW is a psychometrically valid and reliable measurement instrument. The 30-item scale consists of five subdimensions: performance, gender roles, recruitment and retention, career, and emotionality. Impact This scale, which has good psychometric properties, can be used to perform a multidimensional evaluation of the attitudes of healthcare professionals in healthcare workplaces towards female workers. This scale can be useful in shedding light on negative attitudes towards female healthcare professionals in the health sector.
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Affiliation(s)
- Oya Celebi Cakiroglu
- Department of Nursing Administration, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ulku Baykal
- Department of Nursing Administration, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
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22
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Iheduru-Anderson KC, Agomoh CJ, Inungu J. African born black nurses' perception of their U.S. work environment: Race matters. Nurs Outlook 2021; 69:409-424. [PMID: 33353725 DOI: 10.1016/j.outlook.2020.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/15/2020] [Accepted: 11/28/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Healthy work environment is essential to patients' safety, staff recruitment, retention, and organization's financial viability. It is imperative to examine, understand and mitigate any and all factors that may contribute to unhealthy work environment. PURPOSE This study aimed to describe how African-born Black nurses felt their race affected their experience of the work environment and whether these experiences contributed to perceptions of unhealthy work environments. METHOD Thematic analysis was performed on data obtained from unstructured interviews of 17 African born Black nurses in this qualitative descriptive study. FINDINGS Seven themes emerged from the study: disregard for personhood, poor communication, democratic disqualification, lack of recognition, missing authentic leadership, attrition, and finding control. DISCUSSION The finding suggests African born Black nurses' experiences are uniquely and qualitatively different from that of their American born counterparts. Creating healthy work environment require authentic nurse leaders who can influence and support others in its achievement.
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Affiliation(s)
- Kechinyere C Iheduru-Anderson
- The Herbert H. and Grace A. Dow College of Health Professions, CHP 1215, Central Michigan University, Mount Pleasant, MI.
| | | | - Joseph Inungu
- School of Health Sciences, Public Health Division, College of Health professions Central Michigan University, Mount Pleasant, MI
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23
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Spevan M, Kvas A, Bošković S. Job satisfaction of nurses in Croatia, Slovenia and Serbia: a cross-sectional study. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2020. [DOI: 10.15452/cejnm.2020.11.0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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24
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Iheduru-Anderson K. Accent bias: A barrier to Black African-born nurses seeking managerial and faculty positions in the United States. Nurs Inq 2020; 27:e12355. [PMID: 32476211 DOI: 10.1111/nin.12355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 04/02/2020] [Accepted: 04/24/2020] [Indexed: 12/18/2022]
Abstract
The purpose of this study was to examine the perceptions of Black African-born nurses (BABN) with non-native accents regarding their nursing career advancement in the United States. Data were collected using individual interviews. Fifteen nurses originally from three sub-Saharan African countries were included in the study. The findings were reported under six themes: perceived low level of intelligence, not suitable to lead, making fun of/belittling, prejudging without evidence, downgrading, and accent modification. The finding indicated that participants believed that their race and accent influenced their professional nursing opportunities. These results are relevant to BABNs, nurse educators, and healthcare organization leaders. BABNs are capable of participating in nursing leadership and education despite their non-native accent.
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Affiliation(s)
- Kechi Iheduru-Anderson
- School of Rehabilitation and Medical Sciences, The Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University, Mount Pleasant, MI, USA
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25
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Iheduru-Anderson K, Akanegbu C, Inungu J. Outsiders in Nursing - Voices of Black African Born Nurses & Students in the US: An Integrative Review. Open Nurs J 2020. [DOI: 10.2174/1874434602014010120] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
The purpose of this integrative review was to describe the experience of being outsiders in nursing as described by Black African Born Nurses and Student Nurses (BABN&SN) in the U.S., give voice to their experiences in U.S. academia and healthcare settings, discuss the implications of the BABN&SN othering on the U.S. healthcare systems, and offer recommendations to address the issues based on the literature.
Methods:
An integrative review approach discussed by Whittemore and Knafl was utilized to review literature from nursing journal published from 2008 to 2019.
Results:
Major findings include collegial/peer isolation and loneliness; racism and discrimination, unwelcoming environment, silencing of voices, personal resilience, and sense of belonging. The results of this review indicate that BABN&SN experience in U.S. nursing contribute to harrowing periods of feeling like ‘an outsider.’
Conclusions:
BABN&SN are integral part of the U.S. nursing workforce and the healthcare system. Academic and work environments that support all nurses and students, despite their perceived differences, are essential to promoting an inclusive environment. Understanding the relational pattern that guides the BABN&SN socialization into nursing is vital to developing targeted support especially when entering the clinical practice environment.
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26
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Brunton M, Cook C, Walker L, Clendon J, Atefi N. Home and away: A national mixed-methods questionnaire survey of host and migrant Registered Nurses in New Zealand. Collegian 2020. [DOI: 10.1016/j.colegn.2019.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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27
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Uncovering a health and wellbeing gap among professional nurses: situated experiences of direct care nurses in two Canadian cities. Soc Sci Med 2019; 242:112568. [PMID: 31606695 DOI: 10.1016/j.socscimed.2019.112568] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 08/07/2019] [Accepted: 09/24/2019] [Indexed: 11/22/2022]
Abstract
Understanding the drivers of nurses' poor health and the implications for quality of care are important in sustaining a healthy workforce, stimulating professional nursing practice, and ensuring healthy lives while promoting the wellbeing of nurses of all ages. Previous scholarship has identified factors influencing nurses' wellbeing, but have neglected to take a comprehensive approach to assessing the multiple dimensions of nurses' wellbeing and their collective, syndemic effects. Neither have these studies explored the context within which these experiences occur, or how these experiences differ for nurses with multiple marginalized identities in spite of an increasingly diverse workforce. Using the six dimensions of wellness framework, we examined the distinct and interrelated dimensions of nurses' wellbeing that were either enhanced or aggravated by professional practice and how it changed by nurses' race and ethnicity using their situated experiences. The study was conducted using a qualitative research design, which drew on phenomenology and in-depth interviews with Registered and Practical Nurses (n = 70) in two Canadian cities. Of the six dimensions of wellbeing identified, direct care practice enhanced nurses' occupational, intellectual, and spiritual wellbeing, but worsened their physical, emotional and social health. A health gap was found along racial lines, as ethnic minority nurses reported more detrimental effects of direct care nursing on their physical, emotional, occupational, and social wellbeing than their white counterparts. Nurses resorted to institutional structures, social and emotional support from supervisors, coworkers and family members, and engaged in spiritual activities to cope with these adverse health effects. These findings highlight the utility of an adaptable framework in identifying the multiple dimensions and gaps in nurses' wellbeing. Furthermore, our findings echo the urgent need for workplace and safety policies that address issues of diversity and make the work environment safe, equitable and promote nurse productivity and quality care.
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28
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Ingwell-Spolan C. Chief Nursing Officers' Views on Meeting the Needs of the Professional Nurse: How This Can Affect Patient Outcomes. Healthcare (Basel) 2018; 6:healthcare6020056. [PMID: 29857471 PMCID: PMC6023280 DOI: 10.3390/healthcare6020056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 05/25/2018] [Accepted: 05/29/2018] [Indexed: 11/16/2022] Open
Abstract
Chief Nursing Officers (CNOs) have a demanding, complex role that commands accountability in leading the nursing profession and achieving quality patient outcomes. The purpose of this study was to understand the CNO's view of meeting the needs of the Registered Nurse (RN) at point of care and how this could affect quality patient outcomes. In two qualitative studies twenty-five CNOs were individually interviewed in eight states including: Florida, Tennessee, Kentucky, Maine, New Hampshire, Vermont, Massachusetts, and New Jersey. The majority of these CNOs interviewed believed they were doing the best for their nurses and their healthcare facility. After analyzing their responses, it was apparent that some CNOs actually encouraged peer pressure among nurses to achieve compliance and felt patient acuity is being addressed adequately, since most patients were discharged within three to four days and those that were more critical were admitted to the critical care units. The average length of stay, which is the number of paid days a patient remained in the hospital, was an important metric. A large amount of nurses felt they were unable to deliver the care needed for their patients due to patient load, lack of collaboration among the health care team, higher patient acuity and absence of decision-making and autonomy. Many of the CNOs trusted that patient care outcomes, meaning relatively short hospital stays, demonstrated that the nursing practice was successful; rather than first having the nurse being set up for success to provide the best care possible to their patients.
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29
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Belkacem N, Serafini N, Wheeler R, Derrien M, Boucinha L, Couesnon A, Cerf-Bensussan N, Gomperts Boneca I, Di Santo JP, Taha MK, Bourdet-Sicard R. Lactobacillus paracasei feeding improves immune control of influenza infection in mice. PLoS One 2017; 12:e0184976. [PMID: 28931041 PMCID: PMC5607164 DOI: 10.1371/journal.pone.0184976] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 09/05/2017] [Indexed: 01/21/2023] Open
Abstract
Respiratory tract infections such as flu cause severe morbidity and mortality and are among the leading causes of death in children and adults worldwide. Commensal microbiota is critical for orchestrating tissue homeostasis and immunity in the intestine. Probiotics represent an interesting source of immune modulators and several clinical studies have addressed the potential beneficial effects of probiotics against respiratory infections. Therefore, we have investigated the mechanisms of protection conferred by L. paracasei CNCM I-1518 strain in a mouse model of influenza infection. Notably, local myeloid cells accumulation is generated in the lungs after seven days feeding with L. paracasei prior to viral infection. L. paracasei-fed mice showed reduced susceptibility to the influenza infection, associated with less accumulation of inflammatory cells in the lungs, faster viral clearance and general health improvement. Interestingly, Allobaculum was significantly increased in L. paracasei-fed mice 7 days after influenza infection, even if the gut microbiota composition was not altered overall. L. paracasei-purified peptidoglycan partially recapitulated the protective phenotype observed with the entire bacteria. Collectively, our results demonstrate that oral consumption of L. paracasei CNCM I-1518 modulates lung immunity was associated with an improved control of influenza infection. These results further extend the beneficial role for certain lactobacilli to alleviate the burden of respiratory tract infections.
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Affiliation(s)
- Nouria Belkacem
- Institut Pasteur, Invasive Bacterial Infections Unit, Paris, France.,Bioaster, Paris, France
| | - Nicolas Serafini
- Innate Immunity Unit, Institut Pasteur, Paris, France.,Inserm U1223, Paris, France
| | - Richard Wheeler
- Institut Pasteur, Unité Biologie et génétique de la paroi bactérienne, Dept. Microbiologie, Paris, France.,Institut National de la santé et de la Recherche Médicale (INSERM), Paris, France
| | | | | | - Aurélie Couesnon
- Bioaster, Paris, France.,INSERM, U1163, Laboratory of Intestinal Immunity, Université Paris Descartes-Sorbonne Paris Cité and Institut Imagine, Paris, France
| | - Nadine Cerf-Bensussan
- INSERM, U1163, Laboratory of Intestinal Immunity, Université Paris Descartes-Sorbonne Paris Cité and Institut Imagine, Paris, France
| | - Ivo Gomperts Boneca
- Institut Pasteur, Unité Biologie et génétique de la paroi bactérienne, Dept. Microbiologie, Paris, France.,Institut National de la santé et de la Recherche Médicale (INSERM), Paris, France
| | - James P Di Santo
- Innate Immunity Unit, Institut Pasteur, Paris, France.,Inserm U1223, Paris, France
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30
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Blanchet Garneau A, Browne AJ, Varcoe C. Drawing on antiracist approaches toward a critical antidiscriminatory pedagogy for nursing. Nurs Inq 2017; 25. [PMID: 28685947 DOI: 10.1111/nin.12211] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 01/24/2023]
Abstract
Although nursing has a unique contribution to advancing social justice in health care practices and education, and although social justice has been claimed as a core value of nursing, there is little guidance regarding how to enact social justice in nursing practice and education. In this paper, we propose a critical antidiscriminatory pedagogy (CADP) for nursing as a promising path in this direction. We argue that because discrimination is inherent to the production and maintenance of inequities and injustices, adopting a CADP offers opportunities for students and practicing nurses to develop their capacity to counteract racism and other forms of individual and systemic discrimination in health care, and thus promote social justice. The CADP we propose has the following features: it is grounded in a critical intersectional perspective of discrimination, it aims at fostering transformative learning, and it involves a praxis-oriented critical consciousness. A CADP challenges the liberal individualist paradigm that dominates much of western-based health care, and the culturalist and racializing processes prevalent in nursing education. It also situates nursing practice as responsive to health inequities. Thus, a CADP is a promising way to translate social justice into nursing practice and education through transformative learning.
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Affiliation(s)
| | - Annette J Browne
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Colleen Varcoe
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
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31
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Bamonti P, Conti E, Cavanagh C, Gerolimatos L, Gregg J, Goulet C, Pifer M, Edelstein B. Coping, Cognitive Emotion Regulation, and Burnout in Long-Term Care Nursing Staff: A Preliminary Study. J Appl Gerontol 2017; 38:92-111. [PMID: 28671027 DOI: 10.1177/0733464817716970] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Direct care workers (e.g., certified nursing assistants [CNAs]) employed in long-term care (LTC) are particularly vulnerable to the experience of burnout, yet they have received relatively less research attention compared to Licensed Practical Nurses and Registered Nurses. Within the burnout literature, evidence suggests that the deployment of certain coping strategies influences levels of burnout. The current study examined the extent to which coping (e.g., problem-focused, emotion-focused, and dysfunctional coping) and cognitive emotion regulation strategies (e.g., positive reappraisal) predicted burnout after controlling for covariates (age, sleep duration). Fifty-six CNAs were surveyed at four skilled nursing facilities in the United States. Dysfunctional coping was significantly associated with emotional exhaustion and depersonalization. Among cognitive emotion regulation strategies, positive reappraisal was significantly associated with depersonalization. Shorter sleep duration was associated with significantly greater depersonalization. Findings suggest the need to develop interventions for CNAs aimed at reducing dysfunctional coping strategies and increasing sleep duration.
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32
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Feng D, Su S, Yang Y, Xia J, Su Y. Job satisfaction mediates subjective social status and turnover intention among Chinese nurses. Nurs Health Sci 2017. [PMID: 28636135 DOI: 10.1111/nhs.12357] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Nurse turnover is one of the reasons for the global nurse shortage. Although previous studies have examined the determinants of turnover intention in detail, there is limited knowledge on the effect of subjective social status on nurse turnover intention. Therefore, in this study, we examined this relationship, including job satisfaction as a mediator, among Chinese nurses. This cross-sectional study employed questionnaires to assess subjective social status, job satisfaction, and turnover intention in 581 nurses who were randomly recruited from 10 hospitals in Jinan, China. The results partially supported our model. Although subjective social status exerted no significant direct effect on turnover intention, it exerted a significant indirect effect through job satisfaction. These results provide a new insight into why nurses leave their jobs, and possible new solutions to the nurse turnover problem. Efforts should be made to improve nurses' subjective social status.
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Affiliation(s)
- Danjun Feng
- School of Nursing, Shandong University, Jinan, China
| | - Shan Su
- School of Nursing, Shandong University, Jinan, China
| | - Yang Yang
- School of Nursing, Shandong University, Jinan, China
| | - Jinghua Xia
- School of Nursing, Shandong University, Jinan, China
| | - Yonggang Su
- School of Nursing, Shandong University, Jinan, China.,School of Foreign Languages and Literature, Shandong University, Jinan, China
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33
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Dahl K, Dahlen KJ, Larsen K, Lohne V. Conscientious and proud but challenged as a stranger: Immigrant nurses’ perceptions and descriptions of the Norwegian healthcare system. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/2057158517690952] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The number of nurses in Norway educated outside of the European Union is increasing. The purpose of this study is to explore how immigrant nurses, all educated as nurses in their home countries, experience working as a nurse in Norway. The study has a qualitative design with a social constructivist perspective and is based on written narratives from open-ended questions representing 144 nurses from 18 different counties. Two main themes based on patterns from the participants’ text were constructed: ‘conscientious and proud as nurses’ and ‘impressed but challenged as strangers’. The findings are discussed in relation to research in cultural understanding. Immigrant nurses contribute with important knowledge and cultural competence to nursing and the Norwegian healthcare system, but there are also challenges. More knowledge is needed in education, research and in individual institutions about the contributions and challenges immigrant nurses bring with them.
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Affiliation(s)
- Kari Dahl
- Oslo and Akershus University College of Applied Sciences, Norway
| | | | - Kristian Larsen
- Oslo and Akershus University College of Applied Sciences, Norway
| | - Vibeke Lohne
- Oslo and Akershus University College of Applied Sciences, Norway
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34
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Doede M. Race as a predictor of job satisfaction and turnover in US nurses. J Nurs Manag 2017; 25:207-214. [PMID: 28127813 DOI: 10.1111/jonm.12460] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2016] [Indexed: 11/28/2022]
Abstract
AIM The purpose of this analysis is to determine US minority nurses' job satisfaction and turnover using three outcome variables: job dissatisfaction; change of jobs; and intent to quit. BACKGROUND A balanced nursing workforce is essential for supporting a racially diverse nation. Understanding minority nurses' job satisfaction is the first step in achieving this balance. METHODS A secondary data analysis was conducted using the 2008 National Sample Survey of Registered Nurses. The association between race and job satisfaction was examined using logistic regression. RESULTS Black nurses were more likely to intend to quit than white ones (OR = 1.46, 95% CI = 1.31-1.64), as were Hispanics (OR = 1.35, 95% CI = 1.18-1.55). Asians were less dissatisfied (OR = 0.69, 95% CI = 0.57-0.84), and less likely to have changed jobs (OR = 0.71, 95% CI = 0.60-85) or intend to quit (OR = 0.84, 95% CI = 0.75-0.95) than white nurses. CONCLUSIONS This analysis demonstrated that black and Hispanic nurses are more likely to intend to quit, even while controlling for dissatisfaction. The reasons for this, and the increased job satisfaction demonstrated by Asian nurses, are directions for future research. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers should endeavour to create a workplace free of discrimination. Efforts to increase the job satisfaction of all nurses are of equal importance.
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Affiliation(s)
- Megan Doede
- University of Maryland School of Nursing, Baltimore, MD, USA
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35
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Pendleton J. The experiences of black and minority ethnic nurses working in the UK. ACTA ACUST UNITED AC 2017; 26:37-42. [DOI: 10.12968/bjon.2017.26.1.37] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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36
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Browne G, Birch S, Thabane L. Better Care and Better Value for Canadians: A Review of RCT Studies of Nurse Interventions. Can J Nurs Res 2015; 47:41-60. [PMID: 29509477 DOI: 10.1177/084456211504700403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This review is focused on the effectiveness of nursing interventions for patient outcomes and healthcare costs. It was guided by ecological and economic evaluation frameworks. Restricting the first-tier search of over 4,000 articles to randomized controlled trials (RCTs) yielded 203 studies and 9 additional trials that used identical methods of cost evaluation. Of 212 RCTs, 37 met the eligibility criteria. Of the 37 articles, 29 came from the literature search and 8 came from the first author's research unit, which used identical methods of economic evaluation. Of the first 29 studies, 26 found that nurse interventions were more or equally effective and less or equally costly compared to usual care, as was true of 7 of the 9 RCTs with comprehensive economic evaluations. It is effective and efficient to deploy specialty-trained nurses to lead teams of professionals, including physicians, assembled to address complex patient needs. A nurse-led model of proactive and supplemental care for the chronically ill, versus the on-demand, physician-led model now in place, would be more or equally effective and less or equally costly.
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Affiliation(s)
- Gina Browne
- Health and Social Service Utilization Research Unit, and Professor, School of Nursing and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Stephen Birch
- Department of Clinical Epidemiology and Biostatistics, and Member, Centre for Health Economics and Policy Analysis, McMaster University
| | - Lehana Thabane
- Department of Clinical Epidemiology and Biostatistics, and Associate Member, Departments of Anesthesia and Pediatrics, McMaster University; Lead, FSORC, Research Institute at St. Joseph's Healthcare, Hamilton; Director, Biostatistics Unit, St. Joseph's Healthcare; and Senior Scientist, Population Health Research Institute, Hamilton Health Sciences
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37
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Internationally recruited nurses' experiences in England: A survey approach. Nurs Outlook 2015; 63:238-44. [DOI: 10.1016/j.outlook.2014.10.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 09/22/2014] [Accepted: 10/09/2014] [Indexed: 11/20/2022]
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38
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Xue Y. Racial and ethnic minority nurses’ job satisfaction in the U.S. Int J Nurs Stud 2015; 52:280-7. [DOI: 10.1016/j.ijnurstu.2014.10.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 10/14/2014] [Accepted: 10/17/2014] [Indexed: 11/29/2022]
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