Workplace-related generational characteristics of nurses: A mixed-method systematic review

Factors contributing to nurses' intent to leave during COVID-19

To examine the association between demographic characteristics (i.e., gender, race, age, and years of experience), burnout, and nurses' intent to leave their jobs during the first wave of COVID-19 in New Jersey. COVID-19 has exacerbated burnout and intent to leave among acute care nurses. Nonetheless, little is known about demographic factors contributing to nurses' desire to leave their jobs. A cross-sectional survey of actively licensed registered nurses who provided direct patient care in an acute care hospital in New Jersey during COVID-19. Among 2760 nurses, those who reported burnout were 4.78 times more likely to report intent to leave their job within 1 year as compared to nurses who did not report burnout. Black RNs were 2.06 times more likely to report intent to leave as compared to White RNs. Older nurses (aged 40-49) were 36% less likely to report intent to leave as compared to younger nurses (aged 21-29). RNs with 30 years of experience or more were 58% less likely to report intent to leave as compared to RNs with less than 5 years of experience. In addition, Black RNs with 6-12 years of experience were 2.07 times more likely to report intent to leave as compared to White RNs with less than 5 years of experience. Nurses' intent to leave during the first wave of the pandemic was influenced by burnout, race, age, and years of experience. Based on the results of the current study, Black nurses were more likely to report intent to leave their job within 1 year as compared to White RNs. Nurses' intention to leave is one of the most important global issues facing the healthcare system. Findings of the current study demonstrate that burnout, race, age, and years of experience are significant predictors of nurses' intent to leave their jobs. Therefore, organizations should prioritize strategies to reduce burnout and create diverse and inclusive work environments.

A Cycle of Reinforcing Challenges and Ideas for Action in Experiential Settings

Evidence suggests that both pharmacy students and preceptors are struggling in the experiential setting. Underlying this phenomenon is a potential interconnected and cyclic set of behaviors being reinforced between students and preceptors. These behaviors can contribute to or are the result of higher levels of burnout and a decrease in the development of student clinical skills and subsequent performance on rotation. In this review, the authors investigate various challenges commonly encountered in the experiential environment. These challenges can range from an observed decrease in student engagement, motivation, and critical thinking skills to an increase in preceptor burnout and culture shifts in the clinical practice environments. These factors all ultimately impact patient care and overall student performance. For each challenge identified, strategies will be presented that can be implemented by students, preceptors, and pharmacy programs to break the cyclic pattern identified.

Exploring nurses' experiences: Abandoning the profession and migrating for improved opportunities

AIM

This study explores nurses' experiences in migration for employment and professional abandonment in Barcelona (Spain).

METHODS

Employing a mixed-design approach comprising 1) a qualitative descriptive phenomenological study, followed by 2) a subsequent cross-sectional study, 20 and 225 nurses participated in each study, respectively. Qualitative data, gathered through 4 focus group discussions, underwent inductive thematic analysis, following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines, while quantitative data were descriptively analyzed.

FINDINGS

Three qualitative themes emerged: 1) Migration motives, such as improved job opportunities, permanent contracts, continuous training, and professional recognition; 2) Reasons for leaving or contemplating leaving the profession, including excessive workload, lack of recognition, limited development, and exhaustion; 3) Nurses' needs, encompassing more staffing, improved remuneration, permanent contracts, flexible schedules, greater autonomy, and career growth. The cross-sectional study revealed a 13.5 % professional abandonment rate at some point across all demographics and seniority levels. Migration trends varied by professional experience, with younger nurses seeking better conditions and opportunities elsewhere.

CONCLUSIONS

Multifactorial causes underlie job migration and professional abandonment, necessitating comprehensive interventions to improve nurses' working and professional conditions.

New Graduate Nurses' Experiences by Generation in South Korea: A Qualitative Meta-Synthesis

BACKGROUND

As the nursing organization environment evolves into one in which several generations work together, there are concerns about generational differences leading to conflicts.

PURPOSE

A synthesis of qualitative studies was used to gain insight into the experiences and perceptions of new nurses working in South Korean hospitals and identify generational differences between nurses of Generations X and Y.

METHODS

Eight databases were searched systematically for qualitative studies published up to June 2020. The Critical Appraisal Skills Programme Checklist for Qualitative Research was used to evaluate the quality of the retrieved studies, and the data were synthesized thematically using the Thomas and Harden method.

RESULTS

Of the 2,482 studies retrieved, 19 were included in this meta-synthesis. The experience of new nurses were presented in the three analytical themes of work experience, interpersonal relationships, and adaptation, from which eight descriptive themes were derived: (a) dissatisfied with own work performance, (b) negative feedback on work outcomes, (c) irregular daily life, (d) colleagues who help adapt to work life or make work life harder, (e) feelings of sympathy toward peers, (f) disrespectful patients or caregivers, (g) effective reactions, and (h) ineffective reactions. Although the new nurses from Generations X and Y reported similar experiences during their first year of nursing, differences were found in their values and tendencies regarding work and interpersonal relationships. Compared with new Generation X nurses, new Generation Y nurses placed more value on the meaning of individual work contributions, intimacy with colleagues, and appropriate feedback.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The findings of this study support nursing administrators implementing strategies that both acknowledge and reduce the impact of generational category on nursing teams. Furthermore, emphasizing communication and acknowledging ongoing change as generations progress may strengthen bonds that lead nurses to value each other and their work.

Work values and communication styles among Generation X, Y, and Z nurses: A cross-sectional study

AIM

To compare and contrast nurses' work values and communication styles across Generation X, Y, and Z.

BACKGROUND

Intergenerational differences in the work values of nurses are well known, but the commonalities remain largely uninvestigated. It is also unclear if there are intergenerational differences and commonalities in the rhetorical communication style of nurses.

METHODS

This study used a cross-sectional research design. Participants were 243 nurses of Generation X (n = 78), Y (n = 86), and Z (n = 79) working at a general hospital in Korea. Structured questionnaires were used to collect the data from September to October 2019. The differences in work values and communication types were measured and analyzed using the χ2 test.

FINDINGS

The work values of Generation X differed from those of Generation Y and Z, who preferred extrinsic work values. There was no significant intergenerational difference in communication types, although Generation X and Y were similar to each other in communication types and different from Generation Z.

CONCLUSION

Although the work values of the three generations are different, their communication styles are similar so that they may reduce the generational gap through communication. In particular, Generation Y nurses prefer extrinsic work values and share some work values with Generation Z; however, the dominant communication type of Generation Y is similar to Generation X, not Z. Therefore, Generation Y could play a key role in connecting Generation X with Z during communication.

IMPLICATIONS FOR NURSING POLICY

Nursing organizations should delegate the authority to Generation Y so that Y may have a voice in the nursing group as the mediator between X and Z.

Innovative leadership characteristics of Generation X and Y nurses: A cross-sectional study

The study aimed to identify the innovative leadership qualities of Generation X and Y nurses and explore factors affecting these qualities in both generations. This cross-sectional study was conducted with 324 teaching and research hospital nurses. Data were gathered using a Personal Information Form and the Innovative Leadership Scale from October 2021 to March 2022. Descriptive statistics were applied, followed by Mann-Whitney U, Kruskal-Wallis H tests, and multiple linear regression. Of the nurses, 34% were Generation X, while 66% were Generation Y. Both Generation X and Y nurses exhibited high scores of innovative leadership, with no significant difference in their overall scale scores. Generation X nurses scored higher on average in the subscales of being entrepreneur, motivating others, and being energetic. In contrast, Generation Y nurses excelled in being open to new ideas and being a changemaker. The factors influencing nurses' innovative leadership qualities included their educational level, position, work clinic, clinical experience, shift type, and perception of themselves as leaders. These results suggest that nurses from both generations manifest differing innovative leadership qualities.

Latent profiles of nurses' subjective well-being and its association with social support and professional self-concept

AIM

To identify latent profiles of nurses' subjective well-being (SWB) and explore its association with social support and professional self-concept.

DESIGN

This study used an online survey and cross-sectional latent profile analysis design.

METHODS

A total of 1009 nurses from 30 hospitals in Guangdong Province, China, were selected using convenience sampling. An online questionnaire survey comprising the following scales was distributed: Index of Well-Being, Nurses' Professional Self-concept Questionnaire and Multidimensional Scale of Perceived Social Support. Nurses' SWB was examined and categorized into profiles using nine Index of Well-being items as explicit variables and ordinal logistic regression analysis was performed to explore factors related to the distinct categories.

RESULTS

Nurses' SWB was divided into four latent profiles: extremely low, low, moderate and high. Regression analysis showed that social support and professional self-concept influenced SWB. There were statistically significant differences in age, title, working years, social support and professional self-concept among nurses in the different well-being categories. Ordered logistic regression analysis showed that social support and professional self-concept are associated with different SWB profiles.

The experience of good mentoring focused on overcoming turnover intention among millennial nurses

Introduction

Millennials are emerging as a prominent demographic in the nursing workforce. It is necessary to create an environment that harmonizes the advantages of each generation in a nursing workforce in which various generations coexist. As the importance of mentoring programs for millennial nurses grows, it is believed that the effectiveness of mentoring to support millennial nurses can be enhanced by identifying the attributes of good mentors as perceived by nurses. This study aimed to explore the attributes of good mentors according to millennial nurses in the nursing workforce with a focus on overcoming turnover intention problems.

Methods

Four focus group interviews were conducted to collect data, which were subsequently analyzed using Braun and Clarke's thematic analysis method. A descriptive qualitative design involving 22 millennial nurses employed at a tertiary hospital, Hospital A, in Seoul, Republic of Korea was utilized.

Results and discussion

Four themes emerged from the analysis: the concept of a significant others, the presence of a driving force to endure, the importance of a guide to a harmonious life, and the value of a partner for growth. The participants themselves identified these themes. To prevent turnover intention among millennial nurses, mentors should employ diverse strategies, and institutional supports are crucial. Furthermore, since it is unrealistic to expect all ideal mentor characteristics to be present in one person, mentor development education is also necessary. This information is valuable for designing mentor development programs and for establishing a solid framework for effective mentoring programs.

Self-efficacy, grit, and rural career aspirations among early career nurses: a repeated cross-sectional study

BACKGROUND

Global nursing workforce shortage represents an impediment to the delivery of safe, evidence-based healthcare. Despite collective efforts, a consistent stream of nurses leaving the profession remains, particularly within the first five years of practice, which is exacerbated in rural communities. The aim of the study was to compare self-efficacy, grit, and rural career aspirations among nursing graduates between their second and fourth year of their nursing profession.

METHODS

As part of a longitudinal investigation, a repeated cross-sectional design was utilised. Participants included, 117 (response rate 52.2%) who completed an online questionnaire 18-24 months after graduating, and 32 participants (response rate of 21.0%) who agree to repeat the questionnaire 36-48 months after graduating. The questionnaire included demographic, employment, and measures examining general and occupational self-efficacy, grit, and rural career aspirations.

RESULTS

No differences between general and occupational self-efficacy or grit were identified between second- and fourth-year nurses. In addition, the importance placed on undertaking rural career also remains unchanged. However, a higher proportion of fourth year nurses were more likely to be in management or were considering leaving the profession.

CONCLUSIONS

This examination of early career nurses, now in their second and fourth-year post-graduation highlights self-efficacy, grit, and rural career aspirations remains stable between two- and four-years following graduation, while nursing in their fourth year were more likely to consider leaving the profession. Nursing retention is a 'Wicked Problem' that is unavoidably a complex amalgam of macro, meso and micro factors that we are yet to fully appreciate.

Nursing students' evaluation of patient safety culture in three central European countries: a cross-sectional study

OBJECTIVES

This cross-sectional study aimed to investigate and compare the perceptions of nursing students regarding patient safety culture (PSC) during the COVID-19 pandemic in three Central European countries.

METHODS

Data were collected from 624 nursing students between April and September 2021 using the Hospital Survey on Patient Safety Culture.

RESULTS

The evaluation of the PSC dimensions did not reach the expected level of 75 %. Significant associations were found between the perception of the dimensions of the individual PSC and age, student status, study year, and clinical placement. The overall patient safety grade, the number of events reported, and the number of events reported by nursing students were significantly predicted by several dimensions of the PSC (p<0.05).

CONCLUSIONS

The evaluation of patient safety culture by nursing students offers a unique perspective. Students come with 'fresh eyes' and provide different perspectives that can provide healthcare leaders with a practical opportunity to identify blind spots, review and improve safety protocols, and foster a more inclusive culture that prioritizes patient safety.

What are the key factors influencing newly graduated nurses' preference for choosing their workplace? A best-worst scaling approach

INTRODUCTION

The literature cites many factors that influence a nurse's decision when choosing their workplace. However, it is unclear which attributes matter the most to newly graduated nurses. The study aimed to identify the relative importance of workplace preference attributes among newly graduated nurses.

DESIGN

A cross-sectional study.

METHODS

We conducted an online survey and data were collected in June 2022. A total of 1111 newly graduated nurses in South Korea participated. The study employed best-worst scaling to quantify the relative importance of nine workplace preferences and also included questions about participants' willingness to pay for each workplace preferences. The relationships between the relative importance of the workplace attribute and the willingness to pay were determined using a quadrant analysis.

RESULTS

The order according to the relative importance of workplace preferences is as follows: salary, working conditions, organizational climate, welfare program, hospital location, hospital level, hospital reputation, professional development, and the chance of promotion. The most important factor, salary, was 16.67 times more important than the least important factor, the chance of promotion, in terms of choosing workplace. In addition, working conditions and organizational climate were recognized as high economic value indicators.

CONCLUSION

Newly graduated nurses nominated better salaries, working conditions, and organizational climate as having a more important role in choosing their workplace.

CLINICAL RELEVANCE

The findings of this study have important implications for institutions and administrators in recruiting and retaining newly graduated nurses.

Moderating Role of Communication Competence in the Association between Professionalism and Job Satisfaction in Korean Millennial and Generation Z Nurses: A Cross-Sectional Study

Millennial and Generation Z (MZ generation) nurses, the core of the Republic of Korean nursing workforce, are leaving hospitals. We, therefore, aimed to determine the mediating role of communication competence between nursing professionalism and job satisfaction of MZ generation nurses in Republic of Korea. A total of 188 nurses aged 20-39 years belonging to the MZ generation, who had been working in a general hospital for over six months, participated in an online survey from 27 October 2022 to 11 January 2023. Data analysis was conducted using the bootstrapping method with the SPSS PROCESS macro program to confirm the mediating role of communication competence. Job satisfaction, professionalism, and communication skills were significantly positively correlated (r = 0.36-0.72, p < 0.001). Communication competence was found to be a mediating factor in the relationship between professionalism and job satisfaction. The results showed that when professionalism related to job satisfaction, good communication further enhanced job satisfaction. In order to enhance MZ generation nurses' job satisfaction, it is necessary to improve nursing professionalism and implement training programs to improve communication skills considering generation-specific characteristics.

Retaining Healthcare Workers: A Systematic Review of Strategies for Sustaining Power in the Workplace

The shortage of healthcare workers is a growing concern. The COVID-19 pandemic and retirement wave have accelerated turnover rates. This systematic review aimed to identify and analyse the existing interventions for job retention of healthcare workers, in terms of nurses and physicians, in a hospital setting. A comprehensive search was conducted within three electronic databases, guided by the preferred reporting items for systematic review and meta-analyses (PRISMA) and synthesis without meta-analysis (SWiM) guidelines, this resulted in 55 records that met the inclusion criteria. The intervention outcomes are categorized into substantial themes: onboarding, transition program to a different unit, stress coping, social support, extra staffing, coping with the demands of patient care, work relationships, development opportunities and department resources, job environment, work organization, recruitment approach, and technological innovations. Considering the literature, onboarding programs and mentoring for nurses and physicians are recommended. Additionally, other interventions described in this review could positively affect the retention of nurses and physicians. When selecting an intervention for implementation, managers and human resources should consider the intervention that matches the determinant of intention to leave of their healthcare workers and the hospital's mission, vision, and values. Sharing the success stories of implemented interventions may benefit healthcare organizations.

Generational effect on nurses' work values, engagement, and satisfaction in an acute hospital

BACKGROUND

The present nursing workforce comprises four generational of nurses working side-by-side. While such a generation blend adds invaluable diversity to the workforce, it also brings added complexity. The study aimed to describe and summarise work values and attitudes of four nursing generations, namely Baby boomers, Generation X, Y and Z.

METHOD

A cross-sectional questionnaire study was adopted. A total of 778 nurses from an acute hospital in Singapore completed the online questionnaire. The Work Value and Attitude scale measuring seven constructs (Work Centrality, Non-compliance, Technology Challenge, Work life balance, leadership, Power, and Recognition) was employed for data collection.

RESULTS

The Cronbach's alpha was 0.714 for the overall instrument. Statistically significant differences amongst the four generations of nurses emerged in the Work Value and Attitude scale in the construct of non-compliance (p = 0.007), technology challenge (p = 0.027), work-life balance (p < 0.001), and recognition (p < 0.001). No statistically significant differences were noted for the rest of the constructs.

DISCUSSION AND CONCLUSION

The findings of this study highlight that differences in work values and attitudes exist among nurses of different generations. Generation X are less likely to challenge the conventional norm and supervisors. Generation Y and Z are the most tech-savvy generations and can adapt quickly to new technology. There is also a greater emphasis on work-life balance as the generation gets younger. Generation Y and Z nurses perceived that younger nurses do not get due respect and recognition from their colleagues. Acknowledging the generational differences in work values and attitudes can facilitate nursing management to tailor strategies to improve individual and organisation performance while creating a work environment that enhances intergeneration harmony and teamwork.

Povezava lastnosti vodje in vodenja s kakovostjo storitev v zdravstveni negi

Uvod: Vodenje je proces, ki se nanaša na zmožnost vplivati na zaposlene, jih usmerjati in motivirati. Namen članka je bil raziskati povezavo med kakovostjo zdravstvene nege z vodenjem in lastnostmi vodje tima zdravstvene nege.Metode: Uporabljena je bila opisna metoda dela, s katero je bil med 2018 in 2020 izveden sistematični pregled literature po bazah podatkov Medline, CINAHL, Cochrane Library in PubMed. Iskalna strategija je sledila protokolu PICO. Iskalni pojmi so bili: leader, leadership, leaders competencies, quality indicators, health care, nursing leadership, patient outcomes, personnel management, outcome assesment, patient satisfaction.Rezultati: Identificiranih je bilo 462 zadetkov, med katerimi je bilo za analizo izbranih 20 prispevkov, objavljenih med letoma 2010 in 2020. Deset raziskav je bilo sistematičnih pregledov literature, devet kvantitativno presečnih ter ena eksperimentalna raziskava. Prispevki so bili kritično ovrednoteni z orodji JBI. V analizi je bilo identificiranih 163 kod, ki so bile združene v šest kategorij: slogi vodenja v zdravstvu; lastnosti dobrega vodje v zdravstvu; učinkovitost zdravstvenega tima, dejavniki, ki vplivajo na kakovost zdravstvene nege; izidi zdravstvene nege; izidi negativnega delovnega okolja.Diskusija in zaključek: V kliničnem okolju je najpogosteje omenjen in priporočen transformacijski slog vodenja, v katerem ima vodja posluh za zaposlene, vodenje je usmerjeno v odnose. Med zaposlenimi se ustvarja klima zaupanja, ki vpliva na zadovoljstvo zaposlenih in posledično pozitivno tudi na kakovost zdravstvene nege.

Midwives' perceptions of the performance- and transition into practice of newly qualified midwives, a focus group study

PROBLEM

Newly qualified midwives in the Netherlands perceive the adaptation to new responsibilities as difficult due to the autonomous nature of- and required accountability for the work they face in practice.

BACKGROUND

All Dutch newly qualified midwives are accountable for their work from the moment of registration while usually working solistically.

AIM

This paper explores the perceptions of experienced midwives regarding: (1) the performance- and transition into practice of newly qualified midwives, and (2) their supporting role in this transition.

METHODS

The design of this study is qualitative with focus groups. Experienced midwives' perceptions were explored by means of seven semi-structured focus groups (N = 46 participants) with two meetings for each focus group.

FINDINGS

Community-based and hospital-based midwives perceived newly qualified midwives as colleagues who did not oversee all their tasks and responsibilities. They perceived newly qualified midwives as less committed to the practice organisation. Support in community-based practices was informally organised with a lack of orientation. In the hospital-based setting, midwives offered an introduction period in a practical setting, which was formally organised with tasks and responsibilities. Experienced midwives recognised the need to support newly qualified midwives; however, in practice, they faced barriers.

DISCUSSION

The differences in experienced midwives' expectations of newly qualified midwives and reality seemed to depend on the newly qualified midwives' temporary working contracts and -context, rather than the generational differences that experienced midwives mentioned. Dutch midwives prioritised their work with pregnant individuals and the organisation of their practice above supporting newly qualified midwives.

The Postpandemic Nursing Workforce: Increasing Fill Rates and Reducing Workload Through a Generational Design of Workforce Layers

Inequities between nursing workforce supply and demand continue to challenge nurse executives in creating the vision for a postpandemic nursing workforce. Health system's workforce redesign strategies must prioritize the changing needs of the multigenerational workforce to maximize the available supply of nurses willing to remain in the workforce. A test of a newly designed flexible workforce framework, aimed to meet the needs of the multigenerational workforce, resulted in increased fill rates and decreased costs of labor.

Analysis of Factors Affecting Psychological Resilience of Emergency Room Nurses Under Public Health Emergencies

Resilience is essential for frontline health workers to cope with the unfavorable situations, especially under public health emergencies. Emergency room (ER) nurses are a special cohort of health professionals that may present moderate level of resilience. This study aimed to identify factors that are correlated with resilience in this special cohort to provide directions for intervention and management. ER nurses that have encountered a public health emergency within 3 months were recruited using purposive sampling and snowball technique for the study. Questionnaires, including Connor-Davidson Resilience Scale (CD-RISC), Zung Self-Rating Depression Scale (SDS), and Maslach Burnout Inventory-Human Services Survey (MBI-HSS) were established, followed by an in-depth interview to identify different clusters of themes. Thirteen ER nurses were recruited, and the average CD-RISC score was 66 ± 21. Resilience was negatively correlated with SDS index, and positively correlated with personal accomplishment. Five clusters of themes were identified from in-depth interviews, including physical tolerability, psychological tolerability, tenacity of internal drive, institutional implementation, and external adjustment. This study identified factors associated with resilience in ER nurses under public health emergencies, providing useful information for future directions for intervention.

Attentes du personnel infirmier de la relève envers l’employeur pour favoriser l’engagement professionnel : un premier jalon pour la conception d’interventions organisationnelles au Québec (Canada)

Introduction: Poor work conditions jeopardize the quality of nursing jobs and increase turnover and attrition rates, especially for early career nurses and licensed practical nurses. Understanding perspectives of the nursing staff on work engagement is essential to develop innovative and responsive organizational interventions. Objectives: 1- Define the expectations of early career nursing staff with respect to their workplace in order to support work engagement 2- Identify priority actions to support work engagement at organizational level. Methods: A mixed-methods research design based on a conceptual mapping approach was used. Early career nurses and licensed practical nurses (N=14) working in a semi-urban integrated health and social services center in Quebec (Canada) were asked the following question: “What can the workplace do to promote work engagement?” Multidimensional scaling and cluster analysis were used to organize the 49 statements provided by the nursing staff. At the same time, participants prioritized actions by rating the “importance” and “probability of a successful implementation” of each statement. Results: Nursing staffs’ expectations toward their workplace in order to support work engagement were: attractive working conditions, positive leadership, safe working conditions, professional development opportunities, and personalized career path. More specifically, the priority actions identified were: showing respect, providing a healthy environment and avoiding transfer to unwanted departments. Discussion and conclusion: The results suggest several actions to promote work engagement of early career nursing staff working in semi-urban settings in Quebec, including providing human and material resources, implementing a positive organizational culture, and exercising benevolent leadership.

A Systematic Review of Nursing Practice Workarounds

BACKGROUND

Nursing practice workarounds (NPWs) are a significant problem for health care organizations. Identified NPWs serve as a catalyst for innovation to improve efficiency, patient safety, and system design. To date, a systematic review of NPW literature has not been performed.

OBJECTIVES

The aim of this systematic review was to synthesize evidence of NPW definitions, context, and prevention strategies, utilizing previous research to develop a framework that examines the current state of this phenomenon and implications for clinical practice, while highlighting the need for future research.

METHODS

A systematic review of the literature was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Academic Search, Ovid MEDLINE, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Google Scholar databases were reviewed for eligible studies from 2013 to 2020. Results were further screened and sorted by relevance and scored for quality.

RESULTS

Thirteen studies were included. Studies lacked the use of theory, and NPW definitions were varied. Nursing workarounds occurred most frequently when implementing new technology (46%) and when administering medications (31%). Contributing factors were workplace stressors and obstructions in workflow environment. Workaround prevention strategies include open communication and a proactive approach addressing conditions, situations, and processes. Overall study quality was low.

DISCUSSION

This systematic review provides valuable information for critical care nurses and administrators regarding NPW. Implications for practice include the need for proactive and open communication between nurses and administrators when new technology and/or patient care processes require NPW. Administrative considerations include process and environmental improvement strategies to remove perceived workflow barriers. Future research to examine causes and consequences of NPW is needed to identify interventions for NPW prevention. Specific nursing considerations include workload, staffing and time constraints, and impacts of work-related stress levels. Critical care nursing processes should be examined for common NPW challenges. Interventions developed to address these challenges should then be tested to further advance evidence-based critical care nursing care.

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

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

Digital Health Competencies Among Health Care Professionals: Systematic Review

Background

Digitalization is not fully implemented in clinical practice, and several factors have been identified as possible barriers, including the competencies of health care professionals. However, no summary of the available evidence has been provided to date to depict digital health competencies that have been investigated among health care professionals, the tools used in assessing such competencies, and the effective interventions to improve them.

Objective

This review aims to summarize digital health competencies investigated to date and the tools used to assess them among health care professionals.

Methods

A systematic review based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist was performed. The MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and Scopus databases were accessed up to September 4, 2021. Studies assessing digital health competencies with quantitative designs, targeting health care professionals, and written in English were included. The methodological quality of included studies was evaluated using the Joanna Briggs Institute tools.

Results

A total of 26 studies, published from 1999 to 2021, met the inclusion criteria, and the majority were cross sectional in design, while only 2 were experimental study designs. Most studies were assessed with moderate to low methodological quality; 4 categories and 9 subcategories of investigated digital health competencies have been identified. The most investigated category was “Self-rated competencies,” followed by “Psychological and emotional aspects toward digital technologies,” “Use of digital technologies,” and “Knowledge about digital technologies.” In 35% (9/26) of the studies, a previously validated tool was used to measure the competencies assessed, while others developed ad hoc questionnaires.

Conclusions

Mainly descriptive studies with issues regarding methodology quality have been produced to date investigating 4 main categories of digital health competencies mostly with nonvalidated tools. Competencies investigated might be considered while designing curricula for undergraduate, postgraduate, and continuing education processes, whereas the methodological lacks detected might be addressed with future research. There is a need to expand research on psychological and emotional elements and the ability to use digital technology to self-learn and teach others.

Trial Registration

PROSPERO International Prospective Register of Systematic Reviews CRD42021282775; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=282775

Job change among early career nurses and related factors: A postgraduation 4-year follow-up study

AIMS

This study aimed to identify the job change status and related factors among nurses during the first 4 years of their professional life.

BACKGROUND

The early turnover and job change of nurses results in negative patient and nurse outcomes and financial losses.

METHODS

A prospective longitudinal observational design and convenience sampling were used. From five nursing schools in South Korea, 526 individuals participated in the first survey conducted before graduation; 317 and 338 individuals participated in the second and third surveys, respectively (4 months after employment, and 4 years after graduation).

RESULTS

In total, 42.0% of the participants remained at the hospital of their first job, 26.6% switched hospitals, and 12.1% moved to a nonhospital job. Multinomial logistic regression analyses showed that switching hospitals was associated with nurses' grade point average, type of hospital, first job satisfaction, and current pay. Moving to a nonhospital job was related to gender, type of hospital, current pay, and work-life balance.

CONCLUSION

To reduce the early turnover and job change, hospitals should provide educational programmes for nurses, support male nurses, and increase job satisfaction and work-life balance.

IMPLICATIONS FOR NURSING MANAGEMENT

Since this study addresses the working conditions and satisfaction of individuals who were re-employed after experiencing job turnover, it clarifies how nurse managers may reduce turnover. Namely, nurse managers should establish a work environment promoting good work-life balance.

Perceived corporate social responsibility and innovative work behaviour: the role of passion at work

Purpose

Perceived corporate social responsibility (CSR) reflects personal views towards CSR activities that impact emotion, attitude and behaviour. This paper aims to investigate how perceived CSR predicts innovative work behaviour (IWB).

Design/methodology/approach

This study used a survey questionnaire to collect data from Gen Y 508 nurses working in the United Arab Emirates health-care sector. This study used a structural equation model to examine the study’s hypotheses.

Findings

Perceived CSR was found positively and significantly related to employees’ passion at work (PAW). This study also found that PAW positively and significantly mediates the relationship between perceived CSR and IWB in the organisation.

Research limitations/implications

This study’s main limitation is that it used only quantitative methodology to examine the hypotheses. Thus, this study suggests mixed-method investigations in future research.

Practical implications

This study suggests that organisations should significantly engage in CSR-related activities, as it increases employees’ PAW and cause IWB to be in full swing. Passionate Gen Y nurses will improve the quality of patient care services with productive, IWB.

Originality/value

The study’s findings give an insight into how Gen Y nurses’ perceptions of CSR would affect their attitudinal and emotional variables. This study contributes to the knowledge domain of IWB in the organisation. Passionate Gen Y nurses will add value to the health-care system by implementing IWB.

Retention strategies and barriers for millennial nurses: a scoping review

OBJECTIVE

The objectives of this scoping review were to explore the existing literature related to millennial nurse-retention strategies and barriers, to examine and conceptually map the evidence, to extract any differences between Generation Y and Generation Z nurses, and to identify any gaps in the literature.

INTRODUCTION

The millennial generation has become the largest group of nurses in the workforce. As nursing leaders grow to understand this generation's tendency to change employers frequently, organizations need to identify and implement strategies and reduce barriers to retain this generation as employees.

INCLUSION CRITERIA

Studies and reports including registered nurses born between 1980 and 2000 with any level of education preparation and in any setting or geographical location were included. Studies and reports that examined nurse-retention barriers and strategies were considered for inclusion. This review considered experimental and quasi-experimental study designs, analytical observational studies, case-control studies, analytical cross-sectional studies, descriptive observational studies, systematic reviews and meta-analyses, qualitative studies, and text and opinion papers.

METHODS

The review was conducted in accordance with the JBI methodology for scoping reviews. Studies and reports written in English after 2010 were included. The databases searched included MEDLINE, CINAHL, Embase, Scopus, Ovid HealthStar, and PsycINFO. The search for unpublished studies and reports included MedNar and ProQuest Dissertations and Theses. Eligible studies and reports underwent data extraction by two independent reviewers using a tool created by the authors. Along with a narrative summary, results are presented in a diagrammatic format that aligns with the review objectives and questions.

RESULTS

Thirty-eight publications were included in the review. Strategies for millennial nurse retention were provided in 21 publications, barriers were provided in two publications, and 15 publications provided both strategies and barriers. No publications provided information on the differences between Generation Y and Generation Z. The findings from this scoping review were grouped into five concepts, with strategies and barriers for millennial retention identified for each of the concepts. Concepts identified included leadership, work environment, professional growth, professional fatigue, and self-actualization.

CONCLUSIONS

The current evidence base shows that barriers to and strategies for millennial nurse retention commonly focus on the work environment and the relationships between nursing leadership and the bedside nurse. A preliminary scan of the evidence indicates that creating a healthy work environment that is collaborative, fair, flexible, challenging, and provides opportunities for growth may keep millennial nurses engaged. Having nursing leadership that models these values and leads by example may help millennial nurses to feel safe and supported; however, due to the methodology employed in this review, further rigorous research is needed to confirm this.

A mixed-methods systematic review identifying, describing, and examining the effects of school-based care coordination programs in the US on all reported outcomes

Children learn best when they are healthy. Therefore, access to school-based health and providing family support for social needs play an essential role in shaping a child's ability to succeed academically. The purpose of this mixed-methods review, which considers studies with all methods, is to describe and examine the effect of US school-based care coordination programs on all the outcomes reported. Care coordination is an organized approach to connect families to resources in the community to address social needs. The literature search identified 260 papers published since 2012 through CINAHL, ERIC, EMBASE, MEDLINE, Social Sciences Full Text, and Web of Science, from which 11 were included that described a US school-based care coordination program. An a priori organizing framework: Program Development, Implementation, and Evaluation were used to organize the findings. Whether quantitative or qualitative, all evaluation results were transformed into qualitative texts, then converted into codes then themes. Various health and learning issues such as asthma and vision screening were addressed. More than half of the care coordination programs were nurse-led. Parents and students characterized care coordination activities as convenient, trusting, and perceived to improve parent-teacher engagement. They also enhanced asthma knowledge and management, immunization adherence, follow-up care for vision and hearing, mental health, and school attendance. Nevertheless, challenges included staff shortages, unmet family needs, privacy laws regarding student data, and lack of resources (i.e., medications). This review highlights the need to expand school-based care coordination programs in the US and conduct robust program evaluations to assess their effectiveness.

Factors affecting high secure forensic mental health nursing workforce sustainability: Perspectives from frontline nurses and stakeholders

WHAT IS KNOWN ON THE SUBJECT?: There are insufficient nurses to meet current demand for mental health care. This is an international concern. Within England, the impact of staff shortages on the quality of patient care in forensic high secure settings has been highlighted by the national regulatory body for hospitals. Forensic hospital nursing is a distinct specialism within mental health. Forensic nurses must negotiate the therapeutic, ethical and practical challenges of caring for high-risk patients in a locked environment. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: There has been no previous study to ask frontline high secure forensic nurses, union representatives, senior nurses and workforce leads about what factors may be affecting recruitment and retention in their setting. As well as the specialized and challenging nature of the work, participants identified that workforce sustainability was affected by unequal working terms and conditions, the hospital locations and wider national factors, such as changes to how nurse training was funded. They also identified that some strategies that were employed to address workforce shortages, such as day-to-day movement of staff within the hospital and incentive packages for new recruits could be demotivating for established staff. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Forensic high secure nursing workforce strategies should include training, development and career pathways that are specific to the specialism and extend beyond preceptorship for newly qualified staff. There should be clear and equitable employment terms and conditions with remuneration packages that are consistent within and between organizations. Hospital managers should address the effect that movement of staff between wards may have on nurses' morale, therapeutic relationships and safety culture. ABSTRACT: Introduction There has been no previous study of stakeholders' views on recruitment and retention concerns in high secure forensic settings. Aim To identify factors affecting recruitment and retention in high secure hospitals, from the perspectives of stakeholders with experience in forensic mental health nursing. Method Framework analysis of data from fifteen interviews and three focus groups with frontline nurses, nurse leaders, recruitment leads and union representatives from three high secure hospitals in England. Results Six themes emerged from the data: (a) the unique nature of high secure nursing; (b) the impact of short staffing; (c) wider factors affecting the high secure nursing workforce; (d) the location; (e) staff being on different terms and conditions of work; (f) recruitment strategies. Discussion Multiple factors are likely to simultaneously affect high secure hospital recruitment and retention. Findings on the unique nature of high secure work reflect previous qualitative research. The themes of location, working terms and condition and recruitment strategies have not been previously identified in forensic nursing research. Implications for practice Employers should ensure that employment terms and conditions are equitable and consistent. Furthermore, hospital managers should address the effect that movement of staff between wards may have on morale and therapeutic relationships.

Who's more vulnerable? A generational investigation of COVID-19 perceptions' effect on Organisational citizenship Behaviours in the MENA region: job insecurity, burnout and job satisfaction as mediators

BACKGROUND

This paper is an empirical investigation that examines a path model linking COVID-19 perceptions to organisational citizenship behaviour (OCBs) via three mediators: job insecurity, burnout, and job satisfaction. The research examines the path model invariance spanning Generations X, Y, and Z. Three countries in the Middle East and North Africa (MENA) were the focus of the study.

METHODS

The data was collected from a sample of employees in service companies (n = 578). We used a Partial Least Square Structural Equation Modelling (PLS-SEM) to analyse the data.

RESULTS

Our findings reveal that COVID-19 perceptions positively predict job insecurity, which positively impacts burnout levels. Burnout negatively predicts job satisfaction. The findings established that job satisfaction positively predicts OCBs. The mediation analysis determined that job insecurity, burnout and job satisfaction convey the indirect effects of COVID-19 perceptions onto OCBs. Finally, our hypothesised model is non-equivalent across Generations X, Y and Z. In that regard, our multi-group analysis revealed that the indirect effects of COVID-19 perceptions on OCBs were only valid amongst younger generations, i.e., Generation Y and Generation Z. Specifically, younger generations are substantially more vulnerable to the indirect effects of COVID-19 perceptions on their engagement in OCBs than Generation X whose job satisfaction blocks the effects of COVID-19 perceptions on OCBs.

CONCLUSIONS

The present study extends our knowledge of workplace generational differences in responding to the perceptions of crises or pandemics. It offers evidence that suggests that burnout, job attitudes and organisational outcomes change differently across generations in pandemic times.

Generational differences in psychological wellbeing and preventative behaviours among nursing students during COVID-19: a cross-sectional study

BACKGROUND

Many nursing programmes have had to swiftly move online in response to COVID-19. Nursing students are often a heterogenous group that traverses generational boundaries. Exploring generational differences may assist in developing support systems for specific groups. This study sought to examine psychological wellbeing and preventative behaviours among nursing students from the iGeneration in comparison to older generations.

METHOD

A prospective cross-sectional study was undertaken using a convenience sample of pre-registration nursing students studying at two Australian Universities, one regional and one metropolitan. About 631 pre-registration nursing students completed an online survey.

RESULTS

An independent samples t-test revealed that students from the iGeneration possess higher anxiety compared to nursing students from older generations (p = .000). Compared to iGeneration participants, older generation participants had significantly higher scores for knowledge of COVID-19 (p = .015). iGeneration participants utilised social media to source information about COVID-19 far more than older generations (p = .008). iGeneration participants were significantly more concerned than older generations about the impact of COVID-19 on completing their clinical placement (p = .014). Older generations tended to have higher academic preventative behaviours, with significant mean scores for not attending university if they or others they knew had symptoms of COVID-19.

CONCLUSION

Given the differences between generation groups with regard to psychological wellbeing, knowledge about COVID-19, and concerns about studying in an altered study environment, strategies should be targeted to generational groups. Anxiety negatively impacts the quality of life, educational performance and clinical practice and is experienced more frequently in the iGeneration. Therefore it is crucial for nursing educators to reflect on how they engage this generation in the online space to provide support, stability and a sense of connection. This will contribute towards ensuring a well-prepared future nursing workforce who may encounter other pandemics and isolating events.

IMPACT STATEMENT

Compared with other generations, iGeneration students have a greater likelihood to experience mental health issues, isolation and insecurity. Nursing leaders and educators must be sensitive to such intergenerational differences, to ensure they are developing a skilled and productive workforce.

Improvement in the psychological health of nurses working during the COVID-19 pandemic

Background

Nurses are a critical component of any healthcare system. The novel coronavirus pandemic has resulted in an increased workload for nurses and heightened stress.

Aims

To assess the psychological health over time of nurses working during the COVID‐19 pandemic and to examine the factors associated with stress, anxiety, and psychological wellbeing.

Methods

Nurses enrolled in the study between 2 July and 26 August 2020 andcompleted questionnaires about stress, anxiety, and psychological wellbeing at baseline and at a second time point T2 12 weeks later. A paired sample t‐test was used to examine whether changes in stress, anxiety, and psychological wellbeing were significantly different between baseline and T2. Linear regression models examined factors associated with psychological health outcomes.

Results

Of the 600 nurses initially enrolled, 484 (80.7%) completed psychological health measures at T2. Stress, anxiety, and poor psychological wellbeing scores were high at baseline. Unexpectedly, stress and psychological wellbeing significantly improved between baseline and T2, while anxiety levels increased. Younger nurses had higher baseline stress and anxiety scores.

Conclusions

This study demonstrates the potential beneficial effect of effective public health management of the COVID‐19 pandemic on nurses' stress and psychological wellbeing and highlights the importance of longitudinal research to understand psychological health in nurses.

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

PURPOSE

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

DESIGN/METHODOLOGY/APPROACH

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

FINDINGS

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

PRACTICAL IMPLICATIONS

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

ORIGINALITY/VALUE

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

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

AIM

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

DESIGN

Generic qualitative study using half-standardized interviews.

METHOD

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

RESULTS

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

CONCLUSION

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

Nursing leadership succession planning: paths for elaboration

OBJECTIVE

To describe the construction of a nursing leadership succession plan for a hospital based on the appreciative reflection of nurses.

METHOD

Descriptive exploratory study with a qualitative approach carried out with nurses in a federal public teaching hospital. Data collection was carried out in two stages. The first was an individual interview, and the second was group mediation conducted based on the 4D Cycle and the assumptions of Appreciative Inquiry. Descriptive analysis of the findings was carried out.

RESULTS

The data showed a highly qualified team of different generations, concerned with succession planning based on scientific evidence, involving teams and carried out carefully for nurses at different stages of their professional careers.

CONCLUSION

The principles of Appreciative Inquiry allowed the construction of a succession plan to enhance leadership development actions in the hospital. The collaborative environment between generations was valued and planning focused on participatory management was created in the process. This aspect can profoundly change the institution's internal policy in several areas and point out ways to implement succession planning in different contexts.

Job satisfaction and generational nursing characteristics among registered nurses in the United States, Italy and Finland: Results of a survey study

AIMS

The aim of this study is to describe job satisfaction and multigenerational nursing characteristics between nurses in the United States, Italy and Finland.

BACKGROUND

Job satisfaction and work characteristics may be viewed differently among nurses of different generations and countries.

METHODS

Data were collected on the Kuopio University Hospital Job Satisfaction Scale and Multidimensional Nursing Generations Questionnaire. A total of 1,433 usable surveys were returned and analysed using multivariate analysis of variance.

RESULTS

Nurses in the United States were most satisfied in all subareas of job satisfaction. Across all generations and countries, Leadership scores were most consistent. Results did not show any generational similarities on job satisfaction or generational work characteristics that held constant across all countries. Scores on dimensions indicating intergenerational conflict were highest in the United States and lowest in Finland. Measures indicating good intergenerational relationships and teamwork were highest in Finland and lowest in the United States.

CONCLUSIONS

Country impacted job satisfaction and multigenerational characteristics more than generational cohort.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers and leaders leading multigenerational teams occupy a pivotal role in multigenerational teamwork and attitudes toward change.

A qualitative systematic review on nurses' experiences of workplace bullying and implications for nursing practice

AIMS

To explore nurses' experiences of workplace bullying and ways to prevent such occurrences.

DESIGN

A qualitative systematic review was conducted.

DATA SOURCES

Five electronic databases were searched from each database's inception to December 2020.

REVIEW METHODS

Meta-summary and meta-synthesis were conducted using Sandelowski and Barroso's approach.

RESULTS

Twenty-seven studies were included in this review. The overarching theme, 'The Vicious Cycle of Bullying in Nursing', and four themes were synthesized: (a) different 'faces' of bullying, (b) the hidden drivers of bullying, (c) impact of being bullied and (d) responses to bullying.

CONCLUSION

The nursing code of ethics and anti-bullying policies should be consistently enforced by each organization's upper management. Nurses should be provided a safe space to voice their concerns on bullying within the organization.

Nursing career anchors and professional exercise: is there alignment?

OBJECTIVE

to identify the types of career anchors of university hospital nurses and alignment with current work, from the perspective of workers' health.

METHOD

a descriptive and quantitative study, developed in a university hospital with 135 nurses, from December 2018 to February 2019. The Career Orientations Inventory was used as an instrument and an instrument to assess the alignment of career anchors to the current job.

RESULTS

it was identified that the most frequent anchors were: Security/Stability, Service/Dedication to a Cause, and Lifestyle. Among nurses, 63.7% were not aligned with their career anchor.

CONCLUSION

the alignment factor is not prevalent among nurses, demonstrating that most seek to meet their professional motivations, but do not find it in their current work, which can lead to physical exhaustion and psychological distress.

Generational Differences in Nurses' Intention to Leave

There are many studies about nurses' intention to leave their jobs and contributing factors. However, there is a lack of research about generational differences in nurses' intention to leave. This evidence may help with workforce planning and targeting specific generations of nurses with retention interventions. Using the National Database of Nursing Quality Indicators 2018 Annual Registered Nurse Survey, we used descriptive statistics and multivariate logistic regression to examine the prevalence of and reasons for nurses' intention to leave in the next year by generational age group. Our sample included 207,636 hospital nurses from across the United States. We found that 21% of nurses (n = 44,082) reported intention to leave. When comparing generations, there were differences in intention to leave, as well as differences in potentially preventable, career advancement, and personal intention to leave reasons. Workload/staffing was a common reason across generations, indicating that certain interventions may be applicable regardless of generation.

Italian Nurses' experiences during the COVID-19 pandemic: a qualitative analysis of internet posts

Aim

To investigate the experience of Italian nurses during the first wave of the COVID‐19 outbreak by analysing professional social media posts.

Background

The COVID‐19 outbreak has overwhelmed health care institutions; as a consequence, nurses’ lives and psycho‐physical health have been affected.

Introduction

The COVID‐19 pandemic forced nurses to work in physically and psychologically stressful conditions impacting on their life.

Methods

A qualitative descriptive study. All narratives (texts and videos) posted by nurses from the 23^rd of February 2020 to the 3^rd of May (from the start of the outbreak to the end of the first lockdown) were analysed and published on the five most popular Italian professional social media platforms. The Consolidated Criteria for Reporting Qualitative research guidelines were followed.

Results

Five themes emerged from the 380 narratives explored: ‘Sharing what is happening within myself’; ‘Experiencing unprecedented working conditions’; ‘Experiencing a deep change’; ‘Failing to rehabilitate the image of nurses in society’; and ‘Do not abandon us’. Even though nurses appreciated the recognition of their communities, they still felt devalued and not recognized as professionals.

Discussion

Several psychological, physical, social and professional implications emerged from nurses working during the COVID‐19 pandemic. Despite being highly praised, nurses perceived they had failed in rehabilitating the image of nurses in society.

Conclusion

The experience of working during the COVID‐19 pandemic represented a traumatic event for nurses but it offered them personal and professional growth opportunities.

Implications for nursing practice, nursing policy and health policy

Supporting nurses’ mental health is highly recommended, together with a cultural investment on nurses’ role recognition, and a zero‐tolerance policy towards violence and aggression towards nurses.

The Perception of Occupation by Hospital Nurses in Poland and Germany in Terms of the Risk of Excessive Stress and Burnout as Well as Possible Coping and Preventive Solutions

Nurses constitute a professional group exposed to a high risk of stress and occupational burnout. Fewer nurses are recruited every year and the ever higher age of those professionally active is alarming. This article presents the results of international comparative studies from 2018 and 2019 involving Polish and German nurses (747 people) dedicated to the perception of aspects of nurses’ work in terms of the risk of excessive stress and burnout and possible preventive measures. Using a proprietary questionnaire, the authors evaluated differences in the perception of the nursing profession in Poland and Germany, as well as in terms of seniority or decision-making. Next, the relationship between the perception of work specificity and opinions about professional risks and possible preventive measures was evaluated. The analysis used the Mann-Whitney U test and correlation analysis of the questions. Using exploratory factor analysis, the number of dimensions describing the nursing profession was reduced from 16 to four related to (1) workload, (2) job satisfaction, (3) atmosphere in the organisation and (4) sense of control over one’s own work. The results showed statistically significant differences in the perception of professional specificity and risks according to the analysed characteristics.

Reasons Behind Generation Z Nursing Students' Intentions to Leave their Profession: A Cross-Sectional Study

This study aims to identify predictors of turnover intention within 2 years of employment among 3rd and 4th grade Generation Z nursing students. Turnover intention is a multi-stage process ranging from mere desire, to serious thoughts, decision-making, and actual planning. Previous studies have focused on identifying the factors affecting turnover intention among practicing nurses. However, undergraduate nursing students also contemplate their decision to stay or leave the nursing profession after graduation. This cross-sectional descriptive study recruited 210 nursing students from 3 colleges in South Korea. A self-administered survey was conducted using the Career Preparation Behavior Scale, the Calling and Vocational Questionnaire, the Social Responsibility Scale, and the Revised Self-Leadership Questionnaire. Four questions were used to explore participants’ turnover intention, their motivation for studying nursing, their major satisfaction, and their clinical experience satisfaction. Descriptive and multiple logistic regression statistics were obtained using SPSS. Of the participants, 17.6% had turnover intention within 2 years of employment. Multiple logistic regression analysis indicates that clinical experience satisfaction is the only significant predictor. In the univariate analysis, nursing students who had turnover intentions were less likely to practice career preparation behaviors and had lower levels of vocational consciousness and social responsibility. To keep a proficient nursing workforce in the profession, professional commitments from universities and hospital institutions are needed to provide quality clinical learning experiences for nursing students. Further prospective study is needed to observe how Generation Z undergraduate students’ turnover intentions change and what factors influence this process.

Nurses' continuing professional development: A systematic literature review

Nurses' continuing professional development (CPD) improves the quality of nursing care, patients' safety, nurses' satisfaction and healthcare costs. However, evidence has shown that nurses do not always participate in their CPD and that CPD does not always address nurses' real needs. To examine this issue, a systematic review of the literature on nurses' experiences regarding their CPD in the clinical context was carried out. The studies selected for this review (n = 9) were analyzed thematically, through which three themes were identified: The relevance of CPD to nurses; the intrinsic and extrinsic motivations of nurses to participate in CPD; and the specific needs of nurses to participate in CPD. The findings of this review highlight that nurses' experiences regarding their CPD is a key issue that has not been deeply studied. For nurses, their CPD continues throughout their professional career, and keeping their knowledge and skills up to date is important. The goals, motivations and needs that nurses may have to lead and participate in their CPD may vary according to their age and position. Organizations should consider nurses' specific professional situation as well as their actual needs to boost their CPD through different approaches and enhance nurses' retention at hospitals.

What is the most needed competence for newly graduated generation z nurses? Focus groups study

BACKGROUND

Research conducted so far in the area of identifying competence needed for newly graduated nurses has allowed for the identification of both strengths and weaknesses of nurses beginning work. However, the analyses conducted so far requires supplements in terms of difficulties and the strengths in respect to competence of graduates from the currently entering Generation Z.

OBJECTIVES

To explore Generation Z newly graduated nurses' competence that increase their work efficiency and support them during periods of professional adaptation.

DESIGN

A qualitative exploratory-descriptive design.

PARTICIPANTS

Twenty-nine participants attended the interviews conducted in 4 focus groups: nursing students, newly graduated nurses, nurse managers and clinical nurses with at least 10 years of working experience.

METHODS

Qualitative research utilized focus groups that were conducted based on the same semi-structured interview, which ensured similar key topics were discussed by each group. The COREQ criteria were used in the reporting of this study.

RESULTS

We determined the characteristics and difficulties of the adaptation period for newly graduated Generation Z nurses and identified six of the most needed competence: knowledge and the ability to use it in practice, communication skills, teamwork, openness to development, decision-making, coping with stress and empathy. The topics of self-confidence, assertiveness and empathy were also discussed in each group.

CONCLUSION

Analysis based on focus groups identified good preparation in knowledge, openness to development and empathy; however, deficiencies were found in the other competence. Competence indicated as the most important in Generation Z nurses' practice were interrelated. Deficits in some of them can cause difficulties in using others.

Resilience Among Professional Health Workers in Emergency Services

INTRODUCTION

Although it seems logical to assume that working in an emergency service implies having a great capacity to face extreme situations, resilience in health care workers has been shown to be related not only to individual personality characteristics but also with external factors. The objective of this study was to determine the resilience of professional health workers in emergency services and its relationships with sociodemographic and working conditions.

METHODS

This cross-sectional study included emergency physicians, nurses, and nursing assistants. Sociodemographic variables and the Resilience Scale-25 were analyzed.

RESULTS

A total of 320 professionals participated. Their mean age was 43.5 years (SD 8.9), and 81.87% were women. The mean resilience score was 133.52 (SD 7.22), which corresponds to moderately low to moderate levels. An association was found between the highest resilience scores and being a physician (χ² 8.84; P = 0.01) and a higher capacity if working in emergency mobile units (χ² 6.29; P = 0.04). Working the day shift and being a nurse (beta = -5.71; P = 0.02) were associated with lower resilience scores. Age (odds ratio 1.095; P = 0.02; 95% confidence interval 1.015, 1.184), and not having a partner decreased resilience (being divorced odds ratio 5.17; P = 0.01; 95% confidence interval 1.503, 18.235 and being single odds ratio 3.371; P = 0.01; 95% confidence interval 1.259, 9.257). However, more work experience increased the resilience levels (odds ratio 0.906; P = 0.02; 95% confidence interval 0.833, 0.983).

DISCUSSION

Resilience in professional health workers was related to personal and working conditions. The scores of emergency staff were low and should be improved with specific strategies.

Turnover prevention: The direct and indirect association between organizational job stressors, negative emotions and professional commitment in novice nurses

Aims

Getting insight in the most crucial organizational job stressors for novice nurses' professional commitment and whether the job stressors are mediated through negative emotions.

Design

The study used an observational cohort design.

Methods

Organizational job stressors were derived from 580 diary entries by 18 novice nurses combined with measures on emotions and commitment. The diaries were collected from September 2013–September 2014.

Results

Path modelling revealed that lack of support from colleagues, negative experiences with patients and confrontations with existential events were most strongly negatively related to professional commitment through negative emotions. Other indirectly and negatively related organizational job stressors to commitment were complexity of care, lack of control and work‐life imbalance; only conflicting job demands, and lack of control related to professional commitment directly.

Conclusion(s)

To enhance professional commitment, it is important to reduce negative emotions in novice nurses by collegial support in dealing with negative experiences with patients, complexity of care and existential events and to prevent lack of control and an imbalance between private life and work. Nurse supervisors and managers can encourage nurses to share negative patient experiences, issues related to complexity of care and existential events.

Impact

Considering the worldwide nursing shortage and early turnover, more understanding is needed about how negative emotions mediate the relationship between organizational negative job stressors and professional commitment and the relative impact of organizational job stressors to professional commitment. The study stresses the importance of a supportive role of supervisors and nurse managers to improve the work environment and hence increase novice nurses' commitment and retention.