Which Aspects of Professional Commitment Can Effectively Retain Nurses in the Nursing Profession?

The association between school educational atmosphere, learning engagement, and professional commitment of nursing students, and learning engagement as the mediator

BACKGROUND

The current shortage and loss of nurses has become a significant problem in healthcare systems around the world. Professional commitment is essential to prevent the loss of nursing staff and stabilize the nursing workforce.

OBJECTIVES

This study aimed to explore the unique relationship between school educational atmosphere, learning engagement, and professional commitment, and whether learning engagement would mediate the relationship between educational atmosphere and professional commitment.

DESIGN

A cross-sectional study design was used.

SETTINGS

The participants came from six schools in four cities in Hubei Province, China.

PARTICIPANTS

A total of 1009 nursing students above the first year of undergraduate studies were included by convenient sampling method.

METHODS

Data were collected using the Educational Climate Inventory, the Utrecht Work Engagement Scale-student, and the Professional Commitment Scale. Pearson correlation was used to examine the relationship between educational atmosphere, learning engagement, and professional commitment. Mediation analysis was used to test whether learning engagement mediated the relationship between educational atmosphere and professional commitment.

RESULTS

A positive educational atmosphere was associated with a high level of learning engagement, which was associated with a higher level of professional commitment. Learning engagement mediated the relationship between educational atmosphere and professional commitment.

CONCLUSIONS

The findings provide empirical evidence for promoting professional commitment in nursing students. Learning engagement is an important mediating variable connecting educational atmosphere and professional commitment. In order to stabilize the career choices of nursing students, it is necessary to take measures to improve their learning engagement during school.

Predictive factors of turnover intention of newly graduated nurses in their first year of employment: a longitudinal study

BACKGROUND

The turnover of newly graduated nurses is a severe challenge for healthcare systems, and so it is essential to identify its predictive factors. This study investigates whether professional commitment, career adaptability, career self-efficacy, anxiety, and depression levels before and after internship can predict the turnover intention of newly graduated nurses after one year of employment.

METHODS

In a longitudinal study, 271 undergraduate nursing students recruited by convenience sampling were surveyed before internship (T1), after internship (T2), and after one year of employment (T3), with all surveys conducted on the Wenjuanxing survey platform ( www.wjx.cn ). Generalized linear models and restricted cubic spline models were used to explore possible linear and nonlinear relationships between turnover intention and the variables of interest.

RESULTS

Professional commitment both pre-internship (β = -0.060, p = 0.007, 95% CI [- 0.104, - 0.016]) and post-internship (β = -0.053, p = 0.015, 95% CI [- 0.096, - 0.010]) can negatively predict turnover intention. There is also a negative linear relationship between post-internship career self-efficacy and turnover intention (β = -0.308, p < 0.001, 95% CI [- 0.436, - 0.180]). In addition, professional commitment both pre-internship (adjusted R2 = 0.046, p = 0.004) and post-internship (adjusted R2 = 0.068, p < 0.001), career self-efficacy both pre-internship (adjusted R2 = 0.039, p = 0.008) and post-internship (adjusted R2 = 0.116, p < 0.001), career adaptability both pre-internship (adjusted R2 = 0.057, p < 0.001) and post-internship (adjusted R2 = 0.039, p = 0.008), anxiety both pre-internship (adjusted R2 = 0.035, p = 0.014) and post-internship (adjusted R2 = 0.048, p = 0.003), and depression levels both pre-internship (adjusted R2 = 0.031, P nonlinear = 0.021) and post-internship (adjusted R2 = 0.053, p = 0.002) are nonlinearly associated with turnover intention.

CONCLUSIONS

Nursing educators and clinical care administrators must take action to enhance the professional commitment and career self-efficacy of nursing students during their internship. It is also important to pay attention to their career adaptability, as well as to any anxiety or depression that they may experience during clinical practice. This can help to reduce the turnover intention during the first year of their nursing career.

Unraveling the Puzzle of Turnover Intention: Exploring the Impact of Home-Work Interface and Working Conditions on Affective Commitment and Job Satisfaction

This study investigates the antecedents of turnover intention among Vietnamese nurses at a hospital in Quang Ninh Province, North Vietnam. This study evaluates the relationship between home-work interface (HWI) and working conditions (WC) on intrinsic job satisfaction (IJS) and extrinsic job satisfaction (EJS), the relationship between intrinsic job satisfaction (IJS) and extrinsic job satisfaction (EJS) on affective commitment (AC) and turnover intention (TI), and the relationship between affective commitment (AC) and turnover intention (TI). The study employs cross-sectional data and a questionnaire survey to collect the data. The 306 qualified questionnaires were collected, and partial least squares structural equation modeling (PLS-SEM) was employed to analyze the research model and test the hypotheses. The study reveals that working conditions and the home-work interface affect intrinsic job satisfaction. Intrinsic and extrinsic job satisfaction affect affective commitment. Interestingly, affective commitment and intrinsic job satisfaction were not significantly affecting turnover intention. The present study develops and empirically examines a conceptual framework by providing theoretical insight and managerial implications into the turnover intention's antecedents in Vietnamese nursing care at the hospital.

Longitudinal relationships among career adaptability, resilience, and career commitment in chinese nursing undergraduates: testing differences in career interest between cross-lagged models

PURPOSE

Various physiological and psychological negative situations experienced by nurses as a result of COVID-19 pandemic have been shown to increase their perception of organizational difficulty and decrease their career commitment, thereby accelerating the turnover rate of nurses. Resilience and career adaptability have important influences on career commitment, so there is a need to evaluate the relationships between them and the underlying mechanisms.

PATIENTS AND METHODS

Using a cross-lagged design, the Career Adaptability Scale, the Chinese version of career commitment, and Davidson's Resilience Scale as research methods, we studied 692 nursing students for two consecutive years to evaluate the relationship among career adaptability, resilience, and career commitment.

RESULTS

Career adaptability at T1 substantially and positively predicts the career commitment at T2. Career adaptability and resilience are mutually predictive. No interaction is found between resilience and career commitment over time. There is a substantial difference in the cross-lagged relationship among career adaptability, resilience, and career commitment for low- and high-career interest.

CONCLUSION

Our results show the importance of developing career commitment early on. Developing career adaptability, enhancing resilience, and increasing career interest in nursing students might help to increase career commitment.

When caring breeds contempt: The impact of moral emotions on healthcare professionals' commitment during a pandemic

The novel coronavirus (COVID-19) pandemic is a major heath crisis that continues to impact healthcare organizations worldwide. As infection rates surged, there was a global shortage of personal protective equipment, critical medications, ventilators, and hospital beds, meaning that healthcare professionals faced increasingly difficult workplace conditions. In this conceptual study, we argue these situations can lead to healthcare professionals experiencing moral emotions - defined as specific emotions which relate, or occur in response, to the interest or welfare of others - towards their organizations. This paper explores the three moral emotions of contempt, anger and disgust, and their potential influence on healthcare professionals' workplace commitment in the context of a pandemic. Drawing from the moral emotions and organizational commitment literature, we develop a process model to demonstrate how healthcare professionals' affective and continuous commitment are likely to decrease while, paradoxically, normative, and professional commitment may become amplified. The possible potential for positive outcomes from negative moral emotions is discussed, followed by theoretical and practical contributions of the model, and finally, directions for future research.

How do three components of professional commitment influence nurse-reported patient-centred care and care quality?

AIMS AND OBJECTIVES

To test how the three components of professional commitment (i.e. affective, continuance and normative professional commitment) are associated with nurse-reported patient-centred care and care quality.

BACKGROUND

Patient-centred care and care quality are the two critical care outcomes. However, no study has yet examined how the three components of professional commitment are related to nurse-reported patient-centred care and care quality, showing a research gap.

DESIGN

This study adopted a two-wave design (first wave in 2017 and second wave in 2019), which is known to reduce the possibility of reverse causality, and which was conducted in a large hospital in Northern Taiwan.

METHODS

Proportionate random sampling was used. Full-time nurses were surveyed, while nursing students, interns, nurse practitioners and nursing supervisors were excluded. The first wave included 524 nurses, and 438 nurses were retained in the second wave. We used confirmatory factor analysis to verify the psychometric properties of the measures. Structural equation modelling was used to implement hypothesis testing. We used the Professional Commitment Scale of Meyer et al. (Journal of Applied Psychology, 1993, 78, 538), the Patient-Centered Care Scale of Laird-Fick et al. (Patient Education and Counseling, 2011, 84, 90) and the Care Quality Perceptions Scale of Teng et al. (Journal of Nursing Management, 2010, 18, 275). The STROBE statement was chosen as the EQUATOR checklist.

RESULTS

Affective professional commitment was positively associated with nurse-reported patient-centred care (β = .18, p = .002 and .01), which was positively associated with nurse-reported care quality (β = .85, p < .001). Affective and normative professional commitment were also positively associated with nurse-reported care quality (β = .17, p < .001).

CONCLUSIONS

Our findings offer insights for nursing managers that nurses' affective and normative professional commitment could help upgrade care outcomes. Hospital managers should consider professional commitment as relevant to their workforce.

RELEVANCE TO CLINICAL PRACTICE

Nursing managers could publicise reports documenting nurses' significant contributions to public health. This could strengthen affective professional commitment among nurses.

The level and influencing factors of graduating nursing students' professional commitment from the perspective of Ecological Systems Theory: A cross-sectional study

BACKGROUND

Increased professional commitment is essential for relieving the nursing workforce shortage, which is exacerbated by the COVID-19 pandemic. The professional commitment of graduating nursing students is a powerful predictor of their work commitment. However, limited information is available regarding graduating nursing students' professional commitment. Existing studies investigating nursing students' professional commitment are limited by their lack of theoretical foundation.

OBJECTIVES

To investigate the level of graduating nursing students' professional commitment and its multilevel influencing factors from the perspective of the Ecological Systems Theory in the early days following the COVID-19 outbreak.

DESIGN

A descriptive cross-sectional study.

SETTING

Three educational institutions in Shanghai, China.

PARTICIPANTS

513 nursing students who were graduating with an associate or bachelor's degree.

METHODS

The independent variables were measured by a self-designed questionnaire. The dependent variable professional commitment was measured by the Nursing Professional Commitment Scale. Hierarchical regression analyses, which allowed the independent variables entered in order, were performed to identify the significant predictor variables of the professional commitment and its dimensions.

RESULTS

The level of professional commitment was 100.15 ± 20.35 (score ranged between 34 and 136). The individual factors (degree, whether had received a scholarship during the past academic years, ΔR2 = 0.142), family factors (parents and siblings' attitudes towards one's majoring in nursing, ΔR2 = 0.153), educational factors (academic faculty's belief in nursing profession, leaders' emphasis on nursing profession, satisfaction with clinical instructors' role modeling, ΔR2 = 0.097), and social factors (reason for majoring in nursing, perceived nurse-patient relationship, ΔR2 = 0.153) were significant predictors of the graduating nursing students' professional commitment (R2 = 47.6 %, F = 32.277, p < 0.001).

CONCLUSIONS

The graduating nursing students had a moderate level of professional commitment, which needed to be improved. Nursing educators should comprehensively consider various factors to understand the relationship between individuals and environmental systems, and implement targeted interventions to shape the positive professional values of nursing students.

Survey investigating factors affecting recruitment and retention in the UK veterinary nursing profession

BACKGROUND

Recruitment and retention have been identified as contributing factors to workforce shortages in the veterinary team.

METHODS

Results from veterinary nurses to an online questionnaire regarding recruitment and retention were analysed.

RESULTS

Veterinary nurses had few job changes (median 2); however, 53.8% (n = 1060) reported they were likely or very likely to leave their employment within 2 years. Respondents who were recently qualified (p < 0.001) and on lower salaries (p < 0.001) were significantly more likely to plan to leave. The most frequently chosen reasons to stay in a position were team, location and working hours, while reasons to leave were salary, management and work-life balance. Respondents most disliked 'dealing with people', remuneration and work-life balance and would like to change the salary, management and team aspects. Employers reported difficulty in employing an experienced veterinary nurse.

LIMITATIONS

A questionnaire simplifies the nature of retention. Also, a comparatively low number of responses was received, with overrepresentation of some groups. It was conducted in 2018; however, it still provides a useful comparison for studies regarding recent world events.

CONCLUSION

The shortage of veterinary nurses is due in part to the lack of retention within the profession. Adequate recompense for work undertaken and value attributed to the role are suggested as contributing factors.

Occupational benefit perception of acute and critical care nurses: A qualitative meta-synthesis

Background

With the development of society, nurses have an increasingly more important role in the medical team. At the same time, due to various reasons, the number of active nurses is continuously decreasing, and the shortage of nursing personnel is becoming ever more serious. The COVID-19 pandemic made these clinical problems more serious. As the department with the greatest work pressure and the most intense pace, acute and critical care nurses are already facing serious problems related to job burnout and dismission. In the context of the COVID-19 pandemic, these problems should be solved urgently. Furthermore, with the rise of positive psychology, many scholars are turning their research direction to the positive professional experience of nurses so as to get inspiration to encourage nurses to face work with an optimistic attitude and guide nursing managers to better retain nursing talents.

Objective

The purpose of this paper is to summarize and evaluate the positive emotional experience and professional benefit of acute and critical care specialist nurses in the process of work. So as to better interpret their occupational benefit perception and guide nursing managers in adopting positive measures and promoting the development of high-quality nursing.

Methods

Cinahl plus, Embase, Medline and other twelve databases were searched for relevant literature. Meta-aggregation was used to synthesize the findings of the included studies.

Results

From a total of 12 articles included in this study, 55 main results were presented, 8 new categories were integrated, and three themes were formed: professional identity, social support, and personal growth. The professional identity included: being proud of professional ability and increasing professional value; social support included: friends and family support, organizational, environmental support, peer support, and support of patients and their families; personal growth included realizing self-worth and promoting self-development.

Conclusion

Hospital managers should pay attention to the positive emotional experience of nurses in work and based on this, provide practical and beneficial protection for nurses from the aspects of salary, learning opportunities, working environment, social support and internal personality, stimulate work enthusiasm, guide nurses to correctly face negative emotions and occupational pressure, and improve the sense of professional benefit.

The Effect of Antecedents of Teachers' Subjective Career Success

Career success is often seen as identical to objective matters such as high income and position. Meanwhile, one can see their success better when they build their own criteria of career success. In this regard, the present study aims to see the effect of internal (i.e., career commitment and professional commitment) and external variables (leader-member exchange and perceived organizational support) on teachers' subjective career success. This quantitative study involved 320 teachers as participants, recruited using the accidental sampling technique. The data were collected using The Career Commitment Measure, Professional Commitment Scale, Leader-Member Exchange Multidimensionality, Survey of Perceived Organizational Support, and Subjective Career Success Inventory. The analysis result shows that career commitment, professional commitment, leader-member exchange, and perceived organizational support significantly affect teachers' career success.

Professional Commitment, Resilience, and Intent to Leave the Profession among Nurses During the COVID-19 Pandemic

Aim

The three‐component model of commitment, resilience and selected nurse characteristics were tested as predictors of nurses' intent to leave the profession.

Background

In the wake of the COVID‐19 pandemic, news reports suggest that a mass exodus of nursing professionals is occurring.

Method

This nonexperimental, descriptive, correlational, predictive study used a cross‐sectional approach to collect survey data from a convenience sample of 189 registered nurses (RNs) who were providing direct patient care in adult inpatient units with a high likelihood of admitting patients diagnosed with COVID‐19 and met other eligibility requirements.

Results

Most (73.5%) plan to remain in the nursing profession and feel highly resilient. Only affective commitment demonstrated a significant relationship to the intention to leave the nursing profession.

Conclusions

The study was conducted after the pandemic had been in effect for a prolonged time, and it is likely the nurses with the intent to leave the profession had already left. The findings provide a glimpse of a sample of nurses drawn from a population likely much different from only a few months prior.

Implications for Nursing Management

Strategies to retain nurses should include efforts to strengthen professional commitment and build resilience.

Experiences, Perceptions, and Coping Patterns of Emergency Department Nurses with Occupational Stressors in Saudi Arabian Hospitals: Mixed-Method Study

Extended working hours, a complicated workplace environment, and engagement in numerous physical and psychological stressors have been associated with the stressful nature of the nursing profession. Only a few studies have provided some insight into workplace stress and coping strategies adopted by nurses in Saudi Arabia and neighboring countries. Therefore, this study utilized a mixed-method design to explore the numerous factors that lead to stress among emergency nurses, their experience and perception of stress, and the coping mechanisms they find useful. A survey containing four domains and 86 items was adapted, pilot tested, and validated. The quantitative phase recruited 296 nurses who returned completed questionnaires, and then 21 nurses were interviewed for the qualitative phase. In total, 89.5% (n = 265) of the participants were female, 51% (n = 151) were aged 20–29 years, 83% (n = 246) were non-Saudi nationals, 49% (n = 145) were married, and 82% (n = 245) had a bachelor’s degree. The most common causes of occupational stress were work overload, personnel shortages, and inadequate pay. The qualitative phase data revealed five primary themes, including increased workload, rising living costs despite equal compensation, and staff shortages as main stressors. In addition, the study found that praying and spending quality time with friends are the primary coping techniques among nurses. The study results contribute to a better understanding of nurses’ working conditions in the emergency department. Additionally, they may contribute to the development of policies and practice reforms to improve Saudi nurses’ well-being, health, and overall work experience.

Mental health of healthcare professionals: headaches and professional commitment interact to impact nurse turnover intention

Purpose

Nurses' health is vital for retaining nurses in the profession. However, lack of study has examined how headaches and professional commitment interact to impact professional turnover intention. This study aims to examine the moderating effect of nurses' headaches on the relationship among professional commitment factors (affective professional commitment, continuance professional commitment and normative professional commitment) and nurses' professional turnover intention.

Design/methodology/approach

This study employed a two-wave design and questionnaires to survey 524 nurses from a large medical center in Taiwan during February and March 2017 (the first wave) and June and August 2017 (the second wave). Headaches were measured using descriptions formulated by the International Headache Society. Items measuring other constructs came from relevant literature. Regression analysis was used to assess relationships between the constructs.

Findings

All aspects of professional commitment are negatively related to professional turnover intention (B [CI] = −0.47 [−0.58, −0.36], −0.20 [−0.29, −0.11], −0.22 [−0.32, −0.12], p < 0.001). Headaches reduce the negative relation between affective professional commitment and professional turnover intention (B [CI] = 0.14 [0.02,0.27], p = 0.02).

Practical implications

Headaches could interfere with nurses' commitment to the nursing profession and influence nurses' intention to leave. Managers should seek means to help alleviate nurses' headaches.

Originality/value

This study is the first to examine how headaches and professional commitment interact to influence nurses' professional turnover intention.

Factors predicting organizational commitment of nurses in general hospitals: A descriptive-predictive study

This descriptive-predictive, cross-sectional study aimed to explore organizational commitment and to determine the predictability of years of experience, level of education, position, perceived organizational support, and work-life balance on each component of organizational commitment. The participants included 234 nurses who were randomly selected from four general hospitals in the Republic of the Union of Myanmar. The research instruments included a demographic data form, the Organizational Commitment Scale, the Survey of Perceived Organizational Support, and the Work-Life Balance Scale. The data were analyzed using descriptive statistics and stepwise multiple regression. The results revealed that the nurses perceived the three components of organizational commitment at a moderate level. Years of experience, position, perceived organizational support, and work-life balance explained 38.0% of the total variance for affective commitment, 28.3% for continuance commitment, and 35.9% for normative commitment. The findings of this study can inform administrators and policymakers regarding the development of strategies to improve organizational commitment among nurses based on four predictors.

Changes in professional commitment of undergraduate nurse students before and after internship: a longitudinal study

BACKGROUND

Experiencing internship shapes nursing students' professional commitment and aggravates its changes. However, few studies have been investigated how this changes empirically.

OBJECTIVES

The aims of this study are to investigate (a) what are the changes of professional commitment of nursing students before and after the internship? (b) Which of multiple independent variables is the strongest predictor?

METHODS

A longitudinal study was conducted with 996 senior undergraduate nursing students (ready to enter clinical practice) in the China universities. The survey was conducted in the spring of 2015 and autumn of 2016. The data were collected by a paper-and-pencil questionnaire. The instruments used included Professional Commitment Scale and Perceived Stress Scale. Analysis of paired t-test and linear regression analysis were performed on the data.

RESULTS

Nursing students showed lower professional commitment (2.79 ± 0.36) than they were (2.92 ± 0.36) before internship. Socio-demographic variables, pre-internship professional commitment and stress perceived during internship predicted 40.1% of the variance in the post-internship commitment.

DISCUSSION

These data summarize the nursing students' professional commitment changes and the main influential factors that contribute to post-internship professional commitment of undergraduate nursing student. The findings are timely, which indicate that senior nursing students' professional commitment can be increased by enhancing pre-internship commitment and reducing students' stress levels during internship.

Experience of Workplace Violence from the Patients among Mental Health Nurses in Indonesia: A Mixed Method Study

Background: Workplace violence by patients and visitors (PVV) against nurses is regarded a devastating occupational issue around the world. The most frequent perpetrators of violence against nurses were patients, followed by their families and other healthcare professionals. Aim:This study aimed to use a mixed method to analyze violence by patients and visitors against nurses in mental health hospital in Indonesia. Methods: The 250 mental health nurses at two general public hospitals in Bandung were recruited with stratified convenience sampling by years of working experience. Result: All nurses experienced workplace violence from both patients and their families. At least nurses experienced more than 3 types of violence with the most frequent type of violence were verbal and physical violence. The six themes were emerged including variation of violence in nurse, traumatic impact of violence, impacts of violence on profession, violence not only come form patients but also family, reason of violence, and spiritual coping. Conclussion: It is necessary to prioritize more efficient and approachable methods for nurses to deal with patients’ aggresive behavior, and to establish constant training program.

Final clinical practicum shapes the transition experience and occupational commitment of newly graduated nurses in Europe-A longitudinal study

AIMS

The aim of the study was to examine the association between the characteristics of a nursing student's final clinical practicum and the success of transition of newly graduated nurses (NGNs) in six European countries.

DESIGN

A longitudinal design with two data collections points (pre- and post-graduate).

METHODS

The data were collected with an online survey between May 2018 and April 2020 from graduating nursing students (n = 1796) in Finland, Germany, Iceland, Ireland, Lithuania and Spain. Altogether, 642 NGNs responded to the second questionnaire 1 year after graduation. Logistic and linear regression analyses were used to examine the associations between five clinical practicum characteristics and three indicators for the success of transition (ease of transition, turnover intentions and occupational commitment). Models were adjusted for demographic and background/workplace factors and professional competence.

RESULTS

Several associations were observed between the different clinical practicum characteristics and the indicators for a successful transition. Good pedagogical atmosphere and good supervisory relationship were associated with higher likelihood of an easy transition. Good leadership style of the ward manager, good premises of nursing care on the ward and a good supervisory relationship were associated with higher occupational commitment. No consistent association with turnover intention was found.

CONCLUSION

Having a good final clinical practicum before graduation can contribute to an easier transition experience for newly NGNs and strengthen their commitment to the nursing profession.

IMPACT

This study adds to the limited existing knowledge about the importance of final clinical practicums in shaping the transition process and occupational commitment of NGNs. Investing in creating a good final practicum experience could help healthcare organizations engage new nursing professionals and thus alleviate the existing shortage of nurses.

Prevalence, Risk Factors and Burnout Levels in Intensive Care Unit Nurses: A Systematic Review and Meta-Analysis

Nursing is considered to be an at-risk profession of burnout due to daily exposure to difficult situations such as death and pain care. In addition, some units such as the intensive care unit (ICU), can be stressful due to high levels of morbidity and mortality and ethical dilemmas. Burnout causes a deterioration in quality of care, increasing the risk of mortality in patients due to poor performance and errors in the healthcare environment. The aim of this study was to analyse the levels, prevalence and related factors of burnout in ICU nurses. A systematic review and meta-analysis were carried out in the Medline, Scopus and CINAHL databases. Fifteen articles were found for the systematic review and four for the meta-analysis. With a sample of n = 1986 nurses, the meta-analytic estimate prevalence for high emotional exhaustion was 31% (95% CI, 8-59%), for high depersonalization was 18% (95% CI, 8-30%), and for low personal accomplishment was 46% (95% CI, 20-74%). Within the dimensions of burnout, emotional exhaustion had a significant relationship with depression and personality factors. Both sociodemographic factors (being younger, single marital status, and having less professional experience in ICU) and working conditions (workload and working longer hours) influence the risk of burnout syndrome.

Social media addiction and work engagement among nurses

PURPOSE

This study was conducted to investigate the relationship between social media addiction (SMA) and work engagement (WE) among nurses in Turkey.

DESIGN AND METHODS

This cross-sectional and correlational study was conducted with 205 nurses. In the study, the SMA and WE scales were used.

FINDINGS

It was determined that there was a negative significant correlation between the SMA and WE variables and that SMA accounted for 2% of WE.

PRACTICE IMPLICATIONS

The controlled use of social media by nurses and the use of strategies that support work engagement will make significant contributions both to nurses and to the outcomes of patient care.

How Emergency Nurses Develop Resilience in the Context of Workplace Violence: A Grounded Theory Study

Purpose

To understand how emergency nurses develop resilience in the context of workplace violence.

Design

This study employed grounded theory methodology. Thirty nurses from three hospital emergency departments in Taiwan were interviewed between August and December 2018.

Methods

Semistructured interviews were used to collect data. Interviews were audio‐recorded and transcribed verbatim.

Findings

The process through which emergency nurses who had experienced workplace violence developed resilience took place in three stages: the release of emotions after the assault; the interpretation of conflicting thoughts and actions; and the establishment of strategies to cope with workplace violence in the future. The core theme was the motivating role of professional commitment to emergency patient care.

Conclusions

The results of this study can inform the development of support systems to enhance the resilience of nurses experiencing workplace violence by alerting healthcare administrators and governing institutions to their needs.

Clinical Relevance

Emergency nurses viewed professional growth and professional commitment as an invisible motivator in the development of resilience following an encounter with workplace violence.

Factors affecting nurses' professional commitment during the COVID-19 pandemic: A cross-sectional study

Aim

This study aims to investigate the factors affecting nurses' professional commitment during the COVID‐19 pandemic.

Background

Commitment to a profession requires doing the best for that profession. In the case of the nursing profession, professional commitment gains greater importance in times of crisis, like the COVID‐19 pandemic.

Methods

This cross‐sectional study was conducted with 389 nurses in the Turkish state hospital. Institutional permissions, ethical approval and written consents from the participants were obtained before carrying out the study.

Results

The participants’ mean Perceived Organizational Obstruction Scale score was 20.07 ± 8.06 (min = 5.0, max = 35.0), and their mean Nursing Professional Commitment Scale score was 71.20 ± 11.94 (min = 30.0, max = 103.0). Socio‐demographic variables and perception of organisational obstruction predicted 36.7% of the variance in the professional commitment (p < .001).

Conclusion

A road map based on the study results was developed for hospitals and nurse managers to maintain and increase nurses' professional commitment.

Implications for Nursing Management

The results of this study may help institutions and nurse managers understand the factors affecting professional commitment during the pandemic as a whole, as well as determine primary strategies based on the importance of these factors.

Exploring job satisfaction and turnover intentions among general practice nurses in an Australian Primary Health Network

AIM

To explore the job satisfaction and turnover intentions of general practice nurses and examine factors that influence job satisfaction and turnover intention.

BACKGROUND

Workforce issues such as satisfaction, retention and turnover intention have been explored in acute care. However, increasingly nurses are being employed outside hospitals. General practice is a significantly different work environment to acute care. Understanding workforce issues in community settings is important for employers, managers and policymakers to sustain and grow this workforce to meet consumer demands.

METHOD

A descriptive survey was conducted within a single Primary Health Network in Australia.

RESULTS

Having an identified practice nurse leader/manager, feeling that their training and qualifications are used to the full and not feeling isolated, alone or lacking opportunities for mentoring were all significantly correlated with higher job satisfaction. The lowest average satisfaction scores related to pay. 44.9% of participants were unsure whether they would remain working in general practice. The relationship between total job satisfaction and intention to leave was significant.

CONCLUSION

These findings guide managers in developing strategies to recruit and retain nurses in general practice employment.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers must consider factors influencing job satisfaction and turnover intention to maximize recruitment and retention of nurses.

Professional characteristics and work attitudes of hospital nurses who leave compared with those who stay

AIM

To compare characteristics and attitudes of nurses who resigned and those who remained in two Israeli hospitals and assess the reasons for leaving.

BACKGROUND

Nurse turnover is a current global problem in health care system, especially given the severe nurse shortages. Retention of nurses requires an understanding of the characteristics of the resigning nurses, their attitudes and their reasons for leaving.

METHODS

A matching case-control study was conducted among 100 resigning nurses and 200 matched remaining nurses. Questionnaires were used to survey the professional characteristics and attitudes of the participating nurses. In addition, exit interviews were used to assess the reasons to leave of resigning nurses.

RESULTS

Resigning nurses had higher education, less seniority and fewer managerial positions compared with remaining nurses. In addition, resigning nurses had lower professional autonomy and higher aspirations for professional advancement. The reasons to leave cited by the resigning nurses were distance of the workplace from home and working conditions as well as aspiring for professional advancement.

CONCLUSIONS

The interface between high education and having few opportunities for advanced positions may lead to resignation.

IMPLICATIONS FOR NURSING MANAGEMENT

We recommend organisational interventions for training new hospital nurses through professional career path development, such as mentoring programme.

Influence of headaches on nurse intentions to leave the profession and the hospital: a cross-sectional survey

Background: Few studies had examined whether headaches impact emotional exhaustion among nurses, and nurses' intentions to leave the hospital (current employer) or nursing profession. Objectives/Aims/Hypotheses: To examine the impact of headaches on nurses' self-efficacy and emotional exhaustion, and nurses' intentions to leave the hospital or the profession. Design: A cross-sectional survey design with proportional random sampling was used to collect data. Methods: This study was conducted in one medical center in Taiwan during February and March 2017. Inclusion criteria were full-time registered nurses. Totally, 570 full-time registered nurses were surveyed. Results: Nurse headaches were positively related to emotional exhaustion, which was positively related to the intention to leave the hospital, further positively related to the intention to leave the profession. Self-efficacy was negatively related to the intention to leave the profession. Impact statement and Conclusions: Our findings advise nurse managers to take actions to reduce nurses' headaches.

Do emotional labour strategies influence emotional exhaustion and professional identity or vice versa? Evidence from new nurses

AIMS

The aim was to examine the reciprocal relationships of emotional labour strategies with emotional exhaustion and professional identity.

DESIGN

This study adopted a four-wave cross-lagged panel design.

METHODS

Survey data were collected in 2018 from a sample of 171 newly hired nurses from 58 hospitals in 11 provinces of China. Nurses' emotional labour (i.e., deep acting and surface acting), emotional exhaustion and professional identity were repeatedly measured. Cross-lagged panel analyses were conducted to examine the reciprocal relationships we hypothesized.

RESULTS

We found that emotional exhaustion was positively related to surface acting (but not vice versa); deep acting was negatively related to emotional exhaustion (but not vice versa); professional identity was positively related to deep acting (but not vice versa).

CONCLUSION

Our findings suggest that deep acting and professional identity may decrease the level of emotional exhaustion, whereas emotionally exhausted nurses are more likely to employ surface acting strategies.

IMPACT

This research finding will have an impact on the nursing management. Healthcare managers may consider workshops or training and development programs that promote nurses' professional identify to promote nurses' use of deep acting and consequently reduce their level of emotional exhaustion, which has been associated with a variety of negative consequences, such as low quality of patient service, high medical accidents, and turnover rate.

Nurse-Patient Connectedness and Nurses' Professional Quality of Life: Experiences of Volunteering at a Pediatric Oncology Camp

Objective: Pediatric oncology nurses can experience burnout, vicarious traumatization, and compassion fatigue related to the unique stressors of their profession. Opportunities to enhance nurses' professional commitment and nurse-patient connectedness may mitigate these stressors. This study explored the impact of volunteering at a local oncology camp on pediatric oncology nurses' professional quality of life and connectedness with their oncology patients. Method and Sample: Pediatric oncology nurses from a single institution were invited to participate in this mixed methods study. Participants completed a survey assessing professional quality of life, professional commitment, and patient connectedness. Nurses who had oncology camp volunteer experience were invited to participate in a qualitative interview. Results: Compared with noncamp nurses (n = 23), camp nurses (n = 25) had increased odds of a low burnout score (odds ratio = 6.74, 95% confidence interval [1.10, 41.43], p = .039) and increased odds of a high compassion satisfaction score (odds ratio = 4.69, 95% confidence interval [1.14, 19.32], p = .033). Qualitative interviews supported the impact of volunteering at camp on nurses' personal and professional perspective, nursing practice, and delivery of person-centered care. Conclusion: Volunteering at a pediatric oncology camp provided nurses the opportunity to engage with patients, share experiences, and view patients as individuals while still maintaining professional boundaries. Nurses who volunteer at camp described a perspective moving beyond patient-centered to person-centered care, and for some pediatric oncology nurses, camp volunteering may be a novel way to mitigate burnout and an important tool to enhance resiliency.

Development and cross-validation of a new instrument to measure nurse's positive energy of retention: A methodological study

AIM

The aim of this study was to develop and psychometrically test a new instrument for measuring nurse's positive energy of retention (NPER).

BACKGROUND

The shortage of professional nurses is an unresolved global issue. Few studies explored the issue of the retention of nurses in terms of a positive psychological viewpoint.

DESIGN

Methodological study.

METHODS

Data collection was from June 2016-August 2017. Nurses (N = 947) recruited from northern, central and southern Taiwan covering different levels of hospitals were divided into three samples, which were used for explaratory factor analysis (EFA), confirmatory factor analysis (CFA) and cross-validation respectively.

RESULTS

EFA resulted in a three-factor solution: proactive and persevering characteristics, nursing professional identity and passion accounting for 61.8% of total variance. The proposed three-factor model was confirmed by CFA. Cross-validation provided further evidence for the construct validity of the NPER instrument with 24 items. Cronbach's alpha coefficient of three subscales of the instrument were 0.95, 0.89, and 0.92 separately and 0.96 for the total scale.

CONCLUSION

Psychometric properties indicate that the newly formulated NPER instrument is a valid and reliable assessment tool to recruit nurses who are more likely to remain in nursing.

IMPACT

The study addressed the personal intrinsic factors, which are very important for nurses' retention. The NPER instrument consisted of three subscales is a reliable and psychometrically valid new instrument. Managers could apply the NPER instrument to recruit nurses possessing the attributes of positive energy of retention. Furthermore, researchers could use the rigorous process provided in the study to establish a new instrument.

The impact of mentor-mentee rapport on nurses' professional turnover intention: Perspectives of social capital theory and social cognitive career theory

AIMS AND OBJECTIVES

This study examines the impacts of mentor-mentee rapport on willingness to mentor/be mentored, self-efficacy, outcome expectations, career interest and subsequently on nurses' professional turnover intention.

BACKGROUND

Workplace relationships, whether positive or negative, influence nurse turnover within an organisation. Yet little is known about the effects of mentoring on nurses' intentions to leave the nursing profession.

DESIGN

A cross-sectional, survey-based research design was used to collect data from a large medical centre in Northern Taiwan.

METHODS

Study concepts were measured using scales from social capital theory (SCT), social cognitive career theory (SCCT) and the nursing literature. Partial least square structural equation modelling was used to test all study hypotheses. The STROBE statement was chosen as the EQUATOR checklist.

RESULTS

For mentors, rapport was positively related to willingness to mentor, which was positively related to outcome expectations, and further, positively related to career interest and negatively related to professional turnover intention. For mentees, rapport was positively related to willingness to be mentored, which was positively related to self-efficacy, outcome expectations and ultimately to career interest. Career interest was negatively related to professional turnover intentions.

CONCLUSIONS

Rapport between mentors and mentees may be an important means to retain nurses in the profession.

RELEVANCE TO CLINICAL PRACTICE

Managers should consider taking steps to enhance rapport between mentors and mentees. In doing so, managers improve nurse retention, a critical component of providing high-quality patient care.

Factors Influencing Organizational Commitment and Turnover in Nurse Residents

BACKGROUND

Newly licensed RNs (NLRNs) are at risk for leaving employment in the first year. Nurse residency programs have demonstrated success for NLRN retention, yet other variables remain to be explored.

METHOD

A retrospective correlational approach was used to determine the effect of autonomy, competence, group cohesion, structural empowerment, and job satisfaction on organizational commitment, turnover intent, and actual job turnover using secondary data of 1,498 nurse residents.

RESULTS

At 1 year post-residency, turnover intent was low. The turnover rate at year 2 was 8.3% (n = 125). Group cohesion, job satisfaction, and structural empowerment had a significant effect on organizational commitment. Organizational commitment had a significant effect on turnover intent.

CONCLUSION

As part of the global NLRN population, findings based on the U.S. residency programs provide nursing professional development with information to foster the needs of NLRNs and nursing administrators with information to support the development and effectiveness of nurse residency programs in the organization. J Contin Educ Nurs. 2018;49(10):482-488.

Determinants Strengthening Japanese Nurses' Intention to Stay at Their Current Hospital

In order to retain nursing staff, it is crucial to have a comprehensive understanding of the factors that motivate nurses to stay at an institution. Toward this aim, we identified a variety of factors that strengthen nurses' intention to stay at their current hospital. A cross-sectional questionnaire survey was conducted at 12 hospitals in the Tohoku and Kanto regions of Japan. Of the 1,034 nurses working in those hospitals, 713 returned the questionnaire (response rate: 69.0%). Of these, we analysed the data of 485 nurses (17.42 ± 9.83 years of clinical experience, 95.3% female) (valid response rate: 46.9%) who met the inclusion criteria of planning to stay at their current hospital and completing all questionnaire items. An exploratory factor analysis indicated that variables strengthening intention to stay at the current hospital could be grouped into five factors: "comfortable workplace environment," "passive motivational factors," "convenience of hospital location," "favorable work-life balance," and "fulfilment in nursing." Nurses who were married or had children placed a higher priority on a "favorable work-life balance" in remaining at their current workplace. Regular employees or nurses working in the smaller cities tended to display higher "passive motivational factors," which comprised various extrinsic factors. Though extrinsic factors are considered to make only short-term contributions to employee retention, they could generate positive synergistic effects when combined with intrinsic motivations such as "fulfilment in nursing." Effective nurse-retention strategies should be developed by capitalizing on the interaction among the five factors that strengthen nurses to stay at their current hospital.

The importance of contextual, relational and cognitive factors for novice nurses' emotional state and affective commitment to the profession. A multilevel study

AIM

This study explored the effects of contextual, relational and cognitive factors derived from novice nurses' work experiences on emotions and affective commitment to the profession.

BACKGROUND

With an increasing demand for well-trained nurses, it is imperative to investigate which work-related factors most affect their commitment to develop effective strategies to improve work conditions, work satisfaction and emotional attachment.

DESIGN

A repeated measures within subjects design.

METHODS

From September 2013-September 2014 eighteen novice nurses described work-related experiences in unstructured diaries and scored their emotional state and affective commitment on a scale. The themes that emerged from the 18 diaries (with 580 diary entries) were quantified as contextual, relational and cognitive factors. Contextual factors refer to complexity of care and existential events; relational factors to experiences with patients, support from colleagues, supervisors and physicians; cognitive factors to nurses' perceived competence.

RESULTS

The first multilevel regression analysis, based on the 18 diaries with 580 entries, showed that complexity of care, lack of support and lack of competence were negatively related to novice nurses' affective commitment, whereas received support was positively related. The next multilevel regression analyses showed that all contextual, relational and cognitive factors were either related to negative or positive emotions.

CONCLUSION

To retain novice nurses in the profession, it is important to provide support and feedback. This enables novice nurses to deal with the complexity of care and feelings of incompetence and to develop a professional commitment.

Calling to Nursing: Concept Analysis

The aims of this article are (a) to analyze the concept of a calling as it relates nursing and (b) to develop a definition of calling to nursing with the detail and clarity needed to guide reliable and valid research. The classic steps described by Walker and Avant are used for the analysis. Literature from several disciplines is reviewed including vocational psychology, Christian career counseling, sociology, organizational management, and nursing. The analysis provides an operational definition of a calling to nursing and establishes 3 defining attributes of the concept: (a) a passionate intrinsic motivation or desire (perhaps with a religious component), (b) an aspiration to engage in nursing practice, as a means of fulfilling one's purpose in life, and (c) the desire to help others as one's purpose in life. Antecedents to the concept are personal introspection and cognitive awareness. Positive consequences to the concept are improved work meaningfulness, work engagement, career commitment, personal well-being, and satisfaction. Negative consequences of having a calling might include willingness to sacrifice well-being for work and problems with work-life balance. Following the concept analysis, philosophical assumptions, contextual factors, interdisciplinary work, research opportunities, and practice implications are discussed.

New Graduate Nurses' Professional Commitment: Antecedents and Outcomes

PURPOSE

This study examines the factors that increase new graduate nurses' professional commitment and how this professional commitment in turn affects professional turnover intentions, anxiety, and physical health symptoms.

DESIGN

The study was carried out in association with the nursing undergraduate's affiliation of Quebec, Canada. A three-wave longitudinal design was employed among nursing students. Nurses were surveyed before they entered the labor market, and then twice after they started working.

METHODS

Participants were contacted by post at their home address. The hypotheses were tested using structural equation modeling.

FINDINGS AND CONCLUSION

Professional commitment explains why good work characteristics and the provision of organizational resources related to patient care reduce nurses' anxiety and physical symptoms, and increase their professional turnover intentions. Pre-entry professional perceptions moderate the effects of work characteristics on professional commitment such that when participants hold positive pre-entry perceptions about the profession, the propensity to develop professional commitment is higher.

CLINICAL RELEVANCE

There is a worldwide shortage of nurses. From a nurse training perspective, it is important to create realistic perceptions of the nursing role. In hospitals, providing a good work environment and resources conducive to their professional ethos is critical for ensuring nurses do not leave the profession early on in their careers.

Professional commitment: Does it buffer or intensify job demands?

The purpose of this study is to investigate whether professional commitment can be seen as a moderator in the relationship between job demands and emotional exhaustion among Norwegian nurses. Inspired by the job demands-resources model, this study explores whether having a strong commitment to the nursing profession can be seen as a resource that buffers the effect of job demands on emotional exhaustion or, conversely, intensifies the impact of job demands. A survey that comprised Norwegian nurses who had graduated three years previously (N = 388) was conducted. Multiple regression was performed to test the hypothesis. The results provide support to a buffering effect; thus, individuals with a higher degree of professional commitment conveyed a weaker association between job demands and emotional exhaustion compared with nurses with a lower degree of commitment. Developing a better understanding of the potential buffering effect of professional commitment is of great interest. The present study is the first to utilize professional commitment as a resource within the job demands-resources framework.

[Risk factors and burnout levels in Primary Care nurses: A systematic review]

OBJECTIVE

To determine the risk factors and levels of burnout in Primary Care nurses.

METHODS

A systematic review was performed.

DATA SOURCES

CINAHL, CUIDEN, LILACS, PubMed, ProQuest, ScienceDirect and Scopus databases were consulted. Search equations were 'burnout AND community health nursing' and 'burnout AND primary care nursing'. The search was performed in October 2015.

STUDY SELECTION

The final sample was n=12 studies. Quantitative primary studies that used Maslach Burnout Inventory for burnout assessment in Primary Care nurses were included without restriction by publication date.

DATA EXTRACTION

The main variables were the mean and standard deviation of the three burnout dimensions, high, medium and low prevalence rates of each dimension, and socio-demographic, occupational and psychological variables that potentially influence burnout level.

RESULTS

Studies show high prevalence rates, generally between 23% and 31%, of emotional exhaustion. The prevalence rates of high depersonalisation and low personal accomplishment show heterogeneity, varying between 8%-32% and 4%-92% of the sample, respectively. Studies show that older nurses with more seniority, anxiety and depression, among other variables, have higher burnout levels, while nurses with higher salary, high job satisfaction, organisational support, and good self-concept have less burnout.

CONCLUSION

High emotional exhaustion is the main affected dimension of burnout in Primary Care nursing. There is heterogeneity in depersonalisation and personal accomplishment. Burnout must be prevented in these professionals, by increasing protective factors and monitoring its appearance in those with risk factors.

Australian primary health care nurses most and least satisfying aspects of work

AIMS AND OBJECTIVES

To identify the aspects of working in Australian primary health care that nurses rate as the most and least satisfying.

BACKGROUND

The nursing workforce in Australian primary health care has grown exponentially to meet the growing demand for health care. To maintain and further growth requires the recruitment and retention of nurses to this setting. Understanding the factors that nurses' rate as the most and least satisfying about their job will inform strategies to enhance nurse retention.

DESIGN

A cross-sectional online survey.

METHOD

Nurses employed in primary health care settings across Australia were recruited (n = 1166) to participate in a survey which combined items related to the respondent, their job, type of work, clinical activities, job satisfaction and future intention, with two open-ended items about the most and least satisfying aspects of their work.

RESULTS

Patient interactions, respect, teamwork, collegiality and autonomy were identified as the most satisfying professional aspects of their role. Personal considerations such as family friendly work arrangements and a satisfactory work-life balance were also important, overriding negative components of the role. The least satisfying aspects were poor financial support and remuneration, lack of a career path, physical work environment and time constraints. National restructuring of the primary health care environment was seen as a barrier to role stability and ability to work to a full scope of practice.

CONCLUSIONS

This study has identified a range of positive and negative professional and personal aspects of the primary health care nursing role, which may impact on staff recruitment and retention. Findings from the study should be considered by employers seeking to retain and maximise the skills of their primary health care workforce.

RELEVANCE TO CLINICAL PRACTICE

Understanding the factors that nurses perceive as being the most and least satisfying aspects of the work is can open up dialogue about how to improve the working experience of nurses in primary health care.