Career development: graduate nurse views

Cognitive changes in professional value and career development amid the COVID-19 pandemic: A qualitative study of nurses' experiences

AIM

To explore cognitions in nurses' professional value and career development amid the COVID-19 pandemic and to analyse influencing factors.

DESIGN

A qualitative descriptive study design was employed.

METHODS

Thirty practising nurses from three general hospitals in Chengdu, China, were purposively recruited. Face-to-face semi-structured interviews were conducted. The content analysis was used for data analysis.

RESULTS

After the outbreak of the COVID-19 pandemic, there were obvious cognitive changes in nurses' professional value, including improvement in the cognition of professional value, awareness of the broadening of the field of acting professional value, and realization of increasingly high requirements in careers. Approval and gratitude of patients, social recognition and attention, self-awareness of nurses were main influencing factors. For cognitive changes in career development, nurses became more motivated to develop their careers, had a clearer understanding of career development environment, and acquired a clearer understanding of what was needed to advance careers. Hospital support, social respect, family support, and team atmosphere were key influencing factors.

CONCLUSIONS

The contributions made by nurses in the prevention and control of the COVID-19 pandemic have prompted positive changes in their cognition of professional value and career development. To promote nurses' positive understanding and approach to career development, measures should be taken by hospitals. Further, social respect, family support and team cooperation can enhance nurses' enthusiasm for career development.

Status and related factors of professional growth among young nursing talents: a cross-sectional study in China

BACKGROUND

The shortage of nurses has been a global human resources problem. A good professional growth environment is essential to developing potential nursing students and attracting nurses to join, and it has great significance in reducing nurse turnover. However, nurses' comprehensive perceptions of professional growth have not yet been examined.

METHODS

A cluster sampling method was used to conduct a professional growth questionnaire survey on young nursing talents from a large Chinese public tertiary A hospital in March 2022.

RESULTS

The score of professional growth among 243 young nursing talents was 57.92 ± 9.607, with a scoring rate of 77.23%. The scores for dimensions of professional growth, from lowest to highest, were rehabilitation growth, promotion speed, professional goal progress, and professional ability development. Attitudes towards participating in training, service as the quality manager or clinical teacher, self-efficacy, professional title, work-family support, education, and organizational commitment of young nursing talents were significantly associated with professional growth.

CONCLUSION

The professional growth of young nursing talents was at a moderate level and needed to be strengthened. Nursing leaders and managers are expected to develop management practices to enhance young nursing talents' professional growth in combination with the related factors.

Enhancing dermatology nursing education in Scotland and Ireland: a multifaceted approach

The purpose of the National Dermatology Improvement Project was to identify the educational requirements of dermatology nurses and understand factors impacting the uptake of education for nurses. An educational needs analysis was performed to evaluate the strengths and weaknesses of current and future educational provision for all levels of nursing staff. Data were collected from department managers using questionnaires and interviews, and focus groups were held with nursing staff in bands 2-7. The majority of participants felt there was an overall lack of dermatology education, and that most of what was available was peer led and experiential. A number of barriers to the uptake of education were also identified, such as a lack of time, opportunity and motivation. These findings support the need for a nationally coordinated programme of dermatology education with formal and informal education provided for all levels of dermatology nursing staff.

Evaluation of a graduate nurse residency program: A retrospective longitudinal study

BACKGROUND

There is an urgency to retain nurses globally. Evidence has shown that nurse residency programs promote retention of new graduate nurses. However, there is a dearth of studies examining the impact of nurse residency programs longitudinally.

AIM

To evaluate the impact of a transition-to-practice program on new graduate nurses' practice confidence and job satisfaction over 24 months.

DESIGN

A retrospective longitudinal study.

SETTING

A 1200-bed public tertiary academic hospital.

PARTICIPANTS

New graduate nurses from local universities who joined the hospital and were enrolled in the Graduate Nurse Residency Program (n = 104).

METHODS

The program was conducted for 24 months and consisted of modules on bedside knowledge and skills, and a mentorship program with senior nurse leaders. Practice confidence and job satisfaction were measured using the Casey-Fink graduate nurse experience survey. The survey was administered four times over the 24 months as part of the program. Data was analyzed using repeated measures ANOVA.

RESULTS

Practice confidence increased and job satisfaction decreased over the 24 months. Practice confidence total score at 6 months and an extended probation period were factors associated with attrition during the 24-month clinical practice.

CONCLUSIONS

This is the first longitudinal study to demonstrate the impact of a transition-to-practice program in a multiethnic Asian setting. The Graduate Nurse Residency Program enhanced the practice confidence of new graduate nurses.

Transition to Practice Programs in Nursing: A Rapid Review

Background Transition to practice can be exceedingly stressful for newly qualified nurses as they grapple with the "reality shock" of everyday practice as an RN. Transition to practice programs were implemented as a support strategy to ease the transition from student to RN and are designed to increase graduates' confidence and competence, improve their professional adjustment, and increase their retention. Method This rapid review was framed by the Cochrane Methods Rapid Review, supported by the PRISMA statement checklist, aiming to identify and describe the benefits of transition to practice programs for newly graduated RNs and their impact on workforce retention. Results The literature revealed that mixed evidence exists regarding the value and benefits of graduate nurse transition programs to both the graduate and the health service. Conclusion There are multiple inconsistencies across clinical settings, organizations, and preceptor-ship/mentoring training, among others, particularly in relation to duration of the program and the amount of formalized contact/study days. [J Contin Educ Nurs. 2022;53(10):442-450.].

Nurses' perception of workplace discrimination

BACKGROUND

Discrimination and injustice are big obstacles in nurses' way to socialization and are among the major clinical challenges faced by nurses. Workplace discrimination is associated with such negative consequences as stress, fatigue, demoralization, loss of professional commitment, tension and conflicts at work, and resignation. A review of literature shows that not much research has been dedicated to workplace discrimination in nursing.

OBJECTIVE

This study aims to investigate nurses' perception of workplace discrimination.

METHOD

This cross-sectional study was conducted in the hospitals affiliated with a university of medical sciences in the largest city in the south of Iran in 2019. The participants consisted of 597 nurses who were selected through stratified random sampling. Data were collected using a researcher-made workplace discrimination questionnaire and analyzed in SPSS v. 21.

FINDINGS

The mean of the nurses' workplace discrimination scores was found to be 102.57 ± 14.5, which is considered as moderate. The nurses' mean scores for the dimensions of vertical and horizontal discrimination (44.53 ± 6.8), consequences of discrimination (20.52 ± 5.55), and unfair promotion (12.38 ± 2.44) were moderate. As for the two other dimensions of workplace discrimination, namely, gender discrimination (14.41 ± 3.28) and cultural-organizational discrimination (11.88 ± 2.99), the participants' mean scores were low. There was a significant relationship between the nurses' workplace discrimination mean score on the one hand and their employment status (p = 0.016) and work experience (p = 0.002) on the other. However, the nurses' workplace discrimination mean score was not found to correlate with their level of education (p = 0.65), marital status (p = 0.274), and gender (p = 0.479).

ETHICAL CONSIDERATION

This study has been approved by the ethics committee of the university. All the participants had signed the written informed consent form before participation.

CONCLUSION

Hospital managers should take measures to reduce discrimination and establish organizational justice to raise nurses' morale and improve the quality of their performance as caregivers.

Work Environment and Elderly Abuse in Nursing Homes: The Mediating Role of Burnout

The present study focuses on elderly abuse committed by nurses and nurses' aides in nursing homes. Elderly abuse includes neglect and abusive behaviors deleterious to the health and welfare of the elderly. The study aimed at a better understanding of neglect and abusive behaviors by considering caregiver burnout and the work context of these professionals. To achieve this goal, direct effects of job demands (workload and emotional demands) and organizational resources (quality of relationships with colleagues and with the supervisor) on elderly abuse were analyzed. Moreover, the mediating role of caregiver burnout was explored by suggesting that job demands and lack of organizational resources were related to neglect and abusive behaviors through burnout. The study was conducted among 481 nurses and health care assistants from different French nursing homes. Correlations, multiple regressions, and mediation analyses were performed. Results globally confirmed our hypotheses. Emotional demands and poor quality relationships with colleagues and the team supervisor were the most predictive variables for caregiver burnout, neglect, and abusive behaviors toward the elderly. Moreover, the results contributed to the literature by highlighting the mediating effect of burnout and give rise to potential implications in preventing elderly abuse in nursing homes.

Determining nursing service management standards in Turkey: A Delphi study

OBJECTIVE

To establish the current management standards needed by nurse managers in Turkey and to share the process of establishing standards.

BACKGROUND

Relevant and utilizable nursing management standards are needed for effective and efficient nursing administration to achieve better outcomes in health care.

METHODS

A three-round e-Delphi method was used in this study. First, the experts were asked an open-ended question. In the second and third rounds, data analysis measurements included item-by-item per cent agreement, standard deviation, average, median and interquartile range.

RESULTS

At the end of the third round, 49 standards were obtained under five main standards for nurse managers: management and organisation; leadership; human resources management; quality management; and professionalism.

CONCLUSION

The results of this study, which represent a consensus on nursing management standards drawn from the views of experts across regions and institutions in Turkey, provide a baseline to design, manage and evaluate nursing services.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing management standards, which are fundamental for designing, leading and evaluating nursing services, give a framework for nurse managers to provide effective and efficient administrative practices.

Occupational stress and associated risk factors among nurses: a cross-sectional study

Background: Nursing can be demanding and stressful with occupational stress posing a serious threat to nurses and patient outcomes. Aims/Objectives: To determine the prevalence of nurses' occupational stress and its associated risk factors. Design: Cross-sectional survey design. Methods: Nurses in 115 tertiary-level hospitals in 13 provinces in Iran were surveyed from August 2016-December 2017. Demographic information and occupational stress were assessed. 5422 distributed questionnaires were distributed with 2895 of returned surveys analyzed. One-way ANOVA and multiple linear regression analyses identified risk factors for occupational stress. Results: Mean score for overall occupational stress was 3.48 indicating a stress level between moderate and high, with 78.4% of respondents reporting that their job was stressful. Nurses reported issues with shiftwork, staffing, pay, workplace discrimination, management, policy and excessive workloads as sources of occupational stress. Risk factors in the multivariate analysis for higher occupational stress were female gender (p = .002), being married (p = .008), having lower educational levels (p < .001), increased work hours (p <.001), and working in emergency (p = .025), general wards (p = .012) and teaching hospitals (p < .001). Conclusions: The high prevalence of occupational stress amongst nurses in Iran demonstrates the extent of the issue, with recent reforms not effectively addressing occupational stress. The risk factors identified allow for more targeted interventions.

Newly qualified nurses' perceptions of working at mental health facilities: A qualitative study

WHAT IS ALREADY KNOWN ABOUT THE TOPIC?: Newly qualified nurses often feel overwhelmed by the challenges of the work environment and struggle to transition into healthcare work environments. Nurses require opportunities during the transition period to develop both competence and confidence in their ability to practise independently. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Newly qualified mental health nurses experience fear during their adaptation period, especially when they perceive mental healthcare users as dangerous and the working environment as risky, with little concern for their safety. Nurses new to the mental health environment learn from accepting responsibility, taking on challenges and making adjustments, in order to develop confidence as mental healthcare professionals. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nursing management should ensure a safe and supportive mental healthcare environment. The potential for and consequences of negative stereotyping of patients among mental health nurses should be acknowledged and addressed as it may hinder the smooth adaptation of newly qualified nurses. Although stressful experiences can help mental health nurses to develop confidence and skills to manage future demanding situations, newly qualified nurses need to be given appropriate support and debriefing to ensure challenging situations do not "go the wrong way" and decrease confidence levels. Abstract Introduction Much has been written about the experiences of newly qualified nurses in their first year of employment, yet not much has been heard from the perspectives of newly qualified nurses working in mental health facilities. Aim To explore and describe the adaptation process of newly qualified nurses working in public mental health facilities in South Africa. Method Following a qualitative descriptive design, 11 newly qualified nurses in their first 6-18 months of employment were purposively selected from three public mental health facilities in South Africa. Data collected through unstructured individual interviews were thematically analysed. Results Four themes emerged from the analysis: fear related to the mental healthcare environment; self-doubt upon meeting the expectations of the inter-professional team; ways to adjust to the challenges; and confidence as mental healthcare professionals. Discussion During the adaptation process newly qualified nurses working in mental health facilities need support to overcome their initial fears and develop self-confidence in both managerial and therapeutic realms. Implications for practice Management of mental healthcare facilities needs to be cognisant of the importance of creating a supportive and safe environment that discourages negative stereotyping of patients and fosters newly qualified nurses' adaptation.

Working overtime in community mental health: Associations with clinician burnout and perceived quality of care

OBJECTIVE

Funding cuts have increased job demands and threatened clinicians' ability to provide high-quality, person-centered care. One response to increased job demands is for clinicians to work more than their official scheduled work hours (i.e., overtime). We sought to examine the frequency of working overtime and its relationships with job characteristics, work-related outcomes, and quality of care in community health clinicians.

METHOD

One hundred eighty-two clinicians completed demographic and job characteristics questions and measures of burnout, job satisfaction, turnover intention, work-life conflict, and perceived quality of care. Clinicians also reported the importance of reducing stress and their confidence in reducing their stress. Clinicians who reported working overtime were compared to clinicians that did not on demographic and job characteristics and work-related outcomes.

RESULTS

Ninety-four clinicians (52%) reported working overtime in a typical week. Controlling for exempt status and group differences in time spent supervising others, those working overtime reported significantly increased burnout and work-life conflict and significantly lower job satisfaction and quality of care than those not working overtime. Clinicians working overtime also reported significantly greater importance in reducing stress but less confidence in their ability to reduce stress than those not working overtime. There were no significant group differences for turnover intention.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

Working overtime is associated with negative consequences for clinician-related work outcomes and perceived quality of care. Policies and interventions aimed at reducing overtime and work-related stress and burnout may be warranted in order to improve quality of care. (PsycINFO Database Record

Skills Required for Nursing Career Advancement: A Qualitative Study

Background

Nurses require certain skills for progression in their field. Identifying these skills can provide the context for nursing career advancement.

Objectives

This study aimed to identify the skills needed for nurses’ career advancement.

Materials and Methods

A qualitative approach using content analysis was adopted to study a purposive sample of eighteen nurses working in teaching hospitals affiliated with the Qazvin, Shahid Beheshti, and Iran Universities of Medical Sciences. The data were collected through semi-structured interviews, and analyzed using conventional content analysis.

Results

The three themes extracted from the data included interpersonal capabilities, competency for career success, and personal capacities. The results showed that acquiring a variety of skills is essential for career advancement.

Conclusions

The findings showed that personal, interpersonal, and functional skills can facilitate nurses’ career advancement. The effects of these skills on career advancement depend on a variety of conditions that require further studies.

Translation and validation of the Nurses Self-Concept Instrument for college-level nursing students in Taiwan

Nurturing a professional nursing self-concept is crucial in nursing education. To determine whether it has been achieved, a reliable and valid measurement tool is necessary. This study therefore aimed to translate the Nurses Self-Concept Instrument (NSCI), and then ascertain the content and construct validity, and test-retest and internal consistency reliability in the Chinese version of the NSCI (NSCI-C). A methodological design was conducted with 1239 nursing students of a university recruited as the sample frame and 540 randomly selected. The results showed the content validity index of 0.81 overall, alpha of 0.92 overall, and correlation coefficient of 0.87. The mean score of the NSCI-C was significantly higher in freshman than in senior (p<.01). The hypothesized four-factor model did not fit the data well. After restructuring, two factors were explored, with 69.04% explained variance. The findings suggest that the NSCI-C is reliable and valid in nursing students.

Recent graduate nurse views of nursing, work and leadership

AIMS AND OBJECTIVES

To assess recent nurse graduates of a large university and seeks their views of university preparation, requisite nursing skills and qualities, workplace transition, supports received, nurse leadership and role models, and career development and retention.

BACKGROUND

Concern about attracting and retaining registered nurses is a continuing workforce issue in parts of Asia and throughout the world.

DESIGN

Qualitative interviews with recent nursing graduates.

METHODS

Seventeen face-to-face interviews took place using a structured schedule of 23 questions. Data were coded and analysed by hand to determine clusters of interest and develop themes.

RESULTS

Four broad topics emerged: (1) skills and qualities graduates consider central to nursing; (2) the support they received during the transition from graduate to novice practitioner and that which continues; (3) elements they value in nursing role models and leaders; and (4) the ward characteristics that will encourage them to remain in nursing and develop a career. Interviewees expressed concerns about retention-related issues, making suggestions for improvements. Unique findings focus on the blaming culture that many respondents consider they are working in, and the system whereby they are not free to access postgraduate studies until a specific time frame has elapsed, and when they do pursue further studies, they are bonded to the auspicing hospital/health service.

CONCLUSIONS

Responses unique to this research are the explicit concerns about a blaming culture, and complaints about rigid rules (bonding system) that virtually prevent an individual from accessing postgraduate studies independent of the hospital system. Interviewees strongly resent the bonding system that indentures them to that place of work.

RELEVANCE TO CLINICAL PRACTICE

Quality health care is dependent on a well-educated, sustainable and skilled nursing workforce. Recognition of the concerns of newly graduated nurses in relation to nursing skill acquisition, workplace support issues and career concerns can assist in ensuring these issues are adequately addressed and in turn contribute to a stronger, more stable and competent nursing workforce.