The voice of nurses: Novice nurses’ first experiences in a clinical setting. A longitudinal diary study

Acceptability and feasibility of a comprehensive fall prevention model for independent older adults: A qualitative evaluation

Background

Falls amongst the elderly represent a global public health challenge because of their potential to cause illness, death, and reduce the autonomy of this group. They also impact the emotional, family, social and economic well-being of those involved. Various strategies to prevent falls have been reported in the literature, focusing mainly on addressing individual risk factors, and on the continuous assessment of the risk of falls in older people.

Objective

This study evaluated user satisfaction and acceptability of a comprehensive model, implemented in the community, to prevent falls amongst independent older adults aged 65 years and above. It sought to capture both the perceptions of the individuals who received the intervention and of the interventionists who implemented it. The study protocol was registered at ClinicalTrials.gov in November 2020 (ID: NCT04313062).

Design

Qualitative, exploratory study using a case study design. The evaluation of the intervention followed the recommendations proposed by the Medical Research Council for complex interventions. Methods and participants: In the period between April 2021 to April 2022, 11 semi-structured interviews were conducted with independent older adults between 65 and 80 years of age who participated in the implementation of the comprehensive model in Santiago, Chile. Data were also collected with eight interventionists through: three semi-structured interviews at the beginning of the intervention; and two focus groups with seven interventionists at the end of the implementation of the model. The team members undertook a content analysis of the data collected.

Results

Three themes emerged to account for the satisfaction and acceptability of the intervention with the model on the part of the participants and interventionists: (1) Previous experience of older persons and interventionists; (2) The older person-interventionist encounter and its context; and (3) Identification of facilitators, strengths and challenges for the implementation of the model. The results show a positive assessment of the model, highlighting the value of the social contact derived from the intervention by both participants and interventionists. Although the model involved an individual intervention, the participants' accounts indicate that it reached out to others, including family members and other elderly acquaintances. Moreover, the interventionists helped identify challenges in implementation and made recommendations to strengthen the model.

Conclusion

The evaluation of satisfaction and feasibility of implementing the model showed positive results that will nurture the next phase of development of this model, which involves scaling up the intervention.

Examining Relationships Among Nursing Students' Views of Suffering, Positive Thinking, and Professional Quality of Life

BACKGROUND

Exposure to suffering can lead to compassion fatigue in undergraduate nursing students.

OBJECTIVE

Guided by resilience theory, a cross-sectional, correlational design was used to investigate the potential moderating effect of positive thinking skills on the relationships between views of suffering, compassion fatigue, and compassion satisfaction.

RESULTS

In 157 undergraduate nursing students, multiple regressions revealed that views of suffering and positive thinking explained 23.8% of the variance in compassion satisfaction (F11,145 = 4.121, P < .001), and 21.9% of the variance in burnout (F11,144 = 3.786, P < .001). The Suffering God view, which stresses the presence of a compassionate deity amid suffering, and positive thinking had significant main effects on compassion satisfaction (β = 0.349, P = .025; and β = 0.309, P < .001, respectively). Positive thinking, the Suffering God view, and the Random view, in which the occurrence of suffering is random and purposeless, had significant main effects on burnout (β = -0.280, P < .001; β = -0.392, P = .014; and β = -0.206, P = .014, respectively). The Unorthodox view, in which a deity exists that allows suffering, had a significant main effect on secondary traumatic stress (β = 0.232, P = .027). Positive thinking did not moderate any of the relationships between the views of suffering and the dependent variables.

CONCLUSIONS

Knowledge of these relationships can aid in the assessment of nursing students at risk for poor outcomes and guide intervention development to promote professional quality of life.

Ethnic inequalities during clinical placement: A qualitative study of student nurses' experiences within the London National Health Service

AIM

To understand how student nurse experiences on clinical placement, within National Health Service (NHS) hospitals, differ for ethnic minority and White British groups.

DESIGN

A qualitative thematic analysis with an inductive approach.

METHODS

Data from semi-structured interviews with 21 London (United Kingdom) hospital-based student nurses were examined using thematic analysis. Participants were interviewed as part of the Tackling Inequalities and Discrimination Experiences in Health Services (TIDES) study and asked about their experiences during clinical placement.

RESULTS

Five main themes were identified: (1) Role of mentors, (2) Discrimination and unfair treatment, (3) Speaking up/out, (4) Career progression, and (5) Consequences of adverse experiences. All themes were linked, with the social dynamics and workplace environment (referred to as "ward culture") providing a context that normalizes mistreatment experienced by nursing students. Students from ethnic minority backgrounds reported racism as well as cultural and/or religious microaggressions. While being valued for their race and ethnicity, White British students also experienced discrimination and inequity due to their age, sex, gender, and sexual orientation. Students from both White British and ethnic minority groups acknowledged that being treated badly was a barrier to career progression. Ethnic minority students also noted the lack of diverse representation within senior nursing positions discouraged career progression within the UK NHS.

CONCLUSION

These initial experiences of inequality and discrimination are liable to shape a student's perspective of their profession and ability to progress within nursing. The NHS is responsible for ensuring that student nurses' developmental opportunities are equal, irrespective of ethnicity.

IMPACT

Ward culture is perpetuated by others who normalize mistreatment and concurrently disadvantage ethnic minority students, making them feel unvalued. This in turn impacts both staff retention and career progression within the NHS. Training assessors should be aware of the existing culture of discrimination within clinical placements and work to eradicate it.

Turning Points in Professional Commitment Development: The Case of Novice Nurses

We investigated the development of professional commitment over time and its relation to work experiences of novice nurses. We used a longitudinal mixed-method approach based on weekly reported quantitative commitment scores and qualitative descriptions of experiences. Specifically, we examined turning points in commitment trajectories and analyzed qualitative characteristics of the turning point. To determine a turning point, we firstly computed a smoothed trajectory for each individual and defined each point beyond the 95% interval of this smoothed trajectory as exceptional. Secondly, we explored whether the commitment development changed after an exceptional point with regard to the slope-valence or commitment strength. The sample consisted of 18 novice nurses. Two third of them revealed at least one turning point, thus the professional commitment development of novice nurses was characterized by peaks and dips that were followed by changes in the commitment development. The analysis showed that turning points followed by positive commitment development typically were characterized by positive experiences. These experiences often concerned relatedness or competence. Turning points followed by a negative development were not consistent: they could be positive, negative, or ambiguous experiences. Many of the negative experiences concerned negative organizational issues. We concluded that there is not a simple relation between commitment development and positive or negative characteristics of an experience. The context and underlying meaning of the experiences should be taken into account to interpret the commitment changes.

Being a Newly Qualified Nurse: A Nordic Focus Group Study

Introduction

The transition to working life as a newly qualified nurse (NQN) can be challenging, leading to heightened stress levels. While NQNs are generally enthusiastic about starting their careers, they often express concerns about various responsibilities and a perceived lack of experience in independently dealing with clinical care in complex environments.

Objective

To acquire an in-depth understanding, from a caring science perspective, of what it means to be an NQN during the transition period of the first 18 months in the profession.

Methods

This study relied on an exploratory qualitative design. The methodological approach followed Gadamer's hermeneutic philosophy. Six focus group interviews were conducted in northern Norway (n = 3) and northern Sweden (n = 3) from January through May 2021. The interpretation of the data was inspired by Fleming et al. Nineteen female and seven male NQNs working in different contexts, including hospitals and municipalities, participated in the study. The consolidated criteria for qualitative research were used to report the results.

Results

Perspectives on NQNs are presented as three themes: a) the responsibility was perceived as a significant challenge, b) being a nurse is complex and demanding, and c) a desire for personal and professional development. Learning to be a nurse shouldering responsibility necessitates support and guidance from caring and compassionate colleagues and leaders.

Conclusions

This study sheds light on the importance of creating a workplace culture where NQNs' learning is promoted and supported by designated mentors during their transition to working life. The responsibilities should be aligned with their level of knowledge. It is important that leaders hold developmental dialogues and ensure a career plan for NQNs to continuously develop their knowledge and skills. Intervention studies designed to evaluate the meaning of the support from appointed mentors within structured mentorship programs are needed.

Experienced career perspectives of nursing students and their supervisors in learning departments: a qualitative study

BACKGROUND

Due to the nursing shortage, positive work environments are needed to retain (student) nurses. More and attractive internships for students need to be ensured. In order to provide more internship places learning departments were developed, which are characterized by a buddy system and supervisors who coaches at least two students during a shift. Gaining knowledge about career perspectives and job satisfaction is essential within the context of learning departments, as both will contribute to quality and safety of care and will support lifelong learning. The current study aimed to investigate how nurses and nursing students working and learning in learning departments experience preconditions for career opportunities.

METHODS

Using a generic qualitative approach, semi-structured interviews were conducted through videocalls between March and April 2021 in the Netherlands. Inductive qualitative analysis based on 'The Data Analysis Spiral' was used.

RESULTS

Career perspective is explored among six students and seven nurses. Five main themes were generated for both nurses and students; (1) personal goals; (2) skills and self-efficacy; (3) mentoring; (4) job satisfaction; and (5) career perspectives. Within the five main themes, subcategories were developed from 198 codes related to career opportunities. Results show career perspective is experienced differently. For students, the requirements to experience career perspective seem largely existing, as learning departments fits with personal goals, increases self-efficacy and provide coaching mentoring. Students felt learning departments contributed positively to becoming more skilled in working independently and collaborating with fellow students. This resulted in students feeling well prepared for the future. Nurses' career perspectives varied from wanting more personal development to experiencing opportunities due to having great colleagues, a challenging patient category, satisfaction from sharing knowledge and a decreasing physical workload. Nurses who had affinity with coaching students experience more career perspective on learning departments.

CONCLUSION

Interviews provided in-depth insights. Interviews gave in-depth insight into the elements of learning departments that contribute to career perspectives of (student)nurses. The results can be used by nursing supervisors, teachers and policymakers to optimize nurses' work environment, to eliminate leave intentions and improve quality of patientcare. The results should be taken into consideration when coaching students, developing manuals and implementing or optimizing learning departments. Future research is recommended to investigate which tools/interventions are effective for nurses and other healthcare professionals to support career guidance.

First death experiences of newly graduated nurses: A qualitative phenomenological study

Newly graduated nurses typically face death for the first time during the transition to their professional careers. This encounter can cause nurses to experience compelling emotions and make it difficult for them to manage and cope with the process of adaptation to the profession and the death process of the patient. This study aims to retrospectively examine and reveal the first death experiences of newly graduated nurses (N = 15) using a retrospective phenomenological method. Analysis of the responses of the newly graduated nurses revealed three themes: first encounter with death, nothing is like before, and support need. Newly graduated nurses realized that their first death experiences change their perspectives on life and profession and that nursing touches human life.

Success factors in adaptation of newly graduated nurses: a scoping review

BACKGROUND

Difficulties in adapting to the workplace can affect newly graduated nurses' transition. Such nurses must adapt quickly, as it can affect their future career prospects. Therefore, this review aimed to identify the success factors that promote newly graduated nurses' effective transition and adaptation.

METHODS

The Joanna Briggs Institute scoping reviews methodology was used. Data were extracted from MEDLINE, Scopus, EBSCOhost, and Web of Science publications published between 2011 and 2020. A total of 23 articles were included in this review, which comprised qualitative, quantitative, and mixed methods primary research studies focusing on the contributing factors that aided newly graduated nurses' adaptation to the work environment during their transition period. Key emerging themes were identified with thematic analysis.

RESULTS

Three main themes were identified: (1) organisational contribution (social development, organisational culture, work characteristics, work readiness, work commitment, professional role), (2) personality traits (self-embodiment, personality masking, being proactive and confident), and (3) academic institutions (pre-entry knowledge and role of nursing faculty). Newly graduated nurses' adaptation should begin during nursing education, be supported by the workplace organisation, and driven by the nurse's personality. We determined that that the role of nursing education in aiding the provision of the required knowledge and actual clinical experiences to students profoundly affected developing nurses' self-confidence levels in delivering nursing care effectively. Additionally, a warm environment supported nurses emotionally and physically.

CONCLUSIONS

While organisations and educational institutions have undertaken numerous efforts to ensure that newly graduated nurses are adequately supported, the nurse's personality and values are also equally important to ease adaptation during the transition process. Academic and workplace programs designed for newly graduated nurses should apply and emphasise this knowledge to develop and strengthen their personalities and values, especially to increase confidence and promote proactive values that facilitate newly graduated nurses' rapid and effective adaptation to their new employment.

Psychometric properties of Clinical Learning Environment Inventory and its association with Moroccan nursing students' satisfaction: A PLS-SEM approach

Background

The Clinical Learning Environment (CLE) is integral to pre-registration nursing curricula. Assessing the student's perceptions of their CLE is essential to adjust clinical placement to trainees' needs. Clinical Learning Environment Inventory (CLEI) appears to be widely used in measuring CLE, but no previous study has reported a full structural validity and its association with students' satisfaction in the Moroccan context.

Objectives

This study investigated the psychometric properties of the CLEI and its subscales association with Moroccan nursing students' satisfaction.

Methods

The research design was descriptive, cross-sectional, and conducted from March and June 2022 using convenience sampling in three nursing institutes of the Fez-Meknes region of Morocco. The selected sample involved Moroccan nursing students undertaking clinical practice. First, exploratory factor analysis (EFA) was used to determine the factor structure of the pilot sample (N = 143). The second sample (N = 206) was then used to confirm this structure using partial least squares structural equation modeling (PLS-SEM) confirmatory composite analysis (CCA). Finally, using a bootstrapping method, the significance of the structural path was evaluated.

Results

The CLEI scale depicted convergent validity (AVE = 0.56 - 0.71), discriminant validity, estimated by the square roots of AVE and bootstrapped HTMT confidence interval, and significant reliability (rhoC = 0.83 - 0.92). Using a bootstrapping approach, structural path significance displayed a substantial association between task orientation and students' satisfaction (β = 0.29, p <0.001). This ascertains that nurse students need well-planned guidelines from their facilitators in clinical wards.

Conclusions

The CLEI instrument revealed adequate psychometric properties and supported its original structure. As a result, the instrument might be used to measure students' perceptions of their CLE. Task orientation appeared to be the most important factor influencing the students' satisfaction in CLE.

Role transition of newly graduated nurses from nursing students to registered nurses: A qualitative systematic review

BACKGROUND

The transition experience of newly graduated registered nurses is highly stressful and associated with high attrition rates.

OBJECTIVES AND DESIGN

This qualitative systematic review aims to consolidate the available evidence on the experiences of newly graduated registered nurses' role transition from nursing students to registered nurses.

DATA SOURCES

English language research published between 2010 and 2022 was searched using PubMed, CINAHL, Scopus, Embase, PsycInfo and ProQuest Dissertations and Thesis databases.

REVIEW METHODS

Data were extracted using a data extraction form and appraised using the Critical Appraisal Skills Programme (CASP) tool for published studies or the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist for unpublished studies or grey literature, respectively.

RESULTS

The review included 25 studies and the meta-synthesis identified four themes: (a) Knowledge deficit, (b) Overwhelming clinical practise, (c) Importance of workplace support, and (d) Meaning of "being a nurse".

CONCLUSIONS

Newly graduated registered nurses experienced facing knowledge deficits in the clinical setting and felt overwhelmed with work, especially for newly graduated registered nurses during the Covid-19 pandemic. Support from colleagues was invaluable, and they wished for better support through standardised transition programs. Despite nursing being mentally and physically exhausting, many newly graduated registered nurses regarded their profession satisfying and meaningful, however some eventually resigned. Understanding the transition experiences of newly graduated registered nurses can provide valuable insights on how to facilitate their transition and in turn decrease attrition rates, and ensure safe care for the patients and that public healthcare needs are met.

Support Experiences for Novice Nurses in the Workplace: A Qualitative Analysis

Introduction

Since novice nurses need support at the beginning of their work, knowing workplace support resources can help them to experience fewer challenges at the beginning of their work and improve the quality of patient care.

Objectives

The present qualitative study aimed to explore novice nurses' experiences of supporting the workplace at the beginning of their work.

Design

This qualitative study was performed using a content analysis method.

Methods

This qualitative study was conducted with 14 novice nurse participants using the conventional content analysis method, unstructured in-depth interviews were used to collect data. All data were recorded, transcribed, and analyzed based on the Graneheim and Lundman method.

Results

Two major categories and four subcategories were extracted during data analysis as follows: (1) An intimate work environment with subcategories of cooperative work atmosphere and empathetic behaviors, (2) Educational support available for improvement contains subcategories conducting orientation courses and holding retraining courses.

Conclusion

The present study showed that such experiences as an intimate work environment, and educational support help novice nurses to have a supportive workplace and improve their performance. A welcoming and supportive atmosphere should be created for newcomers to ease their anxiety and frustration. Furthermore, they can improve their performance and provide quality care by giving themselves the motivation and spirit of improvement.

Relevance to Clinical Practice

This research highlights the need for new nurses to have support resources in the work environment, and healthcare managers can improve the quality of care by allocating sufficient support resources to this group of nurses.

Health-Related Factors Influencing Nurse Turnover by Clinical Career: A Secondary Data Analysis of Clinical Nurses in South Korea

The increase in clinical nurse turnover is an important issue in human resource management worldwide. Factors influencing it include health-related risk factors such as sleep quality and presenteeism, which need further exploration. We examined differences in job survival time of clinical nurses in relation to nurses' sleep quality and presenteeism. Participants were 857 Korean clinical nurses with more than three months' experience providing direct patient care. Data were analyzed using a time-independent Cox proportional hazard regression analysis of factors affecting actual turnover of clinical nurses. Average job survival times of competent, proficient, and expert nurses were 33, 64, and 143 months, respectively. Sleep quality and presentism significantly affected turnover risk. For clinical nurses with less than three years of experience, sleep quality significantly influenced the risk of turnover. For clinical nurses with more than six years of experience, presenteeism significantly affected the risk of turnover. The findings of this study offer a clinical career-based approach to reduce the turnover rate of clinical nurses. A differentiated approach based on work experience is necessary to establish a turnover management strategy for clinical nurses.

Followership in nurses working in Saudi Arabian hospitals: A cross-sectional study

AIM

To explore the followership styles and their associations with nurses' sociodemographic profiles in Saudi Arabia.

BACKGROUND

In Saudi Arabia, nurses' role is seen as less important and passive. However, whether they were actually passive followers has not been examined. No previous research has examined nurses' followership styles in Saudi Arabia.

METHODS

This cross-sectional study used a convenience sample of nurses. The Kelley followership questionnaire-revised was used to determine the prevalence of the five followership styles. Participants' demographic characteristics, which included age, gender, nationality, education level, years of experience, and role, were collected to investigate their associations with followership styles. An online survey was designed and distributed using SurveyMonkey®. Data were analyzed with logistic regression and expressed as odds ratios.

RESULTS

This study included 355 nurses. Findings revealed that the predominant followership style was exemplary (74%), followed by the pragmatist (19%), conformist (4%), and passive styles (3%). Logistic regression analysis revealed that expatriates, higher education, and a leader role had an independent association with an exemplary followership style. Male gender was associated with a passive style. Younger age, male gender, Saudi Arabian nationality, undergraduate qualification, no previous leadership experience, a follower role, and fewer years of experience increased the odds of having a pragmatist style.

CONCLUSION AND IMPLICATIONS

Followership styles were influenced by sociodemographic and work-related factors. Young nurses with less experience tend to be pragmatist followers. Nursing managers should integrate followership styles when planning leadership and team development courses to ensure maximum team effectiveness as leadership and followership are interdependent.

Community service nurses in primary healthcare clinics: Experiences of supervision and support from professional nurses

BACKGROUND

Newly qualified nurses in South Africa are required to undertake a compulsory 1-year community service (CS) in a public healthcare facility. They are not yet competent to work alone and require supervision and support from senior professional nurses.

AIM

This study aimed to explore and describe the experiences of community service nurses (CSNs) regarding supervision and support from professional nurses at primary healthcare clinics (PHC).

SETTING

The study was conducted with CSNs who were working in PHC clinics in Nelson Mandela Bay (NMB).

METHODS

A qualitative, explorative, descriptive and contextual study was conducted using semi-structured interviews with 10 CSNs. Purposive sampling was used. Data were analysed using Tesch's coding method of content analysis.

RESULTS

Two themes and six sub-themes emerged, the key themes being participants' diverse needs related to CS placement at PHC clinics and participants' social interaction with the professional nurses during CS.

CONCLUSION

Supervision and support for the CSNs during their CS rotation was inadequate at most clinics in this study. Recommendations, based on findings, were made for an improved CS experience and further research.

CONTRIBUTION

The CSNs require supervision and support in the CS year, particularly in PHC clinics, clearly presented in this study. The findings of the study can be used to improve the experience of CS for CSNs in the PHC setting in NMB.

The relationships between novice nurses' emotions management skills and happiness levels: A cross-sectional study

PURPOSE

To determine the relationships between the novice nurses' emotional management skills and their happiness levels.

DESIGN AND METHODS

This cross-sectional study was conducted on 398 novice nurses in Istanbul using a Nurse Fact Sheet, Emotions Management Skills Scale (EMSS), and the Oxford Happiness Scale Short Form.

FINDINGS

It was determined that the "Verbal expression of emotions," "Control of negative body response," and "Coping" subdimensions of the EMSS accounted for 21% of the variance in the total variable of the happiness scale (p < 0.001).

PRACTICE IMPLICATIONS

Novice nurses should be supported with training to improve their emotional management skills throughout their working lives, starting from the hospitalization phase. Factors that negatively affect nurses' happiness levels should be controlled.

Umbrella review: Newly graduated nurses' experiences of providing direct care in hospital settings

AIM

To summarize existing research syntheses reporting newly graduated registered nurses' experiences of providing direct care in hospital settings.

DESIGN

Umbrella review.

DATA SOURCES

An extensive search of all relevant databases was conducted for research syntheses. Initial key terms included "new* nurse", "nursing care" and "hospital setting" in combination with index terms to find relevant literature.

METHODS

Critical appraisal, data extraction and summary were performed independently by two reviewers according to the Joanna Briggs Institute guidelines for undertaking umbrella reviews.

RESULTS

Nine research syntheses published between 2010 and 2019 and representing 173 studies were included following critical appraisal. The evidence was summarized in narrative form with supporting tables. Twenty-six sub-branches and seven main-branches were organized in a coding tree showing the structure of three overlapping themes: "Feeling a lack of competency", "Sense of emotional distress" and "In need of support".

CONCLUSIONS

Evidence demonstrates that newly graduated registered nurses' experiences of a lack of competency, emotional distress and need for support emerged as essential requirements for the provision of competent and safe direct care for the patient.

IMPACT

Newly graduated registered nurses face multiple challenges in the transition from student nurse to practicing nurse. Unmet expectations of being a newly graduated nurse might lead to low levels of job satisfaction, high attrition rates or missed nursing care. Nurse educators, leaders and policy makers should be mindful that newly graduated registered nurses' perceptions of professional and personal identity and degree of support influences newly graduated registered nurses' direct care provision.

Exploring facilitators and barriers for successful transition among new Saudi graduate nurses: A qualitative study

AIM

This study aims at exploring Saudi newly graduated nurses' perspectives on the facilitators and barriers for successful transition from being a student to being a nurse.

DESIGN

A phenomenological qualitative methodology was employed.

METHODS

Focus group discussions were carried out among 35 Saudi nurses at one major university hospital in Saudi Arabia.

RESULTS

Under the theme of barriers to transition three main subthemes emerged, namely "Fear of making medical errors," "Intense Workload and Expectations," "Bullying and lack of support," while under the facilitators of transition the subthemes which emerged were "Supportive preceptor," "Training workshops," "Need for transition programs." This research found that formal and informal techniques for strengthening institutional variables and improving individual factors are critical for new graduate nurses' effective transition into professional responsibilities.

İşe Yeni Başlayan Genç Hemşirelerin Kıdemli Meslektaşları ile İlişkileri: Fenomenolojik Bir Çalışma

Giriş: İşe yeni başlayan genç hemşirelerin uyum süreçleri, arkadaşça olmayan davranışlara maruz aldıkları çalışma ortamlarından olumsuz etkilenmektedir. Bu nedenle, işe yeni başlayan genç hemşirelerin deneyimledikleri meslektaş ilişkilerinin bilinmesi uyum süreçlerinin iyileştirilmesi açısından önemlidir. Amaç: İşe yeni başlayan genç hemşirelerin, çalışma yaşamlarının ilk altı ayında kıdemli meslektaş ilişkileri ile ilgili deneyimlerinin, düşüncelerinin ve duygularının özünü anlamaktır. Yöntem: Araştırma, tanımlayıcı fenomenolojik nitel tasarımda, Nisan-Ağustos 2021 tarihleri arasında İzmir’deki bir üniversite hastanesinde amaçlı örneklem yöntemiyle seçilen 14 işe yeni başlayan genç hemşire ile gerçekleştirilmiştir. Derinlemesine görüşmeler video konferans yöntemi ile yapılmıştır. Görüşme dökümleri Colaizzi’nin tekniğine göre analiz edilmiş ve çalışmanın ana temalarının oluşturulması aşamasında deneyimlerin özüne ulaşmak için “Watson İnsan Bakım Kuramı” kullanılmıştır. Bulgular: İşe yeni başlayan genç hemşirelerin, kıdemli meslektaşlarıyla olan ilişkileri üç ana tema ve iki alt temadan oluşmaktadır: ana temalar; “sevecen/olumlu yaklaşımlar”, “nezaketsiz davranış”, “yetersiz destek”; alt temalar;“destekleyici ve geliştirici yaklaşım”, “kabul görme ve önemsenme” olarak belirlenmiştir. Sonuç: Çalışmanın sonuçları, işe yeni başlayan genç hemşirelerin, geçiş sürecinde özellikle rehber hemşire yaklaşımlarını sevecen ve geliştirici bulması ve olumlu deneyimler yaşamasının destekleyici ilişkinin varlığını; öte yandan yönetici ve kıdemli meslektaşlarının nezaketsiz davranışlarına maruz kalmasının ve yardım görmemesinin olumsuz ilişkilerin varlığını ortaya koymuştur. İşe yeni başlayan genç hemşirelerin, geçiş sürecinde olumsuz meslektaş ilişkilerine maruz kalmasının önlenmesi için kurumsal ve ulusal düzeyde Watson’ın İnsan Bakım Kuramı’na temelli stratejiler geliştirilebilir.

The Daily Basic Psychological Need Satisfaction and Work Engagement of Nurses: A ‘Shortitudinal’ Diary Study

Nurses’ satisfaction and work engagement have been linked to patient outcomes. Nightshift nurses provide healthcare to the population and experience unique challenges in performing their healthcare tasks. Therefore, the current study aimed to investigate the daily basic needs satisfaction and work engagement of nightshift nurses in accordance with the satisfaction of three basic psychological needs as indicated by the Self-Determination Theory. A quantitative, ‘shortitudinal’ design (diary study; over a few days) with a multi-level research approach using a daily diary survey method was completed by a convenience sample of nurses working the nightshift in a public hospital (n = 33). The results revealed that the daily need for autonomy and need for relatedness did not significantly predict variance in daily work engagement. However, need for competence did significantly predict variance in daily work engagement, and general emotional load explained significant variability in daily need satisfaction of competence. Lastly, general role clarity had a negative impact on the daily variability in work engagement. This study provides healthcare organisations with explanations for variance in nursing performance and suggests possible interventions to address nursing outcomes in accordance with the three basic needs of nightshift nurses in daily activity.

Novice nurses' transition to clinical setting in the COVID-19 pandemic: a phenomenological hermeneutic study

Background

: The COVID-19 pandemic both exposed and increased weaknesses in the healthcare system, so that novice nurses have become a more vulnerable group during this context.

Aim

: This study sought to illuminate experience of novice nurses in providing care during the COVID-19 pandemic.

Method

: It consists of a qualitative study conducted with data collected by means of semi-structured interviews, audio recorded, transcribed, anonymised, and analysed in the light of the phenomenological hermeneutic approach. Fourteen registered novice nurses from two health areas in northwest X, being twelve women and two men, who experienced the COVID-19 pandemic within their first five years of professional experience, were selected through a non-statistical snowball sampling.

Results

: After analysing the narratives, we identified four main themes: "Transitioning to a hostile, unknown and uncertain clinical setting from inexperience," "Invisible wounds because of being on the front line," and "Healing to return to the front line."

Discussion

: The uncertainty of an unknown illness and the lack of support during the COVID-19 pandemic has been affecting novice nurses, impacting their health conditions. At the same time, this context created opportunities for professional development. According to the interviewees, self-care and social support were elements to cope with exhaustion.

Conclusion

: Our study investigates the experiences of a group barely approached in the literature, highlighting the reality and difficulties of these nurses in transitioning to the clinical setting and providing insights to managerial leaders and educators.

Role Transition of Newly Graduated Nurses: A qualitative study

BACKGROUND

Newly Graduated Nurses in different socio-cultural contexts confront dissimilar situations and influences on role transfer. It is important to understand how newly graduated nurses reconstruct their own professional concept of clinical nurses.

OBJECTIVES

This study aimed to explore how Taiwanese newly graduated nurses perceived their new role and the process through which they transition into the professional role.

METHODS

Charmaz's constructivist grounded theory guided the study's design and implementation. Purposive and theoretical sampling and the snowball technique were used to recruit 30 participants from 3 tertiary and 2 community hospitals in Taiwan. Interviews were audio-recorded and transcribed verbatim into a readable format. Initial, focused and theoretical coding was utilized for data analysis. The criteria of credibility, originality, resonance and usefulness guided assessment of the study's quality and ensured the trustworthiness of the study process.

RESULTS

The process of role transition to become a nurse comprised four stages: hesitation, psychological preparation, development and appreciation. The hesitation stage was interpreted as a phase of passive learning. In the psychological preparation, newly graduate nurses began to take full work responsibility. The development stage saw them gain work confidence and, in the appreciation stage, they acquired a full picture of their roles.

CONCLUSION

To bridge the gap between theoretical learning and practice and reduce the time new graduate nurses need for role adjustment contributes to an early stage of Hesitation rather than the Appreciation stage of role transition. The findings suggest the need for further research to explore newly graduated nurses' needs during the process of role transition.

Utilizing a Matrix Approach to Analyze Qualitative Longitudinal Research: A Case Example During the COVID-19 Pandemic

Qualitative Longitudinal Research (QLR) is an evolving methodology used in understanding the rich and in-depth experiences of individuals over time. QLR is particularly conducive to pandemic or disaster-related studies, where unique and rapidly changing environments warrant fuller descriptions of the human condition. Despite QLR's usefulness, there are a limited number of articles that detail the methodology and analysis, especially in the social sciences, and specifically social work literature. As researchers adjust their focus to incorporate the impact of the COVID-19 global pandemic, there is a growing need in understanding the progression and adaptation of the pandemic on individuals' lives. This article provides a process and strategy for implementing QLR and analyzing data in online diary entries. In the provided case example, we explore a phenomenological QLR conducted with graduate level students during the COVID-19 pandemic (Saltzman et al., 2021), and outline a matrix framework for QLR analysis. This paper provides an innovative way in which to engage in qualitative data collection and analysis for social science research.

COVID-19 pandemic impact on experiences and perceptions of nurse graduates

BACKGROUND

Transitioning from education to practice is stressful for new nurses and those entering new roles and can lead to workforce attrition and burnout. This dynamic is likely complicated when graduates are transitioning to practice during a pandemic.

PURPOSE

The purpose of this study was to describe recent nurse graduates' perceptions of the impact of the COVID-19 pandemic on their transition from education to practice.

METHODS

We conducted an online survey of BSN, RN-BSN, and DNP students who graduated between December 2019 and April 2020 (n = 82), including demographics, employment information, and free-response questions about the impact of the pandemic on their transition experiences, post-graduation plans, and perceptions of nursing. We used a qualitative descriptive approach to content analysis to synthesize and summarize the data.

RESULTS

Participants expressed three overarching concerns: 1) altered plans such as difficulty finding employment; 2) logistical, system-related stressors including licensing delays and chaotic onboarding; and 3) feeling pride in profession despite perceiving ambivalence in public discourse.

CONCLUSION

COVID-19 exacerbated challenges often experienced by new graduates. Common stressors, intensified during the pandemic, could exert long-term effects on the workforce. Educators and healthcare organizations must work to ensure nursing graduates receive the necessary support for a successful transition.

The experiences of frontline nurses in Wuhan: A qualitative analysis of nurse online diaries during the COVID-19 pandemic

Aims and objective

To explore the experiences of frontline nurses through analyzing nurse online diaries during the pandemic.

Background

Over 42,600 healthcare professionals took care of patients with COVID‐19 in Wuhan in the initial months between 23 January 2020 and 8 April 2020. Many used to write online diaries on Sina Microblog and still wrote about their experiences in the front line on this site. However, there has been little research on frontline nurses' experiences in the initial months of the pandemic through analyzing their narratives.

Design

A qualitative descriptive design.

Methods

A qualitative content analysis was used to analyze online diaries written by frontline nurses in Wuhan. A total of 205 entries in online diaries were collected from 12 frontline nurses, as accessible to those who subscribed to Sina Microblog social media site, between 23 January 2020 and 8 April 2020. NVivo12 was used to help analyze the data, and COREQ reporting guidelines were also used in this study.

Results

Two themes were identified: constructing a better self and constructing a strong support network. A better self was constructed in describing positive emotions, commitment to care, pride and achievements, and whole‐person growth. A strong support network was constructed through social support via different sources and gaining self‐support via narrating their personal experiences in diaries.

Conclusions

Frontline nurses demonstrated personal growth, psychological well‐being, and professionalism in the process of constructing a better self and a strong support network.

Relevance to clinical practice

The findings indicate that frontline nurses can use narratives as debriefing opportunities and a way of gaining self‐support. We suggest that online communities of professional support be used as an essential platform for sharing narratives and gaining a more comprehensive understanding of frontline nurses in the COVID‐19 pandemic and other global public health events.

Nurses and the acceptance of innovations in technology-intensive contexts: the need for tailored management strategies

Background

Several technological innovations have been introduced in healthcare over the years, and their implementation proved crucial in addressing challenges of modern health. Healthcare workers have frequently been called upon to become familiar with technological innovations that pervade every aspect of their profession, changing their working schedule, habits, and daily actions.

Purpose

An in-depth analysis of the paths towards the acceptance and use of technology may facilitate the crafting and adoption of specific personnel policies taking into consideration definite levers, which appear to be different in relation to the age of nurses.

Approach

The strength of this study is the application of UTAUT model to analyse the acceptance of innovations by nurses in technology-intensive healthcare contexts. Multidimensional Item Response Theory is applied to identify the main dimensions characterizing the UTAUT model. Paths are tested through two stage regression models and validated using a SEM covariance analysis.

Results

The age is a moderator for the social influence: social influence, or peer opinion, matters more for young nurse.

Conclusion

The use of MIRT to identify the most important items for each construct of UTAUT model and an in-depth path analysis helps to identify which factors should be considered a leverage to foster nurses’ acceptance and intention to use new technologies (o technology-intensive devices).

Practical implications

Young nurses may benefit from the structuring of shifts with the most passionate colleagues (thus exploiting the social influence), the participation in ad hoc training courses (thus exploiting the facilitating conditions), while other nurses could benefit from policies that rely on the stressing of the perception of their expectations or the downsizing of their expectancy of the effort in using new technologies.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06628-5.

'It was quite a shock': A qualitative study of the impact of organisational and personal factors on newly qualified nurses' experiences

AIMS AND OBJECTIVES

To explore how newly qualified nurses' work experiences are constructed through the interplay between self, workplace and home-life influencing their retention.

BACKGROUND

Nurses are critical to achieving the goal of universal health coverage. However, shortages of nursing staff are endemic. Of particular concern, newly qualified nurses are more likely to leave the nursing workforce. The point of transition to working as a newly qualified nurse is a time of vulnerability. Most studies attempt to discover why nurses leave. This study uses the concept of job embeddedness to examine the experience of this transition and first two years of practice to understand what might help newly qualified nurses stay.

DESIGN

Qualitative approach using semi-structured telephone interviews.

METHODS

Self-selecting sample of nurses (n = 23) who participated 1-year (n = 12) and 2 years (n = 11) post-qualification. Participants were part of a larger longitudinal cohort (n = 867) study which has followed them since September 2013 when they entered nurse education in two Scottish universities. Thematic analysis was used to understand the interplay between organisation/workplace and the individual.

RESULTS

Three themes were developed: transition shock; workplace factors and work/life balance. Two further subthemes were developed: experience of support and belonging; and feeling unsupported and alienated. Eight participants had changed job or left, and two were looking to leave nursing.

CONCLUSION

This study highlights how the experience of transition shock can be positively or negatively impacted by the workplace environment, and how in turn this impacts the home environment. Ultimately, this impacts retention of newly qualified nurses.

RELEVANCE TO CLINICAL PRACTICE

Having adequate support resources, such as staffing, supportive team morale, professional development and family-friendly work environment, can create a work environment where they feel the purpose and meaningfulness of working as a nurse. This 'job embeddedness' can potentially enhance nurse retention. Reporting follows the COREQ checklist.

Exploring newly qualified nurses' experiences of support and perceptions of peer support online: A qualitative study

AIMS AND OBJECTIVES

To explore newly qualified nurses' support needs and their perceptions of online peer support.

BACKGROUND

The experience of being a newly qualified nurse is stressful and isolating. Support from colleagues and peers can enhance perceptions of competence and confidence in newly qualified nurses, improve well-being and aid retention. However, despite initiatives such as preceptorship, support needs may remain unmet in busy clinical environments. Online support has potential to offer a partial solution to professional isolation, but there is a lack of research into how technology can support nurses' emotional and social well-being.

DESIGN

A qualitative exploratory study was designed, employing semi-structured focus groups, analysed using thematic analysis. The study is reported in accordance with the COnsolidated criteria for REporting Qualitative research checklist.

METHODS

Eight focus groups, supplemented by one individual interview, were conducted with newly qualified nurses between June 2018-January 2019.

FINDINGS

Two main themes arose. The first was Drowning, a lot of the time with two sub-themes: (i) Feelings and emotions about being a Newly Qualified Nurse: 'Absolutely terrified' and (ii) Support within the role: 'Somebody you can count on'. The second was Potential advantages and disadvantages of online modality: 'Somebody is going to get in that phone!' which included three sub-themes (i) Potential advantages, (ii) Potential disadvantages and (iii) Preferences and recommendations.

CONCLUSIONS

This study demonstrates that if barriers can be overcome, then online support has potential to contribute to newly qualified nurses' well-being. Further research is needed to explore technical and ethical issues around online support and evaluate its effectiveness for newly qualified nurses.

RELEVANCE TO CLINICAL PRACTICE

Online support has the potential to add to existing strategies to support nurses during stressful times. This may be particularly relevant when many staff are working under increased pressure due to the COVID-19 pandemic.

Strengthened workplace relationships facilitate recovery at work - qualitative experiences of an intervention among employees in primary health care

BACKGROUND

The literature on workplace interventions focusing on recovery is scarce; hence this study intends to expand that knowledge. An intervention was run for one year, aiming at increasing the experience of recovery during the workday among primary health care employees. During the intervention, different forms of recovery activities were integrated into the daily work at six primary health care centres. The aim of this study was to explore the intervention process and its effects.

METHODS

After completion of an intervention, 39 employees in seven focus groups were interviewed about their experiences of the intervention. A semi-structured interview guide was used, and the qualitative analysis was conducted by systematic text condensation.

RESULTS

Despite different conditions and attitudes when the project was launched, the participants portrayed a positive outcome of the intervention at all six workplaces. Four promoting factors for intervention success were identified: support, legitimacy, customization, and simplicity. Also, three areas of improvement during the intervention period were described: the workplace climate, employee well-being, and recovery awareness, which in turn became promoting factors.

CONCLUSIONS

An intervention aiming at increasing workplace recovery can be promoted by support, legitimacy, customization, and simplicity. By using these promoting factors, health care workplaces can implement activity models which could increase employees' experiences of recovery during the workday. Positive effects on workplace climate and employee well-being can also be achieved.

Motivation for vocational training: significance to nurses in neonatal intensive care

OBJECTIVES

To analyze the motivation of neonatal intensive care nurses and the meanings attributed to the continuity of professional training.

METHODS

qualitative study, developed between August and December 2018, based on interviews with 16 nurses working in Neonatal Intensive Care in cities in seven Health Regions in the State of São Paulo. The theory of self-determination and narrative analysis supported this study.

RESULTS

the search for specialization and qualification of care is the plot, with the motivation for training initially based on the specialization and qualification of care. Over time, they revisit understandings carried out about care, making considerations about training, factors that influence motivation.

FINAL CONSIDERATIONS

the motivation expressed by the nurse in the search for training is shown through movements marked by the limitations apprehended in practice on the care of the risk neonate and the acquisition of knowledge to act with quality in this specific health scenario.

Mobile phone addiction and its association with burnout in Chinese novice nurses: A cross-sectional survey

AIM

To explore the levels of mobile phone addiction and burnout and their relationships among novice nurses.

DESIGN

A cross-sectional investigation design.

METHODS

Questionnaires were distributed to 400 novice nurses in five public hospitals in China. A total of 366 participants completed the survey. Data collected in 2020 were analysed by using descriptive statistics, an independent t test and Pearson's correlation analysis.

RESULTS

The results showed that the frequency of nursing adverse events was associated with higher level of mobile phone addiction in novice nurses, and 52.46% of the participants (N = 366) presented a high level of occupational burnout. Moreover, the results indicated that there was a positive correlation between the novice nurses' mobile phone addiction level and burnout (r = .33, p < .01).

CONCLUSION

The level of mobile phone addiction may affect nursing adverse events and nurses' burnout. Education on novice nurses' mobile phone use seems necessary to ensure patient safety and burnout prevention.

IMPACT

Findings of this study expanded important knowledge about mobile phone addiction and its potential influence on nursing safety and nurse burnout and may place significant implications to staff nurse management and in-service education.

Clinical Nursing Introduction Program for new graduate nurses in Sweden: study protocol for a prospective longitudinal cohort study

INTRODUCTION

High levels of nursing turnover represent a problem for healthcare organisations and patient safety. Experiences during the first years in the nursing profession have a significant impact on nurses' future decisions concerning their careers. Nurses at the start of their professional career need to practise their hands-on skills as well as their theoretical knowledge. In addition, new graduate nurses need regular support and opportunities to reflect on experiences in their new profession. The aim of the present study is to describe the Clinical Nursing Introduction Program (CNIP) and present a study design in which the programme is used to support new graduate nurses' transition into the nursing profession.

METHOD AND ANALYSIS

The present study examines the CNIP at a general hospital in southwest Sweden, which lasts for 14 months. The programme has a unique profile based on a person-centred approach and consists of five components: employment and organisation, a compulsory introduction week, two placements in different clinical settings, education days and process-oriented nursing supervision. The present study presents a protocol for a prospective longitudinal cohort study, using qualitative and quantitative methods in the collection and analysis of data. Measurements will include data collection between 2019 and 2023 when the nurses start the CNIP (baseline) and then after 1 and 2 years.

ETHICS AND DISSEMINATION

This study has been approved by the Regional Ethical Review Board in Gothenburg (Dnr 1056-18). Study findings will be presented at national and international conferences and published in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

273573 (https://www.researchweb.org/is/vgr).

Structural empowerment of nurses in the hospital setting

OBJECTIVE

to measure the level of structural empowerment of nurses working in a university hospital.

METHOD

a descriptive, analytical, and cross-sectional study, carried out with 237 nurses, who developed care and management activities. Data collection took place through a self-administered questionnaire with questions on the personal and professional characterization and the Work Effectiveness Conditions Questionnaire II. Data analysis used descriptive and inferential statistics.

RESULTS

it was identified that nurses have a moderate level of structural empowerment (18.06±SD 0.9). The greatest value was obtained in the Opportunity dimension (4.08±SD 0.8), followed by the Resources (3.17±SD 0.8) and Informal power (3,04±SD 0.9) dimensions; while the scores of Support (2.67±SD 1.0), Formal power (2.59±SD 0.9), and Information (2.51±SD 0.9) were lower.

CONCLUSION

the level of structural empowerment of the nurses was moderate, which means partial access to opportunities, resources, support, and information of the institution.

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.

New graduate nurses' clinical competence: A mixed methods systematic review

AIM

To appraise and synthesize evidence of empirical studies reporting assessment of new graduate nurses' clinical competence in clinical settings.

DESIGN

Mixed methods systematic review.

DATA SOURCES

The search strategy included keywords relevant to: new graduate nurse; clinical competence; and competence assessment. The searched literature databases included CINAHL, MEDLINE, Embase, PsycINFO and Web of Science. The search was limited to full-text papers in English or French, published between 2010 -September 2019.

REVIEW METHODS

Inclusion criteria were: 1) empirical studies; 2) detailed method and complete results sections; 3) competence assessment in clinical settings; and 4) new graduate nurses (≤24 months). Two independent reviewers screened eligible papers, extracted data and used the Mixed Methods Appraisal Tool framework for quality appraisal. Divergences were solved through discussion.

RESULTS

About 42 papers were included in this review: quantitative (N = 31), qualitative (N = 7) and mixed methods (N = 4). Findings suggest that new graduate nurses exhibit a good or adequate level of competence. Longitudinal studies show a significant increase in competence from 0-6 months, but findings are inconsistent from 6-12 months.

CONCLUSION

There are a multitude of quantitative tools available to measure clinical competence. This suggests a need for a review of their rigor.

IMPACT

No recent reviews comprehensively synthesized the findings from new graduate nurses' clinical competence. This review has found that new graduate nurses' competence has been mostly assessed as good, despite the expectation that they should be more competent. Longitudinal studies did not always show a significant increase in competence. These findings can help nurse educators in providing more support to new graduate nurses throughout the transition period or design improved transition programme. This review also identified quantitative tools and qualitative methods that can be used for competence assessment.

Novice nurse's transitioning to emergency nurse during COVID-19 pandemic: A qualitative study

AIM

To explore the experiences and perceptions of recent nursing graduates working in emergency departments during the COVID-19 outbreak.

BACKGROUND

Overcrowding in emergency departments has been one of the most prominent issues arising in these units for more than 20 years. However, it has become even more problematic due to the novelty of the coronavirus pandemic, which has forced hospitals to recruit larger numbers of beginner nursing staff as the number of quarantined health professionals increases.

METHODS

Sixteen semi-structured interviews were conducted in Spanish emergency departments, which were analysed and synthesized using content analysis.

RESULTS

Three major themes emerged from the data analysis: (a) Fears and concerns, (b) Organisational issues and (c) Support for novice nurses.

CONCLUSIONS

Our findings may help to understand how shadowing periods as a learning programme for nurses, continuing professional development, evidence-based apps and better planning are needed to ensure both novice nurses' confidence in emergency departments and expert emergency room nurses' ability to cope with complications in critical situations.

IMPLICATIONS FOR NURSING MANAGEMENT

Training periods that include shadowing expert emergency room nurses, along with evidence-based technology, provide an opportunity to support novice nurses' transition into the workplace. These measures would provide a safety net and would increase novice nurses' confidence as well as high-quality care.

Reasons why Dutch novice nurses leave nursing: A qualitative approach

Shortages in the nursing profession are increasing. It is, therefore, imperative to understand why novice nurses are leaving the profession. This qualitative study explores Dutch novice nurses' motives for leaving the profession. Individual semi-structured interviews were held with seventeen former novice nurses who had decided to leave nursing within two years after graduation. Data was collected and analysed following the principles of Thematic Analysis, leading to six themes; 1) Lack of challenge; ambitious to progress further in management or research roles. 2) Lack of passion; no feeling of passion for patient care. 3) Lack of perceived competence; not feeling "up to the challenge". 4) Lack of job satisfaction due to heavy workload; work-life imbalance and inability to deliver high-quality care. 5) Lack of work capacity due to non-work-related health conditions; unmet requirements for job or work environment adjustment. 6) Lack of feeling of belonging; suffering from a negative attitude of colleagues to one another. To prevent novice nurse professional turnover, measures such as capacity building, supervisor support and a tailored personal development plan could be taken. To make novice nurses feel safe and reassured, support from colleagues and supervisors is important. Such measures require thoughtful implementation and evaluation.

Self-assessed competence and need for further training among registered nurses in somatic hospital wards in Sweden: a cross-sectional survey

BACKGROUND

Professional competence and continuous professional development is essential for ensuring high quality and safe nursing care, and it might be important for motivating nurses to stay in the profession. Thus, there is a need to identify the developmental process of nursing competency. Assessment of competence and need for further training helps to identify areas for quality improvement, and to design interventions in order to facilitate continuous competence development in different work contexts. The current study aimed to 1) describe registered nurses' self-assessment of clinical competence as well as the need for further training, and 2) explore possible differences between registered nurses with varying lengths of professional experience as a nurse (≤ 0,5 year, > 0,5-5 years, and ≥ 6 years).

METHODS

A cross-sectional survey design was applied, using the Professional Nurse Self-Assessment Scale of clinical core competencies II. Registered nurses (n = 266) working in medical and surgical contexts in hospitals in Sweden responded (response rate 51%). Independent student t-test and analysis of variance were carried out.

RESULTS

Registered nurses assessed their competence highest in statements related to cooperation with other health professionals; taking full responsibility for own activities; and acting ethically when caring for patients. They assessed their need for further training most for statements related to assessing patients' health needs by telephone; giving health promotion advice and recommendations to patients by telephone; as well as improving a creative learning environment for staff at the workplace. For self-assessed competence and need for further training, differences between the groups for 35 and 46 items respectively, out of 50 were statistically significant.

CONCLUSIONS

Although the registered nurses assessed their competence high for important competence components expected of professionals such as cooperation with other healthcare professionals, it is problematic that knowledge of interactions and side-effects of different types of medication were reported as having the highest need of training. Longitudinal follow up of newly graduated nurses regarding their continuous development of competence as well as further training is needed.

Preventing Stress-Related Ill Health Among New Registered Nurses by Supporting Engagement in Proactive Behaviors-A Randomized Controlled Trial

BACKGROUND

New registered nurses (RNs) are at risk of developing symptoms of stress-related ill health.

OBJECTIVES

To evaluate the effect of a 3 × 3 hour group intervention aiming to prevent symptoms of stress-related ill health among new RNs by increasing engagement in proactive behaviors. The intervention involves discussions and models of newcomer experiences and stress and the behavior change techniques reinforcing approach behaviors, systematic exposure, and action planning.

DESIGN

A randomized parallel group trial with an active control condition.

PARTICIPANTS

The study sample consisted of 239 new RNs participating in a transition-to-practice program for new RNs in a large county in Sweden.

METHODS

Participants were randomized to either the experimental intervention or a control intervention. Data on experiences of stress, avoidance of proactive behaviors, engagement in leisure activities, role clarity, task mastery, and social acceptance were collected before and after the intervention. Effects were evaluated using multilevel model analysis and regression analysis. Missing data were imputed using multiple imputation.

RESULTS

The control group experienced a statistically significant increase in experiences of stress during the period of the study (t(194.13) = 1.98, p = .049), whereas the level in the experimental group remained stable. Greater adherence to the intervention predicted a greater effect on experiences of stress (β = -0.15, p = .039) and social acceptance (β = 0.16, p = .027).

LINKING EVIDENCE TO ACTION

Transition-to-practice programs may benefit from adding an intervention that specifically addresses new RNs' experiences of stress to further support them as they adjust to their new professional role. However, replication studies with larger samples, more reliable measures, and longer periods of follow-up are needed.

Nurse Students' Thoughts on a Sustainable Professional Life as Nurses: A Qualitative Study

INTRODUCTION

In a global context of an increasing and aging population, along with environmental changes, nurses play an important role in relieving suffering among vulnerable people and groups in society. Sustainability in nursing contributes to sustainable development through providing an environment that is not detrimental to/protects present and future generations' opportunities for good health. There is a global shortage of nurses, and it has been shown that, locally, every fifth newly graduated nurse considers leaving their new profession five years after graduation. The aim was to describe how nursing students' thought about a sustainable professional life as nurses before their graduation.

MATERIALS AND METHODS

A qualitative design with a written data set was used, and a thematic analysis was performed. One hundred five students (80 women and 25 men) in semester six out of six of the nursing education program participated.

RESULTS

The analysis resulted in three themes: 1) to have an ethical foundation that guides the individual nurse in protecting the nursing care and developing the nursing care for their patients; 2) to be in a listening, reflexive and supportive workplace enabling a professional nurse to continuously grow and learn and 3) to be a proud professional nurse with integrity, not risking with their own health or personal professional development.

CONCLUSION

The nursing students describe their thoughts on the requirements for having a sustainable professional life as nurses as having a strong inner ethical compass to help guide, protect and develop the nursing care for the patients. In addition, it requires a workplace with a reflexive and supporting culture. However, the nursing students also put their own health and the opportunities for professional growth at the top of their priorities, and if these conditions are lacking, they will switch to another workplace.

Novice nurses' sleep disturbance trajectories within the first 2 years of work and actual turnover: A prospective longitudinal study

BACKGROUND

Novice nurses experience radical changes in their sleep-wake cycle and sleep difficulties after exposure to a rotating shift work schedule. The link between workplace hardship and employee turnover may be dependent on factors at the individual level, e.g., individual health. Nurses with sleep disturbance are more vulnerable to stressful stimuli and lack resilience at work compared with those without sleep disturbance.

OBJECTIVES

To classify novice nurses according to sleep disturbance trajectories during the first 2 years of work, to compare turnover rates according to trajectory classification, and to compare levels of sleep disturbance between stayers and leavers within each trajectory class.

DESIGN

Prospective longitudinal design.

SETTINGS

A tertiary hospital in Seoul, South Korea.

PARTICIPANTS

A total of 465 newly graduated nurses who started work between September 2014 and December 2015.

METHODS

Data were collected 6 times within the first 2 years of work (on the first day of orientation before ward placement, at 6 weeks after starting work, and at 6, 12, 18, and 24 months of work). Sleep disturbance was assessed using the General Sleep Disturbance Scale. Turnover information was retrieved from the hospital's administrative data system to determine whether anyone had left the hospital at each data collection point. Unconditional latent growth curve analysis was performed to identify latent classes of trajectories of sleep disturbance among novice nurses during the first 2 years of work.

RESULTS

The 2-year trajectories of sleep disturbance were classified into two distinct groups: the high symptomatic group (Class 1: 57.4%) and the low symptomatic group (Class 2: 42.6%). In comparison with Class 2, Class 1 consistently showed a higher turnover in each period. In Class 1, leavers who left the hospital at the next measurement point tended to report more severe sleep disturbance at prior measurements. This pattern was also observed for the overall sample. However, in Class 2, an inconsistent pattern between stayers and leavers was observed.

CONCLUSIONS

This study identified two distinct classes of sleep disturbance among novice nurses during the first 2 years of work. Given that many nurses experience sleep problems at pre-employment and during the early career period, a comprehensive approach to address this issue should be implemented in nursing schools and hospitals. The basic nursing curriculum should include self-care management strategies for sleep difficulties to ensure retention at work. At-risk nurses should receive organizational support and early monitoring to prevent the adverse effects of poor sleep.

Factors contributing to stress in clinical practices: A proposed structural equation model

Aim

To propose a predictive model of procedural and emotional stress in clinical placements while testing self-efficacy as a possible mediator factor.

Design

The study used an exploratory correlational design.

Method

A total of 334 nursing students completed the KEZKAK-stress in clinical practice, AG-general self-efficacy and CEA-academic overload questionnaires, along with one about leadership. Sociodemographic information was also included.

Results

Confirmatory factor analyses and internal consistency reliabilities were satisfactory in all questionnaires. Procedural stress and emotional stress were confirmed by KEZKAK [χ2 (674) = 1,555.58, p = .001; χ2/df = 2.308, CFI = .90, IFI = 91, RMSEA = .06]. The structural equation method for procedural stress and emotional stress had an acceptable fit. They revealed that academic level influenced the perception of leadership and academic overload in both procedural stress and emotional stress. General self-efficacy only mediated emotional stress. Hospital unit acted independently as a predictor of procedural stress.

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.