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

Examining how early experiences in oncology settings influence nurses' career decisions

The transition from nursing student to newly registered nurse is a complex process, and subsequent recruitment to cancer nursing posts can be challenging. This article details a service evaluation that aimed to describe the experiences of nursing students on placement and newly registered nurses or nursing associates working in a specialist cancer centre, and how these experiences might influence their future career aspirations. To gather data, the authors undertook a focus group with nursing students ( n= 8) and interviewed newly registered nurses or nursing associates ( n= 19). The data revealed four themes: navigating the nursing student experience; motivation to work in oncology; transition to staff nurse; and looking ahead. The service evaluation identified that education providers often lack awareness of cancer-specific content and career pathways. It also found that some aspects of cancer care, such as gaining specialist skills in systemic anticancer therapy, require particular attention since they were often anxiety-provoking for newly registered nurses.

Factors influencing the job embeddedness of new graduate nurses: A multicentre cross-sectional study

AIM

To identify factors associated with job embeddedness from the perspective of retaining new graduate nurses.

DESIGN

The study was cross-sectional in design.

METHODS

Convenience and stratified sampling were used to recruit 415 newly graduated nurses from 12 tertiary hospitals in China. Anonymized data were collected through self-designed sociodemographic questionnaires, job embeddedness scale, feedback-seeking behaviour scale, authentic leadership perception scale and decent work scale. Appropriate indicators were used for descriptive statistics and t-tests, ANOVA, Pearson correlation analysis and multiple linear regression to examine the influencing factors.

RESULTS

The study showed that monthly income level, decent labour, authentic leadership and feedback-seeking behaviour were significant predictors of job embeddedness among new graduate nurses.

CONCLUSION

The job embeddedness of new graduate nurses is moderate. Nursing managers need to construct reasonable and fair compensation incentives, adopt positive leadership styles and encourage proactive feedback-seeking behaviours to improve the job embeddedness of new graduate nurses and alleviate the nursing talent shortage.

IMPACT

Exploring the factors influencing the job embeddedness of new graduate nurses provides a reference for establishing new graduate nurse retention strategies to help promote the career development of new graduate nurses and alleviate the nursing brain drain.

REPORTING METHOD

We adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Individual and environmental factors that influence longevity of newcomers to nursing and midwifery: a scoping review

OBJECTIVE

The objective of this review was to identify the literature and map the individual and environmental factors that influence registered nurses' and midwives' decision to stay or leave their professions within the first 3 years of practice.

INTRODUCTION

Nursing and midwifery workforce sustainability is an international concern. One aspect is the retention of new registered nurses and midwives in their first years of practice. Several factors are thought to influence the decisions of new registered nurses and midwives to leave or stay in their professions. This review sought to identify and map those factors to enable further research for workforce sustainability development strategies.

INCLUSION CRITERIA

The study cohort included registered nurses and midwives in their first 3 years of practice, which we called newcomers . Nurses who were required to work under the supervision of registered nurses and midwives (ie, enrolled nurses, licensed practical nurses, and licensed vocational nurses) were excluded. Papers were included only if they explored individual or environmental factors influencing nurses' decision to stay in or leave the professions of nursing or midwifery. Studies could be from any country or care environment, and participants were newcomers providing direct clinical care. Newcomers employed in other health roles, such as education, research, administration, or non-nursing/midwifery roles, were excluded. All research designs and peer-reviewed papers were included; policy documents were excluded. The date of inclusion was from the earliest publication on this topic, which was 1974, to the date of the search.

METHODS

The JBI methodology for scoping reviews was followed, and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidance. The search strategy aimed to locate published and unpublished primary studies, reviews, and text and opinion papers. The initial search of relevant databases was conducted in January 2020 and updated in January 2022. Reference lists of included articles were also screened. Following data extraction, descriptive qualitative content analysis was undertaken.

RESULTS

Twelve articles from 11 studies were included in this review. They were published between 2005 and 2020, and originated from 5 countries. Two studies were observational, 3 were cross-sectional, 5 were longitudinal studies, 1 was a pre- and post-program evaluation, and 1 was a scoping review. All studies focused on registered nurses; no publications on registered midwives met the inclusion criteria. Individual factors we identified that impact newcomers' intention to stay in or leave the profession included physical and psychological health, professional identity, professional commitment, and development. Environmental factors included workplace culture, engagement, and management.

CONCLUSIONS

Professional self-image, identity, and a sense of pride in the profession are important components of newcomer retention. Strategies that positively support transition to practice and create realistic expectations were highlighted. Managers play an important role in registered nurse retention, as they can influence many of the newcomers' experiences. It is concerning that no studies about newcomer midwives were found. Many studies explored turnover or intention to leave the job/employer rather than the profession. These are important considerations for future research.

The impact of preceptorship on the newly qualified nurse and preceptors working in a critical care environment: An integrative literature review

BACKGROUND

Preceptorship has been found to be effective in supporting Newly Qualified Nurses (NQNs) during their transition into challenging environments, particularly in addressing issues related to confidence and anxiety. Effective preceptorship is an element of best practice and essential to support NQNs' transition into the critical care setting. However, the impact of preceptorship on NQNs and their preceptors in critical care units is yet to be completely understood.

AIM

To review the impact of preceptorship on NQNs and preceptors working in a critical care environment.

STUDY DESIGN

An integrative literature review of the literature. The review employed Whittemore and Knafl's (2005) five-stage integrative review approach.

METHODS

Three databases (MEDLINE, CINAHL and PsycINFO) were searched for papers published between January 2010 and May 2022. The PRISMA framework was used to guide the search and screening. Thematic analysis was used to extract, organize and analyse the data.

RESULTS

Nine studies were included in this review. Reflective thematic analysis revealed three themes, with four related subthemes. Preceptorship has an impact on the development of the NQNs and preceptors' 'nurturing' relationship. NQNs develop their knowledge, competence and confidence when experiencing supportive preceptorship. Meanwhile, preceptors experience a combination of increased workload and opportunities for learning and professional development as a result of preceptorship.

CONCLUSION

There is evidence of the impact of preceptorship on learning and professional development for both NQNs and preceptors, but this is a complex phenomenon and further research is required to understand this area more fully.

RELEVANCE TO CLINICAL PRACTICE

In nursing practice, it is well-established that Newly Qualified Nurses (NQNs) often face heightened levels of anxiety and a lack of confidence when embarking on their careers, particularly in the demanding and stressful environment of critical care units. This review holds particular significance in the realm of clinical practice as it delves into the pivotal role of preceptorship in nurturing the professional growth and development of NQNs within the challenging domain of critical care. Effective preceptorship, as an essential component of best practice, plays a pivotal role in aiding NQNs' transition into critical care settings.

The role of the nursing work environment, head nurse leadership and presenteeism in job embeddedness among new nurses: a cross-sectional multicentre study

BACKGROUND

The retention of new nurses has become a major challenge for medical institutions. Job embeddedness has been seen as a valuable lens for examining nurse turnover, but greater details about job embeddedness are rarely disclosed, especially among new nurses. This study aimed to reveal how the nursing work environment, head nurse leadership and presenteeism shape job embeddedness in this population from the perspective of conservation of resources (COR) theory.

METHOD

A cross-sectional multicentre study involving 436 participants from 10 cities and 33 hospitals was conducted over 4 months. Samples were selected using a two-stage convenience sampling method. A sequential multiple mediation model performed with SPSS-PROCESS was used to analyse the relationships among the nursing work environment, head nurse leadership, presenteeism and job embeddedness.

RESULTS

The nursing work environment not only directly affects the job embeddedness of new nurses (β = 0.480, p < 0.001) but also indirectly affects it through the sequential multiple mediating effects of head nurse leadership and presenteeism (R2 = 0.535, F = 82.160, p < 0.001).

CONCLUSIONS

New nurses' job embeddedness needs to be improved. These results suggest that preserving adequate resources for new nurses, such as work environment resources, head nurse leadership resources, and individual productivity resources, is an effective way to shape their job embeddedness. In addition, when a certain resource is insufficient, fully considering the principles of investment and buffering between resources and providing reciprocal, alternative, or buffer resources in a timely manner are necessary to improve new nurses' job embeddedness.

LARGE LANGUAGE MODELS

Large language models (LLMs), such as ChatGPT, were not used during the writing of this article. An expert native English speaker performed language revision.

Effects of governmental support on clinical nurse educators in South Korea: A repeated cross-sectional study

AIM

To assess the effectiveness of the Clinical Nurse Educator Support Project and offer valuable insights for supporting nursing education.

BACKGROUND

Allocating clinical nursing educators is crucial for supporting novice nurses' transition into the clinical setting and improving their performance.

INTRODUCTION

In 2019, the Ministry of Health and Welfare in South Korea implemented the Clinical Nurse Educator Support Project, which involves governmental financial support for the employment of clinical nurse educators.

METHODS

This study employed a repeated cross-sectional design to assess the project outcomes. Following the framework of the Kirkpatrick Evaluation Model, secondary data from annual self-program evaluation reports were analyzed to assess program satisfaction, clinical adaptation, and turnover rates of novice nurses. The "Strengthening the Reporting of Observational Studies in Epidemiology checklist" guided the reporting of the study.

RESULTS

The project played a pivotal role in enhancing the quality of nursing education. Novice nurses' program satisfaction and clinical adaptation consistently remained high or exhibited an increase. The project led to a decrease in turnover rate among novice nurses, while the coronavirus 2019 pandemic resulted in increased turnover rates due to limited clinical practice opportunities for nursing students.

CONCLUSION

Government support for clinical nurse educators has positively impacted the institutionalization of nursing education. The pressing need is to prioritize not only the enhancement of nursing education quality and the improvement of nurses' working conditions but also the development of healthcare policies and programs to effectively respond to unforeseen challenges and crises.

IMPLICATIONS FOR NURSING POLICY

Government and healthcare institutions must collaborate to strengthen clinical education, crucial for novice nurses' clinical adaptation. Prioritizing the improvement of nursing education quality and nurses' working conditions is essential. Continuous research and evaluation of the Clinical Nurse Educator Support Project is imperative to assess its impact and make necessary adjustments.

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.

'All we've ever known is Covid': A follow-up study with newly qualified nurses who worked as student nurses during the pandemic

AIMS AND OBJECTIVES

To explore the experiences of nursing students in England who had worked through the first wave and transitioned to qualification in the ongoing pandemic.

BACKGROUND

Experiences of health professionals and student nurses during the pandemic are now well documented, but the transition of students to qualification is less well understood. In Summer 2020, we interviewed 16 student nurses who had worked as health care assistants on paid extended placements as part of the COVID-19 response in the East of England, finding surprisingly positive experiences, including perceived heightened preparedness for qualification. A year later, we re-interviewed 12 participants from the original study to hear about transitioning to qualification during the ongoing pandemic. This study provides novel insights into their experiences.

DESIGN

A qualitative study design was used.

METHODS

Twelve newly qualified nurses who had participated in the original study took part in qualitative, online interviews where they shared their experiences of working and transitioning to qualification during the ongoing pandemic since we spoke to them a year earlier. The data was analysed using thematic analysis. COREQ guidelines were used in developing and reporting this study.

RESULTS

Three themes were identified. Constant change: in the clinical environment and arising out of the transition to newly qualified nurse, mental health and well-being and reflecting on the past to learn for the future.

CONCLUSIONS

Participants experienced a unique transition to qualification. The perceived heightened preparedness for qualification that participants who had worked as students during the first wave of the pandemic had become a reality, ameliorating some of the known effects of transition. However, increased expectations and added responsibilities in extremely busy, fluctuating clinical environments with minimal support add weight to calls for mandatory preceptorship programmes. While heightened resilience was evident, provision of ongoing mental health and well-being support is strongly recommended.

RELEVANCE TO CLINICAL PRACTICE

We need a partnership approach with nurse educators and practice colleagues which ensures preparation for qualified practice is appropriate. If we do not effectively prepare students for qualified nurse posts, patient care will almost certainly be compromised.

Level and influencing factors of transition shock among new nurses in China: A multicenter cross-sectional study

Background and Aims

New nurses are an important part of nursing teams. The failure of new nurses to successfully transition seriously affects personal career development and nursing work quality, and important influencing factors deserve the attention of nursing managers. At present, multicenter, large-sample investigations of transition shock among new nurses are lacking in China. This study aims to investigate the current level and influencing factors of transition shock among new nurses in China.

Methods

We conducted a multicenter, cross-sectional study with 3414 new nurses from 16 provinces in 7 regions in China from October 22, 2021, to November 8, 2021. We used the snowball sampling method and an online questionnaire produced by the researchers to collect data; the questionnaire included questions on demographic information, a transition shock scale for new nurses and open-ended questions. Data were analyzed using SPSS version 24.

Results

The effective response rate of this study was 97.89%, with 3342 effective participants from 189 hospitals in China, most of whom were female (94.88%). The study showed that the transition shock of new nurses in China was at a moderate level, with pre-job anxiety, unsatisfactory welfare treatment, resignation intention, adverse events, poor sleep quality, 1 or fewer exercise sessions per week, inability to balance work and life, and gluttony negatively affecting the transition shock of new nurses in China. Psychological shock was the strongest among the four dimensions of transition shock.

Conclusions

The transition shock of new nurses, especially their psychological shock, deserves more attention from international society. Nursing managers should continue to take supportive measures to intervene in the factors influencing transition shock, with the aim of reducing the level of transition for new nurses, promoting their personal thriving, improving the quality of nursing work and increasing the retention rate of nurses.

The experience of resilience in newly graduated nurses: A qualitative metasynthesis

AIM

The aim of the present study was to understand the experiences and perceptions of newly graduated nurses in relation to resilience by providing an interpretive synthesis of the existing qualitative literature on this topic.

BACKGROUND

Resilience in newly graduated nurses has been associated with increased satisfaction and decreased turnover. As the experience of resilience is unique to each individual, qualitative studies are well suited to explore this concept, yet the existing data is heterogenous.

DESIGN

A qualitative metasynthesis was conducted using a meta-ethnographic approach.

METHODS

The search was performed using PubMed, CINAHL, Embase, PsycINFO, ProQuest Dissertations and Theses Global for the English literature and NDSL, KCI, RISS, KISS and DBpia for the Korean literature. The JBI Critical Appraisal Checklist for Qualitative Research was used to assess the quality of studies. An a priori protocol was created and registered on the Open Science Framework (Randall & De Gagne, 2022).

RESULTS

The final review included seven articles published between 2008 and 2021. Three main themes were identified: (1) internal experience of resilience; (2) external sources of resilience; and (3) building resilience over time. Subthemes were also identified.

CONCLUSIONS

This study indicates that resilience can be developed over time during the period of transition from student nurse to professional nurse and is impacted by personal and organizational influences. The promotion of resilience presents considerations and opportunities for health care leaders and administrators.

Classification by Nurses' Work Values and Their Characteristics: Latent Profile Analysis of Nurses Working in Japanese Hospitals

This study aimed to classify nurses with similar work values into subgroups by examining their intrinsic, extrinsic, social, and prestige work values. Additionally, we clarified the characteristics of the obtained subgroups using personal attributes, work engagement, and life satisfaction. Using a cross-sectional observational study design, we randomly sampled 52 hospitals in the Tohoku region of Japan and conducted a self-administered questionnaire survey with 2600 nurses. Latent profile analysis was performed to identify the number of subgroups. Of the 1627 collected questionnaires, 1587 were regarded as valid. The latent profile analysis revealed the following five subgroups with strong statistical significance: (1) self-oriented, (2) low, (3) medium-low, (4) medium-high, and (5) high types. The means of work engagement and life satisfaction gradually increased from the (2) low- to (5) high-type subgroups. There were significant differences among the subgroups in terms of marital status, child status, and job title. The (5) high-type subgroup had many nurses with job titles, high work engagement, and high life satisfaction. The (2) low-type subgroup included many nurses who were young, had few years of experience, were married, had children, and had low levels of work engagement and life satisfaction. Preregistration: This study was not registered.

Newly qualified registered nurses' and midwives' experiences from rural health district placement in Namibia

BACKGROUND

The transition period for newly qualified registered nurses/midwives (NQRN/Ms) is a fundamental phase in their career. Yet, transition experiences have been studied mostly within urban and/or specialised healthcare settings in high-resource countries. This study aimed to explore and describe the experiences of NQRN/Ms in a rural health district in Namibia.

METHODS

A qualitative, descriptive, explorative, and contextual design was followed. The sample consisted of eight participants who were purposively selected. Data were collected via in-depth individual interviews and analysed following a reflexive thematic analysis. The researchers were guided by Lincoln and Guba's strategies for establishing trustworthiness.

FINDINGS

Themes conceptualised from the analysis include encounters with rural community members; encounters with colleagues; staffing, management, and supervision; shortage of resources; poor infrastructure; unreliable communication networks; and the lack of social life.

CONCLUSION

The NQRN/Ms had mixed experiences related to a variety of aspects such as social life, resources, colleagues and community members. These findings can be used to improve undergraduate nursing curricula, as well as to create graduate job preparation workshops and support networks.

Newly qualified graduate nurses' experiences of workplace incivility in healthcare settings: An integrative review

AIM

To explore, identify and integrate the existing knowledge to categorise the characteristics, likelihood, and consequences of workplace incivility among newly qualified graduate registered nurses. A particular focus of this review is on the experiences of new nurses related to these negative workplace behaviours and the strategies employed by these nurses and their organisations to manage workplace incivility.

BACKGROUND

Workplace incivility has been widely recognised as a global problem in healthcare settings and is known to affect nurses in all facets of their professional and personal life. This might be particularly harmful for newly qualified graduate nurses, as they are unprepared to deal with this uncivil culture.

DESIGN

An integrative review of the global literature, conducted according to the Whittemore and Knafl framework.

METHODS

Database searches (CINAHL, OVID Medline, PubMed, Scopus, Ovid Emcare and PsycINFO), and manual searching generated an aggregate of 1904 articles, which were further screened based on inclusion criteria and eligibility using the Mixed Methods Appraisal Tool (MMAT). Peer-reviewed empirical studies that explored the workplace incivility experiences of new graduate nurses were included in this review. Extracted data were grouped to develop themes and sub-themes.

RESULTS

This review included 14 studies in total with seven quantitative and seven qualitative studies. The data collected from these studies were categorised according to the research questions into a) expectations of civility, b) experiences and exposure to workplace incivility, c) forms and characteristics of incivility, d) sources of incivility, e) consequences of incivility, and f) managing and coping with incivility. Across studies, graduate nurses' views about the prestige and power of the nursing profession are conflicted due to experiences of incivility in clinical practice. New graduate nurses experienced a high but variable prevalence of incivility from their co-workers (25.6-87 %), with manifestations of incivility varying greatly, including eye rolling, yelling, exclusion and sexual harassment. Included studies primarily focused on professional and organisational effects and their outcomes relative to the physical and psychological effects on new nurses.

CONCLUSION

Findings from the literature demonstrate that incivility directed toward newly qualified graduate nurses is prevalent and can have significant negative impact on their self-esteem and confidence, which may ultimately impact on their workforce participation decisions and the quality of patient care. Supportive and empowering work environments are vital not only for improved nurse health and well-being, but also to retain new graduate nurses. The current nursing shortage emphasises the need for such conditions.

Satisfaction and attrition in the UK healthcare sector over the past decade

Existing literature has highlighted concerns over working conditions in the UK National Health Service (NHS), with healthcare workers frequently citing work-life balance issues and stress as being drivers of attrition and burnout. However, we do not know whether these problems have become worse over time, particularly over the past decade, during which there have been multiple shocks to the UK healthcare system. To investigate this, we analysed data from NHS monthly workforce statistics and the UK Household Longitudinal Study. Three times as many workers left the NHS in 2021 for work-life balance reasons than in 2011, while estimated satisfaction with one's amount of leisure time for healthcare workers fell by three times the amount that it fell for non-healthcare workers. Both satisfaction with amount of leisure time and satisfaction with income have remained lower for healthcare workers than for other public sector workers. By 2020, a worker that had low satisfaction with their amount of leisure time was as much as 22 percentage points less likely than in 2010 to remain in healthcare in the following year. Overall, working conditions in UK healthcare have deteriorated between 2010 and 2020, especially relative to the private sector. However, overall job satisfaction has fallen faster in other areas of the public sector than it has in healthcare, which may indicate wider issues within the UK public sector as a whole.

Factors influencing the transition and retention of mental health nurses during the initial years of practice: Scoping review

AIM

This review aims to identify the factors influencing the transition and retention of mental health nurses during the initial years of practice, recognize gaps in the literature and propose evidence-based strategies.

BACKGROUND

Mental health is a challenging specialty; recruitment, transition and retention of mental health nurses are known issues of concern.

EVALUATION

The present study undertakes a scoping review to identify factors influencing the transition and retention of mental health nurses during the initial years of practice and the gaps in that research domain. A literature search was conducted using electronic databases. To gain an understanding of the topic of interest, the review of the literature extended from 2000 to 2022.

KEY ISSUES

Existing evidence focuses on specific perspectives of transition. There is limited literature on factors influencing transition and retention among mental health nurses. Findings suggested that personal and professional factors could influence the transition and retention of mental health nurses during the initial years of practice. The main themes identified were personal attributes and professional factors with a number of subthemes.

CONCLUSION

The scoping review identified only a few studies, which showed personal and professional factors related to the transition and retention of mental health nurses at the early stages of their career.

IMPLICATIONS FOR NURSING MANAGEMENT

Potential benefits of effective transition and support with the understanding of factors influencing transition and retention of early career mental health nurses will enhance staff morale, sustainability of the workforce and better patient outcomes. Additionally, a few recommendations for nurse managers and leaders to improve transitional experiences and retention of early career nurses are highlighted.

Nurses' perceptions of quality of work life in private hospitals in Enugu, Nigeria: A qualitative study

Despite being essential for retaining nurses, not much is known about nurses' quality of work life (QWL) in private hospitals in sub-Saharan Africa, including Nigeria. We explored nurses' perceptions of QWL, factors influencing it, how it affects motivation, and strategies for its improvement. The study was conducted in seven private hospitals in Enugu, Nigeria. The design was qualitative, using focus group discussion (n = 7) with registered nurses (n = 66) purposively selected using maximum variation sampling and the inclusion criteria. Data were analyzed using verbatim transcription and thematic analysis. The nurses understood QWL from work-family life, work design, work context and work world perspectives. Opportunities for skill acquisition, resource availability, helpfulness from colleagues, and a hygienic work environment improved the QWL and motivation of nurses. Work-family life factors including caring obligations, night shifts, long hours, burnout, and inappropriate leave policies; work design factors including declining autonomy, inadequate staffing, and a high workload; work context factors consisting of a lack of participatory decision-making, blaming nurses for gaps, restrictive training policy, limited training opportunity, and insecurity; and work world factors related to poor remuneration, poor community view of nursing and ease of job termination undermined QWL and demotivated nurses. Strategies identified by the nurses to improve QWL included improving staffing, vacation, care coordination, supportive supervision, teamwork, promotion, participatory decision-making, training opportunities, timely hand-over of shifts, job recognition, and compensation. The quality of nursing work life in private hospitals in Enugu needs improvement. Quality improvement programs addressing the barriers to nurses' QWL are warranted.

Long-term mental health treatment on campus; a report from the University of Southern California

The demand for mental health treatment on university campuses continues to increase. This report will outline sources of increased demand and how traditional campus-based models have managed it. It will then describe the University of Southern California's work mobilizing resources to develop a unique model for insurance based long-term care emphasizing the importance of collaboration between long-term and short-term resources. Finally, this report will suggest interventions that may help to ease the burden of increased demand for mental health treatment on campuses.

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.