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

The relationship between nurses' professional commitment and missed nursing care: a cross-sectional study in Iran

BACKGROUND & AIMS

Missed nursing care is a global challenge that can have many consequences and it's known as a common threat to the patient safety and quality of nursing care. The nurses' professional commitment plays the final role in the occurrence of this issue. This study aimed to investigate the relationship between nurses' professional commitment and missed nursing care in Iran.

MATERIALS & METHODS

This cross-sectional descriptive-analytical study was conducted on 270 nurses working in two hospitals affiliated to Tehran University of Medical Sciences (Sina & Shariati) from September to December 2023. The research community included all nurses working in medical-surgical wards in the designated hospitals. The research samples were included in a targeted and quota method after obtaining organizational permits, ethical approval and informed consent. Data collection was done using three questionnaires including demographic information form, Nursing Professional Commitment Scale, and MISSCARE Questionnaire. The collected data was analyzed in SPSS software, version 25.

RESULTS

The results of Pearson's correlation test showed that there is a significant negative relationship between nurses' professional commitment and missed nursing care scores (r=-0.23) (p < 0.001). The mean score of nurses' professional commitment was reported at a moderate to high level (83.72 ± 16.02) and the mean score of missed nursing care was reported at a low level (47.84 ± 16.48). Nurses over 40 years old, morning shift and employed nurses showed higher professional commitment. Also, nurses under 29 years old and male nurses had more missed nursing care other than their participants. No relationship was observed between other demographic variables with nurses' professional commitment and missed nursing care.

CONCLUSION

The results of this study showed that higher nurses' professional commitment leads to higher quality of care and less missed nursing care. Based on findings of this research, it is recommended for health care providers and nursing managers to adopt programs to increase nurses' professional commitment and consequently reduce missed nursing care.

The effect of nursing services management efficiency on nurses' professional commitment: A cross-sectional study

AIM

To determine the effect of nurses' perceptions of the effectiveness of nursing services management on their professional commitment.

BACKGROUND

Effective healthcare management is crucial for improving patient care quality. Understanding nurses' perspectives on nursing services management and their commitment provides valuable insights for management strategies, improving well-being and healthcare outcomes.

METHODS

This descriptive, cross-sectional, and correlational study involved 265 state hospital nurses. Data were collected between November 2020 and June 2021 using descriptive characteristic form, Nursing Services Management Effectiveness Scale, and Nursing Professional Commitment Scale. This study adhered to the STROBE checklist.

RESULTS

Nurses' views on the effectiveness of nursing services management and their professional commitment were found to be influenced by age, professional experience, and institutional positions. The average scores for nursing services management perception and professional commitment were 2.65 ± 0.72 and 66.63 ± 12.40, respectively. A statistically significant positive and low-level correlation was observed between nurses' nursing services management perception and professional commitment scores. Nurses' positive perception of nursing services management explains 17.1% of the variance in nurses' professional commitment levels.

DISCUSSION AND CONCLUSION

This study outlines how nurses' views on effective nursing services management can enhance their professional commitment. Managers should contribute to increase nursing services management efficacy by eliminating deficiencies in management practices to make their institutions successful and to increase their employees' professional commitment level.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Assuming positive perceptions of nursing management increase nurses' professional commitment, developing policies to boost organizational support is vital. Managers should focus on improving nursing services management to increase organizational success, increase nurses' professional commitment, and achieve the best health outcomes by eliminating management deficiencies.

Effects of Self-Leadership on Nursing Professionalism among Nursing Students: The Mediating Effects of Positive Psychological Capital and Consciousness of Calling

To provide high-quality nursing care, nursing education requires the basic quality of self-leadership from professional nurses so that they can make self-directed and responsible judgments and decisions. Therefore, this study aimed to investigate relationships among self-leadership, positive psychological capital, consciousness of calling, and nursing professionalism in nursing students. A cross-sectional online survey of 202 students from two universities in South Korea was conducted between August and September 2022, using a convenience sampling method. A structured questionnaire was used to collect data. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and bootstrapping using Hayes' PROCESS macro for mediation. A significant positive correlation was found between self-leadership, positive psychological capital, consciousness of calling, and nursing professionalism. Positive psychological capital and consciousness of calling showed an indirect mediating effect on the relationship between self-leadership and nursing professionalism. To improve nursing professionalism, programs should be developed to educate nursing students, strengthen their self-leadership skills, and increase the influence of positive psychological capital and consciousness of calling for nursing. This will ultimately contribute to improving the quality of patient care by fostering competent nursing experts.

Middle East Nurses Turnover Intention and its Correlates Amid the COVID-19 Pandemic: A Systematic Review

Global nursing scarcity was more evident during COVID-19. This study investigated the rates and contributing factors of turnover intention in the middle east through meta-analysis. Medline EMCARE, Cochrane, CINAHL, EMBASE, Ovid, Psych Info, PubMed, Science Direct, Scopus, and Web of Science databases searched, Protocol PROSPERO Registration Number was CRD42022337686. The turnover intention rate was 42.3% [CI: 40%, 44.6%]. Working environment, stress, deployment to COVID, fear of infection, long working hours, shift duties, and lack of social support were the major contributing factors.

Professional autonomy among Registered Nurses-Validation of the translation of the Dempster Practice Behaviour Scale and survey results

AIM

To test the psychometric properties of the Finnish version of the Dempster Practice Behaviour Scale and explore nurses' professional autonomy along with which characteristics are related to it.

DESIGN

An instrument validation and a descriptive cross-sectional study.

METHODS

The web-based survey was conducted in September 2021 at two university hospitals in Finland. Exploratory factor analysis (EFA) was used to explore the factor structure of the modified instrument, while Cronbach's α coefficients were calculated to determine the reliability of the scale. Descriptive univariate and multivariate analyses were conducted to examine Registered Nurses' professional autonomy. The study followed STROBE guidelines.

RESULTS

During the validation process, the 30 items of the Dempster Practice Behaviour Scale were reduced to 25 items. The S-CVI/Ave for the translated scale was 0.94. When one additional item was omitted from the EFA, the results supported five factors, which explained 45.9% of the total variance. The mean overall autonomy score was 3.63 out of 5, with readiness and empowerment the subscales with the highest and lowest, respectively, mean values. The linear regression models showed that age, nursing experience, unit type, education, shift, and perceptions of the importance of professional autonomy were related to the subscales describing professional autonomy.

CONCLUSION

The psychometric testing provided evidence that the translated instrument was reliable. Nurses assessed that they are skilled professionals who are accountable for their actions. However, they experienced rather low levels of professional autonomy in empowerment and valuation. Health care organizations should consider this through authentic leadership and, thus, possibly strengthen professional autonomy.

Nurse Preceptor Burnout: Contributing Factors

OBJECTIVE

The aim of this study was to assess nurse preceptor burnout and examine related factors.

BACKGROUND

Nurse preceptors are essential to the provision of optimal hospital-based care. Preceptors guide and support nurses' transition from professional training to practice as well as movement within practice roles.

METHODS

As a component of the DevelopYou database, nurse preceptors (N = 210) were surveyed electronically using the BHLex Preceptor Role Questionnaire. Data retrieved from this data set were analyzed.

RESULTS

Twenty-eight percent (n = 60) of participants experienced burnout. Most (n = 203, 96.7%) enjoyed their role. Reasons for becoming a preceptor included a love for teaching, a desire to help others, and feelings of responsibility to the profession and the institution. Strategies to enable perceived value of the role focused on activities involving person-to-person interactions.

CONCLUSIONS

On the basis of the results of this analysis, it is apparent that nurse preceptors want to feel valued and supported by administration and have opportunities to interact regularly with colleagues.

Nursing Professional Commitment as a Mediator of the Relationship Between Work Environment and Missed Nursing Care Among Nurses: A Cross-Sectional Analysis

Introduction

Nursing care plays a pivotal role in promoting patient well-being and optimizing health outcomes. The nursing profession is characterized by its commitment to delivering high-quality care to patients.

Objective

The purpose of the study was to explore the role of nursing professional commitment as a mediator between the work environment and missed nursing care.

Methods

A cross-sectional analysis study "STROBE guideline" used an online structured questionnaire to collect data. It was conducted on a sample of 813 nurses who worked at seven governmental hospitals in Egypt, in the hospital wards, operating rooms, intensive care unit (ICU) or outpatient clinics, during a 4-month period from April to August 2022. Researchers used Characteristics of nurses, Nursing Work Index-Revised, Nursing Professional Commitment Scale, and MISSCARE Questionnaire to collect the data. Structural equation modeling by AMOS was used for testing nursing professional commitment as a mediator between the work environment and missed nursing care. Nurses' professional commitment was used as a mediator between work environment and missing nursing care.

Results

The working environment has a direct impact of -0.175, an indirect impact of -0.139, and a total impact of -0.314. Furthermore, professional commitment has a direct impact of -0.421. Additionally, when the working environment increases by 1, professional commitment increases by 0.33. Similarly, when the working environment increases by 1, missed care decreases by 0.175. Moreover, when professional commitment, as a mediating factor, increases by 1, missed care decreases by 0.421.

Conclusion

In conclusion, the findings of this study highlight the significant role of professional commitment as an intermediary factor between the working environment and missed nursing care. According to these results, it is necessary to formulate and implement intervention strategies to improve nurses' professional commitment and working environment, which is the key to reducing their missed nursing care.

Prospective association between perceived stress and anxiety among nursing college students: the moderating roles of career adaptability and professional commitment

BACKGROUND

Anxiety may stay with nursing students throughout their internship and even persist afterwards. Although many studies have explored the effects of perceived stress on anxiety, the relationship between pre-internship perceived stress and post-internship anxiety levels has not been clarified. In addition, none had focused on the moderating roles of career adaptability and professional commitment between perceived stress and anxiety. This study aims to investigate the influence of pre-internship perceived stress on the post-internship anxiety level of nursing college students, and to analyze the moderating effects of career adaptability and professional commitment on their relationships.

METHODS

A longitudinal study design was employed. Full-time nursing college students from a Chinese medical university were recruited by convenient sampling. All surveys were conducted via Wen Juan Xing ( www.wjx.cn ), a widely used web-based survey platform in China. Two waves of surveys were collected in the pre-internship and post-internship periods, with an interval of one year. Among 823 nursing students recruited, 692 students completed all two waves of the survey (response rate: 84.08%). Participants completed a series of questionnaires examining general demographic characteristics, perceived stress, anxiety, career adaptability, and professional commitment both before and after the internship. The bias-corrected bootstrap technique of the Hayes PROCESS macro (Model 2) was used to test the moderation effect.

RESULTS

Pre-internship perceived stress was positively associated with post-internship anxiety (β = 0.474, p < 0.001). Career adaptability would mitigate the effect of perceived stress on anxiety (β = -0.009, p < 0.01, 95% CI = [-0.013, -0.004]), and this influence became stronger for nursing college students with higher levels of career adaptability. Instead, the professional commitment would enhance the effect of perceived stress on anxiety (β = 0.004, p < 0.05, 95% CI = [0.001, 0.009]).

CONCLUSIONS

Adequate career adaptability was key to alleviating anxiety among nursing interns. Nursing educators and clinical nursing managers should pay attention to cultivating the career adaptability of nursing college students in order to help them successfully achieve identity transformation and career development. Meanwhile, it is crucial to guide them to develop appropriate professional commitment.

Occupational Challenges of Intensive Care Nurses During the COVID-19 Pandemic: A Qualitative Study

Introduction

The coronavirus disease 2019 (COVID-19) has been spreading rapidly as a pandemic and posed numerous challenges to healthcare workers (HCWs), especially nurses. This study aimed to investigate the occupational challenges experienced by intensive care unit (ICU) nurses in caring for patients with COVID-19.

Methods

This qualitative study was conducted using a conventional content analysis method in September and October 2020. The study environment was the ICU wards dedicated to the patients of COVID-19 in a large hospital in east of Iran. The participants were selected by purposeful sampling method, and data were collected using semi-structured interviews with 17 nurses working in the COVID-19 ICUs. Data analysis was done with MAXQDA 2020.

Results

The data analysis led to the extraction of 6 main categories and 17 sub-categories. The main challenges included "payment system", "human resource management", "consumable resource supply", "psychological and ethical distress", "personal or family problems", and "staff motivation and welfare issues".

Conclusion

Considering the key and important role of nurses in the healthcare system, particularly during the COVID-19 pandemic, it is necessary to increase their motivation by applying a fair and non-discriminatory payment system and paying special attention to psychological issues. Also, managerial support and provision of required facilities and manpower have a significant impact on reducing their occupational challenges in caring for patients with COVID-19.

Teaching behaviours of clinical teachers and professional commitment among nursing students: A moderated mediation model of optimism and psychological well-being

BACKGROUND

Understanding the paths that influence professional commitment among nursing students is important for helping students continue the nursing profession after graduation. The paths between the teaching behaviours of clinical teachers (TBCT) and professional commitment were unknown.

OBJECTIVES

This study aimed to examine whether psychological well-being mediated the relationships between the teaching behaviours of clinical teachers and professional commitment of nursing students. Moreover, we investigated whether the mediating effects of psychological well-being were moderated by optimism.

DESIGN

A cross-sectional design was conducted.

SETTING AND PARTICIPANTS

A total of 318 students from 24 hospitals in 13 cities in northern, north-eastern, and eastern China were included in the study.

METHODS

The instruments used in this study included the scale of teaching behaviours of clinical teachers, a brief inventory of thriving (measuring psychological well-being), a life orientation test (measuring optimism), and a professional commitment scale. The PROCESS macro for SPSS was used to perform mediation analysis and moderated mediation analyses.

RESULTS

Psychological well-being of nursing students partially mediated the relationships between the teaching behaviours of clinical teachers and professional commitment of nursing students. Also, optimism moderated the indirect effect of this mediation model. The indirect effect of clinical teachers' teaching behaviours was stronger for nursing students with low levels of optimism.

CONCLUSION

The findings suggest that the teaching behaviours of clinical teachers and psychological well-being promote professional commitment. In addition, the mediation of psychological well-being between the teaching behaviours of clinical teachers and professional commitment was conditional on different levels of optimism. Clinical teachers should pay special attention to students with low levels of optimism because teaching behaviours of clinical teachers exert more influence on those students' professional commitment.

How nursing students' risk perception affected their professional commitment during the COVID-19 pandemic: the mediating effects of negative emotions and moderating effects of psychological capital

Nurses play a pivotal role in the delivery of medical services. Professional commitment is crucial for nursing professionals' long-term, healthy, and sustainable development. However, nursing students' professional commitment levels are currently unsatisfactory in China, especially given that the COVID-19 pandemic has posed unprecedented challenges to the profession. Therefore, studies investigating the professional commitment levels of nursing students and the underlying influencing factors are urgently required. This study explored how nursing students' risk perceptions, negative emotions, and psychological capital affected their professional commitment during the COVID-19 pandemic. A cross-sectional study was conducted among nursing students using risk perception, professional commitment, negative emotions, and psychological capital scales. An analysis of 1142 Chinese nursing students suggested that nursing students' risk perception positively impacted professional commitment and that negative emotions mediated this association. Importantly, psychological capital moderates the mediating effect of negative emotions and can buffer the negative emotions caused by risk perception. This study demonstrated that effective intervention strategies should be implemented in multiple dimensions such as education, individual, public and society to improve the professional commitment of nursing students.

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

PURPOSE

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

PATIENTS AND METHODS

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

RESULTS

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

CONCLUSION

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

The relationship between nurses fear of COVID-19, professional commitment and tendencies to medical errors

Aim

This study was conducted to investigate the relationship between nurses' fear of COVID-19, professional commitment and medical error tendency.

Methods

This study was use correlational research design with 312 nurses in January-April 2021. Data were collected online using a demographic characteristics questionnaire, the Fear of COVID-19 Scale (FCV-19S), the Professional Commitment Scale (PCS), and the Scale of Tendency to Medical Errors (STME). The study was approved by ethics committee. Number, mean, and standard deviation were used for sociodemographic variables. Participants' FCV-19S, PCS, and STME scores were calculated. The correlations between scale scores were determined using Pearson's correlation coefficient and Spearman correlation analysis.

Results

Participants had a mean FCV-19S, PCS, and STME score of 19±8.17, 72.21±13.58, and 4.58±0.51, respectively. FCV-19S scores were weakly and positively correlated with PCS overall score (r=0.200, p<0.001), "willingness to make an effort (r=0.273, p<0.001)" and "belief in goals and values (r=0.115, p=0.043)" subscale scores. FCV-19S scores were weakly and positively correlated with STME "communication (r=0.119, p=0.036)" subscale score.

Conclusion

Nurses who feared more about COVID-19 were found to have higher professional commitment, greater willingness to make an effort, and stronger belief in goals and values. Nurses who feared more COVID-19 were less likely to make communication-related medical errors.

Nurses' professional commitment in COVID-19 crisis: A qualitative study

Background: Professional commitment is an important factor in employee performance. COVID-19 outbreak has seriously affected the nurses working conditions. Numerous factors can affect nurses' professional commitment in this situation.Aim: To explore the nurses' lived experiences, attitudes, views and perceptions toward professional commitment and factors affecting it in the Covid-19 crisis.Method, Setting and Participants: This qualitative study was conducted using phenomenological approach and content analysis method. Twenty-five nurses were interviewed using semi structured in-depth interviews. Conventional content analysis was used to analyze collected data.Ethical considerations: Ethical approval was obtained from the Ethics Committee of Qazvin University of Medical Sciences.Results: Five themes were extracted as follows: "Collaborative empathetic commitment", "Loyal commitment", "Sacrificial commitment", "Commitment with doubt and concern" and "humanistic commitment".Discussion and Conclusion: The Covid-19 crisis has caused major changes in nurses' working conditions, which have also affected the concept of professional commitment to the nursing profession and revealed new concepts. Identifying internal and external factors that can enhance nurses' commitment to the profession in critical situations such as the Covid-19 outback is of particular importance.

The Factors Associated With Performance Among Infection Prevention and Control Linked Nurse During Covid-19 Pandemic

Background

Infection Prevention and Control Linked Nurses (IPCLN) are the spearhead of implementing the Infection Control Prevention Program. The performance of nurses in preventing and controlling infections during the Covid-19 pandemic greatly influenced the quality of services.

Objective

This study aimed to determine the factors that influence the performance of IPCLN during the Covid-19 pandemic.

Methods

Cross-sectional study was performed on 34 nurses at Cicendo Eye Hospital with a total sampling technique. The questionnaire in this study included knowledge, motivation, supervision, and the performance of nurses which had previously been tested with these characteristics with a result of Cronbach's alpha of 0.75. Data were analyzed using univariate, bivariate, and multivariate analyses.

Results

The mean score of IPCLN knowledge in this study was 14.82 ± 4.01, motivation 92.47 ± 15.85, supervision 34.74 ± 5.89, and performance 7.94 ± 2.71. There is a relationship between knowledge (p = .000), motivation (p = .000), and supervision (p = .000) on nurse performance. Motivation is the dominant factor influencing IPCLN performance compared to knowledge and supervision (Stand. Estimate = 0.5121; 95% CI = 0.1301-0.487; p < .001).

Conclusion

Motivation is a dominant factor in IPCLN performance in this study. However, hospital management needs to maximize and make policies to improve IPCLN performance in terms of motivation. These policies can be through providing incentives for nurses, developing free continuing education programs, and issuing funds for nursing education scholarships.

The psychological impact on frontline nurses in Spain of caring for people with COVID-19

AIM

To understand the perceptions of National Health System nurses who have been working on the frontline of the psychological impact of caring for people with COVID-19 during the first and second waves.

METHODS

A qualitative study, the design and analysis of which was based on phenomenology. For data collection, a semi-structured interview was administered to a sample of nurses who worked on the frontline in public hospitals in Extremadura and Madrid, Spain. The interviews, which followed a script including various topics, were conducted between May and November 2020 so as to include the experiences of the first and second waves of the pandemic. Sample collection continued until data saturation. The data were analysed following the phenomenological method of Giorgi with the help of the Atlas-Ti software.

RESULTS

Two main themes emerged from the data analysis that explained the nurses' perceptions: (i) the main psychological repercussions of being frontline carers (anxiety, fear, stress, impotence, frustration, and an increase in obsessions and obsessive behaviours) and (ii) psychological coping strategies (collapse in the face of the situation, dissociative amnesia, leaning on colleagues and working as a team, resigning oneself, perceiving the situation as a war, and being aware of psychological repercussions).

DISCUSSION

Caring as the first line causes great psychological repercussions for nurses. It is necessary to implement psychological and emotional support programmes to address the post-traumatic stress that nurses can suffer.

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

BACKGROUND

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

OBJECTIVES

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

DESIGN

A descriptive cross-sectional study.

SETTING

Three educational institutions in Shanghai, China.

PARTICIPANTS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Professional commitment and willingness to care for people living with HIV among undergraduate nursing students: The mediating role of empathy

BACKGROUND

As future registered nurses, undergraduate students play a vital role in integrated care for acquired immunodeficiency syndrome; hence, there is a need to examine factors that can increase their willingness to care for persons with such conditions.

OBJECTIVE

This study examined the relationship among nursing professional commitment, empathy, and willingness to care for people living with human immunodeficiency virus and acquired immunodeficiency syndrome among undergraduate student nurses, and the mediating role of empathy in this relationship.

DESIGN

Quantitative, cross-sectional design.

SETTINGS

Nursing schools from five provinces of China, including Hunan, Jiangxi, Guangxi, Henan, and Hebei.

PARTICIPANTS

A total of 747 undergraduate student nurses were recruited via cluster sampling.

METHODS

Online survey was used to collect data. Nursing Willingness Questionnaire, Professional Commitment Scale, and Jefferson Scale of Empathy were the scales used to measure the variables. Structural equation modeling was used to determine significant relationships.

RESULTS

Respondents' professional commitment and empathy demonstrated moderate positive associations with willingness to care. Empathy demonstrated a 21 % mediating effect on the effect of professional commitment and willingness to care (p < 0.05).

CONCLUSIONS

Findings highlight the enabling role of professional commitment and empathy in improving undergraduate student nurses' willingness to care for persons living with human deficiency virus. Nurse educators can help improve the impact of students' professional commitment on their willingness by using educational strategies that enhance their empathy.

Exploring the impact of surface acting on nurse leaders during COVID

PURPOSE

Coronavirus (COVID) has had a massive impact on the health systems of many nations including Australia. Nurse leaders have, as part of their leadership and management roles, had to manage the emotional responses of the people around nurse leaders . The purpose of this study was to explore the experiences of nurse leaders who have held management roles during the health services crisis that has resulted from the COVID pandemic and to look at the emotional work nurse leaders have engaged in and the impact emotional work has had on nurse leaders' emotional well-being.

DESIGN/METHODOLOGY/APPROACH

The study adopted a social constructionist approach and employed unstructured interviews to generate data.

FINDINGS

The findings demonstrate that the nurse leaders were experiencing increased emotional exhaustion, which could be construed as a breach of psychological safety, as nurse leaders engaged in more surface acting. This has negatively impacted their lives outside of work. The study recommends that nurse leaders receive support through counselling and reflective practice activities. Consideration also should be given to renumerating nurse leaders appropriately for the emotional work nurse leaders perform.

RESEARCH LIMITATIONS/IMPLICATIONS

The structural issues endemic in the industry need to be addressed. Human resource management professionals, senior managers and hospital boards are charged with ensuring that the organisations are safe and healthy workplaces. This includes addressing issues that impact psychological health. If nurse leaders must undertake work that impacts negatively on nurse leaders' mental well-being and personal lives, then appropriate safeguards need to be put in place. The scope of the study was small, as the study is limited by the number of interviewees, the number of study sites and the sites' geographical location. Consequently, limited claims are made about the generalisability of the findings or the findings' transferability to other contexts.

PRACTICAL IMPLICATIONS

The findings overwhelmingly support the contention that we need to support nurse leaders in the vital role they play through engaging in surface acting in the workplace. The role needs to be recognised and valued as a critical part of the nurse leader role. The contribution the role makes to the welfare of others in the organisation needs to be acknowledged. Given the emotional and personal price that nurse leaders play for surface acting, organisations need to provide genuine support in the form of counselling and the introduction of opportunities for reflective practice.

SOCIAL IMPLICATIONS

The study suggests that nurse leaders need to be paid for emotional labour (EL) generally and surface acting in particular. The recognition of the value of caring work must go beyond symbols such as the Year of the Nurse and be rewarded financially.

ORIGINALITY/VALUE

The experience of nurse leaders using surface acting has received little attention and this is the first study to look at this particular phenomenon during COVID.

A Study of the Relationship between Professional Communication and Professional Commitment in Operating Room Nurses

Background. Operating rooms are among the most complex clinical environments in hospitals where teamwork and professional communication play a very important part. Professional commitment is an influential factor in the personnel’s professional communication and can affect the outcomes of healthcare services. Objective. The present study aims to investigate the relationship between professional communication and professional commitment in the operating room nurses in teaching hospitals. Study Design. The present study used a descriptive-correlational design. Participants were selected via census sampling from hospitals in Shiraz over a period of three months. The participants were 350 operating room nurses who met the inclusion criteria. Data were collected using professional communication and a professional commitment questionnaire. The collected data were analyzed using the descriptive and inferential statistics in SPSS $v$ v. 22. Findings. The operating room nurses’ mean scores for professional communication (136.81 ± 13.77) and professional commitment (71.42 ± 11.62) were found to be high. The results of the Pearson correlation coefficient test showed that there was a statistically significant linear relationship between professional communication and professional commitment ( $p<0.001$ , r = 0.235). The results also showed that there was a significant relationship between professional commitment on the one hand and gender ( $p=0.042$ ), marital status ( $p=0.047$ ), and interest in work ( $p=0/000$ ) on the other hand. There was also a significant relationship between professional communication and interest in work ( $p=0/000$ ). Conclusion. Given the significance of professional communication and professional commitment in the operating rooms, it is recommended that healthcare administrators and policymakers take steps to improve these areas. It is suggested that measures should be taken to increase the personnel’s awareness of the principles of professional communication and the significance of professional commitment through regular workshops.

Resilience, Occupational Stress, Job Satisfaction, and Intention to Leave the Organization among Nurses and Midwives during the COVID-19 Pandemic

The current study on the intention to leave the organization among nurses and midwives aligns with the broader direction of research on the consequences of demanding jobs. This is particularly important in the context of the COVID-19 pandemic, which began in 2020 and is ongoing. The aim of the current study was to identify the levels of intention to leave the organization and job satisfaction in a sample of 390 Polish nurses and midwives. A multiple stepwise linear regression was carried out to establish which variables are predictors of job satisfaction and intention to leave the organization. The following measures were used in the study: Nurses’ Occupational Stressor Scale, The Brief Resilience Coping Scale, The Turnover Intention Scale, The Job Satisfaction Scale, and an occupational questionnaire (number of workplaces, weekly number of evening and night shifts, working at a unit dedicated to treating COVID-19, working as a supervisor/executive). The current study showed that almost 25% of the sample reported high turnover intention, and a similar proportion reported low job satisfaction. Resilience was related to nurses’ job satisfaction. In the predictive models for job satisfaction, the organizational factor of the number of workplaces was significant (positively related), while job experience was a negative predictor of intention to leave. The practical implications of the results and the need to continue research on this topic are also discussed.

The emotional impact of COVID-19 on Spanish nurses and potential strategies to reduce it

BACKGROUND

Although the emotional and psychological impact of nurses' work had been identified before the COVID-19 pandemic, the pandemic aggravated risk indicators for their mental health.

AIM

The objective of this study was to analyse the levels of anxiety, depression, post-traumatic stress and burnout of nurses in the Balearic Islands (Spain) during the pandemic to identify possible sociodemographic and related occupational factors.

DESIGN

A cross-sectional study of 892 nurses was conducted during four weeks from February to March 2021.

METHODS

Sociodemographic data related to the pandemic were collected and anxiety, depression, burnout and post-traumatic stress were measured with validated scales. A multivariate and predictive analysis was carried out with risk estimates.

FINDINGS

About 75.6% of the nurses had experience in COVID-19 units, and 49.1% had worked for more than 10 months in a COVID-19 unit. Nurses in COVID-19 units (hospital ward or ICU) were more likely to report emotional fatigue (OR 1.9, p < 0.001) and anxiety (OR 1.5, p = 0.021). In general, moderate post-traumatic stress was evident in general nurses (p = 0.027), and severe post-traumatic stress was evident in ICU nurses (p = 0.027). A 1.24-month reduction in COVID-19 patient care predicted reduced levels of emotional fatigue (5.45 points), depersonalisation (1.87 points) and post-traumatic stress (4.65 points) in nurses.

CONCLUSION

Given the occurrence of new waves of COVID-19, the need to establish preventive strategies that focus on the personal and occupational characteristics related to these indicators and to implement urgent psychological support strategies is demonstrated.

IMPACT

Given these findings, it is imperative solutions are urgently applied in order to prevent compounding risk to the health system.

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

BACKGROUND

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

OBJECTIVES

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

METHODS

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

RESULTS

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

DISCUSSION

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

“Fighting for life and losing”: Intensive Care Unit Nursing Staff’s Experience With COVID-19 Patient Deaths During the First Two Waves: A Qualitative Study

The study explored the experiences of intensive care unit nursing staff caring for COVID-19 patients who eventually died during the two first pandemic waves. We used - descriptive-qualitative-phenomenological. The findings included four main themes—the first vs the second COVID-19 waves, fighting for life and being unable to win, a chronicle of pre-determined death, and nurse’s emotional coping with patient death. Based on these findings, we have concluded that in order to enhance nurses’ mental health, policy makers and governments need to create an appropriate support system for them.

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

Aim

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

Background

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

Methods

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

Results

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

Conclusion

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

Implications for Nursing Management

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