Politics, power, and predictability of nursing care

Turnover intention and coping strategies among older nursing assistants in China: a qualitative study

Introduction

With the increasing aging population, older nursing assistants have made significant contributions to institutional eldercare. However, there is a high turnover rate among these workers, and it is crucial to address this issue and find ways to stabilize the workforce. This study aimed to explore the factors influencing turnover intention and coping strategies among older nursing assistants, in order to provide targeted assistance and guidance to reduce their intention to resign and ultimately lower the turnover rate.

Methods

Qualitative research methods were employed to conduct semi-structured interviews with older nursing assistants in Changsha. The data obtained from these interviews were then analyzed using a phenomenological analysis approach and NVIVO (QSR International, Doncaster, Australia) software version 11.0.

Results

It is found that several factors influence turnover intention among older nursing assistants. Which include work pay, work environment, professional identity, external motivation, and work pressure. Additionally, the coping strategies employed by these individuals in relation to their intention to resign include self-regulation, seeking support, self-improvement, and exploring motivation.

Discussion

It is also evident from our study that reducing the turnover intention of older nursing assistants requires a collaborative effort from older adult care institutions, functional departments, and eldercare nursing assistants themselves. By addressing the factors influencing turnover intention and providing support and resources for coping strategies, we can work towards stabilizing the workforce and improving institutional eldercare.

Clustering the engagement of Brazilian nurses in political advocacy

OBJECTIVES

to analyze the level of nurses' engagement in political advocacy by performing cluster analysis.

METHODS

observational study, with a quantitative approach. A total of 184 nurses working in primary, secondary, and tertiary care in a city in the south of Brazil completed the Policy Advocacy Engagement Scale. Data analysis consisted of descriptive statistics, cluster analysis, analysis of variance, and chi2. The Institutional Review Board approved the study.

RESULTS

four differentiated clusters were found according to professional experience, level of healthcare complexity, and unit. The cluster analysis revealed that patient advocacy for community-based obtained the highest mean, indicating that political advocacy is effective in organizational environments and that professional qualification favors greater engagement in political advocacy.

CONCLUSIONS

the results reveal that nurses play an active role in political advocacy, seeking to promote positive changes in health, especially those working in tertiary care, the nurse group that obtained the highest means.

Intervention effect of encouraging mental and programmed nursing of patients in interventional operating room on their compliance and bad moods

BACKGROUND

Patients’ lack of correct understanding of cardiovascular disease and interventional therapy is often accompanied by varying degrees of fear, depression and anxiety. Negative emotion will affect the hemodynamic fluctuation of patients undergoing interventional surgery, which is not conducive to the smooth and safe operation of interventional surgery. Therefore, it is very important to implement effective nursing intervention in the operating room.

AIM

To explore the intervention effect of motivational psychological nursing combined with programmed nursing on compliance and bad mood of patients in interventional operating room.

METHODS

A total of 98 patients in the interventional operating room of our hospital from October 2019 to March 2021 were randomly divided into study group (n = 49) and control group (n = 49). The control group took routine nursing. However, the study group took motivational psychological nursing combined with procedural nursing on the basis of the control group. Statistics were made on rehabilitation compliance, Positive and Negative Affect Schedule of bad mood, Simplified Coping Styles Questionnaire score of coping style and satisfaction of intervention between the two groups before and after intervention.

RESULTS

The rehabilitation compliance of the study group (95.92%) was higher than that of the control group (81.63%) (P < 0.05). After intervention, the scores of upset, fear, irritability, tension and fear in the study group were respectively, which were lower than those in the control group (P < 0.05). After intervention, the score of positive coping in the study group was higher than that in the control group. However, the score of negative coping in the study group was lower than that in the control group (P < 0.05). The intervention satisfaction of the study group (93.88%) was higher than that of the control group (79.59%) (P < 0.05).

CONCLUSION

The intervention of motivational psychological nursing combined with procedural nursing can improve the rehabilitation compliance, and alleviate the bad mood. In addition, it can change their coping style to the disease, and the patients are more satisfied with the nursing work.

Effect of Safewards on reducing conflict and containment and the experiences of staff and consumers: A mixed-methods systematic review

Safewards is an internationally adopted framework that provides interventions to reduce conflict and containment in healthcare settings. This systematic review evaluated the effect of Safewards on conflict and containment events in inpatient units and the perceptions of staff and consumers. Quantitative, qualitative, and mixed-methods studies were considered for inclusion. Following the Joanna Briggs Institute methodology, two reviewers independently screened, appraised, and extracted data. Qualitative data were synthesized using inductive-thematic analysis. Quantitative and qualitative data were integrated with a convergent-segregated approach and presented in tabular and narrative format. A search of 13 databases and grey literature yielded 14 studies of variable methodological quality. Four studies reported reduced rates of conflict and one study reported reductions that were not statistically significant. Six studies reported reductions in rates of containment, three studies found no statistical significance and one study reported statistically significant reductions at follow-up. Staff and consumers in four studies reported an improved experience of safety. Three themes were developed as follows: (i) therapeutic hold, cohesion, support and the environment, (ii) conflict, containment and the experience of safety, and (iii) the complexities of adapting and embedding change. This review found most staff and consumers reported Safewards improved therapeutic relationships, cohesion, and ward atmosphere. Staff and consumers reported improved ward atmosphere, leading to consumer-centred, recovery-oriented care. Safewards improved the experience of safety from the perspective of staff and consumers when combined with ongoing training, leadership and time for consolidation. While results are promising they should be used cautiously until more robust evidence is established.

Cluster do engajamento dos enfermeiros brasileiros na advocacia política

RESUMO Objetivos: analisar o nível de engajamento dos enfermeiros na advocacia política por meio da análise de cluster. Métodos: estudo observacional, com abordagem quantitativa. Um total de 184 enfermeiros que atuam na atenção primária, secundária e terciária em uma cidade do sul do Brasil preencheram a Policy Advocacy Engagement Scale. A análise dos dados consistiu em estatística descritiva, análise de cluster, análise de variância e chi2. O Comitê de Ética em Pesquisa aprovou o estudo. Resultados: foram encontrados quatro clusters diferenciados de acordo com a experiência profissional, nível de complexidade assistencial e unidade. A análise de agrupamento revelou que a advocacia do paciente para a comunidade obteve a maior média, indicando que a advocacia política é efetiva em ambientes organizacionais e que a qualificação profissional favorece maior engajamento na advocacia política. Conclusões: os resultados revelam que os enfermeiros exercem um papel ativo na advocacia política, buscando promover mudanças positivas na saúde, principalmente os que atuam na atenção terciária, grupo de enfermeiros que obteve as maiores médias.

Political power and awareness of nursing during the COVID-19 pandemic from the views of senior nursing students

Studying the impact of the COVID-19 pandemic on the current nursing workforce and the training of future nurses is important. This study aimed to assess the views of senior nursing students pursuing health policy courses on the effects of the COVID-19 pandemic on the political power and awareness of nursing profession. Document analysis method, one of the qualitative enhancement patterns, was employed in this study. This study was conducted in a nursing school with a sample comprising 34 nursing students. The data were collected from online homework documents and evaluated with thematic analysis. Students on the effects of the COVID-19 pandemic on the nursing profession were categorized into three main themes and nine subthemes. Students reported that although the visibility of nursing increased during the COVID-19 pandemic, the problems of this profession did not change. The results showed that depoliticization was an important obstacle in the fight against these problems and students stated that the struggle could be realized together with a unified and strong political voice. Students suggested being organized in the struggle against problems, addressing unions and associations, and political awareness and political participation as a remedy.

Moral distress: A theorized model of influences to facilitate mitigation and resilience

Moral distress results from the threat to professional moral integrity and identity. This phenomenon is well documented in nursing literature. Persistent and unresolved moral distress is frequently linked to high nursing staff turnover and shortages. Engagement in a structured hermeneutic critical reflective process facilitated identification of micro, meso, and macro factors influencing the experience of moral distress. Following this process, a theorized model was developed to illustrate interactions between influences contributing to the experience of moral distress in nurses. The model highlights where opportunities lay to take action to avoid or minimize the negative consequences of this phenomenon. Professional resilience is achieved via the conscientious development of professional identity and practice of critical reflection, as components of enculturation of nurses into the profession. Undergraduate and further nurse education activities must focus on developing the necessary attitude, confidence, and skills to address issues in practice which contribute to the experience moral distress to build resilience.

Is there a place for servant leadership in nursing?

With nursing in the spotlight in 2020, Catherine Best explores the role servant leadership can play in strengthening the profession

As 2020 is the International Year of the Nurse and Midwife, nursing is in the spotlight. Nurses are well-placed to help achieve the United Nations Sustainable Development Goals which aim to improve health globally. However, in order to do so, high-quality healthcare leadership is needed. Disengaged leaders, high turnover, poor organisational culture and dysfunctional external relations can affect nurses' capacity to deliver optimum care. This article considers the role of the servant leader in bringing together nurses from all nations to speak with one voice in order to positively influence global health.