Job crafting as retention strategy: An ethnographic account of the challenges faced in crafting new nursing roles in care practice

Nursing shortages in the global north are soaring. Of particular concern is the high turnover among bachelor-trained nurses. Nurses tend to leave the profession shortly after graduating, often citing a lack of appreciation and voice in clinical and organisational decision-making. Healthcare organisations seek to increase the sustainability of the nursing workforce by enhancing nursing roles and nurses' organisational positions. In the Netherlands, hospitals have introduced pilots in which nurses craft new roles. We followed two pilots ethnographically and examined how nurses and managers shaped new nursing roles and made sense of their (expected) impact on workforce resilience. Informed by the literature on professional ecologies and job crafting, we show how managers and nurses defined new roles by differentiating between training levels and the uptake of care-related organisational responsibilities beyond the traditional nursing role. We also show how, when embedding such new roles, nurses needed to negotiate specific challenges associated with everyday nursing practice, manifested in distinct modes of organising, work rhythms, embodied expertise, socio-material arrangements, interprofessional relationships, and conventions about what is considered important in nursing. We argue that our in-depth case study provides a relational and socio-material understanding of the organisational politics implicated in organising care work in the face of workforce shortages.

The Social Values of Nursing Staff and the Perceived Quality of Their Professional Lives

This study's main purpose involves exploring the relationship between the social values of nursing staff and the perception they have of their professional lives. A further aim is to examine how their terms of employment and tenure of service relate to the quality of their careers and their social values. The research consisted of a non-experimental quantitative approach of a descriptive nature involving 380 nursing staff at four public hospitals in Madrid (Spain). The values were appraised by means of the Schwarz Value Survey (SVS) and the quality of their careers was measured through the Quality of Professional Life (QPL-35) questionnaire. The results reveal significant correlations between the two, highlighting the significance of such values as universalism, benevolence, achievement and power depending on their terms of employment, on the one hand, and all the values in the Schwartz model according to the length of their tenure on the other. The findings suggest that terms of employment and tenure are significantly related to the axiological profile of nursing staff and the quality of their professional lives. This study provides major empirical evidence that contributes to our understanding of how social values and the quality of professional lives are interwoven within the field of nursing in Spain.

The relationship between nurses' personality traits and their perceptions of management by values, organizational justice, and turnover intention

PURPOSE

To determine the relationship between nurses' personality traits and their perceptions of management by values, organizational justice, and turnover intention.

DESIGN AND METHODS

It was a descriptive study. A demographic questionnaire, the big five personality scale, the organizational justice scale, the management by values scale, and the turnover intention scale were used to collect data.

FINDINGS

Data analysis did not demonstrate any relationship between nurses' personality traits and their perceptions of management by values, organizational justice, and turnover intention. However, results of regression analysis concluded that perceptions of management by values affected the nurses' perceptions of organizational justice positively.

PRACTICE IMPLICATIONS

Nurses' perceptions of organizational justice can be raised and turnover intention may be reduced by improving their perceptions of management by values.

When Relationships Get in the Way: The emergence and persistence of care routines

Past research has shown that routines can be a vehicle for both stability and change in organizations. It is unclear however how this relationship alters and solidifies over time. In this paper, the changing behaviours of three newly formed teams within a domiciliary care organization are tracked over a period of two years. It was seen that self-reinforcing processes shaped the emergence and persistence of action patterns within these groups. The first process achieved coordination benefits which drove the emergence of routines, as ‘action patterns’ were first negotiated and then assigned to members of the care team. The second self-reinforcing process involved sets of expectations which deepened interpersonal relationships between the care worker and client. The impact of both these processes, altered the ostensive-performative duality, as routines emerged and persisted over time. This study therefore highlights the changing dynamics of stability and change within routines, and the key role played by social relations in this process.

Moral Recovery and Ethical Leadership

Research on ethical leadership generally falls into two categories: one celebrates individual leaders and their 'authentic' personalities and virtuous stewardship of organizations; the other decries toxic leaders or individuals in positions of power who exhibit 'dark' personality traits or dubious morals. Somewhere between these extremes, leadership is 'done' by imperfect human beings who try to avoid violating their own ethical standards while at the same time navigating the realities of social and organizational life. This paper discusses the concept of 'Moral Recovery' as an ethical leadership process that begins in moral failure, but enables eventual personal, organizational, and social change. It builds on the concept of 'Moral Injury' from the work of the psychiatrist Johnathan Shay and refers to the experiences of armed service personnel traumatized by experiences where either they, or their leaders, violated their own values. 'Morally injured' parties recover their sense of wellbeing through engaging with restorative communal actions which address the social causes of unethical practices. The process of Moral Recovery requires restorative communal actions which address the social causes of unethical practices. This paper will outline the concept of 'Moral Recovery' as a form of practical ethical leadership and change. It will illustrate its relevance to ethical leadership practice with reference to one high-profile case; Ray Anderson of Interface. As this paper is primarily conceptual, avenues for future research are identified, and implications for teaching practice are discussed.