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Zheng Q, Liu S, Zhang Y. Coping Measures for Hospital Nurses' Turnover: A Qualitative Meta-Aggregation (2018-2023). J Clin Nurs 2025; 34:268-286. [PMID: 39604000 DOI: 10.1111/jocn.17545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 10/20/2024] [Accepted: 10/28/2024] [Indexed: 11/29/2024]
Abstract
AIM To identify and synthesise the qualitative evidence that is available regarding reducing the turnover of hospital nurses from their own perspectives. DESIGN A qualitative systematic review using the meta-aggregation design. DATA SOURCES Qualitative studies either in English or in Chinese, dating from 2018 to 2023, were obtained from eight databases, including CINAHL, PubMed, Web of Science, Embase, Ovid, and Chinese National Knowledge Infrastructure (CNKI), Wanfang Database and the China Biomedical Database. METHODS Studies were screened using pre-determined inclusion and exclusion criteria. Quality assessment was done using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. The study was reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. RESULTS Sixteen papers were included that explored nurses' perspectives on enhancing their retention or reducing staff turnover. We developed three synthesised findings and 12 categories from 64 identified findings, including (1) individual adjustment strategy: professional pride, self-growth and psychological adjustment; (2) social support strategy: constructive workplace relationships, balancing work life and recognition of nursing and (3) organisational change strategy: embracing management and leadership, promote nursing professionalisation, workload management and support, flexible work patterns and opportunities, supporting personal career development and competitive salary. CONCLUSION This review provides an in-depth and meaningful understanding of nurses' own perceptions and suggestions for enhancing nursing turnover, which will call for a wide range of measures targeting the individual, social and organisational levels. IMPLICATIONS FOR NURSING MANAGEMENT This study contributes important knowledge to help improve hospital nurse's turnover, which can provide evidence to support nurse managers, other stakeholders and policymakers in correspondingly developing effective measures to address nurse turnover. PATIENT OR PUBLIC CONTRIBUTION There was no direct contribution from patient or caregiver to this study because the data of this study originated from published papers.
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Affiliation(s)
- Qin Zheng
- The School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shihua Liu
- The School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yanyan Zhang
- The School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Messina G, Natale G, Sagnelli C, Vicidomini G, Mancino D, Cerullo G, De Gregorio S, De Angelis S, Otranto C, Leonardi B, Dattolo S, Giorgiano NM, De Masi A, Esposito F, Puca MA, Vicario G, Fiorelli A, Sica A. The Impact of Assessment of Nurses' Experiences in Thoracic Surgery in Onco-Hematological Patients. Healthcare (Basel) 2024; 12:1843. [PMID: 39337184 PMCID: PMC11431484 DOI: 10.3390/healthcare12181843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 08/22/2024] [Accepted: 09/03/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Nowadays, Thoracic Surgery is technologically advanced; therefore, it also focuses its attention on nursing care. The aim of the study is to evaluate the effect of the assessment of a dedicated team of nurses (DTN) in all onco-hematological patients undergoing VATS lobectomy for lung cancer on the outcome of the patient, preventing pressure injuries, reducing perioperative stress, duration of operations, complications, and hospital stay times. Methods: We performed a single-center observational retrospective study, including 31 DTN and 760 onco-hematological patients who underwent thoracic surgery between 30 October 2018 and 30 June 2023 at "Vanvitelli" University of Naples. Results: DTN ensures good nursing care before, during, and after surgery. Operative time was reduced by approximately 20 min, decreasing hospital infections in the DNT period and reducing intraoperative complications such as bleeding and hospital costs (p < 0.05). Conclusions: Thoracic surgery nurses require more specialized training to adapt to the development of sophisticated.
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Affiliation(s)
- Gaetana Messina
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Giovanni Natale
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Giovanni Vicidomini
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Diana Mancino
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Giuseppe Cerullo
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Simona De Gregorio
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Sabrina De Angelis
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Carmela Otranto
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Beatrice Leonardi
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Silvia Dattolo
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Noemi Maria Giorgiano
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Andrea De Masi
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Francesco Esposito
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Maria Antonietta Puca
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Giuseppe Vicario
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, Azienda Ospedaliera Universitaria “Luigi Vanvitelli”, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.N.); (G.V.); (D.M.); (G.C.); (S.D.G.); (S.D.A.); (C.O.); (B.L.); (S.D.); (N.M.G.); (A.D.M.); (F.E.); (M.A.P.); (G.V.); (A.F.)
| | - Antonello Sica
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
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Xie A, Duff J, Munday J. Perioperative Nursing Shortages: An Integrative Review of Their Impact, Causal Factors, and Mitigation Strategies. J Nurs Manag 2024; 2024:2983251. [PMID: 40224775 PMCID: PMC11918777 DOI: 10.1155/2024/2983251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 05/18/2024] [Accepted: 07/05/2024] [Indexed: 04/15/2025]
Abstract
Aim This study aims to explore contributing factors, impacts, and strategies to address perioperative nursing shortages. Background Health facilities worldwide are experiencing nursing shortages, especially in specialty fields such as perioperative nursing. Evaluation. This integrative review is reported according to the PRISMA guidelines. The title, abstract, and full article screening, as well as the quality appraisal process, were performed by two independent reviewers, with a third for disagreement. This review focused on empirical and theoretical research published from 2013 to 2023 using databases including CINAHL, Embase, Emcare (via OVID), Medline (via EBSCOhost), Scopus, Web of Science, ProQuest Dissertations and Theses Global, Overton, and GreyNet. Key Issues. This study thoroughly reviewed 84 articles. The perioperative domain confronts significant staffing challenges due to increased demand, lack of experienced nurses, insufficient new entrants, high turnover, and an aging workforce. Notably significant are the deficiencies in recruiting new nurses and the elevated turnover levels, potentially amendable issues. The shortages negatively impact the remaining nurses, patient care quality, and hospital revenue. Strategies to address perioperative nursing workforce challenges include promoting the specialty to undergraduate nursing students, bolstering recruitment efforts, and retaining experienced perioperative nurses. However, none of the studies examined in this review adopted a comprehensive approach. Furthermore, the effectiveness of these strategies relative to one another remains uncertain due to a lack of reliable measurements. Conclusion Perioperative nursing faces considerable challenges, including an aging workforce, limited new recruits, and high turnover rates. Present strategies primarily prioritise workforce preparation over supporting current staff. Mitigating the perioperative nursing shortages requires comprehensive approaches integrating preparation, recruitment, retention, and retirement plans. In addition, these strategies must be adapted to the diverse regulatory environments of different countries, recognising the absence of a one-size-fits-all solution to perioperative nursing shortages globally. Implication for Nursing Management. Perioperative nursing managers are vital in reducing shortages.
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Affiliation(s)
- Ada Xie
- School of NursingQueensland University of Technology, Brisbane, QLD, Australia
| | - Jed Duff
- School of NursingCentre for Healthcare TransformationQueensland University of Technology, Brisbane, QLD, Australia
- Royal Brisbane and Women's HospitalCentre for Nursing and Midwifery Research, Herston, QLD, Australia
| | - Judy Munday
- School of NursingQueensland University of Technology, Brisbane, QLD, Australia
- School of HealthUniversity of the Sunshine Coast, Sunshine Coast, QLD, Australia
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Zhao Y, Quadros W, Nagraj S, Wong G, English M, Leckcivilize A. Factors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping review. BMC Med 2024; 22:286. [PMID: 38978070 PMCID: PMC11232288 DOI: 10.1186/s12916-024-03509-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 07/01/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Advanced practice providers (APPs), including physician assistants/associates (PAs), nurse practitioners (NPs) and other non-physician roles, have been developed largely to meet changing healthcare demand and increasing workforce shortages. First introduced in primary care in the US, APPs are prevalent in secondary care across different specialty areas in different countries around the world. In this scoping review, we aimed to summarise the factors influencing the development, recruitment, integration, retention and career development of APP roles in hospital health care teams. METHODS We conducted a scoping review and searched Ovid MEDLINE, Ovid Embase, Ovid Global Health, Ovid PsycINFO and EBSCOhost CINAHL to obtain relevant articles published between Jan 2000 and Apr 2023 that focused on workforce management of APP roles in secondary care. Articles were screened by two reviewers independently. Data from included articles were charted and coded iteratively to summarise factors influencing APP development, recruitment, integration, retention and career development across different health system structural levels (macro-, meso- and micro-level). RESULTS We identified and analysed 273 articles that originated mostly from high-income countries, e.g. the US (n = 115) and the UK (n = 52), and primarily focused on NP (n = 183) and PA (n = 41). At the macro-level, broader workforce supply, national/regional workforce policies such as work-hour restrictions on physicians, APP scope of practice regulations, and views of external collaborators, stakeholders and public representation of APPs influenced organisations' decisions on developing and managing APP roles. At the meso-level, organisational and departmental characteristics, organisational planning, strategy and policy, availability of resources, local experiences and evidence as well as views and perceptions of local organisational leaders, champions and other departments influenced all stages of APP role management. Lastly at the micro-level, individual APPs' backgrounds and characteristics, clinical team members' perceptions, understanding and relationship with APP roles, and patient perceptions and preferences also influenced how APPs are developed, integrated and retained. CONCLUSIONS We summarised a wide range of factors influencing APP role development and management in secondary care teams. We highlighted the importance for organisations to develop context-specific workforce solutions and strategies with long-term investment, significant resource input and transparent processes to tackle evolving healthcare challenges.
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Affiliation(s)
- Yingxi Zhao
- Nuffield Department of Medicine Centre for Global Health Research, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK.
| | | | - Shobhana Nagraj
- Nuffield Department of Medicine Centre for Global Health Research, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Geoff Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mike English
- Nuffield Department of Medicine Centre for Global Health Research, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Attakrit Leckcivilize
- Nuffield Department of Medicine Centre for Global Health Research, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK
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Mayes CG, Cochran K. Factors Influencing Perioperative Nurse Turnover: A Classic Grounded Theory Study. AORN J 2023; 117:161-174. [PMID: 36825918 DOI: 10.1002/aorn.13880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/09/2022] [Accepted: 08/04/2022] [Indexed: 02/25/2023]
Abstract
Perioperative nurse turnover rates range from 12% to 18.8%, and approximately 75% of perioperative managers reported at least one vacancy in 2021. Perioperative leaders are challenged to mitigate nurse turnover effectively because factors contributing to a nurse's decision to leave their job are not well defined. The purpose of this qualitative study using classic grounded theory was to explore perioperative nurses' turnover decision-making processes. We used social media to recruit participants and then conducted 26 interviews to collect data. We completed comparative analysis of the data and developed the Perioperative Nurse Turnover Decision-Making Theory, which describes the influence of the dimensions of perioperative nurse well-being (ie, physical and emotional well-being, career development, work-life balance, compensation, workplace culture) on their decision to leave an OR position. Perioperative leaders should consider the nurses' decision-making process when developing and implementing interventions aimed at reducing turnover.
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Jakobsson J, Jangland E, Engström M, Malmström M, Drott J. Work conditions influencing professional development of specialist nurses in surgical care explored using the Job Demand-Resources theory: A qualitative study. J Adv Nurs 2023. [PMID: 36843299 DOI: 10.1111/jan.15618] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 01/12/2023] [Accepted: 02/10/2023] [Indexed: 02/28/2023]
Abstract
AIM The aim of the study was to explore the work conditions that influence the opportunities for professional development of specialist nurses in surgical care. DESIGN A qualitative descriptive design was used. METHODS With a purposeful sampling procedure, 14 specialist nurses in surgical care were included. Four focus-group interviews were conducted during November to December 2021 and deductively analysed using the Job Demand-Resource theory as a guiding framework. Reporting adheres to COREQ guidelines. FINDINGS Work conditions that were identified as job demands and that inhibited nurses' opportunities for professional development were mainly found at an organizational and leadership level. Primarily, those conditions included role ambiguity and time constraints caused by uncompensated nursing shortages that restricted the nurses from exercising their role. Such conditions could also discourage other nurses from further education. Job demands were seen as largely compensated for by work conditions identified as job resources and located mainly at an individual level, for example finding the work interesting and multifaceted. Most prominent was the participants' inner motivation to work with surgical patients and to continue to develop themselves and other nurses professionally. CONCLUSIONS A prerequisite for professional development is that the specialist role is clearly defined in collaboration with representatives from the nursing profession and universities. Hence, hospital organizations need to reflect on how to utilize the competence. Also, it is important that nurse leaders promote the specialist nurses' motivation by supporting them in the exercise of their role. IMPACT Findings from this study revealed work conditions that need to be acknowledged during hospital organizations' endeavours to maintain and enhance nursing competence. PATIENT OR PUBLIC CONTRIBUTION Patient or public contribution was not applicable since the study focused on specialist nurses' working conditions.
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Affiliation(s)
- Jenny Jakobsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Eva Jangland
- Department of Surgical Sciences, Nursing Research, Uppsala University, Uppsala, Sweden
| | - My Engström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Surgery Sahlgrenska, Gothenburg, Sweden
| | - Marlene Malmström
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö/Lund, Sweden
| | - Jenny Drott
- Division of Nursing Science, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Surgery, Linköping University Hospital, Linköping, Sweden
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Arakelian E, Rudolfsson G. Sharing the Same Reality, Healthy Relations Between Colleagues at Work: A Meta-Synthesis. SAGE Open Nurs 2023; 9:23779608231207239. [PMID: 37854790 PMCID: PMC10580729 DOI: 10.1177/23779608231207239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/11/2023] [Accepted: 09/23/2023] [Indexed: 10/20/2023] Open
Abstract
Introduction Good relations are important at work, leading to well-being among coworkers. Since the latest research in nursing is mostly about bullying, and lateral violence, it was important to study what healthy relations mean. Objectives The aim was to identify and synthesize qualitative studies that describe healthy relations, creating health and well-being between colleagues at work. Methods A meta-synthesis approach, inspired by Sherwood's steps of analysis, was chosen for this study. Ten articles from three continents, comprising 230 participants, were included. Results Two themes were identified as follows: (a) creating a mutual bond on a personal level and a permissive atmosphere through the human warmth; and (b) sharing togetherness in a greater whole, offering unconditional help and devoting themselves to taking care of each other. An overarching metaphor implicating the home/homeness was abstracted from the two themes: "Healthy relations between colleagues at work constitute the community as a common world, containing feelings of being at home, implying acting in an expression of the ethos and dignity, a culture created that makes the ideal form of healthy relations visible." Conclusion Nurses find their meaning when they work in a permissive environment, and when they are allowed to be themselves. Such meaning can be found through their engagement with one another, by offering each other unconditional help. Good relationships lead to a place they call their home, where there is trust and friendship.
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Affiliation(s)
- Erebouni Arakelian
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Gudrun Rudolfsson
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Division of Nursing, Department of Health Sciences, University West, Trollhättan, Sweden
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Zhang F, Peng X, Huang L, Liu Y, Xu J, He J, Guan C, Chang H, Chen Y. A caring leadership model in nursing: A grounded theory approach. J Nurs Manag 2022; 30:981-992. [PMID: 35312131 PMCID: PMC9314928 DOI: 10.1111/jonm.13600] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/10/2022] [Accepted: 03/17/2022] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to develop a theoretical model of caring leadership in nursing. BACKGROUND Nurse leader's role plays an integral part in complex health care institutions. As a common feature of leaders, leaders' caring leadership can positively influence the stakeholders in health care institutions. Still, little is known about caring leadership in nursing, especially in the Chinese cultural background. METHODS Grounded theory was used to develop the theoretical model of caring leadership. Both semi-structured interviews and open-ended questionnaire surveys were used to collect data for constructing the theory model. Ten nurse leaders and 11 nurse staff were recruited for an interview, and 168 nurse leaders and 286 nurses were recruited for an open-ended questionnaire survey. RESULTS A theoretical model of caring leadership was developed using five core attributions: benevolent to others, appreciate the uniqueness, facilitate self-actualization, maintain mutual benefit and motivate with charisma. Caring leadership in nurse leaders works through the caring and leading process, resulting in nurses' well-being, patients' healing and organisational excellence. CONCLUSION A caring leadership model was developed through grounded theory, revealing Chinese nurses' perspectives on caring leadership in Chinese cultural background. According to the model, the concept of caring leadership has been further explained, and it makes contributions to the measurement and leaders' practice in health care institutions. IMPLICATIONS FOR NURSING MANAGEMENT This caring leadership model developed in our study provides a new perspective and understanding of caring and leadership for nurse leaders. Nurse leaders need to strengthen their responsibilities and personal qualities while caring for nurse staff to improve leadership efficacy based on the theoretical model. And caring leadership can help nurse leaders to balance the interests of stakeholders, leading to positive consequences for nurse staff, patients and health care organisations.
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Affiliation(s)
- Fengjian Zhang
- Union HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- School of NursingTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Xiao Peng
- Union HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- School of NursingTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Lei Huang
- Union HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- School of NursingTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Yilan Liu
- Union HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Juan Xu
- Union HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Jiao He
- Union HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Chunyan Guan
- Union HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Hongwei Chang
- Union HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- School of NursingTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Yuqin Chen
- Union HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- School of NursingTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
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How Human Resources Index, Relational Justice, and Perceived Productivity Change after Reorganization at a Hospital in Sweden That Uses a Structured Support Model for Systematic Work Environment Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111611. [PMID: 34770126 PMCID: PMC8583354 DOI: 10.3390/ijerph182111611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/28/2021] [Accepted: 11/01/2021] [Indexed: 11/17/2022]
Abstract
To facilitate systematic work environment management, which should be a natural part of business development, a structured support model was developed. The Stamina model has previously been used in Swedish municipalities, showing positive results. The aim was to study how the Human Resources Index (HRI), relational justice, short-term recovery and perceived productivity changed in a recently reorganised perioperative setting in a hospital in Sweden that uses a structured support model for systematic work environment management. A longitudinal design that took measurements at four time points was used in a sample of 500 employees in a perioperative hospital department. The results for the overall sample indicated a positive trend in the HRI (Mt1 = 48.5, SDt1 = 22.5; Mt3 = 56.7, SDt1 = 21.2; p < 0.001). Perceived health-related production loss (Mdt1 = 2, IQR = 3; Mdt3 = 0, IQR = 3; p < 0.001) and perceived work environment-related production loss (Mdt1 = 2, IQR = 3; Mdt3 = 0, IQR = 4; p < 0.001) showed major improvements. Short-term recovery showed a minor improvement (Mt1 = 2.61, SDt1 = 1.33; Mt3 = 2.65, SDt3 = 1.22; p = 0.872). In conclusion, the implementation of the Stamina model, of which the HRI constitutes an important part, seems to be a helpful tool to follow-up on work environment processes, and minimise production losses due to health and work environment-related issues.
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Arakelian E, Rudolfsson G. Managerial challenges faced by Swedish nurse managers in perioperative settings- a qualitative study. BMC Nurs 2021; 20:117. [PMID: 34217294 PMCID: PMC8255012 DOI: 10.1186/s12912-021-00640-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 06/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nurse managers need to create cultures that are worthy, not only of the commitment of everyone who comes to work but also of the trust of everyone who comes to be served. The aim of our study was to describe the challenges faced by Swedish nurse managers in a perioperative setting. METHODS A qualitative study was conducted. The participants were chosen by convenience sampling, and individual in-depth interviews were conducted. Data were analysed by Systematic Text Condensation. The COREQ checklist was consulted throughout the study to optimise the quality. RESULTS Nineteen nurse managers (all women) participated. Six themes were identified: "striving to treat employees with consideration and solicitude"; "the obligation to take care of each employee's individual needs"; "convincing others was an uphill battle", "finding solutions when things seem impossible"; "staff recruitment, allocation, and management"; "working with constantly changing planning". CONCLUSIONS The nurse managers faced challenges because of the overwhelming amount of work tasks, with almost no time for reflection. Having carefully chosen tasks and a realistic time schedule for each work task, plus time to find one's own path to inner peace, are essential for nurse managers. Organisations that provide these prerequisites show that they care about their nurse managers. The results of this study indicate the need for time to reflect, as well as support from superior managers and from the human resources department.
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Affiliation(s)
- Erebouni Arakelian
- Department of Surgical Sciences, Uppsala University, Uppsala University Hospital, Entrance 70, 1st Floor, 751 85, Uppsala, SE, Sweden.
| | - Gudrun Rudolfsson
- Faculty of Nursing and Health Sciences, Nord University, 8049, Bodø, Norway.,Division of Nursing, Department of Health Sciences, University West, SE-461 86, Trollhättan, Sweden
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Arakelian E, Wålinder R, Rask-Andersen A, Rudolfsson G. Nurse managers in perioperative settings and their reasons for remaining in their jobs: A qualitative study. J Nurs Manag 2020; 28:1191-1198. [PMID: 32472713 DOI: 10.1111/jonm.13054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 05/11/2020] [Accepted: 05/19/2020] [Indexed: 01/10/2023]
Abstract
AIM The study describes what helps nurse managers maintain the strength to keep going as leaders. BACKGROUND Good leadership is important for the quality of patient care, patient satisfaction in care and efficiency. Many nurse managers stay on despite challenges at work. METHODS Twelve nurse managers were interviewed. Data were analysed by systematic text condensation according to Malterud. RESULTS The results were as follows: A-Walking side by side with my employees; B-Knowing that I mean something to my employees; C-Talking to myself-asking myself tough questions; D-Having someone to talk to, to decrease the feeling of being alone; E-Leading and managing in my own way-the fear of not succeeding is my motivation. CONCLUSION The nurse managers built their own strategies to get through and get on when difficult situations arose. In order to succeed in leading their employees, the nurse managers gathered their inner strength through moving caritatively back and forth between the 'secret room' and the 'staff room' in the house of leadership. IMPLICATIONS IN NURSING MANAGEMENT The manuscript gives insights into where nurse managers found sources of strengths in their everyday work. To realize their employees' strengths and motivation made a difference for nurse managers as a driving force. By having someone to talk to and by asking themselves tough questions, they were prepared for the challenges that came.
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Affiliation(s)
- Erebouni Arakelian
- Department of Surgical Sciences, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Robert Wålinder
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Anna Rask-Andersen
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Gudrun Rudolfsson
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.,Division of Nursing, Department of Health Sciences, University West, Trollhättan, Sweden
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Arakelian E, Hellman T, Svartengren M. Experiences of the Initial Phase Implementation of the STAMINA-Model in Perioperative Context Addressing Environmental Issues Systematically-A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3037. [PMID: 32349408 PMCID: PMC7246937 DOI: 10.3390/ijerph17093037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/15/2020] [Accepted: 04/24/2020] [Indexed: 12/22/2022]
Abstract
(1) Background: Challenges in perioperative settings put demands on staff working with systematic work environment management. A support model, STAMINA (Structured and Time-effective Approach through Methods for an Inclusive and Active working life), was implemented in a hospital in Sweden, to help staff address environmental issues systematically. The aim was to describe the experiences of the initial phase of implementation of the adapted STAMINA model in perioperative context. (2) Methods: Qualitative individual interviews were held with 14 managers and employees (three men and 11 women). Data were analysed by systematic text condensation. (3) Results: Five themes were identified: Limited knowledge of the model and the implementation process; scepticism, lack of confidence in the model and a passive attitude; the model offered increased participation; the culture in the organization-to understand one's role as employees and managers; and endurance and feedback are key factors for success in the implementation process. (4) Conclusions: Scepticism turned to positive attitude by recognising that the STAMINA model offered increased participation. In order to have successful implementation, the organisational culture must be taken into consideration by giving the employees increased responsibilities and timely feedbacks. Role description, goal definition, feedback, and sticking to one model are key factors for success.
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Affiliation(s)
- Erebouni Arakelian
- Department of Surgical Sciences, Uppsala University, and AnOpIVA, Uppsala University Hospital, 751 85 Uppsala, Sweden
| | - Therese Hellman
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, 752 36 Uppsala, Sweden; (T.H.); (M.S.)
| | - Magnus Svartengren
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, 752 36 Uppsala, Sweden; (T.H.); (M.S.)
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Sigursteinsdóttir H, Skúladóttir H, Agnarsdóttir T, Halldórsdóttir S. Stressful Factors in the Working Environment, Lack of Adequate Sleep, and Musculoskeletal Pain among Nursing Unit Managers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020673. [PMID: 31968675 PMCID: PMC7014039 DOI: 10.3390/ijerph17020673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/05/2020] [Accepted: 01/14/2020] [Indexed: 12/02/2022]
Abstract
Background: Middle managers have not received enough attention within the healthcare field, and little is known how stressful factors in their work environment coupled with a lack of adequate sleep are related to musculoskeletal pain. The aim of this study was to examine the correlation between stressful factors in the work environment, lack of adequate sleep, and pain/discomfort in three body areas. Methods: Questionnaire was sent electronically to all female nursing unit managers (NUM) in Iceland through the outcome-survey system. The response rate was 80.9%. Results: NUM who had high pain/discomfort in the neck area also had very high pain/discomfort in the shoulder area and pain in the lower back. The results also revealed positive a medium-strong correlation between mental and physical exhaustion at the end of the workday and musculoskeletal pain. Stress in daily work, mental strain at work, and being under time-pressures had hardly any correlation with pain/discomfort in the three body parts. Adequate sleep had a significant negative correlation with all stressful factors in the work environment and all three body parts under review. Conclusion: The results will hopefully lead to a better consideration of stressful factors in the work environment, sleep, and musculoskeletal pain in middle managers.
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Affiliation(s)
- Hjördís Sigursteinsdóttir
- School of Business and Science, University of Akureyri, Nordurslod 2, 600 Akureyri, Iceland
- Correspondence:
| | - Hafdís Skúladóttir
- School of Health Sciences, University of Akureyri, Nordurslod 2, 600 Akureyri, Iceland; (H.S.); (S.H.)
| | - Thórey Agnarsdóttir
- Environmental and Public Health Authority, Furuvellir 1, 600 Akureyri, Iceland
| | - Sigrídur Halldórsdóttir
- School of Health Sciences, University of Akureyri, Nordurslod 2, 600 Akureyri, Iceland; (H.S.); (S.H.)
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Eriksson J, Lindgren BM, Lindahl E. Newly trained operating room nurses' experiences of nursing care in the operating room. Scand J Caring Sci 2020; 34:1074-1082. [PMID: 31943310 DOI: 10.1111/scs.12817] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 12/18/2019] [Accepted: 12/30/2019] [Indexed: 01/10/2023]
Abstract
There is limited research on nurses' experiences of nursing care in the operating room. The operating room nurses' responsibility is to ensure good nursing care before, during and after surgery. In an increasingly technological health care environment, there is always a risk of turning the focus away from nursing care towards technology and medicine. Integration of past experiences into the role as an operating room nurse becomes a challenge for those who recently worked as general nurses. The present study aimed to explore newly trained operating room nurses' experiences of nursing care in an operating room. Semi-structured interviews were performed with ten operating room nurses with a maximum three years' work experience from an operating room. The interviews were subjected to qualitative content analysis. The findings revealed three themes describing operating room nurses' searching for their new role. They experienced a gap between theory and practice, felt alone and insignificant and had to find their own place. The operating room nurses' experienced threats to safe nursing when they lacked time for the patients as well as for their own recovery, and they lacked feedback in order to improve care. They ensured security for patients by establishing one-to-one contact, protecting patients' well-being and working in teams for the patients' best interest, participants also focused on the task at hand instead of the patient as a person. New ways of organising work in operating units, and well-functioning teams can be a key to a successful integration of experiences from ward nurse to an operating room nurse, and provide support so that they feel more visible, at ease and safe in their new profession.
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Affiliation(s)
- Johan Eriksson
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
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