Impact of management development on nurse retention

Mediating Influences of the Exchange Relationship with a Preceptor on the Relationship between Burnout and Job Retention Intention among New Nurses in Korea

The main factor in the turnover of new nurses in Korea is burnout, and a high turnover rate can lead to discontinuation in the nursing profession, due to failure to adapt to the organization. This study aimed to examine the mediating influences of an exchange relationship with the preceptor on the relationship between burnout and job retention intention among new nurses in Korea. Data were collected from 210 new nurses in three general hospitals from 2 May to 30 June 2023. The following statistical analysis were conducted: t-test, ANOVA, the Scheffé test, Pearson's correlation coefficient analysis, and Hayes Process Macro Model 4 (to test the mediating effect). Burnout was negatively associated with job retention intention (r = -0.54, p < 0.001) and the exchange relationship with the preceptor (r = -0.29, p = 0.001). The exchange relationship with the preceptor was positively associated with job retention intention (r = 0.38, p < 0.001). Furthermore, the mediation analysis indicated that the exchange relationship with the preceptor mediated the relationship between burnout and job retention intention. According to the results, the impact of burnout on the job retention intention was mediated by the exchange relationship with the preceptor. Therefore, to increase the job retention intention of new nurses, developing programs to enhance the exchange relationship with the preceptor are recommended.

Characteristics of Medical Deserts and Approaches to Mitigate Their Health Workforce Issues: A Scoping Review of Empirical Studies in Western Countries

BACKGROUND

Medical deserts are considered a problematic issue for many Western countries which try to employ multitude of policies and initiatives to achieve a better distribution of their health workforce (HWF). The aim of this study was to systematically map research and provide an overview of definitions, characteristics, contributing factors and approaches to mitigate medical deserts within the European Union (EU)-funded project "ROUTE-HWF" (a Roadmap OUT of mEdical deserts into supportive Health WorkForce initiatives and policies).

METHODS

We performed a scoping review to identify knowledge clusters/research gaps in the field of medical deserts focusing on HWF issues. Six databases were searched till June 2021. Studies reporting primary research from Western countries on definitions, characteristics, contributing factors, and approaches were included. Two independent reviewers assessed studies for eligibility, extracted data and clustered studies according to the four defined outcomes.

RESULTS

Two-hundred and forty studies were included (n=116, 48% Australia/New Zealand; n=105, 44% North America; n=20, 8% Europe). All used observational designs except for five quasi-experimental studies. Studies provided definitions (n=171, 71%), characteristics (n=95, 40%), contributing factors (n=112, 47%), and approaches to mitigate medical deserts (n=87, 36%). Most medical deserts were defined by the density of the population in an area. Contributing factors to HWF issues in medical deserts consisted in work-related (n=55, 23%) and lifestyle-related factors (n=33, 14%) of the HWF as well as sociodemographic characteristics (n=79, 33%). Approaches to mitigate them focused on training adapted to the scope of rural practice (n=67, 28%), HWF distribution (n=3, 1%), support/infrastructure (n=8, 3%) and innovative models of care (n=7, 3%).

CONCLUSION

Our study provides the first scoping review that presents and categorizes definitions, characteristics, contributing factors, and approaches to mitigate HWF issues in medical deserts. We identified gaps such as the scarcity of longitudinal studies to investigate the impact of factors contributing to medical deserts, and interventional studies to evaluate the effectiveness of approaches to mitigate HWF issues.

The Effect of Authentic Leadership on Nurses' Trust in Managers and Job Performance: A Cross-Sectional Study

BACKGROUND

Nurse leaders have the responsibility to build healthy work environments for staff nurses and enhance nurses' outcomes. Authentic leadership is one of the leadership theories that have been shown to have positive impacts on nurses' outcomes. The goal of this study was to test the effect of authentic leadership on trust in managers and job performance among nurses in Saudi Arabia.

METHODS

A non-experimental, cross-sectional design was applied. A total of 116 nurses who met the inclusion criteria completed the survey. To test the study variables, three different scales were used. The data in this study were analyzed using SPSS version 28.0.1.1.

RESULTS

The findings of this study showed that there were significant and positive effects of authentic leadership and its four components on trust in managers. However, no relationships were found between authentic leadership and its four elements, and job performance.

CONCLUSIONS

Authentic leaders have the ability to improve work environments by building a trustful relationship with nurses. This study focuses on the role of authentic leadership in nursing practice and its essential effects to enhance the work environments. It also provides future researchers in Saudi Arabia with comprehensive knowledge about conducting studies of authentic leadership in nursing and examine its effects on outcomes related to nurses.

Nurses' trust in managers and its relationship with nurses' performance behaviors: a descriptive- correlational study

Background

Organizational trust is one of the most important issues in human relations that its importance in organizations is well known. Effective communication and cooperation between individuals require trust. On the other hand, the quality of a nurse’s trust in his/ her manager affects the behavior and performance of the nurse. The purpose of this study was to determine nurses’trust in managers (head-nurses and supervisors) and its relationship with nurses’ performance behavior.

Methods

This descriptive-correlational study was performed with the participation of 431 nurses working in educational centers of Ardabil, Iran. The sampling method was stratified randomly. Questionnaires of the McAllister Trust and Paterson Job Performance were used. Data analysiswas performed using descriptive statistics (mean, standard deviation, frequency) and Chi-square testin SPSS v.22.

Results

The results showed that the majority of nurses trusted head-nurses (80.3%) and supervisors (61.9%). In addition, most nurses’ functional behavior (92.1%) was reported as excellent. There was no significant relationship between nurse trust in head-nurse and nurses’functional behavior (P = 0.58), while it was significant between nurse-supervisor trust and nurses’ functional behavior (P = 0.03).

Conclusion

The results of this study showed a relationship between nurse-supervisor trust and nurses’ functional behavior. Therefore, it is recommended ways to improve the trust between the treatment team, especially among nurses and supervisors are considered as one of the factors influencing the nurses’ behavioral performance.

Transformational Leadership in Health Care Today

Management in nursing is in a state of revolution based on positive transformational changes. Effective leadership on individual nursing units directly affects nursing staff satisfaction. Employees are interested in managers who can lead in a positive and encouraging manner. Nurses who are content in their positions correlate to a reduction in staff turnover and improve retention. When the nursing staff are satisfied with their employment, patient satisfaction rises. Health care organizations can see this trickle-down effect through increases in patient satisfaction scores over time. The promotion of effective communication and positive attitudes enhances a healthy environment for all employees and staff. Health care organizations should evaluate individual nurse managers on units to promote transformational leadership qualities; this will directly result in staff satisfaction, staff retention, and patient satisfaction.

Leader Communication Styles and Organizational Health

Communication is perhaps one of the greatest challenges facing managers and leaders today. Clearly articulating ideas and expectations to employees is vital to the productivity and the longevity of an organization. Furthermore, the style in which the communication is delivered has an influence on the satisfaction levels of employees. Research has discovered that there are many different styles in which a leader may communicate with employees. Research has provided several methods that aid in determining which style is the most appropriate for any given circumstance. Research has demonstrated how appropriate and effective communication is used to promote organizational health. Furthermore, research has demonstrated how inappropriate communication may decrease employee satisfaction. Finally, research has provided methods to aid in improving communication styles and delivery.

Evidence-Based Practice Guideline: Nurse Retention for Nurse Managers

Nursing retention and turnover impacts health care on many facets; pressures are increasing to provide quality care in a cost-effective manner to a satisfied patient with an engaged staff as defined by the Quadruple Aim. Retention of experienced staff nurses is paramount as the nursing profession enters another shortage era, which leads to impact on patient safety and quality of care. The purpose of this nurse retention evidence-based practice guideline is to provide strategies for first line nurse managers in various health care settings to use in enhancing job satisfaction and decreasing turnover of staff nurses. Interventions are focused on three areas that are beyond compensation issues and are within the purview of nurse managers: (a) autonomy; (b) recognition; and (c) communication. Retaining expert nurses will have a positive effect on quality patient care. [Journal of Gerontological Nursing, 45(11), 11-19.].

Individual and organizational predictors of allied healthcare providers' job satisfaction in residential long-term care

Background

Job satisfaction is a predictor of intention to stay and turnover among allied healthcare providers. However, there is limited research examining job satisfaction among allied health professionals, specifically in residential long-term care (LTC) settings. The purpose of this study was to identify factors (demographic, individual, and organizational) that predict job satisfaction among allied healthcare providers in residential LTC.

Methods

We conducted a secondary analysis of data from Phase 2 of the Translating Research in Elder Care program. A total of 334 allied healthcare providers from 77 residential LTC in three Western Canadian provinces were included in the analysis. Generalized estimating equation modeling was used to assess demographics, individual, and organizational context predictors of allied healthcare providers’ job satisfaction. We measured job satisfaction using the Michigan Organizational Assessment Questionnaire Job Satisfaction Subscale.

Results

Both individual and organizational context variables predicted job satisfaction among allied healthcare providers employed in LTC. Demographic variables did not predict job satisfaction. At the individual level, burnout (cynicism) (β = −.113, p = .001) and the competence subscale of psychological empowerment (β = −.224, p = < .001), were predictive of lower job satisfaction levels while higher scores on the meaning (β = .232, p = .001), self-determination (β = .128, p = .005), and impact (β = .10, p = .014) subscales of psychological empowerment predicted higher job satisfaction. Organizational context variables that predicted job satisfaction included: social capital (β = .158, p = .012), organizational slack-time (β = .096, p = .029), and adequate orientation (β = .088, p = .005).

Conclusions

This study suggests that individual allied healthcare provider and organizational context features are both predictive of allied healthcare provider job satisfaction in residential LTC settings. Unlike demographics and structural characteristics of LTC facilities, all variables identified as important to allied healthcare providers’ job satisfaction in this study are potentially modifiable, and therefore amenable to intervention.

Electronic supplementary material

The online version of this article (10.1186/s12913-018-3307-3) contains supplementary material, which is available to authorized users.

Through the Eyes of Nurse Managers in Long-Term Care: Identifying Perceived Competencies and Skills

Nurse managers (NMs) in long-term care supervise health care services for individuals with high acuity levels and numerous comorbidities. There is minimal research identifying NMs' skills and competencies as unit leaders within the long-term care environment. The current mixed-methods study identified NMs' leadership skills and competencies. Nineteen NMs with ≥5 years' long-term care management experience completed the Nurse Manager Inventory Tool and were individually interviewed. They rated their clinical skills at the competent level and their financial/strategic management skills at the novice level. All other skill categories, including leadership reflective practice, diversity, human resource leadership/management, relationship management, performance improvement, and problem solving, were rated at a competent level. Emergent interview qualitative themes included their visibility on the unit, trial and error learning, a sense of "aloneness" due to the absence of other RNs, NM position being a tough job, need for peer support, role modeling, and importance of supporting the resident through their "final journey." [Journal of Gerontological Nursing, 44(5), 32-38.].

Resilience, job satisfaction and anticipated turnover in nurse leaders

AIMS

The aim was to identify relationships between resilience, job satisfaction and anticipated turnover among nurse leaders.

BACKGROUND

Despite the reported value of resilience, there is a lack of research on resilience in nurse leaders. This study examined how nurse leaders describe their resilience and the relationship it has with job satisfaction and anticipated turnover.

METHODS

This quantitative study used a sample of 89 nurse leaders (bedside, department, division and organisational) from a multi-hospital health-care system in southwestern Virginia.

RESULTS

There are significant relationships between resilience, job satisfaction and anticipated turnover. Additionally, it was found that the variables of job satisfaction and anticipated turnover significantly overlapped in their meaning and created a new construct of intent to remain (ITR) that has a statistically significant relationship with resilience.

IMPLICATIONS FOR NURSING MANAGEMENT

A stable nursing team has a positive impact on improving patient outcomes. To mitigate the impact of a nursing shortage, nurse leaders can enhance their own resilience and then recruit, hire and retain resilient staff nurses in an effort to improve nurses' ITR.

CONCLUSION

With higher resilience, nurse leaders are more likely to intend to remain in their leadership positions.

Redefining "charge nurse" within the front line

Don't overlook the importance of charge nurses. Learn how one organization redefined the role and strengthened these leaders, increasing patient and staff satisfaction.

Greek-Cypriot mental health nurses' professional satisfaction and association with mild psychiatric symptoms

The present descriptive correlational study aims to explore among Greek-Cypriot mental health nurses (MHNs) the level of professional satisfaction, potential differences with regard to vocational characteristics, and associations with anxiety and depressive symptoms. A random sample of 225 Greek-Cypriot MHNs employed in hospital and community settings completed Hamilton's Anxiety Scale, Beck's Depression Inventory, and Stamps's Index of Work Satisfaction. Moderate levels of overall professional satisfaction of 4.38 (±0.58) were detected. Work experience was positively correlated with satisfaction from payment (τ = 0.230, P < 0.0001). Men seemed to be more satisfied with organizational policies (P = 0.0043) and performed tasks (P = 0.027) than women. Nurses working in psychiatric clinics of general hospitals experienced higher levels of professional satisfaction in general, and more satisfaction from organizational policies, autonomy, and task requirements than nurses working in community settings, substance misuse programs, and community mental health centres (P = 0.001). Nurses working in acute/admission settings were the less satisfied, compared to nurses working in rehabilitation wards (P = 0.017). Professional satisfaction was associated with anxiety (τ = 0.280, P < 0.0001) and depressive (τ = 0.246, P < 0.0001) symptoms. Greek-Cypriot MHNs seem to get moderate satisfaction from their work, whilst professional satisfaction is associated with their psychological well-being. Targeted managerial interventions and longitudinal research are warranted.

The match between institutional elderly care management research and management challenges - a systematic literature review

BACKGROUND

Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents.

METHODS

This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents.

RESULTS

The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents.

CONCLUSIONS

Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers' and policymakers' scientific literacy needs to be enhanced.

The relationship between quality of work life and turnover intention of primary health care nurses in Saudi Arabia

Background

Quality of work life (QWL) has been found to influence the commitment of health professionals, including nurses. However, reliable information on QWL and turnover intention of primary health care (PHC) nurses is limited. The aim of this study was to examine the relationship between QWL and turnover intention of PHC nurses in Saudi Arabia.

Methods

A cross-sectional survey was used in this study. Data were collected using Brooks’ survey of Quality of Nursing Work Life, the Anticipated Turnover Scale and demographic data questions. A total of 508 PHC nurses in the Jazan Region, Saudi Arabia, completed the questionnaire (RR = 87%). Descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression, and hierarchical multiple regression were applied for analysis using SPSS v17 for Windows.

Results

Findings suggested that the respondents were dissatisfied with their work life, with almost 40% indicating a turnover intention from their current PHC centres. Turnover intention was significantly related to QWL. Using standard multiple regression, 26% of the variance in turnover intention was explained by QWL, p < 0.001, with R² = .263. Further analysis using hierarchical multiple regression found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, p < 0.001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables.

Conclusions

Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes.

What factors affect nursing retention in the acute care setting?

Moral distress and professional stress affect the lives of acute care nurses everyday. The impact of these stressors may be causing nurses to leave the acute care setting. This paper will outline the findings from a descriptive study of acute care nurses in Northeast Florida. The research was conducted in an effort to highlight some of the critical factors that impact nurses in the acute care setting and affect their intent to stay at an institution. The concepts of moral distress and professional stress in relation to nursing retention are highlighted and some strategies for lessening of these stressors are proposed. The study was correlational and conducted among 234 nurses in an institutional setting. The study included an online survey based on established Moral Distress and Professional Stress tools. In addition, a qualitative section was included to explore the nurses’ experiences of stressful inpatient situations. The results of this study demonstrated that when combined, both professional stress and moral distress items were predictive of the nurses’ intent to stay at the institution ( p <.001).

Leader communication styles and organizational health

Communication is perhaps one of the greatest challenges facing managers and leaders today. Clearly articulating ideas and expectations to employees is vital to the productivity and the longevity of an organization. Furthermore, the style in which the communication is delivered has an influence on the satisfaction levels of employees. Research has discovered that there are many different styles in which a leader may communicate with employees. Research has provided several methods that aid in determining which style is the most appropriate for any given circumstance. Research has demonstrated how appropriate and effective communication is used to promote organizational health. Furthermore, research has demonstrated how inappropriate communication may decrease employee satisfaction. Finally, research has provided methods to aid in improving communication styles and delivery.

Predicting nursing turnover with catastrophe theory

AIM

This paper is a report of a study comparing an innovative nonlinear model and a traditional linear model for accuracy in prediction of nursing turnover.

BACKGROUND

An international, sustained nursing shortage creates a need to target accurately the staff population at risk for turnover. Existing linear methodology is cumbersome with the number of variables needed, while producing inadequate results. Nonlinear modelling methods offer increased simplicity and accuracy in predictability.

METHODS

A correlational survey with a longitudinal cohort prospective study was carried out in 2005-2006 with a convenience sample of 1033 Registered Nurses from the Midwest region of the United States of America. At time 1, 756 usable questionnaires were returned and 496 at time 2. Data analysis included analyses of a cusp catastrophe model, a cube-shaped four-dimensional figure with a top that provided a down-turning slope area (the catastrophe/cusp zone). This fluid, dynamic cusp version employed the smallest number of control and dependent variables.

RESULTS

The exceedingly small turnover sample preempted the use of the computerized program Cuspfit; a proven quasi-quantitative methodology demonstrated 80.4% predictability in the cusp catastrophe model overall and 53.6% correct predictions of actual terminations, particularly in nurses with <5 years of nursing experience. Additional accurate predictions were obtained with the use of a time-staged model. Organizational commitment and anticipated turnover were accurate predictor variables; job tension was not.

CONCLUSION

Catastrophe models are useful in predicting nursing turnover. Future nursing researchers should act on this evidence to benefit forthcoming studies and the profession.

Relationship of the Job Tenure of Nursing Home Top Management to the Prevalence of Pressure Ulcers, Pain, and Physical Restraint Use

The association of job tenure among nursing home administrators (NHAs) and directors of nursing (DONs) with the prevalence of pressure ulcers, pain, and physical restraint use was examined. Data sources included the 2004 National Nursing Home Survey and quality measures from the Centers for Medicare and Medicaid Services. Regression models examined NHA tenure ( n = 787) and DON tenure ( n = 703). Control variables included prior prevalence of the respective outcome, NHA/DON education, and facility characteristics among others. Increasing NHA and DON tenure were both associated with decreases in the prevalence of pressure ulcers and pain but not restraint use. DON tenure had more impact on outcomes in earlier stages of tenure than NHA tenure. Effects of NHA tenure were in later stages of tenure. Increasing tenure among NHAs and DONs may influence better resident outcomes within their facility.

Internal marketing and the antecedents of nurse satisfaction and loyalty

Employee satisfaction and retention are critical issues that influence the success of any organization. Yet, one of the most critical problems facing the worldwide health care industry is the shortage of qualified nurses. Recent calls have been made within the traditional nursing literature for research that utilizes marketing and business models to better understand nurse satisfaction and retention. The purpose of this study is to develop scales that can be used to empirically test a model of the proposed antecedents of nurse job satisfaction and loyalty which have been used widely in the internal marketing and the relationship-marketing literature. Specifically, the study will investigate the degree to which structural bonding, social bonding, financial bonding activities, and quality of care impact how well nurses are satisfied with their job and their commitment to the organization. The results show that quality of care most impacted nurse satisfaction and loyalty, followed by structural, social, and financial bonds.

Enhancing nursing leadership in long-term care. A review of the literature

The quality of care provided to nursing home residents has been the subject of broad criticism for years. Mounting evidence suggests that the quality of nursing home care can be improved by strengthening the roles of nurses in these facilities. This article reviews the literature on programs designed to enhance nursing leadership in long-term care, examines outcomes associated with leadership in long-term care, and outlines recommendations for programs to enhance nursing leadership in nursing home settings. The findings suggest that nursing leadership training programs for nurses working in nursing homes are urgently needed to improve quality in the nation's nursing homes and stabilize the workforce. To maximize their effectiveness, these leadership training programs should be part of a continuum of leadership development that begins in nursing education programs and persists throughout a nurse's career trajectory.

Leading change during an inpatient critical care unit expansion

Acute care hospitals are changing rapidly to address economic and technologic advancements and meet community needs. The authors describe 1 medical center's use of Kotter's work on leading change to expand the neuroscience intensive care unit from 10 to 30 beds to meet community needs, improve hospital efficiencies, and increase bed capacity. Nurse satisfaction, retention, and other human resource quality data that showed positive results are compared before and after the change.

Development of a leadership competency model

BACKGROUND

Although research findings support that the nurse manager has a pivotal role in influencing all aspects of the nursing environment, recruiting talented staff into these nursing leadership positions has become increasingly more difficult. There is a need to better understand the competencies needed by contemporary nurse managers and the challenges in the role.

OBJECTIVE

The purpose of this research was to explore the viewpoints of 120 nurse manager study participants on the contemporary nurse manager role and to gain perspective on the critical leadership skills and competencies to build a nursing leadership competency model.

DESIGN

A grounded theory methodology was used in this study to capture the perspectives of the nurse managers interviewed about their role.

RESULTS

Six competency categories emerged from the research findings to form a nursing leadership competency model. Two major themes identified from the data included the nurse manager role as a career choice and the stressors and challenges in the role.

CONCLUSION

The results of this study led to the design of a nursing leadership competency model and confirmed that there is a need to formally develop and mentor our next generation of nurse leaders.