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Anyango E, Adama E, Brown J, Ngune I. An examination of the career decision-making self-efficacy of final-year nursing students. NURSE EDUCATION TODAY 2024; 138:106196. [PMID: 38603828 DOI: 10.1016/j.nedt.2024.106196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 03/21/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND One in four newly graduated registered nurses leave their employment positions within the first year. To reduce this attrition, nursing stakeholders could focus on the final year of nursing education because students at this stage make professional career plans, including their practice destination for the graduate year and their commitment to the profession. Previous studies provide evidence of nursing students' career preferences and specialty choices. However, there is a dearth of data that focuses on the students' career decision-making process. AIM This study examined the self-efficacy or confidence of final-year nursing students in making career decisions and the factors that influence their career decision-making process. SETTING AND PARTICIPANTS Final year pre-registration nursing students (N = 222) at two public universities in Western Australia. METHODS An online survey was used to collect cross-sectional data. The Career Decision Self-Efficacy Scale - Short Form was used to investigate nursing students' confidence in making career decisions. Career decision-making self-efficacy refers to the confidence to successfully complete career decision-making tasks. Descriptive statistics were used to describe the participants' characteristics. The chi-square test was used to assess the significance of the difference between categorical data, and binary logistic regression was used to determine the odds of the factors that predict career decision self-efficacy. RESULTS Forty-seven percent of participants who answered all Career Decision Self-Efficacy Scale - Short Form questions had good confidence in making career decisions. Factors such as the setting of the final clinical placement, the intention to be employed in the specialisation or organisation of their final placement and the students' assessment of their clinical experience were associated with career decision-making confidence. CONCLUSIONS Most participants had low confidence in making career decisions. This study provides ideas for nursing stakeholders to implement measures to improve students' confidence to make informed career decisions.
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Affiliation(s)
- Edah Anyango
- School of Nursing and Midwifery, Edith Cowan University, Western Australia, 270 Joondalup Dr, Joondalup, WA 6027, Australia.
| | - Esther Adama
- School of Nursing and Midwifery, Edith Cowan University, Western Australia, 270 Joondalup Dr, Joondalup, WA 6027, Australia.
| | - Janie Brown
- School of Nursing, Midwifery and Paramedicine, Curtin University, Western Australia, 208 Kent St, Bentley, WA 6102, Australia.
| | - Irene Ngune
- School of Nursing and Midwifery, Edith Cowan University, Western Australia, 270 Joondalup Dr, Joondalup, WA 6027, Australia.
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Bae SH. Assessing the impacts of nurse staffing and work schedules on nurse turnover: A systematic review. Int Nurs Rev 2024; 71:168-179. [PMID: 37216655 DOI: 10.1111/inr.12849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 04/26/2023] [Indexed: 05/24/2023]
Abstract
AIM This study aimed to investigate and synthesize the impacts of nurse staffing and work schedules on nurse turnover in acute hospitals. BACKGROUND The retention of nurses during the COVID-19 pandemic was critical due to the increased demand for nurses. Among the multifaceted factors contributing to nurse turnover, it is worth examining nurse staffing and work schedules while considering policy intervention. METHODS The findings of this systematic literature review were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Using eight databases, including CINAHL and PubMed, research articles published from January 2000 until June 2021 were reviewed. The inclusion criteria were original peer-reviewed research, nonexperimental studies published in English or Korean languages, and studies examining the impacts of nurse staffing and work schedules on nurses' actual turnover. RESULTS Fourteen articles were reviewed. Among them, 12 studies investigated the relationship between nurse staffing and turnover, and four examined the impact of work schedules on nurse turnover. Nurse staffing levels are strongly related to nurse turnover in the expected direction. However, few studies have found that work schedules are significantly related to nurse turnover. CONCLUSION Inadequate and unsafe nurse staffing leads to increased nurse turnover rates. More studies are needed to investigate the impacts of work schedules on nurse turnover. IMPLICATIONS FOR NURSING, HEALTH, AND SOCIAL POLICY Several states in the United States have adopted the nurse staffing policy during the COVID-19 pandemic. More hospitals and the government should adopt and implement policies to regulate nurse staffing, reduce nurse turnover, and increase retention. Policy intervention in nurse work schedules should also be considered to prevent nurse turnover.
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Affiliation(s)
- Sung-Heui Bae
- College of Nursing, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
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Kim JH, Kim O, Cho M, Jeong H, Dan H. Associations of anxiety and fatigue with hazardous occupational conditions of Korean nurses in early pregnancy: A cross-sectional study. Int J Nurs Pract 2024:e13232. [PMID: 38273459 DOI: 10.1111/ijn.13232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 09/15/2023] [Accepted: 12/05/2023] [Indexed: 01/27/2024]
Abstract
AIM To identify occupational conditions associated with anxiety and fatigue among Korean nurses in early pregnancy. BACKGROUND Pregnant nurses, like non-pregnant hospital nurses, are exposed to dangerous and stressful work environments, which can affect fatigue and anxiety. DESIGN AND METHODS This cross-sectional study enrolled 1490 nurses who participated in the early pregnancy module in the Korea Nurses' Health Study between 2014 and 2020. Hierarchical linear regression analyses were employed to identify the factors associated with anxiety and fatigue among nurses in early pregnancy. RESULTS One-fifth of participants were working night shifts, and more than two-thirds were working overtime. When using antineoplastic drugs and disinfectants, the rate of use of protective equipment varied depending on the size of the hospital. Working overtime and lifting heavy objects were associated with increased anxiety and fatigue among nurses. CONCLUSION Overtime work was associated with both anxiety and fatigue among pregnant nurses. Pregnant hospital nurses were exposed to both night shift and overtime work. Therefore, hospital managers should improve hazardous working environments to protect the health of nurses in early pregnancy and their fetuses.
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Affiliation(s)
- Jung-Hee Kim
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
| | - Oksoo Kim
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Mijung Cho
- Department of Nursing, Hallym Polytechnic University, Chuncheon, Republic of Korea
| | - Hyunseon Jeong
- College of Nursing, Seoul Women's College of Nursing, Seoul, Republic of Korea
| | - Hyunju Dan
- Department of Nursing, Hwasung Medi-Science University, Hwasung-si, Kyunggi-do, Republic of Korea
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Lu X, Yang J, Bai D, Cai M, Wang W, He J, Gong X, Hou C, Gao J. The effect of psychological contract on turnover intention among nurses: a meta-analytic review. BMC Nurs 2023; 22:358. [PMID: 37798645 PMCID: PMC10557294 DOI: 10.1186/s12912-023-01496-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/12/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The turnover intention (TI) of nurses is common, posing a threat to modern healthcare organizations. Psychological contract (PC) is a predictor of TI, affecting significantly nurse's TI. However, the extent of the association between PC and nurse's TI is unknown. We performed a meta-analysis to quantitatively analyze the relationship between PC and nurse's TI. METHODS We searched nine electronic databases from inception to July 2023. Observational studies were included using a retrieval strategy related to PC and TI. Meta-analyses of common effect and random effect models were performed using R software with Spearman or Pearson correlation coefficients. Meta-regression, subgroup analysis, publication bias, and sensitivity analysis were also carried out . RESULTS Eighteen studies including 8,908 nurses were identified. Based on various PC-related perspectives, 16 studies explored nurses' TI in terms of the content and three-dimensional structure of PC. Of these, 9 studies reported the negative direction of the correlation between PC and TI (r ranged from - 0.20 to -0.45), whereas 7 studies reported the positive direction of the correlation between PC and TI (r ranged from 0.32 to 0.50). The PC total and its dimensions were found to have moderately significant associations with TI, with the exception of the PCE and PCE-I. Additional, 2 studies reported the relationship between the outcome of PC and TI, the PCF, PCB, and PCV were powerful predictors of nurses' TI. Meta-regression and subgroup analysis found that only nurses working in specialized departments might be the source of heterogeneity. CONCLUSIONS To our knowledge, this was the first meta-analysis to quantitatively examine the relationship between PC and TI among nurses. The findings reaffirmed the necessity for healthcare administrators and the medical profession to valued nurse' good interpersonal, social support, humanistic environment, and meet nurses' psychological and spiritual needs in addition to their material demands. Moderators of the connection between PC and TI, based on meta-regression and subgroup analyses, should be carefully explored as they may aid in identifying nurses' TI. Additional, longitudinal research, as well as mixed research, should be conducted to more comprehensively explore the relationship between PC and TI.
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Affiliation(s)
- Xianying Lu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Jing Yang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Dingxi Bai
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Mingjin Cai
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Wei Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Jiali He
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Xiaoyan Gong
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Chaoming Hou
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
| | - Jing Gao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
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Kim O, Kim B, Kim SY, Cho E, Lee HY, Cha C, Bae N, Kim M, Lee DH, Chavarro JE, Park HY, Kim S. Comparison of factors associated with postpartum depression from two cohorts of nurses: the Korea Nurses' Health Study and the Nurses' Health Study 3. Occup Environ Med 2023; 80:209-217. [PMID: 36823104 DOI: 10.1136/oemed-2022-108609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 02/02/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVES This study aimed to identify whether differences exist in postpartum depression (PPD) in US and Korean nurses and its related factors. Identifying occupational and personal factors that underlie potential differences will be helpful for women's occupational health. METHODS Baseline and postpartum survey data from employed nurses in the Korea Nurses' Health Study and Nurses' Health Study 3 (1244 Korean; 2742 US nurses) were analysed. Postpartum data collection was done via online survey. PPD was analysed based on cultural validation from prior studies using the Edinburgh Postnatal Depression Scale (cut-off of 10 for Korea and 13 for USA); depressive symptoms prior to pregnancy and childbirth, general characteristics and sleep satisfaction were also measured. Descriptive statistics, χ2 tests and t-tests and multivariate ordinal logistic regression analysis were performed. RESULTS 45.9% of Korean participants had clinical symptoms of PPD (≥10), whereas US participants presented with 3.4% (≥13). Prior depressive symptoms were also higher in Korean participants (22.5%) compared with their US counterparts (4.5%). Prior depressive symptoms and poor sleep satisfaction were significant risk factors of PPD in both cohort groups, and vaginal birth was an additional influencing factor in Korean participants. CONCLUSIONS Differences in PPD rates and related factors suggest the role of stress, cultural variation and differing work systems. Nurses and other women shift-workers noted to have depressive symptoms before and during pregnancy and exhibit PPD symptoms should especially be followed closely and offered supportive mental health services that include greater flexibility in returning to work.
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Affiliation(s)
- Oksoo Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Bohye Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Su-Young Kim
- Department of Psychology, Ewha Womans University, Seoul, South Korea
| | - Eunyoung Cho
- Department of Dermatology and Epidemiology, Brown University, Providence, Rhode Island, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Hea Young Lee
- Department of Nursing, Doowon Technical University, Anseong, South Korea
| | - Chiyoung Cha
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Nohyun Bae
- Department of Nursing Science, Seojeong University, Yangju, South Korea
| | - Minjoo Kim
- Department of Psychology, Ewha Womans University, Seoul, South Korea
| | - Dong Hoon Lee
- Department of Sports Industry Studies, Yonsei University, Seoul, South Korea
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jorge E Chavarro
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Hyun-Young Park
- Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea
| | - Sue Kim
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
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Bae SH. Association of Work Schedules With Nurse Turnover: A Cross-Sectional National Study. Int J Public Health 2023; 68:1605732. [PMID: 37168137 PMCID: PMC10164927 DOI: 10.3389/ijph.2023.1605732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/29/2023] [Indexed: 05/13/2023] Open
Abstract
Objective: To examine the relationship of work schedules with nurse turnover across various work settings. Methods: A cross-sectional study design was used with data collected from 17,046 nurses who participated in the 2018 National Sample Survey of Registered Nurses in the U.S. Multivariate logistic regression was used to examine the effects of work hours and overtime on nurse turnover. Results: Longer weekly work hours increased nurse turnover (OR = 1.104, 95% confidence interval [CI] = 1.006-1.023). A non-linear relationship was observed between overtime and turnover. Compared with nurses with no overtime, the turnover for nurses working 1-11 h overtime per week decreased (OR = 0.893, 95% CI = 0.798-0.999). When nurses worked ≥12 h, turnover increased (OR = 1.260, 95% CI = 1.028-1.545). Earning from the primary nursing position decreased turnover among nurses working in hospitals, other inpatient settings, and clinics. Job satisfaction decreased turnover. Conclusion: To prevent nurse turnover, it is important to monitor and regulate nurses' working hours at institutional and government levels. Government support and policy implementations can help prevent turnover.
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Lee EY, Kim KJ, Ko S, Song EK. Communication competence and resilience are modifiable factors for burnout of operating room nurses in South Korea. BMC Nurs 2022; 21:203. [PMID: 35897026 PMCID: PMC9327268 DOI: 10.1186/s12912-022-00985-0] [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: 10/12/2021] [Accepted: 07/19/2022] [Indexed: 12/04/2022] Open
Abstract
Background Burnout negatively impacts the personal and professional life of nurses. Job stress and resilience have been determined to be associated with nurse burnout. Given the importance of communication competence in operating room (OR) nurses, the associations of job stress, resilience, and communication competence with burnout have not been examined. Purpose To determine the relationships of job stress, resilience, and communication competence to burnout of OR nurses in South Korea. Methods This was a cross-sectional, descriptive study of 146 OR nurses. A series of self-reported questionnaires was used to assess job stress, resilience, communication competence, and burnout. Pearson correlation coefficient and a hierarchical linear regression were used for data analysis. Results Communication competence was correlated with resilience (r = 0.65, p < .001) and burnout (r = -0.44, p < .001), and resilience was correlated with burnout (r = -0.48, p < .001). Resilience (β = -0.22, p = .027) and communication competence (β = -0.33, p < .001) were associated with burnout of OR nurses in a hierarchical linear regression (F = 6.28, p < .001). Conclusions Increased resilience and communication competence were associated with lower burnout of perioperative nurses. To prevent and reduce burnout of OR nurses, it is necessary to develop and implement a program targeting for communication competence and resilience. Implications for nursing management Nurse leaders should provide programs fostering communication competence and resilience to OR nurses and encourage them to actively participate in such job trainings.
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Affiliation(s)
- Eun Yeong Lee
- Department of Nursing, Ulsan University Hospital, Ulsan, South Korea
| | - Kyoung-Ja Kim
- Department of Nursing, College of Medicine, Inha University, Incheon, South Korea
| | - Sangjin Ko
- Department of Nursing, College of Medicine, University of Ulsan, Daehak-ro 93, Nam-gu, Ulsan, South Korea
| | - Eun Kyeung Song
- Department of Nursing, College of Medicine, University of Ulsan, Daehak-ro 93, Nam-gu, Ulsan, South Korea.
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Bae SH. Noneconomic and economic impacts of nurse turnover in hospitals: A systematic review. Int Nurs Rev 2022; 69:392-404. [PMID: 35654041 PMCID: PMC9545246 DOI: 10.1111/inr.12769] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/16/2022] [Indexed: 11/29/2022]
Abstract
AIM To examine and synthesize the noneconomic and economic impacts of nurse turnover in acute hospitals. BACKGROUND Nurse turnover occurs when nurses leave their jobs or the profession and is a major concern for the healthcare industry. Many studies have investigated the determinants of nurse turnover. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was utilized in the current review. Article search was conducted in June 2021. Research articles published since January 2000 were included. Eight databases (e.g., CINAHL, PubMed, PsycINFO, and Web of Science) were used. The following eligibility criteria were applied for inclusion: Articles that (1) were nonexperimental quantitative studies, (2) examined the impact of actual nurse turnover in acute hospitals, (3) were a peer-reviewed original research article, and (4) were written in English or Korean. RESULTS Among 9,041 searched articles, 16 were included in the review. Seven studies investigated the association of nurse turnover with processes and outcomes (workgroup processes, nurse staffing, nurse outcomes, and patient outcomes), and partially supported the negative impact of turnover. Nine studies found that nurse turnover is very costly. CONCLUSION Most studies investigated the turnover cost, which is costly. The negative noneconomic impact of nurse turnover was partially supported. IMPLICATIONS FOR NURSING PRACTICE AND NURSING POLICY To prevent the adverse noneconomic and economic impacts of nurse turnover and retain nurses, healthcare organizations, nurse managers, and hospital staff nurses need to develop and implement prevention strategies and policies to address nurse turnover. Efforts to address nurse turnover can increase hospital competency to improve the quality of nursing care services and patient safety.
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Affiliation(s)
- Sung-Heui Bae
- Associate Professor, College of Nursing, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
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Najafi Z, Sadat-Hoseini AS, Imanipour M, Mosadeghrad AM. Factors affecting nurses' retention in Iranian hospitals. J Nurs Manag 2022; 30:785-794. [PMID: 35218597 DOI: 10.1111/jonm.13568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 01/11/2022] [Accepted: 02/19/2022] [Indexed: 11/27/2022]
Abstract
AIM This research was conducted to study the factors affecting nurses' retention in Iranian hospitals. BACKGROUND Health care systems should pay attention to their human resources' retention to deliver health care services and maintain their organizational values. This issue becomes more significant when we consider the human and financial limitations in place. METHOD Data were analyzed using conventional qualitative content analysis based on the model developed by Elo & Kyngäs. Forty-two managers and nurses were selected by purposive sampling. Data were obtained through 45 semi-structured interviews until data saturation was reached. RESULTS The data analysis resulted in four main categories and seventeen subcategories. The main categories included dignity and respect, ethics and spirituality, empathy, and flourishing. The main theme extracted was "maternal management". CONCLUSION The present study proposes "maternal management" as a strategy to increase the retention of nurses. IMPLICATIONS FOR NURSING MANAGEMENT Maternal management is a combination of management knowledge and empathy when dealing with the staff's problems. By creating an amiable and empathetic environment, maternal management motivates and encourages the staff. In the face of financial and human resources shortage, what helps retain the staff is a friendly atmosphere and mutual understanding between them and the nursing manager.
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Affiliation(s)
- Zahra Najafi
- School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Masoomeh Imanipour
- School of Nursing & Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mohammad Mosadeghrad
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Djukic M, Fletcher J. Factors associated with new nurses' career choice as advanced practice nurses: Implications for managing organizational turnover. Appl Nurs Res 2022; 63:151541. [PMID: 35034710 DOI: 10.1016/j.apnr.2021.151541] [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: 07/30/2021] [Revised: 10/29/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Staff nurse turnover is a costly problem for healthcare managers, which has been extensively studied. Now, managers are facing a new challenge attributed to nurses leaving their current positions to become advanced practice nurses. We aimed to identify factors associated with new nurses' career choice as advanced practice nurses. METHODS We used descriptive comparative design to analyze data from 946 nurses who reported working as new staff nurses in 2006 and 10 years later reported working as advanced practice nurses. RESULTS We add to the topic of nurses' turnover by identifying the factors associated with nurses leaving their jobs to become advanced practice nurses. The factors include being younger, not married, enrolled into a formal education program, and having a bachelor's degree at entry into nursing practice. CONCLUSIONS To better manage staff nurse turnover due to nurses becoming advanced practice nurses, managers should monitor educational policy trends on bachelor's entry into practice, new nurses' enrollment status into formal education program upon hire, and new nurses' demographics.
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Affiliation(s)
- Maja Djukic
- Jane and Robert Cizik School of Nursing, The University of Texas Health Science Center at Houston, 6901 Bertner Ave. SON-567B, Houston, TX 77030, United States of America.
| | - Jason Fletcher
- New York University, Rory Meyers College of Nursing, United States of America.
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