The impact of the second victim's experience and support on the career success of psychiatric nurses: The mediating effect of psychological resilience

Mediating Effect of Nursing Organizational Culture on the Relationship Between Ambidextrous Leadership and Staff Nurse Clinical Leadership

Aim: This study aims to explore the relationship of head nurses' ambidextrous leadership with staff nurse clinical leadership and the mediating effect of nursing organizational culture. Background: Clinical nurses are an important part of the nursing team, and their clinical leadership is of great significance to improving the quality of nursing and developing a nursing career. The ambidextrous leadership of head nurses, which combines transformational and transactional leadership, is a new leadership style. There are few studies on the effect of head nurses' ambidextrous leadership on staff nurse clinical leadership. Methods: This study was a cross-sectional study, and convenient sampling method was used to extract 500 nurses from first-class comprehensive hospital in Hangzhou City, Zhejiang Province, as research participants. The participants were administered an electronic questionnaire consisting of the General Information Questionnaire, Ambidextrous Leadership Style Scale, the Chinese version of Nursing Culture Assessment Tool, and the Chinese version of Clinical Leadership Survey. All the three scales used in this study had satisfactory construct validity, content validity, and reliability. Multiple stepwise linear regression analysis was used to explore the influencing factors of staff nurse clinical leadership. AMOS 24.0 software was used to construct a structural equation model to verify the mediating effect of nursing organizational culture between the ambidextrous leadership of head nurses and staff nurse clinical leadership. Results: The score of staff nurse clinical leadership was 66.69 ± 7.42. Significant positive correlations were noted between staff nurse clinical leadership and head nurses' ambidextrous leadership (r = 0.461, p < 0.01), between nursing organizational culture and staff nurse clinical leadership (r = 0.685, p < 0.01), and between ambidextrous leadership and organizational culture (r = 0.641, p < 0.01). Professional title, role at work, marital status, participation in leadership training, and nursing organizational culture were the main predictors of staff nurse clinical leadership, collectively accounting for 49.8% of the total variation. Nursing organizational culture played a complete mediating role between head nurses' ambidextrous leadership and staff nurse clinical leadership, and the mediating effect was 0.555 (95% CI [0.454, 0.692]), accounting for 98.8% of the total effect. Conclusion: Staff nurse clinical leadership represents the upper-middle level of clinical leadership. Nursing organizational culture can independently predict the level of staff nurse clinical leadership and has a complete mediating effect between head nurses' ambidextrous leadership and staff nurse clinical leadership. However, due to time, energy, and sampling methods, this study's sample is insufficient to represent the national nursing staff. Future research should further expand the survey's geographical scope and sample size. Implications for Nursing Management: Senior managers can encourage the head nurses to adopt the ambidextrous leadership style and consequently raise the enthusiasm of the organizational culture to improve staff nurse clinical leadership. Managers should rework the rules and regulations and increase work enthusiasm among nurses. Furthermore, they should carry out hierarchical training of clinical leadership for nurses and reasonably empower them to increase their work autonomy and self-efficacy and to encourage and support them in their clinical leadership practice.

The impact of second-victim syndrome on staff well-being and practice

This study aimed to examine factors influencing psychological well-being and support among healthcare professionals involved in adverse event investigations, complaints, medical errors, and patient injuries from January 2020 to March 2022. The second-victim experience and support tool (SVEST) was used to assess second-victim experiences and support resources. Non-probability purposive sampling was employed, and data were collected through a Monkey Survey sent via email to around 150 clinicians (physicians, nurses, and pharmacists). A total of 100 responses were received. The inclusion criteria required participants to have been involved in adverse event investigations, complaints, medical errors, or patient-related injuries. The SVEST, with 29 items measured on a 5-point Likert scale, evaluated their perceptions of second-victim experiences and support resources. Institutional support was positively perceived by 55.0% of participants, with 52.0% feeling a range of coping resources was available. However, 31.0% felt their well-being was not adequately prioritized. Nonwork-related support was crucial, with 57.0% relying on friends and family. Professional self-efficacy was impacted, with 46.0% feeling inadequate and 39.0% experiencing self-doubt. Turnover intentions were notable, as 39.0% expressed a desire to leave patient care, and 34.0% considered quitting due to stress. This study highlights the need for targeted support systems to address second-victim experiences among healthcare professionals involved in adverse events. Enhancing institutional support, professional self-efficacy, and access to coping resources is crucial. Policymakers and healthcare leaders can help mitigate stress, decrease turnover intentions, and promote psychological resilience by fostering a supportive work environment and providing comprehensive resources, healthcare organizations can improve clinician well-being, reduce stress, and enhance patient care quality.

The mediating role of professional identity between work environment and caring behavior: a cross-sectional survey among hospice nurses in China

BACKGROUND

As core members of hospice care team, the hospice nurses' ability to care for patients not only directly affects the standard of patient care, but also significantly impacts patient quality of life. It can be seen that it is very meaningful for patients to improve the caring behavior of hospice nurses. Therefore, it is necessary to deeply explore the influencing factors of nurses' caring behavior and further clarify the mechanism between them.

METHODS

The STROBE guideline was performed to report this study. We conducted a cross-sectional survey from December 2023 to February 2024. In this study, 392 hospice nurses were recruited from tertiary public hospitals in East China by convenient sampling method. Participants were investigated using the Practice Environment Scale, Professional Identity Scale, and Caring Behaviors Inventory. Structural equation modelling was utilized to verify the research hypotheses.

RESULTS

The results revealed that there were significant and positive correlations between work environment, professional identity and caring behavior. Furthermore, professional identity partially mediated the relationship between work environment and caring behavior.

CONCLUSION

Work environment is critical to improving hospice nurses' caring behavior. Professional identity plays an intermediary role impacting how work environment promotes caring behavior among Chinese hospice nurses. Nursing managers should have a correct understanding of the relationship between them. Targeted measures and coping strategies need to be actively taken to create a better working environment for hospice nurses. This would enhance professional identity, and thereby promote caring behavior.

The relationship between job crafting and work engagement among nurses in China: A latent profile analysis

AIM

To identify subtypes of job crafting among Chinese nurses and to explore the characteristics of different subtypes and their relationship with work engagement.

DESIGN

A cross-sectional study.

METHODS

A survey of 350 clinical nurses was conducted between December 2022 and January 2023. Identify profile categories for nurses' job crafting using a latent profile analysis. Logistic regression and ANOVA were used to explore the characteristics of different categories of nurses' job crafting in terms of sociodemographic, work engagement variables.

RESULTS

Ultimately 3 latent profiles are identified: low job crafting (Class 1, N = 177, 50.7%), moderate job crafting (Class 2, N = 136, 38.9%), high job crafting (Class 3, N = 37, 10.5%). Nurses who are female, aged 31 to 40 and married are more likely to be grouped into Class 2. Nurses with a middle level of title are more likely to be grouped as Class 3. Nurses with high levels of work engagement are more likely to be grouped as Class 2 and Class 3 rather than Class 1.

CONCLUSION

The job crafting has a distinctly classified character among Chinese nurses. 89.6% of nurses were at a low to medium level of job crafting, work engagement is an important predictor of nurses' job crafting. Nursing Managers should focus on the low job crafting group and develop targeted interventions to help nurses improve their job crafting and work engagement levels.

PATIENT OR PUBLIC CONTRIBUTION

None.

Psychological resilience mediates sense of professional mission and career success in Chinese intensive care unit nurses: a cross-sectional study

BACKGROUND

The nursing industry's stability and progress are adversely affected by the high attrition rate and shortage of nurses; therefore, it is critical to investigate the variables that influence the professional stability of nurses. The sense of professional mission and career success have positive significance for reducing nurses' job burnout. The purpose of this study is to explore the potential mediating role of psychological resilience in this relationship.

METHODS

Self-reported questionnaires were utilized by 335 intensive care unit (ICU) nurses to assess their sense of professional mission, psychological resilience, and career success in this cross-sectional study. A structural equation model was developed to validate the relationship between the variables.

RESULTS

There is a correlation among sense of professional mission, psychological resilience and career success. Significant mediating effect of psychological resilience exists between sense of professional mission and career success.

CONCLUSIONS

In this study, psychological resilience plays an intermediary role between sense of professional mission and career success, which provides support for further understanding the mechanism between sense of professional mission and career success and bolstering the case for devising comprehensive intervention strategies for psychological resilience. Nursing managers should focus on nurses' sense of professional mission and psychological resilience, and implement strategies to enhance nurses' psychological resilience in order to boost their career success.

Mediating Effects of Perceived Social Support on the Relationship between Comfort and Hope in Hospitalized Patients with Acute Ischemic Stroke

Background

The relationship among comfort, perceived social support, and hope should still be further explored. Clarifying the relationship between the aforementioned variables can enable clinical staff to implement tailored and effective intervention strategies for enhancing the management and quality of care of patients with ischemic stroke.

Aim

This study aims to investigate the relationship between comfort, perceived social support, and hope in hospitalized patients with acute ischemic stroke and to explore the mediating effect of perceived social support on comfort and hope.

Methods

A correlational cross-sectional study was performed using an online questionnaire. The study was conducted from January to August 2023 among 572 patients with acute ischemic stroke, and finally 534 valid questionnaires were included in the analysis. The general information questionnaire, Modified Barthel Index, Shortened General Comfort Questionnaire, Perceived Social Support Scale, and Herth Hope Index were utilized for investigation. Mediation analysis was performed by structural equation modelling. Indirect effects were evaluated through bootstrapping. Data analysis was performed using the statistical program packages, namely, SPSS 29.0 and AMOS 24.0.

Results

The comfort, perceived social support, and hope scores of patients with acute ischemic stroke were 94.1 (11.92), 72.74 (10.26), and 40.55 (4.99), respectively. The participants' hope was positively related to comfort (r = 0.531, p < 0.001) and perceived social support (r = 0.589, p < 0.001). Perceived social support exerts a partial mediating role between comfort and hope, and the mediating effect was 0.159 (95% CI [0.117, 0.210]), accounting for 25.0% of the total effect.

Conclusion

We reported that comfort-directly and indirectly-exerts a positive impact on hope. Particularly, perceived social support enhances the impact of comfort on hope; perceived social support mediates the relationship between comfort and hope. Clinical staff should correctly understand the relationship among the three variables; they should effects targeted strategies to enhance patient comfort and social support, thereby increasing the hope level among ischemic stroke patients and bolstering confidence in disease management. Implications for Nursing Management. This study demonstrates that comfort and perceived social support serve as protective factors for hope among ischemic stroke patients. This observation provides evidence supporting the optimization of management for ischemic stroke patients from the perspectives of the cognitive adaptation theory and comfort theory. The findings of this study contribute to a more optimal understanding among clinical caregivers regarding the mechanisms underlying the relationship between comfort, social support, and hope, and it facilitates the adoption of effective intervention strategies for promoting the psychological management of ischemic stroke patients and enhancing patient care quality.

Mediating Role of Rumination in Second Victim Experience to Turnover Intention in Psychiatric Nurses

BACKGROUND

Psychiatric nurses often face patient safety incidents that can cause physical and emotional harm, even leading to s econd victim syndrome and staff shortages. Rumination-a common response after nurses suffer a patient safety event-may play a specific role between the second victim experience and turnover intention. Understanding these mechanisms is crucial for supporting psychiatric nurses and retaining psychiatric nursing resources.

OBJECTIVES

The study aimed to explore the associations among second victim experience, rumination, and turnover intention in psychiatric nurses and confirm how second victim experience influences turnover intention through rumination and its subtypes.

METHODS

A descriptive, cross-sectional study was adapted to survey 252 psychiatric nurses who experienced a patient safety incident at three hospitals in China between March and April 2023. We used the Sociodemographic and Patient Safety Incident Characteristics Questionnaire (the Chinese version of the Second Victim Experience and Support Tool), the Event-Related Rumination Inventory, and the Turnover Intention Scale. Path analysis with bootstrapping was employed to accurately analyze and estimate relationships among the study variables.

RESULTS

There was a positive association between second victim experience and turnover intention. In addition, both invasive and deliberate rumination showed significant associations with second victim experience and turnover intention. Notably, our results revealed that invasive and deliberate rumination played partial mediating roles in the relationship between second victim experience and turnover intention in psychiatric nurses.

DISCUSSION

The negative experience and turnover intention of the psychiatric nurse second victims are at a high level. Our results showed that invasive rumination positively mediated the relationship between second victim experience and turnover intention, and deliberate rumination could weaken this effect. This study expands the knowledge of the mechanisms underlying the effect of the second victim experience on turnover intention. Organizations must attach importance to the professional dilemmas of the psychiatric nurses' second victims. Nurse managers can reduce nurses' turnover intention by taking measures to reduce invasive rumination and fostering deliberate meditation to help second victims recover from negative experiences.

A latent profile analysis of resilience and the associations with flourishing in emergency nurses exposed to workplace violence in China

Workplace violence (WPV) exposure has been particularly prevalent in emergency nurses, coupled with negative mental health outcomes. Few explored resilience after WPV exposure using the perspective of positive mental health. We aimed to identify latent profiles of resilience and examine associations with flourishing in emergency nurses with WPV exposure. A total of 1241 Chinese emergency nurses were surveyed on the frequency of WPV exposure, resilience, and flourishing. Eight hundred and twenty five participants (90.1% female, 86.6% aged 20-39) reported WPV exposure at least once in the past 3 months. Latent profile analysis identified profiles of resilience as low resilience (15.0%), moderate decision respond and interpersonal link with low rational thought and flexible adaption (18.0%), moderate resilience (31.0%), high decision respond, interpersonal link, and rational thought with moderate flexible adaption (16.0%), and high resilience (20.0%). Higher flourishing was observed in profiles of moderate resilience, high decision respond, interpersonal link, and rational thought with moderate flexible adaption, and high resilience. We differentiated profiles of resilience and the associations with flourishing in emergency nurses with WPV exposure, which informed targeted interventions for promoting positive mental health.

Factors Influencing Professional Identity of Psychiatric Nurses as Second Victims: A Cross-Sectional Study

The current study aimed to explore the status and influencing factors of professional identity among psychiatric nurses as second victims in China by using a cross-sectional design. We investigated 291 psychiatric nurses from two psychiatric hospitals. Participants were asked to complete a demographic questionnaire, Second Victim Experience and Support Scale, Multidimensional Health Locus of Control Scale, and Professional Identity Scale for Nurses. Scores of professional identity of psychiatric nurses as second victims were moderate. Regression analysis showed that the second victim experience and support and internal control were significant predictors, explaining 34.2% of the variance in professional identity. Identifying risk factors related to the professional identity of psychiatric nurses as second victims will help managers take timely preventive measures to improve the awareness of the self-health responsibility of psychiatric nurses and reduce the adverse effects of patient safety incidents to enhance their professional identity. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 47-54.].

Relationship between emotional intelligence and job stressors of psychiatric nurses: A multi-centre cross-sectional study

AIM

To investigate the impact of socio-demographic factors and job stressors on the emotional intelligence of psychiatric nurses.

BACKGROUND

Emotional intelligence plays a crucial role in enabling nurses to effectively manage their own emotions, comprehend the emotions of others and assist individuals in dealing with diverse stressors. Nevertheless, a comprehensive conceptualization of the relationship between job stressors and emotional intelligence remains lacking.

DESIGN

This study employs a multi-centre cross-sectional design.

METHODS

A multi-centre cross-sectional survey involving 1083 registered nurses from 11 psychiatric hospitals across four provinces in China was conducted. Non-probability sampling was utilised. The survey encompassed assessments of nurse job stressors, emotional intelligence using a scale and socio-demographic characteristics using a questionnaire. A multiple linear regression model was applied to identify significant variables associated with emotional intelligence based on demographic attributes and various nurse job stressors. The study adhered to the STROBE checklist.

RESULTS

The findings revealed a noteworthy negative correlation between nurse job stressors and emotional intelligence. Socio-demographic factors and job stressors of certain nurses were able to predict emotional intelligence and its dimensions among psychiatric nurses, with percentages of 44.50%, 40.10%, 36.40%, 36.60% and 34.60%.

CONCLUSION

Providing emotional intelligence training for psychiatric nurses could enhance their capacity to cope effectively with workplace stress, particularly among younger nurses who engage in limited physical activities.

RELEVANCE TO CLINICAL PRACTICE

The analysis of the relationship between emotional intelligence and nurse job stressors could facilitate early detection and intervention by managers based on pertinent factors. This, in turn, could elevate the emotional intelligence level of psychiatric nurses.

NO PATIENT OR PUBLIC CONTRIBUTION

This study did not recruit participants, so details of participants were not be involved.

Unlocking green growth challenges: role of green HRM, green career adaptability, and green career success

Multiple industries face challenges in achieving green growth that needs a fix. This research presents an alternative explanation for the acquisition of green growth using the perspective of employees of manufacturing industries. Thus, the study examines the role of green HRM, green career adaptability, and green career success in achieving green growth. Green growth drivers can construct green infrastructures for developing green aspects in economic sectors such as power generation, transportation, and the residential sector. We inquired Chinese SME employees to fill out a closed-ended online survey. PLS-SEM techniques are used to estimate how the study will turn out. According to the results, green career adaptability plays a big part in green HRM and career success. It also plays a significant role in bringing the two together. The results shown that green HRM, adapting to a green career and doing well in a green career, all help green growth in manufacturing SMEs in China. The study's results are strong in their ability to explain. This is especially true in the academic world, where people who can adapt to setbacks and have a green career are likelier to have a good career in organizations that care about the environment. By doing this, the study also helps guide the strategic development goals (SDGs) for climate action and environmental management by acquiring green growth. So, the study makes different suggestions for what to do.

Resilience and mental health nursing: An integrative review of updated evidence

Mental health nursing work is challenging, and workplace stress can have negative impacts on nurses' well-being and practice. Resilience is a dynamic process of positive adaptation and recovery from adversity. The aims of this integrative review were to examine and update understandings and perspectives on resilience in mental health nursing research, and to explore and synthesize the state of empirical knowledge on mental health nurse resilience. This is an update of evidence from a previous review published in 2019. Using integrative review methodology, 15 articles were identified from a systematic search (July 2018-June 2022). Data were extracted, analysed with constant comparison method, synthesized narratively and then compared with the findings from the original review. As an update of evidence, mental health nurse resilience was moderate to high across studies, was positively associated with psychological well-being, post-traumatic growth, compassion satisfaction and negatively associated with burnout, mental distress and emotional labour. Lack of support and resources from organizations could negatively impact nurses' ability to maintain resilience and manage workplace challenges through internal self-regulatory processes. A resilience programme improved mental health nurses' awareness of personal resilience levels, self-confidence, capacity to develop coping skills and professional relationships. Some studies continue to lack contemporary conceptualizations of resilience, and methodological quality varied from high to low. Further qualitative and interventional research is needed to investigate the role of resilience in mental health nursing practice, personal well-being, workforce sustainability and the ongoing impacts of the COVID-19 pandemic.

Psychosocial factors associated with career success among nurses: A latent profile analysis

AIM

In this study, a person-centred approach was used to analyse career success profiles and explore the associated psychosocial factors among nurses.

DESIGN

A cross-sectional study was conducted from 15 April to 15 October 2019.

METHODS

A total of 1155 registered Chinese nurses were recruited from two general hospitals using convenience sampling. Participants completed a printed questionnaire, including the Maslach Burnout Inventory, Stress of Conscience Questionnaire, Practice Environment Scale, and Career Success Scale. Latent profile analysis and multinomial logistic regression were performed. The data were analysed with Mplus 8.3 and SPSS version 26.0.

RESULTS

Three latent profiles of career success were identified: high, moderate and low. Nurses with lower educational levels, more years of work experience, lower emotional exhaustion, higher personal achievement, lower stress of conscience and higher participation in hospital affairs were more likely to have higher career success than the other profiles.

CONCLUSIONS

Burnout, stress of conscience, practice environment, educational level and years of work experience were associated with career success among nurses. Targeting interventions may help enhance nurses' career success. Future research should combine subjective and objective indicators (salary, title and so on) to assess career success and explore other determinants for formulating interventions to enhance nurses' career success.

IMPACT

The heterogeneity and psychosocial factors associated with nurses' career success provide valuable evidence for the formulation of individualized interventions. Nursing managers should understand the importance of career success, develop interventions to reduce nurses' burnout and stress of conscience, and improve the practice environment to enhance their career success.

NO PATIENT OR PUBLIC CONTRIBUTIONS

This study was designed to examine the psychosocial factors associated with nurses' career success. The study was not conducted using suggestions from the patient groups or the public.

Career Identity and Career Success among Chinese male nurses: The mediating role of Work Engagement

AIM

This study aimed to investigate the effect of career identity on career success among Chinese male nurses and to examine the mediating role of work engagement in this relationship.

BACKGROUND

Recently, with the development of the nursing career, male nurses take up a higher share and play a more important role in the nursing team. With its own particularity and advantages, this group's stability closely relates to the future of the nursing team. Therefore, promoting the career success of the male nurses is essential to the nursing team development.

METHODS

The data were collected in China. A sample of 557 male nurses completed measures of career identity, work engagement and career success scale. Structural equation model was adopted to verify the research hypotheses.

RESULTS

Career identity was significantly and positively related to male nurses' work engagement and career success (p< .01). And work engagement partially mediated the association between career identity and career success.

CONCLUSION

Career identity are critical to predicting and enhancing male nurses' career success. Work engagement plays an intervening mechanism explaining how career identity promotes career success among male nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing management should minimize the impact of the traditional concept, implement the gender equality and provide moderate care for male nurses to facilitate balanced development of gender by upgrading the management system. The administrators should carry out skill training based on male nurses' features and the need of the department. Given full play to their respective advantages, male nurses will make great progress in professional development and achieve greater career identity and work engagement. Meanwhile, the further exploration of better incentive mechanism also makes sense in improving career identity and work engagement by the reform of performance appraisal mechanism and salary adjustment according to their ability.

Psychological Resilience and Career Success of Female Nurses in Central China: The Mediating Role of Craftsmanship

Background

Nurses’ career success is an important factor affecting the quality of nursing services and the stability of the nursing workforce, and enhancing nurses’ career success level is of key significance to the development of the nursing discipline. As psychological resilience and craftsmanship are important spiritual traits in the process of nurses’ career development, it is important to understand the mechanism of their effects on nurses’ career success level.

Objective

To explore the current situation of craftsmanship, psychological resilience and career success levels of female nurses in central China, and to verify the mediating role of craftsmanship between psychological resilience and female career success using structural equation model.

Methods

A cross-sectional study was conducted among 2359 female nurses from three hospitals in central China through an online questionnaire, including craftsmanship, psychological resilience and career success scale. The data were analyzed by Z-test and Spearman rank correlation with SPSS 23.0 statistical software, and the mechanism of the effect of craftsmanship and psychological resilience on career success was completed by AMOS 23.0 statistical software.

Results

The scores of career success, psychological resilience, and craftsmanship of female nurses in central China were 68.00 (61.00, 75.00), 74.00 (64.00, 84.00), and 83.00 (79.00, 95.25). Spearman rank correlation analysis showed that Chinese female nurses’ career success was positively correlated with craftsmanship (r = 0.511, P < 0.01) and psychological resilience (r = 0.595, P < 0.01). Craftsmanship played a mediating role between psychological resilience and career success, accounting for 39.3% of the total effect ratio.

Conclusion

The scores of career success and psychological resilience of female nurses in central China are at a moderate level, and craftsmanship plays a mediating role between psychological resilience and career success. It is suggested that nursing managers should pay attention to the importance of career success to nurses’ self-development and nursing team stability, and improve their sense of career success by effectively improving nurses’ psychological resilience and craftsmanship.