Explaining Novice Nurses’ Experience of Weak Professional Confidence: A Qualitative Study

Examining the relationship between nurse psychological capital and job burnout: a multilevel analysis across nurse, nurse leader, and nurse family perspectives

BACKGROUND

Nurse job burnout is a critical issue affecting medical quality and safety. Psychological capital (PsyCap) is associated with enhanced career satisfaction and reduced work stress. This study evaluates the relationship between nurses' PsyCap and job burnout, while considering leadership and family as contextual factors.

METHODS

A cross-sectional study design was used, collecting data from 499 nurses via validated questionnaires. Statistical analyses, including descriptive statistics, correlation, and multiple regression, were conducted to assess the relationship between PsyCap and job burnout. Leadership and family were included as contextual variables in hierarchical regression models to evaluate their indirect influences.

RESULTS

Among nurses, 63.9% experienced mild to moderate burnout. The average PsyCap score was 107.88 ± 20.55. PsyCap showed a significant negative correlation with burnout dimensions (correlation coefficients: -0.43 to -0.53, p < 0.01). Higher PsyCap significantly predicted lower job burnout (β = -0.44, p < 0.01). Leadership and family influences had minor but noteworthy indirect effects on this relationship.

CONCLUSION

The results of this study suggest that higher levels of nurses' PsyCap are associated with lower levels of job burnout. While these findings highlight PsyCap's potential role in mitigating burnout, further research is needed to confirm causal relationships and assess the effectiveness of interventions aimed at enhancing PsyCap and supportive environments.

Professional Role Transition in Nursing: Leveraging Transition Theory to Mitigate the Current Human Resource Crises

New graduate nurse (NGN) turnover is emerging as one of the foremost issues in healthcare systems, primarily due to the implications for patient care and the need to secure the human resource future of the nursing profession. The initial months of transitioning into the professional role are crucial for cultivating and developing clinical practice patterns, professional values and a connection to the profession. However, the initial transition period for new nurses is associated with numerous challenges that can interrupt a healthy introduction into practice, justifying the critical prioritization of these issues. In light of these challenges to NGN entry to practice, this paper aims to conceptualize the contemporary professional role transition experiences of new graduate nurses and highlight the potential leverage that transition theories offer in managing this experience. Eleven transition theories relevant to this discourse were identified to enhance the understanding and comprehension of the new graduate nurses to inform future initiatives, directives, interventions and policies.

Evaluating family-centred care at BC Children's Hospital: Healthcare providers' perspectives

BACKGROUND

Family-centred care (FCC) emphasizes a partnership approach to care between healthcare providers (HCPs), patients, and families. FCC provides significant benefits to both children and families; however, challenges exist in implementing FCC into practice. This study aimed to explore HCPs' FCC behaviours in multidisciplinary specialty clinics at a tertiary pediatric health care center in Canada.

METHODS

A demographic survey and the Measure of Processes of Care for Service Providers (MPOC-SP) questionnaire was administered to HCPs in five specialty clinics: orthopaedics, neurology, multi-organ transplant, immunology, and nephrology. Survey data were summarized using descriptive statistics. The association between possible predictor variables (ethnicity, gender, years in clinical practice) and MPOC-SP scores were analysed by analysis of variance (ANOVA) followed by post-hoc Tukey's test. Differences in scores across professional disciplines were analysed by multivariate analysis of variance (MANOVA) followed by ANOVA. Items rated lower (1-4 out of 7 by >33% of participants) were identified as potential areas for improvement.

RESULTS

HCPs (N = 77) from all five clinics rated the MPOC-SP domain 'Treating People Respectfully' the highest (mean 6.00 ± 0.59) and 'Providing General Information' the lowest (mean 4.56 ± 1.27). HCPs with 5-10 years of experience had higher scores across all domains compared to HCPs with <5 years and >10 years of experience. There were no significant differences in scores based on ethnicity, gender, and professional discipline. Items rated lower (1-4 out of 7 by >33% of participants) involved providing general information and emotional support to families.

CONCLUSIONS

Providing general information and emotional support to patients and families are areas for improvement for all specialty clinics surveyed. Given genetic counsellors (GCs) expertise in education and counselling, GC integration in these clinics is one way in which FCC can be improved. Our study also shows that years of work experience influences HCPs' capacity to provide FCC.

Navigating transition shock: The role of system thinking in enhancing nursing process competency among early career nurses

BACKGROUND

Building nursing process competency among beginner nurses is a pivotal need in contemporary, complex, fast-paced nursing practice. However, transitioning from the educational phase to practicing as a nurse can be a significant adjustment. New practitioners often experience a period of shock, which may present challenges in developing nurse competency. Fostering system thinking among those nurses could buffer the negative signs of transition shock and cultivate nursing process competencies at earlier times.

AIM

This study explores the relationship between transition shock and nursing process competency among early career nurses and investigates the moderating effect of system thinking on this relationship.

METHOD

This cross-sectional correlational exploratory study was conducted at four large hospitals in Egypt. Data were collected from 393 nurses from the first of February 2024 to the end of April 2024 using the transition shock scale, the competency of nursing process questionnaire, and the system thinking scale. Correlational and hierarchical regression analyses were used to test the study variables.

RESULTS

A statistically significant negative correlation exists between transition shock, nursing process competency, and system thinking among early-career nurses. System thinking is positively associated with nursing process competency. System thinking positively moderates the relationship between transition shock and nursing process competency among early-career nurses. Transition shock and system thinking account for 23.9% of the variance in nursing process competency among early-career nurses.

LINKING EVIDENCE TO ACTION

Transition shock is an inevitable phenomenon among early-career nurses, negatively affecting their competency in the nursing process. System thinking buffers this adverse effect and significantly augments nursing process competency among this set of nurses. Predicting and mitigating transition shock among early-career nurses is pivotal in building nursing process competency. Nurse educators must develop curricula that cultivate system thinking skills among nursing students, which enables them to buffer transition shock after graduation.

Understanding Career Adapt Abilities, Career Stress, Work Stress, Career Regret, Job Satisfaction Among Nursing Professionals

AIM

This study aims to conduct a comprehensive analysis of the interrelationships among career stress, work stress, career regret, job satisfaction and career adapt abilities within the nursing profession.

DESIGN

The research involved a sample of 576 nurses from ten urban hospitals, distributed across five distinct cities in Turkiye, between December 2023 and January 2024. The study employed regression models to systematically test hypotheses, providing nuanced insights into the complex dynamics of the variables under investigation.

METHODS

Regression models were utilized to test the hypotheses systematically, considering the moderating role of career adapt abilities. The study included a sample of 576 nurses from 10 urban hospitals in Turkey, distributed across five distinct cities. This approach allowed for a detailed examination of the intricate relationships between career stress, work stress, career regret, job satisfaction and career adapt abilities within the nursing profession.

RESULTS

The findings underscore the delicate balance between the positive gains of job satisfaction and the challenges posed by career stress, work stress and career regret in the multifaceted landscape of nursing.

CONCLUSION

In nursing, the relationship between career stress, work stress, career regret and job satisfaction include progress, resilience and obstacles. Developing strategies requires a cooperative effort from health care organizations, nursing leaders and individual nurses.

IMPACT

The research provides valuable insights into the interplay of these factors and emphasizes the moderating role played by career adapt abilities. The implications of the study extend to healthcare organizations, nursing leaders and individual nurses. The research advocates for collaborative strategies aimed at enhancing job satisfaction, alleviating stressors and addressing career regret. The ultimate goal is to contribute to the retention of a resilient nursing workforce, emphasizing the importance of strategies that support the well-being and satisfaction of nurses in their careers.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Job satisfaction, professional competence, and self-efficacy: a multicenter cross-sectional study among registered nurses in Sweden and Norway

BACKGROUND

Healthcare organizations worldwide face persistent challenges relating to turnover and intention to leave the nursing profession among registered nurses. Factors contributing to their retention and well-being at work include high job satisfaction, professional competence, and self-efficacy. Few multicenter studies have investigated these factors in relation to work experience in a Nordic context. Therefore, this study aimed to investigate job satisfaction, professional competence, and self-efficacy among registered nurses.

METHODS

This multicenter cross-sectional study survey was part of a larger overarching Swedish-Norwegian project, and was conducted among registered nurses (n = 1137) in September 2021. The participants worked in a variety of health care units, e.g., hospital units, primary health care, and home care. Data was subjected to descriptive and comparative statistical analysis; chi-square test, one-way between-groups analysis of variance (ANOVA) and Kruskal-Wallis test.

RESULTS

The findings show that job satisfaction is reported as lowest in registered nurses with medium-term work experience as compared to newly qualified and long-term work-experienced registered nurses. Professional competence and self-efficacy are reported as higher among registered nurses with long-term work experience as compared to those with medium-term work experience and newly qualified registered nurses. However, the participants reported their professional competence as highest in relation to the same factor - "Value-based nursing care" - regardless of their work experience.

CONCLUSIONS AND IMPLICATIONS

This study underscores the need for continuous support and professional development for registered nurses throughout their careers. Proactive support for newly qualified nurses may improve job satisfaction as they progress to being registered nurses with medium-term work experience. Tailored interventions to address the distinct needs of both newly qualified and medium-term work-experienced registered nurses are crucial for nurturing a sustainable nursing workforce.

Newly graduated nurses' commitment to the nursing profession and their workplace during their first year of employment: A focused ethnography

BACKGROUND

The commitment of nurses to their profession and workplace is closely linked to the delivery of high-quality patient care. Existing literature highlights the positive impact of commitment on care quality and patient outcomes. Conversely, a lack of commitment can lead to nurse burnout and disengagement. However, it remains unclear whether and how cultural beliefs and practices influence newly graduated nurses' commitment to the nursing profession and their workplace.

AIM

To explore the cultural beliefs and practices influencing newly graduated nurses' commitment to the profession and commitment to their workplace during their first year of employment.

DESIGN

A focused ethnographic study.

METHODS

Data consisted of field notes from 94 h of participant observations and 10 semi-structured interviews with newly graduated nurses working in acute care settings in Denmark. Data were analysed using ethnographic content analysis. Data were collected between March and June 2022.

RESULTS

The findings reveal a major theme, termed 'A State of Transience among Newly Graduated Nurses', consisting of two themes: 'Newly Graduated Nurses' Pursuit of Professional Development and Supportive Work Environments' and 'A Lack of Formal Agreements or Conditions to Meet Expectations for Professional Development.'

CONCLUSION

Hospitals and nurse managers need to support newly graduated nurses in their first employment after registration by providing a range of clinical experiences through job rotation opportunities within the same organization, deliver on promises for onboarding support and foster a culture of trust. These strategies will help maintain the motivation, commitment and ability of newly graduated nurses to deliver high-quality patient care, thereby reducing the likelihood of turnover.

RELEVANCE FOR CLINICAL PRACTICE

A trusting and supportive work environment is fostered by providing diverse clinical experiences and consistent support for newly graduated nurses. To address potential high turnover associated with job rotation, hospitals need to rethink how retention is defined and measured, moving beyond hospital unit-level models and measures.

REPORTING METHOD

This study reports to the SRQR guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Translation and validation of the Persian version of the perception to care in acute situations (PCAS-P) scale in novice nurses

BACKGROUND

Novice nurses providing care in acute conditions should have satisfactory performance. Accurate and appropriate evaluation of the performance of novice nurses in providing care in acute situations is essential for planning interventions to improve the quality of patient care. This study was conducted to translate and evaluate the psychometric properties of the Persian version of the Perception to Care in Acute Situations (PCAS-P) scale in novice nurses.

METHODS

In this methodological study, 236 novice nurses were selected by the convenience sampling method. 17-item scale PCAS-P was translated into Persian by the forward-backward process. Then, this version was used for psychometric evaluation. For this purpose, face validity, content validity, and construct validity were assessed using confirmatory factor analysis. Internal consistency and stability reliability were calculated. The data were analyzed using SPSS and AMOS software.

RESULTS

The PCAS-P scale maintained the meaning of the original English version and was clear, explicit, and understandable for novice nurses. Confirmatory factor analysis showed that this Persian version is consistent with the proposed model and confirmed the fit of the three-factor model. The values of Cronbach's alpha coefficient, McDonald's omega, Coefficient H, and average inter-item correlation were excellent for the overall scale and its dimensions, and the three latent factors had good convergent and discriminant validity. Additionally, the average measurement size was 0.944 ICC (95% CI 0.909 to 0.969).

CONCLUSION

The PCAS-P scale is valid and reliable for measuring novice nurses' perception of acute situations.

Being a Newly Qualified Nurse: A Nordic Focus Group Study

Introduction

The transition to working life as a newly qualified nurse (NQN) can be challenging, leading to heightened stress levels. While NQNs are generally enthusiastic about starting their careers, they often express concerns about various responsibilities and a perceived lack of experience in independently dealing with clinical care in complex environments.

Objective

To acquire an in-depth understanding, from a caring science perspective, of what it means to be an NQN during the transition period of the first 18 months in the profession.

Methods

This study relied on an exploratory qualitative design. The methodological approach followed Gadamer's hermeneutic philosophy. Six focus group interviews were conducted in northern Norway (n = 3) and northern Sweden (n = 3) from January through May 2021. The interpretation of the data was inspired by Fleming et al. Nineteen female and seven male NQNs working in different contexts, including hospitals and municipalities, participated in the study. The consolidated criteria for qualitative research were used to report the results.

Results

Perspectives on NQNs are presented as three themes: a) the responsibility was perceived as a significant challenge, b) being a nurse is complex and demanding, and c) a desire for personal and professional development. Learning to be a nurse shouldering responsibility necessitates support and guidance from caring and compassionate colleagues and leaders.

Conclusions

This study sheds light on the importance of creating a workplace culture where NQNs' learning is promoted and supported by designated mentors during their transition to working life. The responsibilities should be aligned with their level of knowledge. It is important that leaders hold developmental dialogues and ensure a career plan for NQNs to continuously develop their knowledge and skills. Intervention studies designed to evaluate the meaning of the support from appointed mentors within structured mentorship programs are needed.