How do nurse consultant job characteristics impact on job satisfaction? An Australian quantitative study

The effect of sex, age, work experience, education, shift, and ward on nursing autonomy perceptions

BACKGROUND

In Italy, cultural and professional nursing improvements are reached thanks to the university-based education which marks the clinical competency and the professional autonomy in nursing decision-making.

OBJECTIVE

To highlight how Italian nurses perceived their nursing autonomy level in the main action-points highlighted in the Italian regulation law according to sex, age, work experience, education, shift and ward.

METHODS

A cohort explorative study was carried out from September 2022 to January 2023 to highlight how Italian nurses perceived their nursing autonomy levels in the main action-points highlighted in the Italian regulation law for the nursing profession according to demographic characteristics, like: gender, age, work of experience, education, shift, ward employment.

RESULTS

A total of 403 nurses were enrolled. Significant differences were recorded in: decision-making authority in patient care and shift (p≤0.001) and ward employment (p = 0.045); ability to initiate nursing interventions and education (p < 0.001) and ward employment (p = 0.011); collaboration and communication with healthcare team members and education (p < 0.001) and ward employment (p = 0.010); independence in clinical judgment and critical thinking and shift (p < 0.001); responsibility for the planning and evaluation of nursing care and education (p = 0.005) and shift (p = 0.002) and ward employment (p = 0.013); autonomy in professional development and continuing education and shift (p < 0.001) and ward employment (p < 0.001).

CONCLUSIONS

The results highlighted the intricate world both of the healthcare surrounding and the abilities to act autonomously within the multiprofessional staff. Future studies will develop qualitative and phenomenological designs in order to better define in which fields nurses will act their professional autonomy.

Utilizing the Social Determinants of Health Model to Explore Factors Affecting Nurses' Job Satisfaction in Saudi Arabian Hospitals: A Systematic Review

The purpose of this systematic review was to explore factors affecting nurses' job satisfaction in Saudi Arabian hospitals by utilizing the social determinants of a health model. We conducted a systematic review using three databases (PubMed, PsychINFO, and CINAHL) following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. A total of 235 studies were screened. Of these studies, nine met the inclusion criteria. The studies were appraised using the Joanna Briggs Institute checklist tool. The majority of studies reported that salary, years of experience, nationality, and marital status were factors affecting nurses' job satisfaction. Gender and educational level did not impact job satisfaction for male and female nurses. Overall, the review highlighted some knowledge gaps in the assessment of the impact of social determinants of health regarding gender and educational level on nurses' job satisfaction. Further research is needed to address this knowledge gap.

Professional autonomy among nurses in Saudi Arabian critical care units

BACKGROUND

Professional autonomy is essential in expanding the scope of nursing practice and has been recognized as a top nursing priority.

OBJECTIVE

This study aims to assess Saudi nurses' autonomy level in critical care settings and examine the influence of sociodemographic and clinical characteristics on their autonomy level.

METHODS

A correlational design and a convenience sampling approach were used to recruit 212 staff nurses from five Saudi governmental hospitals in Jouf region of Saudi Arabia. The data were collected through a self-administered questionnaire composed of two sections, including sociodemographic characteristics and the Belgen autonomy scale. The Belgen autonomy scale used in this study measures nurses' autonomy levels and consists of 42 items rated on an ordinal scale. The scale's minimum score of 1 indicates nurses with no authority, while the maximum score of 5 indicates nurses with full authority.

RESULTS

Descriptive statistics revealed that nurses in the sample had a moderate overall work autonomy (M = 3.08), with higher autonomy in patient care decisions (M = 3.25) compared to unit operations decisions (M = 2.91). Nurses had the highest level of autonomy in tasks related to preventing patient falls (M = 3.84), preventing skin breakdown (M = 3.69), and promoting health activities (M = 3.62), while they had the lowest level of autonomy in ordering diagnostic tests (M = 2.27), determining the day of discharge (M = 2.61), and planning the unit's annual budget (M = 2.22). The multiple linear regression model (R2 = 0.32, F (16, 195) = 5.87, p < .001) showed that education level and years of experience in critical care settings were significantly related to nurses' work autonomy.

CONCLUSION

Saudi nurses in acute care settings have moderate professional autonomy, with higher autonomy in making patient care decisions than unit operations decisions. Investing in nurses' education and training could increase their professional autonomy, leading to improved patient care. Policymakers and nursing administrators can use the study's results to develop strategies that promote nurses' professional development and autonomy.

Social support and job satisfaction in nursing staff: Understanding the link through role ambiguity

AIM

This study aimed to analyze the mediator effect of role ambiguity between social support from supervisor and colleagues and job satisfaction in Portuguese nursing staff.

BACKGROUND

Few studies have analyzed the processes through which social support increases job satisfaction in the nursing context.

DESIGN

A cross-sectional design using questionnaires.

METHOD

A total of 124 registered nurses and 130 certified nursing assistants participated in the study. Mediation analysis was performed by calculating Percentile confidence intervals (10,000 resamples).

RESULTS

Mediation analysis revealed a partial mediation between social support and job satisfaction through role ambiguity. The direct effect was greater in the case of supervisor support.

CONCLUSIONS

Social support is a crucial resource in the nursing work context with a beneficial effect on well-being (e.g. reducing role stress) and job satisfaction. Implications for Nursing Management Managers of hospitals and health units can establish the organizational bases to facilitate this process, considering the importance of the role of the supervisors and colleagues in the provision of high levels of instrumental and socio-emotional support.

Going the Extra Mile (or Not): A Moderated Mediation Analysis of Job Resources, Abusive Leadership, Autonomous Motivation, and Extra-Role Performance

Abusive leadership is particularly prevalent in nursing and it can have multiple adverse effects on performance at work. However, little research has examined whether and under what conditions abusive leadership may be detrimental to nurses’ extra-role performance. This cross-sectional study explores whether abusive leadership intensifies the effects of emotional job resources on autonomous motivation, a psychological mechanism that could be responsible for extra-role performance. Data were collected from dyads of registered French-Canadian nurses and their immediate supervisors (n = 99 dyads). The models were tested with path analysis using Mplus. Our results show that extra-role performance is positively associated with nurses’ job emotional resources and autonomous motivation, but negatively associated with abusive leadership. Nurses’ cynicism is also negatively associated with autonomous motivation. Importantly, the indirect relation between emotional resources and extra-role performance through autonomous motivation is moderated by abusive leadership, providing support for a moderated mediation effect. These results add to those supporting a similar moderated mediation mechanism to explain employee attitudes and demonstrate the relevance of self-determination theory in a work context. These findings reinforce the need to focus on the quality of leadership practices as well as interventions aimed at promoting the performance of nurses at work.

Scoping review with textual narrative synthesis of the literature reporting stress and burn-out in specialist nurses: making the case for inflammatory bowel disease nurse specialists

Objective

Inflammatory bowel disease clinical nurse specialists (IBD-CNSs) face increasing pressures due to rising clinical and patient demands, advanced complexity of work role, and minimal specialist management training and support. Stress and burn-out could undermine the stability of this workforce, disrupting clinical provision. We reviewed the literature on stress and burn-out to demonstrate the lack of evidence pertinent to IBD-CNSs and make the case for further research.

Design

Following Levac et al’s scoping review framework, relevant databases were searched for publications reporting work-related stress and burn-out among specialist nurses. Following screening and consensus on selection of the final articles for review, all authors contributed to data charting. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension guided reporting of the review.

Results

Of 194 retrieved articles, eight were eligible for review. None focused on IBD-CNSs, were qualitative, or UK-based. Three core themes were identified: Rates of Burn-out, Mitigating and Alleviating Factors, and Preventing and Resolving Burn-out. Risk of burn-out is greatest in novice and mid-career CNSs. Age and duration in role appear protective. Personal achievement is also protective and can mitigate earlier episodes of burn-out; opportunities for career progression are limited. Promoting personal well-being is beneficial. Senior managers have poor understanding of the role and provide inadequate support. Commitment to patients remains high.

Conclusion

Burn-out arises in CNSs across clinical specialisms in the international literature and has a significant negative effect on the workforce. Further research is needed to address the dearth of evidence on burn-out in IBD-CNSs in the UK.

Diagnóstico e tratamento de infecções sexualmente transmissíveis realizados por enfermeiros na Atenção Primária à Saúde

Introdução: No final da década de 1990, iniciou-se as atividades de prevenção das infecções sexualmente transmissíveis para a atenção primária à saúde. Nas duas últimas décadas, vem ocorrendo uma ampliação da assistência de enfermeiros no tratamento dessas infecções. A Lei do Exercício Profissional da Enfermagem nº 7.498./86, garante aos enfermeiros na consulta de enfermagem o direito de realizar a prescrição de medicamentos aprovados por protocolos institucionais. Objetivo: Verificar se os enfermeiros que atuam na Atenção Primária à Saúde de Florianópolis se sentem aptos para a execução do diagnóstico e do tratamento medicamentoso das infecções sexualmente transmissíveis (IST) com base nos Protocolos de Enfermagem do município. Métodos: Pesquisa exploratório-descritiva de abordagem qualitativa realizada por meio de entrevista semiestruturada com perguntas disparadoras. Foram entrevistados dez enfermeiros assistenciais da Atenção Primária à Saúde do município. Os dados foram analisados segundo a técnica de Bardin.  Resultados: Identificaram-se duas categorias analíticas: “O enfermeiro e a (re)construção de sua prática profissional” e “O enfermeiro e a sua contribuição na qualidade de serviço na Atenção Primária à Saúde”.  Conclusões: Os enfermeiros da rede assistencial da Atenção Primária à Saúde de Florianópolis mostram-se altamente qualificados e sentem-se capazes de responder adequadamente às necessidades de sua prática profissional.

Professional autonomy in nursing: An integrative review

AIM

To summarize knowledge of professional autonomy in nursing.

BACKGROUND

Professional autonomy is associated with experienced meaningfulness of the work. This refers to participation in decision-making and the ability to influence working practices.

EVALUATION

In an integrative review, relevant studies were retrieved from four databases. Quality was systematically evaluated using critical appraisal tools. PRISMA guidelines were followed. Inductive content analysis was used to analyse current knowledge of the focal subject.

KEY ISSUES

The search identified 27 relevant studies published between 2000 and 2019. Elements describing nurses' professional autonomy were independence in decision-making and ability to utilize one's own competence. Themes relating to nurses' professional autonomy were shared leadership, professional skills, inter- and intra-professional collaboration and healthy work environment.

CONCLUSION

Understanding the multidimensional nature of professional autonomy is essential to create attractive work environments. It is important to enable nurses to participate in decision-making and develop nursing through shared leadership to enhance the recruitment and retention of a skilled workforce.

IMPLICATIONS FOR NURSING MANAGEMENT

The findings have anticipated utility for supporting nursing practice and nurse leaders' understanding of approaches to foster nurses' professional autonomy.

Nurses' consultative role to health promotion in patients with chronic diseases

AIMS

Although chronic diseases are the most common and expensive health problems, they are preventable too. Nurses play a key role in the care of these patients. One of the important roles of nurses is consultation role. Due to the high impact of nurse consultant role on health promotion and also the fact that this role is not fully understood in Iran, this study aims at clarifying the role of nurse consultant.

MATERIALS AND METHODS

This is a qualitative study with content analysis approach conducted through semi-structured interviews in Isfahan University of Medical Sciences from April to December 2017. A total of 35 participants (11 patients, 9 nurses, 6 faculty members, 4 postgraduate students, and 5 nursing managers) were included in the study. Sampling was done based on purposive sampling method, and participants were asked to express their opinions about nurse consultant.

RESULTS

In this article, we discussed the following three categories and seven subcategories: (1) nursing consultation as a treatment facilitator (nursing consultation as a way to reduce the treatment course, nursing consultation as a way to reduce complications, and nursing consultation as a way to reduce costs); (2) professional performance in nursing consultation (nursing consultation based on problem-solving and evidence-based practice and management and teamwork in nursing consultation); and (3) prerequisites for the nursing consultation role (supporting nurses and introducing the role in decision-making units and creating demand).

CONCLUSION

Nursing consultation has an essential role in patient health promotion. Therefore, it is better that nurses and other health-care team should be familiar with this vital role.

Perceptions, attitudes, and expectation of baccalaureate nurses toward position of nursing in Bosnia and Herzegovina

INTRODUCTION

Numerous challenges and barriers have emerged since changing the minimum requirement for those interested in pursuing employment as a nurse in Europe to a baccalaureate degree. To analyze the perceptions of baccalaureate nurses regarding the current status of their profession and the issues involved in implementing the prerequisite of earning a baccalaureate degree in order to practice as nurses in Bosnia and Herzegovina.

METHODS

A series of six focus groups were undertaken with 49 baccalaureate nurses employed in primary health care centers and regional hospitals. The focus groups were recorded and transcribed verbatim. Data collected were analyzed using conventional content analysis approach.

RESULTS

Baccalaureate nurses report dissatisfaction with their level of autonomy and anxiety over their limited career opportunities. They expressed concern over difficult working conditions, inadequate financial compensation, and ongoing resistance by physicians as the primary barriers to implementing advanced nursing education and professional reform. The global image of the nursing profession is negative.

CONCLUSION

The perception is that revising the legal framework regarding nursing qualifications, duties, and standards will result in reform necessary to positively affect the during profession. Progress toward implementing reform of the nursing profession is negligible. Addressing barriers such as work environment, lack of job classification, fair payment, autonomy, and interdisciplinary collaboration toward the competences of baccalaureate nurse is essential if successful reform is to occur.