Why newly graduated nurses in South Korea leave their first job in a short time? A survival analysis

Coming and going: A narrative review exploring the push-pull factors during nurses' careers

BACKGROUND

Shortages of nurses are one of the biggest challenges healthcare systems face around the world. Given the wide range of contexts and individuals working in nursing, a 'one-size-fits-all' retention strategy is unlikely to be effective. Knowing what matters most to nurses at different career stages would help employers and policy-makers who want to enhance nurse retention to design tailored strategies.

OBJECTIVE

To review and synthesise findings from recently published literature on the push-pull factors influencing nurses' decisions at the micro level, to enter and stay (or leave) at key career stages (i.e. pre-career, training, early-, mid- and late-career, and return to practice).

METHODS

We undertook a set of structured searches of the literature and a narrative synthesis to explore factors that motivate individuals to enter the nursing profession and the push-pull factors influencing nurse retention at different career stages. Electronic databases CINAHL, Medline, Scopus and Embase were searched in December 2022 (and updated in November 2023) for English language publications. Additional health workforce sources, such as King's Fund and Nuffield Trust, were also searched.

RESULTS

227 articles met the criteria for inclusion in the narrative review. Some push-pull factors were common to nurses across all career stages, including workplace support, flexible schedule patterns, opportunities for career advancement, fair treatment and salaries. In contrast, some challenges and push-pull factors were unique to each career stage. Students experienced difficulty in adjusting and balancing education and life; early-career nurses experienced transition shocks; mid-career nurses were frustrated by the lack of career advancement; late-career nurses desired more recognition; nurses returning to practice were discouraged by their lack of confidence and the cost of return-to-practice courses.

CONCLUSION

Our findings reinforce the view that factors influencing nurses' choices about whether to enter, continue or leave nursing jobs are multi-factorial and multi-dimensional. Policy and employment practices should be informed by research that has a more nuanced insight into what matters most to whom and at what career stage.

TWEETABLE ABSTRACT

Nuanced insight into motivations is needed to attract and retain a mix of nurse throughout their careers @ZEjebu @julia_philippou @JaneEball.

Effects of work environments on satisfaction of nurses working for integrated care system in South Korea: a multisite cross-sectional investigation

BACKGROUND

Nurses' satisfaction has an impact on organizational and patient outcomes. Integrated care system in South Korea was established in 2015 to improve care quality and decrease caregiving burden. Since then, nurses' satisfaction has increased due to an increase in nursing staffing. However, besides nurse staffing, various work environments still affect nurse satisfaction.

METHODS

Individual online surveys were conducted with participants to determine their personal characteristics, work environments, and hospital characteristics. We used mixed-effects linear regression equation contained both fixed and random effects.

RESULTS

This study included 2,913 nurses from 119 hospitals. Their average job satisfaction was less than 6 points out of 10 points. Age, shift type, perceived workload, and delegation criteria were significant factors influencing nurses' satisfaction. There was no significant factor among hospital characteristics. The satisfaction level of nurses was high for no-night rotating shift, low perceived workload, and clear delegation criteria.

CONCLUSIONS

Nurses' satisfaction is affected by several work environmental factors. Low nurse satisfaction has a substantial impact on both patients and nurses. Therefore, nurse managers and hospitals should determine factors influencing their satisfaction and develop strategies to improve their satisfaction.

The mediating effect of job embeddedness on the nursing work environment and transition shock among new nurses: A cross-sectional study

AIMS

This study aims to investigate the status of transition shock and test the mediating effect of job embeddedness on the nursing work environment and transition shock among new nurses.

BACKGROUND

Transition shock, primarily experienced during the first two years of employment, manifests itself as an unsettling or discordant experience among new nurses, which is caused by the gap between theoretical learning and clinical practice.

DESIGN

This is a cross-sectional survey study, following the STROBE guidelines.

METHODS

A cross-sectional study was conducted among 435 new nurses from November to December 2022 in Hunan Province, China. The participants were recruited to complete a sociodemographic information questionnaire and rank 3 standardized scales of transition shock (Cronbach's alpha = 0.918), job embeddedness (Cronbach's alpha = 0.890) and nursing work environment (Cronbach's alpha = 0.946). Then, the data were analysed by SPSS 26.0 and mediation testing was performed using Hayes' PROCESS macro (Model 4). A p value of < 0.05 was deemed statistically significant.

RESULTS

The mean score with standard deviation of the transition shock scale in new nurses was 88.86 (22.50). The place of origin, working months and weekly working hours were the significant sociodemographic factors that affected the transition shock score in new nurses. Transition shock was found to be negatively related to both job embeddedness (r = -0.468, p < 0.001) and nursing work environment (r = -0.416, p < 0.001), while job embeddedness mediated the relationship between transition shock and nursing work environment (R2 = 0.262, F = 30.455, p < 0.001).

CONCLUSIONS

New nurses from rural areas and with longer weekly working hours are more prone to transition shock. Those with 6-12 months of employment experience more pronounced transition shock than those with less than 6 months. In addition, the nursing work environment can not only directly influence transition shock for new nurses but also indirectly influence it through job embeddedness. These findings provide a basis for hospitals to develop strategies to effectively address transition shock in new nurses and ultimately solve the nursing shortage issue.

An examination of the career decision-making self-efficacy of final-year nursing students

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.

Global Prevalence of Nurse Turnover Rates: A Meta-Analysis of 21 Studies from 14 Countries

Background

Nurses represent the largest occupational group within the health care system, comprising half of the global health workforce. Health care settings are facing severe shortages in countries worldwide, with nurse turnover being identified as the primary reason for this shortage. However, estimates of nurse turnover rates vary widely in the relevant literature.

Objective

This meta-analysis aimed to investigate the global nurse turnover rate since 2000 and provide evidence-based assistance to health policy makers and hospital managers.

Methods

A systematic search of the PubMed, Web of Science, Embase, CINAHL, and Cochrane Library databases was conducted for relevant articles from January 1, 2000, to February 1, 2023. This study included cross-sectional, cohort, and longitudinal studies. In the meta-analysis, further risk of bias, heterogeneity, and subgroup analyses were conducted. Stata 17.0 was used for all of the statistical analyses.

Results

In total, 48,157 records were scrutinized in this study, and 21 investigations encompassing 213,314 nurses across 14 countries were eventually included. The global nurse turnover rate ranged between 8% and 36.6%, and the combined nurse turnover rate was 16% (95% confidence interval: 14%-17%). Subgroup analysis demonstrated that the turnover rate was 19% (95% CI: 14%-23%) in Asia and 15% (95% CI: 13%-17%) in North America.

Conclusions

This meta-analysis analysed the literature published from January 2020 to February 2023 and demonstrated that the global nurse turnover rate was 16%. It is suggested that all medical and health institutions actively adopt relevant systems that can reduce the turnover of nurses and promote a more harmonious, healthy, and safe occupational environment for nurses to strengthen the sustainable development capacity of the nurse workforce.

Predicting New Graduate Nurses' Retention during Transition Using Decision Tree Methods: A Longitudinal Study

Background

Although retaining new nurses is imperative for the future of the nursing profession, it remains a challenging task in the healthcare industry. Understanding the career journey of new graduates as they transition from students to nurses is vital. However, longitudinal studies investigating the factors influencing retention during this period are lacking.

Aim

The aim of this study is to identify the influencing factors and develop a longitudinal prediction model for new graduate nurse retention.

Methods

A secondary data analysis was conducted using the New Nurse e-Cohort Study dataset from two survey periods, November-December 2020 and February-March 2022. The participants were categorized into either retention or turnover groups based on their turnover experiences. A decision tree based on classification and regression tree (CART) analysis was utilized.

Results

Of the total 586 participants, 463 (79%) were in the retention group. The CART model highlighted that new nurses' retention was significantly associated with younger age, higher readiness for practice (clinical problem-solving) during the nursing program, lower transition shock (such as confusion in professional values, loss of social support, and conflicts between theory and practice), and a higher person-environment fit (person-job fit). The predictive accuracy of the CART model was 79.7%.

Conclusion

To retain new nurses, nursing educators and hospital managers should collaborate to prepare nursing students for actual practice, offer support during organizational socialization, and foster healthy professional values for competence in the workplace. Implications for Nursing Management. Transforming the educational strategies of nursing programs and hospital management policies is imperative to ultimately enhance the retention of new graduate nurses.

Exploring work readiness: A qualitative descriptive study of self-perceptions among new graduate nurses

Background

Reduced work readiness is associated with elevated turnover rates, necessitating efforts to enhance the positive work readiness of newly graduated nurses to alleviate the shortage in the nursing workforce. Research into the work readiness of recent nursing graduates in China is still in its infancy. Most studies employ quantitative research methods, and further exploration of the self-perception of work readiness among new nurses in China is required.

Objectives

This study aimed to investigate genuine experiences and self-perceptions of work readiness among new graduate nurses.

Design

A qualitative descriptive study.

Methods

Sixteen new nurses from a provincial tertiary hospital in China were included in this study, which adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist for reporting. The data collection process involved conducting semi-structured interviews from September to October 2021. Inductive content analysis was employed to analyze the interview data.

Results

The study identified four themes encompassing new nurses' real-life experiences and self-perceptions of work readiness: psychological stress, emotional conflict, empathy fatigue, and ethical dilemmas. Psychological stress comprised three subthemes: knowledge and skill deficits, communication barriers, and fear. Empathy fatigue was primarily characterized by psychological and physical symptoms. Ethical dilemmas involved conflicts over differences in values and between clinical reality and standardized nursing practice.

Conclusion

Drawing from the self-perceptions of work readiness among new nurses found in this study, nursing administrators and educators must enhance the existing transition support program for new nurses. Additionally, the establishment of individualized training programs is recommended to further improve the work readiness of new nurses.

Hesitancy among Iranian nursing students regarding future career trajectory: a qualitative analysis

BACKGROUND

The shortage of skilled nurses is a major concern for health systems worldwide. This may be partly due to the hesitancy of some nurses to enter or remain in the nursing career. This shortage consequently reduces the quality of standard patient care, increases patients' length of stay in a hospital, increases medical costs, and results in patients' dissatisfaction. This study aimed to explore hesitancy among senior undergraduate nursing students to pursue a career in nursing.

METHODS

This qualitative study adopted a thematic analysis approach. The population comprised senior undergraduate nursing students at Isfahan University of Medical Sciences, Iran, who indicated that they were hesitant to pursue a career in nursing. The study sampling was performed from May 2021 till February 2022 and continued until data saturation. Twenty-four interviews were conducted with the selected students. The attributes related to hesitancy among senior undergraduate nursing students to pursue a career in nursing were extracted as themes and sub-themes.

RESULTS

Four themes were identified: academic idiosyncrasies, individual characteristics, poor nursing market regulations (sub-themes: nursing as a tough and intense career, and unfavorable employment contracts), and the peculiarities of the workplace (sub-themes: conflict within work environment, and barriers to professional nursing practice).

CONCLUSIONS

The findings of this study showed that senior undergraduate nursing students weigh their future career options from various academic, personal, professional, and work environment dimensions. The findings provide new insights for decision makers to design and implement innovative strategies to promote retention in nursing careers. We recommend to provide academic counseling for all students and applicants of nursing before they enter the nursing education. Furthermore, we suggest to improve study and work environments, and to implement incentive programs to enhance enthusiasm of nursing students for pursuing a nursing career.

Identifying the predictors of turnover intention based on nurse managers' toxic leadership behaviors among nurses in Iran: a cross-sectional correlational study

BACKGROUND

Unfavorable leadership practices are a growing concern in the field of healthcare and nursing that have adverse consequences on nurses' career outcomes. One of the undesirable leadership styles is the toxic leadership style. Considering the importance of nursing managers' leadership style and its impact on nurses' performance and the scarcity of studies in this field, the present study was conducted to determine toxic leadership behaviors in nursing managers and their relationship with the turnover intention among nurses.

METHODS

A multicenter cross-sectional correlational study. This study involved 551 nurses from 5 educational-medical centers in Ardabil province, north-western Iran. Three self-report scales, including The demographic and occupational information form, the Toxic Leadership Behaviors of Nurse Managers Scale (ToxBH-NM), and the turnover intention questionnaire were adopted for assessment purposes in this study. Data were analyzed using SPSS (Version 22) software using descriptive statistics, Pearson correlation coefficient test, t-test, ANOVA test, and multiple linear regression analysis.

RESULTS

Overall, 551 nurses participated in this research. There was a significantly positive relationship between Turnover intention and Toxic leadership behavior Subscales (r = 0.475, p < 0.001). Furthermore, multiple linear regression analysis showed Toxic leadership behavior Subscales (Intemperate behavior, Narcissistic behavior, Self-promoting behavior, and Humiliating behavior), Hospital, unit, Age, and Marital status predict Turnover intention when other variables are controlled.

CONCLUSION

A leader who directly and indirectly adopts toxic behavior toward their employees destructively affects both individuals and organizations. Nurses who work for a manager exhibiting toxic leadership behaviors demonstrated higher turnover intention.

Effects of Career Adaptability and Self-Efficacy on Transition Shock Among Newly Graduated Nurses During the COVID-19 Pandemic: A Survey Conducted in China

BACKGROUND

The coronavirus disease 2019 (COVID-19) outbreak has increased the work pressure of nurses worldwide, and managers must provide support and assistance for the transition period of newly graduated nurses.

METHOD

A cross-sectional design was adopted to collect a sample of 318 newly graduated nurses from six hospitals in China during the COVID-19 pandemic. Data were collected using a questionnaire that consisted of a demographic questionnaire, the Transition Shock Scale (2015), the Career Adapt-Ability Scale (2012), and the General Self-Efficacy Scale (2001).

RESULTS

The transition shock of newly graduated nurses was 3.77 ± 0.48 in China. Regression analysis showed that transition shock among newly graduated nurses was predicted by career adaptability, general self-efficacy, living with one's parents, and education level, which accounted for 37.7% of the variance in transition shock.

CONCLUSION

Newly graduated nurses experienced a relatively high level of transition shock in China during the COVID-19 pandemic. Managers may offer continuing education to reduce the transition shock of newly graduated nurses based on the factors that affect their transition shock. [J Contin Educ Nurs. 2023;54(11):524-532.].

The effect of psychological contract on turnover intention among nurses: a meta-analytic review

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.

Occupational and Psychological Factors Associated With Burnout in Night Shift Nurses

OBJECTIVE

Providing inpatient nursing care inevitably involves night shift work. However, night shift work nurses often face psychiatric health problems such as burnout. If night shift work is an essential work type for nurses, it is necessary to select personnel suitable for night shift work or establish improvement measures such as psychiatric intervention through psychiatric evaluation. The objective of this study was to identify factors that could be interventional among factors affecting burnout in shift-working nurses.

METHODS

A total of 231 night shift female nurses participated in this study. A questionnaire survey was given to assess their general characteristics. To assess burnout, the Maslach Burnout Inventory-General Survey Korean version was adopted. In addition, several mental health scales were used to identify individual psychological characteristics. To identify variables associated with the presence of burnout, odds ratios were calculated using a logistic regression model taking three dimensions of burnout as a dependent variable after adjusting for psychological and occupational factors.

RESULTS

High resilience was a significant preventive factor in the three dimensions of burnout. Regarding occupational factor, the longer the duration of employment, the higher depersonalization, but the professional efficacy was good.

CONCLUSION

Our results indicate that resilience and social support could be prevention factors for burnout. This study is meaningful in examining items that require active intervention and support for burnout targeting night shift nurses who are indispensable for patient care.

Job satisfaction and moral distress of nurses working as physician assistants: focusing on moderating role of moral distress in effects of professional identity and work environment on job satisfaction

BACKGROUND

Physician assistant was created in response to a shortage of physicians. However, this profession is not officially recognized in Korea. Many nurses are working as physician assistants. Their job satisfaction was low due to role conflict. Job satisfaction plays a major role in providing high quality nursing. This study aimed to investigate effects of work environment and professional identity on job satisfaction and identify the mediating role of moral distress in such effects.

METHODS

Participants were 112 nurses working as physician assistants. They were recruited from three General Hospitals. A questionnaire scale was used to collect data. Data were analyzed using frequency, descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation, and Macro Model 4 with SPSS Statistics.

RESULTS

Job satisfaction of nurses working as physician assistants had a score of 3.08 out of 5. It showed significant associations with work environment and professional identity. Moral distress had a partial mediating role in relationships of job satisfaction with work environment and professional identity.

CONCLUSION

Many nurses are working as physician assistants, although physician assistant as a profession is not officially recognized in Korea. Nurses working as physician assistants experience confusion about their professional identity and moral distress. For better nursing outcomes, physician assistant policy should be improved, and various strategies should be provided to improve their job satisfaction.

Comparison of factors associated with postpartum depression from two cohorts of nurses: the Korea Nurses' Health Study and the Nurses' Health Study 3

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.

A survival analysis approach to determine factors associated with non-retention of newly hired health workers in Iran

BACKGROUND AND AIM

One of the main tasks of the healthcare human resource management is to maintain and retain professional staff. The high level turnover of professional staff may reduce the quality of healthcare service delivery. Therefore, this study investigated the factors associated with the turnover of the newly recruited healthcare professionals using survival analysis method in Iran.

MATERIALS AND METHODS

This historical cohort analysis comprised 6811 employees who began working at Mashhad University of Medical Sciences between 2005 and 2020. Employees recruited at any of the university's units between the years 2005 to 2019 were included. We used appropriate descriptive indices and Log-rank test and the Cox proportional-hazards model to assess the staff turnover. A significance level of 0.05 was used for all tests.

RESULTS

The findings of the survival analysis showed that the probability of turnover in one year, two years, and five years of employment were 0.12, 0.16, and 0.27. Based on the findings of the Log-rank test, the probability of turnover in entire of the study period was not statistically different between male and female (p = 0.573), and likewise between employees with healthcare occupations and non-healthcare occupations (p = 0.351). Employees whose current workplace and birthplace were not similar had a significantly higher probability of turnover (p < 0.001). Accordingly, the Cox regression result showed, the risk of turnover for the singles was 1.22 times higher than the married. For the Ph.D degree was 3.23 times higher compared to those with a diploma or an associate degree, and for a bachelor's or master's degree was 2.06 times more likely to change their workplace than those with a diploma or an associate degree.

CONCLUSION

Policies promoting the recruitment of native-born professionals, given priority to the married candidates than single ones, and/or recurring candidates to pledge to stay in the locality of recruitment site can increase the staff retention and reduce the costs of staff turnover including re-hiring, initial and on-the-job training, accommodation, and other extra living consumptions away from home and family.

Comprehensive assessment of factors contributing to the actual turnover of newly licensed registered nurses working in acute care hospitals: a systematic review

BACKGROUND

During the COVID-19 pandemic, the demand for nursing care increased, making the retention of nurses even more important. Among staff nurses, it is reported that the turnover rate of newly licensed registered nurses is higher. However, no systematic reviews have focused on the factors that influence newly licensed registered nurses' turnover. Additionally, because newly licensed registered nurses are a major source of the supply of nurses, it is critical to retain them to meet patient needs. Therefore, this study aimed to systematically synthesize the factors contributing to the actual turnover of newly licensed registered nurses working in acute care hospitals.

METHODS

CINAHL, Cochrane Library, DBpia, EBSCO, PubMed, PsycINFO, RISS, and Web of Science were searched for studies published between January 2000 and June 2021. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

RESULTS

Ten articles from 9029 were included in this review. All studies used a longitudinal design. The annual turnover rates of newly licensed registered nurses ranged from 12 to 25%. Health status, including sleep and healthy lifestyles, were significant factors affecting turnover. Most studies focused on work environment factors, and emotional exhaustion, job satisfaction, peer support, and intent to leave, were significantly associated with newly licensed registered nurses' turnover. Small hospitals located in nonmetropolitan areas were at risk of high turnover of newly licensed registered nurses.

CONCLUSIONS

Turnover is inevitable in the process of employment, but high turnover can be prevented. Through reviewing ten articles, significant contributing factors for newly licensed registered nurses' turnover included personal factors of health status; work environment factors of physical exhaustion, emotional exhaustion, depersonalization, occupational injuries, income, intent to stay, job satisfaction, and peer support; and hospital factors of hospital size, location, and unionization. Most existing studies focus on work environment factors, which reflects the significance of fostering healthy work conditions to prevent high turnover. These findings can be used to develop strategies and policies for work environment to reduce high turnover of newly licensed registered nurses, and support high-risk groups, such as small hospitals located in nonmetropolitan areas with high levels of nurses' turnover.

The Race to Retain Healthcare Workers: A Systematic Review on Factors that Impact Retention of Nurses and Physicians in Hospitals

The shortage of healthcare workers is a growing problem across the globe. Nurses and physicians, in particular, are vulnerable as a result of the COVID-19 pandemic. Understanding why they might leave is imperative for improving retention. This systematic review explores both the prevalence of nurses and physicians who are intent on leaving their position at hospitals in European countries and the main determinants influencing job retention among nurses and physicians of their respective position in a hospital setting in both European and non-European countries. A comprehensive search was fulfilled within 3 electronic databases on June 3rd 2021. In total 345 articles met the inclusion criteria. The determinants were categorized into 6 themes: personal characteristics, job demands, employment services, working conditions, work relationships, and organizational culture. The main determinants for job retention were job satisfaction, career development and work-life balance. European and non-European countries showed similarities and differences in determinants influencing retention. Identifying these factors supports the development of multifactorial interventions, which can aid the formulation of medical strategies and help to maximize retention.

Association of Work Schedules With Nurse Turnover: A Cross-Sectional National Study

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.

The relationship between nurse-nurse collaboration and work readiness among new graduate nurses

BACKGROUND

Communication and collaboration with colleagues are crucial for new graduate nurses (NGNs) because of the adaptation to both the healthcare system and professional role. Therefore, working units with effective collaboration among nurses may increase new graduates' work readiness.

AIM

This study aimed to determine the relationship between the perceptions of nurse-nurse collaboration and the work readiness level among NGNs.

METHODOLOGY

This descriptive, cross-sectional study was carried out with 198 NGNs in four private hospitals affiliated with a university. A self-administered questionnaire, including a personal information form, the Nurse-Nurse Collaboration Scale, and Work Readiness Scale, was used to collect data. Data analysis was performed using descriptive tests, and Spearman's rank correlation coefficients.

RESULTS

NGNs had moderate perceptions of nurse-nurse collaboration, with a median score of 2.46 (2.23-2.88) out of 4. Work readiness among NGNs was moderate, with a median score of 304 (270-332) out of 460. There was a statistically significant correlation between nurse-nurse collaboration and work readiness (r_s  = 0.26; p < .001).

CONCLUSION

The results of this study demonstrated that improving nurse-nurse collaboration is an effective way to increase work readiness among NGNs.

Difference between perceptions of preceptors and newly graduated nurses regarding delay in professional growth: a thematic analysis

BACKGROUND

Smooth reciprocal relationships enable a preceptee's growth, and it has been suggested that without such relationships, the preceptee may not be able to grow successfully. This study explored the differences in perceptions by matching the perspectives of both the preceptees who did not make progress in workplace adjustment and their preceptors. Identifying the differences in perceptions between the two groups is important for improving nursing education and the relationship between preceptees and preceptors.

METHODS

A pair of nurses who had been with the company for less than 3 years and who had previously been transferred or had resigned due to poor workplace adjustment were designated as preceptees, and those who had directly supervised the preceptee during their first year of employment were included as preceptors in the study. A 50-minute semi-structured interview was conducted separately to examine the perceptions of the preceptee and preceptor. A thematic analysis was used to analyse the interview data.

RESULTS

This study explored the differences in perceptions regarding the clinical practice of nursing between preceptors and their preceptees who did not make progress in workplace adjustment during nursing education; six themes were identified. After interviewing both sides, it became clear that the same event was interpreted differently depending on their positions, perspectives, and contexts. As the preceptees were nurses who had left or had been transferred, the existence of these differences in perceptions suggests that these factors may impact their departure or transfer. However, we do not aim to place blame on one side or the other for the preceptee's turnover or transfer and would like to consider effective support, not only for the preceptee, but also for the preceptor.

CONCLUSIONS

It is necessary to examine nursing education on the premise that differences may occur depending on the position and role of nurses in the workplace and to look at curricular framework changes to bring in a systemic influence towards the training of young nurses.

Job change among early career nurses and related factors: A postgraduation 4-year follow-up study

AIMS

This study aimed to identify the job change status and related factors among nurses during the first 4 years of their professional life.

BACKGROUND

The early turnover and job change of nurses results in negative patient and nurse outcomes and financial losses.

METHODS

A prospective longitudinal observational design and convenience sampling were used. From five nursing schools in South Korea, 526 individuals participated in the first survey conducted before graduation; 317 and 338 individuals participated in the second and third surveys, respectively (4 months after employment, and 4 years after graduation).

RESULTS

In total, 42.0% of the participants remained at the hospital of their first job, 26.6% switched hospitals, and 12.1% moved to a nonhospital job. Multinomial logistic regression analyses showed that switching hospitals was associated with nurses' grade point average, type of hospital, first job satisfaction, and current pay. Moving to a nonhospital job was related to gender, type of hospital, current pay, and work-life balance.

CONCLUSION

To reduce the early turnover and job change, hospitals should provide educational programmes for nurses, support male nurses, and increase job satisfaction and work-life balance.

IMPLICATIONS FOR NURSING MANAGEMENT

Since this study addresses the working conditions and satisfaction of individuals who were re-employed after experiencing job turnover, it clarifies how nurse managers may reduce turnover. Namely, nurse managers should establish a work environment promoting good work-life balance.

Work stress and perceived organisational support on young Korean nurses' care for COVID-19 patients

Background

Since the outbreak of COVID-19 worldwide, frontline nurses have faced tremendous stress. Younger nurses in their early-to-mid careers can be more exposed to burnout and work stress, and perceived organisational support can influence the quality of nursing care for vulnerable patients.

Aim

To identify the impact of younger nurses’ work stress and perceived organisational support on their willingness to care for COVID-19 patients.

Methods

The cross-sectional secondary data analysis included 211 hospital nurses (<35 years) in South Korea with a mean age of 24.60 years (SD=1.90). Multiple logistic regression analysis was used to identify the factors influencing willingness to care.

Findings

Supplying personal protective equipment, training in the use of personal protective equipment, lower work stress, and positive perceptions of organisational support significantly increased early-career nurses’ willingness to care. For mid-career nurses, being male and higher work stress significantly increased their willingness to care.

Discussion

Support, including COVID-19-related education or training, should be provided to reduce work stress arising from being exposed to infection or while providing care to critically ill patients, especially among early-career nurses. Support from nurse managers, senior staff, and colleagues could help younger nurses cope better with the challenges of COVID-19, thus increasing their willingness to care.

Conclusion

Perceived organisational support may facilitate early-career nurses’ organisational commitment. Healthy work environments can relieve early-to-mid-career nurses’ work stress, thus facilitating patient-centred care.

Association Between Dimensions of Professional Burnout and Turnover Intention Among Nurses Working in Hospitals During Coronavirus Disease (COVID-19) Pandemic in Iran Based on Structural Model

Purpose

This study was done to assess the dimensions of professional burnout and turnover intention among nurses working in hospitals during the coronavirus disease 2019 (COVID-19) pandemic in Iran based on a structural model.

Methods

This cross-sectional study was performed among 170 nurses working in two referral hospitals of COVID-19 in Tehran Province, Iran, from September to December 2020. Data were collected using the sociodemographic form, Maslach Burnout Inventory (MBI), and Turnover Intention Questionnaire. Data were analyzed with SPSS and Amos software version 22 using independent t-test, ANOVA, and structural equation model.

Results

The mean scores for burnout in emotional fatigue, depersonalization, and personal accomplishment dimensions were 25.38 ± 7.55, 9.47 ± 4.40, and 34.94 ± 7.80, respectively, moreover for the turnover intention, the score was 6.51 ± 3.17. The reduced personal accomplishment was identified as a positive predictor of turnover intention (p = 0.01). Work position and interest in attending the organization were significantly correlated with the turnover intention (p < 0.05).

Conclusions

There is an immediate need to prepare nurses to cope better with the COVID-19 outbreak. Work-related stressors during the COVID-19 pandemic have led to an increase in nurses' burnout and turnover intention. Identifying and managing the factors related to professional burnout will make it possible to prevent the nurses' turnover intention in such critical situations.

Factors influencing intention to stay of male nurses: A descriptive predictive study

Nurse shortages and nurse attrition are high in many countries, and there is also a dearth of male nurses in the profession. This study aimed to examine the level of intention to stay and ten predictors of this among male nurses in China. A descriptive, predictive study was administered to 480 registered male nurses. Eight research instruments were used to collect data. Descriptive statistics and binary logistic regression were employed to analyze the data. The overall intention to stay in the nursing profession as perceived by male nurses was at a moderate level. Binary logistic regression demonstrated that work group cohesion, transformational leadership, career growth, and job satisfaction were significant predictors, explaining 32.2% of the total variance for intention to stay. The findings of this study provide suggestions for nursing administrators and policymakers to develop appropriate strategies or interventions to increase the intention to stay for male nurses to stay in the profession, based on the four predictors.

Experience of Pediatric Patient Death, Moral Distress, and Turnover Intention among Pediatric Nurses at a Tertiary Hospital in South Korea: A Cross-Sectional Study

Background: Pediatric nurses are particularly vulnerable to moral distress and turnover due to frequent experiences with patient death combined with limited pediatric palliative resources and related support. Objective: This study examined pediatric nurses' experiences of pediatric patient death, moral distress, and turnover intention and identified the correlations between them as well as the mediating role of moral distress. Methods: This cross-sectional study conducted an online survey with 161 pediatric nurses working in a tertiary hospital in Seoul, South Korea. The survey comprised questions to assess nurses' experience of pediatric patient death and turnover intention and a validated instrument to measure their moral distress. Logistic regression was used to examine the relationships between study variables, and structural equation modeling was performed to determine the mediating effect of moral distress. Results: Pediatric nurses (N = 161) reported high levels of moral distress with a mean score of 101.06 (standard deviation = 70.528) on the pediatric version of the Moral Distress Scale. Turnover intention increased 1.01 times for every 1 U increase in moral distress. Moral distress fully mediated the relationship between the experience of pediatric patient death and turnover intention. Conclusion: Pediatric patient death had an indirect effect on turnover intention through moral distress among pediatric nurses. Reducing pediatric nurses' moral distress caused from experiencing patient death may help minimize their turnover intention.

Nurse-physician collaboration, intention to leave job, and professional commitment among new graduate nurses

BACKGROUND

The quality of communication and collaboration with colleagues, managers, and physicians affects the intention to leave a job and the profession for new graduate nurses (NGNs). New graduates have difficulties communicating and collaborating with physicians, especially.

AIM

This study aimed to determine the relationship between the attitudes of nurse-physician collaboration and the levels of intention to leave the current job and professional commitment among NGNs.

METHODOLOGY

This descriptive, cross-sectional study was carried out with 231 NGNs in four private hospitals affiliated with an university. Data were collected by using a self-administered questionnaire, including a personal information form, the Jefferson Scale of Attitudes towards Physician-Nurse Collaboration, Intention to Leave Scale, and Nursing Professional Commitment Scale. Data analysis was performed using descriptive statistics, and Spearman's rank correlation coefficients.

RESULTS

NGNs had a high positive attitude towards nurse-physician collaboration with a median score of 49 (45-54). The professional commitment of NGNs was high level with a median score of 75 (69-86). The intention to leave the current job median score was 3 (2.3-3.6) out of 5. There was a statistically significant correlation between attitudes towards nurse-physician collaboration and the levels of intention to leave the current job (r_s  = -0.22; p < 0.01) and professional commitment (r_s  = 0.42; p < 0.01).

CONCLUSION

The results showed that improving NGNs' attitudes towards nurse-physician collaboration increases the professional commitment and reduces turnover intention.

Identifying the predictors of turnover intention based on psychosocial factors of nurses during the COVID-19 outbreak

AIMS

Because of the direct contact nurses have with patients, they are exposed to more stressful events during the outbreak of infectious diseases, which increases their turnover intention, highly impacting not only nurses, but also patients and organizations. The present study aimed to identify the predictors of turnover intention based on psychosocial factors in nurses of Ardabil pre-hospital emergency and educational and medical centres during the COVID-19 outbreak.

DESIGN

The present descriptive-analytical study was conducted in June, 2020.

METHODS

A total of 479 nurses working in Ardabil pre-hospital emergency and educational and medical centres to fight COVID-19 were recruited for this study using the census method. Data were collected using the Demographic Information Questionnaire, Turnover Intention Questionnaire, Weiss & Marmar Impact of Event Scale-Revised (IES-R), General Health Questionnaire (12 C-GHQ) and Job Content Questionnaire (JCQ). Data were analysed with SPSSv.22 software using correlation, t test, analysis of variance, multiple regression and descriptive tests.

RESULTS

The mean turnover intention score of nurses was 41.73 with a standard deviation of 12.11. The results of correlation coefficient revealed a positive relationship between PTSD, general health, job demand and job strain with turnover intention (p ≤ .01) and a positive and significant relationship between social support and turnover intention (p ≤ .01). Multiple regression analysis showed that the variables of gender, marital status, work position, decision latitude, social support, job strain, general health and post-traumatic stress disorder (PTSD) were predictors of turnover intention.

CONCLUSION

Job stressors during the COVID-19 outbreak have led to an increase in nurses' turnover intention. Identifying and managing the factors related to job stressors will make it possible to prevent nurses' turnover intention in such critical situations.

Factors Influencing Turnover Intention among Male Nurses in Korea

The study examined predictors of male nurse turnover intention in Korea using data collected from Korean hospitals. The results were obtained based on a secondary analysis of data previously collected from 306 male nurses in 16 regions of Korea from December 2014 to February 2015. Our findings suggest that male nurse turnover intention is predicted by (1) individual factors: single (B = 0.93, p = 0.008); (2) organizational factors: organizational commitment (B = -0.36, p < 0.001), job satisfaction (B = -0.27, p = 0.001), and job stress (B = 0.24, p < 0.001); and (3) social factors: hospital location in medium-categorized cities (B = 0.70, p = 0.012) and kinship responsibility (B = 0.13, p = 0.026). These factors accounted for 56.9% of the total variance. To lower the rate of turnover intention among male nurses, strategic interventions should be implemented based on the factors identified in this study.

Psychological Workplace Violence and Health Outcomes in South Korean Nurses

BACKGROUND

Workplace violence (WPV) and its health consequences should continue to be investigated to foster a healthy and safe working environment, which may reduce nurse staff turnover and improve nurse staff shortages. This study aimed to address the gap in understanding WPV in non-western nurses by examining the relationship between psychological WPV experience, psychological well-being, subjective job stress, and presenteeism among South Korean nurses.

METHODS

This cross-sectional study used data from the fifth Korean Working Conditions Survey (KWCS), and 477 nurses were analyzed. For the analysis, selected variables were extracted from the KWCS through a review of the existing literature. In the analysis, we included psychological WPV experiences, such as verbal abuse, unwanted sexual attention, threats, and/or humiliating behaviors over the past 1 month. We measured health outcomes including nurses' psychological well-being, subjective job stress, and presenteeism.

FINDINGS

Psychological WPV within the previous month was experienced by 11.1% of the participants. Experience with verbal abuse, threats, or humiliating behaviors was associated with more job stress, higher presenteeism, and poor psychological well-being.

CONCLUSION/APPLICATION TO PRACTICE

Study findings suggest that a comprehensive WPV prevention program accompanied by interventions aiming to reduce job stress and improve the well-being of nurses should be actively implemented. To prevent psychological WPV and improve the health of nurses, evidence-based efforts, such as establishment of WPV prevention procedures and education/training of workers at the national, organizational, and individual levels are needed.

Factors associated with difficulty in adapting and intent to leave among new graduate nurses in South Korea

BACKGROUND

New graduate nurses experience difficulty in adapting to a new environment, which affects intent to leave. However, data on the factors contributing to difficulty in adapting and intent to leave among new graduate nurses are insufficient.

PURPOSE

The aim of the study was to explore and compare factors associated with difficulty in adapting and the intent to leave among new graduate nurses in South Korea.

METHODOLOGY

This cross-sectional study used secondary data analysis. Primary data were obtained from the 2015-2016 Korean National Graduates Occupational Mobility Survey. Descriptive statistics, independent t tests, and chi-square statistics with weighted samples besides multivariate logistic regression analyses were conducted (N = 467).

RESULTS

Roughly 46% of nurses reported difficulty adapting, and 16% expressed their intent to leave. The factors linked to difficulty in adapting were working at large hospitals with rotating shifts, low person-job fit, and low satisfaction with personal competency; intent to leave was associated with high monthly salary and low satisfaction with the workplace (all ps < .05). Difficulty in adapting did not equate to their intent to leave.

CONCLUSIONS

There were high rates of difficulty in adapting and intent to leave among new graduate nurses. Although different factors were associated with difficulty adapting and intent to leave, workplace condition is a common factor.

PRACTICE IMPLICATIONS

Different strategies are needed to improve adaptation and intention of leaving among new graduate nurses. For better adaptation, developing training programs enhancing professional competency with a sufficient training period is required. In addition, providing staff and resources to reduce the intent to leave is crucial.

Effects of an Adaptive Education Program on the Learning, Mental Health and Work Intentions of New Graduate Nurses

Health care workers are at a higher risk of psychological distress than ordinary people. Stress affects physical and mental health, and can even produce an intention to leave. The current training for new graduate nurses (NGNs) during this transitional period mostly focuses on the cultivation of professional ability, with less attention to mental health or emotional feelings, and thus there are insufficient structured support strategies. As such, this study explores the effects of intervention through an appropriate education program on the learning, mental health and work intentions of new recruits during the transition period. A pre-test and post-test for a single group was designed for new nursing staff in a large teaching hospital in northern Taiwan. The test period was from May 2017 to December 2018, and a total of 293 cases were accepted. A three-month adaptive education program was provided and evaluated in terms of: care for learning, care for health, improving professional ability, and individualized guidance on satisfaction, mental health disturbance and work intention. The new graduate nurses who received gentle care and counseling showed a downward trend in their BSRS-5 scores and statistical differences over time (p < 0.001). The higher the BSRS-5 score, the easier it is for new graduate nurses in acute and intensive care units. There is a tendency for turnover leave (p = 0.03). After the intervention of the overall plan, the turnover rate of new graduate nurses within three months was 12.6%, and the one-year retention rate was 87.9%. The adaptive education program uses multiple support strategies to improve learning and professional abilities, to reduce psychological emotions, and thereby to increase retention. Today will face new medical challenges; the education programs will become more important across clinical care settings, and it will be important to rigorously validate their performance in helping NGNs.

Job Satisfaction and Associated Factors Among Health Care Professionals Working in Public Health Facilities in Ethiopia: A Systematic Review

BACKGROUND

Job satisfaction is a feeling that measure cognitive and behavioral aspects of workers' towards their job. According to the World Health Organization report, it predicts that 40% of health care professionals' (nurses, midwives, and doctors) will leave their job as a result of job dissatisfaction.

METHODS

Studies were searched systematically using International databases from PubMed, Google Scholar, Cochrane Library, Embase, and CINAHL. The quality of searched articles assessed using the New Castle Ottawa scale for a cross-sectional study design. Statistical analysis was performed by using STATA version 14 software for window and systemic review carried out using a random effect method. The Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guideline was followed for reporting results.

RESULTS

From the total 1120 records screened, 8 studies with 4092 participants who fulfilled the inclusion criteria were included in this systematic review. The estimated pooled prevalence of job satisfaction of health care professionals in Ethiopia was 41.17%.

CONCLUSION

About one in three health care professionals were satisfied. Therefore, the government and health institution should focus on strategies to promote health care professionals' of job satisfaction.

Effect of clinical teaching behaviours on transition shock in graduate nurses

AIM

This study aimed to explore the impact of preceptor clinical teaching behaviours on transition shock in graduate nurses using bi-directional feedback between graduate nurses and clinical preceptors and to assess preceptor clinical teaching behaviours.

DESIGN

This was a descriptive cross-sectional study.

METHODS

This study was conducted from January-February 2019. Participants included graduate nurses (N = 117) and clinical preceptors (N = 908) from a major public tertiary hospital in Western China.

RESULTS

Overall level of transition shock of graduate nurses was moderate (mean = 89 SD  17.54). Transition shock level of graduate nurses rose with the increasing of time in clinical work. Intensive care unit graduate nurses suffered the strongest transition shock, whereas surgery graduate nurses suffered the least. Graduate nurses thought that clinical preceptors were best at evaluation and feedback, whereas clinical preceptors thought they were best at showing concern and support. The primary factors associated with transition shock in graduate nurses were the time admitted to the hospital, feedback, and evaluation, use of appropriate teaching strategies, and showing concern and support, explaining 63.5% of the total variation in transition shock in graduate nurses.

CONCLUSION

In Western China, where the development of economic and medical conditions lag, transition shock is a major obstacle to the professional development of graduate nurses and clinical teaching behaviours is the key to overcoming transition obstacles. However, the serious shortage of nurses makes it difficult to not only complete heavy clinical nursing work but also to undertake the teaching of students and graduate nurses. The clinical teaching system is influenced by many factors. Focusing on clinical teaching behaviours and transition shock in graduate nurses will provide valuable data for future intervention studies.

IMPLICATION

The findings of this study will be of interest to managers at all levels and will enable them to support graduate nurses by engaging in excellent clinical teaching behaviours. In the clinical teaching process, giving more feedback and evaluation, improving the ability of using appropriate teaching strategies and focusing on the physical and mental health of graduate nurses may effectively decrease transition shock of graduate nurses and reduce the turnover rate.

Work Schedule Characteristics, Missed Nursing Care, and Organizational Commitment Among Hospital Nurses in Korea

PURPOSE

This study describes Korean nurses' work schedule characteristics and identifies their components to investigate associations of work schedule components with missed nursing care and organizational commitment.

DESIGN

This cross-sectional secondary analysis used survey data of 1,057 nurses in 111 units at six hospitals in South Korea. Data were collected between April 2017 and March 2018.

METHODS

A self-administered survey, including seven work schedule characteristic items, the Korean version of the MISSCARE Survey, and the Korean version of the Organizational Commitment Questionnaire, was employed. To construct independent components of work schedule characteristics, a principal component analysis was performed. The associations of work schedule components with missed nursing care and organizational commitment were analyzed using multiple linear regression models with generalized estimating equation methods.

FINDINGS

The average number of daily work hours was 9.7. Nearly half of the study population worked while sick once or more per month. The two components of nurses' work schedule characteristics were "long work hours" and "lack of rest," and these components showed variations between units. Unhealthy work schedule components were linked to frequently missed nursing care and decreased organizational commitment.

CONCLUSIONS

This study showed that proper work hours and adequate rest are important to reduce missed nursing care tasks and enhance organizational commitment, both of which are critical for better patient care and organizational outcomes.

CLINICAL RELEVANCE

Healthcare organizations should provide adequate nursing staff and assign reasonable workloads. Furthermore, hospitals should periodically monitor the work schedule characteristics of nurses and actively intervene in cases of scheduling issues to resolve them.

Transition shock and job satisfaction changes among newly graduated nurses in their first year of work: A prospective longitudinal study

AIMS

To identify the changes in transition shock and job satisfaction among newly graduated nurses during their first year and examine the factors affecting these changes.

BACKGROUND

Newly graduated nurses' high turnover is related to transition shock and job satisfaction. However, insufficient information exists on changes in these variables among such nurses.

METHODS

A prospective longitudinal design was used. Participants were nurses newly graduated from nursing schools and working in hospitals in South Korea. There were 312, 195 and 120 participants at 4, 8 and 12 months, respectively.

RESULTS

Transition shock and job satisfaction decreased as working period increased; transition shock was lower, and job satisfaction was higher in positive work environments. Linear mixed models revealed work environment was the only factor significantly related to transition shock and job satisfaction changes.

CONCLUSION

The nurses' transition shock and job satisfaction varied as per working period and work environment, which were the most important factors of these changes.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can be aware of transition shock and job satisfaction changes, assess their severity and implement solutions in their hospitals. Thus, retention strategies should differ according to the changing needs of nurses at different stages of their career.

Turnover Rates and Factors Influencing Turnover of Korean Acute Care Hospital Nurses: A Retrospective Study Based on Survival Analysis

PURPOSE

This study aimed to explore turnover rates for Korean acute care hospital nurses and identify factors influencing their turnover.

METHODS

The study was retrospective in nature. Nurse cohort data were obtained from hospital status data from Korea's Health Insurance Review Assessment Service. The observation period was from January 1, 2012 to December 31, 2016, and data for 96,158 nurses were analyzed. Independent variables included nurses' age and sex and hospital setting, type, ownership, and nurse staffing level. Kaplan-Meier analysis was performed to estimate survival curves, and factors influencing turnover were analyzed using Cox's proportional hazard regression.

RESULTS

The cumulative turnover probability for all nurses was .17, .29, .38, .45, and .50 for the first, second, third, fourth, and fifth years, respectively. The results showed that the longer the career duration, the lower the turnover rates. According to the factors influencing nurse turnover, both nurses' (i.e., sex and career duration) and hospitals' (i.e., hospital setting, type, ownership, and nurse staffing level) characteristics were statistically significant.

CONCLUSION

It should be noted that the turnover rate of nurses with less than three year of career duration and of those with less than one year has been shown to be quite high. Therefore, target populations for acute care hospital nurse turnover should be expanded from new graduate nurses to experienced nurses with less than 3 years of career. Further studies are required to examine the causes of high turnover rates in hospitals that are small and/or have low nurse staffing levels.

Predictors of nurses' turnover intention at one and five years' time

AIM

This study examined the role of job dimensions, job satisfaction, psychological stress and job burnout in predicting turnover intention at one and five years' time among professional nurses in the Philippines.

METHODS

A cross-sectional design was utilized in the study using a convenience sample of 549 registered nurses from six hospitals in the Central Philippines during the period of October 2018 to January 2019. Five self-report scales were used in this study.

RESULTS

Overall, 46.1% (n = 253) and 78.9% (n = 433) of nurses reported planning to leave the organization at one and five years' time, respectively. The type of hospital, job satisfaction and job burnout explained variances for turnover intention at one and five years' time. Separately, hospital bed capacity and job stress predicted turnover intention at five years' time. None of the job dimensions accurately predicted turnover intention in nurses.

CONCLUSION

Higher turnover intention results at one and five years' time were dependent on nurses' psychological stress, job burnout and job satisfaction.

IMPLICATIONS FOR NURSING PRACTICE AND POLICY

Organizational measures aimed at reducing stress and burnout and increasing job satisfaction in nurses are critically important to enhance the retention of nurses and ensure continued quality of nursing care.

Association of Working Hours and Patient Safety Competencies with Adverse Nurse Outcomes: A Cross-Sectional Study

The environment of health organizations can determine healthcare quality and patient safety. Longer working hours can be associated with nurses’ health status and care quality, as well as work-related hazards. However, little is known about the association of hospital nurses’ working hours and patient safety competencies with adverse nurse outcomes. In this cross-sectional descriptive study, convenience sampling was employed to recruit 380 nurses from three tertiary care hospitals in South Korea. Data were collected using structured questionnaires from May to June 2016. Hierarchical linear regression analysis was used to identify the association of working hours and patient competencies with adverse nurse outcomes among 364 participants selected for analysis. Most nurses worked over 40 h/week. Working hours (β = 0.202, p < 0.001) had the strongest association with adverse nurse outcomes. Low perceived patient safety competencies (β = −0.179, p = 0.001) and frequently reporting patient safety accidents (β = 0.146, p = 0.018) were also correlated with adverse nurse outcomes. Nursing leaders should encourage work cultures where working overtime is discouraged and patient safety competencies are prioritized. Further, healthcare managers must formulate policies that secure nurses’ rights. The potential association of overtime with nurse and patient outcomes needs further exploration.

Job satisfaction among health care providers: A cross-sectional study in public health facilities of Punjab, India

INTRODUCTION

Job satisfaction is a multidimensional response to work and workplace environment. It depends on many factors, and affects the behavior of employees that, in turn, affects organizational functioning. The aim of the study was to measure job satisfaction among different categories of healthcare providers from the Punjab government health services and to determine the factors that affect job satisfaction the most.

METHODOLOGY

The study was conducted between September 2015 and February 2016 and included 462 participants working under the Punjab Government health services. Multi-stage random sampling was used, and participants were interviewed telephonically. The study instrument comprised the sociodemographic data and questions from Job Satisfaction Scale (JSS).

RESULTS

Three-fourth of the respondents (75.3%) were dissatisfied by their working conditions, followed by fringe benefits facet (34%), promotion facet (25.4%), and contingent rewards facet (23.7%). But they felt satisfied concerning relations with their coworkers (97%), nature of their work (93.3%), supervision (91.2%) and communication facet (80.6). Ambivalence was seen in a range of 2.8% (coworkers facet) to 54.8% (contingent rewards facet).

CONCLUSION

Job satisfaction affects future career goals, social relationships, and personal health. An extremely demanding workplace can make workers susceptible to feelings of uncertainty and low self-esteem. It is recommended to beef up the policies related to healthcare providers and their working conditions regularly. Job responsibilities should have a scope of change to avoid monotony and loss of interest. A conducive working ecosystem can have a positive effect on the evolving health system of a country.