Do preceptorship and clinical supervision programmes support the retention of nurses?

Nurses' and Midwives' Experiences of Clinical Supervision in Practice: A Scoping Review

AIM

To understand the extent and type of evidence that exists related to nurses' and midwives' experiences of participating in clinical supervision and ascertain how clinical supervision is defined in the literature.

DESIGN

A scoping review of peer reviewed research.

DATA SOURCES

CINAHL Complete (EBSCOhost), MEDLINE (Ovid), PsycINFO (EBSCO), Embase (Elsevier) and the Cochrane Library were searched for relevant articles published between 2010 and 2024.

REVIEW METHODS

The scoping review followed the JBI methodology.

REPORTING METHOD

PRISMA-ScR.

RESULTS

Forty-three articles were included, qualitative, quantitative, mixed methods studies and three reviews were found describing nurses' and midwives' experiences of clinical supervision. The studies identified were carried out across 15 countries and reported on experiences of group clinical supervision, one to one clinical supervision or both, more recent studies included a focus on group clinical supervision. All definitions found are reported, and although these varied, there were frequently used terms common in many.

CONCLUSION

Although some evidence exists on how nurses and midwives experience clinical supervision gaps in evidence and detail of supervision practices remain. Inconsistencies of approach to this practice remain and specific detail relating to clinical supervision explored in existing research is frequently lacking. The lack of a universally accepted definition highlighted may influence inconsistences in clinical supervision, key terms identified in this review may assist in the development of a definition. Further research into this support is required to establish its value in practice.

IMPACT

This scoping review progresses the ongoing debate that clinical supervision is a valuable support for nurses' and midwives' but the absence of evidence is an indication that clinical supervision is not fully understood nor is visible in practice. To this end, this review highlights that the lack of consensus on a clinical supervision definition causes ambiguity thus reducing the use of this support for nurses and midwives.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public contribution to this paper as it is a review paper that seeks information on research available on a professional support. Protocol registration@ Open science Framework: identifier 10.17605/OSF.IO/QNKUR.

[Intention to leave the nursing profession due to mental health factors in Navarre (Spain) during the post.COVID-19 pandemic period]

BACKGROUND

This study aimed to assess the intention to leave the current job or the nursing profession among nurses in the Foral Community of Navarre (Spain) during the sixth wave of the COVID-19 pandemic (October 2021-March 2022). The research also evaluated associations between this intention and nurses´ mental health status and sociodemographic characteristics.

METHODS

Descriptive, cross-sectional study that included nurses who worked in healthcare institutions in Navarre during the COVID-19 pandemic. A questionnaire was designed using validated scales to assess depression, anxiety, insomnia, post-traumatic stress, and the intention to leave the job or profession. The questionnaire was distributed via e-mail to all registered nurses, and data collection concluded upon reaching the required sample size.

RESULTS

Of the 693 nurses who participated, 691 completed the questionnaire in full. Overall, 43% of respondents reported an intention to leave the nursing profession, and of these, 52% also considered leaving the current job. Nurses experiencing higher levels of anxiety and post-traumatic stress, as well as those with fewer years of professional experience, were significantly more likely to report an intention to leave.

CONCLUSIONS

A substantial proportion of nurses in Navarre considered leaving the profession during the sixth wave of the COVID-19 pandemic, with mental health -particularly anxiety and post-traumatic stress - and limited professional experience being the key contributing factors. These findings underscore the need for targeted interventions to support nurses´ mental health, improve working conditions, and mitigate job abandonment during and after public health emergencies.

[Effectiveness of a training program in the approach to gender-based violence in emergency professionals: A quasi-experimental study]

BACKGROUND

Health systems play a key role in the detection and management of gender-based violence. This study aimed to evaluate the effectiveness of a training program designed to enhance the knowledge, skills, and attitudes of emergency healthcare professionals in addressing gender-based violence.

METHODOLOGY

A quasi-experimental pre-post study was conducted with 115 emergency health professionals from the Murcian Health Service. Participants completed a 10-hour online training program utilizing active learning methodologies, including guided reflection on didactic and dramatized problem-based videos. The Knowledge, Skills, and Attitudes on Gender-Based Violence Questionnaire (CCHA-VioGen) was administered before and after the training.

RESULTS

Statistically significant improvements were observed in all three dimensions. Knowledge and skills showed medium effect sizes (d=2.07 and d=1.99, respectively), while attitude improved with small effect size (d=0.61). Participants rated the course highly in terms of learning consolidation and applicability, indicating that the course content was perceived as relevant and useful. The perceived need for further training was low, suggesting a strong sense of preparedness following the intervention.

CONCLUSIONS

The training program is highly effective in enhancing healthcare professionals´ competencies in managing cases of gender-based violence. Short, online courses that incorporate innovative resources such as dramatized problem videos represent a feasible and impactful strategy for professional development, especially in setting with limited resources.

Developing preceptorship programmes by exploring the needs of newly qualified sonographers through the lens of experienced ultrasound preceptors

Introduction

This study aimed to explore the needs of newly qualified sonographers with respect to the requirements of preceptorship. This paper describes the first stage of research, with data obtained from a cohort of experienced preceptors. A second stage of research with data from newly qualified sonographers is pending synthesis with this work. The aim is to produce an evidenced-based tool to support departments in developing and implementing effective and robust preceptorship.

Methods

Twelve experienced participants from eight trusts, with a range of clinical backgrounds and experience were recruited. Two focus groups were held with questions structured around known themes highlighted in current evidence regarding newly qualified sonographers. The interviews were recorded and transcribed, and the qualitative data were analysed using thematic analysis.

Results

Four main themes with subthemes emerged. These were: (1) the gaps between qualification and proficiency, (2) the need for managerial investment and formalisation, (3) the preceptor and (4) tools to support the transition and prevent burnout. Frequency data and quotes are given as exemplars.

Conclusion

Participants report that newly qualified sonographers require support in report writing, clinical reasoning and confidence, and this should be addressed within preceptorship while acknowledging individual needs. Managerial investment is essential in ensuring adequate support and protected time is available for important preceptorship activities, such as meeting for feedback and feedforward with opportunity to clearly document progression. Inadequate support may be damaging for the wellbeing of preceptor and preceptee and ultimately impact the standard of our ultrasound services and patient care.

What is the state of play? A nursing and midwifery workplace satisfaction survey across five local health districts

BACKGROUND

The COVID-19 pandemic and recovery period have exacerbated workforce challenges for nurses and midwives. The increasingly complex nature of healthcare, combined with rising workloads and staff attrition highlights the need for initiatives that improve workplace satisfaction and retention. In response, mentoring programs aimed at enhancing job satisfaction and retention are being increasingly implemented.

AIMS

This study sought to measure the workplace satisfaction of nurses and midwives across five New South Wales local health districts, utilising data captured from a wider study investigating the implementation of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring program.

DESIGN

An exploratory, mixed methods study using purposive sampling was employed.

METHODS

A secondary analysis of a modified version of the Nursing Workplace Satisfaction Questionnaire, was used to quantify intrinsic, extrinsic, and relational workplace satisfaction constructs among nursing and midwifery staff. Open ended questions included in the survey were thematically analysed using methods developed by Braun and Clarke (2022).

RESULTS

Between June-October 2023, n = 106 participants returned the survey. Differences between intrinsic (items 2 & 5), extrinsic (item 9) relational (items 13-15) constructs were observed for health districts, Aboriginality, age, and professional role characteristics (P < 0.05). Five qualitative themes emerged from the data: Helping people is the priority; Teams make a difference to my workplace satisfaction; Managers impact my satisfaction; Scope and recognition; and Organisational factors.

CONCLUSIONS

Overall, our findings indicate noticeable differences in workforce satisfaction and retention across various factors, including workforce areas, Aboriginality, age, and professional roles. For these groups, initiatives aimed at improving satisfaction and retention should prioritise fostering teamwork and a sense of belonging, as these elements have significant impact on job satisfaction for nurses and midwives and provide valuable guidance for nursing leaders.

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.

Registered nurses' perceptions of nursing student preceptorship: Content analysis of open-ended survey questions

Nursing preceptors play a crucial role in supporting and educating clinical students. Understanding the perceptions and needs of nurse preceptors is essential to enhance their role as preceptors and to improve their teaching practices. This study aimed to explore preceptorship in diverse settings and specific contexts. Content analysis was performed to analyze open-ended responses from a questionnaire based on nurses' perceptions of preceptorship with undergraduate nursing students. Data were collected from two university hospitals, with different healthcare provision levels. Of the 370 responses, 295 (96%) were those of women, and 34.5% were in the age group of 41-50 years. Three main themes were identified: (1) the role of preceptorship as a key component in learning, (2) challenges in student preceptorship, and (3) personal recognition and compensation for teaching work. This study highlights the positive experiences and provides valuable insights into the challenges and opportunities faced by nurse preceptors in their teaching roles, and emphasizes the need for institutional support and educational programs to enhance their teaching responsibilities. Improving communication and collaboration among stakeholders is crucial for improving learning outcomes and satisfaction.

Factors that influence the clinical supervision implementation for nurses: A scoping review

AIMS

The aim of this review is to identify and map the evidence available on the factors that influence the implementation of clinical supervision for nurses.

DESIGN

The scoping review was conducted and reported following the JBI methodology for scoping reviews.

DATA SOURCES

Searches were conducted on MEDLINE, PsycINFO, and CINAHL databases on 28 March 2023.

REVIEW METHODS

A total of 1398 studies were imported into Covidence for screening. Researchers screened the papers according to the inclusion criteria. Empirical studies in English focusing on the implementation of clinical supervision for nurses were included, without year restrictions. Data from 16 studies were extracted and organized according to the constructs within the Consolidated Framework for Implementation Research (CFIR) domains: intervention characteristics, outer setting, inner setting, characteristics of individuals, and process.

RESULTS

When compared with the CFIR constructs, it was found that the influence of the outer setting on implementation was less explored in the literature. Most of the reviewed data highlighted recurring factors, particularly logistical challenges of nursing work such as shift work and lack of control over work time. Organizational culture and managerial support were also identified as significant factors in the implementation. Another significant challenge in implementation was the variety in clinical supervision's design, purpose, and application, despite sharing the same label, leading to questions about whether studies are implementing the same practice.

CONCLUSION

Policy documents should clearly define both the design and purpose of clinical supervision, beyond just its conceptual definition. Greater emphasis on equitable implementation of clinical supervision is necessary to prevent perpetuating existing inequalities. We conclude that implementation of such complex interventions is not linear, and the implementation strategies need to align with expected implementation challenges.

IMPACT

The advantage of using the implementation framework lies not only in observing what exists as a form of evidence but also in identifying what is underdeveloped. Healthcare services and policy developers can utilize our review to recognize and address potential challenges in introducing, modifying, scaling up, or sustaining their clinical supervision implementation.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Addressing nursing shortages and patient safety using Maslow's hierarchy of needs

ABSTRACT

Healthcare staffing shortages in the US were exacerbated by the COVID-19 pandemic. This article explores the multifaceted challenges and their impact on healthcare organizations, and proposes a framework rooted in Maslow's, hierarchy of needs to guide healthcare organizations in mitigating these shortages and improving patient safety and quality of care.

Supporting the transition from nursing student to newly qualified children's nurse

BACKGROUND

The transition from nursing student to newly qualified nurse is known to be challenging but research on the transition to children's nurse is limited.

AIM

To examine the experience of primary and secondary transitions among newly qualified children's nurses and to identify effective support strategies for this staff group.

METHOD

The study was supported by a literature review and conducted in a children's hospital in Ireland in 2017. A descriptive survey methodology was used. Data were collected using a validated survey tool. The purposive sample encompassed 81 nurses who had qualified as children's nurses from 2011 onwards.

FINDINGS

The transition to children's nurse was found to be a complex but generally positive experience and to require robust support. Transition lasted beyond the first year of practice and the transition experience was similar for all participants, irrespective of whether they had undergone primary or secondary transition. Preceptorship, transition and orientation programmes were reported to be beneficial support strategies.

CONCLUSION

Challenges are to be expected during transition and effective support strategies for new children's nurses are needed, as is further research in this area.