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Kaldal MH, Voldbjerg SL, Grønkjaer M, Conroy T, Feo R. Newly graduated nurses' commitment to the nursing profession and their workplace during their first year of employment: A focused ethnography. J Adv Nurs 2024; 80:1058-1071. [PMID: 37792389 DOI: 10.1111/jan.15883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/21/2023] [Accepted: 09/11/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND The commitment of nurses to their profession and workplace is closely linked to the delivery of high-quality patient care. Existing literature highlights the positive impact of commitment on care quality and patient outcomes. Conversely, a lack of commitment can lead to nurse burnout and disengagement. However, it remains unclear whether and how cultural beliefs and practices influence newly graduated nurses' commitment to the nursing profession and their workplace. AIM To explore the cultural beliefs and practices influencing newly graduated nurses' commitment to the profession and commitment to their workplace during their first year of employment. DESIGN A focused ethnographic study. METHODS Data consisted of field notes from 94 h of participant observations and 10 semi-structured interviews with newly graduated nurses working in acute care settings in Denmark. Data were analysed using ethnographic content analysis. Data were collected between March and June 2022. RESULTS The findings reveal a major theme, termed 'A State of Transience among Newly Graduated Nurses', consisting of two themes: 'Newly Graduated Nurses' Pursuit of Professional Development and Supportive Work Environments' and 'A Lack of Formal Agreements or Conditions to Meet Expectations for Professional Development.' CONCLUSION Hospitals and nurse managers need to support newly graduated nurses in their first employment after registration by providing a range of clinical experiences through job rotation opportunities within the same organization, deliver on promises for onboarding support and foster a culture of trust. These strategies will help maintain the motivation, commitment and ability of newly graduated nurses to deliver high-quality patient care, thereby reducing the likelihood of turnover. RELEVANCE FOR CLINICAL PRACTICE A trusting and supportive work environment is fostered by providing diverse clinical experiences and consistent support for newly graduated nurses. To address potential high turnover associated with job rotation, hospitals need to rethink how retention is defined and measured, moving beyond hospital unit-level models and measures. REPORTING METHOD This study reports to the SRQR guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Maiken Holm Kaldal
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Nursing, UCN, Aalborg, Denmark
| | - Siri Lygum Voldbjerg
- Department of Nursing, UCN, Aalborg, Denmark
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Grønkjaer
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Tiffany Conroy
- College of Nursing and Health Science Flinders University, Bedford Park, South Australia, Australia
| | - Rebecca Feo
- College of Nursing and Health Science Flinders University, Bedford Park, South Australia, Australia
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BowenXue, Feng Y, Zhao Y, Li X, Yang Y, Zhang J, Zhang Y, Hu Z, Luo H. Decent work, work engagement, and turnover intention among registered nurses: a cross-sectional study. BMC Nurs 2024; 23:31. [PMID: 38200595 PMCID: PMC10777638 DOI: 10.1186/s12912-023-01662-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Nurses face substantial career challenges arising from global pandemics, economic crises, and their roles in conflict-ridden areas. In this context, the rights of nurses pertaining to decent work, such as freedom, fairness, safety, and dignity, are not adequately safeguarded. This study examines decent work status among Chinese nurses and its links to demographics, work engagement, and turnover intention. METHODS A cross-sectional study design was used following STROBE guidelines. Through a convenient sampling method, a total of 476 nurses were surveyed. These participants were drawn from three esteemed tertiary Grade A hospitals in Hangzhou, with data collection spanning from June to August in 2023. We used a comprehensive set of assessment instruments, encompassing an evaluation of demographic characteristics, the Decent Work Perceptions Scale (DWPS), the Utrecht Work Engagement Scale (UEWS), and turnover intention questionnaire. Bootstrapping procedures were used to ensure the robustness and reliability of the model. RESULTS The study revealed that nurses' perceptions of decent work significantly impacted work engagement (β = 0.603, p < 0.001) and turnover intention (β = -0.275, p < 0.001). Work engagement operated as a mediator between decent work and turnover intention, decreasing the likelihood of nurses leaving their positions (β = -0.062, p < 0.001). Factors such as age, years of working experience, professional title, job category, and attendance at professional conferences significantly influenced nurses' perceptions of decent work (all p < 0.05). CONCLUSIONS This study examines factors affecting decent work among nurses and explores its connection with work engagement and the intention to leave. Despite limitations (sample, social desirability bias), the study offers valuable insights for nursing practice. This suggests managers improve decent work for young nurses through rational shift schedules and continuous education. Policymakers should consider adjusting nursing policies for better employment conditions.
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Affiliation(s)
- BowenXue
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310007, Zhejiang, China
| | - Yaping Feng
- Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, Zhejiang, China
| | - Yihui Zhao
- Hangzhou Normal University, Hangzhou, 310007, Zhejiang, China
| | - Xin Li
- Hangzhou Normal University, Hangzhou, 310007, Zhejiang, China
| | - Yang Yang
- Hangzhou Normal University, Hangzhou, 310007, Zhejiang, China
| | - Jingxuan Zhang
- Hangzhou Normal University, Hangzhou, 310007, Zhejiang, China
| | - Yu Zhang
- Hangzhou Normal University, Hangzhou, 310007, Zhejiang, China
| | - Zhiguo Hu
- Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, Zhejiang, China.
| | - Hong Luo
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310007, Zhejiang, China.
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Nyholm L, Gunningberg L, Jangland E. Is this to be another project that fizzles out? Using the i-PARIHS framework to evaluate implementation of a mentoring programme. J Adv Nurs 2024. [PMID: 38174632 DOI: 10.1111/jan.16041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024]
Abstract
It is well-known that the implementation of evidence into clinical practice is complex and challenging. The integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework conceptualizes successful implementation of evidence into practice. As the implementation of the mentoring programme proved to be a challenge, it seemed valuable to retrospectively study the implementation process using a framework like the i-PARIHS. AIM The aim of this study was to evaluate implementation of a multifaceted mentoring programme for bedside nurses using the i-PARIHS framework, to identify factors that influenced the implementation. DESIGN A secondary analysis of qualitative data using the i-PARIHS framework as the theoretical lens. METHOD A directed content analysis was performed, driven theoretically by the i-PARIHS framework. The analysis focused separately on (a) characteristics of the innovation and (b) successful and hindering factors in the implementation process. RESULTS The results showed that successful factors influencing implementation of the mentoring programme included supportive and actively involved formal leaders and supervisors at the unit level. A major hindering factor was lack of resources in the form of personnel, time and money. A lack of facilitators, particularly experienced facilitators, throughout the organization hindered implementation. The i-PARIHS framework offered a structured how-to guide to identify factors that influenced the implementation process. CONCLUSION Implementation of the mentoring programme was a challenge for the organization. Investment into implementation should continue, with a more structured facilitation process. A structured and prioritized management system, including supportive leadership at the unit level, should be established by the hospital board. IMPLICATIONS FOR THE PROFESSION There is a need for experienced facilitators throughout the organization. This is crucial to achieve sustainability in the mentoring programme and ensure that the large investments of staff resources and money do not fizzle out. IMPACT What problem did the study address? Implementing a mentoring programme for nurses in a large university hospital proved to be a challenge. Therefore, it seemed valuable to retrospectively study the implementation process using a framework like the i-PARIHS. What were the main findings? A lack of facilitators, particularly experienced facilitators, throughout the organization hindered the implementation. The i-PARIHS framework offered a structured how-to guide to identify factors that influenced the implementation process. Where and on whom will the research have an impact? Our findings are important for leaders on all levels in a hospital setting, including the hospital board, heads of departments and nurse managers. REPORTING METHOD Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups is used. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Lena Nyholm
- Department of Surgical Sciences, Nursing Research, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Lena Gunningberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Eva Jangland
- Department of Surgical Sciences, Nursing Research, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
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Swink K, Berris M, King S, Frame S, Munoz R, Magallon AL. Innovation in Nurse Staffing Models: Implementing a Tele-Critical Care Nurse Program in a Pediatric Cardiac Intensive Care Unit. AACN Adv Crit Care 2023; 34:334-342. [PMID: 38033215 DOI: 10.4037/aacnacc2023719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
A pediatric tele-critical care nursing program provides an extra layer of surveillance for patients and alerts bedside nurses of abnormal trends to mitigate adverse events. Although workforce turnover combined with patient complexity and acuity in a pediatric cardiac intensive care unit strains the sustainability of a healthy work environment, these variables have also opened the door to an innovative approach to tele-critical care nursing care delivery. In addition to virtual surveillance, a clinical bedside intervention was developed to provide hands-on assistance to bedside nurses. This article describes the evolution of this novel technique for enhancing nursing care delivery.
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Affiliation(s)
- Kellie Swink
- Kellie Swink is Clinical Nurse Program Coordinator, Division of Cardiac Critical Care Medicine, Telemedicine Program, Children's National Hospital, 111 Michigan Avenue, NW, Washington DC, 20010
| | - Menchee Berris
- Menchee Berris is Clinical Nurse Program Coordinator, Division of Cardiac Critical Care Medicine, Telemedicine Program, Children's National Hospital, Washington, DC
| | - Simmy King
- Simmy King is Chief Nursing Informatics and Education Officer, Division of Nursing, Children's National Hospital, and George Washington University, School of Medicine and Health Sciences, Washington, DC
| | - Shaun Frame
- Shaun Frame is Director, Nursing Inpatient Heart Institute, Children's National Heart Institute, Children's National Hospital, Washington, DC
| | - Ricardo Munoz
- Ricardo Munoz is Chief, Division of Cardiac Critical Care Medicine, Executive Director of Telemedicine, and Co-director, Children's National Heart Institute, Children's National Hospital, Washington, DC
| | - Alejandro Lopez Magallon
- Alejandro Lopez Magallon is Medical Director, Telemedicine Program, Division of Cardiac Critical Care Medicine, Children's National Hospital, Washington, DC
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Heng LMT, Rajasegeran DD, See AMT, Kannusamy P, Lim SH, Aloweni FBAB, Ang SY. Original Research: Nurse-Reported Missed Care and Its Association with Staff Demographics and the Work Environment. Am J Nurs 2023; 123:28-36. [PMID: 37615466 DOI: 10.1097/01.naj.0000978144.33445.5b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
BACKGROUND Nurses have primary responsibility for many of the care processes and interventions intended to improve patients' health during hospital stays. Accordingly, missed nursing care can negatively impact patient safety and lead to negative clinical outcomes. Missed nursing care is standard care that is not completed, incomplete, or seriously delayed. PURPOSE There is scant literature on nurse-reported missed care (NRMC) in Singapore. Identifying the prevalence of, types of, and reasons for missed care, including staff-related factors, is imperative to understanding the implications of missed care and identifying opportunities for improvement. METHODS Ours is a correlation study of NRMC using convenience sampling. Nurses working on all inpatient units in an acute care hospital in Singapore were recruited to complete the MISSCARE survey, a quantitative tool measuring missed nursing care and the reasons for it. Descriptive statistics was applied to analyze demographics, types of NRMC, and reasons for NRMC. The Pearson χ2 test was used to analyze the correlation between demographics and satisfaction variables and NRMC. RESULTS A total of 314 participants out of 1,944 eligible nurses (response rate, 16%) were recruited. The most commonly reported missed care activities were setting up meals for patients who can feed themselves (87.3%), ambulation (70.1%), attending interdisciplinary conferences (64.3%), providing emotional support to patients and/or family (58%), and turning patients every two hours (56.7%). The most cited reasons for missed care were inadequate number of staff (84.4%), caregiver not in unit or unavailable (76.1%), heavy admission and discharge activity (75.5%), urgent patient situations (74.2%), and unexpected rise in patient volume and/or acuity (73.2%). Younger age, greater experience in role and current unit, inadequate staffing and teamwork, low satisfaction with current role and with being a nurse, and planning to leave the current position were factors significantly associated with greater levels of missed care. CONCLUSION This study demonstrated evidence of NRMC and its associated factors within the local setting. In addition to expanding nursing resources, analyzing nursing work processes, providing support for younger nurses, and improving nursing satisfaction are possible mitigating factors in preventing missed care. Strategies targeting workforce and resource management, greater support for new and younger nurses, and job satisfaction should be considered to address missed care.
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Affiliation(s)
- Laura Mun Tze Heng
- Laura Mun Tze Heng is a staff nurse, Darshini Devi Rajasegeran and Siew Hoon Lim are nurse clinicians, Alicia Min Ting See is a senior staff nurse, and Fazila Binte Abu Bakar Aloweni is senior nurse manager, all at Singapore General Hospital, Singapore. Premarani Kannusamy is deputy director and head of nursing, Youth Preventive Services, and head of nursing, Health Promotion Board, Singapore. Shin Yuh Ang is deputy director of nursing innovation, quality and research, Singapore General Hospital, and director of nursing, National Dental Centre, Singhealth, Singapore. Contact author: Darshini Devi Rajasegeran, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Wray J, Calzolari M, Gammone M, Aleo G, Catania G, Zanini M, Sasso L, Bagnasco A. The potential benefits of legacy mentoring for newly qualified nurses. Nurse Educ Pract 2023; 66:103511. [PMID: 36434921 DOI: 10.1016/j.nepr.2022.103511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jane Wray
- Faculty of Health Sciences, University of Hull, Hull HU6 7RX, UK.
| | - Michela Calzolari
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
| | - Mariarosaria Gammone
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy; S.I.T.R.A, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via G. Celoria, 11, 20133 Milan, Italy.
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy; Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
| | - Annamaria Bagnasco
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
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