A cross-sectional study on turnover intention of nurses in eastern China

BMC Health Services Research, Год журнала: 2024, Номер 24(1)

Опубликована: Апрель 3, 2024

This study aimed to investigate the turnover intention among nurses in eastern China and explore association between personal characteristics, family factors, work-related factors.

Язык: Английский

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Contemporary Factors Influencing Professional Identity in Acute Care Nurses: An Integrative Review

Journal of Advanced Nursing, Год журнала: 2025, Номер unknown

Опубликована: Фев. 20, 2025

ABSTRACT Aim To explore the current state of science on influencing factors acute care nursing professional identity. Design Integrative review. Methods Data were collected and screened using Covidence systematic review software, adhering to pre‐defined inclusion criteria. The Critical Appraisal Skills Programme checklist was used for critical appraisal, content analysis applied analyse data. Sources CINAHL, PsycINFO PubMed utilised search literature published between 2018 2023. Results A total 18 articles included. Five themes identified: (1) internal influences; (2) external (3) externalisation role; (4) early versus seasoned career experiences (5) barriers identity formation. Conclusion This found evidence multiple factors, predominantly external, shaping nurse Research long‐term impacts practice, management, policy education remains limited. Implications Enablers forming foster empowerment, confidence, belonging job satisfaction. Barriers formation lead hesitation, performance impediments, stress exhaustion. Development may be instrumental in tackling workforce challenges. Impact Review findings can guide initiatives enhancing healthy work environments retention. exploration has international contemporary relevance profession with suggestions future research. Statement Existing underscores significance nursing, yet mechanisms underlying its integration maintenance remain unclear. In context overwhelming workloads that adversely affect mental health retention, coupled escalating shortage as we emerge from pandemic, this examination holds evolving landscape, offering implications insights gleaned organisational leaders developing new strategies addressing policy, Reporting Method adheres EQUATOR network, ENTREQ guidelines. Patient or Public Contribution None.

Язык: Английский

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Reclaiming Professional Identity: A Study Exploring the Impact of COVID‐19 on Nurses

Nursing Forum, Год журнала: 2025, Номер 2025(1)

Опубликована: Янв. 1, 2025

The COVID‐19 pandemic affected all roles within healthcare but had a unique impact on the professional identity (PI) of nurses. This study assessed PI practicing nurses in Midwestern US setting using standardized tool and focus groups exploring lived experience nurses’ formation enactment during COVID‐19. survey included 312 responses, 36 participants. Overall, domains were impacted by pandemic, regardless role or years experience. Phenomenological qualitative analysis revealed four themes: polarities identity, wartime relationships flexibility as resilience factors to identity. is linked high quality care, wellness, retention nursing profession, which benefits individual nurse, patients families, organizations, communities. Leaders are urged identify strategies help reclaim strengthen their moving forward from pandemic. These include reclaiming evidence‐based practice, engaging shared governance practice improvement work, recognizing for contributions patient creating opportunities human connections with other professionals.

Язык: Английский

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

Healthcare, Год журнала: 2025, Номер 13(6), С. 671 - 671

Опубликована: Март 19, 2025

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

Язык: Английский

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Transformational Nurse Leaders and Nurse Well‐Being: Examining Mediating Influences of Organizational Justice and Quality of Work Life Mixed Methods Study

Journal of Nursing Management, Год журнала: 2025, Номер 2025(1)

Опубликована: Янв. 1, 2025

Background: Transformational leadership is recognized as a crucial factor influencing nurses' work experiences and well-being. However, the mechanisms through which transformational affects nurse well-being, especially concerning organizational justice quality of life, are not fully understood. Aim: This study investigates direct indirect effects on focusing mediating roles life. Methods: Using sequential explanatory mixed methods design, quantitative data were collected from 580 nurses across five hospitals in Saudi Arabia with validated tools: Global Leadership Scale, Organizational Justice Quality Nursing Work-Life Emotional Exhaustion Subscale Maslach Burnout Inventory, Job Satisfaction Perceived Stress Scale. Qualitative obtained 25 focus group discussions using semistructured discussion guide. Quantitative analyses included hierarchical multiple regression mediation analyses, while qualitative wereanalyzed thematically. Results: significantly reduced emotional exhaustion (β = -0.48, p < 0.001), increased job satisfaction 0.53, lowered perceived stress -0.46, 0.001). Mediation showed significant life (indirect effects: -0.34 to 0.38, findings highlighted importance inspirational motivation, individualized consideration, intellectual stimulation, idealized influence. Conclusions: directly indirectly enhances well-being improved These emphasize need for healthcare organizations foster promote fair, supportive environments enhance

Язык: Английский

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Effectiveness of mental health first aid as a supportive tactic on resilience and organisational environment-related factors among hospital nurses in the wake of COVID-19: the search continues

Journal of research in nursing, Год журнала: 2025, Номер unknown

Опубликована: Апрель 10, 2025

The implementation of Mental Health First Aid (MHFA) has been shown to effectively prevent long-term psychological effects trauma. Additionally, it aids nurses in stabilising their emotional state and facilitates practical recovery. To investigate the effect MHFA on resilience capacity, organisational commitment, job insecurity turnover among working COVID-19 isolation units. Sixty units participated a quasi-experimental two-group, pre-post-test research. Nurses with low capacity due crisis Egypt completed baseline survey. study group employed strategies using RAPID model. At same time, standard care was provided control group. A statistically significant improvement commitments mean scores (62.50 ± 19.33, 21.67 9.66, respectively) post-intervention. Besides, decline group's intention (8.90 2.32, 8.70 2.34, after intervention. Implementing enhances nurses' ability withstand challenges COVID-19, significantly boosting resilience. positively impacts reducing both intention.

Язык: Английский

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The Impact that Postgraduate Fellowship Have on Advanced Practice Registered Nurses in Specialized Areas of Practice

The Journal for Nurse Practitioners, Год журнала: 2024, Номер 20(7), С. 105079 - 105079

Опубликована: Июнь 11, 2024

Язык: Английский

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Web of Mutuality: Relational Integrity in Critical Care Nursing

AACN Advanced Critical Care, Год журнала: 2023, Номер 34(4), С. 381 - 390

Опубликована: Ноя. 30, 2023

Long before the COVID-19 pandemic, relationships with patients and colleagues were fuel that kept nurses coming back day after day. Consistently identified as most ethical trusted profession for more than 2 decades, nursing has enjoyed positive regard admiration by its standards, reliable care, presence.1 Teams comprised of diverse clinicians other health care workers created a foundation competence confidence contributed to safety, quality, camaraderie. Leaders organizations, responsible creating supportive environment, invested in programs excellence such American Nurses Credentialing Center’s Magnet or Pathways Excellence programs. In many communities, there partnerships systems people they served. some places was sense shared purpose solidarity.But things have changed. Levels violence against skyrocketed.2,3 Patients are turning nurses’ expertise advice favor unsubstantiated treatments practices, disrespect become normalized.4 Health teams fractured staff turnover, short-term assignments externally employed nurses, “brain drain” experience workforce is populated less experienced clinicians.5 Communication transactional largely relegated disembodied electronic memes texts. organizations struggling compensate losses pandemic relying on historical strategies increased throughput efficiency balance budget. continue be asked do less. Societal upheaval, conflict, uncertainty destabilized neighborhoods communities. Arguably, relational integrity everyone been eroded.Relational integrity, key component moral resilience, refers dynamic interplay personal engaged delivery care.6 This includes clinicians, workers, leaders, served—our their families. Beyond it encompasses values commitments inherent our professions, outlined codes ethics. Relational reflected choices, behaviors, actions, professionalism, acknowledges compass primarily executed context others. type inevitability being tethered to, thus influenced by, patients, institutions within which we practice. Our interdependence interconnection each myriad ways including micromoments connection occur every Collectively, resonate other’s when manifest degraded. We detect these signals alignment misalignment bodies, hearts, minds. fluctuates practice settings between whole undiminished wholeness temporarily permanently.The quality interprofessional broader community integrity. As ecosystem, involves mutual respect, skillful communication, authentic collaboration. Maintaining building strong among teams, gaining respect collaboration needed desired results. It effective, mindful communication essential achieving patient outcomes, fostering promoting engagement fulfillment. When intact, all parties feel seen heard, transparent honest, patients’ experiences clinician’s expertise. Empathy, understanding, trust, curiosity flourish, thereby contributing everyone’s belonging. fractured, not supported, respected, empowered; likewise, morale can suffer may lead suffering burnout. breakdown result breaches poor collaboration, ineffective delayed interventions, medical errors, ultimately poorer outcomes.7 web extends into communities society at-large. walls complex social, political, economic, racial, cultural forces impact personal, professional, those serve. values, policies, thrives. patterns degraded accumulate constrained work environments, societal disintegration, conflict violence, insidious erosion enterprise becomes undeniable.It’s busy night emergency department (ED). Nurse Isaac clocks his shift receives report from outgoing nurses. There 8 rooms Issacs’s section ED, separated curtains. Because high census, 15 shuffled built accommodate half number. only nurse tonight. He pauses he notices name ED physician charge evening, Dr Fay. recalls prior interactions challenging.Anthony, 65-year-old man, arrives at chief complaint chest pain shortness breath. The history tobacco use, chronic obstructive pulmonary disease (COPD), blood pressure, well family acute coronary syndrome. An electrocardiogram (ECG) ordered Ava, triage nurse, while Ruby, clinical assistant, takes Anthony wheelchair Isaac’s him cardiac monitor pulse oximeter pressure cuff. preoccupied, attempting deescalate ire waiting over hours doctor superficial laceration arm who demanding speak management.Meanwhile Chris, ECG technician, printout hand outside patient’s room share results finishes assessing patient. Five minutes later, Fay steps out handed report; shows non–ST-elevated myocardial infarction (NSTEMI). After taking mutters something unintelligible enters where attending irate comments an urgent situation requiring attention issues will wait. hurriedly enter Anthony’s bedspace find diaphoretic dyspneic, described 9 10. quickly introduces himself but cut off Fay, themself “the doctor.” performs assessment then proceeds walk stopped Isaac, asks verbal confirmation plan care. tells orders record (EMR). reminds order respiratory swab because need admitted intensive unit (CICU). nods dismissively walks off. turns toward Anthony, noticing anxious expression, reassures team doing best help if anyone would like contact.Isaac initiates own repositions support breathing titrates supplemental oxygen appropriate rate given COPD. builds rapport through small talk implements Fay’s orders, appeared EMR. ordered. knows hospital policy requires must test transferred room. Wary reaction reminded second time, opts use messaging system send reminder swab.Over next 5 hours, split across patients. Despite volume, limited resources, no relief, manages keep up critical chagrin stable yet still Finally, sees bed made available CICU Anthony. immediately calls floor give report. receiving notes recorded transported.Exasperated delay, checks EMR see neither nor acknowledged message. leaves remind person place orders. wait review resident’s charting another stands anxiously desk. looks several gathering around A code alarm triggered, doctors rush cyanotic agonal breaths oxygenation 60%. pulseless, compressions started, intubated. Return spontaneous circulation achieved rounds cardiopulmonary resuscitation.Anthony stabilized now, albeit worse condition before. manager expedite transfer floor. overhears commenting Ava this could probably avoided had distracted. responds saying one capable team, fortunate finally gives hand-off CICU, says about missing swab, “Aren’t you aware policy?”Clinical fundamentally meet complex, often uncertain, rapidly evolving context. Each brings them unique fingerprint beliefs, principles along social practices. engages human vulnerabilities interdependence. true one’s establishing effective boundaries decisions.6 inter-connection particularly vital considering situations navigate, balancing competing obligations surrogates, practice, society. Clinicians case consider what owe relationships, expectations willing enact hold themselves accountable for.Respecting humanity, especially serve, crucial integrity.6 demonstrates when, amid crisis, conducting providing reassurance ease anxiety. upheld attune needs others respond nurture wholeness. noticed expression concern, despite time constraints, paused reassure offered reach important him. Throughout scenario, connected core dignity prevention minimization harm prioritizing greatest risk compromise; did this, abilities, fair, equitable, compassionate manner. Research suggests organizational worker necessary conditions compassion arise enhanced.8 leveraged knowledge, skills, navigate complexity without exacerbating tenuous circumstances found in. Although explicitly stated, likely used variety self-regulatory skills self-stewardship practices ability remain chaotic ED.8,9As illustrated case, teamwork safe, high-quality leverages humanity entire team. depends upon solidarity invites contributions achieve priorities, professional goals.6 “divided, lacks solidarity, weakened cowardice leadership, disable group.”6 inclusive diversity perspectives, creates environment left out. Personal knowing having courage defend threats challenges maintaining respectful stood firm her fairness she responded appraisal performance. She constructively offering alternative view modeled someone holding different perspective. illustrates fortified eroded behaviors few. person’s upheld, thrives; compromised, collective eroded. expanded enlarges sphere individual include awareness sensitivity helps define honor roles, authority.Although scenario fictional, reflects lived providers Further, also highlights explicit implicit advantages While decisions experiences, institutional levels trickle down decisions. resides social-ecological impacted dissonant influences. Imbalances power authority, constraints imposed hierarchical systems, dependencies responsibilities values.6 Intact inform group process, culture. Alignment encourage priorities disproportionate stress, distress, well-being.Whether doctor, ancillary staff, shape formed hands engagement, involving transfers numerous junctures fractured. assigned lack trust. hesitates change condition, pattern dismissing concerns. deteriorates, eventually intubation mechanical ventilation. trust delays initiation treatment, resulting longer stay complications. Other members hesitate breech role-based norms ED. dismissive responses suggestions gossip degrading nonverbal communication. interpersonal slight during handoff add adversity.These dynamics already depleted expected safely manage unrealistic numbers sufficient resources. result, flexible collaborative significantly impaired. Where begin increasingly frustrated, unsupported, ignored.10 They hesitant advocate needs, fear reprimanded ignored. Burnout ensues disenchanted escalates gap actions discordant.8 accumulated burnout, residue contributes attrition ongoing recruitment retention challenges. One five quit since 2020, recent survey Elsevier 47% leave jobs 2025.11 loss personnel bound further disrupt strained system. These cumulative understood breeches leaders implicitly promised provide resources fulfill role requirements.In sociopolitical perspective, begins walking unsafe arena, whereby himself.12,13 impossible task current reality United States. More 90% say workplaces understaffed.13 Meanwhile, decade’s worth studies demonstrate outcomes improved increasing nursing-to-patient staffing. Driscoll et al14 conducted systematic suggested staffing reduces adverse events in-hospital mortality.Indeed, inadequate systemic issue addressed legislative However, legislators too distanced consequences well-intentioned even harmful legislation, making hard improve conditions. What follows reverberates political policies undermine accordance values. spheres cascade animates narrative “Us vs Them,” rather pulling stakeholders commitments. Furthermore, face scientific data supporting ensure safe budgetary relegate services flat cost value proposition allows budget cutting services.15,16 way operating changed mandates, involve fundamental paradigm shift.Relational dissonance organization’s values.8 commitments, compromised. degree effectiveness negatively correlated injury scores pandemic.17 high-level scenario.Embedded context, challenged unhealthy culture significant moments deference led delay placed risk. first interrupting present results, step early identification intervention behalf. moment away swab. instances, both Chris concerned sign positioning physician. compromised any member causes harms. Vertical horizontal bullying, disrespect, microaggressions erode community.18 exacerbated stress exhaustion norm exception.Whereas communication—the receive relay information understanding—is cornerstone excess emphasis rigidly defined roles perceived significance authority hinder Such cultures failures, lower-ranking individuals refrain speaking higher-ranking fail listen respond. study, nearly one-third feared repercussions flagging potential errors.19 unintended outcomes. raise safety concerns, contribute medication cause treatment procedures, compromise hygiene care.20 Left unchecked, rigid hierarchies suppress voices lower-ranked individuals, placing responsibility behalf eroding everyone.Clinicians study attempt pressures using direct Direct secure, real-time exchange information, aid timely accurate decision-making agreement Naturally, implementation digital leads decrease face-to-face communications. faster workflow.21 Electronic tends cryptic devoid understanding meaning behind words, goals perspectives values.22,23 surfaced addressed, overt covert emerge degrade functioning integrity.Relational thrives know beings solely positions. Less impacts relationship-building camaraderie colleagues. Trust-building faith others’ capability, character, communication.24 Effective facilitated count on, capabilities appreciated understood, good clarity.24 Data suggest responsiveness level established nurses.25 Myriad factors influence experiences.25Indeed, trusting until invested, clinicians’ premised underdeveloped betrayal. Evidence demonstrated that, betrayal professionals once trusted, care.17,26 required however, undercut turnover brought physicians, advanced providers, 25% switching careers, respondents citing burnout primary reason.27 Until actionable commitment hospitals alleviate underlying turnover.28,29The sociopolitical, dedicated serving. under varying degrees dignitary harms associated listened known caring them.30 efforts engage situation, disconnect. cannot committed identity suffering.31 Over types residues well-being profession.Although presented serves highlight provides framework imagining how intact alter course Beginning surrounding infrastructure, investment guarantee so clinician number Strategies mandated ratios proposed external lever goal.30 related decreases mortality, missed likelihood death.12,14 Whether intended remains sufficiently studied.32 Regardless mechanism accomplish goal, should empowered authorized make allocation based capacities, limitations admissions, transfers, discharges. Association Critical-Care long envisioned—“a driven families optimal contribution” might reality.33 Accomplishing goal require aligning delivering New models governance cocreated solutions accountabilities processes necessary.In typical structure it’s question cases error situation. Hierarchy place, open challenge superiors negative consequences.34 inquiry, discernment, bring concerns addressing shame.6 Unhealthy structures unbalanced create barriers challenging express opinions higher-status due criticism rejection. views, input systematically silenced discounted, element violated. Clinical gradients physicians exacerbate issue.35 reinforce attitudes superiority entitlement suboptimal example, overlook details harm. evident opportunities incorporate discredited.Without hierarchy various influencing members, played differently. First, felt comfortable examination turn Chris’s Early recognition NSTEMI earlier interventions outcomes.36 Next, come same importance ordering transferring higher hesitated doctor. imagine affect advocating perceive concern. Consistent tenets community/society climate (Figure).Relational job satisfaction, retention, better fosters decision-making, dynamic. benefits professionals. adequate material empowering decisions, new governance, align improving provided.We acknowledge helping us enhance topic. specialties serving services.

Язык: Английский

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Post-Graduate Fellowship's Impact on Nurse Practitioners In Specialized Fields

Опубликована: Янв. 1, 2024

Download This Paper Open PDF in Browser Add to My Library Share: Permalink Using these links will ensure access this page indefinitely Copy URL DOI

Язык: Английский

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The Rising Call for Nursing Professional Development to Elevate Preceptor and Clinical Instruction

Journal for Nurses in Professional Development, Год журнала: 2024, Номер 40(4), С. 181 - 183

Опубликована: Июль 1, 2024

Heidi J. Keeler, PhD, MSN/MBA, RN, University of Nebraska Medical Center, Omaha. The author has disclosed that she no significant relationships with, or financial interest in, any commercial companies pertaining to this article. This program is supported by the Health Resources and Services Administration U.S. Department Human under 5T1QHP47311-02-00, Nurse Education Practice Quality Retention: Clinical Faculty Preceptor Academy award. ADDRESS FOR CORRESPONDENCE: 985330 Omaha, NE 68198 (e-mail: [email protected]).

Язык: Английский

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