Sample records for qualified registered nurses
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Competence of newly qualified registered nurses from a nursing college.
Morolong, B G; Chabeli, M M
2005-05-01
The South African education and training system, through its policy of outcomes-based education and training, has made competency a national priority. In compliance to this national requirement of producing competent learners, the South African Nursing Council (1999 B) require that the beginner professional nurse practitioners and midwives have the necessary knowledge, skills, attitudes and values which will enable them to render efficient professional service. The health care system also demands competent nurse practitioners to ensure quality in health care. In the light of competency being a national priority and a statutory demand, the research question that emerges is, how competent are the newly qualified registered nurses from a specific nursing college in clinical nursing education? A quantitative, non-experimental contextual design was used to evaluate the competence of newly qualified registered nurses from a specific nursing college. The study was conducted in two phases. The first phase dealt with the development of an instrument together with its manual through the conceptualisation process. The second phase focused on the evaluation of the competency of newly qualified nurses using the instrument based on the steps of the nursing process. A pilot study was conducted to test the feasibility of the items of the instrument. During the evaluation phase, a sample of twenty-six newly qualified nurses was selected by simple random sampling from a target population of thirty-six newly qualified registered nurses. However, six participants withdrew from the study. Data was collected in two general hospitals where the newly qualified registered nurses were working. Observation and questioning were used as data collection techniques in accordance with the developed instrument. Measures were taken to ensure internal validity and reliability of the results. To protect the rights of the participants, the researcher adhered to DENOSA'S (1998:2.2.1) ethical standards
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Successful preceptorship of newly qualified nurses.
Price, Bob
There is widespread recognition that many newly qualified nurses find it difficult to make the transition from completing their university course to taking up their first registered nurse post. Preceptorship programmes during the first year of registered nurse practice have been recommended by the Department of Health. Preceptors have an important role in ensuring successful transition of the newly qualified nurse; however they also require practical guidance on how best to support the nurse. This article identifies aspects that need to be considered when guiding a registered nurse colleague rather than a student. Preceptorship concerns four main areas: orientation to patients and services provided locally, real-time clinical reasoning, skill review and refinement, and socialisation within the healthcare team. The article will explore each of these areas.
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Birkhead, Susan; Kelman, Glenda; Zittel, Barbara; Jatulis, Linnea
The aim of this study was to describe nurse educators' use of multiple-choice questions (MCQs) in testing in registered nurse licensure-qualifying nursing education programs in New York State. This study was a descriptive correlational analysis of data obtained from surveying 1,559 nurse educators; 297 educators from 61 institutions responded (response rate [RR] = 19 percent), yielding a final cohort of 200. MCQs were reported to comprise a mean of 81 percent of questions on a typical test. Baccalaureate program respondents were equally likely to use MCQs as associate degree program respondents (p > .05) but were more likely to report using other methods of assessing student achievement to construct course grades (p < .01). Both groups reported little use of alternate format-type questions. Respondent educators reported substantial reliance upon the use of MCQs, corroborating the limited data quantifying the prevalence of use of MCQ tests in licensure-qualifying nursing education programs.
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Being a team leader: newly registered nurses relate their experiences.
Ekström, Louise; Idvall, Ewa
2015-01-01
This paper presents a study that explores how newly qualified registered nurses experience their leadership role in the ward-based nursing care team. A nurse's clinical leadership affects the quality of care provided. Newly qualified nurses experience difficulties during the transition period from student to qualified professional and find it challenging to lead nursing care. Twelve nurses were interviewed and the transcribed texts analysed using qualitative content analysis to assess both manifest and latent content. Five themes were identified: feeling stranded; forming well-functioning teams; learning to lead; having the courage, strength, and desire to lead; and ensuring appropriate care. The findings indicate that many factors limit nurses' leadership but some circumstances are supportive. The leadership prerequisites for newly registered nurses need to improve, emphasizing different ways to create a supportive atmosphere that promotes professional development and job satisfaction. To increase nurse retention and promote quality of care, nurse managers need to clarify expectations and guide and support newly qualified nurses in a planned way. © 2013 John Wiley & Sons Ltd.
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Professional socialization: the key to survival as a newly qualified nurse.
Mooney, Mary
2007-04-01
The impact and prevalence of professional socialization in nursing has been written about extensively. Despite the many positive developments that have taken place in nursing within the past decade, the role of professional socialization remains heavily weighted and is of particular significance to those nurses who are newly qualified. The account given by newly registered nurses in this study demonstrates that their ability and willingness to become professionally socialized determines their ease of survival at clinical level. Twelve newly qualified Irish nurses, from two separate cohorts, were interviewed to ascertain their perceptions of becoming newly qualified nurses. A grounded theory approach was used and data were analysed using thematic analysis. A category that emerged was linked very strongly with professional socialization. The respondents did not refer to professional socialization per se, but through the coding process this emerged as the linchpin of the discussion.
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Qualified nurses' rate new nursing graduates as lacking skills in key clinical areas.
Missen, Karen; McKenna, Lisa; Beauchamp, Alison; Larkins, Jo-Ann
2016-08-01
The aim of this study was to explore perceptions of qualified nurses on the abilities of newly registered nursing graduates to perform a variety of clinical skills. Evidence from the literature suggests that undergraduate nursing programmes do not adequately prepare nursing students to be practice-ready on completion of their nursing courses. A descriptive quantitative design was used. Participants were recruited through the Australian Nursing and Midwifery Federation, Victorian branch. A brief explanation of the study and a link to the survey were promoted in their monthly e-newsletter. A total of 245 qualified nurses in the state of Victoria, Australia participated in this study. A survey tool of 51 clinical skills and open-ended questions was used, whereby participants were asked to rate new nursing graduates' abilities using a 5-point Likert scale. Overall participants rated new nursing graduates' abilities for undertaking clinical skills as good or very good in 35·3% of skills, 33·3% were rated as adequate and 31·4% rated as being performed poorly or very poorly. Of concern, essential clinical skills, such as critical thinking and problem solving, working independently and assessment procedures, were found to be poorly executed and affecting new registered nurses graduates' competence. The findings from this study can further serve as a reference for nursing education providers to enhance nursing curricula and work collaboratively with healthcare settings in preparing nurses to be competent, safe practitioners on completion of their studies. Identifying key areas in which new nursing graduates are not yet competent means that educational providers and educators from healthcare settings can focus on these skills in better preparing our nurses to be work ready. © 2016 John Wiley & Sons Ltd.
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Jenkins, Brittany Lauren; Huntington, Annette
2015-01-01
To analyse the literature regarding the context and experiences of internationally qualified registered nurses, particularly Filipino and Indian nurses, who have transitioned to New Zealand. Internationally qualified nurses are a significant proportion of the nursing workforce in many developed countries including New Zealand. This is increasingly important as populations age, escalating demand for nurses. Understanding the internationally qualified nurse experience is required as this could influence migration in a competitive labour market. Examination of peer-reviewed research, policy and discussion documents, and technical reports. A systematic literature search sought articles published between 2001 and 2014 using Google Scholar, CINAHL, and Medline. Articles were critically appraised for relevance, transferability, and methodological rigour. Fifty-one articles met inclusion criteria and demonstrate internationally qualified nurses face significant challenges transitioning into New Zealand. The internationally qualified nurse experience of transitioning into a new country is little researched and requires further investigation.
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Registered nurses' attention to and perceptions of pressure ulcer prevention in hospital settings.
Sving, Eva; Gunningberg, Lena; Högman, Marieann; Mamhidir, Anna-Greta
2012-05-01
To describe how registered nurses perform, document and reflect on pressure ulcer prevention in a specific nurse-patient care situation, as well as generally, on hospital wards. Registered nurses should provide safe and qualified pressure ulcer prevention, but pressure ulcers remain a problem. Compliance with evidence-based guidelines impedes pressure ulcer formation. A descriptive design with a multimethods approach. Nine registered nurses at three wards and hospitals participated. The registered nurses were observed in a specific nurse-patient care situation with patients at risk for pressure ulcers. Interviews followed and patients' records were reviewed. Quantitative and qualitative data analysis methods were used. Pressure ulcer prevention performed by the registered nurses was dependent on the cultural care, which ranged from planned to unplanned prevention. Diversity was found in compliance with evidence-based guidelines across the wards. Although all patients involved were at risk and the nurses described pressure ulcer prevention as basic care, the nurses' attention to prevention was lacking. Few prevention activities and no structured risk assessments using risk assessment tools were observed, and few care plans were identified. The lack of attention was explained by registered nurses' trust in assistant nurses' knowledge, and prevention was seen as an assistant nurse task. Registered nurses paid little attention to pressure ulcer prevention among patients at risk. The planned and unplanned care structures affected the prevention. The nurses trusted and largely delegated their responsibility to the assistant nurses. Evidence-based pressure ulcer prevention is fundamental to patient safety. Care quality is created in situations where patients and care providers meet. How registered nurses work with pressure ulcer prevention, their role and communication, particularly with assistant nurses, should be of major concern to them as well as to healthcare
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Missen, Karen; McKenna, Lisa; Beauchamp, Alison; Larkins, Jo-Ann
2016-10-01
Evidence from the literature and anecdotally from clinical settings suggests that newly graduated nurses are not fully prepared to be independent practitioners in healthcare settings. The aim of this study was to explore perceptions of qualified nurses in relation to the practice readiness of newly registered nursing graduates and determine whether these views differ according to specific demographic characteristics, clinical settings, and geographical locations. A descriptive quantitative design was used. An online survey tool was used to assess how qualified nurses (n=201) in Victoria, Australia, rated newly graduated nurses' abilities on 51 individual clinical skills/competencies in eight key skill areas. A composite score was calculated for each skill area and a comparative analysis was undertaken on the various cohorts of participants according to their demographic and clinical characteristics using one-way ANOVA and post hoc tests. Newly graduated nurses were found to be lacking competence in two key skill areas and were rated as performing adequately in the remaining six skill areas assessed. Significant differences (p≤0.05) in performance were found according to the age of the nurse, number of years registered, the educational setting in which they undertook their nurse education, their role, and the clinical area in which they worked. There were no significant differences according to whether the nurse worked in the private or public healthcare sector. Few differences were found between nurses working in a metropolitan vs. regional/rural healthcare setting. This is the first study to quantify the scale of this problem. Our findings serve as a reference for both nurse education providers and healthcare settings in better preparing nursing graduates to be competent, safe practitioners in all clinical areas. Copyright © 2016 Elsevier Ltd. All rights reserved.
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The practical skills of newly qualified nurses.
Danbjørg, Dorthe Boe; Birkelund, Regner
2011-02-01
This paper reports the findings from a study of newly qualified nurses and which subjects the nurses regarded as the most important in order to be able to live up to the requirements of clinical practice, and how they experience their potential for developing practical and moral skills, after the decrease in practical training. A qualitative approach guided the research process and the analysis of the data. The data was collected by participant observation and qualitative interviews with four nurses as informants. The conclusions made in this study are based on the statements and the observations of the newly qualified nurses. Our findings are discussed in relation to the Aristotelian concept and other relevant literature. The main message is that the newly qualified nurses did not feel equipped when they finished their training. This could be interpreted as a direct consequence of the decrease in practical training. Our study also underlines that the way nursing theory is perceived and taught is problematic. The interviews revealed that the nurses think that nursing theories should be applied directly in practice. This misunderstanding is probably also applicable to the teachers of the theories. Copyright © 2010 Elsevier Ltd. All rights reserved.
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Exploring the transition from registered nurse to family nurse practitioner.
Poronsky, Cathlin Buckingham
2013-01-01
There is limited information available regarding the transition from registered nurse (RN) to family nurse practitioner (FNP). Several authors described this transition as taking place in 4 stages, and others described it as a 2-phase process. However, there is a lack of consensus about the definition of these stages and phases and at what point they occur for nurses who are making the transition from an RN to an FNP. From what is known, this multistage/2-phase transition is accompanied by feelings of anxiety, stress, role confusion, and emotional turmoil. As a nurse faculty member, the author theorized that nurse faculty might be in a position to provide support for graduate students making this transition in role. However, there was little information available about the transition phases, stages, and needs of students during graduate school. The search for a framework to explore transition yielded transition theory, which is described and applied to FNP transition in this article. Transition theory may be useful for examining more fully the phases and stages of RN-to-FNP transition. In this time of increased need for qualified primary care providers, it is essential that graduates of FNP programs transition into practice following graduation. Copyright © 2013 Elsevier Inc. All rights reserved.
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Davis, Geraldine M
2010-11-01
Registered nurses undertaking programmes of study to become non-medical prescribers appear to have limited biological science knowledge. A case study was undertaken to determine whether the nurses entering Prescriber programmes considered studies in bioscience in their pre-registration nursing courses had been sufficient, linked to practice, and had prepared them for their roles as registered nurses. The literature identifies a continuing trend amongst nursing students describing a lack of sufficient bioscience in initial nurse education; there is limited literature on the views of experienced registered nurses. The participants in this study were 42 registered nurses from adult and mental health nursing, community and inpatient services. The results obtained from questionnaires and interviews are described. Questionnaire analysis identified that 57.1% of participants indicated bioscience in their pre-registration nursing programme had been limited and 40.5% stated the bioscience content had not prepared them for their roles on registration. Those reporting extensive coverage of bioscience were all aged over 41 years and had qualified before 1995. Greatest coverage of bioscience in pre-registration programmes was reported in relation to anatomy and physiology, with relatively limited coverage of microbiology, pharmacology or biochemistry. Respondents considered all five topics to be important. Interviews supported the questionnaire findings. Copyright © 2010 Elsevier Ltd. All rights reserved.
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Registered Nurse (Associate Degree).
ERIC Educational Resources Information Center
Ohio State Univ., Columbus. Center on Education and Training for Employment.
This document, which is designed for use in developing a tech prep competency profile for the occupation of registered nurse (with an associate degree), lists technical competencies and competency builders for 19 units pertinent to the health technologies cluster in general and 5 units specific to the occupation of registered nurse. The following…
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Nursing career fulfillment: statistics and statements from registered nurses.
Reineck, Carol; Furino, Antonio
2005-01-01
A state-level survey of registered nurses confirmed national findings and raised new issues. Findings revealed that while nurses love the intrinsic reward of nursing, they report workplace, relationship, and stress issues which contribute to frustration and exhaustion. These issues may prevent registered nurses from giving the nursing care they desire to deliver, hastening preventable retirement and costly turnover decisions.
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An analysis of delegation styles among newly qualified nurses.
Magnusson, Carin; Allan, Helen; Horton, Khim; Johnson, Martin; Evans, Karen; Ball, Elaine
2017-02-15
Aim The aim of this research was to explore how newly qualified nurses learn to organise, delegate and supervise care in hospital wards when working with and supervising healthcare assistants. It was part of a wider UK research project to explore how newly qualified nurses recontextualise the knowledge they have gained during their pre-registration nurse education programmes for use in clinical practice. Method Ethnographic case studies were conducted in three hospital sites in England. Data collection methods included participant observations and semi-structured interviews with newly qualified nurses, healthcare assistants and ward managers. A thematic analysis was used to examine the data collected. Findings Five styles of how newly qualified nurses delegated care to healthcare assistants were identified: the do-it-all nurse, who completes most of the work themselves; the justifier, who over-explains the reasons for decisions and is sometimes defensive; the buddy, who wants to be everybody's friend and avoids assuming authority; the role model, who hopes that others will copy their best practice but has no way of ensuring how; and the inspector, who is acutely aware of their accountability and constantly checks the work of others. Conclusion Newly qualified nurses require educational and organisational support to develop safe and effective delegation skills, because suboptimal or no delegation can have negative effects on patient safety and care.
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Philip, Susan; Manias, Elizabeth; Woodward-Kron, Robyn
2015-09-01
To understand the intercultural communication experiences and associated communication training needs of overseas qualified nurses in the Australian healthcare system from the unique perspectives of nurse educators teaching in accredited bridging programmes. Overseas qualified nurses are an integral part of the nursing workforce in migration destination countries. Communication training needs are more complex when there are cultural, ethnic and language differences between nurses, other health professionals and patients. A qualitative, exploratory research design using semi-structured interviews. All (nine) organisations involved in conducting the Australian Health Practitioner Regulation Agency approved preregistration bridging programmes for overseas qualified nurses within the state of Victoria, Australia, were involved in the study. Participants were 12 nurse educators employed in these organisations. Thematic analysis was undertaken. Three macro themes emerged about the overseas qualified nurses' intercultural communication: (1) pre-existing barriers and enablers to intercultural communication, for example, nurses' reluctance to engage in communicative strategies that build rapport with patients, (2) transitional behaviours and impact on communication, including maintenance of perceived cultural hierarchies between health professionals and (3) development of communicative competence, including expanding one's repertoire of conversational gambits. The findings point to the domains and causes of communication challenges facing overseas qualified nurses in new healthcare settings as well as strategies that the nurse educators and nurses can adopt. Communication cannot be merely regarded as a skill that can be taught in a didactic programme. Comprehensive understanding is needed about the sociocultural dimensions of these nurses' orientation, which can impact on how they communicate in their new healthcare settings. The findings can act as triggers for discussion
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Registered Nurses' views on their professional role.
Furåker, Carina
2008-11-01
The aim is to study Registered Nurses' opinions and reflections about their work tasks, competence and organization in acute hospital care. The definition of the role of nurses has changed over time and it is often discussed whether Registered Nurses have a professional status or not. A qualitative research design was used. Data were derived from written reflections on diaries and from focus group interviews. All respondents had difficulties in identifying the essence of their work. It can be argued that being 'a spider in the web' is an important aspect of the nursing profession. Registered Nurses tend to regard their professional role as vague. Managers must be considered key persons in defining the professional role of Registered Nurses. This study contributes to an understanding of the managers' and the importance of nursing education in Registered Nurses professional development.
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Newly qualified Irish nurses' interpretation of their preparation and experiences of registration.
Mooney, Mary
2007-09-01
The aim of this paper is to report on the insights of newly qualified Irish nurses into their preparation for registration as general nurses and to develop insights into the postregistration experience. Nurse education in Ireland has undergone much reform over the past decade. These changes include the introduction of supernumerary status for nursing students and the formation of links with institutes of higher education. No Irish literature was found on this subject. Individual semi-structured, in-depth interviews were held with 12 newly registered nurses, from two cohorts, within 10 months of qualification. A grounded theory approach was adopted and content analysis employed to analyse the data. Two categories, entitled Learning the Ropes and The Metamorphosis emerged from the analysis of data. Within each of these categories there were two subcategories. All respondents reported that since qualification, they had become increasingly conscious of their isolation and unmet needs as nursing students. Postregistration, they enjoyed their increased status and widespread recognition by others. This study details how improvements can be made at clinical level to assist the preparation of nursing students for registration. The positive aspects of registration are revealed through descriptions of comparisons of pre- and postregistration experiences, while the shortcomings of the journey to registration are described. Pre-registration nurses have unmet clinical needs which, if fulfilled, would benefit them post-registration. Good ward morale is elementary for student learning and enhances the post-registration experience. Registered nurses are highly conscious of their altered status. These findings are pertinent to clinicians and educationalists as they prepare nursing students for practice.
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Current Literature Review of Registered Nurses' Competency in the Global Community.
Liu, Ying; Aungsuroch, Yupin
2018-03-01
In order to enhance international standards of nursing service, this article aims to analyze the English full-text peer-reviewed published articles from the past 10 years that describe contemporary registered nurses' (RNs') competency in the global community. An integrative review of literature was conducted between June 2016 and January 2017. A systematic search was completed using four databases (Science Direct, Scopus, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature) that covered the years between 2007 and 2017, and used the key words nurs * OR (staff nurs * ) OR (register nurs * ) AND competenc * AND international OR global. Ultimately, 32 studies meeting inclusion and exclusion criteria were selected for analysis. Nursing competency trended towards definitions using a holistic lens and behavior statements reflecting the skills, knowledge, attitudes, and judgment required for effective performance in the nursing profession. By using inductive content analysis, 11 components emerged. Additionally, six instruments were found to measure generalist RNs' competencies across countries. The variables related to generalist nursing competency included sociodemographic variables, professional-related variables, and work environment variables. This review provides the research evidence for updating definitions, components, measurements, and variables related to RNs' competency in the global community. Further research should consider cross-cultural validation of instruments and influencing factors related to nursing competency. The components and measurements identified in this review can be used by nursing administrators to select or evaluate qualified nurses. The multivariables related to nursing competency can assistant hospital administrators to recognize and find effective ways to improve nursing competency. © 2018 Sigma Theta Tau International.
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Obesity: attitudes of undergraduate student nurses and registered nurses.
Poon, Man-Yuk; Tarrant, Marie
2009-08-01
To investigate undergraduate student nurses' and registered nurses' attitudes towards obese persons and towards the management of obese patients. Obesity is a global public health problem. Escalating rates of overweight and obesity are also taking a toll in Asian countries that have historically had much lower rates. Despite the growing prevalence of obesity worldwide, studies show that nurses and other health professionals hold negative attitudes towards obese people, which may affect the care of obese patients. Cross-sectional study. A self-administered questionnaire was completed by 352 undergraduate student nurses and 198 registered nurses. The questionnaire consisted of the Fat Phobia Scale, the Attitudes Toward Obese Adult Patients Scale and a demographic profile. Data were analysed using descriptive statistics and student's t-tests. Overall mean scores on the Fat Phobia Scale (3.53 SD 0.47) indicated average levels of fat phobia and mean scores on the Attitudes Toward Obese Adult Patients scale (2.64 SD 0.51) indicated neutral attitudes towards obese patients. Registered nurses had significantly higher levels of fat phobia and more negative attitudes than did student nurses. The majority of participants perceived that obese people liked food, overate, and were shapeless, slow and unattractive. Additionally, over one-half of participants believed that obese adults should be put on a diet while in hospital. Results of this study show that both registered nurses and student nurses have negative perceptions of obesity and are unlikely to attribute positive characteristics to obese individuals. That registered nurses hold more negative attitudes towards obese person is cause for concern. Given the increasing prevalence of obesity and the disproportionate number of obese persons affected by many health conditions, current and future nurses should have positive professional attitudes towards obese individuals. Obesity needs to be more adequately addressed, both in
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Perceptions of newly-qualified nurses performing compulsory community service in KwaZulu-Natal.
Govender, Selverani; Brysiewicz, Petra; Bhengu, Busisiwe
2015-07-08
Compulsory community service (CCS) for nurses commenced in South African January 2008 after it was legislated in the new Nursing Act (Act No. 33 of 2005). Nurses completing their registered nurse programme are registered as community nurse practitioners (CNPs) during the CCS period and make up the largest number of health professionals serving CCS. Whilst health institutions have welcomed CNPs as additional resources for the shortage of nursing staff, no structured guidelines have been provided at a regional level as to how these nurses should be utilised or managed during the CCS year. To date, no large-scale study has been conducted on nurses carrying out CCS in order to generalise the findings. To establish the perceptions of newly-qualified nurses carrying out CCS in KwaZulu-Natal, South Africa. A quantitative survey design was used to obtain data from a randomly selected sample of the 2012 cohort of nurses carrying out CCS in KwaZulu-Natal. CNPs have a positive attitude toward CCS and perceive themselves as being well prepared for the year of community service in terms of knowledge, skills and ability to administer nursing care. They identified positive benefits of the year of community service.The concerns raised were limited orientation and support; and a few CNPs experienced problems of acceptance by the nurses with whom they work. It is recommended that all health institutions who receive CNPs develop structured orientation and support for these nurses in order to promote their development, thereby enhancing their benefit to the communities they serve.
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Job satisfaction of overseas-qualified nurses working in Australian hospitals.
Timilsina Bhandari, K K; Xiao, L D; Belan, I
2015-03-01
The aims of this study were to explore factors associated with the job satisfaction of overseas-qualified nurses working in public hospitals in South Australia and to compare whether factors associated with job satisfaction of overseas nurses from English-speaking backgrounds differed from those from non-English-speaking backgrounds. Overseas-qualified nurses have become an essential part of the nursing workforce in Australia. Although this nurse population has different expectations and values in relation to their jobs when compared with local nurses, studies on job satisfaction among overseas nurses are scarce. A cross-sectional survey using the Job Satisfaction of Overseas-Qualified Nurses questionnaire was conducted in five major public hospitals in South Australia. One hundred and fifty-one overseas-qualified nurses completed the questionnaire. Four factors were found to influence job satisfaction: Supportive work environment, interpersonal relationships, communication in English, and salary and salary-related benefits. Communication in English was the predominant factor that was associated with job satisfaction in nurses from non-English-speaking backgrounds. This group of nurses also showed a negative correlation between length of stay in Australia and satisfaction with their work environment. Participants' responses to open-ended questions revealed issues relating to discrimination and racism. Supportive work environment, interpersonal relationships, communication in English, and salary and salary-related benefits were major factors associated with job satisfaction in overseas-qualified nurses in this study. Nurses from non-English-speaking backgrounds faced additional challenges in communication in the workplace and in dealing with issues of discrimination and racism. Nurses from non-English-speaking backgrounds need to be supported early in their employment, especially with their communication skills. Consideration also needs to be given to the education
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Registered nurses' perceptions of rewarding and its significance.
Seitovirta, Jaana; Lehtimäki, Aku-Ville; Vehviläinen-Julkunen, Katri; Mitronen, Lasse; Kvist, Tarja
2017-11-07
To examine reward type preferences and their relationships with the significance of rewarding perceived by registered nurses in Finland. Previous studies have found relationships between nurses' rewarding and their motivation at work, job satisfaction and organisational commitment. Data were collected in a cross-sectional, descriptive, questionnaire survey from 402 registered nurses using the Registered Nurses' Perceptions of Rewarding Scale in 2015, and analysed with descriptive and multivariate statistical methods. Registered nurses assigned slightly higher values to several non-financial than to financial rewards. The non-financial reward types appreciation and feedback from work community, worktime arrangements, work content, and opportunity to develop, influence and participate were highly related to the significance of rewarding. We identified various rewards that registered nurses value, and indications that providing an appropriate array of rewards, particularly non-financial rewards, is a highly beneficial element of nursing management. It is important to understand the value of rewards for nursing management. Nurse managers should offer diverse rewards to their registered nurses to promote excellent performance and to help efforts to secure and maintain high-quality, safe patient care. The use of appropriate rewards is especially crucial to improving registered nurses' reward satisfaction and job satisfaction globally in the nursing profession. © 2017 John Wiley & Sons Ltd.
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Pre-registration paid employment choice: the views of newly qualified nurses.
Phillips, Craig; Kenny, Amanda; Smith, Colleen; Esterman, Adrian
2012-01-01
In Australia, nurse education was transferred from hospital based nursing schools to the higher education sector. This transfer resulted in a change for students, from hospital employee to an unpaid, supernumerary role during professional placements. The majority of undergraduate nursing students now combine part time employment with their studies, working mainly within health settings or service sectors such as hospitality and retail. The aims of this study were to identify if newly qualified registered nurses engaged in paid employment during their final year of undergraduate studies, the types of employment they chose, reasons for that choice, skills acquired and their views on any link between employment choice and transition to practice. Focus group interviews involving sixty seven new graduates were conducted. From the data, four organising themes were identified; financial independence and autonomy, confidence and experience, future opportunity and ease of transition. The global theme maximising opportunity describes nurse's views about their decisions on student employment. Participants had differing views on employment choice and transition to practice. Further research is needed in the area to identify whether there is any link between student employment choice and transition to practice. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Enhancing the Employability of Newly Qualified Nurses: A Pilot Study
ERIC Educational Resources Information Center
Dray, Beattie; Burke, Linda; Hurst, Heather M.; Ferguson, Anne; Marks-Maran, Diane
2011-01-01
Vocationally based higher education programmes are meant to prepare people for employment in their chosen fields of study. In nursing, historically, employment after qualifying has been almost assured, with sufficient vacancies available for newly qualified nurses. Recently, however, for a number of reasons, primarily related to economic…
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Malaysian registered nurses' professional learning.
Chiu, Lee H
2006-01-01
Findings of a study of the impact of professional learning on Malaysian registered nurses are reported. The offshore delivery post-registration nursing degree programme is a formal aspect of professional learning, which enables Malaysian registered nurses to upgrade their hospital-based training or diploma of nursing qualification to a degree. Using a qualitative case study approach, data were collected from twelve programme graduates, through individual and focus group interviews. The programme promoted their personal professional growth and enhanced their professional development. It increased self-confidence, knowledge, self-fulfillment, critical thinking ability, interpersonal skills, interest in research and research utilisation, and life-long learning. There was evidence of career mobility and a raised awareness of their professional role and responsibility.
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Factors that facilitate registered nurses in their first-line nurse manager role.
Cziraki, Karen; McKey, Colleen; Peachey, Gladys; Baxter, Pamela; Flaherty, Brenda
2014-11-01
To determine the factors that attract and retain Registered Nurses in the first-line nurse manager role. The first-line nurse manger role is pivotal in health-care organisations. National demographics suggest that Canada will face a first-line nurse manager shortage because of retirement in the next decade. Determination of factors that attract and retain Registered Nurses will assist organisations and policy makers to employ strategies to address this shortage. The study used an exploratory, descriptive qualitative approach, consisting of semi-structured individual interviews with 11 Registered Nurses in first-line nurse manager roles. The findings revealed a discrepancy between the factors that attract and retain Registered Nurses in the first-line nurse manager role, underscored the importance of the mentor role and confirmed the challenges encountered by first-line nurse managers practicing in the current health-care environment. The first-line nurse manager role has been under studied. Further research is warranted to understand which strategies are most effective in supporting first-line nurse managers. Strategies to support nurses in the first-line nurse manager role are discussed for the individual, programme, organisation and health-care system/policy levels. © 2013 John Wiley & Sons Ltd.
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Registered Nurse Persistence in Baccalaureate Education
ERIC Educational Resources Information Center
Krov, Kathleen Nadler
2010-01-01
There is a need to increase the number of baccalaureate prepared registered nurses to safely meet the complex healthcare needs of citizens of the United States. Since there is no research on the characteristics of registered nurse students persisting in baccalaureate education, this quantitative descriptive case study was designed to identify the…
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Nursing Practice Environment and Registered Nurses' Job Satisfaction in Nursing Homes
ERIC Educational Resources Information Center
Choi, JiSun; Flynn, Linda; Aiken, Linda H.
2012-01-01
Purpose: Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs…
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The Staff Nurse Clinical Leader at the Bedside: Swedish Registered Nurses' Perceptions.
Larsson, Inga E; Sahlsten, Monika J M
2016-01-01
Registered nurses at the bedside are accountable for and oversee completion of patient care as well as directly leading and managing the provision of safe patient care. These nurses have an informal leadership role that is not associated with any given position. Leadership is a complex and multifaceted concept and its meaning is unclear, especially in the staff nurse context. The aim was to describe registered nurses' perceptions of what it entails to be the leader at the bedside in inpatient physical care. A phenomenographic approach was employed. Interviews were performed with Swedish registered nurses ( n = 15). Five descriptive categories were identified: demonstrating clinical knowledge, establishing a good atmosphere of collaboration, consciously structuring the work in order to ensure patients' best possible nursing care, customized presence in the practical work with patients according to predetermined prerequisites, and monitoring coworkers' professional practice. Registered nurses informal role as leader necessitates a social process of deliberate effort to attain and maintain leader status and authority. Participants used deliberate communicative approaches and interactive procedures. Leader principles grounded in the core values of the nursing profession that ensure nursing values and person-centered attributes were a key aspect.
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Registered nurse buddies: Educators by proxy?
Rebeiro, Geraldine; Evans, Alicia; Edward, Karen-Leigh; Chapman, Rose
2017-08-01
The informal clinical teaching role of the buddy nurse seems to be a uniquely Australian title, with little consistency in terminology for informal nurse educator roles internationally. Not all registered nurses are professionally developed for the informal role of facilitating the clinical learning of students in clinical settings, yet these roles are expected by nursing professional bodies. In Australia the registered nurses (RN) experience of being a buddy nurse has been reported as lacking clarity, being unsupported and structureless. Whist there is a plethora of literature published about formal RN educator roles, little is available on the informal buddy nurse role. A view of the buddy nurse role in reference to the limited but available literature in the Australian context is offered in this paper. International perspectives are also gathered describing informal clinical education RN's roles with similar responsibilities to the Australian buddy nurse. The significance of this dialogue is to ignite debate about the role, potentially informing policy for the improved support of the role within the Australian nursing landscape. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Transcultural nursing practice described by registered nurses and baccalaureate nursing students.
Baldonado, A; Beymer, P L; Barnes, K; Starsiak, D; Nemivant, E B; Anonas-Ternate, A
1998-01-01
Using Leininger's Theory of Culture Care Diversity and Universality as a framework, this research examined transcultural practices of nurses and students. A survey was administered to a convenience sample of registered nurses and senior baccalaureate students with 767 usable questionnaires returned. Neither group expressed confidence in their ability to care for culturally-diverse patients. Registered nurses (RNs) reported assessing cultural factors and modifying practices more frequently than did students. Respondents reported their beliefs about transcultural nursing were influenced by being with people of other cultures, their own personal values, and education. Analysis of the open-ended questions revealed two major themes. First, both nurses and students perceive an overwhelming need for transcultural nursing. Second, nurses and students respond to cultural challenges by modifying their care. Modifications are based on language and communication, pain perception and relief, religious and spiritual dimensions, gender and family roles, and other values. Results suggest that nurses and students are aware of culture, recognize that culture influences the care they provide, and modify their health teaching and nursing care based on culture. The use of a conceptual framework to help make modifications in care was not mentioned.
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Turnover of registered nurses in Israel: characteristics and predictors.
Toren, Orly; Zelker, Revital; Lipschuetz, Michal; Riba, Shoshana; Reicher, Sima; Nirel, Nurit
2012-05-01
In an era of global and local nursing shortages, nursing turnover has negative consequences in terms of diminished quality of care, increased costs and economic losses and decreased job satisfaction. To examine the turnover rate of registered nurses in Israel by assessing the varying degree of turnover between economic sectors, between hospital and community facilities, and/or between types of hospitals; and by examining potential predicting factors of turnover among registered nurses. A national phone survey was undertaken in Israel consisting of a random sampling of registered nurses of working age (up to age 60). The subjects comprised 10% of a national database of 32,000 registered nurses. The turnover rate among working nurses in Israel currently stands at 23%. In addition, 13% of employed nurses have taken a temporary leave of absence for a period greater than 6 months in the past 10 years, most up to 1 year. While job satisfaction rates were relatively high (72%), Professional satisfaction rates were 60% with no significant difference between hospital and community nurses. The turnover rate of registered nurses from a hospital setting to the community was significantly higher (p<.01) than that of community registered nurses to hospitals. Predicting factors of turnover were found to be: young age, part-time work, lack of advanced professional education, academic education and low satisfaction with the nursing profession. The shift of nursing workforce is mainly from hospitals to community health settings. There is a need to monitor and understand the characteristics of job and professional satisfaction among hospital nurses in order to implement crucial organizational interventions and retain hospital nursing staffs. Since young nurses, nurses working part time and nurses with no advanced professional and academic education, tend to move more than others, efforts should be targeted at these specific groups. Copyright © 2012 Elsevier Ireland Ltd. All rights
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Registered Nurses' perceptions of their work and professional development.
Hallin, Karin; Danielson, Ella
2008-01-01
This paper is a report of a study to elucidate Registered Nurses' perceptions of their work and professional development 6 years after graduation. Nursing education and health care has rapidly changed in the last two decades. Education and experience are important components in Registered Nurses' ability to promote a high quality of care, but a great deal depends on their work circumstances. This study emphasizes Registered Nurses' view of their work in health care, at a time in their career when they have several years of experience. Data were collected in 2003 from in-depth interviews with 15 Registered Nurses 6 years after their graduation. The interviews were semi-structured and analysed with interpretive content analysis. The findings revealed two themes and five sub-themes. The first theme, An appropriate but demanding profession, consisted of two sub-themes: 'having found one's niche' and 'growing old in nursing may be difficult'. The second theme, A profession with opportunities and obstacles, consisted of three sub-themes: 'being aware of Registered Nurses' potential', 'having knowledge that is seldom made use of' and 'attaining professional growth is no matter of course'. Keeping Registered Nurses' satisfied and avoiding their dissatisfaction is crucial for both educators and employers. It is essential that employers give priority to Registered Nurses' time with patients and to motivate and support them in professional development. Further intervention studies regarding a change of the balance between obstacles and opportunities are needed.
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Parker, Emese C.; Kong, Kevin; Watts, Leslie A.; Schwarz, Eleanor B.; Darney, Philip D.; Thiel de Bocanegra, Heike
2017-01-01
Background In 2013, California passed Assembly Bill (A.B.) 2348, approving registered nurses (RNs) to dispense patient self-administered hormonal contraceptives and administer injections of hormonal contraceptives. The Family Planning, Access, Care and Treatment (Family PACT) program, which came into effect in 1997 to expand low-income, uninsured California resident access to contraceptives at no cost, is one program in which qualified RNs can dispense and administer contraceptives. Aims The aims of this study were to (a) describe utilization of RN visits within California's Family PACT program and (b) evaluate the impact of RN visits on client birth control acquisition during the first 18 months after implementation of A.B. 2348 (January 1, 2013 to June 30, 2014). Methods A descriptive observational design using administrative databases was used. Family PACT claims were retrieved for RN visits and contraception. Paid claims for contraceptive dispensing and/or administration visits by physicians, nurse practitioners, certified nurse midwives, and physician assistants were compared before and after the implementation of A.B. 2348 at practice sites where RN visits were and were not utilized. Contraceptive methods and administration procedures were identified using Healthcare Common Procedure Coding System codes, National Drug Codes, and Common Procedural Terminology codes. Claims data for healthcare facilities were abstracted by site location based on a unique combination of National Provider Identifier (NPI), NPI Owner, and NPI location number. Results RN visits were found mainly in Northern California and the Central Valley (73%). Sixty-eight percent of RN visits resulted in same-day dispensing and/or administration of hormonal (and/or barrier) methods. Since benefit implementation, RN visits resulted in a 10% increase in access to birth control dispensing and/or administration visits. RN visits were also associated with future birth control acquisition and other
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McMullan, Miriam; Jones, Ray; Lea, Susan
2010-04-01
This paper is a report of a correlational study of the relations of age, status, experience and drug calculation ability to numerical ability of nursing students and Registered Nurses. Competent numerical and drug calculation skills are essential for nurses as mistakes can put patients' lives at risk. A cross-sectional study was carried out in 2006 in one United Kingdom university. Validated numerical and drug calculation tests were given to 229 second year nursing students and 44 Registered Nurses attending a non-medical prescribing programme. The numeracy test was failed by 55% of students and 45% of Registered Nurses, while 92% of students and 89% of nurses failed the drug calculation test. Independent of status or experience, older participants (> or = 35 years) were statistically significantly more able to perform numerical calculations. There was no statistically significant difference between nursing students and Registered Nurses in their overall drug calculation ability, but nurses were statistically significantly more able than students to perform basic numerical calculations and calculations for solids, oral liquids and injections. Both nursing students and Registered Nurses were statistically significantly more able to perform calculations for solids, liquid oral and injections than calculations for drug percentages, drip and infusion rates. To prevent deskilling, Registered Nurses should continue to practise and refresh all the different types of drug calculations as often as possible with regular (self)-testing of their ability. Time should be set aside in curricula for nursing students to learn how to perform basic numerical and drug calculations. This learning should be reinforced through regular practice and assessment.
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Rebeiro, Geraldine; Edward, Karen-leigh; Chapman, Rose; Evans, Alicia
2015-12-01
A significant proportion of undergraduate nursing education occurs in the clinical setting in the form of practising skills and competencies, and is a requirement of all nursing curriculum for registration to practice. Education in the clinical setting is facilitated by registered nurses, yet this interpersonal relationship has not been examined well. To investigate the experience of interpersonal relationships between registered nurses and student nurses in the clinical setting from the point of view of the registered nurse. Integrative review Review methods: The databases of MEDLINE, CINAHL and OVID were searched. Key words used included: Registered Nurse, Preceptor, Buddy Nurse, Clinical Teacher, Mentor, Student Nurse, Nursing Student, Interpersonal Relationships, Attitudes and Perceptions. Additional review of the literature was manually undertaken through university library textbooks. 632 abstracts were returned after duplicates were removed. Twenty one articles were identified for full text read (quantitative n=2, mixed n=6, qualitative n=14); of these, seven articles addressed the experience of interpersonal relationships between registered nurses and student nurses in the clinical setting from the point of view of the registered nurse and these were reviewed. Providing education for registered nurses to enable them to lead student education in the clinical setting communicates the organizational value of the role. Registered nurses identified being supported in having the time-to-teach were considered important in facilitation of the clinical teaching role. The integrative review did not provide evidence related to the impact diverse clinical settings can have on the relationships between registered nurses and student nurses revealing an area for further examination. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.
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Preceptors' perceptions of a preceptorship programme for newly qualified nurses.
Muir, Jenny; Ooms, Ann; Tapping, Jen; Marks-Maran, Di; Phillips, Sonia; Burke, Linda
2013-06-01
A study was undertaken into preceptors' perceptions of a preceptorship programme for newly-qualified nurses. The preceptorship programme is designed to enable newly qualified nurses to make the transition from student to registered nurse. Preceptors undergo a training programme to take on the role of preceptor. To evaluate the preceptors' perception of the preceptorship programme. Mixed method evaluative research design was used. This study took place in one National Health Service Healthcare Trust in South West London, UK. Ninety preceptors were invited to participate in the study and the response rate was 44.4% (n=40). The study took place in 2011. Qualitative and quantitative data were collected through questionnaires and one-to-one interviews with a convenience sample of preceptors. Quantitative data were analysed using SPSS, version 18; qualitative data were analysed using the Framework Method. From the quantitative data seven themes emerged. These were preceptors' perceptions of: the personal development of preceptees; the role development of preceptees; the communication skills development of preceptees; the clinical development of preceptees; the development of professional relationships by preceptees; value of the preceptorship programme to the organisation and value of being a preceptor in terms of their own professional development. Qualitative analysis confirmed many of the findings from the statistical analysis and was used to triangulate those findings. The preceptors largely viewed the preceptorship programme and their role within this programme positively. Although difficulties in making time to meet with preceptees was an issue, the preceptorship experience was perceived to have a positive impact on several aspects of preceptee development as well as on the organisation and on the preceptors' own development. The study is unique when mapped against other research studies because there is little in the literature about studies into preceptors
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Johnson, Martin; Magnusson, Carin; Allan, Helen; Evans, Karen; Ball, Elaine; Horton, Khim; Curtis, Kathy; Westwood, Sue
2015-02-01
The role of the acute hospital nurse has moved away from the direct delivery of patient care and more towards the management of the delivery of bedside care by healthcare assistants. How newly qualified nurses delegate to and supervise healthcare assistants is important as failures can lead to care being missed, duplicated and/or incorrectly performed. The data described here form part of a wider study which explored how newly qualified nurses recontextualise knowledge into practice, and develop and apply effective delegation and supervision skills. This article analyses team working between newly qualified nurses and healthcare assistants, and nurses' balancing of administrative tasks with bedside care. Ethnographic case studies were undertaken in three hospital sites in England, using a mixed methods approach involving: participant observations; interviews with 33 newly qualified nurses, 10 healthcare assistants and 12 ward managers. Data were analysed using thematic analysis, aided by the qualitative software NVivo. Multiple demands upon the newly qualified nurses' time, particularly the pressures to maintain records, can influence how effectively they delegate to, and supervise, healthcare assistants. While some nurses and healthcare assistants work successfully together, others work 'in parallel' rather than as an efficient team. While some ward cultures and individual working styles promote effective team working, others lead to less efficient collaboration between newly qualified nurses and healthcare assistants. In particular the need for qualified nurses to maintain records can create a gap between them, and between nurses and patients. Newly qualified nurses require more assistance in managing their own time and developing successful working relationships with healthcare assistants. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Craft, Judy A; Hudson, Peter B; Plenderleith, Mark B; Gordon, Christopher J
2017-06-01
To explore new graduate registered nurses' reflections of bioscience courses during their nursing programme and the relationship between bioscience content and their clinical practice. Undergraduate nursing students internationally find bioscience courses challenging, which may be due to the volume of content and level of difficulty of these courses. Such challenges may be exacerbated by insufficient integration between bioscience theory and nursing clinical practice. A descriptive, cross-sectional mixed methods study was conducted. A 30-item questionnaire with five written response questions which explored recently registered nurses' reflections on bioscience courses during their nursing degree was employed. Descriptive analyses were reported for individual items. Thematic analysis of qualitative responses was grouped to reveal emerging themes. Registered nurses' (n = 22) reflections revealed that bioscience courses were a significant challenge during their undergraduate programme, and they lacked confidence explaining the biological basis of nursing. Participants would like improved knowledge of the relevant bioscience for nursing and agreed that bioscience courses should be extended into the undergraduate final year. The importance of relating bioscience content to nursing practice was elaborated extensively throughout written responses. Although registered nurses reflected that bioscience courses were difficult with large volumes of content, having more bioscience with greater relevance to nursing applications was considered important in their current clinical practice. It is suggested that bioscience academics develop greater contextual links between bioscience content and clinical practice relevant to nursing. After working as a registered nurse, there was appreciation of bioscience relevance for clinical practice, and the nurses believed they would have benefitted from more nursing-related bioscience during their undergraduate programme. Focussed
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Implementation of a salaried compensation program for registered nurses.
Sills, L R
1993-01-01
Compensation is a key variable in recruitment and retention of registered nurses. A 6-month trial of an exempt/salaried wage program for registered nurses, based on normative change theory, was implemented in the adult critical care division of a 491-bed community hospital. A total of 58 registered nurses participated in the trial. At the end of 6 months on salary, 94% (53) of the nurses voted to remain salaried. The staff perceived that the new wage program increased flexibility in work schedules and promoted teamwork and professional autonomy.
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In-service education and training as experienced by registered nurses.
Norushe, T F; Van Rooyen, D; Strumpher, J
2004-11-01
Nursing is a dynamic profession that is subject to rapid changes in health care provision, hence the need for in-service training programmes for nurses. Newly employed registered nurses require in-service training in order to update them regarding the latest developments in nursing practice. The researcher noted that some newly appointed registered nurses were not competent in all aspects relating to their tasks. This could have been due to a knowledge deficit relating to either new developments or of the procedure relating to a specific task. In some institutions newly-appointed registered nurses on probation reported not receiving in-service training for six months or longer, yet they were still expected to perform their tasks efficiently. The objectives of the study were to, firstly, explore and describe the experiences of registered nurses regarding in-service training programmes in their institutions and, secondly, to make recommendations to Nursing Service Managers relating to the development of effective in-service training programmes in their institutions. A qualitative, exploratory, descriptive design was implemented. Data was analysed using Tesch's descriptive approach (in Creswell, 1994:155). Two main themes emerged, namely that registered nurses experienced in-service training programmes as inadequate and reacted negatively towards them. This article focuses on the experiences of registered nurses relating to in-service training programmes, as well as the formulation of guidelines to assist nursing service managers in the development of effective in-service training programmes.
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Wilkinson, Jill
2015-12-01
In 2013, the Nursing Council of New Zealand consulted on a proposal for introduction of registered nurse (RN) prescribing at two levels (specialist and community) within the designated class of prescriber. The proposal builds on the success of the diabetes nurse specialist prescribing project and the experience of other countries where RN prescribing is well established. To describe the views and intentions of nurses who work in primary health care (PHC) settings about the two levels of RN prescribing proposed. The study involved a self-reported survey using a non-probability sample of RNs working in PHC settings (N=305). Quantitative and qualitative data were analysed descriptively. The respondents were experienced nurses. Overall, 82.3% expressed interest in becoming a community nurse prescriber, and 62.6% expressed interest in the specialist prescriber level. RN prescribing was expected to improve efficiency and access to medicines for high-needs populations, clarify accountability and improve nurses' autonomy. The education requirements for the specialist level were viewed as appropriate but too onerous for many. Requirements were viewed as inadequate for the community level. Concerns were raised about funding for education and support for RN prescribing roles. Nurses were positive about the proposals and see a potential to meet significant unmet health need. Nurses are already engaged in the provision of medicines to patients and prescribing authority would ensure they are suitably qualified to engage in these tasks. A clear policy platform will be needed if the proposed levels of RN prescribing are to be successfully implemented.
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1996-01-01
The American Nurses Association (ANA) is committed to safeguarding the public, protecting and advancing the careers of professional nurses, supporting individual and collective efforts by registered nurses to protect their clients and enhancing the professional development and job security of registered nurses. As the nation's health care system is restructured, ANA is actively engaged in initiatives to strengthen the economic and general welfare of registered nurses, the safety and care for the public, and, in partnership with the state nurses associations (SNAs), oppose efforts to replace registered nurses with inappropriate substitutes.
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Homophobia in Registered Nurses: Impact on LGB Youth
ERIC Educational Resources Information Center
Blackwell, Christopher W.; Kiehl, Ermalynn M.
2008-01-01
This study examined registered nurses' overall attitudes and homophobia towards gays and lesbians in the workplace. Homophobia scores, represented by the Attitudes Toward Lesbians and Gay Men (ATLG) Scale, was the dependent variable. Overall homophobia scores were assessed among a randomized stratified sample of registered nurses licensed in the…
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Jones, Jeffrey S; Fitzpatrick, Joyce J; Drake, Virginia K
2008-12-01
Nurse-Patient boundary violations remain a problem. Efforts to address the problem through postlicensure education and stronger disciplinary measures are well documented. However, efforts to understand this problem based on prelicensure components are less studied. Using data from The Ohio Board of Nursing from 2002 to 2006, the difference in frequency of incidents of violations between associate degree-prepared registered nurses and baccalaureate degree-prepared registered nurses was studied. A statistically significant difference was found through chi-square analysis: Associate degree-prepared nurses had higher frequency of boundary violations. Further studies on prelicensure curricular influences on registered nurses' postlicensure behavior, particularly in relation to curricular content focused on interpersonal skill development, are recommended.
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Nurses On-Line: Career Mobility for Registered Nurses.
ERIC Educational Resources Information Center
O'Brien, Barbara S.; Renner, Alice
2000-01-01
Describes how adult learning theory was used to restructure registered nurse courses for online instruction. Hardware/software needs, technical support, instructional model, teaching-learning considerations, and evaluation are discussed. (SK)
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Education and Practice Barriers for Certified Registered Nurse Anesthetists.
Malina, Debra P; Izlar, Janice J
2014-05-31
Of the recognized advanced practice registered nursing (APRN) specialties, Certified Registered Nurse Anesthetists (CRNAs) have historically experienced the most vigorous and organized resistance from outside entities regarding rights to practice to the full scope of their education and experience. Opposition to nurse anesthetists practicing to the full scope of their education and training is present in the clinical arena and educational milieu.
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Newton, Paul; Chandler, Val; Morris-Thomson, Trish; Sayer, Jane; Burke, Linda
2015-01-01
To map current selection and recruitment processes for newly qualified nurses and to explore the advantages and limitations of current selection and recruitment processes. The need to improve current selection and recruitment practices for newly qualified nurses is highlighted in health policy internationally. A cross-sectional, sequential-explanatory mixed-method design with 4 components: (1) Literature review of selection and recruitment of newly qualified nurses; and (2) Literature review of a public sector professions' selection and recruitment processes; (3) Survey mapping existing selection and recruitment processes for newly qualified nurses; and (4) Qualitative study about recruiters' selection and recruitment processes. Literature searches on the selection and recruitment of newly qualified candidates in teaching and nursing (2005-2013) were conducted. Cross-sectional, mixed-method data were collected from thirty-one (n = 31) individuals in health providers in London who had responsibility for the selection and recruitment of newly qualified nurses using a survey instrument. Of these providers who took part, six (n = 6) purposively selected to be interviewed qualitatively. Issues of supply and demand in the workforce, rather than selection and recruitment tools, predominated in the literature reviews. Examples of tools to measure values, attitudes and skills were found in the nursing literature. The mapping exercise found that providers used many selection and recruitment tools, some providers combined tools to streamline process and assure quality of candidates. Most providers had processes which addressed the issue of quality in the selection and recruitment of newly qualified nurses. The 'assessment centre model', which providers were adopting, allowed for multiple levels of assessment and streamlined recruitment. There is a need to validate the efficacy of the selection tools. © 2014 John Wiley & Sons Ltd.
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Registered nurses' clinical reasoning skills and reasoning process: A think-aloud study.
Lee, JuHee; Lee, Young Joo; Bae, JuYeon; Seo, Minjeong
2016-11-01
As complex chronic diseases are increasing, nurses' prompt and accurate clinical reasoning skills are essential. However, little is known about the reasoning skills of registered nurses. This study aimed to determine how registered nurses use their clinical reasoning skills and to identify how the reasoning process proceeds in the complex clinical situation of hospital setting. A qualitative exploratory design was used with a think-aloud method. A total of 13 registered nurses (mean years of experience=11.4) participated in the study, solving an ill-structured clinical problem based on complex chronic patients cases in a hospital setting. Data were analyzed using deductive content analysis. Findings showed that the registered nurses used a variety of clinical reasoning skills. The most commonly used skill was 'checking accuracy and reliability.' The reasoning process of registered nurses covered assessment, analysis, diagnosis, planning/implementation, and evaluation phase. It is critical that registered nurses apply appropriate clinical reasoning skills in complex clinical practice. The main focus of registered nurses' reasoning in this study was assessing a patient's health problem, and their reasoning process was cyclic, rather than linear. There is a need for educational strategy development to enhance registered nurses' competency in determining appropriate interventions in a timely and accurate fashion. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Mackintosh, Carolyn
2007-08-01
This paper aims to explore and describe how qualified nurses working with in, in-patient surgical areas cope with the daily experiences they are exposed to. It has long been recognised that many aspects of nursing work can result in high levels of stress, with negative consequences for the individual nurse and patient care. Difficulties in coping with nursing work can also result in burnout, as well as raising concerns about cognitive dissonance, emotional labour and the use of emotional barriers. Why some nurses are more prone to experience these phenomena than others, is unclear. A descriptive qualitative approach is taken using a purposive, theoretically congruent sample of 16 qualified registered nurses all of whom participated in a semi-structured interview during 2002. All interviews were tape recorded and transcribed verbatim and then analysed using the four stages outlined by Morse and Field [Morse, J.M., Field, P.A., 1996. Nursing Research: The Application of Qualitative Approaches. Chapman & Hall, London]. Three key themes emerged from analysis; relationships with patients, being a person and the effect of experience. All three interlink to describe a process whereby the individual switches off from the environment around them by adopting a working persona which is different but related to their own personal persona and is beneficially enhanced as a consequence of experience. Working as a nurse results in exposure to potentially distressing and stressful events from which it is important to protect the self. Participants in this study achieve protection by the development of a working persona which facilitates switching off and is beneficially enhanced by experience.
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Registered nurses' use of research findings in the care of older people.
Boström, Anne-Marie; Kajermo, Kerstin Nilsson; Nordström, Gun; Wallin, Lars
2009-05-01
To describe registered nurses' reported use of research in the care of older people and to examine associations between research use and factors related to the elements: the communication channels, the adopter and the social system. Research use among registered nurses working in hospital settings has been reported in many studies. Few studies, however, have explored the use of research among registered nurses working in the care of older people. A cross-sectional survey. In eight municipalities, all registered nurses (n = 210) working in older people care were invited to participate (response rate 67%). The Research Utilisation Questionnaire was adopted. Questions concerning the work organisation and research-related resources were sent to the Community Chief Nurse at each municipality. Descriptive statistics and logistic regression were applied. The registered nurses reported a relatively low use of research findings in daily practice, despite reporting a positive attitude to research. The registered nurses reported lack of access to research reports at the work place and that they had little support from unit managers and colleagues. Registered nurses working in municipalities with access to research-related resources reported more use of research than registered nurses without resources. The factors 'Access to research findings at work place', 'Positive attitudes to research' and 'Nursing programme at university level' were significantly associated with research use. There is a great potential to increase registered nurses' use of research findings in the care of older people. Factors which were linked to the communication channels and the adopter were associated with research use. Strategies to enhance research use should focus on access to and adequate training in using information sources, increased knowledge on research methodology and nursing science and a supportive organisation.
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Physical restraint: perceptions of nurse managers, registered nurses and healthcare assistants.
Leahy-Warren, P; Varghese, V; Day, M R; Curtin, M
2018-02-09
To examine the perceptions of nurse managers, registered nurses and healthcare assistants of physical restraint use on older people in a long-term care setting in the Republic of Ireland. The use of physical restraint, although controversial, persists in long-term care settings, despite recommendations for restraint-free environments. Perception and attitude of staff can influence use of physical restraint. A descriptive cross-sectional design was used. A total of 250 nursing and healthcare assistant staff were recruited. A questionnaire incorporating demographics and the Perceptions of Restraint Use Questionnaire was used. Descriptive and inferential statistical analyses were conducted. Mean age of respondents (n = 156) was 41 years, and the majority were female. Overall, a low level of importance was attached to the use of restraint. Nurse managers and registered nurses compared favourably with healthcare assistants who attached a higher importance to use of restraint. Across all three staff groups, greatest importance was attached to the use of physical restraint for reducing falls, followed by prevention of treatment interference. Restraint was least favoured as a means of impairment management. Education was not an explanatory factor in perceived importance of physical restraint use. Nurse managers and registered nurses are unlikely to use physical restraint. However, there is concern regarding perception of healthcare assistants on use of restraint. Results from this study compare favourably with those in countries that have no policy on physical restraint use. Educational programmes alone are insufficient to address use of physical restraint. Attention to skill mix with adequate support for healthcare assistants in long-term care settings is recommended. © 2018 International Council of Nurses.
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ERIC Educational Resources Information Center
Welch, Gena M.
2017-01-01
Purpose: The purpose of this Scholarly project was to improve Student Registered Nurse Anesthetist (SRNA) clinical education consistency and quality by enhancing communication between Certified Registered Nurse Anesthetists (CRNAs) clinical instructors and SRNAs. This was accomplished by educating CRNA clinical instructors on non-technical skills,…
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Wage Determination of Registered Nurses in Proprietary and Nonprofit Nursing Homes.
ERIC Educational Resources Information Center
Holtmann, A. G.; Idson, Todd L.
1993-01-01
According to data from 2,000 registered nurses, (1) those employed in nonprofit nursing homes earned more than private home nurses; (2) quality differences in care may account for wage differences; and (3) an explanation for quality differences may be that nonprofits exist because of market failure to provide high quality care, and therefore they…
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Shine on: achieving career satisfaction as a registered nurse.
Perry, Beth
2008-01-01
This phenomenological study focuses on the experience of career satisfaction among registered nurses. Potential participants were asked, "Do you love your work as a nurse?" A random sample of eight nurses who answered yes to this question was questioned further during semistructured conversations. Conversations were recorded and transcribed. Data collected were in the form of descriptions of times during the participants' careers when they felt most professionally fulfilled. Through narrative and poetic analysis, themes of "upholding the vulnerable," "going the extra mile," and "attending to the essential ordinary" were identified. Nurse educators play an important role facilitating career satisfaction for registered nurses. Practical implications for continuing education for educators and practicing nurses are addressed.
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Nursing practice environment and registered nurses' job satisfaction in nursing homes.
Choi, JiSun; Flynn, Linda; Aiken, Linda H
2012-08-01
Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs in nursing homes. The sample included 863 RNs working as staff RNs in 282 skilled nursing facilities in New Jersey. Two-level hierarchical linear modeling was used to account for the RNs nested by nursing homes. Controlling for individual and nursing home characteristics, staff RNs' participation in facility affairs, supportive manager, and resource adequacy were positively associated with RNs' job satisfaction. Ownership status was significantly related to job satisfaction; RNs working in for-profit nursing homes were less satisfied. A supportive practice environment is significantly associated with higher job satisfaction among RNs working in nursing homes. Unlike other nursing home characteristics, specific dimensions of the nursing practice environment can be modified through administrative actions to enhance RN job satisfaction.
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Magnet status and registered nurse views of the work environment and nursing as a career.
Ulrich, Beth T; Buerhaus, Peter I; Donelan, Karen; Norman, Linda; Dittus, Robert
2007-05-01
To compare how registered nurses view the work environment and the nursing shortage based on the Magnet status of their organizations. The upsurge in organizations pursuing and obtaining Magnet recognition provides increased opportunities to investigate whether and how registered nurses who are employed in Magnet organizations and organizations pursuing Magnet status perceive differences in the nursing shortage, hospitals' responses to the shortage, characteristics of the work environment, and professional relationships. A nationally representative sample of registered nurses licensed to practice in the United States was surveyed. The views of registered nurses who worked in Magnet organizations, organizations in the process of applying for Magnet status, and non-Magnet organizations were analyzed as independent groups. Significant differences were found. Although there is a clear Magnet difference, there are also identifiable differences that occur during the pursuit of Magnet recognition. Many organizations in the process of applying for Magnet status rated higher than Magnet organizations, indicating that there is much to do to maintain the comparative advantages for Magnet hospitals.
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Magnet status and registered nurse views of the work environment and nursing as a career.
Ulrich, Beth T; Buerhaus, Peter I; Donelan, Karen; Norman, Linda; Dittus, Robert
2009-01-01
To compare how registered nurses view the work environment and the nursing shortage based on the Magnet status of their organizations. The upsurge in organizations pursuing and obtaining Magnet recognition provides increased opportunities to investigate whether and how registered nurses who are employed in Magnet organizations and organizations pursuing Magnet status perceive differences in the nursing shortage, hospitals' responses to the shortage, characteristics of the work environment, and professional relationships. A nationally representative sample of registered nurses licensed to practice in the United States was surveyed. The views of registered nurses who worked in Magnet organizations, organizations in the process of applying for Magnet status, and non-Magnet organizations were analyzed as independent groups. Significant differences were found. Although there is a clear Magnet difference, there are also identifiable differences that occur during the pursuit of Magnet recognition. Many organizations in the process of applying for Magnet status rated higher than Magnet organizations, indicating that there is much to do to maintain the comparative advantages for Magnet hospitals.
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The Career Advancement for Registered Nurse Excellence Program.
Fusilero, Jane; Lini, Linda; Prohaska, Priscilla; Szweda, Christine; Carney, Katie; Mion, Lorraine C
2008-12-01
Nurse administrators focus on factors that influence nurses' levels of satisfaction to reduce turnover and improve retention. One important determinant of nurses' satisfaction is the opportunity for professional development. On the basis of feedback from the nurses, a professional development program, Career Advancement for Registered Nurse Excellence, was instituted. The authors describe one approach to create opportunities to improve professional nurse development and the necessity for ongoing assessment of its impact on nurses' job satisfaction.
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Enhancing resilience in registered aged care nurses.
Cameron, Fiona; Brownie, Sonya
2010-06-01
To identify the factors that impact the resilience of registered aged care nurses, that is their capacity to adapt to the physical, mental and emotional demands of working in aged care facilities. This study explored the lived experience of nine registered nurses working in residential aged care facilities on the Sunshine Coast, Queensland, who were asked to reflect on the phenomenon of resilience in the workplace. This study found that clinical expertise, a sense of purpose in a holistic care environment, a positive attitude and work-life balance are important determinants of resilience in aged care nurses. Resilience in nurses in residential aged care facilities is enhanced when they are able to maintain long-term, meaningful relationships with residents. Collegial support that provides opportunities to debrief and validate experiences as well as the use of humour to defuse stress promotes well-being and builds resilience in the workplace.
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Educational Progression of Licensed Practical Nurses to Registered Nursing Programs. Project Report.
ERIC Educational Resources Information Center
Hosch, India, Comp.
A project was conducted to develop a structural mechanism for articulation between colleges and vocational schools in West Virginia. Such articulation would permit licensed practical nurses (LPNs) desiring to become registered nurses to transfer credits for their licensed practical nursing courses and thereby eliminate unnecessary repetition of…
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Career Motivation in Newly Licensed Registered Nurses: What Makes Them Remain
ERIC Educational Resources Information Center
Banks, Zarata Mann; Bailey, Jessica H.
2010-01-01
Despite vast research on newly licensed registered nurses (RNs), we don't know why some newly licensed registered nurses remain in their current jobs and others leave the nursing profession early in their career. Job satisfaction, the most significant factor emerging from the literature, plays a significant role in nurses' decisions to remain in…
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Exploring Student Perceptions of Retention Issues in a 3-Year Baccalaureate-Level Nursing Program
ERIC Educational Resources Information Center
Taulbee, Rebecca
2017-01-01
The nursing shortage, a major concern for the United States, has a multitude of causative factors. Nursing education has been tasked with helping to decrease the shortage of qualified registered nurses. Poor retention of nursing students in higher education is impacting the number of qualified nurses entering the workforce. Nursing education has…
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Becoming a registered nurse: the nurse extern experience.
Starr, Kimberly; Conley, Virginia M
2006-01-01
Little is known about the perceptions of nursing students externing in newly developed hospital-based programs that focus on socialization and transition to the registered nurse (RN) role rather than on institutional recruitment and retention goals. This qualitative study explored student nurse externs' expectations, experiences, and benefits of participation in a student-focused externship program. Externs wanted to gain experience with skills and learn what it was like to be an RN. Goals were met or exceeded by becoming comfortable in the externship role, growing in skill performance and confidence, and becoming members of the healthcare team. The experience fostered growth from the novice to advanced beginner level of nursing practice. Externs saw the program participation as a valuable way to gain experience and learn what it was like to be an RN.
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ERIC Educational Resources Information Center
Kanda, Katsuya; Mezey, Mathy
1991-01-01
Examined changes in resident acuity and registered nurse staffing in all nursing homes in Pennsylvania before and after introduction of Medicare Prospective Payment System (PPS) in 1983. Found that acuity of nursing home residents increased significantly since introduction of PPS, full-time registered nurse staffing remained unchanged, and…
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Halpin, Yvonne; Terry, Louise M; Curzio, Joan
2017-11-01
To investigate transition in newly qualified nurses through an exploration of their stressors and stress experiences during their first 12 months postqualifying. Globally, thousands of new nurses qualify annually. They are crucial for the profession and healthcare service delivery. Work-related stress has multiple serious consequences, yet there is a lack of robust, empirical evidence that directly analyses newly qualified nurses and the stress they feel and experience in the workplace. Understanding what causes newly qualified nurses' stress is vital to retaining and nurturing this vital component of the workforce. Longitudinal, explanatory sequential mixed methods, cohort study. At the point of qualification (n = 288), 6 months postqualifying (n = 107) and 12 months postqualifying (n = 86), newly qualified nurses completed the Nursing Stress Scale, with 14 completing a one-to-one interview at 12 months postqualifying. Data were collected from 2010 - 2012. Inferential statistics, "thematic analysis" and "side-by-side comparisons in a discussion" were used for analysis. Workload was consistently the highest reported stressor with inadequate staffing and managing multiple role demands given as explanations. Incivility within the workplace was a noted stressor. Conversely, being part of "a good team" provided a civil, supportive, facilitative work environment. Entering nurse education with previous healthcare experience had a mediating effect on the reported frequency of stressors. Newly qualified nurses encounter multiple work-related stressors over their first 12 months postqualifying, which are intrinsically entwined with their transition. Employing organizations need to be more proactive in managing their workload and addressing workplace incivility. © 2017 John Wiley & Sons Ltd.
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[Career guidance for registered nurse in the UK].
Simón Melchor, Lucía; Simón Melchor, Alba
2014-04-01
Cuts in temporary contracts has had big consequences for newly qualified nurses with regards to finding employment. This cut in contracts has resulted in a doubling in the rate of unemployment in this profession. In the past nurses emigrated to other countries for purposes like knowledge of the language or to extend their training and experience, however today the emigration has become the only way out for many professional nurses. The reputation of nurses in Spain is recognised internationally, with the UK being one of the countries with the largest demand for Spanish nurses. Due to the great amount of job opportunities that are emerging in the UK, nurses need help and guidance in their careers, and also nurses need training in areas such as Professional Body, developing a curriculum, facing an interview etc...
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ERIC Educational Resources Information Center
Hamlin, Amy S.
2013-01-01
The United States is in the midst of an increasingly worsening shortage of registered nurses, due, in part, to the nursing educator shortage. Further, nursing programs nationwide are turning away qualified applicants because of a lack of nursing educators. Unfortunately, the nursing educator shortage is not a problem that will be easily fixed. As…
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The value of registered nurses in ambulatory care settings: a survey.
Mastal, Margaret; Levine, June
2012-01-01
Ambulatory care settings employ 25% of the three million registered nurses in the United States. The American Academy of Ambulatory Care Nursing (AAACN) is committed to improving the quality of health care in ambulatory settings, enhancing patient outcomes, and realizing greater health care efficiencies. A survey of ambulatory care registered nurses indicates they are well positioned to lead and facilitate health care reform activities with organizational colleagues. They are well schooled in critical thinking, triage, advocating for patients, educating patients and families, collaborating with medical staff and other professionals, and care coordination. The evolving medical home concept and other health care delivery models reinforces the critical need for registered nurses to provide chronic disease management, care coordination, health risk appraisal, care transitions, health promotion, and disease prevention services. Recommendations are offered for organizational leaders, registered nurses, and AAACN to utilize nursing knowledge and skills in the pursuit of leading change and advancing health.
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McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia
2015-09-01
Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Seitovirta, Jaana; Vehviläinen-Julkunen, Katri; Mitronen, Lasse; De Gieter, Sara; Kvist, Tarja
2017-04-01
To identify meaningful types of rewards and the consequences of rewards as expressed by Finnish registered nurses working in primary and private healthcare. Previous studies have found significant associations between nurses' rewards and both their commitment and job satisfaction. Furthermore, appropriate rewards can have beneficial effects on factors including workforce stability and occupational satisfaction that are highly important in times of nurse shortages. A cross-sectional, qualitative interview study. Data were collected via individual semi-structured interviews (n = 20) with registered nurses working in Finland's primary and private healthcare, and subjected to qualitative content analysis. Six meaningful types of rewards were identified by the registered nurses: Financial compensation and benefits, Work-Life balance, Work content, Professional development, Recognition, and Supportive leadership. Rewards encouraged respondents to perform their work correctly and reinforced occupational satisfaction, but also caused feelings of envy and stress. It is essential to pay attention to nurses' preferences for particular rewards and to reward management. When designing effective reward systems for registered nurses, it is not sufficient to provide financial rewards alone, as various kinds of non-financial rewards are both meaningful and necessary. When trying to improve registered nurses' commitment and job satisfaction through reward management, it is important to listen to nurses' opinions to create a reward system that integrates financial and non-financial rewards and is fair from their perspective. Healthcare organisations that offer registered nurses a holistic reward system are more likely to retain satisfied and committed nurses at a time of increasing nursing shortages. © 2016 John Wiley & Sons Ltd.
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Attitudes toward Older People among Nursing Students and Registered Nurses in Sweden.
ERIC Educational Resources Information Center
Soderhamn, Olle; Lindencrona, Catharina; Gustavsson, Siw Merit
2001-01-01
A survey of 151 undergraduate nursing students and 41 registered nurses in Sweden found that those who were under 25, male, or had limited prior experience caring for older people had less favorable attitudes toward the elderly. First-year students were more negative than third-year students. No differences among nurses in different practice…
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Thinking strategies used by Registered Nurses during emergency department triage.
Göransson, Katarina E; Ehnfors, Margareta; Fonteyn, Marsha E; Ehrenberg, Anna
2008-01-01
This paper is a report of a study to describe and compare thinking strategies and cognitive processing in the emergency department triage process by Registered Nurses with high and low triage accuracy. Sound clinical reasoning and accurate decision-making are integral parts of modern nursing practice and are of vital importance during triage in emergency departments. Although studies have shown that individual and contextual factors influence the decisions of Registered Nurses in the triage process, others have failed to explain the relationship between triage accuracy and clinical experience. Furthermore, no study has shown the relationship between Registered Nurses' thinking strategies and their triage accuracy. Using the 'think aloud' method, data were collected in 2004-2005 from 16 RNs working in Swedish emergency departments who had previously participated in a study examining triage accuracy. Content analysis of the data was performed. The Registered Nurses used a variety of thinking strategies, ranging from searching for information, generating hypotheses to stating propositions. They structured the triage process in several ways, beginning by gathering data, generating hypotheses or allocating acuity ratings. Comparison of participants' use of thinking strategies and the structure of the triage process based on their previous triage accuracy revealed only slight differences. The wide range of thinking strategies used by Registered Nurses when performing triage indicates that triage decision-making is complex. Further research is needed to ascertain which skills are most important in triage decision-making.
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Bae, Sung-Heui; Yoon, Jangho
2014-10-01
To examine the degree to which states' work hour regulations for nurses-policies regarding mandatory overtime and consecutive work hours-decrease mandatory overtime practice and hours of work among registered nurses. We analyzed a nationally representative sample of registered nurses from the National Sample Survey of Registered Nurses for years 2004 and 2008. We obtained difference-in-differences estimates of the effect of the nurse work hour policies on the likelihood of working mandatory overtime, working more than 40 hours per week, and working more than 60 hours per week for all staff nurses working in hospitals and nursing homes. The mandatory overtime and consecutive work hour regulations were significantly associated with 3.9 percentage-point decreases in the likelihood of working overtime mandatorily and 11.5 percentage-point decreases in the likelihood of working more than 40 hours per week, respectively. State mandatory overtime and consecutive work hour policies are effective in reducing nurse work hours. The consecutive work hour policy appears to be a better regulatory tool for reducing long work hours for nurses. © Health Research and Educational Trust.
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In the Balance: Registered Nurse Supply and Demand, 1996. IES Report 315.
ERIC Educational Resources Information Center
Seccombe, I.; Smith, G.
A survey of 6,000 registered nurses in membership in the Royal College of Nursing across the United Kingdom examined some key factors that determined the supply of nurses. A study of the UK nursing labor market indicated that the number of registered nurses has remained more or less static since the late 1980s. Rising demand appeared to be met by…
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Hawthorne, L
2001-12-01
Recent decades have coincided with the rapid globalisation of the nursing profession. Within Australia there has been rising dependence on overseas qualified nurses (OQNs) to compensate for chronic nurse shortages related to the continued exodus of Australian nurses overseas and to emerging opportunities in other professions. Between 1983/4 and 1994/5, 30 544 OQNs entered Australia on either a permanent or temporary basis, counter-balancing the departure overseas of 23 613 locally trained and 6519 migrant nurses (producing a net gain of just 412 nurses in all). The period 1995/6--1999/2000 saw an additional 11 757 permanent or long-term OQN arrivals, with nursing currently ranked third target profession in Australia's skill migration program, in the context of continuing attrition among local nurses. This pattern of reliance on OQNs is a phenomenon simultaneously occurring in the UK, the US, Canada and the Middle East --- the globalisation of nursing reflecting not merely Western demand but the growing agency and participation of women in skilled migration, their desire for improved quality of life, enhanced professional opportunity and remuneration, family reunion and adventure.
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The Challenges of Online Nursing Education
ERIC Educational Resources Information Center
Smith, Glenn Gordon; Passmore, Denise; Faught, Timber
2009-01-01
To meet the current critical need for qualified nurses, many colleges have initiated online programs, primarily aimed towards registered nurse (RN) to BS students. Despite the growing number of online nursing programs, there is little research on instructor views of online learning. This study used interviews to investigate nursing instructor…
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Ó Lúanaigh, Padraig
2015-11-01
This research was undertaken to understand the influence of registered nurses on nursing students' learning in the clinical environment to inform strategies to enable registered nurses to provide effective support to learners while also assisting nursing students to adopt approaches to maximise their learning in the clinical environment. A case study approach was applied in this research to explore descriptions of clinical experience of five final year nursing students. The student participants identified the importance of the clinical environment to their learning and wanted to and had actively managed their learning in the clinical environment. The students did not passively acquire knowledge or simply replicate what they observed from others. There was evidence that the students had strong and established perceptions of what constituted 'good' nursing and described an ability to discriminate between differing levels of nursing practice. Nursing knowledge was gained from respected registered nurses who were best able to describe and demonstrate the 'tricks of the trade' and 'little things that matter' when providing 'good' nursing. The outcomes from this research indicate an important role for registered nurses in both shaping nursing students' professional nursing identity and access to clinical learning. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Östlund, Ann-Sofi; Wadensten, Barbro; Häggström, Elisabeth; Kristofferzon, Marja-Leena
2014-08-01
To examine to what extent district nurses and registered nurses have training in motivational interviewing, to what extent they use it and what prerequisites they have for using it; to compare district nurses and registered nurses, as well as to compare users and nonusers of motivational interviewing; and to examine possible relationships between use of motivational interviewing and the variables training, supervision and feedback in motivational interviewing and prerequisites for use. Motivational interviewing is an effective method for motivating patients to change their lifestyle, used increasingly in primary care. A cross-sectional survey study. A study-specific questionnaire was sent to all district nurses and registered nurses (n = 980) in primary care in three counties in Sweden, from September 2011-January 2012; 673 (69%) responded. Differences between groups as well as relationships between study variables were tested. According to self-reports, 59% of the respondents had training in motivational interviewing and 57% used it. Approximately 15% of those who reported using it had no specific training in the method. More district nurses than registered nurses had training in motivational interviewing and used it. The following factors were independently associated with the use of motivational interviewing: training in and knowledge of motivational interviewing, conditions for using it, time and absence of 'other' obstacles. Having knowledge in motivational interviewing and personal as well as workplace prerequisites for using it may promote increased use of motivational interviewing. Having the prerequisites for using motivational interviewing at the workplace is of significance to the use of motivational interviewing. In the context of primary care, district nurses seem to have better prerequisites than registered nurses for using motivational interviewing. © 2013 John Wiley & Sons Ltd.
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Bae, Sung-Heui; Yoon, Jangho
2014-01-01
Objectives To examine the degree to which states’ work hour regulations for nurses—policies regarding mandatory overtime and consecutive work hours—decrease mandatory overtime practice and hours of work among registered nurses. Methods We analyzed a nationally representative sample of registered nurses from the National Sample Survey of Registered Nurses for years 2004 and 2008. We obtained difference-in-differences estimates of the effect of the nurse work hour policies on the likelihood of working mandatory overtime, working more than 40 hours per week, and working more than 60 hours per week for all staff nurses working in hospitals and nursing homes. Principal Findings The mandatory overtime and consecutive work hour regulations were significantly associated with 3.9 percentage-point decreases in the likelihood of working overtime mandatorily and 11.5 percentage-point decreases in the likelihood of working more than 40 hours per week, respectively. Conclusions State mandatory overtime and consecutive work hour policies are effective in reducing nurse work hours. The consecutive work hour policy appears to be a better regulatory tool for reducing long work hours for nurses. PMID:24779701
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Maintaining Registered Nurses' Currency in Informatics
ERIC Educational Resources Information Center
Strawn, Jennifer Alaine
2017-01-01
Technology has changed how registered nurses (RNs) provide care at the bedside. As more technologies are utilized to improve quality of care, safety of care, maximize efficiencies, and decrease costs of care, one must question how well the information technologies (IT) are fully integrated and utilized by the front-line bedside nurse in his or her…
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ERIC Educational Resources Information Center
Bell, Charlene
2017-01-01
A mounting concern throughout the country is a current and growing nursing shortage. In order to meet the growing demand of nurses, many colleges have created baccalaureate second degree accelerated registered nursing programs. Stressors, experienced by nursing students in these accelerated programs, may affect their retention. A deeper…
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Using nonfaculty registered nurses to facilitate high-fidelity human patient simulation activities.
Foster, Janet G; Sheriff, Susan; Cheney, Susan
2008-01-01
Maximizing faculty resources using nonfaculty registered nurses to supervise high-fidelity human-patient simulation is an innovative strategy for addressing the nursing faculty shortage and preparing graduates to practice safely in hospitals. The authors describe their use of nonfaculty registered nurses and its outcomes.
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Leadership styles of nurse managers and registered sickness absence among their nursing staff.
Schreuder, Jolanda A H; Roelen, Corné A M; van Zweeden, Nely F; Jongsma, Dianne; van der Klink, Jac J L; Groothoff, Johan W
2011-01-01
Sickness absence leads to understaffing and interferes with nursing efficiency and quality. It has been reported in literature that managerial leadership is associated with self-reported sickness absence in the working population. This study investigated the relationship between managerial leadership and sickness absence in health care by associating nurse managers' leadership styles with registered sickness absence among their nursing staff. The cross-sectional study included 699 nurses working in six wards (staff range = 91-140 employees) of a Dutch somatic hospital employing a total of 1,153 persons. The nurse managers heading the wards were asked to complete the Leadership Effectiveness and Adaptability Description questionnaire for situational leadership. The Leadership Effectiveness and Adaptability Description scores were linked to employer-registered nursing staff sickness absence. High relationship-high task behavior (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.65-0.85) and high relationship-low task behavior (OR = 0.37, 95% CI = 0.14 -0.98) were inversely related to the number of short (one to seven consecutive days) episodes of sickness absence among the staff. Low relationship-high task styles (OR = 2.44, 95% CI = 1.14-5.22) as well as low relationship-low task styles (OR = 2.44, 95% CI = 1.26-4.71) were positively associated with the number of short episodes of sickness absence. However, the leadership styles only explained 10% of the variance in short episodes of sickness absence. Leadership styles are associated with registered sickness absence. The nursing staff of relationship-oriented nurse managers has fewer short episodes of sickness absence than the staff of task-oriented managers. Training nurse managers in relational leadership styles may reduce understaffing and improve nursing efficiency and quality.
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Sexual harassment of nurses: an occupational hazard?
Finnis, S J; Robbins, I
1994-03-01
A questionnaire was administered to qualified and student nurses to assess the prevalence and consequences of sexual harassment. There was a 56% completion rate. Of these 43 (66%) of the registered nurses and nine (35%) of the student nurses reported having experienced sexual harassment. The incidence of harassment for registered nurses in the year prior to the study was 46%. Patients were most likely to be the harasser for both student and registered nurses but there was an increased likelihood that other staff were involved in the harassment of registered nurses with doctors and male nursing staff being the predominant perpetrators. Dimensions of assertiveness and sex role identity did not predict the likelihood of harassment. Results are discussed in the context of attribution theory and gender power relationships.
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Experiences of registered nurses from a refugee background: A scoping review.
Ng Chok, Harrison; Mannix, Judy; Dickson, Cathy; Wilkes, Lesley
2018-04-01
This scoping review presents an exploration of international literature on the factors that impact refugees' personal and professional experiences during their journey to being registered nurses in a new host country. Governments of host countries receiving refugees seek to develop strategies that facilitate the successful resettlement, employment and enculturation of refugees that arrive as skilled professionals. There is a scarcity of studies focussing on issues faced by refugees that are RNs or those pursuing nursing registration and employment in a new host country. This study is relevant for resettlement services, nursing registration authorities and education providers and informs the international nursing workforce. Scoping review. Databases such as MEDLINE, EMBASE, Cochrane Library, CINAHL; Google Scholar; PubMed; Scopus and Web of Science were searched for qualitative studies published up to and including 2017. Articles that did not specify explicitly the participants as registered nurses and/or refugees were excluded. All eligible articles were analysed for collective findings, and impact factors were extracted, synthesised and illustrated diagrammatically. This review explored six eligible articles and six impact factors were identified. The challenging impacts were as follows: loss of control; shock in a new environment and bleak employment prospects. Equally three impact factors: reconciling new reality; establishing a new identity and hope for the future, facilitate positive experiences for nurses in their successful transition into society and the nursing workplace. This scoping review reports the small number of international studies on the experiences of refugees seeking to become registered and employed as registered nurses. The six impact factors identified influence the lives of the nurse participants socio-economically in and out of the workplace. Policymakers, managers and educators providing resettlement, registration and employment services
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ERIC Educational Resources Information Center
Spratley, Ernell; Johnson, Ayah; Sochalski, Julie; Fritz, Marshall; Spencer, William
The characteristics, education, employment patterns, salaries, job satisfaction, and other characteristics of registered nurses (RNs) across the United States were examined in a national survey. Of the initial sample of approximately 54,000 of the nation's more than 3,066,000 licensed RNs, 35,579 RNs (72%) submitted usable responses. From 1980 to…
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ERIC Educational Resources Information Center
Smith, Jeff S.
2010-01-01
This narrative inquiry was designed to bring to life the storied experiences of registered nurses who have transitioned from paper to electronic nursing documentation and to provide a foundation for others who may be preparing to implement electronic documentation and wish to consider the significance of these nurses' stories of change in their…
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Projected Supply, Demand, and Shortages of Registered Nurses, 2000-2020.
ERIC Educational Resources Information Center
Health Resources and Services Administration (DHHS/PHS), Rockville, MD. National Center for Health Workforce Analysis.
The supply, demand, and shortages of registered nurses (RNs) were projected and analyzed for 2000-2020. According to the analysis, the national supply of full-time-equivalent registered nurses in 2000 was estimated at 1.89 million versus an estimated demand of 2 million, leaving a shortage of 110,000 (6%). The shortage is expected to grow…
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Jacob, Elisabeth R; McKenna, Lisa; D'Amore, Angelo
2016-01-01
In Australia, like other countries, two levels of nurse are registered for entry to practice. Educational changes for second level nurses in Australia have led to questions regarding roles and career options. This paper reports on interviews with nursing course coordinators to examine educator expectations of roles and career pathways of registered and enrolled nurses. Coordinators of eight degree (registered) and diploma (enrolled) nursing programs were interviewed to determine their opinions on roles and careers that students were prepared for. Transcripts were thematically analysed. Educators reported similar graduate roles, although high acuity care was primarily the role of registered nurses. Career expectations differed with enrolled nurses having limited advancement opportunity, and registered nurses greater career options. Health organisations were unprepared to accommodate increased practice scope of enrolled nurses and limited work practice through policies stipulating who could perform procedures. Organisational health policies need to accommodate increased enrolled nurse skill base. Education of practising nurses is necessary regarding increased scope of enrolled nurse practice to ensure they are used to their full potential. Increasing patient acuity requires more registered nurses, as enrolled nurses are unprepared to care for complex or deteriorating patients. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Registered Nurse Staffing Mix and Quality of Care in Nursing Homes: A Longitudinal Analysis
ERIC Educational Resources Information Center
Kim, Hongsoo; Harrington, Charlene; Greene, William H.
2009-01-01
Purpose: To examine the relationship between registered nurse (RN) staffing mix and quality of nursing home care measured by regulatory violations. Design and Methods: A retrospective panel data study (1999-2003) of 2 groups of California freestanding nursing homes. One group was 201 nursing homes that consistently met the state's minimum standard…
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Exploring sources of knowledge utilized in practice among Jordanian registered nurses.
Al-Ghabeesh, Suhair Husni; Abu-Moghli, Fathieh; Salsali, Mahvash; Saleh, Mohammad
2013-10-01
Understanding sources of knowledge used in everyday practice is very helpful in improving the quality of health care services. There is a consensus in the literature that nurses mostly relied in their practice on experiential knowledge gained through their interactions with other members of health care professionals and patients. The general aim of this study is to explore the sources of knowledge Jordanian registered nurses use during their practice. A descriptive correlational design was used to collect data from 539 Jordanian registered nurses from 10 hospitals using a self-administered questionnaire. The mean year of experience of the sample was 7.08 years. Of the 615 questionnaires distributed, 555 were returned. This yields a response rate of 87.6%. Results revealed that the top five ranked sources used by Jordanian registered nurses include: the information that nurses learned during nursing education, personal experience in nursing over time, what was learned through providing care to patients, information gained through discussion between physicians and nurses about patients, and information from policy and procedure manuals. Jordanian registered nurses recognize the value of research and that research utilization (RU) is an important issue and must not be ignored. The study has many implications for practice, education and research. Health care managers and decision makers need to play a more visible and instrumental role in encouraging RU to improve patients' quality of life. © 2012 John Wiley & Sons Ltd.
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Code of Federal Regulations, 2014 CFR
2014-10-01
... certified registered nurse anesthetist or an anesthesiologist's assistant: Basic rule and definitions. (a... registered nurse anesthetist or an anesthesiologist's assistant who is legally authorized to perform the... assistant and a certified registered nurse anesthetist. Certified registered nurse anesthetist means a...
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Code of Federal Regulations, 2013 CFR
2013-10-01
... certified registered nurse anesthetist or an anesthesiologist's assistant: Basic rule and definitions. (a... registered nurse anesthetist or an anesthesiologist's assistant who is legally authorized to perform the... assistant and a certified registered nurse anesthetist. Certified registered nurse anesthetist means a...
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Upgrading Licensed Practical Nurse to Registered Nurse Program, September 1971 - June 1973. Report.
ERIC Educational Resources Information Center
Holloway, Sally
Twenty Licensed Practical Nurses (LPN) became Registered Nurses (RN) in a pilot program giving partial academic credit for their LPN training and building on their existing skills. The program revolved around three needs: (1) trained nurses; (2) eliminating the notion that jobs were dead-end; and (3) achieving upward mobility for hospital staff.…
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Exploring factors affecting registered nurses' pursuit of postgraduate education in Australia.
Ng, Linda; Eley, Robert; Tuckett, Anthony
2016-12-01
The aim of this study was to explore the factors influencing registered nurses' pursuit of postgraduate education in specialty nursing practice in Australia. Despite the increased requirement for postgraduate education for advanced practice, little has been reported on the contributory factors involved in the decision to undertake further education. The Nurses' Attitudes Towards Postgraduate Education instrument was administered to 1632 registered nurses from the Nurses and Midwives e-Cohort Study across Australia, with a response rate of 35.9% (n = 568). Data reduction techniques using principal component analysis with varimax rotation were used. The analysis identified a three-factor solution for 14 items, accounting for 52.5% of the variance of the scale: "facilitators," "professional recognition," and "inhibiting factors." Facilitators of postgraduate education accounted for 28.5% of the variance, including: (i) improves knowledge; (ii) increases nurses' confidence in clinical decision-making; (iii) enhances nurses' careers; (iv) improves critical thinking; (v) improves nurses' clinical skill; and (vi) increased job satisfaction. This new instrument has potential clinical and research applications to support registered nurses' pursuit of postgraduate education. © 2016 John Wiley & Sons Australia, Ltd.
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Endacott, Ruth; Bogossian, Fiona E; Cooper, Simon J; Forbes, Helen; Kain, Victoria J; Young, Susan C; Porter, Joanne E
2015-01-01
To examine nursing students' and registered nurses' teamwork skills whilst managing simulated deteriorating patients. Studies continue to show the lack of timely recognition of patient deterioration. Management of deteriorating patients can be influenced by education and experience. Mixed methods study conducted in two universities and a rural hospital in Victoria, and one university in Queensland, Australia. Three simulation scenarios (chest pain, hypovolaemic shock and respiratory distress) were completed in teams of three by 97 nursing students and 44 registered nurses, equating to a total of 32 student and 15 registered nurse teams. Data were obtained from (1) Objective Structured Clinical Examination rating to assess performance; (2) Team Emergency Assessment Measure scores to assess teamwork; (3) simulation video footage; (4) reflective interview during participants' review of video footage. Qualitative thematic analysis of video and interview data was undertaken. Objective structured clinical examination performance was similar across registered nurses and students (mean 54% and 49%); however, Team Emergency Assessment Measure scores differed significantly between the two groups (57% vs 38%, t = 6·841, p < 0·01). In both groups, there was a correlation between technical (Objective Structured Clinical Examination) and nontechnical (Team Emergency Assessment Measure) scores for the respiratory distress scenario (student teams: r = 0·530, p = 0·004, registered nurse teams r = 0·903, p < 0·01) and hypovolaemia scenario (student teams: r = 0·534, p = 0·02, registered nurse teams: r = 0·535, p = 0·049). Themes generated from the analysis of the combined quantitative and qualitative data were as follows: (1) leadership and followership behaviours; (2) help-seeking behaviours; (3) reliance on previous experience; (4) fixation on a single detail; and (5) team support. There is scope to improve leadership, team work and task management skills for registered
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20 CFR 655.1116 - Element VI-What notification must facilities provide to registered nurses?
Code of Federal Regulations, 2010 CFR
2010-04-01
... provide to registered nurses? 655.1116 Section 655.1116 Employees' Benefits EMPLOYMENT AND TRAINING... Requirements Must a Facility Meet to Employ H-1C Nonimmigrant Workers as Registered Nurses? § 655.1116 Element VI—What notification must facilities provide to registered nurses? (a) The sixth attestation element...
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20 CFR 655.1116 - Element VI-What notification must facilities provide to registered nurses?
Code of Federal Regulations, 2011 CFR
2011-04-01
... provide to registered nurses? 655.1116 Section 655.1116 Employees' Benefits EMPLOYMENT AND TRAINING... Requirements Must a Facility Meet to Employ H-1C Nonimmigrant Workers as Registered Nurses? § 655.1116 Element VI—What notification must facilities provide to registered nurses? (a) The sixth attestation element...
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Cost analysis of nursing home registered nurse staffing times.
Dorr, David A; Horn, Susan D; Smout, Randall J
2005-05-01
To examine potential cost savings from decreased adverse resident outcomes versus additional wages of nurses when nursing homes have adequate staffing. A retrospective cost study using differences in adverse outcome rates of pressure ulcers (PUs), urinary tract infections (UTIs), and hospitalizations per resident per day from low staffing and adequate staffing nursing homes. Cost savings from reductions in these events are calculated in dollars and compared with costs of increasing nurse staffing. Eighty-two nursing homes throughout the United States. One thousand three hundred seventy-six frail elderly long-term care residents at risk of PU development. Event rates are from the National Pressure Ulcer Long-Term Care Study. Hospital costs are estimated from Medicare statistics and from charges in the Healthcare Cost and Utilization Project. UTI costs and PU costs are from cost-identification studies. Time horizon is 1 year; perspectives are societal and institutional. Analyses showed an annual net societal benefit of 3,191 dollars per resident per year in a high-risk, long-stay nursing home unit that employs sufficient nurses to achieve 30 to 40 minutes of registered nurse direct care time per resident per day versus nursing homes that have nursing time of less than 10 minutes. Sensitivity analyses revealed a robust set of estimates, with no single or paired elements reaching the cost/benefit equality threshold. Increasing nurse staffing in nursing homes may create significant societal cost savings from reduction in adverse outcomes. Challenges in increasing nurse staffing are discussed.
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Measuring Critical Thinking in Newly Licensed Registered Nurses
ERIC Educational Resources Information Center
Rush, Carreen W.
2017-01-01
A national conversation is stirring in the United States about mandating residency programs of newly-licensed nurses as findings indicate that newly-licensed registered nurses are not prepared to make appropriate patient care decisions. Even with many commercial instruments available on the market for outcome measurements, accurately assessing the…
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Chachula, Kathryn M; Myrick, Florence; Yonge, Olive
2015-07-01
The Canadian Nurses Association (CNA) estimates a nursing shortage in Canada will rise to 60,000 registered nurses by 2022. Further compounding this crisis is the approximate 14-61% of new nursing graduates who will change nursing roles or exit the profession. To explore the factors and basic psychosocial process involved in the decisions of newly graduated registered nurses in Western Canada who permanently exit the nursing profession within five years. Data was collected through unstructured and semi-structured interviews using the Glaserian grounded theory method. Participants were found to be in a process of letting go of nursing that commenced as students and continued as they entered practice as registered nurses. Four major themes were identified. 1) Navigating constraints of the healthcare system and workplace: participants encountered difficulties adjusting to shiftwork and workload. 2) Negotiating social relationships, hierarchies, and troublesome behaviors; specifically hierarchal and horizontal violence. 3) Facing fears, traumas and challenges. 4) Weighing competing rewards and tensions which resulted in leaving the nursing profession. Students and subsequently new nursing graduates require a variety of supports to establish a nursing identity and remain in the profession. These supports include a manageable workload; meaningful orientation; interprofessional teamwork; and engagement within transformational and authentic leadership constructs. New nurses require a sense of being welcomed, valued, respected and accepted into the workplace environment, as well as constructive feedback, emotional support and debriefing to face workplace challenges. Copyright © 2015 Elsevier Ltd. All rights reserved.
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New graduate registered nurses' knowledge of patient safety and practice: A literature review.
Murray, Melanie; Sundin, Deborah; Cope, Vicki
2018-01-01
To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses. Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety. A focused review of research literature. The review used key terms and Boolean operators across a 5-year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty-four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review. This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse. Issues raised in the 1970s remain a concern for today's new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety. Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition. © 2017 John Wiley & Sons Ltd.
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National Sample Survey of Registered Nurses II. Status of Nurses: November 1980.
ERIC Educational Resources Information Center
Bentley, Barbara S.; And Others
This report provides data describing the nursing population as determined by the second national sample survey of registered nurses. A brief introduction is followed by a chapter that presents an overview of the survey methodology, including details on the sampling design, the response rate, and the statistical reliability. Chapter 3 provides a…
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Registered Nurses working together with family members of older people.
Weman, Karin; Fagerberg, Ingegerd
2006-03-01
The aim of the study was to reach a more profound understanding, through looking at nurses' working situation, of those factors that influence how nurses are able to work together with family members of older people living in nursing homes or similar facilities. Working with the care of older people as a Registered Nurse provides a varied job with many challenges. Nurses have to co-operate with family members of those in community health care. Co-operation is important and necessary for all involved. Nurses working in elder care in a geographically defined area received a questionnaire with three open-ended questions, on the difficulties and/or problems involved with working together with family members, and the positive or negative aspects of this co-operation. Analysis was carried out using the latent content analysis method. Three themes, problems within the system, interaction with families and caring in nursing work, are presented with categories and their subcategories. The nurses wanted their superior to be a nurse so that their working situation would be better understood. Appreciation from their superior and family members was also a very important part of their work as nurses in community health care. The frequent changes and the lack of time in the work of elder care often put nurses under considerable psychological pressure. For the most part family members are a resource for the elder, but sometimes they will avoid contact, which will make co-operating difficult. Registered Nurses and family members are dependent on each other in their care of the elder. Relevance to clinical practice. More attention should be paid to the working situation of Registered Nurses in community health care, and their ability to work together with family members of older people.
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Code of Federal Regulations, 2012 CFR
2012-10-01
... certified registered nurse anesthetist or an anesthesiologist's assistant: Basic rule and definitions. (a... registered nurse anesthetist or an anesthesiologist's assistant who is legally authorized to perform the... an anesthesiologist's assistant and a certified registered nurse anesthetist. Certified registered...
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Flinkman, Mervi; Salanterä, Sanna
2015-11-01
To describe why young registered nurses (RNs) had previously left an organisation and why they intend to leave the profession. Currently, many young registered nurses, including those in Finland, are considering leaving their job or have an intention to leave the profession. An in-depth, descriptive approach was adopted. Data were collected in 2012 from interviews with 15 registered nurses (under the age of 30 years). The interviews were semi-structured and analysed using conventional content analysis. The main questions addressed were: 'Why had the young registered nurses left their previous organisation?' and 'Why do young registered nurses have an intention to leave the profession?' The findings centre on three themes: poor nursing practice environments; lack of support, orientation and mentoring, and nursing as a 'second best' or serendipitous career choice. The first years of nursing are particularly stressful for newly-graduated and inexperienced registered nurses. An in-depth, qualitative approach reveals more complex reasons behind the turnover of registered nurses and intention to leave the profession than questionnaire surveys. Young registered nurses need social support from nurse managers and experienced colleagues to successfully transition into nursing practice environments. Adequate orientation and mentoring programmes are needed to facilitate this transition. © 2014 John Wiley & Sons Ltd.
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Factors Influencing Female Registered Nurses' Work Behavior
Brewer, Carol S; Kovner, Christine T; Wu, Yow-Wu; Greene, William; Liu, Yu; Reimers, Cordelia W
2006-01-01
Objective To analyze factors that are related to whether registered nurses (RNs) work (WK) or do not work (NW) in nursing; and if the RN works, whether she works full- (FT) or part-time (PT). Data Sources Secondary data from National Sample Survey of Registered Nurses 2000 (NSSRN), the InterStudy Competitive Edge Part III Regional Market Analysis (2001), and the Area Resource File (2002). Study Design Using a cross-sectional design we tested the relationship between WK or NW and FT or PT; and demographic, job-related, and metropolitan statistical area (MSA)-level variables. Data Collection/Extraction Methods We combined the data sources noted above to produce the analytic sample of 25,471 female RNs. Principal Findings Working in nursing is not independent of working FT or PT. Age (55 and older), other family income, and prior other work experience in health care are negatively related to working as an RN. The wage is not related to working as an RN, but negatively influences FT work. Age, children, minority status, student status, employment status, other income, and some job settings have a negative impact on working FT. Previous health care work has a positive effect on whether married RNs worked. Married RNs who are more dissatisfied are less likely to work FT. A greater number of market-level factors influence FT/PT than WK/NW behavior. Conclusions An important contribution of this study is demonstrating that MSA-level variables influence RN work behavior. The market environment seems to have little effect on whether a nurse works, but is influential on how much the nurse works, and has differential effects on married versus single nurses. PMID:16704517
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Burford, Bryan; Morrow, Gill; Morrison, Jill; Baldauf, Beate; Spencer, John; Johnson, Neil; Rothwell, Charlotte; Peile, Ed; Davies, Carol; Allen, Maggie; Illing, Jan
2013-09-01
Newly qualified doctors spend much of their time with nurses, but little research has considered informal learning during that formative contact. This article reports findings from a multiple case study that explored what newly qualified doctors felt they learned from nurses in the workplace. Analysis of interviews conducted with UK doctors in their first year of practice identified four overarching themes: attitudes towards working with nurses, learning about roles, professional hierarchies and learning skills. Informal learning was found to contribute to the newly qualified doctors' knowledge of their own and others' roles. A dynamic hierarchy was identified: one in which a "pragmatic hierarchy" recognising nurses' expertise was superseded by a "normative structural hierarchy" that reinforced the notion of medical dominance. Alongside the implicit learning of roles, nurses contributed to the explicit learning of skills and captured doctors' errors, with implications for patient safety. The findings are discussed in relation to professional socialisation. Issues of power between the professions are also considered. It is concluded that increasing both medical and nursing professions' awareness of informal workplace learning may improve the efficiency of education in restricted working hours. A culture in which informal learning is embedded may also have benefits for patient safety.
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Carlson, Elisabeth; Bengtsson, Mariette
2014-04-01
The expected shortage of registered nurses with an advanced degree as specialists in geriatric care or gerontology is imminent. Previous studies report that clinical practice where student nurses are supervised by registered nurses has a direct impact on how students perceive nursing as a profession and future career choice. Considering the anticipated need for well-educated and specialised nurses it is therefore, relevant as well as necessary to describe clinical learning with a focus on preceptorship in geriatric nursing care. This paper is a report of a study describing registered nurses' experience of precepting undergraduate student nurses during clinical practice in nursing homes and home-based care. A qualitative design, based on seven focus group interviews, was employed with 30 registered nurses with preceptor experience from nursing homes and home-based care for the elderly. Our findings present three precepting strategies that are unique to elderly care: preparing students for end of life care, facilitating a respectful approach to the older person and promoting creativity and independent work. The findings are discussed using a socio-cultural perspective and illustrate how communities of elderly practice can be valuable learning environments. © 2013.
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The impact of postgraduate education on registered nurses working in acute care.
Barnhill, Dianne; McKillop, Ann; Aspinall, Cathleen
2012-07-01
Since 2007, Health Workforce New Zealand has provided District Health Boards (DHBs) with funding to support nurses undertaking postgraduate education. As a result, a significant number of nurses, many working in general medical and surgical wards, have now completed a postgraduate qualification. Anecdotal evidence for one DHB indicated that there were mixed views with respect to how the increase in the number of nurses with postgraduate education had impacted on patient outcomes. Following a review of relevant literature the researchers aimed to ascertain from registered nurses working in acute medical and surgical wards their perception of the impact that further study had on their practice. A quantitative descriptive study was undertaken to answer the question of what impact postgraduate study had on the practice of those nurses working in medical and surgical wards of a District Health Board hospital? An anonymous postal survey was sent to registered nurses (N = 57), and senior nurses (N=25) working in acute medical and surgical areas of practice. The latter group consisted of 16 nurse managers and 9 nurse educators. The results showed that registered nurses, nurse managers and nurse educators all perceived the clinical practice of registered nurses as having improved in some degree as a consequence of postgraduate education. There is also a need for further research to be undertaken in other District Health Boards, especially in non-hospital based areas such as primary health care; and also to investigate ways of linking post graduate education with career pathways, as well as identifying and minimising potential barriers likely to prevent application of post graduate learning in the workplace.
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Registered nurse intent to promote physical activity for hospitalised liver transplant recipients.
Pearson, Jocelyn A; Mangold, Kara; Kosiorek, Heidi E; Montez, Morgan; Smith, Diane M; Tyler, Brenda J
2017-12-26
To describe how registered nurse work motivation, attitudes, subjective norm and perceived behavioural control influence intention to promote physical activity in hospitalised adult liver transplant recipients. Descriptive study of clinical registered nurses caring for recipients of liver transplant at a tertiary medical centre. Intent to Mobilise Liver Transplant Recipient Scale, Work Extrinsic and Intrinsic Motivation Scale, and demographics were used to explore registered nurses' work motivation, attitudes, subjective norms, perceived behavioural control and intention to promote physical activity of hospitalised adult liver transplant recipients during the acute postoperative phase. Data analysis included demographics, comparison between scale items and analysis of factors predicting intent to mobilise. Factors predictive of intention to promote physical activity after liver transplant included appropriate knowledge to mobilise patients (R 2 = .40) and identification of physical activity as nursing staff priority (R 2 = .15) and responsibility (R 2 = .03). When implementing an early mobilisation protocol after the liver transplant, education on effects of physical activity in the immediate postoperative period are essential to promote implementation in practice. Nursing care environment and leadership must be supportive to ensure mobility is a registered nurse priority and responsibility. Nursing managers can leverage results to implement a mobility protocol. © 2017 John Wiley & Sons Ltd.
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Jokiniemi, Krista; Haatainen, Kaisa; Pietilä, Anna-Maija
2015-12-01
The aim of this study is to describe the factors hindering and facilitating the implementation of the advanced practice registered nurses role at Finnish university hospitals, and to examine the implications for its future development. A descriptive qualitative approach, using thematic individual interviews, was conducted in 2011 with a sample of 11 advanced practice registered nurses. The data were analysed using qualitative content analysis. The advanced practice registered nurses role barriers had an impact on the role development needs. In turn, the facilitating factors helped encounter the challenges of the role, therefore having an impact on both the current role achievement, as well as contributing to the future role development. The factors hindering and facilitating the advanced practice registered nurses role need to be acknowledged to support the role implementation and planning of the future of the role. © 2014 Wiley Publishing Asia Pty Ltd.
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78 FR 69539 - Removal of Attestation Process for Facilities Using H-1A Registered Nurses
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-20
... of Attestation Process for Facilities Using H-1A Registered Nurses AGENCY: Employment and Training... registered nurses under the H-1A visa program. These subparts became obsolete after the authorizing statute... nonimmigrant classification exclusively for the temporary admission and employment of registered nurses, which...
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Determining registered nurses' readiness for evidence-based practice.
Thiel, Linda; Ghosh, Yashowanto
2008-01-01
As health care systems worldwide move toward instituting evidence-based practice (EBP), its implementation can be challenging. Conducting a baseline assessment to determine nurses' readiness for EBP presents opportunities to plan strategies before implementation. Although a growing body of research literature is focused on implementing EBP, little attention has been paid to assessing nurses' readiness for EBP. The purpose of this study was to assess registered nurses' readiness for EBP in a moderate-sized acute care hospital in the Midwestern United States before implementation of a hospital-wide nursing EBP initiative. A descriptive cross-sectional survey design was used; 121 registered nurses completed the survey. The participants (n= 121) completed the 64-item Nurses' Readiness for Evidence-Based Practice Survey that allowed measurement of information needs, knowledge and skills, culture, and attitudes. Data were analyzed using descriptive statistics and a post hoc analysis. The majority (72.5%) of respondents indicated that when they needed information, they consulted colleagues and peers rather than using journals and books; 24% of nurses surveyed used the health database, Cumulative Index to Nursing & Allied Health Literature (CINAHL). The respondents perceived their EBP knowledge level as moderate. Cultural EBP scores were moderate, with unit scores being higher than organizational scores. The nurses' attitudes toward EBP were positive. The post hoc analysis showed many significant correlations. Nurses have access to technological resources and perceive that they have the ability to engage in basic information gathering but not in higher level evidence gathering. The elements important to EBP such as a workplace culture and positive attitudes are present and can be built upon. A "site-specific" baseline assessment provides direction in planning EBP initiatives. The Nurses' Readiness for EBP Survey is a streamlined tool with established reliability and
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42 CFR 57.313 - Loan cancellation for full-time employment as a registered nurse.
Code of Federal Regulations, 2010 CFR
2010-10-01
... registered nurse. 57.313 Section 57.313 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... nurse. (a) For loans made after November 18, 1971, and before September 29, 1979. A person who: (1... in full-time employment as a registered nurse (including teaching in any of the fields of nurse...
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42 CFR 57.313 - Loan cancellation for full-time employment as a registered nurse.
Code of Federal Regulations, 2011 CFR
2011-10-01
... registered nurse. 57.313 Section 57.313 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... nurse. (a) For loans made after November 18, 1971, and before September 29, 1979. A person who: (1... in full-time employment as a registered nurse (including teaching in any of the fields of nurse...
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Suresh, Patricia; Matthews, Anne; Coyne, Imelda
2013-03-01
To measure and compare the perceived levels of job-related stress and stressors of newly qualified nurses and fourth-year student nurses in the clinical environment and to explore the participants' views on stress and stressors. Stress in the nursing workplace has significant consequences for the person, the patient and the organisation, such as psychological and physical health deterioration and impaired professional practice. To address this problem, stress and stressors need to be measured and identified. This study used a cross-sectional survey design and self-reporting questionnaires to measure and compare levels of stress in both groups. Convenience sampling involved all newly qualified nurses (n = 120) and fourth-year student nurses (n = 128) in Dublin North-East region in Ireland. The instrument used was 'The Nursing Stress Scale' (Gray-Toft & Anderson 1981, Journal of Behavioral Assessment 3, 11-23). Descriptive, qualitative analysis was conducted on an open-ended question. Data were obtained from newly qualified nurses (n = 31) and fourth-year student nurses (n = 40) in six acute hospital sites. Levels of perceived stress and stressors were high in both groups. Themes identified from the responses to the open question by both groups included excessive workload, difficult working relationships and unmet clinical learning needs. Student nurses also reported the combination of academic demands with clinical placement as a major stressor. There was no significant difference between each group. Stress continues to be a problem for nurses in the clinical setting. Excessive workload requires urgent attention by hospital managers in view of widespread retention difficulties. Themes identified could provide a framework for possible interventions for improving the clinical environment for nurses. These results can help stakeholders in nurse education and practice to develop interventions to reduce stress for both groups and to ease the transition from student to
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ERIC Educational Resources Information Center
DeSantis, Kimberly L.
2012-01-01
The United States faces a critical shortage of full-time registered nurses, which is . directly affected by the shortage of nurse educators. Many schools of nursing are already seeing the impact as qualified program applicants are being turned away due to the lack of qualified educators available to teach them. The trend has become to employ…
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A Survey of Registered Nurses in New York State.
ERIC Educational Resources Information Center
New York State Education Dept., Albany. Bureau of Postsecondary Research and Information Systems.
As part of the 1989 triennial registration of registered nurses (RNs) in New York State, a survey of professional, personal, and practice characteristics of nurses was conducted. Basic information from this survey is enhanced by information from earlier surveys to illustrate significant trends. Usable survey questionnaires were received from…
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Choi, Sandy Pin-Pin; Cheung, Kin; Pang, Samantha Mei-Che
2013-04-01
To examine how front-line registered nurses' perception of their work environment associates with and predicts nurse outcomes in terms of job satisfaction and turnover intention. Mounting evidence has pointed to an inseparable link between attributes of the nursing work environment and nurse outcomes. However, there is a paucity of research examining nurses' perception of their work environment beyond the Western context. This cross-sectional survey involved 1271 registered nurses working in 135 inpatient units in 10 public hospitals in Hong Kong. The instrument comprised items developed from in-depth interviews with front-line nurses that explored nurses' perception of their work environment. Factor analysis identified five dimensions (professionalism, co-worker relationship, management, staffing and resources, and ward practice) of the nursing work environment. Logistic regression analysis further identified professionalism, management and ward practice as significant factors in predicting nurses' turnover intention, and staffing and resources as an additional factor in predicting their job satisfaction. Attributes of the nursing work environment have a significant bearing on nurses' job satisfaction and intention to leave. Managerial effort should focus on improving nurses' work conditions through detailed resource planning, effective management and removal of work constraints that affect nursing practice. © 2012 Blackwell Publishing Ltd.
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Predicting National Council Licensure Examination for Registered Nurses Performance
ERIC Educational Resources Information Center
Whitehead, Charles D.
2016-01-01
The Baccalaureate Nursing program in San Antonio, Texas experienced a decrease in National Council Licensure Examination for Registered Nurses (NCLEX-RN) on the first attempt for students graduating between 2009 and 2014 without a clear explanation for the decline. The purpose of this quantitative non-experimental correlational study was to…
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Taking Part: Registered Nurses and the Labour Market in 1997.
ERIC Educational Resources Information Center
Seccombe, I.; Smith, G.
The labor market participation, pay, job satisfaction, employment patterns, and turnover of registered nurses in the United Kingdom were examined through an analysis of data from the 1997 Royal College of Nursing (RCN) Survey. Of the random sample of 5,984 nurses from the RCN membership records surveyed, 4,288 (72%) returned usable questionnaires.…
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Work values and intention to become a registered nurse among healthcare assistants.
Trede, Ines; Schweri, Juerg
2014-06-01
To examine the work values of Swiss healthcare assistant students, who, at the end of their vocational education in hospitals and nursing homes, choose to pursue a registered nurse degree. A prospective, cross-sectional survey was administered to a full cohort of healthcare assistant students in their last year of study in the canton of Bern (n=272). Multivariate methods (logistic regression) were applied to estimate the joint effect of work experience and work values in choosing to pursue a registered nurse education. Among work values, extrinsic values (regarding wage, career und educational perspectives) had a strong effect on the decisions of healthcare assistant students to pursue further education as registered nurses. Grades, socio-economic background and satisfaction during education also had an effect. Higher valuation of income, career and further education affect the career intentions of nursing assistants who have already obtained a recognized healthcare education and nursing experience. Teachers and trainers should actively identify the work values and expectations of these students. Provision of adequate advice and suggestions for the career development of these students may be an important route by which to address the nursing shortage and recruitment problems. © 2013.
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Job and industry turnover for registered and licensed vocational nurses.
Spetz, Joanne; Rickles, Jordan; Chapman, Susan; Ong, Paul M
2008-09-01
Most studies of nurse turnover focus on job turnover, which could reflect nurse advancement and thus not be detrimental to the workforce. The authors discuss findings from a study that involved 2 cohorts of graduates from registered nursing and licensed vocational nursing community college programs in California. The duration of employment in the healthcare industry, as well as with specific employers, is tracked, lending a more thorough analysis of nursing job and industry turnover than found in other studies.
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Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Services of a certified registered nurse... certified registered nurse anesthetist or an anesthesiologist's assistant: Basic rule and definitions. (a... registered nurse anesthetist or an anesthesiologist's assistant who is legally authorized to perform the...
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Connolly, Megan; Jacobs, Stephen; Scott, Karyn
2018-04-19
To examine clinical leadership of registered nurses in an emergency department, based on evidence that it is important for nurses to feel psychologically and structurally empowered in order to act as clinical leaders. Every registered nurse has the ability to act as a clinical leader. Clinical leadership is the registered nurse's behaviours that provide direction and support to patients and the team in the delivery of patient care. This study explores the connection between the need for structural and psychological empowerment and clinical leadership behaviours. A mixed method, non-experimental survey design was used to examine the psychological empowerment, structural empowerment and clinical leadership of registered nurses working in an emergency department. Emergency department nurses believe they show clinical leadership behaviours most of the time, even though their sense of being psychologically empowered is only moderate. While registered nurses believe they perform clinical leadership behaviours, it is also clear that improvements in structural and psychological empowerment would improve their ability to act as clinical leaders. The results show that for nurses to be able to provide clinical leadership to their patients and colleagues, management must create empowering environments. © 2018 John Wiley & Sons Ltd.
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Registered Nurses Return to College: Lessons Learned from Hindsight
ERIC Educational Resources Information Center
Wolff, Debra A.
2013-01-01
The recent impetus to increase the number of baccalaureate-prepared nurses comes from within and outside the profession, prompting increased numbers of registered nurses (RN-BSN) to return to college. Yet little is known about what these adult, non-traditional students do to prepare for the challenges ahead. Therefore, the purpose of this…
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The changing roles of registered nurses in Pioneer Accountable Care Organizations.
Pittman, Patricia; Forrest, Emily
2015-01-01
This study focuses on whether and how Pioneer Accountable Care Organization (ACO) leaders believe the deployment of the registered nurse workforce is changing in response to the shared savings incentives. Semistructured phone interviews with leaders from 18 of the original 32 Pioneer ACOs were conducted. Narrative analysis suggests that all of the organizations are developing new and enhanced roles for registered nurses across the continuum of care. Overall, eight types of changes were reported: enhancement of roles, substitution, delegation, increased numbers of nurses, relocation of services, transfer of nurses from one setting to another, the use of liaison nurses across settings, and partnerships between nurses coordinating care in primary and acute care settings. This exploratory study suggests that Pioneer ACO leaders believe that payment models are affecting the deployment of the health workforce and that these changes are, in turn, driving outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.
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The Role of Certified Registered Nurse Anesthetists in Patient Education
2000-10-01
As advanced practice nurses, certified registered nurse anesthetists (CRNAs) have a responsibility to engage in patient education about health...Categories and themes include; engaging in perioperative patient education , focusing on explanations about anesthesia and surgery, prior nursing...experiences make patient education easier, documenting patient education is important and uncertainty about where to document it. Common topics and themes
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ERIC Educational Resources Information Center
John, Diane Yvette
2010-01-01
Background. The demands of the current health-care system support the need for more nurses to be prepared at the bachelor's level (American Association of the Colleges of Nursing [AACN], 2007). However, only 28% of the registered nurse (RN) population in Florida holds a bachelor's degree in nursing (BSN), which may be the result of increased…
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Wang, Xiaohui; Chontawan, Ratanawadee; Nantsupawat, Raymoul
2012-02-01
The aim of this study was to describe the relationship between the transformational leadership of nurse managers and job satisfaction among clinical Registered Nurses at a tertiary care hospital in China. The healthcare system is changing rapidly. Research in Western countries has shown that transformational leadership affects job satisfaction. However, very little research related to this subject has been conducted in healthcare settings in China. The sample consisted of 238 nurses who work at a tertiary care hospital in China. Data were collected from April to August 2006. Research instruments included a demographic data form, a Leadership Practice Inventory and a Job Satisfaction Scale for clinical registered nurses. Both the transformational leadership of nurse managers and job satisfaction among clinical Registered Nurses were at a moderate level. There was a statistically significant positive correlation between the transformational leadership of nurse managers and job satisfaction (r = 0·556, P < 0·001). The findings indicate that the transformational leadership of nurse managers could have an effect on the job satisfaction of clinical Registered Nurses. © 2011 Blackwell Publishing Ltd.
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Caring Relationships in Home-Based Nursing Care - Registered Nurses’ Experiences
Wälivaara, Britt-Marie; Sävenstedt, Stefan; Axelsson, Karin
2013-01-01
The caring relationship between the nurse and the person in need of nursing care has been described as a key concept in nursing and could facilitate health and healing by involving the person’s genuine needs. The aim of this study was to explore registered nurses’ experiences of their relationships with persons in need of home-based nursing care. Individual interviews with nurses (n=13 registered nurses and 11 district nurses) working in home-based nursing care were performed. A thematic content analysis was used to analyze the transcribed interviews and resulted in the main theme Good nursing care is built on trusting relationship and five sub-themes, Establishing the relationship in home-based nursing care, Conscious efforts maintains the relationship, Reciprocity is a requirement in the relationship, Working in different levels of relationships and Limitations and boundaries in the relationship. A trusting relationship between the nurse and the person in need of healthcare is a prerequisite for good home-based nursing care whether it is based on face-to-face encounters or remote encounters through distance-spanning technology. A trusting relationship could reduce the asymmetry of the caring relationship which could strengthen the person’s position. The relationship requires conscious efforts from the nurse and a choice of level of the relationship. The trusting relationship was reciprocal and meant that the nurse had to communicate something about themself as the person needs to know who is entering the home and who is communicating through distance-spanning technology. PMID:23894261
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Black, Lisa; Spetz, Joanne; Harrington, Charlene
2010-01-01
Registered nurses (RNs) who work outside of nursing have seldom been examined. This aim of this study was to compare the 122,178 (4%) of RNs who are employed outside of nursing to those who work in nursing jobs in terms of sociodemographic, market, and political variables to determine if these groups are substantively different from one another. Using a logit regression model, wages were a significant predictor of working outside of nursing for unmarried nurses but not for married nurses. Married and unmarried male nurses were more likely to work outside of nursing. Baccalaureate education, children under age 6, higher family income, and years since graduation increased the odds of working outside of nursing for married nurses. Ultimately, identifying characteristics on which these groups differ may inform future policy directions that could target nurses who may leave nursing at a time when retention efforts might be effective to alter their trajectory away from the profession.
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Newton, Louise; Pront, Leeanne; Giles, Tracey M
2016-06-01
To examine the literature reporting the experiences and perceptions of registered nurses who supervise international nursing students in the clinical and classroom setting. Nursing education relies on clinical experts to supervise students during classroom and clinical education, and the quality of that supervision has a significant impact on student development and learning. Global migration and internationalisation of nursing education have led to increasing numbers of registered nurses supervising international nursing students. However, a paucity of relevant literature limits our understanding of these experiences. An integrative literature review. Comprehensive database searches of CINAHL, Informit, PubMed, Journals@Ovid, Findit@flinders and Medline were undertaken. Screening of 179 articles resulted in 10 included for review. Appraisal and analysis using Whittemore and Knafl's (Journal of Advanced Nursing, 52, 2005, 546) five stage integrative review recommendations was undertaken. This review highlighted some unique challenges for registered nurses supervising international nursing students. Identified issues were, a heightened sense of responsibility, additional pastoral care challenges, considerable time investments, communication challenges and cultural differences between teaching and learning styles. It is possible that these unique challenges could be minimised by implementing role preparation programmes specific to international nursing student supervision. Further research is needed to provide an in-depth exploration of current levels of preparation and support to make recommendations for future practice, education and policy development. An awareness of the specific cultural learning needs of international nursing students is an important first step to the provision of culturally competent supervision for this cohort of students. There is an urgent need for education and role preparation for all registered nurses supervising international nursing
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Cardiopulmonary resuscitation knowledge and skills of registered nurses in Botswana.
Rajeswaran, Lakshmi; Ehlers, Valerie J
2014-01-01
In Botswana nurses provide most health care in the primary, secondary and tertiary level clinics and hospitals. Trauma and medical emergencies are on the increase, and nurses should have cardiopulmonary resuscitation (CPR) knowledge and skills in order to be able to implement effective interventions in cardiac arrest situations. The objective of this descriptive study was to assess registered nurses’ CPR knowledge and skills. A pre-test, intervention and re-test time-series research design was adopted, and data were collected from 102 nurses from the 2 referral hospitals in Botswana. A multiple-choice questionnaire and checklist were used to collect data. All nurses failed the pre-test. Their knowledge and skills improved after training, but deteriorated over the three months until the post-test was conducted. The significantly low levels of registered nurses’ CPR skills in Botswana should be addressed by instituting country-wide CPR training and regular refresher courses
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Predictors of Retention and Passing National Council Licensure Examination for Registered Nurses
ERIC Educational Resources Information Center
Elkins, Nancy
2013-01-01
The current nursing shortage has challenged colleges to educate nurses at a faster pace than in previous times. Successful completion of the nursing programs and passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam is important for the students, faculty, and nursing programs. The purpose of this retrospective…
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Reflections on Distributive Leadership for Work-Based Mobile Learning of Canadian Registered Nurses
ERIC Educational Resources Information Center
Fahlman, Dorothy
2017-01-01
The ubiquity, flexibility, and accessibility of mobile devices can transform how registered nurses in Canada learn beyond the confines of traditional education/training boundaries in their work settings. Many Canadian registered nurses have actively embraced mobile technologies for their work-based learning to meet their competency requirements…
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Ramoo, Vimala; Abdullah, Khatijah L; Piaw, Chua Yan
2013-11-01
To assess Malaysian nurses' perceived job satisfaction and to determine whether any association exists between job satisfaction and intention to leave current employment. There is currently a shortage of qualified nurses, and healthcare organisations often face challenges in retaining trained nurses. Job satisfaction has been identified as a factor that influences nurse turnover. However, this has not been widely explored in Malaysia. Cross-sectional survey. Registered nurses in a teaching hospital in Malaysia completed a self-administered questionnaire. Of the 150 questionnaires distributed, 141 were returned (response rate = 94%). Overall, nurses had a moderate level of job satisfaction, with higher satisfaction for motivational factors. Significant effects were observed between job satisfaction and demographic variables. About 40% of the nurses intended to leave their current employment. Furthermore, age, work experience and nursing education had significant associations with intention to leave. Logistic regression analysis revealed that job satisfaction was a significant and independent predictor of nurses' intention to leave after controlling for demographic variables. The results suggest that there is a significant association between job satisfaction and nurses' intention to leave their current employment. It adds to the existing literature on the relationship between nurses' job satisfaction and intention to leave. Methods for enhancing nurses' job satisfaction are vital to promote the long-term retention of nurses within organisations. Attention must be paid to the needs of younger nurses, as they represent the majority of the nursing workforce and often have lower satisfaction and greater intention to leave than older nurses do. Strategies to nurture younger nurses, such as providing opportunities for further education, greater management decision-making capabilities and flexible working environment, are essential. © 2013 John Wiley & Sons Ltd.
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Galbany-Estragués, Paola; Nelson, Sioban
2016-11-01
After the financial crisis of 2008, increasing numbers of nurses from Spain are going abroad to work. To examine the health and workforce policy trends in Spain between 2009 and 2014 and to analyze their correlation with the migration of nurses. Single embedded case study. We examined data published by: Health Statistics, Organization for Economic Cooperation and Development (1996 to 2013); Ministry of Education, Culture and Sports (2006 to 2013); Ministry of Employment and Social Security (2009 to 2014); Ministry of Health, Social Services and Equality (1997 to 2014); and National Institute of Statistics (1976 to 2014). In addition to reviewing the scholarly literature on the topic in Spanish and English, we also examined Spanish mobility laws and European directives. We used the Organization for Economic Cooperation and Development definition of "professionally active nurses" which defines practising nurses and other nurses as those for whom their education is a prerequisite for employment as a nurse. Moreover, we used the term "nursing graduate" as defined by Spanish Ministry of Education to describe those who have obtained a recognized qualification in nursing in a given year, the term "registered nurses" is defined by Spanish law as nurses registered in the Nurses Associations and "unemployed nurses" are those without work and registered as seeking employment. A transformation of the Spanish health system has reduced the number of employed nurses per capita since 2010. Moreover, reductions in public spending, labour market reforms and widespread unemployment have affected nurses in two ways: first by increasing the number of applicants per vacancy between 2009 and 2013, and second, by an increase in casual positions. However, despite the poor job market and decreasing job security, the number of registered nurses and nursing graduates in Spain per year has continued to grow, increasing the pressure on the labour market. Spain is transforming from a stable
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Delegation practices between registered nurses and nursing assistive personnel.
Potter, Patricia; Deshields, Teresa; Kuhrik, Marilee
2010-03-01
To understand registered nurses' (RNs) and nursing assistive personnel's (NAP) perceptions of delegation practices in delivery of oncology patient care. No research to date describes how RNs and NAP communicate and interact during the delegation process. An understanding of the nature of communication during delegation offers direction for how RNs and NAP can improve collaboration. Qualitative descriptive study. Participants described conflict as a central theme during delegation. Sources of conflict varied between RNs and NAP. Successful delegation is characterised by effective communication, teamwork and initiative. Successful delegation depends on the quality of RN and NAP working relationships, timely ongoing communication, initiative and a willingness to collaborate. Nurse managers play a key role in the facilitation of delegation practices. Developing clear guidelines for RN and NAP patient reporting and providing opportunities to discuss conflict-related issues is essential. RNs would benefit from acquiring competency in how to conduct reports, resolve conflicts, and how to convey their role in patient care management. Nursing assistive personnel would benefit from developing competency in using effective communication skills for giving feedback, clarifying tasks and patient status and resolving conflict.
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Measuring Certified Registered Nurse Anesthetist Organizational Climate: Instrument Adaptation.
Boyd, Donald; Poghosyan, Lusine
2017-08-01
No tool exists measuring certified registered nurse anesthetist (CRNA) organizational climate. The study's purpose is to adapt a validated tool to measure CRNA organizational climate. Content validity of the Certified Registered Nurse Anesthetist Organizational Climate Questionnaire (CRNA-OCQ) was established. Pilot testing was conducted to determine internal reliability consistency of the subscales. Experts rated the tool as content valid. The subscales had high internal consistency reliability (with respective Cronbach's alphas): CRNA-Anesthesiologist Relations (.753), CRNA-Physician Relations (.833), CRNA-Administration Relations (.895), Independent Practice (.830), Support for CRNA Practice (.683), and Professional Visibility (.772). Further refinement of the CRNA-OCQ is necessary. Measurement and assessment of CRNA organizational climate may produce evidence needed to improve provider and patient outcomes.
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Factors contributing to registered nurse medication administration error: a narrative review.
Parry, Angela M; Barriball, K Louise; While, Alison E
2015-01-01
To explore the factors contributing to Registered Nurse medication administration error behaviour. A narrative review. Electronic databases (Cochrane, CINAHL, MEDLINE, BNI, EmBase, and PsycINFO) were searched from 1 January 1999 to 31 December 2012 in the English language. 1127 papers were identified and 26 papers were included in the review. Data were extracted by one reviewer and checked by a second reviewer. A thematic analysis and narrative synthesis of the factors contributing to Registered Nurses' medication administration behaviour. Bandura's (1986) theory of reciprocal determinism was used as an organising framework. This theory proposes that there is a reciprocal interplay between the environment, the person and their behaviour. Medication administration error is an outcome of RN behaviour. The 26 papers reported studies conducted in 4 continents across 11 countries predominantly in North America and Europe, with one multi-national study incorporating 27 countries. Within both the environment and person domain of the reciprocal determinism framework, a number of factors emerged as influencing Registered Nurse medication administration error behaviour. Within the environment domain, two key themes of clinical workload and work setting emerged, and within the person domain the Registered Nurses' characteristics and their lived experience of work emerged as themes. Overall, greater attention has been given to the contribution of the environment domain rather than the person domain as contributing to error, with the literature viewing an error as an event rather than the outcome of behaviour. The interplay between factors that influence behaviour were poorly accounted for within the selected studies. It is proposed that a shift away from error as an event to a focus on the relationships between the person, the environment and Registered Nurse medication administration behaviour is needed to better understand medication administration error. Copyright © 2014
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Motivating Nursing Faculty to Use Active Learning Strategies: A Qualitative Multiple Case Study
ERIC Educational Resources Information Center
Hardell, Traci Lee
2011-01-01
The nursing shortage remains of great concern to the nursing profession and to nursing educators. With the projected need for Registered Nurses high and the attrition rate in nursing programs remaining high, a focus on retention of qualified nursing students may be needed. One way to contribute to enhanced retention is using active learning…
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Registered nurse supply grows faster than projected amid surge in new entrants ages 23-26.
Auerbach, David I; Buerhaus, Peter I; Staiger, Douglas O
2011-12-01
The vast preponderance of the nation's registered nurses are women. In the 1980s and 1990 s, a decline in the number of women ages 23-26 who were choosing nursing as a career led to concerns that there would be future nurse shortages unless the trend was reversed. Between 2002 and 2009, however, the number of full-time-equivalent registered nurses ages 23-26 increased by 62 percent. If these young nurses follow the same life-cycle employment patterns as those who preceded them--as they appear to be thus far--then they will be the largest cohort of registered nurses ever observed. Because of this surge in the number of young people entering nursing during the past decade, the nurse workforce is projected to grow faster during the next two decades than previously anticipated. However, it is uncertain whether interest in nursing will continue to grow in the future.
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ERIC Educational Resources Information Center
Posey-Goodwin, Patricia Ann
2013-01-01
The purpose of this study was to explore differences in perceptions of mentoring activities from four generations of registered nurses in Florida, using the Alleman Mentoring Activities Questionnaire ® (AMAQ ®). Statistical procedures of analysis of variance (ANOVA) were employed to explore differences among 65 registered nurses in Florida from…
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Learning styles of registered nurses enrolled in an online nursing program.
Smith, Anita
2010-01-01
Technological advances assist in the proliferation of online nursing programs which meet the needs of the working nurse. Understanding online learning styles permits universities to adequately address the educational needs of the professional nurse returning for an advanced degree. The purpose of this study was to describe the learning styles of registered nurses (RNs) enrolled in an online master's nursing program or RN-bachelor of science in nursing (BSN) program. A descriptive, cross-sectional design was used. Kolb's learning style inventory (Version 3.1) was completed by 217 RNs enrolled in online courses at a Southeastern university. Descriptive statistical procedures were used for analysis. Thirty-one percent of the nurses were accommodators, 20% were assimilators, 19% were convergers, and 20% were divergers. Accommodators desire hand-on experiences, carrying out plans and tasks and using an intuitive trial-and-error approach to problem solving. The learning styles of the RNs were similar to the BSN students in traditional classroom settings. Despite their learning style, nurses felt that the online program met their needs. Implementing the technological innovations in nursing education requires the understanding of the hands-on learning of the RN so that the development of the online courses will satisfactorily meet the needs of the nurses who have chosen an online program. Copyright 2010 Elsevier Inc. All rights reserved.
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Monaghan, Thomas
2015-08-01
This critical analysis of the literature examines the factors and theoretical perspectives contributing to the theory-practice gap for newly qualified nurses within the United Kingdom. This article aspires to inform, guide and promote effective nursing education both academically and practically. A systematic search strategy was conducted to identify relevant literature covering the period of 2000-2014, to include only contemporary theoretical perspectives coinciding with the dearth of contemporary literature post Project 2000. The literature was systematically investigated utilising nursing research databases, the Cumulative Index of Nursing and Allied Health Literature, Allied and Complementary Medicine, the U.S. National Library of Medicine and Internurse. To satisfy the search criteria only articles conducted within the United Kingdom and written in the English language were included. Only literature including nurses and newly qualified nurses were included. To identify relevant literature a series of key words were utilised. Systematic review of the literature revealed that newly qualified nurses feel unprepared for practice, lacking confidence in their own abilities. It was also felt by newly qualified nurses that not enough time was dedicated to the production of clinical skills during their training. The use of preceptorship programmes was found to reduce the transitional stress associated with becoming a qualified nursing practitioner. Despite the increasing research being undertaken in the area of theory-practice gap there is still a need for nursing educators, practice areas and regulatory bodies to invest further in research. The effects of preceptorship and simulation exercises in particular require more research to provide regulatory bodies with enough evidence to make an informed decision as to whether their use should be mandatory. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Influence of Social Support and Self-Efficacy on Resilience of Early Career Registered Nurses.
Wang, Lin; Tao, Hong; Bowers, Barbara J; Brown, Roger; Zhang, Yaqing
2018-05-01
The aim of this study was to examine the relationships among social support, self-efficacy, and resilience in early career registered nurses. A cross-sectional study was conducted with a convenience sample of 747 early career registered nurses. Data collection was performed between August and November 2015. Data were analyzed using structural equation modeling. Among the three factors of social support, only the impact of coworker support on nurse resilience is fully mediated by self-efficacy; friend support had a significant positive direct effect on self-efficacy and an indirect effect on nurse resilience. This would suggest the importance of administrators/managers understanding how to promote coworker support, increase self-efficacy, foster a positive work climate, and develop effective mentorship programs to improve early career registered nurses resilience and mitigate factors leading to turnover.
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ERIC Educational Resources Information Center
National Advisory Council on Nurse Education and Practice, Rockville, MD.
The National Advisory Council on Nurse Education and Practice (NACNEP) initiated an examination of basic registered nurse workforce issues in December 1994. NACNEP took into account the environment in which registered nurses (RNs) would practice, the appropriate educational qualifications needed, and the status of the registered nurse population…
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Outcomes of a career planning and development program for registered nurses.
Hall, Linda McGillis; Waddell, Janice; Donner, Gail; Wheeler, Mary M
2004-01-01
The impact of a career planning and development program (CPDP) for registered nurses (RNs) on nurse and system outcomes was examined. The CPDP was effective as participants were able to create a career vision and individualized career plan.
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Edwards, Deborah; Hawker, Clare; Carrier, Judith; Rees, Colin
2015-07-01
The transition from student to newly qualified nurse can be stressful for many newly qualified nurses who feel inadequately prepared. A variety of support strategies to improve the transition process have been reported across the international literature but the effectiveness of such strategies is unknown. To determine the effectiveness of the main strategies used to support newly qualified nurses during the transition into the clinical workplace and, where identified, evaluate the impact of these on individual and organisational outcomes. Systematic review. A search of electronic databases to identify published studies (CINAHL, MEDLINE, British Nursing Index, Cochrane Library, EMBASE, PsychLit, PsychINFO, PsychARTICLES, Web Of Science, EBM Reviews, BioMed, TRIP, ERIC, SCOPUS (January 2000-April 2011) was conducted. Relevant journals were hand-searched and reference lists from retrieved studies were reviewed to identify any further studies. The search was restricted to English language papers. The key words used were words that described new graduate nurses and support strategies (e.g. internship, residency, orientation programmes). The inclusion criteria were quantitative studies that investigated the effectiveness of support strategies for newly qualified graduate nurses. Studies that involved students in their final year of graduate study were excluded (for example extern programmes). Extraction of data was undertaken independently by two reviewers. A further two reviewers assessed the methodological quality against agreed criteria. A total of 8199 studies were identified from the database search and 30 met the inclusion criteria for the review. The evidence suggests that transition interventions/strategies do lead to improvements in confidence and competence, job satisfaction, critical thinking and reductions in stress and anxiety for the newly qualified nurse. This systematic review demonstrates the beneficial effects of transitional support strategies for
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Johnsen, Hege Mari; Slettebø, Åshild; Fossum, Mariann
2016-05-01
The home healthcare context can be unpredictable and complex, and requires registered nurses with a high level of clinical reasoning skills and professional autonomy. Thus, additional knowledge about registered nurses' clinical reasoning performance during patient home care is required. The aim of this study is to describe the cognitive processes and thinking strategies used by recently graduated registered nurses while caring for patients in home healthcare clinical practice. An exploratory qualitative think-aloud design with protocol analysis was used. Home healthcare visits to patients with stroke, diabetes, and chronic obstructive pulmonary disease in seven healthcare districts in southern Norway. A purposeful sample of eight registered nurses with one year of experience. Each nurse was interviewed using the concurrent think-aloud technique in three different patient home healthcare clinical practice visits. A total of 24 home healthcare visits occurred. Follow-up interviews were conducted with each participant. The think-aloud sessions were transcribed and analysed using three-step protocol analysis. Recently graduated registered nurses focused on both general nursing concepts and concepts specific to the domains required and tasks provided in home healthcare services as well as for different patient groups. Additionally, participants used several assertion types, cognitive processes, and thinking strategies. Our results showed that recently graduated registered nurses used both simple and complex cognitive processes involving both inductive and deductive reasoning. However, their reasoning was more reactive than proactive. The results may contribute to nursing practice in terms of developing effective nursing education programmes. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Generational differences among newly licensed registered nurses.
Keepnews, David M; Brewer, Carol S; Kovner, Christine T; Shin, Juh Hyun
2010-01-01
Responses of 2369 newly licensed registered nurses from 3 generational cohorts-Baby Boomers, Generation X, and Generation Y-were studied to identify differences in their characteristics, work-related experiences, and attitudes. These responses revealed significant differences among generations in: job satisfaction, organizational commitment, work motivation, work-to-family conflict, family-to-work conflict, distributive justice, promotional opportunities, supervisory support, mentor support, procedural justice, and perceptions of local job opportunities. Health organizations and their leaders need to anticipate intergenerational differences among newly licensed nurses and should provide for supportive working environments that recognize those differences. Orientation and residency programs for newly licensed nurses should be tailored to the varying needs of different generations. Future research should focus on evaluating the effectiveness of orientation and residency programs with regard to different generations so that these programs can be tailored to meet the varying needs of newly licensed nurses at the start of their careers. Copyright 2010 Mosby, Inc. All rights reserved.
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The transition from student to new registered nurse in professional practice.
Thomas, Cynthia M; Bertram, Evelyn; Allen, Roberta L
2012-01-01
This qualitative study presents the transition experience of new registered nurses during the first year of professional practice. Four themes emerged: feelings of frustration and being overwhelmed, preceptors, fear, and the orientation process. The orientation process, quality, competent preceptors, and reducing lateral violence are key strategies to successfully retain new nurses. Nurse educators have a crucial role during nurse orientation, training preceptors, and reducing violent behaviors in the workplace.
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Survey of advanced practice registered nurses disciplinary action.
Hudspeth, Randall
2007-04-02
The nursing profession continues to struggle to find the most appropriate approach to credentialing Advanced Practice Registered Nurses (APRNs). One early step in addressing this struggle is determining the incidence of APRN disciplinary actions by boards of nursing. This article presents data from 2003 and 2004 describing the incidence of APRN disciplinary actions by United States boards of nursing. Fifty-one boards of nursing, all members of the National Council of State Boards of Nursing, were asked to report the numbers of APRN discipline cases for 2003 and 2004 which had been resolved, using a tool that differentiated disciplinary cases into four data categories: chemical impairment, exceeding scope of practice, unprofessional conduct, and safety or abuse of patients. Thirty-eight (74.5%) of 51 boards of nursing reported discipline data for a total of 125,882 APRNs showing 688 disciplinary actions were taken during 2003 and 2004. This indicates that APRNs experience a low incidence of discipline related to chemical impairment, exceeding scope of practice, unprofessional conduct, and safety or abuse of patients.
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Effects of learning climate and registered nurse staffing on medication errors.
Chang, Yunkyung; Mark, Barbara
2011-01-01
Despite increasing recognition of the significance of learning from errors, little is known about how learning climate contributes to error reduction. The purpose of this study was to investigate whether learning climate moderates the relationship between error-producing conditions and medication errors. A cross-sectional descriptive study was done using data from 279 nursing units in 146 randomly selected hospitals in the United States. Error-producing conditions included work environment factors (work dynamics and nurse mix), team factors (communication with physicians and nurses' expertise), personal factors (nurses' education and experience), patient factors (age, health status, and previous hospitalization), and medication-related support services. Poisson models with random effects were used with the nursing unit as the unit of analysis. A significant negative relationship was found between learning climate and medication errors. It also moderated the relationship between nurse mix and medication errors: When learning climate was negative, having more registered nurses was associated with fewer medication errors. However, no relationship was found between nurse mix and medication errors at either positive or average levels of learning climate. Learning climate did not moderate the relationship between work dynamics and medication errors. The way nurse mix affects medication errors depends on the level of learning climate. Nursing units with fewer registered nurses and frequent medication errors should examine their learning climate. Future research should be focused on the role of learning climate as related to the relationships between nurse mix and medication errors.
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Effect of Prior Health-Related Employment on the Registered Nurse Workforce Supply.
Yoo, Byung-kwan; Lin, Tzu-chun; Kim, Minchul; Sasaki, Tomoko; Spetz, Joanne
2016-01-01
Registered nurses (RN) who held prior health-related employment in occupations other than licensed practical or vocational nursing (LPN/LVN) are reported to have increased rapidly in the past decades. Researchers examined whether prior health-related employment affects RN workforce supply. A cross-sectional bivariate probit model using the 2008 National Sample Survey of Registered Nurses was esti- mated. Prior health-related employment in relatively lower-wage occupations, such as allied health, clerk, or nursing aide, was positively associated with working s an RN. ~>Prior health-related employ- ment in relatively higher-wage categories, such as a health care manager or LPN/LVN, was positively associated with working full-time as an RN. Policy implications are to promote an expanded career ladder program and a nursing school admission policy that targets non-RN health care workers with an interest in becoming RNs.
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Newton, Jennifer M; Kelly, Cherene M; Kremser, Anne K; Jolly, Brian; Billett, Stephen
2009-04-01
To identify what motivates individuals to engage in a nursing career. Recruitment and retention of nurses is a worldwide concern that is associated with several compounding factors, primarily the high attrition of its new graduates and an ageing workforce. Given these factors, it is necessary to understand why individuals choose to nurse, what keeps them engaged in nursing, and in what ways healthcare systems can support career development and retention. This paper presents initial interview data from a longitudinal multi method study with 29 undergraduate student nurses, 25 registered nurses (RNs), six Nurse Unit Managers (NUMs) and four Directors of Nursing (DoNs) from four hospitals across a healthcare organization in Australia. Thematic analysis yielded four key themes that were common to all participants: (1) a desire to help, (2) caring, (3) sense of achievement and (4) self-validation. These themes represented individuals' motivation to enter nursing and sustain them in their careers as either nurses or managers. Managers need to be cognisant of nurses underlying values and motivators in addressing recruitment and retention issues. Strategies need to be considered at both unit and organizational levels to ensure that the 'desire to care' does not become lost.
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A Multiple Case Study of Associate Degree Nursing Student Experiences on NCLEXRN Preparation
ERIC Educational Resources Information Center
Joseph, Soosannamma
2017-01-01
A major challenge in the nursing education system is to assist nursing students to be successful in the program and on the National Council of Licensing Examination for Registered Nurses (NCLEX-RN). Nursing schools have a critical responsibility for contributing to the nation's need for more qualified nurses in order to reduce the impact of the…
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Report of survey results for newly licensed registered nurses in Washington state.
Hirsch, Anne M
2011-10-01
Current projections for the need for nurses in Washington state are based on an increase in the need for health care, the aging of the population, and the inability of the nursing educational institutions to supply adequate numbers of graduates. Yet many new graduates are providing anecdotal evidence that they cannot find a job in nursing. This study gathered information regarding the employment of newly licensed registered nurses in Washington between May 2009 and August 2010. Questionnaires were administered to a randomly selected sample of 2,200 newly licensed nurses; 532 responses were returned. Nearly 81% reported current employment as a registered nurse and 69.5% reported that they were very or somewhat satisfied with their employment situation. The job search strategies, type of job sought, and factors contributing to their success are reported. Factors contributing to the success of their job search and to job dissatisfaction are explored. Copyright 2011, SLACK Incorporated.
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Registered nurse retention strategies in nursing homes: a two-factor perspective.
Hunt, Selina R; Probst, Janice C; Haddock, Kathlyn S; Moran, Robert; Baker, Samuel L; Anderson, Ruth A; Corazzini, Kirsten
2012-01-01
As the American population ages and the proportion of individuals over the age of 65 expands, the demand for high-quality nursing home care will increase. However, nursing workforce instability threatens care quality and sustainability in this sector. Despite increasing attention to nursing home staff turnover, far less is known about registered nurse (RN) retention. In this study, the relationships between retention strategies, employee benefits, features of the practice environment, and RN retention were explored. Further, the utility of Herzberg's two-factor theory of motivation as a framework for nursing home retention studies was evaluated. This study was a secondary analysis of the nationally representative 2004 National Nursing Home Survey. The final sample of 1,174 participating nursing homes were either certified by Medicare or Medicaid or licensed by state agencies. We used a weighted multinomial logistic regression using an incremental approach to model the relationships. Although most nursing homes offered some combination of retention programs, the majority of strategies did not have a significant association with the level of RN retention reported by facilities. Director of nursing tenure and other extrinsic factors had the strongest association with RN retention in adjusted analyses. To improve RN retention, organizations may benefit greatly from stabilizing nursing home leadership, especially the director of nursing position. Second, managers of facilities with poor retention may consider adding career ladders for advancement, awarding attendance, and improving employee benefits. As a behavioral outcome of motivation and satisfaction, retention was not explained as expected using Herzberg's two-factor theory.
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Defining the role of a forensic hospital registered nurse using the Delphi method.
Newman, Claire; Patterson, Karen; Eason, Michelle; Short, Ben
2016-11-01
A Delphi survey was undertaken to refine the position description of a registered nurse working in a forensic hospital, in New South Wales, Australia. Prior to commencing operation in 2008, position descriptions were developed from a review of legislation, as well as policies and procedures used by existing forensic mental health services in Australia. With an established workforce and an evolving model of care, a review of the initial registered nurse position description was required. An online Delphi survey was undertaken. Eight executive (88.9%) and 12 (58.3%) senior nursing staff participated in the first survey round. A total of four survey rounds were completed. At the final round, there was consensus (70%) that the revised position description was either very or somewhat suitable. There were a total of nine statements, from 31 originally produced in round 1, that did not reach consensus. The Delphi survey enabled a process for refining the Forensic Hospital registered nurse position description. Methods that facilitate executive and senior nursing staff consensus in the development and review of position descriptions should be considered in nursing management. © 2016 John Wiley & Sons Ltd.
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ERIC Educational Resources Information Center
Heiner, Jeremy S.
2013-01-01
Student registered nurse anesthetists are an important part of an operating room team, yet little research has investigated how they perceive teamwork or approach team related issues specific to the operating room. This mixed methods study evaluated junior and senior student registered nurse anesthetists' attitudes toward and perceptions of…
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Factors influencing the retention of registered nurses in the Gauteng Province of South Africa.
Mokoka, Kgaogelo E; Ehlers, Valerie J; Oosthuizen, Martha J
2011-12-14
South Africa is a source country for many destination countries that recruit registered nurses who emigrate for personal and/or professional reasons. A large number of South African nurses belong to the baby boomer generation (born between 1943 and 1964) who will retire within the foreseeable future. Statistics from the South African Nursing Council show a decline of 42.0% in the number of nurses who completed their training in South Africa from 1996 to 2005. These aspects combine to predict a potential dire shortage of nurses in South Africa within the foreseeable future. Retention of registered nurses should be the focus of health-care planners to avoid crises in South Africa's health-care services. This study attempted to identify factors that would influence registered nurses' decisions to stay with their current employers in the Gauteng Province of South Africa. An exploratory descriptive quantitative design was adopted and questionnaires were sent to a sample of nurses, registered with the South African Nursing Council (SANC), with addresses in the Gauteng Province. A total of 108 nurses completed and returned questionnaires, of whom 77 (73.1%) had considered leaving their current employers. The most important factors that would influence more than 90.0% of these nurses' decisions to stay with their current employers related to finances, safety and security, equipment and/or supplies, management, staff and patients. In terms of Maslow's Hierarchy of Needs Theory, deficiency needs (physiological, safety and social needs) should be met by improved salaries revised on an annual basis, paying long-service and outstanding-service bonuses, and improving the safety and security, as well the available equipment and supplies, at institutions. Sufficient numbers of nurses should be employed and vacancies should be filled rapidly. However, not all changes required to enhance nurses' retention rates involve increased costs. Managers should lead by example and respect
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Sorgaard, Knut W; Ryan, Peter; Dawson, Ian
2010-06-14
Unqualified/non-registered caregivers (N-R Cs) will continue to play important roles in the mental health services. This study compares levels of burnout and sources of stress among qualified and N-R Cs working in acute mental health care. A total of 196 nursing staff --124 qualified staff (mainly nurses) and 72 N-R Cs with a variety of different educational backgrounds--working in acute wards or community mental teams from 5 European countries filled out the Maslach Burnout Inventory (MBI), the Mental Health Professional Scale (MHPSS) and the Psychosocial Work Environment and Stress Questionnaire (PWSQ). (a) The univariate differences were generally small and restricted to a few variables. Only Social relations (N-R Cs being less satisfied) at Work demands (nurses reporting higher demands) were different at the .05 level. (b) The absolute scores both groups was highest on variables that measured feelings of not being able to influence a work situation characterised by great demands and insufficient resources. Routines and educational programs for dealing with stress should be available on a routine basis. (c) Multivariate analyses identified three extreme groups: (i) a small group dominated by unqualified staff with high depersonalization, (ii) a large group that was low on depersonalisation and high on work demands with a majority of qualified staff, and (iii) a small N-R C-dominated group (low depersonalization, low work demands) with high scores on professional self-doubt. In contrast to (ii) the small and N-R C-dominated groups in (i) and (iii) reflected mainly centre-dependent problems. The differences in burnout and sources of stress between the two groups were generally small. With the exception of high work demands the main differences between the two groups appeared to be centre-dependent. High work demands characterized primarily qualified staff. The main implication of the study is that no special measures addressed towards N-R Cs in general with regard
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2010-01-01
Background Unqualified/non-registered caregivers (N-R Cs) will continue to play important roles in the mental health services. This study compares levels of burnout and sources of stress among qualified and N-R Cs working in acute mental health care. Methods A total of 196 nursing staff - 124 qualified staff (mainly nurses) and 72 N-R Cs with a variety of different educational backgrounds - working in acute wards or community mental teams from 5 European countries filled out the Maslach Burnout Inventory (MBI), the Mental Health Professional Scale (MHPSS) and the Psychosocial Work Environment and Stress Questionnaire (PWSQ). Results (a) The univariate differences were generally small and restricted to a few variables. Only Social relations (N-R Cs being less satisfied) at Work demands (nurses reporting higher demands) were different at the .05 level. (b) The absolute scores both groups was highest on variables that measured feelings of not being able to influence a work situation characterised by great demands and insufficient resources. Routines and educational programs for dealing with stress should be available on a routine basis. (c) Multivariate analyses identified three extreme groups: (i) a small group dominated by unqualified staff with high depersonalization, (ii) a large group that was low on depersonalisation and high on work demands with a majority of qualified staff, and (iii) a small N-R C-dominated group (low depersonalization, low work demands) with high scores on professional self-doubt. In contrast to (ii) the small and N-R C-dominated groups in (i) and (iii) reflected mainly centre-dependent problems. Conclusion The differences in burnout and sources of stress between the two groups were generally small. With the exception of high work demands the main differences between the two groups appeared to be centre-dependent. High work demands characterized primarily qualified staff. The main implication of the study is that no special measures
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Motivational Factors in Registered Nurses Completing a Baccalaureate Completion Program
ERIC Educational Resources Information Center
Alonzo, Amanda L.
2009-01-01
The purpose of this qualitative descriptive study was to investigate what motivates associate degree (AND) and diploma prepared registered nurses (RN) to pursue a baccalaureate degree (BSN) through an RN-to-BSN program. Studies have shown that the educational level of nurses has direct impact on the safety and quality of care provided to patients.…
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[The registered nurse and the battle against tuberculosis in Brazil: 1961-1966].
Montenegro, Hercília Regina do Amaral; de Almeida Filho, Antonio José; Santos, Tânia Cristina Franco; Lourenço, Lucia Helena Silva Corrêa
2009-12-01
The objective of this study was to describe the circumstances that promoted the implementation of the new Program for Action Against Tuberculosis in Brazil (Programa de Ação na Luta contra a Tuberculose no Brasil) and discuss the strategies used by registered nurses from the Santa Maria State Hospital, Guanabara State, to adjust nursing care to the new program against tuberculosis. This was performed through document research, interviews, and statements from nurses working at the time of the reorganization. Documents were analyzed based on the concepts of habitus, field, and symbolic power by Pierre Bourdieu, and included written and oral documents as well as secondary sources. The reorganization of the nursing service was performed under the leadership of a nurse whose symbolic capital assigned power and prestige to implement the necessary changes. It is concluded that the work of that nurse made it possible to implement the new program and contributed to establishing the position and importance of the registered nurse in providing care to individuals with tuberculosis, for prevention and cure.
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Spirit at work and hope among the ruins: registered nurses' covenant of care.
Wagner, Joan I J; Gregory, David M
2015-09-01
To explore registered nurses' (RNs) perspectives about the health care system, management/leadership, patients and spirit at work (SAW). Researchers investigating RNs experiences of reduced job satisfaction and diminishing organisational commitment are looking carefully at spirit at work as a means to foster healthier workplaces. A descriptive, cross-sectional mixed methods design was used to measure and explore the relationships between spirit at work, job satisfaction and organisational commitment. A 2012 postal survey sent by the provincial licensing body to a random sample of 217 surgical and 158 home care registered nurses' in western Canada returned 179 surveys. Seventy-five respondents answered the open-ended survey question. Their responses warrant further content analysis and serve as the foundation of this article. Participants noted that organisational structures and policies, combined with unsupportive leadership, were associated with a reduced sense of community, lack of trust and diminished accountability. Spirit at work was described as sustaining registered nurses' and providing them with hope as they fulfilled their covenant of care with patients. Leadership attention to the advancement of SAW may support the covenant of care between the registered nurses and patient while fostering healthier workplaces. © 2014 John Wiley & Sons Ltd.
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Jenkins, Constance L; Elliott, Aaron R; Harris, Janet R
2006-08-01
The purposes of this study were to identify the ethical issues Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists (CRNAs) encountered in their anesthesia practice and how disturbed they were by these issues. This descriptive study used a secondary data analysis of a cross-sectional survey of Army Nurse Corps officers and Department of the Army civilian registered nurses (N = 5,293). The CRNA subset (n = 97) was obtained from questionnaires that indicated a primary practice setting as anesthesia. The most frequently occurring ethical issue identified was conflict in the nurse-physician relationship, whereas the most disturbing issue was working with incompetent/impaired colleagues. Unresolved ethical conflicts can negatively influence the nurses' morale, leading to avoidance of the issue and contributing to burnout. Identifying the ethical issues and disturbance level experienced by CRNAs should contribute to the development of an ethics education program that addresses issues encountered in CRNA practice.
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Confidence in delegation and leadership of registered nurses in long-term-care hospitals.
Yoon, Jungmin; Kim, Miyoung; Shin, Juhhyun
2016-07-01
Effective delegation improves job satisfaction, responsibility, productivity and development. The ageing population demands more nurses in long-term-care hospitals. Delegation and leadership promote cooperation among nursing staff. However, little research describes nursing delegation and leadership style. We investigated the relationship between registered nurses' delegation confidence and leadership in Korean long-term-care hospitals. Our descriptive correlational design sampled 199 registered nurses from 13 long-term-care hospitals in Korea. Instruments were the Confidence and Intent to Delegate Scale and Multifactor Leadership Questionnaire. Confidence in delegation significantly aligned with current-unit clinical experience, length of total clinical-nursing experience, delegation-training experience and leadership. Transformational leadership was the most statistically significant factor influencing delegation confidence. When effective delegation integrates with efficient leadership, staff can deliver optimal care to long-term-care patients. © 2016 John Wiley & Sons Ltd.
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Lartey, Sarah; Cummings, Greta; Profetto-McGrath, Joanne
2014-11-01
The aim of this review was to report the effectiveness of strategies for retaining experienced Registered Nurses. Nursing researchers have noted that the projected nursing shortage, if not rectified, is expected to affect healthcare cost, job satisfaction and quality patient care. Retaining experienced nurses would help to mitigate the shortage, facilitate the transfer of knowledge and provision of quality care to patients. A systematic review of studies on interventions that promote the retention of experienced Registered Nurses in health care settings. Twelve studies were included in the final analysis. Most studies reported improved retention as a result of the intervention. Team work and individually targeted strategies including mentoring, leadership interest and in-depth orientation increased job satisfaction and produced higher retention results. Few published studies have examined interventions that promote the retention of experienced Registered Nurses in healthcare. Retention was highest when multiple interventions were used. Further research is needed to inform nurse leaders of ways to retain nurses and to maintain quality care in health care settings. Programmes targeting the retention of experienced nurses need to be considered when implementing measures to decrease the nursing shortage and its effects on quality care. © 2013 John Wiley & Sons Ltd.
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Transitioning from military medics to registered nurses.
Keita, Mohamed D; Diaz, Valerie J; Miller, Audrey P; Olenick, Maria; Simon, Sharon R
2015-01-01
The nursing shortage in the USA is expected to reach 260,000 registered nurses (RNs) by 2025. The most profound shortages are expected in California and Florida, translating into 109,779 and 128,364 RN jobs, respectively. Despite a foreseen growth in nursing career opportunities nationwide, the supply of nurses will be insufficient to meet the corresponding demand. Capitalizing on prior education, experience, and skills of military clinical personnel to fill these jobs could significantly reduce the projected nursing shortage. Florida International University's Nicole Wertheim College of Nursing and Health Sciences is circumventing barriers to recruit, retain, and graduate transitioning veteran medics and corpsmen as Bachelor of Science in Nursing prepared RNs who reintegrate into the civilian workforce. The Veteran Bachelor of Science in Nursing (VBSN) program is in the form of a cooperative agreement between Florida International University and the US Health Resources and Services Administration. The VBSN program's main objective is to build upon the unique leadership skills, clinical education, and training of military medics and corpsmen to ensure successful completion of the Bachelor of Science in Nursing curriculum. VBSN students, as veterans themselves, have unique knowledge and exposure to the specific health issues and needs of the veteran population overall. They are poised and best prepared to effectively care for the US population, particularly the current 22 million US veterans and 1.6 million Florida veterans. Additionally, the VBSN program will alleviate the challenges, such as the lack of recognition of military skills, unemployment, the substandard income, and homelessness that many former service members face after separation from the military.
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Perceptions of registered nurses in four state health insititutions on continuing formal education.
Richards, L; Potgieter, E
2010-06-01
This study investigated registered nurses in four selected state health institutions' perceptions with regard to continuing formal education. The relevance of continuing formal education is being emphasised globally by the increasing quest for quality assurance and quality management systems within an ethos of continuous improvement. According to Tlholoe (2006:5), it is important to be committed to continual learning, as people's knowledge become less relevant because skills gained early in a career are insufficient to avoid costly mistakes made through ignorance. Continuing formal education in nursing is a key element to the maintenance of quality in health care delivery. The study described: registered nurses' views on continuing formal education. Registered nurses' perceived barriers to continuing formal education. A quantitative descriptive survey design was chosen using a questionnaire for data collection. The sample consisted of 40 registered nurses working at four state health institutions in the Western Cape Province, South Africa. Convenience sampling was selected to include registered nurses who were on duty on the days during which the researcher visited the health institutions to distribute the questionnaires. The questionnaire contained mainly closed-ended and a few open-ended questions. Content validity of the instrument was ensured by doing a thorough literature review before construction of items and a pretest. Reliability was established by the pretest and providing the same information to all respondents before completion of the questionnaires. The ethical considerations of informed consent, anonymity and confidentiality were adhered to and consent to conduct the study was obtained from relevant authorities. Descriptive statistics, based on calculations using the Microsoft (MS) Excel (for Windows 2000) programme, were used to summarise and describe the research results. The research results indicated that most registered nurses perceive continuing
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Registered nurses' decision-making regarding documentation in patients' progress notes.
Tower, Marion; Chaboyer, Wendy; Green, Quentine; Dyer, Kirsten; Wallis, Marianne
2012-10-01
To examine registered nurses' decision-making when documenting care in patients' progress notes. What constitutes effective nursing documentation is supported by available guidelines. However, ineffective documentation continues to be cited as a major cause of adverse events for patients. Decision-making in clinical practice is a complex process. To make an effective decision, the decision-maker must be situationally aware. The concept of situation awareness and its implications for making safe decisions has been examined extensively in air safety and more recently is being applied to health. The study was situated in a naturalistic paradigm. Purposive sampling was used to recruit 17 registered nurses who used think-aloud research methods when making decisions about documenting information in patients' progress notes. Follow-up interviews were conducted to validate interpretations. Data were analysed systematically for evidence of cues that demonstrated situation awareness as nurses made decisions about documentation. Three distinct decision-making scenarios were illuminated from the analysis: the newly admitted patient, the patient whose condition was as expected and the discharging patient. Nurses used mental models for decision-making in documenting in progress notes, and the cues nurses used to direct their assessment of patients' needs demonstrated situation awareness at different levels. Nurses demonstrate situation awareness at different levels in their decision-making processes. While situation awareness is important, it is also important to use an appropriate decision-making framework. Cognitive continuum theory is suggested as a decision-making model that could support situation awareness when nurses made decisions about documenting patient care. Because nurses are key decision-makers, it is imperative that effective decisions are made that translate into safe clinical care. Including situation awareness training, combined with employing cognitive
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Registered nurses' experiences of rewarding in a Finnish University Hospital - an interview study.
Seitovirta, Jaana; Partanen, Pirjo; Vehviläinen-Julkunen, Katri; Kvist, Tarja
2015-10-01
The purpose was to describe Finnish registered nurses' experiences of rewarding. The aim was to gather detailed information on the rewarding of nurses to help nurse managers and leaders to update existing reward strategy and to develop an effective reward system. Rewarding has been found positively to influence nurses' occupational well-being and commitment to their work, and the attractiveness of the health care field. A series of focused interviews with 10 registered nurses was conducted in 2011. Qualitative content analysis method was used. The nurses reported positive experiences with rewarding in the form of monetary compensation and other benefits, the positive aspects of nursing work and opportunities for professional development. The experiences of unsatisfactory rewarding generally stemmed from negative emotional experiences, lacking rewards and inequality in rewarding. It is essential to listen to nurses and to provide appropriate acknowledgement and appreciation of their work in order to develop an effective reward system. It is important to listen to nurses' experiences of rewarding because it enables nurse managers to maintain and increase the attractiveness of nursing and health care work in general. © 2014 John Wiley & Sons Ltd.
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Jamieson, Isabel; Kirk, Ray; Wright, Sarah; Andrew, Cathy
2015-07-01
The aim of this article was to report on the analysis of qualitative, open text data, received from a national on-line survey of what factors Generation Y New Zealand Registered Nurses wish to change about nursing and consideration of the potential policy and practice impacts of these requests on their retention. Prior to the economic recession of 2007-2010, the growing shortage of nurses in New Zealand presented a serious concern for the healthcare workforce. Given the ageing New Zealand nursing workforce, an ageing population and the increasing demands for health care, it is imperative that issues of retention of Generation Y nurses are resolved prior to the imminent retirement of more experienced nurses. A descriptive exploratory approach using a national wide, on-line survey, eliciting both quantitative and qualitative data was used. The survey, conducted from August 2009-January 2010, collected data from Generation Y New Zealand Registered Nurses ( n = 358) about their views about nursing, work and career. Herzberg's Motivation-Hygiene theory was used as the framework for the analysis of the open text data. The factors that nurses wanted changed were skewed towards Herzberg's hygiene-maintenance factors rather than motivating factors. This is of concern because hygiene-maintenance factors are considered to be dissatisfiers that are likely to push workers to another employment option.
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Linden, Mark; Kavanagh, Rory
2012-06-01
This paper is the report of a study which sought to compare the attitudes held by student and qualified mental health nurses towards individuals with schizophrenia in the Republic of Ireland. Media portrayals of individuals with schizophrenia often include images of aggression and violence. With global initiatives aimed at reducing the stigma and exclusion associated with mental illness, the attitudes of those who care for people with schizophrenia are of particular interest. A survey was administered to 66 student mental health nurses, and 121 qualified mental health nurses. Participants completed the community attitudes to mental illness scale and the social interaction scale in 2009. Multivariate analysis of variance was used to test for the effects of qualification, work setting, years of experience and education on the measures. Nurses employed in a community setting held more positive attitudes, when compared with colleagues who worked in an inpatient setting, as measured by the community mental health ideology subscale, indicating their desire to promote community care for individuals with schizophrenia. Nurses working in an inpatient setting held more socially restrictive attitudes indicating that they felt individuals with schizophrenia were dangerous and should be avoided. These findings were statistically significant at the P < 0·05 level. Mental health nurses must be alerted to the fact that holding negative attitudes may adversely affect the therapeutic relationship and ultimately lead to stigmatization and its negative consequences. © 2011 The Authors Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.
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Changing Times: A Survey of Registered Nurses in 1998. IES Report 351.
ERIC Educational Resources Information Center
Smith, G.; Seccombe, I.
A national survey of registered nurses and analysis of official statistics provided an overview of the dimensions and dynamics of the labor market for nurses in the United Kingdom. Findings indicated the following: enrollment in preregistration nurse training courses decreased by 27 percent over the 1990s; initial entries to the UK Central Council…
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Gransjön Craftman, Åsa; Grape, Charlotte; Ringnell, Katarina; Westerbotn, Margareta
2016-11-01
The aim was to describe registered nurses' experience in the context of delegating the administration of medication to unlicensed personnel in residential care homes. The residents in residential care homes have a need for extensive care and nursing, and large amounts of medicines are common practice. Registered nurses' workload and difficulties in fulfilling their duties, such as administration of medicines, have led to frequent delegation of this task between the registered nurses and unlicensed assisting personnel. It is, of course, a great responsibility to ensure that the care of the older people remains safe while maintaining quality in the prevailing situation. A qualitative inductive descriptive study. Data were collected using audio-recorded semistructured interviews with a purposive sample of 18 registered nurses and interpreted using manifest content analysis. The study was approved by the ethical research committee. Registered nurses found the organisation unsupportive with regard to nursing interventions. The delegation context was experienced as a grey zone; the rules and regulations were not in line with the unspoken expectation to delegate the administration of medicine to unlicensed personnel, in order to be able to manage their daily work. The slimmed organisation of residential care homes relies upon registered nurses' use of delegation of medicine administration to unlicensed assistant personnel. It becomes an inevitable assignment entailing a challenging responsibility for patient safety and the quality of care. The results of this study may contribute to a better understanding of the complexity of caring for older people in residential care homes and to improving the work environment of all healthcare personnel. © 2016 John Wiley & Sons Ltd.
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Ross-Walker, Cheryl; Rogers-Clark, Cath; Pearce, Susanne
Nursing workload is an issue that effects both the recruitment and retention of nurses, and patient safety. Historically, measurement has focussed on the delivery of direct patient care and excluded workload of facilitating hands-on care and supporting the organisation via duties that reflect organisation cultural and climate needs. Qualitative research is appropriate to understand this complexity. To determine the best available evidence in relation to registered nurses experiences of workplace cultural and climatic factors that influence nursing workloads, in an acute health care setting. This review sought high quality studies which explored registered nurses' experiences of the influence of cultural and climatic factors on their workloads. Qualitative research studies and opinion-based text were considered. An extensive search of the literature was conducted to identify published and unpublished studies between January 1990 and June 2011 in English, and indexed in the following databases: CINAHL, Medline, Medline-In Process, PsychINFO, Emerald, Current Contents, TRIP, JSTOR Nursing Consult Psychology & Behavioural Sciences collections, Emerald Management Reviews, Emerald Full Text Journals, Embase, Dissertation Abstracts, ERIC, Proquest and MedNar, EBSCOhost, Science Direct, Wiley Interscience. Two independent reviewers (CRW and CRC), using appraisal tools from the Joanna Briggs Institute (JBI), assessed fifteen articles; one was excluded. Data were extracted from included papers using standardised tools developed by the JBI. Data from qualitative studies and textual/opinion papers were meta-synthesised separately using standardised instruments. Data synthesis involved the pooling of findings, then grouped into categories on the basis of similarity of meaning. The categories were further aggregated into synthesised findings. 14 papers were identified as high quality and meeting the inclusion criteria. 81 findings were identified from the 10 qualitative research
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Perception of legal liability by registered nurses in Korea.
Kim, Ki-Kyong; Kim, In-Sook; Lee, Won-Hee
2007-08-01
Liability to the nursing profession is imperative if nurses are to act as an autonomous body. Assessing and communicating effectively is a vital part of nursing for patient safety. This study was designed to identify the attitudes of Korean nurses toward liability in assessment and communication and to investigate the relationship among the variables (i.e., legal awareness, attitudes toward doctor's duty to supervise nurses). The attitudes toward doctor's duty reflect the status of nurses' dependency on doctor's supervision. The study participants were 288 registered nurses in RN-BSN courses at two colleges in Korea. The level of legal awareness was measured using a 25-item Legal Awareness Questionnaire developed by the authors. The measuring instrument for attitudes toward doctor's duty to supervise nurses and nurses' liability was the Attitude toward Duty and Liability Questionnaire, which was modified by the authors. There were significant correlation between attitude toward doctor's duty and nurses' liability, but not between legal awareness and liability attitude. The results of this study suggest that the present educational content aimed at improving liability attitudes of nurses should be refocused with attitude-oriented education and should include an understanding of the increased accountability that comes with greater autonomy in nursing practice.
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Registered nurses' attitudes toward the protection of gays and lesbians in the workplace.
Blackwell, Christopher W
2008-10-01
This study explores the attitudes of registered nurses toward a nondiscrimination policy in the workplace protective of gays and lesbians and the overall homophobia of nurses. A potential sample of 520 registered nurses licensed in Florida was randomly selected from the state Board of Nursing licensee database. In all, 165 surveys were used in the analysis of the data. Structural equation modeling indicated that support of a nondiscrimination policy protective of gay men and lesbians in the workplace was negatively correlated with homophobia with a critical ratio value of -4.01. Nonsupport of a nondiscrimination policy was positively correlated with homophobia with a critical ratio value of 3.23. This finding suggests that the inclusion of workplace policies protective of gay men and lesbians might help decrease homophobic and discriminatory treatment that gay and lesbian nurses often encounter in the workplace.
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Increasing Registered Nurse Retention Using Mentors in Critical Care Services.
Schroyer, Coreena C; Zellers, Rebecca; Abraham, Sam
2016-01-01
Recruiting and training 1 newly hired registered nurse can cost thousands of dollars. With a high percentage of these newly hired nurses leaving their first place of employment within their first year, the financial implications may be enormous. It is imperative that health care facilities invest in recruiting and retention programs that retain high-quality nurses. Mentorship programs in retaining and easing the transition to practice for new graduate nurses, re-entry nurses, and nurses new to a specialty area are critical in nurse retention. Discussion in this study includes the effect of implementing a mentor program into the critical care services area of a 325-bed not-for-profit community hospital in northern Indiana. Based on this study, nurses with a mentor were retained at a 25% higher rate than those not mentored. Implementation of a mentor program reduced the training cost to the facility and increased retention and morale.
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Kudo, Yasushi; Kono, Keiko; Kume, Ryuko; Matsuhashi, Ayako; Tsutsumi, Akizumi
Registered nurses and licensed practical nurses have received professional education, but to enhance their work motivation it is necessary to create work environments in which they can concentrate on their jobs as specialists. One of the methods to develop such work environments is to use nursing assistants effectively. We investigated professional nurses' feelings toward nursing assistants and then examined the associations between those feelings and their work motivation. The analyzed subjects were 2,170 female nurses working in 25 hospitals with from 55 to 458 beds. The average age of the respondents was 38.0 (standard deviation, 10.6 years). Factor analyses extracted four factors of professional nurses' feelings toward nursing assistants: 1. knowledge related to healthcare, 2. nursing assistants' attitudes toward work, 3. human relations, and 4. distinguishing between professional nurses' work and nursing assistants' work. Using multiple linear regression analysis, our results revealed that scores of maintaining a high motivation to work thanks to nursing assistants became lower as the ages of the respondents increased. Scores of maintaining a high motivation to work thanks to nursing assistants became higher as professional nurses gained satisfaction from: knowledge related to healthcare, nursing assistants' attitudes toward work, and human relations. Hospital managers should consider these findings to improve working environments in which professional nurses can feel motivated to work.
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The subject of pedagogy from theory to practice--the view of newly registered nurses.
Ivarsson, Bodil; Nilsson, Gunilla
2009-07-01
The aim was to describe, from the newly registered nurses' perspective, specific events when using their pedagogical knowledge in their everyday clinical practice. The design was qualitative and the critical incident technique was used. Data was collected via interviews with ten newly registered nurses who graduated from the same University program 10 months earlier and are now employed at a university hospital. Two categories emerged in the analyses. The first category was "Pedagogical methods in theory" with the sub-categories Theory and the application of the course in practice, Knowledge of pedagogy and Information as a professional competence. The second category was "Pedagogical methods in everyday clinical practice" with sub-categories Factual knowledge versus pedagogical knowledge, Information and relatives, Difficulties when giving information, Understanding information received, Pedagogical tools, Collaboration in teams in pedagogical situations, and Time and giving information. By identifying specific events regarding pedagogical methods the findings can be useful for everyone from teachers and health-care managers to nurse students and newly registered nurses, to improve teaching methods in nurse education.
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Barrientos, Christian; Holmberg, Mats
2018-05-01
The aim of this study was to describe the care of patients assessed as not in need of emergency ambulance care, from Registered Nurse's lived experiences. Non-emergency patients in need of ambulance care are described as vulnerable and patients in ambulance care have earlier been found to be dependent on the Registered Nurse. However, little is known about the care of non-emergency patients in the ambulance setting, from the perspective of Registered Nurses. A reflective lifeworld research design was chosen. Five Registered Nurses with experience of ambulance care were individually interviewed. The result reveals the essence of the phenomenon as a desire to provide good care in an on-going struggle between one's own and others' expectations. Three meaning constituents emerged in the description; Being in a struggle between different expectations, Being in a questioned professional role, and Being in lack of support and formal directives. Registered Nurses' care for patients assessed as not in need of emergency ambulance care, is a complex struggle between different expectations. This may be related to the encounter between the nurse's and the patient's lifeworld. Copyright © 2018 Elsevier Ltd. All rights reserved.
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El Hussein, Mohamed; Hirst, Sandra
2016-02-01
To construct a grounded theory that explains the clinical reasoning processes that registered nurses use to recognise delirium while caring for older adults in acute care settings. Delirium is often under-recognised in acute care settings; this may stem from underdeveloped clinical reasoning processes. Little is known about registered nurses' clinical reasoning processes in complex situations such as delirium recognition. Seventeen registered nurses working in acute care settings were interviewed. Concurrent data collection and analysis, constant comparative analysis and theoretical sampling were conducted in 2013-2014. A grounded theory approach was used to analyse interview data about the clinical reasoning processes of registered nurse in acute hospital settings. The core category that emerged from data was 'Tracking the footsteps'. This refers to the common clinical reasoning processes that registered nurses in this study used to recognise delirium in older adults in acute care settings. It depicted the process of continuously trying to catch the state of delirium in older adults. Understanding the clinical reasoning processes that contribute to delirium under-recognition provides a strategy by which this problem can be brought to the forefront of awareness and intervention by registered nurses. Registered nurses could draw from the various processes identified in this research to develop their clinical reasoning practice to enhance their effective assessment strategies. Delirium recognition by registered nurses will contribute to quality care to older adults. © 2016 John Wiley & Sons Ltd.
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ERIC Educational Resources Information Center
Gilpatrick, Eleanor
To secure information about the characteristics of the practical nurse population and their opinions about registered nurse preparation, questionnaires were distributed to 2,923 practical nurses employed by the New York City Municipal Hospitals. Usable questionnaires numbered 2,361 or 81 percent of the employed PN population. Approximately 9…
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Registered nurses' constructed meaning of concepts of solution and their use in clinical practice
NASA Astrophysics Data System (ADS)
Wilkes, Lesley M.; Batts, Judith E.
1991-12-01
Since the introduction of nursing into tertiary institutions in Australia in 1975, there has been increasing interest in the teaching of physical science to nurses. Various courses in physical science for nurse students have been developed. They vary in length and content but there is agreement that concepts taught should be closely related to nursing applications. The choice of relevant concepts tends to be made by individual curriculum developers. This paper reports an examination of the use of physical science concepts and their relevance from the perspective of registered nurses practising in general ward areas. Inherent in this study is the premise that for registered nurses to have ideas of the physical science underlying their practice they must have constructed meaning first for these concepts. Specific chemical concepts related to solutions are discussed in these terms.
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Priorities for the professional development of registered nurses in nursing homes: a Delphi study.
Cooper, Emily; Spilsbury, Karen; McCaughan, Dorothy; Thompson, Carl; Butterworth, Tony; Hanratty, Barbara
2017-01-08
To establish a consensus on the care and professional development needs of registered nurses (RNs) employed by UK care homes. Two-stage, online modified Delphi study. A panel (n = 352) of individuals with experience, expertise or interest in care home nursing: (i) care home nurses and managers; (ii) community healthcare professionals (including general practitioners, geriatricians, specialist and district nurses); and (iii) nurse educators in higher education. RNs employed by nursing homes require particular skills, knowledge, competence and experience to provide high-quality care for older residents. The most important responsibilities for the nursing home nurse were: promoting dignity, personhood and wellbeing, ensuring resident safety and enhancing quality of life. Continuing professional development priorities included personal care, dementia care and managing long-term conditions. The main barrier to professional development was staff shortages. Nursing degree programmes were perceived as inadequately preparing nurses for a nursing home role. Nursing homes could improve by providing supportive learning opportunities for students and fostering challenging and rewarding careers for newly RNs. If nurses employed by nursing homes are not fit for purpose, the consequences for the wider health and social-care system are significant. Nursing homes, the NHS, educational and local authorities need to work together to provide challenging and rewarding career paths for RNs and evaluate them. Without well-trained, motivated staff, a high-quality care sector will remain merely an aspiration.
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Imai, K
2001-03-01
The present study examines job-related factors leading to low self-esteem in nurses. The lowering of self-esteem suggests that such nurses had difficulty in fully accepting themselves and their circumstances. Subjects were registered nurses (RN) and licensed practical nurses (LPN) at hospitals, and unemployed registered nurses (UEN) seeking employment. Questionnaires were provided at 53 hospitals and a Nurse Bank in Kanagawa Prefecture. The responses of 552 RN, 146 LPN and 433 UEN were analyzed. Questions were asked about personal life, past or present nursing experience, working conditions, nursing skills, satisfaction with work performance and self-esteem. Factors giving rise to low self-esteem were determined using logistic regression analysis and logistic discriminant analysis. Employment status and qualifications were determined to be the most important factors determining the self-esteem of nurses. The next most important factors were 'a limited number of years of experience (less than five years)' and 'dissatisfaction with discretion and responsibility as a nurse' (P < 0.01). Adjusted odds ratio for a reduction in self-esteem for LPN was 4.07 times higher than for UEN, and 2.2 times higher than for RN by logistic regression analysis. LPN are treated as unskilled workers, and thus significant differences were apparent in their performance of certain job tasks. These differences were analyzed using discriminant analysis, and were referred to as follows, 1: Advanced assessment skills, 2: Advanced technical skills, 3: Advanced communication skills, and 4: Nursing plan and documentation (positive discrimination rate was 70.8%). Job dissatisfaction is closely associated with the level of professional training. Continuous education and a feedback system for various levels of nurses are needed.
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Sjögren Forss, Katarina; Nilsson, Jane; Borglin, Gunilla
2018-01-01
The evaluation and treatment of older people's nutritional care is generally viewed as a low priority by nurses. However, given that eating and drinking are fundamental human activities, the support and enhancement of an optimal nutritional status should be regarded as a vital part of nursing. Registered nurses must therefore be viewed as having an important role in assessing and evaluating the nutritional needs of older people as well as the ability to intervene in cases of malnutrition. This study aimed to illuminate the experience of participating in nutritional care from the perspectives of older people and registered nurses. A further aim is to illuminate the latter's experience of nutritional care per se. A qualitative, descriptive design was adopted. Data were collected through semi-structured interviews ( n = 12) with eight registered nurses and four older persons (mean age 85.7 years) in a city in the southern part of Sweden. The subsequent analysis was conducted by content analysis. The analysis reflected three themes: 'participation in nutritional care equals information', 'nutritional care out of remit and competence' and 'nutritional care more than just choosing a flavour'. They were interpreted to illuminate the experience of participation in nutritional care from the perspective of older people and RNs, and the latter's experience of nutritional care in particular per se. Our findings indicate that a paternalistic attitude in care as well as asymmetry in the nurse-patient relationship are still common characteristics of modern clinical nursing practice for older people. Considering that participation should be central to nursing care, and despite the RN's awareness of the importance of involving the older persons in their nutritional care this was not reflected in reality. Strategies to involve older persons in their nutritional care in a nursing home context need to take into account that for this population participation might not always be
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Polster, Debra; Villines, Dana
The aims of this study were to describe registered nurses' levels of personal innovativeness and registered nurses' perceived organizational innovativeness and determine the relationship between these 2 variables. There is limited research to describe the levels of innovation of nurses within a hospital. The levels of innovation can determine the likelihood of adoption of evidence-based practices at the bedside. As change agents, clinical nurse specialists can determine successful implementation strategies tailored to nurse levels of innovation. This was a descriptive study at a midwest, urban, teaching, 408-bed Magnet hospital. Surveys were completed by 217 nurses. The participants reported high personal innovativeness ((Equation is included in full-text article.)= 32.1; SD, 6.4), and the institution was perceived as innovative, with 90.3% of scores categorized as positive innovativeness. The statistically significant correlation was in the medical-surgical unit (r = -0.52, P < .01). There is no correlation between personal innovativeness and organizational innovativeness except for medical-surgical nurses (P = .03). They are likely to perceive the organization more innovative than themselves. Determining adopter characteristics can be valuable to the clinical nurse specialist by adapting strategic interventions to advance nursing practice. Exploring levels of adoption can be an innovative strategy to transform nursing at the bedside and throughout the organization.
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Retaining early career registered nurses: a case study.
Mills, Jane; Chamberlain-Salaun, Jennifer; Harrison, Helena; Yates, Karen; O'Shea, Andrea
2016-01-01
A core objective of the Australian health system is to provide high quality, safe health care that meets the needs of all Australians. To achieve this, an adequate and effective workforce must support the delivery of care. With rapidly changing health care systems and consumer demographics, demand for care is increasing and retention of sufficient numbers of skilled staff is now a critical priority to meet current and future health care demands. Nurses are the largest cohort of professionals within the health workforce. Reducing the rates at which nurses leave the profession and supporting nurses to practice in their profession longer will have beneficial implications for the sustainability of a nursing workforce and, ultimately, to patient outcomes. The aim of the study was to describe and explain early career registered nurses' (ECRNs) experiences and support requirements during the first five years of practice for the purposes of identifying strategies that would support greater retention of ECRNs. A single case study design focused on early career registered nurses (ECRNs) working in a hospital and health service in northern Australia. The research team adopted Djukic et al's definition of ECRNs as "RNs who have practiced for less than 5 years". Data was collected via three individual interviews and two focus groups. Thirty-five ECRNs participated in the study. Qualitative analysis of data generated during interviews and focus groups, identified the key themes of receiving career advice and choice or no choice . Analysis of study data in the context of the broader literature resulted in the researchers identifying six areas of focus for ECRN retention: 1) well-planned, supported and structured transition periods; 2) consideration of rotation through different areas with a six month minimum for skills development; 3) empowering decision making; 4) placement opportunities and choice in decisions of where to work; 5) career advice and support that considers ECRNs
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Sagherian, Knar; Steege, Linsey M; Geiger-Brown, Jeanne; Harrington, Donna
2018-04-01
The optimal performance of nurses in healthcare settings plays a critical role in care quality and patient safety. Despite this importance, few measures are provided in the literature that evaluate nursing performance as an independent construct from competencies. The nine-item Nursing Performance Instrument (NPI) was developed to fill this gap. The aim of this study was to examine and confirm the underlying factor structure of the NPI in registered nurses. The design was cross-sectional, using secondary data collected between February 2008 and April 2009 for the "Fatigue in Nursing Survey" (N = 797). The sample was predominantly dayshift female nurses working in acute care settings. Using Mplus software, exploratory and confirmatory factor analyses were applied to the NPI data, which were divided into two equal subsamples. Multiple fit indices were used to evaluate the fit of the alternative models. The three-factor model was determined to fit the data adequately. The factors that were labeled as "physical/mental decrements," "consistent practice," and "behavioral change" were moderately to strongly intercorrelated, indicating good convergent validity. The reliability coefficients for the subscales were acceptable. The NPI consists of three latent constructs. This instrument has the potentialto be used as a self-monitoring instrument that addressesnurses' perceptions of performance while providing patient care.
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Rosvall, Annica; Carlson, Elisabeth
2017-12-01
To describe how registered nurses having undergone a web-based learning activity perceive their self-efficacy and competence to support patients with smoking cessation in connection with surgery. Smoking cessation in connection with surgery reduces postoperative complications, and the support patients get from registered nurses may be important in helping them become smoke-free in connection with their surgery. Therefore, registered nurses are in need of enhanced understanding about which kind of counselling is the most effective for smoking cessation. Educating large groups of registered nurses in a digital environment appears to be a flexible and cost-effective way. A convergent mixed-method design with data collection was done using questionnaires (n = 47) and semistructured interviews (n = 11). Inclusion criteria were registered nurses in surgical wards. The samples were nonprobability and modified nested. Descriptive statistics and content analysis were used for data analysis. After completing the web-based learning activity, the registered nurses perception was that of good self-efficacy and increased competence in supporting patients with smoking cessation in connection with surgery. They improved their understanding of how to talk about smoking cessation with patients in dialogue using open-ended questions. Nevertheless, the registered nurses requested opportunities for dialogue and interaction with colleagues or topic experts. The results indicate that registered nurses can enhance their competence in supporting patients to embrace smoking cessation by learning in a digital environment. Self-efficacy and understanding of the topic seems to motivate registered nurses to counsel patients about smoking cessation. Findings from this study will be of particular interest to educators in healthcare settings who can devise further development of web-based learning activities. © 2017 John Wiley & Sons Ltd.
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Dyson, Lyn; Hedgecock, Bronwyn; Tomkins, Sharon; Cooke, Gordon
2009-11-01
Ongoing education for the nursing workforce is necessary to ensure currency of knowledge in order to enable evidence based client care. The cost of education is high to the organisation and the individual, and must therefore be cost-effective, relevant and appropriate. According to research, education for nurses is not always systematically planned and developed and often relies on the interest area and assessment of the nurse educators. To survey the learning needs of clinically based registered nurses within an acute care setting. An anonymous questionnaire was used to collect the data. Two groups completed the questionnaire: all eligible registered nurses in two acute care hospitals located in urban New Zealand and their senior nurses such as clinical nurse managers, specialists and educators. The study found agreement on learning needs and also noted differing opinions between the Registered Nurses (RNs), and their senior RNs, RNs initially registered overseas and between levels of practice, on selection and ranking of learning needs. This survey identified a number of high learning needs for RNs working within acute care settings. Differences in perception of learning needs for RNs, between the nurses themselves and the Senior RNs exist, as well as among sub groups of RNs. As a result, educators and managers are encouraged to collaborate to realise the opportunity which exists for the provision of education across specialty areas and to work with the different groups and the individual to ensure unique learning needs are met.
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Brewer, Carol S; Kovner, Christine T; Greene, William; Tukov-Shuser, Magdalene; Djukic, Maja
2012-03-01
This paper is a report of a study of factors that affect turnover of newly licensed registered nurses in United States hospitals. There is a large body of research related to nursing retention; however, there is little information specific to newly licensed registered nurse turnover. Incidence rates of turnover among new nurses are unknown because most turnover data are not from nationally representative samples of nurses. This study used a longitudinal panel design to obtain data from 1653 registered nurses who were recently licensed by examination for the first time. We mailed surveys to a nationally representative sample of hospital registered nurses 1 year apart. The analytic sample consisted of 1653 nurses who responded to both survey mailings in January of 2006 and 2007. Full-time employment and more sprains and strains (including back injuries) result in more turnover. Higher intent to stay and hours of voluntary overtime and more than one job for pay reduces turnover. When we omitted intent to stay from the probit model, less job satisfaction and organizational commitment led to more turnover, confirming their importance to turnover. Magnet Recognition Award(®) hospitals and several other work attributes had no effect on turnover. Turnover problems are complex, which means that there is no one solution to decreasing turnover. Multiple points of intervention exist. One specific approach that may improve turnover rates is hospital policies that reduce strains and sprains. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.
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Registered nurses' self-nurturance and life and career satisfaction.
Nemcek, Mary Ann
2007-08-01
Knowledge of factors that help nurses thrive, including satisfaction with life and self-nurturance, can be used to enhance retention of a healthy work force. This study determined whether nurses are happy or satisfied with their lives; how self-nurturing or "good to self" they are; and whether a relationship exists among self-nurturance, life satisfaction, and career satisfaction. A descriptive, correlational study of 136 registered nurses involving measures of self-nurturance and life and career satisfaction was conducted. Mean scores for life satisfaction and self-nurturance were consistent with those from studies of well adults. Self-nurturance, life satisfaction, and career satisfaction were positively correlated with each other; thus, improving one is expected to improve the others. Knowledge of the significant positive correlation among life satisfaction, self-nurturance, and career satisfaction may prove useful in improving the mental health and safety of nurses. Strategies consistent with Magnet hospital characteristics are suggested for the occupational health nurse.
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VanDenKerkhof, Elizabeth; Sears, Nancy; Edge, Dana S; Tregunno, Deborah; Ginsburg, Liane
2017-04-01
Practical nurses have experienced an increasing scope of practice, including an expectation to care for complex patients and function on interdisciplinary teams. Little is known about the degree to which patient safety principles are addressed in practical nursing education. To examine self-reported patient safety competencies of practical nurses. A cross-sectional online survey (July 2014) and face-to-face interviews (June 2015). Ontario, Canada. Survey participants were practical nurses newly registered with the College of Nurses of Ontario between January 2012 and December 2013. Interview participants were faculty and students in a practical nursing program in Ontario. Survey respondents completed the Health Professional Education in Patient Safety Survey online. Self-reported competencies in various patient safety domains were compared between classroom and clinical settings. Faculty members were interviewed about educational preparation of practical nurses and students were interviewed to provide insight into interpretation of survey questions. The survey response rate was 28.4% (n=1104/3883). Mean domain scores indicated a high level of confidence in patient safety competence (<4.0/5.0). Confidence was highest in respondents registered with the College of Nurses of Ontario >2years and in those who obtained their education outside of Canada. Faculty believed their approach to teaching and learning instilled a deep understanding of the limits to practical nurse autonomous practice. Practical nurses were confident in what they learned about patient safety in their educational programs. The high degree of patient safety competence may be a true reflection of practical nurses understanding of, and comfort with, the limits of their knowledge and, ultimately, the limits of their individual autonomous practice. Further exploration as to whether the questionnaire requires additional modification for use with practical nurse populations is warranted. However, this
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Simonsen, Bjoerg O; Daehlin, Gro K; Johansson, Inger; Farup, Per G
2014-11-21
Nurses experience insufficient medication knowledge; particularly in drug dose calculations, but also in drug management and pharmacology. The weak knowledge could be a result of deficiencies in the basic nursing education, or lack of continuing maintenance training during working years. The aim of this study was to compare the medication knowledge, certainty and risk of error between graduating bachelor students in nursing and experienced registered nurses. Bachelor students in closing term and registered nurses with at least one year job experience underwent a multiple choice test in pharmacology, drug management and drug dose calculations: 3x14 questions with 3-4 alternative answers (score 0-42). Certainty of each answer was recorded with score 0-3, 0-1 indicating need for assistance. Risk of error was scored 1-3, where 3 expressed high risk: being certain that a wrong answer was correct. The results are presented as mean and (SD). Participants were 243 graduating students (including 29 men), aged 28.2 (7.6) years, and 203 registered nurses (including 16 men), aged 42.0 (9.3) years and with a working experience of 12.4 years (9.2). The knowledge among the nurses was found to be superior to that of the students: 68.9%(8.0) and 61.5%(7.8) correct answers, respectively, (p < 0.001). The difference was largest in drug management and dose calculations. The improvement occurred during the first working year. The nurses expressed higher degree of certainty and the risk of error was lower, both overall and for each topic (p < 0.01). Low risk of error was associated with high knowledge and high sense of coping (p < 0.001). The medication knowledge among experienced nurses was superior to bachelor students in nursing, but nevertheless insufficient. As much as 25% of the answers to the drug management questions would lead to high risk of error. More emphasis should be put into the basic nursing education and in the introduction to medication procedures in
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McGilton, Katherine S; Profetto-McGrath, Joanne; Robinson, Angela
2013-11-01
This pilot study was conducted in response to the call in 2009 by the International Association of Gerontology and Geriatrics to focus on effective leadership structures in nursing homes and to develop leadership capacity. Few researchers have evaluated interventions aimed at enhancing the leadership ability of registered nurses in long-term care. The aim of the pilot study was to test the feasibility of a three-part supportive supervisory intervention to improve supervisory skills of registered nurses in long-term care. A repeated measures group design was used. Quantitative data were collected from healthcare aides, licensed practical nurses (i.e., supervised staff), and registered nurses (i.e., supervisors). Focus groups with care managers and supervisors examined perceptions of the intervention. There were nonsignificant changes in both the registered nurse supervisors' job satisfaction and the supervised staff's perception of their supervisors' support. Supervised staff scores indicated an increase in the use of research utilization but did not reflect an increase in job satisfaction. Focus group discussions revealed that the supervisors and care managers perceived the workshop to be valuable; however, the weekly self-reflection, coaching, and mentoring components of the intervention were rare and inconsistent. While the primary outcomes were not influenced by the Supportive Supervision Intervention, further effort is required to understand how best to enhance the supportive supervisory skills of RNs. Examples of how to improve the possibility of a successful intervention are advanced. Effective supervisory skills among registered nurses are crucial for improving the quality of care in long-term care homes. Registered nurses are receptive to interventions that will enhance their roles as supervisors. © 2013 Sigma Theta Tau International.
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Registered nurses' experiences of their decision-making at an Emergency Medical Dispatch Centre.
Ek, Bosse; Svedlund, Marianne
2015-04-01
To describe registered nurses' experiences at an Emergency Medical Dispatch Centre. It is important that ambulances are urgently directed to patients who are in need of immediate help and of quick transportation to a hospital. Because resources are limited, Emergency Medical Dispatch centres cannot send ambulances with high priority to all callers. The efficiency of the system is therefore dependent on triage. Nurses worldwide are involved in patient triage, both before the patient's arrival to the hospital and in the subsequent emergency care. Ambulance dispatching is traditionally a duty for operators at Emergency Medical Dispatch centres, and in Sweden this duty has become increasingly performed by registered nurses. A qualitative design was used for this study. Fifteen registered nurses with experience at Emergency Medical Dispatch centres were interviewed. The participants were asked to describe the content of their work and their experiences. They also described the most challenging and difficult situations according to the critical incidence technique. Content analysis was used. Two themes emerged during the analysis: 'Having a profession with opportunities and obstacles' and 'Meeting serious and difficult situations', with eight sub-themes. The results showed that the decisions to dispatch ambulances were both challenging and difficult. Difficulties included conveying medical advice without seeing the patient, teaching cardio-pulmonary resuscitation via telephone and dealing with intoxicated and aggressive callers. Conflicts with colleagues and ambulance crews as well as fear of making wrong decisions were also mentioned. Work at Emergency Medical Dispatch centres is a demanding but stimulating duty for registered nurses. Great benefits can be achieved using experienced triage nurses, including increased patient safety and better use of medical resources. Improved internal support systems at Emergency Medical Dispatch centres and striving for a blame
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Work force policy perspectives: registered nurses.
Friss, L O
1981-01-01
If the decline in full-time labor force participation by registered nurses in hospitals is to be reversed, the issue of equal pay for comparable work must be addressed. Under pressure for cost containment, policies tend to focus on labor force economics rather than on limitations of services. While the two are interrelated, wage policies must be considered independently. This article describes the network which determines how nurse salaries are set: the relationship between the private sector, the general schedule and the Veteran's Administration. The effects of this system are documented, using testimony from a case in the tenth circuit, as well as comparisons with other reference groups: policemen, teachers, laborers, and VA career fields. The evidence suggests that there is a need for policy intervention. Prime areas for action are the comparability practices by governments, particularly in the areas of classification standards and pay setting. Hospital personnel practices which continue past effects of occupational segregation also should be changed.
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An Analysis of Barriers to Online Learning as Perceived by Registered Nurses
ERIC Educational Resources Information Center
Thomas, Eddie D.
2010-01-01
The United States faces a substantial nursing shortage that is expected to increase over the next decade and beyond. Understaffing and erratic work schedules result in minimal opportunities to participate in continuing education courses, which are required for registered nurses (RNs) to maintaining proficiency and licensure. Online learning is…
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Barriers to Research Utilization by Certified Registered Nurse Anesthetists
ERIC Educational Resources Information Center
Palmer, Timothy J.
2013-01-01
At present, no documentation pertaining to the factors influencing utilization of research into clinical practice by Certified Registered Nurse Anesthetists (CRNAs) exists. An investigation was undertaken to determine perceptions of CRNAs regarding factors within the context of the work setting, which may serve to influence their utilization of…
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Turnover and vacancy rates for registered nurses: do local labor market factors matter?
Rondeau, Kent V; Williams, Eric S; Wagar, Terry H
2008-01-01
Turnover of nursing staff is a significant issue affecting health care cost, quality, and access. In recent years, a worldwide shortage of skilled nurses has resulted in sharply higher vacancy rates for registered nurses in many health care organizations. Much research has focused on the individual, group, and organizational determinants of turnover. Labor market factors have also been suggested as important contributors to turnover and vacancy rates but have received limited attention by scholars. This study proposes and tests a conceptual model showing the relationships of organization-market fit and three local labor market factors with organizational turnover and vacancy rates. The model is tested using ordinary least squares regression with data collected from 713 Canadian hospitals and nursing homes. Results suggest that, although modest in their impact, labor market and the organization-market fit factors do make significant yet differential contributions to turnover and vacancy rates for registered nurses. Knowledge of labor market factors can substantially shape an effective campaign to recruit and retain nurses. This is particularly true for employers who are perceived to be "employers-of-choice."
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Northway, Ruth; Parker, Michelle; James, Neil; Davies, Lynsey; Johnson, Kaye; Wilson, Sally
2015-12-01
Whilst there is a need to develop the research base within learning disability nursing it is also significant that currently there is little published data as to how research is taught to this group of nurses. To increase understanding of how research is currently taught to learning disability nurses within the UK. A survey design was used. The research was undertaken at a conference held in the UK in March 2014. 310 learning disability nurses attending the conference of which 212 completed the free text question. This comprised student nurses (n=158), registered nurses working in practice settings (n=25) and registered nurses working in educational institutions (n=24). Five participants did not specify their background. Participants were invited to complete a questionnaire that included a free text question regarding the teaching of research to learning disability nurses: it is the responses to this question that are reported in this paper. Responses were transcribed and thematically analysed. Eight themes emerged: Teaching approach--the good and the bad; finding the right level; right from the start; we need more time; generic versus specialist; there's not enough; getting research into practice; and what should we focus on? Variations exist in terms of the timing of research education, the teaching approaches used, and hence the quality of student experience. Of particular concern is the apparent gap between research teaching and the use of research in practice, and the reported lack of support for research within practice settings. However, enthusiasm for research is evident and hence recommendations are made both to enhance teaching and to strengthen links with practice. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Nursing record systems: effects on nursing practice and health care outcomes.
Currell, R; Wainwright, P; Urquhart, C
2000-01-01
A nursing record system is the record of care planned and/or given to individual patients/clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. To assess the effects of nursing record systems on nursing practice and patient outcomes. We searched The Cochrane Library, MEDLINE, Cinahl, Sigle, and databases of the Royal College of Nursing, King's Fund, the NHS Centre for Reviews and Dissemination, and the Institute of Electrical Engineers up to August 1999; and OCLC First Search, Department of Health database, NHS Register of Computer Applications and the Health Visitors' Association database up to the end of 1995. We hand searched the Journal of Nursing Administration (1971-1999), Computers in Nursing (1984-1999), Information Technology in Nursing (1989-1999) and reference lists of articles. We also hand searched the major health informatics conference proceedings. We contacted experts in the field of nursing informatics, suppliers of nursing computer systems, and relevant Internet groups. Randomised trials, controlled before and after studies and interrupted time series comparing one kind of nursing record system with another, in hospital, community or primary care settings. The participants were qualified nurses, students or health care assistants working under the direction of a qualified nurse and patients receiving care recorded and/or planned using nursing record systems. Two reviewers independently assessed trial quality and extracted data. Six trials involving 1407 people were included. In three studies of client held records, there were no overall positive or negative effects, although some administrative benefits through fewer missing notes were suggested. A paediatric pain management sheet study showed a positive effect on the children's pain intensity. A computerised nursing care planning study showed a negative effect on documented nursing
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WITHDRAWN: Nursing record systems: effects on nursing practice and healthcare outcomes.
Urquhart, Christine; Currell, Rosemary; Grant, Maria J; Hardiker, Nicholas R
2018-05-15
A nursing record system is the record of care that was planned or given to individual patients and clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. To assess the effects of nursing record systems on nursing practice and patient outcomes. For the original version of this review in 2000, and updates in 2003 and 2008, we searched: the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; MEDLINE, EMBASE, CINAHL, BNI, ISI Web of Knowledge, and ASLIB Index of Theses. We also handsearched: Computers, Informatics, Nursing (Computers in Nursing); Information Technology in Nursing; and the Journal of Nursing Administration. For this update, searches can be considered complete until the end of 2007. We checked reference lists of retrieved articles and other related reviews. Randomised controlled trials (RCTs), controlled before and after studies, and interrupted time series comparing one kind of nursing record system with another in hospital, community or primary care settings. The participants were qualified nurses, students or healthcare assistants working under the direction of a qualified nurse, and patients receiving care recorded or planned using nursing record systems. Two review authors (in two pairs) independently assessed trial quality and extracted data. We included nine trials (eight RCTs, one controlled before and after study) involving 1846 people. The studies that evaluated nursing record systems focusing on relatively discrete and focused problems, for example effective pain management in children, empowering pregnant women and parents, reducing loss of notes, reducing time spent on data entry of test results, reducing transcription errors, and reducing the number of pieces of paper in a record, all demonstrated some degree of success in achieving the desired results. Studies of nursing care planning
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Nursing record systems: effects on nursing practice and health care outcomes.
Currell, R; Urquhart, C
2003-01-01
A nursing record system is the record of care planned and/or given to individual patients/clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. To assess the effects of nursing record systems on nursing practice and patient outcomes. We searched The Cochrane Library, the EPOC trial register (October 2002), MEDLINE, Cinahl, Sigle, and databases of the Royal College of Nursing, King's Fund, the NHS Centre for Reviews and Dissemination, and the Institute of Electrical Engineers up to August 1999; and OCLC First Search, Department of Health database, NHS Register of Computer Applications and the Health Visitors' Association database up to the end of 1995. We hand searched the Journal of Nursing Administration (1971-1999), Computers in Nursing (1984-1999), Information Technology in Nursing (1989-1999) and reference lists of articles. We also hand searched the major health informatics conference proceedings. We contacted experts in the field of nursing informatics, suppliers of nursing computer systems, and relevant Internet groups. To update the review the Medline, Cinahl, British Nursing Index, Aslib Index to Theses databases were all searched from 1998 to 2002. The Journal of Nursing Administration, Computers in Nursing, Information Technology in Nursing were all hand searched up to 2002. The searches of the other databases and grey literature included in the original review, were not updated (except for Health Care Computing Conference and Med Info) as the original searches produced little relevant material. Randomised trials, controlled before and after studies and interrupted time series comparing one kind of nursing record system with another, in hospital, community or primary care settings. The participants were qualified nurses, students or health care assistants working under the direction of a qualified nurse and patients receiving care recorded
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Watkins, Chanell; Hart, Patricia L; Mareno, Nicole
2016-03-01
The first year turnover rate for newly licensed registered nurses is roughly 30% and increases to about 57% in the second year (Twibell et al., 2012). An effective preceptorship has been shown to better facilitate the first year transition (Hodges et al., 2008) and increase retention rates (Pine and Tart, 2007). The purpose of this study was to examine the relationships between newly licensed registered nurses' perceived preceptor role effectiveness, psychological empowerment and professional autonomy. A prospective, cross-sectional, descriptive research design was used. Sixty-nine newly licensed registered nurses were recruited and surveyed. Newly licensed registered nurses were found to have moderately high levels of perceived preceptor role effectiveness, psychological empowerment, and professional autonomy. Preceptor role effectiveness had significant, moderately, positive relationships with professional autonomy and psychological empowerment. There was also a significant relationship found between professional autonomy and psychological empowerment. Results show that preceptor role effectiveness is linked to increased professional autonomy and psychological empowerment. Therefore, effective preceptorships are necessary in easing the newly licensed registered nurse's transition to practice. Strategies to ensure effective preceptorships and enhance the NRLN's transition to practice are proposed. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Early-career registered nurses' participation in hospital quality improvement activities.
Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida K; Bernstein, Ilya
2013-01-01
We surveyed 2 cohorts of early-career registered nurses from 15 states in the US, 2 years apart, to compare their reported participation in hospital quality improvement (QI) activities. We anticipated differences between the 2 cohorts because of the growth of several initiatives for engaging nurses in QI. There were no differences between the 2 cohorts across 14 measured activities, except for their reported use of appropriate strategies to improve hand-washing compliance to reduce nosocomial infection rates.
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Aggar, Christina; Gordon, Christopher J; Thomas, Tamsin H T; Wadsworth, Linda; Bloomfield, Jacqueline
2018-03-26
Australia has an increasing demand for a sustainable primary health care registered nursing workforce. Targeting graduate registered nurses who typically begin their nursing career in acute-care hospital settings is a potential workforce development strategy. We evaluated a graduate registered nurse Community Transition to Professional Practice Program which was designed specifically to develop and foster skills required for primary health care. The aims of this study were to evaluate graduates' intention to remain in the primary health care nursing workforce, and graduate competency, confidence and experiences of program support; these were compared with graduates undertaking the conventional acute-care transition program. Preceptor ratings of graduate competence were also measured. All of the 25 graduates (n = 12 community, n = 13 acute-care) who completed the questionnaire at 6 and 12 months intended to remain in nursing, and 55% (n = 6) of graduates in the Community Transition Program intended to remain in the primary health care nursing workforce. There were no differences in graduate experiences, including level of competence, or preceptors' perceptions of graduate competence, between acute-care and Community Transition Programs. The Community Transition to Professional Practice program represents a substantial step towards developing the primary health care health workforce by facilitating graduate nurse employment in this area. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Al-Sagarat, Ahmad; Qan'ir, Yousef; Al-Azzam, Manar; Obeidat, Hala; Khalifeh, Anas
2018-04-23
To assess the impact of nursing competences on workplace bullying among registered nurses in Jordanian public hospitals. Workplace bullying has serious organizational and health effects on nursing staff. Little is known about the relationship between bullying and nursing competence worldwide. A cross-sectional descriptive study using a quantitative method was adopted for this study. The Negative Act Questionnaire-Revised (NAQ-R) and Nurse Professional Competence (NPC) questionnaire were used. A convenience sample of 272 nurses completed the study questionnaires. The results revealed that there were negative correlations between all NAQ scales and all NPC scales. The higher scores indicated better degrees of perceived competency, while the lower scores indicated the frequency of bullying reported by nurses. These results suggest that nurses who have more clinical competencies are less likely to experience work-related bullying. The study found that workplace bullying against nursing staff is still a considerable problem in participating Jordanian hospitals. To prohibit bullying behavior, nurse administrators have to construct a work environment that demonstrates respect and fairness and which is transmitted through nurses' communication pathways. © 2018 Wiley Periodicals, Inc.
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ERIC Educational Resources Information Center
Bergen Community Coll., Paramus, NJ.
The Associate Degree Nursing Program at Bergen Community College developed and field tested competency-based instructional modules in a program designed to allow licensed practical nurses to qualify to take the certification examination for registered nurses after a year of study. Thirteen licensed practical nurses were enrolled in the first class…
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The role of the nurse executive in fostering and empowering the advanced practice registered nurse.
Talbert, Tukea L
2012-06-01
The nurse executive plays a critical role in the design, oversight, and outcomes of the delivery of care and a key role in the success of the integration of advanced practice registered nurses (APRNs) into an organization. The critical areas that nurse executives must consider to foster and empower APRNs are: (1) knowledge and self preparation, especially of political initiatives that affect the role, (2) visionary leadership and development of clear role expectations and appropriate credentialing, (3) strategies to reduce disconnection between the APRN and their practice setting, and (4) appropriate education and marketing of the role to stakeholders. Copyright © 2012 Elsevier Inc. All rights reserved.
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Violence and sexual harassment: impact on registered nurses in the workplace.
Williams, M F
1996-02-01
This study sought to determine the prevalence and impact of violence and sexual harassment experienced by registered nurses (RNs) in their workplaces in Illinois. A random sample of 1,130 RNs were selected to participate in the mail survey. The instrument used was the Nurse Assault Survey originally developed by the Nurse Assault Project Team in Ontario, Canada, and modified by the author. Three hundred forty-five subjects completed the survey (response rate: 30%). Fifty-seven percent of those responding reported personal experience with some aspect of sexual harassment, and 26% reported being victimized by physical assault while on the job. About one third of those who indicated they had been sexually harassed also had been physically assaulted. Patients/clients were the most frequent perpetrators of sexual harassment and physical assault, while physicians committed over half of the sexual assaults. Bivariate analysis showed a significant relationship between physical assault and levels of job satisfaction. A significant relationship also was found between sexual harassment and levels of job satisfaction. Results demonstrate that nurses need to take and active role in fostering a work environment free from violence and sexual harassment. They should be knowledgeable about institutional policies and, where none exist, they should work with administrators to develop them. Prevention and intervention programs should be developed for both student and registered nurses.
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Asman, Oren; Melnikov, Semyon; Barnoy, Sivia; Tabak, Nili
2017-01-01
Nurses engaging in research are held to research ethics standards. Research aim: Examine experiences, behaviors, and perceptions of nurses in Israel regarding research ethics and explore possible related factors. An original investigator-designed self-administered questionnaire measured five variables: (a) ethics in research, (b) encountered research misconduct during the course of one's studies, (c) the inclination to fabricate data, (d) the inclination to select or omit data, and (e) knowledge of research misconduct in the workplace. Additionally, demographic data were collected. Participants and research context: The questionnaire was completed by 151 Israeli registered nurses. 10.2% hold a PhD, 34 % hold an MA, 42.2% hold a BA, and 13.6% with no academic degree. Ethical considerations: The study was approved by the University's ethics committee; anonymity and consent of the respondents were respected. Registered nurses' level of studies achieved was significantly associated with a lower inclination to fabricate data, with one exception-PhD nurses were more inclined to fabricate data than nurses with a Master's degree. A trend was found in which a higher level of studies is associated with higher knowledge of research misconduct in the workplace. Results indicate that nurses' perceptions of research ethics change throughout their academic studies, indicating a positive influence of level of studies, research experience, and work experience on ethics perceptions. Nevertheless, PhD nurses showed a greater inclination to actually select, omit, or even fabricate data than MA nurses. This may be related to pressure to publish. PhD nursing programs should include ethics training. Academic faculty members should serve as role models regarding research integrity. Research ethics deserves further emphasis on all levels of nurse education in Israel, as well as in the nurses' code of ethics and related documents. This may positively impact ethical research practices.
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Hicks, Beverly
2011-01-01
In Canada, psychiatric nursing care is provided by two kinds of nurses. East of Manitoba, it is provided by registered nurses who may or may not have specialized psychiatric nursing education. In the four western provinces, a distinct professional group, registered psychiatric nurses, also provide care. Saskatchewan was the first province to achieve distinct legislation, in 1948, followed by British Columbia in 1951, Alberta in 1955, and Manitoba in 1960. Several factors coalesced to sway Manitoba to adopt the distinct profession model. First, there was little interest by the general nursing body in mental hospital nursing. Second, the other three western provinces had formed a Canadian Council of Psychiatric Nursing that encouraged mental hospital attendants and nurses in Manitoba. Third, a group of male attendants took on leadership roles supported by the mental hospital superintendents. Finally, Manitoba was culturally and geographically more aligned with western than eastern Canada.
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Work engagement of older registered nurses: the impact of a caring-based intervention.
Bishop, Mary
2013-10-01
The aim of this evaluation research was to measure the impact of a caring-based intervention on the level of work engagement in older nurses. Every effort is needed to retain older nurses at the bedside by assisting them to revitalise the internal motivation and self- reward that brought them to nursing. A mixed method evaluation research approach using both qualitative and quantitative measurements was used to determine the impact of a caring-based programme on improving the work engagement scores of older Registered Nurses (RNs). The results of this study suggest that leadership strategies aimed at improving work engagement using caring theories have a significant positive impact. The findings contribute to our understanding of how work engagement can be enhanced through building work environments where there is a sense of belonging and teamwork, where staff are allowed time to decompress as well as build positive work relationships. Nurse Leaders (NLs) bear a responsibility to partner with older Registered Nurses (RNs) to build engagement in their work life while enhancing the quality of care. Successful leaders will find ways to meet these unique challenges by creating a healthy work environment. © 2013 John Wiley & Sons Ltd.
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O'Donovan, Geraldine
2009-06-01
Smoking is the leading preventable cause of premature mortality, killing approximately 6000 people in Ireland each year. On 29 March 2004, the Republic of Ireland became the first country in the world to ban smoking in all workplaces, including bars and restaurants. This study took place after the introduction of this smoking ban. An admission to hospital provides an opportunity to help people stop smoking. Nurses' role and wide availability puts them in a prime position to encourage people to quit smoking. To examine the smoking prevalence among qualified nurses at a large university teaching hospital in Cork Southern Ireland and their role in smoking cessation. This was a descriptive cross-sectional study using a calculated sample of 430 qualified nurses (with a 70% response rate). A structured questionnaire was used. It was found that 21% (n = 63) of nurses were smokers, 23% (n = 70) were ex-smokers and 56% (n = 167) were non-smokers. The highest prevalence of smokers was found in the age groups 20-25 years (28%, n = 17) and 26-30 years (34%, n = 21). Nurses working within psychiatric care (47.4%) and coronary care (33.3%) had the highest smoking prevalence among the nurses who smoked. The study found that there was a significant difference between the attitudes of smokers and non-smokers, 89% (n = 211) of non-smokers strongly agreed that cigarette smoke represents a major risk to health in comparison with only 65% (n = 41) of smokers. Only 14% (n = 43) of the nurses surveyed had received training in smoking cessation. Lack of time (74%) and lack of training (65%) were the two main reasons given by nurses for not giving smoking cessation advice to patients. Nurses' potential in preventive health care has been largely under-utilized. Lack of time and training are major factors inhibiting nurses' role in smoking cessation with their patients.
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Factors associated with work satisfaction of registered nurses.
Kovner, Christine; Brewer, Carol; Wu, Yow-Wu; Cheng, Ying; Suzuki, Miho
2006-01-01
To examine the factors that influence the work satisfaction of a national sample of registered nurses in metropolitan statistical areas (MSAs). A cross-sectional mailed survey design was used. The sample consisted of RNs randomly selected from 40 MSAs in 29 states; 1,907 RNs responded (48%). The sample of 1,538 RNs working in nursing was used for analysis. The questionnaire included measures of work attitudes and demographic characteristics. The data were analyzed using ordinary least-squares regression. More than 40% of the variance in satisfaction was explained by the various work attitudes: supervisor support, work-group cohesion, variety of work, autonomy, organizational constraint, promotional opportunities, work and family conflict, and distributive justice. RNs who were White, self-perceived as healthy, and working in nursing education were more satisfied. RNs that were more career oriented were more satisfied. Of the benefits options, only paid time off was related to satisfaction. Work-related factors were significantly related to RNs' work satisfaction.
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The Experiences of Registered Nurses Transitioning from Patient Care Settings to Academia
ERIC Educational Resources Information Center
Gwin, Teresa
2012-01-01
Registered nurses (RNs) who make the move from a patient-care service setting to an academic teaching environment often go through a transition phase in their first semesters of teaching that is difficult and traumatic. RNs that go on to higher academic degrees often do so in order to teach in schools of nursing. However, graduate work in nursing…
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An integrative review of the literature on registered nurses' medication competence.
Sulosaari, Virpi; Suhonen, Riitta; Leino-Kilpi, Helena
2011-02-01
The aim of this integrative literature review was to describe registered nurses' medication competence. The objectives of the literature review were to chart the need for future studies and use the results for instrument development. Nurses play a vital role in different phases of a patient's medication process and thus need adequate competence to fulfil their role. Research on nurses' level of medication competence in different competency areas has been published. However, previous studies have lacked a comprehensive or integrated definition or description of medication competence in nursing. Integrative literature review. The integrative literature review followed five stages: (1) problem identification, (2) literature search, (3) data evaluation, (4) data analysis and (5) presentation. Eligible articles were identified via systematic literature search of research and evidence-based--databases. Twenty-one studies met the selection criteria. Eleven competency areas that constitute nurses' medication competence were identified: (1) anatomy and physiology, (2) pharmacology, (3) communication, (4) interdisciplinary collaboration, (5) information seeking, (6) mathematical and medication calculation, (7) medication administration, (8) medication education, (9) assessment and evaluation, (10) documentation and (11) promoting medication safety as part of patient safety. The analysis revealed three major categories which integrate these competency areas: (1) decision making competence, (2) theoretical competence and (3) practical competence. Medication competence requires a solid knowledge base and the ability to apply that knowledge in real-life situations during often complex and dynamic patient medication processes. Decision making competence was found to be an important and integral part of a nurses' theoretical and practical competence. These main competence categories integrated all of the 11 competency areas identified in this review. It is important to determine
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Purpora, Christina; Blegen, Mary A
2015-08-01
To describe the association between horizontal violence and job satisfaction in hospital staff registered nurses and the degree to which peer relationships mediates the relationship. Additionally, the association between nurse and work characteristics and job satisfaction were determined. Horizontal violence is a major predictor of nurses' job satisfaction. Yet, not enough is known about the relationship between these variables. Job satisfaction is an important variable to study because it is a predictor of patient care quality and safety internationally. Peer relationships, a job satisfier for nurses, was identified as a potential mediator in the association between horizontal violence and job satisfaction. Cross-sectional mediational model testing. An anonymous four-part survey of a random sample of 175 hospital staff registered nurses working in California provided the data. Data about horizontal violence, peer relationships, job satisfaction, and nurse and work characteristics were collected between March-August 2010. A statistically significant negative relationship was found between horizontal violence and peer relationships, job satisfaction and a statistically significant positive relationship was found between peer relationships and job satisfaction. Peer relationships mediated the association between horizontal violence and job satisfaction. Job satisfaction was reported as higher by nurses who worked in teaching hospitals. There were no statistically significant differences in job satisfaction based on gender, ethnicity, basic registered nurse education, highest degree held, size of hospital or clinical area. The results suggest that peer relationships can attenuate the negative relationship between horizontal violence and job satisfaction. This adds to the extant literature on the relationship between horizontal violence and job satisfaction. The findings highlight peer relationships as an important factor when considering effective interventions that
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Prentice, Dawn; Black, Margaret
2007-09-01
Aim. This paper reports on a qualitative study that explored the reasons why Registered Nurses (RNs) chose to work in nursing homes in Southern Ontario, Canada and what factors attracted them to remain. Background. There is a paucity of information about factors associated with the recruitment and retention of RNs within long-term care (LTC) in Canada. As the population of older people is growing in Canada and elsewhere, it is essential that we better understand what attracts RNs to work and remain in this setting. Design and method. A case study approach was used in this study of nine RNs working in three nursing homes. Data were collected through in-depth interviews. Findings. Six sub-themes were identified: 'Job of Choice', 'Job of Convenience', 'Caring for the Residents', 'A Supportive Environment', 'Heavy Workload' and 'Supervisory Role of the RN'. Conclusion. Nurses chose to work in the nursing home because it was a 'Job of Convenience'. However, characteristics of the organizational environment played a major role in their remaining. Also, the caring relationship with residents played a role in the nurses remaining in this setting. Relevance to clinical practice. Strategies are provided that nurse managers may consider when planning recruitment and retention activities for LTC settings.
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Allan, Helen T; Magnusson, Carin; Evans, Karen; Ball, Elaine; Westwood, Sue; Curtis, Kathy; Horton, Khim; Johnson, Martin
2016-12-01
The invisibility of nursing work has been discussed in the international literature but not in relation to learning clinical skills. Evans and Guile's (Practice-based education: Perspectives and strategies, Rotterdam: Sense, 2012) theory of recontextualisation is used to explore the ways in which invisible or unplanned and unrecognised learning takes place as newly qualified nurses learn to delegate to and supervise the work of the healthcare assistant. In the British context, delegation and supervision are thought of as skills which are learnt "on the job." We suggest that learning "on-the-job" is the invisible construction of knowledge in clinical practice and that delegation is a particularly telling area of nursing practice which illustrates invisible learning. Using an ethnographic case study approach in three hospital sites in England from 2011 to 2014, we undertook participant observation, interviews with newly qualified nurses, ward managers and healthcare assistants. We discuss the invisible ways newly qualified nurses learn in the practice environment and present the invisible steps to learning which encompass the embodied, affective and social, as much as the cognitive components to learning. We argue that there is a need for greater understanding of the "invisible learning" which occurs as newly qualified nurses learn to delegate and supervise. © 2016 John Wiley & Sons Ltd.
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Job satisfaction of Malaysian registered nurses: a qualitative study.
Atefi, Narges; Abdullah, Khatijah L; Wong, Li P
2016-01-01
Job satisfaction is an important factor in health care settings. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care. However, there have not been any studies exploring the job satisfaction of Malaysian nurses. The main purpose of this qualitative descriptive study was to explore the factors related to feelings of job satisfaction as well as job dissatisfaction experienced by registered nurses in Malaysia. A convenient sample of 46 Malaysian nurses recruited from a large hospital (number of beds = 895) participated in the study. A total of seven focus group discussions were conducted with nurses from surgical, medical and critical care wards. A semi-structured interview guide was used to facilitate the interviews, which were audio-recorded, transcribed verbatim and checked. The transcripts were used as data and were analysed using a thematic approach. The study identified three main themes that influenced job satisfaction: (1) nurses' personal values and beliefs; (2) work environment factors and (3) motivation factors. Concerning the nurses' personal values and beliefs, the ability to help people made the nurses felt honoured and happy, which indirectly contributed to job satisfaction. For work environment factors, team cohesion, benefit and reward, working conditions play an important role in the nurses' job satisfaction. Motivation factors, namely, professional development and clinical autonomy contributed to job satisfaction. It is important for nurse leaders to provide more rewards, comfortable work environments and to understand issues that affect nurses' job satisfaction. Our findings highlight the importance of factors that can improve nurses' job satisfaction. The study provides basic information for hospital administrators in planning effective and efficient policies to improve nursing job satisfaction in order to increase the quality of patient care and decrease nursing turnover. © 2014
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Central and peripheral information source use among rural and remote Registered Nurses.
Kosteniuk, Julie G; D'Arcy, Carl; Stewart, Norma; Smith, Barbara
2006-07-01
This paper reports a study examining the use of central (colleagues, inservice and newsletters) and peripheral information sources (Internet, library, journal subscriptions and continuing education) among a large sample of rural and remote nurses and explores the factors associated with the use of particular peripheral information sources. There have been few studies of the specific sources of information accessed by Registered Nurses, particularly rural or remote nurses, and the characteristics of nurses and their organizations that are associated with the use of particular information sources. A questionnaire survey was conducted with 3933 Registered Nurses from all regions of rural and remote Canada between October 2001 and July 2002. We used frequencies and cross-tabulations to describe rates of information use, and forward selection logistic regression with likelihood ratio selection to build the best-fitting model of the variables that affected the odds of using each peripheral information source. Nursing colleagues ranked as the information source most frequently used, and the Internet and library ranked lowest. On average, nurses used a statistically significantly greater number of central than peripheral sources. Peripheral information source use was higher among nurses who had access to current information, opportunities to share their knowledge with others, higher education levels, were in positions of authority and worked with healthcare students. The associations between age and geographical location varied according to the peripheral information source under consideration. The vast majority of rural and remote nurses used at least one peripheral information source to inform their practice. Increasing the number of research sources used by these nurses requires attention to issues of information access in these areas, as well as issues of staff recruitment and retention of staff in under-serviced rural and remote regions.
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Registered nurse leadership style and confidence in delegation.
Saccomano, Scott J; Pinto-Zipp, Genevieve
2011-05-01
Leadership and confidence in delegation are two important explanatory constructs of nursing practice. The relationship between these constructs, however, is not clearly understood. To be successful in their roles as leaders, regardless of their experience, registered nurses (RNs) need to understand how to best delegate. The present study explored and described the relationship between RN leadership styles, demographic variables and confidence in delegation in a community teaching hospital. Utilizing a cross-sectional survey design, RNs employed in one acute care hospital completed questionnaires that measured leadership style [Path-Goal Leadership Questionnaire (PGLQ)] and confidence in delegating patient care tasks [Confidence and Intent to Delegate Scale (CIDS)]. Contrary to expectations, the data did not confirm a relationship between confidence in delegating tasks to unlicensed assistive personnel (UAPs) and leadership style. Nurses who were diploma or associate degree prepared were initially less confident in delegating tasks to UAPs as compared with RNs holding a bachelor's degree or higher. Further, after 5 years of clinical nursing experience, nurses with less educational experience reported more confidence in delegating tasks as compared with RNs with more educational experience. The lack of a relationship between leadership style and confidence in delegating patient care tasks were discussed in terms of the PGLQ classification criteria and hospital unit differences. As suggested by the significant two-way interaction between educational preparation and clinical nursing experience, changes in the nurse's confidence in delegating patient care tasks to UAPs was a dynamic changing variable that resulted from the interplay between amount of educational preparation and years of clinical nursing experience in this population of nurses. Clearly, generalizability of these findings to nurses outside the US is questionable, thus nurse managers must be familiar
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From Being a Nurse to Becoming a "Different" Doctor
ERIC Educational Resources Information Center
McLean, Michelle
2017-01-01
Using interpretative phenomenological analysis to make meaning of the experiences of three highly qualified registered nurses who had enrolled in an undergraduate medical programme, this study provides insight into their personal journeys of wanting to become "different" doctors. In so doing, they conceptualised their future selves as…
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Visits to Registered Nurses: An Opportunity to Increase Contraceptive Access in California.
Parker, Emese C; Kong, Kevin; Watts, Leslie A; Schwarz, Eleanor B; Darney, Philip D; Thiel de Bocanegra, Heike
In 2013, California passed Assembly Bill (A.B.) 2348, approving registered nurses (RNs) to dispense patient self-administered hormonal contraceptives and administer injections of hormonal contraceptives. The Family Planning, Access, Care and Treatment (Family PACT) program, which came into effect in 1997 to expand low-income, uninsured California resident access to contraceptives at no cost, is one program in which qualified RNs can dispense and administer contraceptives. The aims of this study were to (a) describe utilization of RN visits within California's Family PACT program and (b) evaluate the impact of RN visits on client birth control acquisition during the first 18 months after implementation of A.B. 2348 (January 1, 2013 to June 30, 2014). A descriptive observational design using administrative databases was used. Family PACT claims were retrieved for RN visits and contraception. Paid claims for contraceptive dispensing and/or administration visits by physicians, nurse practitioners, certified nurse midwives, and physician assistants were compared before and after the implementation of A.B. 2348 at practice sites where RN visits were and were not utilized. Contraceptive methods and administration procedures were identified using Healthcare Common Procedure Coding System codes, National Drug Codes, and Common Procedural Terminology codes. Claims data for healthcare facilities were abstracted by site location based on a unique combination of National Provider Identifier (NPI), NPI Owner, and NPI location number. RN visits were found mainly in Northern California and the Central Valley (73%). Sixty-eight percent of RN visits resulted in same-day dispensing and/or administration of hormonal (and/or barrier) methods. Since benefit implementation, RN visits resulted in a 10% increase in access to birth control dispensing and/or administration visits. RN visits were also associated with future birth control acquisition and other healthcare utilization within the
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Education Policy Initiatives To Address The Nurse Shortage In The United States
Aiken, Linda H.; Cheung, Robyn B.; Olds, Danielle M.
2009-01-01
Employment opportunities are expected to grow much faster for registered nurses (RNs) than for most other occupations. Yet a major shortage of nurses is projected by 2020. A nurse faculty shortage and financially strapped colleges and universities are limiting the ability of U.S. nursing schools to take advantage of historically high numbers of qualified applicants. Increased public subsidies are needed to provide greater access to nursing education, with a priority on baccalaureate and graduate nursing education, where job growth is expected to be the greatest. PMID:19525285
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Santos, Susan R; Carroll, Cathryn A; Cox, Karen S; Teasley, Susan L; Simon, Stephen D; Bainbridge, Lynda; Cunningham, Marion; Ott, Lynn
2003-04-01
Because today's nursing workforce faces a multitude of stressors, the objective of this study was to describe stress, strain, and coping across institution types for inpatient registered nurses (n = 694), and to identify the influence of age on these findings. This study, using a multi-site, mixed methods approach, provides data to support more focused interventions that address the challenges of specific types of stressors and age cohort needs. The worst scores for sub-scales addressing stress and strain for this sample of inpatient nurses were problems associated with physical environment and responsibility. Consistency was found across the four institutions for the sub scale of responsibility. Baby Boomer nurses (born between 1946 and 1964) had significantly worse scores than other age cohorts, specifically with the stress and strain sub-scales of role overload, role insufficiency, role ambiguity, role boundary, and interpersonal strain. The authors outline specific ways to support registered nurses by using staffing metrics that factor in unit activity as well as supporting the Baby Boomer nurse, both physically and psychosocially.
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ERIC Educational Resources Information Center
Wisner, Patricia; And Others
In 1988, a study was conducted at William Rainey Harper College (WRHC) to assess the needs of registered nurses in the college's service district for continuing education courses, seminars, and workshops. A survey was mailed to 6,228 registered nurses to determine their awareness of and/or past participation in WRHC's continuing education program,…
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A preceptorship programme for newly qualified nurses: a study of preceptees' perceptions.
Marks-Maran, Di; Ooms, Ann; Tapping, Jen; Muir, Jenny; Phillips, Sonia; Burke, Linda
2013-11-01
This paper presents the evaluation of a preceptorship programme for newly-qualified nurses (NQNs) to determine preceptee engagement with the preceptorship programme, and the impact, value and sustainability of the programme from the preceptees' perspectives. The literature suggests that NQNs find the transition from student to qualified nurse to be stressful and that preceptorship can reduce this stress and promote adaptation to the new role. This study took place in one NHS Healthcare Trust in South West London, UK. Ninety NQNs were invited to participate in the study and the response rate was 48.9% (n=44). The study took place in 2011. Evaluative research design was used incorporating a fourfold evaluation framework of preceptee engagement, impact, value and sustainability (Ooms et al., 2011). This was a mixed methods study. Qualitative and quantitative data were collected through questionnaires, reflective journals and through personal audio recordings made by the preceptees. Quantitative data were analysed through descriptive statistics and t-tests, and Cronbach's alpha coefficient was used to assess reliability of impact and value scales. In addition analysis of open-ended questions and qualitative data was undertaken using the Framework Method of analysis. Findings show that preceptee engagement in the programme was high and preceptorship was highly valued by the majority of preceptees (85%). Preceptors played a positive role in terms of alleviating stress. Preceptorship impacted positively on preceptees in terms of development of communication skills and clinical skills, and role, personal and professional development. In addition, preceptees felt that the programme was of value despite acknowledging difficulties in making time to meet with preceptors. Preceptees also indicated that they would wish to be preceptors in the future and that they would recommend preceptorship to all nurses who are either newly qualified or new in role. Preceptees judged the
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Effects of leadership characteristics on pediatric registered nurses' job satisfaction.
Roberts-Turner, Reneé; Hinds, Pamela S; Nelson, John; Pryor, Juanda; Robinson, Nellie C; Wang, Jichuan
2014-01-01
Job satisfaction levels among registered nurses (RNs) influence RN recruitment, retention, turnover, and patient outcomes. Researchers examining the relationship between characteristics of nursing leadership and RN job satisfaction have treated RNs as a monolithic group with little research on the satisfaction of hospital-based pediatric RNs. This study assessed the relationship of transformational and transactional nursing leadership characteristics and RN job satisfaction reported by pediatric RNs. This single site study included 935 hospital-based pediatric RNs who completed validated survey items regarding nursing leadership and job satisfaction. A structural equation model (SEM) was applied to assess how autonomy (transformational leadership) and distributive justice (transactional leadership) influence RN job satisfaction, and how RN socio-demographic characteristics influence job satisfaction via autonomy and distributive justice. Findings revealed that both autonomy and distributive justice had significant positive effects on RN job satisfaction but the largest source of influence was autonomy.
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ERIC Educational Resources Information Center
Lobo, Rosale Constance
2017-01-01
Registered Nurses use clinical documentation to describe care planning processes, measure quality outcomes, support reimbursement, and defend litigation. The Connecticut Department of Health, guided by federal Conditions of Participation, defines state-level healthcare policy to include required care planning processes. Nurses are educated in care…
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Birks, Melanie; Cant, Robyn; James, Ainsley; Chung, Catherine; Davis, Jenny
2013-01-01
The purpose of pre-service nursing education programs is to prepare competent graduates who are able to function as safe, professional registered nurses. An extensive element of these programs is the teaching of physical assessment skills, with most programs educating students to perform over 120 such skills. Previous research from North America suggests that the majority of skills taught to nurses in their pre-service programs are not used in practice. As part of a larger study, an online survey was used to explore use of 121 physical assessment skills by Australian nurses. Recruitment occurred via mailed invitation to members of the Australian Nursing Federation. Data were extracted from 1220 completed questionnaires returned by nurses who were mostly employed in New South Wales, were female and experienced nurses. Respondents indicated that they used only 34% of skills routinely. Results reinforce evidence found in the literature that many of the skills taught to nurses are either not used at all (35.5%) or are used rarely (31%). These findings have implications for the teaching of physical assessment skills in pre-service nursing programs, and raise questions about the value of extensive skills teaching in the context of contemporary health care. Further research into barriers to the use of physical assessment skills in nursing and the need for comprehensive skills preparation for the generalist nurse is likely to offer some solutions to these questions.
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Gusdal, Annelie K; Josefsson, Karin; Thors Adolfsson, Eva; Martin, Lene
2016-01-01
Heart failure is a growing public health problem associated with poor quality of life and significant morbidity and mortality. The majority of heart failure care is provided by family caregivers, and is associated with caregiver burden and reduced quality of life. Research emphasizes that future nursing interventions should recognize the importance of involving family caregivers to achieve optimal outcomes. The aims of this study are to explore registered nurses' perceptions about the situation of family caregivers to patients with heart failure, and registered nurses' interventions, in order to improve family caregivers' situation. The study has a qualitative design with an inductive approach. Six focus group interviews were held with 23 registered nurses in three hospitals and three primary health care centres. Data were analysed using qualitative content analysis. Two content areas were identified by the a priori study aims. Four categories and nine sub-categories emerged in the analysis process. The content area "Family caregivers' situation" includes two categories: "To be unburdened" and "To comprehend the heart failure condition and its consequences". The content area "Interventions to improve family caregivers' situation" includes two categories: "Individualized support and information" and "Bridging contact". Registered nurses perceive family caregivers' situation as burdensome, characterized by worry and uncertainty. In the PHCCs, the continuity and security of an RN as a permanent health care contact was considered an important and sustainable intervention to better care for family caregivers' worry and uncertainty. In the nurse-led heart failure clinics in hospitals, registered nurses can provide family caregivers with the opportunity of involvement in their relative's health care and address congruence and relationship quality within the family through the use of "Shared care" and or Family-centred care. Registered nurses consider it necessary to have
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Speaking up, being heard: registered nurses' perceptions of workplace communication.
Garon, Maryanne
2012-04-01
The aim of the present study was to explore nurses' perceptions of their own ability to speak up and be heard in the workplace. Nurses are central to patient care and patient safety in hospitals. Their ability to speak up and be heard greatly impacts their own work satisfaction, team work as well as patient safety. The present study utilized a qualitative approach, consisting of focus group interviews of 33 registered nurses (RNs), in staff or management positions from a variety of healthcare settings in California, USA. Data were analysed using thematic content analysis. Findings were organized into three categories: influences on speaking up, transmission and reception of a message and outcomes or results. The present study supported the importance of the manager in setting the culture of open communication. It is anticipated that findings from the present study may increase understandings of nurse views of communication within healthcare settings. The study highlights the importance of nurse managers in creating the communication culture that will allow nurses to speak up and be heard. These open communication cultures lead to better patient care, increased safety and better staff satisfaction. © 2011 Blackwell Publishing Ltd.
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Lefave, Melissa; Harrell, Brad; Wright, Molly
2016-06-01
The purpose of this project was to assess the ability of anesthesiologists, nurse anesthetists, and registered nurses to correctly identify anatomic landmarks of cricoid pressure and apply the correct amount of force. The project included an educational intervention with one group pretest-post-test design. Participants demonstrated cricoid pressure on a laryngotracheal model. After an educational intervention video, participants were asked to repeat cricoid pressure on the model. Participants with a nurse anesthesia background applied more appropriate force pretest than other participants; however, post-test results, while improved, showed no significant difference among providers. Participant identification of the correct anatomy of the cricoid cartilage and application of correct force were significantly improved after education. This study revealed that participants lacked prior knowledge of correct cricoid anatomy and pressure as well as the ability to apply correct force to the laryngotracheal model before an educational intervention. The intervention used in this study proved successful in educating health care providers. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
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Factors influencing turnover intention among registered nurses in Samar Philippines.
Labrague, Leodoro J; Gloe, Donna; McEnroe, Denise M; Konstantinos, Kostas; Colet, Paolo
2018-02-01
Despite the massive nurse migration and turnover of nurses in the Philippines, there remains a lack of studies describing factors influencing the migration of Filipino nurses. This study explored the effects of nurses' characteristics, work satisfaction, and work stress with the intent to leave an organization among registered nurses in the Philippines. This study utilized a descriptive, cross-sectional approach. One hundred sixty six (166) nurses participated in the study during the months of September 2015 to December 2015. Three standardized instruments were used in the study: Job Satisfaction Index (JSI), Job Stress Scale (JSS), and Turnover Intention Inventory Scale (TIIS). Data were analyzed using descriptive and inferential statistical tools. Nurses' ages were found to significantly influence their turnover intentions. Job satisfaction (β=-0.47, p=0.001) and job stress (β=0.23, p=0.001) strongly predicted turnover intentions in the nurses. The mean values for the job satisfaction scale, job stress scale, and turnover intention inventory scale were 3.13 (SD=0.60), 2.74 (SD=0.71), and 2.43 (SD=0.67) respectively. Several predictors of turnover intentions were determined in this study through nurses' age, job satisfaction, and job stress as being the most influential factors. Efforts to increase nurses' job satisfaction and reduce job stress should be implemented to halt further loss of these skilled groups of healthcare professionals. Copyright © 2017 Elsevier Inc. All rights reserved.
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Registered nurse-administered sedation for gastrointestinal endoscopic procedure
Amornyotin, Somchai
2015-01-01
The rising use of nonanesthesiologist-administered sedation for gastrointestinal endoscopy has clinical significances. Most endoscopic patients require some forms of sedation and/or anesthesia. The goals of this sedation are to guard the patient’s safety, minimize physical discomfort, to control behavior and to diminish psychological responses. Generally, moderate sedation for these procedures has been offered by the non-anesthesiologist by using benzodiazepines and/or opioids. Anesthesiologists and non-anesthesiologist personnel will need to work together for these challenges and for safety of the patients. The sedation training courses including clinical skills and knowledge are necessary for the registered nurses to facilitate the patient safety and the successful procedure. However, appropriate patient selection and preparation, adequate monitoring and regular training will ensure that the use of nurse-administered sedation is a feasible and safe technique for gastrointestinal endoscopic procedures. PMID:26191341
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ERIC Educational Resources Information Center
Pooyan, Abdullah; And Others
Turnover rates for nurses are among the highest for all professional employees. This study investigated the potential predictors of registered nurses' intention to quit. Survey questionnaires were mailed to a population of 779 registered nurses from two hospitals in North Dakota. Approximately 4 weeks later, usable responses were received from 353…
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ERIC Educational Resources Information Center
Pipkin, Jessica Monique
2015-01-01
A high-demand is placed on healthcare providers to be educators during student clinical training evolutions. Certified registered nurse anesthesia clinical educators (CRNACEs) affiliated with nurse anesthesia education programs (NAEPs) in the United States face the complex duality of assuming the combined role of teacher and anesthesia provider.…
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Pryor, Julie; Smith, Clair
2002-08-01
This study sought to explore systematically the role of Registered Nurses working in rehabilitation in Australia. Rehabilitation has been identified as an important aspect of health care. However, evidence of a comprehensive investigation of the nurses' role in rehabilitation cannot be found. From Australia, in particular, no research has been published in this area. This study used a qualitative approach by engaging 13 nurses in one-to-one interviews and a further 21 in focus group discussions. Thematic analysis was conducted on the interview and focus group data. Seven domains of practice were identified and are suggested as a framework for the specialty practice of rehabilitation nursing. They capture the 'how' and 'what' of rehabilitation nursing practice. Central to this practice is a rehabilitative approach to patient care, teaching and coaching, and continual assessment. The nurses explained in detail how these aspects of rehabilitation nursing differentiate their practice from that of their acute care colleagues. The rehabilitative approach is one of a variety of approaches to nursing care, but should not be seen as the exclusive domain of rehabilitation nurses. Rehabilitation belongs in every nurse's toolkit.
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Verbal abuse from nurse colleagues and work environment of early career registered nurses.
Budin, Wendy C; Brewer, Carol S; Chao, Ying-Yu; Kovner, Christine
2013-09-01
This study examined relationships between verbal abuse from nurse colleagues and demographic characteristics, work attributes, and work attitudes of early career registered nurses (RNs). Data are from the fourth wave of a national panel survey of early career RNs begun in 2006. The final analytic sample included 1,407 RNs. Descriptive statistics were used to describe the sample, analysis of variance to compare means, and chi square to compare categorical variables. RNs reporting higher levels of verbal abuse from nurse colleagues were more likely to be unmarried, work in a hospital setting, or work in a non-magnet hospital. They also had lower job satisfaction, and less organizational commitment, autonomy, and intent to stay. Lastly, they perceived their work environments unfavorably. Data support the hypothesis that early career RNs are vulnerable to the effects of verbal abuse from nurse colleagues. Although more verbal abuse is seen in environments with unfavorable working conditions, and RNs working in such environments tend to have less favorable work attitudes, one cannot assume causality. It is unclear if poor working conditions create an environment where verbal abuse is tolerated or if verbal abuse creates an unfavorable work environment. There is a need to develop and test evidence-based interventions to deal with the problems inherent with verbal abuse from nurse colleagues. © 2013 Sigma Theta Tau International.
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Huynh, Truc; Alderson, Marie; Nadon, Michelle; Kershaw-Rousseau, Sylvia
2011-01-01
Recognizing the emotional labour underlying interprofessional collaborations (IPCs) could be considered a crucial step towards building a cohesive nursing team. Although IPCs between registered nurses (RNs) and licensed practical nurses (LPNs) have been linked to quality nursing care, little is known about the emotions experienced by LPNs during their interactions with RNs or those factors that influence IPCs. A questionnaire administered to 309 LPNs found that (1) the professional identity of LPNs has evolved into a that of a unique social group; (2) LPNs define IPC as an interpersonal process of exploring similar or dissimilar assessments of a patient's status with RNs and, together, establishing a course of nursing actions; (3) the primary organizational factor facilitating IPCs is inclusive nursing leadership; (4) the interpersonal factor promoting IPCs is the level of trust RNs extend to LPNs; and (5) an LPN's emotional labour (i.e., internal emotional regulation) is most tangible during uncollaborative interactions with RNs. PMID:22135732
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A prospective cohort study examining the preferred learning styles of acute care registered nurses.
McCrow, Judy; Yevchak, Andrea; Lewis, Peter
2014-03-01
This paper reports on the preferred learning styles of Registered Nurses practicing in acute care environments and relationships between gender, age, post-graduate experience and the identified preferred learning styles. A prospective cohort study design was used. Participants completed a demographic questionnaire and the Felder-Silverman Index of Learning Styles (ILS) questionnaire to determine preferred learning styles. Most of the Registered Nurse participants were balanced across the Active-Reflective (n = 77, 54%), and Sequential-Global (n = 96, 68%) scales. Across the other scales, sensing (n = 97, 68%) and visual (n = 76, 53%) were the most common preferred learning style. There were only a small proportion who had a preferred learning style of reflective (n = 21, 15%), intuitive (n = 5, 4%), verbal (n = 11, 8%) or global learning (n = 15, 11%). Results indicated that gender, age and years since undergraduate education were not related to the identified preferred learning styles. The identification of Registered Nurses' learning style provides information that nurse educators and others can use to make informed choices about modification, development and strengthening of professional hospital-based educational programs. The use of the Index of Learning Styles questionnaire and its ability to identify 'balanced' learning style preferences may potentially yield additional preferred learning style information for other health-related disciplines. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Work engagement and its predictors in registered nurses: A cross-sectional design.
Wan, Qiaoqin; Zhou, Weijiao; Li, Zhaoyang; Shang, Shaomei; Yu, Fang
2018-04-23
Nurses are key staff members of health-care organizations. Nurse engagement directly influences quality of care and organizational performance. The purpose of the present study was to understand the state of work engagement and explore its predictors among registered nurses in China by using a descriptive, cross-sectional survey design (n = 1065). Work engagement was measured with the Chinese version of the Utrecht Work Engagement Scale. The results showed that the average work engagement of Chinese nurses was 3.54 (standard deviation = 1.49), and that nurses' age (β = .16, t = 5.32), job characteristics (β = .33, t = 9.43), and practice environment (β = .23, t = 6.59) were significant predictors of work engagement. Thus, nurse leaders should be encouraged to shape motivational job characteristics and create supportive practice environment so as to increase nurses' work engagement. © 2018 John Wiley & Sons Australia, Ltd.
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ERIC Educational Resources Information Center
Safian-Rush, Donna
During the past few years, there has been a drastic shortage of registered nurses in the field of psychiatric mental health. An evaluation conducted on an internship curriculum designed to facilitate effective nursing care in the treatment of clients who exhibit emotional problems is presented with details on a study to attract and retain nurses…
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Millennials Almost Twice As Likely To Be Registered Nurses As Baby Boomers Were.
Auerbach, David I; Buerhaus, Peter I; Staiger, Douglas O
2017-10-01
Baby-boomer registered nurses (RNs), the largest segment of the RN workforce from 1981 to 2012, are now retiring. This would have led to nurse shortages but for the surprising embrace of the profession by millennials-who are entering the nurse workforce at nearly double the rate of the boomers. Still, the boomers' retirement will reduce growth in the size of the RN workforce to 1.3 percent per year for the period 2015-30. Project HOPE—The People-to-People Health Foundation, Inc.
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Understanding skill acquisition among registered nurses: the 'perpetual novice' phenomenon.
Wilson, Barbara; Harwood, Lori; Oudshoorn, Abe
2015-12-01
To determine whether the perpetual novice phenomenon exists beyond nephrology nursing where it was first described. The perpetual novice is a state in which nurses are unable to progress from a novice to an expert in one or more essential clinical skills which are used in their practice area. Maintaining clinical competence is essential to quality patient care outcomes. An exploratory, sequential, mixed methods design was used, comprised of a quantitative component followed by in-depth interviews. Registered nurses employed in one of four roles were recruited from two university-affiliated hospitals in London, Ontario, Canada: Clinical Educator, Clinical Nurse Specialist, Advanced Practice Nurse and Nurse Practitioner. Participants were first asked to complete and return a survey and demographic questionnaire. Following the return of the completed surveys, ten participants were interviewed to enhance the results of the surveys. The results of the surveys confirmed that the perpetual novice phenomenon exists across multiple nursing care areas. Four contributing factors, both personal and structural in nature, emerged from the interviews: (1) opportunities for education, (2) the context of learning, (3) personal motivation and initiative to learn and (4) the culture of the units where nurses worked. The perpetual novice phenomenon exists due to a combination of both personal factors as well as contextual factors in the work environment. The results assist in directing future educational interventions and provide nursing leaders with the information necessary to create work environments that best enable practicing nurses to acquire and maintain clinical competence. © 2015 John Wiley & Sons Ltd.
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Educational strategies for rural new graduate registered nurses.
Dowdle-Simmons, Sara
2013-03-01
Rural health care facilities are geographically remote, tend to be small, and often possess limited resources. Although newly graduated registered nurses are important to the work force of many rural communities, maintaining a formal preceptorship/mentorship program within a rural hospital may prove difficult as a result of limited resources. Unfortunately, the new graduate may become overwhelmed by the many expectations for clinical practice and the facility can experience high turnover rates of new graduate hires. This article explores the unique traits of the rural hospital and the new graduate nurse as well as the pros and cons of a formal preceptorship program within a rural setting. Constructivist learning theory is used to develop practical teaching strategies that can be used by the preceptor and the new graduate. These strategies are inexpensive, yet effective, and are feasible for even the smallest of facilities. Copyright 2013, SLACK Incorporated.
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Mock Code: A Code Blue Scenario Requested by and Developed for Registered Nurses
Rideout, Janice; Pritchett-Kelly, Sherry; McDonald, Melissa; Mullins-Richards, Paula; Dubrowski, Adam
2016-01-01
The use of simulation in medical training is quickly becoming more common, with applications in emergency, surgical, and nursing education. Recently, registered nurses working in surgical inpatient units requested a mock code simulation to practice skills, improve knowledge, and build self-confidence in a safe and controlled environment. A simulation scenario using a high-fidelity mannequin was developed and will be discussed herein. PMID:28123919
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Rall, M; Meyer, S M
2006-03-01
Existing literature on the marketing of primary healthcare services was reviewed to determine the role of registered nurses in this regard. The systematic review included five searches and ensured wide coverage of the results of available primary research studies on the topic. The results were summarised and the role of registered nurses in the marketing of primary healthcare services was identified. Primary research sources on the topic included textbooks on marketing by experts in the field and relevant journal articles by authorities on healthcare marketing. The data were analysed and four main categories identified. To ensure the trustworthiness of the research, Lincoln and Guba's (1981: 215-216) criteria, as explained by Krefting (1991: 217), were applied. Because the population consisted of only literature, ethical considerations concerning human subjects were irrelevant. Results indicated that the basic commercial marketing principles (the so-called 4Ps--product, price, place, and promotion) could be adapted for the health sector. The conclusion was that registered nurses could contribute to the marketing of primary healthcare services by communicating with the community (promotion) and by ensuring effective service (product) delivery at the right price and place. Registered nurses could influence the community's perceptions of health care and facilitate behaviour changes, thereby promote health. The implementation of the findings and recommendations of this research could create a new awareness among registered nurses of their role in the marketing of primary healthcare services in South Africa and improve their skills in this regard.
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Renal in-patient ward nurse experience and job satisfaction: A qualitative study.
McKenzie, Aisha Tamika; Addis, Gulen
2018-06-13
The aim of this study was to examine the experience of registered nurses working in renal inpatients wards at an acute National Health Service (NHS) hospital Trust. Nurse perceptions of their experience particularly in relation to job satisfaction was analysed. Increased understanding of workplace organisation and culture can contribute to improved nurse work experience and better patient care. Worldwide many studies conducted on nurse experience and job satisfaction show that job satisfaction level varies across work settings so analysis of job satisfaction at a local level such as in a ward is important for producing useful analysis and recommendations. Using purposive sampling, semi structured individual interviews were conducted on twelve registered nurses working on renal inpatient wards. The study identified three themes: safe care, organisational culture and work environment. Although staffing was identified as a key element to providing safe care maintaining adequate staffing levels remained a challenge. Whilst there were opportunities for professional development more support is needed for newly qualified nurses. Findings highlighted that renal patients were complex. It is important to maintain adequate staffing levels. Good clinical leadership is required to support and develop the positive experience of nurses. The high turnover of newly qualified nurses is a particular problem and nurse managers need to develop strategies to retain such nurses. Regular audits on staffing levels as part of improving workforce planning and patient safety need to be conducted. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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The visible problems of an "invisible" profession: the crisis and challenge for nursing.
Fagin, C M
1987-01-01
Although I found the special fall 1986 issue of Inquiry, on social responsibility in health care, thought provoking, the nursing profession was conspicuous by its absence. This evoked a letter to the editor, which resulted in an invitation to write this paper, dealing with the challenges and issues facing nursing in the years to come. Among the matters I discuss are the looming shortage of skilled registered nurses, the expanding roles of and opportunities for nurses, the alarming drop in the numbers of highly qualified young people interested in nursing careers, and the necessity of educating nurses in mainstream university baccalaureate programs.
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Penny, Robyn A; Bradford, Natalie K; Langbecker, Danette
2018-03-01
To synthesise evidence of registered nurses' and midwives' experiences with videoconferencing and identify perceptions of the appropriateness, meaningfulness and feasibility of this technology in professional and clinical practice. Videoconferencing is a form of telehealth that can facilitate access to high-quality care to improve health outcomes for patients and enable clinicians working in isolation to access education, clinical supervision, peer support and case review. Yet use of videoconferencing has not translated smoothly into routine practice. Understanding the experiences of registered nurses and midwives may provide practitioners, service managers and policymakers with vital information to facilitate use of the technology. A qualitative meta-synthesis of primary qualitative studies undertaken according to Joanna Briggs Institute methodology. A systematic search of 19 databases was used to identify qualitative studies that reported on registered nurses' or midwives' experiences with videoconferencing in clinical or professional practice. Two reviewers independently appraised studies, extracted data and synthesised findings to construct core concepts. Nine studies met the criteria for inclusion. Five key synthesised findings were identified: useful on a continuum; broader range of information; implications for professional practice; barriers to videoconferencing; and technical support, training and encouragement. While videoconferencing offers benefits, it comes with personal, organisational and professional consequences for nurses and midwives. Understanding potential benefits and limitations, training and support required and addressing potential professional implications all influence adoption and ongoing use of videoconferencing. Registered nurses and midwives are well placed to drive innovations and efficiencies in practice such as videoconferencing. Nursing and midwifery practice must be reframed to adapt to the virtual environment while retaining
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Registered nurses with disabilities: legal rights and responsibilities.
Neal-Boylan, Leslie; Miller, Michelle D
2015-05-01
The purpose of this legal case review and analysis was to determine what kinds of cases involving nurses with disabilities are typically brought to attorneys, which cases tend to be successful, and how and when a nurse with a disability should pursue legal action. The review used the standard legal case analysis method to analyze legal cases that have been brought by registered nurses (RNs) with physical or sensory disabilities from 1995 to 2013. The cases span the period following the enactment of the Americans With Disabilities Act (ADA) of 1990 through the ADA Amendments Act (ADAAA) of 2008. A nurse attorney reviewed the background material to find every case involving an RN with a disability, excluding those with mental health disabilities or substance abuse issues. Case analysis was conducted using standard legal case analysis procedures. Fifty-six cases were analyzed. The cases were categorized into five types of legal claims: (a) disability discrimination (84%); (b) failure to accommodate (46%); (c) retaliation (12.5%); (d) association (3.6%); and (e) hostile work environment (7%). The cases were largely unsuccessful, particularly those brought under the ADA instead of the ADAAA. The case analysis revealed that several cases brought by RNs with disabilities using the ADA might have been successful under the ADAAA. In addition, the case analysis has provided vital information for administrators, leaders, and clinical nurses regarding when a case is appropriate for legal action. These findings from this review will help nurses recognize when they are being treated in a discriminatory way in the workplace, what their legal rights and responsibilities are, and at what point they should pursue legal action. This review has relevance to all RNs working in clinical and academic settings who may have a congenital or acquired physical or sensory disability. © 2015 Sigma Theta Tau International.
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Factors associated with National Council Licensure Examination-Registered Nurse success.
Arathuzik, D; Aber, C
1998-01-01
Identification of factors associated with National Council Licensure Examination-Registered Nurse (NCLEX-RN) success is critical at public colleges of nursing with diverse student populations. This issue was the purpose of this research study. A descriptive correlational research design was used. Seventy-nine generic senior students enrolled in an urban public university participated in the study. Several internal and external blocks to success were described by the students, including family responsibilities, emotional distress, fatigue, and financial and work burdens. Significant correlations were found between success in the NCLEX-RN and cumulative undergraduate nursing program grade point average, English as the primary language spoken at home, lack of family responsibilities or demands, lack of emotional distress, and sense of competency in critical thinking. Establishment of a comprehensive data base-including factors associated with success in the NCLEX-RN and programs of advisement, tutoring, and stress management as well as classes in study skills, test taking, and NCLEX preparation-are recommended for public colleges of nursing with diverse student populations.
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Penney, Wendy; Poulter, Nola; Cole, Clare; Wellard, Sally
2016-01-01
Nurses worldwide are expected to take a leading role in caring for older people. Considerable literature dedicated to the range and application of assessment skills used by nurses vary. There is limited knowledge of registered nurses' (RNs) views of their assessment of older adults. The aim of this project was to explore RNs current perceptions of nursing assessment, and the core skills they identified as necessary. A qualitative descriptive design study was conducted in three inpatient units in one regional hospital in Victoria. Date were collected through participant observation of RNs (n = 13) followed by 1:1 semi-structured interviews. Data were analysed thematically. This research has illuminated that an ill-defined repertoire of skills was used by RNs when assessing older persons. Skills identified appeared to be based on years of personal-professional experience. Differences were noted between the descriptions nurses gave and what was observed during interactions with older persons.
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King, L A; McInerney, P A
2006-11-01
Hospital workplace experiences of registered nurses that have contributed to their resignation in the Durban Metropolitan Area. The purpose of this research was to explore and describe the hospital workplace experiences that had contributed to the resignations of Registered Nurses in the Durban Metropolitan Area. The broad perspective governing this research is qualitative in nature. The researcher employed a phenomenological approach specifically because the researcher was interested in identifying, describing and understanding the subjective experiences of individual nurses at the two Private and two Provincial health care institutions selected to participate in the study - in respect of their decision (s) to resign from their employment, and/or to leave the nursing profession. Two semistructured interviews were conducted with each participant by the researcher. The researcher applied the principle of theoretical saturation and a total of fifteen participants were interviewed and thirty interviews were conducted. Experiential themes and subthemes in the data were identified by a process of meaning condensation, and the data were managed by means of a qualitative software package - NVIVO (QSR - NUD*IST). The resignations of registered nurses in the Durban Metropolitan Area were found to be linked to their respective hospital workplace experiences. These experiences related to their physical working conditions and environment and included the following: unsupportive management structures, autocratic and dehumanizing management styles, negative stereotypy of nurses and the nursing profession, lack of autonomy in the workplace, professional jealousies and fractures within the profession, sub-optimal physical working conditions and shortage of staff, equipment and lack of appropriate surgical supplies, concerns regarding occupational safety e.g. the increasing exposure of health care personnel to HIV and AIDS; lack of opportunities for promotion or continuing one
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Gunningberg, Lena; Mårtensson, Gunilla; Mamhidir, Anna-Greta; Florin, Jan; Muntlin Athlin, Åsa; Bååth, Carina
2015-08-01
The aim of this study was to describe and compare the knowledge of registered nurses (RNs), assistant nurses (ANs) and student nurses (SNs) about preventing pressure ulcers (PUs). PU prevention behaviours in the clinical practice of RNs and ANs were also explored. A descriptive, comparative multicentre study was performed. Hospital wards and universities from four Swedish county councils participated. In total, 415 participants (RN, AN and SN) completed the Pressure Ulcer Knowledge Assessment Tool. The mean knowledge score for the sample was 58·9%. The highest scores were found in the themes 'nutrition' (83·1%) and 'risk assessment' (75·7%). The lowest scores were found in the themes 'reduction in the amount of pressure and shear' (47·5%) and 'classification and observation' (55·5%). RNs and SNs had higher scores than ANs on 'aetiology and causes'. SNs had higher scores than RNs and ANs on 'nutrition'. It has been concluded that there is a knowledge deficit in PU prevention among nursing staff in Sweden. A major educational campaign needs to be undertaken both in hospital settings and in nursing education. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
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Promoting Trust in the Registered Nurse-Patient Relationship.
Leslie, Jamie Lynn; Lonneman, William
2016-01-01
The establishment of trust in the registered nurse (RN)-patient relationship promotes patient engagement and improves the likelihood that the patient will be an active member of the patient care team. The purpose of this article is to examine nursing literature to identify the antecedents, attributes, and outcomes of trusting relationships between RNs and patients in home healthcare. Antecedents of trust for the RN-patient relationship included 1) meeting a need, 2) respect, 3) attention to time, 4) continuity of care, and 5) the initial visit. Attributes of trust between RN and patient in the home healthcare setting were identified as communication, connection, and reciprocity. For the RN and patient who established mutual trust, patients demonstrated better adaptation and collaboration for improvement of health, expressed a sense of security, and indicated a willingness to engage in additional trusting relationships. Barriers to a trusting relationship included a lack of respect and incompetent and/or unethical care.
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Creating a culture of professional development: a milestone pathway tool for registered nurses.
Cooper, Elizabeth
2009-11-01
The nursing shortage continues to be a significant threat to health care. Creating a culture of professional development in health care institutions is one way to combat this shortage. Professional development refers to a constant commitment to maintain one's knowledge and skill base. Increasing professional development opportunities in the health care setting has been shown to affect nurse retention and satisfaction. Several approaches have been developed to increase professional development among nurses. However, for the most part, these are "one size fits all" approaches that direct nurses to progress in lock step fashion in skill and knowledge acquisition within a specialty. This article introduces a milestone pathway tool for registered nurses designed to enhance professional development that is unique to the individual nurse and the specific nursing unit. This tool provides a unit-specific concept map, a milestone pathway template, and a personal professional development plan. Copyright 2009, SLACK Incorporated.
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Mazurenko, O; Gupte, G; Shan, G
2014-12-01
This study examined the education and work experience of immigrant and American-trained registered nurses from 1988 to 2008. The USA increasingly relies on immigrant nurses to fill a significant nursing shortage. These nurses receive their training overseas, but can obtain licenses to practice in different countries. Although immigrant nurses have been in the USA workforce for several decades, little is known about how their education and work experience compares with USA-trained nurses. Yet much is presumed by policy makers and administrators who perpetuate the stereotype that immigrant nurses are not as qualified. We analysed the National Sample Survey of Registered Nurses datasets from 1988 to 2008 using the Cochran-Armitage trend tests. Our findings showed similar work experience and upward trends in education among both groups of nurses. However, American-trained nurses were more likely to further advance their education, whereas immigrant nurses were more likely to have more work experience and practice in a wider range of healthcare settings. Although we discovered differences between nurses trained in the USA and abroad, we theorize that these differences even out, as education and work experience each have their own distinct caregiving advantages. Immigrant nurses are not less qualified than their American-trained counterparts. However, healthcare providers should encourage them to further pursue their education and certifications. Even though immigrant nurses' education and work experience are comparable with their American counterparts, workforce development policies may be particularly beneficial for this group. © 2014 International Council of Nurses.
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Cady, Rhonda G; Kelly, Anne M; Finkelstein, Stanley M; Looman, Wendy S; Garwick, Ann W
2014-01-01
Care coordination is an essential component of the pediatric health care home. This study investigated the attributes of relationship-based advanced practice registered nurse care coordination for children with medical complexity enrolled in a tertiary hospital-based health care home. Retrospective review of 2,628 care coordination episodes conducted by telehealth over a consecutive 3-year time period for 27 children indicated that parents initiated the majority of episodes and the most frequent reason was acute and chronic condition management. During this period, care coordination episodes tripled, with a significant increase (p < .001) between years 1 and 2. The increased episodes could explain previously reported reductions in hospitalizations for this group of children. Descriptive analysis of a program-specific survey showed that parents valued having a single place to call and assistance in managing their child's complex needs. The advanced practice registered nurse care coordination model has potential for changing the health management processes for children with medical complexity. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.
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Kash, Bita A; Castle, Nicholas G; Naufal, George S; Hawes, Catherine
2006-10-01
We examined the effects of facility and market-level characteristics on staffing levels and turnover rates for direct care staff, and we examined the effect of staff turnover on staffing levels. We analyzed cross-sectional data from 1,014 Texas nursing homes. Data were from the 2002 Texas Nursing Facility Medicaid Cost Report and the Area Resource File for 2003. After examining factors associated with staff turnover, we tested the significance and impact of staff turnover on staffing levels for registered nurses (RNs), licensed vocational nurses (LVNs) and certified nursing assistants (CNAs). All three staff types showed strong dependency on resources, such as reimbursement rates and facility payor mix. The ratio of contracted to employed nursing staff as well as RN turnover increased LVN turnover rates. CNA turnover was reduced by higher administrative expenditures and higher CNA wages. Turnover rates significantly reduced staffing levels for RNs and CNAs. LVN staffing levels were not affected by LVN turnover but were influenced by market factors such as availability of LVNs in the county and women in the labor force. Staffing levels are not always associated with staff turnover. We conclude that staff turnover is a predictor of RN and CNA staffing levels but that LVN staffing levels are associated with market factors rather than turnover. Therefore, it is important to focus on management initiatives that help reduce CNA and RN turnover and ultimately result in higher nurse staffing levels in nursing homes.
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Huria, Tania; Cuddy, Jessica; Lacey, Cameron; Pitama, Suzanne
2014-10-01
Substantial health disparities exist between Māori--the indigenous people of Aotearoa New Zealand--and non-Māori New Zealanders. This article explores the experience and impact of racism on Māori registered nurses within the New Zealand health system. The narratives of 15 Māori registered nurses were analyzed to identify the effects of racism. This Māori nursing cohort and the data on racism form a secondary analysis drawn from a larger research project investigating the experiences of indigenous health workers in New Zealand and Canada. Jones's levels of racism were utilized as a coding frame for the structural analysis of the transcribed Māori registered nurse interviews. Participants experienced racism on institutional, interpersonal, and internalized levels, leading to marginalization and being overworked yet undervalued. Māori registered nurses identified a lack of acknowledgement of dual nursing competencies: while their clinical skills were validated, their cultural skills-their skills in Hauora Māori--were often not. Experiences of racism were a commonality. Racism--at every level--can be seen as highly influential in the recruitment, training, retention, and practice of Māori registered nurses. The nursing profession in New Zealand and other countries of indigenous peoples needs to acknowledge the presence of racism within training and clinical environments as well as supporting indigenous registered nurses to develop and implement indigenous dual cultural-clinical competencies. © The Author(s) 2014.
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Avis, Mark; Mallik, Maggie; Fraser, Diane M
2013-11-01
Transition experiences of newly qualified midwives were examined in depth during the third phase of a UK evaluation study of midwifery education. The fitness to practise and the retention of newly qualified nursing and midwifery graduates are pressing concerns for health care managers. The advantages of preceptorship are reported in the literature but the content and timing of schemes remain unclear. A semi-structured diary was kept for up to 6 months by 35 newly qualified midwives in 18 work sites covering all countries in the UK. The preceptor and supervisor of midwives for each newly qualified midwife completed short questionnaires about their preceptee's performance, and a further sub-sample of newly qualified midwives and preceptors participated in a semi-structured interview. Data were analysed to elicit aspects of newly qualified midwives transition experiences. Findings confirm that structured preceptorship schemes are not widely available. Newly qualified midwives primarily obtained transition support from members of the midwifery team. Although perceived as competent, there is no demarcation point in becoming confident to practise as a registered practitioner. Implications for managers include the importance of a supportive culture within clinical teams for successful transition and the introduction of structured preceptorship schemes facilitated by appropriate rotation patterns. © 2012 John Wiley & Sons Ltd.
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Health for all--interpretation of meaning by newly qualified general and staff certified nurses.
Ndlovu, R J
1991-06-01
Zimbabwe adopted P.H.C. approach in 1980 in order to provide equitable distribution of health services and to achieve H.F.A. In 1985 new Nursing education curriculae were introduced to orient student nurses and their teachers to this approach. Between 1986 and 1990 a study was conducted in which 416 newly qualified General and State Certified Nurses answered a comprehensive questionnaire relating to how the nurse training programme prepared them for their work. One question from the self administered questionnaire required them to state their interpretation of H.F.A. and indicate whether they believed that such a goal was achievable by the year 2000. Over 50 pc of respondents from the new curriculae interpreted H.F.A. as physical and financial accessibility of health services and that this goal was not achievable by the year 2000. The interpretation by candidates from the old curriculae was divided among four concepts and over 50% of the respondents believed that the goal was achievable by the target date.
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Höglander, Jessica; Eklund, Jakob Håkansson; Eide, Hilde; Holmström, Inger K; Sundler, Annelie J
2017-12-01
This study aims to explore nurse assistants' and Registered Nurses' responses to older persons' expressions of emotional needs during home care visits. Communication is a central aspect of care. Older persons might express different emotions and needs during home care visits and such expressions can be challenging to respond to. Little is known about communication in home care or nursing staff responses to older persons' expressed emotional needs. Descriptive, cross-sectional design on nursing staff responses to older persons' negative emotions in home care. Collected data consisted of audio recordings of home care visits between older persons and nursing staff. Data were collected between August 2014-November 2015. The nursing staff responses to older persons' negative emotions in the communication were analysed with the Verona Coding Definitions of Emotional Sequences (VR-CoDES). The nursing staff most often give non-explicit responses, providing space for further disclosure of older persons' expressed negative emotions. Such responses were more frequent if the nursing staff had elicited the older persons' expressions of a negative emotion than if such expressions were elicited by the older persons themselves. Most frequent types of responses were backchannel, active invitation or information advice. The nursing staff responses were mainly non-explicit responses providing space for older persons to tell more about their experiences. Such responses can be discussed in terms of person-centred communication and is important for the comfort of emotional concerns. © 2017 John Wiley & Sons Ltd.
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Drennan, Vari M; Porter, Elizabeth M J; Grant, Robert L
2013-08-01
Educationalists and managers internationally are challenged to find ways of preparing, recruiting early in their careers, and retaining nurses into public health roles in primary care. Public health nursing qualifications are post-initial nurse registration in the United Kingdom as in some other countries. In the mid twentieth century there were a number of innovative programmes of dual qualification: registered nurse and health visitor (the United Kingdom term for public health nurse). To investigate the career histories of graduates from courses integrating both nursing and health visitor qualifications. An observational, survey study. The United Kingdom. A purposive sample of graduates from integrated registered nurse and health visitor programmes, 1959-1995, from one University. Self completed, anonymous, survey sent to graduates, with contact details known to the University and through snowballing techniques, in 2011. Forty five women (56%), graduates in all four decades, returned the survey. A significant majority (82%) had taken up health visitor posts on completing the course. Over their careers, 42% of all jobs held were as health visitors. Only four never worked in a post that required a health visiting qualification. Most had undertaken paid work throughout their careers that focused on aspects of public health, often linked to child, maternal and/or family wellbeing. Many held teaching/lecturing and management posts at some point in their career. Those holding management posts were more likely to report leaving them as a result of organisational re-structuring or redundancy than those in non-management posts. Courses that prepare students to be both nurses and health visitors result in a majority of graduates who take up posts as health visitors on qualification and subsequently. Nurse education planners may find this evidence of value in determining ways of providing a future workforce for public health nursing. Copyright © 2012 Elsevier Ltd. All
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Evaluation through research of a three-track career ladder program for registered nurses.
Korman, Carol; Eliades, Aris Beoglos
2010-01-01
A descriptive study design was employed to survey registered nurse participants in a career ladder program comprising of three tracks: clinical, education, and management. Findings indicate that participation allows nurses of varying education preparation and roles to demonstrate professional development. Implications for staff development include efficacy of the online survey technique, provision of a reliable tool to evaluate a career ladder, and evaluation of a career ladder that includes the staff development educator.
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ERIC Educational Resources Information Center
Coffey, Sue; Lindsay, Gail M.; Cochrane, Marianne; Cummings, Katherine; Macdonald, Karen; Mairs, Sandra; Sproul, Susan; Bouchard, Shelley; Lulat, Zainab; Salamat, Nadia; Bell, Ronald
2016-01-01
Background: Education of nurses from a diploma to a degree is a global phenomenon. However, bridging is often seen as a "backdoor" route to becoming a Registered Nurse and very little evaluation data exists to challenge this notion. Objectives: This research project was undertaken to explore student characteristics, academic performance,…
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The effect of Reiki on work-related stress of the registered nurse.
Cuneo, Charlotte L; Curtis Cooper, Maureen R; Drew, Carolyn S; Naoum-Heffernan, Christine; Sherman, Tricia; Walz, Kathleen; Weinberg, Janice
2011-03-01
The Reiki Master Teacher group at a large academic, urban medical center studied the effects of Reiki on work-related stress in Registered Nurse Reiki I class participants. Research suggests that work-related stress is an influential factor in nursing burn out and retention. Reiki, an ancient form of Oriental "energy work" or healing, has been found to decrease stress. The Perceived Stress Scale tool was administered prior to the Reiki I class and after three weeks of practicing self-Reiki. Seventeen participants returned follow-up data. Results indicated that practicing Reiki more often resulted in reduced perceived stress levels. Data from this small pilot study supports educating nurses about Reiki practice to decrease work-related stress.
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Ding, Xiaotong; Yang, Yajuan; Su, Dan; Zhang, Ting; Li, Lunlan; Li, Huiping
2018-04-01
Low job satisfaction is the most common cause of nurses' turnover and influences the quality of nursing service. Moreover, we have no idea regarding whether job control, as an individual factor, can play a role in the relationship. To explore the relationship between work-family conflict and job satisfaction among Chinese registered nurses and the mediating role of job control in this relationship. From August 2015 to November 2016, 487 Chinese registered nurses completed a survey. The study used work-family conflict scale, job control scale, job satisfaction scale, as well as general information. Multiple regression analysis was used to explore the independent factors of job satisfaction. Structural equation model was used to explore the mediating role of job control. Work-family conflict was negatively correlated with job satisfaction (r ‑0.432, p<0.01). In addition, job control was positively related to job satisfaction (r 0.567, p<0.01). Work-family conflict and job control had significant predictive effects on job satisfaction. Job control partially mediated the relationship between work-family conflict and job satisfaction. Work-family conflict affected job satisfaction and job control was a mediator in this relationship among Chinese registered nurses. Job control could potentially improve nurses' job satisfaction.
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Registered nurses' perceptions of cultural and linguistic hospital resources.
Whitman, Marilyn V; Davis, Jullet A
2009-01-01
As the patient population continues to diversify, the need to provide care that is culturally and linguistically appropriate is intensifying. This study describes the perceptions of registered nurses (RNs) in Alabama hospitals regarding the training and resources available for providing culturally and linguistically appropriate care. The population consists of all RNs working in Alabama hospitals. A sample of 1976 RNs was obtained using an online survey. The findings indicate that although some resources and training are currently provided to nurses, the majority of respondents still lack sufficient resources and training to provide culturally and linguistically appropriate care. The lack of uniformity in resources and training makes it difficult to ensure that all healthcare providers are receiving the same information. However, hospitals do have the flexibility to tailor training to areas that are specific to their population needs.
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ERIC Educational Resources Information Center
Doe, Patience Fakornam; Oppong, Elizabeth Agyeiwaa; Sarfo, Jacob Owusu
2018-01-01
The decreasing performance of student nurses in the professional licensure examinations (LE) in Ghana is a major concern to stakeholders, especially at a time when the nurse-patient ratio stands at 1: 1500. The study sought to determine the effect of students' demographic and academic characteristics on performance in the Registered General…
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Gambino, Kathleen M
2010-11-01
This paper is a report of a study of the relationships between Registered Nurses' motivation for entering the profession, occupational commitment and intent to remain with an employer until retirement. Identifying and supporting nurses who are strongly committed to their profession may be the single most influential intervention in combating the nursing shortage. An understanding of the characteristics these individuals possess could lead to a decline in the high attrition rates plaguing the profession. Using a survey design, Registered Nurses enrolled at the school of nursing and/or employed at the associated university medical centre of a large, not-for-profit state university were polled in 2008. Logistic regression analysis was used to determine how the variables of motivation for entry and occupational commitment could indicate intent to remain. The strongest indicators of intent to remain were normative commitment and age, with a 70% average rate of correctly estimating retention. Exp(B) values for normative commitment (1·09) and age (1·07) indicated that for each one-point increase on the normative commitment scale or one-point increase in age, the odds of remaining with an employer until retirement increased by 1·1%. Transformational changes in healthcare environments and nursing schools must be made to encourage loyalty and obligation, the hallmarks of normative commitment. Retention strategies should accommodate mature nurses as well as promote normative commitment in younger nurses. © 2010 Blackwell Publishing Ltd.
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Edgecombe, Kay; Bowden, Margaret
2009-03-01
This article describes the development of a model of nursing students as evolving registered nurses (RNs). It aims to generate critical debate about innovations in nursing teaching and learning. The model is the outcome of research conducted with undergraduate nursing students (n=111) from Flinders University, Adelaide, South Australia. It identifies the positive and negative intrinsic and extrinsic factors that impact on nursing students' clinical learning development and progression from students to proficient novice RNs. This model has implications for future curriculum development, staff development, placement approaches and research in relation to clinical teaching and learning.
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Wheeler, Rebecca M; Foster, Jennifer W
2013-01-01
This study compared the perspectives of internationally educated nurses (IENs) and registered nurses (RNs) educated in the United States regarding participation in hospital governance structures and professional advancement. Nurses' participation in hospital governance is reported to contribute to empowerment. No research has examined how IENs' perceptions about participation in governance compared with those of U.S. RNs. Semistructured interviews were held with 82 nurses in 2 urban hospitals. Forty nurses were reinterviewed to follow up on themes. Internationally educated nurses and US RNs shared similar perspectives. Nurses in both samples did not value participation in governance, lacked guidance about how to advance, and preferred to at the bedside. Strategies to encourage nurses to participate in and value governance and professional advancement opportunities should be explored and adopted.
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Registered nurse job satisfaction and satisfaction with the professional practice model.
McGlynn, Karen; Griffin, Mary Quinn; Donahue, Moreen; Fitzpatrick, Joyce J
2012-03-01
This paper describes the initial assessment of job satisfaction and satisfaction with the professional practice environment of registered nurses working on units where a professional practice model was implemented and the relationship between these two variables. The nursing shortage has been linked to overall job satisfaction and specifically to nurses' satisfaction with the professional practice environment. Initiatives to increase retention and recruitment and decrease turnover have been linked to work satisfaction among nurses. A descriptive, cross-sectional design was used with participants (N = 101) from four patient care units; this represented a 55% response rate. The nurses were moderately satisfied with the professional practice environment but had overall low job satisfaction. There was a significant negative relationship between overall work satisfaction and satisfaction with the professional practice environment (P < 0.0001). The introduction of the professional practice model may have raised awareness of the components of job satisfaction that were not being met. Thus, the nurses may have become more knowledgeable about the potential needs in these areas. Nurse managers and leaders must recognize that job satisfaction consists of many dimensions, and each of these dimensions is important to nurse retention. Implementation of a professional practice model may heighten awareness of the missing components within a practice environment and lead to decreased overall satisfaction. A broader understanding of characteristics associated with increased satisfaction may aid in development of organizational change necessary to retain and attract nurses. © 2012 Blackwell Publishing Ltd.
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Murray-Parahi, Pauline; DiGiacomo, Michelle; Jackson, Debra; Davidson, Patricia M
2016-11-01
To summarise the literature describing new graduate nurse transition to professional practice within the primary health care (PHC) setting. There is a plethora of research literature spanning several decades about new graduate nurse transition in the acute care setting. Yet, the experiences of new graduate nurse in the PHC setting is unremarkable particularly considering the increasing demand for skilled health care workers and focus of health reform to provide care where people work and live. Electronic data bases, Academic Search Complete, EBSCO, Medline, PsycINFO, CINHAL, and ERIC were searched using a combination of terms and synonyms arising from three key concepts which identify the phenomenon; 'transition', 'new graduate registered nurse' and 'primary health care. An inclusive search strategy placed no limits on language or publication date. Of the 50 articles located and examined for relevance; 40 were sourced through databases and 10 from Google Scholar/Alerts and hand-searching references. None of the 19 articles retained for analysis addressed all key concepts. Some challenges of researching the professional transition of graduate nurses in PHC settings included, an absence of definitive transition models, a dearth of literature and deference to acute care research. Nursing in PHC settings, particularly the client's home is notably different to hospital settings because of higher levels of isolation and autonomy. Societal changes, health reform and subsequent demand for skilled workers in PHC settings has caused health care providers to question the logic that such roles are only for experienced nurses. Implications arise for education and health service providers who desire to close the theory practice gap and mitigate risk for all stakeholders when next generation nurses have limited opportunities to experience PHC roles as undergraduates and newly graduated registered nurses are already transitioning in this setting. © 2016 John Wiley & Sons Ltd.
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Saber, Deborah A
2014-01-01
Frontline registered nurses' job satisfaction is important because it is tied to retention, organizational commitment, workforce safety, patient safety, and cost savings. The purpose of this study was to comprehensively, quantitatively examine the largest, moderate, and smallest predictors of frontline registered nurse job satisfaction from 1980 to 2009. A non-a priori meta-analysis was used to analyze studies that met inclusion. Sixty-two studies and 27 job satisfaction predictors met inclusion for analysis. The largest effect sizes were found for task requirements (r = .61), empowerment (r = .55), and control (r = .52), and moderate effect sizes were found for 10 predictors. Fail-safe N indicates high reliability. Heterogeneity between studies was present in all of the 27 predictor analyses. The largest predictors of job satisfaction for the frontline registered nurse may be different than previously thought. Supporting past research, autonomy and stress were found to be moderate predictors of satisfaction. Heterogeneity indicates study differences or moderator influence in studies. Copyright © 2014 Elsevier Inc. All rights reserved.
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Ruesch, Amy L
2018-01-01
Poor communication between the Registered Nurse and a hearing impaired patient can affect quality of care and health outcomes. Communication skills training programs for healthcare providers are needed to improve patient centered care. A descriptive research study, using a knowledge assessment tool developed and validated by the researcher, was conducted on 339 Registered Nurses to identify knowledge deficits to be addressed in a communication skills training program being designed. The educational tool measured the Registered Nurses' knowledge across four areas - hearing impairment, hearing aids, communication strategies, and regulations regarding access to care for a person with a hearing disability. Knowledge deficits were detected in all four areas. Using this educational assessment tool may enable nurse educators to tailor communication skills training programs to specifically address the gaps identified regarding hearing impairment and how to effectively communicate with the hearing impaired patient. Post training program, nurse educators can use the tool to evaluate effectiveness. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Xu, Lijuan; Song, Rhayun
2016-08-01
The purpose of the study was to determine how work-family-school role conflict and social support influence psychological well-being among registered nurses pursuing an advanced degree. A cross-sectional, correlational study design was used. Convenience sampling was used to recruit 320 registered nurses pursuing an advanced nursing degree at 13 hospitals in Korea, from June to October 2011. Data were analyzed using structural equation modeling with the AMOS program. Confirmatory factor analyses were conducted to evaluate the measurement model prior to the testing of study hypotheses before and after controlling for extraneous variables. The fit parameters of the modified model (χ(2)/df=2.01, GFI=0.91, AGFI=0.89, CFI=0.92, SRMR=0.068, and RMSEA=0.065) indicated its suitability as the research model. This model explained 45% of the variance in work-related psychological well-being and 52% of the variance in general psychological well-being. Both social support and work-family-school role conflict exerted significant effects on work-related psychological well-being and general psychological well-being. The findings of the present study imply that work-family-school role conflict influences the psychological well-being of registered nurses pursuing an advanced degree. It is necessary for nursing administrators to develop strategies to help registered nurses to manage their multiple roles and improve both their work-related psychological well-being and their general psychological well-being. Copyright © 2015 Elsevier Inc. All rights reserved.
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Stewart, Malcolm; Cox-Davenport, Rebecca A
2015-08-01
Despite the benefits that nonpharmacologic methods of pain management have to offer, nurses cite barriers that inhibit their use in practice. The purpose of this research study was to compare the perceptions of prelicensed student nurses (SNs) and registered nurses (RNs) toward nonpharmacologic methods of pain management. A sample size of 64 students and 49 RNs was recruited. Each participant completed a questionnaire about their use and perceptions nonpharmacologic pain control methods. Sixty-nine percent of RNs reported a stronger belief that nonpharmacologic methods gave relief to their patients compared with 59% of SNs (p = .028). Seventy-five percent of student nurses felt they had adequate education about nonpharmacologic pain modalities compared with 51% of RN who felt less than adequately educated (p = .016). These findings highlight the need for education about nonpharmacologic approaches to pain management. Applications of these findings may decrease barriers to the use of nonpharmacologic methods of pain management. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
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Generational differences in work ethic among 3 generations of registered nurses.
Jobe, Laura L
2014-05-01
The purpose of this study was to understand if differences in dimensions of work ethic exist among 3 generations of nurses working in an inpatient setting at an acute care facility. Generational differences are linked with increased turnover, with work ethic frequently cited as an important difference. The quantitative, quasi-experimental cross-sectional study recruited inpatient registered nurses from 2 teaching hospitals in a southern US metropolitan area to complete the Multidimensional Work Ethic Profile online. The 285 completed surveys indicated that similarities exist among the 3 generations, with statistically significant differences only in leisure, hard work, and delay of gratification dimensions. Understanding differences in work ethic dimensions could lead to strategies for improving the generational conflict. These results also lead to the conclusion that work ethic differences may not be the cause of the generational conflict among nurses.
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Examination of socio-demographics and job satisfaction in Australian registered nurses.
Reid, Carol; Hurst, Cameron; Anderson, Debra
2013-01-01
The results of the few studies found investigating relationships between sociodemographic variables and job satisfaction in nurses are mixed. Nevertheless some evidence exists which indicates that some socio-demographic variables are related to nurses' job satisfaction. Moreover reports indicate that job satisfaction is Linked to the retention of nurses. Relationships between socio-demographics and job satisfaction of Australian nurses are examined in the current study. To examine relationships between socio-demographic factors and job satisfaction and identify if these factors predicted job satisfaction Levels in Australian nurses. A cross sectional survey was conducted of 2000 Australian registered nurses who were at the time members of an industrial and professional organisation. The nurses were randomised and stratified according to gender and were asked to answer questions on a socio-demographic questionnaire developed by the researcher. The majority of respondents showed positive job satisfaction scores. Pearson's correlation coefficients (r) found the covariates age, years of experience and years in current job were all moderately to highly positively correlated with each other (all r > 0.40, p < 0.001), however there were no significant interactions between these covariates and Job Satisfaction. Multivariable analysis found significant positive relationships existed between job satisfaction, specialty area and health sector. Specialty area and health sector showed significant associations with job satisfaction in nurses. These variables should be considered by governments, nursing, organisational leaders and policy makers when developing future policies and strategies aimed at retention. These variables should be investigated further in relation to nursing job satisfaction.
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46 CFR 4.03-6 - Qualified medical personnel.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 46 Shipping 1 2012-10-01 2012-10-01 false Qualified medical personnel. 4.03-6 Section 4.03-6... AND INVESTIGATIONS Definitions § 4.03-6 Qualified medical personnel. The term qualified medical personnel means a physician, physician's assistant, nurse, emergency medical technician, or other person...
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46 CFR 4.03-6 - Qualified medical personnel.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 46 Shipping 1 2010-10-01 2010-10-01 false Qualified medical personnel. 4.03-6 Section 4.03-6... AND INVESTIGATIONS Definitions § 4.03-6 Qualified medical personnel. The term qualified medical personnel means a physician, physician's assistant, nurse, emergency medical technician, or other person...
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46 CFR 4.03-6 - Qualified medical personnel.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 46 Shipping 1 2011-10-01 2011-10-01 false Qualified medical personnel. 4.03-6 Section 4.03-6... AND INVESTIGATIONS Definitions § 4.03-6 Qualified medical personnel. The term qualified medical personnel means a physician, physician's assistant, nurse, emergency medical technician, or other person...
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Critical thinking of registered nurses in a fellowship program.
Zori, Susan; Kohn, Nina; Gallo, Kathleen; Friedman, M Isabel
2013-08-01
Critical thinking is essential to nursing practice. This study examined differences in the critical thinking dispositions of registered nurses (RNs) in a nursing fellowship program. Control and experimental groups were used to compare differences in scores on the California Critical Thinking Disposition Inventory (CCTDI) of RNs at three points during a fellowship program: baseline, week 7, and month 5. The control group consisted of RNs who received no education in critical thinking. The experimental group received education in critical thinking using simulated scenarios and reflective journaling. CCTDI scores examined with analysis of variance showed no significant difference within groups over time or between groups. The baseline scores of the experimental group were slightly higher than those of the control group. Chi-square analysis of demographic variables between the two groups showed no significant differences. Critical thinking dispositions are a combination of attitudes, values, and beliefs that make up one's personality based on life experience. Lack of statistical significance using a quantitative approach did not capture the development of the critical thinking dispositions of participants. A secondary qualitative analysis of journal entries is being conducted. Copyright 2013, SLACK Incorporated.
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Self-transcendence and work engagement in acute care staff registered nurses.
Palmer, Beth; Quinn Griffin, Mary T; Reed, Pamela; Fitzpatrick, Joyce J
2010-01-01
The ability of human beings to find meaning by being directed toward something, or someone, other than themselves is termed "self-transcendence." Previous research indicated that the ability of nurses to self-transcend and thus derive positive meaning from patient-caring experiences increased work commitment and fostered work engagement. However, the relationship between self-transcendence and work engagement had not been investigated. The purpose of this study was to explore the levels and relationships of self-transcendence and work engagement in acute care staff registered nurses (ACSRNs). This was a descriptive correlational study using Reed's theory of self-transcendence. The Self-transcendence Scale, the Utrecht Work Engagement Scale, and a demographic questionnaire were completed by a convenience sample of 84 ACSRNs who attended an annual acute care nursing conference in northern Illinois. ACSRNs level of self-transcendence was high, similar to that of other nurses, but higher than that of nonnurses. ACSRNs level of work engagement was at the high end of the "average" range. There was a significant positive correlation between self-transcendence and work engagement. Nurses with higher levels of self-transcendence had more energy toward and were more dedicated and absorbed in their work.
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Nowrouzi, Behdin; Rukholm, Ellen; Lariviere, Michel; Carter, Lorraine; Koren, Irene; Mian, Oxana; Giddens, Emilia
2016-03-10
The purpose of the study was to examine factors related to the retention of registered nurses in northeastern Ontario, Canada. A cross-sectional survey of registered nurses working in northeastern Ontario, Canada was conducted. Logistic regression analyses were used to consider intent to stay in current employment in relation to the following: 1) demographic factors, and 2) occupation and career satisfaction factors. A total of 459 (29.8% response rate) questionnaires were completed. The adjusted odds logistic regression analysis of RNs who intended to remain in their current position for the next five years, demonstrated that respondents in the 46 to 56 age group (OR: 2.65; 95% CI: 1.50 to 4.69), the importance of staff development in the organization (OR: 3.04; 95% CI: 1.13 to 8.13) northeastern Ontario lifestyle (OR: 2.61; 95% CI: 1.55 to 4.40), working in nursing for 14 to 22.5 years (OR: 2.55; 95% CI: 1.10 to 5.93), and working between 0 to 1 hour of overtime per week (OR: 1.20; 95% CI: 1.20 to 4.64) were significant factors in staying in their current position for the next five years. This study shows that a further understanding of the work environment could assist with developing retention for rural nurses. Furthermore, employers may use such information to ameliorate the working conditions of nurses, while researchers may use such evidence to develop interventions that are applicable to improving the working conditions of nurses.
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Ricks, Esmeralda; Benjamin, Valencia; Williams, Margaret
2015-11-19
The volume of health information necessary to provide competent health care today has become overwhelming. Mobile computing devices are fast becoming an essential clinical tool for accessing health information at the point-of-care of patients. This study explored and described how registered nurses experienced accessing information at the point-of-care via mobile computing devices (MCDs). A qualitative, exploratory, descriptive and contextual design was used. Ten in-depth interviews were conducted with purposively sampled registered nurses employed by a state hospital in the Nelson Mandela Bay Municipality (NMBM). Interviews were recorded, transcribed verbatim and analysed using Tesch's data analysis technique. Ethical principles were adhered to throughout the study. Guba's model of trustworthiness was used to confirm integrity of the study. Four themes emerged which revealed that the registered nurses benefited from the training they received by enabling them to develop, and improve, their computer literacy levels. Emphasis was placed on the benefits that the accessed information had for educational purposes for patients and the public, for colleagues and students. Furthermore the ability to access information at the point-of-care was considered by registered nurses as valuable to improve patient care because of the wide range of accurate and readily accessible information available via the mobile computing device. The registered nurses in this study felt that being able to access information at the point-of-care increased their confidence and facilitated the provision of quality care because it assisted them in being accurate and sure of what they were doing.
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ERIC Educational Resources Information Center
Harris, Leslie J.
2013-01-01
The population of adults over age 65 must have competently prepared registered nurses to meet their current and future health care needs. There is a societal component in nursing to ensure that all nurses have the content, skills, and strategies, which includes a focus on basic gerontology preparation. Therefore, the purpose of this descriptive…
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Lukewich, Julia; Edge, Dana S.; VanDenKerkhof, Elizabeth; Williamson, Tyler; Tranmer, Joan
2016-01-01
Background: As the organization of primary care continues to evolve toward more interdisciplinary team structures, demonstrating effectiveness of care delivery is becoming important, particularly for nonphysician providers. Nurses are the most common nonphysician provider within primary care. The purpose of this study was to examine the relation between primary care delivery models that incorporate registered nurses and clinical outcomes of patients with type 2 diabetes. Methods: Patient data from the Canadian Primary Care Sentinel Surveillance Network were matched with survey data from 15 Family Health Team practices in southeastern Ontario. Included patients were adults with type 2 diabetes mellitus who had at least 1 primary care encounter at a Family Health Team practice that completed the organizational survey between Apr. 1, 2013, and Mar. 31, 2014. The clinical outcomes explored included hemoglobin A1c, fasting plasma glucose, blood pressure, low-density lipoprotein cholesterol and urine albumin:creatinine ratio. Results: Of the 15 practices, 13 (86.7%) had at least 1 registered nurse. The presence of 1 or more registered nurses in the practice was associated with increased odds of patients' having their hemoglobin A1c, fasting plasma glucose, blood pressure and low-density lipoprotein cholesterol values meet recommended targets. Practices with the lowest ratios of patients with diabetes to registered nurse had a significantly greater proportion of patients with hemoglobin A1c and fasting plasma glucose values on target than did practices with the highest ratios of patients to registered nurse (p < 0.01 and p = 0.03, respectively). Interpretation: The findings suggest that registered nurse staffing within primary care practice teams contributes to better diabetic care, as measured by diabetes management indicators. This study sets the groundwork for further exploration of nursing and organizational contributions to patient care in the primary care setting
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Cooper, Mary Anne; Tinmouth, Jill Margaret; Rabeneck, Linda
2014-01-01
Although colorectal cancer is a leading cause of death in Canada, it is curable if detected in the early stages. Flexible sigmoidoscopy has been shown to reduce the incidence and mortality of colorectal cancer in patients who are at average risk for this disease and, therefore, is an appropriate screening intervention. Moreover, it may be performed by nonphysicians. A program to enable registered nurses to perform flexible sigmoidoscopy to increase colorectal cancer screening capacity in Ontario was developed. This program incorporated practical elements learned from other jurisdictions as well as specific regional considerations to fit within the health care system of Ontario. The nurses received structured didactic and simulation training before performing sigmoidoscopies on patients under physician supervision. After training, nurses were evaluated by two assessors for their ability to perform complete sigmoidoscopies safely and independently. To date, 17 nurses have achieved independence in performing flexible sigmoidoscopy at 14 sites. In total, nurses have screened >7000 Ontarians, with a cancer detection rate of 5.1 per 1000 screened, which is comparable with rates in other jurisdictions and with sigmoidoscopy performed by gastroenterologists, surgeons and other trained nonphysicians. We have shown, therefore, that with proper training and program structure, registered nurses are able to perform flexible sigmoidoscopy in a safe and thorough manner resulting in a significant increase in access to colorectal cancer screening. PMID:24416735
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Role stress among first-line nurse managers and registered nurses - a comparative study.
Johansson, Gunilla; Sandahl, Christer; Hasson, Dan
2013-04-01
Studies show that first-line nurse managers (F-LNMs) experience high psychological job demands and inadequate managerial guidance. The purpose of this study was to investigate whether F-LNMs have higher stress levels and show more signs of stress-related ill health than registered nurses (RNs). The aim of this study was to examine possible differences in self-rated health between F-LNMs and RNs on various psychosocial factors (e.g. job demand, job control and managerial support). Data were collected at a university hospital in Sweden. Sixty-four F-LNMs and 908 RNs filled in a web-based questionnaire. Both F-LNMs and RNs reported having good health. Approximately 10-15% of the F-LNMs and RNs showed signs of being at risk for stress-related ill health. Statistically significant differences (Mann-Whitney U-test) were found in the distribution between the F-LNMs and the RNs on three indices of job control, job demand and managerial support. Our findings suggest that F-LNMs were able to cope with high-demand job situations because of relatively high control over work. The implication for nursing management shows the needs for a work environment for both F-LNMs and RNs that includes high job control and good managerial support. © 2011 Blackwell Publishing Ltd.
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Development of an Intravenous Therapy Module for Second Year Registered Nursing Students.
ERIC Educational Resources Information Center
Balint, Marilyn
A study aimed at developing an intravenous therapy module for second-year registered nursing students is described in this practicum report. The report's five chapters define the underlying problem and purpose of the study; discuss the history of intravenous therapy and the significance of the module to the host institution; review the relevant…
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The National Competency Framework for Registered Nurses in Adult Critical Care: An overview
Baldwin, Andrea; Donnelly, Karen A; Freeman, Pauline; Himsworth, Angela P; Kinoulty, Sheila M; Kynaston, Melanie; Platten, Julie; Price, Ann M; Rumsby, Neville; Witton, Nicola
2017-01-01
In the years following the abolition of the English National Board for Nursing, Midwifery and Health Visiting in 2002, concerns were raised within the Critical Care nursing community about a lack of consistency in post-registration education programmes. In response to this, the Critical Care Network National Nurse Leads (CC3N) formed a sub-group, the Critical Care Nurse Education Review Forum (CCNERF) to address these concerns. A review of UK course provision confirmed marked inconsistency in the length, content and associated academic award. The CCNERF commenced a two-phase project, first developing national standards for critical care nurse education such as length of course and academic credit level, followed by the development of a national competency framework. Following significant review and revision, version two of the National Competency Framework for Registered Nurses in Adult Critical Care was published by CC3N in 2015. This paper introduces the National Competency Framework and provides an overview of its background, development and implementation. It then considers the future direction of UK post-registration Critical Care nurse education. PMID:28979563
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The National Competency Framework for Registered Nurses in Adult Critical Care: An overview.
Deacon, Kate S; Baldwin, Andrea; Donnelly, Karen A; Freeman, Pauline; Himsworth, Angela P; Kinoulty, Sheila M; Kynaston, Melanie; Platten, Julie; Price, Ann M; Rumsby, Neville; Witton, Nicola
2017-05-01
In the years following the abolition of the English National Board for Nursing, Midwifery and Health Visiting in 2002, concerns were raised within the Critical Care nursing community about a lack of consistency in post-registration education programmes. In response to this, the Critical Care Network National Nurse Leads (CC3N) formed a sub-group, the Critical Care Nurse Education Review Forum (CCNERF) to address these concerns. A review of UK course provision confirmed marked inconsistency in the length, content and associated academic award. The CCNERF commenced a two-phase project, first developing national standards for critical care nurse education such as length of course and academic credit level, followed by the development of a national competency framework. Following significant review and revision, version two of the National Competency Framework for Registered Nurses in Adult Critical Care was published by CC3N in 2015. This paper introduces the National Competency Framework and provides an overview of its background, development and implementation. It then considers the future direction of UK post-registration Critical Care nurse education.
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Beogo, Idrissa; Liu, Chieh-Yu; Dlamini, Colile P; Gagnon, Marie-Pierre
2015-01-01
Nursing education has evolved over time to fit societies' increasing care needs. Innovations in nursing education draw thorny debates on potential jeopardy in the quality, safety, and efficacy of nurse graduates. Accelerated nursing education programs have been among landmark strategic changes to address the persistent bedside nurse shortage. Despite the dearth of empirical studies in sub-Saharan Africa (SSA), the National School of Public Health of Burkina Faso has developed a State Diploma Nursing (SDN) fast-track program. With innovative features, the program is nested into the traditional SDN program. This study investigates preliminary outcomes of the implemented policy using the initial cohort that went through the program. Comparison of the traditional generic program and the fast-track one is drawn to inform nursing education policy. The study was conducted in the three campuses delivering the SDN program. Data collected from a representative sample included 255 students from the 2006-2009 cohort, after concluding the program. Surveyed students were assessed according to the program entry status. Outcomes were measured using students' academic performance. Besides descriptive analysis, bivariate t-test, F-test, and multivariate ordinary least square regression (OLSR) were employed to determine the comparative pattern between the traditional generic and the newly nested fast-track program. Students' varied statuses (private pre-registration, state pre-registration, private post-registration, and state post-registration) were kept to better outline the findings trend. A fifth (19.6 %) of surveyed students were enrolled in the fast-track stream from which, one third (33.7 %) consisted of post-registered students. Fast-track students comparatively achieved the best academic performance (mean: 73.68/100, SD: 5.52). Multivariate OLSR confirmed that fast-track students performed better (β: 5.559, p < 0.001), and further informed differences between campuses
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Brewer, Carol S; Chao, Ying-Yu; Colder, Craig R; Kovner, Christine T; Chacko, Thomas P
2015-11-01
Key predictors of early career nurses' turnover are job satisfaction, organizational commitment, job search, intent to stay, and shock (back injuries) based on the literature review and our previous research. Existing research has often omitted one of these key predictors. The purpose of this study in a sample of early career nurses was to compare predictors of turnover to nurses' actual turnover at two time points in their careers. A multi-state longitudinal panel survey of early career nurses was used to compare a turnover model across two time periods. The sample has been surveyed five times. The sample was selected using a two-stage sample of registered nurses nested in 51 metropolitan areas and nine non-metropolitan, rural areas in 34 states and the District of Columbia. The associations between key predictors of turnover were tested using structural equation modeling and data from the earliest and latest panels in our study. We used predictors from the respondents who replied to the Wave-1 survey in 2006 and their turnover status from Wave 2 in 2007 (N=2386). We compared these results to the remaining respondents' predictors from Wave 4 in 2011 and their turnover status in Wave 5 in 2013 (N=1073). We tested and found no effect for missingness from Wave 1-5 and little evidence of attrition bias. Strong support was found for the relationships hypothesized among job satisfaction, organizational commitment, intent to stay, and turnover, with some support for shock and search in the Wave 1-2 sample. However, for Wave 4-5 sample (n=1073), none of the paths through search were significant, nor was the path from shock to turnover. Nurses in the second analysis who had matured longer in their career did not have a significant response to search or shock (back injuries), which may indicate how easily experienced registered nurses find new jobs and/or accommodation to jobs requiring significant physicality. Nurse turnover is a major concern for healthcare organizations
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Melrose, Sherri; Miller, Jean; Gordon, Kathryn; Janzen, Katherine J.
2012-01-01
This paper presents findings from a qualitative descriptive study that explored the professional socialization experiences of Licensed Practical Nurses (LPNs) who attended an online university to earn a Baccalaureate degree in nursing (BN), a prerequisite to writing the Canadian Registered Nurse (RN) qualifying exam. The project was framed from a constructivist worldview and Haas and Shaffir's theory of legitimation. Participants were 27 nurses in a Post-LPN to BN program who came from across Canada to complete required practicums. Data was collected from digital recordings of four focus groups held in different cities. Transcripts were analyzed for themes and confirmed with participants through member checking. Two overarching themes were identified and are presented to explain how these unique adult learners sought to legitimize their emerging identity as Registered Nurses (RNs). First, Post-LPN to BN students need little, if any, further legitimation to affirm their identities as “nurse.” Second, practicum interactions with instructors and new clinical experiences are key socializing agents. PMID:22548165
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Melrose, Sherri; Miller, Jean; Gordon, Kathryn; Janzen, Katherine J
2012-01-01
This paper presents findings from a qualitative descriptive study that explored the professional socialization experiences of Licensed Practical Nurses (LPNs) who attended an online university to earn a Baccalaureate degree in nursing (BN), a prerequisite to writing the Canadian Registered Nurse (RN) qualifying exam. The project was framed from a constructivist worldview and Haas and Shaffir's theory of legitimation. Participants were 27 nurses in a Post-LPN to BN program who came from across Canada to complete required practicums. Data was collected from digital recordings of four focus groups held in different cities. Transcripts were analyzed for themes and confirmed with participants through member checking. Two overarching themes were identified and are presented to explain how these unique adult learners sought to legitimize their emerging identity as Registered Nurses (RNs). First, Post-LPN to BN students need little, if any, further legitimation to affirm their identities as "nurse." Second, practicum interactions with instructors and new clinical experiences are key socializing agents.
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Dhaini, Suzanne R; Denhaerynck, Kris; Bachnick, Stefanie; Schwendimann, René; Schubert, Maria; De Geest, Sabina; Simon, Michael
2018-06-01
Emotional exhaustion among healthcare workers is a widely investigated, well-recognized problem, the incidence of which has recently been linked to work environment factors, particularly work/family conflict. However, another environmental feature that may be equally influential, but that is more amenable to nurse manager action, remains less recognized: shift schedule flexibility. This study's main purposes were to assess variations in work schedule flexibility between Swiss acute care hospital units, and to investigate associations between psychosocial work environment (e.g. work schedule flexibility) and self-reported emotional exhaustion among registered nurses. This is a secondary analysis of data collected for the multi-center observational cross-sectional Match RN study, which included a national sample of 23 hospitals and 1833 registered nurses across Switzerland. Overall, self-reported work schedule flexibility among registered nurses was limited: 32% of participants reported little or no influence in planning their own shifts. Work schedule flexibility (β -0.11; CI -0.16; -0.06) and perceived nurse manager ability (β -0.30; CI -0.49; -0.10) were negatively related to self-reported emotional exhaustion. Work-family conflict (β 0.39; CI 0.33; 0.45) was positively correlated to emotional exhaustion. The study results indicate that managerial efforts to improve working environments, including special efforts to improve work schedule flexibility, might play an important role in promoting nurses' emotional health. Copyright © 2018 Elsevier Ltd. All rights reserved.
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An exploratory study of selected female registered nurses: meaning and expression of nurturance.
Geissler, E M
1990-05-01
The words 'nurse' and 'nursing' originate in the word 'nurture' which dates back to the 14th century. 'Nurturance' appeared for the first time in the 1976 Supplement to the Oxford English Dictionary and in a United States dictionary in 1983. Etymologically and semantically bound to nursing, little is known about the term nurturance. An exploratory design using phenomenological analysis was applied to understand the female registered nurses' experience of nurturing patients throughout the life-span and to uncover behaviours commonly believed nurturant. Interviews with 14 RNs practising in diverse settings revealed 39 nurturant behaviours that were intuited into four themes describing the subjects' perceived structure of nurturance as: (1) enabling maximum potential; (2) providing physical and emotional protection; (3) engaging in a supportive interaction; and (4) conveying shared humanity. Data were formulated into an exhaustive description of the phenomenon nurturance. Additionally, the results support Greenberg-Edelstein's theoretical model of the positive reciprocity of nurturance between nurse and patient.
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Understanding the factors that determine registered nurses' turnover intentions.
Osuji, Joseph; Uzoka, Faith-Michael; Aladi, Flora; El-Hussein, Mohammed
2014-01-01
Turnover among registered nurses (RNs) produces a negative impact on the health outcomes of any health care organization. It is also recognized universally as a problem in the nursing profession. Little is known about the turnover intentions and career orientations of RNs working in Calgary, Alberta, Canada. The aim of this study is to contribute to the knowledge of and to advance the discussion on the turnover of nursing professionals. The study population consisted of RNs employed in the five major hospitals in Calgary. There were 193 surveys returned, representing a response rate of 77.2%. The results show that age and education have a negative effect on turnover intention. Education was found to have a significant negative effect on career satisfaction but not on job satisfaction and organizational commitment. Length of service has a significant negative effect on turnover intention. Role ambiguity has significant highly negative effect on career satisfaction. Growth opportunity and supervisor support have a very significant positive effect on job satisfaction, career satisfaction, and organizational commitment. External career opportunities and organizational commitment do not seem to have a significant effect on turnover intention. Career satisfaction, on the other hand, had negative significant effects on turnover intention.
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Kim, Young Im; Geun, Hyo Geun; Choi, SookJa; Lee, Young Sil
2016-09-01
This study aimed to describe the perceived level of organizational commitment and organizational culture of Korean American Registered Nurses (KARNs) and to investigate predictors of job satisfaction. A total of 163 KARNs working in U.S. hospitals responded to a Web survey. Descriptive analysis, t test, analysis of variance, and stepwise regressions were used for data analysis. KARNs reported moderate levels of job satisfaction (3.5 ± 0.58). Job satisfaction was positively correlated with both organizational commitment (r = .85, p < .001) and culture (r = .66, p < .001). KARNs who were aged ≥50, married, hospital-employed, had longer nursing experience, and experienced turnover at least once were more likely to report higher job satisfaction compared with other nurses. Organizational commitment, culture, marital status, and workplace were significant predictors of and explained 76.8% of the variance in job satisfaction. This study provides evidence to help nursing managers and health policy makers develop educational programs aimed at enhancing job satisfaction and retention of KARNs. © The Author(s) 2016.
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[The construction of professional images of healthcare assistants and registered nurses].
Robin, Dominik; Schaffert, René
2016-02-01
In the field of nursing in Switzerland, educations have experienced a fundamental reorganization with the implementation of the new law on Vocational and Professional Education and Training (2004). Among other things, this change affects professional images. To show how the different professional images in the field of nursing are being constructed in the descriptions of professions by graduates after the reshaping of the educations and the occupational field in general. In 110 semi-structured interviews, healthcare assistants and registered nurses (college diploma and Bachelor of Science) in their early careers were asked to explain their professional image. The participant's answers were analysed based on a qualitative content analysis and considering the theoretical background of Berger and Luckmann (1977). The interviews show that professional images emerge on the interaction of societal attributes and individual processes of adoption and revision. Graduates are challenged to adjust stereotypes and to achieve a balance between their own professional image and a missing or inappropriately perceived societal image. There should be further emphasis on the differentiation between the professions and the different educations in the field of nursing in order to achieve a better public perception of the different professions.
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Flinkman, Mervi; Isopahkala-Bouret, Ulpukka; Salanterä, Sanna
2013-01-01
In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the profession. In this qualitative case study we investigate in depth why young nurses leave nursing profession and reeducate themselves for a new career. The study is based on longitudinal interviews of three young registered nurses in Finland. These nurses were first interviewed between December 2006 and May 2007, when they were 29-32 years old and having an intention to leave the profession. The second interview took place four years later, from January 2011 to March 2011 when all of them had made the transition to a new career. Data were analyzed in two stages. In the first stage, comprehensive career story narratives were formed on the basis of the interviews. In the second stage, emerging themes in these stories were compared, contrasted, and interpreted in the context of the overall career histories. Nursing as a second career choice and demanding work content as well as poor practice environment and the inability to identify with the stereotypical images of nurses were main themes that emerged from these career stories. The results of this interpretative qualitative study reflect a shift toward insights into understanding professional turnover as a complex and long-lasting process.
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Kunyk, Diane
2015-01-01
To investigate substance use disorders, impaired practice and health risks among nurses in a disciplinary jurisdiction. The relationship between substance-related risks to patient safety, nurse health and discipline is understudied. A convenience sample of 4064 registered nurses responded to an Internet survey in 2010. Self-reports were given to psychometrically robust measures of health, substance use disorders and organisational support. Perceptions on the treatment and disposition of impaired nurses were also asked. The prevalence of substance use disorders was similar to the general population. Most nurses' coded high risk for impaired practices were working, unknown by their employer/regulator and not receiving treatment. When compared with nurse-peers, their health and organisational support were compromised. Nurse-peers viewed impaired nurses as having a treatable illness that their employers/regulators should assist and afford confidentiality. In this jurisdiction, discipline was not rated as effective for risk mitigation, supportive of nurses with substance use disorders or in alignment with nurse perceptions. Nursing managers play a significant role in addressing substance-related issues among nurses and can be key to influencing the outcomes of these difficult situations. For these reasons, it is important they recognize the ineffectiveness of discipline for substance-related risk mitigation. © 2013 John Wiley & Sons Ltd.
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Carlson, Elisabeth; Rämgård, Margareta; Bolmsjö, Ingrid; Bengtsson, Mariette
2014-05-01
In Sweden, as well as in most industrialised countries, an increasing older population is expected to create a growing demand for health care staff. Previous studies have pointed to lack of proficient medical and nursing staff specialised in geriatric care, which poses serious threats to the care of a vulnerable population. At the same time, there are studies describing elderly care as a low-status career choice, attracting neither nurses nor student nurses. Judging from previous research it was deemed important to explore how nurses in elderly care perceive their work, thus possibly provide vital knowledge that can guide nurse educators and unit managers as a means to promote a career in elderly care. The aim of the present study was to illuminate how nurses, working in nursing homes and home-based care, perceived their professional work. This was a qualitative study using focus groups. 30 registered nurses in seven focus groups were interviewed. The participants worked in nursing homes and home-based care for the elderly in rural areas and in a larger city in southern Sweden. The interviews were analysed in line with the tradition of naturalistic inquiry. Our findings illustrate how nurses working in elderly care perceived their professional work as holistic and respectful nursing. Three categories of professional work emerged during analysis: (1) establishing long-term relationships, (2) nursing beyond technical skills, and (3) balancing independence and a sense of loneliness. The findings are important as they represent positive alternatives to the somewhat prevailing view on elderly care as depressing and undemanding. Nurse educators might use the key aspects as good examples, thus influencing student nurses' attitudes towards elderly care in a positive way. Elderly care agencies might find them helpful when recruiting and retaining nurses to a much needed area. Copyright © 2013 Elsevier Ltd. All rights reserved.
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An Exploration of Registered Nurses' Intentions to Leave the Profession: A Qualitative Study
ERIC Educational Resources Information Center
Lutter, Stacy Lynn
2011-01-01
The purpose of this qualitative study was to explore the perceptions of female registered nurses who have intentions to leave the profession with particular attention to the influence of gender. The theoretical framework of feminist poststructuralism informed this study, which emphasizes the role of discourse and power relations in the…
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Emotional intelligence levels in baccalaureate-prepared early career registered nurses.
Reemts, Glenda S
2015-01-01
The increasing complexity of the healthcare environment calls for increasing emotional intelligence (EI) competence in nurses. This study assessed the EI competence of 164 baccalaureate nursing alumni who graduated during the years 2007-2010 from three Benedictine institutions located in the Midwestern United States to see if there was growth of EI with experience as a registered nurse (RN), and to determine if age, gender, grade point average (GPA), and years of total healthcare work experience prior to graduation predicted EI. Participants completed the web-based Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and a demographic survey. Findings indicated 79.4% of participants were competent or higher on the MSCEIT total EI score. Percentages of nurses scoring in the competent or higher range on each of the four branch scores of perceiving, using, understanding and managing emotions were 80.6%, 72.7%, 84.2%, and 84.9% respectively. There were no significant differences on EI scores between graduates with 1-2 years compared to 3-5 years of experience as a RN. Results of a linear stepwise regression indicated being female was a significant predictor on the MSCEIT total EI score ( P = 0.015) and using emotions branch ( P = 0.047). Findings also indicated GPA ( P < 0.001) and being female ( P = 0.023) were significant predictors of EI on the understanding emotions branch. The findings indicate there is work to be done to improve the EI competence of nursing graduates. Continued research on the topic of EI and nursing is needed to build the knowledge base on how to promote positive patient outcomes.
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Simons, Shellie
2008-01-01
This descriptive study examines bullying behavior among nurses and tests the relationship between bullying and a nurse's intention to leave their organization. Data were collected from 511 randomly selected newly licensed registered nurses by using the Revised Negative Acts Questionnaire, an instrument that measures perceived exposure to bullying at work. Results found that 31% of respondents reported being bullied and that bullying is a significant determinant in predicting intent to leave the organization (B = 3.1, P < .0005). Data suggest that effective interventions are needed to stop workplace bullying that contributes to high rates of nurse turnover.
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Nurses' perceptions of the challenges related to the Omanization policy.
Al-Riyami, M; Fischer, I; Lopez, V
2015-12-01
Human resource development has become a major concern in Oman since the inception of the 'Omanization' policy in 1988. The main goal of this policy was to replace the expatriate nursing workforce with similarly qualified local nurses to develop a sustainable workforce and achieve self-reliance. The aim of this study is to explore the nurses' perceptions of Omanization policy. A qualitative research design was used and 16 Omani registered nurses and 26 student nurses were interviewed in depth. Transcribed data were analysed using content analysis. Two main themes emerged from the data: 'Challenges of sustaining the local nursing workforce' and 'Challenges of educational preparation for local nurses'. The participants agreed that Omanization benefited national development, social stability and ensuring local workforce. The challenges faced were cultural and work life balance, preparation of nurses and pace of replacement. The participants were concerned that the pace of replacement could leave behind a marked experience gap. A slow-phased approach to Omanization of the nursing workforce was recommended by the participants. Results obtained from this study reflect the perceptions and voices of student nurses and registered nurses only from the Institute of Nursing and Oman Ministry of Health. A policy of this magnitude requires gradual establishment. The upgrading of the nursing education to degree level, continuous professional development, mentoring and role modeling of expert nurses should be established to prepare local nurses for the localization of the nursing workforce. © 2015 International Council of Nurses.
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Turnover intention among hospital-based registered nurses in the Eastern Caribbean.
Lansiquot, Beverley Anne; Tullai-McGuinness, Susan; Madigan, Elizabeth
2012-06-01
Vacancy rates for nurses in the English-speaking Caribbean are estimated at 30% with turnover typically associated with migration. The purpose of this study was to describe the characteristics of hospital-based registered nurses (RNs) in the sub-region, their practice environment and turnover intention in two and five years, respectively, and to determine the relationships among practice environment characteristics and turnover intention. A descriptive correlational design was used with self-reported questionnaires from a convenience sample of 301 RNs working in hospitals in four English speaking Eastern Caribbean countries. Single-item visual analog scales (VAS) were used to measure turnover intention in 2 years and 5 years. The Practice Environment Scale of the Nursing Work Index (PES-NWI) measured the characteristics in the practice environment. The mean age of the nurses was 32.5 (SD = 6.75) years. Most nurses (58.8%) were single and 91.4% had relatives living abroad. Nurses scored three PES-NWI subscales < 2.5, indicating a less positive practice environment: resource adequacy, nurse participation in hospital affairs, and nurse managers' ability, leadership, and support. The subscale for collegial nurse-physician relations received the best rating (mean = 2.61, SD = .62). For 2-year intention to leave, the mean rating on the 100-mm VAS was 63.2, while that for the 5-year intention to leave was 65.6. No significant correlations were found among four of the five PES-NWI subscales and turnover intention in 2 and 5 years. The practice environment, while generally unfavorable, is not associated with the nurses' intention to leave their jobs. These findings support the current policy position that calls for managing turnover among nurses. Nursing and health system administrators should assess, plan, and implement workforce policies to slow the outflow of nurses. Initiatives to improve the work environment and the delivery of high-quality care are important to RNs in
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Moaveni, Azadeh; Gallinaro, Anna; Conn, Lesley Gotlib; Callahan, Sheilagh; Hammond, Melanie; Oandasan, Ivy
2010-12-01
This paper describes the results of a Delphi panel process to gain consensus on a role description and competency framework for family practice registered nurses (FP-RNs) in Ontario. Based on the findings from interviews and focus groups with family practice registered nurses and their inter-professional colleagues throughout Ontario, a core competency framework for FP-RNs emerged consisting of six distinct roles - Professional, Expert, Communicator, Synergist, Health Educator and Lifelong Learner - with accompanying enabling competency statements. This framework was refined and validated by a panel of experts from various nursing and family medicine associations and organizations through a Delphi consensus process. This core competency framework for FP-RNs was developed as a stepping stone for clarifying this very important and poorly understood role in family practice. As a result of this research, we expect a greater acknowledgement of the contributions and expertise of the FP-RN as well as the need to celebrate and profile this role. This work has already led to the establishment of a network of stakeholders from nursing organizations in Ontario who are considering opportunities to move the development and use of the competency framework forward.
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Stratton, T D; Dunkin, J W; Juhl, N; Geller, J M
1995-05-01
Researchers have demonstrated repeatedly the importance of the relationship linking job satisfaction to employee retention. In rural areas of the country, where a persistent maldistribution of nurses continues to hamper health care delivery, the potential benefits of bolstering retention via enhancements in job satisfaction are of utmost utility to administrators and providers alike. Data were gathered from a multistate survey of registered nurses (RNs) practicing in rural hospitals, skilled nursing facilities, and community/public health settings (N = 1,647; response rate = 40.3%). The investigators found that the use of tuition reimbursement corresponded significantly with increased levels of job satisfaction among nurses in all three practice environments, as did day care services for nurses in acute care settings. Also, among hospital-based RNs, level of nursing education was found to be a significant factor in the relationship between tuition reimbursement and job satisfaction, with the highest level occurring among diploma-prepared nurses.
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Perceptions of intentional wrongdoing and peer reporting behavior among registered nurses.
King, G
2001-11-01
How a person perceives a wrongdoing being committed by a coworker will affect whether the incident is reported within the organization. A significant factor that may influence the decision to report a wrongdoing is the perceived intentionality of the wrongdoer. This study sought to examine if differences in perceptions of a wrongdoing could affect the disclosure of unethical behavior. Three hundred seventy-two registered nurses (N=372) responded to a survey consisting of both intentional and unintentional wrongdoings that could occur by a nurse. Results of a paired t-test were as predicted. More wide ranging revelations found that respondents were more likely to discuss the unintentional wrongdoings with the wrongdoer in lieu of officially reporting to an immediate supervisor, or a member of upper management. Discussion, limitations, and suggestions for future research are provided.
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Salanterä, Sanna
2013-01-01
In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the profession. In this qualitative case study we investigate in depth why young nurses leave nursing profession and reeducate themselves for a new career. The study is based on longitudinal interviews of three young registered nurses in Finland. These nurses were first interviewed between December 2006 and May 2007, when they were 29–32 years old and having an intention to leave the profession. The second interview took place four years later, from January 2011 to March 2011 when all of them had made the transition to a new career. Data were analyzed in two stages. In the first stage, comprehensive career story narratives were formed on the basis of the interviews. In the second stage, emerging themes in these stories were compared, contrasted, and interpreted in the context of the overall career histories. Nursing as a second career choice and demanding work content as well as poor practice environment and the inability to identify with the stereotypical images of nurses were main themes that emerged from these career stories. The results of this interpretative qualitative study reflect a shift toward insights into understanding professional turnover as a complex and long-lasting process. PMID:24027640
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North, Nicola; Leung, William; Lee, Rochelle
2014-12-01
To describe temporary and permanent separation patterns and changes in nursing practice over 5 years, for the 2006 cohort of nurses aged ≥50 years in New Zealand. As ageing populations increase demand on nursing services, workforce projections need better information on work and retirement decision-making of large 'baby-boomer' cohorts. Retrospective cohort analysis using the Nursing Council of New Zealand administrative dataset. A cohort of all nurses aged ≥50 years on the register and practising in 2006 (n = 12,606) was tracked until 2011. After 5 years, a quarter (n = 3161) of the cohort (equivalent to 8·4% of all 2006 practising nurses) was no longer practising. There were no significant differences in permanent separation rates between the ages of 50-58; between 18-54% of annual separations re-entered the workforce. On re-entry, 56% returned to the same clinical area. Annual separations from the workforce declined sharply during the global financial crisis and more of those leaving re-entered the workforce. In 2006, half the cohort worked in hospitals. After 5 years, the number of cohort nurses working in hospitals fell by 45%, while those in community settings increased by 12%. Over 5 years, weekly nursing practice hours declined significantly for every age-band. To retain the experience of older nurses for longer, workforce strategies need to take account of patterns of leaving and re-entering the workforce, preferences for work hours and the differences between the sub-groups across employment settings and practice areas. © 2014 John Wiley & Sons Ltd.
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Downsizing and reorganization: demands, challenges and ambiguity for registered nurses.
Hertting, Anna; Nilsson, Kerstin; Theorell, Töres; Larsson, Ullabeth Sätterlund
2004-01-01
The 1990s were characterized by substantial financial cuts, and related staff redundancies and reorganizations in the Swedish health care sector. A large hospital in Sweden was selected for the study, in which downsizing had occurred between 1995 and 1997. The number of staff in the hospital was reduced by an average of 20%, and 10% were relocated to other departments. The aims of this study were to explore registered nurses' experiences of psychosocial 'stressors' and 'motivators', and how they handled their work situations, following a period of personnel reductions and ongoing reorganization. Interviews were undertaken with 14 nurses working in one Swedish hospital. Nurses were interviewed in 1997 about the recent and last round of redundancies, and were followed up 1 year later in 1998 and again in 2001. Interviews were audiotaped, transcribed and analysed for thematic content. Five themes emerged in relation to nurses' perceived stressors, motivators, and coping options: 'distrust towards the employer', 'concurrent demands and challenges', 'professional ambiguity, 'a wish for collaboration', and 'efforts to gain control'. A common feature was duality and ambiguity in nurses' descriptions of the phenomena studied, meaning that identified themes had underlying sub-themes with both negative and positive dimensions. The concurrence of 'ever-growing job demands' and 'work going unrewarded' contributed to a feeling of being taken advantage of by the employer. The 'waste of human resources' and 'competence drain' that followed redundancies provoked anger. Unfulfilled collaboration with doctors was a major stress producer, which related to both the downsized work organization, and the complex 'deference-dominance' doctor-nurse relationship. The well-being of nurses depends on being an equal/parallel health professional in a comprehensive team that shares knowledge and improves collaborative care of patients. A consciously formulated nursing philosophy emerged as a
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Jones, Cheryl B; Toles, Mark; Knafl, George J; Beeber, Anna S
A more diverse registered nurse (RN) workforce is needed to provide health care in North Carolina (NC) and nationally. Studies describing licensed practical nurse (LPN) career transitions to RNs are lacking. To characterize the occurrence of LPN-to-RN professional transitions; compare key characteristics of LPNs who do and do not make such a transition; and compare key characteristics of LPNs who do transition in the years prior to and following their transition. A retrospective design was conducted using licensure data on LPNs from 2001 to 2013. Cohorts were constructed based on year of graduation. Of 39,398 LPNs in NC between 2001 and 2013, there were 3,161 LPNs (8.0%) who had a LPN-to-RN career transition between 2001 and 2013. LPNs were more likely to transition to RN if they were male; from Asian, American Indian, or other racial groups; held an associate or baccalaureate degree in their last year as an LPN (or their last year in the study if they did not transition); worked in a hospital inpatient setting; worked in the medical-surgical nursing specialty; and were from a rural area. Our findings indicate that the odds of an LPN-to-RN transition were greater if LPNs were: male; from all other racial groups except white; of a younger age at their first LPN licensure; working in a hospital setting; working in the specialty of medical-surgical nursing; employed part-time; or working in a rural setting during the last year as an LPN. This study fills an important gap in our knowledge of LPN-to-RN transitions. Policy efforts are needed to incentivize: LPNs to make a LPN-to-RN transition; educational entities to create and communicate curricular pathways; and employers to support LPNs in making the transition. Copyright © 2017 Elsevier Inc. All rights reserved.
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Non-hospital based registered nurses and the risk of bloodborne pathogen exposure.
Gershon, Robyn R M; Qureshi, Kristine A; Pogorzelska, Monika; Rosen, Jonathan; Gebbie, Kristine M; Brandt-Rauf, Paul W; Sherman, Martin F
2007-10-01
The aim of this study was to assess the risk of blood and body fluid exposure among non-hospital based registered nurses (RNs) employed in New York State. The study population was mainly unionized public sector workers, employed in state institutions. A self-administered questionnaire was completed by a random stratified sample of members of the New York State Nurses Association and registered nurse members of the New York State Public Employees Federation. Results were reviewed by participatory action research (PAR) teams to identify opportunities for improvement. Nine percent of respondents reported at least one needlestick injury in the 12-month period prior to the study. The percutaneous injury (PI) rate was 13.8 per 100 person years. Under-reporting was common; 49% of all PIs were never formally reported and 70% never received any post-exposure care. Primary reasons for not reporting included: time constraints, fear, and lack of information on reporting. Significant correlates of needlestick injuries included tenure, patient load, hours worked, lack of compliance with standard precautions, handling needles and other sharps, poor safety climate, and inadequate training and availability of safety devices (p<0.05). PAR teams identified several risk reduction strategies, with an emphasis on safety devices. Non-hospital based RNs are at risk for bloodborne exposure at rates comparable to hospital based RNs; underreporting is an important obstacle to infection prevention, and primary and secondary risk management strategies appeared to be poorly implemented. Intervention research is warranted to evaluate improved risk reduction practices tailored to this population of RNs.
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Stimpfel, Amy Witkoski; Brewer, Carol S; Kovner, Christine T
2015-11-01
Registered nurses across the globe bear a heavy injury burden. Every shift, nurses are exposed to a variety of hazards that can jeopardize their health, which negatively impacts their ability to provide high-quality patient care. Previous research suggests that inexperienced, or newly licensed nurses, may have an increased risk for certain occupational injuries. However, the current knowledge base is insufficient to fully understand how work hours influence newly licensed nurses' occupational injury, given the significant variation in hospital organization and work characteristics. To describe newly licensed nurses' shift work characteristics and determine the association between shift type and scheduling characteristics and nurse injury, before and after adjusting for individual and combined effects of demographics, external context, organizational context, and work context, following the Organization of Work model. This study is a secondary analysis of a nationally representative survey of newly licensed registered nurses using a cross-sectional design. The analytic sample includes 1744 newly licensed registered nurses from 34 states and the District of Columbia who reported working in a hospital and were within 6-18 months of passing their state licensure exam at the time of survey administration. Descriptive statistics were calculated, followed by bivariate and multivariate Poisson regression models to assess the relationship between shift type and scheduling characteristics and nurse injury. Lastly, full models with the addition of demographics, external context, organizational context, and work context variables were calculated. The majority (79%) of newly licensed nurses worked 12-h shifts, a near majority worked night shift (44%), and over half (61%) worked overtime (mandatory or voluntary) weekly. Nurses working weekly overtime were associated with a 32% [incidence rate ratio (IRR) 1.32, CI 1.07-1.62] increase in the risk of a needle stick and nurses
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Han, Kyu-Tae; Kim, Sun Jung; Jang, Sung-In; Kim, Seung Ju; Lee, Seo Yoon; Lee, Hyo Jung; Park, Eun-Cheol
2015-01-01
Cerebrovascular diseases are the second-highest cause of death in South Korea (9.6% of all causes of mortality in 2013). South Korea has a shortage of trained medical personnel compared with other countries and the demands for health care are continuously increasing. Our study sought to determine the relationship between hospital human resources and the outcomes of stroke patients. We used data from NHI claims (n=99,464) at 120 hospitals to analyze readmission or death within 30 days after discharge or hospitalization for stroke patients during 2010-2013. We used multilevel models that included both patient-level and hospital-level variables to examine factors associated with readmission or death within 30 days. A total of 1782 (1.8%) patients were readmitted within 30 days, and death occurred within 30 days for 6926 (7.0%) patients. Patients cared for by a higher percentages of specialists or registered nurses had a lower risk of readmission or death within 30 days (readmission per 10% increase in registered nurses, OR=0.89 and SD=0.85-0.94; death per 10% increase in specialists, OR=0.93 and SD=0.89-0.98). The percentages of specialist and registered nurses caring for stroke patients were positively correlated with better patient outcomes, particularly for patients with cerebral infarction. Copyright © 2015 Elsevier B.V. All rights reserved.
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Lifestyle and Depression among Hong Kong Nurses.
Cheung, Teris; Yip, Paul S F
2016-01-16
Recent longitudinal data suggest a close association between depression and lifestyle. Little work to date has estimated the prevalence of depression in the nursing workforce in China, nor considered what lifestyle factors might be correlated with it-a gap filled by the present study. The study's web-based cross-sectional survey solicited data from qualified nurses aged between 21 and 65 registered with the Hong Kong Nursing Council. The Depression, Anxiety and Stress Scale 21 was used to measure 850 nurses for depression, anxiety and symptoms of stress; a generalized linear regression model examined associations between lifestyle factors and depression. Mean depression symptom scores show a downward linear trend for male and female participants. Gender and age, however, did not emerge as significant predictors of depression. Three lifestyles factors (sleep, entertainment and hobbies) showed a significant association with depression. Nurses should make therapeutic lifestyle changes to improve their work-life balance and safeguard their functioning at work and personal well-being.
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Lifestyle and Depression among Hong Kong Nurses
Cheung, Teris; Yip, Paul S.F.
2016-01-01
Recent longitudinal data suggest a close association between depression and lifestyle. Little work to date has estimated the prevalence of depression in the nursing workforce in China, nor considered what lifestyle factors might be correlated with it—a gap filled by the present study. The study’s web-based cross-sectional survey solicited data from qualified nurses aged between 21 and 65 registered with the Hong Kong Nursing Council. The Depression, Anxiety and Stress Scale 21 was used to measure 850 nurses for depression, anxiety and symptoms of stress; a generalized linear regression model examined associations between lifestyle factors and depression. Mean depression symptom scores show a downward linear trend for male and female participants. Gender and age, however, did not emerge as significant predictors of depression. Three lifestyles factors (sleep, entertainment and hobbies) showed a significant association with depression. Nurses should make therapeutic lifestyle changes to improve their work-life balance and safeguard their functioning at work and personal well-being. PMID:26784216
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ERIC Educational Resources Information Center
Doyle, Timothy C.; And Others
A study was conducted to assess the impact of three anticipated changes in the health care system on the future requirements for registered nurses. The changes investigated were the introduction of national health insurance (NHI), the increased enrollment in health maintenance organizations (HMOs), and the reformulation of nursing roles. Following…
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Martiniano, Robert; Mcginnis, Sandra; Moore, Jean
2010-01-01
Health workforce researchers routinely conduct studies to determine whether a profession is currently in short supply and whether future shortages are likely. This is particularly important for registered nursing since the profession has experienced periodic shortages over the past three decades. Registered nurse (RN) forecast studies can be valuable in quantifying supply and demand gaps and identifying the most appropriate strategies to avert future shortages. In order to quantify RN supply/demand gaps, it is important to have accurate data on RNs, including the number of active RNs as well as their demographic, education, and practice characteristics, and work location(s). A lack of relevant and timely data on the nursing workforce is a significant barrier to identifying where nursing shortages exist, where they are most severe, and determining the factors that contribute to them. This lack of understanding impedes the development of effective health workforce programs and policies to mitigate shortages and the ability to evaluate these programs and policies for effectiveness. This study describes the national data sources available to nursing researchers to study the supply and distribution of the RN workforce and assesses the sources' strengths and limitations. This study also explores the potential for using state-level data for nursing workforce research.
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Sundqvist, Ann-Sofie; Anderzén-Carlsson, Agneta; Nilsson, Ulrica; Holmefur, Marie
2018-02-01
To translate and adapt the Protective Nursing Advocacy Scale (PNAS) into a Swedish version (PNAS-Swe), evaluate its psychometric properties, and describe registered nurse anesthetists' (RNAs) advocacy beliefs and actions from a protective perspective. A cross-sectional design was used. First, the PNAS was translated into Swedish. Next, the content and construct validity of the PNAS four subscales was evaluated. Finally, the PNAS-Swe was used to describe Swedish RNA beliefs and actions regarding protective nursing advocacy. The final PNAS-Swe has 29 items in four subscales. The RNAs reported that they feel that they should provide protective nursing advocacy for their patients. There were no differences in gender, or associations with age, or work experience regarding their advocacy beliefs or actions. The PNAS-Swe is valid for use in a Swedish context. Protective nursing advocacy is important to the RNAs, which is in congruence with earlier qualitative studies. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
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United States Registered Nurse Workforce Report Card and Shortage Forecast: A Revisit.
Zhang, Xiaoming; Tai, Daniel; Pforsich, Hugh; Lin, Vernon W
This is a reevaluation of registered nurse (RN) supply and demand from 2016 to 2030 using a previously published work forecast model and grading methodology with more recent workforce data. There will be a shortage of 154 018 RNs by 2020 and 510 394 RNs by 2030; the South and West regions will have higher shortage ratios than Northeast and Midwest regions. This reflects a nearly 50% overall improvement when compared with the authors' prior study, and the low-performing states have improved from 18 "D" and 12 "F" grades as published earlier to 13 "D" and 1 "F" in this study. Although progress has been made, efforts to foster the pipelines for improving the nursing workforce need to be continued.
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Rapley, Pat; Davidson, Laura; Nathan, Pauline; Dhaliwal, Satvinder S
2008-01-01
There is a shortage of registered nurses (RN) globally and equally in rural areas of Australia. The sparsely populated areas of rural Australia prompted the development of an external-mode EN-to-RN pathway course for enrolled nurses (EN) who want to complete a nursing degree. However, the awarding of advanced standing for EN clinical experience, regardless of educational background, is a new initiative that needs to be evaluated. Hence, this paper reports on the link between initial EN educational preparation and its impact on course completion. This exploratory correlation study used existing course data from four cohorts between 2000 and 2003. The comparisons included educational background, years of experience, and location of the EN-to-RN students. Significant differences were not found between rural and metropolitan students who completed or who withdrew from the course. Logistic regression analysis indicated that ENs in this sample with a hospital-based certificate rather than a technical college qualification were more likely to complete the course: Location and years of experience as an EN did not contribute significantly to course completion. The findings provide support for the same recognition of prior learning, regardless of educational background, for ENs entering a bachelor level nursing degree. The findings have relevance for Australia and other countries with similar challenges for ENs who want to become RNs without relocating to a city.
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Hopkins, Una; Itty, Any Sajan; Nazario, Helen; Pinon, Miriam; Slyer, Jason; Singleton, Joanne
Delegation by the registered nurse is a decision making process that includes assessment, planning, implementation, and evaluation. Due to an ever-expanding global shortage of nurses, registered nurses are increasingly dependent on unlicensed assistive personnel to assist in the provision of safe patient care. Delegation is recognised as a fundamental nursing skill that can be utilised effectively to improve quality care. To examine and synthesize the best available evidence regarding the impact of delegation interventions used by the registered nurse with the unlicensed assistive personnel and their impact on quality of care, patient satisfaction, and registered nurse staff satisfaction. Registered nurses and unlicensed assistive personnel in patient care settings where delegation occurs.This review considered studies that evaluated the effectiveness of delegation interventions by registered nurses to unlicensed assistive personnel.The outcomes examined were quality of care, patient satisfaction, and/or registered nurse staff satisfaction as measured by validated and reliable tools.The review first considered randomised controlled trials; in their absence other research designs, such as non-randomised controlled trials, or other quasi-experimental studies, observational studies and descriptive studies were considered for inclusion in the systematic review. The search strategy aimed to find both published and unpublished studies in the English language from the inception of the included databases through December 2011. The databases searched included the Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, CINAHL, Healthsource Nursing/Academic edition, and PsycINFO. A search of the grey literature and electronic hand searching of relevant journals was also performed. The studies selected for retrieval were critically evaluated by two independent reviewers for methodological quality using standardised critical appraisal instruments from the Joanna
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The influence of authentic leadership and areas of worklife on work engagement of registered nurses.
Bamford, Megan; Wong, Carol A; Laschinger, Heather
2013-04-01
To examine the relationships among nurses' perceptions of nurse managers' authentic leadership, nurses' overall person-job match in the six areas of worklife and their work engagement. Reports have highlighted the impact of demanding and unsupportive work environments on nurses' wellbeing, resulting in a need for strong nursing leadership to build sustainable and healthier work environments. A secondary analysis of data collected from a non-experimental, predictive design survey of a random sample of 280 registered nurses working in acute care hospitals was conducted. An overall person-job match in the six areas of worklife fully mediated the relationship between authentic leadership and work engagement. Further, authentic leadership, overall person-job match in the six areas of worklife and years of nursing experience explained 33.1% of the variance in work engagement. Findings suggest that nurses who work for managers demonstrating higher levels of authentic leadership report a greater overall person-job match in the six areas of worklife and greater work engagement. As nurse managers' play a key role in promoting work engagement among nurses, authentic leadership development for nurse managers focusing on self-awareness, relational transparency, ethics and balanced processing would be beneficial. © 2012 Blackwell Publishing Ltd.
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What implies the good work for registered nurses in municipal elderly care in Sweden?
Josefsson, Karin; Aling, Jenny; Östin, Britt-Louise
2011-08-01
The aim was to describe registered nurses' perceptions of what the good work implies to them in municipal elderly care. A descriptive design and a structured questionnaire specifically designed for this study were used. Sixty housing units for older people and 213 nurses participated, with a response rate of 62%. The good work included the following aspects: intellectually stimulating without guilt feelings; freedom and independence with the possibility to influence; having appreciative and pleasant fellow workers and a fair and understanding manager; a good physical and risk-free environment; work security and a steady income with the possibility of improving salary through work effort; work effort should be beneficial to others; innovative thinking and initiative should be highly valued; and pride in work without compromising personal values. Employers must take this into consideration to retain those nurses already employed and recruit nurses to municipal elderly care.
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Examination of the Use of Healing Touch by Registered Nurses in the Acute Care Setting.
Anderson, Joel G; Friesen, Mary Ann; Swengros, Diane; Herbst, Anna; Mangione, Lucrezia
2017-03-01
Acute care nursing is currently undergoing unprecedented change, with health systems becoming more open to nonpharmacological approaches to patient care. Healing Touch (HT) may be a valuable intervention for acute care patients. Research has shown that HT helps both the patient and the caregiver; however, no study to date has examined the impact that the education of nurses in and their use of HT have on daily care delivery in the acute care setting. The purpose of the current qualitative study was to examine the use of HT by registered nurses in the acute care setting during their delivery of patient care, as well as the impact of education in and use of HT on the nurses themselves. Five themes were identified: (1) use of HT techniques, processes, and sequence; (2) outcomes related to HT; (3) integration of HT into acute care nursing practice; (4) perceptions of HT, from skepticism to openness; and (5) transformation through HT. Education in HT and delivery of this modality by nurses in the acute care setting provide nurses with a transformative tool to improve patient outcomes.
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Suicide in Guyana: Nurses' Perspectives.
Anthony, Maureen; Groh, Carla; Gash, Jean
Guyana, an English-speaking country on the north coast of South America, has the highest suicide rate in the world. Nurses are an integral part of the healthcare team working with patients experiencing psychological distress and are uniquely qualified to add to the discourse on factors contributing to the high suicide rate in Guyana. The purpose of this study was to explore the attitudes and experiences of nurses and nurse assistants in Guyana related to suicide. Nine registered nurses and nurse assistants who worked at a private hospital in Georgetown, Guyana, were recruited to participate in a focus group. The focus group lasted approximately 70 minutes and was recorded. The audio recordings were later transcribed word for word. Four themes emerged from the data: family issues as they relate to the high suicide rate, suicide attempts as a cry for help, lack of support, and coping mechanisms used by nurses when caring for victims of attempted suicide. Nurses are uniquely positioned to intervene with families in crisis, whether it be suicide, suicide attempts, or the underlying factors of family dysfunction, child maltreatment, poverty, or alcoholism. Establishing forensic nursing as a specialty in Guyana would validate this important role through education and certification of nurses.
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Substance abuse among registered nurses.
Epstein, Patricia M; Burns, Candace; Conlon, Helen Acree
2010-12-01
The stressful conditions under which nurses work, due in part to the nursing shortage, are among the risk factors that contribute to nurses' abuse of illicit drugs. Nurses differ from the general population in that they work in an environment where they not only have access to controlled substances, but also are exposed to death and dying, the stress of which can increase the risk of drug abuse. However, practicing while impaired places patients' lives at risk and decreases staff morale. Copyright 2010, SLACK Incorporated.
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Newton, Sarah E; Moore, Gary
2009-01-01
Attrition is a serious issue among Bachelor of Science in Nursing (BSN) students with attrition rates around 50% nationwide. To help minimize BSN student attrition, many nursing programs use commercially available standardized nursing aptitude tests as adjuncts to scholastic aptitude data, usually operationalized as pre-nursing grade point average, to select students for admission. Little is known regarding the usefulness of scholastic and nursing aptitude data for predicting long-term retention in a BSN program and readiness for the National Council Licensure Examination-Registered Nurse (NCLEX-RN). Therefore, the purpose of this study was to describe the relationships among scholastic aptitude, nursing aptitude, BSN student attrition prior to the final semester of the curriculum, and BSN student readiness for the NCLEX-RN. This study's findings, along with other findings in the literature, suggest the need for a parsimonious explanatory model of BSN student attrition that can be used to guide admission and progression policies, and ensure that students ready for the NCLEX-RN are the ones graduating from BSN programs.
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Barriers to and Facilitators of Research Utilization: A Survey of Registered Nurses in China
Wang, Li-Ping; Jiang, Xiao-Lian; Wang, Lei; Wang, Guo-Rong; Bai, Yang-Jing
2013-01-01
Aims This survey aims to describe the perception of barriers to and facilitators of research utilization by registered nurses in Sichuan province, China, and to explore the factors influencing the perceptions of the barriers to and facilitators of research utilization. Methods A cross sectional survey design and a double cluster sampling method were adopted. A total of 590 registered nurses from 3 tertiary level hospitals in Sichuan province, China, were recruited in a period from September 2006 to January 2007. A modified BARRUERS Scale and a Facilitators Scale were used. Data were analyzed with descriptive statistics, rank transformation test, and multiple linear regression. Results Barriers related to the setting subscale were more influential than barriers related to other subscales. The lack of authority was ranked as the top greatest barrier (15.7%), followed by the lack of time (13.4%) and language barrier (15.0%). Additional barriers identified were the reluctance of patients to research utilization, the lack of funding, and the lack of legal protection. The top three greatest facilitators were enhancing managerial support (36.9%), advancing education to increase knowledge base (21.1%), and increasing time for reviewing and implementing (17.5%), while cooperation of patients to research utilization, establishing a panel to evaluate researches, and funding were listed as additional facilitators. Hospital, educational background, research experience, and knowledge on evidence-based nursing were the factors influencing perceptions of the barriers and facilitators. Conclusions Nurses in China are facing a number of significant barriers in research utilization. Enhancing managerial support might be the most promising facilitator, given Chinese traditional culture and existing health care system. Hospital, educational background, research experience and knowledge on evidence-based nursing should be taken into account to promote research utilization. The BARRIERS
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Pesut, Barbara; McLean, Tammy; Reimer-Kirkham, Sheryl; Hartrick-Doane, Gweneth; Hutchings, Deanna; Russell, Lara B
2015-09-01
Collaborative education that prepares nursing and healthcare assistant students in supportive care for older adults living at home with advanced chronic illness is an important innovation to prepare the nursing workforce to meet the needs of this growing population. To explore whether a collaborative educational intervention could develop registered nursing and healthcare assistant students' capabilities in supportive care while enhancing care of clients with advanced chronic illness in the community. Mixed method study design. A rural college in Canada. Twenty-one registered nursing and 21 healthcare assistant students completed the collaborative workshop. Eight registered nursing students and 13 healthcare assistant students completed an innovative clinical experience with fifteen clients living with advanced chronic illness. Pre and post-test measures of self-perceived competence and knowledge in supportive care were collected at three time points. Semi-structured interviews were conducted to evaluate the innovative clinical placement. Application of Friedman's test indicated statistically significant changes on all self-perceived competence scores for RN and HCA students with two exceptions: the ethical and legal as well as personal and professional issues domains for HCA students. Application of Friedman's test to self-perceived knowledge scores showed statistically significant changes in all but one domain (interprofessional collaboration and communication) for RN students and all but three domains for HCA students (spiritual needs, ethical and legal issues, and inter-professional collaboration and communication). Not all gains were sustained until T-3. The innovative community placement was evaluated positively by clients and students. Collaborative education for nursing and healthcare assistant students can enhance self-perceived knowledge and competence in supportive care of adults with advanced chronic illness. An innovative clinical experience can
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Nursing 2000: Collaboration to Promote Careers in Registered Nursing.
ERIC Educational Resources Information Center
Wilson, Connie S.; Mitchell, Barbara S.
1999-01-01
The effectiveness of the collaborative Nursing 2000 model in promoting nursing careers was evaluated through a survey of 1,598 nursing students (637 responses). Most effective techniques were the "shadow a nurse" program, publications, classroom and community presentations, and career-counseling telephone calls. (SK)
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Arnetz, Judith E; Zhdanova, Ludmila
2015-02-01
To introduce and define the patient involvement climate and measure its quality and strength via views and behaviours among nurses in coronary care units. Patient involvement is receiving increased attention among healthcare providers. To better understand and optimise the interpersonal dynamics of patient involvement, it is important to study the organisational context in which the patient-provider interaction occurs. Cross-sectional, self-report questionnaire study. Registered nurses across 12 coronary care units (n = 303) completed a questionnaire reporting their views and behaviours regarding patient involvement. Analyses assessed climate quality (the positive or negative nature of nurses' perceptions) and climate strength (the degree of consensus within coronary care units). Climate quality and strength were greatest for the dimensions measuring nurses' views of patient involvement, the nurse-patient information exchange process and nurses' responsiveness to patient needs. Climate quality and strength were weaker for the dimensions measuring nurses' views of the hindrances associated with patient involvement, discussion of daily activities and efforts to motivate patients to take responsibility for their health. In units with consensus that patient involvement poses hindrances, nurses were less likely to address patient needs. When nurses perceived patient involvement as less of a hindrance in their work, they were more responsive to patient needs. A patient involvement climate characterised by motivational behaviour among nurses was marked by better information exchange and discussion of suitable activities postdischarge. Managers can capitalise on positive climate aspects by encouraging ward activities that facilitate active patient involvement among nurses. One suggestion is educational interventions at the workplace focused on reducing perceptions of patient involvement as a hindrance and encouraging the attitudes that it can enrich nursing work and
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Emotional intelligence as a noncognitive factor in student registered nurse anesthetists.
Collins, Shawn
2013-12-01
Current nurse anesthesia program admissions requirements usually focus on high grade point averages, Graduate Record Examination scores, number of years of acute care experience, and a personal interview to assist in predicting those who will succeed in these intensive academic and clinical programs. Some people believe these criteria may not be sufficient in predicting success and have suggested that the use of noncognitive criteria such as emotional intelligence measurements may be helpful. The purpose of this cross-sectional correlational study was to explore the relationship between emotional intelligence and academic factors of student registered nurse anesthetists at 3 points in a program--matriculation, at 1 year of study, and in the last semester of study--and the relationship of these to clinical scores and National Certification Examination scores. An ex post facto cross-sectional study design was used to gather data at 3 critical times in nurse anesthesia programs to explore the relationships between emotional intelligence scores, preadmission demographics, clinical scores, and National Certification Examination scores. The online Mayer-Salovey-Caruso Emotional Intelligence Test instrument provided 15 individual emotional intelligence scores for each subject. The statistical relationship between variables was examined.
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Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey.
Delaney, Kathleen R; Drew, Barbara L; Rushton, Amy
2018-06-01
Further exploration of the practice roles of psychiatric mental health (PMH) advanced practice registered nurses (APRNs) is warranted. In March of 2016, the American Psychiatric Nurses Association (APNA) conducted a national survey to gather data on the demographics, practice roles, and activities of certified PMH APRNs. The e-mail survey contained 46 questions consistent with minimum data set requirements of the Forum of State Nursing Workforce Centers. The data indicate that PMH APRNs are a clinically active workforce; the majority deliver a wide variety of mental health services including diagnosis and management of both acute and chronic mental illness, prescribing, and providing psychotherapy. PMH APRNs are delivering care to clients dealing with a range of serious mental illnesses across the life span in a variety of roles. It will be critical to monitor the activities and outcomes of this expanding behavioral health care workforce.
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Nursing values in China: the expectations of registered nurses.
Pang, Dong; Senaratana, Wilawan; Kunaviktikul, Wipada; Klunklin, Areewan; McElmurry, Beverly J
2009-09-01
Abstract The purpose of this study was to identify the essential professional values of Chinese nurses and their manifestations in the current health-care environment. Data were collected from 29 nurse experts by semi-structured individual interviews or focus groups in Beijing and Shanghai, China. Thematic analysis was used to analyze the data. Seven themes were identified: altruism, caring, trustworthiness, dignity, responsibility for the development of the profession, autonomy, and justice. On the whole, these values were in accordance with the codes of the International Council of Nurses and the Chinese Nursing Association. Additionally, culture and socioeconomic trends were found to have an influence on nurses' understanding and explanation of professional values. The findings of this study provided insight into Chinese nurses' professional values and might contribute to the future development of a culturally sensitive scale to measure nursing values in China.
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Providing support to nursing students in the clinical environment: a nursing standard requirement.
Anderson, Carina; Moxham, Lorna; Broadbent, Marc
2016-10-01
This discussion paper poses the question 'What enables or deters Registered Nurses to take up their professional responsibility to support undergraduate nursing students through the provision of clinical education?'. Embedded within many nursing standards are expectations that Registered Nurses provide support and professional development to undergraduate nursing students undertaking clinical placements. Expectations within nursing standards that Registered Nurses provide support and professional development to nursing students are important because nursing students depend on Registered Nurses to help them to become competent practitioners. Contributing factors that enable and deter Registered Nurses from fulfilling this expectation to support nursing students in their clinical learning include; workloads, preparedness for the teaching role, confidence in teaching and awareness of the competency requirement to support students. Factors exist which can enable or deter Registered Nurses from carrying out the licence requirement to provide clinical education and support to nursing students.
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Impact of High-Reliability Education on Adverse Event Reporting by Registered Nurses.
McFarland, Diane M; Doucette, Jeffrey N
Adverse event reporting is one strategy to identify risks and improve patient safety, but, historically, adverse events are underreported by registered nurses (RNs) because of fear of retribution and blame. A program was provided on high reliability to examine whether education would impact RNs' willingness to report adverse events. Although the findings were not statistically significant, they demonstrated a positive impact on adverse event reporting and support the need to create a culture of high reliability.
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McCrae, N; Askey-Jones, S; Laker, C
2014-01-01
Accelerated mental health nurse training attracts talented graduates, many with a psychology degree. Our study shows that such trainees feel incompatible with the nursing culture. Consequently, professional identification is inhibited, and on qualifying these nurses may choose to develop their careers elsewhere. Nurse educators and mentors should pay greater attention to nurturing a positive professional identity in trainees. Alongside their attainment of knowledge and skills, nursing trainees are moulded by a professional culture and inculcated to norms of beliefs and behaviour. The process of professional identification may be inhibited by accelerated nurse training and an influx of psychology graduates potentially using mental health nursing qualification as a springboard to other career opportunities. This study explored facilitators and barriers to professional identification in newly qualified nurses of accelerated postgraduate training. Qualitative interviews were conducted with 10 nurses who had recently completed a postgraduate diploma in mental health nursing at King's College London. Participants identified more with the mental health field than with the broader profession of nursing. They defined their practice in terms of values rather than skills and found difficulty in articulating a distinct role for mental health nursing. Although participants had found experience in training and as a registered practitioner rewarding, they were concerned that nursing may not fulfil their aspirations. Professional identity is likely to be a major factor in satisfaction and retention of nurses. Training and continuing professional development should promote career advancement within clinical nursing practice. © 2014 John Wiley & Sons Ltd.
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Ammi, Mehdi; Ambrose, Sarah; Hogg, Bill; Wong, Sabrina
2017-12-01
Nurses, whether registered nurses (RNs) or nurse practitioners (NPs), are becoming key providers of primary care services. While evidence for the influence of NPs on patient experience in primary care is mounting, this is less so for RNs. We use the Canadian component of the international Quality and Costs of Primary Care 2013/14 survey to investigate the mechanisms by which nurses can affect patients' experience in primary care, focusing on accessibility and appropriateness of care. The data allow us to distinguish between family practice RNs, specialised RNs and NPs, and covers all types of patients visiting a primary care clinic in a variety of contexts in all Canadian provinces. In addition to the types of nurses and full-time equivalent (FTE) numbers, we explore the role of nurse autonomy and collaboration. Our regression results show that one of the most important predictors of patient experience is the collaboration between health professionals, whereas nurse staffing in terms of FTE numbers has little influence by itself. Different types of nurses influence different dimensions of accessibility, and the association between patient experience and nurse staffing depends on the number of physicians in the clinic. Our results can inform decision-makers on how to strengthen primary care provision, and particularly in Canadian context, the adaptation of the recently implemented interprofessional primary care teams. Copyright © 2017 Elsevier B.V. All rights reserved.
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Political participation of registered nurses.
Vandenhouten, Christine L; Malakar, Crystalmichelle L; Kubsch, Sylvia; Block, Derryl E; Gallagher-Lepak, Susan
2011-08-01
Level of political participation and factors contributing to participation were measured among Midwest RNs (n = 468) via an online survey (Cronbach's α = .95). Respondents reported engaging in primarily "low cost" activities (e.g., voting, discussing politics, and contacting elected officials), with fewer reporting speaking at public gatherings, participating in demonstrations, and membership in nursing organizations. Psychological engagement was most predictive (p < .001) of political participation with the dimensions of political interest, political efficacy, and political information/knowledge highly significant (p < .001). Resources (time/money/civic skills) significantly contributed to political participation (p < .001). Less than half (40%) felt they could impact local decisions, and fewer (32%) felt they could impact state or national government decisions. Most respondents (80%) indicated their nursing courses lacked political content and did not prepare them for political participation. Findings showed that nurse educators and leaders of professional nursing organizations need to model and cultivate greater psychological engagement among students and nurses.
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Atefi, Narges; Lim Abdullah, Khatijah; Wong, Li Ping; Mazlom, Reza
2015-05-01
Job satisfaction is a critical factor in health care. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care. To determine the level of nurses' job satisfaction and its associated factors. A stratified random sample of 421 registered nurses working at a large hospital in Mashhad, Iran was surveyed. The results showed that autonomy, task requirement and work interaction had scores higher than their respective median on the subscales. There were significant differences between demographic characteristics and the autonomy, task requirement, work interaction, salary, work condition, professional development, supportive nursing management, decision making, professional status subscales and mean total job satisfaction. In univariate analysis, young age, being female and being married were significantly associated with a higher level of job satisfaction. The adjusted R(2) for this model was 0.14, indicating that the model explained 14% of the variability. The regression model was highly significant, F (4298) = 13.194, P < 0.001. The authors emphasise that the human resources policies and incentives need to be re-visited. Efforts undertaken to improve working conditions, supportive nursing management, improved professional status, professional development and increased salaries are some of the ways for nurse managers to improve job satisfaction. © 2013 John Wiley & Sons Ltd.
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Violence against women: the phenomenon of workplace violence against nurses.
Child, R J Howerton; Mentes, Janet C
2010-02-01
Registered nurses have been the recipients of an alarming increase in workplace violence (WPV). Emergency and psychiatric nurses have been found to be the most vulnerable and yet few solid reporting procedures exist to fully account for a true number of incidents. Further compounding the problem is the lack of a standard definition of violence to guide reporting procedures, interventions, legislation, and research. While there are certain risk factors that not only predispose the nurse and the patient to WPV, research continues to attempt to parse out which risk factors are the key determinants of WPV and also which interventions prove to be significant in reducing WPV. The nursing shortage is expected only to increase; recruitment and retention of qualified staff members may be deterred by WPV. This necessitates focused research on the phenomenon of workplace violence in health care.
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The effect of prior healthcare employment on the wages of registered nurses.
Yoo, Byung-Kwang; Kim, Minchul; Lin, Tzu-Chun; Sasaki, Tomoko; Ward, Debbie; Spetz, Joanne
2016-08-19
The proportion of registered nurses (RNs) with employment in health-related positions before their initial RN education has increased in the past two decades. Previous research found that prior health-related employment is positively associated with RN workforce supply, potentially due to the wage differences based on different career paths. This study's objective is to test the hypotheses that prior health-related employment is associated with differences in starting wages and with different rates of wage growth for experience as an RN. We conducted a cross-sectional analysis using the 2008 National Sample Survey of Registered Nurses (NSSRN) linked with county-level variables from the Area Health Resource File. We estimated a Heckman model where the second-stage equation's outcome variable was the logarithm of the RN hourly wage, accounting for the self-selection of working or not working as an RN (i.e., the first-stage equation's outcome variable). Key covariates included interaction terms between years of experience, experience squared, and six categories of prior health-related employment (manager, LPN/LVN, allied health, nursing aide, clerk, and all other healthcare positions). Additional covariates included demographics, weekly working hours, marital status, highest nursing degree, and county-level variables (e.g., unemployment rate). We estimated the marginal effect of experience on wage for each type of prior health-related employment, conducting separate analyses for RNs whose initial education was a Bachelor of Science in Nursing (BSN) (unweighted N = 10,345/weighted N = 945,429), RNs whose initial education was an Associate degree (unweighted N = 13,791/weighted N = 1,296,809), and total population combining the former groups (unweighted N = 24,136/weighted N = 2,242,238). Prior health-related employment was associated with higher wages, with the strongest wage differences among BSN-educated RNs. Among BSN-educated RNs, previous
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Full Practice Authority for Advanced Practice Registered Nurses is a Gender Issue
Rudner Lugo, Nancy
2016-05-04
In the United States, Advanced Practice Registered Nurse (APRN) regulations are determined at the state level, through legislation and rule making. The lack of an evidence base to APRN regulation has resulted in a patchwork of varied regulations and requirements for nurse practitioners. The author begins this article by reviewing the history of the Equal Rights Amendment (ERA) in the United States and describing her study that assessed APRN fullpractice authority in states that ratified the ERA versus states that opposed it. She presents the study findings, limitations of the comparison, and discussion of the findings and implications. In conclusion, the findings demonstrated that progress toward full APRN practice will require building strategies for political support and framing the need to update APRN regulations in a manner that aligns with each state’s social and political values.
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42 CFR 409.46 - Allowable administrative costs.
Code of Federal Regulations, 2010 CFR
2010-10-01
... billable include, but are not limited to, the following: (a) Registered nurse initial evaluation visits. Initial evaluation visits by a registered nurse for the purpose of assessing a beneficiary's health needs... be an administrative cost. (b) Visits by registered nurses or qualified professionals for the...
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Belief in the "free choice" model of homosexuality: a correlate of homophobia in registered nurses.
Blackwell, Christopher W
2007-01-01
A great amount of social science research has supported the positive correlation between heterosexuals' belief in the free choice model of homosexuality and homophobia. Heterosexuals who believe gay, lesbian, bisexual, and transgender (GLBT) persons consciously choose their sexual orientation and practice a lifestyle conducive to that choice are much more likely to possess discriminatory, homophobic, homonegative, and heterosexist beliefs. In addition, these individuals are less likely to support gay rights initiatives such as nondiscrimination policies or same-sex partner benefits in the workplace or hate crime enhancement legislation inclusive of GLBT persons. Although researchers have demonstrated this phenomenon in the general population, none have specifically assessed it in the nursing workforce. The purpose of this study was to examine registered nurses' overall levels of homophobia and attitudes toward a workplace policy protective of gays and lesbians. These variables were then correlated with belief in the free choice model of homosexuality. Results indicated that belief in the free choice model of homosexuality was the strongest predictor of homophobia in nurses. Implications for nursing leadership and management, nursing education, and future research are discussed.
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Han, Robin M; Carter, Patricia; Champion, Jane Dimmitt
2018-02-01
This systematic review explores relationships between advanced practice registered nurses' (APRN) job satisfaction and intent to leave. There exists a dearth of APRN providers compared with the ever-growing need for their services. Furthermore, the organizational costs associated with the APRN turnover are extremely high. It, therefore, behooves practice administrators to understand what factors most contribute to APRN job satisfaction and retention. A search of research databases CINAHL, PubMed, and PsycINFO, using keywords "Advanced Practice Registered Nurse," "job satisfaction," "intent to leave," "anticipated turnover," and "Nurse Practitioner" to yield articles included in this review. The strength of existing evidence for this topic is weak. Studies have found that extrinsic factors, such as administrative support and salary, significantly contribute to job dissatisfaction, whereas intrinsic factors, such as autonomy and finding work meaningful, most significantly contribute to job satisfaction. Additional research is needed to better understand the factors relating to APRN job satisfaction and dissatisfaction, and how those factors influence practitioners' intent to leave. Efforts to improve APRN job satisfaction will have positive implications for provider retention, practices, and patients. Administrators should consider the job satisfaction factors identified herein when implementing practice improvement and retention efforts.
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Venturato, Lorraine; Kellett, Ursula; Windsor, Carol
2007-01-01
The aim of the study was to explore registered nurses' experiences in long-term aged care in light of the political reform of aged care services in Australia. In Australia, the aged care industry has undergone a lengthy period of political and structural reform. Despite reviews into various aspects of these reforms, there has been little consideration of the effect these are having on the practice experiences and retention of nursing staff in long-term care. In this critical hermeneutic study, 14 nurses from long-term care facilities in Australia were interviewed about their experiences during the reform period. The data revealed a sense of tension and conflict between nurses' traditional values, roles and responsibilities and those supported by the reforms. Nurses struggled to re-negotiate both their practice roles and values as the reforms were implemented and the system evolved. Nursing management support was an important aspect in mediating the effect of reforms on nursing staff. This research highlights both the tensions experienced by nurses in long-term aged care in Australia and the need to re-negotiate nursing roles, responsibilities and values within an evolving care system. This research supports a role for sensitive and proactive nursing management during periods of industry reform as a retention strategy for qualified nursing personnel.
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Nowrouzi, B; Rukholm, E; Larivière, M; Carter, L; Koren, I; Mian, O
2015-01-01
Literature from the past two decades has presented an insufficient amount of research conducted on the nursing practice environments of registered practical nurses (RPNs). The objective of this article was to investigate the barriers and facilitators to sustaining the nursing workforce in north-eastern Ontario (NEO), Canada. In particular, retention factors for RPNs were examined. This cross-sectional research used a self-administered questionnaire. Home addresses of RPNs working in NEO were obtained from the College of Nurses of Ontario (CNO). Following a modified Dillman approach with two mail-outs, survey packages were sent to a random sample of RPNs (N=1337) within the NEO region. Logistic regression analyses were used to determine intent to stay (ITS) in relation to the following factor categories: demographic, and job and career satisfaction. Completed questionnaires were received from 506 respondents (37.8% response rate). The likeliness of ITS in the RPNs' current position for the next 5 years among nurses aged 46-56 years were greater than RPNs in the other age groups. Furthermore, the lifestyle of NEO, internal staff development, working in nursing for 14-22.5 years, and working less than 1 hour of overtime per week were factors associated with the intention to stay. Having an understanding of the work environment may contribute to recruitment and retention strategy development. The results of this study may assist with addressing the nursing shortage in rural and northern areas through improved retention strategies of RPNs.
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Fernet, Claude; Trépanier, Sarah-Geneviève; Demers, Mireille; Austin, Stéphanie
Staff turnover is a major issue for health care systems. In a time of labor shortage, it is critical to understand the motivational factors that underlie turnover intention in newly licensed nurses. To examine whether different forms of motivation (the reasons for which nurses engage in their work) predict intention to quit the occupation and organization through distinct forms (affective and continuance) and targets (occupation and organization) of commitment. Cross-sectional data were collected from a sample of 572 French-Canadian newly registered nurses working in public health care in the province of Quebec, Canada. The hypothesized model was tested by structural equation modeling. Autonomous motivation (nurses accomplish their work primarily out of a sense of pleasure and satisfaction or because they personally endorse the importance or value of their work) negatively predicts intention to quit the profession and organization through target-specific affective commitment. However, although controlled motivation (nurses accomplish their work mainly because of internal or external pressure) is positively associated with continuance commitment to the occupation and organization, it directly predicts, positively so, intention to quit the occupation and organization. These results highlight the complexity of the motivational processes at play in the turnover intention of novice nurses, revealing distinct forms of commitment that explain how motivation quality is related simultaneously to intention to quit the occupation and organization. Health care organizations are advised to promote autonomous over controlled motivation to retain newly recruited nurses and sustain the future of the nursing workforce. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
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ERIC Educational Resources Information Center
Fortier, Mary E.
2010-01-01
This quantitative research study (N=175) examined predictors of first time success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) among transfer students in a baccalaureate degree program (BSN). The predictors were chosen after an extensive literature review yielded few studies related to this population. Benner's…
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Professional conduct among registered nurses in the use of online social networking sites.
Levati, Sara
2014-10-01
To explore the use of Facebook by Registered Nurses (RNs) in Italy and the United Kingdom (UK), focusing on the disclosure of personal and professional information. The use of online social network sites among medical students and doctors is posing new ethical challenges to the profession. To date, little research has explored the use of online social networking sites among nurses. A cross-national survey. Data were assessed on 124 nurses' profile pages, readily available without viewing restrictions. Content analysis and inferential statistics were undertaken to describe usage and identify similarities and differences between the two country-groups of nurses. Data were collected between December 2011-January 2012. Overall, UK and Italian RNs showed a similar use of the online platform, tending to disclose personal pictures, home town and current home location, as well as updates and comments related to personal and work-related activities. A statistically significant higher proportion of nurses in Italy disclosed their sexual orientation. In both groups, a few cases were observed of potentially unprofessional content in relation to the use of alcohol, nudity and material of a salacious nature. Although most of the UK and Italy RNs appear to be aware of the risks posed by their online exposure, their online activity indicates the blurring of their personal and professional lives; this is posing new ethical, legal and professional challenges to members of the nursing profession. Further research and debate is encouraged at national and international level. © 2014 John Wiley & Sons Ltd.
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Carpenter, Iain; Perry, Michelle; Challis, David; Hope, Kevin
2003-05-01
to determine if a combination of Minimum Data Set/Resident Assessment Instrument (MDS/RAI) assessment variables and the Resource Utilisation Groups version III (RUG-III) case-mix system could be used as a method of identifying and reimbursing registered nursing care needs in long-term care. the sample included 193 nursing home residents from four nursing homes from three different locations and care providers in England. The study included assessments of residents' care needs using either the MDS/RAI assessments or RUG stand-alone questionnaires and a time study that recorded the amount of nursing time received by residents over a 24-h period. Validity of RUG-III for explaining the distribution of care time between residents in different RUG-III groups was tested. The difference in direct and indirect care provided by registered general nurses (RGN) and care assistants (CA) to residents in RUG-III clinical groups was compared. the RUG-III system explained 56% of the variance in care time (Eta2, P=0.0001). Residents in RUG-III groups associated with particular medical and nursing needs (enhanced RGN care) received more than twice as much indirect RGN care time (t-test, P<0.001) and 1.4 times as much direct RGN and direct CA time (t-test, P<0.01) than residents with primarily cognitive impairment or physical problems only (standard RGN care). Residents with enhanced RGN care received an average of 48.1 min of RGN care in 24 h (95% CI 4.1-55.2) compared with an average of 31.1 min (95% CI 26.8-35.5) for residents in the standard RGN care group. A third low RGN care group was created following publication of the Department of Health guidance on NHS Funded Nursing Care. With three levels, the enhanced care group receives about 38% more than the standard group, and the low group receives about 50% of the standard group. the RUG-III system effectively differentiated between nursing home residents who are receiving 'low', 'standard' and 'enhanced' RGN care time. The
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Moon, Chooza; Phelan, Cynthia H; Lauver, Diane R; Bratzke, Lisa C
Sleep-related breathing disorders (SRBDs), including obstructive sleep apnea and central sleep apnea, are common among patients with cardiovascular disease (CVD), but clinicians often do not pay enough attention to SRBDs. The purpose of this narrative review is to update advanced practice registered nurses on the literature focusing on the relationship between SRBDs and CVD (eg, hypertension, heart failure, coronary artery disease, arrhythmias, and stroke) and on treatments that can improve SRBDs in patients with CVD. We conducted an electronic search of the literature published between 1980 and 2016 from PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Academic Search Premier, and related health resource Web sites to address the aims of this study. Fifty-six primary research articles (42 observational studies and 14 experimental and quasi-experimental studies) were selected based on our study aims and inclusion criteria. The studies revealed that individuals with CVD are at a greater risk for SRBDs and that SRBDs can worsen CVD. The findings from the studies also suggest that positive airway treatment could improve both SRBDs and CVD. This review found a close relationship between SRBDs and CVD. Advanced practice registered nurses are in key positions to identify and help patients manage SRBDs. In particular, advanced practice registered nurses can educate staff and establish standards of practice to improve outcomes for patients with CVD.
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The contextual issues associated with sexual harassment experiences reported by registered nurses.
Madison, Jeanne; Minichiello, Victor
The study aimed to explore contextual conditions in Australian health care workplaces that make sex-based and sexual harassment (SB&SH) a relatively common experience for registered nurses (RNs). Unstructured, in-depth interviews with a convenience sample of Australian RNs. The informants were 16 RNs (15 female and one male), working in health care, who were students enrolled in advanced tertiary preparation in nursing, counselling, and health care management at an Australian university. Experiences described by the interview informants identified four conditions present in their workplace when they experienced SB&SH. Informants noted: 1) the silence that surrounds harassment; 2) that they could not expect support from their peers and professional colleagues; 3) that education did not exist in their workplaces regarding (SB&SH) and, 4) that traditional stereotypes associated with RNs were closely linked to the experience of harassment in the workplace. Inadequate coverage of workplace issues related to (SB&SH) in undergraduate or postgraduate educational programs were identified.
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Bray, Benjamin D.; Ayis, Salma; Campbell, James; Cloud, Geoffrey C.; James, Martin; Hoffman, Alex; Tyrrell, Pippa J.; Wolfe, Charles D. A.; Rudd, Anthony G.
2014-01-01
Background Observational studies have reported higher mortality for patients admitted on weekends. It is not known whether this “weekend effect” is modified by clinical staffing levels on weekends. We aimed to test the hypotheses that rounds by stroke specialist physicians 7 d per week and the ratio of registered nurses to beds on weekends are associated with mortality after stroke. Methods and Findings We conducted a prospective cohort study of 103 stroke units (SUs) in England. Data of 56,666 patients with stroke admitted between 1 June 2011 and 1 December 2012 were extracted from a national register of stroke care in England. SU characteristics and staffing levels were derived from cross-sectional survey. Cox proportional hazards models were used to estimate hazard ratios (HRs) of 30-d post-admission mortality, adjusting for case mix, organisational, staffing, and care quality variables. After adjusting for confounders, there was no significant difference in mortality risk for patients admitted to a stroke service with stroke specialist physician rounds fewer than 7 d per week (adjusted HR [aHR] 1.04, 95% CI 0.91–1.18) compared to patients admitted to a service with rounds 7 d per week. There was a dose–response relationship between weekend nurse/bed ratios and mortality risk, with the highest risk of death observed in stroke services with the lowest nurse/bed ratios. In multivariable analysis, patients admitted on a weekend to a SU with 1.5 nurses/ten beds had an estimated adjusted 30-d mortality risk of 15.2% (aHR 1.18, 95% CI 1.07–1.29) compared to 11.2% for patients admitted to a unit with 3.0 nurses/ten beds (aHR 0.85, 95% CI 0.77–0.93), equivalent to one excess death per 25 admissions. The main limitation is the risk of confounding from unmeasured characteristics of stroke services. Conclusions Mortality outcomes after stroke are associated with the intensity of weekend staffing by registered nurses but not 7-d/wk ward rounds by stroke
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College nursing faculty job satisfaction and retention: A national perspective.
Lee, Peggy; Miller, Michael T; Kippenbrock, Thomas A; Rosen, Chris; Emory, Jan
The need for registered nurses in the United States continues to grow. To meet this need for increased numbers of nurses, recruitment and retention of qualified nurse educators has become a priority. In addition, the factors associated with nursing faculties' intent to stay have emerged as important considerations for administrators. The concepts of job satisfaction and intent to stay become vital to recruiting and retaining nursing faculty. In the past decade few empirical studies have been conducted on a national scale to address job satisfaction and intent to stay in academia. The purpose of this retrospective study is to analyze variables of relationships with nurse faculty job satisfaction and intent to stay from data collected throughout the United States. The Collaborative on Academic Careers in Higher Education (COACHE) survey was employed for the purposes of this study. Over 1350 nurse educators were included in the survey. The findings support a variety of modifiable variables that are viewed as important by nursing faculty. The strongest relationship was found to be institutional leadership. The implications can inform academic administrators seeking to retain nursing faculty. Copyright © 2017 Elsevier Inc. All rights reserved.
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Nhongo, Dorika; Hendricks, Joyce; Bradshaw, Julie; Bail, Kasia
2018-06-12
Registered nurses (RNs) working in Residential Aged Care Facilities are required to undertake complex management tasks including leading nursing care teams, supervising non-nursing staff, and allocating workloads according to residents' care needs, staff skills and experience. Registered nurses plan, assess, manage medication, evaluate each resident's care, liaise with doctors and allied health professionals and are responsible for evidence-based practice in accordance with the Nursing Standards for Practice (2016). Researchers have commented that effective nurse leadership can improve quality of care, improved resident outcomes and reduce adverse events. The aim of this literature review is to synthesise and analyse the literature pertinent to the RN's competence and confidence to undertake the leadership role when working in residential aged care facilities after-hours and to determine any association of leadership with quality resident outcomes. A review of original research papers based on the structured methodology described by Kable, Pich and Maslin-Prothero (2012). The review was conducted according to the 12-step structured framework by Kable et al. (2012). The search included peer-reviewed papers published between 2002 and 2017 on RN leadership after-hours, factors contributing to or with relationships to nursing leadership. Nineteen papers were found that researched the impact of leadership in aged care settings. The literature review concluded that nursing leadership has been linked to the quality of care and clinical outcomes in the aged care setting. However, RNs in the aged care setting have limited opportunities to develop key leadership competencies and confidence in order to meet the many challenges found in this environment due to lack of access to aged-care-specific leadership education. Minimal publications address the importance of the leadership of after-hours RNs. Results from this literature review will inform future research in this area
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... nurse with a graduate degree in advanced practice nursing. This type of provider may also be referred to as an ARNP (Advanced Registered Nurse Practitioner) or APRN (Advanced Practice Registered Nurse). Types of health care providers is a related topic.
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Grundy, Quinn; Bero, Lisa A; Malone, Ruth E
2016-06-07
The mainstay for addressing conflicts of interest in health care is disclosure of personal financial ties to industry. However, this approach fails to capture the complexity of industry interactions that are built into clinical practice. Further, the policy climate focuses on physicians and traditional pharmaceutical marketing. To describe industry activities targeted at registered nurses. Qualitative, ethnographic study conducted from January 2012 to October 2014. Four acute care hospitals in a western U.S. city. A purposive sample of 72 participants with direct experience with industry, including staff nurses, administrators, and industry and supply chain professionals. Fieldwork, including observations (102 hours), semistructured in-depth interviews (n = 51), focus groups (n = 4), and documents analysis. Nurses' reported financial relationships with industry were similar to those reported by prescribers. However, nurses reported that their most significant interactions with industry occurred in daily practice. The current policy environment rendered these interactions invisible, leaving nurses with little guidance to ensure that the boundary between service and sales remained intact. This study could not determine the frequency or prevalence of nurse-industry interactions. The sample is not representative. Nurse-industry interactions may be common and influential, but they remain invisible in the current policy climate. Although some aspects of these interactions may be beneficial, others may pose financial risks to hospitals or safety risks to patients. Disclosure strategies alone do not provide health professionals with adequate support to manage day-to-day interactions. Management of industry interactions must include guidance for nurses. Agency for Healthcare Research and Quality; Canadian Institutes of Health Research; and University of California, San Francisco.
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Blöndal, Katrin; Zoëga, Sigridur; Hafsteinsdottir, Jorunn E; Olafsdottir, Olof Asdis; Thorvardardottir, Audur B; Hafsteinsdottir, Sigrun A; Sveinsdóttir, Herdis
2014-08-01
The purpose of this study was to examine attitudes of registered nurses and licensed practical nurses about the importance of the family in surgical hospital units before (T1) and after (T2) implementation of a Family Systems Nursing educational intervention based on the Calgary Family Assessment and Intervention Models. This study was part of the Landspitali University Hospital Family Nursing Implementation Project and used a nonrandomized, quasi-experimental design with nonequivalent group before and after and without a control group. There were 181 participants at T1 and 130 at T2. No difference was found in nurses' attitudes as measured by the Families Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire, before and after the educational intervention. Attitudes toward families were favorable at both times. Analysis of demographic variables showed that age, work experience, and workplace (inpatient vs. outpatient units) had an effect on the nurses' attitudes toward families. The influence of work experience on attitudes toward family care warrants further exploration. © The Author(s) 2014.
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Peltzer, Jill N; Ford, Debra J; Shen, Qiuhua; Fischgrund, Avery; Teel, Cynthia S; Pierce, Janet; Jamison, Marian; Waldon, Trynn
2015-01-01
The Institute of Medicine's Future of Nursing report advocates for full nurse leader representation across multiple settings to address current challenges in our health care system. The purpose of this study was to examine nursing leadership development needs among Kansas registered nurses (RNs). Data were collected through an online survey and analyzed using quantitative and qualitative methods. Nearly 1,000 Kansas RNs participated. Most reported holding one or more leadership positions. Prevalent leadership goals were health care organization volunteer administrative roles. The most frequently identified barrier to developing leadership roles was time constraints. Many wanted to develop skills to serve on a board, 20% were interested in personal leadership development, and 19% in policy development. Based on the findings, the Kansas Action Coalition leadership team is developing programs to address the leadership needs of Kansas RNs. By building capacity in advanced leadership roles, RNs will be better prepared serve as full partners and lead efforts to promote the health of Kansans. Copyright © 2015 Elsevier Inc. All rights reserved.
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Maze, Claire D Martino
2005-05-01
Health disparities exist and refer to the chasms in health status between the advantaged and disadvantaged. Intense multiculturalism will require different approaches and moral obligations to work with these groups and urgency exists to develop nursing caring strategies when dealing with these populations. Development of nursing curricula which identify prejudicial thinking and intolerance for marginalized groups will help to decrease fears and increase nurses' willingness to provide culturally competent health care for underserved and disenfranchised populations. Caring for members of disenfranchised groups instills fear at some level in nurses who are working with these individuals. This fear may be due, in part, to the potential harm nurses perceive the patient may cause them, or perhaps it is because they feel they could possibly be in the individual's situation at some point in their lives. Prejudice and discrimination continue to exist in society and have adversely affected the health care system and the nursing profession. Discrimination may be based on differences due to age, ability, gender, race, ethnicity, religion, sexual orientation, or any characteristics by which people differ. Registered Nurses are accountable for nursing decisions and actions regardless of personal preferences. Due to the rapidly changing healthcare system the nurse faces increasing ethical dilemmas and human rights issues. Nurses are individually accountable for caring for each patient and the right to refuse an assignment should be carefully interpreted to avoid patient abandonment. Nurses' objections can be based on moral, ethical, or religious beliefs not on personal preferences and in an emergency the nurse must provide treatment regardless of any personal objections.
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Mariano, Micah Celine O; Maniego, John Christian M; Manila, Hariette Lou Marie D; Mapanoo, Ram Cedrick C; Maquiran, Kerwin Miguel A; Macindo, John Rey B; Tejero, Lourdes Marie S; Torres, Gian Carlo S
2018-04-01
Social media has become increasingly important over the past decades and has been integrated in various environments, including the healthcare setting. Yet, the influence of social media use on the social skills and nurse-patient interaction of nurses is an area in nursing that requires further studies. This study determined the interrelationships among social media use profile, social skills, and nurse-patient interaction of Registered Nurses in tertiary hospitals. Employing structural equation modeling, a descriptive-correlational study was conducted among 212 consecutively-selected nurses from two tertiary hospitals. Consenting respondents completed a two-part survey composed of the respondent profile sheet and the Social Skills Inventory. The respondent profile sheet assessed demographic profile and social media use profile in terms of the mode, frequency, and duration of utilization. Three trained team members observed each nurse-patient dyad and completed the Nurse-Patient Bonding Instrument. A good fit model illustrated the negative effects of frequent social media use to patient openness (β = -0.18, p < 0.05) and engagement (β = -0.11, p ≤ 0.05). Longer use of social media on a daily basis, however, positively affected both dimensions of social skills. Accessing social media platforms using non-handheld devices showed the most influential positive effects to social skills and nurse-patient interaction. Additionally, although verbal social skills positively affected most dimensions of nurse-patient interaction, non-verbal social skills negatively influenced patient engagement (β = -0.19, p = 0.019) and nurse openness (β = -0.38, p ≤ 0.05). The structural model illustrates the effects of using social media on the social skills and nurse-patient interaction of nurses and emphasizes the need for implementing institutional policies on the judicious use and application of social media in the workplace. Further, social
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Haider, Adil H; Schneider, Eric B; Sriram, N; Scott, Valerie K; Swoboda, Sandra M; Zogg, Cheryl K; Dhiman, Nitasha; Haut, Elliott R; Efron, David T; Pronovost, Peter J; Freischlag, Julie A; Lipsett, Pamela A; Cornwell, Edward E; MacKenzie, Ellen J; Cooper, Lisa A
2015-06-01
Implicit bias is an unconscious preference for a specific social group that can have adverse consequences for patient care. Acute care clinical vignettes were used to examine whether implicit race or class biases among registered nurses (RNs) impacted patient-management decisions. In a prospective study conducted among surgical RNs at the Johns Hopkins Hospital, participants were presented 8 multi-stage clinical vignettes in which patients' race or social class were randomly altered. Registered nurses were administered implicit association tests (IATs) for social class and race. Ordered logistic regression was then used to examine associations among treatment differences, race, or social class, and RN's IAT scores. Spearman's rank coefficients comparing RN's implicit (IAT) and explicit (stated) preferences were also investigated. Two hundred and forty-five RNs participated. The majority were female (n=217 [88.5%]) and white (n=203 [82.9%]). Most reported that they had no explicit race or class preferences (n=174 [71.0%] and n=108 [44.1%], respectively). However, only 36 nurses (14.7%) demonstrated no implicit race preference as measured by race IAT, and only 16 nurses (6.53%) displayed no implicit class preference on the class IAT. Implicit association tests scores did not statistically correlate with vignette-based clinical decision making. Spearman's rank coefficients comparing implicit (IAT) and explicit preferences also demonstrated no statistically significant correlation (r=-0.06; p=0.340 and r=-0.06; p=0.342, respectively). The majority of RNs displayed implicit preferences toward white race and upper social class patients on IAT assessment. However, unlike published data on physicians, implicit biases among RNs did not correlate with clinical decision making. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
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The experience of learning to speak up: a narrative inquiry on newly graduated registered nurses.
Law, Bernice Yee-Shui; Chan, Engle Angela
2015-07-01
To explore the process of learning to speak up in practice among newly graduated registered nurses. Speaking up is an important aspect of communication to ensure patient safety within a healthcare team. However, nurses have reported being hesitant about speaking up or being unable to be heard, despite adopting various safety tools. A power differential could be a factor in their hesitation to speak up. While a large number of new graduates are employed in the lower rungs of the hospital hierarchy to resolve local and global nursing shortages, the process of their learning to speak up remains under-explored. The narrative concept of experience is addressed through the three-dimensional space of a narrative inquiry. Eighteen new graduates were recruited. Stories of experiences of speaking up emerged naturally during repeated unstructured interviews and ongoing email conversations with three participants. The complex process of learning to speak up is schematically represented. Three interrelated narrative threads were identified: (1) learning to speak up requires more than one-off training and safety tools, (2) mentoring speaking up in the midst of educative and miseducative experiences and (3) making public spaces safe for telling secret stories. Speaking up requires ongoing mentoring to see new possibilities for sustaining professional identities in the midst of miseducative experiences under the potential shaping of the Chinese culture and generational differences. Appreciative inquiry might be a new approach that can be used to promote positive cultural changes to encourage newly graduated registered nurses to learn to speak up to ensure patient safety. Cultivating a safe and open culture of communication and mentoring new graduates to speak up will benefit patient safety now and in the future by helping to retain committed patient advocates who could mentor future generations. © 2015 John Wiley & Sons Ltd.
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Doughty, Lesley; McKillop, Ann; Dixon, Robyn; Sinnema, Claire
2018-05-01
New graduate nurses are the future of nursing and the education they receive as they transition into the workforce as a newly registered nurse is critical for building a suitably qualified nursing workforce that will adequately serve the future population. Variation exists in education programmes for new graduate nurses in their first year of practice which is known to impact on transition experience. A qualitative study using focus groups and semi-structured interviews was undertaken to explore the experiences and perceptions of New Graduate Nurses undertaking a new graduate programme and Directors of Nursing supporting them to complete the programme which may or may not have been inclusive of a postgraduate course (Masters Level). The findings of this study are in line with previous research and support the value of new graduate programmes but did reveal a lack of consensus in regards to the structure and content of such programmes. This study revealed some commonalities and challenges between the differing programmes but has identified the need for further research to establish the impact of postgraduate education in the first year of practice and how this impacts on nursing practice and patient care. There are numerous terms in the literature with reference to new graduate programmes; transition to practice programme, nurse entry to practice programme, first year of clinical practice programme, new graduate programme and early career nursing programme. For the purpose of this article the term Nurse Entry to Practice (NETP) will be used in reference to any form of new graduate programme. Copyright © 2018 Elsevier Ltd. All rights reserved.
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US nurse labor market dynamics are key to global nurse sufficiency.
Aiken, Linda H
2007-06-01
To review estimates of U.S. nurse supply and demand, document trends in nurse immigration to the United States and their impact on nursing shortage, and consider strategies for resolving the shortage of nurses in the United States without adversely affecting health care in lower-income countries. Production capacity of nursing schools is lagging current and estimated future needs, suggesting a worsening shortage and creating a demand for foreign-educated nurses. About 8 percent of U.S. registered nurses (RNs), numbering around 219,000, are estimated to be foreign educated. Eighty percent are from lower-income countries. The Philippines is the major source country, accounting for more than 30 percent of U.S. foreign-educated nurses. Nurse immigration to the United States has tripled since 1994, to close to 15,000 entrants annually. Foreign-educated nurses are located primarily in urban areas, most likely to be employed by hospitals, and somewhat more likely to have a baccalaureate degree than native-born nurses. There is little evidence that foreign-educated nurses locate in areas of medical need in any greater proportion than native-born nurses. Although foreign-educated nurses are ethnically more diverse than native-born nurses, relatively small proportions are black or Hispanic. Job growth for RNs in the United States is producing mounting pressure by commercial recruiters and employers to ease restrictions on nurse immigration at the same time that American nursing schools are turning away large numbers of native applicants because of capacity limitations. Increased reliance on immigration may adversely affect health care in lower-income countries without solving the U.S. shortage. The current focus on facilitating nurse immigration detracts from the need for the United States to move toward greater self-sufficiency in its nurse workforce. Expanding nursing school capacity to accommodate qualified native applicants and implementing evidence-based initiatives to
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Integrated Employee Occupational Health and Organizational-Level Registered Nurse Outcomes.
Mohr, David C; Schult, Tamara; Eaton, Jennifer Lipkowitz; Awosika, Ebi; McPhaul, Kathleen M
2016-05-01
The study examined organizational culture, structural supports, and employee health program integration influence on registered nurse (RN) outcomes. An organizational health survey, employee health clinical operations survey, employee attitudes survey, and administration data were collected. Multivariate regression models examined outcomes of sick leave, leave without pay, voluntary turnover, intention to leave, and organizational culture using 122 medical centers. Lower staffing ratios were associated with greater sick leave, higher turnover, and intention to leave. Safety climate was favorably associated with each of the five outcomes. Both onsite employee occupational health services and a robust health promotion program were associated with more positive organizational culture perceptions. Findings highlight the positive influence of integrating employee health and health promotion services on organizational health outcomes. Attention to promoting employee health may benefit organizations in multiple, synergistic ways.
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Egues, Aida L
2013-01-01
The purpose of this qualitative descriptive study was to explore the meaning of the experiences of mentoring influences on the personal and professional growth of Hispanic registered nurses (RNs). Focus group methodology was employed in the New York City metropolitan area with monolingual English or bilingual English/Spanish RNs (N = 20) who perceived themselves to be at all levels of practice. The findings offer a summary of the experiences of mentoring for the 20 Hispanic RNs that includes little advancement support; hesitancy to being mentored; dependency on the self for personal and professional growth; and educational, practice, and socioeconomic barriers. This study suggests that mentoring of Hispanic nurses needs to be reexamined to improve and sustain a culture of mentoring that may enhance the education, recruitment, and retention of Hispanic RNs.
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Application of Guided Imagery to Facilitate the Transition of New Graduate Registered Nurses
Boehm, Laura B.; Tse, Alice M.
2016-01-01
Traditionally, the new graduate registered nurse (RN) transition has included a didactic and skills-based orientation accompanied by a period of preceptored practice. However, these methods do not ensure that new RNs are in a state of reduced anxiety to fully interact with their new environment. Transition to practice may cause anxiety, and the new graduate RN may perceive moderate to severe stress. One method of stress reduction is the use of guided imagery, which has shown strong potential with a variety of populations undergoing stressful events. Today, new graduate RNs expect institutions to facilitate orientation to their new employment settings and assist in the transition to their role as a professional nurse. This article proposes a model that incorporates guided imagery for refining the new graduate RN transition process. The model can be adapted for use in the context of orienting other adult learners to unfamiliar practice situations. PMID:23330588
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U.S. Nurse Labor Market Dynamics Are Key to Global Nurse Sufficiency
Aiken, Linda H
2007-01-01
Objectives To review estimates of U.S. nurse supply and demand, document trends in nurse immigration to the United States and their impact on nursing shortage, and consider strategies for resolving the shortage of nurses in the United States without adversely affecting health care in lower-income countries. Principal Findings Production capacity of nursing schools is lagging current and estimated future needs, suggesting a worsening shortage and creating a demand for foreign-educated nurses. About 8 percent of U.S. registered nurses (RNs), numbering around 219,000, are estimated to be foreign educated. Eighty percent are from lower-income countries. The Philippines is the major source country, accounting for more than 30 percent of U.S. foreign-educated nurses. Nurse immigration to the United States has tripled since 1994, to close to 15,000 entrants annually. Foreign-educated nurses are located primarily in urban areas, most likely to be employed by hospitals, and somewhat more likely to have a baccalaureate degree than native-born nurses. There is little evidence that foreign-educated nurses locate in areas of medical need in any greater proportion than native-born nurses. Although foreign-educated nurses are ethnically more diverse than native-born nurses, relatively small proportions are black or Hispanic. Job growth for RNs in the United States is producing mounting pressure by commercial recruiters and employers to ease restrictions on nurse immigration at the same time that American nursing schools are turning away large numbers of native applicants because of capacity limitations. Conclusions Increased reliance on immigration may adversely affect health care in lower-income countries without solving the U.S. shortage. The current focus on facilitating nurse immigration detracts from the need for the United States to move toward greater self-sufficiency in its nurse workforce. Expanding nursing school capacity to accommodate qualified native applicants and
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26 CFR 1.1092(c)-3 - Qualifying over-the-counter options.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Qualifying over-the-counter options. 1.1092(c)-3...-counter options. (a) In general. Under section 1092(c)(4)(B)(i), an equity option is not a qualified covered call option unless it is traded on a national securities exchange that is registered with the...
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Caring behaviour perceptions from nurses of their first-line nurse managers.
Peng, Xiao; Liu, Yilan; Zeng, Qingsong
2015-12-01
Nursing is acknowledged as being the art and science of caring. According to the theory of nursing as caring, all persons are caring but not every behaviour of a person is caring. Caring behaviours in the relationship between first-line nurse managers and Registered Nurses have been studied to a lesser extent than those that exist between patients and nurses. Caring behaviour of first-line nurse managers from the perspective of Registered Nurses is as of yet unknown. Identifying caring behaviours may be useful as a reference for first-line nurse managers caring for nurses in a way that nurses prefer. To explore first-line nurse managers' caring behaviours from the perspective of Registered Nurses in mainland China. Qualitative study, using descriptive phenomenological approach. Fifteen Registered Nurses recruited by purposive sampling method took part in in-depth interviews. Data were analysed according to Colaizzi's technique. Three themes of first-line nurse managers' caring behaviours emerged: promoting professional growth, exhibiting democratic leadership and supporting work-life balance. A better understanding of the first-line nurse managers' caring behaviours is recognised. The three kinds of behaviours have significant meaning to nurse managers. Future research is needed to describe what first-line nurse managers can do to promote nurses' professional growth, increase the influence of democratic leadership, as well as support their work-life balance. © 2015 Nordic College of Caring Science.
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Suhaila, O; Rampal, K G
2012-10-01
This study focuses on sexual harassment, a form of psycological hazard that female registered nurses face throughout their day to day routine. The objective of this study is to find the prevalence of sexual harassment among female registered nurses working in government hospitals in Melaka, Malaysia and factors affecting them. This is a cross sectional study conducted on 455 female registered nurses who have worked more than one year in the present 3 government hospitals in Melaka, Malaysia. A validated and pre tested questionnaires were given for the respondents to answer. Before respondents answer the questionaires, they are required to read the definition and the forms of sexual harassment provided. This is to help them to understand the correct definition and forms of sexual harassment that they could have experienced. The researcher is available during the distribution of the questionnaires and the respondents are free to ask the researcher anything that they do not understand about it. The results of this study show that the prevalence of sexual harassment among these nurses was 51.2% with the past one year incidence recorded at 22.8%. The most common forms of sexual harassment were verbal (46.6% ), visual (24.8% ), psycological (20.9%), physical (20.7%) and non -verbal (16.7% ). The study showed that 74.7% of the victims suffered from psychological effects brought upon by their encounter with various types of sexual harrasement at work. The study also found that the victims' self-perception of their physicality was a contributing factor to the prevalance of this situation. Those who were pretty, with attractive body figure, a friendly character and easy going had a higher prevalence of sexual harassment in the workplace. Meanwhile, those who were strict, and those who had a fierce character were not prone to sexual harassment. The prevalence of sexual harassment among registered nurses in the workplace found in this study was high and self-perception profile
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Armellino, Donna; Quinn Griffin, Mary T; Fitzpatrick, Joyce J
2010-10-01
The aim of the present study was to examine the relationship between structural empowerment and patient safety culture among staff level Registered Nurses (RNs) within adult critical care units (ACCU). There is literature to support the value of RNs' structurally empowered work environments and emerging literature towards patient safety culture; the link between empowerment and patient safety culture is being discovered. A sample of 257 RNs, working within adult critical care of a tertiary hospital in the United States, was surveyed. Instruments included a background data sheet, the Conditions of Workplace Effectiveness and the Hospital Survey on Patient Safety Culture. Structural empowerment and patient safety culture were significantly correlated. As structural empowerment increased so did the RNs' perception of patient safety culture. To foster patient safety culture, nurse leaders should consider providing structurally empowering work environments for RNs. This study contributes to the body of knowledge linking structural empowerment and patient safety culture. Results link structurally empowered RNs and increased patient safety culture, essential elements in delivering efficient, competent, quality care. They inform nursing management of key factors in the nurses' environment that promote safe patient care environments. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
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Kishi, Yuka; Inoue, Kumiyo; Crookes, Patrick; Shorten, Allison
2014-04-01
The purpose of the study was to investigate the experiences of Japanese nurses and their adaptation to their work environment in Australia. Using a qualitative research method and semistructured interviews, the study aimed to discover, describe, and analyze the experiences of 14 Japanese nurses participating in the study. A qualitative study. Fourteen Japanese registered nurses working in Australian hospitals participated in the study. Individual semistructured interviews were conducted from April to June in 2008. Thematic analysis was used to identify themes within the data. Analysis of qualitative open-ended questions revealed the participants' adaptation process. It consists of three themes or phases: seeking (S), acclimatizing (A), and settling (S), subsequently named the S.A.S. model. The conceptual model of the adaptation processes of 14 Japanese nurses working in Australia includes the seeking, acclimatizing, and settling phases. Although these phases are not mutually exclusive and the process is not necessarily uniformly linear, all participants in this study passed through this S.A.S. model in order to adapt to their new environment. The S.A.S. model of adaptation helps to describe the experiences of Japanese overseas qualified nurses working in Australian hospitals. Future research is needed to examine whether this model can be applied to nurses from other countries and in other settings outside Australia.
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Registered nurses' attitudes towards the role of the healthcare assistant.
Alcorn, Jason; Topping, Anne Elizabeth
To elicit the views of registered nurses (RNs), working in the surgical directorate of an acute NHS trust, concerning the responsibilities of RNs to healthcare assistants (HCAs), specifically in relation to delegation, development and accountability. A survey using a 24-item questionnaire and a six-point Likert scale design was administered to a convenience sample of 219 RNs working within the surgical directorate. A total of 148 completed questionnaires were returned, giving a 68% response rate. The results suggested that the majority of RNs were aware of their responsibilities regarding accountability for delegated tasks, believe that HCAs should be regulated and, once prepared adequately, held individually accountable for their actions. RNs should undertake appropriate skill development in pre-registration programmes and be provided with preceptorship to ensure they are equipped adequately to supervise and delegate work to HCAs.
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Hahn, Joan Earle
2014-09-01
To describe the most frequently reported and the most central nursing interventions in an advance practice registered nurse (APRN)-led in-home preventive intervention model for adults aging with developmental disabilities using the Nursing Intervention Classification (NIC) system. A descriptive data analysis and a market basket analysis were conducted on de-identified nominal nursing intervention data from two home visits conducted by nurse practitioners (NPs) from October 2010 to June 2012 for 80 community-dwelling adults with developmental disabilities, ages 29 to 68 years. The mean number of NIC interventions was 4.7 in the first visit and 6.0 in the second visit and last visit. NPs reported 45 different intervention types as classified using a standardized language, with 376 in Visit One and 470 in Visit Two. Approximately 85% of the sample received the Health education intervention. The market basket analysis revealed common pairs, triples, and quadruple sets of interventions in this preventive model. The NIC nursing interventions that occurred together repeatedly were: Health education, Weight management, Nutrition management, Health screening, and Behavior management. Five NIC interventions form the basis of an APRN-led preventive intervention model for individuals aging with lifelong disability, with health education as the most common intervention, combined with interventions to manage weight and nutrition, promote healthy behaviors, and encourage routine health screening. Less frequently reported NIC interventions suggest the need to tailor prevention to individual needs, whether acute or chronic. APRNs employing prevention among adults aging with developmental disabilities must anticipate the need to focus on health education strategies for health promotion and prevention as well as tailor and target a patient-centered approach to support self-management of health to promote healthy aging in place. These NIC interventions serve not only as a guide for
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Van Osch, Mary; Scarborough, Kathy; Crowe, Sarah; Wolff, Angela C; Reimer-Kirkham, Sheryl
2018-03-01
To explore the influential factors and strategies that promote an experienced nurse's intent to stay in their emergency or critical care area. Turnover among registered nurses (herein referred to as nurses) working in specialty areas of practice can result in a range of negative outcomes. The retention of specialty nurses at the unit level has important implications for hospital and health systems. These implications include lost knowledge and experience which may in turn impact staff performance levels, patient outcomes, hiring, orientating, development of clinical competence and other aspects of organizational performance. This qualitative study used an interpretive descriptive design to understand nurses' perceptions of the current factors and strategies that promote them staying in emergency or critical care settings for two or more years. Focus groups were conducted with 13 emergency and critical care nurses. Data analysis involved thematic analysis that evolved from codes to categories to themes. Four themes were identified: leadership, interprofessional relationships, job fit and practice environment. In addition, the ideas of feeling valued, respected and acknowledged were woven throughout. Factors often associated with nurse attrition such as burnout and job stresses were not emphasised by the respondents in our study as critical to their intent to stay in their area of practice. This study has highlighted positive aspects that motivate nurses to stay in their specialty areas. To ensure quality care for patients, retention of experienced emergency and critical care nurses is essential to maintaining specialty expertise in these practice settings. © 2017 John Wiley & Sons Ltd.
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Kekana, H P P; du Rand, E A; van Wyk, N C
2007-06-01
Nurses are confronted daily with the demands of an increased workload and insufficient facilities in the public healthcare sector in South Africa. The purpose of the study was therefore to determine the degree ofjob satisfaction of registered nurses in a community hospital in the Limpopo Province of South Africa. A quantitative descriptive design was used to meet the objectives of the study. The population was not sampled because of the small size of it. All the registered nurses who had one or more years experience in this hospital were included in the study. A self-administered questionnaire was used to collect data from them regarding the working conditions in the hospital including the emotional and social climate. The questionnaire was based on an instrument developed by Humphries and Turner (1989:303) to determine the degree of job satisfaction of nursing staff in a unit for elderly mentally retarded patients. The findings indicated that the majority of the respondents were dissatisfied about the working conditions and emotional climate in the hospital while they were fairly satisfied with the social climate. The workload and degree of fair remuneration, under the working conditions, were the most highly rated as dissatisfying (83% of the participants) while under the emotional climate they indicated that the pressure under which they worked was highly dissatisfying (82% of the participants). As the results indicated that the social climate was satisfactory; having a best friend at work and the chance to help other people while at work, were rated positively by 88% and 76% of the participants respectively. Recommendations made included that managers have to show the staff that their best interest is their number one concern. Leaders have to be available for the staff and being willing to buffer the stress caused by increased workload and insufficient resources. Greater visibility of supervisory staff should therefore be encouraged.
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Nurses' attitudes towards euthanasia: a cross-sectional study in Iran.
Naseh, Ladan; Rafiei, Hossein; Heidari, Mohammad
2015-01-01
Nurses have an important role in caring for terminally ill patients. They are often confronted with euthanasia but little is known about their attitudes towards it. The present study aimed to examine Iranian Muslim nurses' attitudes towards euthanasia. In this exploratory cross-sectional study, all qualified registered nurses working in two teaching hospitals (Kashani and Hajar hospitals) in Iran were invited to participate. The Euthanasia Attitude Scale (EAS) was used to assess the nurses' attitude towards euthanasia. Of 266 nurses who fit the criteria, 190 participated in the study (response rate 72.9%); 91.1% (n=173) were female and 8.9% (n=17) were male. In total, 57.4%, 3.2% and 39.5% of nurses reported a negative, neutral and positive attitude to euthanasia respectively. Nurses reported their most negative attitude to the domain 'practical consideration' with mean of 2.36±0.9 and most positive attitude to the domain 'treasuring life' with a mean EAS score of 2.85±0.4. The majority of Muslim nurses were found to have negative attitudes to euthanasia. We recommend that future studies should be conducted to examine Muslim nurses' attitudes to euthanasia in different cultures to determine the role of culture and religious beliefs in attitude to euthanasia.
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Aggar, Christina; Bloomfield, Jacqueline; Thomas, Tamsin H; Gordon, Christopher J
2017-01-01
Increases in ageing, chronic illness and complex co-morbidities in the Australian population are adding pressure to the primary care nursing workforce. Initiatives to attract and retain nurses are needed to establish a sustainable and skilled future primary care nursing workforce. We implemented a transition to professional practice program in general practice settings for graduate nurses and evaluated graduate nurse competency, the graduate nurse experience and program satisfaction. This study aimed to determine whether a transition to professional practice program implemented in the general practice setting led to competent practice nurses in their first year post-graduation. A longitudinal, exploratory mixed-methods design was used to assess the pilot study. Data were collected at three times points (3, 6, 12 months) with complete data sets from graduate nurses ( n = 4) and preceptors ( n = 7). We assessed perceptions of the graduates' nursing competency and confidence, satisfaction with the preceptor/graduate relationship, and experiences and satisfaction with the program. Graduate nurse competency was assessed using the National Competency Standards for Nurses in General Practice. Semi-structured interviews with participants at Time 3 sought information about barriers, enablers, and the perceived impact of the program. Graduate nurses were found to be competent within their first year of clinical practice. Program perceptions from graduate nurses and preceptors were positive and the relationship between the graduate nurse and preceptor was key to this development. With appropriate support registered nurses can transition directly into primary care and are competent in their first year post-graduation. While wider implementation and research is needed, findings from this study demonstrate the potential value of transition to professional practice programs within primary care as a nursing workforce development strategy.
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Lifestyle practices and the health promoting environment of hospital nurses.
Hope, A; Kelleher, C C; O'Connor, M
1998-08-01
Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.
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Nurses' experiences working with nursing students in a hospital: a phenomenological enquiry.
Lapeña-Moñux, Yolanda Raquel; Cibanal-Juan, Luis; Orts-Cortés, M Isabel; Maciá-Soler, M Loreto; Palacios-Ceña, Domingo
2016-01-01
this paper explores the experiences of registered nurses working with Spanish nursing students within the hospital. a qualitative phenomenological approach was followed. Purposeful sampling was employed. Twenty-one registered nurses, from a public hospital located in Spain, were included in the study. Data were collected by means of unstructured and semi-structured interviews and were analysed using Giorgi's proposal. The Consolidated Criteria for Reporting Qualitative Research were followed. three main themes described the experience of registered nurses: "The nurse's relationship with nursing students"; most nurses emphasized the importance of the first contact with students and they considered students' attitude to be key. "Defining the role of the student in clinical practice"; it is necessary to unify the nurse's role and interventions to avoid misleading students and establish priorities in clinical practice. "Building bridges between clinical settings and the University"; the need to establish a common ground and connection between the university and hospital clinical settings was emphasized. Nurses felt that the training program should also be designed by the clinical settings themselves. understanding the meaning of nursing students with registered nurses might gain a deeper insight into their expectations.
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Hospital nurses' work environment, quality of care provided and career plans.
Hinno, S; Partanen, P; Vehviläinen-Julkunen, K
2011-06-01
In several European countries, the availability of qualified nurses is insufficient to meet current healthcare requirements. Nurses are highly dissatisfied with the rising demands of the healthcare environment and increasingly considering leaving their jobs. The study aims to investigate the relationships between the characteristics of hospital nurses' work environment and the quality of care provided, and furthermore to examine Dutch nurses' career plans. A cross-sectional, questionnaire survey of registered nurses (n = 334) working in the academic and district hospitals was conducted in 2005/2006. Previously validated questionnaires translated into the participants' language were used. Factor and regression analysis were used for data analysis. Overall, nurses rated their work environment rather favourably. Five work environment characteristics were identified: support for professional development, adequate staffing, nursing competence, supportive management and teamwork. Significant relationships were found between nurses' perceptions of their work environment characteristics and quality of care provided and nurses' career plans. When work environment characteristics were evaluated to be better, nurse-assessed quality of care also increased and intentions to leave current job decreased linearly. Study findings suggest that nurses' perceptions of their work environment are important for nurse outcomes in hospital settings. Further research is needed to explore the predictive ability of the work environment for nurse, patient and organizational outcomes in hospitals. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.
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McCorkell, Gillian; Brown, Geraldine; Michaelides, Bernie; Coates, Vivien
2015-03-01
The project aims to assess current specialist practice in relation to the new and ever-changing healthcare climate and explore some of the issues that specialist nurses encounter. The current financial recession is driving a range of economic policy changes and consequently service provision, in particular the work and impact of nurses working in a specialist role, being examined. This has resulted in many specialist nurses feeling very vulnerable. A cross sectional survey was completed by nurses working in specialist roles (n = 96) in a large health and social care setting in the United Kingdom. A response rate of 62% was achieved: 44% provide nurse led clinics and 42% are nurse prescribers. The mean length of time qualified as a registered nurse was 27 years. Less than a third felt that the current computer system for activity recording reflected their current workload and 65% needed administrative support. This study demonstrates the insufficient resources available to specialist nurses resulting in inappropriate but necessary, use of time and restricted opportunities for learning and development. © 2013 John Wiley & Sons Ltd.
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ERIC Educational Resources Information Center
Owens, Denise; Rutherford, June
2007-01-01
This paper describes the conception and progress to date of the development of work-based learning as part of post-qualifying education in the School of Nursing at the University of Salford. There is a changing culture in the university in relation to the delivery of programmes via non-traditional routes. In this context, work-based learning is a…
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Supply and distribution of primary healthcare registered nurses in british columbia.
Wong, Sabrina T; Watson, Diane E; Young, Ella; Mooney, Dawn
2009-11-01
WHAT DID WE DO?: This study uses an existing data source to (a) describe the population and geographic distribution of registered nurses (RNs) working in primary healthcare (PHC) in British Columbia, (b) compare this workforce to PHC physicians and (c) assess the distribution of PHC-RNs relative to population health status. WHAT DID WE LEARN?: Of the 27,570 practising RNs in British Columbia in 2000, there were 3,179 (12%) in the PHC workforce. This translates into 147 people per practising RN and 1,277 people per PHC-RN. In 2000, there were 990 people per PHC physician. PHC-RNs represented 43% of the combined PHC workforce of physicians and RNs. A large proportion (47%) of PHC-RNs worked in community health centres, whereas less than 2% worked in physicians' offices. Geographic distribution of PHC-RNs is similar to the distribution of PHC physicians and is not associated with population health status. WHAT ARE THE IMPLICATIONS?: There seem to be sufficient PHC-RNs to implement policy objectives in support of interdisciplinary PHC teams, but physicians and nurses will increasingly need to practice in the same location or have access to electronic information systems to support coordination, continuity and comprehensiveness of PHC. The PHC workforce could be better deployed to align with population health status.
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Aiyub, S; Linh, N N; Tayler-Smith, K; Khogali, M; Bissell, K
2013-03-21
Fiji's schools of nursing and government health services, 2001-2010. To report on 1) the number and characteristics of nurses who graduated in Fiji, 2) the proportion of vacant nursing positions in the government health services and 3) attrition among nurses. Descriptive study involving a retrospective record review of Ministry of Health annual reports and nursing registers. Over the period 2001-2010, a total of 1500 nurses graduated, with the overall trend being a gradual increase in newly qualified nurses year on year. Available data from 2007 onwards showed relatively low vacancy rates (range 0.4-2%), with a sharp rise to 15% in 2009. Complete data on nurse attrition were available only from 2007 onwards, with rates of attrition ranging from 4% to 10%; the most common reason for attrition was resignation. While it was unable to directly assess whether Fiji's supply of nursing graduates has been meeting the country's health service demands, this study provides a series of baseline data on Fiji's nurse graduate and nursing workforce. In addition, it identifies some of the challenges and gaps that need to be considered to better assess and address nursing staff shortages.
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A student nurse experience of an intervention that addresses the perioperative nursing shortage.
Monahan, J Carter
2015-11-01
Registered nurses are the largest group of professionals in the global healthcare system. The number of nurses is estimated to be 19.3 million throughout the world (Flinkman et al 2013). In the United States the need for registered nurses is growing. It has been predicted that 260,000 positions for registered nurses will remain unfilled by the year 2025 (Harris et al 2014) with a shortage of registered nurses projected to spread across the United States between 2009 and 2030 (Juraschek et al 2012). Compounding the projected nursing shortage is the increased attrition rate, which is as high as 61% within the first year (Pine & Tart 2007). There are several reasons for this shortage including supply and demand issues, projected changes to healthcare and the aging population. Additionally, the number of college graduates who have majored in nursing has not met the demand (Dunn 2014).
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Urban, Ann-Marie; Wagner, Joan I
2013-12-01
Hospitals are situated within historical and socio-political contexts; these influence the provision of patient care and the work of registered nurses (RNs). Since the early 1990s, restructuring and the increasing pressure to save money and improve efficiency have plagued acute care hospitals. These changes have affected both the work environment and the work of nurses. After recognizing this impact, healthcare leaders have dedicated many efforts to improving the work environment in hospitals. Admirable in their intent, these initiatives have made little change for RNs and their work environment, and thus, an opportunity exists for other efforts. Research indicates that spirit at work (SAW) not only improves the work environment but also strengthens the nurse's power to improve patient outcomes and contribute to a high-quality workplace. In this paper, we present findings from our research that suggest SAW be considered an important component in improving the work environment in acute care hospitals.
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McEwen, Melanie; Farren, Elizabeth
2005-01-01
Studies indicate that roughly half of health care workers are not immunized against hepatitis B and influenza. Findings from a survey of 1,000 registered nurses (RNs) conducted to analyze their beliefs and actions related to immunization recommendations are reported. Only 8% of the responding RNs chose not to receive vaccination against hepatitis B. The primary reasons that nurses declined hepatitis B vaccination were because they were not working in nursing or did not believe they were at risk of exposure. Similarly, 86% of the RNs reported they had ever received a flu shot, and 69% reported of being immunized during 2 of the previous 4 years. Rationale for receiving immunization included belief in its effectiveness, belief that they were at risk of exposure, and that it was provided free of charge. Reasons for declining included concerns about side effects, lack of concern about getting the illness, and doubts about effectiveness. The nurses who responded to the survey appear to value immunizations and generally adhere to immunization recommendations. Further study needs to be conducted on related issues, including follow-up for assessment of long-term protection of hepatitis B immunization and adherence to guidelines for postexposure prophylaxis. Ongoing monitoring and further study of serious complications of hepatitis B immunizations are also needed.
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Empowering aged care nurses to deliver person-centred care: Enabling nurses to shine.
Marriott-Statham, Kelly; Mackay, Maria; Brennan, Ngaire; Mackay, Jacinta
2018-05-23
In this paper, the authors will describe the journey of registered nurses across a series of workshops as part of a research project that was undertaken in a regional aged care service in New South Wales, Australia. The aim of the project was to empower the participant registered nurses to positively influence the health care workplace culture within the residential care home by raising consciousness about their own practice. Registered nurses were actively involved in this reconnaissance phase of a participatory action research project through practice development principles and methods. Registered nurses determined the content and the outcomes of the overall program. The researchers evaluated the impact of a series of workshops, designed to develop skills and knowledge using nominal group technique. Results revealed registered nurses perceived they were empowered to flourish, and developed an understanding of the uniqueness of their role. A shared understanding of the role of the registered nurse in the aged care setting was fundamental in enabling them to feel empowered to lead their team and contribute positively to the workplace culture. Overall, the outcomes of this project have positively impacted workplace culture. Copyright © 2018. Published by Elsevier Ltd.
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Nursing work directions in Australia: does evidence drive the policy?
Roche, Michael; Duffield, Christine; Aisbett, Chris; Diers, Donna; Stasa, Helen
2012-01-01
A significant body of research has shown a relationship between nurse staffing (in particular, skill-mix: the proportion of Registered Nurses [RNs]) and both morbidity and mortality. This relationship is typically investigated by measuring the incidence of Nursing Sensitive Outcomes (NSOs) under different skill-mix levels. Yet whilst the evidence suggests that richer skill-mix is associated with a lower incidence of NSOs, recent Australian policy reforms have proposed the replacement of Registered Nurses with less qualified staff. The present study sought to examine the relationship between staffing, skill-mix, and incidence of NSOs at two hospitals in one Australian state. The study sought to determine the rate of occurrence of several NSOs, the relationship of skill-mix to that rate, and the number of patients affected per annum. It was found that the current rate of NSOs across wards ranged from 0.17% to 1.05%, and that there was an inverse relationship between the proportion of hours worked by RNs and NSO rates: an increase of 10% in the proportion of hours worked by RNs was linked to a decrease in NSO rates by between 11% and 45%. It was estimated that increasing the RN staffing percentage by 10% would mean 160 fewer adverse outcomes for patients per year across these two hospitals. Importantly, increases in nursing hours overall (without increases in skill-mix) had no significant effect on patient outcomes. These findings challenge current policy recommendations, which propose increasing the number of unregistered staff without increasing skill-mix.
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El Hussein, Mohamed; Hirst, Sandra
2016-02-01
The aim of this study was to construct a grounded theory that explains the clinical reasoning processes that registered nurses use to recognize delirium in older adults in acute care hospitals. Delirium is under-recognized in acute hospital settings, this may stem from underdeveloped clinical reasoning processes. Little is known about registered nurses' (RNs) clinical reasoning processes in complex situations such as delirium recognition. A grounded theory approach was used to analyse interview data about the clinical reasoning processes of RNs in acute hospital settings. Seventeen RNs were recruited. Concurrent data collection and comparative analysis and theoretical sampling were conducted in 2013-2014. The core category to emerge from the data was 'chasing the mirage', which describes RNs' clinical reasoning processes to recognize delirium during their interaction with older adults. Understanding the reasoning that contributes to delirium under-recognition provides a strategy by which, this problem can be brought to the forefront of RNs' awareness and intervention. Delirium recognition will contribute to quality care for older adults. © 2015 John Wiley & Sons Ltd.
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Draper, Jan
2018-07-01
There has been increasing international research and policy interest concerning the transition from student to newly qualified nurse (NQN). However, the influence of previous employment as a healthcare assistant (HCA) on students' experiences of this transition is comparatively under-researched. To explore the experiences of NQNs also employed as HCAs during their pre-registration education programme and how this prior and ongoing HCA experience influenced their transition experiences. Qualitative research design using a descriptive method. Former students (n = 14) of a unique four year, part-time, employer-sponsored pre-registration nursing programme, specifically designed for HCAs and delivered by supported open learning, located in different regions and nations of the United Kingdom who had qualified within the last two years. Telephone interviews, digitally recorded, transcribed verbatim and analysed using NVivo8. Four themes described participants' experiences of transition: In at the deep end, Changing identities, Coming together and Scaffolding. Findings confirm existing literature that all NQNs appear to experience a similar overarching experience of transition, including those with prior HCA experience. However, familiarity with people, place and routines afforded by this previous experience appeared to ease transition, particularly if the NQNs stayed in their previous HCA work location. However, managing the dual roles of being both HCA and student and adapting to their changing identities were frequently cited as particular challenges. Van Gennep's Rites de Passage and Bridge's work on organisational change were combined to theoretically analyse participants' accounts of transition. This illustrated that transition is not always linear with clearly defined and bounded stages but can also be seen as a more undulating or organic process with curving, slanting and overlapping phases. NQNs can therefore simultaneously occupy more than once phase in their
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Yang, J C; Noble, J
1990-01-01
This study investigated the validity of three American College Testing-Proficiency Examination Program (ACT-PEP) tests (Maternal and Child Nursing, Psychiatric/Mental Health Nursing, Adult Nursing) for predicting the academic performance of registered nurses (RNs) enrolled in bachelor's degree BSN programs nationwide. This study also examined RN students' performance on the ACT-PEP tests by their demographic characteristics: student's age, sex, race, student status (full- or part-time), and employment status (full- or part-time). The total sample for the three tests comprised 2,600 students from eight institutions nationwide. The median correlation coefficients between the three ACT-PEP tests and the semester grade point averages ranged from .36 to .56. Median correlation coefficients increased over time, supporting the stability of ACT-PEP test scores for predicting academic performance over time. The relative importance of selected independent variables for predicting academic performance was also examined; the most important variable for predicting academic performance was typically the ACT-PEP test score. Across the institutions, student demographic characteristics did not contribute significantly to explaining academic performance, over and above ACT-PEP scores.
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California's minimum-nurse-staffing legislation and nurses' wages.
Mark, Barbara; Harless, David W; Spetz, Joanne
2009-01-01
In 2004, California became the first state to implement minimum-nurse-staffing ratios in acute care hospitals. We examined the wages of registered nurses (RNs) before and after the legislation was enacted. Using four data sets-the National Sample Survey of Registered Nurses, the Current Population Survey, the National Compensation Survey, and the Occupational Employment Statistics Survey-we found that from 2000 through 2006, RNs in California metropolitan areas experienced real wage growth as much as twelve percentage points higher than the growth in the wages of nurses employed in metropolitan areas outside of California.
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Zimmerman, Sheryl; Gruber-Baldini, Ann L; Hebel, J Richard; Sloane, Philip D; Magaziner, Jay
2002-12-01
Determine the relationship between a broad array of structure and process elements of nursing home care and (a) resident infection and (b) hospitalization for infection. Baseline data were collected from September 1992 through March 1995, and residents were followed for 2 years; facility data were collected at the midpoint of follow-up. A stratified random sample of 59 nursing homes across Maryland. Two thousand fifteen new admissions aged 65 and older. Facility-level data were collected from interviews with facility administrators, directors of nursing, and activity directors; record abstraction; and direct observation. Main outcome measures included infection (written diagnosis, a course of antibiotic therapy, or radiographic confirmation of pneumonia) and hospitalization for infection (indicated on medical records). The 2-year rate of infection was 1.20 episodes per 100 resident days, and the hospitalization rate for infection was 0.17 admissions per 100 resident days. Except for registered nurse (RN) turnover, which related to both infection and hospitalization, different variables related to each outcome. High rates of incident infection were associated with more Medicare recipients, high levels of physical/occupational therapist staffing, high licensed practical nurse staffing, low nurses' aide staffing, high intensity of medical and therapeutic services, dementia training, staff privacy, and low levels of psychotropic medication use. High rates of hospitalization for infection were associated with for-profit ownership, chain affiliation, poor environmental quality, lack of resident privacy, lack of administrative emphasis on staff satisfaction, and low family/friend visitation rates. Adjustment for resident sex, age, race, education, marital status, number of morbid diagnoses, functional status, and Resource Utilization Group, Version III score did not alter the relationship between the structure and process of care and outcomes. The association between RN
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Adhikari, Radha
2015-04-01
It is vital for all healthcare systems to have a sufficient number of suitably trained health professionals including nurses at all levels of health services to deliver effective healthcare. An ethnographic, qualitative method was chosen for this study, which included open-ended, in-depth interviews with a range of stakeholders including student nurses, qualified nurses, nurse managers and lecturers, and the human resource co-ordinator in the Ministry of Health and Population. Available records and policy documents were also analysed. Study findings suggest that there is a severe mal-distribution of the nursing workforce in rural and urban healthcare centres in Nepal. Although there is an oversupply of newly qualified nurses in hospitals in Kathmandu, the staffing situation outside the valley is undesirable. Additionally, the turnover of junior nursing staff remains high in major urban hospitals. Most qualified nurses aspire to work in developed countries, such as the UK, North America, Australia and New Zealand. Between 2000 and 2008, as many as 3000 nurses have left Nepal for jobs in the developed west. There is no effective management strategy in place to retain a nursing workforce, particularly in rural Nepal. This article concludes by proposing some suggestions for a nursing workforce retention policy to address this critical issue. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.
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Brackney, Dana E; Lane, Susan Hayes; Dawson, Tyia; Koontz, Angie
2017-11-01
This descriptive field study examines processes used to evaluate simulation for senior-level Bachelor of Science in Nursing (BSN) students in a capstone course, discusses challenges related to simulation evaluation, and reports the relationship between faculty evaluation of student performance and National Council Licensure Examination for Registered Nurses (NCLEX-RN) first-time passing rates. Researchers applied seven terms used to rank BSN student performance (n = 41, female, ages 22-24 years) in a senior-level capstone simulation. Faculty evaluation was correlated with students' NCLEX-RN outcomes. Students evaluated as "lacking confidence" and "flawed" were less likely to pass the NCLEX-RN on the first attempt. Faculty evaluation of capstone simulation performance provided additional evidence of student preparedness for practice in the RN role, as evidenced by the relationship between the faculty assessment and NCLEX-RN success. Simulation has been broadly accepted as a powerful educational tool that may also contribute to verification of student achievement of program outcomes and readiness for the RN role.
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Vogelsmeier, Amy; Anderson, Ruth A; Anbari, Allison; Ganong, Lawrence; Farag, Amany; Niemeyer, MaryAnn
2017-08-04
Medication reconciliation is a safety practice to identify medication order discrepancies when patients' transitions between settings. In nursing homes, registered nurses (RNs) and licensed practical nurses (LPNs), each group with different education preparation and scope of practice responsibilities, perform medication reconciliation. However, little is known about how they differ in practice when making sense of medication orders to detect discrepancies. Therefore, the purpose of this study was to describe differences in RN and LPN sensemaking when detecting discrepancies. We used a qualitative methodology in a study of 13 RNs and 13 LPNs working in 12 Midwestern United States nursing homes. We used both conventional content analysis and directed content analysis methods to analyze semi-structured interviews. Four resident transfer vignettes embedded with medication order discrepancies guided the interviews. Participants were asked to describe their roles with medication reconciliation and their rationale for identifying medication order discrepancies within the vignettes as well as to share their experiences of performing medication reconciliation. The analysis approach was guided by Weick's Sensemaking theory. RNs provided explicit stories of identifying medication order discrepancies as well as examples of clinical reasoning to assure medication order appropriateness whereas LPNs described comparing medication lists. RNs and LPNs both acknowledged competing demands, but when performing medication reconciliation, RNs were more concerned about accuracy and safety, whereas LPNs were more concerned about time. Nursing home nurses, particularly RNs, are in an important position to identify discrepancies that could cause resident harm. Both RNs and LPNs are valuable assets to nursing home care and keeping residents safe, yet RNs offer a unique contribution to complex processes such as medication reconciliation. Nursing home leaders must acknowledge the differences
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An explanatory model of nurse practitioner job satisfaction.
Koelbel, P W; Fuller, S G; Misener, T R
1991-01-01
Job satisfaction influences employee retention, worker productivity, and performance quality. To retain qualified nurse practitioners (NPs), health administrators must identify sources of job satisfaction and dissatisfaction. Herzberg's dual-factor theory of job satisfaction addresses extrinsic and intrinsic work-related factors. Expansion of the model to include global job satisfaction and individual differences provided a broad framework for the assessment of nurse practitioner job satisfaction. The expanded model was used to analyze the job satisfaction of 132 NPs registered with the South Carolina State Board of Nursing in 1988 (final response rate = 90%). Participants completed the Index of Job Satisfaction (IJS), the Minnesota Satisfaction Questionnaire-Short Form (MSQ-SF), and the Personal and Work Background Questionnaire (PWBQ). Although the NPs were moderately satisfied with their overall jobs, extrinsic factors were found to be major sources of dissatisfaction. The optimal combination of variables predicted by regression analysis to influence global job satisfaction were age, number of children, urban locations, achievement, company policies and practices, creativity, independence, and compensation. Implications for health administrators to improve the work environments of NPs are discussed.
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ERIC Educational Resources Information Center
Belock, Shirley
The planning and design of a course for the inactive registered nurse desiring to return to active practice is reported in this practicum paper. Current literature was reviewed with emphasis on the needs in rural states, such as Vermont, and characteristics of the target group. The first three modules of the course were developed, entitled: The…
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Academic Incivility in Nursing Education
ERIC Educational Resources Information Center
Marlow, Sherri
2013-01-01
A well-documented and growing problem impacting the nursing shortage in the United States is the increasing shortage of qualified nursing faculty. Many factors contribute to the nursing faculty shortage such as retirement, dissatisfaction with the nursing faculty role and low salary compensation (American Association of Colleges of Nursing (AACN),…
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Violence in municipal care of older people in Sweden as perceived by registered nurses.
Josefsson, Karin; Sonde, Lars; Wahlin, Tarja-Brita Robins
2007-05-01
The main aim was to describe registered nurses' perceptions of violence and threats, as well as their access to prevention measures and routines for handling violent behaviour in municipal care of older people. Another aim was to compare nurses' perceptions working solely in dementia care with those working in general elder care where older people have diverse diagnoses. Violence is often reported in care of older people. The development of dementia units and the implementation of reform have changed care of older people. Dementia disorders have been shown to be a predisposing factor to violence. A non-experimental, descriptive design with a survey research approach was used. The setting was 60 special types of housing with subunits in a large town. The response rate was 62% (n = 213). Forty-five per cent (n = 95) of the nurses worked in dementia care and 55% (118) in general elder care. A questionnaire. Results. Nurses had experienced a high degree indirect threats (dementia care, 45%; general elder care, 51%), direct threats of violent acts (dementia care, 35%; general elder care, 44%) and violent acts (dementia care, 41%; general elder care, 43%). Nurses had witnessed violence and threats towards staff (dementia care, 49%; general elder care, 38%). Even care receivers (dementia care, 20%; general elder care, 19%) were subjected to violence and threats. No statistical differences were found between groups. The nurses in dementia care had more access to education in managing violence and threats, as well as routines for handling violence and a door with a lock to their working unit. Violence occurred frequently in municipal care of older people without any difference between dementia care and general elder care. Nurses in dementia care were more often offered education on how to manage violence and had routines for when violence occurs. Municipal authorities should increase staff education for handling violence and creating safety routines. Violence needs to be
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Cavanaugh, Debra A; Huse, Anita L
2004-01-01
The shortage of nurses has reached crisis proportions around the world. In response to a critical shortage of qualified neonatal intensive care nurses, one institution developed an educational program so comprehensive that they were able to increase their nursing staff by 20% and staff the neonatal intensive care unit with well-prepared and proficient nurses. This strategy has also resulted in high retention rates, a decrease in overtime, and a relatively low error rate by new nurses.
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Factors that influence the decisions of men and women nurses to leave nursing.
Rajapaksa, Sushama; Rothstein, William
2009-01-01
The health and long-term care systems in the United States rely heavily on the services of registered nurses, but concerns exist about the adequacy of the current and projected supply of registered nurses to meet the nation's needs. One way to increase the nursing supply is to increase the retention rates of nurses, especially men nurses who are much more likely to leave nursing than are women. The study hypothesizes that the different retention rates of men and women can be explained in part by their different gender roles and careers goals. A secondary analysis was conducted of the registered nurses who left nursing for other occupations in the National Sample Survey of Registered Nurses, 2000. Three reasons for leaving nursing were cited most often by the male and female nurses who left nursing: better salaries available in current type of position, hours more convenient in other position, and find current position more rewarding professionally. Results of a multivariate logistic regression analysis show that men were 2.5 times more likely than women to cite better salaries as a reason for leaving the nursing profession, but no more likely to cite more convenient hours or to state that the non-nursing position was more professionally more rewarding. Thus, the men differed from the women in their attitudes toward the financial aspects of nursing but not the professional aspects. Suggestions are provided to redress the dissatisfactions of men nurses.
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The relationship between supervisor support and registered nurse outcomes in nursing care units.
Hall, Debra S
2007-01-01
Workplace social support is a major characteristic related to the Job Demand-Control model of job stress. Organizational and managerial support have an effect on nurse satisfaction and burnout. The relationships between perceived supervisor support and measures of nurse occupation-related outcomes were investigated in 3 nursing units within an academic medical center. Nurses with greater levels of perceived supervisor support experienced more positive job outcomes and less negative outcomes, including less occupational stress, than nurses with less perceived supervisor support. Implications for refocusing the role of the nurse supervisor and its effect on multiple nursing occupation-related outcomes are discussed.
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Bellury, Lanell; Hodges, Helen; Camp, Amanda; Aduddell, Kathie
2016-10-01
Teams of unlicensed personnel and registered nurses have provided hospital-based nursing care for decades. Although ineffective teamwork has been associated with poor patient outcomes, little is known of the perspectives of nursing assistive personnel (NAP). The purpose of this study was to gain insights into the perceptions of NAP and professional registered nurses (RNs) on teamwork in acute care. In a qualitative descriptive approach in a metropolitan hospital in the southeastern United States, 33 NAP participated in audio-recorded focus group sessions, and 18 RNs provided responses to open-ended electronic survey questions. Findings were examined in relation to previously identified coordinating mechanisms of teamwork: shared mental models, closed-loop communication, and mutual trust. None of the mechanisms was strongly represented in these data. In contrast to RNs' mental models, NAP perceptions of teamwork included the centrality of holistic caring to the NAP role, functional teams as NAP-only teams, NAPs and RNs working in parallel spheres rather than together, and team coordination in silos. Closed-loop communication was less common than one-way requests. Mutual trust was desired, but RNs' delegation of tasks conveyed to NAP a lack of value and respect for the NAP role, while RNs perceived a professional obligation to delegate care to ensure quality of care amid changing patient priorities. Further empirical research into NAP practice is needed to enhance understanding of teamwork issues and direct effective interventions to improve work environments and ultimately patient outcomes. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
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Xu, Lijuan; Song, Rhayun
2013-10-01
The purpose of this study was to develop work-family-school role conflicts and role-related social support scales, and to validate the psychometrics of those scales among registered nurses with multiple roles. The concepts, generation of items, and the scale domains of work-family-school role conflicts and role-related social support scales were constructed based on a review of the literature. The validity and reliability of the scales were examined by administering them to 201 registered nurses who were recruited from 8 university hospitals in South Korea. The content validity was examined by nursing experts using a content validity index. Exploratory factor analysis and confirmatory factor analysis were used to establish the construct validity. The correlation with depression was examined to assess concurrent validity. Finally, internal consistency was assessed using Cronbach's alpha coefficients. The work-family-school role conflicts scale comprised ten items with three factors: work-school-to-family conflict (three items), family-school-to-work conflict (three items), and work-family-to-school conflict (four items). The role-related social support scale comprised nine items with three factors: support from family (three items), support from work (three items), and support from school (three items). Cronbach's alphas were 0.83 and 0.76 for the work-family-school role conflicts and role-related social support scales, respectively. Both instruments exhibited acceptable construct and concurrent validity. The validity and reliability of the developed scales indicate their potential usefulness for the assessment of work-family-school role conflict and role-related social support among registered nurses with multiple roles in Korea. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Christensen, Martin; Aubeeluck, Aimee; Fergusson, Diana; Craft, Judy; Knight, Jessica; Wirihana, Lisa; Stupple, Ed
2016-11-01
The transition shock or Imposter Phenomena sometimes associated with moving from student to Registered Nurse can lead to feelings of self-doubt and insecurity especially with the increased expectations and responsibilities that registration brings. The aim of this study was to examine the extent at which imposter phenomenon is evident in four final year nursing student cohorts in Australia, New Zealand and the UK. A survey design. The study took place at four higher education institutes - two metropolitan campuses and two regional campuses between October 2014 - February 2015 in Australia, New Zealand and the UK. A sample of 223 final year nursing students undertaking nationally accredited nursing programmes were approached. Each cohort exhibited mild to moderate feelings of Imposter Phenomena. A positive weak correlation between imposter phenomena and preparedness for practice was found. The New Zealand cohort scored higher than both the Australian and UK cohorts on both feelings of imposterism and preparedness for practice. Nursing students possess internalized feelings which suggest their performance and competence once qualified could be compromised. There is some speculation that the respective curriculums may have some bearing on preparing students for registration and beyond. It is recommended that educational programmes designed for this student cohort should be mindful of this internal conflict and potential external hostility. © 2016 John Wiley & Sons Ltd.
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Carlson, Elisabeth; Idvall, Ewa
2014-07-01
One major challenge facing the health care systems worldwide is the growing demand for registered nurses able to provide qualified nursing care for a vulnerable population. Positive learning experiences during clinical practice influence not only learning outcomes, but also how students reason in relation to future career choices. To investigate student nurses' experiences of the clinical learning environment during clinical practice in nursing homes, and to compare perceptions among student nurses with or without prior work experience as health care assistants in elderly care. A cross-sectional study was designed, utilising the Swedish version of the CLES+T evaluation scale. 260 student nurses (response rate 76%) who had completed a five week long clinical placement in nursing homes returned the questionnaire during the data collection period in 2011-2012. Data were analysed using descriptive statistics. Mann-Whitney U-test was used to examine differences in relation to students with or without prior experience of elderly care. Overall, the clinical learning environment was evaluated in a predominantly positive way. The sub-dimension Supervisory relationship displayed the highest mean value, and the lowest score was calculated for the sub-dimension Leadership style of the ward manager. Statistical significant differences between sub-groups were displayed for four out of 34 items. The supervisory relationship had the greatest impact on how student nurses experienced the clinical learning environment in nursing homes. It is therefore, of utmost importance that collaborative activities, between educational and nursing home settings, supporting the work of preceptors are established and maintained. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Lacher, Stefanie; De Geest, Sabina; Denhaerynck, Kris; Trede, Ines; Ausserhofer, Dietmar
2015-09-01
Anticipating nursing shortages, the Swiss healthcare system recently introduced the position of allied healthcare assistant (AHA). However, indicators of AHAs' integration and stability, particularly their perceptions of their work environment quality and related outcomes (i.e., burnout, job satisfaction, and intention to leave), remain unclear. (a) To describe AHAs' ratings of the quality of the nurse work environment, job satisfaction, burnout, and intention to leave their workplaces; (b) to compare AHAs' and registered nurses' (RNs') work environment quality ratings and related outcomes; and (c) to assess links between AHAs' work environment quality ratings and related workforce outcomes. A secondary analysis of RN4CAST data (October 2009 to June 2010) on 61 AHAs and 466 RNs in 13 Swiss acute care hospitals. We used descriptive statistics to summarize data of AHAs and RNs on their units and hospitals. Via binary logistic regression models, we compared AHAs and RNs and identified associations between work environment ratings and workforce outcomes. AHAs' work environment quality ratings were significantly higher than those of RNs, and were associated with lower odds of burnout and intention to leave their current job and higher odds of reported job satisfaction. This study provides primary evidence linking AHAs' work environment quality ratings to burnout, job satisfaction, and intention to leave in acute care hospitals. Given the increasing importance of AHAs for nursing care provision, hospitals should assess the quality of nurse work environment and nurse outcomes from the perspective of all nurses. © 2015 Sigma Theta Tau International.
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Bontrager, Sarah; Hart, Patricia L; Mareno, Nicole
2016-03-01
Thirteen percent of newly licensed registered nurses (NLRNs) vacate their first job after 1 year, and 37% report that they feel ready to change jobs. Turnover can lead to consistent and detrimental nursing shortages in nursing units, as well as increased costs for health care systems. A descriptive, prospective, cross-sectional design was used to understand how preceptor role effectiveness and group cohesion affect NLRNs' satisfaction and intent to stay. NLRNs reported high levels of perceived preceptor role effectiveness, group cohesion, and job satisfaction, with only moderate levels of intent to stay. Statistically significant relationships were found among preceptor role effectiveness, job satisfaction, and intent to stay, as well as among group cohesion, job satisfaction, and intent to stay. Preceptor role effectiveness and group cohesion are predictors of NLRNs' level of job satisfaction. Job satisfaction is a predictor of NLRNs' intent to stay. Effective preceptors and positive group cohesion are factors that are important to NLRNs' job satisfaction and intent to stay. Copyright 2016, SLACK Incorporated.
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ERIC Educational Resources Information Center
Desir, Johanna E.
2017-01-01
Nurse shortages and nurse turnover are major issues in the health care industry. As 4 generations of nurses are working side-by-side for the first time in history in the health care industry, nurse leaders need to understand the generational differences in order to bridge the gap on retaining the nurses in the workforce. The primary focus of this…
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Djukic, Maja; Kovner, Christine; Budin, Wendy C; Norman, Robert
2010-01-01
The impact of personal, organizational, and economic factors on nurses' job satisfaction have been studied extensively, but few studies exist in which the effects of physical work environment--including perceptions of architectural, interior design, and ambient features on job satisfaction-are examined. The purpose of this study was to examine the effect of perceived physical work environment on job satisfaction, adjusting for multiple personal, organizational, and economic determinants of job satisfaction. A cross-sectional, predictive design and a Web-based survey instrument were used to collect data from staff registered nurses in a large metropolitan hospital. The survey included 34 questions about multiple job satisfaction determinants, including 18 Likert-type measures with established good validity (comparative fit index = .97, Tucker-Lewis index = .98, root mean square error of approximation = .06) and reliability (r ≥ .70). A response rate of 48.5% resulted in a sample of 362, with 80% power to detect a medium effect of perceived physical environment on job satisfaction. On average, nurses had negative perceptions of physical work environment (M = 2.9, SD = 2.2). Although physical environment was related positively to job satisfaction (r =.256, p = .01) in bivariate analysis, in ordered probit regression, no effect of physical work environment on job satisfaction was found. In future studies, this relationship should be examined in larger and more representative samples of nurses. Qualitative methods should be used to explore how negatively perceived physical work environment impacts nurses. Rebuilding of U.S. hospitals, with a planned investment of $200 billion without considering how physical environment contributes to nurse work outcomes, threatens to exacerbate organizational nurse turnover.
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Purpora, Christina; Blegen, Mary A; Stotts, Nancy A
2015-01-01
To test hypotheses from a horizontal violence and quality and safety of patient care model: horizontal violence (negative behavior among peers) is inversely related to peer relations, quality of care and it is positively related to errors and adverse events. Additionally, the association between horizontal violence, peer relations, quality of care, errors and adverse events, and nurse and work characteristics were determined. A random sample (n= 175) of hospital staff Registered Nurses working in California. Nurses participated via survey. Bivariate and multivariate analyses tested the study hypotheses. Hypotheses were supported. Horizontal violence was inversely related to peer relations and quality of care, and positively related to errors and adverse events. Including peer relations in the analyses altered the relationship between horizontal violence and quality of care but not between horizontal violence, errors and adverse events. Nurse and hospital characteristics were not related to other variables. Clinical area contributed significantly in predicting the quality of care, errors and adverse events but not peer relationships. Horizontal violence affects peer relationships and the quality and safety of patient care as perceived by participating nurses. Supportive peer relationships are important to mitigate the impact of horizontal violence on quality of care.
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Nursing students' attitudes about home health nursing.
Prestia, Mindy; Murphy, Susan; Yoder, Marian
2008-09-01
In an effort to address the home care nursing shortage, this pilot study was designed to measure nursing students' attitudes toward home health nursing and to test the Home Health Attitude Questionnaire developed specifically for this study based on the Theory of Planned Behavior. Senior undergraduate nursing students and registered nursing to bachelor of science in nursing students completed the questionnaire.
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Nurses with disabilities: can changing our educational system keep them in nursing?
Neal-Boylan, Leslie J; Guillett, Sharron E
2008-01-01
A recent qualitative study revealed that registered nurses with physical disabilities experience discrimination in the workplace and frequently leave their jobs and the profession. In light of these findings, it is vital that nursing faculty begin to inculcate students with an appreciation for collegial support before they enter the workplace as registered nurses. The familiar refrain "nurses eat their young" is apparently also true of nurses who have physical limitations. This article will discuss the findings from a qualitative study and offer recommendations for how nurse educators can educate students to help prevent the loss of nurses with disabilities from the profession.
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Nutrition for Nurses: Nursing 245.
ERIC Educational Resources Information Center
Palermo, Karen R.
A description is presented of "Nutrition for Nurses," a prerequisite course for students anticipating entrance into the junior level of a state university registered nursing program. Introductory material highlights the course focus (i.e., the basics of good nutrition; nutrition through the life cycle; nursing process in nutritional care; and…
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Déry, Johanne; Clarke, Sean P; D'Amour, Danielle; Blais, Régis
2018-01-01
While professional nursing, like other health professions, has a recognized educational base and a legal scope of practice that is remarkably consistent across societies, there are important variations even within the same institution or organization in the extent to which professional nurses engage in the full range of activities for which they are qualified. There has been limited study of enacted (actual) scope of nursing practice (ESOP) or of its impacts on nurse job outcomes, such as job satisfaction. The aim of this study is to measure ESOP, as well as its predictors and impact on job satisfaction, in a specialty university-affiliated tertiary referral center in one of the few remaining jurisdictions outside the United States that continue to educate registered nurses at multiple educational levels. This was a correlational cross-sectional design using structural equation modeling. Self-administered questionnaires were completed by 301 registered nurses holding permanent positions in specific clinical areas for 6 months or longer in a pediatric hospital in the province of Quebec, Canada. ESOP or actual scope of practice was low-on average, nurses applied the range of skills within their theoretical scopes of practice only occasionally or "less than frequently" in their daily work (3.21 out of a possible 6 points). ESOP was strongly related to decision latitude (β = 0.319; p = .012), role ambiguity (β = 0.297; p = .011), and role overload (β = 0.201; p = .012). The personal characteristics that exerted the greatest direct influence on ESOP were education level (β = 0.128; p = .015) and growth need strength (β = 0.151; p = .008). Results also showed that ESOP exerts a direct positive influence on nurses' job satisfaction (β = 0.118; p = .006). Structural equation modeling analyses revealed a good fit of the data to the hypothesized conceptual model (χ²/df ratio index = 1.68, root mean square error of approximation = 0
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Predictors of situation awareness in student registered nurse anesthetists.
Wright, Suzanne M; Fallacaro, Michael D
2011-12-01
Situation awareness (SA) is defined as one's perception of the elements of the environment, the comprehension of their meaning, and the projection of their status in the near future. The concept of SA is well known in the aviation industry, which is characterized by complexity and dynamism. The discipline of anesthesia shares these same environmental characteristics, yet the study of SA in this setting is in its infancy. Guided by Endsley's theory of SA, the purpose of this study was to provide educators with a best-evidence predictor model of SA in student registered nurse anesthetists (SRNAs). Seventy-one SRNAs were randomly selected from 3 US universities. A nonexperimental, correlational design and multiple regression analysis were used to measure the relationship between memory, cognition, and automaticity and SA. Findings from this study reveal cognition as the best predictor of SA in graduate SRNAs, with the addition of memory and automaticity contributing no additional predictive value to the model. The results of this study have the potential to make a positive impact on the admission, education, and training of SRNAs. This study contributes evidence for further research examining the use of high-fidelity simulation in promoting SA in SRNAs.
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Use of technical skills and medical devices among new registered nurses: A questionnaire study.
Ewertsson, Mona; Gustafsson, Margareta; Blomberg, Karin; Holmström, Inger K; Allvin, Renée
2015-12-01
One comprehensive part of nursing practice is performing technical skills and handling of medical equipment. This might be challenging for new registered nurses (RNs) to do in patient-safe way. The aim of this study was to describe and compare the extent to which new RNs perform various technical skills and handle medical devices in different settings, and to investigate their possibility for continued learning in this respect. A further aim was to describe their perceptions of incident reporting related to technical skills and medical devices. A cross-sectional study with descriptive and comparative design. RNs who recently graduated from a nursing programme at three Swedish universities and had worked as a RN for up to 1 year were included in the study (n=113, response rate 57%). Data were collected by means of a postal questionnaire. Half of the RNs reported that they performed several of the listed tasks every day or every week, regardless of workplace. These tasks were most frequently performed in surgical departments. The majority of the participants (76%) stated a need of continued practical training. However, less than half of them (48%) had access to a training environment. Several participants (43%) had been involved in incidents related to technical skills or medical devices, which were not always reported. Nearly a third of the participants (31%) did not use the existing guidelines when performing technical skills, and reflection on performance was uncommon. This study highlights the importance of shared responsibilities between nurse educators and health care employers to provide learning opportunities for new RNs in technical skills, to maintain patient safety. To increase the safety culture where nursing students and new RNs understand the importance of using evidence-based guidelines and taking a reflective approach in the performance of technical tasks is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Competence for older people nursing in care and nursing homes: An integrative review.
Kiljunen, Outi; Välimäki, Tarja; Kankkunen, Päivi; Partanen, Pirjo
2017-09-01
People living in care and nursing homes are vulnerable individuals with complex needs; therefore, a wide array of nursing competence is needed to ensure their well-being. When developing the quality of care in these units, it is essential to know what type of competence is required for older people nursing. The aim of this integrative review was to identify the competence needed for older people nursing in licensed practical nurses' and registered nurses' work in care and nursing homes. Integrative literature review. We performed an integrative review using Whittemore and Knafl's method. The CINAHL, MEDLINE, PsycINFO, SocINDEX and Scopus databases were searched for studies published from 2006 to April 2016. We assessed the quality of the studies using Joanna Briggs Institute critical appraisal tools and analysed the data by applying qualitative content analysis. Ten articles were included in the review. Most of the studies focused on registered nurses' work. We identified five competence areas that are needed for older people nursing in registered nurses' work in care and nursing homes: attitudinal and ethical, interactional, evidence-based care, pedagogical, and leadership and development competence. Empirical evidence of competence requirements related to licensed practical nurses' work in these facilities was scarce. The competence required for registered nurses and licensed practical nurses should be clearly identified to support competence management in the care and nursing home context. Well-educated nursing staff are needed in care and nursing homes to provide high-quality care because comprehensive and advanced nurse competence is required to meet the needs of older people. © 2016 John Wiley & Sons Ltd.
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ERIC Educational Resources Information Center
Lee, Amy; Kiemle, Gundi
2015-01-01
Background: This study examines the experiences of qualified nurses working with individuals diagnosed with both intellectual disability and personality disorder (PD) in a medium-secure forensic intellectual disability setting. Potential training needs are highlighted, as well as other ways in which services could better support staff to work…
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Using operations research to plan the british columbia registered nurses' workforce.
Lavieri, Mariel S; Regan, Sandra; Puterman, Martin L; Ratner, Pamela A
2008-11-01
The authors explore the power and flexibility of using an operations research methodology known as linear programming to support health human resources (HHR) planning. The model takes as input estimates of the future need for healthcare providers and, in contrast to simulation, compares all feasible strategies to identify a long-term plan for achieving a balance between supply and demand at the least cost to the system. The approach is illustrated by using it to plan the British Columbia registered nurse (RN) workforce over a 20-year horizon. The authors show how the model can be used for scenario analysis by investigating the impact of decreasing attrition from educational programs, changing RN-to-manager ratios in direct care and exploring how other changes might alter planning recommendations. In addition to HHR policy recommendations, their analysis also points to new research opportunities. Copyright © 2008 Longwoods Publishing.
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Stories of Exemplary Hospital Registered Nurses: A Narrative Analysis
ERIC Educational Resources Information Center
Snelson, Donna Ayers
2010-01-01
Today the multidimensional global shortage of nurses is negatively impacting the work environment of hospital nurses and causing, in a cyclical fashion, decreasing work satisfaction, increasing nurse turnover, and decreasing patient outcomes. While strategies aimed at causation of the nursing shortage must be addressed, to support nursing until…
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38 CFR 51.130 - Nursing services.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Nursing services. 51.130... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.130 Nursing services. The facility management must provide an organized nursing service with a sufficient number of qualified nursing personnel...
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38 CFR 51.130 - Nursing services.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Nursing services. 51.130... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.130 Nursing services. The facility management must provide an organized nursing service with a sufficient number of qualified nursing personnel...
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38 CFR 51.130 - Nursing services.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Nursing services. 51.130... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.130 Nursing services. The facility management must provide an organized nursing service with a sufficient number of qualified nursing personnel...
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38 CFR 51.130 - Nursing services.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Nursing services. 51.130... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.130 Nursing services. The facility management must provide an organized nursing service with a sufficient number of qualified nursing personnel...
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38 CFR 51.130 - Nursing services.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Nursing services. 51.130... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.130 Nursing services. The facility management must provide an organized nursing service with a sufficient number of qualified nursing personnel...
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Training rotations at hospitals as a recruitment tool for Certified Registered Nurse Anesthetists.
Wachtel, Ruth E; Dexter, Franklin
2012-08-01
Recruiting newly graduating Certified Registered Nurse Anesthetists (CRNAs) is expensive. Recruitment into rural areas is especially challenging. We analyzed the first jobs of all 95 graduates of the University of Iowa's CRNA training program, from the initial graduating class of 1997 through the class of 2009. We compared the location of the student's first job to where the student lived at the time of application to the program. Hospitals enhanced recruitment of CRNAs by having student rotations (P = .001). Most students who joined a practice offering an outside rotation were not from the county or contiguous counties of the hospital they joined (P < .001). In years that hospitals with rotations hired more than the median number of students, significantly more students had rotated through the hospital (P = .02). Offering a CRNA training program did not facilitate the university's retention of nurses already living in its county or contiguous counties (P = 0.58). Consequently, rural hospitals can view sponsoring rotations as a recruitment tool for graduating CRNAs. The university sponsoring the training program did not retain an advantage, however, in hiring its own graduates. Because this case study provided valuable insights, other programs should consider performing similar analyses.
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Raynor, Michael; Iggulden, Helen
2008-06-01
Anatomy and physiology (A&P) teaching and learning in nursing curricula poses problems for educators because of the often varying levels of students' background knowledge. This study reports on a pilot project that attempted to normalize these differentials by delivering A&P teaching using an online interactive e-book-virtual learning environment (VLE) hybrid. Evaluate the effectiveness of using an online interactive resource to deliver A&P teaching. Data were collected from pre-registration and post-qualifying students by questionnaire and observation, and from lecturers by structured interviews. Scale-up issues were identified and documented as part of support for the ongoing pilot. The pre-registration group encountered problems accessing the resource and yielded evidence to suggest that inexperienced learners require a high level of direction to use the resource effectively. The post-qualifying group benefited from the resource's interactive elements and 24/7 availability. There was clear evidence that the group were able to relate knowledge gained from the resource to practice. This hybrid has great potential to add value to A&P learning on nursing programmes at post-qualifying level. The resource could replace its printed equivalent; however, negotiations need to take place between institutions and publishers in order to resolve scale-up issues.
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Primary health care registered nurses' types in implementation of health promotion practices.
Maijala, Virpi; Tossavainen, Kerttu; Turunen, Hannele
2016-09-01
Aim This study aimed to identify and reach consensus among primary health care participants [registered nurses (RNs) who receive clients, directors of nursing, senior physicians, health promotion officers, and local councillors] on the types of service provider that RNs who receive clients represent in the implementation of health promotion practices in primary health care in Eastern Finland. There is an increasing focus on public health thinking in many countries as the population ages. To meet the growing needs of the health promotion practices of populations, advance practice has been recognized as effective in the primary health care setting. The advance practice nurses share many common features, such as being RNs with additional education, possessing competencies to work independently, treating clients in both acute and primary care settings, and applying a variety of health promotion practices into nursing. The two-stage modified Delphi method was applied. In round one, semi-structured interviews were conducted among primary health care participants (n=42) in 11 health centres in Eastern Finland. In round two, a questionnaire survey was conducted in the same health centres. The questionnaire was answered by 64% of those surveyed (n=56). For data analysis, content analysis and descriptive statistics were used. Findings This study resulted in four types of service provider that RNs who receive clients represented in the implementation of health promotion practices in the primary health care setting in Eastern Finland. First, the client-oriented health promoter demonstrated four dimensions, which reached consensus levels ranging between 82.1 and 89.3%. Second, the developer of health promotion practices comprised four dimensions, which reached consensus levels between 71.4 and 85.7%. Third, the member of multi-professional teams of health promotion practices representing three dimensions, with consensus levels between 69.6 and 82.1%. Fourth, the type who showed
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Registered nurses' and midwives' knowledge of epidural analgesia.
Bird, Annette; Wallis, Marianne; Chaboyer, Wendy
2009-01-01
Despite epidural analgesia increasingly being utilized in hospitals, very little research-based evidence is available about registered nurses' (RNs) and midwives' knowledge of this technique. To describe the current epidural knowledge levels of RNs and midwives in a multi-site setting. RNs and midwives at four, regional teaching facilities completed an epidural knowledge test. The instrument included demographic items and five knowledge subscales relating to epidural analgesia: spinal cord anatomy and physiology; epidural pharmacology; complications of epidural analgesia; assessment of sensory and motor blockade and the general management of patients with epidural analgesia. A total of 408 (99.7% response) RNs and midwives completed the test. Respondents demonstrated good knowledge of sensory and motor blockade assessment and the general management of epidural analgesia subscales with correct responses to 75 and 77% of the questions in these subscales, respectively. Fair knowledge relating to the spinal cord anatomy and physiology subscale was demonstrated with 69% of the questions answered correctly. The knowledge subscales relating to epidural pharmacology (57% correct responses) and the complications of epidural analgesia (56% correct responses) were problematic for the sample. The research results provide generalizable information about what RNs and midwives know about epidural analgesia. These results are an important guide in the development of new and existing dedicated epidural education programs. The results also provide some direction for further research into this important topic.
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ERIC Educational Resources Information Center
Lovan, Sherry R.
2009-01-01
The inconsistencies between the perception of the profession of nursing and the reality of practice can lead to problems in student attrition or result in disillusionment with a career in nursing after a new graduate enters practice. With the nursing shortage reaching critical levels, it is important to examine possible discrepancies that exist…
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Educational audit on drug dose calculation learning in a Tanzanian school of nursing.
Savage, Angela Ruth
2015-06-01
Patient safety is a key concern for nurses; ability to calculate drug doses correctly is an essential skill to prevent and reduce medication errors. Literature suggests that nurses' drug calculation skills should be monitored. The aim of the study was to conduct an educational audit on drug dose calculation learning in a Tanzanian school of nursing. Specific objectives were to assess learning from targeted teaching, to identify problem areas in performance and to identify ways in which these problem areas might be addressed. A total of 268 registered nurses and nursing students in two year groups of a nursing degree programme were the subjects for the audit; they were given a pretest, then four hours of teaching, a post-test after two weeks and a second post-test after eight weeks. There was a statistically significant improvement in correct answers in the first post-test, but none between the first and second post-tests. Particular problems with drug calculations were identified by the nurses / students, and the teacher; these identified problems were not congruent. Further studies in different settings using different methods of teaching, planned continuing education for all qualified nurses, and appropriate pass marks for students in critical skills are recommended.
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Brewer, Carol S; Kovner, Christine T; Obeidat, Rana F; Budin, Wendy C
2013-01-01
Verbal abuse in the workplace is experienced by registered nurses (RNs) worldwide; physicians are one of the main sources of verbal abuse. To examine the relationship between levels of physician verbal abuse of early-career RNs and demographics, work attributes, and perceived work environment. Fourth wave of a mailed national panel survey of early career RNs begun in 2006. RNs' perception of verbal abuse by physicians was significantly associated with poor workgroup cohesion, lower supervisory and mentor support, greater quantitative workload, organizational constraints, and nurse-colleague verbal abuse, as well as RNs' lower job satisfaction, organizational commitment, and intent to stay. RNs working in unfavorable work environments experience more physician abuse and have less favorable work attitudes. Causality is unclear: do poor working conditions create an environment in which physicians are more likely to be abusive, or does verbal abuse by physicians create an unfavorable work environment? Copyright © 2013 Elsevier Inc. All rights reserved.
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Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida K; Seltzer, Joanna R
2013-01-01
Increasing participation of registered nurses (RNs) in quality improvement (QI) is a promising strategy to close the health care quality chasm. For RNs to participate effectively in hospital QI, they must have adequate QI knowledge and skills. This descriptive study assessed employer-sponsored QI education and RNs' preparedness across a wide range of QI steps and processes. RNs from 15 U.S. states who were employed in hospitals and were initially licensed to practice in 2007 to 2008 were surveyed. Fewer than one third of respondents reported being very prepared across all measured QI topics. More than half reported receiving zero hours of training in these same topics in the last year. Lack of educational offerings on the topic was the top reason respondents gave for not obtaining QI training. The QI education offered by employers to RNs could be substantially improved. Nurse educators play a critical role in making these improvements. Copyright 2013, SLACK Incorporated.
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Factors associated with resident aggression toward caregivers in nursing homes.
Zeller, Adelheid; Dassen, Theo; Kok, Gerjo; Needham, Ian; Halfens, Ruud J G
2012-09-01
Caregivers in nursing homes often experience aggressive behavior of residents. The aim of this study was to explore the caregivers' experiences with aggressive behavior from residents and to identify environmental factors as well as caregiver and resident characteristics related to aggressive behavior in Swiss nursing homes. A retrospective cross-sectional survey was conducted between November 2010 and April 2011 with a sample of caregivers working in various nursing homes in the German-speaking part of Switzerland. In total, 814 caregivers (response rate 51.8%) of 21 nursing homes participated in the study. Data were collected using the German version of the Survey of Violence Experienced by Staff (SOVES-G-R). Standard descriptive statistics were used to describe and summarize the date. To identify risk factors related to the experience of aggression by residents, multilevel logistic regression analysis was applied. The prevalence of participants reporting an aggressive incident during the 12-month period prior to data collection was 81.6%. Of these, 76.5% had experienced verbal aggression, 27.6% threats, and 54.0% physical aggression. The predictive variables in the multiple regression model for physical aggression were: staff education level (odds ratio [OR]= 1.82), gender (OR = 1.82), age (< 30 years vs. 30-45 years: OR = 1.46; < 30 years vs. > 45 years: OR = 2.13), and confidence in managing physical aggression (OR = 1.49). The predictive variables for threatening behavior were staff education level (registered nurses vs. non-registered nurses: OR = 1.70; nonstudent vs. student: OR = 1.89) and age (< 30 years vs. 30-45 years: OR = 2.00; < 30 years vs. > 45 years: OR = 2.04). Caregivers in nursing homes are at high risk for experiencing aggressive behavior. The identified risk factors are in line with earlier investigations, but some contradictory results also were observed. The high risk for registered nurses exposed to aggressive behavior and the increased
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Linh, N. N.; Tayler-Smith, K.; Khogali, M.; Bissell, K.
2013-01-01
Setting: Fiji’s schools of nursing and government health services, 2001–2010. Objectives: To report on 1) the number and characteristics of nurses who graduated in Fiji, 2) the proportion of vacant nursing positions in the government health services and 3) attrition among nurses. Design: Descriptive study involving a retrospective record review of Ministry of Health annual reports and nursing registers. Results: Over the period 2001–2010, a total of 1500 nurses graduated, with the overall trend being a gradual increase in newly qualified nurses year on year. Available data from 2007 onwards showed relatively low vacancy rates (range 0.4–2%), with a sharp rise to 15% in 2009. Complete data on nurse attrition were available only from 2007 onwards, with rates of attrition ranging from 4% to 10%; the most common reason for attrition was resignation. Conclusion: While it was unable to directly assess whether Fiji’s supply of nursing graduates has been meeting the country’s health service demands, this study provides a series of baseline data on Fiji’s nurse graduate and nursing workforce. In addition, it identifies some of the challenges and gaps that need to be considered to better assess and address nursing staff shortages. PMID:26392998
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Tallier, Peggy C; Reineke, Patricia R; Asadoorian, Kathy; Choonoo, John G; Campo, Marc; Malmgreen-Wallen, Christine
2017-08-01
Hospital acquired pressure ulcers have a detrimental effect on patient quality of life, morbidity, mortality, and cost to the healthcare industry. Little is known about pressure ulcer prevention in perioperative services. The objectives of this study were to describe perioperative registered nurses (RNs) knowledge, attitudes, behaviors, and barriers about pressure ulcer prevention and to determine if knowledge and the availability of a pressure ulcer staging tool are predictors of pressure ulcer prevention behavior. A cross-sectional descriptive pilot study was conducted. Sixty-two perioperative RNs from 10 acute care hospitals participated. Perioperative nurses believed carrying out pressure ulcer prevention strategies is essential to nursing practice but only two-thirds reported conducting pressure ulcer risk assessment on all patients and daily assessment on at risk patients. Results indicated a knowledge deficit regarding assessment and prevention of pressure ulcers as performance on the PUKT (72%) fell below the recommended score of 90%. Results of binary logistic regression indicated that knowledge as measured by the PUKT and availability of a pressure ulcer staging tool were statistically significant (p=0.03) predictors of pressure ulcer prevention behavior. The initial model without the predictor variables, indicated an overall success rate of correct predictions of 64% which increase to 73% when the predictor variables were added to the initial model. Although perioperative nurses believe that pressure ulcer prevention is important, a knowledge deficit exists and there is a need for pressure ulcer prevention education. Copyright © 2017 Elsevier Inc. All rights reserved.
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Perceptions and characteristics of registered nurses' involvement in decision making.
Mangold, Kara L; Pearson, Kristina K; Schmitz, Julie R; Scherb, Cindy A; Specht, Janet P; Loes, Jean L
2006-01-01
This study aimed to determine the level of actual and preferred decisional involvement and ascertain whether there is decisional dissonance among registered nurses (RNs). A convenience sample of 196 RNs completed a demographic form and the Decisional Involvement Scale, a tool that measures actual and preferred decisional involvement for RNs in 6 categories: unit staffing, quality of professional practice, professional recruitment, unit governance and leadership, quality of support staff practice, and collaboration/liaison activities. From these data, the level of and difference between RN's actual and preferred decisional involvement was analyzed. In addition, the impact of level of education, years of experience, hours worked per pay period, and work setting on actual and preferred decisional involvement were measured. A statistically significant difference was found between RNs' actual and preferred decisional involvement, with RNs preferring more decisional involvement than they actually experienced. Work setting was the only variable to which a difference could be attributed. Further study is warranted to find causes of decisional dissonance and interventions that could help alleviate the problem and potentially increase job satisfaction.
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Present and Future Supply of Registered Nurses.
ERIC Educational Resources Information Center
Altman, Stuart H.
During the 1960's, nursing education shifted dramatically away from hospital-operated diploma schools toward associate degree and baccalaureate programs. This report examines the nature of this shift in training and its anticipated impact on future supply. Other important factors affecting the future supply of nurses are analyzed, including the…
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Cost-benefit study of school nursing services.
Wang, Li Yan; Vernon-Smiley, Mary; Gapinski, Mary Ann; Desisto, Marie; Maughan, Erin; Sheetz, Anne
2014-07-01
In recent years, across the United States, many school districts have cut on-site delivery of health services by eliminating or reducing services provided by qualified school nurses. Providing cost-benefit information will help policy makers and decision makers better understand the value of school nursing services. To conduct a case study of the Massachusetts Essential School Health Services (ESHS) program to demonstrate the cost-benefit of school health services delivered by full-time registered nurses. Standard cost-benefit analysis methods were used to estimate the costs and benefits of the ESHS program compared with a scenario involving no school nursing service. Data from the ESHS program report and other published studies were used. A total of 477 163 students in 933 Massachusetts ESHS schools in 78 school districts received school health services during the 2009-2010 school year. School health services provided by full-time registered nurses. Costs of nurse staffing and medical supplies incurred by 78 ESHS districts during the 2009-2010 school year were measured as program costs. Program benefits were measured as savings in medical procedure costs, teachers' productivity loss costs associated with addressing student health issues, and parents' productivity loss costs associated with student early dismissal and medication administration. Net benefits and benefit-cost ratio were calculated. All costs and benefits were in 2009 US dollars. During the 2009-2010 school year, at a cost of $79.0 million, the ESHS program prevented an estimated $20.0 million in medical care costs, $28.1 million in parents' productivity loss, and $129.1 million in teachers' productivity loss. As a result, the program generated a net benefit of $98.2 million to society. For every dollar invested in the program, society would gain $2.20. Eighty-nine percent of simulation trials resulted in a net benefit. The results of this study demonstrated that school nursing services provided in
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Park, Shin Hye; Boyle, Diane K; Bergquist-Beringer, Sandra; Staggs, Vincent S; Dunton, Nancy E
2014-08-01
We examined the concurrent and lagged effects of registered nurse (RN) turnover on unit-acquired pressure ulcer rates and whether RN staffing mediated the effects. Quarterly unit-level data were obtained from the National Database of Nursing Quality Indicators for 2008 to 2010. A total of 10,935 unit-quarter observations (2,294 units, 465 hospitals) were analyzed. This longitudinal study used multilevel regressions and tested time-lagged effects of study variables on outcomes. The lagged effect of RN turnover on unit-acquired pressure ulcers was significant, while there was no concurrent effect. For every 10 percentage-point increase in RN turnover in a quarter, the odds of a patient having a pressure ulcer increased by 4 percent in the next quarter. Higher RN turnover in a quarter was associated with lower RN staffing in the current and subsequent quarters. Higher RN staffing was associated with lower pressure ulcer rates, but it did not mediate the relationship between turnover and pressure ulcers. We suggest that RN turnover is an important factor that affects pressure ulcer rates and RN staffing needed for high-quality patient care. Given the high RN turnover rates, hospital and nursing administrators should prepare for its negative effect on patient outcomes. © Health Research and Educational Trust.
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Park, Shin Hye; Boyle, Diane K; Bergquist-Beringer, Sandra; Staggs, Vincent S; Dunton, Nancy E
2014-01-01
Objective We examined the concurrent and lagged effects of registered nurse (RN) turnover on unit-acquired pressure ulcer rates and whether RN staffing mediated the effects. Data Sources/Setting Quarterly unit-level data were obtained from the National Database of Nursing Quality Indicators for 2008 to 2010. A total of 10,935 unit-quarter observations (2,294 units, 465 hospitals) were analyzed. Methods This longitudinal study used multilevel regressions and tested time-lagged effects of study variables on outcomes. Findings The lagged effect of RN turnover on unit-acquired pressure ulcers was significant, while there was no concurrent effect. For every 10 percentage-point increase in RN turnover in a quarter, the odds of a patient having a pressure ulcer increased by 4 percent in the next quarter. Higher RN turnover in a quarter was associated with lower RN staffing in the current and subsequent quarters. Higher RN staffing was associated with lower pressure ulcer rates, but it did not mediate the relationship between turnover and pressure ulcers. Conclusions We suggest that RN turnover is an important factor that affects pressure ulcer rates and RN staffing needed for high-quality patient care. Given the high RN turnover rates, hospital and nursing administrators should prepare for its negative effect on patient outcomes. PMID:24476194
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Spetz, Joanne; Ash, Michael; Konstantinidis, Charalampos; Herrera, Carolina
2011-01-01
We estimate the impact of unionisation on the wage structure of hospital-employed registered nurses in the USA. We examine whether unions have an effect on wage differences associated with race, gender, immigration status, education and experience, as well as whether there is less unexplained wage variation among unionised nurses. In the past decade, there has been resurgence in union activity in the health care industry in the USA, particularly in hospitals. Numerous studies have found that unions are associated with higher wages. Unions may also affect the structure of wages paid to workers, by compressing the wage structure and reducing unexplained variation in wages. Cross-sectional analysis of pooled secondary data from the United States Current Population Survey, 2003-2006. Multivariate regression analysis of factors that predict wages, with models derived from labour economics. There are no wage differences associated with gender, race or immigration status among unionised nurses, but there are wage penalties for black and immigrant nurses in the non-union sector. For the most part, the pay structures of the union and non-union sectors do not significantly differ. The wage penalty associated with diploma education for non-union nurses disappears among unionised nurses. Unionised nurses receive a lower return to experience, although the difference is not statistically significant. There is no evidence that unexplained variation in wages is lower among unionised nurses. While in theory unions may rationalise wage-setting and reduce wage dispersion, we found no evidence to support this hypothesis. The primary effect of hospital unions is to raise wages. Unionisation does not appear to have other important wage effects among hospital-employed nurses. © 2010 Blackwell Publishing Ltd.
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42 CFR 482.62 - Condition of participation: Special staff requirements for psychiatric hospitals.
Code of Federal Regulations, 2014 CFR
2014-10-01
... provide the nursing care necessary under each patient's active treatment program. (e) Standard... program. (d) Standard: Nursing services. The hospital must have a qualified director of psychiatric nursing services. In addition to the director of nursing, there must be adequate numbers of registered...
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42 CFR 482.62 - Condition of participation: Special staff requirements for psychiatric hospitals.
Code of Federal Regulations, 2012 CFR
2012-10-01
... provide the nursing care necessary under each patient's active treatment program. (e) Standard... program. (d) Standard: Nursing services. The hospital must have a qualified director of psychiatric nursing services. In addition to the director of nursing, there must be adequate numbers of registered...
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42 CFR 482.62 - Condition of participation: Special staff requirements for psychiatric hospitals.
Code of Federal Regulations, 2013 CFR
2013-10-01
... provide the nursing care necessary under each patient's active treatment program. (e) Standard... program. (d) Standard: Nursing services. The hospital must have a qualified director of psychiatric nursing services. In addition to the director of nursing, there must be adequate numbers of registered...
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42 CFR 482.62 - Condition of participation: Special staff requirements for psychiatric hospitals.
Code of Federal Regulations, 2011 CFR
2011-10-01
... provide the nursing care necessary under each patient's active treatment program. (e) Standard... program. (d) Standard: Nursing services. The hospital must have a qualified director of psychiatric nursing services. In addition to the director of nursing, there must be adequate numbers of registered...
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Using advanced mobile devices in nursing practice--the views of nurses and nursing students.
Johansson, Pauline; Petersson, Göran; Saveman, Britt-Inger; Nilsson, Gunilla
2014-09-01
Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses' and nursing students' views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research. © The Author(s) 2013.
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ERIC Educational Resources Information Center
Franklin, John
1976-01-01
Gerontological nursing (the care of the elderly) as a specialization for registered nurses, licensed practical nurses, and nursing aides is discussed with respect to training and qualifications, employment outlook, and earnings for each group. (JT)
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Rhodes, Catherine A; Bechtle, Mavis; McNett, Molly
2015-01-01
Advanced practice registered nurses (APRNs) are integral to the provision of quality, cost-effective health care throughout the continuum of care. To promote job satisfaction and ultimately decrease turnover, an APRN incentive plan based on productivity and quality was formulated. Clinical productivity in the incentive plan was measured by national benchmarks for work relative value units for nonphysician providers. After the first year of implementation, APRNs were paid more for additional productivity and quality and the institution had an increase in patient visits and charges. The incentive plan is a win-win for hospitals that employ APRNs.
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Nursing: Supply and Demand through 2020
ERIC Educational Resources Information Center
Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem
2015-01-01
This report analyzes the growing need for qualified nurses. The study projects that the economy will create 1.6 million job openings for nurses through 2020. Yet, there will not be enough nurses to fill those openings. this report projects that the nursing workforce will be facing a shortfall of roughly 200,000 nursing professionals by 2020. One…
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Enrolled nurse medication administration.
Kimberley, Anne; Myers, Helen; Davis, Sue; Keogh, Penny; Twigg, Di
2004-01-01
This paper describes an initiative undertaken at Sir Charles Gairdner Hospital in Perth, Western Australia to enhance the professional development of enrolled nurses to allow them to administer medications without the direct supervision of a registered nurse. This practice change proved to be a positive step for the hospital and for enrolled nurses. Benefits for patients were identified as greater continuity of care and increased timeliness of medication admiuistrqtion. The benefits for enrolled nurses were increased job satisfaction, improved morale and self esteem while the main benefit for registered nurses was decreased stres and workload.
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Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida; Greene, William H
2014-08-01
We explored direct and indirect influences of physical work environment on job satisfaction in a nationally representative sample of 1,141 early-career registered nurses. In the fully specified model, physical work environment had a non-significant direct effect on job satisfaction. The path analysis used to test multiple indirect effects showed that physical work environment had a positive indirect effect (p < .05) on job satisfaction through ten variables: negative affectivity, variety, workgroup cohesion, nurse-physician relations, quantitative workload, organizational constraints, distributive justice, promotional opportunity, local and non-local job opportunities. The findings make important contributions to the understanding of the relationship between physical work environment and job satisfaction. The results can inform health care leaders' insight about how physical work environment influences nurses' job satisfaction. © 2014 Wiley Periodicals, Inc.
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Simpson, Kathleen Rice; Lyndon, Audrey; Wilson, Jane; Ruhl, Catherine
2012-01-01
Objective To solicit input from registered nurse members of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) on critical considerations for review and revision of existing nurse staffing guidelines. Design Thematic analysis of responses to a cross-sectional on-line survey question: “Please give the staffing task force your input on what they should consider in the development of recommendations for staffing of perinatal units.” Participants N = 884 AWHONN members. Main Outcome Measure Descriptions of staffing concerns that should be considered when evaluating and revising existing perinatal nurse staffing guidelines. Results Consistent themes identified included the need for revision of nurse staffing guidelines due to requirements for safe care, increases in patient acuity and complexity, invisibility of the fetus and newborn as separate and distinct patients, difficulties in providing comprehensive care during labor and for mother-baby couplets under current conditions, challenges in staffing small volume units, and the negative effect of inadequate staffing on nurse satisfaction and retention. Conclusion Participants overwhelmingly indicated current nurse staffing guidelines were inadequate to meet the needs of contemporary perinatal clinical practice and required revision based on significant changes that had occurred since 1983 when the original staffing guidelines were published. PMID:22690743
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NMC defends disciplinary record as ex-mid staffs director leaves register.
Keogh, Kat
2014-02-05
The Nursing and Midwifery Council has defended its disciplinary process after moving to have Stafford Hospital's former chief nurse struck from the nursing register, just two months after she was given a caution.
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Doran, Diane; Duffield, Christine; Rizk, Paul; Nahm, Sang; Chu, Charlene H
2014-01-01
The purpose was to describe the number, demographic characteristics, work patterns, exit rates, and work perceptions of nurses in Ontario, Canada, in 4 specialty classifications: advanced practice nurse (APN)-clinical nurse specialist (CNS), APN-other, primary healthcare nurse practitioner [RN(extended class [EC])], and registered nurse (RN) with specialty certification. The objectives were to (1) describe how many qualified nurses are available by specialty class; (2) create a demographic profile of specialist nurses; (3) determine the proportions of specialist and nonspecialist nurses who leave (a) direct patient care and (b) nursing practice annually; (4) determine whether specialist and nonspecialist nurses differ in their self-ratings of work environment, job satisfaction, and intention to remain in nursing. Employment patterns refer to nurses' employment status (eg, full-time, part-time, casual), work duration (ie, length of employment in nurses and in current role), and work transitions (ie, movement in and out of the nursing workforce, and movement out of current role). A longitudinal analysis of the Ontario nurses' registration database from 2005 to 2010 and a survey of specialist nurses in Canada was conducted. The setting was Canada. The database sample consisted of 3 specialist groups, consisting of RN(EC), CNS, and APN-other, as well as 1 nonspecialist RN staff nurse group. The survey sample involved 359 nurses who were classified into groups based on self-reported job title and RN specialty-certification status. Data sources included College of Nurses of Ontario registration database and survey data. The study measures were the Nursing Work Index, a 4-item measure of job satisfaction, and 1-item measure of intent to leave current job. Nurses registered with the College of Nurses of Ontario were tracked over the study period to identify changes in their employment status with comparisons made between nurses employed in specialist roles and those
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38 CFR 52.130 - Nursing services.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing personnel...
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38 CFR 52.130 - Nursing services.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing personnel...
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38 CFR 52.130 - Nursing services.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing personnel...
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38 CFR 52.130 - Nursing services.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing personnel...
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38 CFR 52.130 - Nursing services.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Nursing services. 52.130... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program management must provide an organized nursing service with a sufficient number of qualified nursing personnel...
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A survey-based exploration of the impact of dyslexia on career progression of UK registered nurses.
Morris, David; Turnbull, Patricia
2007-01-01
To explore the effects of dyslexia on the practice and career progression of UK registered nurses (RN). Literature suggests dyslexia can have a negative impact in the workplace and may pose particular difficulties for nurses, where accuracy in information processing activities is essential for practice. A questionnaire was used to survey RNs with dyslexia (n = 116) and results analysed using content analysis. Dyslexia provided a challenge to the everyday work of RNs, which was often met successfully using a range of individualized strategies. Career progression was achievable but compared with peers, was perceived to take longer. Disclosure of dyslexia to work-colleagues was selective and dependent on the perceived benefits. Informal support mechanisms were commonly utilized with formal management support less well defined. Dyslexia appears to have a negative impact on working practices and career progression, but remains a poorly understood and often hidden disability.
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17 CFR 210.6-03 - Special rules of general application to registered investment companies.
Code of Federal Regulations, 2011 CFR
2011-04-01
... of assets. The balance sheets of registered investment companies, other than issuers of face-amount.... As required by section 28(b) of the Investment Company Act of 1940, qualified assets of face-amount... outstanding face-amount certificates. If the nature of the qualifying assets and amount thereof are not...
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Moloney, Willoughby; Boxall, Peter; Parsons, Matthew; Cheung, Gordon
2018-04-01
To develop a comprehensive model of nursing turnover intention by examining the effects of job demands, job resources, personal demands and personal resources on burnout and work engagement and subsequently on the intention to leave the organization and profession. The ageing population and a growing prevalence of multimorbidity are placing increasing strain on an ageing nursing workforce. Solutions that address the anticipated nursing shortage should focus on reducing burnout and enhancing the engagement of Registered Nurses (RNs) to improve retention. A cross-sectional survey design. Data were collected in 2014-2015 via an e-survey from 2,876 RNs working in New Zealand. Data were analysed with structural equation modelling. Higher engagement results in lower intention to leave the organization and profession. Burnout has significant effects on intentions to leave through lower engagement. While most of the demands and resources' variables (except professional development) have effects on intentions to leave, greater workload and greater work-life interference result in higher burnout and are the strongest predictors of intentions to leave. Greater emotional demands (challenges) and greater self-efficacy also have strong effects in lowering intentions to leave through higher engagement. Employee burnout and work engagement play an important role in transmitting the impacts of job demands, job resources, personal demands and personal resources into RN intention to leave the organization and profession. Work-life interference and high workloads are major threats to nursing retention while challenge demands and higher levels of self-efficacy support better retention. © 2017 John Wiley & Sons Ltd.
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Keeping the nursing shortage from becoming a nursing crisis.
Erickson, Jeanette Ives; Holm, Lauren J; Chelminiak, Lee
2004-02-01
Healthcare organizations are experiencing an unprecedented shortage of qualified nurses. How can we increase our understanding of how the potential labor pool views the nursing profession and identify recruitment themes to encourage young people and adult career switchers to choose a career in nursing? The authors discuss the results of a study that was conducted to gain a better understanding of the dynamics of career selection among these two target groups and identify what types of communication would motivate young people and career switchers to be drawn to the nursing profession.
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42 CFR 417.416 - Qualifying condition: Furnishing of services.
Code of Federal Regulations, 2014 CFR
2014-10-01
... following services may be furnished without the direct personal supervision of a physician: (1) Services of physician assistants and nurse practitioners (as defined in § 491.2 of this chapter), and the services and... 42 Public Health 3 2014-10-01 2014-10-01 false Qualifying condition: Furnishing of services. 417...
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42 CFR 417.416 - Qualifying condition: Furnishing of services.
Code of Federal Regulations, 2012 CFR
2012-10-01
... following services may be furnished without the direct personal supervision of a physician: (1) Services of physician assistants and nurse practitioners (as defined in § 491.2 of this chapter), and the services and... 42 Public Health 3 2012-10-01 2012-10-01 false Qualifying condition: Furnishing of services. 417...
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42 CFR 417.416 - Qualifying condition: Furnishing of services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... following services may be furnished without the direct personal supervision of a physician: (1) Services of physician assistants and nurse practitioners (as defined in § 491.2 of this chapter), and the services and... 42 Public Health 3 2010-10-01 2010-10-01 false Qualifying condition: Furnishing of services. 417...
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42 CFR 417.416 - Qualifying condition: Furnishing of services.
Code of Federal Regulations, 2013 CFR
2013-10-01
... following services may be furnished without the direct personal supervision of a physician: (1) Services of physician assistants and nurse practitioners (as defined in § 491.2 of this chapter), and the services and... 42 Public Health 3 2013-10-01 2013-10-01 false Qualifying condition: Furnishing of services. 417...