Original Research: Nurses' Attitudes Toward Brain Drain and the Associated Factors.

BACKGROUND: Brain drain refers to the emigration of scientists and other educated professionals from a low- or middle-income country to a high-income country for work. In recent years, this trend has increased, particularly in the health care arena. Prior studies among nurses and nursing students indicate that migration mainly occurs from low- and lower middle-income countries to high-income countries. This study aimed to explore the attitudes of Turkish nurses, nurse academics, and nursing students toward brain drain and the factors associated with these attitudes. METHODS: The study used a mixed-methods research design. The quantitative part of the study was conducted with 1,018 participants. The qualitative part was conducted with 26 participants from the larger sample who volunteered for focus group interviews. Data were collected from June through August 2022 using an online survey, the Attitude Scale for Brain Drain, and a semistructured interview guide. RESULTS: Of all participants, 84.3% indicated that they wanted to work and live abroad. Nearly 95% stated that there was a risk of brain drain in the nursing profession, with economic factors given as the most significant reason. As age and years of professional experience increased, brain drain tendency decreased. Nurses and nursing students had higher brain drain tendencies than nurse academics. In focus group interviews, participants reported concern that the brain drain might lead to losses in the qualified nursing workforce and increase the workload for the remaining nurses in the migrant-sending country, while cultural adaptation issues can be difficult for nurses in the migrant-receiving country. CONCLUSIONS: Brain drain in the nursing profession continues to be a current, crucial problem. This study showed that among Turkish nurses, nursing students, and nurse academics, the desire to work abroad was quite high, and all three groups had high brain drain tendency scores. Brain drain has serious consequences for both migrant-receiving and migrant-sending countries. These findings can help inform the development of initiatives aimed at preventing or mitigating nursing brain drain.

The effect of self and peer assessment training on stoma care skills of nursing students: A randomised controlled experimental study.

BACKGROUND: In nursing education, it is important to acquire and assess psychomotor skills. Traditional assessment and evaluation methods are outcome-oriented and educator-centred. In education, there is a greater need for the use of process-oriented and student-oriented complementary assessment methods. AIM: The aim of this study is to examine the effect of self and peer assessment training given to nursing students on stoma care skill success. METHODS: This study was conducted using a randomised controlled experimental design model. The sample consisted of a total of 53 students (27 in the intervention group and 26 in the control group). The data were collected using the Information Form, the Stoma Care Skill Rubric, the View Scale for Peer and Self Assessment and the Impression Scale for the Peer and Self Assessment. The intervention group received a training on self and peer assessment. The students were trained on stoma care and they were asked to practice stoma care. The applications were recorded on video. At the end of application, each student in both the intervention and control groups was assessed by himself, his peers and the educator. Number, percentage, mean, standard deviation, Shapiro-Wilk, chi-square, Mann-Whitney U tests were used to analyse the data. RESULTS: No difference was found in the stoma care skill scores in the intervention and control groups at the end of stoma care practice. When the stoma care skill scores were examined within the group, there was a significant difference between the self assessment scores and the peer, educator and self-assessment-video watching scores in both groups. No difference was observed between the self assessment-video watching scores and the peer and educator scores. In the intervention and control groups, the scores of the view scale for the peer and self assessment and the scores of the impression scale for the peer and self assessment increased, but there was no significant difference between them. The students stated that they intended to use the self and peer assessment method in other skills as well since it enabled them to notice its mistakes and helped them learn the skill better. CONCLUSIONS: It is recommended that the use of self and peer assessment methods be expanded in nursing education during skill acquisition and assessment practices. It is thought that using video recording, scales, or rubrics in conjunction with these methods would be beneficial.

The relationship among educational skills, general self-efficacy perceptions and performance in nursing instructors.

BACKGROUND: In a study conducted by the World Health Organization in 2016, the core competencies of nurse educators were revealed to increase the quality of nursing education and ensure accountability. It is considered that nursing instructors' perceptions of self-efficacy and performance are effective in their educational skills. OBJECTIVES: This study aimed to examine the correlation between nursing instructors' educational skills, their perception of general self-efficacy and performance evaluation levels. METHODS: This study was conducted with a correlational design. The population of the study included 2183 nursing instructors who were working in the department of nursing of universities in Turkey, and the sample included 548 nursing instructors. Data were collected using an information form, the Educational Skills Scale, the General Self-Efficacy Scale and the Instructors' Performance Evaluation Scales Instructor Form. The data were analyzed using descriptive statistical analyses, structural equation modeling, t-test, ANOVA, correlation analysis and chisquared test. RESULTS: Of the nursing instructors, 52.7% stated to have received training for academic formation skills, and 89.0% stated that this training should be mandatory. It was determined that there was a predictive relationship and a good fit between the nursing instructors' educational skills, general self-efficacy perceptions and performance. It was determined that the participants' perceptions of general self-efficacy and performance increased as their frequency of using educational skills increased, and their performance increased as their perceptions of general self-efficacy increased. It was found that the educational skills, general self-efficacy perceptions and performance of the male instructors were higher than those of the female instructors, and the participants' educational skills, general self-efficacy perceptions and performance levels increased as their age, occupational experience and academic experience increased. CONCLUSION: It is recommended to determine the education needs of instructors regarding their educational skills, self-efficacy perceptions and performance levels, provide education based on their needs and evaluate the effectiveness of such educational activities.

Nurse instructors' perception towards distance education during the pandemic.

BACKGROUND: The nursing department also completely switched to distance education during the COVID-19 pandemic. This new situation made the studies regarding attitudes, experiences, and difficulties of nursing instructors towards distance education more important. OBJECTIVES: To determine the factors affecting the perceptions of nurse instructors towards distance education during the pandemic. DESIGN: This is a descriptive and cross-sectional study. PARTICIPANTS: A total of 389 nurse instructors working at a university constituted the sample. METHODS: An information form and the Perceptions of Distance Education scale were used for data collection. The data were analyzed using frequency, percentage, arithmetic mean, Cronbach Alpha internal consistency analysis, t-test, one-way ANOVA and Kruskal Wallis test were used in the analysis of the data. RESULT: The nurse instructors' distance education perception scale score and perception regarding basic perspective, and resource access subdimension scores were at a medium level and the education-planning subdimension score at a high level. Those whose opinions on distance education changed compared to the pre-COVID-19 period, those who received education related to distance education, those who used new practices in the lessons, those who believed that distance education is effective, and those who thought that nursing is a suitable program for distance education had higher distance education perception scores. CONCLUSIONS: It was determined that difficulties experienced by nurse instructors in distance education negatively affected the perception of distance education, and that positive experiences in distance education affected the perception positively. It is recommended to organize trainings for instructors to improve distance education skills, to encourage students to participate in classes, and to support nurse lecturers in overcoming difficulties.

New graduate nurses' satisfaction, adaptation and intention to leave in their first year: A descriptive study.

AIM: To determine the factors affecting the professional and institutional satisfaction of new graduate nurses in their first year of work, their adaptation process and their intentions of leaving the nursing profession. BACKGROUND: The number of new graduates has been increasing in the global labour force, yet a significant proportion of them have left their profession. The first year in the nursing profession is particularly stressful and challenging for new graduate nurses. METHODS: The study was conducted at four hospitals with 428 new graduate nurses who were in the first years of their careers. RESULTS: The nurses' mean score, out of ten, was 5.52 points for job satisfaction and 5.16 points for satisfaction with their institution. Of them, 47.7% had difficulties adapting to nursing, and 53.5% had issues adapting to their jobs. Of them, 42.5% had considered leaving nursing, and 50.9% planned to leave their institutions. CONCLUSIONS: New graduates that perceive high workload, poor communication with patients and families or team members or inadequate skills and knowledge are more likely to consider turnover or leaving the profession. IMPLICATION FOR NURSING MANAGEMENT: New graduates suggested that better cooperation and teamwork, participation in decisions, consideration of requests for placement in a specific department, fair distribution of duties and shifts and in-unit professional development opportunities would all improve the work environment and decrease risk of turnover.

The Effect of a Cartoon and an Information Video About Intravenous Insertion on Pain and Fear in Children Aged 6 to 12 Years in the Pediatric Emergency Unit: A Randomized Controlled Trial.

INTRODUCTION: Intravenous insertion is the most common invasive procedure made for administering intravascular fluid and medicine. Peripheral venous catheterization may cause pain, fear, and stress in children. This study aimed to compare the effects of watching a cartoon and an information video about intravenous insertion on the pain and fear levels of children aged 6-12 years. METHODS: The study was an experimental, randomized controlled clinical trial. It was conducted with 477 children aged 6-12 years randomized into 3 groups: the informative animated video group, the cartoon group, and the control group. Fear and pain perception were evaluated on the basis of the feedback from the child, observer nurse, and parents. The Children's Fear Scale was used to evaluate the fear level and the Wong-Baker FACES Scale was used to assess pain levels. Data were analyzed using one-way analysis of variance, the chi-square test, and the intraclass correlation coefficient test. RESULTS: The children who watched the information video before the intravenous insertion procedure and those who watched a cartoon during the procedure had lower mean pain and fear scores as evaluated by the child (pain: F = 278.67, P = 0.001; fear: F = 294.88, P = 0.001), parent (pain: F = 279.53, P = 0.001; fear: F = 294.47, P = 0.001), and nurse (pain: F = 286.88, P = 0.001; fear: F = 300.81, P = 0.001) than children in the control group. DISCUSSION: This study showed that watching an animation video or a cartoon was effective in lowering children's perceived level of pain and fear during an intravenous insertion intervention.

Determining the learning needs of new graduated nurses working in inpatient care institutions.

BACKGROUND: The first year of practice impacts newly graduated nurses' adaptation to both work and profession life. During this period, new graduates most need to improve their professional knowledge and skills. OBJECTIVES: This study determined the learning needs of newly graduated nurses working in hospitals. DESIGN: This is a descriptive study. SETTINGS AND PARTICIPANTS: The sample consisted of 459 newly graduated nurses at six hospitals in Istanbul in Turkey. METHODS: The data were collected with a collection tool developed by the researchers. The data were analyzed using mean, frequency, percentage, and the chi-square test. RESULTS: The study determined that 34.6% of the newly graduated nurses were working in the emergency room and intensive care unit and 50.5% did not choose their unit voluntarily. Although 67.8% stated that their theoretical training in school was sufficient, 53.2% found clinical and 67.3% found laboratory practices insufficient. Of them, 67.1% stated that they participated in a unit orientation program and nearly half found the program insufficient for solving clinical issues. The newly graduated nurses specified they needed to learn more about nursing interventions such as resuscitation, postmortem care, efficient crisis management and code/emergency management. Newly graduated nurses who chose their unit voluntarily, found their undergraduate education sufficient preparation for the profession, and found the orientation program effective felt more competent in nursing practices. They made several suggestions for their professional development: effective feedback, in-unit trainings, working with a mentor during the first year of practice and more clinical practice during undergraduate education. CONCLUSIONS: This study includes data on the learning needs of newly graduated nurses and the factors that affect them. These results will be beneficial for planning studies to help newly graduated nurses to improve their skills.

Does participation of nursing students in social activities affect their social emotional learning skills?

BACKGROUND: One of the basic conditions for raising qualified and equipped individuals in today's world is to ensure their participation in social activities. Participation in social activities supports the development of social emotional learning skills in individuals. Providing scientific evidence supporting social emotional learning is also important for developing the social emotional learning skills of nursing students. OBJECTIVES: This study examined the effect of nursing student participation in social activities on their social emotional learning skills. DESIGN: Descriptive study. SETTING AND PARTICIPANTS: The population of this descriptive study consisted of all undergraduate students studying in the nursing faculty at a state university in Turkey (1202 students). No sample was selected in the study with the goal of assessing the entire study population. The study was conducted with 715 students who voluntarily agreed to participate in the study. METHOD: Data were collected using the Information Form and the Social Emotional Learning Skills Scale. The data was analyzed using frequency, arithmetic mean, standard deviation, Pearson-correlation, one-way ANOVA, t-test, and Chi-square statistical methods. RESULTS: More than 50% of the students did not participate in social activities. The students that did participate in social activities made more friends, found more opportunities for socialization, had increased self-confidence, and approached different views with tolerance. The students did not participate in social activities due to lack of time and financial difficulties. The students had high social emotional learning skills total and subscale scores. The participation of students in social activities affects their social emotional learning skills positively. CONCLUSION: Therefore, nursing students' opportunities for participating in social activities should be increased and their participation in social activities should be supported through encouraging initiatives.