The nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision in clinical practicum: a European cross-sectional study of graduating nursing students.

BACKGROUND: A supportive clinical practicum experience may enhance the successful transition and socialization to working life of graduating nursing students. Nurse teachers have the main responsibility of supporting and guiding nursing students with their pedagogical expertise during the students' clinical practicum. Thus, the clinical role of nurse teachers is seen as an essential part of a high-quality clinical practicum. Nursing students appreciate the nurse teacher's cooperation with students, but it is often reported to be unattainable. The aim of this study was to explore and compare graduating nursing students' experiences of the nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision in their final clinical practicum, and to analyze factors associated with these experiences in six European countries. METHODS: A cross-sectional comparative international survey design was used. The modified Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) Scale, with a new subscale measuring the nurse teacher's pedagogical cooperation with students, was used. A convenience sample of graduating nursing students in Finland, Germany, Iceland, Ireland, Lithuania and Spain completed the online survey in 2018-2019. The data were analyzed using a Chi-Square test, Pearson's correlation coefficients, and linear models. RESULTS: A total of 1796 (response rate 49%) nursing students completed the survey. Overall, students had positive experiences of the nurse teacher's pedagogical cooperation, the clinical learning environment and supervision in their final clinical practicum. Students in Spain had the most positive experiences. Educational background factors appeared to be associated with the students' experiences of the nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision. The relationships between the subscale Nurse teacher's pedagogical cooperation with students and the Clinical Learning Environment and Supervision Scale were perceived as weak to strong depending on the country. CONCLUSIONS: This study reveals that nurse teachers play an essential role in supporting and guiding nursing students' final clinical practicum. In this light, researchers, educators, and leaders should collaborate seamlessly between educational institutions and healthcare organizations to establish the nurse teachers' pedagogical cooperation role within the clinical learning environment.

Analysis of graduating nursing students' moral courage in six European countries.

BACKGROUND: Moral courage is defined as courage to act according to one's own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses' career. AIM: To analyse graduating nursing students' moral courage and the factors associated with it in six European countries. RESEARCH DESIGN: A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, moral courage was assessed with a single question (visual analogue scale 0-100), the questionnaire also covered several background variables. PARTICIPANTS AND RESEARCH CONTEXT: The sample comprised graduating nursing students (n = 1796) from all participating countries. To get a comprehensive view about graduating nursing students' moral courage, the views of nurse managers (n = 538) and patients (n = 1327) from the same units in which the graduating nursing students practised were also explored, with parallel questionnaires. ETHICAL CONSIDERATIONS: Ethical approvals and research permissions were obtained according to national standards in every country and all participants gave their informed consent. RESULTS: The mean of graduating nursing students' self-assessed moral courage was 77.8 (standard deviation 17.0; on a 0-100 scale), with statistically significant differences between countries. Higher moral courage was associated with many factors, especially the level of professional competence. The managers assessed the graduating nursing students' moral courage lower (66.5; standard deviation 18.4) and the patients slightly higher (80.6; standard deviation 19.4) than the graduating nursing students themselves. DISCUSSION AND CONCLUSIONS: In all countries, the graduating nursing students' moral courage was assessed as rather high, with differences between countries and populations. These differences and associations between moral courage and ethics education require further research.

Connection between organizational culture and climate and empowerment: The perspective of nurse managers.

Health-care organizations differ from other institutions due to their unique structure and management. Organizational culture and climate are the key constructs that compose the organizational social context, and might have an impact on employees, such as nurse managers, and the organization itself. The aim of this study was to analyze the connections between organizational culture and climate and work-related empowerment, and also to present culture and climate profiles at team and organization levels. The research was carried out in Lithuania among 193 nurse managers in seven hospitals using a questionnaire that measured organizational culture and climate (Organizational Social Context instrument), and work-related empowerment (Conditions for Work Effectiveness Questionnaire-II and Work Empowerment Questionnaire). The findings showed that nurse managers were both structurally and psychologically empowered when the organizational culture was proficient and resistant, and the climate was engaged and functional. These results suggest that nurse managers are more likely to be empowered when there is an appropriate organizational culture and climate in the workplace. Creating an empowering work environment might have a positive impact on individual and organizational outcomes.

International Nursing: How Much Power Do Nurse Managers Have?

This study was conducted to explore issues of nurse managers' power and empowerment. Data were collected from nurse managers by way of a questionnaire consisting of background factors, work-related questions, and power-related questions at the unit and organization levels. The degree of empowerment was evaluated using 2 established instruments (CWEQ-II and Work Empowerment Questionnaire). The overall level of managers' personal power within their own units was relatively high. Nurse managers' perception of their power at an organizational level was found to be at a moderate level. Several factors related to an individual's professional background were correlated to power issues, both at the unit and organizational levels. Structural and psychological empowerment correlated with the overall level of power at a unit level and the overall level of power at an organizational level. Nurse managers self-reported their own general power at a unit level as high, which offers them possibilities to lead the development of nursing care in their units. Organizations may benefit more from nurse managers' leadership by more fully integrating them in the development processes of the entire organization.

Work-related empowerment of nurse managers: a systematic review.

The present study discusses how nurse managers' work-related empowerment has been investigated, in order to determine the level and relationships of empowerment among them. A systematic review was carried out, and a literature search was conducted with certain electronic databases for the period 1990-2009, using the main key words in various combinations. Only nine empirical studies in English were selected for review, in accordance with the requirements for the methodological quality and inclusion criteria. The most common type of study design was a descriptive survey (n = 5), and included various questionnaires, scales, and interviews. Nurse managers' structural, psychological, and work empowerment was found to be high or moderately high. The empowerment of nurse managers correlated positively with job satisfaction, perceived organizational support, role satisfaction, and managerial self-efficacy, and correlated negatively with emotional exhaustion and own health outcomes. Different theoretical approaches ensure a clear understanding of empowerment, but difficulties arise when the findings are synthesized across studies and settings because of the different theoretical frameworks used to conceptualize empowerment.

Nurses' perceived work-related empowerment in Lithuanian context.

UNLABELLED: STUDY'S RATIONALE: Empowerment is widely used within the nursing literature in different countries, but perceived empowerment of Lithuanian nurses has not been studied before. There is a lack of research which has analysed nurses' views and feelings of empowerment. AIMS AND OBJECTIVES: The aim of this study was to describe the perception of Lithuanian nurses' work-related empowerment. The study describes how empowered the nurses felt in their work and how background factors were related to empowerment. ETHICAL ISSUES: The permission to use the questionnaire was given by copyright holders. The questionnaire was approved by the Ethics Committee. RESEARCH METHODS AND INSTRUMENT: The data were collected using a structured questionnaire comprised of two parts: the background questions and the Work Empowerment Questionnaire divided into three areas: verbal, behavioural, and outcome empowerment. The data were analysed statistically using SPSS, and Microsoft Excel programs. The descriptive statistics, non-parametric tests and Spearman correlations were conducted. The sample consisted of 212 participants. RESULTS: The nurses experienced strong general empowerment (mean 7.9; max 10.0). They were more confident in their abilities to perform actions related to behavioural (mean 8.3) and verbal (mean 8.0) empowerment, and less confident in outcome (mean 7.3) empowerment. All aspects of empowerment were closely related to each other (p ≤ 0.001). Several significant relations were found between the aspects of empowerment and the background variables. STUDY LIMITATIONS: The Work Empowerment Questionnaire used in the study was originally developed in Canada. Differences in language, culture, health care organizations, and nursing practice may affect the validity of translated questionnaire in Baltic context. CONCLUSIONS: To prepare nurses for roles in which they may successfully exercise the power to create change, they need experience the process of empowerment during their education, and experience later supportive management.

Perception of work-related empowerment of nurse managers.

PURPOSE/AIM: The paper aims to analyse the perception of being empowered according to the self-evaluation of nurse managers, presenting it as structural and psychological empowerment. METHODS: A questionnaire-based study was conducted. The sample consisted of 193 nurse managers working in a total of seven university and general level hospitals in Lithuania. The Conditions of Work Effectiveness Questionnaire-II measuring structural empowerment and the Work Empowerment Questionnaire measuring psychological empowerment were used. RESULTS: The paper reveals that nurse managers experienced structural empowerment at a moderate level and were highly psychologically empowered. CONCLUSIONS: These findings are in line with previous research. The results showed that particular background factors were related to aspects of empowerment. The findings of this research can be used to examine the structural and psychological aspects that function as barriers to feeling empowered. The results are also useful for chief nurses who are involved in the recruitment and retention of nurse managers. Further research is needed to look into the question of improving formal power issues, e.g. the rewards for innovation at work, and also outcome empowerment aspects that may affect changes in the way that nurse managers carry out their work.