Expectations of millennial nurse graduates transitioning into practice.

AIMS: Identified as Millennials, nurses born after 1980 are anticipated to redefine the employer-employee relationship as one based on the employee's wants and needs. The purpose of this study is to portray the expectations of Millennial student nurses immediately before graduation. Understanding these expectations may provide insight for leaders who are responsible for crafting a successful transition experience. Successful transition and decreased turnover are important elements of cost management for the nursing enterprise. METHODS/SUBJECTS: A qualitative descriptive design was used to collect data from 14 students enrolled in a traditional BSN academic nursing program approximately 2 months prior to graduation. Upon completion of private, confidential semistructured interviews, data were transcribed, coded, and analyzed. Demographic data were compiled and interview data summarized according to identified themes. RESULTS/CONCLUSIONS: Three overarching themes emerged: the expectation that transition would be stressful, the expectation that there would be a safety net of support, and the expectation to be valued and respected as a professional. Revealing was the expectation of supportive relationships and a collaborative approach to patient care. Failure to meet those expectations may result in turnover as Millennials seek opportunities that meet their expectations.

The influence of staff nurse perception of leadership style on satisfaction with leadership: a cross-sectional survey of pediatric nurses.

BACKGROUND: There is evidence that transformational leadership style promotes nursing excellence. Differences in how supervisees and supervisors perceive the supervisor's leadership style may also be related to satisfaction with leadership. Research demonstrates that satisfaction with leadership is a critical element in the retention of nurses. OBJECTIVE: To evaluate staff nurse and nurse leader perceptions of leadership style. METHODS: 16 supervisors and 179 supervisees completed the Multifactor Leadership Questionnaire and a demographic survey. Data were analyzed using parametric statistical techniques. RESULTS: Although staff perceived leaders as employing largely transformative leadership strategies, differences existed in leader-staff congruence in interpretation of leadership style and as related to the role of the leader. CONCLUSIONS: Differences in interpretation of leadership style between supervisors and supervisees were associated with diminished satisfaction with leadership. In addition, those serving in a direct operational role (assistant nurse manager) were viewed as less transformative than leaders who maintained broader administrative responsibilities.

Nurses' self-concept and perceived quality of care: a narrative analysis.

The perceptions of staff nurses on factors affecting patient care quality and safety have received little attention in the literature. Narrative analysis of comments provided by 106 staff nurses working in a medical-surgical setting revealed that nurses experienced contradictions and unmet expectations related to their professional role. The consequence was feelings of powerlessness, isolation, and low self-esteem, which affected nurses' perceived ability to provide quality patient care and ensure patient safety. This perceived inability to act in a professionally autonomous manner on behalf of patients, in turn, influenced nurses' professional self-concept. Recommendations are offered to enhance nurses' professional self-concept through staff development and policy changes.

Using a structured review of the literature to identify key factors associated with the current nursing shortage.

The current population of nurses is aging and rapidly approaching retirement, and graduation of new nurses is not expected to meet demand. Multiple reports have offered information regarding the pending shortage and made recommendations regarding interventions. It is important that suggested interventions be based upon current evidence. An integrated review of literature was undertaken, searching CINAHL, PubMed, Academic Search Premier, Medline, and PsychInfo. Studies were limited to those conducted in the United States and published in English between 2000 and 2007. Search terms were nursing shortage, job satisfaction in nursing, stress in nursing, nursing turnover, nursing image, nursing work environment, physical demands of nursing, and nursing faculty shortage. The identified reasons for nurses leaving hospital practice were management issues, job design, job stress, physical demands, and the failure to nurture new nurses. The education issues include a lack of qualified faculty and clinical sites to allow for more students to be accepted into the programs. These are issues that can be addressed; and changes, implemented. Steps must be taken immediately to resolve these issues in an effort to keep an adequate supply of nurses at the bedside.

Factor Structure of the Denyes Self Care Practice Instrument (DSCPI-90).

This study evaluates the factor structure and concurrent validity of a measure of self-care, the Denyes Self Care Practice Instrument (DSCPI-90), when used with adults. Three hundred eight participants complete the 18-item DSCPI-90 and a measure of general health status. Data are examined using descriptive statistics, exploratory factor analysis, and correlation. An efficient 12-item, two-factor model is identified. Reducing the number of items from 18 to 12 does not have an untoward effect on either scale reliability or the amount of variance explained. Correlations with a measure of health status are modest, lending validity to the construct of self-care as being distinct from, yet related to, health status. It is concluded that the 12-item version of the DSCPI is reliable and valid when used with adults.

The importance of mental health to the experience of job strain: an evidence-guided approach to improve retention.

AIMS: The purpose of this study was to evaluate the causal relationships between job strain, the practice environment and the use of coping skills in order to assist in the prediction of nurses who are at risk for voluntary turnover and identify potential intervention strategies. BACKGROUND: Analysis of the US nurse workforce indicates that it will be necessary to identify new strategies that will promote a healthy workforce and retain nurses in the workplace. METHODS: Exploratory cross-sectional survey of 1235 staff nurses resulted in 308 usable surveys (25%). Data were analysed using multivariate statistical techniques (SEM). RESULTS: It was determined that diminished mental health status as a component of job strain was predictive of propensity to leave as was a diminished assessment of the professional practice environment. Mental health was favourably influenced by coping behaviour. CONCLUSIONS: Evidence-based strategies which support mental health and reinforce the positive role of coping as a mediating factor may aid in nurse retention efforts. IMPLICATIONS FOR NURSING MANAGEMENT: This study expands the literature by offering a theoretically supported model to evaluate the response of individuals to the experience of job strain in the work environment. The model demonstrated that the health consequences of job strain are modified through the use of active coping behaviour, and that those nurses with elevated self-assessed health had a lower propensity to leave. As active coping may be taught, the model suggests a means to identify those at risk and support manager intervention.

The nurse manager: job satisfaction, the nursing shortage and retention.

A critical shortage of registered nurses exists in the United States and this shortage is expected to worsen. It is predicted that unless this issue is resolved, the demand for nursing services will exceed the supply by nearly 30% in 2020. Extensive analysis of this pending crisis has resulted in numerous recommendations to improve both recruitment and retention. The purpose of this article is to clearly outline the issues contributing to this problem, and to provide the nurse manager with information regarding specific influences on job satisfaction as it relates to job turnover and employee retention. To accomplish this, an analysis of the literature using both national and international sources is used to formulate the lessons learned as well as strategies and future courses of action designed to address this shortage.

The Nurse Reinvestment Act: the impact of governmental and nongovernmental administrative tools.

The Nurse Reinvestment Act has ushered in a new wave of federal involvement intended to address the issue of the critical nursing shortage. To implement this act, administrators will rely on a series of governance tools often called upon to address issues related to the social welfare of the country. Included among these tools are grants and loans through which the intent of the legislation will be formalized. The purpose of this analysis is to provide an overview of the characteristics associated with these tools, specifically as they relate to nursing education. Consideration will be given to the political environment through which funding, and thus the ability to implement the Nurse Reinvestment Act, will be realized, and the potential obstacles when executing federal programs in a market-driven economy.

Lessons from the past: Confronting past discriminatory practices to alleviate the nursing shortage through increased professional diversity.

A critical shortage of nurses has focused attention on the current demographics of practicing nurses. Data from the most recent analysis of the nursing workforce reveals that only 4.9 percent of practicing nurses are African American as compared with 12.1 percent of the general population. This disparity of representation has implications as resources are established from which the future workforce might be drawn. Efforts to achieve parity require recognition of the lingering effects of past social injustice and determination of strategies to overcome current barriers in education and practice. Strategies designed to encourage an increase in ethnic participation include efforts directed to recruitment, retention, graduation, and practice.