Occupational nursing during disasters from the perspective of holistic theory.

Disasters are defined as unpredictable and complex situations. This theoretical-reflective study, conducted from August 2020 to December 2020, reflected on occupational nursing during disasters in light of Myra Levine's holistic theory. The first principle of her model is to conserve human energy, focusing on vital sign measurement; the second, conservation of structural integrity, focuses on multiple injuries; the third, conservation of personal integrity, focuses on relationships; while the fourth, conservation of social integrity, involves public and private dimensions beyond an individual level. Levine's conservation model is of special utility in disaster situations, since it is rooted in occupational nursing care, working toward effective adaptation of nursing processes for individuals and families, aiming to achieve professional autonomy and quality care for patients, their families, and society.

Os desastres caracterizam-se como situações imprevisíveis e complexas. Este artigo objetivou refletir sobre a ótica da enfermagem do trabalho em desastres, fundamentada na teoria holística de Myra Estrin Levine. Trata-se de um estudo teóricoreflexivo desenvolvido no período de agosto a dezembro de 2020. Na teoria holística, o primeiro princípio é a conservação da energia do ser humano, com foco na medida dos sinais vitais. Já a conservação da integridade estrutural foca nas experiências múltiplas com lesões. A conservação da integridade pessoal se refere aos relacionamentos para definirem a si mesmos. Por fim, a conservação da integridade social, por sua vez, envolve a definição do ser que vai além do indivíduo e possui dimensões pública e particular. O modelo holístico de Myra Estrin Levine contribui em especial com a temática de desastres, tendo em vista que, ancorada no cuidado de enfermagem no contexto ocupacional, baseia-se em trabalhar de forma didática a adaptação eficaz do processo de enfermagem aos indivíduos e às famílias, além de contribuir com o processo de enfermagem, visando alcançar a autonomia profissional e a boa qualidade da assistência prestada ao cliente, à família e à sociedade.

Improved Nursing Workload by Introducing a Traceability System to Manage Medical Materials.

This paper reports a case study in which an improvement in nursing work was achieved through the introduction of a traceability system compatible with radio-frequency identification (RFID) and bar codes for the management of medical materials. In verifying the RFID-based system in an operating room, the work time was reduced to approximately one-tenth of that of barcode reading. In the catheterization laboratory, a system consisting of a cartel management system utilizing bar codes and an RFID-compatible inventory management cabinet was introduced. The system eliminates the need to cut and paste packages onto vouchers after the cases are completed and digitizes the data sent to the medical affairs department for secure billing. We are implementing this system at many facilities, and, in addition to improving the work of nurses, we are taking new steps to improve hospital management through data linkage.

The mediating effect of job embeddedness on the nursing work environment and transition shock among new nurses: A cross-sectional study.

AIMS: This study aims to investigate the status of transition shock and test the mediating effect of job embeddedness on the nursing work environment and transition shock among new nurses. BACKGROUND: Transition shock, primarily experienced during the first two years of employment, manifests itself as an unsettling or discordant experience among new nurses, which is caused by the gap between theoretical learning and clinical practice. DESIGN: This is a cross-sectional survey study, following the STROBE guidelines. METHODS: A cross-sectional study was conducted among 435 new nurses from November to December 2022 in Hunan Province, China. The participants were recruited to complete a sociodemographic information questionnaire and rank 3 standardized scales of transition shock (Cronbach's alpha = 0.918), job embeddedness (Cronbach's alpha = 0.890) and nursing work environment (Cronbach's alpha = 0.946). Then, the data were analysed by SPSS 26.0 and mediation testing was performed using Hayes' PROCESS macro (Model 4). A p value of < 0.05 was deemed statistically significant. RESULTS: The mean score with standard deviation of the transition shock scale in new nurses was 88.86 (22.50). The place of origin, working months and weekly working hours were the significant sociodemographic factors that affected the transition shock score in new nurses. Transition shock was found to be negatively related to both job embeddedness (r = -0.468, p < 0.001) and nursing work environment (r = -0.416, p < 0.001), while job embeddedness mediated the relationship between transition shock and nursing work environment (R2 = 0.262, F = 30.455, p < 0.001). CONCLUSIONS: New nurses from rural areas and with longer weekly working hours are more prone to transition shock. Those with 6-12 months of employment experience more pronounced transition shock than those with less than 6 months. In addition, the nursing work environment can not only directly influence transition shock for new nurses but also indirectly influence it through job embeddedness. These findings provide a basis for hospitals to develop strategies to effectively address transition shock in new nurses and ultimately solve the nursing shortage issue.

Working on differentiated nursing practices in hospitals: A learning history on enacting new nursing roles.

OBJECTIVE: This study aims to better understand how new future-oriented nursing roles are enacted in a general hospital. DESIGN: A learning history, that is, a participatory action-oriented research design to explore and foster organizational learning. METHODS: Data collection consisted of a (historical) document analysis, the shadowing of differentiated nursing practices (36 h), 22 open interviews, 4 oral history interviews, 2 focus groups and a podcast series (7 h) created with participants. RESULTS: The data gathered revealed three important themes regarding enacting new nursing roles: (1) stretching the nature of nursing work, (2) using earlier experiences and (3) collectively tackling taboos. CONCLUSIONS: Differentiated nursing practices and enacting new nursing roles have long and complex histories. Attempts to differentiate are often met with resistance from within the nursing profession. This study shows how the new role of nurse coordinator was negotiated in nursing teams. With a bottom-up approach focused on collective responsibilities. By acknowledging and reflecting on the past, spaces were enacted in which the role of nurse coordinator became one role, among others, in the delivery of patient care. IMPACT: This study provides an innovative perspective on differentiated nursing practices by focusing on the past, the present and the future. We found that local, situated conditions can be taken as starting points when new nursing roles are enacted. In addition, shifting focus from individual nursing roles to nursing team development, emphasizing collective responsibilities, softens strong (historically) grown emotions and creates spaces in which new roles become negotiable. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Invisibility and devaluation of nursing work: related factors and coping strategies

Nursing represents the largest professional category in the health field worldwide, with 27.9 million professionals, representing 59% of the entire health workforce.(1) The World Health Organization has warned of the need for greater investments in training, better working conditions and encouraging the development of nursing leadership as one of the means to achieve universal health coverage and the Sustainable Development Goals (SDGs).(1) However, even though they are essential to health systems, these professionals face problems related to the representation of their image, which contributes to a scenario of devaluation, which has proved to be an obstacle to the development of the profession. Thus, in an exercise of understanding this phenomenon, it is considered that the factors that follow contribute greatly to configure the devaluation scenario

The role of the nursing work environment, head nurse leadership and presenteeism in job embeddedness among new nurses: a cross-sectional multicentre study.

BACKGROUND: The retention of new nurses has become a major challenge for medical institutions. Job embeddedness has been seen as a valuable lens for examining nurse turnover, but greater details about job embeddedness are rarely disclosed, especially among new nurses. This study aimed to reveal how the nursing work environment, head nurse leadership and presenteeism shape job embeddedness in this population from the perspective of conservation of resources (COR) theory. METHOD: A cross-sectional multicentre study involving 436 participants from 10 cities and 33 hospitals was conducted over 4 months. Samples were selected using a two-stage convenience sampling method. A sequential multiple mediation model performed with SPSS-PROCESS was used to analyse the relationships among the nursing work environment, head nurse leadership, presenteeism and job embeddedness. RESULTS: The nursing work environment not only directly affects the job embeddedness of new nurses (ß = 0.480, p < 0.001) but also indirectly affects it through the sequential multiple mediating effects of head nurse leadership and presenteeism (R2 = 0.535, F = 82.160, p < 0.001). CONCLUSIONS: New nurses' job embeddedness needs to be improved. These results suggest that preserving adequate resources for new nurses, such as work environment resources, head nurse leadership resources, and individual productivity resources, is an effective way to shape their job embeddedness. In addition, when a certain resource is insufficient, fully considering the principles of investment and buffering between resources and providing reciprocal, alternative, or buffer resources in a timely manner are necessary to improve new nurses' job embeddedness. LARGE LANGUAGE MODELS: Large language models (LLMs), such as ChatGPT, were not used during the writing of this article. An expert native English speaker performed language revision.

Organizational characteristics of nursing practice environments related to registered nurses' professional autonomy and job satisfaction in two Finnish Magnet-aspiring hospitals: structural equation modeling study.

BACKGROUND: Nurses are leaving their profession because of poor personal job satisfaction, heavy workload, and unfavorable work environments with low professional autonomy. Professional autonomy involves the possibility to influence one's work and have a sense of control - the ability to contribute to a workplace culture and influence how decisions are made. This study explores registered nurses' perceptions of the nursing practice environment, using the Nursing Work Index-Revised (NWI-R), and its relationships with professional autonomy and job satisfaction. METHODS: A cross-sectional study along with instrument re-validation was conducted using a web-based survey for nurses in two Magnet-aspiring hospitals in Finland in September 2021 (n = 586). Structural equation modeling was used to find out the relationships of the NWI-R components with professional autonomy and job satisfaction. RESULTS: Principal component analysis and confirmatory factor analysis supported seven components with 34 items. Collegial nurse-doctor relationships, organization's quality standards, and nursing involvement and expertise sharing (means of 3.23, 2.96, and 2.66, respectively) demonstrated a favorable nursing practice environment; professional nursing standards, nurse management and leadership, staffing and resource adequacy, and professional advancement (means of 2.38, 2.18, 2.15, and 2.13, respectively) demonstrated an unfavorable nursing practice environment. The presented model (RMSEA 0.068, CFI 0.987, TLI 0.946) indicated that nursing involvement and expertise sharing, organization's quality standards, nurse management and leadership, and collegial nurse-doctor relationships were related to professional autonomy. Nurse management and leadership, staffing and resource adequacy, and organization's quality standards were related to job satisfaction. Moreover, professional autonomy was related to job satisfaction. CONCLUSION: Nurses' professional autonomy is important due to its relationship with job satisfaction. When factors that increase professional autonomy are taken into account and attention is paid to the promotion of autonomy, it is possible to improve nurses' job satisfaction. These issues cannot be solved at the unit level; investment is needed at the organizational and political levels. The results introduce nurses, managers, researchers, and stakeholders to improvements in the nursing practice environment toward an organizational culture where nurses may utilize their professional autonomy to its full potential.

"We don't experiment with our patients!" An ethnographic account of the epistemic politics of (re)designing nursing work.

This article draws on ethnographic research investigating experimental reform projects in local nursing practices. These are aimed at strengthening nursing work and fostering nurses' position within healthcare through bottom-up nurse-driven innovations. Based on literature on epistemic politics and critical nursing studies, the study examines and conceptualizes how these nurses promote professional and organizational change. The research draws on data from two pilot projects to show how epistemic politics frame the production and use of knowledge within reform efforts. The study finds that knowledge produced through such experimenting is often not considered valid within the contexts of broader organizational transitions. The nurse-driven innovations fail to meet established legitimate criteria for informing change, both among stakeholders in the nurses' socio-political environment, as well as within the nursing community. The research reveals that the processes inadvertently reinforce normative knowledge hierarchies, perpetuating forms of epistemic injustice, limiting both nurses' ability to function as change agents and healthcare organizations' capacity to learn.

Overview and Enlightenment of Codes of Ethics for Nurses at Home and Abroad / 中国医学伦理学

Formulating codes of ethics for nurses are not only the need of establishing nurses’ professional image and dignity, but also the demand of nursing discipline development. By combing the relevant documents of codes of ethics for nurses at home and abroad, this paper summarized the main contents and application of codes of ethics for nurses, found that codes of ethics for nurses were based on the basic principle of "patient-oriented", discussing the relationship between nurses and patients, collaborators, environment, society, specialty and personal development, and forming the constraint standard for nurses’ behavior in combination with the expectation of local cultural values for nursing industry. The codes of ethics for nurses in China need to further clarify the scope of nursing, formulate behavioral norms in various specialties, and through clinical evaluation, education, management and other aspects to promote its popularization and implementation.

Evolution of an Instrument: Measuring the Nursing Work Environment: A Scoping Review.

Background and Purpose: The Nursing Work Index (NWI) was developed in the 1980s to measure the nursing work environment (NWE). Instruments descended from the NWI continue to measure the NWE today. The purpose of this review was to identify instruments derived from the NWI, examine how they have been used and revised, and evaluate their ability to capture elements of the current work environment. Methods: A scoping literature review. Results: Forty articles were included. Instruments developed from the NWI have been translated into numerous languages and administered to hundreds of thousands of nurses globally. Conclusions: The study of the NWE remains extensive throughout the world. Future research should examine the factorial structure of instrument adaptions and ensure that items are relevant to contemporary nursing practice.

The relationship between presenteeism among nurses and patients' experience in tertiary hospitals in China.

This study aims to observe the current situation of nurses' presenteeism and the relationship between presenteeism among nurses and patient perceptions and examine its implications for nursing management. The study design was quantitative, correlational and cross-sectional. The researchers used convenience samples of nurses and patients from five hospitals who agreed to participate in an online survey distributed using Sojump Survey Software. A total of 500 in-service nurses from five tertiary hospitals in Henan Province in China were recruited as the nurse participants. Among them, 433 met the inclusion criteria and completed the general information questionnaire and the presenteeism scale. Patients who were hospitalised for three days or more and were cared for by one or more nurse participants were included in the study. In total, 435 patient participants answered the Inpatient Experience Questionnaire. The responses collected from both groups were analysed using descriptive and inferential statistics.Nurses' presenteeism was a key factor that affected patient experience. Presenteeism among nurses is a common phenomenon. Although patients' experience was overall positive, there is still room for improvement. Reducing presenteeism among nurses is crucial for improving patient experience, creating harmonious nurse-patient relationships and sharing a common mission.

Translations of the Practice Environment Scale of the Nursing Work Index: A systematic review.

Since 2002, the Practice Environment Scale of the Nursing Work Index has been used worldwide to evaluate nurse work environments. High quality translations in different languages can help advance science and inform practice globally. The study purposes were to conduct a systematic review of published translations of the instrument and to assess their linguistic equivalence and psychometric performance. We conducted a comprehensive search, a quality assessment and synthesis of linguistic equivalence, reliability, and validity data. Studies published through July 2021 were identified in the CINAHL, LILACS, EMCare, and Scopus databases. Thirty-eight publications were selected, comprising 46 translations into 24 languages and 15 language variants, and 35 countries. Translations are in predominantly European, Southeast Asian, and Middle Eastern languages. Two-thirds of the translations reflected medium to high fulfillment of translation quality criteria. The GRADE ratings, reflecting satisfactory fulfillment of cross-cultural equivalence and psychometric properties, were predominantly high (n = 23), then low (n = 15), then moderate (n = 8). The identified translations will support the advancement of global science and the improvement of nurses' work environments.

The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal's Long-Term Care Units.

BACKGROUND: The morbidity associated with ageing has contributed to an increase in the prevalence of Pressure Ulcers (PUs) in all care settings. The impact of these on people's quality of life and the extent of the associated economic and social burden constitutes today, by their importance, a serious public health problem. This study aims to describe the nursing work environment in Portuguese long-term care (LTC) units and to assess how this environment relates to the quality of PU care. METHODS: A longitudinal study among inpatients with PUs was conducted in LTC units. The Nursing Work Index-Revised Scale (NWI-R) was sent to all nurses in these units. Cox proportional hazard models were used to relate the satisfaction degree with the service (measured by the NWI-R-PT items) to the healing time of the PUs, adjusting for confounders. RESULTS: A total of 165 of 451 invited nurses completed the NWI-R-PT. Most were women (74.6%) and had 1 to 5 years of professional experience. Less than half (38.4%) had education in wound care. Of the 88 patients identified with PUs, only 63 had their PU documented, highlighting the difficulties in updating electronic records. The results showed that the level of concordance with Q28 "Floating so that staffing is equalised among units" is strongly associated with a shorter PU healing time. CONCLUSION: A good distribution of nursing staff over the units will likely improve the quality of wound care. We found no evidence for possible associations with the questions on participation in policy decisions, salary level, or staffing educational development and their relationship with PUs healing times.

Using item response theory to develop a shortened practice environment scale of the nursing work index.

The 31-item Practice Environment Scale of the Nursing Work Index (PES-NWI) has been frequently used globally to measure the nurse work environment. However, due to its length and subsequent respondent burden, a more parsimonious version of the PES-NWI may be desirable. Item response theory (IRT) is a statistical technique that assists in decreasing the number of items in an instrument without sacrificing reliability and validity. Two separate samples of nurses in the United States (one called the "internal data source" and the other called "external data source"; sample sizes = 843 and 722, respectively) were analyzed. The internal data source was randomly split into training (n = 531) and validating data sets (n = 312), while a separate whole external data source was used as the final validating data set. Using IRT with training data, we removed nine items; two additional items were removed based on recommendations from a previous study. Confirmatory factor analyses supported the validity of the measurement model with the 20-item of PES-NWI in both internal and external validation data sources. The correlations among subscales between 31- and 20-item versions were high magnitude for five subscales in both validation data sets (τ = 0.84-0.89). Ultimately, we identified a 20-item version of the PES-NWI which demonstrated adequate validity and reliability properties while decreasing data collection burden yet maintaining a similar factor structure to the original instrument. Additional research may be necessary to update the items themselves on the PES-NWI.

Effects of External Employment Opportunities, Nursing Professionalism, and Nursing Work Environments on Korean Hospital Nurses' Intent to Stay or Leave.

This study aims to explore Korean Hospital nurses' intent to stay or leave their working environment, and to identify the difference between the intent to stay and the intent to leave by identifying the relationship between external employment opportunities, professionalism, and work environment. Data were collected via an online survey and analyzed using stepwise multiple regression analysis. As a result of the analysis, the intent to stay among Korean hospital nurses was influenced by the work environment, external employment opportunities, education level, and marital status, whereas the intent to leave was influenced by the nursing work environment, marital status, and total clinical experience. As a result, the reflected variables differed. Thus, it can be concluded that hospital nurses' intent to either stay or leave are not concepts that simply contradict each other in the same context but are, in fact, influenced differently by various factors. Nevertheless, it can also be concluded that nursing managers should make efforts to improve the nursing work environment to lower nurses' intent to leave and increase their intent to stay by improving only the nursing work environment.

Factors associated with the extent of nurses' involvement in promotion of the nursing profession: a cross-sectional study among nurses working in diverse healthcare settings.

AIMS AND OBJECTIVES: To examine factors associated with promotion of the nursing profession, to the nursing community, other healthcare professionals and the general public, by nurses employed in diverse healthcare settings. BACKGROUND: Little is known about the factors that contribute to nurses' involvement in the promotion of the nursing profession. METHODS: This cross-sectional study comprises a convenience sample of registered nurses (n = 526) with ≥ 3 months' experience in nursing, who are employed in internal and surgical units, pediatric wards, psychiatric wards or in the community across Israel. Participants completed a self-administered questionnaire addressing socio-demographic, occupational and organizational factors relating to the nursing work environment and to the extent of nurses' involvement in promotion of the nursing profession. Descriptive statistics, one-way analysis of variance, Pearson's correlation analysis, and multivariate linear regression were performed. RESULTS: Nurses in all the surveyed healthcare settings reported relatively low levels of involvement in promotion of the profession, either to the nursing community or to other healthcare professionals and the public. Being a female-nurse was significantly negatively associated with nurses' involvement in promotion of the nursing profession. In contrast, holding a master's degree in nursing, having a managerial role, and working in a supportive organizational nursing work environment were the principal factors associated with positive promotion of the nursing profession. CONCLUSION: The extent of nurses' involvement in promotion of the nursing profession mainly depends on occupational factors and a supportive organizational nursing work environment. CLINICAL RELEVANCE: Healthcare managers may advance nurses' involvement in promotion of the profession by modifying the organizational nursing work environment. Specifically, we recommend nurse leaders to dedicate efforts to make professional promotion an integral part of a nurse's role.

The newly-licensed registered nurse workforce: Looking back to move forward.

BACKGROUND: Newly licensed registered nurses (NLRNs) are a vital health human resource necessary for the sustainability of the nursing workforce. There are challenges associated with the transition of NLRNs into practice; yet, new nurses continue to leave their positions within the first year. To compound the situation, a global pandemic hit in 2020. To leverage a sustainable future for our nursing workforce we must examine workforce data of NLRNs. PURPOSE: The purpose of this descriptive study was to review the most recent national source of workforce data to determine if the data reveals insight to help renew the focus on the NLRN workforce. METHODS: This descriptive study was a secondary analysis of demographic, education, employment, and work environment variables from the 2018 National Sample Survey of Registered Nurses. FINDINGS: The NLRN workforce is slightly more diverse, seeking a BSN as the first degree, and funding their initial education with federal loans. NLRNs cite inadequate staffing, stressful work environments, burnout, and salary as the reasons for leaving the first job. NLRNs cite a balanced schedule, experience in the job, and a sense of community with peers as reasons why they stay. DISCUSSION: This study joins the decades of literature that points to a small group of problems that account for the overwhelming majority or nursing turnover and attrition. After analyzing the data, the authors pose several questions to readers for consideration about the NLRN workforce. The authors' hope is to garner renewed attention to the issues facing NLRNs.

Decent work in nursing: Relationship between nursing work environment, job satisfaction, and physical and mental health.

AIM: To examine the relationship between nursing work environment, nurses' perception of decent work, job satisfaction, and physical and mental health. BACKGROUND: According to the psychology of working theory, work-related and overall well-being levels of employees with decent work increase as their basic needs are met. METHODS: This study was conducted as a cross-sectional, correlational study. The study sample consisted of 311 nurses working in two hospitals in a province of Turkey. The participants were selected using convenience sampling method. The model of the research was analyzed using structural equation modeling. This study was reported using the STROBE checklist for cross-sectional studies. RESULTS: The four dimensions of the nursing work environment were found to have a significant relationship with decent work. Decent work was found to have a direct relationship with physical and mental health. It had an indirect relationship between three subscales of work environment and physical and mental health, however, decent work had no significant relationship with job satisfaction. CONCLUSIONS: The findings of this study indicated the role of decent work environment and its relationship with nurses' physical and mental health. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse managers, policy makers, and decision-makers at all levels should improve nursing work environment and working conditions.

High-Risk Symptom Cluster Groups for Work-Life Quality and Turnover Intention among Nurses.

This cross-sectional study aims to identify high-risk symptom cluster groups for assessing the quality of nursing work life (QNWL) and turnover intention among Korean nurses who have experienced workplace violence. Nurses were recruited for an online survey in May 2021 (n = 203). The following four symptom clusters are extracted: (a) depression-anxiety, (b) shame-somatization, (c) nightmare-loss of appetite, and (d) anger-shock. Three symptom cluster groups were identified. Group 1 had the highest score for the anger-shock symptom cluster, as well as the highest symptom scores and turnover intention. Group 2 had the highest score for the nightmare-loss of appetite symptom cluster and the lowest QNWL. Group 3 had a similar symptom cluster pattern to Group 1 but lower scores for all symptom clusters. Symptom monitoring and programs tailored to symptom cluster groups at the institutional level could be useful for managing QNWL and turnover intention.

Construction of evaluation index system for difficulty of nursing work items in post anesthesia care unit / 中国实用护理杂志

Objective:To explore the nursing work items and the technical difficulty in post anesthesia care unit, so as to provide the basis for accurate calculation of anesthesia nursing workload and reasonable matching of human resources.Methods:The primary and secondary indicators of the nursing working system in post anesthesia care unit were determined through the literature review and group discussion. Delphi method was used to revise the indicators and evaluate the importance and difficulty degree of the indicators. Finally, analytic hierarchy process and linear weighted sum method were used to calculate the weight value and difficulty coefficient of each index.Results:The positive coefficients of the experts in the two rounds were 100.00%, the authority coefficients of the experts were 0.90 and 0.96, the variation coefficients ranged from 0.000 to 0.342 and 0.042 to 0.307, and the Kendall coefficients were 0.239 and 0.273 (both P<0.01). The evaluation index system of the difficulty of nursing work in post anesthesia care unit was finally composed of 10 primary indicators and 85 secondary indicators. The weight of the primary index ranged from 0.016 4 to 0.186 4, and the weight of the secondary index ranged from 0.000 8 to 0.064 3. The standardized difficulty coefficient of the secondary index ranged from 1.02 to 1.59. Conclusions:The evaluation index system of the difficulty of nursing work items in post anesthesia care unit was comprehensive and the difficulty coefficient was in line with the actual clinical work in this study, which provides reference for the follow-up scientific calculation of nursing workload and human resources matching in post anesthesia care unit.