Exploration of the occupational and personal dimensions impacted by the COVID-19 pandemic for nurses: A qualitative analysis of survey responses.

AIM: To explore the occupational and personal life dimensions that have been impacted by the COVID-19 pandemic for registered nurses (RN) and licensed practical nurses (LPN). DESIGN: Qualitative interpretive description approach. METHODS: Between July and September 2020, a web-based cross-sectional study was conducted among RNs and LPNs in Quebec, Canada. Included in this survey was an open-ended question allowing nurses to describe the occupational and personal life dimensions that were impacted by the COVID-19 pandemic. Thematic analysis was used to interpret the qualitative data from this open-ended question. Reporting followed the Standards For Reporting Qualitative Research (SRQR). RESULTS: Of the 1860 survey respondents, 774 RNs and 43 LPNs responded to the open-ended question (total n = 819). For the occupational dimension, six themes were identified: impacts of infection control on work, change in daily work tasks, offloading and reorganization of care, deterioration of working conditions, increased stress at work and issues related to the profession. For the personal dimension, four themes were found: impacts on the family, dealing with changes about leisure and personal life, impacts on physical and psychological health. CONCLUSION: Knowing the dimensions affected by the COVID-19 pandemic could help to identifying appropriate interventions to support RNs and LPNs. IMPACT: The COVID-19 pandemic has significantly impacted the occupational and personal lives RNs and LPNs working in the Quebec healthcare system. More specifically, Quebec's nurses experienced a major reorganization of care generated by important government decisions. Knowing how the pandemic affected different life dimensions will help in the development of support adapted to nurses' realities. Even in a pandemic context, improvements in the work environment or appropriate support could lead to an improved psychological health for nurses.

Percepção de cuidados desproporcionais entre médicos seniores, médicos residentes, enfermeiros e técnicos de enfermagem em um centro de terapia intensiva / Perception of disproportionate care among staff physicians, training physicians, nurses, and practical nurses in an intensive care unit

Introdução: O aumento progressivo de medidas avançadas para manutenção da vida em pacientes com pouca expectativa de sobrevida gera percepção de cuidado desproporcional. Objetivamos averiguar a prevalência de cuidado desproporcional em equipe médica e enfermagem que atuam na Unidade de Terapia Intensiva (UTI) em um hospital público do Brasil.Métodos: Estudo transversal envolvendo equipe médica e enfermagem em uma UTI multidisciplinar de 34 leitos de um hospital terciário no sul do Brasil de janeiro a julho de 2019. Ao total 151 profissionais responderam a um questionário eletrônico anônimo.Resultados: A taxa de resposta foi de 49,5%. Cento e dezoito (78,1%) profissionais identificaram cuidado desproporcional no ambiente de trabalho. Enfermeiros e técnicos de enfermagem receberam menos treinamento formal em comunicação de fim de vida do que médicos (10,6% versus 57,6%, p < 0,001). Vinte e nove (28,1%) enfermeiros e técnicos de enfermagem e 4 (0,08%) médicos responderam que não havia discussão sobre terminalidade na UTI (p = 0,006). Quarenta e três (89,5%) médicos afirmaram que havia colaboração entre equipe médica e equipe de enfermagem, ao passo que 58 (56,3%) enfermeiros e técnicos de enfermagem discordaram da assertiva (p < 0,001).Conclusão: Este é o primeiro estudo sobre percepção de cuidado desproporcional conduzido na América Latina, envolvendo residentes e técnicos de enfermagem e um centro de alta complexidade do sistema público de saúde. A vasta maioria dos profissionais percebe a existência de cuidado desproporcional em sua prática diária, independentemente da classe profissional.

Introduction: The increased use of life-sustaining measures in patients with poor long- and middle-term expected survival concerns health care providers regarding disproportionate care. The objective of this study was to report the prevalence of perceived inappropriate care among intensive care unit (ICU) staff physicians, training physicians, nurses, and practical nurses in a Brazilian public hospital.Methods: We conducted a cross-sectional study with the medical and nursing team of a 34-bed multidisciplinary ICU of a tertiary teaching hospital in Southern Brazil from January to July 2019. A total of 151 professionals completed an anonymous electronic survey. Results: The response rate was 49.5%. One hundred and eighteen (78.1%) respondents reported disproportionate care in the work environment. Nurses and practical nurses were less likely to receive formal training on end-of-life communication compared to physicians (10.6% vs. 57.6%, p < 0.001). Twenty-nine (28.1%) nurses and practical nurses vs. 4 (0.08%) physicians claimed that there were no palliative care deliberations in the ICU (p = 0.006). Of 48 senior and junior physicians, 43 (89.5%) believed that collaboration between physicians and nurses was good, whereas 58 out of 103 (56.3%) nurses and practical nurses disagreed (p < 0.001).Conclusion: This is the first survey on the perception of inappropriate care conducted in Latin America. The study included junior physicians and practical nurses working in a high-complexity medical center associated with the Brazilian public health system. Most health care providers perceived disproportionate care in their daily practice, regardless of their professional class.

Produção de corpos generificados em um bloco cirúrgico: uma análise pelo trabalho como atividade / Production of bodies generated in a surgical ward: an analysis by work as an activity / Producción de cuerpos generados en uma unidad quirúrgica: una análisis por trabajo como actividad

Neste artigo, analisamos o trabalho em saúde em um bloco cirúrgico a partir do referencialteóricoda Clínica da Atividade, atentando para a especificidade da performatividade do gênero por entre esta experiência. Para tanto, produzimos um percurso transverso do ponto devista do método, operando por entre Clínica da Atividade e pistas do Método Cartográfico, realizando, ainda, articulações com a proposta praxiográfica. As análises apontam que, apesar das fortes prescrições que compõem o trabalho em um bloco cirúrgico, ostrabalhadores e trabalhadoras problematizam as normas de trabalho e de gênero nas situações laborais, produzindo estilizações. É na atividade que as normas de trabalho, e também de gênero, são colocadas em questão abrindo brechas e críticas a modelos regulatórios, e também violentos, que ancoram, por vezes, as práticas em saúde. A partir dessa pesquisa, apontamos a importância de produzir estudos relativos à produção do gênero em meio aos processos operativos do trabalho. (AU)

In this article, we analyzed the health work in surgical ward based on the theoretical references of the Clinic of Activity, taking into account specificity of gender performativity among this experience. For this purpose, we produced a transversal path from the point of view of the method, operating methodologically between the Clinic of Activity and clues from the Cartographic Method, also performing articulations with the praxiographic. The analyzes point out that, despite the strong prescriptions that make up the work in surgical ward, the workers problematize labor and gender norms in work situations, producing stylizations. It's in the activity that work norms, as well as gender, they are called into question, opening loopholes and criticisms of regulatory models, and also violent, that sometimes anchor health practices. This research indicates the importance of further studies towards the production involving gender and labor processes. (AU)

En este artículo analizamos el trabajo em salud en una Unidad Quirúrgica de un Hospitala partir de los referentes teóricos de la Clínica de Actividad, prestando atención a la especificidad del performatividad de género em esta experiencia.Para eso, producimos un recorrido transversal desde el punto de vista del método, operando entre la Clínica de Actividad y las pistas del Método Cartográfico, realizando también articulaciones com la propuesta praxiográfica. Los análisis muestran que, a pesar de lãs fuertes prescripciones que conforman el trabajo en una unidad quirúrgica, los trabajadores y trabajadoras problematizan las normas laborales y de género em lãs situaciones laborales, produciendo estilizaciones. Es em la actividad donde se cuestionan las normas laborales, así como el género, abriendo lagunas y críticas a modelos regulatorios, y también violentos, que en ocasiones anclanlas prácticas de salud. A partir de esta investigación, señalamos la importancia de producir estudios relacionados com la producción de género em medio de los procesos operativos del trabajo. (AU)

Translation and validation of the Alberta Context Tool for use in Norwegian nursing homes.

PURPOSE: Organizational context is recognized as important for facilitating evidence-based practice and improving patient outcomes. Organizational context is a complex construct to measure and appropriate instruments that can quantify and measure context are needed. The aim of this study was to translate and cross-culturally adapt the Alberta Context Tool (ACT) to Norwegian, and to test the reliability and structural validity among registered nurses (RNs) and licenced practice nurses (LPNs) working in nursing homes. METHODS: This study was a validation study utilizing a cross-sectional design. The sample consisted of n = 956 healthcare personnel from 28 nursing homes from a municipality in Norway. In the first stage, the ACT was translated before being administered in 28 nursing homes. In the second stage, internal consistency and structural validity were explored using Cronbach's alpha and confirmatory factor analysis. RESULTS: A rigorous forward-and-back translation process was performed including a team of academics, experts, professional translators and the copyright holders, before an acceptable version of the ACT was piloted and finalized. The Norwegian version of the ACT showed good internal consistency with Chronbachs alpha above .75 for all concepts except for Formal interactions where the alpha was .69. Structural validity was acceptable for both RNs and LPNs with factors loadings more than .4 for most items. CONCLUSIONS: The Norwegian version of the ACT is a valid measure of organizational context in Norwegian nursing homes among RNs and LPNs.

Percepções de trabalhadores readaptados sobre o contexto de trabalho e riscos psicossociais organizacionais / Perceptions of readapted workers about work environment and organizational psychosocial risks / Percepciones de trabajadores readaptados sobre el contexto de trabajo y riesgos psicosociales organizacionales

Introdução: Os fatores psicossociais têm sido descritos como importantes agentes relacionados com o retorno ao trabalho, podendo ser facilitadores ou barreiras neste processo. Objetivo: Apreender as representações que trabalhadores readaptados têm das condições, organização e relações socioprofissionais do contexto de trabalho, onde foram alocados após readaptação, a fim de identificar possíveis fatores psicossociais organizacionais favoráveis ou desfavoráveis para eficácia deste processo Método: Trata-se de uma pesquisa de abordagem quantitativa, com natureza descritiva, segundo o tipo de pesquisa de levantamento. Para a coleta de dados, foi utilizada a Escala de Avaliação do Contexto de Trabalho (EACT) que possibilita a análise de três dimensões: Organização, Condições e Relações Socioprofissionais do Trabalho. Participaram deste estudo 23 trabalhadores, sendo 16 técnicos e 7 auxiliares de enfermagem atuantes em diferentes lotações de um hospital de ensino público. Resultados: Os dados da média bruta das três dimensões ficaram entre 2,3 e 3,69, o que indica um contexto crítico, considerado situação-limite. O contexto de trabalho apresenta aspectos que potencializam o mal-estar, colocando os trabalhadores em risco de adoecimento. Conclusão: Mediante a identificação dos elementos estressores, vê-se a necessidade de produzir ações no sentido de modificar aspectos do contexto de trabalho de modo a eliminar situações estressoras.

Introduction: Psychosocial factors, being facilitators or barriers, have been described as important agents related to return-to-work process. Goals: To understand the representations of the condition, organization and socio-professional relations in the work environment that readapted workers have after being re-allocated. In order to identify possible favorable or unfavorable organizational psychosocial factors for the effectiveness of this process. Method: A quantitative research, with descriptive nature, according to the type of survey. For data collection: We used the Work Environment Impact Scale (WEIS), which allows the analysis of three dimensions: Organization, Condition and Socio-professional labor relations. A total of 23 workers took part in this study, 16 technicians and 7 nursing assistants working in different parts of a public teaching hospital. Results: Data from the gross average of the three dimensions were between 2.3 and 3.69, which indicates a critical context, a limit situation.The work environment presents aspects that enhance malaise, creating a risk of illness for the workers. Conclusion: By identifying the stressful elements, it is possible to modify aspects of the work environment in order to eliminate stressful situations.

Introducción: Los factores psicosociales se han descrito como importantes agentes relacionados con el retorno al trabajo, pudiendo ser facilitadores o barreras en este proceso. Objetivo: Apreciar las representaciones que los trabajadores readaptados tienen de las condiciones, organización y relaciones socio profesionales del contexto de trabajo donde fueron asignados después de la readaptación a fin de identificar posibles factores psicosociales organizacionales favorables o desfavorables para la eficacia de este proceso Método: Se trata de una investigación de abordaje cuantitativa, con naturaleza descriptiva, según el tipo de investigación de estudio de caso. Para la recolección de datos se utilizó la Escala de Avaliação do Contexto de Trabalho (Evaluación de Contexto de Trabajo) que posibilita el análisis de tres dimensiones: Organización, Condiciones y Relaciones Socioprofesionales del Trabajo. Participaron de este estudio 23 trabajadores, siendo 16 técnicos y 7 auxiliares de enfermería actuantes en diferentes locales de un hospital de enseñanza pública. Resultados: Los datos del promedio bruto de las tres dimensiones se situaron entre 2,3 y 3,69; estos indicadores revelan un contexto clasificado como crítico, considerado situación límite. El contexto de trabajo posee aspectos que potencian el malestar, colocando a los trabajadores en riesgo de enfermedad. Conclusión: Mediante la identificación de los elementos estresores, se ve la necesidad de producir acciones en el sentido de modificar aspectos del contexto de trabajo para eliminar situaciones estresantes.

Aspecto psicossocial do ambiente de trabalho de profissionais de enfermagem segundo o modelo demanda-controle / Psychosocial aspect of nursing personnel's work environment according to the demand-control model / Aspecto psicosocial del ambiente de trabajo del personal de enfermería según el modelo demanda control

Objetivo: avaliar o aspecto psicossocial do ambiente de trabalho de profissionais de enfermagem de um hospital universitário. Método: estudo transversal, exploratório e quantitativo realizado com 124 profissionais de enfermagem de um hospital universitário do interior de Minas Gerais, A coleta de dados foi realizada entre os meses de julho e setembro de 2018 e utilizouse a Job Stress Scale (JSS). O presente estudo foi aprovado pelo CEP/UFTM. Resultados: os profissionais foram alocados nos quadrantes do modelo Demanda-Controle e identificou-se a seguinte prevalência: 30,6% na situação de alta exigência; 28,2% na de baixa exigência; 21,8% de trabalho ativo e 19,4% na situação de trabalho passivo. Conclusão: a avaliação do aspecto psicossocial do ambiente de trabalho evidenciou maiores taxas de indivíduos em situação de trabalho de alta exigência entre profissionais de enfermagem atuantes nas enfermarias (41,9%) e no setor de bloco cirúrgico (33,3%).

Objective: to evaluate the psychosocial aspect of the work environment of nursing personnel at a university hospital. Method: in this exploratory, quantitative, cross-sectional study of 124 nursing professionals at a university hospital in Minas Gerais state, data were collected between July and September 2018. The Job Stress Scale (JSS) was used. The study was approved by the research ethics committee of the Universidade Federal do Triângulo Mineiro. Results: participants were allocated to quadrants of the Demand-Control model, and the following prevalences were identified: 30.6% in high-stress situations; 28.2% in lowstress; 21.8% in active work; and 19.4% in passive work. Conclusion: assessment of the psychosocial aspect of the work environment found higher rates of individuals in high-stress jobs among nursing personnel on the wards (41.9%) and in the surgical sector (33.3%).

Objetivo: evaluar el aspecto psicosocial del entorno laboral del personal de enfermería de un hospital universitario. Método: en este estudio exploratorio, cuantitativo y transversal de 124 profesionales de enfermería de un hospital universitario del estado de Minas Gerais, se recolectaron datos entre julio y septiembre de 2018. Se utilizó la Job Stress Scale (JSS). El estudio fue aprobado por el comité de ética en investigación de la Universidade Federal do Triângulo Mineiro. Resultados: los participantes fueron asignados a cuadrantes del modelo Demanda-Control, y se identificaron las siguientes prevalencias: 30,6% en situaciones de alto estrés; 28,2% en bajo estrés; 21,8% en trabajo activo; y el 19,4% en trabajo pasivo. Conclusión: la evaluación del aspecto psicosocial del ambiente de trabajo encontró tasas más altas de individuos en trabajos de alto estrés entre el personal de enfermería en las salas (41,9%) y en el sector quirúrgico (33,3%).

ESPPE debate virtual: os desafios do trabalho e da formação dos trabalhadores técnicos em saúde

ESPPE Debate Virtual - Os desafios do trabalho e da formação dos trabalhadores técnicos em saúde no contexto da COVID-19.

Leadership and job satisfaction in the Mobile Emergency Care Service context.

OBJECTIVE: to evaluate the correlation between the practice of Coaching Leadership performed by nursing coordinators and job satisfaction, in the self-perception of coordinators and the perception of nursing technicians of the Mobile Emergency Care Service. METHOD: a descriptive, correlational study that used the Questionnaire on Self-Perception of the Nurse in the Exercise of Leadership to measure the self-perception of leadership of the eleven nursing coordinators and the Questionnaire on Nursing Technician Perception in the Exercise of Leadership to verify the perception of 155 nurse technicians. The Job Satisfaction Questionnaire assessed job satisfaction in both categories. Correlations among instrument domains were determined using the Spearman test (p<0.05) and the association was analyzed. RESULTS: the Coaching Leadership exercise correlated with job satisfaction (p-value=0.001), both in the self-perception of nursing coordinators, with high correlation (Spearman coefficient - (0.835), and in the perception of nursing technicians, with moderate association (Spearman coefficient - 0.678). CONCLUSION: coaching Leadership showed a positive correlation with job satisfaction, marked by mutual trust, continuous interaction between nurse and nursing technicians, and the pursuit of professional and personal development.

Organizational Trust, Psychological Empowerment, and Organizational Commitment Among Licensed Practical Nurses.

In this study, we examine the influence of organizational trust on organizational commitment among licensed practical nurses (LPNs). Guided by prior research and theory, we also consider whether psychological empowerment mediates the influence of organizational trust on organizational commitment. To accomplish these tasks, we examine data from our survey of all registered LPNs in a Midwestern US state on their levels of organizational trust, psychological empowerment, and organizational commitment. Using path decomposition procedures, we isolate the net effect of organizational trust on organizational commitment into total, direct, and indirect effects. Our findings suggest that organizational trust is positively associated with higher levels of organizational commitment. Furthermore, more than a fifth of this relationship is mediated through one's level of psychological empowerment. These findings provide some insight into antecedents of organizational commitment among LPNs. The results of this investigation are especially timely considering the extant issues associated with staffing levels in facilities employing LPNs in the United States.

Psychometric properties of an instrument measuring communication within and between the professional groups licensed practical nurses and registered nurses in anaesthetic clinics.

BACKGROUND: The most common cause of clinical incidents and adverse events in relation to surgery is communication error. There is a shortage of studies on communication between registered nurses and licenced practical nurses as well as of instruments to measure their perception of communication within and between the professional groups. The aim of the present study was to evaluate the psychometric properties of the Swedish version of the adapted ICU Nurse-Physician Questionnaire, designed to also measure communication within and between two professional groups: licensed practical nurses and registered nurses. Specifically, the aim was to examine the instrument's construct validity using confirmatory factor analysis and its internal consistency using Cronbach's Alpha. METHODS: A cross-sectional and correlational design was used. The setting was anaesthetic clinics in two Swedish hospitals. A total of 316 questionnaires were delivered during spring 2011, of which 195 were analysed to evaluate the psychometric properties of the questionnaire. Construct validity was assessed using confirmatory factor analysis and internal consistency using Cronbach's Alpha. To assess items with missing values, we conducted a sensitivity analysis of two sets of data, and to assess the assumption of normally distributed data, we used Bayesian estimation. RESULTS: The results support the construct validity and internal consistency of the adapted ICU Nurse-Physician Questionnaire. Model fit indices for the confirmative factor analysis were acceptable, and estimated factor loadings were reasonable. There were no large differences between the estimated factor loadings when comparing the two samples, suggesting that items with missing values did not alter the findings. The estimated factor loadings from Bayesian estimation were very similar to the maximum likelihood results. This indicates that confirmative factor analysis using maximum likelihood produced reliable factor loadings. Regarding internal consistency, alpha values ranged from 0.72 to 0.82. CONCLUSIONS: The tests of the adapted ICU Nurse-Physician Questionnaire indicate acceptable construct validity and internal consistency, both of which need to be further tested in new settings and samples. TRIAL REGISTRATION: Current controlled trials http://www.controlled-trials.com Communication and patient safety in anaesthesia and intensive care. Does implementation of SBAR make any differences? Identifier: ISRCTN37251313, retrospectively registered (assigned 08/11/2012).

The Similarities and Differences in Transition to Practice Experiences for New-Graduate RNs and Practical Nurses in Long-term Care.

OBJECTIVE: The aim of this study was to describe the transition-to-practice experience of new-graduate nurses (NGNs) in long-term-care (LTC) settings. BACKGROUND: Transitioning to professional practice is a challenging time for an NGN. This experience is scarcely described for RNs outside of acute care settings and not described for the LPN. METHODS: A qualitative case study was used to explore the described transition-to-practice experience of new-graduate RNs and LPNs in LTC. RESULTS: This study revealed that the transition-to-practice experience of new-graduate LPNs was similar to the experience described by RNs. Differences in experience were related to leadership roles in the setting. CONCLUSIONS: Findings contribute to new understanding of the experience of the NGN in LTC settings. This study reinforces the need for greater support for nursing graduates in this setting.

Rural and Remote Licensed Practical Nurses' Perceptions of Working Below Their Legislated Scope of Practice.

Over the past two decades in Canada, licensed or registered practical nurses (LPNs) have experienced an extension of their educational preparation and scope of practice. Simultaneously, there has been an increase in the number of LPNs employed in rural and remote communities. These changes have influenced the practice environment and LPNs' perceptions of their work. The aim of this article is to examine what factors predict rural and remote LPNs' perceptions of working below their legislated scope of practice and to explore their perceptions of working below scope. The findings arise from a national survey of rural and remote regulated nurses, in which 77.3% and 17.6% of the LPNs reported their practice as within and as below their legislated scope of practice, respectively. Three factors, age, stage of career and job-resources related to autonomy and control, predicted that LPNs would perceive themselves to be working below their scope of practice. These results suggest that new ways to communicate nurses' scope of practice are needed, along with supports to help rural and remote LPNs more consistently practice to their legislated scope of practice. Without such changes, the LPN role cannot be optimized and disharmony within rural and remote settings may be exacerbated.

Do Uncivil Nursing Students Become Uncivil Nurses? A National Survey of Faculty.

BACKGROUND: Faculty frequently express anecdotal concerns that poorly behaving nursing students will go on to behave poorly as licensed nurses. Unfortunately, no empirical evidence exists to support or refute these concerns. AIM: The purpose of this study was to determine what knowledge faculty have of poorly behaving nursing students who also behaved poorly in subsequent practice. METHOD: A cross-sectional, descriptive design using online survey methods was used to gather data from a national sample of nurse educators. RESULTS: Approximately 37 percent of respondents reported having personal knowledge of a former poorly behaving student who went on to display poor behavior as a licensed provider; 71 percent reported that at least one student had graduated in the previous year whom they thought should not have graduated based on unprofessional behaviors. CONCLUSION: Study findings provide troubling evidence that at least some poorly behaving students continue to demonstrate unprofessional behavior as licensed nurses.

Collaboration among registered nurses and practical nurses in acute care hospitals: A scoping review.

AIM: This study examined the extent, range, and nature of registered nurse (RN) and practical nurse (PN) collaboration in acute care hospitals and identified research gaps in the existing literature. BACKGROUND: Optimal patient care requires collaboration between RNs and PNs. A lack of unity and unresolved tension among different types of nurses influences collaboration and has significant implications on practice and the organizations where nurses work. METHODS: Using Arksey and O'Malley's (2005) framework, a scoping review was undertaken to answer the research question: what is known from the existing literature about the structures, processes, and outcomes of RN-PN collaboration in hospitals? RESULTS: Twenty-nine studies were included with the majority coming from North America. Donabedian's model assisted with the identification of three themes: scope of practice, interpersonal skills, and nurse and patient-related outcomes. CONCLUSION: The findings demonstrate there is a paucity of research specific to RN-PN collaboration. Nurse administrators/managers play an important role in addressing the interpersonal skills of nurses and providing an ongoing education on collaboration in the practice setting. Additional studies should focus on the development of nursing collaborative practice models of patient care, the examination of interventions to improve RN-PN collaborative practice, and the assessment of outcomes relating to collaboration among nurses.

Transitioning to practice in long-term care: New graduate nurses' experience of an accelerated transition to nurse leader.

AIM: To describe the transition to practice experience of new graduate nurses in long-term care. BACKGROUND: Nursing is facing increasing pressures related to outpaced demands and a greater acuity of patients accessing services. Hiring new graduate nurses into long-term care (LTC) is a strategy to counteract these pressures, however, little is known about the transition experience of new graduate Registered and Licensed Practical Nurses in this setting. DESIGN: A qualitative, explanatory case-study design explored the transition to practice experience of seven new graduate nurses and the observations of two LTC directors from two homes. The study focused on the self-described transition to practice experience and those contextual factors present in LTC that influenced this experience. METHODS: Thematic analysis of semi-structured interview transcripts and key document review were completed in 2017. RESULTS: Results of this study introduced contextual factors that must be considered in LTC as each influences the transition to practice experienced by new graduate nurses. These factors included five processes that resulted in an accelerated transition to practice experience: (a) struggling to meet expectations; (b) practicing in isolation; (c) relying on others; (d) developing skill and confidence despite challenges; and (e) recognizing complexity and value in LTC practice. CONCLUSION: The findings from this study refute universally applied transition to practice theory and contribute new understanding of the experience of the new graduate nurses in LTC settings. This study reinforces the need for greater support for nursing graduates in LTC settings.

Practical Nurses' Lived Experience of Returning to School.

The lived experience of licensed practical nurses (LPNs) pursuing Bachelor of Nursing (BN) education is not commonly studied in Canada. The aim was to understand the transition experience of LPNs who bridged into a BN program. Max van Manen's phenomenological methodology was used through use of a semistructured interview guide to explore the lived experience of LPNs who pursued baccalaureate nursing education. Five themes were found: seeking advancement; stepping back into the student role; juggling work, school, and family; struggling to be understood; and seeing things differently. In summary, LPN-to-BN students have a well-developed sense of identity as nurses. These students can benefit from a specifically designed, stand-alone bridge course to situate them within a BN program that leads to successful fulfillment of entry-to-practice competencies for RN licensure.

Impactos da Síndrome de Burnout na qualidade de vida dos profissionais de enfermagem da atenção básica à saúde / Impacts of burnout syndrome on the quality of life of basic health care nursing professionals

Objetivo: Identificar o impacto da Síndrome de Burnout (SB) na qualidade de vida dos profissionais de enfermagem da Atenção Básica à Saúde. Métodos: Estudo exploratório e descritivo, com caráter quanti-qualitativo, desenvolvido com 52 profissionais da Rede de Atenção Básica à Saúde da Cidade de Bayeux, região metropolitana de João Pessoa-PB. Resultados: 13,5% das pro-fissionais estudadas manifestaram características relacionadas à SB e 30,8% apresentaram predisposição para o desenvolvi-mento da mesma. Conclusão: O profissional acometido pela SB tende a apresentar diminuição em seu rendimento de trabalho e dificuldades na relação com a equipe de trabalho, refletindo o impacto negativo que a síndrome traz para a qualidade de vida. (AU)

Objective: To identify the impact of the Burnout Syndrome (SB) on the quality of life of nursing professionals in Basic Health Care. Methods: An exploratory and descriptive study, with quantitative and qualitative character, developed with 52 professionals from the Network of Basic Attention to Health of the city of Bayeux, metropolitan region of João Pessoa-PB. Results: 13.5% of the professionals studied showed character-istics related to SB, and 30.8% presented a predisposition for its development. Conclusion: the professional affected by SB tends to present a decrease in his work income and difficulties in the relationship with the work team, reflecting the negative impact that the syndrome brings to the quality of life. (AU)

Information literacy skills and training of licensed practical nurses in Alberta, Canada: results of a survey.

BACKGROUND: Although information literacy skills are recognized as important to the curriculum and professional outcomes of two-year nursing programs, there is a lack of research on the information literacy skills and support needed by graduates. OBJECTIVE: To identify the information literacy skills and consequent training and support required of Licensed Practical Nurses (LPNs) in Alberta, Canada. METHOD: An online survey using a random sample of new graduates (graduated within 5 years) from the registration database of the College of Practical Nurses of Alberta (CLPNA). RESULTS: There was a 43% response rate. Approximately 25-38% of LPNs felt they were only moderately or to a small extent prepared to use evidence effectively in their professional practice. LPNs use the internet and websites most frequently, in contrast to library resources that are used least frequently. Developing lifelong learning skills, using information collaboratively, and locating and retrieving information are areas where LPNs desire more effective or increased training. CONCLUSION: The results suggest there are significant gaps in the preparedness and ability of LPNs to access and apply research evidence effectively in the workplace. There are several areas in which the training provided by Librarians appears either misaligned or ineffective.

Comparison of reports of missed nursing care: Registered Nurses vs. practical nurses in hospitals.

BACKGROUND: Missed nursing care is an error of omission defined as standard, required nursing care that is not completed or is seriously delayed. Study findings from around the world show that missed nursing care is a global concern. PURPOSE: The purpose of this study was to compare reports of missed nursing care by two types of nurses - registered nurses and practical nurses - in acute care hospitals in Iceland. Former studies in the USA indicate a variance in reports of missed nursing care by staff with different roles. METHODS: This was a cross-sectional descriptive study using the MISSCARE Survey-Icelandic questionnaire for data collection. The questionnaire asks about the amount of missed nursing care on the unit for 24 nursing elements (Part A) and 17 reasons of care being missed (Part B). Participants were nursing staff from medical, surgical and intensive care units in all hospitals in Iceland. FINDINGS: A t-test for independent groups showed a significant difference for the overall missed nursing care score (Part A) between registered nurses (M = 2.09, SD = 0.51) and practical nurses (M = 1.82, SD = 0.59) [t(541) = 5.703, p < 0.001]. A comparison of the overall mean score for reasons of missed nursing care (Part B) between registered nurses (M = 2.32, SD = 0.38) and practical nurses (M = 2.21, SD = 0.62) indicated a significant difference in their reporting [t(299) = 2.210, p = 0.028]. In spite of the overall significant difference in ratings of the elements and reasons for missed nursing care by registered nurses and practical nurses, a pattern is evident in the ranking of the elements of nursing care being missed and reasons. CONCLUSIONS: The findings of this study point to the need to acknowledge certain aspects of missed nursing care and the different roles within nursing. They indicate a need to improve open, sincere and structured communication and mutual respect and trust within healthcare teams in Icelandic hospitals.

Building Capacity for Evidence-Based Practice: Understanding How Licensed Practical Nurses (LPNs) Source Knowledge.

BACKGROUND: In Canada, all nurses are required to engage in evidence-based practice (EBP) as an entry-to-practice competency; however, there is little research that examines Licensed Practical Nurses' (LPNs') information seeking behaviors or preferred sources of knowledge to conduct EBP. AIMS: Due to the differences in education and roles of LPNs and Registered Nurses (RNs), it is both necessary and important to gain an understanding of how LPNs utilize evidence in their unique nursing practice. The purpose of this study was to investigate how LPNs source knowledge for their nursing practice. METHODS: A descriptive, cross-sectional survey of LPNs from Alberta, Canada asked participants to rank sources of knowledge that inform their practice. Responses were correlated with age and years of practice. Analysis of variance was used to determine if there were significant mean differences between average scores and place of employment. RESULTS: LPN participants used similar sources of knowledge as RNs. The top source of knowledge for both RNs and LPNs was the information they learn about each individual client and the least utilized sources of knowledge were articles published in nursing, medical, and research journals, tradition, and popular media. This finding is consistent with previous studies on RNs that found nurses do not often access current research evidence to inform their practice. LINKING EVIDENCE TO ACTION: Since relatively few LPNs access nursing and research journals, it is important to tailor EBP education information to the workplace context. Future avenues of research might explore the potential of using in-services and webinars to disseminate information and skills training on EBP to the LPNs, as this was a popular source of practice knowledge.