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.

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.

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.

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.

Teoria das Representações Sociais e os Sentidos da Aposentadoria no Brasil / Theory of Social Representations and the Meanings of Retirement in Brazil / Teoría de las Representaciones Sociales y los significados de la jubilación en Brasil

Objetivo: refletir acerca das contribuições da Teoria das Representações Sociais para a compreensão dos sentidos da aposentadoria no Brasil. Conteúdo: trata-se de um estudo teórico-reflexivo elaborado com base em leitura crítica de artigos científicos, disponíveis on-line em diversas bases de dados e obras clássicas sobre a teoria das representações sociais bem como aquelas relativas ao fenômeno da aposentadoria. Estrutura-se em duas seções: i) Teoria das Representações Sociais e ii) Os sentidos da Aposentadoria no Brasil. Considerações finais: verifica-se que pesquisas utilizando a teoria das representações sociais possibilitam conhecer o modo como a aposentadoria é compreendida por diferentes grupos sociais e, assim, fornecer subsídios para melhor orientar estes grupos tanto durante o planejamento da aposentadoria quanto na decisão de aposentar-se ou não.

Objective: to reflect on the contributions of the Theory of Social Representations to understanding the meanings of retirement in Brazil. Content: this theoretical-reflective study, based on a critical reading of scientific articles available online in databases and both classic studies of social representations theory and studies of the phenomenon of retirement, is divided into two sections: i) Theory of Social Representations and ii) The meanings of retirement in Brazil. Final remarks: research using the social representations theory was found to help understand how retirement is understood by different social groups and, thus, provide input to guide these groups better, both during retirement planning and in deciding whether or not to retire.

Objetivo: reflexionar sobre los aportes de la Teoría de las Representaciones Sociales para la comprensión de los significados de la Jubilación en Brasil. Contenido: se trata de un estudio teórico-reflexivo basado en la lectura crítica de artículos científicos, disponibles en línea en varias bases de datos y obras clásicos sobre la teoría de las representaciones sociales, así como las relacionadas con el fenómeno de la jubilación. Se divide en dos apartados: i) Teoría de las Representaciones Sociales y ii) Los significados de la jubilación en Brasil. Consideraciones finales: se constata que investigaciones que utilizan la teoría de las representaciones sociales pueden ayudar a conocer la forma cómo los diferentes grupos sociales entienden la jubilación y, por lo tanto, proporcionar subsidios para orientar mejor a estos grupos, tanto durante la planificación de la jubilación, como en la decisión de jubilarse o no.

Consequences of Nurse Presenteeism in Switzerland and Portugal and Strategies to Minimize It: A Qualitative Study.

Nurses exhibit higher rates of presenteeism than other professionals, with consequences for the quality of care and patient safety. However, nurses' perceptions of these issues have been poorly explored. This study investigated the perceptions and experiences of frontline nurses and nurse managers in Switzerland and Portugal about the consequences of presenteeism and strategies to minimize it in different healthcare settings. Our qualitative study design used video focus groups involving 55 participants from both countries. Thematic analysis of their transcribed discussions revealed six themes surrounding the consequences of presenteeism: the personal impact on nurses' health and wellbeing, on their family relationships, and on professional frustration and dissatisfaction; the professional impact on work dynamics; the social impact on the quality of care and patient safety and on society's impressions of the profession. At the individual, collective, and institutional levels, six strategies were evoked to minimize presenteeism: encouraging professionals' self-knowledge; creating a positive work atmosphere; facilitating communication channels; developing a positive organizational culture; implementing preventive/curative institutional interventions; identifying and documenting situations linked to presenteeism. Nurses' perceptions and experiences provided a deeper understanding of their presenteeism and revealed underused pathways toward preventing and minimizing presenteeism via bottom-up approaches.

Effects of Online Teaching during the COVID-19 Pandemic on Nursing Students' Intention to Join the Nursing Workforce: A Cross-Sectional Study.

Nursing education programs were interrupted and largely moved online as a result of the COVID-19 pandemic. The purpose of this study was to explore Taiwanese nursing students' perspectives on online teaching during the COVID-19 pandemic and whether changes in teaching models have affected their intention to join the nursing workforce. A multi-center cross-sectional survey was conducted. Nursing students at universities and those at 5-year junior colleges were recruited to participate in the study. Data were collected through an online questionnaire survey. A total of 687 students responded to the questionnaire. The results were analyzed using percentages, mean ranks, and nonparametric methods. The results showed that 78.6% of the students agreed that online teaching was more flexible; most students stated that technical problems with computer equipment and stability of the network were large challenges that impeded online teaching. Furthermore, up to 64.8% of the students considered that online courses had affected their preparations for future nursing jobs, especially in terms of a lack of proficiency in nursing skills and inadequacy in actual interactions with patients. Online teaching is a powerful tool for nursing education, but a thoughtful strategy and more proactive approach are necessary to overcome the existing challenges for online teaching.

Quality of nursing work life, job satisfaction, and intent to leave among Jordanian nurses: A descriptive study.

Background: Nurses' intentions to leave their job are considered among the several difficulties encountered by any health system. Quality of nursing work life (QNWL) and job satisfaction are among the significant factors that impact this intention. Purpose: To explore the relationship between quality of work-life job satisfaction and the intention to leave among registered nurses (RNs) in Jordanian hospitals. Methods: A cross-sectional study using a self-administered questionnaire was conducted to collect data from 200 RNs from three hospitals in Jordan to measure the main variables from July 11 to 25,2020. Data were analyzed using descriptive and inferential statistics using SPSS version 25. Results: A total of 193 RNs participated in the study and were moderately satisfied with their quality of work life and job satisfaction. QNWL correlated positively with job satisfaction (r = 0.579, p = 0.000) and negatively with intent to leave (r s = - 0.204, p-value = 0.002). Job satisfaction was negatively correlated with the intent to leave (r s = - 0.174, p-value = 0.008). Sociodemographic and work-related variables (hospital type, sex, educational level, and salary) showed significant differences and correlations with at least one of the main variables. Conclusion: This study's results can be used by health care managers and policymakers to implement successful plans and policies to improve the QNWL and job satisfaction of RNs. This, in turn, may assist in enhancing individual and organizational performance; improving home and job environments; increasing nurses' commitment and increasing nursing retention. Further research is needed to develop effective measures for enhancing QNWL and job satisfaction among RNs.

Same place but different experience: A qualitative study on gender and the nursing work environment.

AIM: This study aimed to reveal the opinions and experiences of male and female nurses concerning the nursing work environment in hospitals. BACKGROUND: The quality of the nursing work environment greatly impacts the improvement of the patient, nurse and organizational outcomes. Therefore, a better understanding of the experiences of male and female nurses can contribute to the creation of a more positive work environment. METHODS: In this descriptive qualitative study, data were collected with semi-structured interviews conducted in 2020 with 18 nurses who were recruited via purposive and maximum variation sampling. Data was analysed with content analysis. RESULTS: The content analysis revealed two major themes (the effects of gender on workplace practices and the image of nursing and gendered communication in the nursing work environment) and eight subthemes. CONCLUSION: This study concluded that male and female nurses experience advantages/disadvantages and similarities/differences in the nursing work environment and that both male and female nurses experience challenges regarding workplace relations and the work environment. IMPLICATIONS FOR NURSING MANAGEMENT: A better understanding of the problems associated with the different experiences of male and female nurses in the workplace may help nurse managers to create a more positive work environment.

The Demand for Specialization and Its Influence on the Design of Inpatient Nursing Units: Can Standardized Design Be Done Once and for All?

OBJECTIVES: This study explores the specialized nursing requirements of different clinical departments and their influence on the design of nursing units, which ultimately improves the nursing staff's efficiency and work experience. BACKGROUND: Specialization of nursing work is important in the provision of quality of healthcare. Most of the research related to nursing units has focuses on general medical-surgical nursing units and has not differentiated between clinical departments. METHOD: This study was conducted in one inpatient building at a large general hospital in China. Survey data were collected from 11 clinical departments via questionnaire, and interviews were conducted in 10 of the clinical departments. RESULTS: All 11 clinical departments had significant differences in their evaluations of and requirements for the arrangement of their physical space. Specialized requirements were found in three areas: nursing work processes, arrangement and needs of clinical spaces, and allocation of facilities and equipment. CONCLUSION: Evaluation of the specialized requirements of different clinical departments would contribute to the body of knowledge on nursing unit design and has a positive effect on the development and improvement of design theory. Suggestions for how the design of nursing units could be improved to support the specialized demands of different departments are provided.

Appraisal and evaluation of the instruments measuring the nursing work environment: A systematic review.

AIMS: To appraise the current instruments available for measuring the nursing work environment and re-examine the definition and construct of the nursing work environment. BACKGROUND: A psychometrically sound instrument is fundamental to understanding and improving the nursing work environment. The nursing work environment is a complex construct, and its definition remains inconclusive. None of the instruments available is considered as the gold standard. EVALUATION: A comprehensive searching was undertaken in August 2021 in six databases according to PRISMA. The COSMIN and modified GRADE were applied to assess the methodological quality and measurement properties of the instruments. Instruments were categorized into three levels. The definition and construct of nursing work environment were revisited. KEY ISSUES: Forty-one studies (19 instruments) were included. One, fourteen, and four instruments are respectively appraised as A-, B- and C-level recommendation. Definition and eight labels of nursing work environment are identified. CONCLUSION: This paper provides recommendations for selecting a proper instrument for the nursing work environment. IMPLICATIONS FOR NURSING MANAGEMENT: This study helps nurse managers to select instruments and understand the construct of the nursing work environment. The eight labels can be used as a reference for tailoring policy aimed at creating a favourable nursing work environment.