Journal of Nursing Management最新文献

Introduction: Using the COVID-19 pandemic as an example of a national and international crisis, it has been possible to show how critical care nurses (CCNs) were affected by their work situation with impact on health and wellbeing. This study sought out to investigate how CCNs stress was affected and to provide some answers as to how to react and organize care in a future crisis. The specific focus was CCNs’ stressors related supervision of nurses untrained in intensive care and how these were handled in a salutogenic perspective.

Aim: The aim of this study was to analyze CCNs’ experiences of supervision of nurses without training in intensive care during the COVID-19 pandemic, and to analyze these experiences with the help of the salutogenic concept sense of coherence.

Materials and Methods: The phenomena under study were explored during the years of 2021–2022 through in-depth interviews and interpreted using deductive content analysis.

Results: By analyzing CCNs experiences of supervising nurses without training in intensive care with the lens of sense of coherence, it was possible to show in what way these concepts influenced how to cope with the demanding situation. Sense of coherence was influenced by the inevitable prioritization of patient care and nursing interventions. This prioritization caused moral distress, but was also enhanced or decreased by CCNs sense of coherence.

Conclusion: When recruiting and introducing new personnel in a future crisis to any field of healthcare, but particularly to the intensive care, we would, on the basis of these findings, suggest that well-established plans are vital for how to move personnel throughout the organization, and for how to introduce the field of intensive care. Plans for how to model care with the help of RNs without specialist training should be put in place. A communication plan for the organization is also of importance to enhance transparency.

Introduction: Nurses, as frontline healthcare professionals, play a crucial role in ensuring patient safety, making their ability to speak up imperative. However, there are limited studies categorizing nurses based on their speaking-up behaviors and comparing their organizational characteristics. This study aimed to identify patterns of nurses’ speaking-up behaviors and examine differences in organizational cultures, teamwork climates, and working conditions according to these patterns.

Methods: A cross-sectional survey was conducted, involving 597 nurses directly participating in nursing care in Korean hospitals. The Speaking Up about Patient Safety Questionnaire (SUPS-Q), Nursing Organizational Culture Questionnaire, and Safety Attitude Questionnaire-Korean version (SAQ-K) were employed to measure nurses’ speaking-up-related behaviors, organizational culture, teamwork climate, and working conditions. Cluster analysis was used to identify clusters of nurses based on their speaking-up-related behavior. Differences in nursing organizational culture, teamwork climate, and working conditions among clusters were analyzed using one-way analyses of variance.

Results: Three clusters of nurses were identified based on their speaking-up-related behaviors. Cluster 1 (35%) showed high perceived concerns, moderate withholding, and speaking up, while Cluster 2 (37%) had moderate concerns, low withholding, and high speaking up. Cluster 3 (28%) had moderate concerns but low withholding and speaking up. Clinical experience significantly differed among clusters, with less experienced nurses predominantly in Cluster 1. Cluster 2 had the most collaborative culture, best teamwork climate, and working conditions.

Conclusion: Ensuring patient safety requires nurses to speak up about patient safety concerns. Creating safe working environments and fostering an organizational culture that prioritizes patient safety are essential steps in promoting nurses’ willingness to speak up about patient safety.

Aim: The present study aims to analyze the presence of gender stereotypes in the metaphors nurse clinicians use to describe their patients.

Methods: This study was conducted with 149 nurse clinicians working at a university hospital. Data were collected using a metaphor survey.

Results: The most common metaphors for female patients were “flower” (f: 23) and “mother/my mother” (f: 8), whereas the most common metaphors for male patients were “wood” (f: 10) and “cactus” (f: 7). These metaphors were more frequently produced by female nurses. Female patients were often described as “delicate, in need of attention and help, and fragile,” while male patients were described as “strong, authoritative, head of the family, and tough.” Female nurses likened a more delicate male patient to a “delicate woman,” and male nurses likened the strength of a male patient to a “man.” Furthermore, eight nurses, five male nurses and three female nurses, frequently used the metaphor of “patient” (f: 6) while stating that they did not view patients as female or male. Male nurses (f: 4) produced the metaphor of “patient” (f: 6) the most.

Conclusion: It is important not to overlook the factors underlying the metaphors produced by nurse clinicians. In this regard, extensive studies are needed to take into account additional factors such as cultural background, experience, or specific patient interactions that may have a major impact on how nurses perceive gender.

Implications for Nursing Management: This study evaluates nurse clinicians’ perceptions of patients in the context of gender stereotypes and highlights some important points in terms of nursing and patient care.

Introduction: The need for innovative technology in healthcare is apparent due to challenges posed by the lack of resources. This study investigates the adoption of AI-based systems, specifically within the postanesthesia care unit (PACU). The aim of the study was to explore staff needs and expectations concerning the development and implementation of a digital patient flow system based on ML predictions.

Methods: A qualitative approach was employed, gathering insights through interviews with 20 healthcare professionals, including nurse managers and staff involved in planning patient flows and patient care. The interview data were analyzed using reflexive thematic analysis, following steps of data familiarization, coding, and theme generation. The resulting themes were then assessed for their alignment with the modified technology acceptance model (TAM2).

Results: The respondents discussed the benefits and drawbacks of the proposed ML system versus current manual planning. They emphasized the need for controlling PACU throughput and expected the ML system to improve the length of stay predictions and provide a comprehensive patient flow overview for staff. Prioritizing the patient was deemed important, with the ML system potentially allowing for more patient interaction time. However, concerns were raised regarding potential breaches of patient confidentiality in the new ML system. The respondents suggested new communication strategies might emerge with effective digital information use, possibly freeing up time for more human interaction. While most respondents were optimistic about adapting to the new technology, they recognized not all colleagues might be as convinced.

Conclusion: This study showed that respondents were largely favorable toward implementing the proposed ML system, highlighting the critical role of nurse managers in patient workflow and safety, and noting that digitization could offer substantial assistance. Furthermore, the findings underscore the importance of strong leadership and effective communication as key factors for the successful implementation of such systems.

Aim: To examine the prevalence of dysmenorrhea in the predominantly female nursing profession and investigate the role of occupational characteristics in dysmenorrhea.

Background: Studies on working women have mostly examined the effects of dysmenorrhea symptoms on work performance, as opposed to shedding light on the association between work-related characteristics and dysmenorrhea.

Methods: In this cross-sectional study, we used data obtained from survey 9 of the Korea Nurses’ Health Study. The participants were female nurses of childbearing age. Statistical analysis included descriptive statistics and multivariable logistic regression.

Results: Data from 6697 participants were analyzed. Of the total sample, 47.3% had dysmenorrhea. After adjusting for confounders to examine the relationship between occupational characteristics and dysmenorrhea, the odds for dysmenorrhea were 1.230 times higher among women who lifted heavy objects at least six times a day compared to those who did not engage in heavy lifting (95% confidence interval: 1.028–1.473) and 1.042 times higher among women with higher physical fatigue (odds ratio: 1.042, 95% confidence interval: 1.023–1.061).

Conclusion: The findings clarify the potential for reducing dysmenorrhea through the improvement of work environment factors. Thus, this study may prove useful for developing educational programs and policies that aim to alleviate dysmenorrhea among working women, including nurses.

Implications for Nursing Management: Nursing managers and health policymakers need to understand the factors influencing dysmenorrhea and minimize female nurses’ physical burden by implementing appropriate nurse–patient ratios and improving their work environment.

Background: Organizational turnover exacerbates the shortage of nurses in the global workforce. However, no study has yet explored how deep structure usage—nurses’ integration of electronic patient records into nursing practice delivery—reduces their turnover intention and moderates the impact of affective, continuance, and normative professional commitment on their turnover intention.

Aims: To ascertain (1) the linkage between the deep structure usage of electronic patient records and nurses’ organizational turnover intention and (2) the moderating role of deep structure usage on the associations between elements of commitment (affective, continuance, and normative) and turnover intention.

Methods: Using a cross-sectional survey and proportionate random sampling by ward unit, we collected data from 417 full-time nurses via a self-administered questionnaire. We performed hierarchical regression analyses to test the study hypotheses.

Results: Deep structure usage was not directly related to organizational turnover intention (β = −0.07, p = 0.06). However, the results suggested that deep structure usage may enhance the effect of high affective commitment on nurses’ organizational turnover intention (β = −0.09, p = 0.04), while potentially mitigating the effect of low continuance commitment on organizational turnover intention (β = 0.10, p = 0.01).

Conclusions: Deep structure usage of electronic patient records helps to ease nurses’ workload and facilitates their retention, which is particularly due to their affective commitment (attachment) but not their continuance commitment (switching costs).

Implications for Nursing Management: Nursing management may advise hospital management that medical records systems need to be improved and fully embedded for nursing care delivery, as a more in-depth use of these systems can help to retain nurses.

Purpose: Nursing is a representative profession with a high prevalence of presenteeism, which is usually associated with negative outcomes. Therefore, it is important to explore the antecedent factors of nurse presenteeism behavior. This study aims to explore the impact and mechanism of head nurses’ cognitive preference toward presenteeism on subordinate nurses’ presenteeism (SNP), and the mediation effects of subordinate nurses’ perception of head nurses’ cognitive preference.

Patient and Methods: A cross-sectional study was conducted from July to August 2022. A total of 256 head nurses and 1424 subordinate nurses were recruited from six hospitals located in Zhengzhou, Henan Province, China. The Nurse Presenteeism Questionnaire (NPQ) and Cognitive Preference Questionnaire were used to assess head nurses’ cognitive preference toward presenteeism, SNP, and subordinate nurses’ perception of head nurse’s cognition of presenteeism. We conducted description, multilevel correlation, and multilevel structural equation models for the data analysis.

Results: In the past 6 months, 93.4% of nurses experienced presenteeism. Within and between the team, head nurses’ cognitive preference toward presenteeism is positively associated with SNP. The mediation effect of nurses’ perception of head nurses’ cognitive preference was also significant.

Conclusion: Head nurses’ cognitive preferences are essential predictors of subordinates’ presenteeism. In this process, subordinates’ subjective initiative plays a crucial role.

Implications for Nursing Management: Hospital managers should focus on head nurses’ values to formulate multiple interventions of presenteeism and strengthen communication between leaders and subordinates to promote transforming negative outcomes into positive outcomes.

Background:​ Empathy is a fundamental component of the therapeutic relationship between healthcare providers and patients and has the potential to yield significant benefits, including heightened care satisfaction, enhanced care quality, and improved mental well-being for patients. As nursing assistants (NAs) are primary direct care providers in long-term care facilities (LTCFs), it is necessary to understand NAs’ views on empathy in their care provision for residents, but a gap exists in the literature regarding NAs’ perspectives on empathy in this context.

Aim: In this study, we aimed to explore perceptions of empathy among NAs in LTCFs.

Research Design: A qualitative approach was applied in this study.

Participants and Research Context: Through purposive and snowball sampling, 18 NAs who provided care for residents in six LTCFs in Taiwan were recruited. Face-to-face in-depth interviews were conducted using a semistructured interview guide, and data were analyzed using a content analysis.

Ethical Considerations: Ethical approval was obtained from the Institutional Review Board. All participants signed a written informed consent form prior to the interview.

Results: Four themes encompassing 11 categories were generated including “being fundamental to caregiving to establish trust and enhance quality care,” “practicing altruistic behavior in the pursuit of ethical caregiving,” “cycling empathic flow in care,” and “facing challenges in delivering empathetic care.”

Conclusions: NAs in LTCFs viewed empathy as an essential element of the caregiving process. They saw empathy as selfless care, assistance to others, and alleviation of residents’ suffering. Understanding residents’ emotions, thoughts, and needs, active listening and compassionate engagement were vital to expressing empathy. However, NAs faced challenges in expressing empathy due to demanding tasks, time limitations, and insufficient knowledge and communication skills. In addition, emotional desensitization further complicated the provision of empathic care. The findings of this study can provide information for nurse managers and directors to understand NAs’ perspectives on empathy and difficulties when providing empathic care in the long-term care context.

Aim(s): To understand how nurses experience their positioning amidst hospital crises.

Background: Nursing leadership literature is predominantly focused on the skills and competencies of nurses and less on the relations in practice with nurses. Nurses are often valued for bedside care but are overlooked in strategic decision-making during crises. Foundational research emphasizes the need for nurses’ equal participation in interprofessional healthcare practices and governance.

Methods: We conducted a qualitative interpretive interview and focus group study, amidst the COVID-19 crisis. We interviewed 64 chairs of nurse councils and deepened our understanding of our initial findings in four focus groups with 34 participants.

Results: Nurses differ widely on (a) what is important to them in crisis management, (b) how they can contribute to crisis management, and (c) how they value their involvement or lack of it. Furthermore, we uncovered three relational leadership struggles for nurses concerning (1) navigating, (2) positioning, and (3) collaborating, in crisis management structures.

Conclusion: The ailing positioning and representation of nurses in crisis management result from their limited participation in strategic decision-making, and the lack of intervention on this by board members, physicians, and managers.

Implications for Nursing Management: This study highlights the need for agents such as board members, managers, physicians, and nurses themselves to create clear frameworks and policies that define nurses’ roles in crisis situations, emphasizing the importance of addressing power dynamics and enhancing communication and collaboration in hospital settings. Effective crisis management requires involving nurses from the start, providing regular training, and promoting a more equal approach to teamwork. Understanding relational leadership and its impact during crises can empower nurses and improve overall hospital crisis response.

Aims: This study examines the contribution of top management’s transformational leadership behaviors on two targets of nurses’ turnover intention (organization and occupation) by focusing on the indirect (through vigor and dedication) and conditional indirect associations (involving autonomous motivation as a moderator).

Background: Although the issue of nurse turnover has received growing scientific attention, the research is currently silent about the specific targets of turnover intention and more importantly, the potential pathways through which top management’s transformational leadership behaviors relate to each target.

Method: Cross-sectional data from a sample of 426 French–Canadian nurses and structural equation modeling were used to test the proposed model.

Results: Top management’s transformational leadership behaviors distinctly predicted organizational and occupational turnover intention through specific nurses’ states of engagement. While perceived transformational leadership positively predicted vigor, its indirect associations (via dedication) with organizational and occupational turnover intention depend on nurses’ level of autonomous motivation at work.

Conclusion: In times of nurse shortage, the present findings provide insights into how and when top management’s transformational leadership behaviors relate to nurses’ organizational and occupational turnover intention.

Implications for Nursing Management: Healthcare organizations are advised to foster top management transformational leadership behaviors and autonomous motivation to sustain the nursing workforce.