Journal of Nursing Management最新文献

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.

Aim: To translate the Rushton Moral Resilience Scale (RMRS) into Japanese and validate its applicability among Japanese healthcare professionals.

Background: To overcome daily challenges in the field of healthcare, in which moral difficulties are routinely encountered, the development of intervention methods to address moral suffering and moral distress is crucial.

Methods: We conducted a cross-sectional survey using a web-based questionnaire. The RMRS-16 was translated into Japanese and confirmed through back-translation. Reliability analyses (Cronbach’s alpha and intraclass correlation coefficient [ICC]), confirmatory factor analyses (CFAs), correlation analyses, t-tests, and analysis of variance (ANOVA) were used to assess the validity of the scale.

Results: Participants comprised 1295 healthcare professionals, including 498 nurses. All subscales and the total scale had acceptable reliability values (α ≥ 0.70). CFA supported the original four-factor structure (response to moral adversity, personal integrity, relational integrity, and moral efficacy), with acceptable fit indices. The ANOVA results suggested that, among Japanese healthcare professionals, nurses and individuals from other professions showed lower average moral resilience scores compared to physicians, consistent with previous research on mental health and moral distress. In addition, women scored lower for moral resilience than men. However, the ICC values for the subscales of the RMRS were below acceptable levels, and the results of the standardized residual covariances also suggested a model misfit.

Conclusion and Implications: The reliability, validity, and utility of the Japanese version of the RMRS were generally supported. However, there were areas at the item level that required structural examination. The current findings suggest that there are cultural differences in the concept of moral resilience. Therefore, for future cultural comparisons, the original four-factor structure was maintained in the Japanese version without modifications. Further conceptual development of moral resilience is needed in Japanese healthcare.

Objective: Hand functionality, defined as the ability to perform tasks requiring fine motor skills, is crucial for emergency service nurses as it directly affects their ability to perform tasks requiring fine motor skills, such as administering medication, operating equipment, and providing patient care. This study, therefore, aimed to investigate the effects of an 8-h work shift on hand functionality and perceived exertion among emergency service nurses.

Method: Employing a cross-sectional design, the study measured manual dexterity, handgrip, and pinch strength, and perceived exertion using the Minnesota Manual Dexterity Test (MMDT), Nine-Hole Peg Test (9-HPT), Handgrip Strength Test, Pinch Strength Test, and the Borg Rating of Perceived Exertion (RPE) Scale. Data were collected from 34 emergency service nurses both before and after their shifts.

Results: The present findings indicated significant postshift declines in manual dexterity as evidenced by the MMDT and 9-HPT, with the former demonstrating a large effect size and the latter a small effect size. No significant changes were observed in handgrip and pinch strength. Notably, Borg RPE scores increased significantly postshift, indicating substantial perceived fatigue with a nearly perfect effect size. Correlation analyses revealed significant relationships between increased physical exertion and changes in hand dexterity and strength, underscoring the physical demands placed on nurses during typical work shifts.

Conclusions: These findings highlight the need for healthcare institutions to reassess work schedules and ergonomic practices to mitigate fatigue and preserve nurses’ hand functionality, thereby enhancing patient care and nurse well-being. The study calls for further research to explore more comprehensive strategies aimed at reducing the occupational strain on emergency service nurses.

Background: Newly graduated registered nurses face more challenges than their experienced counterparts, as they not only confront the high pressures of an increasingly complex medical environment but also need to quickly adapt to their jobs and role transitions. The emotional burden arising at this stage is referred to as transitional shock. Self-depletion, as proposed by Baumeister, refers to the process by which individuals exhaust their internal psychological control resources when facing challenges, subsequently affecting cognition and emotion. The occurrence of transitional shock and the process of individual self-depletion appear to be closely related. However, to our knowledge, there has been limited research exploring the occurrence of transitional shock from the perspective of self-depletion theory.

Aim: Investigating the emergence process of transition shock through the lens of self-depletion theory entails an examination of the mechanisms by which individuals engage in self-regulation when confronted with challenges and how transition shock manifests throughout this process.

Designs: A descriptive qualitative study.

Methods: Between August and November 2023, using maximum variation sampling and purposive sampling methods, 16 nurses were selected for semistructured interviews at a tertiary hospital in Suzhou, China.

Results: Employing thematic analysis, three interconnected themes were identified, encompassing the entry-level workforce challenges, the subsequent effects of energy depletion, and the sources and replenishment of energy.

Conclusion: As new nurses adapt to their roles and environments, they encounter numerous pressures that markedly drain their psychological energy. This ongoing depletion of self-regulation energy can lead to transitional shock, impulsive decision-making, and missed nursing care.

Implications for Nursing Management: Managers should implement comprehensive support strategies, including optimized work environments, enhanced training, and personal development, to help newly graduated nurses successfully transition and improve care quality and retention.

Objective: To assess the effects of the nurse–manager dualistic intervention (NMDI) program on work engagement and job crafting of ICU burnout nurses.

Background: Work engagement is crucial for nurses’ job performance and quality of clinical care. Personal and work resources are important antecedents of work engagement. However, few intervention studies focused on improving nurses’ personal and work resources to promote work engagement and job crafting of burnout nurses.

Methods: This was a quasi-experimental study. One hundred and two ICU nurses from two tertiary hospitals in Shandong Province were recruited. Forty-two ICU nurses from one hospital were set as the intervention group and underwent NMDI. Sixty ICU nurses from the other hospital constituted the control group, which received routine occupational health guidance from the hospital. Demographic characteristics, burnout, work engagement, and job crafting were collected at baseline (T0), postintervention (T1), and 3-month postintervention (T2).

Results: Compared to baseline, both work engagement and job crafting scores increased in the intervention group at postintervention (T1). At postintervention (T1), work engagement and job crafting were significantly higher in the intervention group than in the control group (β_{workengagement} = 3.894, p = 0.016 and β_jobcrafting = 6.104, p = 0.010), but the difference between the two groups was not significant at the 3-month follow-up (β_{workengagement} = 3.618, p = 0.066 and β_jobcrafting = 3.554, p = 0.15).

Conclusion: The NMDI program can significantly improve ICU burnout nurses’ work engagement and job crafting. Nevertheless, the sustainability of these effects over time has been found to be limited, indicating that future research needs to explore and implement strategies to bolster the long-term efficacy of this intervention.

Implications for Nursing Management: Nurse managers are suggested to integrate the NMDI program into routine nursing management. Managers ought to prioritize appreciative and constructive dialog between themselves and nurses in order to support nurses in inquiring personal and work resources and encourage nurses to develop work plans to utilize resources. This will help to increase nurses’ engagement and job crafting.

Trial Registration: ClinicalTrials.gov identifier: ChiCTR2100047974

Nursing interruptions occur frequently and often have adverse outcomes, threatening patient safety. Emergency departments have a high incidence of nursing interruptions owing to the concentration of critically ill patients and frequent emergencies. Current research mainly focuses on large hospitals and uses observation and interview methods. Therefore, there is a need to develop tools for measuring emergency nursing interruptions. This study develops a survey questionnaire on emergency nursing interruptions. It tests its validity and reliability by building on the conceptual framework of emergency nursing interruption proposed in the literature. Specifically, we develop a test version of the emergency nursing interruption survey questionnaire using a Delphi expert inquiry and preinvestigation. We selected 1047 emergency nurses in 22 provinces and autonomous regions of China to participate in the survey by completing the questionnaire between June and July 2023 to evaluate the validity and reliability of the questionnaire. The final questionnaire comprised 26 items across 5 dimensions—sources, types, interrupted nursing activities, consequences of interrupted nursing activities, and management of nursing interruptions. The content validity indexes were 0.948 at scale level and 0.842–1.000 at item level. We used exploratory factor analysis (EFA) to extract five common factors with a cumulative variance contribution rate of 66.550%. The results of the confirmatory factor analysis (CFA) demonstrated a good model fit. Cronbach’s α coefficient of the questionnaire was 0.912, split-half reliability was 0.846, and the retest reliability calculated using the intraclass correlation coefficient was 0.915. To ensure the structural validity of the scales, EFA and CFA were conducted using two different datasets. Thus, the questionnaire showed good validity and reliability and can be used to evaluate how nurses understand emergency nursing interruptions.

Background: When nurses feel that the learning processes in their organization are fair and just, they are more likely to feel confident about sharing their knowledge, expressing their concerns, and contributing to the learning process. Conversely, suppose employees perceive a lack of organizational justice. In that case, they may be less likely to speak up and share their valuable input due to concerns about unfair treatment or possible negative consequences.

Objective: Nurses’ silence and organizational learning may have a connection yet to be thoroughly investigated. We are exploring whether organizational justice mediates this relationship by improving nurses’ perception of it and reducing silence among them.

Methods: A study was conducted in Ardabil, Iran, to analyze the correlation between organizational learning, organizational justice, and organizational silence among 319 healthcare professionals from five hospitals. The study utilized three assessment tools: the organizational learning questionnaire, the organizational justice scale, and the organizational silence scale. The collected data were analyzed using IBM SPSS Statistics, and a structural equation model (SEM) was developed using the bootstrap method in AMOS 24.0 to test the proposed model.

Results: Our study found a strong positive relationship between organizational learning and organizational justice and a significant negative correlation between organizational learning and silence. Also, there was a significant negative relationship between organizational justice and silence. SEM showed that organizational learning indirectly affects organizational silence through organizational justice as a mediator, explaining 72.3% of all variance in organizational silence.

Conclusion: Our findings indicated that organizational learning is positively associated with justice but negatively associated with silence. When nurses experience organizational justice, they are less likely to remain silent. Encouraging nurses to share their opinions and concerns reduces silence and improves working conditions, morale, and patient care. Further research is needed to understand the complex interplay between organizational learning, justice, and silence in nursing settings.

Aim: This study aims to evaluate how strength use affects thriving at work among Chinese nurses, with a focus on the mediating effects of control beliefs about stress and cognitive reappraisal.

Background: Nurses’ thriving at work is essential for their well-being, highlighting the importance of understanding factors that contribute to their thriving.

Methods: A comprehensive questionnaire was administered to measure nurses’ strength use, control beliefs about stress, cognitive reappraisal, and thriving at work. Data were analyzed using SPSS 25.0, with mediation analyses conducted via the PROCESS macro. The study followed the STROBE checklist to ensure quality and transparency.

Results: Based on data from 434 nurses, strength use was positively related to thriving at work (β = 0.455, p < 0.001), control beliefs about stress (β = 0.375, p < 0.001), and cognitive reappraisal (β = 0.467, p < 0.001). Mediation analyses showed that both control beliefs about stress and cognitive reappraisal independently mediated the relationship between strength use and thriving at work, with indirect effects of 0.068 (95% CI [0.011, 0.141]) and 0.092 (95% CI [0.037, 0.154]), respectively. The serial mediation model was also significant (indirect effect = 0.067, 95% CI [0.025, 0.108]).

Conclusions: The study highlights the critical role of strength use in enhancing workplace thriving among Chinese nurses, with control beliefs about stress and cognitive reappraisal serving as key mediators.

Implications for Nursing Management: Encouraging strength use in healthcare and implementing programs to develop control beliefs about stress and cognitive reappraisal can enhance thriving at work, contributing to a more effective healthcare system.

Background: The adaptation process for new nursing graduates is challenging, with transition shock and colleague violence impacting both individuals and institutions.

Objective: This study investigates transition shock and colleague violence among newly graduated nurses in Turkey during their adaptation process.

Methods: The study involved 235 newly graduated nurses from a state university in Turkey with at least six months of clinical experience. Data were collected using the Nursing Transition Shock Scale and the Exposure to Colleague Violence Scale.

Results: Among the participants, 27.23% experienced colleague violence and 56.17% witnessed it. The mean score on the Nursing Transition Shock Scale was 53.62 ± 15.39. Female nurses and younger age groups faced more challenges.

Conclusion: Supportive work environments, mentorship programs, and collaborative teamwork are crucial for newly graduated nurses. Updating nursing education programs to prepare students for these challenges is essential. This study underscores the need for targeted interventions.