Policy, Politics, and Nursing Practice最新文献

The global migration of nurses, particularly from developing nations like Nepal, is a complex tapestry woven with threads of ambition, sacrifice, and resilience. This longitudinal qualitative study followed the journeys of 17 Nepali nursing graduates, some who embarked on international careers and others who chose to remain in their homeland. Their narratives challenge simplistic notions of "brain drain," revealing a dynamic interplay of evolving motivations, unexpected opportunities, and the bittersweet realities of pursuing dreams abroad. The study uncovers a stark contrast between the idealized vision of working in "modern, first-world hospitals" and the lived experiences of migrant nurses, highlighting the emotional toll of cultural adjustment and the often-unmet expectations related to financial gains and professional advancement. Yet, amidst these challenges, nurses demonstrated remarkable adaptability, leveraging language acquisition, mentorship, and community building as strategies for integration and resilience. The study also sheds light on the unexpected paths to fulfillment found by those who remained in Nepal, challenging the prevailing narrative that migration is the sole route to success. These findings underscore the urgent need for comprehensive policies and support systems that address both the structural factors driving migration and the individual needs of nurses, fostering a more equitable and sustainable global healthcare workforce.

Quebec's (Canada) nurses experienced a major reorganization of care during the first wave of the COVID-19 pandemic. This study aimed at investigating nurses' psychological health and its determinants during this highly uncertain time, with a particular focus on posttraumatic stress disorder (PTSD), anxiety, and depression. In 2020, a web-based cross-sectional survey was completed by a large sample of Quebec nurses (n = 1,773). High prevalence of PTSD (14.3%), anxiety (39.4%), and depression (46.7%) was observed. Overcommitment at work was associated with higher prevalence of PTSD, anxiety, and depression. More years since licensure, feeling safe with protective measures and increased social support were associated with lower prevalence of PTSD, anxiety, and/or depression. Our study identified modifiable personal and workplace factors that could be targeted by healthcare organizations and policymakers to promote nurses' well-being and enhance the resilience of healthcare systems to resist future global health crises or pandemics. Future research is needed to better understand the potential long-term consequences of the COVID-19 pandemic on nurses' psychological health.

While many metrics may be used to assess the quality of U.S. prelicensure nursing programs, one commonly accepted metric is the student pass rate on the National Council Licensure Exam (NCLEX). NCLEX pass rates are increasingly being used in research projects, and it is critical to have consistent and complete data for such projects. These data are also important to the public for informed decision-making. In the age of open science and data sharing, there is no reason that these data should not be readily available and consistently reported to the public. The aim of this study was to determine how many, and which, state boards of nursing (BONs) publicly report NCLEX pass rates by nursing program. A descriptive, cross-sectional study design was used to examine each state BON website for NCELX pass rate data by program. Initial results indicated that 47 states and the District of Columbia reported NCLEX pass rate data by nursing program through their BON website. At the outset of this study, Alaska, Michigan, and Vermont did not report NCELX pass rate data by program. Michigan posted four years (2021-2024) of NCLEX pass rates by nursing program in February 2025. Amounts and types of data reported were reported inconsistently across states. NCLEX pass rate data by program should be transparently and consistently reported, in a standardized format by all states to facilitate nursing research, equitably inform the public, and increase trust.

The migration of skilled professionals from low- and middle-income countries to developed nations, commonly called the "brain drain," has emerged as a significant political, social, and economic issue in the healthcare sector, particularly among nurses. This paper aims to analyze the emigration of Nigerian nurses to the United Kingdom, the immediate challenges, and the efforts to address the issue. A narrative review approach was employed, which involved the identification of relevant literature utilizing search terms with various Boolean combinations derived from multiple electronic databases, organizational websites, and major news outlets. The results revealed that in the last 3 years (2022-2024), about 42,000 nurses have left Nigeria, with a large number moving to the United Kingdom, accounting for the largest portion of the NHS nursing workforce from sub-Saharan Africa in Great Britain. This accelerated emigration rate from Nigeria has been influenced by occupational dissatisfaction, sociopolitical instability, and inadequate social welfare provisions. This unbalanced emigration has caused a severe shortage of nurses in Nigeria, weakening the nation's healthcare system. As a result, there is an increased workload, lower quality of care, and ultimately, a negative impact on the morbidity and mortality rate. Therefore, it is recommended that the country reconsider its approach to manpower management by integrating technology and implementing policies to prolong nurses' retention and retirement age. Additionally, there is a need for research in nursing to assess the impact and effectiveness of existing policies and to develop strategies for controlling the emigration of nurses.

Hospital nurses report that improving patient-to-nurse staffing ratios is a priority intervention to improve their well-being. In 2004, California became the first state to implement a hospital-wide policy mandating safe staffing ratios. This cross-sectional study determined whether nurses in California hospitals exposed to a staffing policy ("California advantage") experienced lower nurse burnout compared to those in hospitals not exposed, and whether part of the differences in burnout can be attributed to better hospital staffing. Nurse job outcomes (burnout [primary], job dissatisfaction, and intent to leave [secondary]), and nurse staffing variables were derived from the RN4CAST-US 2016 survey of 14,518 registered nurses in California, Florida, New Jersey, and Pennsylvania in 463 hospitals. Nurses in California had lower burnout, job dissatisfaction, and intentions to leave their employer, as compared to nurses in other states (p < .001). Mean patient-to-nurse staffing ratios were lower in California compared to non-California hospitals (3.8 vs. 4.7, p < .001). In bivariate logistic regression models, the California advantage was associated with lower odds of all nurse job outcomes (e.g., burnout OR = 0.81; 95% CI [0.74, 0.89]; p < .001). The California advantage, while smaller, remained statistically significant with the addition of nurse staffing in the model. Every patient added to a nurse's workload was associated with higher odds of nurse burnout (aOR = 1.12; 95% CI [1.06, 1.19]; p < .001), job dissatisfaction, and intent to leave. Better hospital nurse staffing partially mediated the California advantage on all job outcomes. California nurses experience better job outcomes, attributed in part to safer staffing due to a policy.

BackgroundHealthcare worker migration, influenced by push and pull factors, is accentuated by active recruitment strategies of developed nations. This scoping review explores experiences of internationally educated nurses, midwives, and healthcare professionals in the UK since 2010, acknowledging the historical context of UK recruitment policy and the implementation of codes of practice by the World Health Organisation and the UK government.MethodsUsing the Population, Concept, and Context framework, systematic literature searches were conducted in various databases, including CINAHL, Science Direct, Scopus, PubMed/Medline, and Google Scholar. Covidence software facilitated screening, with data systematically extracted and analyzed.ResultsThe scoping review included 24 papers focusing on nurses (n = 19), midwives (n = 1), and various allied health professions (n = 4), spanning from 2010 to 2023. Findings revealed diverse challenges and facilitators, from professional recognition and career opportunities to discrimination, language barriers, and socioeconomic factors influencing integration and retention.ConclusionThe review highlights the multifaceted experiences of internationally educated healthcare professionals (IEHPs) in the UK workforce. Despite their significant contributions, IEHPs face challenges such as unrecognized skills, third-party recruitment issues, and cultural adjustment difficulties. Addressing registration processes, recruitment practices, and cultural competence training is crucial to creating an inclusive environment that maximizes IEHPs' contributions and ensures their professional growth and well-being, ultimately benefiting the healthcare sector.