Clinical Nursing Experience Research Articles

Experiences of clinical nurses with medication interruption: A systematic review and qualitative meta-synthesis.

Managing medication interruptions is considered one of the biggest dilemmas for nurses in clinical settings. To improve medication safety, it was imperative to conduct a systematic review to get a deeper understanding of nurses' experiences with medication interruptions. A systematic review and qualitative meta-synthesis aimed to explore clinical nurses' experiences of interruption during medication in hospitals. Systematic searches were conducted in PubMed, CINAHL, Ovid Medline, Embase, Web of Science, and The Cochrane Library from inception to January 2024. The search strategy included four groups of keywords: (1) qualitative research, (2) nurses, (3) medication interruption, and (4) experience. Critical Appraisal Skills Programme was used to assess the quality of the studies. Meta-ethnography was utilized to synthesize the findings of the included studies. Nine articles published between 2012 and 2023 were included; the number of participants varied from 5 to 40, aged 20-68 years, and the majority were female. Four synthesized findings were identified as follows: (1) an inevitable part of the routine, (2) a decision-making process, (3) working in a minefield, and (4) coping with interruption. Nurses embraced interruptions as an inherent component of clinical care. Previous experience and nursing culture, encompassing personal and professional aspects, significantly influence nurses' attitudes toward medication interruptions. It is crucial to incorporate the distinctive work experiences of nurses into techniques aimed at efficiently handling interruptions in future research. The registration number in PROSPERO is CRD42023470276.

A Psychometric Development and Evaluation of the Flow State Scale for Caregiving Tasks Among Clinical Nurses.

The extensive research already conducted in numerous non-healthcare disciplines has consistently demonstrated the effectiveness of flow in alleviating work-related stress and boosting employee engagement in the workplace. Despite the potential benefits to nursing of improving flow, no valid instrument is currently available to measure the work-related flow experience of clinical nurses. This study was designed to develop the Flow State Scale for Caregiving Tasks (FSS-CT) and to evaluate its psychometric properties in the context of clinical nurses. This study, guided by the flow theory of Mihaly Csikszentmihalyi (1975), employed a three-phase approach to developing and evaluating the psychometric properties of the FSS-CT. Five hundred thirty-six full-time clinical nurses working in hospitals of various levels in Taiwan were recruited via cluster random sampling to participate in an anonymous online survey. The content validity of the developed scale was established through expert panel verification, criterion-related validity was assessed by correlating the scale with the Work-related Flow Inventory, and construct validity was evaluated via explanatory and confirmatory factor analyses. Scale reliability was determined using Cronbach's α coefficient. The FSS-CT, a 12-item Likert scale comprising four domains, was developed. These domains capture the elements of nurses' work-related flow, including professional confidence, merging of action and awareness, balance between skill and challenge, and autotelic experience. The FSS-CT demonstrated high content validity (content validity index > .90) and satisfactory criterion-related validity (coefficient = .55, p < .001). Furthermore, the scale was found to have excellent internal consistency (Cronbach's α = .91). Factor analyses yielded a four-factor structure accounting for 69.34% of the total variance, indicating a good fit for the final model based on recommended goodness-of-fit indices. The FSS-CT is a viable and dependable instrument for assessing the work-related flow experiences of nurses, with the measured outcomes offering to nursing administrators valuable insights into or directions for personnel development and work allocation initiatives.

Factors related to resilience and attitudes towards care of the dying among critical care nurses.

Many critical care nurses provide care to patients who are injured or ill and are at the end-of-life. Therefore, they are at high risk for developing negative emotional responses due to exposure to patient suffering and death. To determine the association between attitudes towards care of the dying, resilience, and Sense of Coherence. A cross-sectional descriptive approach was used. Head nurses at 74 hospitals in Japan were sent a letter about the study; 29 head nurses agreed to send information to the critical care nurses in their hospital. Demographic factors, attitudes towards care of the dying, resilience, and Sense of Coherence were collected using Google Forms. Structural equation modelling was used to analyze the associations among the variables. A total of 229 nurses completed the survey. The average years of clinical experience were 10.5 ± 8.4 years. Factors directly related to positive attitudes towards care of the dying were higher resilience, more years of clinical nursing experience, and having a Master's degree. Sense of Coherence was the strongest predictor of resilience. Other predictors for higher resilience included confidence in nursing skills, social support, and religious beliefs towards death. The main predictor for higher Sense of Coherence was workplace satisfaction. Nurses with higher resilience had more positive attitudes about care of the dying. Individual factors, such as a Sense of Coherence, confidence in caring for patients, and religious beliefs were the most important factors related to resilience. It is necessary to support newer nurses especially those with lower educational attainment, to increase workplace satisfaction, Sense of Coherence and resilience. It is necessary to develop educational programs focused on care of dying patients and to evaluate their effect so that critical care nurses have a positive response to caring for dying patients.

Development of best performance evaluation indicators based on value-based healthcare for general hospital nursing: A Delphi study.

To establish and validate a set of best nursing practice indicators for medical groups in Chinese general hospitals based on value-based healthcare (VBHC) theory. A modified Delphi method. This study engaged experienced clinical nurses from public hospitals and multidisciplinary experts in operations management. Through a literature review and structured brainstorming, a comprehensive framework for assessing best nursing practices in Chinese general hospital medical groups was developed. A modified Delphi method was then employed to establish an indicator framework, followed by the Combined Empowerment-MABAC method to weight and validate the indicators using empirical data collected between June 2023 and October 2023. The CREDES checklist guided the reporting of this study. Sixteen experts, each with at least 10 years of experience in nurse management from nine healthcare organizations, participated in two rounds of consultation. The experts' responses and suggestions for rewording, deleting and adding items were incorporated into each round. Of the 34 proposed indicators, 25 were approved, covering healthcare service capacity, efficiency, quality and safety, patient experience and cost. The Delphi survey reached a consensus on necessary actions to improve nursing performance. The developed indicator system provides a foundational framework for standardizing the monitoring of care quality and performance assessment in Chinese clinical healthcare groups, with broad applicability. This study provides a reliable basis for developing a nursing performance assessment database, offering crucial insights for measuring quality of care and improving patient value. No Patient or Public Contribution.

Mentoring Experiences of New Nontenured Faculty in Undergraduate Nursing: A Qualitative Study.

Mentoring is crucial for professional development and retention of newly hired nurse faculty, yet little is known about the actual mentoring experiences of clinical nurses in their first few years following transition into academic teaching. Individual semistructured interviews were conducted with 23 full-time nontenure-track faculty from 10 higher education institutions in seven states in the United States. All of the faculty were in the first 3 years of teaching in 4-year undergraduate nursing programs. Five themes emerged: (1) chaotic work environments characterized by unpredictable workloads, absence of reliable support, and inconsistent access to information; (2) a de facto do-it-yourself system in which nurses pieced together their own support; (3) reliance on personal social networks; (4) yearning for real mentorship; and (5) future plans about staying in the role. A gap exists between widely touted recommendations about mentoring and the reality of mentoring for newly hired nontenure-track faculty. [J Nurs Educ. 2024;63(8):525-532.].

An Exploratory Study on Non-Contact Nursing Experiences of Clinical Nurses during the COVID-19 Pandemic

This study aimed to understand the non-contact nursing experiences of clinical nurses during the COVID-19 pandemic. A qualitative research design applying thematic analysis was used. The participants were purposive sampled from three institutes: a tertiary hospital, a general hospital, and a residential treatment center in Seoul. Data were collected between December 2021 and January 2022 through individual in-depth interviews with 12 clinical nurses. The data were analyzed using Braun and Clarke's method to identify the meaning of the participants' experiences. During the COVID-19 pandemic, the fields where the participants performed non-contact nursing included intensive care units and isolation wards of hospitals, a residential treatment center, and home cares. Their tasks in non-contact nursing commonly involved remote monitoring using digital devices or equipment, consultation and education. From their experiences performing tasks in these fields, the four theme clusters and nine themes were derived. The four theme clusters are as follows: (1) Confusion of nursing role; (2) Conflict due to insufficient support system; (3) Concern about the quality of nursing; (4) Reflection on the establishment of nursing professionalism. This study highlights the necessity for institutionalizing professional nursing areas, nursing education, and practical support by clarifying the purpose and goals of non-contact nursing and developing nursing knowledge through frameworks.

Transcendental Meditation Enriches Nurses' Authentic Presence Through Caring for Self and Others.

Purpose of Study: Given the enormity of the most recent challenges to clinician well-being, intensified by the pandemic, we decided to explore the influence of Transcendental Meditation® (TM)® on the well-being of clinical nurses. The purpose of our study was to use qualitative analysis to enhance our understanding of the experiences of clinical nurses who practiced TM, as viewed through the lens of our conceptual model and Watson's holistic unitary caring science theory. Design and Method: This qualitative study involved a thematic analysis of clinical nurses' written descriptions following the completion of the TM program during the COVID-19 pandemic. Findings: The nurse participants shared their experiences with the practice of TM as creating present moment focus, leading to enhanced self-care, and development of authentic presence with others. The overall theme uncovered in the analysis is that authentic presence is veritas (truth) in knowing, being, doing, and becoming. Conclusions: The findings were congruent with Watson's unitary caring science theory and provided illumination of the holistic value of TM as a self-care strategy for supporting nurses' well-being with the goal of retaining nurses in practice. When nurses care for themselves, they are more likely and able to care for others, thus helping them to enjoy their nursing careers.

Clinical nurses' experiences about "breaking bad news" during the COVID-19 pandemic: A qualitative study.

Nurses have the most contact with COVID-19 patients and their families, while it is unclear how nurses react when they give bad news during pandemic disaster, particularly in the cultural and social context of Iran. So, our main purpose was to explore the experiences of clinical nurses about breaking bad news (BBN) in the context of the COVID-19 epidemic era. The study was a qualitative content analysis approach. Data were collected by the purposive sampling method through in-depth interviews with 13 nurses in Isfahan University of Medical Sciences. The method of data analysis was conventional qualitative content analysis. The participants of this study were 13 nurses. The work experience range was from 2 to 18 years, and in terms of education, one of them was Ph.D., eight had a bachelor's degree education, and four had a master's degree in nursing. Qualitative data of content analysis were obtained in four main categories such as nurses' avoidance of BBN, considering the patient's and family's beliefs in BBN, nurses' unpreparedness to deliver bad news during the pandemic crisis, and surrender of the patient and family members in the face of the COVID-19 bad news. The results of the research showed that due to probability of occurrence of pandemic in the futureand also the nature of the nursing profession, so nurses should be familiar with the correct ways of BBN and existing protocols on crisis conditions and cultural and religious context of the society to provide a high quality of care for patients and their families.

Outcomes of professional misconduct by nurses: a qualitative study

BackgroundProfessional misconduct by nurses is a critical challenge in providing safe quality care, which can lead to devastating and extensive outcomes. Explaining the experiences of clinical nurses and nursing managers in this regard using an in-depth qualitative method can be beneficial. This study was conducted with the aim of explaining the experiences of nurses regarding the outcomes of professional misconduct.MethodsThe present study used a qualitative descriptive with a conventional content analysis approach. A total of 22 clinical nurses and nursing managers were selected through purposive sampling until data saturation was reached. Data were collected using semi-structured in-depth interviews and analyzed using Graneheim and Lundman’s approach.ResultsAnalyzed data were categorized into four main themes and 11 subthemes: (1) Physical outcomes: critical threat and weakening patients’ safety; (2) Psychological outcomes: psycho-emotional responses of patients and their families, moral distress, and cautionary tale of nurses; (3) Financial outcomes: imposing costs on the patient and financial loss of the nurse; (4) Organizational outcomes: the normalization of misconduct, chaos in the organization, waste of the organization’s resources, and reputational damage to the organization.ConclusionProfessional misconduct by nurses can have adverse outcomes for patients in physical, mental, and financial dimensions, their families, nurses, and healthcare organizations. Therefore, it is indispensable to adopt management strategies to reduce the rate of professional misconduct.

A Healthcare-Academic Practice Partnership Program to Promote Student Nurse Readiness for Work.

Highly skilled new graduate nurses must be better prepared to face the clinical and professional challenges in today's healthcare environment. Compounding these challenges are the growing resignations of clinical faculty and experienced clinical nurses. Innovative programs are needed to bridge the knowledge-practice gap with opportunities to create pipelines to aid the future nursing workforce. A multihospital health system partnered with a local college of nursing to develop a Nursing Student Pipeline Program, which allows nursing students to perform select nursing tasks as employees of the health system. Fifty-six students have been hired to participate in the pilot program. Of the students eligible for hire and who completed the program, 24 are current employees with the healthcare system. Students, preceptors, and managers report the benefits of this program, including that participating in the program supports increasing readiness for practice upon graduation.

Prerequisites for entry to advanced nurse practitioner studies- a qualitative study of Norwegian nurse anesthetist students' experiences.

Nurse anesthesia is acknowledged as advanced practice nursing, and requires independency in patient monitoring and clinical decision-making. In Norway, 2022, a prerequisite to nurse anesthesia education programs of at least two years of clinical nursing experience prior to entry, was removed. The consequences of removing the prerequisite of clinical nursing experience prior to entering the nurse anesthetist education program on academic progression or on students' qualifications after completion of the program remain unexplored. Hence, the purpose of the current study was to explore nurse anesthetist students' experiences of the impact their previous clinical nursing experience had on their academic progression. A qualitative design with semi-structured individual interviews was used. The sample consisted of 12 nurse anesthetist students at the end of the education program. The data were analyzed using thematic analysis in-line with recommendations from Braun & Clarke. Two main themes with in total six subthemes were identified, namely 1) Experience develops non-technical skills, with subthemes (a) feeling secure in task management, (b) recognizing different situations, (c) understanding my role in teamwork, and 2) Integration of non-technical and technical skills, with subthemes (a) possessing procedural competence, (b) taking responsibility in medication administration, and (c) including a patient-centred approach. Previous clinical experience as a nurse prior to entry to a NA education program had provided a basis of non-technical and technical competencies, that supported further learning and development of advanced level competencies that are needed for NAs. Non-technical and technical nursing competence represented a solid base for achievement of anesthesia competence within the same areas, also ensuring patient-centred practice. Hence, the change in prerequisites to the NA education program must be followed by evaluations of consequences on students' academic progress and competence at the end of the program, as well as a possible increased need for supervision throughout.

Oncology nurses’ experiences of providing emotional support for cancer patients: a qualitative study

BackgroundA high percentage of cancer patients may experience emotional distress. Oncology nurses are expected to play an important role in recognizing emotional distress and planning and delivering care that meets the individual needs of each patient. However, few studies have focused on the experiences of clinical nurses in such cases. This study adopted a qualitative research method to gain an in-depth understanding of the experience of nursing staff in caring for cancer patients with emotional distress.MethodsA qualitative descriptive design and semi-structured interviews were used in this study. Twenty-one oncology nurses were interviewed, and the qualitative content analysis suggested by Graneheim & Lundman (2004) was used to interpret the data.ResultsSix themes were identified, as follows: (1) dictating the abnormality of emotion, (2) soothing and comforting patients, (3) a lack of psychology knowledge and communication skills, (4) negative impacts of a lack of time, (5) managing emotional labor, and (6) reflecting on the experiences.ConclusionHospital administrators should arrange pre-employment education and training as well as on-the-job education to help nurses in caring for cancer patients with emotional distress. They should also focus attention on the personal emotional states of nursing staff in a timely manner and provide psychological support and emotional counseling as necessary.

INSIGHTS ON THE CLINICAL NURSE ROLE IN IMPLEMENTING WHAT MATTERS FOR OLDER ADULTS IN ACUTE CARE

Abstract The Age-Friendly Health System (AFHS) evidence-based 4Ms framework (What Matters, Medication, Mentation, &amp; Mobility) is designed to be implemented in clinical settings to reliably provide high-quality age-friendly care to older adults and reduce harm and hospital-associated complications. The 4M concept of ‘What Matters to You’ (WMTY) refers to assessing and aligning an individual’s specific health outcome goals and care preferences to ensure patient-centered care with a measurable impact on patient experience. While published toolkits support the implementation of WMTY for all disciplines, there is limited guidance and empirical evidence about the implementation and impact of this concept when used by clinical nurses in acute care. Some researchers have identified issues with implementing WMTY with patients who are not able to articulate their wishes or when the question is posed in a granular way. A large healthcare system in the Midwest supported five hospitals to implement the AFHS 4Ms including the WMTY concept but did not observe an improvement in nurse-sensitive patient experience measures. A qualitative study is in progress aimed at gaining an in-depth understanding of the knowledge, perceptions, and experiences of leaders and clinical nurses who have implemented the WMTY concept for older adults in their hospital to evaluate the implementation and impact on patient care. The results gathered by this study will lay the foundation for designing clinical nurse-targeted interventions to successfully implement WMTY and identifying supportive strategies for partnering with patients and their caregivers to ensure that their goals/preferences are fully integrated into care.

Challenges of Novice Nurse Educators’ Transition from Clinical Practice to Academia in Ghana: A Qualitative Study

Background: The recruitment of experienced clinical nurses into vacant faculty positions is a global strategy for preparing, employing, and retaining competent nurse educators. As clinical nurses transition to academia, many struggle with unique challenges that affect their adaptation to the academic setting. Thus, understanding novice nurse educators’ transitional challenges is critical to addressing this threat. Aim: This study aimed to explore the challenges of novice nurse educators’ transition from clinical practice to academia in Ghana. Methods: A descriptive qualitative study design was employed for this study. A purposive sampling technique was used to recruit 12 novice nurse educators from three health training institutions in the Upper East Region of Ghana. A semi-structured interview guide was used to collect data through in-depth individual interviews. The interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Results: Four themes emerged: poor administrative support, poor preparation, increased workload and stress, and role ambiguity. Novice nurse educators lacked formal orientation, formal mentorship, formal education in teaching, and post-graduate education. Novices were also challenged by increased workload and role ambiguity. Conclusion: Supporting novice nurse educators' transition from clinical practice would be better served by college administrators’ creation and implementation of formal orientation and mentorship programs.

The Impact of Clinical Experience in Advanced Practice Nursing Education-A Cross-Sectional Study of Norwegian Advanced Practice Nurses' Perspectives.

An Advanced Practice Nurse (APN) is a specialized nurse who has acquired context specific knowledge, complex decision-making skills, and clinical competencies. Previously in Norway, APN education programs had a prerequisite of a minimum of two years of clinical nursing experience. Recently, the government decided to abandon this prerequisite. The objectives of this study were to assess APN's and APN students' (1) perspectives on the impact of clinical nursing experience on various aspects of nursing practice, (2) perspectives on the association between APN students' previous clinical experience and the ability to achieve the learning outcomes in the education program, and (3) attitudes towards clinical nursing practice as a prerequisite before entry to APN education programs. An observational, cross-sectional design. APN and APN students were invited to respond to a researcher-developed questionnaire. A snowballing sampling method was used. The questionnaire included 24 questions scored on a five-point Likert scale, and two questions with text responses. Quantitative data were analyzed using descriptive statistics, and text responses with thematic analysis. In total, 1767 APNs (92.9%) and APN students (7.1%) responded. Between 93.6 and 98.2% of the respondents (n = 1767) agreed that clinical nursing experience leads to experience with communication, collaboration, basic procedures, medical equipment and documentation, and to the development of situation awareness, increased awareness on own role in teams, the ability to provide person-centered nursing, an independent nursing identity, and feeling of security. Over 90% of the respondents agreed that students' previous clinical experience was associated with the ability to achieve the learning outcomes in the APN program. In addition, 93.7% of the respondents agreed that clinical nursing experience should be a prerequisite before entry to APN programs. Advantages of clinical experience were reported as 'Professional identity', 'Intuitive grasp', 'Integration of technical skills', and 'See the whole picture'. Disadvantages were reported as 'Prejudice and bad habits', 'The importance of relevant experience', and 'Recruitment issues'. This study adds insights into the impact of clinical nursing experience as a prerequisite to APN education programs. The results indicate that clinical nursing experience is an essential contributor to the development of nursing competence and a nursing identity. This study was not registered.

Exploring the Reasons for Dissatisfaction of Nurses Working in Psychiatric Wards: A Qualitative Study

Objectives: This study sought to learn more about psychiatric nurses’ experiences working in Iraq because it has been reported that the field of mental health nursing is challenging and has low job satisfaction. Methods: This research is a qualitative study and draws on lived experience conducted on 24 nurses working at Al-Rashad a special hospital in Baghdad that included psychiatric wards selected via purposeful sampling in, 2021-2022. Data were gathered using smartphone-recorded interviews. The seven steps of Colaizzi’s data analysis were used by Husserlian phenomenology. To aid in the bracketing and reflection process, each nurse’s interview was verbatim recorded, along with their thoughts, feelings, and past experiences in this hospital. Results: Three themes were identified as the root reasons for participants’ dissatisfaction (DSS) with their jobs in mental hospitals; insufficient training for providing psychiatric treatment, a negative reputation for psychiatric nurses in the public, and concerns of nurses. These findings were collected during the interview sessions, and notes and ideas were classified and assorted. Analysis of the qualitative data provided insights into the barriers to psychiatric nurses’ satisfaction. Discussion: The present research contributes to the experiences of clinical nurses concerning clinical intervention and care processes in Iraqi psychiatric hospitals. Confrontation of mental patients by nurses in the work environment remains crucial. The findings emphasize the importance of listening to psychiatric nurses and considering how the name of the hospital and patient type and contexts affect nursing satisfaction. Understanding the challenges in the nursing workplace has increased the quality of care providers and satisfaction in the nursing and psychiatric field.

Lama Pengalaman Klinik Perawat Dengan Ketepatan Skoring Virulensi COVID-19 Menggunakan Aplikasi EWSS (Early Warning System Score)

Over time, the COVID-19 virus mutates and can spread rapidly, requiring more accurate treatment. Adequate treatment is essential for healing and reducing the spread of diseases. Moreover, nursing has become the main health workforce in controlling COVID-19. The study aims to test the relationship between nursing clinical experience and the accuracy of COVID-19 virulence scoring using the Early Warning System Score application. The study used a correlation analytic design with a cross sectional approach. The population used in this study was nurses who filled out questionnaires online in East Java. A sample of 311 respondents. The results showed a significant relationship between nursing clinical experience and accuracy of scoring virulence of COVID-19 using the Early Warning System Score application. Treatment of COVID-19 should remain in the evaluation, especially the provision of appropriate nursing care for patients with COVID-19 by nurses. Researchers can add clinical experience-supporting variables to find out the various compensators of nurses’ competence.

Women's health nurses' experiences of menopause: Considerations for nurse leaders.

Women's health nurses' experiences of menopause: Considerations for nurse leaders.

The relationship between ethical leadership and nurse well-being: The mediating role of workplace mindfulness.

The purpose of this study was to explore the relationship between nurses' well-being and their ethical leadership, and the mediating role of workplace mindfulness in this relationship. This was a quantitative cross-sectional study. This cross-sectional study was conducted in three tertiary hospitals in central China from May 2022 to July 2022, and the Nurses' Workplace Mindfulness, Ethical Leadership and Well-Being Scale were distributed and collected via the Internet. A total of 1579 nurses volunteered to participate in this study. SPSS 26.0 statistical software was used to analyse the data by Z-test and Spearman's rank correlation; the internal mechanism of workplace mindfulness and ethical leadership on nurses' well-being was completed by AMOS 23.0 statistical software. The scores of nurses' well-being, workplace mindfulness and ethical leadership were 93.00 (81.00, 108.00), 96.00 (80.00, 112.00) and 73.00 (67.00, 81.00) respectively. The professional title, age and department atmosphere affect their well-being. Spearman's analysis showed that nurses' well-being was positively correlated with ethical leadership (r = .507, p < .01) and workplace mindfulness (r = .600, p < .01); workplace mindfulness partially mediated the relationship between ethical leadership and nurses' well-being accounting for 38.5% of the total effect ratio [p < .001, 95% CI = (0.215, 0.316)]. Nurses' well-being was at a medium level, and had a higher score in ethical leadership and workplace mindfulness, and workplace mindfulness played a partial mediating role between ethical leadership and nurses' well-being. This suggests that nursing managers need to pay attention to clinical nurses' well-being experience, actively focus on the relationship among ethical leadership, workplace mindfulness and well-being and integrate core values such as positivity and morality into nurses' daily routines, so as to improve the work enthusiasm and well-being experience of clinical nurses, enhancing the nursing quality and stabilizing the nursing team.

Opportunity for Innovation: Community Nursing Clinical Experiences.

Kobiske, Karie R. PhD, RN; Bright, Elizabeth MSN, RN; Ulmen, Brenda F. PhD, RN; Cronin, Lori DNP, RN Author Information