Nurses In Finland Research Articles

The Associations among Destructive Leadership, Job Demands and Resources, and Burnout among Nurses: A Cross-Sectional Survey Study

Background. Nurses demonstrate high burnout prevalence. Moreover, destructive leadership, as well as job demands and resources, are associated with burnout. However, these associations, particularly in the context of nursing, warrant further investigation. Objective. To explore the associations of destructive leadership, as well as job demands and resources, with burnout in registered nurses. Design. A cross-sectional survey. Participants. 2115 registered nurses in Finland. Methods. The self-administered questionnaire survey was distributed nationwide to 106,000 members of the Finnish trade union for health and social care professionals via an online newsletter in February 2023. Nurses’ burnout was measured with the Burnout Assessment Tool (BAT). The data were analysed through descriptive statistics and linear regression analysis. Results. Destructive leadership and job demands were positively associated with burnout (β = 0.39 and 0.32, respectively; both p<0.001), whereas job resources and burnout were negatively associated (β = −0.41, p<0.001). The associations of destructive leadership and job demands with burnout became less positive when job resources were added to the regression model (β = 0.21 and 0.14, respectively; both p<0.001). Conclusions. Job resources led to the greatest reduction in burnout among registered nurses. Moreover, job resources reduced burnout by diminishing the negative effects of destructive leadership and job demands. Providing a sufficient amount of job resources might reduce burnout and diminish the negative effects of destructive leadership and job demands among nurses. These relationships warrant examination in other cultural settings.

Recognition of nursing qualification and credentialing pathway of Filipino nurses in Finland: A qualitative study.

To understand the experiences of Filipino internationally educated nurses (FIENs) on their recognition and credentialing pathway in the recruitment process in Finland. The nursing shortage in Finland results in the recruitment of internationally educated nurses (IENs) such as those from the Philippines. In the context of migration, IENs experience a rigorous process to become qualified nurses in the destination country. A thematic analysis of the secondary data from qualitative interviews was conducted. Ten FIENs (n=10) were recruited from university hospitals in Finland through purposeful and snowball sampling. The study adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist. Three main themes were identified. First, pre-migration victories and predicaments described the experiences of FIENs during the recruitment process and the pathway to acquiring a Registered Nurse qualification. Second, ambiguous integration implied integrating into the workplace while working on the top-up education programme as a prerequisite to nursing registration. Lastly, migration uncertainty discussed the interest among FIENs to continue practising as Registered Nurses (RNs) in Finland. Pre-migration orientation and workplace integration experiences influenced FIENs' choice to practise as RNs in Finland. The licensure pathway for FIENs required collaboration from various stakeholders in Finnish society. It is recommended to structure the system for the recognition and qualification process of IENs by creating a national model in line with international standards and requirements in collaboration with higher education institutions. Recognition of previous education and clinical experience can facilitate the transition to becoming an RN for IENs, but the lack of a clear education model and recognition of foreign nursing qualifications leads to deskilling and hinders IENs from practising. Policies prioritising education and integration into the local healthcare system can facilitate the integration and professional growth of IENs, enabling them to contribute significantly to the healthcare system.

Linguistic racism towards internationally educated nurses in Finland: Critical reflective analysis.

The shortage of nurses in Finland has prompted the recruitment of Internationally Educated Nurses (IENs) from developing countries mostly with fragile health systems. However, linguistic racism has emerged as a growing threat to the safety and well-being of IENs in the country. To discuss the consequences of linguistic racism directed towards IENs and to propose solutions to address this issue. This discussion employed self-reflection as a means of engaging in critically reflective analysis. The discussion highlighted the factors contributing to linguistic racism, including poor language proficiency, misrepresentation of the nursing profession due to skin color, and political tensions. The phenomenon of linguistic racism affects IENs' communication with patients and colleagues and has a detrimental impact on the mental health and overall health of IENs. To address the issue of linguistic racism, this discussion proposed a comprehensive strategy that includes anti-racism training for healthcare personnel, the establishment of a conducive workplace culture that fosters diversity and inclusivity, and the provision of adequate assistance and support for IENs.

The experiences of Finnish dental professionals in handling child abuse and neglect issues in their daily work

Objective This study aimed to assess the experiences, attitudes and knowledge of child abuse and neglect (CAN) among dentists, dental hygienists and dental nurses in Finland. Material and methods A web-based CAN survey was sent to 8500 Finnish dental professionals, covering demographic characteristics, dental education, suspicion of CAN, actions taken and reasons for inaction as well as training on CAN issues. The chi-squared (χ2) test was used to analyse associations. Results In total, 1586 questionnaires with valid data were completed. Among respondents, 25.8% had received at least some undergraduate training and 36.3% had received postgraduate training on child maltreatment issues. In addition, 43% of respondents had at least one suspicion of CAN at some point during their career. Of those, 64.3% did not refer to social services. Training positively associated with the identification of CAN and referral frequencies. Uncertainty about an observation (80.1%) and a lack of knowledge regarding procedures (43.9%) were the most frequently reported barriers. Conclusions Finnish dental professionals need more education on child abuse and neglect issues. Competence related to CAN is fundamental to their skills given that all dental professionals regularly work with children and are obligated to report their concerns to proper authorities.

Consensus recommendations on the role of nurses in the care of headache patients: protocol for a european e-delphi study

BackgroundNurses play an important role in the treatment of headache patients at the specialized headache centers in Europe, however, a unified definition of nursing tasks and conduction of tasks is lacking. The objective of this e-Delphi study is twofold. Initially, to obtain healthcare professional headache experts’ opinions on which tasks are associated with nurses’ care in migraine treatment. Then, through an iterative multi-staged process, to combine the opinions into group consensus statements and develop evident European nursing recommendations for migraine treatment.MethodsIn Delphi studies there are no unambiguous methodological guidelines and this protocol is being published to ensure transparency and quality in the study process. We invite nurses working in specialized headache centers and neurologists co-working with nurses in Finland, Denmark, Norway, Sweden, United Kingdom, Netherlands, Germany, Ireland, Estonia and Switzerland to participate anonymously in the expert panel. This e-Delphi study consists of three rounds of online questionnaires. We use Open-ended questions to capture the essentials of nurse tasks as understood by the expert panel members. Data are analyzed using content analysis. Predefined statements are applied for the experts to rate the importance of nurses’ tasks synthesized from a systematic examination of the existing literature. Consensus is measured using descriptive statistics; median, Interquartile range (IQR) and percentage agreement. Measurement of agreement between participants will be analyzed using inferential statistics; Kendall’s coefficient and stability between rounds; Wilcoxon rank-sum test. Statements, which receive consensus in the third round, are included in the final compilation of European recommendations for nurse care for migraine patients.DiscussionThe e-Delphi study will provide European recommendations on nurse care in migraine treatment, which could not be created on the basis of the existing literature. The recommendations can open for the conduction of further research including measurement of efficacy of clinical implementation of the recommended tasks.Trial registrationThe study is registered at The Region of Southern Denmark (21/52,885). According to The Regional Ethical Committee and Danish law, no additional approval is relevant (20212000-145). A written informed consent is obtained from all participants before inclusion in the study.

COVID-19-Related Job Demands and Resources, Organizational Support, and Employee Well-Being: A Study of Two Nordic Countries

The purpose of this study is to examine how COVID-19-related job demands and resources have been associated with employee well-being in Nordic countries across specific occupational groups. The study investigated four occupational groups: (1) professional, scientific, and technical occupations in Norway (n = 301); (2) teachers in Finland (n = 315); (3) health and social service occupations in Norway (n = 267); and (4) geriatric nurses in Finland (n = 105). Hypotheses were tested using two-step hierarchical regression analysis. Work–home imbalance in Groups 1, 2, and 3, workload increase in Groups 1 and 3, and fear of infection in Groups 2 and 3 were positively related with exhaustion. A positive attitude towards digital solutions was positively related to work engagement in Groups 2 and 3. In addition, there was a significant positive relationship between COVID-19-related organizational support and work engagement in Groups 2, 3, and 4, and a negative relationship with exhaustion in Group 2. In conclusion, pandemic-related job demands and resources were differently associated with employee well-being across different occupational groups and countries. Further, organizational support may act as a supportive element for sustaining employee well-being during pandemics.

Assistant nurses and orientation to care robot use in three European countries

ABSTRACT This study investigates assistant nurses’ views on and needs for orientation to care robot use in three European countries. The use of care robots is gradually being incorporated into welfare services. Orientation to care robot use (in short, introduction to the use of the care robot technology) has thus become a key issue for care services. A survey was sent to assistant nurses in Finland, Germany, and Sweden, to which 302 participants responded (Finland n = 117; Germany n = 73; Sweden n = 112). Only 11.3% of assistant nurses had experience of giving orientation to care robot use to older adults or colleagues, but over 50% were willing to do so. Those with experience of using care robots should take part in orientation. Orientation to care robot use should be seen as part of care management and an issue that may affect the whole organisation. Management should, firstly, allow assistant nurses to get to know care robots by offering information, and secondly, consider with the assistant nurses the ways care robots can change their work and the implications of this change. Emphasising the social factors and practical orientation to care robot use extends the previous theories and perspectives of technology acceptance, adoption and diffusion.

Knowledge of patient observation among critical care nurses.

The clinical observations made by critical care nurses are vital for maintaining patient safety and making appropriate decisions in the care of patients who are critically ill. Evaluating the reliability of observations and applying analytical thinking are essential elements of patient observation. Previous studies of critical care nurses' knowledge have focused either on specific aspects of patient observation or on critical care nursing in general; therefore, the findings are not comprehensive. The aim of this study was to evaluate critical care nurses' level of knowledge in patient observation and to explore the factors that are associated with it. A cross-sectional knowledge test survey with critical care nurses in Finland was used. Data were collected in seven adult intensive care units in all five university hospitals in Finland between September 2017 and January 2018 by using a knowledge test (20 items) developed for this study. All critical care nurses were eligible to participate. The data were analysed using descriptive and inferential statistics. Altogether, 372 nurses responded (response rate 49%). Their average scores in the knowledge test were 77% (mean 15.29/20, SD 2.41) for correct answers, 75% (mean 8.2/11, SD 1.54) in the sum-variable "Evaluating the reliability of observation" and 79% (mean 7.08, SD 1.45) for "Analytical thinking." A higher knowledge level was associated with education in special tasks in an intensive care unit. The critical care nurses' knowledge level was considered to be suboptimal. There is a need for improving knowledge of patient observation among Finnish critical care nurses to ensure safe and good quality care. Finnish critical care nurses' knowledge of patient observation could be improved by providing specific continuing education for new nurses entering intensive care units and for experienced critical care nurses throughout their career.

Promoting education on the health effects of climate change for nurses in Finland

Abstract Background Climate change has a direct and indirect impact on human health that include health impacts from rising temperatures and poor air quality. Without changes in our greenhouse gas emissions, it is estimated that by the end of this century average temperatures will rise from two to four degrees Celsius worldwide. In Finland, this rise in temperature is estimated to be 1.5-2 times higher than other regions of the world. During the heatwaves in Finland in the 2000s, the mortality rate among the elderly increased by 21%. Nurses should be aware of these health effects and the patients who are particularly vulnerable to the health impacts caused by climate change. Purpose The purpose of the study was to identify the health issues that Finnish nurses associate with climate change. The purpose was also to find out how prepared nurses are to deal with the health effects of climate change. Methods A qualitative descriptive study was conducted in November 2018 using focus group interviews to collect data. Results Interviews revealed that nurses have seen much of the health damage caused by climate change in their patients. However, they had not linked their observed changes in patients' health to climate change. Nurses interviewed felt unaware of the health effects of climate change. In addition, nurses felt that climate change was not adequately addressed in basic and in-service training. Conclusions Education could strengthen the competence of nurses in helping their patients prevent and reduce the health impacts caused by climate change. It is therefore important to include climate change and its impact on human health in the nursing curriculum. Key messages Nursing organizations can influence nurses’ understanding of climate change in their practice. Nurses' understanding can be used leverage their role in reaching nurses for new and emerging health conditions that influence public health.

Physicians’ and nurses’ experiences on EHR usability: Comparison between the professional groups by employment sector and system brand

BackgroundUsability associates with patient safety and quality of care. This article reports results from nation-wide usability-focused survey studies for physicians and nurses in Finland. Earlier research has shown dissatisfaction and serious deficiencies, which hamper the efficient use of health information systems (HIS); however, evaluation studies covering the viewpoints of both user groups are practically lacking. Our study aimed at comparing end-users’ experiences on the usability of electronic health record (EHR) systems by employment sector and EHR brand. MethodsTo measure usability, we used the validated National Usability-focused HIS Scale (NuHISS). For this study, we selected 11 usability statements that relate to technical quality (n = 3), ease of use (n = 6), benefits (n = 1) and collaboration (n = 1), and were identical in both surveys. We report the responses from 3013 physicians and 2560 nurses working in public sector hospitals or primary care health centers in 2017. ResultsResults in total and by healthcare sector showed notable differences between nurses’ and physicians’ experiences on usability of their EHR systems. Physicians were more satisfied than nurses on technical quality and learnability of the EHR-systems, while nurses experienced the ease of use better and were more satisfied with collaboration aspects than physicians. Two EHR brands used in hospitals appeared to have succeeded in supporting physician workflows, while two others used in health centers were more suitable for nurses’ needs. ConclusionsNurses’ and physicians’ experiences on EHR usability appear to vary more by EHR brand and employment sector rather than either professional group being generally more satisfied. Development of EHR systems should consider the perspectives of these two main user groups and their working contexts.

The association between cross-cultural competence and well-being among registered native and foreign-born nurses in Finland.

BackgroundA growing body of research indicates that cross-cultural competence in nurses can improve migrant patients’ health-related outcomes, but little is known about the potential benefits of cross-cultural competence on the nurses’ own well-being.ObjectiveTo examine whether cross-cultural competence (empathy, skills, positive attitudes, and motivation) is associated with perceived time pressure at work, psychological distress, and sleep problems among registered nurses in Finland, and whether there are differences in these potential associations between native and foreign-born nurses.MethodsThe present cross-sectional study was based on a sample of 212 foreign-born nurses licensed to practice in Finland and a random sample of 744 native Finnish nurses. Data were collected with a questionnaire and analyzed using multiple linear regression and structural equation modeling (SEM).ResultsOf all four dimensions of cross-cultural competence, only empathy was associated with perceived time pressure (β = –0.13, p = .018), distress (β = –0.23, p < .001), and sleep problems (β = –0.14, p = .004) after the adjustment for gender, age, employment sector, and frequency of interacting with patients and colleagues from different cultures. There were no differences between native and foreign-born nurses in these observed associations (all ps > .05).ConclusionsCross-cultural empathy may protect against perceived time pressure, distress, and sleep problems in both native and foreign-born nurses. Thus, the promotion of this component of cross-cultural competence among nursing personnel should be encouraged.

Factors associated with employment barriers faced by foreign-born nurses in Finland

Factors associated with employment barriers faced by foreign-born nurses in Finland

Factors associated with employment barriers faced by foreign-born nurses in Finland

Factors associated with employment barriers faced by foreign-born nurses in Finland

Access to a school health nurse and adolescent health needs in the universal school health service in Finland.

Universal school health services are expected to offer similar, needs‐based services to all students across schools, service providers and students’ socio‐economic statuses and health needs. This study investigates access to school health nurses in Finland. The objectives were to study the differences in access to school health nurse between service providers, schools, students’ characteristics and school health nurse resources. Access was examined through a nationwide School Health Promotion study, which is a self‐reporting, voluntary and anonymous survey for 8th and 9th graders (15 to 16‐year old, N = 71865). The ethical committee of the National Institute for Health and Welfare has approved procedure for the School Health Promotion study. Data on school health nurse resources and service providers were obtained from the national database (534 schools; 144 service providers). Multilevel logistic regression was used. Of the pupils, 15% of girls and 11% of boys reported difficult access to a school health nurse. The number of adolescents who reported difficult access ranged between service providers (0%–41%) and schools (0%–75%). Students with lower socio‐economic background, poorer well‐being at school, lack of support for studying and greater health needs reported difficult access more often. School health nurse resources were associated with difficult access only among boys, when resources were under the national recommendations. These findings raise concern about equality and unmet health needs in school health services.

NON - PHARMACOLOGICAL PAIN MANAGEMENT IN POSTOPERATIVE CARE OF SCHOOL - AGE CHILDREN

The aim of this study was to evaluate children‘s postoperative pain assessment and management methods applied in practice by nurses from Lithuania and Finland. Methods. Individual in - depth semi - structured interviews by non - probabilic snowball (network) and purposive sampling, data content analysis. 20 nurses in Lithuania and 5 nurses in Finland, who work at pediatric surgical and pediatric wards, where children after surgeries are treated. Results. The research has shown differences between postoperative school - age children‘s pain management practise by Lithuanian and Finnish nurses. Lithuanian nurses use smaller variety of these methods than nurses from Finland. All nurses agree that non - pharmacological children pain management is effective and useful. Conclusions. The usage of subjective and objective pain assessment methods by Finnish and Lithuanian nurses is similar, just Lithuanians mostly trust subjective verbal and objective behavioral, appearance pain assessment methods, whereas Finnish combine and use all the subjective pain assessment methods like verbal, parental assessment and using scales as well as objective behavioural assessment. There is a difference between pain management practise by Finnish and Lithuanian nurses. Finnish nurses evenly use all of non - pharmacological methods, whereas Lithuanian nurses mostly trust on physical and rehabilitation methods as well as communication.

Registered nurses' perceptions of rewarding and its significance.

To examine reward type preferences and their relationships with the significance of rewarding perceived by registered nurses in Finland. Previous studies have found relationships between nurses' rewarding and their motivation at work, job satisfaction and organisational commitment. Data were collected in a cross-sectional, descriptive, questionnaire survey from 402 registered nurses using the Registered Nurses' Perceptions of Rewarding Scale in 2015, and analysed with descriptive and multivariate statistical methods. Registered nurses assigned slightly higher values to several non-financial than to financial rewards. The non-financial reward types appreciation and feedback from work community, worktime arrangements, work content, and opportunity to develop, influence and participate were highly related to the significance of rewarding. We identified various rewards that registered nurses value, and indications that providing an appropriate array of rewards, particularly non-financial rewards, is a highly beneficial element of nursing management. It is important to understand the value of rewards for nursing management. Nurse managers should offer diverse rewards to their registered nurses to promote excellent performance and to help efforts to secure and maintain high-quality, safe patient care. The use of appropriate rewards is especially crucial to improving registered nurses' reward satisfaction and job satisfaction globally in the nursing profession.

A vision of ethics in efficient occupational healthcare.

Occupational healthcare is nowadays more and more regulated by economic demands of gain and efficiency. The aim of this study is to reach a new understanding of ethics in occupational healthcare by uncovering this from occupational healthcare nurses' own views. The research questions are as follows: (1) What is the core of an ethical value base in occupational healthcare? (2) What does it mean for occupational healthcare nurses to fulfill their ethical value base in occupational healthcare? The study uses a hermeneutical approach. The context of the study is occupational healthcare. The material was collected through interviews with four occupational healthcare nurses in Finland. The texts were interpreted through hermeneutical reading. The data storage, study participation, and data handling for research purposes were approved by the participants when they provided their informed consent. The study revealed that the core of ethical values in occupational healthcare is something universal that concerns justice, honesty, and faithfulness. To fulfill the ethical value base means to continuously strive toward the inner core of love and bravely choose to listen to the this core in the name of the client and the universal good even if it involves a struggle or a sacrifice. The ethical value base is not primarily tied to profession but is something that is general and universal. Nor do ethics and the implementation of ethical values stand in opposition to, for example, external values such as demands for efficiency and economic gain. However, ethics may promote efficiency. The fulfillment of nurses' ethical value base in occupational healthcare requires that ethics first and foremost is allowed to enter the leadership and is prioritized on a leadership level. Creating caring cultures that encourage openness and support ethical discussions is fundamental.

Identifying and Intervening in Child Maltreatment and Implementing Related National Guidelines by Public Health Nurses in Finland and Japan.

Aim. This study aimed to investigate how public health nurses identify, intervene in, and implement the guidelines on child maltreatment in Finland and Japan and to compare the data between the two countries. Method. This study employed a cross-sectional design. Public health nurses' knowledge and skills with respect to child maltreatment prevention were assessed using a questionnaire consisting of three categories: identification, intervention, and implementation of guidelines. Public health nurses working in the area of maternal and child health care in Finland (n = 193) and Japan (n = 440) were the participants. Results. A significantly higher percentage of Japanese public health nurses identified child maltreatment compared to Finnish public health nurses, while Finnish nurses intervened in child maltreatment better than their Japanese counterparts. In both countries, public health nurses who had read and used the guidelines dealt with child maltreatment better than those who did not. Conclusion. The results suggest that effective training on child maltreatment and the use of guidelines are important to increase public health nurses' knowledge and skills for identifying and intervening in child maltreatment.

Does Organizational Justice Modify the Association Between Job Involvement and Retirement Intentions of Nurses in Finland?

Given the growing aging population in Finland, retaining health staff to care for them is important. In an exploration of predictors of quitting before the typical retirement age, which ranges from 63 to 68 years in Finland, we examined whether organizational justice moderated the association between job involvement and retirement intentions among nurses 50 years and over. The sample was 446 nurses (70% practical nurses) working in 134 assisted living facilities providing 24-hour care for older residents in Finland. Job involvement was measured with the Job Involvement Questionnaire, and organizational justice with a scale that tapped its three dimensions: distributive justice, procedural justice, and interactional justice. In covariance analyses, low organizational justice and low job involvement were associated with a higher likelihood of retirement intention. Both interactional justice and procedural justice moderated the association of job involvement with retirement intentions. Among nurses with low job involvement, those who experienced unjust treatment, that is, low interactional justice, and evaluated organizational procedures as unjust had significantly stronger retirement intentions than nurses with high levels of interactional and procedural justice. Distributive justice was associated with retirement intentions in both high and low job-involved respondents. Organizational justice may act as a buffer against retirement intention as one consequence of nurses' low job involvement. © 2016 Wiley Periodicals, Inc.

Newly graduated nurses' occupational commitment and its associations with professional competence and work-related factors.

To explore newly graduated nurses' occupational commitment and its associations with their self-assessed professional competence and other work-related factors. As a factor affecting nurse turnover, newly graduated nurses' occupational commitment and its associations with work-related factors needs exploring to retain adequate workforce. Nurses' commitment has mainly been studied as organisational commitment, but newly graduated nurses' occupational commitment and its association with work-related factors needs further studying. This study used descriptive, cross-sectional, correlation design. A convenience sample of 318 newly graduated nurses in Finland participated responding to an electronic questionnaire. Statistical software, NCSS version 9, was used in data analysis. Frequencies, percentages, ranges, means and standard deviations summarised the data. Multivariate Analyses of Variance estimated associations between occupational commitment and work-related variables. IBM SPSS Amos version 22 estimated the model fit of Occupational Commitment Scale and Nurse Competence Scale. Newly graduated nurses' occupational commitment was good, affective commitment reaching the highest mean score. There was a significant difference between the nurse groups in favour of nurses at higher competence levels in all subscales except in limited alternatives occupational commitment. Multivariate analyses revealed significant associations between subscales of commitment and competence, turnover intentions, job satisfaction, earlier professional education and work sector, competence counting only through affective dimension. The association between occupational commitment and low turnover intentions and satisfaction with nursing occupation was strong. Higher general competence indicated higher overall occupational commitment. Managers' recognition of the influence of all dimensions of occupational commitment in newly graduated nurses' professional development is important. Follow-up studies of newly graduated nurses' commitment, its relationship with quality care, managers' role in enhancing commitment and evaluation of the impact of interventions on improving commitment need further studying.