Nursing Work Research Articles

Factors Influencing Children’s Hospital Nurses’ Safety Accident Management Activities for Hospitalized Children

Background: We aimed to identify the factors influencing safety accident management activities for hospitalized children in children’s hospitals. Methods: In August 2022, data were collected from 170 nurses across seven children’s hospitals in Gwangju Metropolitan City, Korea. The collected data were analyzed using independent t-tests, analysis of variance, Pearson’s correlation analysis, and multiple regression analysis. Results: Safety accident management activities for hospitalized children differ significantly based on nurses’ experience in children’s hospitals (P=0.048). Safety accident management activities were positively correlated with patient safety culture (r=0.47, P<0.001), critical thinking (r=0.35, P<0.001), and nursing work environment (r=0.51, P<0.001). Furthermore, the most influential determinant of safety accident management activities for hospitalized children was the nursing work environment (β=0.42, P<0.001), followed by nurses’ experience in children’s hospitals (β=0.20, P=0.004), and patient safety culture (β=0.17, P=0.041). These variables had an explanatory power of 34.0 % (adjusted R2=0.34, P<0.001). Conclusion: A positive nursing work environment and strong patient safety culture are essential for increasing safety accident management activities among children’s hospital nurses. Additionally, children’s hospitals should provide support to the nursing staff and implement policies that encourage long-term retention of experienced nurses.

The Correlation Between Effort–Reward Imbalance at Work and the Risk of Burnout Among Nursing Staff Working in an Emergency Department—A Pilot Study

Background: Nurses in emergency rooms face high levels of psychological stress during their work, which is why they have an increased risk of burnout. The aim of this pilot study was to determine the extent to which effort–reward imbalance (ERI) at work is connected to the risk of burnout among emergency nurses. Methodology: Thirty-five nurses from the central emergency department of a maximum care provider, aged 35.1 ± 0.6 years, voluntarily participated in this pilot study. ERI was recorded using the Effort–Reward Imbalance questionnaire. The nurses were then divided into two groups: the nonrisk group (ERI ratio < 1, n = 19) and the risk group (ERI ratio ≥ 1, n = 16). The burnout dimensions were determined via the Maslach Burnout Inventory (MBI) and the burnout risk was then determined. Results: Nurses in the nonrisk group were significantly less emotionally exhausted (1.6 ± 1.1 points) and had a lower overall risk of burnout (MBI total score 1.2 ± 0.67 points) than the nurses of the risk group. (3.3 ± 1.5 and 2.2 ± 1.2 points, respectively). Eighteen nurses from the total sample had a medium or high risk of burnout. There is a correlation between the risk of burnout and the ERI ratio (r = 0.392, p < 0.05) and the ERI scale “job promotion” (r = −0.462, p < 0.05). Conclusions: The pilot study provides indications of a relationship between effort–reward imbalance at work and burnout risk in emergency nurses. These findings may improve rewards for nurses in the form of increased salary and/or recognition to reduce the risk of burnout among employees and avoid turnover. Further research is needed to investigate the influence of preventive measures on the risk of burnout and gratification crises, particularly with regard to the influence of status and recognition on the risk of burnout.

The professional quality of life of flight nurses: a cross-sectional study

Background The role of a Flight Nurse is specialised; they must have both education and experience to fulfil the requirements of the role. Mastering these skills takes time, thus long-term retention is essential. When nurses experience their work as more fulfilling, they are more inclined to remain within a role for an extended period. One of the ways to determine the lived experience of nurses is to measure their Professional Quality of Life. This is the first study to look at the Professional Quality of Life of Flight Nurses who work in public sector Aeromedical Retrieval Services in New Zealand. Aims The aim of this study was to determine the Professional Quality of Life of Flight Nurses working in the public sector in New Zealand. Design A survey based cross-sectional design was employed, using the Professional Quality of Life (ProQOL) V Health survey tool. Methods Online survey data was collected from a convenience sample of 169 Flight Nurses working in public sector Aeromedical Retrieval services in New Zealand. Results Of the 88 respondents, all reported either high or average levels of Compassion Satisfaction (High 48.86%, Average 51.13%) and Perceived support (High 44.31%, Average 55.68%). The majority reported Low to Average scores for Secondary Traumatic Stress (Low 30.68%, Average 67.04% and High 2.27%), Burnout (Low 4.54%, Average 89.77% and High 5.68%) and Moral Distress (Low 23.86% and Average 76.13%). Conclusion This study highlights that Flight Nurses in New Zealand’s public sector generally experience a positive Professional Quality of Life, but that there are also instances of Burnout and Secondary Traumatic stress. Impact statement The finding of this study indicates that Flight Nurses who work in the public sector in New Zealand, have an average to high degree of the positive Professional Quality of Life – Compassion Satisfaction and Perceived Support, and a lower degree of the negative aspects of their work – Burnout, Secondary Traumatic Stress and Moral Distress.

Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care

Occupational burnout syndrome is characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment and is prevalent among nurses. Although previous meta-analyses have explored the correlates of nurse burnout, none have estimated their association with health care quality and safety and patient morbidity and mortality. To evaluate the magnitude and moderators of the association between nurse burnout and patient safety, patient satisfaction, and quality of care. The Web of Science, Scopus, MEDLINE, Embase, PsycINFO, CINAHL, and ProQuest databases were searched from January 1, 1994, to February 29, 2024. Two reviewers independently identified studies that reported a quantifiable association between nurse burnout and any of the outcomes of patient safety, patient satisfaction, or quality of health care. The PRISMA 2020 guideline was followed. Two reviewers independently extracted the standardized mean difference (SMD) (Cohen d) estimates for a random-effects meta-analysis. Subgroup analyses and meta-regressions were conducted using prespecified variables. Any measure of patient safety, patient satisfaction, or quality of health care previously associated with nurse burnout. A total of 85 studies (81 cross-sectional and 4 longitudinal) involving 288 581 nurses from 32 countries (mean [SD] age, 33.9 (2.1) years; 82.7% female; mean [SD] burnout prevalence rate with study-specific ascertainments, 30.7% [9.7%]) were included. Nurse burnout was associated with a lower safety climate or culture (SMD, -0.68; 95% CI, -0.83 to -0.54), lower safety grade (SMD, -0.53; 95% CI, -0.72 to -0.34), and more frequent nosocomial infections (SMD, -0.20; 95% CI, -0.36 to -0.04), patient falls (SMD, -0.12; 95% CI, -0.22 to -0.03), medication errors (SMD, -0.30; 95% CI, -0.48 to -0.11), adverse events or patient safety incidents (SMD, -0.42; 95% CI, -0.76 to -0.07), and missed care or care left undone (SMD, -0.58; 95% CI, -0.91 to -0.26) but not with the frequency of pressure ulcers. Nurse burnout was also associated with lower patient satisfaction ratings (SMD, -0.51; 95% CI, -0.86 to -0.17) but not with the frequencies of patient complaints or patient abuse. Finally, nurse burnout was associated with lower nurse-assessed quality of care (SMD, -0.44; 95% CI, -0.57 to -0.30) but not with standardized mortality rate. The associations were consistent across nurses' age, sex, work experience, and geography and persistent over time. For patient safety outcomes, the association was smaller for the low personal accomplishment subcomponent of burnout than for emotional exhaustion or depersonalization, as well as for nurses with a college education. In this systematic review and meta-analysis, nurse burnout was found to be associated with lower health care quality and safety and lower patient satisfaction. This association was consistent across nurse and study characteristics.

Differentiating Occupational Burnout Among Chinese Nurses: Moderating Roles in Nursing Work Environment and Perceived Care Quality

Objective: To investigate and identify different profiles of occupational burnout among Chinese nurses and explore how these burnout profiles moderate the relationship between the nursing work environment and perceived care quality. Methods: Cross-sectional data retrieved from the Chinese Nursing Work Environment Survey (C-NWES) were used for analysis. Variables of interest included occupational burnout, the nursing work environment, nurses’ perceived care quality, and demographic characteristics. Latent profile analysis was employed to identify potential profiles of occupational burnout, which were subsequently used as moderating variables to explore the relationship between the nursing work environment and perceived care quality. Results: Four profiles of occupational burnout were identified among Chinese nurses: Self-Fulfillment profile (38.3%), Emotional Exhaustion profile (37.7%), Lack of Accomplishment profile (16.6%), and Self-Isolation profile (7.4%). Among these, nurses in the Self-Fulfillment profile showed the greatest responsiveness to changes in the work environment, followed by those in the Self-Isolation profile, with the Emotional Exhaustion profile being the least responsive. Conclusions: The findings highlight the need for tailored interventions to address the specific needs of distinct nurse groups experiencing burnout, enabling organizations to improve nurses’ well-being, work performance, and patient care quality.

Workplace Bullying and Sustainable Development Goals among Nurses Working in Different Health Care Sectors

Workplace Bullying and Sustainable Development Goals among Nurses Working in Different Health Care Sectors

Nursing in a culture of peace

The knowledge and practice in the field of Peacebuilding is congruent with Nursing and offers important dimensions and insight that can strengthen the work of Nurses in building safe and healthy communities and individuals. This article summarizes key literature and discussions with faculty in each field to outline impactful opportunities for interprofessional collaboration around peace and health. An exemplary case for collaboration is found in the work of understanding and addressing direct and indirect violence locally and globally.

Navigating uncertainties for promoting nurse-led changes in work environments: a participatory action research

BackgroundThe nursing work environment is crucial for nurses' well-being and patients’ quality of care. Despite effective interventions to improve the nursing work environment, understanding the most effective types and integration mechanisms for nurses remain challenging. As nursing practices evolve amid complex care demands and staff shortages, understanding nurses’ challenges, support systems, and adoption mechanisms is vital to optimize the work environment and to enhance quality of care, job satisfaction, and staff retention. PurposeTo explore strategies for promoting and supporting nurse-led changes to improving their work environment. MethodsThe study employed a participatory action research design on three nursing wards in a Dutch academic hospital. Action research teams with diverse ward nurses were established on each ward. The research took place between September 2022 and October 2023. Data were collected during observations, PhotoVoice workshops, and individual interviews. Data were analyzed using the rigorous and accelerated data reduction technique. ResultsNurses and managers showed patterns of behavior that either hindered or facilitated changes, leading to the emergence of three themes: strengthening relationships, taking the lead, and being up to the task. These themes highlight the importance of fostering collaboration, encouraging proactive attitudes, and building capabilities to address challenges and drive positive changes in their work environment. Feelings of uncertainty emerged in all themes, and this uncertainty hindered nurses from taking responsibility for facilitating change. ConclusionsThis study demonstrated different mechanisms that either facilitate or hinder nurse-led changes and how feelings of uncertainty play a role. Nurses emphasized the importance of collaboration and proactive attitudes but faced challenges in recognizing responsibility and their perceived competencies. Strengthening nurses' resilience to and management of uncertainty is essential. Healthcare organizations should help nurses navigate uncertainty to foster positive changes. Tweetable abstractCollaboration, proactivity, and competency are key in nurse-led changes. Strengthening nurses' resilience and uncertainty management is crucial.

Effectiveness of End-of-Life Care Debriefing for Intensive Care Unit Nurses

Purpose : This study aimed to determine the effectiveness of end-of-life care debriefing as an intervention to reduce moral distress among intensive care unit (ICU) nurses after end-of-life care. Methods : This quasiexperimental study included 104 nurses (46 in the control group and 58 in the intervention group) working in three medical ICUs and two surgical ICUs. The data collection period was from September 1, 2017, to January 31, 2018, and end-of-life care debriefing in the intervention group was implemented over three months. Debriefings were conducted in groups or individually, with eight people participating in three or more debriefings. Comparisons of end-of-life care stress, end-of-life care attitudes, and wellness between the two groups were performed using an ANCOVA. Satisfaction with the debriefing was analyzed using descriptive statistics. Results : End-of-life care stress and wellness did not differ between the groups, but there was a significant difference in end-of-life care attitudes. Overall, 50% of the participants were satisfied with the debriefing. Conclusion : Based on the finding that end-of-life care debriefing has a positive impact on ICU nurses’ attitudes toward end-of-life care, it can be used as an effective measure to reduce nurses’ moral distress. An institutional debriefing system should be established and operationalized.

Relationship of the Perioperative Nurse Work Environment With a Culture of Safety and High Reliability

PurposeThe purpose of this study was to examine dimensions of the perioperative work environment and their associations with the operating room (OR) culture of safety and high-reliability characteristics. DesignA predictive correlational design using a cross-sectional survey was used. MethodsA convenience sample of perioperative nurses (N = 96) was used to evaluate strength of associations of their work environment with OR safety culture and high-reliability organizational culture. In addition, the best predictive models for OR culture of safety and high-reliability characteristics were used. FindingsFindings indicated that the five dimensions of the work environment are significant predictors of a safety culture; however, only Collegial Relationships and Nursing Foundations for Quality of Care significantly predict high reliability. ConclusionsDue to the extraordinary responsibility perioperative nurses hold to maintain safety standards for surgical patients, it is critical to fortify elements of the nurse work environment.

Which diversity factors influence the attribution of competences and co-operation in nursing teams?

Abstract Background Diversity within nursing teams increases due to staff shortages in Germany, nurse migration and the current academization of the profession. Quality of patient care is associated with intraprofessional teamwork. Little is known about how nurse’s own diversity factors and those of team members impact nurse’s perception and behavior in team situations. Methods A quasi-experimental, cross-sectional study with a factorial online survey with fictional case studies (vignettes) was conducted in two German hospital operators in 2023. Nurses of legal age working in hospitals or nursing homes were eligible to participate. Associations of diversity factors, i.e., gender, age, migration background, and qualification, on the participant and vignette level on perceived competences and willingness to cooperate were preliminary analyzed via multi-level fixed effects models in SPSS. Results N = 684 nurses participated (76% female; mean age: 44.2 years; 88% born in Germany; 75% completed vocational training). Competency of team members in patient’s personal hygiene was rated higher by respondents born in Germany (.36), when fictional colleagues were of middle age (.06) compared to higher age and were from Germany (.22) or France (.08) compared to China. Competency in inserting infusions was rated higher by respondents born in Germany (.56), when fictional colleagues were from Germany (.29) or France (.20) compared to China and when one worked together for months compared to days (-.39). Willingness to swap shifts was affected by the fictional length of collaboration (-.08). All significance levels were p<.02. Conclusions How nurses perceive their colleagues’ competences is mainly influenced by their own and the other’s migration background, while willingness to cooperate is only affected by length of collaboration. Improving the onboarding process of new nurses in teams, and providing the time and space for professional exchange might improve mutual trust and teamwork. Key messages • Diversity in German nursing teams increases due to nurse migration and plurality of qualifications. • Facilitating professional exchange about individual competences might improve team work in nurses.

It must not be dangerous to talk about it! Parents views of communication with schoolnurses on weight

Abstract Background The study aimed to describe parents’ experiences of communication with school nurses concerning the growth data and weight development of their children aged 8 and 10 years old in Sweden. Methods The design was descriptive and qualitative. 15 women and 3 men in south Sweden were included, with children who had performed health visits in the School Health Service (SHS). Data were collected through in - person semi structured interviews. Qualitative content analysis was used. Results The results illustrated the health visit’s purpose as unclear with need for improved dialogue and lacking feedback from the SHS. “To be able to get guidelines of what is the normal growth and what is a normal deviation and maybe a bit more about diet and lifestyle and movement.” The need for an improved channel for receiving information from SHS, and access to their child’s growth data. “Couldn’t they have a school nurse site or information page, where you get information about your child from the day they enroll in school until they leave.” Parents experienced a lack of a child-centered perspective, described the child’s context as not in focus, and desired collaboration. “I think that it is very important that children feel good in their bodies, and that is a really important task for health care.” Conclusions (a) Initiating a discussion regarding the preventive health work of school nurses and the main assignment of SHS. (b) Development of a child-centered perspective towards parents and children with focus on the child’s entire social context. (c) Implementation of evidence-based methods for communicating growth data and weight development between SHS and parents. Key messages • An increased dialogue between parents and SHS was requested, with a reachable way of communication via a digital platform. • A holistic view of the child, with positive professional attitudes seem essential to meet the needs of the child.

ATUAÇÃO DA ENFERMAGEM À CRIANÇA COM LEUCEMIA E EM CUIDADOS PALIATIVOS

Introduction: Cancer in pediatrics is always a challenge. Palliative care is a difficult discussion to be dealt with the family and the role of the nurse in this matter is essential. Objective: To describe the nursing practice in children with leukemia and in palliative care. Materials and methods: This is an integrative literature review that took as a research question "what is the role of nursing in children diagnosed with leukemia and in palliative care?". To this end, the search for articles took place through the Virtual Health Library, using the following inclusion criteria: publications between the years 2019 and 2023, in Portuguese and English. Results: A total of 20 articles were included in this review, 13 of which were developed in Brazil. Discussion: To facilitate the understanding of the findings, three topics were established: the implications of leukemia in children and caregivers; nurses' role in the care of children and families with leukemia and in palliative care; Importance of the nurse's role as a health educator. Conclusions: The results emphasized an important participation of the nurse in palliative care, being part of the reception of both the child and the family members/guardians. However, there is a limitation regarding specific studies that relate to the work of nurses, palliative care and children with leukemia.

Experts in promotion and prevention - The 100th Anniversary of Finnish public health nurse education

Abstract Issue/Problem Two key public health issues at present are mental health problems and obesity. Both typically begin before adulthood and once occurred, typically persist. Prevention would be important but also economically and humanely sensible. For this, competent experts in preventive work and health promotion are needed. Description of the problem Public health nurse education, originally known as health sister education, was initiated in Finland in 1924, by the Mannerheim League for Child Welfare. The six-month health sister education was targeted at nurses and began from the desire to focus not only on treating diseases but also on promoting health. In the 1940s, education was reformed and in the 1950s significantly expanded. In the 1970s, the professional title changed from ‘health sister’ to ‘public health nurse’. In 1987, the education was extended to 3 years, including the education of registered nurses. In 1992, the education was further extended to 3.5 years. By the beginning of the 21st century, education evolved into 4 years bachelor’s degree. Results In 2024, eighteen Universities of Applied Sciences provide public health nurse education in Finland. The 4-year Bachelor of Health Care in Public Health Nursing -degree (240 ECTS credits) also qualifies for a registered nurse. Nearly half of the education consists of clinical training. In addition, registered nurses can supplement their degrees by completing a one-year education (60 ECTS credits) that qualifies them as public health nurses. Lessons In Finland, approximately 700 new public health nurses graduate annually. They are trained to work independently as experts in preventive work, health promotion, and public health. Around 9,500 Finnish public health nurses work in settings such as maternity and child health clinics, school health services, occupational health care, and outpatient clinics. Key messages • Due to the overcrowding in many healthcare services providing treatment, educating experts in health promotion and disease prevention is crucial now and in the future. • By ensuring competent experts in health promotion and disease prevention, future healthcare services can continue to provide economically and humanely sensible and effective help for people.

"Organizing practice": The hidden work of homecare nurses in fighting health inequity and advancing social justice.

The nursing profession has a long history of advocating for social justice and health equity, and both values profoundly infuse nursing ethics, theory, and education. Homecare nursing occurs between the patient's daily life at home and the public health care system. Therefore, homecare nurses ideally possess insight into the living conditions and social determinants of health that their patients experience. This interpretive phenomenological study explores the strategies employed by homecare nurses to fight health inequity and advance social justice. Data were collected through participant observations, situational interviews, and small group interviews with 12 homecare nurses from two municipalities. Three analytical approaches were used: paradigm cases, exemplars, and thematic analysis. The data identified two primary strategies homecare nurses use to circumvent, solve, and mitigate the negative consequences of social determinants of health on patients' care and treatment: "Negotiating practice" and "Aligning practice." "Negotiating practice" ensures that care and treatment are delivered in a way acceptable to all involved. "Aligning practice" ensures cohesion, progression in the treatment and care trajectory, and support for patients and relatives in navigating the system. Both strategies are part of nurses' largely hidden work, reflecting the nursing profession's position as nested between the individual patient and the system.

Attitude toward vital signs monitoring and its predictors among clinical nurses in Saudi Arabia.

Positive attitudes toward assessing vital signs are essential in ensuring quality assessments and recognizing patients' declining conditions. However, few studies have been conducted that examine the attitudes of nurses toward this fundamental nursing skill. This research investigated the predictors of clinical nurses' attitudes toward vital signs monitoring in identifying the patients' deteriorating state. A cross-sectional, correlational study was conducted in two hospitals in Saudi Arabia. A sample of 427 clinical nurses was surveyed from February 2023 and April 2023 using a questionnaire on attitudes toward vital signs monitoring. The subscale "key indicators" achieved the highest mean, followed by "workload," "communication," and "knowledge." The hospital where the nurses work (Hospitals 1 and 2), younger age, gender (being male), marital status (being single), clinical area (working in intensive care unit), number of handled patients per shift (handling 11-20 and > 20 patients), and longer years of experience were identified as significant predictors of the nurses' positive attitude toward vital signs monitoring. This research provides valuable knowledge on which aspect of the attitudes toward vital signs monitoring necessitates educational enhancement among clinical nurses. The factors influencing the clinical nurses' attitude toward vital signs monitoring reported in this study may be useful for nurse managers and other hospital policymakers in developing focused continuing educational interventions targeting enhanced vital signs monitoring competencies.

ANXIETY, DEPRESSION, AND QUALITY OF LIFE OF NURSES WORKING IN PUBLIC HOSPITALS

Nursing is often described as the art of caring, providing holistic patient assistance without time restrictions. However, due to this nature of work, it is common for these professionals to present symptoms of mental illnesses such as anxiety and depression. This results in a reduction in the quality of life at work, directly affecting the efficiency of care provision. This study aimed to verify the presence of anxiety and depression symptoms, as well as the index of quality of life at work among nurses working in the inpatient sector of public hospitals in the city of Aracaju. Among the 128 professionals included in the sample, 46.1% presented anxiety symptoms and 30.5% depression symptoms, according to the HADS scale. Additionally, 66.4% of nurses reported an unsatisfactory quality of life at work index (QLWI). The majority of professionals who presented symptoms of both diseases were female; 17.2% had two employment bonds, and 19.5% reported an unsatisfactory QLWI. Therefore, it is possible to infer that the accumulation of employment bonds and the reduction in quality of life at work may have been determining factors for the development of these symptoms. It is concluded that it is extremely important to improve working conditions, safety, and remuneration, as well as increase the institutional appreciation and recognition of nursing professionals. This would contribute to raising the quality of life indices at work and reducing the need for multiple employment bonds.

Factors influencing medication errors among nurses at a tertiary level hospital in Bangladesh

Medication errors represent a significant global issue, leading to numerous fatalities each year and adding complexity to healthcare systems. In Bangladesh, the prevalence of medication errors stands at 38%. This study aimed to identify the factors that influence medication errors among nurses at a tertiary-level hospital in the country. A descriptive cross-sectional study was conducted involving 114 registered nurses at Dhaka Medical College Hospital, utilizing a convenience sampling method. Data were gathered through face-to-face interviews using a structured questionnaire and analyzed using both descriptive and inferential statistics. The findings indicated that nurses in Bangladesh exhibited moderate to high susceptibility to medication errors in a tertiary-level setting. Key factors identified as contributing to these errors included inadequate staffing levels (4.41 ± 0.81), patients being off the ward for other care (4.39 ± 0.74), communication issues between nurses and physicians (4.36 ± 0.95), nurses being pulled between teams and other units (4.32 ± 0.77), and insufficient in-service training on new medications (4.23 ± 0.87). Moreover, nurses working ward (F=11.51, P=.001) and working experience (t=4.13, P=.041) had a significant relationship with factors influencing medication errors. The research found several variables that cause medication mistakes, including nurses' service experience and working ward. This study's results might help hospital administrators establish effective intervention methods and mitigate medication error risk variables to improve patient safety and care. Asian J. Med. Biol. Res. 2024, 10(4), 131-140

Exploring The Connection of Spirituality at Work in Enhancing Nurses’ Job Performance: Insight from Malaysian Hospitals

The performance of nurses can be seen as a reflection of healthcare organizations, as they constitute the most critical human resources within hospitals. However, challenges arise when issues such as staff shortages, high turnover rates, and burdensome workloads contribute to poor nurse performance. Conversely, the incorporation of spirituality in the workplace provides nurses with an opportunity to align their inner selves within a supportive community environment, fostering a deeper sense of purpose in their professional responsibilities. This study sought to determine the connection between spirituality at work and nurses’ job performance, surveying 350 nurses employed in public hospitals across Malaysia. Data analysis was conducted using Statistical Package for Social Sciences (SPSS) software version 27, revealing that all three aspects of spirituality at work, namely inner life, meaningful work, and sense of community, had a positive and significant influence on nurses’ job performance. This study provides potential aid to decision-makers in Malaysian healthcare organizations by offering significant insights for the development of strong spirituality at work values within their organizational setting. Additionally, this study presents recommendations for future research and proposes methods for the authorities to incorporate spirituality at work values into nurses’ jobs, ultimately enhancing the overall performance of healthcare services.

Examining graduate student perspectives on supervision and peer mentoring across four professional faculties

Purpose The purpose of the study was to examine graduate student perspectives on the common and unique roles peer mentors and supervisors play in supporting student success and wellbeing during their program. Design/methodology/approach A qualitative research design involving semistructured interviews with 62 thesis-based masters and doctoral students from four professional faculties, Education, Medicine, Nursing and Social Work, at a large public research-intensive university in Canada. Findings Findings transcend the four disciplines of study. Communities of support are described that involve both supervisors and peers in combination, clusters of meaning by supervisory paradigm are identified and original findings presented that expand upon the learning alliance framework by explicitly considering the role of peer mentors in graduate student success. Research limitations/implications While supervisors bear primary responsibility for fostering effective research-based relationships, this study’s findings strengthen the argument that mentoring and advising of graduate students is most effective when conducted within a collaborative community of support that involves learning alliances among faculty, peers, program staff and academic leaders across the institution. Practical implications A four-pronged approach to graduate education that emphasizes the collective responsibility of institutions, programs, supervisors and students in creating a supportive ecosystem for holistic graduate student academic success and wellbeing is recommended. Social implications Key argument that it is essential to embrace a collaborative and community of support mindset, where multiple stakeholders actively contribute to the wellbeing and academic development of graduate students throughout their programs. Originality/value A cross-disciplinary perspective is offered on the importance of both supervisors and peers in assisting thesis-based graduate students to successfully navigate academic, social and personal journeys through graduate school.