Graduate Nurses Research Articles

Assessment the Job Satisfaction and Intention to Quit the Job among Staff Nurses

Background: The nursing profession is essential to the healthcare system, primarily focused on patient care and health restoration. Recent studies have highlighted a global shortage of nurses and the consequential impact on healthcare delivery. Job satisfaction and retention are crucial in addressing these shortages, yet little is known about the current state of these factors among nurses in teaching hospitals. Objective: This study aimed to assess job satisfaction and the intention to quit among nurses in a teaching hospital to identify key factors that could help improve retention rates and job satisfaction. Methods: A descriptive cross-sectional survey was conducted over a six-month period at a teaching hospital. The study involved 138 nurses, including registered nurses, diploma nurses, and graduate nurses. Data were collected using a validated questionnaire, focusing on demographic variables, job satisfaction, and turnover intentions. The sample size was calculated using Sullivan's formula, and the analysis was performed using SPSS version 25. Descriptive statistics were employed, and the normality of data distribution was verified. Results: The study found varying degrees of job satisfaction among nurses. Only 30.4% of participants were satisfied with their compensation, and 52.1% doubted their career choice. About 50% were actively looking for better job opportunities. A significant 60.1% reported that working hours negatively impacted their social life, and 70.3% experienced a lack of support from management. Additionally, only 51.0% of nurses found communication from management to be clear. Conclusion: The low level of job satisfaction and high intention to quit among nurses at the teaching hospital indicate urgent needs for improvement in compensation, management support, and work-life balance. Strategies to enhance communication and support from management could potentially increase job satisfaction and reduce turnover intentions.

Implementation of Cultural Awareness and Cognitive Bias Training Within Graduate Nursing Programs.

Cognitive bias negatively affects patient outcomes, resulting in medical errors, sentinel events, and legal claims. The brunt of bias-induced inequities and disparities has fallen on Black and Brown people, women, and the LGBTQ+ communities. Faculty training programs have rapidly increased in number, whereas student training has lagged. A three-part curricular series was developed for students seeking nurse practitioner (NP) training. The series addressed racial bias, microaggression, and gender bias using vignettes and guided pre- and debriefing. The series was initially implemented to 70 students from four different specialty areas of study. Students resoundingly reported the content as valuable and challenging and the environment as a safe space to learn, be vulnerable, and be empathetic to the experiences of others. This three-part series has been implemented across eight NP majors and has become a required component of the NP on-campus intensive experience. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Twitter Chats as an Alternative to Discussion Boards in Graduate Nursing Courses.

Health care is increasingly dependent on technology and social media for communication. Nurse educators are tasked with developing a nursing workforce equipped with digital literacy to deliver safe, quality patient care. Twitter (now X) chats are an alternative social engagement opportunity for online nursing education students that can facilitate digital literacy. The instructor of an 8-week online nursing education course revised three required discussions as Twitter chats. Written instructions for the Twitter chats were provided, as well as a podcast. Self-report data and Twitter analytics were analyzed. Findings identified the benefits of incorporating a social media platform into traditional coursework. Chats helped students view course objectives in a new light and increased understanding of class content. Twitter is a social media technology that can help nursing students educationally and professionally. [J Nurs Educ. 2024;63(10):709-712.].

Developing a ‘national module’ for nurses considering a career in general practice: addressing the workforce crisis in primary care

The age profile of GPNs means that the pool of experienced GPNs available to recruit is rapidly shrinking. This article looks at potential solutions to the workforce crisis affecting practice nursing If the predicted workforce crisis in primary care is to be avoided, there is a clear need to increase the number of student nurses considering a career in general practice. Initiatives such as the NHS England national module, described here, are integral to this process. Of the HEIs nationally that responded to a tender from NHS England, SHU was one of seven HEIs awarded a contract to deliver the module. The SHU module uses a blended approach to learning and provides learners with an insight into general practice and the role of the general practice nurse. It is unique in that it is delivered in partnership with the South Yorkshire Primary Care Workforce and Training Hub and is designed to create a workforce ‘pipeline’ of new graduate nurses who will be equipped to access a regional career pathway for general practice nurses.

New Graduate Nurses' Experiences by Generation in South Korea: A Qualitative Meta-Synthesis.

As the nursing organization environment evolves into one in which several generations work together, there are concerns about generational differences leading to conflicts. A synthesis of qualitative studies was used to gain insight into the experiences and perceptions of new nurses working in South Korean hospitals and identify generational differences between nurses of Generations X and Y. Eight databases were searched systematically for qualitative studies published up to June 2020. The Critical Appraisal Skills Programme Checklist for Qualitative Research was used to evaluate the quality of the retrieved studies, and the data were synthesized thematically using the Thomas and Harden method. Of the 2,482 studies retrieved, 19 were included in this meta-synthesis. The experience of new nurses were presented in the three analytical themes of work experience, interpersonal relationships, and adaptation, from which eight descriptive themes were derived: (a) dissatisfied with own work performance, (b) negative feedback on work outcomes, (c) irregular daily life, (d) colleagues who help adapt to work life or make work life harder, (e) feelings of sympathy toward peers, (f) disrespectful patients or caregivers, (g) effective reactions, and (h) ineffective reactions. Although the new nurses from Generations X and Y reported similar experiences during their first year of nursing, differences were found in their values and tendencies regarding work and interpersonal relationships. Compared with new Generation X nurses, new Generation Y nurses placed more value on the meaning of individual work contributions, intimacy with colleagues, and appropriate feedback. The findings of this study support nursing administrators implementing strategies that both acknowledge and reduce the impact of generational category on nursing teams. Furthermore, emphasizing communication and acknowledging ongoing change as generations progress may strengthen bonds that lead nurses to value each other and their work.

Taking New Approaches to Coaching and Care Can Lift Nursing Numbers.

Nurses are the backbone of healthcare. Their retention and recruitment are essential to the success and sustainability of healthcare providers. For many years, Portland, Oregon-based Legacy Health enjoyed the luxury of a registered nurse (RN) turnover rate consistently as low as 7.6 percent and a vacancy rate of 2.49 percent. Suddenly, COVID-19 and a confounding exodus of nurses from the profession overran this excellent track record. Today, Legacy Health is rebuilding its RN workforce and staff resilience through new initiatives. Even with a dwindling RN talent pool and vacancy rates rapidly growing into the double digits, the leadership is closing the gap. For example, a coach model for precepting new graduate nurses has allowed the RN residency program to grow by more than 300 percent. Programs such as Schwartz Rounds, Code Lavender, and an inpatient throughput initiative are also improving RN wellness, reducing stress, and increasing retention.

Prelicensure Nursing Students' Attitudes Toward Patients With Cancer Revisited.

Recruiting graduate nurses into oncology practice postgraduation continues to be challenging. Graduate nurses tend to prefer clinical settings that they consider high-tech or challenging, with oncology ranking low. In additio.

New Graduate Nurses' Approaches to Death and Dying Patients and the Relationship Between Death Anxiety and Death Awareness: A Cross-Sectional Study.

One of the challenges experienced by new graduate nurses during the transition into practice is caring for dying patients. This study aimed to determine new graduate nurses' approaches to death and dying patients and the relationship between death anxiety and death awareness. This descriptive, cross-sectional study was conducted with 226 new graduate nurses in Istanbul, Türkiye. A personal and work environment characteristics form, the Approach to Death and Dying Patients Attitude Scale, Templer's Death Anxiety Scale, and Multidimensional Mortality Awareness Measure were used to collect data. Hardness in communicating with the dying patients (hardness: meaning difficulty) and their relatives and avoiding death and dying patients were considered moderate, with mean scores of 2.64 ± .63 and 2.45 ± .40, out of 4. Death anxiety accounted for approximately 7% of the variance of hardness in communicating with dying patients and their relatives, which is statistically significant. Death awareness statistically significantly explained 9.7% of avoiding death and dying patients. For new graduate nurses, besides simulation-based training on end-of-life care, approaches to sharing their experiences about death and programs to determine a value system related to death may be recommended.

Effects of a Standardized Patient-Based Delirium Care Education Program.

Background and Purpose: An education program to improve the delirium care competency of nurses is important as they play an integral role in caring for patients with delirium. This study aimed to examine the effects of a standardized patient (SP)-based delirium care education program on new graduate nurses' performance and self-confidence. Methods: A waitlist control group with a crossover design was adopted. The SP-based delirium care education program was designed, implemented, and evaluated. Generalized estimating equations were used to analyze differences in performance and self-confidence scores between the intervention and waitlist control groups. Results: The education program was found to significantly affect rater-assessed performance, SP-assessed performance, and self-confidence when controlled for gender and age. Implications for Practice: An SP-based delirium care education program improved new graduate nurses' performance and self-confidence in caring for patients with delirium. Nurse educators should provide experiential learning opportunities to ensure that recent nurse graduates have achieved optimal delirium care competency.

Exploring work readiness: A qualitative descriptive study of self-perceptions among new graduate nurses

BackgroundReduced work readiness is associated with elevated turnover rates, necessitating efforts to enhance the positive work readiness of newly graduated nurses to alleviate the shortage in the nursing workforce. Research into the work readiness of recent nursing graduates in China is still in its infancy. Most studies employ quantitative research methods, and further exploration of the self-perception of work readiness among new nurses in China is required. ObjectivesThis study aimed to investigate genuine experiences and self-perceptions of work readiness among new graduate nurses. DesignA qualitative descriptive study. MethodsSixteen new nurses from a provincial tertiary hospital in China were included in this study, which adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist for reporting. The data collection process involved conducting semi-structured interviews from September to October 2021. Inductive content analysis was employed to analyze the interview data. ResultsThe study identified four themes encompassing new nurses' real-life experiences and self-perceptions of work readiness: psychological stress, emotional conflict, empathy fatigue, and ethical dilemmas. Psychological stress comprised three subthemes: knowledge and skill deficits, communication barriers, and fear. Empathy fatigue was primarily characterized by psychological and physical symptoms. Ethical dilemmas involved conflicts over differences in values and between clinical reality and standardized nursing practice. ConclusionDrawing from the self-perceptions of work readiness among new nurses found in this study, nursing administrators and educators must enhance the existing transition support program for new nurses. Additionally, the establishment of individualized training programs is recommended to further improve the work readiness of new nurses.

Evaluating the association between effort-reward imbalance and suboptimal health status among hospital nurses: a cross-sectional study.

Occupational stress is a common complaint in nurses, who perceived more sense of effort-reward imbalance (ERI). Suboptimal health status (SHS) is a state between health and disease. However, the correlation between ERI and SHS is unclear. Therefore, the aim of this study was to examine the prevalence of SHS and ERI and evaluate the relationship between ERI and SHS in clinical nurses by a cross-sectional study. The current cross-sectional study was conducted through an online survey at Dongping People's Hospital in China. A total of 633 completed surveys were received. Effort-reward imbalance was measured by subscales of the ERI questionnaire. SHS was measured by the Suboptimal Health Status Questionnaire - 25 (SHSQ-25). The relationship between ERI and SHS in nurses was subsequently assessed by Spearman's correlation coefficient and logistic regression model. The mean age of the optimal health status (OHS) group (M±SD 26.3±7.3 years) was younger than the SHS group (M±SD 30.3±6.9 years). The prevalence of SHS was 54.5% (345/633). Female nurses aged ≥30 years, a junior college or university graduate educational level, smokers, and nurses without regular exercise were at a higher risk of SHS. In Spearman's correlation analysis, ERI reflected by the effort-reward ratio was correlated with SHSQ-25 score (r = 0.662, p < 0.001). In logistic regression, ERI was strongly associated with SHS after potential confounding factors adjusting (OR 27.924, 95% CI 22.845-34.132). The prevalence of SHS was significantly high in clinical nurses. Administrators should pay more attention to health status of female nurses aged ≥30 years, with a junior college or bachelor's degree, smoking, and without regular exercise to reduce the SHS and ERI. Int J Occup Med Environ Health. 2024;37(2):166-75.

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.

New Graduate Nurses Transition: Role of Lack of Experience and Knowledge as Challenging Factors

Background: Insufficient experience and practical knowledge makes challenges in addressing health-care practice-related issues. Being a professional nurse after completing your nursing studies is a challenging time. Most frequently, the quantity of patients with severe illnesses and co-morbidities, the lack of mentorship, performance anxiety, communication issues, and the blame/complaint culture are blamed for the difficulties faced by inexperienced nurses. The study aimed to identify the challenges and the associated factors which limit the knowledge acquisition of new nurse graduates in Oman. Methodology: Using a cross-sectional study design, 104 people were selected as a sample from Ibri Hospital. We have adopted convenience and snowball sampling methods to reach out to the participants. The data was collected between June, 2022, to September, 2022. Data from nurses was gathered by a primary survey approach utilizing a closed-ended questionnaire. The statistical analysis was carried out using IBM SPSS (Statistical Tool for Social Sciences) version 20.0. Results: Nursing professionals face a number of obstacles, including role expectations, lack of confidence, workload, fear, and orientation concerns. In addition, variables including the physical environment, responsibility, support, and professional development contribute to their dissatisfaction. It is rare for newly graduated nurses to be assigned to cases where they lack the confidence to handle clinical cases. The study also found positive relationship between preceptor support and leadership/communication, organizing and prioritizing, professional satisfaction, and work satisfaction. Conclusion: The study came to the conclusion that the main problem facing nurses in the healthcare setting is transition. During their transitional time, newly graduated nurses face a variety of obstacles related to job expectations, confidence, workload, orientation, and concerns. To overcome these obstacles, nursing administrators and preceptors must come up with and apply important solutions. As a result, the current study suggests that transitional support initiatives are helpful in assisting recently graduated nurses. Also, hospital orientation programs are necessary to adapt to the changing demands of new nurses in a constantly evolving healthcare setting.

Experiences of Workplace Violence in Graduate Nursing Clinical Education.

Exposure to workplace violence (WPV) is common in health care, and little is known about nurse practitioner (NP) students' experiences during graduate nursing clinical education. This study described experiences of WPV among NP students during their clinical education. We conducted a cross-sectional, quantitative survey of a random sample of NPs licensed in Texas examining graduate nursing education experiences. A total of 334 NPs responded, a 12% response rate. More than a quarter (27%) experienced WPV during their graduate nursing clinical experience. Preceptors were the most reported perpetrators (44%). Most NPs remained in their clinical site after their WPV experience (55%); a majority felt they had no alternative clinical placement option. Nurse practitioner students experience WPV, and there may be implications for educational persistence and their careers. Future work should attempt to reduce the frequency of student WPV experiences and examine implications for NP careers.

Follow-Up of a Program to Improve Undergraduate and Graduate Nursing Student Diversity.

Underrepresented student recruitment is critical to resolve persistent gaps in workforce diversity in the United States. Prenursing and nursing students participated in a nursing workforce diversity program designed to recruit and graduate underrepresented students, which provided academic and student support, financial support, and mentoring. A follow-up study was conducted to identify the impact of the program. Participants were surveyed about educational and employment information, perceptions about factors that contributed to success, benefits of the program, and educational experience. Descriptive summaries of data and thematic analysis of qualitative comments occurred. Financial support, program quality, mentoring, career guidance, and meeting basic security needs were the strongest factors contributing to success. Program benefit themes included: feeling empowered, encouraging success, building confidence, and easing financial strain. Negative experiences with discrimination and bias were reported. Cocurricular support can help facilitate belonging. Scholarship awards communicate belief in student success, which impacts confidence and achievement.

Consumers’ Experiences of Comprehensive-Prepared Graduate Nurses and Their Nursing Care in Acute Mental Health Settings

Pre-registration nursing education has long moved away from preparing nurses with mental health specialisation to nurses with comprehensive knowledge and skills. However, the consumers’ experiences of comprehensive-prepared nurses and their nursing care has not been widely explored. This paper reports on a study with consumers to explore their experiences with comprehensive-prepared graduate nurses and the nursing care that they provide in acute mental health settings. An exploratory qualitative study using semi-structured interviews was chosen as the research method. Purposeful sampling recruited 12 consumers and data saturation was achieved. Braun and Clarke’s method of thematic analysis was used to analyse the collected data and three themes emerged. The themes are: (i) You got what it takes to be a mental health nurse, (ii) Slow down and spend quality time with us, and (iii) Read in between the lines when we share our negative lived experiences. The findings are useful for identifying strategies to develop evidence-based nursing education for comprehensive-prepared graduate nurses to improve the consumers’ experiences of their nursing care.

Observed Use of Clinical Judgment Among New Graduate Nurses.

Despite the efforts of academic nursing educators to prepare students to make sound clinical judgments, the literature suggests new graduate nurse (NGN) competence with this critical skill continues to decline. This study sought to identify how practicing nurses describe their observations of the use and outcomes of clinical judgment by NGNs in nursing practice. A multisite, cross-sectional survey using multiple-choice, Likert scale, and open response items to identify participants' observations of NGN clinical judgment was sent with snowball sampling and resulted in a sample of 314 participants from 19 U.S. states. Practice partners identified a wide discrepancy between how they expect NGNs to use clinical judgment and what they actually see NGNs do, with resultant negative effects on patients and NGNs. These results provide a beginning understanding of NGNs' specific challenges with clinical judgment. Efforts to improve clinical judgment across nursing education and practice are needed. [J Contin Educ Nurs. 2024;55(8):399-406.].

Clinical decision-making processes among graduate nurses, specialist nurses and nurse practitioners A collaborative international study.

To explore clinical decision-making by comparing the processes used by three groups of nurses in the emergency departments of three hospitals: in Norway, Finland and Ireland. Clinical decision-making in an emergency department environment is a complex process often occurring in times of crisis. It is an important aspect contributing to the quality of care. However, empirical research is limited regarding the decision-making process in different nursing roles. In accordance with the consolidated criteria for reporting qualitative research, a qualitative and observational study was conducted to explore clinical decision-making by comparing the processes used by three groups of nurses in the emergency departments of three hospitals: in Norway, Finland and Ireland. Six Registered Nurses, six Nurse Specialists and six Nurse Practitioners were observed. A total of 40hours of observation was made at each setting according to a structured observation guideline, followed by clarifying questions. The data material was analysed by means of a qualitative manifest and latent content analysis. Three themes arose: acting in accordance with routines, previous experience and intuition; considering patient experience; and facilitating new alternatives based on critical thinking. The Registered Nurses mainly used the first approach, the Nurse Specialists used the first and the second approaches, and the Nurse Practitioners used all three approaches. The results highlight the differences in decision-making processes between these groups. Nurse Practitioners were the only group that facilitated and evaluated new alternatives using their clinical autonomy, such as stepping up and making independent and collaborative decision-making. The results can be used in countries developing advanced practice nursing education and defining their scope of practice to inform stakeholders.

Influence of Academic Advising on Autonomy Support and Tasks Procrastination among Post Graduate Nursing Students

Influence of Academic Advising on Autonomy Support and Tasks Procrastination among Post Graduate Nursing Students

Knowledge of Nurses Regarding Palliative Care in Tertiary Care Hospitals of Peshawar: A Cross-Sectional Study

Background: Palliative care represents a crucial element in enhancing the quality of life for patients facing life-limiting illnesses. Despite its importance, there exists a significant gap in knowledge among nurses, who are pivotal in delivering this care. The literature reveals diverse levels of understanding and practices across different healthcare settings globally, underscoring the need for focused research and educational interventions in specific regions, including Pakistan. Objective: This study aimed to assess the knowledge of nurses regarding palliative care in tertiary care hospitals in Peshawar, Pakistan, identifying key areas for improvement and contributing to the global discourse on enhancing palliative care education and practices among nursing professionals. Methods: A cross-sectional study design was employed, with a sample size of 377 nurses selected through convenient sampling from August to November 2023. The Palliative Care Quiz for Nurses (PCQN) was utilized to assess knowledge across three domains: philosophy and principles, control of pain and other symptoms, and psychosocial aspects. Data were analyzed using SPSS version 25, employing descriptive statistics and chi-square tests to examine the association between demographic variables and knowledge levels. Results: The study found that 61.3% of participants were female, with the majority (81.5%) born between 1991 and 2000. Regarding educational background, 53.3% were Post RN nurses, 45.6% BSN Graduate Nurses, and 1.1% MSN Graduate Nurses. The PCQN results indicated that 31.8% of nurses demonstrated good knowledge of palliative care, while 37.7% exhibited a lack of knowledge. Notably, post RN nurses showed higher knowledge levels compared to their BSN and MSN counterparts. Conclusion: The findings highlight a substantial need for targeted palliative care education and training among nurses in Peshawar, Pakistan. Tailored educational programs, continuous professional development, and specific interventions are essential to bridge the identified knowledge gaps, ensuring that nurses are equipped to provide high-quality palliative care.