Acknowleding attributes that enable the career academic nurse to thrive in the tertiary education sector: A qualitative systematic review

ObjectiveTo optimise the career development in early career academic nurses by providing an overview of the attributes necessary for success.BackgroundEvidence of early prospective career planning is necessary to optimise success in the tertiary sector. This is particularly important for nurse academics given the profession's later entry into academia, the ageing nursing workforce and the continuing global shortage of nurses.DesignA qualitative systematic review.MethodsAcademic Search Complete, CINAHL, Medline, ERIC, Professional Development Collection and Google Scholar databases were searched; resulting in the inclusion of nine qualitative nurse-only focussed studies published between 2004 and 2014. The studies were critically appraised and the data thematically analysed.ResultsThree abilities were identified as important to the early career academic nurse: a willingness to adapt to change, an intention to pursue support and embodying resilience. These abilities give rise to attributes that are recommended as key to successful academic career development for those employed on a continuing academic basis.ConclusionsThe capacity to rely on one's own capabilities is becoming seen as increasingly important. It is proposed that recognition of these attributes, their skilful application and monitoring outlined in the review are recommended for a successful career in academia.     

Nurses and midwives teaching in the academic environment: An appreciative inquiry

BackgroundThe past two decades has seen significant change in nursing and midwifery education in Australia. Although, regulatory documents explicate expectations of teaching, and supervising in the context of being a nurse or midwife, the move from hospital-based to higher education learning nessitated a change in how students receive their education and who provides it. The quality of teaching by nurse or midwife academics is subject to the academic's ability to transition from a clinical educator to academic.ObjectiveTo explore the experiences of nurse and midwife academics teaching in the academic environment.DesignAppreciative Inquiry (AI) was used to explore the experiences of academics teaching final year nursing and midwifery students.SettingTwo regional universities in Australia.ParticipantsSeven nursing and midwifery academics teaching a unit of study focusing on mentorship, leadership and teaching.MethodsNarrative data from interviews conducted using AI were collected, transcribed and analysed to produce themes.ResultsThree key themes were identified; ‘Feeling valued’, ‘Feeling safe’ and ‘Having connections’. These themes and related subthemes impacted teaching experiences and role transition from experienced clinician to academic.ConclusionNursing and midwifery academics would benefit from organisational support in their role transition from clinician to academic. Further research is crucial regarding initiatives that can support academics to feel safe, valued and connected when teaching the next generation of nurses and midwives.     

Fostering scholarship in doctoral education: Using a social capital framework to support PhD student writing groups

The shortage of nurse scientists in the United States complicates nursing's ability to sustain research-intensive environments, build knowledge for translation, and advance nursing science. More emphasis is needed on the preparation of PhD doctoral students to better equip them for a career of scholarship. Four recent PhD graduates participating in a writing group, examined the influence of social capital on their ability to develop capacity for scholarship. They found that a strong social factor supported their efforts to engage as scholars, be accountable for their writing, and make contributions to the research community. Although the writing group provided a space to practice scholarly writing and increased scholarly productivity, the experience was transformative in building capacity for scholarship. This article includes recommendations for academic leaders to both create and support writing groups within doctoral nursing programs using a social capital framework. Strategies are provided using the three dimensions of social capital: structural, relational, and cognitive. Investing in strategies that build social capital within a community can directly impact the advancement of science by elevating capacity for scholarship.     

Learning from history: Frances Gillam Holden,a leadership perspective then and now

BackgroundCritical evaluation of leadership styles through a historical lens is uncommon. There could be missed opportunity for current and emerging nurse leaders to critically evaluate the leadership styles of the past in order to discerningly reflect on their own current leadership.AimTo critically examine the work of Australian nurse Frances Gillam Holden as she developed her vision for servant leadership for nursing in Australia in the late 19th century.MethodsExploration of, and critical reflection on, literature outlining Frances Gillam Holden's work.FindingsHolden's work and experience demonstrate the challenges faced by the profession's leaders at the turn of the century as they attempted to negotiate new ‘scientific’ knowledge and integrate this into nursing leadership. An examination of Holden's experience also demonstrates the difficulties faced by Australian nurse leaders during this time and consideration is given to what leadership in nursing looks like in the present day.DiscussionWithin the wealth of historical narratives, along with their complexities, the impact of this knowledge can have a demonstrated effect that can be far reaching and long lasting. This is particularly evident in regard to the role of nurses, nursing, and the development of modern approaches to nursing leadership, particularly with regard to the rise of nurse leaders in the form of ‘e-nurses’ and the use of social media to inform and lead the profession.ConclusionUnderstanding the influence and impact of nursing history, and historical nursing leaders such as Holden, on current leadership practices is being recognised more as contributing to contemporary nursing identity.     

The influence of staff nurse perception of leadership style on satisfaction with leadership: A cross-sectional survey of pediatric nurses

BackgroundThere is evidence that transformational leadership style promotes nursing excellence. Differences in how supervisees and supervisors perceive the supervisor's leadership style may also be related to satisfaction with leadership. Research demonstrates that satisfaction with leadership is a critical element in the retention of nurses.ObjectiveTo evaluate staff nurse and nurse leader perceptions of leadership style.Methods16 supervisors and 179 supervisees completed the Multifactor Leadership Questionnaire and a demographic survey. Data were analyzed using parametric statistical techniques.ResultsAlthough staff perceived leaders as employing largely transformative leadership strategies, differences existed in leader-staff congruence in interpretation of leadership style and as related to the role of the leader.ConclusionsDifferences in interpretation of leadership style between supervisors and supervisees were associated with diminished satisfaction with leadership. In addition, those serving in a direct operational role (assistant nurse manager) were viewed as less transformative than leaders who maintained broader administrative responsibilities.     

Are we there yet? A scoping review of factors that increase academic research capacity in schools of nursing and midwifery

Aims1. To identify approaches and strategies that can build research capacity among academics from the disciplines of nursing and midwifery working in tertiary education institutions. 2. To identify evidence-informed strategies that enable academic transformation of professional identity from clinician to researcher.BackgroundNurses and midwives are core to leading health practice and system change through research. Despite manifold efforts to build research capacity among nurse academics over the past two decades, there is scant evidence about what specific strategies are effective and few robust evaluations of any capacity building strategies.DesignThis scoping review was guided by Arksey and O’Malley’s framework to identify key concepts and map the available evidence specifically related to volume, nature and characteristics.MethodsThe authors followed a scoping review framework and used a PRISMA flowchart to report findings. Electronic data bases (CINAHL, ERIC, Medline and Scopus) were searched between April and June 2020. Literature published between 2000 and 2020 was searched. The Mixed Methods Appraisal Tool (MMAT) was used for data coding and extraction and all included papers were subsequently thematically analysed.ResultsFourteen studies from seven countries met the inclusion criteria and were comprised of literature reviews (n = 4) case studies (n = 3) qualitative survey (n = 1) and intervention studies (n = 6). Four themes were identified as follows: academic identity, organisational changes, leadership and research skills development.ConclusionsRigorous evaluation of research capacity building strategies for academics from the disciplines of nursing and midwifery is a significant gap in the literature. To promulgate research among nurse and midwife academics, strong, supportive leadership and a range of inclusive and targeted approaches are needed. Significant work remains in terms of negotiating with the broader university to operationalise supportive systems and structures. Clarifying how self-concept has an impact on building and maintaining a research identity for nurse and midwife academics is an area worthy of further study.Tweetable abstractStrong, supportive leadership with inclusive and targeted research skills development is key to reorienting academic nursing and midwifery research culture.     

Enhancing student understanding of nursing inherent requirements using assessment for learning

ProblemWhere misperceptions and a lack of understanding of the realities of the Nursing profession exist, this can result in students entering into Nursing degrees without understanding the academic knowledge, behavioural and physical attributes and other inherent requirements necessary to undertake and succeed in their studies and subsequent career.QuestionCan an ‘Assessment for Learning’ approach result in enhanced student understanding of inherent requirements and their relationship to registered nurse attributes?MethodsThis interpretive study analysed students’ written reflections on two Bachelor of Nursing inherent requirement statements using latent content analysis. Purposive sampling of all 165 students enrolled in an introductory professional nursing unit was undertaken with 162 (98.2%) consenting to provide demographic data and have their reflections analysed following completion of their unit.FindingsFour themes were identified: Eye opening, responding to self-examination, setting goals and effecting change, and affirming beliefs and attributes.DiscussionAnalysis of the students’ reflections on the nursing inherent requirements showed they exhibited enhanced awareness, understanding and acknowledgement of personal areas to be addressed, as well as goal setting and the beginnings of acculturation and movement along the pre-professional identity to professional identity continuum.ConclusionAn assessment for learning approach enhanced beginning students understanding of requirements inherent in undertaking a Bachelor of Nursing degree, enabling them to set goals for their development as they linked the BNIRs to the attributes required of a registered nurse.     

Business acumen for nursing leaders,optional or essential in today's health system? A discussion paper

BackgroundOver the last number of years, the healthcare system has become more complex in managing increasing costs and outcomes within a defined budget. To be effective through reform, especially moving forward from the COVID-19 pandemic, healthcare leaders, specifically in nursing, have an increased need for business acumen beyond traditional leadership and management principles.AimThis paper examines the concept of business acumen in the profession of nursing, specifically for managers and higher nurse leaders, establishing whether these skills are optional or essential.DiscussionNurses learn and develop broad skills in leadership and management, but less specifically about business or the broader system. With a contemporary Australian health system aiming to be more effective, nurses may require a greater level of business acumen to adequately understand the mechanics of business decision making in the system when designing care models, as well as representing the business potential of nursing in balance with clinical outcomes through reform.ConclusionThe modern nurse, in addition to clinical skills, may need a foundational understanding of business evolving throughout their career, to maximise innovative growth across the system, in meeting the healthcare needs of our community now and into the future. Without a foundation level of business acumen and an understanding of the system across the profession, nurses may not be empowered with their full potential of being a strong voice influencing health system reform.     

Clinical leadership and pre-registration nursing programmes: A model for clinical leadership and a prospective curriculum implementation and evaluation research strategy

AimTo present for wider debate a conceptual model for clinical leadership development in pre-registration nursing programmes and a proposed implementation plan.BackgroundGlobally, leadership in nursing has become a significant issue. Whilst there is continued support for leadership preparation in pre-registration nursing programmes, there have been very few published accounts of curriculum content and/or pedagogical approaches that foster clinical leadership development in pre-registration nursing. A doctoral research study has resulted in the creation of an overarching model for clinical leadership.DesignA multi-method research study using theoretical and empirical literature 1974–2015, a focus group, expert opinion and a national on-line survey.DiscussionA conceptual model of clinical leadership development in pre-registration nursing programme is presented, including the infinity loop of clinical leadership, an integral curriculum thread and a conceptual model: a curriculum-pedagogy nexus for clinical leadership. In order to test out usability and evaluate effectiveness, a multi method programme of research in one school of nursing in Australia is outlined.ConclusionImplementation of the proposed conceptual model for clinical leadership development in pre-registration nursing programmes and a programme of (post-doctoral) research will contribute to what is known about curriculum content and pedagogy for nurse academics. Importantly, for nursing students and the profession as a whole, there is a clearer expectation of what clinical leadership might look like in the novice registered nurse. For nurse academics a model is offered for consideration in curriculum design and implementation with an evaluation strategy that could be replicated.     

Challenges and strategies of early career nurse scientists when the traditional postdoctoral fellowship is not an option

PurposeThe purpose of this article is to discuss challenges and strategies related to maintaining a program of research for early career nurse scientists. Nurse scientists who do not complete a traditional postdoctoral fellowship or who work in low research-resourced institutions may struggle with research collaboration and development.Principal resultsSpecific challenges experienced by nurse scientists in early career development included: advanced age at the completion of the research doctorate, gender roles and research careers, sustainable work-life balance, employment in low research-resourced institutions, and time. Strategies to assist nurse scientists in finding support and opportunities for research and career development included: professional networking, institutional collaboration, non-traditional training experiences for new nurse scientists, sustainable work-life balance, professional development and service, and competing needs of teaching mission and research. One group's experience with fostering support and collaboration is presented as an example.Major conclusionsIt is possible for nurse scientists in low research-resourced institutions to find opportunities to develop their program of research and foster their professional growth. Implementing the identified strategies helps to provide sustainability of new nurse scientists' research efforts. Engaging nurse scientists in supportive and collaborative opportunities paves the way for early career nurse scientists to become experts in their field.     

Fulfillment in the role of academic nurse leader: A grounded theory study

BackgroundUnlike many other disciplines, academic nurse leaders are challenged with multiple expectations. The many vacancies in these positions indicate that further study on this phenomenon is needed to disclose aspects of their roles.PurposeThe purpose of this study is to describe the factors that influence academic nurse leaders' role attainment and fulfillment.MethodAnalysis of 18 interviews with nurse deans, directors, and chairpersons was performed with grounded theory methodology.ResultsPersonality traits such as having a “skillset” and a “sense of calling” positively affected the nurse leader's role attainment and fulfillment. Other outside factors that affected role fulfillment were “experiencing a variety of relationships”, “seeing positive change”, “enjoying creative freedom”, “experiencing professional growth” and “having support from administration”. Some negative themes that resulted in a lack of fulfillment were “feeling overwhelmed with the number of hours and duties”, “being coerced into the role”, the “faculty shortage” and a “lack of mentorship”.ConclusionBy disclosing aspects of fulfillment and the academic nurse leader role, recruitment and retention within academic leadership will be affected.     

Lived Experiences of Male Nurse Educators: An Interpretive Phenomenological Inquiry

BackgroundMale nurses experience stereotypes and obstacles that affect their career progression in clinical and leadership roles. The experiences of male students and nurses in educational and clinical settings are documented, but no research explored the experiences of nurse educators.PurposeTo explore and develop a deeper understanding of the lived experiences of male nurse educators.MethodsAn interpretive phenomenological inquiry was used. Semi-structured interviews were conducted with 12 male educators in Khyber Pakhtunkhwa. Ricoeur's interpretation theory was used for data analysis.FindingsThe themes included “searching for respect and autonomy: from discrimination to recognition”, “keeping up the pace: proving worth as nurse educators”, “building relationship with the opposite gender: overcoming cultural constraints”, “withstanding unfair female nursing and non-nursing management”, “appreciating support from democratic management” and “envisioning a non-gendered nursing profession”.ConclusionMale educators surmounted various challenges while searching for respect and recognition and felt content with their professional growth. The greatest challenge was discriminative institutional and the government policies. The educators recognized that female dominance in nursing can be a hurdle, but they indicated that gender discrimination can be ended with collaborative efforts at personal, institutional, and governmental levels. Nursing regulatory bodies and institutions should develop policies that are conducive to recruitment of male and female educators. Separate sub-divisions could be established to provide support to and advocate for the rights of male nurses in clinical, educational, and leadership positions.     

Association between early career nurses’ social jetlag,affect, depression,and quality of life

BackgroundSocial jetlag in nurses is a long-standing challenge for nursing management. It has been attributed to the effects of shift work that disrupts nurses’ circadian rhythms, may be detrimental to their health, and can lead to rapid turnover.AimWe aimed to identify the association between social jetlag, affect, depression, and quality of life of early career nurses.MethodsIn this cross-sectional study, 201 early career nurses at three tertiary hospitals in South Korea were included. Data were collected from May to July 2018. Social jetlag, affect, depression, and quality of life were measured using the Munich Chronotype Questionnaire (shift version), the Positive and Negative Affect Scale, the Centre for Epidemiological Studies Depression Scale (Korean version), and the Korean World Health Organization Quality of Life Scale (abbreviated version), respectively.FindingsParticipants’ mean overall social jetlag and quality of life scores were 4 hours 28 minutes and 80.21, respectively. Multiple regression analyses identified overall social jetlag, positive and negative affect, and depression as factors influencing the nurses’ quality of life.DiscussionUnderstanding the implications of factors affecting early career nurses’ quality of life, including social jetlag, is vital to ensure staff retention. Nursing management should consider the individual social jetlag of nurses when scheduling shifts and accordingly create institutional human resources management strategies to reduce negative affect and depression while promoting positive affect in early career nurses.ConclusionSocial jetlag, negative affect, and depression negatively impact early career nurses’ quality of life, whereas positive affect positively impacts their quality of life.     

Current turnover intention among nurse managers,directors, and executives

BackgroundNursing leadership turnover can adversely affect nurse retention and thus quality of care. Little research has examined the way nurses at differing levels of leadership experience their workplace and voluntarily decide to leave.PurposeOur study sought to explore and compare intent to leave and turnover experiences of acute care nurse managers, directors, and executives.MethodsData were collected via an online survey. Participants included nurse managers, directors, and executives from 47 states (n = 1880) working in acute care settings.FindingsOver 50% of respondents intend to leave their current positions within the next 5 years with reasons for leaving differing by type of nurse leader. Retirement was a factor for slightly over 30% of those nurse leaders overall and almost 50% of nurse executives.DiscussionNurse managers, directors, and executives experience turnover and intent to leave differently. Most frequently, voluntary factors for leaving a position include job dissatisfaction and a desire for promotion and advancement.     

A Dedicated Education Unit and a Novel Resident Nurse Transition-to-Practice Program in an Ambulatory Oncology Setting

ObjectiveTo summarize an innovative initiative in oncology nurse workforce development that addresses critical current and future gaps and encompasses use of dedicated education units for student nurse rotation and a transition-to-practice residency program.Data SourcesReview of institutional data including original pilot analysis and ongoing programmatic metrics (N=8 years), consensus, professional guidelines, and published literature.ConclusionThe dedicated education unit serves as a conduit for recruitment into institutional oncology nurse residency positions, and retention rates in the residency program continue to exceed national averages. Subsequent mentoring of these nurses in transition to practice has manifested high rates of promotion into nurse leadership roles year over year.Implications for Nursing PracticeOncology nurse practice incorporates state-of-the-science approved therapies, early phase clinical trial implementation, and evidence-based complex oncology patient care management. A new model of student clinical nurse rotations in ambulatory settings, nurse resident transition to practice, and ongoing leadership mentoring is essential in creating a sustainable, highly skilled, and robust oncology nurse work force.     

Curbing the urge to care: A Bourdieusian analysis of the effect of the caring disposition on nurse middle managers’ clinical leadership in patient safety practices

BackgroundNurse managers play an important role in implementing patient safety practices in hospitals. However, the influence of their professional background on their clinical leadership behaviour remains unclear. Research has demonstrated that concepts of Bourdieu (dispositions of habitus, capital and field) help to describe this influence. It revealed various configurations of dispositions of the habitus in which a caring disposition plays a crucial role.ObjectivesWe explore how the caring disposition of nurse middle managers’ habitus influences their clinical leadership behaviour in patient safety practices.DesignOur paper reports the findings of a Bourdieusian, multi-site, ethnographic case study.SettingsTwo Dutch and two American acute care, mid-sized, non-profit hospitals.ParticipantsA total of 16 nurse middle managers of adult care units.MethodsObservations were made over 560 h of shadowing nurse middle managers, semi-structured interviews and member check meetings with the participants.ResultsWe observed three distinct configurations of dispositions of the habitus which influenced the clinical leadership of nurse middle managers in patient safety practices; they all include a caring disposition: (1) a configuration with a dominant caring disposition that was helpful (via solving urgent matters) and hindering (via ad hoc and reactive actions, leading to quick fixes and ‘compensatory modes’); (2) a configuration with an interaction of caring and collegial dispositions that led to an absence of clinical involvement and discouraged patient safety practices; and (3) a configuration with a dominant scientific disposition showing an investigative, non-judging, analytic stance, a focus on evidence-based practice that curbs the ad hoc repertoire of the caring disposition.ConclusionsThe dispositions of the nurse middle managers’ habitus influenced their clinical leadership in patient safety practices. A dominance of the caring disposition, which meant ‘always’ answering calls for help and reactive and ad hoc reactions, did not support the clinical leadership role of nurse middle managers. By perceiving the team of staff nurses as pseudo-patients, patient safety practice was jeopardized because of erosion of the clinical disposition. The nurse middle managers’ clinical leadership was enhanced by leadership behaviour based on the clinical and scientific dispositions that was manifested through an investigative, non-judging, analytic stance, a focus on evidence-based practice and a curbed caring disposition.