Factors associated with the intention to leave among newly graduated nurses in advanced‐treatment hospitals in Japan

Aim: The early resignation of newly graduated nurses (NGNs) will become a concern in Japan as the need for nurses increases. The aim of this study was to conduct an investigation using the Effort–Reward Imbalance (ERI) questionnaire to examine the effect of stressful experiences in the work environment and over‐commitment on NGNs' intention to leave and to identify the factors that were associated with their intention to leave, clarifying the appropriate times at which to conduct interventions to prevent NGNs from leaving advanced‐treatment hospitals. Methods: Anonymous self‐administered questionnaires were distributed to all the NGNs (n = 1364) in 14 advanced‐treatment university hospitals. Questionnaires with no missing data were returned by 737 NGNs (54%). For the development of the questionnaire, we designed a framework that consisted of the factors that occur during three stages of the NGNs' transition into the workplace. The questions addressed items for individual attributes, employment and organizational characteristics, the Role Model Scale, the ERI questionnaire, two scale items for health status, and the intention to leave. In order to determine the factors that related to the dependent variables, hierarchical multiple linear regression analyses were carried out. Results: We revealed that effort, subjective health status, role models, and effort were important factors that related to the NGNs' intention to leave, as well as their age and city size. Over‐commitment and reward were not significant factors. We also found that three subscales of the Job Readiness Scale independently related to the NGNs' intention to leave. Conclusion: These findings can help employers, supervisors, and senior staff of advanced‐treatment university hospitals in Japan to improve their work environment in order to benefit NGNs and aid in their retention.     

Profile of first-line nurse managers in New South Wales, Australia, in the 1990s

AIMS: To determine a demographic profile, employment history and career plans of a sample of nursing unit managers (first-line managers) in New South Wales (NSW), Australia in 1999. To compare the profile of first-line nurse managers in 1999 with those in 1989. BACKGROUND: This study replicates another undertaken a decade earlier (see Duffield 1992). Tracking the changes to nurse manager positions is important, given changes to the educational preparation of nurses and restructuring within hospitals which have occurred in the past decade. METHOD: The same questionnaire was used in both studies, with minor amendments and the addition of two items to reflect changes to organizational structures, whereby nurse managers are now responsible for non-nursing staff. In 1999 all first-line nurse managers in the largest health service in NSW were invited to participate in the study. RESULTS: A response rate of 77% was achieved. There were few differences of note in the demographic profile from 1989 to 1999. However educationally, first-line nurse managers in 1999 were more highly qualified. A greater proportion had higher degrees and increasingly, in the management discipline. CONCLUSION: Perhaps reflecting these qualifications, more managers in 1999 indicated their intention to move to more senior management positions in the next decade. The mode for experience in this role of 1 year in both 1989 and 1999 reflects a worrying trend of high turnover and inexperience amongst this group of managers. While maternity relief might account for this result, further research needs to determine more precise reasons. The ad hoc bases on which expert clinicians (clinical nurse specialists) act as the manager in his/her absence need to be critically examined. Alternative strategies such as introducing a formal second- in-charge position may ensure more successful recruitment and retention of staff to these critical management positions.     

精神科临床一线护士工作压力源调查

目的了解精神科临床一线护士主要的压力来源及程度,为制定减压措施提供科学依据。方法采用问卷调查法,对精神科63名临床一线护士和50名非一线护士进行工作压力源的调查分析。结果在压力源量表5个子条目的比较中,工作量及时间分配方面、病人护理方面、管理及人际关系方面两组比较有显著性差异（P〈0．05或0．01）,临床一线护士的压力程度明显高于非一线护士。结论精神科临床一线护士的压力程度较高,压力源主要来自服务对象和周围环境。     

The USA's nurse managers and UK's ward sisters: critical roles for empowerment

• ? The nurse manager/ward sister^* role is becoming endangered as many of these nurses are being asked to take fiscal and personnel responsibility for multiple units/programmes and supervise more non-registered nursing staff.
• ? Loss of this important nurse manager/ward sister role could severely decrease nursing's voice in the development and implementation of policies that affect nurses arid the care they deliver.
• ? The authors review 20 years of literature from both the USA and the UK regarding supportive supervision and the role of the nurse manager/ward sister. Nurse managers/ward sisters were found to be key individuals within the entire health-care organization.
• ? Nurse managers/ward sisters can empower the nurses they surpervise to initiate changes that will improve patient care. Nurse managers/ward sisters can also improve the working conditions and thus increase the job satisfaction and retention of those they supervise.
• ? Strategies for being more supportive of these overworked and endangered nurse managers/ward sisters are suggested.

     

Patient safety culture in acute care: A web‐based survey of nurse managers' and registered nurses' views in four Finnish hospitals

Nurse managers (NMs) and registered nurses (RNs) have key roles in developing the patient safety culture, as the nursing staff is the largest professional group in health‐care services. We explored their views on the patient safety culture in four acute care hospitals in Finland. The data were collected from NMs (n = 109) and RNs (n = 723) by means of a Hospital Survey on Patient Safety Culture instrument and analyzed statistically. Both groups recognized patient safety problems and critically evaluated error‐prevention mechanisms in the hospitals. RNs, in particular, estimated the situation more critically. There is a need to develop the patient safety culture of hospitals by discussing openly about them and learning from mistakes and by developing practices and mechanisms to prevent them. NMs have central roles in developing the safety culture at the system level in hospitals in order to ensure that nurses caring for patients do it safely.     

‘Why nurses are leaving the profession … lack of support from managers’: What nurses from an e‐cohort study said

The shortage of nurses is known. We explored nurses' reasons for leaving the profession based on responses from an e‐newsletter of the Nurses and Midwives e‐cohort Study. Qualitative content analysis of data from email responses (n = 66) showed ‘Lack of support’ as a social work value describing their manager's lack of support, unsupportive relationships within their work group, and a health‐care system putting business principles before care resulting in job dissatisfaction and nurse turnover. These findings are examples of a ‘complex'/‘wicked’ problem and as such will resist simple solutions to the presenting issues. The dialogic process such as Open Space Technology and Talking Circles should be considered as potentially suitable to the needs of nurses.     

Leadership and management skills of first-line managers of elderly care and their work environment

abdelrazek f. , skytt b. , aly m. , el-sabour m.a. , ibrahim n. & engström m. (2010) Journal of Nursing Management  18 , 736–745
Leadership and management skills of first-line managers of elderly care and their work environment Aim To study the leadership and management skills of first-line managers (FLMs) of elderly care and their work environment in Egypt and Sweden. Background FLMs in Egypt and Sweden are directly responsible for staff and quality of care. However, FLMs in Sweden, in elderly care, have smaller units/organizations to manage than do their colleagues in Egypt. Furthermore, family care of the elderly has been the norm in Egypt, but in recent years institutional care has increased, whereas in Sweden, residential living homes have existed for a longer period. Methods A convenience sample of FLMs, 49 from Egypt and 49 from Sweden, answered a questionnaire measuring leadership and management skills, structural and psychological empowerment, job satisfaction and psychosomatic health. Results In both countries, FLMs’ perceptions of their leadership and management skills and psychological empowerment were quite high, whereas scores for job satisfaction and psychosomatic health were lower. FLMs had higher values in several factors/study variables in Egypt compared with in Sweden. Conclusion and implications The work environment, both in Egypt and Sweden, needs to be improved to increase FLMs’ job satisfaction and decrease stress. The cultural differences and levels of management have an effect on the differences between the two countries.     

Factors contributing to managerial competence of first‐line nurse managers: A systematic review

Aims

To determine the factors contributing to managerial competence of first‐line nurse managers.

Background

Understanding factors affecting managerial competence of nurse managers remains important to increase the performance of organizations; however, there is sparse research examining factors that influence managerial competence of first‐line nurse managers.

Design

Systematic review.

Data sources

The search strategy was conducted from April to July 2017 that included 6 electronic databases: Science Direct, PROQUEST Dissertations and Theses, MEDLINE, CINAHL, EMBASE, and Google Scholar for the years 2000 to 2017 with full text in English. Quantitative and qualitative research papers that examined relationships among managerial competence and antecedent factors were included.

Review methods

Quality assessment, data extractions, and analysis were completed on all included studies. Content analysis was used to categorize factors into themes.

Results

Eighteen influencing factors were examined and categorized into 3 themes—organizational factors, characteristics and personality traits of individual managers, and role factors.

Conclusion

Findings suggest that managerial competence of first‐line nurse managers is multifactorial. Further research is needed to develop strategies to develop managerial competence of first‐line nurse managers.