Newly licensed registered nurses' perceptions of job difficulties, demands and control: individual and organizational predictors

unruh l.y. & nooney j. (2011) Journal of Nursing Management 19 , 572–584
Newly licensed registered nurses’ perceptions of job difficulties, demands and control: individual and organizational predictors Aims To determine predictors of newly licensed registered nurses’ perceptions of job difficulties, job demands and job control. Background In previous studies, new registered nurses describe their work environment as stressful, yet little is known about factors that influence these experiences. Methods We surveyed a random sample of newly licensed registered nurses in Florida. Dependent variables included indicators of job difficulty, job demand and job control. Independent variables included individual and organizational characteristics hypothesized to be related to the dependent variables. Logistic and ordinary least squares regressions were used to analyse survey data. Results Inadequate orientation, working the day shift, working a greater number of hours and caring for a higher number of patients were significantly related to a greater likelihood of perceptions of job difficulty and job demand. Less adequate orientation and a greater number of float shifts were related to a lower likelihood of perceptions of job control. Conclusions and implications Adequacy of orientation, patient load, work hours, shift work and floating are priority items that need improvement in the work environment of newly licensed registered nurses. Implications for Nursing Management The present study identified factors involved with newly licensed registered nurses’ perceptions of job difficulties, job demands and job control which will help managers redesign work settings to retain new nurses.     

Creating the conditions for growth: a collaborative practice development programme for clinical nurse leaders

boomer c.a. & mccormack b. (2010) Journal of Nursing Management  18, 633–644
Creating the conditions for growth: a collaborative practice development programme for clinical nurse leaders Aim To evaluate a 3-year practice development (PD) programme for clinical nurse leaders. Background The development of effective leaders is a key objective to progress the modernization agenda. This programme aimed to develop the participants alongside development of the culture and context of care. Methods Programme evaluation methodology to determine the ‘worth’ of the programme, inform the experience of the participation, effect on workplace cultures and determine effectiveness of the process used. Results Created the conditions for growth under two broad themes: process outcomes demonstrating growth as leaders contributing to cultural shifts; and general outcomes demonstrating practice changes. Conclusions Developing communities of reflective leaders are required to meet demands within contemporary healthcare. PD provides a model to develop leaders to achieve sustainable changes and transform practice. Implications for nursing management Active collaboration and participation of managers is crucial in the facilitation of and sustainability of cultural change. Approaches adopted to develop and sustain the transformation of practice need to focus on developing the skills and attributes of leaders and managers as facilitators.     

Revitalizing the charge nurse role through a bespoke development programme

Aims This article describes the genesis, contents and outcomes of a bespoke Charge Nurse Development Programme which was designed to enhance the propensity of nurses to manage in an acute hospital setting. Background The charge nurse role is pivotal to the provision of high‐quality care and effective ward management. However, many nurses are promoted to these roles of substantial responsibility commonly with no formal management preparation, an inherent under‐confidence and in some cases a tangible reluctance to manage. Evaluation Evaluations from 95 charge nurses were obtained using an anonymous questionnaire. Key issues Qualitative analysis demonstrated the programme satisfied its original aims by having role models and experts teaching relevant subjects to a group who have consequently established their own peer network. Conclusions The pragmatic consequences of the programme were that charge nurses have perceived themselves to become empowered and more focussed on solutions. Implications for nursing management Creating a supportive but challenging programme has resulted in charge nurses behaving more reflexively by combining reflection with action. This has helped them enhance their confidence, autonomy and responsiveness to organizational, personal and professional objectives. Further work needs to be undertaken to correlate the charge nurses’ perceived outcomes against audited standards of their ward performances.     

Alleviating the nurse faculty shortage: designating and preparing the academic nurse educator as an advanced practice registered nurse

A lack of qualified nurse faculty is a persistent problem in the discipline of nursing. It limits the number of nurses prepared to provide safe, quality care in settings around the world. Many individuals, groups, and organizations have studied the nurse faculty shortage and recommended resolutions, yet the shortage persists. This opinion paper contends that designating the academic nurse educator (ANE) as an advanced practice registered nurse and identifying an educational pathway that ensures academic preparation for the role could help to alleviate the nurse faculty shortage. Evidence disseminated by national and international constituents that influence nursing and nursing education supports the perspective and serves as the basis for recommendations that could attract more nurses to faculty positions in nursing education and ensure preparation of ANEs for their role.     

The Cockcroft difference: an analysis of the impact of a nursing leadership development programme

Aim Identifying impact areas of nursing leadership development programmes is needed to determine if there are measureable effects on participants. Background These impact areas help to identify measures to substantiate the benefits of nursing leadership programmes for organization leaders making decisions about support and implementation of such opportunities for their emerging leaders. Method Using mixed qualitative/quantitative methods, the impact of a nursing leadership development programme, the Amy V. Cockcroft Fellowship, is examined to determine if there are measureable influences. Results Themes of four areas of impact: improved conflict resolution/negotiation skills, communication skills, personal development and career action or change were identified through content analysis. Conclusions These themes provide the basis for creating measureable indicators for nursing organizations to use in determining the value of nursing leadership development programmes such as the Amy V. Cockcroft Fellowship. Implications for nursing management Based on the findings established in this research article, nurse managers can focus on developing themselves and their peer groups through nursing leadership development programmes to prepare for leading in the present and future healthcare environment.     

Supporting newly hired nurses: a program to increase knowledge and confidence while fostering relationships among the team

BACKGROUND. It is important for newly hired nurses to be supported throughout their first year of employment by nurse leaders on their team. Newly hired nurses struggle with application of new clinical skills and critical thinking skills as well as integrating into unit culture. PROGRAM DESIGN. The Post Orientation Education Program (POEP) provided 18 newly hired nurses with clinical knowledge and support through one‐on‐one meetings with the nurse leaders on their unit. The nurse leaders discussed common diagnoses, laboratory tests, and medications in addition to providing support to the newly hired nurses as they adapted to the newness of nursing. Early in their career the newly hired nurses developed relationships with the leadership team that may have taken longer if not for the POEP. The program gave the newly hired nurses an opportunity to experience different teaching styles of the nurse leaders and offered them the chance to engage in conversations about both clinical and nonclinical information. OUTCOMES. The program was evaluated through pre/post tests and written evaluations. Evaluations revealed increased knowledge about common diagnoses, increased confidence in role, and the development of trusting relationships with the leadership team. CONCLUSION. The newly hired nurses valued the time that they spent with the leadership team as it helped them to integrate into the unit and feel comfortable using the leaders as resources for patient care. The POEP proved to be a program that impacted not only relationships among the team, but it increased retention and quality of patient care as the nurses felt supported by the team, knowledgeable about the care they were delivering and confident in their ability to seek out resources. A program like the POEP could be adapted to various healthcare settings based on individual needs of the team.