The issues of job satisfaction for nurses and nurses' continuing clinical competence have become major concerns for the nursing profession as evidenced by a growing volume of research into these areas. Both job satisfaction and clinical competence of nurses can affect quality of care (of which patient satisfaction is one facet). This study focussed on the concepts of job satisfaction and clinical competence of nurses, and patient satisfaction-their interelationships, and how they were affected by the implementation of a Staff Development Nurse on one nursing unit in an active treatment hospital. A hospital-based Job Enhancement Project provided a unique opportunity to combine a dynamic real-life situation with an additional case study approach to examining the issues though interviews and documentation of the relationships among the nursing staff over an 18-month period of time. Both quantative and qualitative methods were used to gather pertinent information in addressing the research questions. Focus unit nursing staff questionnaires returned initially (13 of 27) and at the one-year mark (six of 27) of the Project, and interviews with six key participant nursing staff were used to survey nurses' perceptions of their own job satisfaction and clinical competence as well as their perceptions of their peers' job satisfaction and clinical competence. The patients admitted to the focus unit during the Project time frame were also invited to complete patient satisfaction surveys. The Staff Development Nurse and the Nursing Unit Manager were interviewed to give their perspectives. The Staff Development Nurse kept a journal of her work for the 18 month period, and so did the researcher. Frequencies, percentages, and content analysis of qualitative data provided the statistical and descriptive information for inerpretation. One finding in this study was that the Staff Development Nurse did have a positive influence on the clinical competence of some of the nursing staff on the focus unit, which may have in turn had a positive influence on nurses' perceptions of job satisfaction. The Staff Development Nurse was an immense support for the Nursing Unit Manager. However, the major finding in this study was that there were many other factors which influenced nurses' perceptions of job satisfaction, many of them which were beyond the control of the SDN. The SDN actually became a mitigating factor or a buffering agent in helping the nursing staff cope with these other factors. This study contributes to the growing body of research on nurses'quality of working life and some of the influecing factors. It may also provide insights into the realtionships between nurses and patients, and the role definition of a nurse educator on one nursing unit. / xiii, 246 leaves : ill. ; 29 cm.

The purpose of this study is to gain a richer understanding of the experiences of moral distress for nursing students within the context of psychiatric-mental health clinical placements, examine strategies students use to effectively manage distress, and explore student and instructor roles as agents of change to reduce the negative impact of moral distress. Nursing students and instructors engaged in semi-structured interviews and focus groups, respectively, to examine the complexities of this phenomenon. This study utilized second-person action research based on Jürgen Habermas’ Theory of Communicative Action. Findings indicated that nursing students experience moral distress when they are powerless and lack role models to follow in taking action to address situations that are “not right”. Nursing instructors acknowledge their responsibility to prepare students for practice, but are also powerless as “guests” within the practice setting and are powerless to effect change on a hierarchical medical system. Findings indicate that both nursing education and health care institutions must make changes in their approaches to practice if they wish to empower nursing professionals to provide safe, competent, and ethical care to patients. / vii, 139 leaves ; 29 cm

Stresas darbe apibrėžiamas, kaip emocinė būsena ar nuotaika, kurios priežastis – prieštaravimas tarp darbe keliamų reikalavimų ir asmens sugebėjimo atlikti juos, arba asmens suvokimas, jog nesugebės atlikti darbo pagal keliamus jam reikalavimus. Vyraujanti pakeliamo lygmens įtampa darbe suteikia energijos ir motyvuoja kovoti su iššūkiais, tačiau per dideli reikalavimai ir per didelė įtampa sukelia stresą, kuris turi neigiamą poveikį darbuotojams ir jų organizacijoms. Nustatytos streso darbe, jį sukeliančių veiksnių ir simptomų sąsajos nuo slaugytojų amžiumi, šeimine padėtimi, pamaina. Tikslas – Ištirti slaugytojų su darbu susijusio streso, pasitenkinimo darbu ir ketinimų keisti darbą pasireiškimą bei sąsajas Tyrimo metodas – 2012 m. gegužės mėn. 1-31 d. atlikta anoniminė anketinė apklausa. Tyrime dalyvavo keturių Kauno miesto poliklinikų bendrosios praktikos ir bendruomenės slaugytojai (n=280, atsako dažnis - 87,5 proc.). Visos respondentės buvo moterys. Tyrimui naudota Išplėstinė slaugos streso skalė (56 teiginiai). Tyrimui atlikti Lietuvos Sveikatos mokslų universiteto Medicinos akademijos Bioetikos centras 2012-04-16 išdavė leidimą Nr. BC- KS (M)-260. Rezultatai: Dažniausiai stresą darbe slaugytojams sukelia situacijos, kai jie susiduria su paciento mirtimi ar mirimo procesu bei situacijos, susijusios su pacientų slauga ir bendravimu su pacientų artimaisiais; rečiausiai stresą keliantis veiksnys yra diskriminacija kolektyve. Nustatyta, kad slaugytojos dirba... [toliau žr. visą tekstą] / Work related stress is described as emotional state or mood, emerging from contradiction between work requirements and personal ability to fullfil them; this is personal perception of inability to perform the work tasks that are expected from him. Moderate strain at work acts as motivator and supply with energy to accept the challenges, although very high expectations and strong pressure results stress that negatively affects personell and organisation. There is the data about relationship of stress, its factors and symptoms with nurses age, family status and shift. The purpose – to investigate nurses‘ work related stress, satisfaction with work and intent to leave, and the relationship between these variables. Methods. Anonymous questionnairing was performed on 1-31 of May, 2012. Nurses of general practice and community care from four primary care centers of Kaunas city participated in the survey (N=280, response rate was 87,5%). All the respondents were females. The Extended Nursing Stress Scale with 56 items was used. Commettee on Bioethics at Lithuanian University of Health Sciences provided permission to perform this survey. Results: The most often stressful situation for nurses are related to patient‘s death and dying, also to situations of patient care and communication with his relatives. Discrimination was the rearest stresfull factor for nurses. Nurses are enthusiastic at work and the negative item that nurses dislike their work was scored with the lowest value... [to full text]

Burnout is reflected in pathological emotional depletion and maladaptive detachment that is a secondary result of exposure prolonged occupational stress. It is comprised of three dimensions, namely, emotional exhaustion, depersonalization and reduced personal accomplishment. It is becoming increasingly recognized as one of the most serious occupational hazards for nurses who work in critical care units. The objectives of this study are to assess the prevalence of burnout among a sample of nurses who worked in the critical care units in a particular hospital in Kenya, to analyze factors that contributed to the development of burnout and to identify measures for the mitigation of burnout. For this study, the researcher utilized a mixed methods research design in two phases. Phase one assessed the prevalence of burnout in nurses working in the critical care units by making use of the Maslach Burnout Inventory – Human Services Survey. Focus groups discussions were then held in Phase two to investigate the factors that the nurses perceived as the main causes of burnout and to solicit their ideas about it could be mitigated. Convenience sampling and purposive sampling were used in the two phases of the study respectively. / Health Studies / M.A. (Health Studies)

A critical care unit is a dynamic and highly technological environment. Professional nurses who have been working in the critical care unit for a period of time are passionate about the environment in which they work. They find their on duty time challenging and stimulating. The critical care environment is slowly changing. Due to the fact that there are fewer professional nurses with an additional qualification in critical care available to work in the critical care units. The utilisation of an increasing number of agency nurses leads to an increase in sub-standard nursing care as well as dissatisfied doctors and patients. The shortage of critical care staff has resulted in the need to find an alternative human resources framework and still provide cost effective, safe quality patient care. This leads to the design and implementation of a team nursing care framework for critical care. The research objectives for this study were: - To explore and describe the experiences of professional nurses with regard to a team nursing care framework in private critical care units. - Develop guidelines to optimize the team nursing care framework in critical care units in a private hospital group. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is based on a phenomenological approach to inquiry. Eleven in-depth semi structured face-to-face phenomenological interviews were utilized as the main means of collecting data. A purposive, criterion based, sampling method was used. Specific inclusion criteria were met and consent was obtained from the participants and from the management of the private clinic where the research was conducted. Two central themes were identified:- Theme One: The professional nurses experienced the team nursing care framework in the critical care unit as a burden. Six sub-themes were identified. - Theme Two: Professional nurses made recommendations for improvement of the team nursing care framework in the critical care unit. By describing the lived experiences of the professional nurses in the critical care units, based on research interviews, the researcher painted a clear picture of the team nursing care framework in the critical care unit. Guidelines were developed based on the identified themes. The broad guidelines are aimed at ensuring that the nurses are competent to care for critical care patients prior to them commencing work in the critical care unit. The researcher concludes this study by making recommendations for Nursing practice, education and research.

This study reports the effects of a 4-week online mindfulness meditation practice in a sample of undergraduate and graduate nursing students. Self-reported levels of mindfulness, depression, stress, and anxiety were measured pre- and post-intervention. A randomized pretest posttest control group design was implemented, and members of the National Student Nurses Association were invited via email to participate. A total of 145 participants completed the study.During the study the active control group received audio modules reporting nursing news and the experimental group received audio meditation modules. Meditation modules were created and recorded by the researchers. Participants in both groups were asked to utilize the audio modules at least three times a week. All participants completed the 21-item Depression, Anxiety, and Stress Scale and the 39-item Five Facet Mindfulness Questionnaire online before and after the intervention. Results revealed a statistically significant interaction between group and time of test for all four outcome variables. Simple main effects analyses showed a reduction in symptoms of depression, stress, and anxiety, as well as a significant increase in reported feelings of mindfulness in the experimental group. Findings of the study support the need to better recognize mental health challenges in nursing students and to consider the use of meditation practice in nursing programs to improve psychological outcomes.

Nurses have been on the front line of the COVID-19 pandemic and experienced direct impacts over the last few years. Many encountered additional stressors of isolation from loved ones and the challenges of parenting school-age children. Additionally, due to the recent and significant departure of nurses from bedside nursing, there has been greater need for remaining nurses to precept new staff coming into the hospital. Some nurses assumed a preceptor role in addition to their direct care responsibilities. It has been reported that combined home and work-life burdens put nurses at higher risk of burnout, resulting in poor health outcomes and increased depression, anxiety, and stress. Mindfulness meditation is an evidenced-based tool to help acknowledge surroundings and to help to lower or decrease perceived stress. A randomized controlled design with a two-group pretest-posttest was used to evaluate the impact of a mindfulness smartphone application on the perceived levels of burnout, stress, anxiety, depression, and mindfulness of nurses. After taking a pretest, participants were randomized to either a waitlist control group or an intervention smartphone group. The waitlist group did not have any intervention during the 30 -day study period. The intervention group was asked to complete sessions via a smartphone mindfulness app for 30 days. The instruments used in this study were the Maslach Burnout Inventory (MBI), Depression, Anxiety, and Stress Scale 21 questions (DASS-21), Mindfulness Attention Awareness Scale (MAAS), and the Mobile Device Proficiency Questionnaire 16 questions (MDPQ-16). This dissertation includes three reports based on the same dataset. The first report analyzed the effects of a smartphone mindfulness application on burnout in nurse preceptors. Results of the study indicated that a smartphone application can reduce burnout in the subscales of Personal Accomplishment and Depersonalization but not in Emotional Exhaustion. The second report examined the impact of a smartphone mindfulness application on scores of depression, anxiety, and stress of nurses. The study results indicated a significant improvement in the smartphone application group compared to the waitlist group for the variables of depression and stress. The third report evaluated the impact of the smartphone mindfulness application on the mindfulness levels of participants and the relationship between their technology proficiency to their interaction with the application. The smartphone group's mindfulness scores increased significantly compared to the waitlist group. However, mobile proficiency was not significantly related to the participants’ use of the mindfulness application. The findings of this study indicate that the use of a smartphone application can effectively increase mindfulness when used by nurses at the bedside. The smartphone mindfulness app also showed potential benefits in reducing self-perceived levels of several aspects of burnout, depression, and stress in nurses. Hospitals could choose to embed mindfulness principles into the hospital environment's culture or provide staff opportunities to practice mindfulness through a smartphone application during the day. Such mindfulness may decrease the consequences of burnout, which include increased nurse turnover, decreased quality of care, and high costs of recruiting and training new nurses. Further research is needed to study the long-term impact of using the smartphone application and the time required daily to show results

Simulation in nursing education involves an instructor observing students performing a specific task using an anatomical model, standardized patients, or high-fidelity simulation using a simulator. This education method allows creation of realistic clinical scenarios to allow nurses to perform tasks in a safe learning environment. However, accurate performance in the simulation lab must be replicated in the clinical environment to impact patient outcomes. Chapter 2 is a systematic literature review resulting in 21 articles addressing dependent variables, conceptual frameworks, study designs and outcomes measured in new nurses. Knowledge, simulation satisfaction, confidence, and clinical performance were common simulation outcomes studied. Only 7 research articles reported using a theoretical framework. Even though most of the studies used self-reported measures to demonstrate improvement in the studied variables after simulation, none of the studies used objective observation in the actual clinical setting after simulation. Assessing performance in the actual clinical environment after simulation is an opportunity to link simulation education to patient outcomes. Researchers should explore if learned skills in simulation are transferred to the real clinical setting resulting in safe and competent care. This gap in the literature was the impetus for the study described in Chapter 3. Chapter 3 focuses on a quasi-experimental study on new nurses hired at an oncology institution to determine if skills learned in the simulation lab transferred to the clinical setting. The study’s aim addressed if a difference exists in clinical observation scores between the intervention group (involved in simulation) and control group (not involved in simulation) when performing a central line dressing change. Fifty-six participants were consented with 19 nurses completing all data collection points. No significant differences were identified between groups. Chapter 4 is a narrative account applying the concept of resilience to the doctoral dissertation experience during a pandemic. Using Richardson’s Resiliency Model, the challenges of performing research on staff development during a pandemic are presented. The presence of a stressor (pandemic) and the resulting stages of disruption and reintegration are described resulting in resilient reintegration during the doctoral research process. Simulation is an educational methodology in academia and staff development. However, outcomes such as confidence, knowledge and simulation satisfaction are over-studied and there is a need for studies to focus on if skills performed during simulation are replicated accurately in the clinical setting. In addition, simulations should be designed to ensure they are addressing the identified construct (e.g. clinical judgement). In addition, the logistics involved in observing practice at the point of care is challenging due to unpredictable factors such as staffing, patient acuity, and operational decisions that may impact study design present unique challenges. Keywords: Simulation, new nurses, resilience

The aim of this study is to explore and describe the coping skills of registered nurses in a changed working environment. The research is conducted in the City Health clinics. The objectives of the study are:  to identify strategies which nurses use to cope with the changes in the health care services;  to explore appropriate support systems that will enhance the coping skills of registered nurses in clinics in the City Health Department; and  to deduce guidelines on how to support staff from the literature study and the results of the research. The research problem is the following: nurses in primary health care facilities do not adequately cope with major changes in health care delivery. A qualitative approach for the research was chosen. Personal interviews and focus group discussions were used to identify the coping skills of registered nurses. Data analysis was done manually. Transcriptions of recordings of the individual interviews and group discussions were done. Themes were organized and categorized into meaningful links and relationships. The findings indicate that the following factors improve the coping skills of registered nurses:  team-work and support;  to voice your opinion when necessary and good communication between staff;  regular breaks during working hours;  inherent factors for example strong spiritual and emotional strength that assist registered nurses to cope;  family support;  the provision of quality care is rewarding;  the assistance and support from the church (congregation);  the effective re-organisation of health services;  continuous support programs for staff; and  continuous education to develop skills of registered nurses. / Advanced Nursing -- Psychological aspects / M.A.

Dissertation submitted in fulfillment of the requirements for the Degree in Masters of Technology: Nursing, Durban University of Technology, 2011. / Background Working in the intensive care unit can be traumatic for nursing personnel. Critical care nurses are faced with repeated exposure to death and dying as they are involved in caring for patients who are actively dying or who have been told that they have a terminal illness and are faced with the possibility of impending death. Critical care nurses relate in different ways to the phenomena of death and dying within their nursing profession and their scope of practice. These nurses often have a difficult time coping with the stress that comes with caring for those who are dying or relating to loved ones of those that are dying. Aim of the study The aim of the study was to explore the critical care nurse’s experiences of death and dying. Methodology A qualitative, descriptive phenomenological approach was used to guide the study. Four nurses were recruited and rich descriptions of their experiences were gained through individual face-to-face interviews. One broad question was asked: ‘What are your experiences regarding death and dying of your patients in ICU?’ iii Results The findings of this study revealed that issues such as communication, multicultural diversity, education and coping mechanisms relating to caring for the critically ill and dying patient are essential in nursing education and practice. Critical care nurses need to have support networks in place, not only to assist in providing care, but also for their own emotional support / M