<p>Abstract Background: End-of-life care has become the focus of most health care organizations due to the increasing number of patients who are living longer with chronic and terminal diseases. Today, patients are more involved in the discussion towards end-of-life care, and nurses are the ones who provide this care. Most studies that explore the experiences of nurses providing end-of-life care focused mostly on nurses working in oncology and pediatrics. These studies suggested that nurses caring for patients at the end of life lack formal training in end-of-life care. This lack of knowledge and training was perceived to have a negative impact on patients' care. These studies, however, lack generalization, as nurses in varies clinical settings other than oncology and pediatric will likely care for a dying patient at some point in their nursing career. Purpose: The purpose of this study explored the lived experiences of nurses who provide care to patients at the end of life. Exploring the nurses' experiences in various clinical settings, such as an acute care and long-term care facilities will bring more knowledge and a deeper understanding about the essence of the experience of nurses who provide end-of-life care to dying patients. This study has the potential to provide information on nurses? experiences in order to develop end-of-life care educational programs for nursing students based on nurses? needs. Methods: This study was guided by Moustakas's (1994) Transcendental Phenomenological approach to phenomenology. The target population was registered nurses and licensed practical nurses who experienced caring for dying patients and have had no prior education or training in palliative or hospice care, post nursing school graduation. Results: From the experiences of 16 nurses who provides end of life care in clinical settings, one primary theme and three subthemes were identified. Conclusion: Experiences of nurses? generosity as described in kind acts and empathetic behavior and their commitment to patients who are dying, illustrates the essence of dedication. Daily interactions support their commitment to patients and competence increase their confidence and improve the skills needed to create a balance between daily work challenges and patient's care. The results of this study supports the need for nurse educators and employers to provide more opportunities to end life care educational programs for professional nurses and nursing students.

<p> <b>Background:</b> With the current nursing shortage there are fewer experienced nurses and more newly licensed registered nurses (NLRNs) in the workplace. This shortage may be due in part to inconsistencies between role expectations learned in school and the practice environment. These inconsistencies may make it challenging to transition from nursing school into professional healthcare organizations. Nurses with certain person-level traits, including resilience and emotional intelligence, may be more likely to make a successful transition into practice. Findings may improve our understanding of what person-level traits are important for making the successful transition to the workforce. </p><p> <b>Purpose:</b> The current study explored whether emotional intelligence (EI) and resilience influenced transition into professional roles. </p><p> <b>Theoretical Framework:</b> Understanding how cultural shock and adaptation are challenging for many NLRNs is important. Duchscher transition theory provided an overview of how NLRNs engaged in the professional practice role as they are confronted with the realities of the work environment. </p><p> <b>Methods:</b> A non-experimental research design with descriptive cross-sectional study is used to determine if EI and resilience have any effect on NLRNs transitioning into their professional roles. </p><p> <b>Results:</b> With a sample size of 63, there is a direct positive linear relationship between resilience and global trait EI and its subscales for NLRNs. The correlation is significant with the exception of the EI subscale emotionality. Also there was no significance with NLRNs who transitioned in a critical care setting and those in other specialty care areas. </p><p> <b>Conclusions:</b> There is a need for further exploration of this relationship with a larger sample size and the need to investigate person-level characteristics in NLRNs who successfully transition to their professional role.</p><p>

<p> Incivility, also known as bullying or horizontal violence, can take many forms from derogatory statements to physical harm. Incivility can create physical, emotional, and psychological symptoms leading to job dissatisfaction and increased turnover. Incivility can impact patient care and patient safety. Organizational impacts include increased turnover and decreased productivity. Regulatory and professional agencies have issued recommendations for leaders of organizations to address incivility in the workplace. The purpose of the study was to determine if an educational program for nurse leaders can improve the perceived ability of the leaders to act with moral courage to address uncivil behavior. Two theories identified as relevant to incivility in the workplace, Freire&rsquo;s Oppression Theory and Kanter&rsquo;s Structural Theory of Power. A quasi experimental design, one group pretest-posttest, was used. The study took place in a 363-bed tertiary care facility. A convenience sample of nurse leaders completed a pre-survey, education, and post-survey. Analysis was conducted on 37 matched pairs of surveys. The tool, the Professional Moral Courage (PMC) Scale, is comprised of fifteen statements divided into five themes; three statements per theme. Three areas of statistical significance were found using a paired t-test comparing the pre-survey to the post-survey scores. The results indicated improvement in two out of five themes, acting morally and proactive approach, and the overall score. Leaders need to utilize moral and address incivility. By witnessing the leaders&rsquo; role modeling civil behaviors and taking action in the face of incivility, staff should also demonstrate the same behaviors.</p><p>

Although research shows that nurses are dissatisfied with conditions in work environments, they generally do not initiate behaviors that could produce change. Reasons for this lack of initiating or leadership behaviors among nurses are unclear. The purpose of this study was to explore the phenomenon of sex-typing among nurses and to investigate the relationship between sex-typing and some elements of leadership behavior. Specifically, the following research question and two hypotheses directed the study. Research Question I. What is the nature of the distribution among female nurses who practice in five general hospitals in Massachusetts of the four sex-type groups as determined by the Bem Sex-Role Inventory? Null Hypothesis I. There are no significant differences among the four sex-type groups of female nurses practicing in five hospitals in Massachusetts and their identification of problems in the work setting that hinder their effectiveness in providing optimal services to clients. Null Hypothesis II. There are no significant differences among the four sex-type groups of female nurses practicing in five hospitals in eastern Massachusetts and their perception that staff nurses should initiate action necessary to solve the problems identified that hinder their effectiveness in providing optimal services to clients. Data collection included a mailed survey and personal interviews using the Bem Sex-Role Inventory, (BSRI) and the Practice Environment Inventory (PEI). The BSRI identified sex-type and the PEI identified perceptions about problems in work environments and problem solving initiators. Chi square tests were computed to compare the distribution of sex-type of the sample to others and Analysis of Variance Procedures were used to test the relationship between sex-type and (1) numbers of problems identified in work settings, (2) number of times staff nurse was named as the appropriate person to initiate action. The results showed no significant differences between the sample's distribution of sex-type and two others to which it was compared. Further, no significant relationships were found between sex-type and numbers of problems or choice of problem solving initiator. Data also showed that nurses recognize the need for change and think that nurses should respond.

<p> Currently there is a high rate of registered nurse (RN) turnover due in part to bullying and harassment among peers; which fosters lower quality nursing care, jeopardizes patient safety, and increases healthcare costs. The purpose of this quantitative nonexperimental study was to examine the relationship between inpatient nurses&rsquo; individual self-esteem and reported bullying and harassment with their intent to leave their job. Two theories were used to provide structure to this work: cognitive experimental self theory and oppressed group theory. Data were collected using the Negative Acts Questionnaire, the Rosenberg Self-Esteem Scale, and the Turnover Intentions Measure. All RNs in a Midwestern state were emailed an invitation link to the instruments housed on SurveyMonkey. Only those respondents who claimed to be inpatient RNs were included in the study (<i>n</i> = 770). The three research questions asked about bullying and harassment among inpatient RNs, about the self-esteem of RNs who experienced bullying and harassment and those who have not, and if those RNs who experienced bullying and harassments intended to leave their jobs. With a 2.1% response rate, results indicated that there was a relationship among RNs and bullying and harassment, the self-esteem of RNs who did not experience bullying and harassment was higher than those who did experience bullying and harassment, and there was a positive relationship between RNs experiencing bullying and harassment and their intent to leave their jobs. This research suggests that if bullying and harassment patterns among RNs are identified sooner, RN turnover can be reduced, patient care quality and safety can be improved, and U.S. healthcare costs can decrease. </p><p>

<p> The purpose of this quantitative study was to assess the impact of mentorship on job satisfaction and intent to stay in the current position among NPs. The theoretical frameworks that provided context for this study were interpersonal relations theory and novice to expert theory. Using a convenience sample of NPs belonging to private LinkedIn and Facebook groups, data was collected through an online survey consisting of the Misener Nurse Practitioner Job Satisfaction Scale and demographic questions. An independent samples <i> t</i>-test was used to test the null hypothesis. The study findings indicated that there were significant differences in job satisfaction scores between the group that was mentored and the group that was not mentored. No significant difference was found in intent to stay between NPs that were and were not mentored. The findings suggest that NPs who are mentored have higher job satisfaction and provides evidence to organizations that employ nurse practitioners to consider the development and initiation of mentorship programs. Further interventional research is recommended to confirm the findings of this study.</p><p>

<p> The goal of this dissertation was to contribute to research on practical nursing students&rsquo; self-efficacy and the sources that build self-efficacy including mastery experience, vicarious learning, social persuasion, and physiological and affective states (Bandura, 1986). Specifically, the focus in this study was on students&rsquo; self-efficacy change and development through the measurement of students&rsquo; confidence in ability to engage in medical surgical simulations during the last semester of a practical nursing program. The results of this study revealed perceived self-efficacy did not change, but participants indicated an overall strong sense of efficacy to engage in medical surgical simulations. Additionally, students relied on all four sources that build self-efficacy (Bandura, 1986). In other words, students relied on personal perseverance in facing obstacles, sought the nursing faculty&rsquo;s assistance and encouragement to perform well, observed and modeled their teachers&rsquo; behaviors, and successfully managed their physiological and emotional states. Strong self-efficacy was concluded to be a key factor in the success of practical nursing students. Thus, there is a need for future experimental and theory-driven studies that utilize the self-efficacy approach to reduce student attrition and contribute to academic and professional accomplishment of practical nursing students. </p>

The purpose of the study is to present a different perspective from which to evaluate two patient outcomes--infection and pressure ulcer. Past research has looked at the relationship of various medical treatments and/or nursing interventions to these outcomes. This descriptive exploratory study uses a cross-sectional design to investigate the variables being studied. In this study personality type and the performance of nursing staff and the organizational climate on long term care wards is examined in relationship to patient outcomes (infection and pressure ulcer rates). A questionnaire was completed by two hundred and seventy-six nursing employees who worked on 25 long term care wards at three medical centers. The Myers Briggs Type Inventory was used to measure personality. The Ward Environment Scale was used to measure organizational climate. Of the sixteen possible personality types, four types occurred with the greatest frequency. Collectively, these four types accounted for 60% of the staff participating in this study. Of the four bipolar personality dimensions, only extroversion/introversion had a significant effect on patient outcomes. Two of the organizational climate subscales were significantly related to patient outcomes--peer cohesion and task orientation. Six organizational climate dimensions were significantly related to performance ratings. Several organizational climate dimensions were also related to personality. Surprisingly, although both personality and organization climate related to performance and patient outcomes, no significant correlations were identified between staff performance ratings and patient outcomes. This raises several questions about the relationship between staff performance and patient outcomes for future studies. This study supports the belief that organizational climate influences the work site and is a factor worthy of management's attention. Implications for nursing management and nursing are discussed, Several recommendations for future research are offered including longitudinal studies to identify the effects of organizational climate and personality on and patient outcomes over time. The use of personality types to enhance team building and communications, and reduce turnover rates among nurses is also discussed.

<p> The purpose of this study was to assess the relationship between emotional intelligence and work engagement in the context of frontline nurses in acute care settings. The relationship between age, gender, years of experience, educational attainment, and specialization was investigated in relation to frontline nurses&rsquo; emotional intelligence and work engagement. This quantitative nonexperimental study was conceptualized to bridge a knowledge gap regarding the extent to which emotional intelligence and demographic factors are associated with work engagement in nursing. This study was based on theories concerning emotional intelligence and work engagement constructs. Participants included 142 frontline nurses working in an acute care setting within the United States. All data were gathered quantitatively using an online survey. The survey instrument included a compilation of two measurement scales (the Assessing Emotions Scale [AES] and the Utrecht Work Engagement Scale [UWES]) and a demographic questionnaire. The data analysis procedures included one-way analysis of variance, Spearman&rsquo;s <i> rho</i> correlations, independent <i>t</i>-tests, and multiple regression analysis. The results of the study revealed that there is no statistically significant correlation between age, gender, years of experience, educational attainment, and specialty with emotional intelligence. Moreover, the findings revealed that there was a statistically significant positive correlation between emotional intelligence and age with work engagement level among frontline nursing. There was no statistically significant correlation found between gender, years of experience, educational attainment, and specialty with work engagement. The study results provide a pathway for researchers to better understand nurse emotional intelligence and work engagement in relation to demographic variables.</p><p>

<p> Organizational work climates in healthcare organizations were described in the literature using a social framework of structured interactions, defined roles, and behavioral responses between team members of physicians and nurses. It was hypothesized that the characteristics of physician-nurse collaboration, physician dominance, and nurse autonomy in socially complex work settings have relationships to turnover intent in nurses who work in operating room settings. In an era of nursing shortages the challenge of nurse retention and the evidence of challenging work climate become even more critical for healthcare organizations. This research study examined a gap in knowledge regarding the extent to which aspects of organizational work climate predict nurse turnover in operating room work settings. A quantitative correlational study using three work climate characteristics of physician-nurse collaboration, physician dominance, and nurse autonomy was conducted using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (Hojat &amp; Herman, 1985, <i>Developing an Instrument to Measure Attitudes toward Nurses: Preliminary Psychometric Findings</i>) and the Anticipated Turnover Scale (Hinshaw &amp; Atwood, 1983, <i>Nursing Staff Turnover, Stress, and Satisfaction: Models, Measures, and Management</i>). Responses from 322 Operating Room staff nurses who were members of a national professional nursing organization were examined in the analyses. The study concluded that the independent variables of collaboration, dominance, and autonomy were not significant in predicting turnover among nurses in the operating room setting.</p>