The nursing workforce has experienced considerable change during the previous decade, resulting in a chronic shortage of nurses. Issues such as economic rationalism, increased workloads, changes in nursing education and the advancing age of the current nursing workforce are the chief contributors to this shortage (Australian Institute of Health & Welfare, 2005b; Buerhaus, Staiger, & Auerbach, 2000b). Operating room (OR) nursing is a primary specialty area that has been especially affected by rising nurse attrition and a reduction in nurse recruitment (Australian College of Operating Room Nurses, 2003; Australian Health Workforce Advisory Committee, 2002). Accordingly, the loss of skilled nurses from the OR specialty compounds the negative effects on morale for those who remain in the environment, as they struggle to provide safe patient care while concomitantly being responsible for the clinical development of neophyte and inexperienced nurses (Australian Health Workforce Advisory Committee, 2002; Arndt, 1998). In the midst of working in the OR environs where the nature of the associated stressors is unique, resilient qualities may assist nurses to meet and overcome these challenges. If there is to be a continued nursing presence in the OR, it is essential that nurses be given the opportunity to develop resilience. At this time when nurse retention rates are continuing to decline steadily, there is a compelling need to identify and describe the relationship between resilience and its predictors in the context of the OR. To date, little is known about predictors of resilience and their potential to ameliorate the effects of workplace stress in the OR. The overall purpose of this study was to identify and describe the predictors of resilience in OR nurses. A literature review and concept analysis of resilience was initially conducted. Hope, self-efficacy, coping and personal characteristics were identified as defining characteristics of resilience. Next, the research was conducted as a mixed method phased study that was underpinned by the pragmatist paradigm, and employed a sequenced combination of qualitative followed by quantitative inquiry (Morgan, 1998). The first phase used a mini-ethnography to identify and describe the components of workplace culture in an OR in relation to their potential impact on nurses’ ability to adapt in this culture. A triangulated approach was used involving participant observation, a reflective journal, field notes and interviews. This phase revealed that competence, knowledge, collaboration, peer support and the ability to manage challenges were central components of OR workplace culture. From these categories, three themes were abstracted and subsequently developed into constructs that were measured and validated in the larger second phase. The second phase used a predictive correlation survey to describe empirically the relationship between resilience and its hypothesised predictors in a systematic random national sample of nurses who were members of the Australian College of Operating Room Nurses (ACORN), and a combined sample of hospital nurses purposively drawn from two similar hospital sites. The survey included scales measuring perceived competence, collaboration, managing stress, self-efficacy, hope, coping, and resilience, as well as gathering information about the demographic characteristics of nurse respondents. Out of a total potential sample of 1,730 OR nurses, the overall response rate was 51.7% (n = 896). Differences between the ACORN and hospital samples were found in age, years of experience, education and years of employment; therefore, the national and hospital samples’ findings were analysed separately. Five independent variables – hope, self-efficacy, coping, managing stress and competence – predicted resilience in the larger sample of ACORN respondents (n = 772). For the substantially smaller sample of hospital respondents (n = 124), hope, self-efficacy and managing stress predicted resilience. Given that the smaller hospital sample resulted in a similar model, this consistency lends strength and weight to the revised resilience model. Over 60% of the variance in resilience was explained by the independent variables in each model. Given the dearth of literature describing the efficacy of resilience in ameliorating stress in OR contexts, the results of this study have extended the theoretical application of the resilience concept to include a nursing context. There is a need to implement resilience-building strategies that address the culture of the OR, both at the departmental and organisational levels. Strategies that provide a supportive workplace environment in relation to goal-orientation, the provision of stress management and education programs, and strategies that facilitate cultural assimilation may improve resilience, and hence retention and recruitment rates in the OR. The findings of this study support the need for further research not only to test the stability of the proposed model among other groups of nurses but also to explore further predictors of resilience in the OR setting.

The fluctuation of nursing staff in the medical facilities is not just current problem in the Czech Republic. Aging population will present higher demand for number of nursing staff. It is assumed that the insufficient number of nursing staff will remain and even rise (also due to aging of the staff) if appropriate actions are not taken (Simoens et al., 2005). This thesis discusses the decision to migrate amongst the nursing staff - general nurses, practical nurses, midwives, and emergency paramedics within the medical facility. It analyses the reasons for changing their workplace. The investigation was executed using the questionnaire method. It was conducted in January and February of 2020 in the selected medical facility in the Czech Republic. Total of 701 questionnaires were distributed to all inpatient wards, outpatient departments and intensive care units. The investigation targeted nursing medical staff. A statistical analysis of the results was performed Mann-Whitney U test was used to monitor the differences for decision to migrate based on various characteristics and responses. Total of 415 completed questionnaires were analysed in this investigation. 61/415 (14.7 %) responders consider the change of workplace. The most common nursing staff members to consider the change were general...

Cette étude vise à étoffer la base conceptuelle du phénomène de sens au travail permettant ainsi de mieux le comprendre et le saisir et cherche à proposer un modèle théorique pouvant expliquer le processus de construction d’un sens au travail par des infirmières libanaises. Le sens au travail se présente à la fois en tant qu’un processus qui émerge suite aux interactions dynamiques qui s’établissent entre un individu et son contexte de travail et en tant que produit qui s’exprime chez un individu au niveau de la satisfaction, la motivation, l’engagement organisationnel, la performance et la santé au travail. L’étude de ce phénomène constitue une nouvelle voie permettant d’apporter un nouvel éclairage à un contexte de travail, tel que le contexte libanais, qui souffre depuis des années d’un problème de pénurie du personnel infirmier. L’interactionnisme symbolique a constitué le cadre épistémologique et méthodologique de cette étude qui a adopté une approche qualitative par théorisation ancrée. L’étude s’est déroulée dans une région libanaise auprès de neuf infirmières hospitalières exerçant la profession dans des contextes de travail variés. La collecte des données a été faite par le recours à des entrevues individuelles enregistrées sur un support numérique ; les données ont été par la suite transcrites et analysées suivant la méthode constructiviste de Charmaz (2006). Les résultats ont permis de proposer un modèle théorique qui explique le processus de construction d’un sens au travail qui découle des interactions des infirmières libanaises avec les divers éléments du contexte de travail. Ces infirmières ont développé une représentation du contexte de travail marquée par une surcharge de travail, un salaire inadéquat, des opportunités de développement et d’avancement professionnel réduites, un comportement inéquitable des supérieurs et un image publique dévalorisée de l’infirmière. Ce contexte porte atteinte à la satisfaction de trois objectifs recherchés par ces infirmières à travers leur travail et qui sont : 1) prendre soin des patients ; 2) subvenir à ses propres besoins ; et 3) être reconnue en tant que professionnelle. Afin de construire un sens au travail et composer avec ce contexte contraignant, les infirmières se basent sur leurs ressources intrinsèques. La valorisation de l’infirmière et du travail infirmier, la satisfaction de l’effort fourni, l’actualisation de soi et l’avancement professionnel permettent à ces infirmières de protéger et de maintenir un sens au travail. Finalement, il était possible de conceptualiser le sens au travail en tant qu’un phénomène subjectif et multidimensionnel, nourri par l’amour de la profession et se traduisant par un travail qui répond aux attentes des infirmières. Les connaissances qui ont émergé de cette étude pourront aider à mettre en place des stratégies personnelles et contextuelles permettant de favoriser le processus de construction de sens au travail chez les infirmières libanaises afin de réduire le problème de pénurie du personnel infirmier. Des pistes de recherches sont encore avancées et des recommandations pour la formation sont proposées. / This study aims to expand the conceptual basis of the phenomenon of meaning at work and seeks to provide a theoretical model to explain the process of constructing meaning at work by Lebanese nurses. The meaning at work is presented as a process that emerges through the dynamic interactions developed between an individual and his work environment and as a product that is expressed by the individual level of satisfaction, motivation, organizational commitment, performance and health at work. The study of this phenomenon is a new way to shed light to a work context, such as the Lebanese context, suffering for years from a problem of shortage of nurses. Symbolic interactionism was the epistemological and methodological framework of this study based on a qualitative approach using grounded theory. The study was conducted in a region with nine Lebanese hospital nurses practicing the profession in various work contexts. Data collection was done by the use of individual interviews recorded on digital media; data were subsequently transcribed and analysed following the constructivist method developed by Charmaz (2006). The results were used to propose a theoretical model that explains the process of constructing meaningful work that arises from interactions of the Lebanese nurses with the various elements of their work context. These nurses have developed a representation of the work context marked by an excessive workload, an inadequate pay, an reduced opportunities for development and professional advancement, an unfair behaviour of their supervisors and a devalued nurse’s public image. This context affects the satisfaction of these three objectives that emerged threw analysis witch are pursuit by these nurses through their work: 1) to take care for patients; 2) to meet they one needs; and 3) to be recognized as a professional. These nurses construct meaning at work and compose with theses context constraints by using their personal resources. By enhancing the value of the nurse and the value of her work, by getting satisfied threw their effort, by self-actualization and career advancement, these nurses get to protect and maintain meaningful work. Finally, the meaning at work could be conceptualized as a subjective and multidimensional positive phenomenon fuelled by the love of the profession and resulting in work that meets the expectations of nurses. Knowledge that emerged from this study will help develop personal and contextual strategies to foster the process of construction of meaning at work in order to reduce the shortage of nurses. Research avenues and recommendations for education are suggested.