The difficulties new nurses experience when first entering acute care work environments have been recognized since Kramer’s seminal work in the 1970s. Despite the implementation of interventions designed to help ease the transition, the literature continues to report that new graduates undergo stress when beginning their careers as nurses. The purpose of this study was to examine the effects of perceived demands, control, social support and self-efficacy on the job stress, job satisfaction and intention to leave of new nurses. The conceptual framework used in the study was Karasek’s (1979) Job Demands-Control-Support (JDC-S) model. This model posits that job demands increase employee stress, but that increasing control can alleviate the negative effects of high demands. Social support and self-efficacy were included in this study as potential moderators of the relationships between demands and control and the outcome variables. This was an exploratory study that utilized a cross-sectional survey was used to gather data. Surveys were mailed to the homes of new nurses working in acute care hospitals across Ontario, Canada. Data were received from 232 new nurses, a response rate of 23.8%. Nurses in the sample had an average of 18.2 months of experience. Data were analyzed using separate hierarchical regression models for each dependent variable. The results showed that the main effects of job demands, social support and self-efficacy provided partial support for the JDC-S model when examining job stress, job satisfaction and intention to leave the job. Only self-efficacy was significantly related to intention to leave the profession. There was no evidence of moderating effects of social support or self-efficacy. An understanding of factors in the work environment that influence new nurses may assist in supporting them during the transition. By exploring the effects of demands, control, social support and self-efficacy on new graduates’ job stress, job satisfaction and intention to leave, this study may provide direction to nursing leaders who are working new nurses in acute care.

The difficulties new nurses experience when first entering acute care work environments have been recognized since Kramer’s seminal work in the 1970s. Despite the implementation of interventions designed to help ease the transition, the literature continues to report that new graduates undergo stress when beginning their careers as nurses. The purpose of this study was to examine the effects of perceived demands, control, social support and self-efficacy on the job stress, job satisfaction and intention to leave of new nurses. The conceptual framework used in the study was Karasek’s (1979) Job Demands-Control-Support (JDC-S) model. This model posits that job demands increase employee stress, but that increasing control can alleviate the negative effects of high demands. Social support and self-efficacy were included in this study as potential moderators of the relationships between demands and control and the outcome variables. This was an exploratory study that utilized a cross-sectional survey was used to gather data. Surveys were mailed to the homes of new nurses working in acute care hospitals across Ontario, Canada. Data were received from 232 new nurses, a response rate of 23.8%. Nurses in the sample had an average of 18.2 months of experience. Data were analyzed using separate hierarchical regression models for each dependent variable. The results showed that the main effects of job demands, social support and self-efficacy provided partial support for the JDC-S model when examining job stress, job satisfaction and intention to leave the job. Only self-efficacy was significantly related to intention to leave the profession. There was no evidence of moderating effects of social support or self-efficacy. An understanding of factors in the work environment that influence new nurses may assist in supporting them during the transition. By exploring the effects of demands, control, social support and self-efficacy on new graduates’ job stress, job satisfaction and intention to leave, this study may provide direction to nursing leaders who are working new nurses in acute care.

Background: Studies have demonstrated that new graduate nurses' (NGNs) transition experience is complex and often negative leading to dissatisfaction with nursing and increased attrition. Many existing studies of NGNs' transition experience are small, qualitative, concerned with NGNs experiences in the West. No study has been conducted to date examining NGNs' transition experience in any of the developing countries where the cultural context and nursing education and practice are different to those in the West. Aim: To explore the experience of NGNs during their transition period in one of the developing countries, the Sultanate of Oman. Method: Qualitative case study utilising an embedded-single case design was conducted to investigate the transition experience of baccalaureate NGNs graduating from Sultan Qaboos University (SQU) and working at Sultan Qaboos University Hospital (SQUH). Data were collected from the perspective of NGNs and also from the perspective of other key informants using triangulated methods. This includes individual and focus group interviews, observation and documentary analysis. Results: Four over-arching themes are identified from NGNs' transition experience in the Sultanate of Oman. These are 'Studying Experience'; 'Role Transition'; 'Working Conditions' and 'Status of the Nursing Profession'. This study showed that nursing is not an attractive choice for Omani students to study and pursue as a future career because of its low status. During the transition period, NGNs experienced reality shock which mainly resulted from a theory-practice gap. NGNs had limited practical experience but a high level of theoretical knowledge, which they were unable to utilise in practice. They found the working environment to involve many competing priorities resulting in task-orientation and compromised patient care. This study showed that many NGNs resented their involvement in basic nursing care, which they believed should not be part of their role as degree nurses. Despite the challenges of the transition period, many NGNs remarked that nurses play the most important role at the hospital and they are proud being nurses. Conclusion: Omani NGNs' transition experience is complex and similar in many respects to NGNs experience in the West. However, there are distinctive challenges Omani NGNs faced due to the Omani culture, working environment and the status of nursing in Oman.

Sjuksköterskor väljer att lämna yrket på grund av rådande arbetsvillkor. I den kliniska verkligheten är det högt arbetstempo samtidigt som krav och ansvar över patienten måste uppfyllas. Nyutexaminerade sjuksköterskor upplever en hög stressbelastning vilket ger konsekvenser på hälsan och ökar benägenhet att vilja lämna professionen. Sjuksköterskans kärnkompetens handlar om att främja patientens hälsa och lindra lidande samtidigt som den egna hälsan ska skötas så förmågan att ge en god vård inte äventyras. En komplex problematik för den enskilde individen och samhället. Syftet med studien var att undersöka upplevelser av orsaker till stress i arbetet bland nyutexaminerade sjuksköterskor. Metoden som använts är en litteraturöversikt över befintligt forskningsläge där både kvalitativa och kvantitativa studier har sammanställts. I databearbetningen framkom tre teman, Känsla av otillräcklighet, Känsla av utsatthet och utanförskap samt Individen i professionen. Resultatet visar att nyutexaminerade sjuksköterskor upplever ett flertalstressfaktorer och att det verkar vara en allmängiltig upplevelse runt om i världen i denna yrkesgrupp. Upplevelser av orsaker till stress visades i samband med rollanpassning, klinisk kompetens, hantering av palliativ vård, konflikter, brist på stöd, mobbning, arbetsbelastning samt schema. Ålder, yrkeserfarenhet och karaktärsdrag påverkade upplevelsen av arbetsrelaterad stress och det framgick att vissa grupper av nyutexaminerade sjuksköterskor har en ökad sårbarhet. Dessa kunskaper är viktiga för att utveckla strategier som kan minska stressrelaterad ohälsa i denna yrkesgrupp och föra yrket mot en mer hållbar utveckling. / Nurses choose to leave the profession because of prevailing working conditions. In the clinical reality, it is a high workload, while demands and responsibilities over the patient must be fulfilled. Newly graduated nurses experience high rate of stress load, which have consequences on their health and increases the tendency for wanting to leave the profession. The core competence of the nurse’s is about promoting the patient’s health and alleviating suffering while at the same time managing their own health so that the ability to provide good care is not compromised. A complex problem for the individual and society. The purpose of the study was to investigate experiences of causes of stress in the work of newly graduated nurses. The method used is a literature review of the existing research situation where both qualitative and quantitative studies have been compiled. In the data processing, three themes could be revealed, Feeling of inadequacy, Feeling of vulnerability and exclusion and The person in the profession. The result shows that newly graduated nurses experience a number of stress factors and that it seems to be a universal experience around the world in this professional group. Experiences of causes of stress were shown in connection with role adaptation, clinical competence, management of palliative care, conflicts, lack of support, bullying, workload and schedule. Such as age, professional experience and character traits affected the experience of work-related stress and it emerged that certain groups of newly graduated nurses have an increased vulnerability. These insights are important for developing strategies that can reduce stress-related ill-health in this professional group and lead the profession towards a more sustainable development.

Background: previous studies have revealed that newly hired nurses experience stress and anxiety when entering a new clinical setting. Failure to support and prepare these nurses may affect their ability to deliver the required level of nursing care. Preceptorship is a time limited, organised clinical instructional programme, which promotes staff development, improves nursing education, reduces nursing shortages, promotes staff retention and decreases staff turnover. Little evidence expounds about how newly hired nurses perceive preceptorship. The impact of preceptorship on the clinical nursing care of newly hired experienced nurses has not been investigated or verified globally neither has it been investigated from a Saudi context. Aims and Objectives: the study aimed to explore the nature of preceptorship and its impact on clinical nursing care as perceived by the nurses who had taken part in a preceptorship programme in Saudi Arabia. The study elicited the participants' understanding and expectations of the preceptorship programme in an attempt to identify those factors that may be directly related to the success or failure of the programme. Furthermore, it aimed to examine the role of preceptorship in developing the clinical practice of newly hired experienced nurses. Methodology: a qualitative design based on the principles of naturalistic inquiry underpinned this study. Thirty national and international nurses of five different grades across wards in one Saudi hospital were first purposively and subsequently convenience sampled to take part in the study. Most participants were of international origin, possessing various levels of experience and education. Preceptees were younger and less experienced than other programme stakeholders. Data were generated using tape-recorded semi-structured individual and focus groups interviews. This action was also supported by a review of the hospital's preceptorship policy documents. All the interviews were transcribed verbatim and analysed concurrently using thematic analysis based on a constant comparative method. Findings and discussion: Six themes were derived from the interview data to generate an account of participants' experiences. Social learning theory was used as an explanatory framework for understanding the study's findings. Thus, preceptorship was seen as an important supportive, learning process, although inconsistencies were highlighted related to the participants' understanding and expectations of the programme. The duration of preceptorship was also contested with some needing longer than allocated. Hence, confusion arose regarding when preceptorship should begin and end due to ambiguities within the preceptorship policy documentation. Furthermore, participants perceived preceptorship had a mixed impact on clinical nursing care depending on preceptee/preceptor preparation and workload. Surprisingly recruitment was found to have the biggest impact on the success or failure of the preceptorship programme an unexpected and new finding highlighted by this study. Conclusion: preceptorship is important for the integration of newly hired experienced nurses into their new roles. The meaning of preceptorship as applied to each hospital needs to be defined and articulated clearly and concisely. In order to meet the objectives of preceptorship, policy documentation needs to be clearer, and recruitment processes need to be reviewed in order to match both preceptee experience and qualifications with organisational requirements.

Bakgrund: Palliativ vård och vård i livets slutskede är vård utan bot. Vården utgår ifrån att lindra lidande och öka välbefinnande, både för patienter och anhöriga. Kunskapen brister hos nyutbildade sjuksköterskor och utbildningen är otillräcklig. Det är problematiskt att sjuksköterskor saknar kunskap om palliativ vård och vård i livets slutskede, och tror att det är samma sak. Brister i utförandet kan öka oro och lidande, trots att vården ska lindra lidande. Syfte: Syftet var att beskriva nyutbildade sjuksköterskors upplevelser av vård i livets slutskede. Metod: En allmän litteraturöversikt där vetenskapliga artiklar analyserades för att söka likheter och skillnader ur artiklarnas syfte, metod, urval och resultat. Resultat: Nyutbildade sjuksköterskor upplevde bristande förberedelse, osäkerhet, känslomässig påverkan samt betydelse av stöd. Nyutbildade sjuksköterskor var oförberedda inför mötet med döden eller hade bristfälliga kliniska färdigheter. De upplevde osäkerhet och otillräckliga i yrkesrollen, både för patienter och anhöriga. De upplevde ångest, stress eller en rädsla för döden vid vård av döende patienter i livets slut. Fåtal givande upplevelser framkom. De upplevde att stöd från erfarna sjuksköterskor var viktigt. Slutsats: Nyutbildade sjuksköterskor behöver välfungerande stöd i yrkesrollen, för att undvika att orsaka ett ökat lidande för patienter, anhöriga eller sjuksköterskor själva. / Background: Palliative care and end-of-life care is care without cure. The care intends to ease suffering and increase well-being, both for patients as well as families. Newly graduated nurses’ lack in knowledge and the education is insufficient. It’s problematic that nurses lack knowledge about the care and believes that palliative care and end-of-life-care are the same. Insufficient care could increase worries and suffering, even though the care intends to ease suffering. Aim: The aim was to describe newly graduated nurses’ experiences of end-of-life care. Method: A literature review based on scientific articles that was analyzed to seek similarities and differences in aims, methods, selections, and results. Result: Newly graduated nurses experienced lacking preparations, insecurity, emotional affect, and the need for support. They felt not prepared to encounter death and lacked clinical skills. Newly graduated nurses experienced anxiety, emotional strain and a personal fear of death when caring for dying patients at the end of life. Only few beneficent experiences were found. Newly graduated nurses felt that support from more experienced nurses was important. Conclusion: Newly graduated nurses need well-functional support in their professional role, to avoid causing an increased suffering to the patients, families or to nurses themselves.

The Adaptation Process Plan document should serve as a tool for ensuring that the adaptation process of a new employee to an intensive care unit is properly led. It is also supposed to help with feedback and evaluation of the level of the newcomer's skills. The main goal of this thesis was to find out how effectively the Adaptation Process Plan document is currently used for nurses in intensive care units in the Czech Republic. We furthermore aimed to ascertain how the plans are filled in, whether their individual parts are filled in on a regular basis, as well as whether the parts which have been graded as insufficient are explained again to the employee. Last but not least, we tried to compare how the document is used in the Czech Republic and in the United Kingdom. The qualitative research was carried out by interviewing three nurses who have completed the adaptation process to intensive care units - one in the United Kingdom and two in the Czech Republic. The results show that according to our research group, the Adaptation Process Plan document is not effectively used in the Czech Republic, especially in comparison with the United Kingdom. The ways of filling in the document differ in these countries, particularly with regard to its regularity and thoroughness. The parts which had been graded...