The purpose of this article is to describe the research mentoring process used with a small team of nurses by a PhD prepared nurse certified as a Nursing Professional Development Specialist and as a Critical Care Clinical Nurse Specialist. It will describe how bedside nurses were actively engaged in the research process by having them learn about research while operationalizing that knowledge as simultaneously were mentored in conducting a relevant research study. The process described and discussed in this article should be useful to nurse leaders to facilitate removing the traditional barriers to nursing research that still remain in healthcare organizations today. These include lack of time and knowledge, about the process, lack of institutional support, and lack of mentoring through the process. It should also be helpful to nurse educators in the clinical area to encourage more nurses to participate in nursing research.

Abstrakt Bakgrund: Palliativ vård baseras på ett förhållningssätt utifrån ett helhetsperspektiv av människan. Målet med palliativ vård är att minska lidande och att öka livskvaliteten i livets slutskede. Det handlar inte bara om att lindra det fysiska lidandet, utan även om att ge stöd till patienten och dennes anhöriga. Att ge palliativa omvårdnad innebär att stödja och underlätta för den döende och dennes anhöriga utan att påskynda eller fördröja döden. Den palliativa vården hjälper också patienten att leva med värdighet och välbefinnande under den sista tiden som är kvar. Syfte: Syftet med denna litteraturstudie är att beskriva sjuksköterskors upplevelser av att ge omvårdnad till patienter i livets slutskede. Metod: En integrativ litteraturöversikt användes. Databaser som användes var Cinahl och PubMed, där tio vetenskapliga artiklar utvaldes. Artiklarna var kvalitativa och kvantitativa som analyserades enligt metoden av Friberg (2022). Resultat: I resultatet framkom olika upplevelser som sjuksköterskor lyfte fram i omvårdnaden av patienter i livets slutskede och anhörigas betydelse. Resultatet presenteras i fyra kategorier. (1) Kommunikation och samarbete, (2) Andliga och existentiella behov, (3) Kunskaper och färdigheter och (4) Anhörigas betydelse i omvårdnad. Slutsats: Sjuksköterskorna kunde tillfredsställa en god och säker vård för patienter i livets slutskede genom att tillgodose deras önskemål, bevara deras värdighet samt genom att stödja deras andliga och existentiella behov. Grundutbildade sjuksköterskor upplevde brist på kompetens, så som utbildning och kliniska erfarenheter inom palliativ vård, vilket påverkar deras upplevelser negativt av att ge omvårdnad till patienter i livets slutskede.

Front-line registered nurses (RNs) make up the workforce that directly affect the care of patients in a variety of different healthcare settings. RN job satisfaction is important because it is tied to retention, organizational commitment, workforce safety, patient safety, and cost savings. The strongest predictors have been difficult to determine because workplaces differ, numerous tools to measure satisfaction exist, the workforce is diversified by generations and work positions, and ongoing policy changes directly impact the work of the front-line RN. The strength and stability of the workforce depends on an accurate understanding of the predictors of job satisfaction for the front-line RN. The purpose of this study was to comprehensively, quantitatively examine predictors of front-line RN job satisfaction from 1980-2009 to provide overarching conclusions based on empirical evidence. Of interest was: the (1) estimation of large, moderate, and small predictor summary effect sizes; (2) assessment of predictor differences among decades (i.e., 1980s, 1990s, and 2000s); (3) identification of causes for predictor differences among studies (i.e., moderators); and (4) investigation of predictor differences between generations (i.e., Baby Boomers, Generation X, and Millennials). A non-a priori meta-analysis approach was guided by inclusion and exclusion criteria to review published and unpublished studies from 1980–2009. The search process identified 48 published and 14 unpublished studies used for analysis. Within the studies that met inclusion criteria, 27 job satisfaction predictors met inclusion for analysis. Studies were coded for Study Characteristics (e.g., Year of Publication, Country of Study) that were needed for moderator analysis. Predictors were coded for data that were necessary to calculate predictor summary effect sizes (i.e., r, n). Coding quality was maximized with a coding reliability scheme that included the primary investigator (PI) and secondary coder. A random-effects model was used iv to guide the calculation of summary effect sizes for each job satisfaction predictor. Publication bias was examined using funnel plots and Rosenthal’s Fail-safe N. An analysis of variance (ANOVA) was used to evaluate predictor differences among decades (i.e., 1980s, 1990s, and 2000s). Heterogeneity among studies was calculated (i.e., Q-statistic, I-squared, and Tausquared) to guide the need for moderator analysis. Moderator analyses were conducted to evaluate Study Characteristics as sources of predictor differences among studies, and to investigate the influence of Age (i.e., generation) on predictor effect sizes. The largest effect sizes were found for three predictors: Task Significance (r=.61), Empowerment (r=.55), and Control (r=.52). Moderate effect sizes were found for 10 predictors (e.g., Autonomy: r=.44; Stress: r=-.43), and small effect sizes were found for nine predictors (e.g., Wages: r=.23; Staffing Adequacy: r=.19). Significant heterogeneity between studies was present in all of the 27 predictor analyses. Effect size differences were not found between decades or generations. Moderator analysis found that the sources of the difference between studies remain unexplained indicating that unknown moderators are present. Findings from this study indicate that the largest predictors of job satisfaction for the front-line RN may be different than previously thought. Heterogeneity between studies and unidentified moderators indicate that there are significant differences among studies and more research is needed to identify the source(s) of these differences. The findings from this study can be used at the organizational, state, and national level to guide leaders to focus efforts of workplace improvements that are based on predictors that are most meaningful to front-line RNs (i.e., Task Requirements, Empowerment, and Control). Future research is needed to determine contemporary predictors of job satisfaction for the front-line RN, and the causes of heterogeneity between studies. The findings from the current study provide the critical synthesis needed to v guide educational and practice recommendations aimed at supporting job satisfaction of frontline RNs, thereby, maintaining this integral component of the healthcare workforce.

Background: Every day Lesbian, Gay, Bisexual and Transsexual (LGBT-persons [LGBT]) meet difficulties in life. Within healthcare they face discrimination and difficulties. The development of LGBT in society is on the rise, but still persons who don't fit the sexuality norm struggles to be accepted. Aim: The aim was to discover if nurses values effect on the meeting with persons who don't fit the sexuality norm. Method: This paper is a literature review which is based on nine quantitative articles. All the articles were analyzed by the authors looking for similarities and differences. Results: The result of the literature review was that the nurse's values do effect on their attitudes toward LGBT-persons. The result showed that nurses who had previous experience in LGBT-persons was more accepting in their meeting. It also shows that the nurse's ethnicity and religious values had effect on their attitude toward LGBT-persons. Overall majority weighs toward difficulties in the meeting with persons who don't fit the sexuality norm. Subcategories became accepting in the meeting, difficulties in the meeting, ethnicities and accepting and previous experience with LGBT-persons. Conclusion: Nurses today is more accepting in the meeting with LGBT-persons than they were 10 years ago. Still persons who don't fit the sexuality norm is feeling discriminated because of their sexuality. Nurses need more knowledge about how they can make LGBT-persons feel more accepted in their meeting. More research about LGBT-persons in healthcare is needed.

This thesis examines issues pertaining to health human resources in the Ontario nursing profession, focusing on registered nurses (RNs) and registered practical nurses (RPNs). It consists of four chapters that explore the following nursing labour market trends: (1) multiple jobholding, part-time and casual employment, and other individual nurse and job-level characteristics (2) nursing job instability as measured by turnover and the number of years a job-worker (job-nurse) match exists, (3) nurse staffing agency employment, and (4) occupational attrition or turnover rates. The first two chapters compare nurses employed in the long-term care home (LTCH) sector, to the following healthcare sectors: hospitals, primary care, home care, supportive housing, public health (Chapter 2 only), and an aggregate “other” category. In Chapters 2 to 4, pre-COVID-19 trends are compared with the first, and where possible, the second year of the pandemic. All chapters in this thesis employ the Health Professions Database (HPDB), a dataset from the Ontario Ministry of Health, which derives from regulatory registration data. Chapter 1 examines the prevalence of multiple jobholding, part-time and casual employment, employment status versus employment preference, and other individual nurse and job level characteristics (e.g., the location of first education, languages spoken in practice). The results indicate the likelihood of multiple jobholding does not significantly differ in the LTCH sector compared to other healthcare sectors, especially among RPNs. Moreover, there is no evidence of excessive part-time and casual employment in LTCHs compared to other sectors. However, LTCH RNs and RPNs are significantly more likely to prefer full-time employment, while being employed in part-time or casual positions, referred to as involuntary part-time or casual status. Nurses are heterogenous across sectors in their individual characteristics and employment preferences. Notably, LTCH nurses are more likely to be internationally educated, and primary care nurses are more likely to prefer part-time employment. Chapter 2 investigates nursing job instability across the healthcare sectors found in Chapter 1, with the addition of public health. Average annual turnover (2014-2019) was 25.7 percent among LTCH RNs and 22.9 percent among LTCH RPNs. These findings demonstrate RN job turnover rates in LTCHs do not substantially deviate from those observed in other sectors and fall in the middle of the distribution. RPN job turnover rates in LTCHs are the second lowest observed, where turnover rates are lower in the hospital sector. Across both nurse categories, hospital jobs are the most durable, where a job-nurse match lasts 0.6 to 0.8 years longer than the average RN LTCH job, and 0.1 to 0.2 years longer than the average RPN LTCH job (over a five-year period). Results from 2020 indicate turnover increased the most in the LTCH and supportive housing sectors (by a maximum of 7.5 percent among LTCH RPNs) – the only two sectors where a single site restriction was implemented in 2020, making it difficult to interpret the cause of these findings. Chapter 3 documents the share of agency employed nurses, and the rate at which previously non-agency employed nurses obtain at least one agency position (the agency transition rate) over the 2011-2021 period. The results show that over the data period, the share of agency RNs was small (ranging from 2.4 to 3.4 percent), and slightly higher among RPNs (ranging from 6.1 to 7.1 percent). The agency transition rate is also low – ranging from 0.7 to 1.1 percent among RNs and 1.9 to 2.5 percent among RPNs from 2011-2021. The share of agency employment and the agency transition rate decreased during the first year of the pandemic (2020), and subsequently increased back to pre-pandemic levels in 2021. However, mean hours of work increased among agency (and non-agency) nurses, which may explain a small part of the increase in public spending on agency fees. Chapter 4 measures occupational turnover, where nurses leave the profession altogether, as opposed to job turnover (Chapter 2), which includes nurses who change jobs within the profession. Occupational turnover, or attrition rates, are lower compared to the job turnover rates found in Chapter 2. Annual attrition rates ranged from 6.1 to 7.2 percent among RNs and 6.6 to 7.5 percent among RPNs pre-pandemic (2014-2019). In the first two years of the pandemic, attrition rates increased modestly to 7.7 (2020) and 8.1 (2021) percent among RNs, and 8.0 (2020) and 8.6 percent (2021) among RPNs. Over the entire period of analysis, a larger share of attrition derives from nurses who register active, but are without Ontario nursing employment, compared to nurses who register inactive or do not register. Nurses who register active without Ontario nursing employment may be viewed as undertaking a more temporary exit, as such nurses are significantly more likely to return to the profession. / Thesis / Candidate in Philosophy / This thesis examines health policy relevant issues in the Ontario nursing labour market. Reports of health human resource deficiencies, especially in the nursing profession and the long-term care home (LTCH) sector, increased throughout the COVID-19 pandemic. I perform empirical analysis to ratify such claims. First, I compare the rate of multiple jobholding, part-time and casual employment, and other individual and job-related characteristics among nurses employed in LTCHs compared to five other healthcare sectors. Next, I measure nursing job turnover in LTCHs compared to six other healthcare sectors. Third, I examine the count and share of nurses employed at private staffing agencies, and the rate at which nurses in traditional jobs transition to agency employment. Finally, in contrast to job turnover, which includes nurses who change jobs within the profession, I measure occupational turnover at the individual level where nurses leave the profession altogether. In most analyses, I compare pre-pandemic and pandemic (2020 and 2021 where possible) trends.

Yes / This study aimed to determine factors that influence the nursing workforce shortage and their impact on nurses. This study applied a systematic review design. Using Cochrane library guidelines, five electronic databases were systematically searched (Research 4life-PubMed/Medline, Scopus, Embase, CINAHL) from 2010-2021. The remaining articles with pertinent information were presented in a data extraction sheet for further thematic analysis. A Reporting Items for Systematic Reviews and Meta-Analysis Flow Diagram was adopted and used. The studies published from 2010-2021 and in English language were examined and included in the systematic review. Four themes were identified as factors influencing the nursing workforce shortage, including Policy and planning barriers, Barriers to training and enrolment, Factors causing nursing staff turnover and Nurses' stress and burnout. Nursing workforce shortage is a global challenge that roots in multiple causes such as individual, educational, organizational and managerial and policy-making factors.

Yes

Uppsatsens syfte var att belysa relationen mellan sjuksköterska och patient när sjuksköterskan var stressad. För att fördjupa oss i relationens betydelse har vi använt oss av Joyce Travelbees teori kring mellanmänskligheten. Uppsatsen är gjord som en systematisk litteraturstudie där sex artiklar analyserades. Vårt resultat visade att stress påverkade relationen negativt. Våra fynd visade att förmågan att skapa en relation minskade då både sjuksköterskan och patienten skapade en distans till varandra. Sjuksköterskans stress gjorde att hon ändrade sitt fokus i arbetet, patienten mötte då en uppgiftsorienterad sjuksköterska som inte tillgodosåg patientens emotionella behov i relationen. Både sjuksköterskans och patientens personlighet, i stress, visade sig ha betydelse för hur relationen utvecklades. Författarna ansåg att när relationen sattes åt sidan var det även av stor vikt att patientens åtsidosatta emotionella behov synliggjordes. Sjuksköterskan behövde också få förståelse och stöd för hennes stressiga situation, såsom till exempel utbildning i stresshantering. Vi ansåg att det skulle vara av intresse med fortsatta studier kring strategier för sjuksköterskan att hantera stress.

Bakgrund: Många av de patienter som insjuknar i stroke kommer till sjukhus med ambulans. Ambulanssjuksköterskors bedömning kan ha betydelse för att dessa patienter ska få ett snabbt omhändertagande och tidig behandling, vilket kan minska risken för bestående funktionsnedsättning och lidande samt påverka framtida livskvalitet. Som stöd i bedömningen finns idag behandlingsriktlinjer. Syfte: Syftet var att undersöka ambulanssjuksköterskors bedömning av patienter som drabbats av stroke avseende träffsäkerhet, samt skillnader i bedömning mellan de som bedömts ha stroke och de som ej bedömts ha stroke. Metod: Retrospektiv studie där journaler granskats med en kvantitativ ansats. Studiens urval bestod av patienter som skrivits ut från ett medelstort sjukhus i Västsverige under 2015, med ett vårdtillfälle där huvuddiagnos stroke angetts och som åkt ambulans till sjukhus med initial bedömning av en ambulanssjuksköterska, vilket resulterade i 454 journaler att granska. Resultat: För alla patienter med stroke som inkluderats i studien hade endast 52% av patienterna bedömts av ambulanssjuksköterskor ha stroke. Primär och sekundär bedömning var gjord i hög grad för alla patienter. Signifikanta skillnader fanns kring hur strokespecifika symtom var bedömda. Symtom från ansikte, arm eller ben, påverkan på tal och ögon var i högre grad bedömt i gruppen där ambulanssjuksköterskor bedömt att patienter drabbats av stroke. Huvudvärk, yrsel och illamående bedömdes i högre grad i gruppen ej stroke. Slutsatser: Mer forskning inom området behövs för att öka andelen patienter med stroke som identifieras av ambulanssjuksköterskor.

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