查看更多>>摘要：Abstract The COVID‐19 pandemic has taught us some very painful lessons about underinvestment in healthcare and the lack of adequate preparation for a pandemic。 In this article， ICN Chief Executive Officer Howard Catton examines the World Health Organization's review of global preparedness and looks to the future and how nursing can contribute to better planning and health outcomes for all。
查看更多>>摘要：There are concerns that the future balance between the supply and demand for nurses will result in major nursing shortages around the world。 Some think that nurses are leaving nursing because of the COVID‐19 pandemic。 In the United States， nurses may be leaving their jobs， but not nursing。 Enrollments in nursing programs have increased。 Nurse migration to the United States has decreased。 This paper， using examples from the United States mainly， aims to explore the issue of supply of nurses and argues that it is not clear that we will have a worldwide nursing shortage going forward。
查看更多>>摘要：Abstract Investing in nursing and its leadership has been a key global priority in achieving world health。 This paper aims to explore what it means to invest in nursing and its leadership and whether we are progressing in its endeavour。 Consideration is given to whose responsibility it is to invest， the importance of education to support strategic nurse leaders and enable them to have a voice to lead as well as create a culture in which their staff wish to stay。 Further， the paper explores the importance of each country accepting responsibility for developing and funding its strategic workforce plan and paying nurse professionals fairly and taking steps to reduce workforce shortages。 Finally， the paper examines the progress the United Kingdom is making and concludes that investment in nursing is everyone's business， the government， healthcare organisations， society and above all nurses themselves。 Collectively， we must step up to influence change and have nursing voices heard。
查看更多>>摘要：Abstract Aim This paper is part of a larger doctoral study that investigated the impact of nationality on the job satisfaction of nurses and their intentions to leave Saudi Arabian government hospitals。 The paper aims to gain an understanding of the impact of expatriate status on nurses’ perceptions， by comparing the factors that influence job satisfaction among Saudi nurses to those that affect nurses recruited from other countries。 Background Job satisfaction is a known predictor of nurse retention。 Although there is a broad understanding of the factors that affect job satisfaction， little is known about how these vary between home and expatriate nurses working in countries which rely on a multicultural migrant workforce。 Methods A descriptive qualitative approach was taken， in which 26 semi‐structured interviews were conducted with nurses selected from different nationalities， all of whom were working in Saudi Arabian hospitals。 Eight participants were Saudi Arabian， six Filipino， four Indian， four South African， two Jordanian and two Malaysian。 Findings Five themes were identified that differentiated the perceptions of expatriates regarding their job satisfaction from those of the home nurses: separation from family， language and communication， fairness of remuneration， moving into the future and professionalism。 Conclusion Focusing on the enhancement of job satisfaction experienced by expatriate nurses can result in a healthier work environment and greater retention of these nurses。 Implications for nursing and nursing policy To enhance nurse retention， policy makers in countries with migrant nurses should address their socio‐economic needs。 This includes providing both greater access to their dependent family members， and language lessons and cultural orientation to reduce linguistic and cultural challenges。
查看更多>>摘要：Abstract Aim: To define nurse managers’ organizational silence behaviors and examine the demographic， occupational， and practice environment factors that may influence their silence。 Background: Organizational silence is affected by organizational structures， policies and procedures， team structures， and practice environments。 Whether nurse managers’ behaviors affect the organizational silence and practice environment in particular has not been thoroughly studied。 Methods: This cross‐sectional study was conducted using an online survey of 169 nurse managers working in a group of private hospitals in Turkey。 Data were collected using the Nurse Manager Practice Environment Scale， the Organizational Silence Behavior Scale， and a questionnaire with 16 sociodemographic and job‐related questions， and descriptive statistics， correlations， and regression analyses were used to analyze the data。 Results: Nurse managers exhibited acquiescent silence and silence for the protection of the organization。 There was a negative correlation between scores on the two scales。 Regression analysis showed that nurse managers’ organizational silence was affected by the two subscales of nurse managers’ practice environment and the ability to express opinions openly。 Conclusion: Positive work environment and being able to express opinions comfortably decrease the level of organizational silence of nurse managers。 Implications for nursing and health policy: In order to reduce organizational silence behaviors， along with open‐door policies and a corporate culture where ideas can be expressed freely， health institutions should implement measures to ensure a positive work environment that empowers administrative leaders to create a culture of patient safety and culture of generativity。 Regulating the roles and responsibilities of nurse managers at the institutional level and implementing appropriate nursing laws and regulations at the national level will facilitate changes to improve their management practices。
查看更多>>摘要：Abstract Aim This study was conducted to explore the factors affecting nurses’ intentions to leave or stay in their profession during the coronavirus pandemic in Iran。 Introduction Because the effectiveness of a healthcare response to a disaster depends on an available， skilled， and motivated healthcare workforce， it is essential to understand and address potential barriers to and reasons for the intentions of medical staff to leave or stay in their profession。 Methods A qualitative study with a conventional content analysis approach was conducted。 The participants included nurses working in hospitals during the COVID‐19 pandemic， and nurses who had previously left their job or had been absent from work for a period of time。 The participants were selected using a purposeful sampling strategy。 Data were collected through 19 in‐depth， individual semi‐structured interviews with 16 nurses。 The COnsolidated criteria for REporting Qualitative research checklist was used to report the study。 Findings Three categories; commitment and work conscience (with a subcategory of risk‐taking)， fear (with two subcategories of fear of family infection and fear of protective equipment shortages)， and organizational factors (with two subcategories of organizational atmosphere of the hospital and motivational factors)， emerged from the analysis。 Conclusion The reasons for quitting a nursing job or to keep working as a nurse during the pandemic include both personal and organizational factors。 Commitment and work conscience in pandemic conditions is one of the main factors for keeping nurses in their profession。 Implication for nursing practice and policy Gaining insight into nurses’ understanding of the situation and perspectives is the key to being able to provide appropriate support and keep them in the workforce。 Peer support can play an important role in supporting novice nurses in facing challenges posed by a pandemic and should be improved。 Also， programs and strategies need to be planned to improve resilience among nurses and to help them to manage their stress and fear。
查看更多>>摘要：Abstract Aim To examine the nature and prevalence of Cambodian nurses’ work hours and overtime and related factors Background The chronic shortage of nursing workforce is a major cause of overtime among nurses。 Introduction Nursing shortage and working overtime among nurses negatively affect nurse and patient outcomes， but nurses’ work hours and overtime in Cambodia have not been comprehensively examined。 Methods A multicenter cross‐sectional study was conducted in four Cambodian hospitals。 Data were collected from 253 nurses providing direct nursing care using a questionnaire。 The STROBE checklist was used for reporting this study。 Results More than a fifth of staff nurses worked more than 48?h， which is the legal work hour limit in Cambodia。 Two major reasons for working mandatory or voluntary overtime， on‐call or 24‐h on‐call were (a) not wanting to let down colleagues and (b) able to get all work done。 The number of patients cared for was related to whether or not nurses worked 48?h or more。 Conclusion Overtime work and adverse nurse scheduling are common in Cambodia。 Implications for nursing and health policy Nurse managers and healthcare institutes in Cambodia need to monitor Cambodian nurses’ work hours， which are often beyond the legal work hour limit。 Moreover， it is important to understand why nurses work overtime and develop health policies， strategies， and programs that can help promote patient and nurse safety and retain qualified nursing staff。 The 24‐h on‐call practice needs to be regulated according to the labor policy in healthcare institutes to prevent adverse nurse and patient outcomes。
查看更多>>摘要：Background In 2016， the Act on Decisions on Life‐Sustaining Treatment for Patients in Hospice and Palliative Care was implemented in Korea， providing a broad framework for end‐of‐life decision‐making for the first time and making advance directives legally recognized documents。 This Act can correct long‐standing under‐recognition of patients as valid decision makers for their own treatment choices。 However， limited recognition of patient self‐determination， rigid legal forms for documenting patient wishes， and the roles of family under the Act may pose challenges both to patients and nurses。 Aim This paper critiques whether this newly introduced system of advance directives can truly guarantee protection of the patient’s interests and respect for patient autonomy in real life?， and discusses ethical and legal issues regarding the Act。 Source of evidence We reviewed the current system of advance directives by raising three questions: (1) Do advance directives reflect a competent person’s voluntary and informed choice?， (2) Are advance directives applicable in diverse clinical situations?， and (3) Does the Korean advance directive system ensure that such directives are honored in reality? Conclusion Although the Act is an important first step in respecting patient autonomy in end‐of‐life decision‐making， it remains inadequate as it fails to provide thorough guidance in terms of the quality of writing process， applicability， and the guaranteed effects of advance directives。 Implications for nursing and health policy As nurses are best situated for addressing these limitations due to their roles and competencies in clinical practice， expanding the roles of nurses in every stage of advance directive practice could help achieve the original purpose of advance directives。 This calls for a policy that promotes an expanded role of nurses to improve the quality of advance directive practice。
查看更多>>摘要：Aim To examine the extent to which the type of financial assistance (personal resources， social programmes and earnings) and source country influence the length of time for internationally educated nurses to secure employment as regulated nurses in Canada。 Background Internationally educated nurses must professionally recertify in order to work as regulated nurses in Canada。 For many， it can be a lengthy， cumbersome and costly process that delays employment， while others recertify and secure employment quickly。 Financial assistance in the form of personal resources， or from social programmes or earnings from working could contribute to the length of time to recertify。 When internationally educated nurses cannot readily recertify， they turn to survival jobs where they can remain and never practice their profession in Canada or leave the country to work in jurisdictions where it easier to obtain professional credentials。 Methods Data were collected via cross‐sectional survey of internationally educated nurses (n?=?1186) who were immigrants， permanent residents and employed as regulated nurses。 Multiple linear regression was employed to examine the influence of the type of financial assistance (personal resources， social programmes and earnings) and source country on time to regulated nurse employment。 Results Regression model explained 9。3% of variance in time to regulated nurse employment。 Three predictors were statistically significant: source country， social programmes and earnings。 Personal resources was not a significant predictor。 Conclusion Financial assistance helps internationally educated nurses survive the regulated nurse employment gap。 The type of financial assistance and source country influences the length of time to regulated nurse employment。 Implication for nursing and social policy Provides initial evidence to support the development of policies， and educational and social programmes to assist internationally educated nurses with financially surviving the gap in regulated nurse employment。
查看更多>>摘要：Abstract Background Studies performed in Central European countries showed a high prevalence of missed nursing care in various clinical settings before the COVID‐19 pandemic。 Aims The aim of the study was to investigate which domains of the work environment were significant predictors of missed nursing care activities in Czech hospitals during the COVID‐19 pandemic。 Methods A cross‐sectional study was used。 The RANCARE guideline and STROBE checklist were followed for reporting in the study。 The sample consisted of 371 nurses from four acute care hospitals。 The MISSCARE Survey and the Practice Environment Scale of the Nursing Work Index questionnaires were used to collect data。 The data were analyzed using multiple linear and logistic regression analyses。 Results Nurses reporting unfavorable environments consistently describe a higher frequency of episodes of missed care。 Prevalence estimates of missed care in Czech acute care hospitals during the COVID‐19 pandemic was predicted from the overtime work， the nurses’ perception of the “Nursing foundations for the quality of care，” and their satisfaction with their current position。 Conclusions Missed nursing care could be mitigated by improving the nurses’ work environment。 Domains of the nurse work environment are known as structural modifiable factors and their refinement could be a cornerstone for interventions to reduce the prevalence of missed nursing care。 Implications for nursing policy Monitoring the conditions and aspects of the nurse work environment in hospitals and considering nurses’ concerns about the work environment on an ongoing basis are important strategies for nurse supervision as well as for policymakers。
NSTL
Wiley