Professionalism: the major factor influencing job satisfaction among Korean and Chinese nurses

Background:  The nursing shortage has become an internationally important issue. Nurses' professionalism and job satisfaction have been recognized as strong factors influencing their turnover. As international interchanges in nursing education are growing between Korea and China, understanding the commonalities and differences in factors associated with job satisfaction is critical to improving nurses' job retention.
Aim:  To compare the factors influencing job satisfaction among Korean and Chinese nurses.
Method:  A cross-sectional survey was conducted. The participants were comprised of 693 nurses at three general hospitals in Jinan, People's Republic of China and 593 nurses at two general hospitals in Seoul, Korea. A questionnaire was designed to measure the nurses' professionalism and job satisfaction. Stepwise multiple regression analysis was performed to identify factors related to job satisfaction.
Results:  Professionalism was the common factor influencing job satisfaction in Korean and Chinese nurses. Professionalism was positively related to job satisfaction in both groups. Additional factors associated with job satisfaction were demographics and job characteristics such as age, job position and department of work, which were significant only in Korean nurses.
Conclusions:  Professionalism was the most important factor influencing job satisfaction in both Korean and Chinese nurses. Enhancing nursing professionalism is recommended as a common strategy to improve nurses' job retention across different healthcare systems.     

我院护理给药差错管理办法的实施与效果

目的有效控制护理给药差错的漏报率，提高住院病人的安全。方法成立护理给药差错评定小组，强化护理人员的安全意识，扩充有效的给药差错报告渠道，细化奖惩细则及评价标准。结果实施护理给药差错管理办法后，给药差错漏报率有明显降低，差异具有统计学意义（P〈0．01）。结论合理的护理给药差错管理办法能激励当事人和科室管理者主动上报差错的发生情况，使护理给药差错管理纳人良性循环。     

Antecedents of Severe and Nonsevere Medication Errors

Purpose: To investigate if differences in antecedents of severe and nonsevere medication errors exist.
Design: A longitudinal study of 6 months of data from 279 nursing units in 146 randomly selected hospitals in the United States (US).
Methods: Antecedents of severe and nonsevere medication errors included work environment factors (work dynamics and RN hours), team factors (communication with physicians and nurses' expertise), person factors (nurses' education and experience), patient factors (age, health status, and previous hospitalization), and medication-related support services. Generalized estimating equations with a negative binomial distribution were used with nursing units as the unit of analysis.
Findings: None of the antecedents allowed predicting both types of medication errors. Nurses' expertise had a negative and medication-related support services had a positive association with nonsevere medication errors. Nurses' educational level had a significant nonlinear relationship with severe medication errors only: As the percentage of unit BSN-prepared nurses increased, severe medication errors decreased until the percentage of BSN-prepared nurses reached 54%. In contrast, RN experience had a statistically significant relationship with nonsevere medication errors only and nursing units with more experienced nurses reported more nonsevere medication errors.
Conclusions: Severe and nonsevere medication errors might have different antecedents.
Clinical Relevance: Error prevention and management strategies should be targeted to specific types of medication errors for best results.     

Workplace empowerment, job satisfaction and job stress among Italian mental health nurses: an exploratory study

Aim  The purpose of the present study was to investigate the relationship between staff nurses' structural empowerment, work stress and job satisfaction in two health care settings in Italy using Kanter's Empowerment Theory.
Background  With the current scarcity of economic resources and shortage of nurses, it is essential to empower nurses to perform at a high level to ensure high-quality patient care. Structural empowerment is a process that can optimize use of nursing skills and professional expertise, thereby increasing job satisfaction among nurses.
Method  A convenience sample of 77 nursing staff employed in the Department of Mental Health in central Italy was used in this study (return rate 64%).
Results  Structural empowerment was significantly related to their job satisfaction ( r  = 0.506, P  < 0.001), as was global empowerment ( r  = 0.62). Empowerment also had a significant negative relationship to nurses' work stress ( r  = −0.28, P  < 0.05).
Conclusion  The results of this study support Kanter's theory of structural empowerment in an Italian nursing sample – a previously unstudied population.
Implications for nursing management  Organizational administration must make every effort to create organizational structures and systems that empower nurses to practice according to professional standards and optimize the use of their knowledge and expertise.     

The leadership concept in Iranian nursing

Background:  Although greater emphasis has been placed on leadership skills in nursing management in the last decade, the concepts are often confused or used erroneously by Iranian nurses. At the same time we have observed that wide variations in nurses' clinical practice appeared to be related to the presence or absence of leadership skills among senior nurses.
Aim:  To begin to identify the concepts used for expressing leadership in nursing within the Iranian cultural context.
Methods:  A qualitative approach was adopted using content analysis of semi-structured interviews carried out with 10 nurse managers from hospitals in Teheran. The data were analysed using the constant comparative method.
Findings:  Fifty-five primary codes were identified from the respondents' experiences and from these three main themes were abstracted for describing the leadership concept. These were 'personality traits', 'being a model', and 'being a spiritual guide for the nursing profession'.
Conclusion:  Implementing the culture of patient safety and dignity needs leadership. From Iranian nurse managers' perspectives a leader as a spiritual guide should empower nurses spiritually; it means he/she has a vision for nursing; has clear and explicit objectives; and has a commitment to nursing. Nurses who are confident about the underlying concepts of leadership in their culture can help to adapt nursing to an ever-changing healthcare environment.     

The relationship between nursing leadership and nurses' job satisfaction in Canadian oncology work environments

Background  Current Canadian oncology work environments are challenged by the same workforce statistics as other nursing specialties: nurses are among the most overworked, stressed and sick workers, and more than 8% of the nursing workforce is absent each week due to illness.
Aim  To develop and estimate a theoretical model of work environment factors affecting oncology nurses' job satisfaction.
Methods  The sample consisted of 515 registered nurses working in oncology settings across Canada. The theoretical model was tested as a structural equation model using LISREL 8.54.
Results  The final model fitted the data acceptably ( χ ² = 58.0, d.f. = 44, P  =   0.08). Relational leadership and physician/nurse relationships significantly influenced opportunities for staff development, RN staffing adequacy, nurse autonomy, participation in policy decisions, support for innovative ideas and supervisor support in managing conflict, which in turn increased nurses' job satisfaction.
Conclusions  These findings suggest that relational leadership and positive relationships among nurses, managers and physicians play an important role in quality oncology nursing environments and nurses' job satisfaction.
Implications for nursing management  Oncology nursing work environments can be improved by focusing on modifiable factors such as leadership, staff development and staffing resources, leading to better job satisfaction and hopefully retention of nurses.     

Burnout in hospital nurses: a comparison of internal, surgery, psychiatry and burns wards

Introduction:  Burnout is a phenomenon in which the cumulative effects of a stressful work environment gradually overwhelm the defenses of staff members, forcing them to withdraw psychologically. This study compared the levels of burnout among nurses in different nursing specialties.
Materials and methods:  The sample of the study consisted of all the nurses working in all public hospitals in Shiraz, Iran who were graduates of either technological educational institutions or universities and had experienced clinical nursing practice for at least 1 year. Using Maslach Burnout Inventory and General Health Questionnaire (28-item version), we identified the psychiatric morbidity and burnout among nurses.
Results:  Study results indicated that nurses of psychiatry wards showed significantly higher levels of emotional exhaustion and depersonalization in comparison with nurses working in other wards, and burn wards nurses showed significantly higher levels of personal accomplishment. Also, nurses who were single were more emotionally exhausted.
Conclusion:  Different clinical working environments appear to have an impact on the development of nurses' burnout.     

Nurses' experiences and perceptions of influencing barriers to postoperative pain management

Despite decades of research and the availability of effective analgesic approaches, many patients continue to experience moderate to severe pain after surgery. Greater research efforts are needed to identify the factors that impede effective pain management. Despite the fact that a variety of research and clinical studies on all aspects of pain have been conducted in many countries, the factors affecting pain management have not been completely identified.
Aim:  To identify nurses' experiences and perceptions about the barriers to postoperative pain management.
Methods:  A qualitative approach was adopted using content analysis of semi-structured interviews carried out with 26 Iranian registered nurses from three large educational hospitals in Tehran city. The data were analysed using constant comparative method.
Findings:  Ninety-three primary codes were achieved. Four main themes emerged from the data. From the participants' points of view, 'lack of educational preparation', 'nurses' limited authority', 'limited nurse–patient relationship', and 'disturbances in pain management interventions' are considered barriers to pain management.
Conclusion:  The conclusion embraces implications for clinical practice to improve the knowledge of nurses and nursing manager and insight in postoperative pain management. Clearly, programmes for change must address not only knowledge improvement, but also the wider complex influences on barriers to pain management.     

'I love nursing, but..'- qualitative findings from Australian aged-care nurses about their intrinsic, extrinsic and social work values

Aim.  The aim of this qualitative analysis – a component of a larger survey study, was to provide insights and understandings about intrinsic and extrinsic work values for nurses in aged-care.
Background.  Intrinsic and extrinsic work values impact on nurses' job satisfaction and ultimately nursing retention. This study contributes further to knowledge development in this area by building on a previous work values study in aged-care nursing.
Methods.  This paper presents the qualitative research findings from the final open-ended question from a survey of nurses employed in the aged-care sector in the State of Queensland, Australia in 2007. Data from a cohort of 105 aged care sector nurses was analysed relying on deductive content analysis.
Findings.  Two intrinsic work values emerged – low morale and images of nursing and two extrinsic work values emerged – remuneration and working conditions. The work value 'working conditions' comprised four aspects of aged-care work, specifically staff turnover, workplace violence, care team membership specifically the Assistants-in-Nursing and paperwork. A single social workplace value 'support by management' is discussed as identified as important to these nurses.
Conclusion.  Qualitative insights into aged-care nurses' intrinsic and extrinsic work values suggest that work satisfaction is low. Workforce policy makers and employers of nurses in aged-care need to comprehend the relationship between job satisfaction, retention and work values.
Relevance to clinical practice.  These findings have implications for recruitment, retention and workforce planning within the aged-care environment.     

Swedish student nurses' knowledge of health statutes: a descriptive survey

Background:  The nurse's function, no matter the working area, is guided by ethical approaches, grounded in science and well-tried experiences, and has to be conducted according to national laws, statutes and instructions.
Aim:  To survey newly graduated Swedish nurses' knowledge about current statutes and laws that govern their healthcare system.
Method:  A questionnaire was developed from facts in relevant statutes and laws presented and used in the nursing education programmes. Following a pilot study testing the items, a 20-item questionnaire, with mostly open-ended questions, was distributed to student nurses in the last semester of their nursing education programme before graduation.
Results:  One hundred and seventy-eight participants answered the questionnaire (response rate 59%). Only 29% of responses on all questions showed correct knowledge about the different statutes and laws that regulate their work as nurses. The best knowledge was found in the area of documentation (range 35–86%) and in the area of information (range 16–54%) on group scores.
Conclusion:  This survey concerning novice nurses' knowledge about statutes and laws showed great deficiencies. It was surprising to find that, on existing demands regarding nurses delegating medical tasks, not a single respondent presented a correct answer. Evidence-based knowledge was difficult to recognize. Nurses will be more conscious of their own limitations and more prepared to meet the reality of practice if there is emphasis on relevant statutes and laws during their education.