Amy Witkoski Stimpfel

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The aim of this study was to explore the strategies utilized by working adults to maintain health and well-being within the context of informal caregiving of a family member with Parkinson's Disease.

Abstract

The ongoing regional nursing shortages in the United States, exacerbated by the COVID-19 pandemic, compromise patient safety and quality. Additionally, an aging workforce coupled with an aging population requiring more nursing care services limits organizations' ability to adequately staff their facilities. Nurses' turnover from the profession has been studied less than organizational turnover, thus, the purpose of this integrative review is to identify factors associated with intention to leave the nursing profession in the United States. Using Whittemore and Knafl's (2005) guidelines for integrative review methods, we conducted systematic searches in CINAHL, PubMed, and Web of Science in July 2024. There were 39 peer-reviewed studies that met inclusion criteria. Synthesis of findings resulted in four individual and four work-level themes associated with intent to leave the nursing profession. Individual themes included individual beliefs, health and wellbeing, individual work experiences, and career stability. Work-level themes included job characteristics, job demands/workload, resources and support, and work environment. Notably, job-level factors (i.e., workload, work environment, and support) were associated with professional turnover intention, which suggests that nurses do not believe their experiences will improve at another nursing job. Gaps in the literature include studies with nationally representative samples, studies using validated measures of health, and qualitative studies conducted with the aim of understanding why nurses want to leave the profession. To promote retention of nurses at the professional and organizational level, organizations should measure and modify relevant job-level factors, and the protection of nurses' wellness should be a top organizational priority.

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The purpose of study was to explore family caregiver perspectives on work-life balance while caring for adults with Parkinson's disease.

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Shift work and scheduling are major contributors to occupational stress for nurses, leading to job dissatisfaction and risk of turnover. Nurse scheduling processes are complex, as they are dynamically linked to nurse staffing and patient demand.

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The multiple impacts of the environment on the health of populations can oftentimes be clouded by the daily care practices of healthcare providers. This case study describes an innovative graduate level elective course that uses a problem-based approach to apply evidence-based principles of environmental health to the care of populations. Initial implementation of the course, over two cohorts in 2023, had primarily second-degree undergraduate nursing students. Lessons learned included the necessity to provide peer-to-peer support for several of the graduate level assignments. Positive student outcomes included an expanded understanding of the three main content areas of the course: (1) how soil, air, and water must be considered in individual and population-centered care; (2) the impact of the design of the built and healthcare built environment; and (3) considerations of planetary health for sustainability and mitigation. Faculty outcomes included coaching of undergraduate students in this graduate course and the development of peer-to-peer mentoring activities.

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The pandemic exacerbated job stress and burnout among nurses, increasing turnover and intentions to leave, in a workforce struggling with severe shortages. Shortages and turnover are associated with decreased quality of care, poor nurse health, and increased costs. This article reports the findings of a study that sought to identify characteristics of the job, work environment, and psychosocial health outcomes that may predict nurses' intent to stay at their current nursing position within the next year. Utilizing a cross-sectional design, we electronically surveyed working nurses (n = 629) during the summer of 2020 across 36 states. Demographics, work characteristics, and validated measures of anxiety, insomnia, and depressive symptoms were assessed. Logistic regression models identified factors associated with nurses' intent to stay at their jobs. Colleague support, organizational support, and organizational pandemic preparedness were associated with increased odds of intent to stay, while both mild and moderate/severe depressive symptoms were associated with decreased odds of intent to stay. Because over a quarter of nurses surveyed reported moderate to severe depressive symptoms, which were strongly associated with turnover intention, organizational leadership should examine mental health resources available to nurses and work characteristics that could be contributing to nurses' poor psychosocial health. Additionally, further research is needed to assess the meaning of organizational support to nurses in a post-COVID-19 context, as well how to create a work environment in which nurses are able to provide support to their colleagues.

Abstract

The pandemic exacerbated job stress and burnout among nurses, increasing turnover and intentions to leave, in a workforce struggling with severe shortages. Shortages and turnover are associated with decreased quality of care, poor nurse health, and increased costs. This article reports the findings of a study that sought to identify characteristics of the job, work environment, and psychosocial health outcomes that may predict nurses’ intent to stay at their current nursing position within the next year. Utilizing a cross-sectional design, we electronically surveyed working nurses (n = 629) during the summer of 2020 across 36 states. Demographics, work characteristics, and validated measures of anxiety, insomnia, and depressive symptoms were assessed. Logistic regression models identified factors associated with nurses’ intent to stay at their jobs. Colleague support, organizational support, and organizational pandemic preparedness were associated with increased odds of intent to stay, while both mild and moderate/severe depressive symptoms were associated with decreased odds of intent to stay. Because over a quarter of nurses surveyed reported moderate to severe depressive symptoms, which were strongly associated with turnover intention, organizational leadership should examine mental health resources available to nurses and work characteristics that could be contributing to nurses’ poor psychosocial health. Additionally, further research is needed to assess the meaning of organizational support to nurses in a post-COVID-19 context, as well how to create a work environment in which nurses are able to provide support to their colleagues.

Abstract

Aim(s): Organizational culture has been studied for over four decades among nurses, across countries and contexts. However, wide variation exists in how the concept has been defined and at what level of the organization it is measured. The aim of this study was to use a dimensional analysis to conduct a conceptual synthesis of unit culture from a nursing perspective. Design: Dimensional analysis, rooted in grounded theory methodology, was used to describe unit culture from a nursing perspective. Methods: A literature search was conducted in April 2022. Inclusion criteria were (1) peer review publications, (2) used the term ‘unit culture’ or ‘ward culture’, (3) references nurses' role in unit culture, (4) published in the last 20 years and (5) written in English. One hundred fifteen articles met inclusion criteria, but dimensional saturation was researched after coding 24 articles. Results: Findings were synthesized into four core dimensions and 10 subdimensions. Dimensions of unit culture included customs (practice norms, communication and prioritization), shared beliefs (assumptions, values and attitudes), hierarchy (social and informational) and atmosphere (emotional climate and collaboration). Conditions that shape unit culture include individual nurse characteristics, working conditions, unit policies/procedures and leadership. Unit culture impacts nurse work experiences and decision-making processes, which can affect outcomes including nurse wellbeing, practice behaviours and adherence to unit policies. Conclusions: Identifying the dimensions of unit culture helps to bring clarity to a concept that is not well defined in existing literature. Impact: This model of unit culture can be used to guide development of new instruments to measure unit culture or guide researchers in utilizing existing measures. Developing measures specific to unit culture are warranted to strengthen researchers' ability to assess how changing conditions of a unit (e.g. leadership, workload) changes unit culture and its related outcomes. Patient or Public Contribution: No Patient or Public Contribution.

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