This document summarizes a study that aimed to identify transitional challenges experienced by intern nurses at Labasa Hospital in Fiji. The study found that reality shock was a significant challenge. Reality shock includes role ambiguity where intern nurses were unsure of their role and responsibilities, especially in difficult situations. Intern nurses also experienced self-doubt, questioning if they had the right skills and knowledge to perform procedures and handle situations. They found the work environment challenging as well, with different routines across wards and some experienced nurses being unhelpful. The transition from student to registered nurse is difficult as intern nurses must adapt to new responsibilities and accountabilities.
A prominent nursing center in the mid-size East South Central city in the South has come under the fire due to a major challenge of shortage in the nursing staff. An increase in the health care expenses led to a temporary reduction in the staff’s earning that led them to decrease in the number of nurses. Decreasing the nursing staff is the only logical way to combat the increased health costs, however, it partly kills the working enthusiasm of the staff.
But, the decreased staff is birthing more problems, as there is an array of patients that come to this center for care and cure and the decreased number of nurses cannot put up with all of them.
This study explored the relationship between work stress, workload, and quality of life among 152 rehabilitation professionals in Taiwan. The results showed that for female respondents, factors like educational level, length of service, leisure time, expenses, work stress, and workload significantly impacted their quality of life. However, for male respondents, no factors showed a statistically significant relationship with their quality of life. The study suggests hospitals establish stress relief programs, evaluate workloads, provide training on stress management, and implement health promotion programs to improve employees' well-being.
This study explored reasons for nurse turnover at BPKIHS hospital in Nepal. The researchers surveyed 150 current and resigned nurses about job satisfaction factors. They found that the major reasons nurses left BPKIHS were career opportunities elsewhere, opportunities for further education, negative attitudes of nursing leaders, inadequate salary, and poor promotion opportunities. The study concluded that increasing salary, job security, starting a bachelor's nursing program, a fair evaluation system, and clear promotion policies could help retain nurses and reduce turnover at the hospital.
This annotated bibliography examines the impact of perinatal loss and death on nurses and healthcare providers. It summarizes 10 sources that explore how witnessing perinatal death affects medical professionals psychologically and identifies coping strategies they employ. Common themes across the sources include the need for support systems, training, and debriefing for staff dealing with perinatal loss. Healthcare providers experience grief, stress, and trauma from perinatal deaths similar to family members, yet often do not receive adequate support themselves.
Dr Patricia Benner has presented the idea that it is the obligation of the medical caretakers to grow better help and comprehension of the patient with the progression of time and this is conceivable through great instructive base. Benner has proposed the aptitude that an individual can pick up information without learning the hypothesis and the other related ideas. Further, there will be arrangements for advancement of information and this is conceivable in the event of applied controls of nursing and drug.
Measuring “Culture of Safety” Tawam’s Experience
Discovery:
Tawam Hospital’s Executive leadership realized the need to establish a “Culture of Safety” within the organization and implemented the Johns Hopkins Medicine “Comprehensive Unit based Safety Program” (CUSP). CUSP was introduced as a pilot project in the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NNU) and Paediatric Oncology Unit (Peds Onc).
Prior to implementation the leadership decided to measure staff perception of safety using evidence based tool.
Solution:
Tawam partnered with Pascal Metrics to implement the Safety Attitude Questionnaire survey. The SAQ was administered to all Tawam Hospital staff in three phases (2008, 2010 and 2011). In 2010 the pilot CUSP units were also resurveyed to determine the status of safety culture since its introduction in 2008.
An email from the CEO was sent to the participants encouraging them to participate in the SAQ survey.
Physicians, nurses, ward-clerks; respiratory therapist, physiotherapist, dieticians etc were included in the survey.
Those who spent at least 50% of their time in the identified units were only included to participate in the survey.
Survey was administered during departmental meetings to increase response rate.
Conducted separate sessions of physicians.
Staff dropped the completed surveys in an envelope.
82% of staff in the patient care areas of the whole hospital participated in the overall 3 phases of SAQ Survey.
The three CUSP pilot units were re-surveyed in 2010.
Anonymity, privacy and confidentiality were maintained from the beginning till the end.
Outcome:
The survey results were graded against percentage positive responses. Responses that were less than 60% mark were graded in the danger zone and anything above the 80% mark were graded in the goal zone. Teamwork climate and Safety climate scale scores are considered to be primary dependent variables, because they are important in preventing patient harm.
The overall hospital score on all the domain scores were in the danger zone, less than 60%. 20 clinical locations in 2010 and 7 clinical locations in 2011 had less than 60% scores in the primary dependent variables.
The SAQ results were disseminated department wise in the presence of a hospital Senior Executive. Every department did an action plan using the SAQ de-briefer tool. The hospital administrators to bring about the change played a facilitators role and helped the departments to come up with their actionable plans.
The hospital leadership in their pursuit to continuing the culture of safety journey, identified six more units for CUSP implementation based on the Phase 2 SAQ scores of 2010. Accordingly the Medical 1, Medical 2, Surgical 1, Surgical 2, Day Case and OBGYN Units were identified for the CUSP roll out. Senior Executive leaders were assigned to each of these new CUSP units to ensure leadership commi
Nursing service aims to satisfy patient and community nursing needs. Placement involves assigning specific jobs, ranks, and responsibilities to candidates based on job requirements and qualifications. This improves employee outcomes like morale and turnover. Patient care is organized through assignment and delegation of duties among nursing personnel. Factors like patient characteristics and organizational support affect assignment patterns. Various nursing care delivery models distribute direct and indirect patient care functions among different roles.
A prominent nursing center in the mid-size East South Central city in the South has come under the fire due to a major challenge of shortage in the nursing staff. An increase in the health care expenses led to a temporary reduction in the staff’s earning that led them to decrease in the number of nurses. Decreasing the nursing staff is the only logical way to combat the increased health costs, however, it partly kills the working enthusiasm of the staff.
But, the decreased staff is birthing more problems, as there is an array of patients that come to this center for care and cure and the decreased number of nurses cannot put up with all of them.
This study explored the relationship between work stress, workload, and quality of life among 152 rehabilitation professionals in Taiwan. The results showed that for female respondents, factors like educational level, length of service, leisure time, expenses, work stress, and workload significantly impacted their quality of life. However, for male respondents, no factors showed a statistically significant relationship with their quality of life. The study suggests hospitals establish stress relief programs, evaluate workloads, provide training on stress management, and implement health promotion programs to improve employees' well-being.
This study explored reasons for nurse turnover at BPKIHS hospital in Nepal. The researchers surveyed 150 current and resigned nurses about job satisfaction factors. They found that the major reasons nurses left BPKIHS were career opportunities elsewhere, opportunities for further education, negative attitudes of nursing leaders, inadequate salary, and poor promotion opportunities. The study concluded that increasing salary, job security, starting a bachelor's nursing program, a fair evaluation system, and clear promotion policies could help retain nurses and reduce turnover at the hospital.
This annotated bibliography examines the impact of perinatal loss and death on nurses and healthcare providers. It summarizes 10 sources that explore how witnessing perinatal death affects medical professionals psychologically and identifies coping strategies they employ. Common themes across the sources include the need for support systems, training, and debriefing for staff dealing with perinatal loss. Healthcare providers experience grief, stress, and trauma from perinatal deaths similar to family members, yet often do not receive adequate support themselves.
Dr Patricia Benner has presented the idea that it is the obligation of the medical caretakers to grow better help and comprehension of the patient with the progression of time and this is conceivable through great instructive base. Benner has proposed the aptitude that an individual can pick up information without learning the hypothesis and the other related ideas. Further, there will be arrangements for advancement of information and this is conceivable in the event of applied controls of nursing and drug.
Measuring “Culture of Safety” Tawam’s Experience
Discovery:
Tawam Hospital’s Executive leadership realized the need to establish a “Culture of Safety” within the organization and implemented the Johns Hopkins Medicine “Comprehensive Unit based Safety Program” (CUSP). CUSP was introduced as a pilot project in the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NNU) and Paediatric Oncology Unit (Peds Onc).
Prior to implementation the leadership decided to measure staff perception of safety using evidence based tool.
Solution:
Tawam partnered with Pascal Metrics to implement the Safety Attitude Questionnaire survey. The SAQ was administered to all Tawam Hospital staff in three phases (2008, 2010 and 2011). In 2010 the pilot CUSP units were also resurveyed to determine the status of safety culture since its introduction in 2008.
An email from the CEO was sent to the participants encouraging them to participate in the SAQ survey.
Physicians, nurses, ward-clerks; respiratory therapist, physiotherapist, dieticians etc were included in the survey.
Those who spent at least 50% of their time in the identified units were only included to participate in the survey.
Survey was administered during departmental meetings to increase response rate.
Conducted separate sessions of physicians.
Staff dropped the completed surveys in an envelope.
82% of staff in the patient care areas of the whole hospital participated in the overall 3 phases of SAQ Survey.
The three CUSP pilot units were re-surveyed in 2010.
Anonymity, privacy and confidentiality were maintained from the beginning till the end.
Outcome:
The survey results were graded against percentage positive responses. Responses that were less than 60% mark were graded in the danger zone and anything above the 80% mark were graded in the goal zone. Teamwork climate and Safety climate scale scores are considered to be primary dependent variables, because they are important in preventing patient harm.
The overall hospital score on all the domain scores were in the danger zone, less than 60%. 20 clinical locations in 2010 and 7 clinical locations in 2011 had less than 60% scores in the primary dependent variables.
The SAQ results were disseminated department wise in the presence of a hospital Senior Executive. Every department did an action plan using the SAQ de-briefer tool. The hospital administrators to bring about the change played a facilitators role and helped the departments to come up with their actionable plans.
The hospital leadership in their pursuit to continuing the culture of safety journey, identified six more units for CUSP implementation based on the Phase 2 SAQ scores of 2010. Accordingly the Medical 1, Medical 2, Surgical 1, Surgical 2, Day Case and OBGYN Units were identified for the CUSP roll out. Senior Executive leaders were assigned to each of these new CUSP units to ensure leadership commi
Nursing service aims to satisfy patient and community nursing needs. Placement involves assigning specific jobs, ranks, and responsibilities to candidates based on job requirements and qualifications. This improves employee outcomes like morale and turnover. Patient care is organized through assignment and delegation of duties among nursing personnel. Factors like patient characteristics and organizational support affect assignment patterns. Various nursing care delivery models distribute direct and indirect patient care functions among different roles.
1) The study examined factors that influence oncology nurses' perceived quality of work life and risk of compassion fatigue. It explored the relationship between nurse characteristics and quality of work life, the impact of personal life stress on quality of work life, and nurses' beliefs about their risk of compassion fatigue.
2) Personal life stressors were found to impact 30% of nurses' well-being, theoretically placing them at risk for compassion fatigue. However, qualitative data did not support this and 55% of nurses described their work as life-affirming and rewarding.
3) Nurses reported multiple sources of work-related stress, including issues with communication, their work environment, and factors related to patient care. However,
Patient ASSIGNMENT does not only mean that dividing the patient among available staff nurses but it is assigning an individual patient or group of patients to nurses according to the required nursing care needs and nurses capability to provide the quality care
Emergency department staffing is a complex process that requires workload managers to consider many factors such as patient acuity, employee skill levels, and work standards. Workload managers are responsible for scheduling staff and allocating resources based on these factors to ensure quality care while containing costs. Proper staffing is a balance that affects quality, costs, employee and patient satisfaction. Work standards establish time allotments for care and depend on variables like season, day of week, and time of day. Patient acuity classification systems are used to determine staffing needs based on individual patient needs rather than just patient volume. Employee skill levels and experience are also important considerations for staffing the emergency department due to the wide variety of patients and conditions treated.
Presented before the International Council of Nurses in Durban, South Africa. Contact me for more information on creating a Positive Practice Environment.
This document discusses staffing and scheduling in nursing management. It provides information on determining staffing needs based on patient acuity levels and calculating the number of nurses required. The document categorizes patients into four levels of care based on nursing hours needed per day. It demonstrates how to assess nursing hours required per shift and allocate nurses to units based on patient numbers and care needs. The objectives of effective staffing and criteria for scheduling such as coverage, quality, stability and flexibility are also mentioned.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Challenges in Everyday Leadership Capabilities Conversations with Senior Clin...ijtsrd
Abstract Senior Charge Nurses SCNs are faced with an increasingly wide range of responsibilities as part of their workload and consequently devote less time to patient care. It is noted that Leadership and organizational management are also important, although adequate training, education, resources, and support to realize these ambitions lag needs. Design A mixed method focus group informed by a well established leadership framework was used to explore senior clinical nurses perceptions of their Leadership. Methods Purposive sampling of SCNs working in Scotland was employed. Data sources included a small focus group and one to one face to face interview. 142 SCNs participated in this interview from 2000 to 2013. Results Twelve main themes were identified Patient focused leadership and Organization focused leadership These two themes were further described through domains of Leadership and capabilities that articulate confidence, quality improvement, and team performance. Grace M Lindsay | Sahar Mohammed Aly | Pushpamala Ramaiah "Challenges in Everyday Leadership Capabilities - Conversations with Senior Clinical Nurses" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33442.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/33442/challenges-in-everyday-leadership-capabilities--conversations-with-senior-clinical-nurses/grace-m-lindsay
One of the areas which creates satisfaction in individuals is their work life. Lack of job satisfaction causes negative feelings within an individual. Low job satisfaction can have negative effects such as resigning or absenteeism from work, arriving late at work and working slowly. For this reason, it is important to investigate job satisfaction levels and the factors affecting this in midwives giving health services. This work was carried out with the aim of detemining the relationship between the levels of job satisfaction in midwives and some socio-demographic characteristics of the job satisfaction levels. Within the framework of this descriptive study, 106 midwives who worked within the Sivas province and agreed to participate in this study were studied. Data were collected using ‘Socio-Demographic Questionnaire for Midwives’ and ‘Scale of Job Satifaction in Nursing’. The data collected from the research were analysed using the Kruskal Wallis, Student t and Mann-Whitney U tests within the SPSS 10.0 computer program. The average general job satisfaction points of the midwives was 47.08 ± 15.52. The average job satisfaction levels in midwives who chose the occupation themselves, wanted to be in the profession and found that midwifery suited them were found to be high at a significant level (p<0.05).>0.05). It was established that the organisation they work at, length of working life, whether they had worked continuously or had a break from work, weekly working hours, way of working and amount of individuals to whom care was given did not affect their job satisfaction point averages (p>0.05). It was also determined that the general job satisfaction point average levels were not affected by whether they had children or not, the number of children they had and the age of the youngest child (p>0.05). In contrast, the job satisfaction levels of midwives who worked in hospitals in terms of the possibility of development and working conditions were significantly higher than midwives who worked at health centres (p<0.05). Job satisfaction levels in midwives who chose the occupation themselves, wanted to be in the profession and found that midwifery suited them were high. Midwives who worked in hospitals who had the possibility of development and different working conditions had greater job satisfaction than midwives who worked at health centres. The remaining socio-demographic charateristics did not affect job satisfaction in the midwives.
This document summarizes research on the relationship between nurse staffing levels and patient outcomes. It identifies several influential studies that found associations between higher nurse staffing levels and lower mortality rates, failure to rescue rates, and nosocomial infection rates. The document also discusses different approaches to establishing minimum nurse staffing standards and ratios. It concludes that simply requiring more nurses may not improve patient care without also enhancing working conditions and support for nurses.
Interprofessional Simulation: An Effective Training Experience for Health Car...Dan Belford
Background
This descriptive study measured the effectiveness of and participants' satisfaction with an interprofessional simulation education workshop as a teaching strategy for health care professionals.
Method
Health care professionals completed a 1-day clinical simulation workshop on interprofessional collaboration, after which they had the opportunity to fill out 4 evaluative instruments
This document discusses sedation and guidelines for qualified sedation providers. It defines levels of sedation from minimal to general anesthesia. Certified registered nurse anesthetists, anesthesiologists, and specifically trained physicians, dentists, oral surgeons, and registered nurses can provide conscious sedation. The American Society of Anesthesiologists' practice guidelines for non-anesthesiologist sedation were developed through an extensive review process. The guidelines also address training requirements for sedation personnel. Kaiser Moanalua's registered nurse training involves an online test and hands-on training in an operating room. A sedation simulation aims to supplement online training through realistic scenarios that simulate dynamic decision making. Evaluation of the simulation involves surveys of
The document discusses collaboration in nursing. It begins by noting the increasing complexity of healthcare issues and need for collaboration. It then defines collaboration as working together through communication, information sharing, coordination and cooperation. The document outlines several objectives and needs for collaboration in healthcare, including providing client-centered care and improving outcomes. It also discusses some issues that can impact collaboration among nurses, such as staffing shortages and mandatory overtime.
The document discusses factors that affect staffing and duty scheduling in nursing. It outlines 12 factors that must be considered when determining staffing needs, including patient acuity, characteristics of nursing staff, standards of care, and work schedules. It also describes different levels of patient care classification from minimal to highly specialized care. Using a sample staffing formula, it demonstrates how to calculate the number of nursing personnel needed based on patient census and levels of care. Key aspects of an effective scheduling system include meeting unit needs, fairness to staff, stability, and flexibility.
This document discusses implementing a strict nurse-patient staffing ratio policy. It describes a nurse's experience being assigned 18 patients instead of the standard 1:7 ratio due to call-outs. The nurse became overwhelmed and forgot to attend to patients. Research shows improved patient outcomes with better ratios. A 1:5 ratio is advocated to protect patients and nurses. While California has implemented ratios, most other states have not passed legislation and instead leave the decision to individual hospitals.
“A STUDY TO ASSESS THE EFFECTIVENESS OF INDIVIDUAL STRUCTURED TEACHING PROGRAMME (ISTP)ON THE USE OF BRADEN SCALE FOR PREDICTING PRESSURE SORE RISK FOR BED FAST PATIENT AMONG STAFF NURSES AT SELECTED HOSPITAL OF BIJAPUR”
This document discusses methods for estimating nursing staff requirements through activity analysis. It begins by introducing the importance of having an orderly staffing methodology. Various approaches to classifying patients based on their care needs are described, such as completely dependent, partially dependent, and ambulatory. The document then shows how to calculate the estimated nursing hours required for each patient classification in different shifts. It provides an example of allocating nurses across morning, evening, and night shifts based on the workload and number of patients in each classification. The conclusion discusses different approaches to allocating nursing staff and importance of monitoring unit census data.
Nurse administrators believe that staffing plans should match employee skills and knowledge to patient needs to optimize care quality and job satisfaction. They believe all aspects of care for critically ill patients should be provided by professional nurses given the complexity of needs. For chronically ill patients, professional and technical nurses should provide health teaching and rehabilitation. Patient assessments, work quantification, and job analysis should determine personnel levels for each patient type. A master staffing plan should be developed centrally but administered locally by head nurses to accommodate unit-level needs.
Salon 1 14 kasim 11.00 12.00 mari̇on mi̇tchelltyfngnc
1. The document discusses using simulation and an Objective Structured Clinical Examination (OSCE) to assess candidates for senior clinical nurse positions in an intensive care unit.
2. During the simulation, candidates participated in a simulated clinical scenario involving a patient, doctors, and nurses to demonstrate their skills and abilities.
3. The OSCE approach proved to be an innovative, valid and reliable way to identify the most competent candidates who displayed crucial skills for the senior nurse role, such as expert clinical care and supporting best practices.
Norms are standards that guide nursing staffing levels. The document discusses nursing staffing norms recommended by various committees in India, including the Staff Inspection Unit (SIU) in 1991-92. The SIU norms recommend nurse-patient ratios of 1:3 for non-teaching hospitals and 1:5 for teaching hospitals. The norms also provide ratios for different units like ICU, labor room, and operation theaters. Most hospitals in India follow the SIU norms for calculating nursing staff entitlement and defining nursing roles.
1) The study examined factors that influence oncology nurses' perceived quality of work life and risk of compassion fatigue. It explored the relationship between nurse characteristics and quality of work life, the impact of personal life stress on quality of work life, and nurses' beliefs about their risk of compassion fatigue.
2) Personal life stressors were found to impact 30% of nurses' well-being, theoretically placing them at risk for compassion fatigue. However, qualitative data did not support this and 55% of nurses described their work as life-affirming and rewarding.
3) Nurses reported multiple sources of work-related stress, including issues with communication, their work environment, and factors related to patient care. However,
Patient ASSIGNMENT does not only mean that dividing the patient among available staff nurses but it is assigning an individual patient or group of patients to nurses according to the required nursing care needs and nurses capability to provide the quality care
Emergency department staffing is a complex process that requires workload managers to consider many factors such as patient acuity, employee skill levels, and work standards. Workload managers are responsible for scheduling staff and allocating resources based on these factors to ensure quality care while containing costs. Proper staffing is a balance that affects quality, costs, employee and patient satisfaction. Work standards establish time allotments for care and depend on variables like season, day of week, and time of day. Patient acuity classification systems are used to determine staffing needs based on individual patient needs rather than just patient volume. Employee skill levels and experience are also important considerations for staffing the emergency department due to the wide variety of patients and conditions treated.
Presented before the International Council of Nurses in Durban, South Africa. Contact me for more information on creating a Positive Practice Environment.
This document discusses staffing and scheduling in nursing management. It provides information on determining staffing needs based on patient acuity levels and calculating the number of nurses required. The document categorizes patients into four levels of care based on nursing hours needed per day. It demonstrates how to assess nursing hours required per shift and allocate nurses to units based on patient numbers and care needs. The objectives of effective staffing and criteria for scheduling such as coverage, quality, stability and flexibility are also mentioned.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Challenges in Everyday Leadership Capabilities Conversations with Senior Clin...ijtsrd
Abstract Senior Charge Nurses SCNs are faced with an increasingly wide range of responsibilities as part of their workload and consequently devote less time to patient care. It is noted that Leadership and organizational management are also important, although adequate training, education, resources, and support to realize these ambitions lag needs. Design A mixed method focus group informed by a well established leadership framework was used to explore senior clinical nurses perceptions of their Leadership. Methods Purposive sampling of SCNs working in Scotland was employed. Data sources included a small focus group and one to one face to face interview. 142 SCNs participated in this interview from 2000 to 2013. Results Twelve main themes were identified Patient focused leadership and Organization focused leadership These two themes were further described through domains of Leadership and capabilities that articulate confidence, quality improvement, and team performance. Grace M Lindsay | Sahar Mohammed Aly | Pushpamala Ramaiah "Challenges in Everyday Leadership Capabilities - Conversations with Senior Clinical Nurses" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33442.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/33442/challenges-in-everyday-leadership-capabilities--conversations-with-senior-clinical-nurses/grace-m-lindsay
One of the areas which creates satisfaction in individuals is their work life. Lack of job satisfaction causes negative feelings within an individual. Low job satisfaction can have negative effects such as resigning or absenteeism from work, arriving late at work and working slowly. For this reason, it is important to investigate job satisfaction levels and the factors affecting this in midwives giving health services. This work was carried out with the aim of detemining the relationship between the levels of job satisfaction in midwives and some socio-demographic characteristics of the job satisfaction levels. Within the framework of this descriptive study, 106 midwives who worked within the Sivas province and agreed to participate in this study were studied. Data were collected using ‘Socio-Demographic Questionnaire for Midwives’ and ‘Scale of Job Satifaction in Nursing’. The data collected from the research were analysed using the Kruskal Wallis, Student t and Mann-Whitney U tests within the SPSS 10.0 computer program. The average general job satisfaction points of the midwives was 47.08 ± 15.52. The average job satisfaction levels in midwives who chose the occupation themselves, wanted to be in the profession and found that midwifery suited them were found to be high at a significant level (p<0.05).>0.05). It was established that the organisation they work at, length of working life, whether they had worked continuously or had a break from work, weekly working hours, way of working and amount of individuals to whom care was given did not affect their job satisfaction point averages (p>0.05). It was also determined that the general job satisfaction point average levels were not affected by whether they had children or not, the number of children they had and the age of the youngest child (p>0.05). In contrast, the job satisfaction levels of midwives who worked in hospitals in terms of the possibility of development and working conditions were significantly higher than midwives who worked at health centres (p<0.05). Job satisfaction levels in midwives who chose the occupation themselves, wanted to be in the profession and found that midwifery suited them were high. Midwives who worked in hospitals who had the possibility of development and different working conditions had greater job satisfaction than midwives who worked at health centres. The remaining socio-demographic charateristics did not affect job satisfaction in the midwives.
This document summarizes research on the relationship between nurse staffing levels and patient outcomes. It identifies several influential studies that found associations between higher nurse staffing levels and lower mortality rates, failure to rescue rates, and nosocomial infection rates. The document also discusses different approaches to establishing minimum nurse staffing standards and ratios. It concludes that simply requiring more nurses may not improve patient care without also enhancing working conditions and support for nurses.
Interprofessional Simulation: An Effective Training Experience for Health Car...Dan Belford
Background
This descriptive study measured the effectiveness of and participants' satisfaction with an interprofessional simulation education workshop as a teaching strategy for health care professionals.
Method
Health care professionals completed a 1-day clinical simulation workshop on interprofessional collaboration, after which they had the opportunity to fill out 4 evaluative instruments
This document discusses sedation and guidelines for qualified sedation providers. It defines levels of sedation from minimal to general anesthesia. Certified registered nurse anesthetists, anesthesiologists, and specifically trained physicians, dentists, oral surgeons, and registered nurses can provide conscious sedation. The American Society of Anesthesiologists' practice guidelines for non-anesthesiologist sedation were developed through an extensive review process. The guidelines also address training requirements for sedation personnel. Kaiser Moanalua's registered nurse training involves an online test and hands-on training in an operating room. A sedation simulation aims to supplement online training through realistic scenarios that simulate dynamic decision making. Evaluation of the simulation involves surveys of
The document discusses collaboration in nursing. It begins by noting the increasing complexity of healthcare issues and need for collaboration. It then defines collaboration as working together through communication, information sharing, coordination and cooperation. The document outlines several objectives and needs for collaboration in healthcare, including providing client-centered care and improving outcomes. It also discusses some issues that can impact collaboration among nurses, such as staffing shortages and mandatory overtime.
The document discusses factors that affect staffing and duty scheduling in nursing. It outlines 12 factors that must be considered when determining staffing needs, including patient acuity, characteristics of nursing staff, standards of care, and work schedules. It also describes different levels of patient care classification from minimal to highly specialized care. Using a sample staffing formula, it demonstrates how to calculate the number of nursing personnel needed based on patient census and levels of care. Key aspects of an effective scheduling system include meeting unit needs, fairness to staff, stability, and flexibility.
This document discusses implementing a strict nurse-patient staffing ratio policy. It describes a nurse's experience being assigned 18 patients instead of the standard 1:7 ratio due to call-outs. The nurse became overwhelmed and forgot to attend to patients. Research shows improved patient outcomes with better ratios. A 1:5 ratio is advocated to protect patients and nurses. While California has implemented ratios, most other states have not passed legislation and instead leave the decision to individual hospitals.
“A STUDY TO ASSESS THE EFFECTIVENESS OF INDIVIDUAL STRUCTURED TEACHING PROGRAMME (ISTP)ON THE USE OF BRADEN SCALE FOR PREDICTING PRESSURE SORE RISK FOR BED FAST PATIENT AMONG STAFF NURSES AT SELECTED HOSPITAL OF BIJAPUR”
This document discusses methods for estimating nursing staff requirements through activity analysis. It begins by introducing the importance of having an orderly staffing methodology. Various approaches to classifying patients based on their care needs are described, such as completely dependent, partially dependent, and ambulatory. The document then shows how to calculate the estimated nursing hours required for each patient classification in different shifts. It provides an example of allocating nurses across morning, evening, and night shifts based on the workload and number of patients in each classification. The conclusion discusses different approaches to allocating nursing staff and importance of monitoring unit census data.
Nurse administrators believe that staffing plans should match employee skills and knowledge to patient needs to optimize care quality and job satisfaction. They believe all aspects of care for critically ill patients should be provided by professional nurses given the complexity of needs. For chronically ill patients, professional and technical nurses should provide health teaching and rehabilitation. Patient assessments, work quantification, and job analysis should determine personnel levels for each patient type. A master staffing plan should be developed centrally but administered locally by head nurses to accommodate unit-level needs.
Salon 1 14 kasim 11.00 12.00 mari̇on mi̇tchelltyfngnc
1. The document discusses using simulation and an Objective Structured Clinical Examination (OSCE) to assess candidates for senior clinical nurse positions in an intensive care unit.
2. During the simulation, candidates participated in a simulated clinical scenario involving a patient, doctors, and nurses to demonstrate their skills and abilities.
3. The OSCE approach proved to be an innovative, valid and reliable way to identify the most competent candidates who displayed crucial skills for the senior nurse role, such as expert clinical care and supporting best practices.
Norms are standards that guide nursing staffing levels. The document discusses nursing staffing norms recommended by various committees in India, including the Staff Inspection Unit (SIU) in 1991-92. The SIU norms recommend nurse-patient ratios of 1:3 for non-teaching hospitals and 1:5 for teaching hospitals. The norms also provide ratios for different units like ICU, labor room, and operation theaters. Most hospitals in India follow the SIU norms for calculating nursing staff entitlement and defining nursing roles.
Essay On Nursing Leadership CompetencyDiana Turner
This document discusses effective approaches to leadership and management in nursing. It notes that nurses have two key roles: as care providers and care coordinators. As care coordinators, nurses take on management responsibilities that involve organizing complex care using thinking skills. The document will explore transformational leadership as an effective style that can motivate staff and improve outcomes. It emphasizes the importance of leaders adapting their style to the situation.
Nursing Challenges in Transitional Care Research.pdfbkbk37
The document discusses challenges in transitional care nursing. It identifies that lack of specialized nursing intervention causes issues like high rates of elderly patient readmission and improper care transitions between medical settings. Poor communication during care handoffs and lack of education for caregivers on how to care for patients at home can result in health declines. The problem is significant for nursing as it raises awareness of weaknesses in providing continuity of care during transitions and ensuring quality care movements within hospitals. Specializing in transitional care nursing could help address these challenges.
This document discusses implementing a planned change in a maternal child health setting using a shared governance model. It notes that shared governance aims to improve nursing practice through collaboration between nurses, patients, and other providers. The planned change would establish a shared governance council to help address challenges in promoting interdisciplinary team collaboration. Educational workshops would be held for all nursing staff to introduce the shared governance model and gain input from different specialties. A pilot study on one unit would evaluate the model's impact before full implementation. The goal is to enhance quality of care through nurse empowerment and involvement in decision making.
Evidence-based practice is important for nurses to utilize when making decisions about client care. Using the most up-to-date evidence alongside a client's values and preferences can help guide the healthcare process. When evidence-based guidelines are included in a client's plan of care, the clinician has substantial data to make sound decisions and develop the best strategy for delivering care. One study found that pain from venous ulcers was not always properly addressed, negatively impacting healing. This highlighted the need for evidence-based wound care practices that adequately treat pain.
The Impact of Burnout syndrome on Nurse Workers .docxrtodd33
The Impact of Burnout syndrome on Nurse Workers !1
The Impact of Burnout Syndrome on Psychosocial Wellbeing, Expected Outcomes, Self-efficacy,
Turnover, and Interest in Career of Nurse Workers.
Olajumoke Omiyale
Aspen University
Author Note
Essentials of Nursing Research N494
Dr. Keshea Britton
Date of Submission February 11, 2020
Burnout Among Nurses !2
Background
Burnout is a very common condition across the world and especially in the nursing
career. It's the reduction in the energy and zeal of nurses manifesting in form of being
emotionally exhausted, lacking motivation, feeling frustrated, fatigued, and low reaction time
which reduces individuals' output and work efficacy in general. Burnout has been strongly
attributed to the deficit in the number of healthcare professionals, a concern that goes way to be a
matter of global importance. The rapidly changing healthcare landscape that brings a paradigm
shift to increased demand for healthcare services in the world population has come with its
challenges. Although experts associate the change to improvement in the quality of life for which
people become capable of seeking healthcare services, the move has placed a lot of pressure on
not only the healthcare systems but particularly on the workforce (Mudallal, Othman, & Al
Hassan, 2017). However, governments have not moved at a similar pace to address these
pressures, leaving the mantle on the health institutions and professionals. To be specific, nurses,
as well as other healthcare providers, are left with a large number of patients to takes care of, a
number that keeps on increasing day after day, keeping them on the run all the time. The absolute
result of this healthcare environment is burning or wearing out, which without doubt minimizes
the efficacy of the nurse’s output.
The working environment for which the nurse staff doesn't match the care demand
culminated by poor leadership creates unattractive working conditions. Indeed, WHO reports
indicate that shortages of nurses would nationally and internally interfere with the efforts to
health and well being of the world population. Where staff shortage exists, human resources are
Burnout Among Nurses !3
overstretched, working conditions become poor and unbearable, work becomes increasingly
hazardous to the health of the nurse- they get no rest, become stressed, productivity decrease
with the poor patient outcome which add up to the trauma of the workers. They end up losing
interest in their job, become highly dissatisfied, burnout and increase the chances of quitting the
job. In return, the turnover of nurses affects the quality of healthcare services offered because of
a lack of expertise and increasing the workload burden on the remaining staff (Sobral, et. al,
2018). .
The Impact of Burnout syndrome on Nurse Workers !1
The Impact of Burnout Syndrome on Psychosocial Wellbeing, Expected Outcomes, Self-efficacy,
Turnover, and Interest in Career of Nurse Workers.
Olajumoke Omiyale
Aspen University
Author Note
Essentials of Nursing Research N494
Dr. Keshea Britton
Date of Submission February 11, 2020
Burnout Among Nurses !2
Background
Burnout is a very common condition across the world and especially in the nursing
career. It's the reduction in the energy and zeal of nurses manifesting in form of being
emotionally exhausted, lacking motivation, feeling frustrated, fatigued, and low reaction time
which reduces individuals' output and work efficacy in general. Burnout has been strongly
attributed to the deficit in the number of healthcare professionals, a concern that goes way to be a
matter of global importance. The rapidly changing healthcare landscape that brings a paradigm
shift to increased demand for healthcare services in the world population has come with its
challenges. Although experts associate the change to improvement in the quality of life for which
people become capable of seeking healthcare services, the move has placed a lot of pressure on
not only the healthcare systems but particularly on the workforce (Mudallal, Othman, & Al
Hassan, 2017). However, governments have not moved at a similar pace to address these
pressures, leaving the mantle on the health institutions and professionals. To be specific, nurses,
as well as other healthcare providers, are left with a large number of patients to takes care of, a
number that keeps on increasing day after day, keeping them on the run all the time. The absolute
result of this healthcare environment is burning or wearing out, which without doubt minimizes
the efficacy of the nurse’s output.
The working environment for which the nurse staff doesn't match the care demand
culminated by poor leadership creates unattractive working conditions. Indeed, WHO reports
indicate that shortages of nurses would nationally and internally interfere with the efforts to
health and well being of the world population. Where staff shortage exists, human resources are
Burnout Among Nurses !3
overstretched, working conditions become poor and unbearable, work becomes increasingly
hazardous to the health of the nurse- they get no rest, become stressed, productivity decrease
with the poor patient outcome which add up to the trauma of the workers. They end up losing
interest in their job, become highly dissatisfied, burnout and increase the chances of quitting the
job. In return, the turnover of nurses affects the quality of healthcare services offered because of
a lack of expertise and increasing the workload burden on the remaining staff (Sobral, et. al,
2018). .
The document discusses nursing practice and responsibilities. It notes that nursing practice is established through customs, formal consideration, and institutional arrangements. Over the past decade, nurses have been asked to demonstrate that their practices are effective. This has led to a focus on using evidence-based practices to improve patient outcomes and healthcare quality and safety. The essay will discuss the differences between rituals in nursing practice and evidence-based practice, and how encounters between taught practices and actual clinical practices can impact nursing students.
The Lived Experience of New Graduate Nurses DQ.pdfsdfghj21
This document summarizes a study that explored the lived experiences of new graduate nurses working in acute care settings. Through interviews with 10 new graduate nurses, the researchers identified three overarching themes: knowledge, skills, and environment. While nursing school provided a basic foundation of knowledge, participants felt it did not fully prepare them for their current roles and responsibilities in acute care settings. They noted a lack of exposure to real-world scenarios and a focus on test preparation over practical experience. The high turnover of new graduates negatively impacts patient care and costs employers money. Understanding new graduates' experiences can help educators better prepare students and support a smooth transition to practice.
- Nursing informatics is defined as integrating nursing, information, and technology to support health worldwide. A master's-prepared nurse discussed her role in a military hospital, which involves obtaining patient data from various sources and presenting it to help improve care.
- She advised that nursing informatics is a growing field with many opportunities for self-starters interested in technology. Shadowing her showed her taking on roles like mentoring others and evaluating education programs on any given day.
This document discusses the definition of nursing. It examines definitions from nursing theorists like Henderson, who defined nursing as caring for individuals to help them attain health and independence. The Royal College of Nursing defined it as using clinical judgment to provide necessary care for optimal life throughout one's lifetime. Nursing aims to promote health, prevent illness, and care for those who are sick, disabled or dying. It also discusses the evolving roles and functions of nurses throughout history.
Newly graduated nurses face challenges transitioning from the classroom to professional practice. They must adjust to differing expectations between academic training and real-world nursing. In particular, new nurses must learn to apply theoretical knowledge from limited clinical experiences to providing safe, quality patient care. They also need to develop confidence in their abilities and skills while working with real patients, where mistakes can have serious consequences. Additionally, the professional environment involves higher stress levels than clinical training, which if unmanaged can lead to burnout.
practice issue that would benefit from utilizing a mixed methods.pdfsdfghj21
This document discusses a proposed mixed methods study to examine challenges in transitional care. The study would involve observing the admission and discharge processes of elderly patients between hospitals, nursing homes, and home care. Both qualitative and quantitative data would be collected through participant observation, open-ended conversations with patients and caregivers, and semi-structured interviews with nursing leaders. The mixed methods approach would allow the qualitative data to provide context and explanations for the quantitative results. The goal is to better understand transitional care challenges and improve quality of care.
practice issue that would benefit from utilizing a mixed methods.pdfsdfghj21
This document discusses a proposed mixed methods study to examine challenges in transitional care. The study would involve observing the admission and discharge processes of elderly patients between hospitals, nursing homes, and home care. Both qualitative and quantitative data would be collected through participant observation, open-ended conversations with patients and caregivers, and semi-structured interviews with nursing leaders. The mixed methods approach would allow the qualitative data to provide context and explanations for the quantitative results. The goal is to better understand transitional care challenges and improve quality of care.
Successful Aging Theory Review Discussion.pdfsdfghj21
1) The theory proposes that aging is a process of adapting to changes through increasingly complex coping processes. A person's choices influence whether their aging is successful.
2) Key aspects of successful aging according to the theory are physical and mental health, meaningful activities, relationships, spirituality, creativity, and a sense of control.
3) The theory was influenced by Roy's adaptation model and aims to help nurses support older adults' transition to later life.
1) The author, a student nurse, found that a postoperative patient was in pain and had a distended abdomen, contrary to the previous nurse's assessment that the patient was confused.
2) Ultrasound revealed the patient had a residual urine volume of 998mls. Inserting a catheter drained 1650mls of urine, relieving the patient's pain and discomfort.
3) The author learned the importance of comprehensive assessment, advocacy, and challenging colleagues' practices that could put patients at risk, to fulfill their duty of care and prevent potential health issues.
This document discusses the challenges new graduate nurses face when transitioning from nursing school to working in a hospital setting. Due to the nursing shortage, new graduates have little experience but are expected to fill open staff positions. This lack of experience and inadequate support from hospitals leads to high stress and turnover rates among new nurses. The article then examines the competencies needed for new graduates to provide safe and effective patient care, including communication, leadership, conflict resolution, prioritization, and time management skills. Mentorship programs are shown to help improve new graduates' confidence and abilities in these areas.
2Nursing Staff Shortage in HealthcareRuta Arefaine.docxrobert345678
2
Nursing Staff Shortage in Healthcare
Ruta Arefaine
Oak Point University
NUR 4642: Professional Role Transition
Professor Josette Cabatingan-Oribello
Nursing Shortage
The shortage in the nursing profession has been an issue for over several years. Especially following COVID-19 suddenly gotten worse. St. Mary Elizabeth Hospital is no exception to this growing issue. Nurses make up the majority of medical practitioners and are essential to the industry. There remains a demand for more skilled educators in the perioperative environment and less even workforce distribution. Many serious factors cause the lack of nurses. As the age increases, there is a greater necessity for medical coverage. The authenticity is that, instead of taking just one illness, senior adults typically have illnesses and founders that necessitate professional care. Overall, individuals exist lengthier, a growing ultimatum for well-being care. Many chronic illnesses that were previously fatal are now treatable (Mar et al., 2019). The baby boom generation is still at a stage where they might need more medical attention as society ages. Today, more incredible Americans than ever previously time in history are above the age of 65.
According to Haddad et al. (2022, disclosed Nursing employment is anticipated to increase by 6% during the following ten years, according to the Bureau of Labor Statistics Number Of simulations 2021–2031. The number of Nurses working in the profession is expected to rise by 195,400 from 3.1 million in 2021 to 3.3 million in 2031. When nurses retire, they get pension benefits and labor strength leave benefits which are prudently essential in the United States. More than 203,200 positions for Nursing professionals have become vacant in consecutive years. In addition, the nursing staff is shrinking. There are about one million nurse practitioners who are above 50. Thus, it shows that in ten to fifteen years, one in the workforce may be quitting. This figure includes medical faculties, which poses a unique problem since it necessitates training many more nurses with scarce assets. Constraints on admittance and a decline in the nursing practice's number of nurses can generate both results of a nursing faculty shortage.
Fewer students may register, and the curriculum's and the scholar's general superiority of education may worsen due to a condensed and forced facility. Some newly hired nurses find that the profession differs from what they had imagined after starting their jobs. Others might become employed for a while before giving up after getting overworked. The incidence of nurse burnout is tapering off after years of progressively increasing levels. Furthermore, the spectrum of the average income employee turnover, which spans between 8.8% to 37.0%, is determined by nursing discipline and locale (Rosseter, 2014). Enhancing nurses' labor conditions is insufficient. It is also essential to consider the caliber of nursing knowledge prov.
Similar to Reality Shock: A Transitional Challenge Faced By Intern Nurses at Labasa Hospital, Fiji (20)
Carbon monoxide (CO) poisoning is a major public health issue in the United States that accounts for approximately 50% of poisoning cases in the nation each year and around 50,000 emergency room visits. In most instances of CO poisoning, the culprit is a malfunctioning or poorly tended heating system within the home or, occasionally, commercial building, which causes the system to leak this hazardous gas. One of the more insidious aspects of CO poisoning is that the gas is odorless and colorless, and victims of CO poisoning often do not realize that there is a problem until they begin to experience the effects of poisoning and have no choice but to seek medical attention. Unfortunately, many victims of CO poisoning die before they are able to seek treatment. This paper makes use of a qualitative, systematic literature review to examine the four major parts of the brain that are most severely affected by CO poisoning. Overall, the literature review showed that the white matter, globus pallidus, basal ganglia, and cortex are the parts of the brain most severely impacted by CO poisoning. While many CO poisoning victims do make it to the hospital on time and are treated, they may nonetheless suffer long-term neurological consequences as a result of their exposure. As such, CO poisoning is a major public health issue.
Drug abuse has now become a major public health problem in Nigeria requiring urgent attention. Although drug abuse cut across all age groups, the youths are however the most affected. This study aimed at assessing Community Pharmacists involvement in the rehabilitation of drug abuse victims. The study was carried out in Abuja Municipal Area Council, questionnaires were administered to Community Pharmacists practicing within the Area Council. A total of 176 Community Pharmacists participated in the study, and slightly above a quarter (27.43%) of them had post-graduate degrees. More than three-quarters (79.5%) of the study participants had received training on drug abuse. A total of 89.2% of the study participants had come across persons suspected to be abusing prescription medicines. Almost all (96.6%) of the study participants indicated that they are willing to advise persons suspected to be abusing drugs on the dangers of drug abuse, and 88.1% of the study participants had spoken to clients concerning abuse of prescription medicines. Also, more than three-quarters (80.1%) of the study participants indicated that pharmacists’ role in the prevention of drug abuse is very important. The study has revealed that Community Pharmacists can play an invaluable role in the rehabilitation of drug abuse victims in Nigeria.
Background; Social Class has shown relation with admissions at Emergency Departments. To assess whether there is a relationship between the level of triage and the social class of patients who attend the emergency department and whether there are other variables that can modulate this association. Methods Observational study with 1000 patients was carried out between May and July 2018 in the Emergency Department of the University Hospital Arnau de Vilanova in Lleida. Sociodemographic variables such as age, gender, country of origin and marital status were analyzed. The triage level and the main explanatory variable was social class. Social class was calculated based on the CSO-SEE 2012 scale. Results 49.4% were male and the average age was 51.7 years. Most of the patients (66.6%) attended the emergency department under their own volition and the most common triage levels were level III or Emergency (45%). There is a significant relationship between age and triage level. The younger patients had a lower triage level (p <0.001). The percentage of patients with lower social class who attended the emergency department for minor reasons was 42% higher compared to the rest of the patients (RR = 1.42; 1.21-1.67 95% CI, p <0.001). Conclusions; Patients with a lower socioeconomic class go to the Emergency Department for less serious pathologies.
This document summarizes a study exploring child healthcare and treatment-seeking behavior in a village located in a haor region of Bangladesh. The study utilized interviews and focus groups to understand the various factors influencing healthcare choices, including the interrelationship between local ecology and health. Key findings were that the haor ecosystem is declining due to overuse of resources, and villagers utilize multiple healthcare sectors - including popular/family-based care, folk healers, and biomedical professionals - with choices influenced by cultural and socioeconomic factors. Government and NGOs could help improve child health by increasing access to services and promoting awareness of nutrition and sanitation practices.
Objective: The purpose of this paper is to review literature on music and biomarkers of stress in order to (1) Identify music interventions and (2) Detail the biomarkers of stress associated with music. Methods: PRISMA guidelines were followed in performing this systematic review. Studies published from January 1995 to January 2020 that pertain to biomarkers of stress and music were identified through the use of the PubMed database, using the keywords: ‘music’ AND ‘biomarker’ OR ‘marker’ OR ‘hormone’. Two authors independently conducted a focused analysis and reached a final consensus on 16 studies that met the specific selection criteria and passed the study quality checks. Results: The reviewed studies were all randomized controlled trials. Reviewed music interventions included Music Listening (ML), Meditational Music (MM), ‘Guided Imagery and Music’ (GIM), and Singing. The studies showed that music is associated with a decreasing trend in cortisol, salivary α-amylase, heart rate, and blood pressure, as well as an increasing trend in Immunoglobulin A (IgA), oxytocin, and EEG theta wave, while testosterone was associated with sex-related differences. Conclusion: Music is associated with significant changes in biomarkers of stress, suggesting that it could be utilized for the development of stress reduction tools.
Background: Nurse practitioners play a vital role in wound care and management because of the prevalence of wounds in the community and hospital setting. Aims and objectives: The purpose was to identify current knowledge and practices of nurses with respect to wound management. Method: A qualitative descriptive research was designed, nineteen nurses in wound care wards in Bingham University teaching hospital were recruited into this study. This was achieved with the aid of a self-administered questionnaire for a two-week period. Results: Three groups of nurses responded to this survey (73.7% males; 31.6% aged 31-40 years). Registered nurses dominated (68.4%), majority of them worked in male ward (36.8%) and private ward (36.8%). Almost on full-time (94.7%), more than half were diploma holders (57.9%) with 1 to 5 years of experience (47.4%). Majority (84.2%) were involved in wound treatment and management, there were significant association between years of experience and wound classification, wound treatment, treatment failure and treatment failure factors. Conclusion: Wound care practices require accurate knowledge and assessment skills, a better understanding of wound management provides comprehensible, rapid patient wound care and minimizes patient mortality as well as reduces health services financial costs.
Background: Job satisfaction is a significant indicator of the way nurses feel about their profession, the efforts to perform their professional duties, or otherwise abandons it willingly. Method: cross-sectional research design approach was used to assess the job satisfaction and the associated factors among 300 hundred nurses. Data was analyzed using descriptive statistics and kruskal wallis test for association between the socio-demographic variables and job satisfaction at significance level of 0.05 Result: About 1/3 of the respondents (31%) reported gross dissatisfaction with their job, 0% reported being well satisfaction while (68.7%) respondents reported moderate satisfaction with their job. Across items on the scale, gross dissatisfaction was noted on key managerial factors and the salary of the workers. Job satisfaction was associated with specialty (p<0.018), gender (P<0.002) and age (P<0.000) of Nurses. Conclusion: majority of the respondents were moderately satisfied with their job but grossly dissatisfied with salary and administrative roles like communication flow.
Viral infections have always been of major concern in communities, health care settings and medical fields including radiotherapy and Radiology. Recently corona virus infection has attained global attention in the wake of covid-19 outbreak and consequently highlighted importance of viral prevention, diagnostic and therapeutic strategies to control and treat viral disease. In view of the recent events, the author reviewed the current and past literature to discuss contagious versus infectious viral transmission, as well as simple and effective ways of preventing the spread of viral diseases in community and health care setting so that this information can be used for preventing viral transmission at all levels. The article is written for a wide variety of audiences i.e. scientific and medical communities policy makers and general public.
The Coronavirus Disease – 2019 (COVID-19) is officially now a pandemic and not just a public health emergency of international concern as previously labelled. Worldwide, the new coronavirus has infected more than 4.9 million people and leaving more than 300,000 people dead in 188 countries. As countries of the world get locked down in an effort to contain the widespread of the virus, experts are concern about the global impacts of the pandemic on individuals, countries and the world at large. Millions of people are currently under quarantine across the globe. Many countries have responded by proclaiming a public health emergency, closed their borders and restrict incoming flights from high risk countries. This has grossly affected the travel plan of many. Several international programs, conferences, workshops and sporting activities are either postponed or cancelled. As the number of confirmed cases continues to escalate across the globe, hospitals seems to be running out of medical supplies, hospital spaces and personnel. Health workers are being overwhelmed by the numbers of people requesting for testing and treatment. Many of such health workers have been infected with the coronavirus and even lost their lives since the fight against COVID-19 started. Public health experts are also concerned about the huge medical wastes coming from the hospitals at this time and the adverse effects associated with improper management of such medical wastes, both at the hospital and community levels. The pandemic has also impacted negatively on the global economy. There have been serious crises in the stock market, with gross fall in the price of crude oil resulting in inflation and economic hardship among the populace. Many are currently out of job and as a result, the level of crime, protest and violence have continued to escalate in different parts of the world. The deaths of loved ones due to the coronavirus has left many emotionally traumatized. Nigeria, like other African countries is not spared of the ravaging effects of the pandemic, even as the government take strict measures to contain the virus. No doubt, this is very challenging, but the country is capable of surmounting the virus with the needed help from her international partners and cooperation from the citizenry. But if we as a people, remain complacent and continue with business as usual, without taking measures to flatten the curve, the disease will escalate too quickly beyond our capacity to handle and our health system will be overwhelmed and may collapse eventually. We cannot therefore afford to be complacent in our response to containing the pandemic.
Purpose: To investigate the effect of sulfur dioxide on the lung microbiota of healthy rats. Methods Fifteen male rats were randomly divided into high dose and low dose exposure group and control group. After 7 days of SO2 exposure, the lung tissues were obtained and the lung microbiota was identified by Illumina high-throughput sequencing. Results The microbial community of lung microbiota was significantly alternated in the exposure group and the dominant phylum changed from Firmicutes to Proteobacteria. In addition, the SO2 exposure caused the bronchial wall thickening and a large number of inflammatory cell infiltration in the lungs of rats in exposure groups. Conclusions The results suggest that SO2 can significantly alter the lung microbiota and pathological structure of the lungs.
Malaria is still considered globally as a leading cause of morbidity with Nigeria carrying the highest burden of 19%. Coinfection of malaria and Human Immunodeficiency Virus (HIV) accelerate disease progression of HIV/AIDS subjects. This study investigated the prevalence and predictors of malaria among HIV infected subjects attending the antiretroviral therapy Clinic at Federal the Medical Centre, Keffi, Nigeria. After ethical clearance, 200 whole blood specimens were collected from patients who gave informed consent and completed a self-structured questionnaire. The specimens were examined for malarial parasite using rapid kits and microscopy. The overall prevalence of the infection was 78/200 (39.0%). The prevalence was higher in male (44.7%) than female (34.0%) subjects. Those subjects aged < 20 years (54.5), male gender (44.7%), non-formal education holders (61.5%), farmers (62.5%), stream water users (48.1%), those that lives in rural setting (43.6%), those that do not use Insecticides Treated Nets (ITNs) (39.4%) and swampy environment dwellers (41.7%) were identified predictors for malaria infection in the area. All the predictors studied did not show any statistically significant difference with the infection but some arithmetic difference exists (P > 0.05). The 39.0% prevalence of malaria in HIV infected subjects is a public health concern. Therefore, Public health surveillance and health education among HIV population should be advocated to help eradicate malaria comes 2030. Further study that will characterize the genes of the parasite should be carried out.
This document presents a mathematical model to eliminate malaria transmission by breaking the life cycle of Anopheles mosquitoes. The model introduces two natural enemies - copepods to prey on mosquito larvae and tadpoles to prey on pupae. Differential equations were derived to model the growth of each mosquito life stage from egg to adult when under attack by these predators. Stability analysis of the disease-free equilibrium was conducted using equilibrium points, Beltrami's conditions, and Diekmann's conditions. The results indicate that introducing copepods and tadpoles makes the disease-free equilibrium stable, meaning the mosquito life cycle would be broken and no adult mosquitoes emerge to transmit malaria.
Spindle cell neoplasms usually occur in head, neck, orbit, soft tissues of scalp and along the upper aerodigestive tract. They are relatively uncommon in lower gastrointestinal tract and represent a distinct clinical entity. Increased awareness is required among colorectal surgeons and pathologists due to their benign nature & uncertain etiology, to avoid misdiagnosis of rectal cancer. Definitive diagnosis necessitates immunohistochemical analysis. We present an unusual case of spindle cell neoplasm of rectum in an asymptomatic elderly gentleman, detected on screening colonoscopy. Following thorough evaluation with MRI pelvis, CT scan thorax, abdomen, pelvis with contrast and multidisciplinary meeting discussion (MDT) at our institution, he was successfully treated with a specialized minimally invasive approach (TAMIS). Histopathology with immunohistochemistry confirmed the diagnosis of spindle cell neoplasm. As they are uncommon in colorectum & non-invasive, management and long-term follow-up is still under study. These lesions should be differentiated from other stromal tumours in GIT.
This document summarizes a study on the relationship between socio-demographic characteristics and the prevalence of brucellosis among community members in Mandera East Sub-County, Kenya. Blood samples from 420 respondents were tested for brucellosis using the Rose Bengal Plate Test (RBPT) and Serum Slow Agglutination Test (SSAT). The RBPT indicated a prevalence of 24.8% while the SSAT, a confirmatory test, indicated a prevalence of 14.3%. The study found the seroprevalence was higher among males (98% by RBPT and 98% by SSAT) and there was a significant relationship between gender and seroprevalence. Socio-demographic data
The Matrix metalloproteinase-9 is involved in several pathologies. Its strong presence in ocular pathologies explains our interest for its genetic variation in cataract, glaucoma and retinoblastoma in Senegal. MMP9 is highly polymorphic with cataract and glaucoma. 77 mutations were noted with 21 haplotypes for the entire population. The haplotype diversity Hd is 0.831 and the nucleotide diversity Pi is 0.016; k = 17.395. The polymorphism of the Matrix metalloproteinase-9 gene is associated with all three diseases and SNP 3918249 is found in both cataract and glaucoma.
This paper proposes the development of a software that performs the pre-diagnosis of malignant melanoma, spincellular carcinoma and basal-cell carcinoma. The software is divided into five modules, these being: digital imaging, analysis and processing, storage, feature extraction and classification by means of an Artificial Neural Network (ANN). The results shown the performance of the software for two different combination of activation functions in the network. With the use of spectroscopic techniques for the acquisition of images and the combination of non-linear and linear activation functions in the ANN, the software shows an effectiveness greater than 80%, concluding that it can be an effective tool as an aid in the diagnosis of cancer of skin.
Background: Tuberculous meningitis is defined as an inflammatory response to mycobacterial bacterial infection of the pia, arachnoid and CSF of the subarachnoid space. It is a dangerous form of extrapulmonary tuberculosis because it can cause permanent neurological disabilities and even death. Stroke is a devastating complication which further increase the morbidity and mortality in the disease. Matrix metalloproteinases are endopeptidases which degrade all the components of the extracellular matrix and thus have potential to disrupt blood brain barrier and cause CNS damage. Matrix metalloproteinases have been associated with pathophysiology of ischemic stroke. MMP levels in serum and CSF have also been seen to rise with advancing stage of TBM. So it is postulated that MMP may have role in the pathophysiology of stroke in TBM and may serve as a biomarker to predict stroke in TBM. Aims: To compare Serum Matrix metalloproteinase-9 in patients with Tuberculous Meningitis with and without Stroke and correlate it with various clinical, biochemical and radiological features of TBM. Methods: 40 Patients of probable or definite TBM and 40 age and sex matched patients of TBM with clinical stroke were enrolled in the study and formed two groups i.e. cases and controls. The two groups were compared for various clinical parameters, biochemical parameters (CSF cytology, glucose and protein), neuroimaging parameters and serum MMP-9 levels. Serum MMP-9 was estimated by ELISA method. Results: Serum MMP-9 levels were (224 ± 261.627 ng/ml) in cases and (157.23 ± 197.155 ng/ml) controls, which though higher in cases but no difference was statistically significant (p value 0.157) between two groups. Also there was no correlation between the serum MMP-9 levels and various clinical features (duration of illness, fever, headache, vomiting, weight loss, seizure, hemiparesis), CSF characteristics (protein, sugar and cytology) and radiological findings (tuberculoma, and hydrocephalus). Conclusion: we conclude that MMP-9 levels is not correlated with occurrence of stroke in TBM. MMP-9 levels were not increased with severity of disease, complications and outcomes.
This study aimed to determine factors influencing postnatal monitoring in the Bafang Health District of Cameroon. The study found that women who were informed of postnatal appointment dates by midwives, those who believed the appropriate period for follow-up was 6 weeks postpartum, and those who massaged their abdomen after childbirth were more likely to have knowledge of postnatal follow-up. In contrast, women with no knowledge of the appropriate periods for postnatal consultations were less likely to have knowledge. The study concluded that lack of knowledge about postnatal consultations and traditional practices are factors influencing postnatal follow-up in the district, and increased awareness campaigns are needed.
Aim: To highlight the challenge in the management of Arginosuccinic acidemia as well as demonstrate the importance of newborn screening for inborn errors of metabolism. Method: Report of two cases of neonatal onset ASA with encephalopathy and review of relevant literature. Conclusion: Early diagnosis and institution of appropriate intervention can significantly improve outcome. Routine newborn metabolic screening should not only be implemented universally, the result should be available promptly.
To form the basis of a respiratory disease model in rats by investigating the microbial distribution and composition in the lower respiratory tracts of normal rats. Methods: DNA was extracted from the intestine, trachea, bronchus and lung samples collected from healthy rats under sterile conditions. The 16S rDNA V4-V5 region was sequenced using Illumina high-throughput technology. Results: The sequencing results showed that there was no significant difference in abundance and species diversity of microbiota between the lower respiratory and the intestine. The microbiota structure analysis showed samples from lungs and intestinal shared similarity. However, the dominant species at the levels of phylum, family, and genus diverged. The similarity analysis showed that the lung microbiota were different from the intestines. The linear discriminant analysis showed significantly different species in different tissues; function prediction also showed different microbiota function in different tissues. Conclusions: These results suggest that bacterial colonization depends on the sample’s anatomical location. The human pathogen Acinetobacter lwoffii was also detected in the rat lower respiratory tract samples.
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdfVedanta A
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NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPTblessyjannu21
Prepared by Prof. BLESSY THOMAS, VICE PRINCIPAL, FNCON, SPN.
Emphysema is a disease condition of respiratory system.
Emphysema is an abnormal permanent enlargement of the air spaces distal to terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.
Emphysema of lung is defined as hyper inflation of the lung ais spaces due to obstruction of non respiratory bronchioles as due to loss of elasticity of alveoli.
It is a type of chronic obstructive
pulmonary disease.
It is a progressive disease of lungs.
Sectional dentures for microstomia patients.pptxSatvikaPrasad
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Reality Shock: A Transitional Challenge Faced By Intern Nurses at Labasa Hospital, Fiji
1. International Journal of Healthcare and Medical Sciences
ISSN(e): 2414-2999, ISSN(p): 2415-5233
Vol. 4, Issue. 9, pp: 158-164, 2018
URL: http://arpgweb.com/?ic=journal&journal=13&info=aims
Academic Research Publishing
Group
*Corresponding Author
158
Original Research Open Access
Reality Shock: A Transitional Challenge Faced By Intern Nurses at Labasa
Hospital, Fiji
Devina Gaundan*
Master in Health Services Management, School of Public Health and Primary Care, Fiji National University, Fiji
Masoud Mohammadnezhad
Associate Professor in Public Health (Health Promotion), School of Public Health and Primary Care, Fiji National University, Fiji
Abstract
Introduction and Aim: Transition from being a student nurse to a full time registered nurse is a difficult phase in the
lives of intern nurses. During this phase they face many challenges which influence their professional lives as well as
their transitional experience. This study aimed to identify the transitional challenges experienced by intern nurses at
Labasa Hospital, Fiji. Methodology: This qualitative study was conducted using a phenomenological approach. Data
collection through semi structured in-depth interviews commenced after ethical approval was obtained. Each
interview lasted between 40 to 60 minutes. The 22 participants were intern nurses of Labasa Hospital, Fiji who were
either current intern nurses and had worked for more than 6 months or had completed internship within the past 5
years at Labasa Hospital and currently working as registered nurses within various units in the facility. Written
consent was obtained from intern nurses who were willing to participate before the commencement of the interview
on a one to one basis. The interview data was transcribed verbatim and interpreted thematically. Results: The intern
nurses participating in the study were between the ages of 22 and 26 years old. Only one participant was 46 years
old. 10 were current intern nurses while the remaining 12 had completed their internship and working as registered
nurses. Reality shock is one of the challenges identified as a subtheme through thematic analysis in this study. The
categories identifies under reality shock are role ambiguity, self-doubt, and work environment. Conclusion: The
findings of the study identified reality shock as one of the many challenges experienced by intern nurses of today.
There is an immediate need for healthcare providers and nursing leaders to recognize and address the reality shock in
order to facilitate better transitional experiences for intern nurses. Easing the burden of reality shock will promote a
healthy working environment as well as initiate better clinical outcomes.
Keywords: Intern nurses; Transition; Challenges; Qualitative study; Fiji.
CC BY: Creative Commons Attribution License 4.0
1. Introduction
Transition from being a student to working as a registered nurse is not just a phenomenon that begins with
familiarization of the new workplace but it is an experience that influences the professional lives of intern nurses.
Intern nurses are new graduate nurses or novice nurses who have just began a career in nursing after attaining a
nursing qualification. During the first year of nursing most countries including Fiji have internship programs to
support intern nurses in their transition. Internship programs usually last for one to two years, during which intern
nurse must adapt to the new role and deal with the emotions and challenges of professional integration.
The transition from being a nursing student to working with real patients can range from just feeling
uncomfortable to a highly shocking experience. Jewell [1] describes transition into full time nursing as complicated
and difficult experience. Similarly, Abdelsalam, et al. [2] describe transition as a phase with overwhelming
responsibilities and accountabilities. Additionally, it is a period of learning, adjusting, socializing and gaining
competence in knowledge, skills and attitude. Teoh, et al. [3] state that the transition from a student to a fully
pledged registered nurse presents with new challenges, stressors, and inconsistencies in professional practise for the
new recruit. The transitional phase is usually accompanied by experiences of self-doubt and inadequacy leading to
discouragement and exhaustion. One of the many challenges faced by the intern nurses is reality shock, whereby,
after commencing internship, the intern nurses often realize that the on-the-job demands are not mentioned in the
textbooks.
Reality shock has been defined as an unsettling and/or jarring experience resulting from wide disparity
between what was expected and what the real situation turns out to be. According to Caliskan, et al. [4] reality
shock is a term for describing the reaction of an individual who has received education in the field and has just
started work. Sparacino [5] stated differences in language, customs and social norms as burdens for reality shock.
The study highlighted reality shock has the same basic concept as culture shock. The same attributes are present in
both; differences in language, custom, social norms, and new comers feeling alienated. Once new comers can
acclimate successfully, they are able to enjoy their transition. The same applies to intern nurses whereby they enter
the workplace excited about their new career, yet the euphoria is short lived when they realize the inconsistencies
between their expectations and the reality. Once they are able to perceive the positivity, they are able to acclimate to
the work culture and the outcome is a successful transition [5].
2. International Journal of Healthcare and Medical Sciences
159
Similarly, Clair [6] stated that rapid immersion into the modern day acute work environment and the feeling of
inadequacy lead to “reality shock‟. Silva, et al. [7] described reality shock as a conflict that occurs when intern
nurses discover that the knowledge they acquired in school is different from what is being practiced in health
institutions. Shipman [8] stated that reality shock occurs when intern nurses lack the ability to connect nursing
education with the realities of practice. Intern nurses may feel insecure and be unprepared to face the challenge of
reality shock. Reasons leading to reality shock, as stated by Silva, et al. [7] include; leadership, management and
technical skills; whereas Shipman [8] identified the inability to resolve conflicts, adapting to new shift routines and
initiating decision on clinical issues as reasons for reality shock. According to Hezaveh, et al. [9] reality shock
results in high levels of stress in intern nurses and the condition can impact their physical, emotional, mental status
and even their health.
Kramer [10] theorized reality shock as, “the reactions of new workers when they find themselves in a work
situation for which they have spent several years preparing, for which they thought they were going to be prepared,
and then suddenly find they are not”. According to Kramer [10] reality shock theory, the intern nurses undergo a
process of learning and growing as they transition into nursing. This process is characterized by four phases:
honeymoon, shock, recovery, and resolution. The honeymoon phase is a period full of excitement. When joining the
profession, the intern nurses are excited and eager to learn new things. The excitement is short lived as the intern
nurses are faced with the realities of the new work place; this leads them to the second phase known as the shock
phase. Shock phase is a time when the intern nurse is most vulnerable and negative feelings towards the new
profession surfaces. The shock phase often occurs when the intern nurses realise the expectations of the new role
being consistent with the day to day responsibilities. During this negative phase, there is a risk that the intern nurse
might quit the profession, leave the unit or it can even lead to burnout [5]. When the intern nurse starts to recover
from the negativity of the shock phase and move back to the positive side, it‟s the beginning of the recovery phase.
During this phase the intern nurses can look at the job realities with a new and more open perspective. Usually,
around a year the fourth and final phase, which is the resolution phase, eventuates. During the resolution phase the
nurse is able to see her role in perspective and make a full contribution to the profession. Sparacino [5] states that the
reality shock model helps the colleagues of intern nurses understand the different situational phases they go through
during transition. The intern nurses may have accepted the position but may not be prepared for some of the
responsibilities associated with the position. The uneasiness intern nurses face can be minimised if the nursing
leaders and senior colleagues understand the reality shock faced by the intern nurses and show understanding and
empathy towards the intern nurses. This study aimed to identify the transitional challenges experienced by intern
nurses at Labasa Hospital, Fiji.
2. Methodology
This study is a qualitative research using a phenomenological approach to explore the transitional experiences of
intern nurses at Labasa Hospital. Twenty two intern nurses participated in this study through convenient sampling.
The participants were either employed as an intern at Labasa Hospital for more than six months or had completed an
internship at Labasa hospital in the last five years and currently working as registered nurses at Labasa Hospital.
Recruitment of participants was carried out by identifying potential participants through conversation with the
Human resource manager. They were approached by the research assistant and given a verbal explanation and a
participant information sheet outlining the purpose of the study and the timeframes of the interview. Upon agreeing
to participate, each participant was asked to sign a written consent prior to the interview. Their participation was
voluntary. Data was collected through in-depth semi‒structured interview, conducted by a research assistant.
Interviews were conducted face to face in a quiet room. The interviews lasted between 40 to 60 minutes. All
interviews were audio recorded while unstructured note were taken as well. All interview audio recordings were
transcribed verbatim by the principal researcher. Following which a review of transcriptions was carried out to
correct errors and to remove references to names, places and significant events to ensure anonymity for the
participants. Once the transcriptions were clarified, data analysis was carried out.
Thematic analysis was the choice for data analysis in this study. It was carried out using four steps identified by
Green, et al. [11]; immersion in the data, coding, creating categories and the identification of themes and subthemes.
The principle researcher read and reread each transcript line by line, identifying similar phrases and words than
assigned numbers to that word or concept. The coded data that had similar characteristics were grouped together.
Once grouping of similar data was completed, descriptive themes were identified to reflect the lived experiences
described by the participants.
Trustworthiness of the results of the study was examined through Lincoln and Guba [12] strategies of
credibility, dependability, conformability and transferability . Ethical approval for this study was obtained from Fiji
National University (FNU) College Health Research Ethics Committee (CHREC) and Fiji National Health Research
Ethics Committee (FNHREC). Permission was obtained from the Medical Superintendent of Labasa Hospital prior
to the commencement of the interviews.
3. Results
The demographical characteristics of the Participants (P) are provided in the table below:
3. International Journal of Healthcare and Medical Sciences
160
A total of 22 participants took part in data collection through in‒depth interviews. Out of the 22, 86.4% were
females and 13.6% males. 95.5% of the participants were between the ages of 22 and 32 while only 4.5% was
between 33 and 43. The ethnic distribution if the participants included 50 % being I‒Taukei while 36.4% were
Fijians of Indian origin and the remainder 13.6% were Fijians of other origin. 63.6% had Bachelor in Nursing and
36.4% had Diploma in Nursing. The participants included 59% intern nurses who were single, 36.4% married and
4.5% divorced. The table below shows the findings of this study.
Theme Subtheme Categories
Challenge Reality shock Role ambiguity
Self-doubt
Work environment
Thematic analyses of the interview findings indicate that „reality shock” was one of the challenges experienced
by the participants of this study. Three categories of „reality shock” identified were role ambiguity, self-doubt and
work environment. The following section is an account of role ambiguity.
Personal Information Frequency Percentage (%)
Gender
Male
Female
3
19
13.6
86.4
Age (years)
22- 32
33-43
21
1
95.5
4.5
Ethinicity
I‒Taukei
Fijians of Indian Origin
Fijians of Other Origin
11
8
3
50
36.4
13.6
Education Level
Bachelor in Nursing
Diploma in Nursing
14
8
63.6
36.4
Years of Experience
6 months to 1 year
1 year to 3 years
3 years to 5 years
11
6
5
50
27.3
22.7
Marital Status
Single
Married
Divorced
13
8
1
59
36.4
4.5
Personal Information Frequency Percentage (%)
Gender
Male
Female
3
19
13.6
86.4
Age (years)
22- 32
33-43
21
1
95.5
4.5
Ethinicity
I‒Taukei
Fijians of Indian Origin
Fijians of Other Origin
11
8
3
50
36.4
13.6
Education Level
Bachelor in Nursing
Diploma in Nursing
14
8
63.6
36.4
Years of Experience
6 months to 1 year
1 year to 3 years
3 years to 5 years
11
6
5
50
27.3
22.7
Marital Status
Single
Married
Divorced
13
8
1
59
36.4
4.5
4. International Journal of Healthcare and Medical Sciences
161
3.1. Role Ambiguity
Some of the participants indicated that at the commencement of their career they had mixed feelings. P4 (a 22
years old nurse) stated that:
“I started off my career with mixed feelings; at times I wasn’t sure what I really felt happy
or sad.”
Similarly, P22 (a 22 years old nurse) indicated that she found it difficult to fit in:
“How to fit in? Was the issue I was worried about during rotation”
Additionally, P10 (a 24 years old nurse) voiced that she knew her role but got confused during difficult
situations:
“I was aware of my role as a nurse, but in some situations I wasn’t sure what I was
required to do, like the first time I saw a MVA (motor vehicle accident) victim in
emergency, I didn’t know what to do.”
Together with role ambiguity, several participants talked about having self-doubt, which is reflected in the next
section.
3.2. Self-Doubt
There were circumstances when the intern‒nurses had less confidence in themselves while carrying out
procedures. P15 (a 25 years old nurse) indicated that she was unsure whether she was carrying out the procedure
correctly:
“During the early days, I was confused when caring out procedures, whether I was doing
things right or not”
Similarly, P 18 (a 24 years old nurse) found the commencement of a career difficult and she stated:
“The first few weeks were really difficult, I wasn’t sure I had the right skills to carry out the
nursing care.”
Additionally, P7 (a 23 years old nurse) voiced that she had lack of confidence in herself to deal with certain
situations:
“In some situations I asked myself weather I had the right knowledge to handle it”
A few of the participants voiced that the Work environment had an impact on their transition.
3.3. Workplace Environment
Work environment in this study is reflected as situations where the participants found the physical layout, work
routines and work culture of the workplace challenging. P2 (a 32 years old nurse) stated that:
“During rotations, I realized different wards have different routines.”
A few of the participants talked about experienced nursing staff being unhelpful. P20 (a 22 years old male nurse)
said that:
“Some nurses are helpful; others let you do your own stuff.”
While some nurses found it challenging to adapt to the work culture in the clinical setting. As some of the
intern‒nurses had not been to Labasa Hospital before, two of the participants found it challenging to adapt to a new
environment together with starting a new career. P6 (a 24 years old nurse) stated:
“I found the environment very new, during student days I was based at a different hospital;
I found it very difficult to adjust to the new environment, I was so lost”
Correspondingly, P22 (a 24 years old nurse) voiced that:
“It was difficult for me to find my way at first. I was not familiar with the place as I had never been to this hospital
before.”
4. Discussion
The transition from an undergraduate student to being a registered nurse has been recognized as a difficult
transition by many researchers. During transition the intern nurses leave behind the security of being a student and
adapt to the responsibilities and accountabilities of a registered nurse [13]. The challenges associated with intern
nurses entering the workforce are numerous and complex. This study reflected reality shock as one of the challenge
faced by the intern nurses during transition.
Duclos‒Miller [14] describes reality shock as the incongruence between perceived role and expectations due to
the change in status from a student to registered nurse, challenges of the new role, and lack of information on the
expected behaviour and responsibilities, lack of competence and self-doubt. The findings of this study is consistent
with Hezaveh, et al. [9] which states that at the beginning of their career intern nurses are faced with reality shock
during which they recognize the difference between the expectations of workplace and their abilities. Similarly,
Rush, et al. [15] states that during transition intern nurses are anticipated to adopt an expanded role that is
accompanied with overwhelming responsibilities and unfamiliar expectations. Correspondingly, Teoh, et al. [3]
states that even though intern nurses have completed their nursing education and attained a registration to practise,
many of them still fell ill‒prepared to face the realities of clinical practise. Additionally, Qiao, et al. [16] state that
there is a gap between theory and practical, once the intern nurses join the workforce they realize that what they
learnt in school is different from what is being practised in the clinical areas. The difficulties of reconciling the
difference between „idealised role conceptions‟ and „actualized role conceptions‟ termed as reality shock give rise
to role conflicts and associated role ambiguity impacting the intern nurses‟ ability to meet the organizational
5. International Journal of Healthcare and Medical Sciences
162
obligations, whilst maintaining a sense of professional integrity [17]. This study has identified role ambiguity, self-
doubt, work culture and new environment as different forms of „reality shock” faced by the intern nurses.
Role ambiguity is defined as having mixed feelings about new responsibilities and role expectations. McKenna
and Newton [18] state that role ambiguity is lack of role clarity and understanding of expectations. Intern nurses are
unable to identify their roles in clinical settings, their preconceived role from student days hinder the development
of their new role. According to Duclos and Patricia [19] role ambiguity occurs in the first few months of internship
and is the lack of information needed for role definition. It included the social and psychological aspects of role
performance. Consistently, Karen Missen, et al. [20] states that intern nurses struggle with role ambiguity during
transition; there is a detachment between their ideology of nursing and actual experiences during transition. This
creates an inner conflict and confusion about the actual role of a registered nurse. Having an inner conflict about
the actual role of a registered nurse often leads to self-doubt amongst intern nurses.
Self-doubt is defined as having lack of confidence in oneself and one's abilities. Participants in this study
indicated that they had some moments of self‒doubt at the commencement of their career especially when faced
with new or difficult situations. This finding is similar to Dyess and Sherman [21] which states that intern nurses
are both confident and fearful when commencing their nursing career. Similarly, Greenlees‒Rae [22] states that
intern nurses doubt their clinical judgement during transition. The self‒ doubt is a result of lack of knowledge,
clinical expertise and little to no support from the senior colleagues. According to Ebrahimi, et al. [23] intern nurses
have little trust in their own capabilities and manifest behaviours such as self‒doubt and fear. During the initial few
months of transition they may feel unqualified, inadequate and helpless in addition to the self-doubt and insecurities
intern nurses may already have. Work environment as identified through is study is another category of reality
shock that adds to the challenges felt by the intern nurses.
Work environment in the context of this study includes the physical setting of the facility as well as the work
culture. Rhéaume, et al. [24] describes a healthy work environment as one that has sufficient resources, appropriate
nurse-patient ratios, positive relationships between interdisciplinary health care team, and administrative support in
providing quality care. The findings of this study indicate that some of the participants found the setting unfamiliar
as they had never been to Labasa Hospital or were attached to different hospitals during their student days. The
unfamiliarity of work environment proved to be a challenge for intern nurses. This finding is consistent with
Malouf and West [25] which states that new clinical environment increases the challenge of role adaptation for
intern nurses. Likewise, Laschinger, et al. [26] states that new work environment and culture play a significant role
in influencing the transitional experiences on intern nurses.
Work culture plays an important role in extracting the best out of employees and plays an influential role in
determining the learning culture of the workplace. The perceptions of the work experience which vary among intern
nurses are a direct reflection of environmental factors including people and processes of the workplace [27]. The
findings of this study indicate that intern nurses find it difficult to adapt to the work culture. This is consistent with
Peterson [28] who states that intern nurses are overwhelmed by the demands and the unit routines of the workplace.
Correspondingly, Williams [27] articulated that intern nurses are dissatisfied with environments that lack support,
nurturing and are faced with hostile colleagues who are unwilling to share the workload.
The findings of this study add to the existing knowledge on reality shock being a challenging transitional
experience for intern nurses. [Sparacino [5], Clair [6], Kramer [10]] agree that reality shock results in high levels of
stress in intern nurses. This can impact their physical, emotional and mental status and their health. Furthermore,
Teoh, et al. [3] states that reality shock can have detrimental effects of the level of nursing care provided by the
intern nurses leading to professional dissatisfaction. Boamah, et al. [29] emphasized that intern nurses suffer
ambiguities in their role and experience more stress as well as lack of power, lack of recognizing other‟s
expectations and lack of sufficient authority, Stress can lead to health risks, absenteeism, decrease in quality of
patient care, medical errors, aggressive behaviours and changing career.
In order to ease reality shock as a transitional challenge for intern nurses, organizations need to recognize its
existence and articulate strategies to curtail its impact. Senior nursing staff should be encouraged to eradicate the
hostile nature and promote a positive work culture. Duchscher [30] emphasizes that support from nursing
colleagues will help the intern nurses in developing their thinking and clinical expertise thus making their entry into
full time nursing a smooth transition. Additionally, administrative support is vital in providing a healthy learning
environment for intern nurses. According to Teoh, et al. [3] intern nurses assimilate better into units where
experienced staff is willing to teach, mentor, provide learning opportunities, exemplify teamwork and maintain a
positive work environment.
5. Conclusion
This study recognized reality shock as one of the challenges faced by intern nurses of this era. It is perceived
nursing students are often not fully exposed to the real world demands of nursing in their undergraduate
preparation, leading to reality shock during transition into their new role of intern nurse. Support and guidance
together with acceptance from senior nurse reduce the burden of reality shock and positively influence transition..
Creating work environments that are conducive to fostering learning and professional development are crucial to
increasing intern nurses‟ confidence and competence. Conclusively, there is an immediate need for nursing
administrators, supervisors and experienced nurses to commit to empowering intern nurses to increase their clinical
knowledge and skills. Encouraging a smooth transitional journey would ultimately lead to satisfied intern nurses
and improved patient care outcomes.
6. International Journal of Healthcare and Medical Sciences
163
References
[1] Jewell, A., 2013. "Supporting the novice nurse to fly: A Literature review." Nurse Education in Practice,
vol. 13, p. 323‒327.
[2] Abdelsalam, G., Basal, A. A., Ebrahem, R. A., and Elnagar, S. A., 2016. "Perceptions of Role Transition
among Nursing interns at Tanta University." Journal of Nursing and health Sciences, vol. 5, p. 16‒22.
[3] Teoh, Y. T. E., Pua, L. H., and Chan, M. F., 2012. "Lost in Transition‒ A review of qualitative literature of
newly qualified Registered Nurses' experiences in their transition to practice journey." Nurse Education
Today, vol. 33, p. 143‒ 147.
[4] Caliskan, A., Yasemin, A., and Ergun, 2012. "Examining Job satisfaction burnout and reality shock
amongst newly graduated nurses." Procedia Social and Behavioural Sciences, vol. 47, pp. 1392-1397.
[5] Sparacino, L., 2016. "faculty's Role in Assisting new Graduate Nurses' Adjustment to Practice." SAGE
Journals, vol. 2, pp. 1-9.
[6] Clair, M. B. S., 2013. "New Graduate Nurses' Experiences of Transition During Orietation into Critical
Care." Theses and Dissertations, vol. 378, Available: https://dc.uwm.edu/etd/378/
[7] Silva, D. G. V. s., Souza, S. d. S. d., Trentini, M., Bonetti, A., and Mattosinho, m. M. S., 2010. "The
challenges coped by the novice in nursing practise." Online Journals, vol. 44, pp. 511–516. Available:
http://www.scielo.br/pdf/reeusp/v44n2/en_38.pdf
[8] Shipman, D., 2014. "Lived experience of transtioning to a new graduate nurse following a prelicenture
hospital based externship experience." New Southestern University Works, vol. 1,
[9] Hezaveh, M. S., Rafil, F., Khosravi, S., and Seyedfatemi, N., 2014. "The experience of stress among new
clinical nurses." Nursing Practice Today, vol. 4, p. 199‒206.
[10] Kramer, M., 1974. "Realty Shock: Why nurses leave nursing." American Journal of Nursing, vol. 75, p.
981.
[11] Green, J., Willis, K., Hughes, E., Small, R., Welch, N., Gibbs, L., and Daly, J., 2007. "Generating best
evidence from qualitative research: the role of data analysis." Australia, new Zealand Journal of Public
health, vol. 31, pp. 545-550.
[12] Lincoln, Y. S. and Guba, E. G., 1985. Naturalistic Inquiry. Newbury park, Canada: Sage.
[13] Walton, J. A., Lindsay, N., Hales, C., and Rook, H., 2018. "Glimpses into the transition world: New
graduate nurses' written reflections." Nurse Education Today, vol. 60‒66, p. 62.
[14] Duclos‒Miller, P. A., 2011. "Successful Graduate Nurse Transition: Meeting the Challenge." Nurse Leader,
[15] Rush, K. L., Aamack, M., Gordon, J., and Janke, R., 2014. "New Graduate nurse transition programs:
Relationships with bullying and access to support." Contemporary Nurse, vol. 48, p. 219‒228.
[16] Qiao, G., Li, S., and Hu, J., 2011. "Stress, coping and psychological well-being among new graduate nurses
in China." Home Health Care Management and Practice, vol. 23, pp. 398-403. Available:
http://hhc.sagepub.com/content/23/6/398.full.pdf+html
[17] Parker, V., Giles, M., Lantry, G., and McMillan, M., 2012. "New Graduate nurses' experiences in their first
year of practise." Nurse Education Today,
[18] McKenna, L. and Newton, J. M., 2008. "After the graduate year: a phenomenological exploration of how
new nurses develo thier knowledge and skills over the first 18 months following graduation." Australian
Journal of Advanced nursing, vol. 25, p. 9‒15.
[19] Duclos, M. and Patricia, A., 2011. Successful graduate nurse transition meeting the challenge nurse leader.
[20] Karen Missen, Lisa McKenna, and Alison Beauchamp, 2014. "Graduate nurse program coordinators‟
perceptions of role adaptation experienced by new nursing graduates: A descriptive qualitative approach."
Journal of Nursing Education and Practice, vol. 4, p. 134.
[21] Dyess, S. and Sherman, R. O., 2009. "The First Year of Practice: New Graduate Nurses's Transition and
Learning needs." The Journal of Continuing Education in Nursing,
[22] Greenlees‒Rae, J., 2016. "Being Confident in Practice: A study on confidence in new graduate nurses."
Master in Nursing, Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington.
New Zealand.
[23] Ebrahimi, H., Hassankhani, H., Negarandeh, R., Gillespie, M., and Azizi, A., 2016. "Emotional Support for
New Graduated Nurses in Clinical Setting: a Qualitative Study." Journal of Caring Sciences, vol. 5, pp. 11–
21.
[24] Rhéaume, A., Clément, L., and LeBel, N., 2011. "Understanding intention to leave amongst new graduate
Canadian nurses: a repeated cross sectional survey." International Journal of Nursing Studies, vol. 48, pp.
490-500.
[25] Malouf, N. and West, S., 2010. "Fitting in: A pervasive new grduate nurse need." Nurse Education Today,
vol. 31, p. 488‒493.
[26] Laschinger, H., Finegan, J., and Wilk, P., 2009. "New Graduate burnout: The Impact of Professional
Practice Environment, Workplace Civility and Empowerment." Nursing Economics, vol. 27,
[27] Williams, F. S., 2013. "Influences on Transition to Practise Among New Nurses." Doctor of Philosophy,
Department of Nursing, East Carolina University. USA.
[28] Peterson, J. Z., 2009. "Job Stress, Job Stisfaction and Intention to Leave Among New Nurses." Doctor of
Philosophy, Graduate Department of Nursing Science, University of Toronto. Canada.
7. International Journal of Healthcare and Medical Sciences
164
[29] Boamah, S. A., Read, E. A., and Laschinger, H., 2016. "Factors influencing new graduate nurse burnout
development, job satisfaction and patient care quality: a time‒lagged study." Journal of Advanced Nursing,
vol. 73, p. 1182‒1195.
[30] Duchscher, J. B., 2009. "Transition Shock: the initial Stage of role adaptation for newly graduated
Registered Nurses." Journal of Advanced Nursing, vol. 65, p. 1103‒1113.