Experiences of Generation Z Nurses Adapting to Work in a Tertiary Hospital: A Grounded Theory Study.

AIM: To investigate the adaptation process of Generation Z nurses at a tertiary hospital in Korea. DESIGN: This qualitative study using grounded theory. METHODS: The participants were 17 Generation Z nurses who were working at tertiary hospitals in Korea. Data were collected through in-depth interviews from September 2022 to July 2023. FINDINGS: Eight categories and 19 concepts were extracted. The core category was 'accepting deficient myself as a nurse in a vertical culture', which consisted of three phases: chaos, endeavouring to adapt and accepting myself. In the adaptation process at the tertiary hospital, most of the participants felt embarrassed by tasks. The most of them tended to stay away from stressors and endeavour to improve their competence. The participants who had familiarity and a sense of belonging and achievement tended to acknowledge themselves. CONCLUSIONS: This study provides help in suggesting the importance of a horizontal organisational culture to Generation Z nurses. Also, the support of senior nurses is needed to encourage Generation Z nurses to accept deficient themselves. IMPLICATIONS FOR THE PROFESSION: Generation Z nurses tended to feel confused by the vertical culture, uncertainty of work and daunting tasks; excessive criticism and rebuke seems to make Generation Z nurses feel a sense of shame. The family-centred culture of nursing organisations could cause conflicts for Generation Z nurses who tend to separate their personal lives from work. IMPACT: Generation Z nurses had no difficulty acquiring knowledge because they had the skills to search for the necessary information, but they experienced difficulty applying this knowledge in practice and becoming familiar with their role as a nurse. REPORT METHODS: We adhered to relevant EQUATOR guidelines of the Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC INVOLVEMENT AND ENGAGEMENT: No patient or public involvement.

Nursing Leaders' Knowledge and Awareness of Bullying and Lateral Violence: A Qualitative Study.

Introduction: Bullying and lateral violence are prevalent phenomena within the nursing profession, exerting significant impacts on patient safety, the nursing profession and the organisation. The pivotal role of nurse leaders is paramount in both the prevention and resolution of these issues. Aim: The aim is to explore the level of awareness and knowledge of bullying and lateral violence of nurse leaders in a public hospital in Switzerland. Methods: A qualitative descriptive study has been conducted. Data were collected from February to August 2020 using semi-structured interviews and focus groups that were recorded and transcribed verbatim. Two researchers independently utilised Braun and Clarke's thematic analysis to code, categorise and synthesise the data. The sample of nursing middle-management leaders was purposive. Results: The study involved 35 nurse leaders as participants. Through data analysis, 15 themes were identified, which were further grouped into five major themes: characteristics of the phenomena, facilitating and hindering factors, emotions/experiences, strategies and supports. The results highlighted that nurse leaders may have a lack of knowledge about these phenomena, leading to challenges in their identification. The awareness achieved by the nurse leaders highlighted their need to understand what they were 'fighting against'. Conclusion: It is essential to consider the impact of these phenomena on employees' well-being and their potential consequences for patient safety, quality of care and financial performance. A preventive approach by increasing nurse leaders' competence in observing everyday working realities and identifying strategies for addressing bullying is required. Further research on the construction and implementation of specific interventions is essential, aimed at preventing and addressing these phenomena comprehensively.

Navigating Uncertainty with Compassion: Healthcare Assistants' Reflections on Balancing COVID-19 and Routine Care through Adversity.

The coronavirus disease 2019 pandemic created unprecedented challenges for healthcare systems around the world. Healthcare assistants played a vital role in the provision of frontline patient care during this crisis. Despite their important contribution, there exists limited research that specifically examines the healthcare assistant's experiences and perspectives of care provision during the COVID-19 pandemic. This study explored healthcare assistants' caring experiences and perspectives on resilience and self-efficacy during the COVID-19 pandemic in Hong Kong. A qualitative descriptive study with semi-structured interviews was conducted with 25 healthcare assistants from public hospitals. Interview recordings were analyzed using thematic analysis. Five main themes emerged from the data: frontline reinforcement: supporting HCAs through resourcing and education amidst the COVID-19 crisis, confronting uncertainty: building personal fortitude in the face of the COVID-19 pandemic, fostering collective resilience through shared support, self-efficacy as a catalyst for adaptive growth, and paving the way for transformation. These findings advocate for the resilience and self-efficacy of healthcare assistants; this may potentially strengthen healthcare system preparedness for navigating unpredictable challenges in the future.

Nurses' Roles in Artificial Intelligence Implementation: Results from a Mixed-Methods Study.

We aimed to understand nursing informaticists' perspectives on key challenges, questions, and opportunities for the nursing profession as it prepares for an era of healthcare delivery enriched by artificial intelligence (AI). We found that nursing practice is currently, and will continue to be, directly influenced by AI in healthcare. Educating and training nurses so that they may safely and effectively use AI in their clinical practice and engage in implementation planning and evaluation will help overcome predicted challenges. Defining the key tenets of AI literacy for nurses and re-envisioning nursing models of care in the context of AI-enriched healthcare are important next steps for nursing informaticists. If embraced, AI has the potential to support the existing nursing workforce in the context of major shortages and augment the safe and high-quality care that nurses can deliver.

Effectiveness of interventions for the prevention or management of workplace violence in student nurses during clinical placement: A systematic review.

AIM: To systematically investigate the effectiveness of interventions for managing workplace violence experienced by registered nursing students during clinical placement. DESIGN: A systematic review of experimental studies. METHODS: The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The key search concepts such as "Nursing students", "Education", "workplace violence", "clinical placement" and "clinical study" were inspected to identify relevant articles (Appendix A). Two independent reviewers completed screening, critical appraisal and data extraction. Due to heterogeneity among the included studies, results were synthesized narratively. DATA SOURCES: MEDLINE (Ovid), CINAHL (EBSCOhost), Web of Science Core Collection (Clarivate Analytics), Scopus (Elsevier), Embase (Ovid), Cochrane CENTRAL, ERIC (ProQuest), ProQuest Central and ProQuest Social Science Premium Collection were searched from inception to 27th February 2023. RESULTS: A total of 13 studies were included in this review. The predominant intervention for managing workplace violence experienced by registered nursing students during clinical placements was education. Approaches varied among studies and included didactic teaching, e-learning, role-playing and simulation practice. The included studies showed uncertain improvements in registered nursing students' confidence, coping skills, knowledge, competence and self-efficacy in dealing with workplace violence during clinical placements. Only one study assessed the incidence rate of workplace violence and found that a multi-faceted intervention involving both staff and students decreased the incidence. CONCLUSION: Given the heterogeneity of educational interventions, the effect of interventions for managing workplace violence during students' clinical placement is uncertain. To address this gap, high-quality, proactive and combined interventions at both institutional and organizational levels are needed.

The social processes that emergency nurses use to achieve sustainability: A constructivist grounded theory.

AIM: To examine the experiences of emergency nurses and develop a substantive theory that describes the processes they use to support or prevent sustainability in their nursing practice. DESIGN: Constructivist grounded theory. METHODS: Between February 2018 and January 2019, observations and semi-structured interviews were conducted with 29 emergency nurses. Data underwent constant comparison, and coding was performed in three phases: open, focused, and theoretical, employing constructivist grounded theory. Additionally, some situational analysis mapping was undertaken and integrated as a method to explore the broader context affecting nursing practice. The study achieved theoretical saturation and rigour was ensured through evaluations of credibility, transferability, and confirmability. RESULTS: A substantive grounded theory was constructed to describe the basic social process of 'Achieving Personal and Professional Sustainability' with subprocesses that included 'Driving forces', 'Developing and using armouries', 'Balancing work-life', and 'Making emergency work effective'. This theory delineates two phases, 'exploration and establishment' and 'maintenance', and two key properties: 'Constructing and evolving professional identity' and 'Perceiving and reshaping the meaning of effective work and care'. The theory also highlights the dynamic interplay of individual, social, and institutional elements. CONCLUSION: 'Achieving Personal and Professional Sustainability' is important for emergency nurses to sustain themselves personally and professionally in their work. IMPACT STATEMENT: This research has substantial and global impacts. Emergency nursing can use this information as a guide to better understand strategies for both personal and professional sustainability. Policymakers may use the findings to foster a supportive work environment and enhance nurse well-being. Implementation of recommendations can lead to improved patient care outcomes. The methodological approach offers potential for future research, positively impacting emergency nursing practice and workforce sustainability worldwide. REPORTING METHOD: Reporting adheres to EQUATOR's COREQ guidelines for qualitative studies. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Digital Skills, STEM Occupation, and Job Automation Risks Among the Older Workers in the United States.

BACKGROUND AND OBJECTIVES: Advancing automation technologies are replacing certain occupations such as those involving simple food preparation more than occupations such as those in STEM fields (e.g., engineering and health care). Older workers generally face higher job automation risks in part due to their lower levels of digital skills. A better understanding of the associations between job automation risk, digital skills, and type of occupation (e.g., STEM vs non-STEM) can facilitate preparations for job automation and workforce population aging. RESEARCH DESIGN AND METHODS: We analyzed a nationally representative sample (N = 1,560) of middle-aged and older U.S. workers aged 50-74 years from the 2012/2014/2017 Program for International Assessment of Adult Competencies (PIAAC) restricted-use file. The estimated job automation risks (i.e., percentage of jobs to be automated in the next decades) were derived from the previous studies. PIAAC digital problem-solving skills proficiency (measured on a scale of 0-500 points) was assessed based on a series of practical digital tasks (e.g., finding a job research website that does not require registration). RESULTS: Linear regression analysis showed that greater digital skill proficiency (b = -0.04, p < .05) and STEM occupations (b = -17.78, p < .001) each were associated with lower job automation risks, even after adjusting for a series of demographic, socioeconomic, and civic engagement characteristics. DISCUSSION AND IMPLICATIONS: Education and labor policy interventions to promote digital skills among older workers and non-STEM workers may better prepare an aging workforce for the dynamic labor market needs in the United States.

The role of evidence-based practice and empathy in shared decision-making attitudes among newly graduated nurses: A cross-sectional study.

AIM: Examine the levels of variables and explore drivers associated with shared decision-making attitudes among newly graduated nurses. DESIGN: This was a descriptive and cross-sectional study. METHODS: From August 2022 to October 2022, a cross-section of 216 newly graduated nurses from four comprehensive A-level hospitals in northern China was recruited using convenience sampling. Newly graduated nurses are generally defined as nurses with a service period of six months to one year. Data were collected using an online questionnaire support platform, including the Nursing Shared Decision-Making Attitude scale, Jefferson scale of Empathy-Health profession students and the Health Sciences Evidence-Based Practice questionnaire. All data were analysed descriptively, and correlational analysis and hierarchical regression were used to make identical connections between variables. RESULTS: Newly graduated nurses supported shared decision-making. Perceptions of shared decision-making were correlated with the experiences of empathy and evidence-based practice. Additionally, perspective-taking of empathy and beliefs, and the ability to search for and apply existing scientific findings of evidence-based practice had a significant impact on more positive attitudes. CONCLUSION: The survey showed that acceptance of shared decision-making was positive among newly graduated nurses. Clinical nursing managers and teachers should pay attention to cultivating the evidence-based practice and empathy of newly graduated nurses to adopt an optimistic attitude towards shared decision-making in the long term. IMPACT: The survey addresses attitudes of shared decision-making among newly graduated nurses and determines whether empathy and evidence-based practice has an impact on it. The main finding is that newly graduated nurses have an optimistic outlook on the implementation of shared decision-making. This survey showed that empathy and evidence-based practice competencies are associated with shared decision-making attitudes among newly graduated nurses. The results of this survey have an impact on educational institutions and hospitals in the form of recommendations. Several training programmes on empathy and evidence-based practice can help adopt the shared decision-making attitudes of newly graduated nurses. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

"I Like the Feeling of Connecting With People": A Mixed-Methods Study of Nursing Assistants Experiences Across the Care Continuum.

Nursing assistants (NAs) are critical professionals across the long-term care continuum. Despite the demands of NAs, these frontline personnel experience workplace challenges and turnover at a disproportionate rate compared to other professionals. Much research has explored the experiences of nursing assistants using federal survey data and national datasets. Guided by a socio-ecological model and the job-demands resource model, this study utilized a sequential mixed-methods approach to uncover a more nuanced understanding of NA workplace experience. Results from this combined qualitative (N = 17) and quantitative (N = 354) study found that there are several workplace aspects, such as organizational culture and supervisor relationships, that contribute to NA experiences across system levels. Further exploration of direct care tasks directly from nursing assistants is necessary to understand full intentions.

Workforce strategies to address children's mental health and behavioural needs in rural, regional and remote areas: A scoping review.

INTRODUCTION: Children living in rural, regional and remote locations experience challenges to receiving services for mental illness and challenging behaviours. Additionally, there is a lack of clarity about the workforce characteristics to address the needs of this population. OBJECTIVE: To scope the literature on the rural, regional and remote child mental health and behavioural workforce and identify barriers and enabling mechanisms to mental health service provision. DESIGN: A scoping review utilising the Joanna Briggs Institute methodology. A database search was undertaken using Medline, CINAHL, PsycINFO, ProQuest and Scopus to identify papers published 2010-2023. Research articles reporting data on mental health workforce characteristics for children aged under 12 years, in rural, regional or remote locations were reviewed for inclusion. FINDINGS: Seven hundred and fifty-four papers were imported into Covidence with 22 studies being retained. Retained studies confirmed that providing services to meet the needs of children's mental health is an international challenge. DISCUSSION: The thematic analysis of the review findings highlighted four workforce strategies to potentially mitigate some of these challenges. These were: (1) The use of telehealth for clinical services and workforce upskilling; (2) Role shifting where non mental health professionals assumed mental health workforce roles; (3) Service structure strategies, and (4) Indigenous and rural cultural factors. CONCLUSION: A range of potential strategies exists to better meet the needs of children with mental health and behavioural issues. Adapting these to specific community contexts through co-design and production may enhance their efficacy.

Transforming health care delivery: The role of primary health care nurses in rural and remote Australia.

AIM: This paper describes the policy context and approaches taken to improve access to primary health care in Australia by supporting nurses to deliver improved integrated care meeting community needs. CONTEXT: In Primary Health Care (PHC), the nursing workforce are predominantly employed in the general practice sector. Despite evidence that nurse-led models of care can bridge traditional treatment silos in the provision of specialised and coordinated care, PHC nurses' scope of practice varies dramatically. Nurse-led models of care are imperative for rural and remote populations that experience workforce shortages and barriers to accessing health care. Existing barriers include policy constraints, limited organisational structures, education and financing models. APPROACH: The Australian Primary Health Care Nurses Association (APNA) received funding to implement nurse-led clinics as demonstration projects. The clinics enable PHC nurses to work to their full scope of practice, improve continuity of care and increase access to health care in under serviced locations. We reviewed a range of peer-reviewed literature, policy documents, grey literature and APNA provided sources, particularly those relevant to rural and remote populations. We argue more focus is needed on how to address variations in the scope of practice of the rural and remote PHC nursing workforce. CONCLUSION: Despite growing evidence for the effectiveness of nurse-led models of care, significant policy and financial barriers continue to inhibit PHC nurses working to their full scope of practice. If their potential to transform health care and increase access to health services is to be realised these barriers must be addressed.

Advanced Practice Nurses and Their Roles in Swiss Cancer Care: A Cross-Sectional Study.

OBJECTIVES: To examine the advanced practice nurse workforce in Swiss cancer care and how their roles are being implemented (eg, role structures, processes) to achieve optimal outcomes for patients and their families, care organizations, and the broader health care system. METHODS: A cross-sectional study was conducted. The sample included master-prepared advanced practice nurses in cancer care, who completed an online questionnaire from December 2021 to January 2022. Thirty-nine items assessed structures (eg, role characteristics, utilization), processes (eg, role activities, interventions), and perceived outcomes (eg, for patients, the health care system) of advanced practice nurses in Swiss cancer care. Data from closed questions were analyzed using descriptive statistics. Data from open-ended questions were organized and summarized into categories related to domains of advanced practice nursing and its reported frequency by the advanced practice nurses. RESULTS: The participating advanced practice nurses (n = 53), worked in half of the 26 Swiss cantons. Interventions were identified within nine categories, of which most were targeted to patients and their families (n = 7), followed by health care professionals (n = 2). Perceived positive outcomes were patient symptom management, length of hospital stay, and health care costs. Participants felt less confident in cancer care (eg, autonomous practice) and reported 15 professional development needs (eg, medical interventions, teaching). CONCLUSIONS: This study provides a comprehensive examination of 53 advanced practice nurses, detailing the characteristics of their roles and utilization across various jurisdictions and health care settings. The results highlight the diverse dimensions of advanced practice nursing and its potential to enhance cancer services and outcomes in Switzerland. Opportunities for role development support and expansion are identified. IMPLICATIONS FOR NURSING PRACTICE: More systematic health human resource planning is needed to expand the deployment of advanced practice nurses across jurisdictions, practice settings, and more diverse patient populations. Role development needs show the desire for specialized educational preparation in cancer care.

Nurses' use of 'wellness' supplements during the COVID-19 pandemic in the United States.

AIM: Quantify disparities and identify correlates and predictors of 'wellness' supplement use among nurses during the first year of the pandemic. DESIGN: Longitudinal secondary analysis of Nurses' Health Studies 2 and 3 and Growing Up Today Study data. METHODS: Sample included 36,518 total participants, 12,044 of which were nurses, who completed surveys during the first year of the COVID-19 pandemic (April 2020 to April 2021). Analyses were conducted in March 2023. Modified Poisson models were used to estimate disparities in 'wellness' supplement use between nurses and non-healthcare workers and, among nurses only, to quantify associations with workplace-related predictors (occupational discrimination, PPE access, workplace setting) and psychosocial predictors (depression/anxiety, county-level COVID-19 mortality). Models included race/ethnicity, gender identity, age and cohort as covariates. RESULTS: Nurses were significantly more likely to use all types of supplements than non-healthcare workers. Lacking personal protective equipment and experiencing occupational discrimination were significantly associated with new immune supplement use. Depression increased the risk of using weight loss, energy and immune supplements. CONCLUSION: Nurses' disproportionate use of 'wellness' supplements during the COVID-19 pandemic may be related to workplace and psychosocial stressors. Given well-documented risks of harm from the use of 'wellness' supplements, the use of these products by nurses is of concern. IMPACT: 'Wellness' supplements promoting weight loss, increased energy, boosted immunity and cleansing of organs are omnipresent in today's health-focused culture, though their use has been associated with harm. This is of added concern among nurses given their risk of COVID-19 infection at work. Our study highlighted the risk factors associated with use of these products (lacking PPE and experiencing occupational discrimination). Findings support prior research suggesting a need for greater public health policy and education around the use of 'wellness' supplements. REPORTING METHOD: STROBE guidelines were followed throughout manuscript. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was involved.

Considering the impact of shift working on health.

Shift work is necessary for the provision of health services, especially in hospitals as it is the only way to provide continuous care to patients. Working at night is inconsistent with the body's biological clock and night shift working hugely disrupts the circadian and sleep wake cycles. In 2020, the World Health Organization classified night shift working as being a 'probable' class 2A carcinogen and a number of independent cohort studies of both night workers and shift workers have observed increased incidence of certain cancers. Altered sleep timing, food timing and light exposure typical for shift workers leads to an acute circadian disruption and misalignment of regulatory hormones. This straying from synchronisation has been shown to result in individuals being more vulnerable to a number of chronic health conditions. Night shift work disrupts the normal sleep-wake cycle, often leading to shortened sleep duration and excessive fatigue and the results of this are far reaching. This article will explore the full impact of shift working, questioning if current practices employed within the NHS should continue.

Student nurse retention. Lived experience of mature female students on a UK Bachelor of Nursing (Adult) programme: An interpretative phenomenological analysis.

AIMS: To explore the lived experiences of mature female students undertaking a Bachelor of Nursing (Adult) programme in the UK, to gain insight into the challenges and barriers faced by students and investigate the factors that support students who have considered leaving, to stay and continue with their studies. BACKGROUND: There is a global shortage of nurses and challenges exist in ensuring that enough nurses are available to provide care in the complex and rapidly changing care environments. Initiatives introduced to increase the number of Registered Nurses (RN), include increasing the number of students enrolled on pre-registration nursing programmes. However, the success of this intervention is contingent on the number of students who go on to complete their course. DESIGN: This qualitative study employed Interpretative Phenomenological Analysis (IPA), which provided a methodological framework and analytical approach to enable an exploration of participants' individual and shared lived experiences. METHODS: Eight female, mature students at the end of their second year of a Bachelor of Nursing (Adult) programme at a Higher Education Institution in South Wales participated in semi-structured, face-to-face interviews, which were analysed idiographically before group-level analysis was undertaken. FINDINGS: The analysis revealed three superordinate themes: 'Ambition to become a Registered Nurse'; 'Jugging Roles' and 'Particular Support Needs for a Particular Student'. CONCLUSION: Each student had a unique history, their past and present social and psychological experiences were multifaceted and complex. These differences resulted in varying degrees of resilience and motivations to continue their studies. These findings are important for ensuring that services develop and provide effective support to maximize retention and, ultimately, increase the number of students entering the RN workforce. PATIENT OF PUBLIC CONTRIBUTION: No patient or public contribution. IMPACT STATEMENT: This research expands on current literature regarding the needs of mature female students, a growing student nurse demographic. Every student had a dynamic set of circumstances and demonstrated that the identification of 'at-risk' students, purely based on demographics or information on a Curriculum Vitae, is problematic and potentially futile. This knowledge could be used to tailor University support systems and inform curriculum development and support systems for maximizing student retention. These findings are important for ensuring that services continue to develop and provide effective support to maximize retention and completion and, ultimately, increase the number of students entering the Nursing and Midwifery Council register.

Individual, family, job, and organizational factors associated with retirement intentions among older long-term care workers: A systematic review.

This systematic review synthesized prior quantitative research on individual, family, job, and organizational factors associated with retirement intentions (RI) among older long-term care (LTC) workers. Seven databases were searched for peer-reviewed studies. RI were defined as early (<65 years) or late (>65 years). To assess the methodological quality, we used JBI's checklists. The PRISMA statement guided this review. After duplicates were removed, 4 489 records were identified. A final sample of six articles was selected as eligible for inclusion. Current findings show weak social support, high physical job demands, and type of LTC occupation as important determinants for early RI. Strong social support and good job resources are important determinants fore late RI. In contrast to earlier research on other groups of older workers, this review shows no statistically associations between health nor emotional job demands and early RI for LTC workers. The results are discussed using the JD-R theory.

The role of healthcare leaders in implementing equitable clinical academic pathways for nurses: An integrative review.

AIM: To identify and synthesize empirical evidence on the role of healthcare leaders in the development of equitable clinical academic pathways for nurses. DESIGN: Integrative literature review. DATA SOURCES: Literature was searched using CINAHL, PubMed, ProQuest and Google Scholar databases. REVIEW METHODS: A total of 114 eligible articles published between 2010 and2022 were screened, 16 papers were selected. RESULTS: Results highlighted the need for consistent national, regional, and organizational policy approaches to developing clinical academic careers for nurses. Government health departments and National Health boards must focus on increasing engagement in research and evidence-based nursing practice for high-quality patient care. Discriminatory practices and attitudes were identified as barriers. Discrimination due to gender was evident, while the impact of race, ethnicity, and other social categories of identity are under-researched. Educational leaders must unravel misconceptions about research, highlighting its relevance to patient care and bedside nurses' work. Academic leaders together with executive nurses, research funders and professional nursing bodies must create appropriately remunerated career structures. Transformative approaches are required to develop the clinical academic nurse role and understand its value in clinical practice. CONCLUSION: Multiple elements exist within complex systems that healthcare leaders can navigate collaboratively to develop and implement clinical nurse academic roles. This requires vision, acknowledgement of the value of nursing research and the importance of evidence-based research infrastructures. IMPACT: Findings highlight the collaborative role of healthcare leaders as critical to the success of critical academic careers for nurses. This review can inform those still to formalize this innovative role for nurses. REPORTING METHOD: The review complies with the PRISMA guidelines for reporting systematic reviews. This paper contributes evidence about the healthcare leader's role in developing clinical academic pathways for nurses to the wider global clinical community. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was included in this review.

Investigating the impact of temporary nurses on permanent nurses' commitment via perceptions of illegitimate tasks: A cross-sectional study.

AIMS: To explore illegitimate tasks as a potential mechanism that links permanent nurses' perceived exposure to temporary nurses to lower levels of affective organizational commitment. DESIGN: A time-lagged cross-sectional survey study. METHODS: Survey data from N = 239 permanent nurses in the German-speaking part of Switzerland were analysed via Structural Equation Models. RESULTS: The study revealed a negative relationship between permanent nurses' perceived exposure to temporary nurses and their level of organizational commitment that was mediated by perceptions of unreasonable and unnecessary tasks. CONCLUSION: Healthcare institutions increasingly depend on temporary nurses to fill staffing vacancies. Our data suggest that the deployment of temporary nurses may have adverse effects on permanent nurses' affective organizational commitment via perceptions of illegitimate tasks. IMPACT: Our quantitative survey study provides a novel, theory-driven understanding of how perceived exposure to temporary nurses may impact work-related attitudes of permanent nurses. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Our findings suggest that the clinical community should limit permanent nurses' exposure to temporary nursing staff to protect their commitment. If this is not possible, we encourage strategies to counteract associated feelings of illegitimacy, for example, by showing appreciation for permanent nurses' willingness to take over responsibility for temporary nurses. REPORTING METHOD: The study adheres to the STROBE reporting guidelines for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Solving the shortage of psychiatric - mental health nurses in acute inpatient care settings.

INTRODUCTION: This debate essay proposes possible remedies to the shortage of nurses in acute inpatient mental health settings and draws inspiration from a Journal of Psychiatric and Mental Health Nursing editorial, Glascott and McKeown (2022, 29, 767). AIM: The aim is to stimulate debate within the profession. The art and science of nursing continues to develop but staffing shortages in key areas undermine practice, leadership, academic and policy efforts to improve the quality of care for people attending services. METHOD: This is a debate essay which draws on the authors' experience and presents ideas based on extant literature. RESULTS: Organisational, professional and wider societal challenges are explored. Practice-based solutions as well as recommendations for improving the terms and conditions of employment of nurses are made. Opportunities which may empower the nursing profession are promulgated. DISCUSSION: It is intended that this paper will provoke further discourse and may reflect the 'call to action' advocated by Glascott and McKeown (Journal of Psychiatric and Mental Health Nursing, 2022, 29, 767). IMPLICATIONS FOR PRACTICE: While the focus is on acute inpatient mental health nursing, the ideas presented may have an application to wider nursing groups or a wider cadre of public sector workers.