Relationships among meal time, break time and workplace characteristics of nurses who work day, evening and night shifts: a cross-sectional study.

Objectives. This study aimed to examine the relationships among shift-working nurses' meal time, break time and workplace characteristics. Methods. The cross-sectional study analyzed 351 questionnaires from 117 nurses who worked three shifts, drawn from eight nursing units in two tertiary hospitals located in South Korea. Meal time and break time during work were investigated through a questionnaire that participants completed immediately after the end of each shift. Regression analysis was conducted to investigate the associations between nurses' work characteristics and meal time and break time. Results. Meal time and break time were less than 30 min on all shifts and significantly longer on the night shift than on the other shifts. As patients' average length of stay increased, meal time increased on day and night shifts, while break time decreased on evening shifts. Overall, a higher nursing staff-to-patient ratio was associated with shorter meal and break times. Conclusions. It was found that nurses were not able to take proper time for meals and breaks while working. A realistic and specific strategy should be prepared to address this issue, with appropriate consideration of the specific characteristics of nurse staffing, patients' conditions and shifts.

Clinical nurses' patient safety competency, systems thinking and missed nursing care: A cross-sectional survey.

AIM: The aim of this study was to examine the relationships among patient safety competency, systems thinking and missed nursing care. BACKGROUND: Patient safety competency and systems thinking are important nurse attributes that promote patient safety. Missed nursing care is known to negatively impact patient safety. However, how nurses' patient safety competency and systems thinking relate to missed nursing care is unknown. METHODS: A cross-sectional survey design was used to collect data from nurses practicing in two general hospitals in South Korea. Data were collected between 3 March and 17 April 2020. Questionnaires were distributed to nurses providing direct care in general and specialty units. Patient safety competency, systems thinking and missed nursing care were measured using reliable and valid instruments. A total of 432 complete sets of data were used in final analysis. RESULTS: Higher patient safety competency of nurses was associated with lower missed nursing care. Systems thinking partially mediated the relationship between knowledge of patient safety competency and missed nursing care, and attitudes of patient safety competency and missed nursing care. CONCLUSIONS: The knowledge, skills and attitudes sub-scales of patient safety competency showed somewhat different effects in the relationship between missed nursing care and systems thinking, suggesting that each attribute may tap into a separate aspect of patient safety.

Turnover intention and retention of newly licensed nurses in their first job: A longitudinal study.

AIM: To examine newly licensed nurses' retention in their first job and factors related to their turnover. BACKGROUND: Newly licensed nurses have a high turnover rate within three years of entering their first job. INTRODUCTION: The factors affecting newly licensed nurses' turnover should be identified and prevented. METHODS: This longitudinal study tracked newly licensed nurses for three years. Data were collected online, and nurses could participate four times in the survey. The Kaplan-Meier method was used to estimate survival curves and to present nurses' retention. Cox proportional hazards regression model was used to analyze factors related to turnover. RESULTS: The estimated survival probabilities in nurses' first job at one, two, and three years were 0.927, 0.778, and 0.686, respectively. Nurses who reported turnover intention within one year in the first survey had significantly lower survival probabilities than those who did not have turnover intention. Turnover was more likely among male nurses. Turnover intention was associated with a significant increased likelihood of nurses leaving their first job. DISCUSSION: More than one third of newly licensed nurses left their first job within three years of employment. To reduce nurses' turnover, it is necessary to understand and manage turnover intention in advance. Specific steps should be taken to address male nurses' turnover. CONCLUSIONS: Turnover intention was the most powerful predictor of turnover. Further research should investigate reasons for turnover intention at the beginning of employment, and strategies to prevent turnover should be developed before nurses enter the workforce. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Newly licensed nurses with turnover intention at the beginning of their career should receive particular attention, and wellness programs should be prepared to promote retention.

Workplace sexual harassment toward male nurses in South Korea: a cross-sectional online survey.

BACKGROUND: Many studies have focused on sexual harassment of female nurses perpetrated by patients and coworkers. However, as males in a female-dominated occupation, male nurses are also at risk of being exposed to sexual harassment. The aim of this study was to examine the prevalence of workplace sexual harassment faced by male nurses in South Korea and to identify related factors. METHODS: A cross-sectional study was conducted using an online survey that recruited male nurses working in various general hospitals in South Korea. In total, 246 participants with at least 6 months of clinical experience enrolled in an online survey, and 155 male nurses were included in the final analysis. Data were collected from May 31, 2019 to July 26, 2020. Items on the questionnaire included sexual harassment experiences, nursing work environment, and general characteristics of the participants. Descriptive statistics were used to analyze participants' general characteristics and a negative binomial regression model was used to analyze predictors of workplace sexual harassment. RESULTS: The mean number of sexual harassment incidents was 3.2 ± 5.5. The majority (65.2%) of male nurses had experienced sexual harassment at least once at work. The negative binomial regression model in the study was found to be acceptable (likelihood ratio chi-square = 30.03, df = 18, p = .037). The perceived nursing work environment was the only significant predictor of sexual harassment towards male nurses (p = .001; incidence rate ratio = 0.37; 95% CI, 0.20-0.66). CONCLUSIONS: Nursing administrators must recognize that men in female-dominated occupation may experience sexual harassment in the workplace. Specific and realistic managerial policies and educational programs should be implemented to prevent workplace sexual harassment and improve the nursing work environment for male nurses.

Nurses' steps, distance traveled, and perceived physical demands in a three-shift schedule.

BACKGROUND: The physical job demands of hospital nurses are known to be very high. Although many studies have measured the physical activities of nurses subjectively using questionnaires, it remains necessary to quantify and measure nurses' physical activity at work using objective indicators. This study was conducted to address this gap in the literature by analyzing nurses' physical activity using both objective measurements and subjective perceptions. The number of steps, distance traveled, and actual work hours were measured during work, and the influence of related factors was analyzed. METHODS: Using a cross-sectional design, survey and activity tracking data were collected from nurses who worked in three shifts in two tertiary hospitals located in the capital region of South Korea. The participants comprised 117 nurses working in four different units (medical ward, surgical ward, intensive care unit, emergency room), and data from 351 shifts were used in the final analysis. Between-group differences in the main variables were analyzed using the t-test, the Mann-Whitney test, analysis of variance, or the Kruskal-Wallis test, as appropriate. The relationships were examined through multiple linear regression analysis. RESULTS: The average number of steps and distance traveled were greatest for nurses working in the emergency room, followed by the intensive care unit, surgical ward, and medical ward (in descending order). Younger nurses and those with shorter unit experience tended to have the greatest number of steps and distance traveled. CONCLUSION: Using activity trackers, this study derived physical activity measures such as number of steps and distance traveled, enabling an objective examination of physical activity during shifts. Nurses' level of physical activity differed depending on the type of nursing unit, nurses' age, and unit experience. These results suggest the need for support programs that are specific to the job demands of specific nursing units.

Male Nurses' Experiences of Workplace Gender Discrimination and Sexual Harassment in South Korea: A Qualitative Study.

PURPOSE: The purpose of this study was to explore male nurses' experiences of workplace gender discrimination and sexual harassment in South Korea. METHODS: Phenomenological qualitative methodology exploring male nurses' experiences was employed to collect data, and thematic analysis of the data was conducted. Research subjects were recruited by convenience and snowball sampling. Ten male nurses participated in individual in-depth interviews via mobile phone. Data were collected from June 15 to July 24, 2020. FINDINGS: Two themes were extracted that described male nurses' experiences of workplace gender discrimination and sexual harassment. In the first theme, "facing gender discrimination from various dimensions," nurses' thoughts and feelings regarding gender discrimination from various sources were expressed. The second theme, "experiencing sexual harassment at work as a man," presented experiences of sexual harassment as a male nurse and difficulties in being recognized as a victim. CONCLUSION: Gender discrimination and sexual harassment experienced by male nurses stem from a wide range of socio-cultural factors, ranging from individuals to organizations, and institutions. Therefore, this problem requires a correspondingly broad approach for improvement, such as making efforts to avoid classifying certain roles according to gender, developing new standards considering the specific experiences of men as victims of sexual discrimination and sexual harassment, and continuing training to increase social sensitivity and interest in the harm suffered by minorities in society.

The Influence of Social Support on the Relationship between Emotional Demands and Health of Hospital Nurses: A Cross-Sectional Study.

Social support reduces the negative results of emotional labor. A more detailed analysis should be performed to facilitate adequate social support for nurses. Therefore, this study was conducted to examine the relationships among nurses' emotional demands, social support, and health. A cross-sectional survey was conducted at two tertiary hospitals in South Korea. A sample of 117 nurses from eight units participated. Between-group differences in the main variables were analyzed using the t-test or Mann-Whitney test, and analysis of variance or the Kruskal-Wallis test. Nurses were classified into eight groups according to emotional demands and type of social support, and the effects of social support were analyzed based on mean scores. Greater social support from colleagues was associated with better health on all measures. However, greater social support from supervisors was associated with a higher incidence of burnout, stress, and sleeping troubles. Nurses' high emotional demands must be managed actively by hospitals to maintain and promote their health. Providing appropriate social support with consideration of the nurse's unit experience would help decrease the effects of emotional demands. Enhancing social support from nursing colleagues is a powerful way to manage the negative effects of nurses' emotional demands.

Nurses' Clinical Work Experience during Pregnancy.

The working environment of nurses contains numerous hazards that can be particularly harmful to pregnant women. In addition, pregnancy-induced changes can themselves cause discomfort. Therefore, it is necessary to analyze pregnant nurses' experiences of clinical work. This qualitative study analyzed data collected through in-depth interviews. From January to June in 2020, 12 shift-work nurses who had experienced pregnancy within three years were interviewed. The main question was "Could you describe your clinical work experience during pregnancy?" Qualitative data from field notes and transcriptions of the interviews were analyzed using Colaizzi's method. Six categories were extracted that described the nurses' clinical work experience during pregnancy, as follows: "enduring alone," "organizational characteristics of nursing," "risky work environment," "strengths that sustain work during pregnancy," "growth as a nurse," and "methods to protect pregnant nurses." Pregnant nurses experienced various difficulties due to physical and mental changes during pregnancy, and the clinical working environment did not provide them with adequate support. The findings of this study will be helpful for developing and implementing practical maternity protection policies and work guidelines.

Relationships among demands at work, aggression, and verbal abuse among registered nurses in South Korea.

BACKGROUND: In order to improve organizational culture and job outcomes, it is important to characterize and better understand the relationship between aggression and verbal abuse among nurses. PURPOSE: To examine the relationships among demands at work, aggression, and verbal abuse among nurses. METHODS: A cross-sectional study was conducted using survey data from three tertiary hospitals located in South Korea. Sixteen nursing units were selected and 378 nurses' data were used as the final sample. The relationships were examined by multiple linear or logistic regression analyses. FINDINGS: More than 70% of the nurses had experienced at least 1 type of verbal abuse. Higher physical aggression and hostility were significantly related to greater verbal abuse experience. CONCLUSION: To prevent the vicious cycle of victims becoming perpetrators, it is necessary to develop and implement concrete strategies to manage verbal abuse and aggression among nurse colleagues.

Relationships Between Nurse Staffing and Patients' Experiences, and the Mediating Effects of Missed Nursing Care.

PURPOSE: The aims of this study were to examine the relationships between nurse staffing and patients' experiences, and to determine the mediating effects of patient-reported missed care on the relationship between nurse staffing and patients' experiences. DESIGN: The study included 362 nurses and 208 patients from 23 nursing units of six hospitals in South Korea. METHODS: Nurse staffing was measured by patient-to-nurse ratios and by nurse- and patient-perceived staffing adequacy. Patients' experiences included adverse events, communication with nurses, and overall hospital rating. Patient-reported missed care was measured using the MISSCARE Survey-Patient with three domains: communication, basic care, and timely response. FINDINGS: Lower nurse-perceived staffing adequacy was associated with more patient-reported missed communication. Lower patient-perceived staffing adequacy was associated with more missed care and adverse events, and a lower likelihood of experiencing good communication with nurses and of giving a high overall rating to the hospital. Patient-reported missed care mediated the relationship between nurse staffing and patients' experiences. CONCLUSIONS: Nurse staffing adequacy, particularly as perceived by patients, was significantly associated with patient-reported missed communication and basic care, as well as patients' experiences. CLINICAL RELEVANCE: Appropriate nurse staffing is required to reduce missed care and to improve patients' experiences.

Workplace Violence and Job Outcomes of Newly Licensed Nurses.

PURPOSE: The purpose of this study was to examine the prevalence of workplace violence toward newly licensed nurses and the relationship between workplace violence and job outcomes. METHODS: An online survey was conducted of newly licensed registered nurses who had obtained their license in 2012 or 2013 in South Korea and had been working for 5-12 months after first being employed. The sample consisted of 312 nurses working in hospitals or clinics. The Copenhagen Psychosocial Questionnaire II was used to measure violence and nurse job outcomes. Multiple linear and logistic regression analyses were conducted to examine the relationship between violence and job outcomes. RESULTS: Verbal abuse was most prevalent (59.6%), followed by threats of violence (36.9%), physical violence (27.6%), bullying (25.6%), and sexual harassment (22.4%). Approximately three quarters of the nurses had experienced at least one type of violence. The main perpetrators were patients and nurse colleagues, although the distribution of perpetrators varied depending on the type of violence. Bullying had a significant relationship with all four job outcomes (job satisfaction, burnout, commitment to the workplace, and intent to leave), while verbal abuse was associated with all job outcomes except for intent to leave. Violence perpetrated by nurse colleagues had a significant relationship with all four job outcomes, while violence by physicians had a significant inverse relationship with job satisfaction. CONCLUSIONS: Workplace violence is experienced by a high percentage of newly licensed nurses, and is associated with their job outcomes.

Average hospital length of stay, nurses' work demands, and their health and job outcomes.

PURPOSE: To examine the relationship between average hospital length of stay (LOS) of nursing units and work demands perceived by nurses, and between work demands and nurses' health and job outcomes. DESIGN: A cross-sectional study using nurse survey data collected in a tertiary university hospital in Seoul, South Korea, in 2013 including 746 staff nurses working on 36 general, oncology, or intensive care units. METHODS: Each unit's average LOS was categorized as short (1st quartile), medium (2nd and 3rd quartiles), or long (4th quartile). Work demands (i.e., quantitative demands, work pace, and emotional demands), and nurses' health and job outcomes were measured using the Copenhagen Psychosocial Questionnaire II. Their relationships were examined by multiple linear or logistic regression analyses with multilevel modeling. FINDINGS: The nurses reported high mean scores of work demands and poor health and job outcomes, compared with other occupations. The nurses working on units with a short or medium (vs. long) LOS perceived higher quantitative and emotional demands, and a higher work pace. Greater quantitative and emotional demands were associated with poor self-rated health, greater sleeping troubles, work-family conflict, stress and burnout, lower job satisfaction, and a greater intent to leave. A higher work pace was also significantly related to greater work-family conflict. CONCLUSIONS: A shorter LOS was associated with higher work demands, and higher work demands were associated with worse nurse outcomes. Thus, excessive work demands should be avoided to prevent nurses' health and job outcomes from deteriorating. CLINICAL RELEVANCE: Nurse managers need to monitor the impacts of reducing LOS on work demands and nurse outcomes and request additional nurses to meet increasing work demands.