Purpose This study employs Giorgi's descriptive phenomenological approach to explore the experiences of retired military nurse officers transitioning to civilian hospitals and to identify the essential meanings and underlying structures of this transition.
Methods Eleven participants with over two years of military hospital experience, now employed in civilian hospitals, were recruited via snowball sampling. Data were collected through in-depth interviews conducted between December 2023 and March 2024.
Results Analysis using Giorgi’s four-stage method identified 257 meaning units, 37 central meanings, 12 themes, and six general structures: 1) Positive perceptions of the nursing profession, 2) Confusion due to lack of information, 3) Difficulty in adapting due to differences between military and civilian hospitals, 4) Self-blame for a lack of competence, 5) Struggles in finding a position suitable for one’s career, and 6) Satisfaction with freedom and a stable life.
Conclusion These findings emphasize the need for tailored transition programs, including job placement support, skill development, and cultural adaptation training. Socialization and communication programs can further aid integration and contribute to the professional growth. Additionally, a positive perception of nursing significantly influenced the decision to return to the workforce, highlighting the importance of fostering professional identity and confidence among transitioning military nurses.
Purpose This study identified the influence of self-leadership, managers’ authentic leadership, and nurses’ organizational culture relationships on hospital nurses‘organizational silence. Methods An explanatory sequential mixed-method study was conducted. For the quantitative portion, 138 nurses from seven hospitals participated. For the qualitative portion, ten nurses with high organizational silence scores were interviewed. Quantitative data were analyzed with SPSS/WIN 26.0. Qualitative data were analyzed by content analysis using NVivo 12.0. Results Quantitative results indicated that self-expectations and a relation-oriented culture explained 14.0% of the variance in acquiescent silence. The combined effect of rehearsal, constructive thought, and relational transparency associated with managers’ authentic leadership on prosocial silence was 15.0%. Qualitative results revealed eight primary themes related to organizational silence: 1) being unable to voice my opinion because I feel insignificant, 2) things that middle managers cannot say, 3) earnest managers, 4) receptive managers, 5) indifferent managers, 6) feeling of camaraderie, 7) selective silence based on performance, and 8) mandatory following of directives. Conclusion Programs to improve managers’ leadership skills and reduce hospital nurses’ organizational silence should be implemented consistently. Hospitals should strive to foster a positive and equitable organizational culture.
Purpose This study aimed to identify factors influencing nursing professionalism among outpatient nurses. Methods Data were collected through a self-evaluation survey of 157 nurses from general and tertiary hospitals in Seoul and Gyeonggi-do, Korea. Data were analyzed using independent t-tests, one-way ANOVA, Importance-Performance Analysis, Pearson correlation coefficients, and multiple regression analysis. Results The mean scores were as follows: importance, 3.29 out of 5; performance, 2.50 out of 4; role conflict, 3.23 out of 5; and nursing professionalism, 3.23 out of 5. There were statistically significant positive correlations between the importance (r=.32, p<.001) and performance (r=.38, p<.001) of nursing activities and professionalism. There were statistically significant negative correlations between role conflict and nursing professionalism (r=-.20, p=.014). Stepwise multiple regression analysis showed that the importance of nursing activities, performance of nursing activities, role conflict, working department, and sex explained 33.0% of outpatient nurses’ professionalism (F=8.66, p<.001). Conclusion The findings indicate educational system about important and highly accomplished tasks would be useful to improve nursing professionalism of outpatient nurses. Furthermore, reducing role conflicts by clearly distinguishing tasks is necessary to increase nursing professionalism.
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Purpose To investigate the influence of violence experience and response of coping with violence on professional QoL among emergency department. Methods This cross-sectional study, included 179 subjects. Data were collected online from June 24 to July 31, 2022, and were analyzed using independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple regression. Results In the compassion satisfaction category, the problem focused coping (β=.328, p<.001) was a significant influencing factor (adj. R2 =.103) (F=21.36, p<.001). In the burnout category, violence response (β=.460, p<.001), problem focused coping (β=-.306, p<.001), and violence experience (β=.151, p=.030) were significant influencing factors (adj. R2 =.288) (F=24.99, p<.001). In the secondary traumatic stress category, violence response (β=.587, p<.001) and emergency department career (β=.177, p=.011) were significant influencing factors (adj. R2 =.383) (F=41.90, p<.001). Conclusion To improve professional QoL, it is necessary to understand the current situation related to violence and prepare a coping support system and intervention to prevent violence experiences and reduce negative consequences related to violence for a safe working environment for emergency department nurses.
Purpose The purpose of this study was to develop and validate the Job Competency Scale (JCS) for insurance review nurses working in hospitals. Methods The initial items were generated through a literature review and interviews with 10 experts. The content validity of the items was evaluated through content validity and face validity tests. Data from 301 insurance review nurses working in hospitals were analyzed using item analysis, exploratory and confirmatory factor analysis, and convergent validity; reliability was tested using Cronbach’s ⍺. Results The final JCS consisted of 25 items and five factors (knowledge integration, professional ethics, communication and interpersonal relationship, information literacy and problem solving, self-development) that explained 72.4% of the variance. Confirmatory factor analysis indicated that the theoretical model comprising 25 items satisfied all goodness-of-fit parameters. Convergent validity was confirmed by the Task Performance Scale for insurance review nurses (r=.53, p<.001). The total Cronbach’s ⍺ score for scale was .94. Conclusion The JCS was found to be a reliable and valid instrument that can be used to measure the job competency of insurance review nurses working in hospitals.
Purpose This study examined hospital nurses’ perception of work-life balance, nursing work environment, nursing organizational culture, and job satisfaction before turnover, and compared differences in variables between current clinical nurses and non-clinical nurses. Methods This descriptive study involved 172 nurses with over six months experience, who changed jobs within the last 5 years in G Province. Data were collected from September 5th-22nd, 2022, and analyzed through independent t-test, one-way ANOVA, and Pearson correlation coefficient using SPSS/WIN 25.0 program. Results Total work-life balance (t=3.85, p<.001), work-family balance (t=4.79, p<.001), work-leisure balance (t=2.96, p=.004), work-growth balance (t=3.01, p=.003), and overall work-life balance (t=2.95, p=.004) in work-life balance, the role of professionalism (r=2.05, p=.042) and interpersonal relationships (t=2.59, p=.011) in job satisfaction, the relationship-oriented nursing organizational culture (t=2.68, p=.008), and the nurse-doctor relationship within the nursing work environment (t=2.51, p=.013) were all significantly higher among current clinical nurses than non-clinical nurses. Conclusion Hospital-level interventions should be established and implemented to improve work-life balance, the relationship-oriented nursing organizational culture, and job satisfaction through interprofessional relationships to retain hospital nurses.
Purpose This study is qualitative study using phenomenology approach of Colazzi, to identify meaning and essential structure of the hospitalization with Complex Regional Pain Syndrome (CRPS).
Methods: Experiential data were collected through in-depth interviews with 10 patients who had been hospitalized in hospital rehabilitation medical wards. The main question was ‘Could you describe your hospitalization experience with CRPS? Results: Five categories obtained were ‘Experience despair in the swamp of long suffering’, ‘A hospital system that only adherence to treatment procedures’, ‘There are aggravating factors all over the hospital environment’, ‘Finding support to cover the disease’, and ‘Cross the tunnel of pain with the medical staff’.
Conclusion: Patients with complex pain syndrome experienced extreme pain and sudden pain even after hospitalization, and were more aggravated due to treatment procedures and regulation systems. It is thought that multidisciplinary team approach nursing intervention is necessary to improve this situation.
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Purpose This study was to identify how a nursing management practicum was operated during the COVID-19 pandemic in Korea.
Methods: This study surveyed instructors teaching the nursing management practicum with a questionnaire covering five domains and 42 items. The data were analyzed using descriptive statistics and content analysis.
Results: The practicum was performed mainly by mixed methods (40.8% and 38.5%), in hospitals only (30.8% and 60.4%), online only (19.8% and 1.1%) in 2020 and 2021, respectively. The mixed methods were most frequently used for instructor teaching and conferences (43.9% and 58.3%). and the average teaching time per week was 9.40 and 8.69 hours per week, respectively. Taking charge in one to three core nursing skill items, 87.8% and 90.1% of the respondents each year performed face to face evaluation for the skills. Four to six out of 12 POs were covered by 58.2% and 54.9% of the participants, respectively, in 2020 and 2021. The greatest difficulty under the pandemic was securing students’ hospital assignments.
Conclusion: The nursing management practicum needs to adopt various digital technologies, and create new education models including hybrid ones combining both contact and untact methods to improve the educational effect for the post COVID-19 era.
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Purpose This study aimed to elucidate the situational context and describe the factors and attributes pertaining to occupational stress among hospital nurses in Korea.
Methods: Secondary data from focus group interviews conducted with 26 hospital nurses were analyzed using the content analysis method. Data were analyzed using Graneheim and Lundman’s content analysis method.
Results: Based on the job demand-resource theory, the contents were divided into two major themes: the “excessive job demands” and the “shortage of job resources”.
The first theme was summarized into the following four categories: excessive workload and work intensity, complex and difficult work demands, hazardous work environment, and role- and relationship-related conflicts. The second theme was summarized into the following five categories: inadequate staffing, insufficient education and training, lack of support system, poor monetary compensation, and low internal compensation.
Conclusion: The occupational stress factors of Korean hospital nurses can be summarized as excessive job demands and a lack job resources.
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Purpose This study examined patients’ call bell use and the relationship between call bell use and nursing care needs.
Methods: Nursing staff was asked to report patients’ call bell use during 15 shifts over five days in integrated nursing care wards. Nursing care needs were measured using summary scores of nursing activities and activities of daily living (ADLs). The relationship between call bell use and nursing care needs was analyzed using a zero-inflated negative binomial regression model.
Results: A total of 251 patients used call bells 235 times, with an average of 0.94 times per day. Only 72 patients (28.7%) used call bells once or more per day (range, 1~14 times), whereas the rest did not use call bells. Male gender, a high risk for falling, and a higher score on nursing activities were associated with a greater likelihood of using call bells. Pain and higher dependency on ADLs were associated with an increase in the frequency of call bell use.
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Purpose This study aimed to explore nurses’ experience in caring for COVID-19 patients.
Methods: A total of 10 nurses working in a COVID-19 ward of a public hospital in South Korea were recruited using purposeful sampling. Individual telephone interviews were conducted and then transcribed verbatim. Data were analyzed using qualitative content analysis.
Results: Two categories of nurses’ experience in caring for COVID-19 patients emerged; “unstable psychological status” and “adaptation and self-esteem”. “Shortage of staff due to the increase in infected people”, “poor environment due to the urgent construction of a COVID-19 ward”, “unstable operating system”, and “excessive demands and verbal abuse from patients” were “obstacles”, while “cooperation and consideration between colleagues” and “interest and support from the manager” were found to be “sources to boost morale” for nurses in caring for COVID-19 patients.
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Purpose The aim of this study was to explain the patient assessment experiences of the medical staff responsible for customer satisfaction and quality improvement at their respective medical institutions. Methods This was a qualitative study using a focus group with quality improvement or custom service department managers. Participants were selected using purposive sampling. Data collection was conducted with seventeen participants divided into three focus group interviews from July 3 to 5, 2017. Each interview took an average of 1 hour and 40 minutes. Transcribed data were analyzed using qualitative thematic analysis. Results Base on the analysis, four categories and eight themes were derived. The categories were: 1) what is the quality of hospital service? 2) between directionality and timeliness, 3) variations in recognition and application, and 4) changing in hospital culture Conclusion: The assessment of patient's experience has spread a patient-centered culture and elicited significant changes in the behavior of medical and hospital staff. However, the survey instruments and procedures for assessing patient experiences need to be continuously improved, and additional research is required to secure evidence related to patient experiences.
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Purpose To analyze the changes in nurse staffing grades and to estimate the revenue growth generated by applying government guidelines for improving nurses’ working conditions.
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Results: Grade 1 GHs increased from 6.9% in 2018 to 39.6% in 2020, whereas grades 6-7 decreased from 31.8% to 17.6%. NGHs with grades 6-7 decreased from 81.8% to 61.6%. GHs and NGHs with no reported staffing grades decreased from 10.6% to 0% and from 63.2% to 14.8%, respectively. The estimated annual revenue growth per nurse from inpatient nursing care fees resulting from 1-grade improvements in staffing was 1.44~7.26 million Korean won (KRW) and 1.25~9.75 million KRW for GHs and NGHs, respectively, while the results from night shift nursing fees were 2.37~5.54 million KRW and 2.20~5.14 million KRW for GHs and NGHs, respectively.
Conclusion: The increased revenues should be utilized to augment nurses’ wages and staffing levels as the guidelines recommend.
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Purpose The purpose of this study was to explore the experiences of the relationship between nurses working on comprehensive nursing care service wards and the inpatients on those wards.
Methods: The phenomenological research method was used. Participants in the study were seven women.
Data were collected through individual in-depth interviews from December, 2018 to January, 2019 Results: Five theme clusters were extracted that described nurses’ patient experiences for comprehensive nursing care service wards. They are “Expansion of relationship formation”, “Transition of place to provide nursing care”, “Expansion of communication”, “Maintaining professional boundaries” and “Realization of professional nursing”.
Conclusion: The results of this study provide a deep understanding and insight in to the nature for nurses on comprehensive nursing care service wards and patients' relationships. It is thought that active development of strategies to support positive relationships will enhance the quality of the comprehensive nursing care service wards and help improve patient care outcomes.
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Purpose The purpose of this study was to investigate the status of the near miss by nurses in small-medium hospitals and to identify the factors that affect the near miss.
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Results: Overall, 155 nurses (63.8%) experienced near misses during the previous 1 year. Among those who experienced a near miss, the medication-related error was the highest at 58.3%. As a result of the stepwise logistic regression analysis, the odds ratio over time work of over 3 hours increased near misses 2.48 (95% CI: 1.21~5.08) compared to the group without overtime.
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Purpose The purpose of this study was to identify the work activities of nurse-led rapid response teams (RRT).
Methods: For this study a methodological approach was used to identify work activities for nurse-led RRT. The study was conducted in two stages. The first step was to analyze the work activities of domestic nurse-led RRTs using the interview method, and then develop a questionnaire based on the results of the interviews. As a second step, field surveys were conducted by nurse-led RRT nurses to investigate importance and performance based on the developed questionnaire.
Results: Fifty-eight work activities were identified for nurse-led RRTs in the following nine core areas: advanced nursing practice, education, counseling, consultation, collaboration, ethical decision-making, research, evidence-based practice, and leadership.
Conclusion: The identified work activities for nurse-led RRTs will be used as basic data in nurse-led RRTs job description, developing job standards and can also serve as basic data for developing a nurse-led RRT educational curriculum. The results of this study suggest that follow-up research is needed to develop job standards based on the identified nurse-led RRT's work activities.
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Purpose To analyze the effects of average length of stay (ALOS) on RN staffing.
Methods: Public data of patient surveys collected 8 times between 1996 and 2016 were analyzed. The sample included 2,408,669 discharged patients from 2,266 general hospitals. The ALOS for each hospital was computed by dividing the sum of inpatient days by the number of discharges. RN staffing was defined as the number of RNs per 100 inpatients. ALOS was transformed into base-2 logarithmic values for regression analysis.
Results: ALOS decreased from 13.3 to 9.6 days.
Large hospitals in the capital region had the greatest reduction, from 15.7 to 7.4 days. RN staffing increased from 32.7 to 54.8 RNs per 100 patients. ALOS had an inverse relationship with RN staffing. Controlling for other factors, a 50% reduction in ALOS was associated with increases in RN staffing by 12.18 and 13.72 RNs per 100 inpatients in large hospitals in the capital region and elsewhere, respectively.
Conclusion: Hospitals may have to increase staffing to respond to the increased workload resulting from the shortened ALOS. It remains uncertain whether such increases in staffing were sufficient for the increased workload. Changes in ALOS should be taken into account when determining appropriate staffing.
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