AIM
To summarize existing research syntheses reporting newly graduated registered nurses' experiences of providing direct care in hospital settings.


DESIGN
Umbrella review.


DATA SOURCES
An extensive search of all relevant databases was conducted for research syntheses. Initial key terms included "new* nurse", "nursing care" and "hospital setting" in combination with index terms to find relevant literature.


METHODS
Critical appraisal, data extraction and summary were performed independently by two reviewers according to the Joanna Briggs Institute guidelines for undertaking umbrella reviews.


RESULTS
Nine research syntheses published between 2010 and 2019 and representing 173 studies were included following critical appraisal. The evidence was summarized in narrative form with supporting tables. Twenty-six sub-branches and seven main-branches were organized in a coding tree showing the structure of three overlapping themes: "Feeling a lack of competency", "Sense of emotional distress" and "In need of support".


CONCLUSIONS
Evidence demonstrates that newly graduated registered nurses' experiences of a lack of competency, emotional distress and need for support emerged as essential requirements for the provision of competent and safe direct care for the patient.


IMPACT
Newly graduated registered nurses face multiple challenges in the transition from student nurse to practicing nurse. Unmet expectations of being a newly graduated nurse might lead to low levels of job satisfaction, high attrition rates or missed nursing care. Nurse educators, leaders and policy makers should be mindful that newly graduated registered nurses' perceptions of professional and personal identity and degree of support influences newly graduated registered nurses' direct care provision.

Umbrella review: Newly graduated nurses' experiences of providing direct care in hospital settings.

To explore the mediating role of self‐esteem in the relationship between perceived organizational support and professional benefits among Registered Nurses in China.

Nurses' sense of organizational support, Self‐esteem and perceived professional benefits: A mediating model

Background High self-esteem can help people with disabilities overcome barriers and improve their mental health and well-being. This study sought to examine self-esteem levels among Saudis with physical disabilities based on socio-economic factors. It also aimed to determine the minimum weekly duration of physical activity performed by participants and examine its effects, along with those of other socio-economic factors, on participants’ self-esteem. Methods A participant sample (N = 582) consisting of Saudi individuals aged 33.78 ± 9.81 years with physical disabilities (males, n = 289; females, n = 293) was recruited to participate in this study. Levels of self-esteem were measured using the Arabic version of the Rosenberg Self-Esteem Scale. Results Compared to women, men demonstrated significantly higher levels of overall self-esteem, positive feelings, and negative feelings (p < 0.01). The respondents’ average levels of overall self-esteem (p < 0.001), positive feelings (p < 0.01), and negative feelings (p < 0.001) also varied by type of physical disability. Wheelchair-using participants had the highest values for self-esteem and positive feelings; cane-using participants or those who did not use mobility aids had the lowest values. Weighted least squares regression showed that weekly physical activity was the factor that most affected self-esteem (β = 0.002), followed by education level (β = 0.115), then type of mobility device used (β = −0.07). Conclusion Increased weekly physical activity, higher education levels, and the use of mobility aids were the factors likely to improve the self-esteem of Saudis with physical disabilities.

/pdf/increased-physical-activity-higher-educational-attainment-ur3bzqpc.pdf

Increased physical activity, higher educational attainment, and the use of mobility aid are associated with self-esteem in people with physical disabilities

Healthcare organizations worldwide face persistent challenges relating to turnover and intention to leave the nursing profession among registered nurses. Factors contributing to their retention and well-being at work include high job satisfaction, professional competence, and self-efficacy. Few multicenter studies have investigated these factors in relation to work experience in a Nordic context. Therefore, this study aimed to investigate job satisfaction, professional competence, and self-efficacy among registered nurses. 

pdf/job-satisfaction-professional-competence-and-self-efficacy-a-3h2aea9y6w.pdf

Job satisfaction, professional competence, and self-efficacy: a multicenter cross-sectional study among registered nurses in Sweden and Norway

Abstract Aim To explore newly graduated registered nurses' perceptions of their work situation and management of nursing care in complex patient situations after 18 months of work experience. Background Newly graduated registered nurses working in acute care hospital settings play a critical role in providing safe nursing care. Methods An explorative qualitative design, with four focus group interviews with 14 newly graduated registered nurses working in acute care hospital settings. Results One theme emerged: ‘Clarity and security in one's own nursing role despite facing challenges that hinder professional development’ and three categories: ‘Independency due to one's own efforts and experience’, ‘Well‐functioning teamwork’ and ‘Challenges in the work situation’. Conclusion After 18 months in the profession, the nurses were considered to be advanced beginners; at the same time, the most experienced nurses on their respective wards. They found it challenging and need to further develop competences concerning managing and organizing the nursing care of several complex patient situations or new patient groups, as well as supervising novice registered nurses and nursing students. Implication for Nursing Management Powerful and urgent action is needed to be taken by national healthcare policymakers as well a hospital and nurse managers to develop long‐term strategies to improve working conditions for newly registered graduated nurses.

/pdf/professional-development-among-newly-graduated-registered-95923au9.pdf

Professional development among newly graduated registered nurses working in acute care hospital settings: A qualitative explorative study

Abstract Background Novice nurses’ responsibilities are greater than what their actual level of competence can cope with. This can cause increased levels of stress, which many studies have shown is a factor resulting in reduced self-esteem, which affects not only the well-being of nurses but also the quality of care provided. Aims To investigate the relationship between the self-assessment of nursing competencies and self-esteem among novice nurses and the moderation role of the sociodemographic variables and intention to leave the nursing profession on this relationship. Material and methods A correlational cross-sectional study was performed using an online questionnaire. The study was conducted between July and October 2019 among 122 novice nurses. The study tool consisted of the Rosenberg Self-Esteem Scale, the Nurse Professional Competence Scale-Short Version, and metrics. Calculations were performed using SPSS Statistics, version 25. To approach research questions hierarchical multiple regression was performed. Results The self-esteem level of novice nurses have been identified as low. Novice nurses who declared their willingness to leave their profession had a higher level of self-esteem than nurses who did not declare this willingness. The highest-rated competencies were in the fields of nursing care and value-based nursing care, while the lowest were in the areas of development, leadership, and the organisation of nursing care. Correlations between postgraduate education and competencies in the majority subscales were revealed. The results showed a negative correlation between self-esteem and all subscales of the competence scale. Seniority and postgraduate education were important moderators in the relationship between some competence subscales and self-esteem. Conclusion Novice nurses present a low level of self-esteem. Nurses with a higher competence level showed lower self-esteem. Developing competencies at the beginning of one’s nursing practice, which is crucial for patients’ outcomes, should be accompanied by the strengthening of novice nurses’ self-esteem. KEY MESSAGES Novice nurses with a higher level of self-esteem more often declared their willingness to leave their profession. The results showed a negative correlation between self-esteem and all subscales of the competence scale. Seniority and postgraduate education are important moderators in the relationship between some competence subscales and self-esteem.

https://www.tandfonline.com/doi/pdf/10.1080/07853890.2022.2032820?needAccess=true

The relationship between perceived competence and self-esteem among novice nurses – a cross-sectional study

Abstract Aim. The purpose of the work is to present nursing care for a pediatric patient with extreme circulatory failure, assisted by a device to Extracorporeal membrane oxygenation (ECMO) in the Intensive Care and Post-Operative Care Unit (ICPOCU) based on the International Classification of Nursing Practice (ICNP®). Material and methods. The work uses the individual case method based on the following techniques: analysis of medical records, observation and measurement of vital signs. Results. The most common and most dangerous care problem that may occur during therapy in extreme circulatory failure is the risk of cardiac dysfunction [10037314]. In this situation, the only life-saving method is often to support the circulatory and respiratory systems with the ECMO method. Another care problem is the risk of pressure sores [10027337]. The main goal of nursing care is to prevent their creation by minimizing risk factors and monitoring the patient’s skin condition. The problem of bleeding risk was also identified in the analyzed case [10017268] due to the need for heparin treatment. The goal of care is to minimize the risk and possible effects of bleeding. Because of taking care of the newborn baby, it is very important in planning activities to take into account the needs and problems of carers. One of the diagnosed problems is caregiver stress [10024773]. Conclusions. Nursing care for a pediatric patient with extreme circulatory failure supported by ECMO apparatus due to the impact of blood circulation on the functioning of the whole body does not focus solely on cardiovascular problems.

/pdf/designing-nurse-care-for-a-child-with-extreme-cardiac-4qzjm0s6nv.pdf

Designing nurse care for a child with extreme cardiac failure in the Intensive Care and Post-Operative Care Unit based on the International Classification of Nursing Practice (ICNP)

/pdf/what-do-we-know-about-our-professional-self-government-of-34wvont4mu.pdf

What do we know about our professional self-government of nurses and midwives? Preliminary study

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The relationship between perceived competence and self-esteem among novice nurses – a cross-sectional study

Designing nurse care for a child with extreme cardiac failure in the Intensive Care and Post-Operative Care Unit based on the International Classification of Nursing Practice (ICNP)

What do we know about our professional self-government of nurses and midwives? Preliminary study