Unveiling the challenges encountered by newly graduated nurses during night shifts:A descriptive qualitative study

Objectives:Newly graduated nurses commence night shifts during a phase of heightened vulnerability to reality shock,exacerbating the challenges faced by these graduates.Therefore,this study aimed to identify the challenges experienced by newly graduated nurses when undertaking night shifts in order to help identify a strategy for supporting their adaptation to these shifts.Methods:Semi-structured personal interviews were used to collect data.Fifteen newly graduated nurses were selected to participate in the study by purposive sampling method from November 2021 to March 2022 in one of four general hospitals situated in the southwestern region of Japan.Semi-structured interviews were analyzed by using thematic analysis.Results:The analysis revealedfive central themes and nine subthemes:challenges in task efficiency(task organization challenges,challenges in time-constrained task performance),challenges in responding to patients’changing conditions(challenges in responding to patients’irregular conditions,challenges in responding to nighttime changes in patients’behaviors),challenges in independent practice(challenges in engaging in independent nursing practice,challenges in dealing with unexpected events),challenges in establishing collaborative relationships(challenges in working closely with other staff,challenges in establishing collaborative relationships during night shifts with limited resources),challenges in adapting to shift work(challenges in managing physical conditions for shift work).Conclusions:Newly graduated nurses often encounter challenges in performing their tasks during the transition period.When working night shifts,they face additional hurdles unique to nocturnal duties.Thefindings underscore the necessity for these graduates to develop night shift-specific readiness to effectively navigate the demands inherent in such work schedules.

应用文本挖掘方法分析患者跌倒发生的方式和原因

目的本研究旨在探讨从护士角度审视患者跌倒事件中患者、环境和护士实践的相互作用。方法从日本优质保健委员会项目设立的数据库中检索2016-2020年由护士登记的患者跌倒事件报告,并进行回顾性审查。逐字提取“跌倒的背景”中的文字描述,并采用文本挖掘的方法进行分析。结果共分析了4176例患者跌倒事件报告。这些跌倒事件中,79.0%是护士没有亲眼目睹的,8.7%发生在直接护理期间。通过文件聚类分析,共确定了16个集群。4个集群与患者状况有关,如患者的生理/认知功能下降、失去平衡、以及使用催眠剂和精神药物。3个集群与护士实践有关,其中包括缺乏对实际情形的认识、依赖于患者家属、以及护理程序执行不到位。6个集群与患者和护士有关,包括患者徒劳地使用床头警报器和呼叫铃、穿着不合适的鞋子、使用助行器和床栏杆方面存在问题、以及护士对患者的日常生活活动能力了解不足。1个集群为与椅子有关的跌倒,同时涉及患者和环境因素。2个集群同时涉及患者、护士和环境因素,这些跌倒发生在患者洗澡/淋浴或使用床边坐便器时。结论跌倒往往由于患者、护士和环境之间的动态相互作用引起。由于许多因素很难在短时间内改变,所以必须把重点放在护理和环境因素上,以预防和减少患者跌倒。其中,提高护士对患者跌倒的态势感知能力尤为重要,这影响着他们预防患者跌倒的决定和行动。

Students' perceptions of teaching factors that demotivate their learning in lectures and laboratory-based skills practice

Objectives: The objective of this paper is to report students' perceptions of factors that demotivated their learning in lectures and laboratory-based skills practice settings.Methods: A total of 23 students were recruited from the Bachelor of Nursing courses at three Japanese universities,using purposive sampling.A semi-structured interview was conducted with each participant between November 2017 and January 2018 to elicit their perceptions about which aspects of the teaching context demotivated their engagement in learning.The results were analyzed using thematic analysis.Results: Three themes were generated: a restrictive environment,discouraging attitudes and discouraging teaching approaches.Conclusions: To prevent students from experiencing demotivation,teachers in the nursing faculty need to manage learning resources more effectively,create a quiet and focused atmosphere to allow students to concentrate,and be enthusiastic about teaching.They also need to add value to their classes,help students to follow lectures,and ensure that the workload they give their students is appropriate.

Exploring factors that motivate nursing students to engage in skills practice in a laboratory setting:A descriptive qualitative design

Objectives:The aim of this study was to explore factors that motivate students to engage in skills practice in a laboratory setting,and to identify their motivation types and the regulatory styles.Methods:Semi-structured interviews were conducted with 23 nursing students from three universities between November 2017 and January 2018.A thematic analysis was used to identify factors associated with students’motivation to engage in skills practice in a laboratory.The types and the regulatory styles of student motivation were identified based on the self-determination theory.Results:Seven motivating factors were identified.These factors included the students’desire“to acquire the skills necessary to work as a nurse”,the“desire to improve skills in preparation for clinical practicum”,and their felt“obligations to patients as a nurse”.Moreover,“the impetus to study arising from the objective evaluation of oneself and others”and“wanting to pass the skills examination”motivated the students to engage in skills practice.A“learning environment that facilitates students’learning”and the“supportive involvement of educators”facilitated their learning.Based on the self-determination theory,the students were found to embrace extrinsic motivation with four regulatory styles of motivation,namely integrated,identified,introjected,and external regulation.Conclusions:Nurse educators should understand the motivating factors of students,and help students embrace a more internally controlled motivation by helping them envision their future careers as nurses,and by fostering their ethical duty to care for patients.