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Aim: The Late Career Nurse project examined views and characteristics of nurses working in New Zealand who were born before 1960. This paper focuses on the experiences of such nurses who undertake shift work., Background: The mean age of registered nurses in New Zealand has been rising steadily, and 40% are now aged 50 years or over. While there is substantial literature on the phenomenon and consequences of the ageing nursing workforce, little is known of the particular experiences of nurses aged over 50 years who work shifts., Method: An anonymous online survey was emailed to eligible nurse New Zealand Nurses Organisation members aged over 50 years in February 2012. Quantitative and qualitative analyses of the 3273 responses received were undertaken., Result: Over 45% of respondents worked shifts or flexible hours. While shift work suited many, others noted deleterious effects on family and social relationships, physical and mental health (notably sleep patterns and fatigue), and decreasing tolerance for shift work as they age. Poor scheduling practices were particularly detrimental., Conclusion and Implications for Nursing Management: Worldwide, workforce ageing means strategies are required to retain older nurses in the workforce. Improved scheduling practices including increasing access to flexible and part time work hours, and development of resources on coping with shift work are recommended., (© 2013 John Wiley & Sons Ltd.)

Aim: To examine an employer response to a government employment policy, the Nursing Graduate Guarantee (NGG), over a 2-year period (2008-2009 and 2009-2010)., Background: Healthcare organizations rely on a stable supply of nurses to meet their staffing needs. However, employment trends have indicated a propensity for part-time employment. The NGG was created to stimulate full-time employment of new graduate nurses in Ontario, Canada., Methods: A mixed methods design was used, which included online surveys and focus groups. All healthcare providers (n = 1198) were surveyed in 2008-2009 and 2009-2010. Each year, a sample of NGG employers participated in sector-specific focus groups., Results: Approximately 20% of potential healthcare employers participated in the NGG. Reasons for non-participation included lack of awareness of the initiative and lack of full-time jobs. Barriers to offering full-time employment to new graduates included lack of full-time vacancies and budget constraints., Conclusions: Employers perceive flexible staffing practices as a way to contain personnel costs but often at the expense of a stable full-time nursing workforce., Implications for Nursing Management: This research contributes to an understanding of employers' perspectives on full-time hiring and participation in a government employment policy., (© 2012 Blackwell Publishing Ltd.)

Aims: This paper explores the collaborative development of a Master's level advanced practice programme in the context of the radical reform and remodelling of the UK's National Health Service. Some of the educational, managerial and practice challenges are discussed., Background: Changes to education and training in response to key strategic reviews undertaken by the Greater Manchester Strategic Health Authority (North West of England) established a need to develop nurses and allied health care practitioners to advanced practitioner level. This paper considers how employers, commissioners and educationalists worked together to produce a Master's level programme to prepare nurses and other health care practitioners for sustainable advanced practice roles., Key Issues: Developing innovative and effective curricula to meet the needs of post graduate students from varied backgrounds preparing to practice in different contexts with different client groups is challenging. However, the development of individual learning pathways and work-based learning ensures that the student's work and intended advanced practice role remains at the centre of their learning. Analysis of each student's knowledge and skill deficits alongside an analysis of the organization's readiness to support them as qualified advanced practitioners (APs) is instrumental in ensuring that organizations are ready to support practitioners in new roles., Conclusion: Work-based learning and collaboration between students, employers and higher education institutions can be used to enable managers and students to unravel the network of factors which affect advanced practice in health and social care. Additionally, collaborative working can help to create opportunities to develop strategies that will facilitate change. Implications for nursing management Sustainable change concerned with the introduction of advanced practitioner roles present a real challenge for managers at a strategic and operational level. Commissioning flexible, collaborative and service-led educational programmes can assist in ensuring that change is sustainable and produce practitioners who are fit for practice, purpose and award.

Aims: This mapping study describes current or planned introduction of assistant practitioner roles in English National Health Service Acute Hospital Trusts., Background: In the last decade there has been a growth in nursing support workforce numbers and their scope of practice. An important United Kingdom support worker development is the Assistant Practitioner role., Method: A national census was carried out (April 2007) via an emailed questionnaire to Directors of Nursing. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using thematic analysis., Results: Eighty-five per cent (143/168) of Directors of Nursing, from all 10 English Strategic Health Authorities, responded. Forty-six per cent (n = 66) of Trusts had introduced assistant practitioners and 22% (n = 31) were planning to implement the role before 2009. There is wide variation in assistant practitioner numbers across and between Strategic Health Authorities, Trusts and clinical areas. Resistance to the role existed in 32% (n = 46) of Trusts. Reasons for resistance included no perceived need for the role, lack of evidence of effectiveness, financial constraints and professional and patient safety concerns., Implications for Nursing Management: These findings, which contribute to the international evidence-base on health care support workers roles, provide nurse managers with numbers of assistant practitioners and their deployment. This is useful for Nurse Managers making workforce decisions.

Aims: This paper reports on a Training Needs Analysis for Non-Medical Prescribers commissioned by a south of England Strategic Health Authority., Background: The aim of the TNA was to inform future policy, educational provision and practice development and provide nurse managers with significant information on the perceived Continuing Professional Development (CPD) needs of the non-medical prescribers., Methods: Data were collected from a sample of 270 non-medical prescribers using an in-depth questionnaire, and telephone interviews with a purposive sample of 11 key stakeholders., Results: The findings report: * The qualifications that non-medical prescribers possess. * The level of confidence described by the non-medical prescribers in their role. * What non-medical prescribers identify as their present and future CPD requirements in relation to prescribing. * What education and training provision non-medical prescribers have attended in relation to their prescribing role since qualifying., Conclusions: The findings suggest, first that short courses that were specific to the non-medical prescribers role were considered to be the most popular and useful. However, courses needed to be advertised well in advance. Second, training gaps were identified., Implications for Nursing Management: Pharmacology and prescribing are rapidly changing and require regular CPD in order to keep up to date with the latest developments. Non-medical prescribing is a comparatively new innovation to the NHS, therefore those who are not medically qualified need mentorship from experienced prescribers, as well as the encouragement from nurse managers to be confident prescribers themselves and enhance patient care.

Aims: A graduate entry workforce for nurse registration has been approved for England by 2010/11. The aim of this research was to discover the immediate tasks facing nurse managers in implementing that change. Previous research has focused on making the case for change rather than on implementation., Background: Similar to the implementation of Project 2000, this change in nurse education and employment will raise questions for employers and for higher education institutions. It will also raise questions about nurse recruitment numbers, workforce development, and the profiles of entrants to a changing workforce., Method: In preparation for these changes, we conducted a scope review of published and grey literature in the English language. We also reviewed the earlier experiences of transfer to graduate status amongst other workforces such as teaching and social work and we investigated reported practice in other industrialised countries., Results: The education provider changes necessary for such a large professional workforce will need considerable leadership skills from within nursing and nurse management. At present, there are too many employers and education providers in England who appear to be relatively unaware of the changes facing nurse education and professional practice and the urgency needed to lead that change., Conclusions: Education, training and development as well as employer/commissioner practice will rely on leadership from within the nurse profession itself. For nurse managers, this requires a rapid planning process in order to ensure smooth implementation. The danger is that either education providers or commissioners of nursing services will react rather than proactively plan for the changes that are already in progress.

Aim: To develop a theory that explains the 'realities' of part-time nursing., Background: While little is known about the phenomenon of part-time nursing, increasing numbers of nurses work in part-time employment., Methods: Grounded theory., Results: The problem that part-time nurses shared was an inability to achieve their personal optimal nursing potential. Motivators to work part-time, employment hours, specialty, individual and organizational factors formed contextual conditions that led to this problem. Part-time nurses responded to the challenges through a process of adaptation and adjustment., Conclusion: Harnessing the full productive potential of part-time nurses requires support to limit the difficulties that they encounter. The developed theory provides a valuable guide to managerial action., Implications for Nursing Practice: Nurse Managers need to consider the developed substantive theory when planning and managing nursing workforces.

Aim and Background: The purpose was to explore the relationship between multidimensional leadership and burnout among nursing staff. There exists little research evidence of the relation between these phenomena., Method: The study used a non-experimental survey design. The sample consisted of 601 nurses and nurse managers working in different health care organizations., Results: Rewarding transformational leadership seems to protect particularly from depersonalization. Active management-by-exception protected from depersonalization and increased personal accomplishment. Passive laissez-faire leadership functioned as an exposing factor for emotional exhaustion as well as a decreasing factor for personal accomplishment. However, the employment status and the character of work tasks affected the connection between leadership and burnout., Conclusions: The relation between leadership and burnout is complex, affected by situational factors of leadership and the ambiguous nature of burnout. Nurses of various ages, at different stages of career development and participating in different work tasks require different kinds of leadership.

Aims: This study explores whether there is evidence of an ideological component in the psychological contracts of professional employees, as well as evidence of credible supporting commitments by their employer., Background: Fundamental changes in the employment context have prompted many individuals to seek a closer alignment between themselves and their work, as well as with the organizational and broader societal contexts. For many professional employees identification with their professional ideology is a significant factor in producing such an alignment., Method: The study uses an exploratory qualitative approach to analyse interview data collected from a sample of registered nurses employed in an Australian public hospital., Results: The analysis identifies psychological contract terms best understood by reference to an ideological currency. It also suggests that the organization is perceived as obligated to provide credible support for that professional contribution, and the perceived lack of such support has significant impacts., Conclusions: The findings raise doubts about the utility of the concept of a psychological contract that recognizes only economic and socio-emotional exchanges for understanding the psychological contracts of professional employees.

Aim: This paper reports the views of nurses graduating from the University of Nottingham School of Nursing, UK, 1994-2000, Bachelor of Nursing (Hons) course, concerning career aspirations, progress and reflections on their qualification., Background: Alongside academic knowledge and practical skills, this four-year Bachelor of Nursing course aimed to develop students' critical thinking and research skills. The degree's effect on nurses' career trajectories is unknown., Methods: Self-completion questionnaires employing open and closed questions were sent to graduates 9 months after graduation and at intervals over the next 6 years., Results: Most respondents were confident and motivated in their nursing careers. Promotion, increased responsibility, further study, specialization and qualifications were career priorities. Recent qualifiers also focused on changing jobs, travel and working overseas., Conclusion: The graduates' experience has salience for nurse managers, especially when matching graduates against post outlines within the knowledge and skills framework, considering staff skill mix, and advising graduates about their development and assisting them to find satisfaction in their nursing careers.

Aim: To explore the effects of dyslexia on the practice and career progression of UK registered nurses (RN)., Background: Literature suggests dyslexia can have a negative impact in the workplace and may pose particular difficulties for nurses, where accuracy in information processing activities is essential for practice., Methods: A questionnaire was used to survey RNs with dyslexia (n = 116) and results analysed using content analysis., Findings: Dyslexia provided a challenge to the everyday work of RNs, which was often met successfully using a range of individualized strategies. Career progression was achievable but compared with peers, was perceived to take longer. Disclosure of dyslexia to work-colleagues was selective and dependent on the perceived benefits. Informal support mechanisms were commonly utilized with formal management support less well defined., Conclusion: Dyslexia appears to have a negative impact on working practices and career progression, but remains a poorly understood and often hidden disability.

Aim: To compare views of nurse executives with those of nurses who have left the profession on the importance of retention strategies., Background: Although much has been written about nursing turnover, there continues to be dissonance among decision makers as to why nurses leave the profession and what the most crucial issues are for retention., Method: Factor analysis was undertaken to compare responses of nurse executives with those of nurses employed outside of nursing., Results: Contract requirements represented the greatest discrepancy, 1.07, followed by legal and employer issues, 1.02; worklife/homelife balance, 0.91; external values and beliefs about nursing, 0.75; and professional practice, 0.29., Conclusions: A disparity exists between perceptions of nurse executives and those of nurses who have left the profession as to which issues are most critical in retention. We suggest that nurse executives ensure sufficient organizational support for nursing unit managers who are more likely to understand methods of retaining nurses at the clinical interface.

Aim: This study examines the association of high involvement nursing work practices with employer-of-choice (magnet) status in a sample of Canadian nursing homes., Background: In response to a severe shortage of registered nursing personnel, it is imperative for health care organizations to more effectively recruit and retain nursing personnel. Some long-term care organizations are developing employee-centred cultures that allow them to effectively enhance nurse and resident satisfaction. At the same time, many nursing homes have adopted progressive nursing workplace practices (high involvement work practices) that emphasize greater employee empowerment, participation and commitment., Method: A mail survey was sent to the director of nursing in 300 nursing homes in western Canada. In total, 125 useable questionnaires were returned and constituted the data set for this study. Separate ordinary least squares regressions are performed with magnet strength, nurse satisfaction and resident satisfaction used as dependent variables., Results: Nursing homes that demonstrate strong magnet (employer-of-choice) characteristics are more likely to have higher levels of nurse and patient satisfaction, even after controlling for a number of significant factors at the establishment level. Magnet nursing homes are more likely to have progressive participatory decision-making cultures and much more likely to spend considerable resources on job-related training for their nursing staff. The presence of high involvement work practices is not found to be a significant predictor in magnet strength, nurse or resident satisfaction., Conclusion: Merely adopting more high involvement nursing work practices may be insufficient for nursing homes, which desire to become 'employers-of-choice' in their marketplaces, especially if these practices are adopted without a concomitant investment in nurse training or an enhanced commitment to establishing a more democratic and participatory decision-making style involving all nursing staff.

Aim: This paper examines education's contribution to labour force reform in the nursing profession within the United Kingdom., Background: In a globalized society there is increasing demand for more flexible forms of working. Nursing faces radical change in its employment characteristics if it is to continue to meet the health care needs of the population in the new century. ORIGINS OF INFORMATION AND DATA ANALYSIS: Key sociological texts and contemporary analysis of nursing skill have been analysed and synthesized to identify the dynamic of change in nursing and nursing education's contribution to these changes., Key Issues: Patterns of upskilling and multiskilling are leading to the breakdown of professional role boundaries in the broader workforce. These patterns can also be seen in nursing. Upskilling is associated with increased stress and 'risk' for the individual, therefore achievement of flexibility is not without cost. Changes in the skill level in nursing lead many to conclude that the profession will become divided into a core and periphery distinction. This simplistic analysis does not account for the complexities of nursing and nursing skill although there is clearly a growing need for a 'knowledge and technical elite'., Conclusions: The core-periphery distinction is too simplistic to analyse nursing skills and the dynamic of change in the workforce. A radical perspective of nursing characterized by workers with a range of skills and competencies is less likely to lead to rigid professional boundaries. There is a clear need for multiskilled and knowledgeable workers; the 'technical and knowledge elite'. These nurses may be recognized as advanced practice nurses. High quality education is required to prepare these practitioners. Adaptation of nursing to the postmodern world needs to be facilitated by changes in current educational policy and practice.