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Background: Workplace incivility is a common problem in nursing, and novice nurses are particularly vulnerable to incivility., Method: Cognitive rehearsal training to defend against incivility was presented to resident nurses., Results: Three months after the educational intervention, 55% of nurses reported that they had witnessed incivility in the past month and 45% reported that they had responded to the incivility when it occurred., Conclusion: Most of the nurses expressed that the training improved their ability to manage incivility. Responses to open-ended comments revealed that incivility adversely affects the workplace and that leaders also may benefit from education on incivility and cognitive rehearsal. [ J Contin Educ Nurs . 2021;52(5):232-239.] .

Stress, suboptimal mental health and an inadequate work-life balance are underlying and serious issues in the nursing profession, affecting staff recruitment and retention and potentially having a detrimental effect on patient care. While compassion towards patients is central to the nursing role, often 'compassion towards the compassionate' is lacking. The need for compassion is even more important now, and in the months ahead, due to the additional stressors experienced by nurses during the COVID-19 pandemic, whether they are on the front line, furloughed or shielding. This article includes reflections from nursing staff and uses their stories to encourage reflection on ethical and moral dilemmas experienced during the pandemic. The Compassion in the Workplace model is suggested as a tool that can be used by nurse managers to examine their compassion levels and to support the development of a compassionate workplace. In addition, this article offers some practical ideas on what compassionate leadership might look like in day-to-day practice., Competing Interests: None declared, (© 2021 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Objectives: To clarify the concept of workplace violence in nursing and propose an operational definition of the concept., Methods: The review method used was Walker and Avant's eight-step method., Results: Identification of the key attributes, antecedents, consequences, and empirical referents of the concept resulted in an operational definition of the concept. The proposed operational definition identifies workplace violence experienced by nurses as any act or threat of verbal or physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the worksite with the intention of abusing or injuring the target., Conclusions: Developing insights into the concept will assist in the design of new research scales that can effectively measure the underlying issues, provide a framework that facilitates nursing interventions, and improve the validity of future studies., (© 2021 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health.)

By 2043, it is projected that more than half of the nation's population will belong to a minority ethnic group. Health care organizations are challenged to create teams that mirror the communities they serve. Diversity in health care leadership can improve community relations, enhance quality of care, and reduce disparities in care. While the profession of nursing has made positive strides toward increased diversity, this is not reflected in nursing leadership. This article discusses how organizations can support the leadership development of underrepresented minority nurses through connection, collaboration, and commitment. Also highlighted are strategies that underrepresented minority nurses can employ, as they pursue leadership roles.

Bullying can occur at all levels of nursing, and anyone could be targeted. This article offers strategies to identify bullying behaviors and discusses the prevalence of incivility in the nursing profession with a focus on vertical violence.

Aims: Examine the presence and various sources of incivility among nursing staff working within an academic medical centre utilizing the Nurse Incivility Scale (NIS)., Background: Evidence suggests various forms of negative behaviour including incivility exist among nurses. Established consequences of these behaviours include increased employee turnover rates, decreased job satisfaction, decreased productivity and increased absenteeism., Methods: A descriptive survey design was used which included the NIS instrument to measure the presence of incivility within the nursing workforce and specific sources of these behaviours among 414 nurses in an academic medical centre., Results: Hospital nurses working within the intensive and intermediate care unit experienced significantly greater incivility from patients and families than other participants within the study [F (3, 413) 8.62, p = .001]. No other significant differences existed in sources of incivility between various levels of direct care., Conclusions: Nursing staff working within high-risk areas for incivility such as the intensive care and intermediate care units may require additional interventions to reduce perceptions of incivility from patients/families., Implications for Nursing Management: Findings suggest further research is necessary to develop targeted interventions for nurses practicing within intensive care and intermediate units to alleviate the perceived burden of incivility from patients/families., (© 2019 John Wiley & Sons Ltd.)

To meet today's challenges and prepare for the future, our health system's "My Health 2022" strategic plan recommends development of prevention and health promotion and better access to quality care. This requires development of co-ordinated exercise between professionals and support structures and further development of digital and e-health., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Background: Negative interactions among nurses are well recognized and reported in scientific literature, even because the issues may have major consequences on professional and private lives of the victims. The aim of this paper is to detect specifically the prevalence of workplace incivility (WI), lateral violence (LV) and bullying among nurses. Furthermore, it addresses the potential related factors and their impact on the psychological and professional spheres of the victims., Methods: A review of the literature was performed through the research of papers on three databases: Medline, CINAHL, and Embase., Results: Seventy-nine original papers were included. WI has a range between 67.5% and 90.4% (if WI among peers, above 75%). LV has a prevalence ranging from 1% to 87.4%, while bullying prevalence varies between 2.4% and 81%. Physical and mental sequelae can affect up to 75% of the victims. The 10% of bullied nurses develop Post-Traumatic Stress Disorder Symptoms. Bullying is a predictive factor for burnout (β=0.37 p<0.001) and shows a negative correlation with job efficiency (r=-0 322, p<0.01). Victims of bullying recorded absenteeism 1.5 times higher in comparison to non-victimized peers (95% CI: 1.3-1.7). 78.5% of bullied nurses with length of service lower than 5 years has resigned to move to other jobs., Conclusions: There is lack of evidence about policies and programmes to eradicate workplace incivility, lateral violence and bullying among nurses. Prevention of these matters should start from spreading information inside continue educational settings and university nursing courses.

Elizabeth Rosser, Acting Executive Dean, Bournemouth University, considers the human aspects of global partnerships and the sense of belonging that comes with actively engaging with others in the profession.

Aim: To provide a synthesis of the evidence of health-promoting leadership related to nursing by exploring definitions, core attributes and critical conditions., Background: Increasing pressure in healthcare settings due to efficiency requirements, population ageing with complex illnesses and projected global shortage of nurses, is a potential threat to nurses' health and job satisfaction, and patient quality of care and safety. New ways of thinking about nursing leadership and evidence-based human resource management are required to improve nursing environments., Design: Integrative literature review., Data Sources: Eight databases were searched: Academic Search Premier, CINAHL, Emerald, ERIC, Web of Science, MEDLINE, Psychinfo and Science Direct. Included papers were published between 2000-2016., Review Methods: Of 339 papers, 13 were eligible for inclusion: eight qualitative and five quantitative. Studies were assessed for quality using standardized checklists. Framework-based synthesis was used, allowing for themes identified a priori to be specified as coding categories. This method also allows new themes to emerge de novo., Results: Four themes were identified. There are multiple definitions of health-promoting leadership, along with description of the non-health-promoting leader. The health-promoting nurse leader engages in employees' health promotion, and takes responsibility for actions and maintains open communication, accommodating nurses' participation in change processes. Through competence development, the health-promoting organization builds capacity., Conclusion: Health-promoting leadership may be a promising path to optimizing nursing outcomes through holistic thinking, which emphasizes the importance of context. Accumulated research is required to build a stronger line of international research, with attention to underlying mechanisms, limiting conditions and behaviours known to health-promoting leadership., (© 2018 John Wiley & Sons Ltd.)

Ian Peate, Editor-in-Chief, British Journal of Nursing, reports on the issues highlighted at the recent meeting of nursing and midwifery leaders, including nurse-patient ratios, resilient leadership and integrated care.

Purpose: To develop and perform reliability and validity assessments of the international Multidimensional Nursing Generations Questionnaire., Background: There are three generations of nurses in the European workforce. There is little research on the characteristics of these generations and the ways in which to manage them professionally, and no instrument has yet been developed to measure these aspects specifically., Methods: With results from previous studies, 69 nursing generations-oriented items were created in English, translated into Italian and Finnish, and pretested to form the basis of an instrument that was tested between September and October 2014 on a sample of Finnish and Italian nurses (n = 1302) using principal component analysis and Cronbach's alpha., Results: Fifty-four items and eight components (Cronbach's α range: 0.61-0.81) were identified in the instrument: (1) conflicts between generations; (2) patient safety view; (3) relationships between generations; (4) working as a multigenerational team; (5) orientation to change; (6) presenteeism and job propensity; (7) intention to leave, and (8) flexibility and availability., Conclusions: The instrument showed acceptable preliminary psychometric properties and satisfactory internal consistency., Implications for Nursing Management: The Multidimensional Nursing Generations Questionnaire is a useful tool to measure the characteristics of different generations of nurses and to develop management strategies tailored to those generations., (© 2017 John Wiley & Sons Ltd.)

'Leaving a job is never a decision you should take lightly,' says Nick Simpson, CEO of health recruitment agency MSI Group. 'Every nursing professional has things about their job they find frustrating and daily tasks they may not necessarily enjoy doing, but it's important to consider the positive aspects of your current role before you make a decision.'

Aim: This review aimed to synthesise literature describing the development and/or implementation and/or evaluation of a professional practice model to determine the key model components., Background: A professional practice model depicts nursing values and defines the structures and processes that support nurses to control their own practice and to deliver quality care., Evaluation: A review of English language papers published up to August 2014 identified 51 articles that described 38 professional practice models. Articles were subjected to qualitative analysis to identify the concepts common to all professional practice models., Key Issue: Key elements of professional practice models were theoretical foundation and six common components: leadership; nurses' independent and collaborative practice; environment; nurse development and reward; research/innovation; and patient outcomes., Conclusions: A professional practice model provides the foundations for quality nursing practice. This review is an important resource for nurse leaders who seek to advance their organisation in a journey for excellence through the implementation of a professional practice model., Implications for Nursing Management: This summary of published professional practice models provides a guide for nurse leaders who seek to develop a professional practice model. The essential elements of a professional practice model; theoretical foundation and six common components, are clearly described. These elements can provide the starting point for nurse leaders' discussions with staff to shape a professional practice model that is meaningful to direct care nurses., (© 2015 John Wiley & Sons Ltd.)

The Senior Living Lab (SLL) is dedicated to the care of older adults and exemplifies how nursing leadership can influence clinical practice by designing research models capable of configuring interdisciplinary partnerships with the potential of generating innovative practices and better older patient outcomes. Demographic change resulting in growing numbers of older adults requires a societal approach, uniting stakeholders in social innovation processes. The LL approach is an innovative research method that values user perceptions and participation in the cocreation of new products and services. The SLL is crafting a platform responsive to change. It is a learning organization facilitating community-based participatory research methods in the field. Advanced nurse practitioners are well positioned to lead the way forward, fostering interdisciplinary academic collaborations dedicated to healthy aging at home. The SLL demonstrates how nursing science is taking the lead in the field of social innovation.

Purpose: To analyze World Health Organization (WHO) documents to identify global nursing issues and development., Design: Qualitative content analysis., Methods: Documents published by the six WHO regions between 2007 and 2012 and with key words related to nurse/midwife or nursing/midwifery were included. Themes, categories, and subcategories were derived. The final coding reached 80% agreement among three independent coders, and the final coding for the discrepant coding was reached by consensus., Findings: Thirty-two documents from the regions of Europe (n = 19), the Americas (n = 6), the Western Pacific (n = 4), Africa (n = 1), the Eastern Mediterranean (n = 1), and Southeast Asia (n = 1) were examined. A total of 385 units of analysis dispersed in 31 subcategories under four themes were derived. The four themes derived (number of unit of analysis, %) were Management & Leadership (206, 53.5), Practice (75, 19.5), Education (70, 18.2), and Research (34, 8.8)., Conclusions: The key nursing issues of concern at the global level are workforce, the impacts of nursing in health care, professional status, and education of nurses. International alliances can help advance nursing, but the visibility of nursing in the WHO needs to be strengthened., Clinical Relevance: Organizational leadership is important in order to optimize the use of nursing competence in practice and inform policy makers regarding the value of nursing to promote people's health., (© 2015 Sigma Theta Tau International.)

Background: The majority of care for people with type 2 diabetes occurs in general practice, however when insulin initiation is required it often does not occur in this setting or in a timely manner and this may have implications for the development of complications. Increased insulin initiation in general practice is an important goal given the increasing prevalence of type 2 diabetes and a relative shortage of specialists. Coordination between primary and secondary care, and between medical and nursing personnel, may be important in achieving this. Relational coordination theory identifies key concepts that underpin effective interprofessional work: communication which is problem solving, timely, accurate and frequent and relationships between professional roles which are characterized by shared goals, shared knowledge and mutual respect. This study explores roles and relationships between health professionals involved in insulin initiation in order to gain an understanding of factors which may impact on this task being carried out in the general practice setting., Method: 21 general practitioners, practice nurses, diabetes nurse educators and physicians were purposively sampled to participate in a semi-structured interview. Transcripts of the interviews were analysed using framework analysis., Results: There were four closely interlinked themes identified which impacted on how health professionals worked together to initiate people with type 2 diabetes on insulin: 1. Ambiguous roles; 2. Uncertain competency and capacity; 3. Varying relationships and communication; and 4. Developing trust and respect., Conclusions: This study has shown that insulin initiation is generally recognised as acceptable in general practice. The role of the DNE and practice nurse in this space and improved communication and relationships between health professionals across organisations and levels of care are factors which need to be addressed to support this clinical work. Relational coordination provides a useful framework for exploring these issues.

Background: PaTz (an acronym for 'PAlliatieve Thuis Zorg'; palliative care at home) is an intervention to improve palliative care provision and strengthen the generalist knowledge of palliative care. In PaTz general practitioners and district nurses meet on a regular basis to identify patients with palliative care needs and to discuss care for these patients. This study explores experiences with regard to collaboration between general practitioners and district nurses, and perceived benefits of and barriers for implementation of PaTz., Methods: This study is conducted within the primary care setting. Participants were 24 general practitioners who filled in a questionnaire, and seven general practitioners, five district nurses and two palliative care consultants who attended one of two focus groups., Results: PaTz led to improved collaboration. Participants felt informational and emotional support from other PaTz participants. Also they felt that continuity of care was enhanced by PaTz. Practical recommendations for implementation were: meetings every 6 to 8 weeks, regular attendance from both general practitioners and district nurses, presence of a palliative care consultant, and a strong chairman., Conclusions: PaTz is successful in enhancing collaboration in primary palliative care and easy to implement. Participants felt it improved continuity of care and knowledge on palliative care. Further research is needed to investigate whether patient and carer outcomes improve.

The relational aspect of care is as essential to the overall patient experience as the technical aspects of care. The relational aspect of care hinges on how the caregiver uses his or her self as an instrument of care. For caregivers to fully engage in the art of healing, they must be mindful of the self they are bringing to every encounter. This mindfulness can be strengthened through the thoughtful pursuit of self-attunement, self-clarity, and self-compassion.

The purpose of a concept analysis is to examine the structure and function of a concept by defining its attributes and internal structure. Concept analysis can clarify an overused or vague concept and promote mutual understanding by providing a precise operational definition. Mentoring is a concept more fully used by other fields, such as business, than in nursing and may not always translate well for use in nursing. Therefore, clarifying the meaning of the existing concept of mentoring and developing an operational definition for use in nursing are aims of this concept analysis. Mentoring is broadly based and concentrates on developing areas such as career progression, scholarly achievements, and personal development. Mentoring relationships are based around developing reciprocity and accountability between each partner. Mentoring is seen related to transition in practice, role acquisition, and socialization, as a way to support new colleagues. Mentorship is related to nurses' success in nursing practice linked to professionalism, nursing quality improvement, and self-confidence.

Background:   The concept of nursing power has not been extensively reported in the nursing literature. Power is an extremely abstract concept, making it difficult to define and study. However, when defined as the capacity to achieve goals, power becomes a significant resource in nursing., Aims:   The aim of this study was to describe how nursing professionals perceive the level of nursing group power in public healthcare organizations. Additionally, the connections between the background variables and nursing group power were analysed., Methods:   The participants in the study consisted of 289 Finnish nurses working in the specialist healthcare sector in Finland. The Sieloff-King Assessment of Group Outcome Attainment within Organizations© (SKAGOAO) instrument was utilized to assess the level of nursing group power within the selected organizations., Findings:   According to the present study, nursing professionals rated the outcome attainment (mean, 1.93), as well as goals/outcome competency (mean, 2.24), as very good. The position of nursing (mean, 2.55) as part of the healthcare service system was considered fairly respected. The role of nursing (mean, 2.54) was also considered to be at a good level. As regards to the actualization of power or outcome attainment capacity, respondents gave the lowest ratings to controlling the effects of environmental forces (mean, 2.75), resources (mean, 3.48), communication competency (mean, 3.00) and group supervisor's outcome attainment competency (mean, 2.87). Age, education, type of employment and work experience had an impact on how nursing group power was perceived., Conclusions:   The results of the present study indicated that the nurses perceived the lowest levels of group power in relation to the subscales of controlling the effects of environmental forces, resources, communication competency and group supervisor's outcome attainment competency., (© 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.)

This study aimed to understand the nurses' contributions in the network of relationships and interactions of community health workers (CHW) in a city located in the south of the country. The Grounded Theory was used and twenty individuals were interviewed, among health professionals and users of the health center, divided into three sample groups. The nurse is recognized as a key element in the network of relationships and interactions of the CHW with the community, being viewed as a leader. Although showing signs of an authoritarian leadership, the nurse promotes dialogue and acts as a facilitator of teamwork in health promotion. It was concluded that the nurses of the Family Health Strategy have a significant role in the health team, providing clinical support to organize the care, and management, to foster good relations, direct the activities and conduct the flow of information.