Naughton Corina, O'Shea Katie L, Hayes Nicky
School of Nursing and Midwifery, College of Medicine and Health, University College Cork, Cork, Ireland.
Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
Int J Older People Nurs. 2019 Dec;14(4):e12256. doi: 10.1111/opn.12256. Epub 2019 Jul 12.
Nurse vacancy rates in older adult services are disproportionately high compared to other areas of nursing. This is partly because few student nurses consider it an attractive career option once qualified due to perceptions of low-status, strenuous nature of the work and impoverished care environments. The study aimed to explore students' perceptions of incentives that could counterbalance the barriers for new graduate nurses joining this speciality.
A qualitative descriptive design using focus group interviews was carried out with six groups of student nurses (n = 27) following completion of their acute care older adult placements in three hospitals. Data were analysed using thematic analysis.
The barriers from students' perspectives were constructed as a vicious cycle of staff shortages and inadequate resources that created impoverished environments leading to a dissonance between ideal and delivered care. Over one-third of students were unlikely to consider a career in older adults nursing, but the remaining students could identify incentives that may tempt them. Four main themes and eight subthemes were identified: gerontological status and leadership (ward leadership; respected others); relational care (legitimising emotional support, care vs. cure goals); quality work environment (pay as recognition, 12-hr shifts); and education-career pathways (gerontological knowledge, career progression).
Radical new approaches, based on student and nurse engagement, are required to incentivise a career in gerontological nursing. A combination of shorter and longer term strategies that include education-career pathways, a focus on relation care, and improved work conditions including financial incentives should be trialled.
In terms of practice, addressing high nurse vacancy rates in older adult services that negaively impacts on patient outcomes requires a suite of incentives informed by 'what matters' to students and nurses working in the speciality.
与其他护理领域相比，老年护理服务中的护士空缺率高得不成比例。部分原因在于，很少有学生护士在取得资格后会认为这是一个有吸引力的职业选择，因为他们觉得该职业地位低、工作强度大且护理环境差。本研究旨在探讨学生对能够抵消新毕业护士进入该专业所面临障碍的激励因素的看法。
在三组医院完成急性护理老年患者实习后，对六组学生护士（n = 27）进行了焦点小组访谈，采用定性描述性设计。使用主题分析法对数据进行分析。
从学生的角度来看，障碍被构建为人员短缺和资源不足的恶性循环，这导致了恶劣的环境，进而造成理想护理与实际提供的护理之间的脱节。超过三分之一的学生不太可能考虑从事老年护理工作，但其余学生能够识别出可能吸引他们的激励因素。确定了四个主要主题和八个子主题：老年护理地位与领导力（病房领导力；尊重他人）；关系护理（使情感支持合法化、护理与治疗目标）；优质工作环境（薪酬作为认可、12小时轮班）；以及教育 - 职业路径（老年护理知识、职业发展）。
需要基于学生和护士的参与，采取全新的激进方法来激励从事老年护理工作。应尝试包括教育 - 职业路径、关注关系护理以及改善包括经济激励在内的工作条件等短期和长期策略的组合。
在实践方面，解决对患者预后产生负面影响的老年护理服务中高护士空缺率问题，需要一系列基于对从事该专业的学生和护士“重要的因素”的激励措施。
