Susan Yarbrough

Changes in Taiwanese nursing student values during the educational experience

Professional values are standards for action and provide a framework for evaluating behavior. This study examined changes in the professional values of nursing students between their entrance to and graduation from an undergraduate nursing program. A pre- and post-test design was employed. A convenience sample of 94 students from a university in Taiwan was surveyed. Data were collected from students during the sophomore and senior years. Total scores obtained for the revised Nurses Professional Values Scale during the senior year of the nursing program were significantly higher than upon program entry. The ‘caring’ subscale was scored highest at both program entry and graduation, but the pre- and post-test scores were not significantly different from each other. The students scored significantly higher on the ‘professionalism’ and ‘activism’ subscales at post-test than they did at pre-test. Professional values changed in a positive direction between the beginning of the student nurses’ educational experience and their graduation. The results supported the premise that education had a positive effect on these students’ professional values but causality could not be assumed.

Research study: professional values and retention.

N urses around the world adhere to a common set of professional values; terminology may vary, but basic beliefs and underlying meanings are similar. These professional values include respect for human dignity, protection of patient privacy, protection from harm, and personal and professional responsibility and accountability.1,2 Nurses, it has been shown, have an ethical obligation to advocate.3 Through the processes of education and socialization, professional nurses also have a strong sense of right and wrong. Professional and healthcare organizations have promulgated codes of ethics to guide values development and ethical decision making in education, practice, and research. Across these codes of ethics, three major thematic categories are recognized: nursing values related to the profession, to patients, and to society.4 For example, the American Nurses Association (ANA) Code of Ethics for Nurses has undergone several revisions, but the thematic categories have remained constant over time.5 Therefore, when nurses find their professional values are in conflict with the values of the employing organization, dissonance occurs and nurses become disenchanted and disenfranchised.6,7 Age is only one reason that nurses are leaving the workforce. Adding to the shortage is the loss of experienced, caring nurses due to moral strain caused by values dissonance. This strain is associated with the “stress of conscience” that occurs when nurses can’t provide the quality of care inherent in their practice.6 For example, environmental barriers, such as a lack of support for nurse involvement in ethical decision making and a lack of concern for nurses’ security and the institutional hierarchy, can prevent nurses from acting in ways that they feel are in the best interest of patients and are consistent with their own values.7 This conflict may contribute to high staff turnover rates and subsequent staff shortages. In addition, advances in technology and expansion of nursing roles continue to create chaos in the healthcare arena. This chaos leads to frustration and subsequent career abandonment when nurses aren’t able to address the complex ethical moral dilemmas common in the profession today. The enormous responsibility of ensuring patients’ well-being and preventing negative outcomes can be a major stressor for nurses.6 If nurses lack time for adequate patient interactions, they may feel that their altruism is constantly being tested, leading to feelings of inadequacy in their role of professional nurse. Stresses in the workplace put moral values to the test and create conflicts when nurses are pressured to act in ways that may not be congruent with their professional values. When a mismatch between workers’ values and job environment exists, there’s good reason for burnout or for abandoning the profession entirely.8 Thus, value congruence is a vital piece of worker satisfaction and influences individuals’ decisions about remaining in the workplace.

Comparison of professional values of Taiwanese and United States nursing students

Globalization is a part of modern life. Sharing a common set of professional nursing values is critical in this global environment. The purpose of this research was to examine the professional values of nursing students from two distinct cultural perspectives. Nurse educators in Taiwan partnered with nurse educators in the United States to compare professional values of their respective graduating nursing students. The American Nurses Association Code of Ethics served as the philosophical framework for this examination. The convenience sample comprised 94 Taiwanese students and 168 US students. Both groups reported high scores on an overall measure of values. They did differ substantially on the relative importance of individual items related to advocacy, competence, education, self-evaluation, professional advancement, and professional associations. Global implications for the collaborative practice of nurses from different cultures working together can be improved by first recognizing and then attending to these differences in value priorities.

Journal Editor Survey: Information to Help Authors Publish

Faculty are expected to publish but often do not know how to write a manuscript that avoids major reasons for subsequent rejection. The authors share the results of a survey of 63 journal editors who reported journal characteristics and reasons for rejection of manuscripts. Suggestions to improve the acceptance rate of faculty publications are offered.

The Patient Self-Determination Act: 20 Years Revisited

Evidence exists that the goals of the Patient Self-Determination Act (PSDA), which went into effect December 1991, have fallen significantly short of their achievement. The purpose of this paper is to explore the outstanding and controversial issues that continue to impact both health care providers

Professional values, job satisfaction, career development, and intent to stay

Background: Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from

Military Nurses Caring for the Enemy

44,380 -

Journey to a Doctoral Program

63,400 per nurse—an estimated

Professional values held by baccalaureate and associate degree nursing students

4.21 to

Incorporating Cultural Issues in Education for Ethical Practice

6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future. Research objective: The purpose of the study was to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system. Research design: A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system. Findings: Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention. Discussion: Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future. Conclusion: Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities.