The nursing associate (NA) role was introduced in 2017 with a pilot programme of trainees, and in 2019 became regulated by the Nursing and Midwifery Council (NMC). The role bridges the gap between the healthcare assistant (HCA) and registered nurse (RN), allowing RNs to focus on complex care. With over 9000 NAs on the NMC register and more in training, it is important to understand RN perceptions of the NA professional identity. The findings of a qualitative survey of RNs (n=23) identified the following themes: NMC standards and scope of practice; The \'cheap nurse\'; Skills development and progression; A supportive bridging role. Although valued, the role was perceived as a threat, ambiguous and inconsistently implemented. The implications are that the role ambiguity and lack of standardisation need addressing and a clear understanding of these must be articulated for the professions and public alike.

BACKGROUND: The registered nurse (RN) workforce experienced critical pre-pandemic and pandemic shortages of labor in some areas in the United States. People living in these health professional shortage areas (HPSAs) may have less access to health services. The Bureau of Health Workforce within the Health Resources and Services Administration administers Nurse Corps scholarship and loan repayment programs to increase healthcare access by increasing the supply and distribution of RNs, nurse practitioners, and nurse faculty to HPSAs. The American Rescue Plan Act of 2021 (ARPA) made available considerable new resources for the program.
OBJECTIVE: This paper reports on Nurse Corps applications, awards, and distribution in 2 cohorts in the period 2017 to 2022 to assess the impact of receiving an additional $200 million appropriated in 2021.
CONCLUSIONS: Additional funds through ARPA were associated with nearly threefold increases in the number of Nurse Corps awards. Program participants worked in a total of 1,316 counties (42% of all U.S. counties) in 2020 to 2022, a 76% increase from 749 counties in 2017 to 2019.
CONCLUSIONS: Increased funding for scholarship and loan repayment can help to improve the distribution of nurse labor to a greater number of critical shortage areas in the United States.

Oral immunotherapy (OIT) emerged into clinical practice, and its delivery highlights the multifaceted expertise of registered nurses (RN) as central to allergy/immunology interprofessional collaborative teams. The allergist-RN model of clinical evidenced-based OIT provision is presented. RN competencies, role components, and intervention examples are included to assist RNs and allergists in maximizing RN capabilities. RNs\' patient-centered focus, and the ability to evaluate and incorporate physical, psychological, and sociological patient aspects are assets to OIT teams. RNs can establish best practices, initiate scholarly inquiry, and disseminate new knowledge to interdisciplinary colleagues. RNs also implement allergist-prescribed standing protocols within their legal practice scope by using their clinical judgment during evaluation of a patient receiving OIT. The same RN may serve as a nurse clinician, patient and family educator, case manager, research collaborator, and OIT program manager. Allergy/immunology practices use diverse staffing models, which thus require adaptation of presented descriptions per clinical team needs and resources.

UNASSIGNED: To investigate whether the location and the number of nurse consultations have changed in response to the continuously decreasing number of GP consultations in the fourth-largest city in Finland. It has been suggested that nurse consultations are replacing GP consultations.
UNASSIGNED: A retrospective register-based follow-up cohort study.
UNASSIGNED: Public primary health care in the City of Vantaa, Finland.
UNASSIGNED: All documented face-to-face office-hour consultations with practical and registered nurses, and consultations with practical and registered nurse in the emergency department of Vantaa primary health care between 1 January 2009 and 31 December, 2014.
UNASSIGNED: Change in the number of consultations with practical and registered nurses between 2009 and 2014 in primary health care both during office-hours and in the emergency department.
UNASSIGNED: Over the follow-up period, the monthly median number of practical nurse consultations in the emergency department per 1000 inhabitants increased from 1.6 (interquartile range [IQR] 1.3-1.7) to 10.5 (10.3-12.2) (p < 0.001) and registered nurse consultations from a median of 3.6 (3.0-4.0) to 14.5 (13.0-16.6) (p < 0.001). However, there was no significant change in the median monthly number of office-hour consultations with practical or registered nurses.
UNASSIGNED: It appears that in primary health care, medical consultations have shifted from GPs to nurses with lower education levels, and from care during office-hours to emergency care.
The number of general practitioner (GP) consultations are decreasing. Tasks are being transferred from GPs to nurses to improve access to care.The number of office-hour consultations with nurses did not change, despite the decrease in GP consultations.In the emergency department, the number of nurse consultations increased significantly when GP consultations decreased.Medical consultations seem to have shifted to the emergency department and the nurses.

OBJECTIVE: To describe what registered nurses\' experience to be important to job satisfaction in nursing home settings.
METHODS: This is a qualitative study based on data from individual interviews.
METHODS: Sixteen registered nurses working in nursing homes were interviewed, and their responses were analysed with systematic text condensation.
RESULTS: A total of six categories were developed to describe various aspects of job satisfaction among registered nurses at nursing homes: meaningfulness is essential, to possess control and manageability is central, a possibility to balance daily challenges with professional development, supportive leadership is imperative, the nursing team\'s competence and companionship, and being confident in one\'s own profession.
CONCLUSIONS: In the present study, meaningfulness was essential to job satisfaction, and work was experienced to be meaningful and engaging when the demands were manageable, the workload controllable, and when the registered nurses felt supported by management and co-workers. Conversely, if the demands were too high, the workload was beyond their control and the nurses felt unsupported, then the work felt meaningless and thus unsatisfactory.

UNASSIGNED: To assess the knowledge, attitudes and practices of Registered Nurses working in residential aged care facilities pertaining to pain management for residents living with dementia.
UNASSIGNED: Sub-optimal pain management continues for people living with dementia in residential aged care. Registered Nurses are the pivotal staff responsible for complex assessment and management of people residing in residential aged care facilities.
UNASSIGNED: :This integrative literature review was informed by Whittemore (2005). Searching and screening followed the PRISMA guidelines.
UNASSIGNED: Thirteen papers were identified, the major themes identified were gaps in knowledge and skills, uncertainty of assessment, and delays in treatment.
UNASSIGNED: Registered Nurses require education on pain management for people living with dementia in residential aged care. Broader issues in residential aged care contribute to the problem and require examination. Research pertaining to Registered Nurses\' roles pain management for residents living with dementia is required.

BACKGROUND: The need for advanced home healthcare (HHC) is expected to increase, with registered nurses (RNs) as key figures. Given the difficulties recruiting and retaining RNs in the HHC sector, understanding their work satisfaction is imperative.
OBJECTIVE: This study aimed to explore RNs\' experiences of work satisfaction in the municipal HHC.
METHODS: Individual interviews were conducted with RNs (n = 8) in four municipalities in Norway. The data were evaluated using qualitative content analysis.
RESULTS: Work satisfaction in HHC was organised into one theme \'alone and together\' under four categories-the patient, the co-worker, the registered nurse, and the organisation-and 15 subcategories, including patient diversity, supportive co-workers and professional environment, appropriate workload and responsibilities, and provision of preconditions for self-management.
CONCLUSIONS: Patients, co-workers, and organisations were identified as crucial areas affecting RNs\' work satisfaction in the municipal HHC. Awareness of these areas is essential to promote RNs\' work satisfaction. Patients\' diversity adds positively to RNs\' work satisfaction. Notably, RNs working alone can affect their work satisfaction not only negatively but also positively.

OBJECTIVE: To identify, synthesize and evaluate primary research on registered nurses\' (RN) knowledge, attitudes and beliefs about sleep health and sleep health management of older adults living in residential aged care.
METHODS: Integrative review.
METHODS: Medline, Embase and CINAHL databases from inception to September 2023.
METHODS: Databases were searched using a combination of key words, subject heading terms. All abstracts and full-text articles were screened by two researchers. Qualitative synthesis of the included articles was conducted. Inductive content analysis was used to identify themes and analyse data.
RESULTS: A total of 923 abstracts were screened resulting in a final yield of 13 articles. Three themes were identified: (i) RN experience with sleep-disturbed residents, (ii) the emotional burden of sleep disturbances on RN and, (iii) organizational barriers to promoting resident\'s healthy sleep. Inappropriate administration of benzodiazepines and psychotropic drugs to manage residents\' sleep disturbances was a major issue and lack of resources in residential aged care to facilitate sleep. There were concerns on nursing activity that disturbed residents\' sleep and striking a balance between facilitating sleep and meeting managerial expectations was challenging.
CONCLUSIONS: This review identified that nurses\' decision-making has an integral role in the management of sleep health in residents in aged care. Whilst evidence-based guidelines for managing sleep in residential aged care are available, there is a lack of translation to practice. Understanding RN perspectives is critical to improving sleep health models of care in residential aged care.
CONCLUSIONS: This review found that RN are attuned to the implications of sleep disturbance in residential aged care but are constrained by current sleep health models of care.
UNASSIGNED: Not applicable.

BACKGROUND: Having more registered nurses (RNs) leave their workplace, with a shortage of RNs in healthcare as a consequence, might pose a risk to patient safety. According to the Job Demands Resource model, social support is a resource that can enhance work motivation, and if RNs are motivated at work, their willingness to remain in the workplace may increase.
OBJECTIVE: The aims were to explore (1) differences in RNs\' experiences of social support from their immediate manager and co-workers between different healthcare settings, (2) associations between RNs\' experiences of social support and aspects of work motivation, and (3) if these associations differed in strength between healthcare settings.
METHODS: A cross-sectional study design.
METHODS: A stratified population of Swedish RNs, n = 2290, working in either hospitals, primary care, or home healthcare, responded to a survey in 2022. Chi-squared tests and linear and logistic regression analyses were used to analyze the data. Interaction was measured by adding an interaction term to the fully adjusted regression models. The findings\' generalizability was strengthened by including calibrating weights in all analyses.
RESULTS: RNs in primary care reported higher social support from their immediate manager than RNs in hospitals and home healthcare. RNs in home healthcare reported lower social support from co-workers than RNs in hospitals and primary care. There were statistically significant associations between higher levels of social support from the immediate manager and co-workers, respectively, and higher ratings in all aspects of work motivation: work engagement (manager: beta coefficient [b] = 0.08, confidence interval [CI] 95% = 0.05; 0.10; co-workers: b = 0.12, CI 95% = 0.08; 0.16), job satisfaction (manager: b = 0.24, CI 95% = 0.21; 0.27; co-workers: b = 0.22, CI 95% = 0.16; 0.28), opportunities to provide high-quality care (manager: b = 0.15, CI 95% = 0.11; 0.18; co-workers: b = 0.19, CI 95% = 0.13; 0.24), satisfaction with the employer (manager: b = 0.46, CI 95% = 0.42; 0.50; co-workers: not statistically significant) and intention to remain at the workplace (manager: odds ratio = 1.89, CI 95% = 1.69; 2.13; co-workers: odds ratio = 1.42, CI 95% = 1.17; 1.72). The associations differed in strength between hospitals, primary care, and home healthcare.
CONCLUSIONS: Strengthening social support from the immediate manager and co-workers appears to be a way to increase RNs\' work motivation, including their intention to remain at the workplace. This may be important, particularly in primary care and home healthcare.
CONCLUSIONS: To strengthen RNs\' work motivation and willingness to stay in the workplace, it appears important for healthcare organizations to provide RN social support.

OBJECTIVE: To test the psychometric properties of the Finnish version of the Dempster Practice Behaviour Scale and explore nurses\' professional autonomy along with which characteristics are related to it.
METHODS: An instrument validation and a descriptive cross-sectional study.
METHODS: The web-based survey was conducted in September 2021 at two university hospitals in Finland. Exploratory factor analysis (EFA) was used to explore the factor structure of the modified instrument, while Cronbach\'s α coefficients were calculated to determine the reliability of the scale. Descriptive univariate and multivariate analyses were conducted to examine Registered Nurses\' professional autonomy. The study followed STROBE guidelines.
RESULTS: During the validation process, the 30 items of the Dempster Practice Behaviour Scale were reduced to 25 items. The S-CVI/Ave for the translated scale was 0.94. When one additional item was omitted from the EFA, the results supported five factors, which explained 45.9% of the total variance. The mean overall autonomy score was 3.63 out of 5, with readiness and empowerment the subscales with the highest and lowest, respectively, mean values. The linear regression models showed that age, nursing experience, unit type, education, shift, and perceptions of the importance of professional autonomy were related to the subscales describing professional autonomy.
CONCLUSIONS: The psychometric testing provided evidence that the translated instrument was reliable. Nurses assessed that they are skilled professionals who are accountable for their actions. However, they experienced rather low levels of professional autonomy in empowerment and valuation. Health care organizations should consider this through authentic leadership and, thus, possibly strengthen professional autonomy.