The purpose of this study was to describe the trends in occupational commitment before and after employment, and to examine the relationship between intentions to continue nursing profession. A longitudinal study with self-administered questionnaire survey was conducted. T1 was prior to employment, T2 was three months and T3 was one year after employment. Data from 138 new graduate nurses for whom no data were missing from T1 to T3 were analyzed. Affective commitment decreased from T1 to T2 (p < .001), and increased form T2 to T3 (p < .001). Continuance commitment increased from T1 to T2 (p < .001) and form T2 to T3 (p = .012). Normative commitment stayed flat from T1 to T2, and decreased form T2 to T3 (p < .001). Not only all the three dimensions of occupational commitment, but also were the increase of affective commitment (p < .001) and continuance commitment (p = .012) were significantly correlated with the willingness to continue nursing profession of T3. This study suggests the need of nursing organizations to consider with the condition and the conception of occupational commitment to support new graduate nurses.

We conducted a longitudinal study to assess workplace adjustment (burnout scores) and clarify the influence of factors that promote or detract from it (training systems, emotional support, stressors, and stress release measures) in newly graduated nurses using data obtained from surveys conducted on 64 nurses at 3 months and 6 months after beginning employment. Results revealed an increase in depersonalization and burnout scores. Results also indicated that 50% or fewer of respondents participated in half or more of the in-service training items surveyed. Scores recorded in the 3-month survey showed Lack of ability, Relationship with patients and their families, and Dilemma regarding care to be high stressors. Scores from the 6-month survey showed a significant reduction in stress from Lack of ability and a marked increase in stress from Dilemma regarding care. While "preceptors," "team leaders & senior nurses," and "chiefs" received high scores for Emotional support in the 3-month survey, they had dropped significantly by the time 6 months had passed. Burnout scores and stressor scores as well as emotional support scores and stress release measures were correlated, suggesting their impact on workplace adjustment. Stress from workplace relations and evasive stress release measures correlated with maladjustment at the workplace. Findings suggest that promoting workplace adjustment for newly graduated nurses requires the development of educational systems that build confidence in nursing skills, improvement of the supportive environment at the workplace, and provision of opportunities to learn desirable stress release behaviors.

The FISH! Philosophy is a pioneering workplace management system developed by the observation of work culture at Pike Place Fish Market in Seattle. The purpose of this research is to clarify how the introduction of the FISH! Philosophy into a nurses' workplace changes and stimulates its work culture. We launched a committee and conducted a staff training to revitalize the workplace of an acute hospital under study, and then introduced the FISH! Philosophy into it on March 2009. We, then, conducted satisfaction surveys of patients and nurses before and after the introduction of the FISH! Philosophy, and surveys of the FISH!-level in each hospital department and of self-judgment of motivation among nurses after its introduction. A total of 1,382 nurses and 4,573 patients were surveyed. We evaluated their practices of the FISH! Philosophy objectively and divided them into two groups — the departments that worked well to introduce it and the departments that did it poorly for making a comparison between them. There were following findings. In good-outcome groups of the FISH!-level three scores of the satisfaction survey at the workplace — occupation status, self-sufficiency as a member of profession, and the influence of interactive relations between nurses — became high. On self-judgment of motivation among nurses the scores of human relationship, environmental arrangement, and expectation/evaluation went up. On the satisfaction survey of patients the scores of greeting, explanation, response to nurse call, attention to noises, and the score of a nurse in charge became especially high in good-outcome groups. These findings reveal that the introduction of the FISH! Philosophy into nurses' working places properly improves nurses' satisfaction at work and motivation to work, leading to the improvement of patients' satisfaction.

Nurses of varying ages commonly work together as a team at medical care sites. Nurses aged 40 years or older account for greater than 30% of the nursing workforce. Of this number, the majority are employed as regular nurses who have not served in a supervisory position. However, few studies have been undertaken to investigate the process and background of career continuation among middle-aged and senior nurses. Because of this, questions such as how and when career motivation is generated remain unanswered. Therefore, this study was undertaken to clarify the perception of career continuation and structure the processes among middle-aged and senior nurses. Semi-structured interviews were conducted with 20 generalist nurses in their 40's or older using a revised grounded theory approach. As a result, seven categories and 37 subcategories were extracted. The seven extracted categories are "maintaining professional attitude," "understanding and cooperation from family," "well-developed work environment," "satisfaction with recognition," "confidence in practical ability," "adaptation to changing social needs," and "passion for work." The study showed that middle-aged and senior nurses perceive their work as an important means for self-realization, set their focus on satisfaction rather than comparison with others, develop emotional attachments to their work through support in the work environment and their own perception of nursing, and positively continue self improvement.

The purpose of this study was to elucidate factors related to career continuation among nurses raising children. Participants were 11 female nurses raising children aged 8 or under working full-time at hospitals within the Kinki region. After receiving written consent for participation, we conducted semistructured interviews and analyzed interview contents qualitatively and descriptively. Fifteen categories and 59 subcategories were identified in the analysis. To establish the rigor, participants were asked to review the results.

As a core factor that determines whether nurses raising children continue their careers, we identified the category "striking a balance between work and child growth." With respect to factors that serve as the foundation for career continuation, we identified the categories "emotional involvement with nursing," "the will to continue working," and "being aware of emotional support." With respect to factors that serve as back-up for career continuation, we identified the categories "consideration from coworkers," "help from family," and "available resources." Receiving "consideration from coworkers," such as from supervisors and colleagues, allowed nurses to "truly feel they are needed," which gave them the strength to continue working within the organization. Yet, at the same time, we identified categories related to factors that prevented nurses from continuing their careers, such as "experiencing hardship in the workplace" and "experiencing hardship as a mother." While these factors made it difficult to continue working, "efforts to overcome difficulties" allowed participants to continue their nursing careers. Furthermore, factors implicated in growth as nurses and the discovery of value in their work were identified in the following categories: "feeling consideration for others and gratitude," "realization of personal growth through the process of child-raising," "realization of the value of working," and "realization of the meaning of one's existence as a nurse raising a child." These factors helped nurses develop their own practical working models.

In order for nurses raising children to continue their careers, they must be respected as individuals, and working arrangements must be developed that consider the diverse working styles each has chosen to accommodate their individual needs.

We performed interviews in order to examine behavior and perception in the establishment of the role and range of practices of nurse practitioners (NPs) in the United States and to apply the findings in future Japanese NP systems. Seven NPs from a university faculty and hospital in the western US were interviewed. Two behavior categories were proposal and utilization of regulations and the quality assurance of NP practices. The behaviors were political and strategic.Four perception categories were good relationship between NPs and physicians, necessity of behavior for establishment, the traditional differences between physicians and nurses, and the affection for patients and nursing.The relationship between NPs and physicians was almost good, the standpoints as nurses were valued, and NPs are willing to provide the healthcare that nurses think significant.