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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.

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OBJECTIVE: Our New York City Municipal Public Health System-based multisite ambulatory and school-based Gotham Health clinics offer waived point-of-care tests and provider-performed microscopy to the local communities. Our Gotham Health laboratory service conducts system-wide centralized implementation, monitoring, and oversight of the POCT operations. Laboratory staffing has always been an issue for us as there is a decades-long shortage of laboratory staff, primarily licensed medical technologists and technicians, in New York, like many other states. Our clinical laboratory operations team struggled to hire qualified people even before the COVID-19 pandemic onset. It has faced more significant challenges with the emergence of SARS-CoV-2 pandemic cases in New York City and across the country since mid-March 2020. METHODS: As staffing continues to be a struggle, it directly affected the POCT performances and a system-wide reduction in the test numbers during the pandemic. We investigated to identify the factors that made staffing more challenging. RESULTS: The impact on our POCT started after laboratory staff relocated to the acute care hospital laboratories to provide testing support during the pandemic's peak. That caused significant delays or complete cessation of POCT operations in the clinics due to a lack of oversight support. We also experienced the risk of more vacated positions where staff already feel overworked, overwhelmed, and emotionally drained, causing professional burnout. The significant challenges identified are noncompliance with vaccine mandates resulting in job dismissal and voluntary resignations in exchange for higher-paying laboratories. Finally, the other challenges identified were frequent sick calls due to mental fatigue, retirement of seasoned staff, and inability to attract qualified technologists to meet the demands of increasing test-ordering patterns. CONCLUSIONS: Determining the factors that culminated in the staffing issues becoming more challenging during the COVID-19 pandemic in our ambulatory care clinic laboratory operations will help us in future crisis planning and mitigation.

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It is estimated that more than 9% of the global nursing workforce is male and that this share will gradually rise over the next decade. Although there are some positive aspects of having a male nursing workforce, men in the profession still experience discriminatory behaviours and practices. Fortunately, this does not deter a number of men entering undergraduate degree programmes. The aim of this study was to understand the experiences of 14 male nursing students in their first year of the adult Bachelor of Nursing programme. Using the Inventory of Male Friendliness in Nursing Programs and the Gender Role Conflict Scale, this study found that the male students felt welcomed, supported and included into the nursing programme. In addition, they felt no overall gender-role conflict, although feelings of success and achievement caused some challenges. The results of this study suggest that the male students did not necessarily experience those inequitable behaviours and practices reported in the literature. It has been suggested that perhaps the reality of clinical practice may change the perception of nursing for male students. Therefore, implications for further research could include a longitudinal study to ascertain where the perceptions of the nursing programme change for the male nursing students over time.

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NICUs have evolved in the last 20 years. Patients are being rescued at earlier gestation, and with this comes potential sequelae and complex issues throughout the hospitalization. As a result, there is an increased need for experienced, well-rounded neonatal nurse practitioners (NNPs) to care for these patients. Staff ratios are slow to catch up to the needs of the patients; NNPs are often caring for 15-30 patients at a time. This can leave the provider with a sense of not providing good enough care, burnout, and disillusionment with the reasons they entered school to become an NNP. This article provides a unique alternative to improve staffing ratios of students who are already familiar with not only the NICU, but your NICU: Relationships have been established and engagement of the unit is already present in the candidates.

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BACKGROUND: A lower recruitment and high turnover rate of registered nurses have resulted in a global shortage of nurses. In the UK, prior to the COVID-19 epidemic, nurses' intention to leave rates were between 30 and 50% suggesting a high level of job dissatisfaction. METHODS: In this study, we analysed data from a cross-sectional mixed-methods survey developed by the Royal College of Nursing and administered to the nursing workforce across all four UK nations, to explore the levels of dissatisfaction and demoralisation- one of the predictors of nurses' intention to leave. We carried out logistic regression analysis on available data in order to determine what impacts job dissatisfaction. RESULTS: In total, 1742 nurses responded to questions about working conditions on their last shift. We found that nearly two-thirds of respondents were demoralised. Nurses were five times more likely (OR 5.08, 95% CI: 3.82-6.60) to feel demoralised if they reported missed care. A perceived lack of support had nearly the same impact on the level of demoralisation (OR 4.8, 95% CI: 3.67-6.38). These findings were reflected in the qualitative findings where RNs reported how staffing issues and failures in leadership, left them feeling disempowered and demoralised. CONCLUSION: A large proportion of nurses reported feeling dissatisfied and demoralised. In order to reduce the negative impact of dissatisfaction and improve retention, more research needs to investigate the relationship dynamics within healthcare teams and how the burden experienced by RNs when unsupported by managers impacts on their ability to provide safe, good-quality care. These findings predate the current Covid-19 pandemic outbreak which may have had a further detrimental effect on job satisfaction in the UK and other nation's nursing workforce.

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The compendium of extraordinary operational skills required, the lack of recognition about the exact nature of nursing work, and deeply imbedded negative mind-sets result in staff nurses experiencing guilt and anger rather than the satisfaction of knowing they made a difference in someone's life because of the nursing care they gave. A change of mind-set from entitlement thinking to entrepreneurial thinking, with an emphasis on maximizing available resources, will empower nurses to understand that they have the right and the responsibility to decide what to do and what not to do when there is more work to do than time available.

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