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European Journal of Applied Sciences – Vol. 11, No. 5
Publication Date: October 25, 2023
DOI:10.14738/aivp.115.15723
Salminen-Tuomaala, M. (2023). What Factors Affect the Attractiveness of Nursing Education-Nurse Teachers’ Experiences.
European Journal of Applied Sciences, Vol - 11(5). 352-365.
Services for Science and Education – United Kingdom
What Factors Affect the Attractiveness of Nursing Education- Nurse Teachers’ Experiences
Mari Salminen-Tuomaala
Seinäjoki University of Applied Sciences,
Health Care and Social Work, Finland
ABSTRACT
Effective measures are required to mitigate the persisting nursing staff shortage. As
the number of applicants for nursing education is decreasing, it is important to
identify factors which can make the profession more appealing. This qualitative,
observational, cross-sectional study brings in the nurse teachers’ perspective. It
presents nurse teachers’ perceptions of factors that influence the attractiveness of
nursing profession to potential recruits. Data was collected through online essays
in May 2023 from 22 nurse teachers at a University of Applied Sciences in Finland.
As in earlier studies with nurses, nurse students and nurse managers, the
importance of improving the working conditions and promoting the general
appreciation of nursing and nursing education was emphasized. The teachers
appealed to nursing unions to speak for the importance of the profession in society
rather than emphasize the poor pay and stressful working conditions. The
participants also suggested improving the quality of teaching through evidence- based knowledge, individualized support, multiple modes of learning and effective
teamwork between teachers. Concern was raised over the quality of the clinical
training; finding clinical placements had been harder and clinical supervisors
overburdened.
Keywords: (4-6) Attractiveness, Experience, Nursing Education
INTRODUCTION
Effective measures are required across the world to mitigate the persisting nursing staff
shortage [1-3]. According to the International Council of Nurses, 13 million more nurses may
be needed by the year 2030 worldwide [3, 4]. Among the causes of the shortage are the ageing
of the population and of the workforce, a skewed work-life balance and decreased work
satisfaction among nursing professionals. Further frequently cited background factors involve
poor pay and working conditions, increased workload [1] and, most recently, the burden
imposed by the COVID-19 pandemic [5].
The decreasing number of applicants for nursing courses increases the need to attract and
retain nurses in the workforce [6]. Further research is required to examine what factors
influence the attractiveness of the nursing profession [7, 8]. This study, conducted in Finland,
presents nurse teachers’ perceptions of the topic. Until now, there has been little research on
the teachers’ perspective. The information produced can contribute to the body of information
that can be used to make the nursing profession more appealing to potential recruits. The
article is part of a series of articles on the attractiveness and retention in the nursing profession.
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353
Salminen-Tuomaala, M. (2023). What Factors Affect the Attractiveness of Nursing Education-Nurse Teachers’ Experiences. European Journal of
Applied Sciences, Vol - 11(5). 352-365.
URL: http://dx.doi.org/10.14738/aivp.115.15723
Besides nurse teachers, the articles will cover the perspectives of nurses, nurse students and
nurse leaders.
BACKGROUND
Some research has been conducted on factors that affect the attractiveness of the nursing
profession from the perspectives of registered nurse students [9-11]; practical (enrolled) nurse
students [12, 13], registered nurses [14] and nurse managers [15].
According to Wilkes et al. [16], the students’ reasons for applying to nursing programmes are
both personal and career related, with personal being more dominant. Although the desire to
help seems to persist as a compelling motivator for nursing students [10, 17, 18], job security
and a favourable employment situation may also affect students’ decision to apply to nursing
programmes. [10, 19]. Other potential reasons for choosing the profession have been found to
involve family or friend role models [18, 20], prior healthcare exposure [19], and being suited
for the profession [10, 21]. The image of nursing affects potential recruits’ decisions
significantly [21]. According to a recent study, nursing students found that the attractiveness
of nursing could and should be increased by enhancing the social recognition of the profession
at the level of individuals, organizations and society. Nursing students would appreciate
meaningful duties, influence over their work and fair employment conditions and salary. Work
and career advancement and good leadership were considered important for the appeal of the
profession [9].
Similarly, nurses often report having chosen the profession because of their “calling” [23] and
seem to find their work meaningful [24]. However, many of them report disillusionment later
during their career [23], often due to an unhealthy work environment characterized by
inadequate staffing, support and salary [25]. A current study reveals the nurses’ wish that their
profession should be made more appealing through increased appreciation and influence,
compassionate leadership and professional development and wellbeing at work [11].
In a study from the nurse manager perspective, the results were not different from those with
nurses and nurse students. The importance of good leadership and emotional atmosphere was
emphasized. According to the managers, nursing could be an appealing choice, if the workplace
ensured employee influence over their work and invested in constant development, flexible
rota planning and diversification of duties. Employers and workplaces with a good reputation
can attract and retain employees [15].
To summarize briefly factors that seem to undermine the attractiveness of the profession:
Nursing is still sometimes perceived as a course for (female) students with poor academic
ability and the work considered inferior to doctors’ work, with a limited level of autonomy [19,
26, 27). The gap between theory and practice [2] and idealism and realism [28], as well as safety
threats experienced during clinical practice [29] can undermine students’ will to continue
studying. On the other hand, newly qualified nurses have found that they are entering an
overburdened and understaffed healthcare system where they must transition quickly from
students to effective, competent practitioners [30]. New nurses may experience a “transition
shock” characterized by confusion and uncertainty [2]. Some studies have also raised concerns
about the competence of new nurses [31-33]. According to nurse managers, the attractiveness
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European Journal of Applied Sciences (EJAS) Vol. 11, Issue 5, October-2023
of nursing is marred by lack or resources, poor pay, stressful working conditions and a negative
media image [15].
Some recruitment and retention strategies have been proposed to address the nursing shortage
and to make the profession more attractive. Some of the proposals concern education, which
might be one of the easiest areas to start with. In concrete terms, young people could be exposed
to nursing in early school years to promote a better understanding of the role of nurses and
their career options [16, 19]. Researchers agree that both students and the public need more
realistic information of the nursing profession [9, 27]. In addition, exploring students’ career
choices by screening early during their enrolment might help understand factors that influence
career choices [34]. During the nursing studies, clinical teaching behaviour is an important
component [2]. Orientation and graduate transition programmes have been developed [30, 35]
to support recently graduated nurses on entering the profession. It is important that new nurse
gain access to supportive teams, and feel accepted and welcome at the workplace [36].
This study from the nurse educator perspective presents nurse teachers’ perceptions of factors
that influence the attractiveness of nursing profession to potential recruits.
METHODS
Study Design, Data Collection and Analysis
The study is based on an observational, cross-sectional online survey and on inductive content
analysis of qualitative data. The COREQ checklist for qualitative studies was used to help
conduct the study.
In May 2022, 22 nurse teachers at a University of Applied Sciences in Finland were contacted
via a group e-mail address designed for nurse teachers at the University. They received a cover
letter and a link to an online survey tool called Webropol, which allowed them to respond
anonymously to the following question: “Describe factors that, in your opinion, influence the
attractiveness of nursing education.” The response rate was 54.5% (n=12). The teachers were
also asked to give their age and number of years in nursing and teaching. They were not
requested about their gender, as there was only one male teacher in the organization.
Inductive content analysis was used to analyse the data [37]. First, the data (16 pages, Times
New Roman 12, spacing 1.5) was read through several times. Phrases, clauses and sentences
with similar contents were colour-coded, and relevant parts underlined and reduced to 124
expressions. The reduced expressions were grouped to subcategories, which were combined
into generic categories and finally collapsed to 2 main categories.
Ethics
The Code of Ethics Declaration of Helsinki of the World Medical Association [38] and Ethical
guidelines of the Finnish National Board on Research Integrity TENK [39] were observed
throughout the study process. Potential recruits were explained about the anonymity and
voluntary nature of participation in the cover letter. They gave their consent to participate by
ticking a box following the consent clause in the online form. Ethics committee approval was
not required, because the study did not involve health service users [40]. The Research and
Development Manager of the University granted the study permission. The response rate of