Occupational Health Nursing Responsibilities

Chapter 1: Introduction

1.0 Background and context of the study

Nursing sector has, over time, developed into a vital element in the healthcare. Within healthcare sector, nursing practice advocate for health promotion, provision of care and health support, participation in rehabilitation, and importantly educating the public and patients on injury and illness prevention. As pointed by Pender et al. (2006) nursing play a critical role in aiding the families and societies at large to learn about healthy living by educating them on range of physical, environmental, emotional, and cultural aspects experience in different settings and within social or individual levels. World Health Organization (2017) describe the responsibilities and roles of occupational health nurses as part of larger health care providers involved in delivering services related to individual and public health. They work independently or as members of large multi-professional team aimed at promoting and protecting health of the population. Broadly, nurses ensure acceptable levels of care and hygiene is maintained while also monitoring health signs, giving IV’s, administering medication, and making sure adherence to prescribed medication. Numerous studies have been conducted on correlation between leadership and mentorship in different occupational field in particularly various fields of nursing. As pointed by mentorship programs as a platform of transferring knowledge, skills, and experiences that include benefits, challenges, and strategies within the fields. Fundamentally, it critical to have an insight into employees career objectives, personal mission, values in life, and desires in order to get the most out of an individual (Nowell et al., 2017; Flynn et al., 2018). By encouraging mentorship culture such as learning process driven by experienced individuals giving advice and direction to new and co-workers, organizations ensures employees are engaged actively in transferring culture, values, beliefs, and best practices core to the organization and field (DeForge et al., 2018). Evidently, organizations with structured and effective mentorship process experience high employee retention, taking ownership of individual and organization development, and delivery of cost-effective programs. These are elements of employee high satisfaction levels.

With respect to evolution in medical field with time, importance of nursing of generally ensuring care to patients and other individuals has grown. In modern society characterised by complicated medical condition and illnesses and growing rates of obesities, cancer, and diabetes, the need of nurses in these medical centres like hospitals, clinics, and care centres has intensified. Based on Griffiths et al. (2007) and Kemppainen et al. (2013) assertion, nursing has not only become broader field but also deeper. Based on the view nurses have responsibility that include nursing practices, illness prevention, consultation concerning health provision and promotion, conducting a follow-up treatment, and patient and community education on concerns relating to their health, it models the influence and significance of nurses to improvement and sustainability of care services, mitigation of chronic diseases, and enhancement of patients experiences towards the services. Keleher et al. (2009) and Bosch‐Capblanch et al. (2007) further pointed that health promotion done by professions in nursing filed can result in positive health outcomes such as enhancement of quality of life, adherence to medications and prescription, and patient and society knowledge on self-management and illnesses. Key factors of public health nursing is partnering and collaborating with communities and players in sector towards mitigating health obstacles. As asserted by Kemppainen et al. (2013), although credit has been directed to public health nurses on improvement in health for vulnerable individuals and population, all professions in nursing field should have deep understanding and awareness of link health promotion and preventive care on well-being of community and patients. Nevertheless, the nursing field has and continue to evolve becoming more complex exerted by increase and complicated health problems. Recently, considerably focus has been on re-examining the role and degree to which health promotion has impacted nursing (Polit, & Beck, 2008; Van Bogaert, & Clarke, 2018). Given that nurses are in directly and routine interaction with patients, they are in position to provide information on health management and improvement. As illustrated by Peate and Wild (2018), addressing effectively challenges and issues faced in health services require employing a holistic approach as opposed to lecturing or dictating patients and communities on factors and practices that negatively affects their health. For example, health practices such as exercising and smoking cessation are not new concepts to most people but tobacco smoking and lack of exercising related illnesses are big problem in most societies. These have led to development of perspective that health promotion is more availability and access of resources structured to advocate for healthy living rather than just education and information.

Survey conducted by Nursing and Midwifery Council (NMC) found that of 4,544 participants approximately half noted the reasons for leaving the profession was not retirement but rather workplace-related reasons cited by 44% of the respondents, personal reasons such as illnesses (28%), while 27% indicating disillusionment with care quality offered as reason. In addition to high number of nurses and midwives profession leaving the NMC register than those registering, another concern is recent findings of reducing number of nurses and midwives applying to work in the UK from European (NMC, 2017). According to Ford (2018) and Campbell (2018), the phenomenon is attributable to recent exit from European Union (EU) where workforces from other EU nationals refuse to work in the country. Based on the findings by NMC (2018) showing more than 3,000 fewer nurses from European Economic Area (EEA) work directly or indirectly the NHS in comparison to previous year, majority of professions claiming Brexit played a key role in their leaving or joining the council but other pointed the working conditions and environment as critical element (Matthews-King, 2018; Wight, 2018). In addition to disparities between those leaving and those joining the profession, shortage of nurses is associated with such factors as an aging workforces, limited nursing facilities, job stress and burnout, increasing demands for quality and efficient services, and dissatisfaction among the nurse on the compensation, working condition, and supporting structures (Lim et al., 2010; Flinkman et al., 2010; Coventry et al., 2015).

Historically, nursing field has encountered number of challenges ranging to poor working condition, limited support, and infrastructural aspects. In contemporary workplace, compensation, workplace hazards, and shortness in workforces resulting in increased occupational stress among the nurses and midwives (Lim et al., 2010; Flinkman et al., 2010). One of the great attributes of nursing is demand for patience, adaptability, time consuming, great attitudes, enormous demand of kindness and compassion. Lacking in any aspect of these qualities ultimately deems quality and efficiency of healthcare system (Burgess et al., 2010; Laal, & Aliramaie, 2010). As pointed by Rice (2012), nursing is among most strenuous jobs with most profession nurses reporting facing occupational stress and burnout. Studies by Gibbons (2010) and Burgess et al. (2010) found a strong correction emotional, physical, and mental exhaustion collective culminating to occupational health problem. Survey conducted recently across different nations indicate high prevalence of burnout among nurses with as high as half of registered nurses under 30 years experiencing high levels of exhaustion and stress (Van der Colff, & Rothmann, 2009; Chen et al., 2009; Khamisa et al., 2015). Extensively, stress in workplace has been viewed as hazardous in relation to provision of quality health services and dissatisfaction from both providers (nurses) and patients. In nursing profession, mentorship has gained great reputation and proving beneficial to the services provided and growing nursing profession as well as career satisfaction (Gruber-Page, 2016; Aston et al., 2014). National League for Nursing describes mentorship as core approach of dealing with shortages in the field. The NMC has maintained a description of mentorship grounded on offering support learning aimed improvement of quality of services, mentor being a registrant facilitating learning, and assesses and supervises knowledge and skills sharing (NMC, 2018)

1.2 Research problem and Justification

Evidently, nursing has been experiencing drastic changes including increased demands for efficiency and quality, shortages on professions, and increasing occupations stresses. Largely, shortages in professions in the field is attributable to increasing occupations stresses, burnout, low work-life relation (spending long hours working), and demand for quality services because of the time spend with patients. Ideally, the shortages in the fields cannot ne pinpoint to a particularly causing factors but rather multiple element ranging working condition, compensation, stress, and recently misaligned of structural support of nursing profession (Zarea et al., 2009; Allen, 2008; Combes et al., 2018). In the UK, the problem is attributable to poor working condition, aging population, and recently shortages as result of low EU nationals joining the council. In this perspective, this research focuses on investigating the role of mentorship on the nursing profession and influence it has on the registered nurses. It is a review study examining the contribution mentorship has had on nurses in terms of impacts and improvement of nurses’ retention, career satisfaction, advancement of services quality, promotion of nursing professional growth, and sustainability of nursing profession.

1.3 Scope of the study

Based on the government publication, the average age of the profession nurses was 48 years a worrying phenomenon as most approach retirement age. Moreover, NMC found that most of the nurses leaving the practices pointed to working condition such as workload and staffing levels, disillusionment with quality of services provided, poor pay and benefits, leaving the UK, concerns on abilities of meeting requirement for validation, and personal circumstance like childcare responsibilities and health problems. There is a gap of mismatch between the numbers of nurse professions leaving the practice and those who join. This has raised major concern on sustainability of the nursing practice in the country. One of the approaches perceived to mitigate dissatisfaction, enhance employee involvement, and promote engagement resulting in high retention level is motivation and mentoring employee on the challenges and positive elements in the field. As such, the study employs systematic review approach to capture the relation of mentorship and employee engagement, satisfaction, and career development within the nursing profession in the UK. Building on the significance and influence of mentorship on various fields as well as given that the mentoring is not a standard set in the nursing field, systematic review of literature is expected to demonstrated and outline progress of utilization mentoring approach to enhance career development, satisfaction, progress, and promotion of quality services. Therefore, it focused on determining whether such information are sufficient enough for warranting advocacy for developing and promoting mentorship programs within the nursing practice. Based on Chafin and Biddle (2013) assertion, systematic review on the components of mentorship, career satisfaction and development, and retention levels can acts as key element in examination of short falls and guidance towards organizational, individual, and profession practice in this case design of sustainable nursing. Moreover, reviewing existing studies systematic appraising critically to completely and exhaustively summarise the components of mentorship, career satisfaction, and development in nursing taking into account available evidences, strength, and nature for mentorship within the practice. In attempt to capture extensively and inclusively the fundamental elements and beliefs of this research, both qualitative and qualitative research approaches was anticipated to adequately covers literary information in the nursing practices that include attitudes, knowledge, skills, experiences, values, perception, career progress, structural support, retention, and recruitment process (Darby-Davis, 2014). In essence, the findings of this systematic review study could be useful not only at local and national level but regional because problems of dissatisfaction, low retention, and low career advancement opportunities are common across nursing practices in different regions and nations. Ideally, within clinical workplace in nursing practice, proportion of newly qualified and experienced nurses in the field is huge where the former can significantly benefit from mentorship program while experienced individuals could gain renewed viewpoint and perception of mentoring others through sharing skills, knowledge, challenges, and experience within the field.

1.4 Study aim

As pointed above, relationship between mentorship and career satisfaction, development, and delivery of quality services huge. Numerous studies have extensively highlighted the significance of career satisfaction and working condition on quality of services offered by respective individuals as well as supporting employees to gain experience and skills in the field. Similarly, there is undeniable relationship between mentorship and retention levels in different profession due to enhanced satisfaction levels. Therefore, this study aimed at reviewing systematically existing qualitative and quantitative studies on ways in which shortages of nurse practicing can be addressed through implementation of mentorship programs in the nursing filed. In essence, it focused on linking the mentorship programs to career satisfaction levels, career development, and challenges encountered by nurses that have forced majority to leave or consider not joining the field.

1.5 Research questions

In order to address effectively and extensively the above aims, this study worked towards answering the following questions critical to attainment to research topic.

Principal questions: Does mentorship in nursing influence career satisfaction of qualified and registered nurses?

Other questions answered within this study

Are the relationships between career satisfaction and retention levels in nursing?

How do mentee nurses benefit from mentoring by experienced and registered nurses?

Can implementation of mentoring programs in nursing practices across the country aid in overcoming the shortages of nurses, boosting career satisfaction, and enhancing quality of services offered?

1.6 Objectives of the research

With intention of answering and capturing the above mention aims and formulated questions, the objectives driving the direction of this research are:

To critically review existing literature on mentorship, career satisfaction, development, improving quality of services, and shortages in workforces predominantly in nursing field

To critically examine ways in which mentoring process in nursing can aid in addressing the problems of dissatisfaction within working condition, limited opportunities of career development, and low recruitment process.

To critically appraise the findings of systematic review before development of evidence based inferences on influence of mentoring nurses on career satisfaction

1.7 Conceptual framework

Studying the concept of high motivation in workplace, Winer and Schiff (1980) outlined achievement, opportunities for career development, and recognition were found as priorities to employees. Numerous researchers have outlined the motivating concepts that include offering better salary and benefits does not necessarily reflect to higher performance brought by increased satisfaction levels but rather in means employees are no longer dissatisfied. Dartey-Baah & Amoako (2011) illustrated that organizations must manage its workforce with same emphasis as motivating elements in order to develop lasting and long-term employee engagement and performance. Fundamentally, according to Aguenza & Som (2018) and Fernet et al. (2012) organizational management must figure out factors that directly affect employees working aspects by addressing complain and concerns raised. According to Parvin and Kabir (2011), one of key approaches is making sure supportive and effective supervision are in place, set platforms where employees can build their status and achieve personal goals while tailoring the tasks given to be in line with employees’ talents and abilities. Recent research has found that engaging workers predominantly in health sector and satisfying their respective primary needs stating that fostering as factors as intangible improvements through aiding employees have deep influence into their purpose and role in an organization and overall performance and service delivery.

Chapter 2: Literature review

2.0. Introduction

Within the literature review chapters, the theoretical concepts associated to satisfaction of employees with their careers, working environments, retention, career development, and demands levels in workplace. The chapter encompasses the concepts of such theorized concept as Maslow’s Needs Hierarchy, Herzberg’s Motivator-Hygiene, Dispositional approach, and Job Characteristics Model. It covers the concepts forwarded by existing findings of existing studies concerning correlation of satisfaction with conditions and working environment in one’s profession and advancement and retention of such profession. Lastly, it outlines missing link between the findings research relating career satisfaction with mentoring as captured by previous studies.

2.1. Definition of terms

2.1.1 Career satisfaction

Theoretically, career satisfaction is a measure of employees’ contentedness with tasks and responsibilities given within one’s job. According to Faragher et al. (2013), it describable within job or individual aspects of work given that it includes supervision or nature of work. Career satisfaction is measurable by behavioural perspective, affective (emotional aspects), or cognitive (evaluative). Studies have argued on the extent of measuring satisfaction pointing that individuals’ feelings and perspective towards jobs variables vary particularly due to affective and cognitive aspects of job satisfaction (Peng et al., 2016; Zopiatis et al., 2014). In their studies, Sageer et al. (2012) pointed that job satisfaction is relatable to numerous components that include amount of work, motivation, compensation, work characteristics, working conditions, growth and development opportunities, and rules and policies promoted by organizations or within particular field. Several studies have linked job satisfaction to employee and organization turnover, absenteeism, and productivity asserting that one attitude and perception towards given tasks and responsibilities significantly defines his/her behaviour (Martín Cruz et al., 2009; Mowday, 2013; Yücel, 2012). Beliefs and attitude held by a person pushes one to either exert more effort and commitment to the tasks and responsibility or decide to work less or even change profession (Judge, & Kammeyer-Mueller, 2012; Lee, & Cummings, 2008). Significantly, satisfaction to one jobs or career strengthens a company in terms of turnover, reducing absenteeism, increasing revenue, higher productivity, and enhancement of consumer satisfaction. Studies conducted by Macey & Schneider (2008) and demonstrated that employee engagement and satisfaction requires more than just structured benefits and compensation system but grounded on trust between senior management and employees, providing sense of security through transparency and honest communication, respectful treatment, established career development pathway with opportunities for higher responsibilities, and heathy working environment. In addition to remaining committed to their tasks and responsibilities, satisfied employees are extremely loyal towards their employer, organizations, and ultimately profession (Yee et al., 2008; Chi, & Gursoy, 2009). Turkyilmaz et al. (2011) argued that satisfied employees will stick even in the worst scenario, change in responsibilities, working conditions, or demands. Zigarmi et al. (2009) pointed that career satisfaction aligns with the passion employees have towards their jobs and subsequently organization. Dahlgaard-Park (2012) founded that satisfied employees lead a positive ambient life concentrating to their respective tasks and responsibilities. According to Lumley et al. (2011) and Hausknecht et al. (2009), satisfaction with job including tasks and responsibilities is a recipe of retention and sustainable workforce in terms of long term growth and guaranteed success. Research done by Aydogdu & Asikgil (2011) and Tsai et al. (2010) found that organizations with considerably high retention rate all of its trained workforce show higher success and growth in comparison to those with low retention rates.

2.1.2 Employee retention

Arguably, if employees leave the organizations or even profession after training it will ultimately cause significant problem towards sustainability. Undeniably, experience workforces bring in more than completing given tasks but core to organizational or profession growth through guiding newly recruited or qualified into beliefs and values held. Hancock et al. (2013) highlighted that employee attrition have pernicious effect on corporate performance as well as mission and culture. Examining the effect of employee attrition where workers depart organizations either voluntarily or following layoff in business environment. Subramony and Holtom (2012) pointed that it has a significant effect on branding and organizational bottom line. The findings indicate that service brand image (SBI) and employee turnover interconnect where it being determined by customers evaluations of services, perception levels on unit staff, and profitability. In healthcare sector, Moncarz et al. (2009) and Hausknecht et al. (2009) argued that the cost of attrition is very high both in terms of cost and quality of services offered. According to Collins and Collins (2004), highlighted that fostering an environment dedicated to employee retention is first step towards reduction of employee turnover in corroborating structures determining reasons for low retention rate particularly in health care system acts as key variable in developing an effective strategy of understanding employee needs. Although employee attrition vary depending on such factors as sub-nation regions, age of health workers, and health facility, and working environment, regions (countries) with high attrition rate often face a problem of meeting population need for health care, lower quality of care, and ultimately unsustainable healthcare system (Johnson, 2009; Pawar, & Chakravarthy, 2014).

2.2 Theoretical framework Job satisfaction

Theoretical aspects of job satisfaction and mentorship are subsumed under either process theories or content theories. As highlighted by Dugguh, & Dennis (2014), theorised concepts within job satisfaction and motivation overlap. The prominent theories capturing employee satisfaction and factors driving one to commit to given tasks and responsibilities include Rage of Affect theory, Maslow’s Needs Hierarchy, Herzberg’s Motivator-Hygiene, Dispositional approach, Job Characteristics Model, core of self-evaluations model, and expectancy-disconfirmation theory. Evidently, numerous studies have been conducted focused on concept of employee motivating factors and elements putting forwards theorised concepts and hypothesis aimed relating with respective performance. Nevertheless, within this study, it will focus on concepts as captured by attachment theory. Although it will not disregard those held by Herzberg’s Motivator-Hygiene and dispositional theory in attempt to bring the insight on ways motivation and performance in overall perspectives influence employees performance as well as outline factors purported by previous studies as fundamental to employee’s effective and high outcome.

2.2.1 Attachment theory

In psychological paradigm, attachment theory outlines the dynamics of long-term relationship developed by people with shared interest or characteristics. According to Bretherton & Munholland (2008), the theory depends on the proximity maintenance, safe haven, secure base, and separation distress among the people who are will to connect and maintain bondage with other in their respective lives (partners, siblings, friends, and colleagues). Supporters of the theory argue that this connection develops based on the needs of the involved parties for instance a baby forms attachment with its parent to ensure basis needs like care, pleasure, comfort, and safety are provided (Fonagy, 2018; Simpson, & Rholes, 1998; Holmes, 2014; Versaci, 2016; Bowlby, 1977). Moreover, the proponents of this theory have describe interconnects proposed as a ‘lasting psychological connectedness between human beings.’ Although it largely viewed in the form of child-parent attachment during development period, the concept holds significant aspect in development of future beliefs and perception towards environment and world (Slade, 1999; Simpson, & Rholes, 1998; Holmes, 2014). According to Fonagy (2018), Ontai & Thompson (2008), and Bowlby (2008), individuals with strong attached relations or rather safe and secure base have objective view in which to explore the world or relationship with others. Bowlby (2008) argued that cared individuals (babies) develop the notion to venture out and explore their respective environment with belief that the caregiver is always available to offer comfort and support in the event s/he encounter stress, difficulty, or discomfort. In workplace environment, according to Richards & Schat (2011) and Lin (2010) attachment theory implies that people have innate desire to seek support and care in the form of someone to look up to from caregivers. It distinguished into three styles namely avoidant (fearful and dismissing), anxious, and secure (become close to others). Leiter et al. (2015) highlighted that in workplace there are two attachment dimension: avoidance and anxiety where the former is strongly associated with positive social constructs (trust, psychological, and civility) while anxiety is largely linked to incivility and exhaustion. Collectively, these two dimension of attachment within burnout as determinant in work effectiveness and performance acts as congruence of value and improve incivility of employees. These findings are in line with those found by Hazan and Shaver (1990) who were among the first individuals researching into application of attachment theory into workplace. Recently studies have focused on linking attachment theory in workplace as a potentially viable for effective practice for workforce. Exploring the influence of experience faced during the early stages of employment or entry into potential career practice, Bond et al. (2010) and Law et al. (2011) claimed that first psychosocial experiences particularly caused by other people already in the field have fundamental effect on individual perception towards entire practice. McMillen (1992) described the theory in the form of cognitive paradigm stating that its congenial elements leaves lasting linkage with other individuals. Study conducted by Bear et al. (2015) into effect of attachment anxiety and avoidance in workplace concerning performance and propensity, argued that attachment theory outlines the mirroring process whereby individuals learn and acquire knowledge, values, relationships, and beliefs from the others (caregivers or mentors). According to Wilkinson (2014), initial development that includes in workplace acquiring knowledge and values pertinent to occupation is grounded on associative and rational nature of mind in which are products of inner and outer experience acquired from earliest experiences faced from key individuals (parents, caregivers, supervisors, or mentors). Kolb (2014) and Ng et al. (2009) illustrated that development of mind and genetic expression are interlinked depending on experience encountered.

Similarly, studies into extent to which disruptive base both emotional and physical during development of skills and knowledge, Bushnell et al. (2013) and Otto & Belardo (2009) pointed that it either result in insecurity and trauma or acts as core elements becoming schemas and models of one’s beliefs and perception within given environment. Critchfield et al. (2008) and Harms (2011) asserted that insecure attachment have lasting effect on decision-making process and leadership characterised by less delegation and micromanagement of employees while leaders as seen as inconsistent and exhibiting high-maintenance relationship with employees and other stakeholders. Lee and Hankin (2009) demonstrated that anxious attachment and avoidant attachment in workplace is associated with anxiety, depression, low self-esteem, and dysfunctional attitudes. According to Gillath et al. (2008) and Geller & Bamberger (2009), this ultimately results in low work performance. On the other hand, Simmons et al. (2009) and Scrima et al. (2015) demonstrated that secure individuals in workplace exhibits higher levels of engagement, more open-mindedness, involved, and supportive to organization’s goals and outcomes in comparison to those with insecure attachment. As argued by Simmons et al. (2009), secure working environment allows employee-management (supervisors) relationship to develop where individuals work autonomously and with others appropriately. Importantly, it affords individuals flexible and constructive working environment and space within interpersonal relationships consisting trust and hope. The findings from the study conducted by Simmons et al. (2009) where it surveyed 161 employees within secure workplace characterised by assisted living centre and supervision found a positive interpersonal relationship with both colleagues and supervisors. Numerous studies have found that securely attached individuals report being more satisfied with various elements of their respective jobs feeling challenged, secure, competent, and engagement with co-workers (Scrima et al., 2015; Towler, & Stuhlmacher, 2013; Simmons et al., 2009). Findings also indicate fewer physical, psychosomatic, and psychological symptoms of illness in secure individuals compared to attached individuals (Hazan, & Shaver, 1990). Individuals reported being ambivalent or anxious were found being worried and concerned about of rejection or approval by co-workers, on similar note avoidant individuals preferred working alone using work as inter-personal relationship and engagement with others. Moreover, according to Mende & Bolton (2011) and Rahimnia & Sharifirad (2015), employees with high abandonment issues or feeling unsupported tend to develop misperceive social situations due to perception of being rejected, criticised, or judged as well as pervasive social interaction that would be very exhaustive. Chugh et al. (2014) and Inalhan (2009) argued that these anxiety in employees emanating from responsiveness from social behaviour might be reflected on engagement and relationships with colleagues and costumers leading to strain relationship or increased work demands. Savicks (2001) and Harms (2011) pointed that individuals with careers in healthcare and preferring to work with people might lack insight that include core values, challenges, objectives, and mission of the occupation as well as actual capacity to find fulfilment in job description. Based on the above findings and arguments into attachment dimensions, one can argue in context that in presence of attachment figure, individuals tends to form stronger physical contacts paying special attention to characteristics, values, and beliefs of these individuals they look up to viewed in the form of leader-follower relationship.

Furthermore, Mount et al. (2006) exemplified that personality trait bound by secure attachment sets that individuals who can work autonomously and with others show positive relationship with hope and trust as well as recipe of good performance. The findings by Richards and Schat (2011) emphasised avoidant individuals tend to be self-reliant disengaging from affiliation with co-workers or leaders in workplaces by suppressing stress or negative influencers while ate the same time not seeking support for challenging tasks. On the other hand, anxious employees tend to display dysfunctional interaction patterns harbouring more of anti-social behaviour and high likelihood of quitting their jobs (ibid). Other significant concepts that need consideration in understanding relation between motivation and performance in workplace environment are Maslow’s Hierarchy of Needs and Herzberg, the motivation-hygiene theory. These two theories hold the argument towards elements that motivate employees to effectively output desired outcome. As such, giving insight into variables in put into consideration while seeking mentoring an individual in workplace, that is, what are the factors the pushes a person to work harder and exert more commitment into tasks given?

2.3 Motivating factors

Studies have demonstrated that encouraging employees to attain their potential and goals boosts self-esteem that in return result in enhanced commitment and input to the tasks and responsibilities given. According to Danish & Usman (2010) and Dobre (2013), recognising employers for individual and team input enhance self-esteem as well as perception towards the entire organization and its culture and values. Creating a workplace that allows employees to feel valued, appreciated, important, and comfortable through implementation of such structure as life-work balance, moderate workload, and encourage participation (Hafiza et al., 2011; Mone, & London, 2018). Lastly, Maslow indicated that people strive to attain self-actualization through realization of personal potential, seeking personal growth, and self-fulfilment stating “desire to become everything one is capable of becoming”. Elaborating the self-actualization need, Lazaroiu (2015) indicated that human are driven by need to fulfil personal goals, satisfaction, happiness, and ‘ideal self’. Jonas (2016) perceived theorised concepts by Maslow as enabling platforms that allows employees to be involved and be part of organization and creates a sense of belonging. Building from Maslow’s hierarchy on needs, one can argue that such elements as self-actualization and esteem are core in understanding reasons why employees decide to pursue or left certain profession over the others and reasons behind building strong relationship with particular employer (De Vito et al., 2018; Jonas, 2016). In writing, Meijerink et al. (2016) and Wang & Hou (2015) argued that organizations that can fulfil workers understanding the worker’s personal objectives and driving factors and design structure that takes advantages of such desire including aligning organization culture and values to match individual motivating factors will ultimately result in employee loyalty and retention. Unlike extrinsic motivators that demotivate employees when they are absent, intrinsic motivators are factors that in their present tends to create motivation. According to Herzberg, intrinsic motivators represent emotional aspects such as inter-personal relationship, career development, attainment of personal objectives, recognition, and challenging work whereas extrinsic motivators represents tangible needs that include salary, job security, basic needs, status, and job benefits (Herzberg, 2017; Jowett, 2008; Çınar et al., 2011). Lacking in extrinsic elements (hygiene factors) definitely leads to dissatisfaction, poor performance, and disengagement with one job and tasks given while intrinsic needs provide extra motivation. Basing on the concept of the theory, Dartey-Baah & Amoako (2011) suggested that organizations’ attempt to enhance employees’ performance and satisfaction with occupations and job must be grounded on nature of work that include opportunities it presents to an employee in achieving personal objectives, self-realization, and assuming responsibility. Subsequently, as asserted by Cummings et al. (2014) and Littlejohn (2012), management need to work on job environment such as policies, working conditions, procedures, supervision, and freedom availed to workers in focus to reducing dissatisfaction. Importantly, in order to ensure productive and satisfied workforce, employer must set deep consideration of both set of elements. As pointed by Ajala (2012), the theory sets in place platforms for answering such questions as factors that people seek in jobs and ways of engaging with employees as root of motivation and enhancing perception towards satisfaction with the jobs. Based on Lundberg et al. (2009) perception of the theory, a job or occupation with many satisfiers ultimately motivate workers, prompt effective performance, and provide job satisfaction but lacking of these satisfaction elements leads in dissatisfaction, poor engagement, and involvement resulting in poor performance.

Studying the concept of high motivation in workplace, Winer and Schiff (1980) outlined achievement, opportunities for career development, and recognition were found as priorities to employees. According to Lazaroiu (2015) and Cerasoli et al. (2014) offering better salary and benefits does not necessarily reflect to higher performance brought by increased satisfaction levels but rather in means employees are no longer dissatisfied. Dartey-Baah & Amoako (2011) illustrated that organizations must manage its hygiene factors with same emphasis as motivating elements in order to develop lasting and long-term employee engagement and performance. Fundamentally, according to Aguenza & Som (2018) and Fernet et al. (2012) organizational management must figure out factors that directly affect employees working aspects by addressing complain and concerns raised. According to Parvin and Kabir (2011), one of key approaches is making sure supportive and effective supervision are in place, set platforms where employees can build their status and achieve personal goals while tailoring the tasks given to be in line with employees’ talents and abilities. Research conducted by Nohria et al. (2008) found that engaging workers and satisfying the primary needs stating that fostering as factors as intangible improvements through aiding employees have insight into their purpose and role in an organization boost engagement and involvement into its mission and objectives.

2.4 Mentoring in workplace

As illustrated by Morris & Venkatesh (2010), under job characteristics models, management specifically the human resource personnel have responsibility to design a job structure and description that befits and satisfies requirements and employees qualification and personality. According to Hutchens (2010) and Cogliser et al. (2009), employees performance in terms of the output to the given tasks and responsibilities is largely grounded on description, perception, and relationship with other members as well as understanding of core values and culture within an organization. In addition to required skill and talents, implication of tasks on society or organization bottom line, understanding the tasks and expected outcome, and autonomy given while undertaking respective tasks and scheduling their tasks, extent to which employees are involved and engaged in tasks given such as guideline and expectation as well as constructive criticism acts as fundamental aspect to attainment of organization objectives and aims effectively and in depth (Luthans et al., 2008; Sadikoglu, & Zehir, 2010; Hameed, & Waheed, 2011). Katzenbach and Smith (2015) explained that employees receiving constructive criticism are forced to make adjustments in addition to developing deep knowledge and understanding of the concepts and requirements and averting severe consequences. Moreover, according to Hughes & Rog (2008) and Zhang & Bartol (2010, this approach of rotating and enriching employees in terms of the knowledge and skills held on particular field enhances engagement and exerts an element of empowerment to the large organizational contribution. Conducting study on relation between employee satisfaction and performance in financial industry, Hatane (2015) asserted that these variables to organizations output stating that employees who have positive relation with each other in workplace (that include management-employee relationship). Interviewing 33 companies in manufacturing sector and other 34 organizations in non-manufacturing industry, it found that performance-satisfaction of employees has a positive influence to organization or given industry market and financial performance. Elaborating further, the findings by Bakotić (2016) showed that organization performance is not determined by job satisfaction but rather vice-versa where satisfied employed drives the industry formulating the efficiency and output levels. Findings of the research done by Hmieleski and Corbett (2008)) highlighted some of the approaches where employee satisfaction and subsequently organization efficiency, effectiveness, and performance are structuring approaches and systems that optimises individuals’ values, skills, beliefs, and attributes. According to Bakotić (2016), job performance is a subject to nature of work, possibility of career advancement, supervision, relation with other employees, leaderships, and working condition. Bin (2015) argued that key elements to understanding employee satisfaction with tasks and job given are measuring job attitudes that incorporate sense of social responsibility and motivation. Studying mentoring and job satisfaction in small and medium-sized enterprises, Lo and Ramayah (2011) commented that significant relationship between job satisfaction and mentoring exist taking into account the co-workers and promotion. Building from the attachment and Herzberg two-factor theory and in focus to improve job attitudes and productivity, supervisors and employers must put more emphasis on both characteristics not assuming that increase in satisfactions elements will ultimately lead to decrease in dissatisfaction levels.

Methodology of systematic review

Similarly, this reviewed was expected to provide a fresh and new perspective on career goals and satisfaction levels for registered members who have had experience in the field. Therefore, employing a PICO (Population, Intervention, Control, and Outcome) provide an evidence based research where the conclusion made concerning career satisfaction as determined by mentoring (Aslam, & Emmanuel, 2010; Uman, 2011). First process involved identifying the problem and population of the study. Notably, registered nurses work in different capacities that include nurse practicing as clinical nurses, researchers, educators, and administrators. As such, the study population target included nurses working in this capacities in order to capture not only those practicing as clinical nurses but incorporate the entire nursing spectrum as profession. It considered registered nurses with mentorship training with anticipation of provide an insight into satisfaction with the approach or rather ways in which the profession could benefit with mentoring inexperience and newly qualified staffs part of research aim was to provide avenues and platforms where nurses would be offered mentorship in attempt to enhance satisfaction levels as well as retention rate. The control group consisted of the nursed with no prior mentorship programs training or being mentored within nursing profession. The data and acquired findings from these controlled and targeted population (trained and untrained or those who have not undergone mentorship training) comparing the findings to identify distinctive differences. Intervention technique sufficient in addressing the problem and attaining pre-formulated objectives adequately, the comparison or alternative of comparing the methodologies followed, data collected, findings, and assertion made in relation mentorship in nursing occupation. Lastly, the study had hypothesised significant influence of mentorship program in nursing occupation. Moreover, the study aimed to appraised and publish the outcome raising awareness of key variables that include career development, employee objectives, working conditions, motivation factors, and engagement as factors of career satisfaction and harboured by mentorship within nursing profession. Additionally, the expectation of the study prior to commencement of the research was to address low retention rate in nursing profession through use of mentoring to enhance intention to stay in nursing profession by nurses (qualified and newly qualified). The expectation of the research was that it could be able to address the rising shortage of nurses.

Chapter 3: Methodology

3.1 Overview of the chapter

The methodology chapter consists of the approaches and beliefs observed in development of knowledge and understanding onto influence of mentoring on job satisfaction, employee retention, and intention to stay in nursing occupation. It outlines the beliefs, values, and perception held pre- and post- data collection as well as during analysis process towards various research variables and concepts. Furthermore, it encompasses the procedures and plans embodying the steps observed from generalised perspective to detailed techniques in which the study obtained data and subsequent analysis and interpretation into usable information. Lastly, the chapter highlights the ethical consideration taken into account during entire research process that includes the integrity and relevance of the study to the academic paradigm and practical application of the findings.

3.2 Research ideological framework

Saunders et al. (2009) defined philosophical framework in academic research aspects as believes about educational process and approaches and values held in addressing the questions or problem at hand. According to Creswell & Clark (2017) and Speziale et al. (2011), it outlines the ideological beliefs on holds on ways and perception towards data collection, analysis, interpretation, and usage in attempt to answer or solve given problems and concerns. In academic research, several ideological framework can be adopted but it largely depended on expected results and one perception of the study variables. Saunders et al. (2009), Crossan (2013), and Hughes & Sharrock (2016), big proponents of the research philosophies, argued that belief had by research defines and decide the approach to be adopted and reasons all derived from research problems and pre-formulated questions. Ideally, it presents the researcher’s perception and views as well as assumption regarding the core researcher variables. According the Saunders et al. (2009), these assumptions acts as grounds for developing research approaches, strategy, and designs for tackling posted problems and questions. Ontology research ideology largely bases view and beliefs on nature of reality. As illustrated by Scotland (2012), it classifies study variables either objectively or subjectively. Unlike subjectivism that concerns on social phenomena emerging from individual’s perceptions and subsequent consequence of existence of these perceptions and assumptions, objectivism is founded on portraying social objects as subject of external reality to social elements that constitutes its existence (Bahari, 2010; Hamati-Ataya, 2014). Brown (2009) illustrated that objectivist perceive social phenomena and meaning derived from these components such poverty, social status, interpersonal relationship, and work-life balance exist independently. According to Goodwin & Darley (2008), these recognize the idea that one can develop knowledge and assertion from source and nature of variable in society that include moral while thinking and acting freely and independently. On the other hand, epistemology is another research belief that a research holds towards constituent of knowledge. According to Gray (2013) and Goodwin & Darley (2008), the ideology is focuses with possibility, source, and nature of knowledge emphasising on variables that are known being true. As mentioned before, the study focused on investigating and ascertaining the role of mentorship as a core determinant of nurses’ job satisfaction and retention rate by enhancing career satisfaction, involvement, and promoting nursing working environment. The variables of the research such as job satisfaction, retention rate, career development, service quality, personal growth, recognition, and incentives in, predominantly, nursing occupation can be subject in realistic spectrum. Unlike epistemological perspective that requires viewing these variables and subsequent influence on nurses’ occupation and job satisfaction in either true or true perspective, using ontological framework gave the study a platform viewing and discussing the variables of job satisfaction irrespective of either being true or false but represented in realistic spectrum (Scotland, 2012; Saunders et al., 2009; Hughes, & Sharrock, 2016). Oliver (2014) and Valentine & Fleischman (2008) argued that satisfaction is perceivable in subjective paradigm where it is derived from one individual’s opinion, tastes, emotion, intuitive, and feelings. As illustrated by Rogelberg et al. (2010), Sageer et al. (2012), and Auer Antoncic, J., & Antoncic, B. (2011), such factors as employee engagement, respecting, praising, appreciation, fair compensation, motivation, and life satisfaction are core determinants of job satisfaction and varies extensively from one person to another based on one beliefs and views. Hence, the use of ontological (subjectivism) research philosophical framework. Building from the fact that shortage of nurses is a resultant of several factors including early retirement, huge gap between those joining and leaving, and aging registered nursing workforce. The findings and data from government institutions indicate average age of registered nurses in the UK is very high at 39 years. Although these is attributable to official retirement age being relatively low set at 55 years especially in comparison to other nations such as Australia where ranges between 55 and 70 years of age (Scott, 2017, NMC, 2017).

Similarly, the dimension of qualified nurses joining and those leaving the profession has shifted, for instance, in 2016/2017, 20% more registrants left the register in comparison to those who joined. The findings indicate that more registered nurses leave the profession before retirement age. In fact, the study conducted by NMC surveying 4,544 individuals who had left the profession on their reasons for leaving found that 2,240 respondents did not cite retirement (NMC, 2017). However, their cited working conditions such as workload and staffing levels (44% of 2,240), disillusionment with quality of care provided by institutions to patients (27%) and personal reasons such as ill-health and family responsibilities. The data from NHS (2017) indicate more than 33,000 registered nurses left the registry. In this line of thinking where understaffing high leavers than joiners and big threat of aging workforce sets viewing the researching on the job satisfaction and mentoring in more subjective perspective. These include seeking answers to such concerns as reasons as for rising aging workforce, high early retirement, and very low number of individual joining the profession. Moreover, the research needed to seek whether the reasons to these concerns were related to working condition or rather individuals’ perception towards the entire nursing occupation. As illustrated by Jones (2013), Straus et al. (2009), and Renick & Zand (2010), mentorship is greatly grounded on relationship between mentee and mentor but not limited to such variables as communication, expectation, trust, and appreciation from both parties. Proponents of mentorship in workplace argue that for mentorship to be effective and attain its primal objective of supporting learning and development, it is instrumental for individuals with experiences in the field, in this case qualified nurses to have shared expectations and perception towards the profession with newly qualified and students in order to enhances one’s views towards the occupation (Renick, & Zand, 2010; Kahle-Piasecki, 2011; Sanfey et al., 2013). Therefore, grounding research process on the belief and perceptive that mentoring and satisfaction are interlinked by relationship of and expectation held by registered nurses in the field and newly qualified. Ideally, these variables are not measureable in either truthfulness or falseness but rather the elements that influence one’s behaviour or perception towards job satisfaction, mentorship, and retention in a realistic spectrum.

3.3 Research design and strategy

Using Cochrane (2013) definition of systematic review stating “A systematic literature review attempts ‘to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question”, investigation into mentorship of nurses in attempt to boost job satisfaction, retention rate, and performance levels followed integrating different and wide existing information in attempt to get a balanced viewed with minimised bias. Typically, systematic review of literature entails employing a well-structured and methodical plan in an orderly manner of collecting data from secondary sources, appraising synthesised sources, and then deriving an evidence-based inference on research concerns (Crossan, & Apaydin, 2010; Singh et al., 2012; Peters et al., 2015). According to Hammick et al., (2010) and Smith et al. (2011), it is pertinent to formulate a well-defined aims, objectives, and question appropriate to concerns raised or gaps intended to close. In writing, Mallett et al. (2012) argues that one must identify core variables to the research that acts as building blocks research question, identified gaps, and confirmation of duplication of previously conducted studies. It is worth noting that systematic review bases its entire process on developing an informed inference of research topics and subsequent concerns, problems, and questions using existing documentations predominantly published articles and journals. Ideally, as acknowledged by Ham-Baloyi & Jordan (2016) and Egger et al. (2008), the technique allows drawing inferences from experiences of several researchers from different fields and background. In addition to capturing a wide perception and view in addressing the research problems and questions, the approach improves the breadth and rigour. According to Peters et al. (2015) and Singh et al. (2012), systematic review should be taken as a ways of finding a sensible and robust answer to focused study aims. Nevertheless, it is time and resource-intensive process characterised by number of practical difficulties that include accessing, screening, and assessing intensively huge bunch of documentation while following similar steps on each articles, inherent contradiction such as unclear and vagueness in wording, title, and abstract (Mallett et al., 2012; Egger et al. (2008). Therefore, in attempt to counter these influential challenges, the study focused primarily on peer-reviewed articles and journals accessed from major databases and university library. Several keywords and phrases that focused on aims, objectives, and research problems were formulated then keyed to online search engines. The process encompassed randomly and sequentially searching of journals and articles that aimed to address concerns on job satisfaction, mentorship, and retention predominantly on healthcare sector. Although other fields were not directly rejected but rather researcher had to skim through the abstract checking whether the aims, concerns, and findings resonated with pre-formulated concerns and questions of this study. Moreover, as pointed out by American Nurses' Association (2010) and Watson (2011), given that nursing occupation is a multidimensional characterised several specialization and recently rapid expansion in term of number of staffers and job description where new staff members who may benefit from mentorship join the occupation annually, the approach offered a wide research spectrum.

3.4 Research approach

Lewis (2015) and Neuman (2013) described research approach as a plan and procedure embodying steps building on individual assumptions towards data acquisition techniques, assessment, transformation, and interpretation. In writing, Creswell, W. & Creswell, D. (2017) argued that it defines steps to be followed based on the nature and scope of the research problem and objectives aimed to attain. Two most prominent research approaches are qualitative and quantitative approaches. These approaches are differentiated by the nature of data collected, findings analysis, and presentation (statistically or capturing underlying factors) each describes. According to Punch (2013) and Johnson & Christensen (2008), qualitative explores the problem in attempt to gain an in depth understanding of underlying reasons, perceptions, and opinions derived from directly engaging the data sources for instance interviewing participants. Lewis (2015) illustrated that in addition to capturing the insight of the problem, it uncovers trends and opinions. On the other hand, quantitative research approach quantifies such variables as attitude, behaviours, opinions at hand expressing the findings statistically (Johnson, & Christensen, 2008; Teddlie, & Tashakkori, 2009). In essence, the technique uses large data to formulate facts and uncover trends developed from structured data collection methods such survey. Nevertheless, in order to capture both the numerically aspect of the research problem while also focusing on exploring the underlying factors and variables, a mixed method consisting of the elements of both qualitative and qualitative methods is used (Creswell, W., & Creswell, D., 2017; Teddlie, & Tashakkori, 2009). Garcia and Zazueta (2015) exemplified that it allows the research to gain the breadth and depth of research variables while able to triangulate aspects and phenomena more accurately by approaching from different angles and dimension. Within this study, career satisfaction and retention of nurses in the profession required employ more than one dimension that include investigating the numerical aspect of relationship between mentorship and job satisfaction in addition to exploring core and underlying on the linkage between these two variables. Furthermore, review into the research problem, influence of nursing mentorship on career satisfaction and retention rate of registered nurses, required taking into account, and reviewing the skills, knowledge, recruitment, retention, personal objectives, values, beliefs, and career progression held by registered nurses. As such, the study employed a mixed approach. As illustrated by Johnson & Christensen (2008) qualitative research methods accounts only for small data explored deeply and intensively hence failing to consider the large number of nurses involved and directly subjected into mentorship programme. Broadly, the research hypothesised using the results of the study in not only at national nursing level but also used in addressing issues faced in employee satisfaction and career development using mentorship program regionally (Europe) and internationally. In this perspective, the need to capture both underlying research factors and extent to which the phenomena affects career satisfaction and development in nursing occupation can be addressed by mentoring junior or newly registered nurses necessitated adopting a mixed research approach.

3.5 Data collection

This study into influence of mentoring newly qualified and junior nursing professions on career satisfaction and enhancement of retention rate employed purely secondary data and information as sources grounding inferences. As stated before, this is a systematic review of existing literature investigating and exploring studies on employee satisfaction, career development, elements of considered on career advancement, and retention levels. Ideally, the systematic review allowed integrating existing data and analysed information from a wide range of sources, research approach, data format, beliefs, and research environment (Smith et al., 2011; Dwan et al., 2008). As such and in focus to maintain validity and relevance, the data and information sources were selected from journals with structured inclusion and exclusion procedure. The data techniques employed was scientific replicable approach that involved a standardised and structured criteria designed to minimise biasness and promote a balanced view. Building from Berkley and Glenn (2009) assertion, the reviewing the previous articles and journals systematically provided a ground or a basis for rational decision making. The articles were located primarily through computerised searches and bit searching library journals and articles (manual). The internet databases considered and accessed include MEDLINE, Science Direct, British Nursing Info (BNI), CINAHL, PSYCHIINFO, EMBASE, Cochrane, and HMIC. These databases were accessed because of the reputable nature in provide well researched and comprehensive articles. The internet search involved keying keywords such as career satisfaction, mentoring, career development, employee retention, workforce motivation, employee’s beliefs and values, and importantly mentorship process in respective databases search engine predominantly focusing on nursing field. In manual search, the study accessed published articles and books the university library by using inverse searching. These involved locating index terms relevant to texts and articles searching systematically through documentation relevant to career satisfaction and mentorship in healthcare primarily nursing profession. Additionally, aforementioned keywords were searched directly on internet but prioritising on such websites as Department of Health, Google search engine, Royal College of Nursing, Nursing and Midwifery Council, and National Institute of Clinical Excellence.

3.6 Data collection process

The data collection processes employed within this study was systematic literature review involving identifying, assessing, and reviewing data and information previously gathered by other researchers. Broadly, the information obtained from these sources would be used to draw inferences into correlation between mentorship and career satisfaction while taking into account development and retention rate of professional nurses. Although the research had aimed to employee both online platforms and manuals components that include searching on internet databases and university library of articles relevant to career satisfaction, mentorship, and retention within nursing profession, it grounded the sources identification process to online databases. Primarily, it keyed in predefined keywords that include mentorship, career satisfaction, job retention, career development, working conditions, employees’ goals, engagement, involvement, and inclusion into several databases. The processes was conducted several times varying keywords, rephrasing searched terms, using different comparators and differentiators, rearranging the searched terms and words, and importantly limiting results literature to peer reviewed, nursing, and 2008-2018 since publication. Each process was replicated in different databases while noting found documents. During the documents gathering process, inclusion and exclusion criteria played a significantly role ensuring the literature to be reviewed captured adequately core variables the study while putting significant emphasis on addressing aims and objectives. The key components that were pertinent for inclusion included aims centred on career satisfaction, mentorship, retention rate, nursing profession, available in English language, and not older than 10 years since publication. All the identified literature were subjected to PRISMA flowchart aimed at enhancing transparency and scope of reporting by highlighting identification process, screening, eligibility, and included sources.

It is worth noting that the above findings were subject to limiters, expanders, source types, and data of publication, language, and combination of various keywords. The keywords that include career satisfaction, mentorship, mentoring, career development, and retention were varied randomly with each combination taken independently and as a new entirety but limited healthcare and nursing profession. Therefore, ultimately, duplication of articles was notable. In order to remove the duplication while retaining relevant documents that answers and address the research problems and concerns adequately, the employed the use PRISMA framework as outlined in figure 1 below.

3.7 Sampling process

As anticipated the documentations and studies in career satisfaction, career development, and mentorship programmes in workplace including occupations in healthcare was vast. Therefore, in order to ensure the data retrieved from these secondary sources were relevant and valid to address the questions and achieve objectives adequately, the study employed inclusion and exclusion criteria as highlighted in the table below. Based on Chafin et al. (2013) and Robinson (2014) illustration, the criteria broadens the viewpoint of the objectives and aims being examined but scope of inclusion as well as exclusion must be sufficient enough in order to incorporate variables that are irrelevant to the topic and aims of the studies that can skew the findings. Whereas, excluding too many variables can significantly limit the scope of the study leading to incomprehensive inferences. Robinson (2014) emphasised the importance balancing the inclusion and exclusion variables stating that researchers should consider developing a well thought and design approach sufficient enough to include relevant articles and journals.

Due to scope of the study (mentorship and career satisfaction in nursing profession while also focusing enhancing the intention of staying in the profession in not only the UK but globally), the expected existing literature covering the research variables within past 10 years since research being conducted or published was extremely many. As mentioned before, the articles accessed for review and assessment was projected to quite many because of the scope of the study (job satisfaction, mentorship, and retention rate) and dimension of nursing profession not only in the UK but global. Therefore, these necessitate of a structured system for effective elimination of irrelevant documents without bias while retaining those that could answer the research questions and address the objectives adequately and extensively. Employing the use of the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guideline to supplement inclusion and exclusion technique facilitate a checked protocol for items significant to the research in a flow chart format. According to Moher et al. (2009) and Shamseer et al. (2015), the approach enhances transparency and scope of reporting by providing a checklist of essential items pertaining the research variables and importantly capturing identified articles, duplicates, screened for relevance, eligibility, and either qualitative or quantitative synthesis.

3.8 Sampling and assessment process

The PRISMA below highlights the procedure followed in elimination of documents deemed invalid and irrelevant to the research. Ideally, the process entailed identifying duplicated documents obtained from above databases, online searches, and library, screening for relevance, and examining for eligibility. Following online and manual searches, more than 583,000 articles were identified across all platforms. However, after checking for duplication and similarity, only 9230 articles were available for screening. During screen process, the researcher had to skim through abstract and conclusion of identified articles (sources) capturing the concepts, contexts, opinions, and inferences made by authors while relating to aims, objectives, and importantly whether it resonates with research problems or not. Although the approach saved a lot of time, care had to be observed to avoid excluding useful articles and at the same time including documents that do not capture explicitly the aims and research questions. Further, 2030 articles were screened for eligibility with 1650 documents excluded because their failed to meet requirements such as context, methodology, findings, and conclusion. Lastly, the study categorised the findings into either qualitative based research approach or quantitative method. The 24 articles had followed qualitative research approach during initial study that focused exploring and expressing the data and findings with aims to gain underlying reasons, opinions, and concept. On the other hand, with that focused on capturing the data and findings numerically and statistically. Broadly, focusing on both research approaches ensures the research into correlation between mentoring and career satisfaction in nursing profession. Ultimately, 42 documents derived from both qualitative and quantitative research approach all obtained from online databases or manual searches from university library.

Respondents of the study conducted by Norman (2015) aiming to investigate extent to which mentors can help foster pre-registered nurses to instil positive aspects and attitude towards the profession highlighted significant influence and a leading approach in promoting concept of excellence and engagement. In their studies, Nelsey & Brownie (2012) and Ferguson (2011) corroborated this findings by claiming that in addition to creating an environment with shared, clearly articulated, and firmly established goals and culture within the profession, mentorship programs facilitate structured communication unit and understanding of core values integrated by organizations and within the profession. While seeking to determine whether mentorship program influences newly qualified nurses in transitioning into practice and intention to stay in the occupation, Szalmasagi (2018) and found participants who participate in the program had easier transition process and adoption to requirements and demands of nursing profession. Research conducted by Mariani (2012) aiming explore the effects of mentoring on career satisfaction and intention of registered nurses to stay in nursing profession by surveying RNs practicing as clinical nurses, in education, research, or administration. Despite majority of nurses claiming being mentored (in mentoring relationship), the findings indicated no statistically significant effect and relationship between intention of staying as well as career satisfaction and mentorship.

3.9 Ethical consideration

In conducting any research not just social studies, it is pertinent to observe ethical guidelines as outline within British Psychological Society. In writing, Smith (2015) and Hammersley & Traianou (2012) defined ethics as rules and guidelines adhered while conducting a research but particularly observed in social research. It comprise of protection of participants, informed consent, upholding confidentiality, being able to withdraw freely, privacy, and participants protection. It worth noting that this study did not engage or involved the participants directly (used secondary data) hence not privacy or consent letter was required to be signed prior to conducting the research. Nevertheless, the obtained data from these secondary sources and subsequently information acquired need to be reliable and valid. As asserted by Walker and Solvason (2014), reliability and validity a research builds trustworthiness of findings and inference made. In order to ensure the research was reliable and valid, the study ensured all data and information obtained and used within the study are well and accurately represented. Additionally, it focused on maintaining academic and social integrity.

Chapter 4: Findings and Discussion

4.0. Overview of the chapter

Within this section of the study, it outline the data gathered from secondary sources, examination and assessment process, and subsequent transformation into usable information in addressing pre-formulated research questions, problems, and concerns. As mentioned above, this research intended to address benefits of mentoring on career satisfaction and correlation to retention rate in nursing profession by systematically reviewing existing literature. Therefore, the findings obtained are primarily from secondary sources predominantly peer-reviewed articles pertaining mentorship, career satisfaction, and intention of staying in the profession within nursing occupation not only within the UK but globally. The chapter encompasses the process followed, the guidelines, and values observed, and principles core to data acquisition, assessment, interpretation, presentation, and discussion. Ideally, the section is sub-divided into two parts namely findings and discussion. The findings sub-section consists of process employed that include keywords used, websites accessed, inclusion and exclusion criteria, PRISMA flowchart, and raw data obtained whereas the discussion part outlines the gathered data in relation to existing views, opinions, discussion, and inferences while reflecting on objectives and questions held at the start of the study.

4.1 Findings

Using the above-identified articles, the researcher went through all articles both qualitative and quantitative categorised with aim of identifying data, arguments, discussion, and assertion with similar views or grounds. Those perceived held similar line of thinking were grouped together through coding. Nevertheless, key consideration during coding process was capturing data and findings aligned to mentoring of the nurses towards achievement of objectives and goals stipulated as well as efficacy of services delivered. As such, the keywords, meaning, and discussion on mentorship, career development, career satisfaction, employee retention rate, and mentoring process collectively modelled towards nursing profession. Through coding (process of identifying patterns in data and findings from previous studies and labelling them accordingly), the researcher was able to highlight features related to research variables after taking theoretical and analytical perspective towards texts and ideas presented.

4.2.1 Mentorship, career development, and career satisfaction

Exploring the impact mentorship programs on commitment and job satisfaction by new staff nurses, the research by Weng et al. (2010) administered questionnaire to 306 nurses within Taiwan hospital revealed role modelling has a positive effects on new nurses’ commitment, career development, and job satisfaction. After reviewing and analysing relating the job satisfaction among registered nurses, Lu et al. (2012) and Peters et al. (2010) found levels of similarity in source and effect of job satisfaction in nursing occupation. The findings reflected the correlation between working conditions and role conflict, job stress, ambiguity, occupation environment, role perception, and commitment. The assertion held by respondents was that absence of a robust casual model driven by supportive and guidance newly recruited staff members undermine improvement of retention rate. Similarly, analysis of more than 900 survey outcome by Yıldız et al. (2009) designed to work characteristics influencing intention to quit nursing profession it revealed a significant linkage between motivation to work and nurses’ intention to stay in the profession. Assessing the articles focusing on mentorship in workplace, all have a striking agreement on influence held by mentoring the newly qualified individuals on career satisfaction, development, and performance. Key findings posted by Heinrich and Oberleitner (2012) concerning implementation of mentoring programs in a bid to develop and enhance relationship between newly qualified (recruited) staff members and experiences (registered) nurses established a generic view of the role structured programs in integrating specific roles and responsibilities core to nursing occupation. According to Brown et al. (2009) and Eller et al. (2014), using the experiences and perspectives of experienced individuals in the field enhances diversity of knowledge and skills that include respective development. Moreover, through implementation and emphasis of mentorship programs ensures stressing of clinical tracking forms, appropriate feedback mechanism, and planning as well as monitoring system, which, according to Annear et al. (2014) and Rooke (2014), are key elements of career development and competency. Collectively, this propels pre-registered nurses be conversant with regulation and guidelines during early stages into the profession. Fundamentally, workers’ satisfaction is grounded on perception and interest towards their role and responsibility on respective jobs. Significantly, it has pertinent influence on input and subsequently affecting productivity. Research conducted by Fox (2010) and Mariani (2012) pointed that the moment employees feel their roles and responsibility are monotonous and maybe not challenging enough or they do not sufficiently grasp core elements and values of occupation or organization, interest of workforce towards organizational or occupation values and objectives, problems to be solved, and mission to be attained become limited or challenged experience within the occupation. In essence, as elaborated by Atefi et al. (2014) and Wang et al. (2012), in nursing occupation, jobs have mundane attributes and characteristics that are only bounded within tasks and responsibility as descripted and required.

According to organizational psychologist and management theorist, argue that responsibilities and duties given to employees are occasionally repetitive and counter-productive that leads to demotivated workforce. Based on this assertion, Halbesleben & Wheeler (2008) and Wood et al. (2012) perceived job satisfaction as founded on itself where interactive, involving, and varying tasks improves motivation and perception towards respective responsibilities and task. Furthermore, the findings on job embeddedness and work engagement indicated distinctness empirically in the two variables stating that each share unique constructs on performance and intention of employee to leave organization or occupation (Halbesleben, & Wheeler, 2008). Importantly, developing a two-communication channel designed to vary job and provide meaningful sharing of information and ideas between senior/management with the junior staff employees results in more engagement coupled with increased sense of responsibility for the outcomes (Van den Broeck et al., 2008; Clynes, & Raftery, 2008). Subsequently, Webb & Shakespeare (2008) and Semper et al. (2016) highlighted that extent to which constructive feedbacks aid in promoting performance and learning on pre- and registered nurses through clarification and instilling preferred and actual behaviour and values. Majority of participants to the study on importance of integrating constructive feedback as element of support and promoting learning argued that in addition to providing a platform for professional growth, constructive feedback sets roadmap, confidence, and motivation to both newly qualified and registered nurses (Eller et al., 2014; Nelsey, & Brownie, 2012). Theoretically, in development of job characteristic model, Hackman and Oldham identified job rotation and job enrichment aimed to incorporated tasks and responsibilities meant to taken by other members and enlightening employees on skills and knowledge form other fields hence creating diverse individual and knowledgeable on other areas of the occupation. Ideally, positive feedbacks enable the newly recruited nurses or students to determine their respective progress as well as expected outcome and responsibility. Plakht et al. (2013) and Chen & Lou (2014) asserted that foundation of effective and beneficial mentorship is development of mutual understanding grounded on learning the challenges experienced in the field coupled with mentee’s strength, weaknesses, and values.

4.2.2 Mentoring in nursing profession

In study on career development of physician with aims of exploring the role and functions of mentoring and role-modelling, Taylor et al. (2009) interviewed twenty-five participants where 11 were aspiring leaders and 14 physician-leaders. The findings found three emerging themes; first, respondents highlighted the significance of observational learning (watching leaders-in-action). Secondly, psychological and emotional support perceived most valuable interventional activity, and lastly, respondents highlighted strategic interactions addressing individual professional elements directly rather traditional longitudinal approach. The findings from studies conducted by Perry (2009) and Felstead (2013) examining the influence of role modelling as a form of mentorship indicated that exemplary nurses acts as excellent models such as making connections, guarding the others, and maintaining a light-hearted attitude contributing greatly to learning in practice setting. Dimitriadou et al. (2015) found that qualified staff and teachers exemplify the attitudes, behaviour and significantly influence professional development of students and newly qualified nursing. Similarly, studies conducted by Akerjordet & Severinsson (2010) and Fox (2010) identified four themes stating that roles models acts as guide towards professionalism, resources of knowledge and skills, cultural learning, and psychological and mental support. Respondents of studies done by Vinales (2015) and McInnes et al. (2015) lamented that mentors emulate the behaviour and work ethics of mentees. Furthermore, in addition to providing appropriate learning opportunities that include understanding the role played by nurses in primary care and challenges encountered during practice, participants argued that role models offer concept of belongingness and support of pre-registered nurses into the practice. Researching on the role played by mentor in advancing performance as grounded by engagement and involvement of workforces in attempt to advance commitment conducted by Gutierrez et al. (2012) and McDonald et al. (2010) found measure of success requires help of workforce feeling need and integrated into organizational culture and structures. According to Bramble et al. (2018), the best approach of such bring in and engagement is through a person with indent understanding and commitment to tasks and responsibility given leads to improved outcome. In essence, workforce performance, clinical quality, retention rate, and satisfaction are subject to leadership and involving the employees to organizational culture and objectives. Cottingham et al. (2011) found a significant correlation between mentoring and employee retention rate especially after integration of Partners in Nursing (PIN), a community-based mentoring program. The findings are in line to those of the research conducted by Chen and Lou (2013) where it revealed implementation of mentorship programmes in healthcare environment reduces employee turnover and rate of negligence while subsequently increasing job satisfaction and professional identity. In similar scope of mentorship and retention rate, recently registered nurses, as participants of study conducted by Laschinger (2012) and Brown et al. (2013) asserted that multi-dimensional teaching and support system are greatly beneficial to them in both short- and long- term perspective to profession.

4.2.3. Mentoring and intention to stay (retention)

According to Rhéaume et al. (2011) and Cottingham et al. (2011), implementation of supportive concepts to pre-registered and new staff members aid in accelerating the workforce through the novice to experienced-expert state. Hamburg (2013) and Leggat et al. (2015) indicated that the idea of learning intervention involving direct interaction between novice mentee and experienced mentor promotes personal attitude, skills, knowledge, and competencies. These are achievable through sharing insights of an organization or profession, expanding mentee networks, and harnessing developmental feedbacks acts as psychological trigger to workforce as being valued and engaged. According to Naim and Lenka (2017), in addition to providing coaching, counselling, and guidance, mentors provide sponsorship, exposure, and appraisal to mentees that go a long way in facilitating competencies development. Majority of participants to the research on RNs retention and the working environment, Duffield et al. (2011) stated that offering supportive and learning methods from experienced experts appreciably benefits retention within hospital environment. By using open-ended research question to survey whether mentoring had a positive influence to nurses job satisfaction and retention rate, the findings by Horner (2017) were in agreement with assertion made by respondents to Job stress, psychological empowerment, and job satisfaction research conducted by Chung and Kowalski (2012) where all participants held the view that mentor experience/relationship greatly and positively influences job and career satisfaction through direct learning, communication, and interaction with experienced individuals in the respective field. Evaluating the pre- and post-intervention technique designed to measure job satisfaction and retention rate in nursing, Latham et al. (2008) and Harrington (2011) found an increase intention to stay mean score as well as satisfaction levels with the programs. Studies have identified sources of occupational stress and burnout in the sector highlighting changes in working environment and medical sector at large, increased responsibilities, decision making, and patient care as major causes. Historically, nursing medical practice has been associated to stress-filled caused by physical labour, interpersonal relationship, staffing, working hours, demand of efficiency, and turbulence in working environment (Woodhead et al., 2016; Yıldırım et al., 2017). Ribeiro et al. (2014) found prevalence of burnout syndrome among nurses at 10.1% while more than 55% showed propensity of developing the problem. Similarly, in evaluating the components of socio-demographic profile among nursing professions, the findings showed majority, over 35 years women, had no children, working more than 36 hours a week, and without extra employment. The assertion points that such factors as emotion, marital status, and workload aggravate occupational stress and subsequent burnout syndrome. In addition to these work-related stresses, burnout, and challenges on nursing fields, nurses both newly qualified and postdoctoral nurses have experiences great difficulties developing sustainable practice measured by satisfaction levels, advancement, and number of individuals leaving before retirement (including low early retirement) due to lack or limited career development opportunities (Richardson et al., 2015; AnAaker, & Elf, 2014). Several strategies tailored to address the issues of occupational stress and burnout while enhancing satisfaction among patients and providers have been forwarded. Among them are stress reduction classes, recognition and rewards, compensation, involvement, and importantly mentorship programs (Rushton et al., 2015; Gunasingam et al., 2015; Woodhead et al., 2016). According to Butterworth & Faugier (2013), importance of mentorship to nurses whether newly qualified or experienced is observable in sustainability in healthcare provision and career development. Johnson and Ridley (2018) described mentoring in workplace as a mutual professional relationship where experienced individual help less or newly qualified employee to learn and acknowledge knowledge, skills, and experiences within a shared goals. An experienced individual (mentor) is a trusted adviser and role models towards mentored (mentee) in terms of career development and personal growth (Nowell et al., 2015; Johnson, & Ridley, 2018). The core principles of mentorship are built on support, encouragement, and direction offered by mentors either specifically or generally through suggestions and knowledge. As illustrated by Ali (2008) and Nickitas (2014), the goals of the process are helping mentees gaining job and life experiences, improve skills, and grow career-wise.

Chapter 5: Conclusion

This review study was driven by need to explore through systematic assessment of existing studies the effects of mentoring on job satisfaction, workforce retention rate, and intention to stay by qualified nurses in the nursing occupation. Broadly, nursing profession has been experiencing increasing shortage in registered nurses due to early retirement, huge difference between leavers and those joining the profession, and failure to instigate effective retention strategy where high portion of qualified nurse do not remaining in the profession as clinical nurses, administrators, educators, or researchers but rather opt to leave the occupation. This study employed ontological philosophical framework focusing on both qualitative and quantitative research articles retrieved from online databases such as Medline, CINAHL, EMBASE, Science Direct, and PSYCHINFO. Pre-defined keywords and phrases relating to mentorship, career satisfaction, career development, retention, and intention to stay within nursing were searched directly in these databases, internet searches, and university library. It employed inclusion and exclusion technique and subsequently PRISMA framework where it identified and examined the articles for relevance and validity within the scope and dimension of the formulated aims and objectives. 42 articles were identified for review to answer and address research problem on job satisfaction, retention, and mentoring in nursing profession. Employing qualitative perspective in exploring the retention probability of nurses using mentorship programs contended that contemporary mentoring approaches that include developing quality life elements of nurses goes a long way in promoting the intention of staying. Review of literature showed integration of mentoring programs into organization or occupation culture and structures leads to increased retention. The review literature relating mentorship and nursing retention rate highlighted increased recognition and commitment significantly following integration of mentoring programs by organizations and healthcare environment. Although, it is worth noting that the findings gathered depicted little correlation statistically in terms of the extent to which retention rate is influenced by mentoring. Most of the reviewed literature held the view that mentorship programs characterised by teaching-learning engagement acts as framework for supporting and fostering pre-registered (newly qualified) career development, competencies, confidence. From the findings, by mentoring newly qualified individual, they are able to gain practical advice, encouragement, and support, learn from the experienced registered nurses on the challenges, difficulties, and positive elements in the occupation, enhances individuals’ social and academic confidence, work towards developing communication, study, and personal skills, creates platforms for dealing with personal and academic issues, and importantly identifying goals, and establishing sense of direction to new staff into occupation. Collectively, this sets premises of being satisfied with tasks and responsibilities allocated within the occupation. Theoretically, employees satisfaction with structures, conditions, environment, tasks, responsibilities, cultures, and values held within an organization or occupation lies deeply on conceptualization and perceptions held towards the same. As such, core principles of mentoring are creating environment and platforms where newly qualified (pre-registered) or students can gain insights understanding of demands, values, expectation, beliefs, and responsibilities within the profession.

References

Aguenza, B. B., & Som, A. P. M. (2018). Motivational factors of employee retention and engagement in organizations. IJAME.

Ajala, E. M. (2012). The influence of workplace environment on workers’ welfare, performance and productivity. In The African Symposium (Vol. 12, No. 1, pp. 141-149).

Akerjordet, K., & Severinsson, E. (2010). The state of the science of emotional intelligence related to nursing leadership: an integrative review. Journal of Nursing Management, 18(4), 363-382.

Allen, L. (2008). The nursing shortage continues as faculty shortage grows. Nursing Economics, 26(1), 35.

AnAaker, A., & Elf, M. (2014). Sustainability in nursing: a concept analysis. Scandinavian journal of caring sciences, 28(2), 381-389.

Aslam, S., & Emmanuel, P. (2010). Formulating a researchable question: A critical step for facilitating good clinical research. Indian journal of sexually transmitted diseases, 31(1), 47.

Atefi, N., Abdullah, K. L., Wong, L. P., & Mazlom, R. (2014). Factors influencing registered nurses perception of their overall job satisfaction: a qualitative study. International nursing review, 61(3), 352-360.

Auer Antoncic, J., & Antoncic, B. (2011). Employee satisfaction, intrapreneurship and firm growth: a model. Industrial Management & Data Systems, 111(4), 589-607.

Aydogdu, S., & Asikgil, B. (2011). An empirical study of the relationship among job satisfaction, organizational commitment and turnover intention. International review of management and marketing, 1(3), 43-53.

Bear, J. B., & Segel‐Karpas, D. (2015). Effects of attachment anxiety and avoidance on negotiation propensity and performance. Negotiation and Conflict Management Research, 8(3), 153-173.

Bin, A. S. (2015). The relationship between job satisfaction, job performance and employee engagement: An explorative study. Issues in Business Management and Economics, 4(1), 1-8.

Bosch‐Capblanch, X., Abba, K., Prictor, M., & Garner, P. (2007). Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities. Cochrane Database of Systematic Reviews, (2).

Bramble, M., Maxwell, H., Einboden, R., Farington, S., Say, R., Beh, C. L., ... & Rickard, G. (2018). Exploring and Improving Student Engagement in an Accelerated Undergraduate Nursing Program through a Mentoring Partnership: An Action Research Study. International journal of nursing education scholarship, 15(1).

Brown, C. E., Wickline, M. A., Ecoff, L., & Glaser, D. (2009). Nursing practice, knowledge, attitudes and perceived barriers to evidence‐based practice at an academic medical center. Journal of advanced nursing, 65(2), 371-381.

Brown, P., Fraser, K., Wong, C. A., Muise, M., & Cummings, G. (2013). Factors influencing intentions to stay and retention of nurse managers: a systematic review. Journal of Nursing Management, 21(3), 459-472.

Burgess, L., Irvine, F., & Wallymahmed, A. (2010). Personality, stress and coping in intensive care nurses: a descriptive exploratory study. Nursing in critical care, 15(3), 129-140.

Cerasoli, C. P., Nicklin, J. M., & Ford, M. T. (2014). Intrinsic motivation and extrinsic incentives jointly predict performance: A 40-year meta-analysis. Psychological bulletin, 140(4), 980.

Chen, C. K., Lin, C., Wang, S. H., & Hou, T. H. (2009). A study of job stress, stress coping strategies, and job satisfaction for nurses working in middle-level hospital operating rooms. Journal of Nursing Research, 17(3), 199-211.

Chen, C. M., & Lou, M. F. (2014). The effectiveness and application of mentorship programmes for recently registered nurses: a systematic review. Journal of nursing management, 22(4), 433-442.

Chugh, D., Kern, M. C., Zhu, Z., & Lee, S. (2014). Withstanding moral disengagement: Attachment security as an ethical intervention. Journal of Experimental Social Psychology, 51, 88-93.

Cogliser, C. C., Schriesheim, C. A., Scandura, T. A., & Gardner, W. L. (2009). Balance in leader and follower perceptions of leader–member exchange: Relationships with performance and work attitudes. The Leadership Quarterly, 20(3), 452-465.

Combes, J. B., Elliott, R. F., & Skåtun, D. (2018). Hospital staff shortage: the role of the competitiveness of pay of different groups of nursing staff on staff shortage. Applied Economics, 1-6.

Coventry, T. H., Maslin‐Prothero, S. E., & Smith, G. (2015). Organizational impact of nurse supply and workload on nurses continuing professional development opportunities: an integrative review. Journal of advanced nursing, 71(12),

Critchfield, K. L., Levy, K. N., Clarkin, J. F., & Kernberg, O. F. (2008). The relational context of aggression in borderline personality disorder: Using adult attachment style to predict forms of hostility. Journal of Clinical Psychology, 64(1), 67-82.

Cummings, G. G., Grau, A. L., & Wong, C. A. (2014). Resonant leadership and workplace empowerment: The value of positive organizational cultures in reducing workplace incivility. NURSING, 32(1), 6.

Danish, R. Q., & Usman, A. (2010). Impact of reward and recognition on job satisfaction and motivation: An empirical study from Pakistan. International journal of business and management, 5(2), 159.

De Vito, L., Brown, A., Bannister, B., Cianci, M., & Mujtaba, B. G. (2018). Employee motivation based on the hierarchy of needs, expectancy and the two-factor theories applied with higher education employees. IJAMEE.

Dimitriadou, M., Papastavrou, E., Efstathiou, G., & Theodorou, M. (2015). Baccalaureate nursing students' perceptions of learning and supervision in the clinical environment. Nursing & health sciences, 17(2), 236-242.

Duffy, K. (2013). Providing constructive feedback to students during mentoring. Nursing Standard (through 2013), 27(31), 50.

Dwan, K., Altman, D. G., Arnaiz, J. A., Bloom, J., Chan, A. W., Cronin, E., ... & Ghersi, D. (2008). Systematic review of the empirical evidence of study publication bias and outcome reporting bias. PloS one, 3(8), e3081.

Eller, L. S., Lev, E. L., & Feurer, A. (2014). Key components of an effective mentoring relationship: A qualitative study. Nurse education today, 34(5), 815-820.

Faragher, E. B., Cass, M., & Cooper, C. L. (2013). The relationship between job satisfaction and health: a meta-analysis. In From Stress to Wellbeing Volume 1 (pp. 254-271). Palgrave Macmillan, London.

Fernet, C., Guay, F., Senécal, C., & Austin, S. (2012). Predicting intraindividual changes in teacher burnout: The role of perceived school environment and motivational factors. Teaching and teacher education, 28(4), 514-525.

Flinkman, M., Leino‐Kilpi, H., & Salanterä, S. (2010). Nurses’ intention to leave the profession: integrative review. Journal of advanced nursing, 66(7), 1422-1434.

Flynn, J. P., Gascon, G., Doyle, S., Matson Koffman, D. M., Saringer, C., Grossmeier, J., ... & Terry, P. (2018). Supporting a Culture of Health in the Workplace: A Review of Evidence-Based Elements. American Journal of Health Promotion,

Fox, K. C. (2010). Mentor program boosts new nurses’ satisfaction and lowers turnover rate. The Journal of Continuing Education in Nursing, 41(7), 311-316.

Furnham, A., Eracleous, A., & Chamorro-Premuzic, T. (2009). Personality, motivation and job satisfaction: Hertzberg meets the Big Five. Journal of managerial psychology, 24(8), 765-779.

Gerhart, B., 2005. The (affective) dispositional approach to job satisfaction: Sorting out the policy implications. Journal of Organizational Behavior: The International Journal of Industrial, Occupational and Organizational Psychology and Behavior, 26(1), pp.79-97.

Gillath, O., Selcuk, E., & Shaver, P. R. (2008). Moving toward a secure attachment style: Can repeated security priming help?. Social and Personality Psychology Compass, 2(4), 1651-1666.

Griffiths, C., Miles, K., Aldam, D., Cornforth, D., Minton, J., Edwards, S., & Williams, I. (2007). A nurse‐and pharmacist‐led treatment advice clinic for patients attending an HIV outpatient clinic. Journal of advanced nursing, 58(4), 320-326.

Griffiths, C., Miles, K., Aldam, D., Cornforth, D., Minton, J., Edwards, S., & Williams, I. (2007). A nurse‐and pharmacist‐led treatment advice clinic for patients attending an HIV outpatient clinic. Journal of advanced nursing, 58(4), 320-326.

Gruber-Page, M. (2016, July). The value of mentoring in nursing: an honor and a gift. In Oncology nursing forum (Vol. 43, No. 4, p. 420). Oncology Nursing Society.

Gunasingam, N., Burns, K., Edwards, J., Dinh, M., & Walton, M. (2015). Reducing stress and burnout in junior doctors: the impact of debriefing sessions. Postgraduate Medical Journal, 91(1074), 182-187.

Gutierrez, A. P., Candela, L. L., & Carver, L. (2012). The structural relationships between organizational commitment, global job satisfaction, developmental experiences, work values, organizational support, and person‐organization fit among nursing faculty. Journal of advanced nursing, 68(7), 1601-1614.

Hafiza, N. S., Shah, S. S., Jamsheed, H., & Zaman, K. (2011). Relationship between rewards and employee’s motivation in the non-profit organizations of Pakistan. Business Intelligence Journal, 4(2), 327-334.

Hamati-Ataya, I. (2014). Transcending objectivism, subjectivism, and the knowledge in-between: the subject in/of ‘strong reflexivity’. Review of International Studies, 40(1), 153-175.

Hameed, A., & Waheed, A. (2011). Employee development and its affect on employee performance a conceptual framework. International journal of business and social science, 2(13).

Hancock, J. I., Allen, D. G., Bosco, F. A., McDaniel, K. R., & Pierce, C. A. (2013). Meta-analytic review of employee turnover as a predictor of firm performance. Journal of Management, 39(3), 573-603.

Harrington, S. (2011). Mentoring new nurse practitioners to accelerate their development as primary care providers: A literature review. Journal of the American Academy of Nurse Practitioners, 23(4), 168-174.

Hatane, S. E. (2015). Employee satisfaction and performance as intervening variables of learning organization on financial performance. Procedia-Social and Behavioral Sciences, 211, 619-628.

Hausknecht, J. P., Rodda, J., & Howard, M. J. (2009). Targeted employee retention: Performance‐based and job‐related differences in reported reasons for staying. Human Resource Management: Published in Cooperation with the School of Business Administration, The University of Michigan and in alliance with the Society of Human Resources Management, 48(2), 269-288.

Heinrich, K. T., & Oberleitner, M. G. (2012). How a faculty group's peer mentoring of each other's scholarship can enhance retention and recruitment. Journal of Professional Nursing, 28(1), 5-12.

Hmieleski, K. M., & Corbett, A. C. (2008). The contrasting interaction effects of improvisational behavior with entrepreneurial self-efficacy on new venture performance and entrepreneur work satisfaction. Journal of business venturing, 23(4), 482-496.

Hughes, C. J., & Rog, E. (2008). Talent management: A strategy for improving employee recruitment, retention and engagement within hospitality organizations. International Journal of Contemporary Hospitality Management, 20(7), 743-757.

Jerome, N. (2013). Application of the Maslow’s hierarchy of need theory; impacts and implications on organizational culture, human resource and employee’s performance. International Journal of Business and Management Invention, 2(3), 39-45.

Jerome, N. (2013). Application of the Maslow’s hierarchy of need theory; impacts and implications on organizational culture, human resource and employee’s performance. International Journal of Business and Management Invention, 2(3), 39-45.

Jonas, J. (2016). Making practical use of Maslow’s Hierarchy of Needs theory to motivate employees: a case of Masvingo Polytechnic. Journal of Management & Administration, 2016(2), 105-117.

Jowett, S. (2008). What makes coaches tick? The impact of coaches' intrinsic and extrinsic motives on their own satisfaction and that of their athletes. Scandinavian Journal of Medicine & Science in Sports, 18(5), 664-673.

Kahle-Piasecki, L. (2011). Making a mentoring relationship work: What is required for organizational success. Journal of Applied Business and Economics, 12(1), 46-56.

Khamisa, N., Oldenburg, B., Peltzer, K., & Ilic, D. (2015). Work related stress, burnout, job satisfaction and general health of nurses. International journal of environmental research and public health, 12(1), 652-666.

Kizilci, S., Erdogan, V., & Sozen, E. (2012). The Influence of Selected Personality and Workplace Features on Burnout among Nurse Academics. Turkish Online Journal of Educational Technology-TOJET, 11(4), 307-314.

Larsen, R. J., Buss, D. M., Wismeijer, A., Song, J., & van den Berg, S. M. (2017). Personality psychology: Domains of knowledge about human nature. McGraw Hill Education.

Law, R., Dollard, M. F., Tuckey, M. R., & Dormann, C. (2011). Psychosocial safety climate as a lead indicator of workplace bullying and harassment, job resources, psychological health and employee engagement. Accident Analysis & Prevention, 43(5), 1782-1793.

Lee, A., & Hankin, B. L. (2009). Insecure attachment, dysfunctional attitudes, and low self-esteem predicting prospective symptoms of depression and anxiety during adolescence. Journal of clinical child & Adolescent Psychology, 38(2), 219-231.

Lee, M. T., & Raschke, R. L. (2016). Understanding employee motivation and organizational performance: Arguments for a set-theoretic approach. Journal of Innovation & Knowledge, 1(3), 162-169.

Leggat, S. G., Balding, C., & Schiftan, D. (2015). Developing clinical leaders: the impact of an action learning mentoring programme for advanced practice nurses. Journal of clinical nursing, 24(11-12), 1576-1584.

Li, N., Liang, J., & Crant, J. M. (2010). The role of proactive personality in job satisfaction and organizational citizenship behavior: A relational perspective. Journal of applied psychology, 95(2), 395.

Littlejohn, P. (2012). The missing link: using emotional intelligence to reduce workplace stress and workplace violence in our nursing and other health care professions. Journal of Professional Nursing, 28(6), 360-368.

Lumley, E. J., Coetzee, M., Tladinyane, R., & Ferreira, N. (2011). Exploring the job satisfaction and organisational commitment of employees in the information technology environment. Southern African Business Review, 15(1).

Luthans, F., Norman, S. M., Avolio, B. J., & Avey, J. B. (2008). The mediating role of psychological capital in the supportive organizational climate—employee performance relationship. Journal of Organizational Behavior: The International Journal of Industrial, Occupational and Organizational Psychology and Behavior, 29(2), 219-238.

Mallett, R., Hagen-Zanker, J., Slater, R., & Duvendack, M. (2012). The benefits and challenges of using systematic reviews in international development research. Journal of development effectiveness, 4(3), 445-455.

Martín Cruz, N., Martín Pérez, V., & Trevilla Cantero, C. (2009). The influence of employee motivation on knowledge transfer. Journal of knowledge management, 13(6), 478-490.

McInnes, S., Peters, K., Hardy, J., & Halcomb, E. (2015). Primary care clinical placements: the views of Australian registered nurse mentors and pre-registration nursing students (part 2). Nurse Education in Practice, 15(6), 443-449.

Meijerink, J. G., Bondarouk, T., & Lepak, D. P. (2016). Employees as active consumers of HRM: Linking employees’ HRM competences with their perceptions of HRM service value. Human resource management, 55(2), 219-240.

Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of internal medicine, 151(4), 264-269.

Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., ... & Stewart, L. A. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic reviews, 4(1), 1.

Moncarz, E., Zhao, J., & Kay, C. (2009). An exploratory study of US lodging properties' organizational practices on employee turnover and retention. International Journal of Contemporary Hospitality Management, 21(4), 437-458.

Mount, M., Ilies, R., & Johnson, E. (2006). Relationship of personality traits and counterproductive work behaviors: The mediating effects of job satisfaction. Personnel psychology, 59(3), 591-622.

Nelsey, L., & Brownie, S. (2012). Effective leadership, teamwork and mentoring–Essential elements in promoting generational cohesion in the nursing workforce and retaining nurses. Collegian, 19(4), 197-202.

Ng, K. Y., Van Dyne, L., & Ang, S. (2009). From experience to experiential learning: Cultural intelligence as a learning capability for global leader development. Academy of Management Learning & Education, 8(4), 511-526.

Norman, K. (2015). How mentors can influence the values, behaviours and attitudes of nursing staff through positive professional socialisation. Nursing Management (2014+), 22(8), 33.

Ontai, L. L., & Thompson, R. A. (2008). Attachment, parent–child discourse and theory‐of‐mind development. Social Development, 17(1), 47-60.

Otto, P., & Belardo, S. (2009). Dynamics in IS Development: A Multi-Method Experiment to Measure the Effects of Disruptions during the Development Process. International Journal of Decision Support System Technology (IJDSST), 1(2), 1-19.

Pawar, I. A., & Chakravarthy, V. (2014). Factors influencing employee turnover in fusion healthcare organization. International Journal of Management Research and Reviews, 4(9), 834.