Young Registered Nurses’ Intent to Leave the Profession in Finland - A Mixed-Method Study

The purpose of this study was to examine and expand understanding concerning young Finnish registered nurses (RN) with an intention to leave the profession and the related variables, specifically when that intention has emerged before the age of 30. The overall goal of the study was to develop a conceptual model in relation to young RNs’ intention to leave the profession. Suggestions for policymakers, nurse leaders and nurse managers are presented for how to retain more young RNs in the nursing workforce. Suggestions for future nursing research are also provided. Phase I consists of two sequential integrative literature reviews of 75 empirical articles concerning nurses’ intention to leave the profession. In phase II, data had been collected as part of the Nurses’ Early Exit (NEXT) study, using the BQ-12 structured postal questionnaire. A total of 147 young RNs participated in the study. The data were analysed with statistical methods. In phase III, firstly, an in-depth interpretive case study was conducted in order to understand how young RNs explain and make sense of their intention to leave the profession. The data in this study consisted of longitudinal career stories by three young RNs. The data was analysed by using narrative holistic-content and thematic methods. Secondly, a total of 15 young RNs were interviewed in order to explore in-depth their experiences concerning organizational turnover and their intent to leave the profession. The data was analysed using conventional content analysis. Based on earlier research, empirical research on the young RNs intention to leave the profession is scarce. Nurses’ intention to leave the profession has mainly been studied with quantitative descriptive studies, conducted with survey questionnaires. Furthermore, the quality of previous studies varies considerably. Moreover, nurses’ intention to leave the profession seems to be driven by a number of variables. According to the survey study, 26% of young RNs had often considered giving up nursing completely and starting a different kind of job during the course of the previous year. Many different variables were associated with an intention to leave the profession (e.g. personal burnout, job dissatisfaction). According to the in-depth inquiries, poor nursing practice environments and a nursing career as a ‘second-best’ or serendipitous career choice were themes associated with young RNs’ intention to leave the profession. In summary, young RNs intention to leave the profession is a complex phenomenon with multiple associated variables. These findings suggest that policymakers, nurse leaders and nurse managers should enable improvements in nursing practice environments in order to retain more young RNs. These improvements can include, for example, adequate staffing levels, balanced nursing workloads, measures to reduce work-related stress as well as possibilities for advancement and development. Young RNs’ requirements to provide high-quality and ethical nursing care must be recognized in society and health-care organizations. Moreover, sufficient mentoring and orientation programmes should be provided for all graduate RNs. Future research is needed into whether the motive for choosing a nursing career affects the length of the tenure in the profession. Both quantitative and in-depth research is needed for the comprehensive development of nursing-turnover research.

Sick leave prescribing practices in Finland

Background: Sick leave prescribing is a common task of doctors and being on sick leave results in notable economic consequences to society. However, there appears to be limited research into this field and the factors affecting sick leave prescribing practices of doctors. Aims: To examine the prescribing of sick leave by doctors and dentists, the extent of variation in practices, whether clinician-related factors and local structural factors affect variation, and the economic consequences of varying practices. Materials and methods: Questionnaire studies with 19 or 16 hypothetical patient cases were conducted among 165 primary health care (PHC) physicians, 356 occupational health care (OHC) physicians, 338 surgeons and 1132 dentists. Results: The difference between the lowest and the highest number of sick leave days prescribed for the 19 patient cases was almost four-fold in PHC physicians and surgeons and eight-fold in OHC physicians, which represents a societal cost of tens of thousands of euros. Some dentists did not prescribe sick leave to any of the 16 patient cases, and some prescribed nearly a hundred days altogether. The overall number of sick leave days OHC physicians prescribed was smaller than in PHC physicians. More days of sick leave were prescribed by those working in smaller municipalities than larger population centres. Conclusion: There was considerable variation in the sick leave prescribing practices of Finnish health care professionals. This means that patients may not receive equal social benefits. Sick leave carries considerable economic consequences, and unifying prescribing practices could bring significant cost savings to society.

Leave a light on – Terracotta lamps from Agia Paraskevi of Arachamitai, from the Classical period until Roman times

This thesis deals with terracotta lamps found at the archaeological site of Agia Paraskevi of Arachamitai during the years 2010–2014. The research questions are: What kind of lamps were used on the site and when? For what purposes were the lamps used? Where were they manufactured? In order to address these questions, a total of fifty lamps have been chosen to form the body of research material. To answer the first research question, a typology for these lamps has been created with twenty-one types and one variant, after examining various lamp typologies and previous publications. The find contexts and distribution of the lamps are both examined to test the dates for the different lamp types gathered from other publications, and to answer the question on what purposes the lamps were used on the site. Visual observation of the clay of the lamps and information on clay materials from other sites are both examined to determine the lamps' origins. The lamps in this study date from the 5th century BC to the 2nd century AD. The find contexts allow the dating of the lamps according to the other publications, but suggestions of more site-specific dates are given to some lamps. The distribution of the lamps indicates that while most were used for everyday lighting at the sanctuary, some may have had ritual connections. Most of the lamps were manufactured locally or at a nearby Arcadian site. Few lamps can be regarded as imports.

Voiko totuutta tavoittaa? : direct cinema -tyylisuunnan käyttö dokumenttielokuvassa

The subject of this study is the use of direct cinema style in documentary film. The main purpose of this thesis was to the research the ways in which direct cinema style attempts to show and achieve truth in documentary films. The following questions were posed: Is it possible to depict reality in a documentary film; how does the choice of using this style affect the final documentary? The essential purpose of this study was to try to see whether the direct cinema style works when trying to achieve truth in a documentary film. This work consints of two elements, the theoretical part and the short documentary. The theoretical part deals with the history, the truth, and the direct cinema- style in documentaries. The theoretical information of direct cinema has been used when making the short documentary. In the documentary Tuloaula 2 I have studied the way in which using direct cinema -style works in practise. The documentary has followed as strictly as possible the direct cinema style. I was the director, the cameraman and the editor of my documentary film. In the documentary film Tuloaula 2 it appeared that the direct cinema style works best when filming everyday life. By using this style it is easy for the director to observe and leave his own persona in the background. The strength in using the direct cinema style is that it enables the viewer to build his/her own impression on the subject. Even though the direct cinema style aims to achieve objectivity the director has to make numerous subjective choices during both the filming and the editing process. These subjective choices automatically effect the "truth" of the documentary film. The difficulty in a direct cinema style is the large amount of material. This often leads to a long editing phase, which is not often possible in the busy production schedules. The direct cinema style is not at its best when shooting people who are passive because their attention often focuses too much on the camera. In general, the best way to make a documentary film would be to use many documentary styles in one film and not to srictly concentrate on only one style.