In China, specialist nurse is defined as someone who have obtained a specialized post certificate after professional training, they can provide high-quality nursing services to the clients according to their own judgment in the complex and uncertain nursing situation, the services provided by them are different from general clinical nurses[1]. To this day, the professional training for Specialist Nurse have covered 9 directions in Anhui, China, such as intensive care, blood purification, wound/ostomy, tumor, diabetes, pediatric intensive care, emergency, orthopedics and operating. The main purpose of professional training for specialist nurses is to develop their core competence. The core competence of nurses refers to the organic combination of the three basic attributes: professional knowledge, professional skills and service attitude. It is reflected in the seven dimensions of critical thinking/research aptitude, clinical care, leadership, interpersonal relation, legal/ethical practice, professional development and teaching–coaching [2–4]. In recent years, the research on the core competence of nurses has attracted the attention of researchers in the world, but, it is not systematic and comprehensive to study the core competence of specialist nurses. What are the relevant factors of core competence in specialist nurses?
The negative effects of job stressors on health have been extensively reported[5], and all the reports indicated that increasingly job stressors affect the workforce [6]. Nurses work with sick people, their work includes mental and physical nursing and they always have to face patients, family members, doctors and other health workers. Nursing has been considered as the profession highly susceptible to stress. Nursing stress has been considered as a problem which affects practice [7]. The effect of stress has been considered as an important cause of decreasing health and reduction in the level of efficiency of nursing[8].
Several studies have shown that job stress of nurses was mainly caused by critical condition of patients, high requirements of patients and their families, heavy work burden, insufficient nurses on duty, and conflicts with colleagues, patients and their families and so on[9, 10].The result of nurses' job stress was job burnout[11, 12]. Job burnout often manifested as indifference to work, even leaving or changing jobs[13, 14] .The main job stressors of nurses in China can be divided into five aspects as following: (1) professional and career issues, such as the low social status, less opportunities for promotion and further study, frequent night shifts, low salary and welfare, less independence of work, etc. ;(2) workload and time pressure: insufficient stuff on duty, heavy workload, too much non-nursing work, etc.; (3) resource and environmental problems: too crowded working environment, insufficient equipment, etc.; (4) patient care and interaction: fear of errors or accidents, unadmitted nursing contributions by patients and family members, bad manners of patients and family members, uncooperative patients, and the implementation of operations that will cause pain to patient, etc.; (5) interpersonal relationships and management issues: less understanding and support from nursing managers, lack understanding and respect from other medical staffs, and conflicts with doctors, etc.. These factors contribute the high working pressure to nurses in China[15].
The professional nature, special environment and complex interpersonal relationship of nursing work can cause great pressure on nurses and affect their physical and mental health directly. The incidence of depression is higher in nurses than the general population, 49.7% of nurses have different levels of depression, job stressors such as unrecognized work by the patients and their families, heavy workload and frequent shifts have been reported to associate with the depression of nurses[16].However, little is known about how job stressors affect depressions of specialist nurses in China.
As such, the core competence, job stressors and depression of specialist nurses might differ from general clinical nurses in China. Therefore, firstly, we investigated the status of the core competence, job stressors and depression of Chinese specialist nurses. Secondly, we explored the relationship between socio-demographic variables, job stressor, core competence and depression in Chinese specialist nurses.