The effects of work readiness, organizational justice and professional identity on the work performance of new nurses: A cross-sectional survey

doi:10.21203/rs.3.rs-4342257/v1

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Research Article

The effects of work readiness, organizational justice and professional identity on the work performance of new nurses: A cross-sectional survey

https://doi.org/10.21203/rs.3.rs-4342257/v1

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published 16 Oct, 2024

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Background:With the evolution of disease patterns and the continuous pursuit of persons for high-quality nursing services, new nurses are the reserve talents of the nursing team and shoulder a major mission. However, due to their low work performance and high turnover rate, this is not conducive to the stable development of nursing teams, and it is urgent to solve this problem. This study aimed to explore the relationship between work readiness and work performance as well as the mediating roles of organizational justice and professional identity in this relationship.

Method: A cross-sectional design was employed. From January to February 2023, 607 new nurses were surveyed at five hospitals in Henan Province, China. Work performance, work readiness, organizational justice and professional identity were assessed by the Work Performance Scale, the Work Readiness Scale for Graduate Nurses, the Organizational Justice Scale and the Professional Identity Rating Scale for Nurses, respectively. AMOS 26.0 was used for model drawing and mediation path testing, and SPSS 25.0 was used for data analysis. This study complies with the STROBE Statement of Observational Studies.

Results:Work readiness had a positive predictive effect on work performance of new nurses (r = 0.580, p ＜ 0.01); Organizational justice and professional identity play a chain mediatingrole in work readiness and work performance (β= 0.066).

Conclusions: The study highlights the importance of improving the work performance of new nurses. Organizational justice and professional identity can be used as mediating factors between new nurses’ work readiness and work performance. To improve new nurses’ work readiness, enhance organizational justice and improve professional identity and improve the work performance is conducive to stabilizing the nurse team, improving medical environment, stimulating new nurses to develop innovative ideas and contributing to the long-term development of the hospital.

new nurses

organizational justice

professional identity

work readiness

work performance

The World Health Organization estimates that a global shortage of nurses and midwives will be around 7.6 million by 2030 [1]. The nurse shortage has become an ongoing and urgent problem worldwide [2], as an important part of medical and health human resources, clinical nurses are a basic link that cannot be ignored in the daily operation of medical institutions [3]. With the gradual increase of the turnover rate of clinical nursing staff, there is a negative impact on nursing professions, medical institutions, as well as on high-quality nursing services [4, 5, 6]. New nurse refers to the working time of less than a year after graduation nurses [7]. Compared with nurses with work experience, new nurses are more likely to leave the nursing profession, and studies have shown that the turnover rate of new nurses (29.0%) is 2.1 times that of experienced nurses (13.9%) [8]. According to the Transition Shock Theory [9], because the nursing work has strong professional, high risk and large workload, new nurses into clinical will face more difficulties and challenges, directly affecting work enthusiasm [10], which may lead to their work performance being relatively low [11, 12]. The high turnover rate of new nurses is not conducive to the stable development of their careers, which not only brings heavier work burden to the existing nurses, but also causes the waste of medical expenses and educational resources. Work performance can directly affect employees’ job stability, enhance personal happiness, and stimulate work enthusiasm and responsibility [13,14, 15]. As the new nurses are the fresh blood of the clinical nursing team, they are the reserve force of a new generation of nursing talents [16]. Therefore, to explore the influencing factors affecting new nurses’ work performance to realize the sustainable development of the hospital is the problem that cannot be ignored and must be solved.

Work performance refers to the work behaviour that perfectly matches the work objectives of the organization [17], and its essence is the result that the organization expects [18]. Borman and Motowidle [19] divide work performance into task performance and relationship performance, the task performance mainly refers to the completion of work content and tasks; relationship performance refers to the improvement of organizational operation efficiency under the influence of external factors. In recent years, many scholars have explored the influencing factors of work performance. Work performance influenced by the personal characteristics of employees, such as gender, education, working years, professional title [20, 21], and also related to the working environment [22, 23, 24] and the style of the manager [25, 26]. Studies show that organizational resilience, social support, organizational commitment, job satisfaction, and burnout also affect employees’ work performance [27, 28, 29]. At present, the relationship between work readiness and work performance has attracted more and more attention from scholars, and this paper explores the mechanism of work preparation, organizational justice and professional identity affecting work performance from the perspective of new nurse.

Work readiness is seen as an indicator of graduate’s future job performance, promotion, and career development potential [30, 31]. Due to the gap between theory and practice in nursing education, work readiness is often used to indicate whether new nurses can immediately enter the role [32], whether they can seamlessly connect with clinical practice [33], and whether they can independently conduct clinical nursing practice at the initial stage of work [34]. Nurses with good work readiness can greatly shorten the time they grow to become clinical nursing backbone, and can predict long-term work ability [35]. Job demands-resources theory believes that work resources help to achieve work goals and stimulate personal growth and development [36], so when work readiness is a work resource, new recruits gain more motivation and enthusiasm for work, thus increasing work engagement [37]. Studies have shown that work readiness is positively correlated with job satisfaction and job engagement [38], and that employees’ high engagement in work can achieve high work performance [39]. In view of this, this study proposes hypothesis 1: work readiness has a positive predictive effect on work performance.

Professional identity, as a variable beneficial to both individuals and organizations [40], is defined as the individual’s view of the goals, attitudes, values and other related factors of the profession that is consistent with the society’s evaluation and expectations of the profession [41]. There is literature indicating that good readiness to work helps nurses affirm their professional roles and professional value [42], when a person affirms his professional value, it will promote his professional identification [43]. Studies have shown that professional identity affects work performance [44, 45], and social identity theory suggests that individuals’ actions are based on their recognition of the group [46]. When employees recognize their group, they may identify more with their profession and influence their work attitudes and behaviors [42], which may affect their work performance. Hall and Chandler [47] have pointed out that professional identity will make employees have a heartfelt sense of mission, which will bring them positive feedback on work performance. Therefore, this study proposes hypothesis 2: Professional identity is a mediating variable between work readiness and the work performance of new nurses.

Organizational justice is fair feelings of people in the organization or unit to the organizational system and policies and measures related to individual interests [48]. The core view of fairness theory [49] is that employees’ satisfaction with distribution fairness affects their working enthusiasm. When a person is in a fair environment, it will have an impact on work performance, and some scholars also believe that the organizational justice is related to work performance [50, 51, 52]. On the relationship between work readiness and organizational justice, Walker et al. [30] divides work readiness into five dimensions, two of which are organizational acuity and social competence. Firstly, when organizational acumen is high, it is conducive to the individual’s understanding of fair behaviors such as distribution in the organization [53, 54, 55], thereby affecting the individual’s sense of fairness. Studies have shown that social interaction has a positive predictive effect on interpersonal justice (a dimension in organizational justice), and strong personal social competence means more adequate social interaction [56], which shows the strength of personal social competence may affect interpersonal justice. Secondly, when nurses are fully prepared for their careers, they are more likely to take a positive and healthy attitude to view things [57], which in the process deepens their perception and experience of fairness [58]; thus, forming a virtuous cycle. Social identity theory [46] holds that if the distribution of labor results meets the internal needs of employees, this distribution makes them feel fair, they are easy to derive a sense of identity. There are also studies verifying that organizational justice will affect individual’s professional identity [43, 59]. So, this study proposes hypothesis 3: organizational justice is a mediating variable between work readiness and work performance of new nurses and hypothesis 4: professional identity is a mediating variable between organizational justice and work performance of new nurses.

Based on the above reasoning and analysis of previous studies, this study explores the relationship between work readiness and work performance of new nurses, and further explores the mediating effect of professional identity and organizational justice between work readiness and work performance, so as to provide scientific basis and guidance for promoting the new nurses’ work performance. A basic diagram of the framework for this study is shown in Fig. 1.

3.1 Research design, participants and data collection

A cross-sectional study was adopted to explore the relationship between work readiness, work performance, organizational justice and professional identity. The study conducted an anonymous questionnaire survey of new nurses from five hospitals in Henan Province, China from January to February 2023. Inclusion criteria were (a) nurses with a nurse qualification certificate (b) nurse working for less than 1 year and (c) voluntarily participated in the study and (d) nurses working in the clinical front line. Exclusion criteria were (a) nurses who were on leave for reasons and (b) nurses who were undergoing further study in hospital. After the approval of the hospital leaders, the separate anonymous questionnaire was distributed to each participant who was aware of the purpose and significance of this study. The overall questionnaire needs 10–15 minutes to fill in. Sample size was calculated according to the formula [60]: N = 4Uα²S²/δ², and pre-survey calculation S = 0.56, allowable error δ was set to 0.1 and α was set to 0.05, so N = 4×1.96²×0.56²/0.1² = 482. This study issued 689 questionnaires, excluded 82 questionnaires with incomplete answers and the unreliable data, we recovered 607 valid questionnaires, the effective recovery ratio was 88.10%.

3.2 Measures

3.2.1 Demographic characteristics

It involved gender, age, marital status, highest education, hospital type, and other factors.

3.2.2 Work performance

The Work Performance Scale compiled by Borman and Motowidlo [19] and translated by Yu [61], was used to evaluate the work performance of new nurses. This scale was tested in nurses showed good reliability and validity (Cronbach’s α coefficient = 0.900) [43]. This scale consists of two dimensions: task performance and relationship performance, with 11 items. It uses the Likert-5 score method, which ranges from 1 (absolutely inconsistent) to 5 (absolutely consistent). A higher score on this scale represents a higher work performance of new nurse. In this study, the Cronbach’s α coefficient was 0.938.

3.2.3 Work readiness

We used the Work Readiness Scale for Graduate Nurses compiled by Walker et al. [30] and localized by Li [62] to evaluate the work readiness of new nurses, which has 37 items in five dimensions: job competitiveness, social competence, vocational development, organizational acuity, and personal work characteristics. It uses the Likert-10 score method, completely disagree to completely agree is counted as 1–10 points respectively. Higher scores indicate a higher level of work readiness for new nurses. The Cronbach’s α coefficient of the scale was 0.920 [30]. The Cronbach’s α coefficient was 0.985 in this study.

3.2.4 Professional identity

Professional Identity Rating Scale for Nurses, which was compiled by Liu et al. [63] was used to measure the professional identity of new nurses. The scale consists of 30 items used for testing 5 dimensions: occupational cognitive evaluation, occupational social support, occupational social skills, occupational frustration coping and occupational self-reflection. It uses a Likert-5 point scoring method, which ranges from 1 (very non-compliant) to 5 (very compliant). Higher scores on this scale, indicate a higher level of professional identity among nurses. The Cronbach’s α coefficient of the scale was 0.938 [63]. The Cronbach’s α coefficient in this study was 0.978.

3.2.5 Organizational justice

We used the Organizational Justice Scale to measure organizational justice, which was compiled by Colquitt [64] and translated by Zhang [65]. This scale consists of twenty items, including the following four parts: distributive, procedural, interpersonal and informational justice. It adopts the Likert-5 point scoring method, which ranges from 1 (highly disagree) to 5 (highly agree). The higher the score on this scale, the higher the organizational justice of the new nurse. The Cronbach’s α coefficient of the scale was 0.910 [64]. The Cronbach’s α coefficient in this study was 0.933.

3.2.6 Ethics considerations

First, this study is a cross-sectional study without clinical experiments and has no impact on the body and mind of the participants. Second, before filling the questionnaire, we informed the participants about the purpose and importance of the study, and they were able to dropout at any time. Third, we will not disclose information about the participants, and the data and information collected were only used for this study. The study obtained the informed consent of all study participants. Finally, we passed the ethical review by the Ethics Committee of Henan University on November 16, 2022. (ID: HUSOM 2022 − 375).

3.3 Statistical analysis

We performed the data analysis using SPSS 25.0 and AMOS 26.0 software. Firstly, this study applied descriptive statistics to measure demographic characteristics, work readiness, work performance, professional identity, and organizational justice exhibited by participants. Secondly, we used Pearson’s correlation analysis to consider the relationship between the four variables. Furthermore, AMOS 26.0 was used to map the model and explore the relationships and parameters among the variables. This study performed chi-square test and degree of freedom (χ²/df), comparative fix index (CFI), adjusted goodness of fit index (AGFI), root mean square error of approximation (RMSEA), goodness-of-fit index (GFI), incremental fit index (IFI) and Tucker-Lewis index (TLI) to measure the overall fit of the hypothetical model. The smaller the value of χ²/df, the higher the model fit; the smaller RMSEA, the better the model fit; GFI, TLI, CFI and AGFI are 0 to 1, the closer 1 indicates the better the fit [66]. Finally, this study calculated a 95% confidence interval (CI) for bias-corrected percentile bootstrapping across a 5000 bootstrapped sample [67] and the p value is two-tailed, below 0.05, showing statistical significance.

4.1 Participant characteristics

Of the 607 valid questionnaires, 73.10% were female and 26.90% were male; New nurses aged under 25 years were 94.40%, unmarried people accounted for 93.10% and 67.20% had bachelor’s degrees; more than half of participants had monthly income not more than 4000 RMB (64.40%). See Table 1 for details.

Table 1

Descriptions of nurse characteristics (N = 607)
Variables		n	%
Gender	Male	163	26.90
	Female	444	73.10
Age (years)	≤ 25	573	94.40
	>25	34	5.60
Marital status	Unmarried	565	93.10
	Married	42	6.90
Highest education	Junior college and below	114	18.80
	Bachelor’s	408	67.20
	Master’s or above	85	14.00
Hospital level	Tertiary	431	71.00
	Secondary or below	176	29.00
Labor and personnel relations	Regular establishment staff	110	18.10
	Personnel agency	112	18.50
	Contract worker	385	63.40
Departments	Internal medicine department	181	29.80
	Surgery department	125	20.60
	Obstetrics and gynecology	42	6.90
	Pediatric department	35	5.80
	Emergency department	49	8.10
	Intensive care unit	34	5.60
	Other departments	141	23.20
Average monthly income	Less than 4000 RMB	391	64.40
(salary + bonus)	4000 ~ 7000 RMB	170	28.00
	7001 ~ 10000 RMB	25	4.10
	Above 10000 RMB	21	3.50
Average daily working hours	≤ 8	190	31.30
	8 ~ 10	341	56.20
	≥ 10	76	12.50
Average monthly night shifts	≤ 5	273	45.00
(times)	5 ~ 8	235	38.70
	≥ 8	99	16.30

4.2 Pearson’s correlation analysis

The range, median, standard deviation, sig (two-tailed) and correlation coefficient of each of the variables in this study are shown in Table 2. The new nurses’ work readiness average score was 272.19 ± 64.75, their professional identity was 111.78 ± 24.85, their organizational justice was 72.78 ± 18.00 and their work performance was 39.29 ± 10.52.

Table 2

Descriptive statistics and correlations of the study variables (N = 607)
Variable	Work readiness	Work performance	Professional identity	Organizational justice	Range	Median	Mean ± SD
Work readiness	1				1 ~ 10	290.00	272.19 ± 64.75
Sig (two-tailed)	N/A
Work performance	0.580^**	1			1 ~ 5	41.00	39.29 ± 10.52
Sig (two-tailed)	0.000	N/A
Professional identity	0.647^**	0.635^**	1		1 ~ 5	114.00	111.78 ± 24.85
Sig (two-tailed)	0.000	0.000	N/A
Organizational justice	0.604^**	0.676^**	0.634^**	1	1 ~ 5	75.00	72.78 ± 18.00
Sig (two-tailed)	0.000	0.000	0.000	N/A
**P < 0.01 (two-tailed).

Correlation analysis found positive relations between work readiness and professional identity (r = 0.647, p < 0.01), organizational justice (r = 0.604, p < 0.01), and work performance (r = 0.580, p < 0.01). Moreover, there were positive correlations between organizational justice and professional identity (r = 0.634, p < 0.01), work performance (r = 0.676, p < 0.01), and the relationship between work performance and professional identity was also positive (r = 0.635, p < 0.01).

4.3 Mediating effect analysis and hypothesis testing

Firstly, according to the mediation effect testing procedure [68], this study applied the structural equation model of AMOS 26.0 to analyse the relationship of four variables, the result is shown in Fig. 2, work readiness has positive predictive effect on work performance, professional identity and organizational justice (β = 0.16, P < 0.01; β = 0.42, P < 0.01 and β = 0.62, P < 0.01, respectively); organizational justice positively predicted professional identity and work performance (β = 0.39, P < 0.01; β = 0.43, P < 0.01); professional identity positively predicted work performance (β = 0.27, P < 0.01). Therefore, we obtained the model for this experiment, see Fig. 2 for details. The model fitting indexes were χ² = 263.721, df = 96, χ² /df = 2.747, CFI = 0.987, GFI = 0.948, AGFI = 0.926, TLI = 0.984, IFI = 0.987, and RMSEA = 0.054, which indicated that the model could be successfully established.

Secondly, the nonparametric percentile bootstrap program was selected to test the mediating significance level. This study was sampled 5000 times from the raw data to calculate a 95% confidence interval. As shown in Table 3, from work readiness to work performance, bootstrap 95% CI is (0.054, 0.265), P<0.05, thus confirms hypothesis 1; from work readiness to professional identity to work performance, bootstrap 95% CI is (0.061, 0.179), P<0.01, thus confirms hypothesis 2; from work readiness to organizational justice to work performance, bootstrap 95% CI was (0.204, 0.345), P<0.01, thus confirms hypothesis 3; from work readiness to organizational justice, professional identity to work performance, the chain of mediating role of 95% CI was (0.039, 0.101), P<0.01, thus confirms hypothesis 4. Besides, the direct effect of work readiness on work performance is 0.155, the total mediation effect value was 0.448, is the sum of the mediation effect of the three mediation paths, namely the total indirect effect. The effect value of the three mediation pathways in this study were 18.56%, 44.17% and 11.66%, respectively.

Table 3

Total, direct, and indirect effect of professional identity on job embeddedness
Effect	Path relationship	Effect	Bootstrap SE	Bootstrap 95% CI	P-value	Relative mediating effect (%)
Direction effect	work readiness → work performance	0.155	0.054	(0.054, 0.265)	0.003	25.70
Indirection effect	work readiness → professional identity → work performance	0.113	0.030	(0.061, 0.179)	0.000	18.74
	work readiness → organizational justice → work performance	0.269	0.036	(0.204, 0.345)	0.000	44.61
	work readiness → organizational justice → professional identity → work performance	0.066	0.015	(0.039, 0.101)	0.000	10.95
Total mediating effect		0.448	0.033	(0.363, 0.541)	0.000	74.30

In this study, the work readiness scores higher than the results of the survey of newly graduated nurses by Li et al. [31]. The difference may be due to the fact that most of the respondents in this study work in tertiary hospitals with higher management level. Before the entry of new nurses, hospital managers will conduct induction training for them. In this process, the managers pay more attention to the cultivation of practical skills and social abilities of new nurses, so the participants have a relatively high degree of work readiness. Participants’ professional identity scores were slightly higher than the findings of Zhou et al. [69]. Different from experienced clinical nurses, new nurses, as newcomers to the workplace, may have higher enthusiasm in the process of translating theory into practice, and they can get care and help from colleagues and teachers, which helps new nurses to familiarize themselves with job responsibilities and maintain their love for the profession, thus promoting their professional identity. Participants’ organizational justice scored slightly higher than previous findings [70], The difference in results may be due to the fact that their subjects were all staff members (including physicians, nurses, technicians, clerks, and other staff) of this hospital in Lazio, Italy, whereas our subjects were only new nurses. New nurses starting their careers have a higher level of trust in the organisation and are likely to experience fewer incidents of injustice; it may also be related to differences in traditional culture. Work performance scored was lower than in the study by Li et al. [71], which may be due to the fact that new nurses are not familiar with the department environment, rules and regulations and work habits, and lack rich work experience and problem-solving ability, so their work performance is slightly lower.

This study found that new nurses’ work readiness had a significant positive impact on work performance, confirming Hypothesis 1. This is because when new nurses have higher work readiness to enter the post, they will have more comprehensive work ability, which may enable them to experience less transition shocks and enhance confidence, and make them more enthusiastic to work [31, 72], thus improving work performance. The above results show that we should strengthen the awareness of the importance of work readiness for new nurses. Universities can set up relevant courses and training to improve nursing students’ professional skills and social ability, and organize campus activities to simulate clinical work scenes, so that they can better understand their future work content and procedures, and strengthen their work readiness. Nursing managers should pay attention to the intensive training of new nurses’ professional skills, and hold lectures to cultivate new nurses’ social skills, so that they can improve their communication skills with colleagues, leaders, patients and their families, which can improve the level of work readiness.

This study found that professional identity was a mediating variable for work readiness and work performance of new nurses, validating Hypothesis 2. When new nurses were well prepared for work, their role perception, interpersonal relationships, care responsibilities, and knowledge and skills were significantly improved [62]. When they recognize their profession, their personal value can be reflected in the career they are willing to fight for [73, 74]. Professional identity can help nurses actively engage clinical work, which has a positive impact on work performance [45]. This result suggests that we should strengthen the fostering of new nurses’ professional identity, nursing educators can pass on professional values to students through formal classroom teaching and after-school communication and guidance. Clinical teachers should be role models to guide new nurses to closely combine their own development with the nursing profession and enhance their professional identity.

This study found that organizational justice was a mediating variable for work readiness and work performance of new nurses, validating Hypothesis 3. When new nurses have a high level of work readiness, it helps them to understand fair behavior within the organization [55], and helps them to be adaptable and flexible in dealing with patients and colleagues, which helps to strengthen interpersonal justice [56]. Nurses with a high sense of organizational justice are more inclined to invest and contribute, more focused on job and pay more attention to personal growth and work performance [52]. Conversely, new nurses lack of experience and large mental fluctuations, when feeling unfair treatment, doubt and even distrust the organization and reduce work passion [50], thus having a negative impact on performance. This result reminds nursing managers that they should create a good and fair atmosphere, help new nurses establish the correct concept of pay and return, make reasonable explanations on decision-making or distribution at the appropriate time, and make transparent policies, so that they can better take initiative in work and improve work performance, and achieve a good and stable circular development.

This study found that professional identity was a mediating variable of organizational justice and work performance of new nurses, validating Hypothesis 4. According to the cognitive-emotional theory, individual cognition and emotional response mainly come from the role of situational information, and then activate individual behavior decisions [75], this suggests that open and transparent decision-making and management will help individuals to fully understand the distribution process [62] and strengthen the individual trust and identity of the organization, so that they are willing to contribute to the organization, even to improve their professional thinking and ameliorate poor behavior tendency [76], which positively affect the staff’s work performance. The results showed that hospitals should establish reasonable salary standards, create a more equitable environment and performance appraisal system, fully consider the rationality of distribution, and let new nurses know the salary adjustment and job promotion information of the hospital, which is of great significance to improve their sense of organizational justice, professional identity and work performance.

5.1 Limitation and future research direction

Firstly, this study only investigated some of the newly recruited nurses in five hospitals in Henan Province, and the number of interviewees was small and concentrated in one region. Therefore, future studies could expand the sample source and adopt a multi-centre survey method for different regions to improve the generalizability of the study. Secondly, this study is a cross-sectional study, which cannot explain the causal relationship well, and in the future, longitudinal study combined with interdisciplinary approach should be adopted to understand the dynamic process of nurses’ psychological changes. Third, this study collected data by subjectively filling out a questionnaire, which is easily influenced by the social expectation effect, and future studies could adopt a more objective approach and study from multiple perspectives. Finally, another limitation relates to the potential role of personality traits in influencing employee performance, as a study by Iliescu et al. [77] found that extraversion and agreeableness’ persons predicted their job performance. Thus, future research could explore the role of personality traits in work readiness and work performance.

This study examined work readiness, work performance, professional identity and organizational justice among new nurses. The process and mechanism by which the work readiness of new nurses influenced work performance was explored. The study found that professional identity and organizational justice play a chain mediating role in the effect of work readiness on work performance of new nurses. It provided some theoretical support and guidance for the research and intervention of the work performance of new nurses and also helped the hospital to maintain and cultivate the new generation of nursing talents and constantly improve the development prospect of the nursing industry.

As the backbone of future clinical nursing, new nurses may suffer a lot of setbacks due to their lack of work experience in the early stage of entry. They are worried about mistakes and criticism in nursing operations, and are prone to depression and negativity, which will affect the improvement of new nurses’ work performance to a certain extent. Our findings in this study have some important implications for managers to develop measures and policies to improve the job performance of new nurses. Therefore, the following suggestions are put forward. Firstly, nursing educators should strengthen teaching training centred on post competence, integrate real clinical cases into the classroom, and combine teaching methods such as situational teaching to enhance the work readiness of nursing students, so as to help nursing students adapt to the clinical environment as soon as possible. Secondly, hospitals can organize training on the topic of career development prospect and planning to help new nurses understand their own career value and cultivate their ability to sum up experience in practice, so as to develop their own professional growth potential and strengthen their professional identity. Thirdly, hospitals and nursing administrators should be more protective of the rights and interests of new nurses, respect their opinions and suggestions, and ensure that everyone can be treated fairly and justly in the organization. Finally, in clinical practice, hospitals managers should timely evaluate the level of new nurses’ work readiness, professional identity and organizational justice, and timely carry out appropriate intervention measures according to the specific psychological situations of new nurses, which will continuously improve their work performance.

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1. Ethics approval and consent to participate

Before filling the questionnaire, we informed the participants about the purpose and importance of the study, and they were able to dropout at any time. We will not disclose information about the participants, and the data and information collected were only used for this study. The study obtained the informed consent of all study participants and passed the ethical review by the Ethics Committee of Henan University on November 16, 2022, and the ethics review number is HUSOM2022-375.

2. Consent for publication

The subjects of this study consented to publication.

3. Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

4. Competing interests

The authors declare that they have no competing interests

5. Funding

This research was sponsored by the Key Project of Undergraduate Teaching Reform Research and Practice of Henan University (Grant Number: HDXJJG2020-25) and "Research on the Status Quo and Cultivation Mechanism of Social and Emotional Ability of Henan Adolescents" (Grant Number: SKL-2022-55).

6. Authors’ contributions

JZ and SY finished the manuscript of the article. JZ, SY and CCR provided the study design. JZ, MR, SY and LSJ conducted data collection and data processing. CCR and LGL proposed key revisions. All authors read and approved the final manuscript.

7. Acknowledgements

We would like to thank the Key Project of Undergraduate Teaching Reform Research and Practice of Henan University (Grant Number: HDXJJG2020-25) and "Research on the Status Quo and Cultivation Mechanism of Social and Emotional Ability of Henan Adolescents" (Grant Number: SKL-2022-55) for the funding of this study. We would like to sincerely thank all the nurses involved in the survey and the hospital for their support of this study.

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The effects of work readiness, organizational justice and professional identity on the work performance of new nurses: A cross-sectional survey

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Abstract

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1. INTRODUCTION

2. BACKGROUND

3. METHODS

3.1 Research design, participants and data collection

3.2 Measures

3.2.1 Demographic characteristics

3.2.2 Work performance

3.2.3 Work readiness

3.2.4 Professional identity

3.2.5 Organizational justice

3.2.6 Ethics considerations

3.3 Statistical analysis

4. RESULTS

4.1 Participant characteristics

4.2 Pearson’s correlation analysis

4.3 Mediating effect analysis and hypothesis testing

5. DISCUSSION

5.1 Limitation and future research direction

6. CONCLUSION

7. RELEVANCE TO CLINICAL PRACTICE

Abbreviations

Declarations

References

Additional Declarations

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Journal Publication

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