Students' career preferences are an important issue to various stakeholders: to university administration, career counselors, higher education policy makers as well as to human resource managers in companies. Students, whose career preferences and goals are fulfilled, are better and more highly motivated employees. By a questionnaire survey carried out in 2016 in two institutions of higher education the present study compares career preferences and attitudes of 478 German and Croatian students. Factor analyses identify latent variables behind students' preferences. The identified significant differences between the Germans and Croatians are related to differences in socioeconomic environment and cultural differences derived through the Hofstede model. German students value safe jobs, trust and a high income significantly more, whereas for Croatian students stimulating tasks, career opportunities, a recognized profession and social responsibility are more important. Our results indicate that Hofstede's findings for the uncertainty avoidance index and the individualism/collectivism index might be questioned for the subsample of a young student population who show different value criteria in their career preferences. JEL Classification: J24

To gain autonomous practice, nurses must be competent and have the courage to take charge in situations where they are responsible. This study shows the challenges in handling this autonomous practice.

Aim To explore general hospital ward nurses' experiences with the National Early Warning Score and to determine its impacts on their professionalism. Background The National Early Warning Score has broad appeal; it is a patient safety initiative designed to ensure early identification of and response to deteriorating patients in hospitals. However, it is still unclear how the tool impacts nurses' professionalism. Methods A qualitative study with a hermeneutic design was conducted in autumn 2017; the study consisted of semi‐structured, in‐depth interviews with 14 hospital nurses. The data were analysed thematically to understand and interpret the nurses' experiences. Methods are reported using COREQ guidelines (see Appendix S1). Results The study examined nurses' experience with the National Early Warning Score and its perceived impact on their professionalism. Four themes were identified: (a) the National Early Warning Score and clinical judgement in patient assessment, (b) responding to the National Early Warning Score standard, (c) involving the professional community and (d) adjusting the tool. Conclusion The National Early Warning Score may impact nurses' professionalism in diverse ways. Nurses are aware of the importance of incorporating all of their professional competence, comprising clinical judgement, discretion and accountability, with the National Early Warning Score to accurately assess patients' conditions. Findings indicated that the National Early Warning Score was beneficial to nurses' professional practice; however, accountability to this standard alone does not ensure quality care and patient safety. Relevance to clinical practice A greater understanding of the role of nurses' professional accountability when using the National Early Warning Score is needed to improve practice and ensure patient safety.

BackgroundPeople living with dementia in nursing homes are most likely to be restrained. The primary aim of this mixed-method education intervention study was to investigate which factors hindered or facilitated staff awareness related to confidence building initiatives based on person-centred care, as an alternative to restraint in residents with dementia in nursing homes. The education intervention, consisting of a two-day seminar and monthly coaching sessions for six months, targeted nursing staff in 24 nursing homes in Western Norway. The present article reports on staff-related data from the study.MethodsWe employed a mixed-method design combining quantitative and qualitative methods. The P-CAT (Person-centred Care Assessment Tool) and QPS-Nordic (The General Nordic questionnaire for psychological and social factors at work) instruments were used to measure staff effects in terms of person-centred care and perception of leadership. The qualitative data were collected through ethnographic fieldwork, qualitative interviews and analysis of 84 reflection notes from eight persons in the four teams who facilitated the intervention. The PARIHS (Promoting Action on Research Implementation in Health Services) theoretical framework informed the study design and the data analysis. Six nursing homes were selected for ethnographic study post-intervention.ResultsQualitative data indicated increased staff awareness related to using restraint - or not- in the context of person-centered care. A slight increase in P-CAT supported these findings. Thirteen percent of the P-CAT variation was explained by institutional belonging. Qualitative data indicated that whether shared decisions of alternative measures to restraint were applied was a function of dynamic interplay between facilitation and contextual elements. In this connection, the role of the nursing home leaders appeared to be a pivotal element promoting or hindering person-centered care. However, leadership-staff relations varied substantially across individual institutions, as did staff awareness related to restraint and person-centeredness.ConclusionsLeadership, in interplay with staff culture, turned out to be the most important factor hindering or promoting staff awareness related to confidence building initiatives, based on person-centered care. While quantitative data indicated variations across institutions and the extent of this variation, qualitative data offered insight into the local processes involved. A mixed method approach enabled understanding of dynamic contextual relationships.Trial registrationThe trial is registered at Clinical Trials gov. reg. 2012/304 NCT01715506.Electronic supplementary materialThe online version of this article (10.1186/s12912-017-0244-0) contains supplementary material, which is available to authorized users.

A greater understanding of nurses' development of competence when using the Early Warning Score and Rapid Response Systems will facilitate the design of implementation strategies and the use of these systems to improve practice.