In patient safety accidents, nurse managers are indirectly victimized by the pressures from many aspects and become the second victim. This study delves into the experiences of nurse managers in China, aiming to uncover their cognition and provide reference for relevant managers. A descriptive phenomenological approach was used to gain insight into the inner reality of nurse leaders’ experiences and management perceptions of experiencing patient safety incidents. The data of 15 nurse leaders who experienced patient safety incidents in Bethune Hospital, Shanxi Province, China, were collected via face‒to‒face semi-structured interviews, and the data were analyzed via the 7-step analysis method of Colaizzi. On the basis of the content of the interviews, three themes were identified, the emotional experience of experiencing patient safety events, role dilemmas, the obstruction and conceptual reshaping of nursing management. Eight subthemes as follows: physical and mental health-related symptoms due to passive coping and life and work disorder, self-relief, playing multiple roles with lack of role adjustment ability, blurred role positioning and initial signs of job burnout, event replay is impeded, Inaccurate analysis of safety incidents, subversion and remolding of the nursing management concept. Finally, it can be abstracted as “forced growth in patient safety events”. Patient safety incidents can lead to negative impacts, role dilemmas, and management confusion for head nurses, but they also promote purposeful rumination, meditation, and growth. Medical institutions should pay attention to special groups that are second victims of head nurses and construct a safety event support system for nurse leaders to improve the post-training and education system for nurse leaders, help them better adapt to their roles, break through their role dilemmas, improve their post-competence, and construct an effective safety event management system.

Aim: This study developed a set of competency evaluation indicators for billing nurses in China. Background: In clinical practice, nurses often take up billing responsibilities that are accompanied by certain risks. However, the competency evaluation index system for billing nurses has not been established in China. Methods: This study consisted of two main phases of research design: the first phase included a literature review and semi-structured interviews. Individual semi-structured interviews were conducted with 12 nurses in billing departments and 15 nurse managers in related departments. Concepts distilled from the literature review were linked to the results of the semi-structured interviews; this phase produced the first draft of indicators for assessing the professional competence of nurses in billing departments. In the second phase, two rounds of correspondence were conducted with 20 Chinese nursing experts using the Delphi method to test and evaluate the content of the index. The consensus was defined in advance as a mean score of 4.0 or above, with at least 75% agreement among participants. In this way, the final indicator framework was determined. Results: Using the iceberg model as a theoretical foundation, the literature review identified four main dimensions and associated themes. The semi-structured interviews confirmed all of the themes from the literature review while generating new themes, both of which were incorporated into the first draft of the index. Then two rounds of the Delphi survey were conducted. The positive coefficients of experts in the two rounds were 100% and 95%, respectively, while the authority coefficients were 0.963 and 0.961, respectively. The coefficients of variation were 0.00–0.33 and 0.05–0.24, respectively. The competency evaluation index system for billing nurses consisted of 4 first-level indicators, 16 s-level indicators, and 53 third-level indicators. Conclusion: The competency evaluation index system for billing nurses, which was developed on the basis of the iceberg model, was scientific and applicable. Implications for nursing management: The competency assessment index system for billing nurses may provide an effective practical framework for nursing administration to evaluate, train, and assess the competency of billing nurses.

Aim: This study developed a set of competency evaluation indicators for shift work nurses in China.Background: Nurses on night shifts must deal with the treatment, nursing, and management work, which requires excellent competency of night shift nurses in their knowledge, skills, and ability. However, the competency evaluation index system for shift work nurses has not been established yet in China.Methods: This study performed a literature review and semi‐structured interviews to draft the preliminary competency evaluation indicators for nursing shift work. The Delphi technique was adopted to administer two rounds of questionnaires on 21 nursing experts.Results: The positive coefficients of experts in the two rounds were 100% and 90.48%, respectively, whereas the authority coefficients were 0.974 and 0.971, respectively. The coefficients of variation were 0.00–0.26 and 0.00–0.16, respectively. The competency evaluation index system for shift work nurses consisted of 2 first‐level indicators, 16 second‐level indicators, and 67 third‐level indicators.Conclusion: The competency index system of shift work nurses is scientific and applicable.Implications for Nursing Management: The competency evaluation index system of shift work nurses would provide an effective practical framework for shift nursing administration to evaluate, train, and assess the competency of shift work nurses.

Patient safety incidents are unavoidable and nurses, as parties involved, become second victims due to the incident itself and the way it is handled. In China, reconstructing the course of events is a crucial step in the aftermath of the incident; however, its impact on the emotional well-being of the second victim remains unclear. The purpose of this study is to gain insight into the psychological experiences and current conditions of nurses who act as second victims during the process of reconstructing the sequence of events. Additionally, the study aims to provide justifications for supporting these individuals. An exploratory mixed research method was adopted to understand the emotional experience of the second victim when reconstructing the passage of the incident through qualitative research. Fourteen nurses with experience as second victims were selected for semi-structured interviews using purposive sampling according to the maximum difference sampling strategy. Through quantitative research, we explored the negative psychology and support needs of the second victims when they reverted to the incident, and a self-developed questionnaire (the Cronbach’s alpha coefficient was 0.895) was used to survey 3,394 nurses with experiences as second victims in 11 tertiary hospitals in Shanxi Province. In the qualitative part of the study, the emotional experience of the second victim’s reconstruction of the course of events after a patient safety incident could be categorized into 3 themes: negative views as initial psychological impact, avoidance as part of psychological impact, and expectations and growth in overcoming negative psychological impact. The quantitative part of the study revealed that the emotions of guilt and self-blame accounted for the highest percentage after a patient safety incident. The second victim presented a high score of 39.58 ± 5.45 for support requirements. This study provides a better understanding of the true emotional experiences and the need for support of the second victim in the process of reconstructing the course of events. Following a patient safety incident, nursing administrators and healthcare institutions should consider the adverse psychological effects on the second victim, prioritize their support needs during the incident’s reconstruction, create a positive safety culture, and reduce the risk of secondary victimization for these individuals.

Purpose: Elucidation of the cardio-oncologic knowledge among the oncology nurses of tertiary hospitals in Shanxi Province to provide better insights and directions for management by nursing managers. Background: China’s National Health and Wellness Commission issued the Action Plan for Further Improving Nursing Services in June 2023, which requires nurses to provide patients with physical and mental holistic nursing services, such as medical care, condition observation, assistance with treatment, and health guidance. Most oncology patients are treated with chemotherapy, but the modality can cause greater harm to patients, especially cardiotoxicity. How to provide precise care for chemotherapy patients is a problem for nursing managers. Methods: In order to investigate the level of cardio-oncologic knowledge among the oncology nurses of tertiary care hospitals in Shanxi Province, China, a questionnaire was created based on the relevant literature and the provided instructions on cardio-oncology. The chi-squared test was performed for multiple comparisons of the level of knowledge of disease observation, health guidance, and implementation of treatment. Spearman correlation analysis was performed to analyze the correlation between the levels of cardio-oncologic knowledge and general information of hospitals and nurses. Results: Cardio-oncology awareness among the oncology nurses was 0.1%– 44.7%, the awareness rate of single dimension was 0 to 3.9%, and overall awareness rate was 0. A partially significant difference was revealed in the two-by-two comparisons of the awareness rates of the three dimensions of disease observation, health guidance, and implementation of treatment (P < 0.05). A correlation was observed between the cardio-oncologic knowledge and some of the hospital and the nurses’ general information data (P < 0.05). Conclusion: Oncology nurses exhibited a low rate of awareness related to cardio-oncology. Hospitals could establish oncology nursing teams to train the oncology nurses to promote their cardio-oncologic knowledge and ensure the quality of daily care provided by these nurses.

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