Abstract
Aims
To review the literature and identify factors that make sense of and influence nurses' career success. We sought to provide insights into achieving nurses' career success.
Design
An integrative review conducted in May 2022 using Whittemore and Knafl's methodology of integrative review.
Methods
The databases searched were PubMed, Web of Science, Scopus, and CINAHL. Search criteria included the keywords “nurs*” and “career success” in the title and abstract. The quality of the reviewed papers was assessed using the JBI Critical Appraisal Tool for cross‐sectional studies and qualitative research. We extracted five types of information from quantitative studies: the definition of career success, factors of career success instruments, reliability or validity of career success instruments, and factors influencing nursing career success. Furthermore, we extracted two types of information from qualitative studies: themes that imply career success and factors that influence nurses' career success. Primary data were categorized into two perspectives: (1) what nurses' career success means and (2) what influences nurses' career success. Categorized data were unified into similar contents. Themes were developed from unified subgroups.
Results
Fourteen studies were included in the analysis. Seven themes were integrated into the factors that make sense of nurses' career success: satisfaction, positive attitude towards work, quality work in nursing, continuation of career and professional development, positive interaction at work, person–organization fit, and enrichment of an individual's life. Three themes were integrated into the factors influencing nursing career success: personal resources, positive behavior toward nursing work and research, and job resources and environment.
No Patient or Public Contribution
Patients or members of the public were not involved in this review.
Keywords: career, career success, integrative review, nurses, nursing
1. INTRODUCTION
Successful nursing career development can be deeply related to an individual nurse's work and life. This achievement is vital to continuing nursing as a profession or extracting pleasure from nursing work. Nursing professionals worldwide are required to take responsibility for their careers and professional development (Donner & Wheeler, 2010; Philippou, 2015; Yamada et al., 2022). In particular, as professionals, individual nurses are expected to keep their knowledge and skills up to date in order to adapt to dynamically evolving healthcare settings (Hakvoort et al., 2022; King et al., 2021; Mlambo et al., 2021). Thus, the importance of career and professional development for nurses has been emphasized over time and across borders.
However, it remains unclear as to what a successful nursing career requires and what constitutes success. To clarify these issues, we focused on the concept of career success, that is, career outcomes. Integrating the factors that make sense of and influence career success using previous research conducted with nurses provides insights into achieving nurses' career success. This review aimed to clarify what influences and shapes career success for nurses.
2. BACKGROUND
Career studies have focused on the concept of career success to address the issue of measuring career outcomes. Career success is defined as “the achievement of desirable work‐related outcomes at any point in a person's work experiences over time” (Arthur et al., 2005). Traditionally, career success has been measured in objective or subjective terms (Arthur et al., 2005; Heslin, 2005). Typically, objective career success is indicated by salary and promotion, while subjective career success is indicated by job or career satisfaction (Heslin, 2005). However, the labor market has become increasingly dynamic over time, leading to people pursuing more flexible careers. These changes have resulted in most studies in the past decade examining subjective career success, with only a few assessing objective career success (Akkermans & Kubasch, 2017). As subjective career success criteria are based on personal standards and preferences, what makes career success meaningful and how career success should be measured are explored (Mayrhofer et al., 2016; Shockley et al., 2016).
In the last few decades, several studies have reported that future research should investigate the constructs and antecedents of career success for different occupational groups. Heslin (2005) mentions paying greater attention to how people in different career contexts conceptualize their career success. Nonetheless, Akkermans and Kubasch (2017) reviewed all papers from four core career journals published between 2012 and 2016 and pointed out that such research seems yet to have gained real momentum and that it is necessary to examine the unique dimensions and antecedents of career success for specific groups in the labor market. Thus, exploring the components that account for career success and identifying antecedents for nurses, a large segment of the healthcare workforce, would contribute to expanding career literature.
Some studies on nurses' career success have claimed that it is helpful for professional behavior and improving clinical nursing quality (Zamanzadeh et al., 2019; Zhang et al., 2022). However, there is no standard view of what constitutes career success for nurses. Since career success is a multidimensional concept, previous quantitative studies have used varying variables to assess career success in the nursing context. For example, some studies assessed career success using a three‐factor structure that measured career satisfaction, perceived organizational competitiveness, and perceived external organizational competitiveness (Al‐Ghazali, 2020; Dan et al., 2018a, 2018b; Li et al., 2014; Liu & Liu, 2016; Wang et al., 2019). One study measured only one aspect of career satisfaction (Allen, 2011), while another has evaluated career success using eight aspects: recognition, quality work, meaningful work, influence, authenticity, personal life, growth and development, and satisfaction (Sönmez et al., 2021). Whereas a career success in nursing scale developed by Asghari et al. (2021) measures four‐dimensions: expected career development, providing quality care, effective self‐regulation, person‐organization fit. This is quite different from the general worker's career success scale. Meanwhile, qualitative study identifies that nurses' career success involves unique dimensions such as providing nursing care and general dimensions like nurses' personal life (Zamanzadeh et al., 2019). To develop a holistic understanding of nurses' career success, it is necessary to integrate these findings. In doing so, we can gain insight into what shapes career success and how to achieve it for nurses.
Therefore, the first aim of this study was to review the literature and identify factors that make sense of nurses' career success. Our review contributes to the discussion around distinguishing the unique and general dimensions of nurses' career success, thereby addressing the challenge of providing a standard view of what constitutes it. The second aim of this review was to integrate findings on the influencing factors for the achievement of career success for nurses. Engaging in a review to identify these challenges would provide practical suggestions for achieving career success. We expand the literature by integrating the antecedents and attributes of career success and challenging how we theorize about the phenomenon of career success for nurses.
3. THE STUDY
3.1. Design
We conducted an integrative review to investigate the factors related to career success of nurses in previous studies. The review was conducted according to Whittemore and Knafl's methodology (Whittemore & Knafl, 2005).
3.2. Method
3.2.1. Search strategy
The search was conducted in May 2022. The four electronic databases used for the search strategy were PubMed, Web of Science, Scopus, and CINAHL. Since the number of records identified from each database was 14 to 59, we assessed the lack of studies on career success conducted with nurses. Thus, this review did not limit the deadline for published articles to enable identification of all existing research in the field. This resulted in a hit for studies published between June 1986 and May 2022. The keywords were “nurs*” and “career success,” with search criteria including keywords in the title and abstract.
3.2.2. Inclusion and exclusion criteria
We checked the abstracts to identify if the hit literature met the following inclusion criteria: (1) peer‐reviewed research article, (2) full‐text articles published in English, (3) included registered nurses involved in direct care, (4) nursing scholars who have a master's or doctoral degree included since they may be directly involved in patient care, (5) measured career success, examined relationships between career success and other factors, and (6) mentioned what career success means for nurses, or what factors influence nurses' career success.
We excluded studies that (1) focused on nurses working in specific domains, such as infection control, psychiatric nursing, and emergency nursing, because we believe that the findings of these articles might include the possibility that a culture specific to a particular domain might affect career success. (2) involved nursing students, because they did not have a professional career; (3) included nurses as well as employees in other fields, because that implied career success as a general worker. We also excluded studies that (4) quantitative studies that do not describe the definition of career success, (5) used a career success scale that has poor reliability, or (6) with small participant sample that may have biased the results, because it may be considered to lack sufficient evidence.
3.2.3. Screening and selection
A total of 143 articles were identified. Seventy duplicates were excluded. Furthermore, we removed 30 papers that were not peer‐reviewed original articles, and one paper could not be obtained even when we contacted the library. Subsequently, the first author and co‐authors read 42 papers to determine whether the title, abstract, and content of the paper met the inclusion criteria. Thirteen papers that did not mention career success were excluded. Five papers that targeted nurses working in particular situations, such as psychiatric nurses and nurses in emergency departments, were excluded because they are unlikely to present findings generalizable to all nurses. Three papers that involved nurses as well as other occupations among the study participants were excluded because the findings of those papers did not directly provide insight into career success for nurses. One study involved nursing students who were excluded because they were in the preprofessional stage of their careers. Among the quantitative studies, five papers with unreliable scales for measuring career success and one with an inappropriate sample size were excluded. Thus, 14 quantitative and qualitative studies were included in this analysis. Figure 1 shows that the flowchart of this review, which is in line with the PRISMA 2020 statement (Page et al., 2021).
FIGURE 1.
PRISMA flowchart.
3.2.4. Quality appraisal
To ensure the quality of the data for this review, the quality of the reviewed papers was assessed using the JBI Critical Appraisal Tool for cross‐sectional studies and qualitative research. Each item on these checklists was rated on a 3‐point scale (2 = yes, 1 = unclear, 0 = no), and the total score was calculated. All the papers that scored at least 56% were included in the review. Table 1 shows the results of the cross‐sectional study and Table 2 shows the results of the critical appraisal for the qualitative study.
TABLE 1.
Critical appraisal for analytical cross‐sectional studies.
| Author (s) | Criterion | Results (%) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | ||
| Al‐Ghazali (2020) | U | Y | Y | Y | Y | Y | Y | Y | 15/16 (94%) |
| Allen, B.C. (2011) | Y | Y | Y | U | Y | Y | Y | Y | 15/16 (94%) |
| Asghari et al. (2021) | Y | Y | U | Y | U | U | N | Y | 11/16 (69%) |
| Dan et al. (2018a) | Y | Y | Y | Y | U | N | Y | Y | 13/16 (81%) |
| Dan et al. (2018b) | Y | Y | U | Y | U | U | Y | Y | 13/16 (81%) |
| Han et al. (2022) | U | Y | Y | Y | U | N | Y | Y | 12/16 (75%) |
| Li et al. (2014) | Y | Y | U | U | U | N | U | U | 9/16 (56%) |
| Liu et al. (2015) | U | Y | U | Y | U | N | U | U | 9/16 (56%) |
| Liu and Liu (2016) | U | U | U | Y | Y | Y | U | Y | 12/16 (75%) |
| Sönmez et al. (2021) | Y | Y | U | Y | Y | Y | U | Y | 14/16 (88%) |
| Wang et al. (2019) | Y | Y | Y | Y | U | Y | Y | Y | 15/16 (94%) |
| Wu et al. (2022) | U | U | U | Y | U | U | Y | U | 10/16 (63%) |
Abbreviations: N, no; U, unclear; Y, yes.
1. Were the criteria for inclusion in the sample clearly defined? 2. Were the study subjects and the setting described in detail?
3. Was the exposure measured in a valid and reliable way? 4. Were objective, standard criteria used for measurement of the condition?
5. Is there congruity between the research methodology and the interpretation of results?
6. Were strategies to deal with confounding factors stated? 7. Were the outcomes measured in a valid and reliable way?
8. Was appropriate statistical analysis used?
TABLE 2.
Critical appraisal for qualitative research.
| Author (s) | Criterion | Results (%) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | ||
| Sheikhi et al. (2016) | U | Y | Y | Y | Y | U | Y | Y | Y | U | 17/20 (85%) |
| Zamanzadeh et al. (2019) | U | Y | Y | Y | Y | N | N | Y | Y | U | 14/20 (70%) |
Abbreviations: N, no; U, unclear; Y, yes.
1. Is there congruity between the stated philosophical perspective and the research methodology? 2. Is there congruity between the research methodology and the research question or objectives? 3. Is there congruity between the research methodology and the methods used to collect data? 4. Is there congruity between the research methodology and the representation and analysis of data? 5. Is there congruity between the research methodology and the interpretation of results? 6. Is there a statement locating the researcher culturally or theoretically? 7. Is the influence of the researcher on the research, and vice‐ versa, addressed? 8. Are participants, and their voices, adequately represented? 9. Is the research ethical according to current criteria or, for recent studies, and is there evidence of ethical approval by an appropriate body? 10. Do the conclusions drawn in the research report flow from the analysis, or interpretation, of the data?
3.2.5. Data extraction
We focused on what career success means and what influences it. The information outlined below was extracted as data from all 14 articles analyzed in this review: author, publication date, journal, purpose, subject, analysis, and results. We extracted the following five pieces of information from quantitative studies: definition of career success, factors of career‐success instruments, the reliability or validity of career‐success instruments (e.g., Cronbach's alpha), and factors influencing nursing career success. We extracted two pieces of information from two qualitative studies: themes that implied career success and factors influencing nursing career success. These primary data were matrixed for analysis (see Tables 3 and 4).
TABLE 3.
Characteristics of the included quantitative studies.
| Author(s)/year journal/country | Purpose | Participants | Defining career success | Measures of career success/reliability/factor structure | Other measures/instruments | Analysis | Result |
|---|---|---|---|---|---|---|---|
|
Al‐Ghazali (2020) Leadership & Organization Development Journal [Arabia] |
To give insights into the interplay between transformational leadership and perceived career success by examining the indirect effects through serial mediation of career adaptability and job embeddedness, respectively. | 469 nurses working in government hospitals in Saudi Arabia. | The accomplishment of desirable work‐related outcomes at any point in a person's work experiences over time (Arthur et al., 2005). |
The Chinese version Career Success Scale (Li et al., 2014) Reliability: α = 0.91 3 factor structure Career satisfaction Perceived organizational competitiveness Perceived external organizational competitiveness |
Independent variables Transformational leadership* Career Adaptability* Job embeddedness* |
Structural equation modeling | Transformational leaders enhance perceived career success. Moreover, the relationship between transformational leadership and perceived career success is serially mediated by career adaptability and job embeddedness. |
|
Allen (2011) Career Development International [Australia] |
To examine potential differences in identity commitment and career success perceptions between casually and permanently employed nurses. | 181 casually employed nurses and 476 permanently employed nurses. | Satisfaction with the success they had been able to achieve in their career (Greenhaus et al. 1990). |
Satisfaction with career success (Greenhaus et al. 1990) Reliability: α = 0.86 1 Factor structure (5‐item) |
Independent variables Employment status*(negative) Identity commitment Affective commitment* Interactional commitment |
Regression analyses | Casual nurses had lower levels of identity commitment and more negative career success perceptions. Affective commitment fully mediated the relationship between employment status and subjective career success. |
|
Asghari et al. (2021) International Nursing Review [Iran] |
To develop and test the psychometric properties of an instrument assessing career success in nurses | 530 nurses worked in university hospitals located in Tabriz, Iran. | Career success can be conceptualized as a wide variety of positive outcomes brought about by employment, such as positive self‐perceptions about work experience and achievements (Li et al., 2014) |
The career success in Nursing Scale (Asghari et al. 2021) Reliability: α = 0.93, ICC = 0.90 4 factor structure Expected career development Providing quality care Effective self‐regulation Person‐organization fit |
Based on existing literature and previous qualitative study, followed by testing content and face validity of the items. Exploratory factor analysis (N = 530 nurses), Cronbach's alpha and a 2 weeks test–retest correlation was conducted. | This multidimensional nursing‐specific scale with very good psychometric properties is suitable for individual/group‐based decisions. | |
|
Dan et al. (2018a) International Journal of Nursing Practice [China] |
To explore the relationships among structural empowerment, innovative behavior, self‐efficacy, and career success by nurses in mainland China. |
460 registered nurses recruited from 6 tertiary hospitals in Tianjin, China. | Career success is defined as the accumulated positive work and psychological outcomes arising from one's work experiences (Seibert, Kraimer, & Crant, 2001). |
The Chinese version Career Success Scale (Li et al., 2014) Reliability: α = 0.90 3 factor structure Career satisfaction Perceived organizational competitiveness Perceived external organizational competitiveness |
Independent Variables Structural empowerment* Innovative behavior* Self‐efficacy* |
Structural equation modelling analyses |
Innovative behavior is positively associated with career success and self‐efficacy, which, in turn, mediates the relationship between structural empowerment and career success. Structural empowerment is positively associated with innovative behavior and career success. Self‐efficacy is positively associated with career success and mediates the relationship between innovative behavior and career success. |
|
Dan et al. (2018b) International Journal of Nursing Sciences [China] |
To explore the relationships amongst innovative behavior, self‐efficacy, colleague solidarity of nurses and career success of nurses in Mainland China |
848 nurses were recruited from eight tertiary hospitals and four secondary hospitals in Tianjin, China. |
The positive psychological feelings and work‐related achievements accumulated by individuals in their work experience |
The Chinese version Career Success Scale (Li et al., 2014) Reliability: α = 0.87 3 factor structure Career satisfaction Perceived organizational competitiveness Perceived external organizational competitiveness |
Independent variable Personal innovation behaviors* Self‐efficacy* Colleague solidarity of nurses* |
Structural equation model analysis |
Innovative behavior, self‐efficacy and colleague solidarity of nurses had a positive predictive effect on career success, with the path coefficients at 063, 0.19 and 0.13, respectively (p < 0.01) |
|
Han et al. (2022) PLOS ONE [China] |
To investigate different patterns of emotional labor among community nurses in China and analyzed the relationships between the sense of career success and emotional labor. | 385 community nurses from Beijing | Career success refers to the gradual accumulation or acquisition of work‐related achievements and positive feelings by individuals throughout their work experience, including remuneration, promotion, recognition, and acceptance (Sutin et al., 2009). |
the Career Success Scale: CSS (Li, 2017) Reliability: α = 0.95 4 factor structure Career development Freedom and happiness Gain recognition International network |
the Emotional Labor Scale | Latent class analysis (LCA) | Our study indicated that the active emotional labor class of community nurses had significantly higher career success (p < 0.05). |
|
Li et al. (2014) Journal of Advanced Nursing [China] |
To examine the psychometric properties of the 11‐item Chinese version of the Career Success Scale. | 1148 clinical nurses working at 10 level‐3 hospitals in Guangdong Province, mainland China | Career success is the combination of positive mental feelings and achievements pertaining to work that one accumulates and obtains gradually in the course of their work experience (Arthur et al., 2005). |
The Chinese version Career Success Scale (Li et al., 2014) Reliability: α = 0.87, ICC = 0.93 3 factor structure Career satisfaction Perceived organizational competitiveness Perceived external organizational competitiveness |
Reliability assesses the Cronbach coefficient and interclass correlation coefficient (ICC). The construct validity assesses principal component analysis. |
the Chinese Career Success Scale demonstrated good internal consistency and test–retest reliability. |
|
|
Liu et al. (2015) International Journal of Nursing Science [China] |
To investigate the relationships among perceived organizational support, intention to remain, career success and self‐esteem in male nurses in China |
405 full‐time male Registered Nurses, from Grade A hospitals in Tianjin. |
Career success refers to a means which embodies achievements and power acquisition through the vocational lifespan (Ng et al, 2005). |
The Chinese version Career Success Scale (Li et al., 2014) Reliability: α = 0.86 3 factor structure Career satisfaction Perceived organizational competitiveness Perceived external organizational competitiveness |
Independent Variables Perceived organizational support* Self‐esteem* Dependent Variable Intention to remain* |
structural equation modelling | Self‐esteem mediated the relationship between perceived organizational support and career success. Career success mediated the relationship between self‐esteem and intention to remain. |
|
Liu and Liu (2016) International Journal of Nursing Practice [China] |
To explore the relationships among perceived organizational support, career success, self‐esteem and intention to remain. | 610 nurses recruited from six nonprofit organizations in China. |
Career success refers to achievements and power acquisition through the vocational lifespan. Recent research suggests that career success entails work achievement and psychological development. |
The Chinese version Career Success Scale (Li et al., 2014) Reliability: α = 0.86 3 factor structure Career satisfaction Perceived organizational competitiveness Perceived external organizational competitiveness |
Independent Variables Perceived organizational support* Self‐esteem* Dependent Variable Intention to remain* |
Structural equation modelling analyses |
Perceived organizational support was positively associated with intention to remain and career success, which, in turn, mediated the relationship between perceived organizational support and intention to remain. Self‐esteem mediated the relationships between perceived organizational support and career success and between career success and intention to remain. Higher perceived organizational support, career success and self‐esteem can increase intention to remain in Chinese nurses. |
|
Sönmez et al. (2021) Journal of Nursing Scholarship [Turkey] |
To test the hypothesis model showing the relationship between nurses' individual and working characteristics, nursing work environment, subjective career success, job satisfaction, intent to leave, and professional commitment. | 604 nurses working in four hospitals in Istanbul, Turkey. | The accomplishment of desirable work‐related outcomes at any point in a person's work experiences over time (Arthur et al., 2005). |
Subjective Career Success Inventory (Shockley et al., 2016) Reliability: α = 0.91 8 factor structure Recognition Quality work Meaningful work Influence Authenticity Personal life Growth and development Satisfaction |
Independent variable Nursing work environment* (PES‐NWI) [Characteristics] Education level* (Master's degree) Income*(good) Work schedule (rotating shifts)* (negative) Dependent variable Job Satisfaction* Intent to leave*(negative) Professional commitment* |
The independent‐samples t‐test was used for two groups and one‐way analysis of variance for three or more groups. Structural equation modeling (SEM) was used to test the hypothesis model. |
Although all PES‐NWI subdimensions were included in the model, only participation in hospital affairs, staffing and resource adequacy and nurse–physician relations were significantly associated with SCS of nurses. |
|
Wang et al. (2019) International Journal of Nursing Practice [China] |
To investigate the career success and work environment among nurses with a master's or doctoral degree and analyze the effect of work environment on their career success. |
1223 nurses with a master's or doctoral degree from 115 tertiary hospitals across mainland China. | Career success is the combination of achievements and positive mental feelings pertaining to work that one accumulates and obtains gradually during their work experience (Arthur et al., 2005). |
The Chinese version Career Success Scale (Li et al., 2014) Reliability: α = 0.87 3 factor structure Career satisfaction Perceived organizational competitiveness Perceived external organizational competitiveness |
Independent variable Work environment (The PES‐NWI) Job‐related characteristics Teaching(3 items) Academic research (6 items) Clinical nursing practice (3 items) |
Hierarchical regression analysis |
Work environment was positively correlated with career success for three of the four subscales. (Nurse participation in hospital affairs, Collegial nurse‐physician relations, Staffing and resources adequacy) Attending academic conferences, acting as peer reviewer, giving theoretical lectures to students, and publishing papers in journals listed in scientific citation index as the first author were also significant influencing factors of career success. |
|
Wu et al. (2022) Journal of Nursing Management [China] |
To explore the relationships among self‐efficacy, information literacy, social support and career success of clinical nurses and identify factors influencing clinical nurses' career success in northwestern China. |
3011 clinical nurses from 30 hospitals in northwestern China. | Career success refers to a person's accumulated positive work‐related achievements or psychological sense of achievement (Cumbler et al., 2018). |
Career success scale (Woolston, 2016) Reliability: α = 0.95 2 factor structure Career satisfaction Career competition |
Independent Variables 1. Self‐efficacy* 2. Information literacy 3. Social support* |
t test, analysis of variance, Pearson's correlation, multiple linear regression, Structural equation model (SEM) |
In structural equation modelling, social support and self‐efficacy had significant impact on career success. |
*Indicates that values are statistically significant.
TABLE 4.
Characteristics of the included qualitative studies.
| Author (s)/year journal/country | Purpose | Participants | Meaning of career success/subthemes | Factors influencing career success | Analysis |
|---|---|---|---|---|---|
|
Sheikhi et al. (2016) Nurs Midwifry Stud. [Iran] |
To identify the skills needed for nurses' career advancement. | 18 nurses working in teaching hospitals in Iran |
Interpersonal capabilities Interaction Sensitivity to hospital problems Being a good mentor Sensitivity to ethical issues Career competency for career success Experimenting Management ability Clinical skills mastery Personal Capacities Attachment of importance to work Commitment to professional values |
Content analysis approach | |
|
Zamanzadeh et al. (2019) International Nursing Review [Iran] |
To explore nurses' perceptions of career success. | 27 nurses working across 14 hospitals in north Iran. |
Providing quality care Patient‐Centered care Clinical competence Knowledge‐based nursing Exemplary employee Sharing organizational values Effective team member Career growth Organizationally driven progression Professional development Professional attributes Dynamic engagement Benevolence Self‐confidence Self‐regulation Advance cognitive appraisal Internal satisfaction Feeling of usefulness Work‐life balance |
Content analysis approach |
3.3. Analysis
Based on our aims, first, extracted primary data were categorized into two perspectives: (1) what career success means and (2) what influences success. Data on the factors consisting of career success scales and themes that implied career success were divided from data on factors influencing nursing career success. Second, categorized data were unified into similar contents and matrixed (see Tables 5 and 6). Third, themes were developed from unified subgroups. In these ways, factors that make sense career success as a nurse and influence it were integrated from the quantitative and qualitative findings. At this stage, rigor was ensured by the first author who has a master's degree, the corresponding author with a doctoral degree and two co‐authors who also have doctoral degrees independently checking the analysis and carefully naming the themes through multiple discussions.
TABLE 5.
Themes and elements that make sense of nurses' career success.
| Theme | Elements | Author(s) |
|---|---|---|
| 1. Satisfaction |
Satisfaction Career satisfaction |
Al‐Ghazali (2020) Allen (2011) Dan et al. (2018a) Dan et al. (2018b) Li et al. (2014) Liu and Liu (2016) Sönmez et al. (2021) Wang et al. (2019) Wu et al. (2022) Zamanzadeh et al. (2019) |
| 2. Positive attitude toward work |
Meaningful work Effective self‐regulation Professional attributes [Dynamic engagement, Benevolence, Self‐confidence, Self‐regulation, Advanced cognitive appraisal] Feeling of usefulness |
Asghari, E. et al. (2021) Sönmez et al. (2021) Zamanzadeh et al. (2019) |
| 3. Quality work in nursing |
Quality work Providing quality care Perceived organizational competitiveness Perceived external organizational competitiveness Career competition |
Al‐Ghazali (2020) Asghari et al. (2021) Dan et al. (2018a) Dan et al. (2018b) Li et al. (2014) Liu et al. (2015) Liu and Liu (2016) Sönmez et al. (2021) Wang et al. (2019) Wu et al. (2022) Zamanzadeh et al. (2019) |
| 4. Continuation of career and professional development |
Growth and development Expected career development Career development Professional development |
Asghari et al. (2021) Han et al. (2022) Sönmez et al. (2021) Zamanzadeh et al. (2019) |
| 5. Positive interaction at work |
Influence Recognition International network Being an effective team member |
Han et al. (2022) Sönmez et al. (2021) Zamanzadeh et al. (2019) |
| 6. Person‐organization fit |
Person‐organization fit Sharing organizational values Organizationally driven progression |
Asghari et al. (2021) Zamanzadeh et al. (2019) |
| 7. Enrichment of an individual's life |
Authenticity Personal life Freedom and happiness Work‐life balance |
Han et al. (2022) Sönmez et al. (2021) Zamanzadeh et al. (2019) |
TABLE 6.
Themes and elements influencing nurses' career success.
| Theme | Elements | Author(s) |
|---|---|---|
| 1. Personal resources |
Self‐efficacy Self‐esteem Affective commitment Personal Capacities Career competency Interpersonal capabilities |
Allen (2011) Dan et al. (2018a) Dan et al. (2018b) Liu et al. (2015) Liu and Liu (2016) Sheikhi et al. (2016) Wu et al. (2022) |
| 2. Positive behavior for nursing work and research |
Personal innovation behaviors Attending academic conferences Acting as peer reviewer Giving theoretical lectures to students Publishing papers in journals listed in scientific citation index as the first author Career Adaptability Job embeddedness |
Al‐Ghazali (2020) Dan et al. (2018a) Dan et al. (2018b) Wang et al. (2019) |
| 3. Job resources and environment |
participation in hospital affairs staffing and resource adequacy nurse–physician relations Work schedule: rotating shifts (negative) Colleague solidarity of nurses Social Support Structural empowerment Perceived organizational support Transformational leadership |
Al‐Ghazali (2020) Dan et al. (2018a) Dan et al. (2018b) Liu et al. (2015) Liu and Liu (2016) Sönmez et al. (2021) Wang et al. (2019) Wu et al. (2022) |
4. RESULTS
4.1. Search results
Tables 3 and 4 present the data extracted from the included studies. Most of the studies defined career success based on either career achievements, positive feelings related to work experiences, or both. Nine papers defined career success as work achievements or accomplishments (Al‐Ghazali, 2020; Dan et al., 2018a, 2018b; Han et al., 2022; Liu et al., 2015; Liu & Liu, 2016; Sönmez et al., 2021; Wu et al., 2022; Zamanzadeh et al., 2019), and six defined it as positive psychological feelings (Allen, 2011; Dan et al., 2018a, 2018b; Han et al., 2022; Liu & Liu, 2016; Wu et al., 2022). Three papers described these achievements and positive psychological feelings as outcomes of experiences at work (Asghari et al., 2021; Li et al., 2014; Wang et al., 2019).
Eleven quantitative studies utilized career success scales that can be applied to any occupations (Al‐Ghazali, 2020; Allen, 2011; Dan et al., 2018a, 2018b; Han et al., 2022; Li et al., 2014; Liu et al., 2015; Liu & Liu, 2016; Sönmez et al., 2021; Wang et al., 2019; Wu et al., 2022). One quantitative study addressed the development of a career success scale for nurses (Asghari et al., 2021). Among the two qualitative studies, one explored the meaning of career success for nurses (Zamanzadeh et al., 2019); the other explored the factors that influenced nurses' career success (Sheikhi et al., 2016).
Eight studies were conducted in China (Dan et al., 2018a, 2018b; Han et al., 2022; Li et al., 2014; Liu et al., 2015; Liu & Liu, 2016; Wang et al., 2019; Wu et al., 2022) and three in Iran (Asghari et al., 2021; Sheikhi et al., 2016; Zamanzadeh et al., 2019). The remaining studies were conducted in Turkey (Sönmez et al., 2021), Arabia (Al‐Ghazali, 2020), and Australia (Allen, 2011).
Seven themes were identified by integrating the factors included in career success (see Table 5). We also identified three themes related to factors influencing nurses' career success were identified (see Table 6).
4.2. Findings
4.2.1. Factors that make sense of career success as a nurse
The following seven themes were extracted from the included literature to explain nurses' career success.
Satisfaction
Satisfaction or career satisfaction was measured as a subscale construct of career success in nine quantitative studies (Al‐Ghazali, 2020; Allen, 2011; Dan et al., 2018a, 2018b; Li et al., 2014; Liu & Liu, 2016; Sönmez et al., 2021; Wang et al., 2019; Wu et al., 2022). These studies focused on measuring individuals' satisfaction levels regarding their career achievements and progress toward career or skill development goals (Al‐Ghazali, 2020; Allen, 2011; Dan et al., 2018a, 2018b; Li et al., 2014; Liu & Liu, 2016; Sönmez et al., 2021; Wang et al., 2019; Wu et al., 2022). A qualitative study also demonstrated that achievement leads to nurses feeling internally satisfied (Zamanzadeh et al., 2019).
Positive attitude towards work
The second theme was a positive attitude towards work. Meaningful work and effective self‐regulation were measured as subscale constructs of career success in two quantitative studies (Asghari et al., 2021; Sönmez et al., 2021). Meaningful work refers to work that an individual perceives as contributing to society (Shockley et al., 2016; Sönmez et al., 2021). People with effective self‐regulation achieve work–life balance despite demanding workloads and time pressures and are self‐aware and able to continuously monitor and manage the self and the environment to be more effective and respected in their work (Asghari et al., 2021). Professional attributes and feelings of usefulness have been identified as themes or subthemes in qualitative nursing career success studies (Zamanzadeh et al., 2019).
Quality work in nursing
Providing quality care, quality work, perceived organizational competitiveness, perceived external organizational competitiveness, and career competition were combined in the third theme: quality work in nursing (Al‐Ghazali, 2020; Asghari et al., 2021; Dan et al., 2018a, 2018b; Li et al., 2014; Liu & Liu, 2016; Sönmez et al., 2021; Wang et al., 2019; Wu et al., 2022; Zamanzadeh et al., 2019). Zamanzadeh et al. (2019) found that providing quality care was involved in nurses' perceptions of career success, and Asghari et al. (2021) developed a nursing career success scale involving this factor. Quality work, perceived organizational competitiveness, perceived external organizational competitiveness, and career competition were integrated into this theme and used as subscales of career success that could be adapted to any occupation in the other eight quantitative studies (Al‐Ghazali, 2020; Dan et al., 2018a, 2018b; Li et al., 2014; Liu & Liu, 2016; Sönmez et al., 2021; Wang et al., 2019; Wu et al., 2022). We included these subscales in the theme “quality work in nursing” because, in the nursing work context, work is defined as providing care to patients through the practice of nursing.
Continuation of career and professional development
The fourth theme was continuation of career and professional development. A qualitative study conducted by Zamanzadeh et al. (2019) demonstrated that continuing professional development is an essential element of staying up to date. Three quantitative studies measured whether participants were addressing career development, and their main concerns were continuous learning and development (Asghari et al., 2021;Han et al., 2022; Sönmez et al., 2021).
Positive interaction at work
All the factors included in the fifth theme originated from positive interactions with others at work. The following factors were included: influence, gaining recognition, international networks, and effective team members (Han et al., 2022; Sönmez et al., 2021; Zamanzadeh et al., 2019). Sönmez et al. (2021) measured influence and recognition using the subjective career success inventory subscales developed by Shockley et al. (2016). Influence was defined as having an impact on others within the organization and on the organization itself; gaining recognition was defined as being formally or informally acknowledged for one's work by valued others (Shockley et al., 2016). Han et al. (2022) also measured gaining recognition as a factor of career success. In addition, they measured international networks as a factor of career success. A qualitative study demonstrated the following factors as effective team members involved in career success: being able to collaborate with other staff and assist other nurses, becoming a role model for other staff, and being a colleague who can be trusted and relied upon (Zamanzadeh et al., 2019).
Person–organization fit
Person–organization fit, the sharing of organizational values, and organizationally driven progression were integrated into the sixth theme (Asghari et al., 2021; Zamanzadeh et al., 2019). This theme consisted of factors drawn from two career success studies conducted with nurses. Zamanzadeh et al. (2019) demonstrated that exemplary nurses share organizational values, such as showing expected professional behavior at work when dealing with patients and other staff. Based on these findings, in the nursing scale developed by Asghari et al. (2021), career success included person–organization fit as a factor. It included roles such as supporting one's coworkers, being a team member, and working collaboratively toward meeting organizational goals and expectations (Asghari et al., 2021).
Enrichment of an individual's life
Authenticity, personal life, freedom, happiness, and work–life balance were integrated into the seventh theme (Han et al., 2022; Sönmez et al., 2021). These elements focused on enriching an individual's life. The qualitative study conducted by Zamanzadeh et al. (2019) reported that nurses who achieved this were considered successful because they achieved work–life balance despite high job demands and work shifts. Authenticity, personal life, freedom, and happiness were measured as subscale constructs of career success in two quantitative studies (Han et al., 2022; Sönmez et al., 2021). Authenticity refers to shaping the direction of one's career according to personal needs and preferences (Shockley et al., 2016; Sönmez et al., 2021). Personal life entails having a career that positively impacts life outside of work (Shockley et al., 2016; Sönmez et al., 2021).
4.2.2. Factors influencing nursing career success
A total of 21 factors were categorized into three themes: personal resources, positive behavior for work and research, and job resources and environments.
Personal resources
Six quantitative studies examined influencing factors that can be considered personal resources, such as self‐efficacy, self‐esteem, and affective commitment (Allen, 2011; Dan et al., 2018a, 2018b; Liu et al., 2015; Liu & Liu, 2016; Wu et al., 2022). Self‐efficacy was positively associated with career success and mediated the relationship between innovative behavior and career success (Dan et al., 2018a, 2018b; Wu et al., 2022). Self‐esteem mediated the relationship between perceived organizational support and career success (Liu et al., 2015; Liu & Liu, 2016). According to one quantitative study, affective commitment fully mediated the relationship between employment status and subjective career success (Allen, 2011). One qualitative study revealed that personal capacities, such as attachment of importance to work and commitment to professional values, are required for nurses' career advancement (Sheikhi et al., 2016).
Positive behavior for nursing work and research
Four quantitative studies examined influencing factors that can be considered positive work behaviors, such as personal innovation behaviors and attending academic conferences (Dan et al., 2018a, 2018b; Wang et al., 2019). Personal innovation behaviors were reported to be positively associated with career success (Dan et al., 2018a, 2018b). Attending academic conferences, acting as a peer reviewer, delivering theoretical lectures to students, and publishing papers in journals listed in the Scientific Citation Index as the first author were significant influencing factors of career success (Wang et al., 2019).
Job resources and environments
Eight quantitative studies examined influencing factors that can be considered job resources and environments (Al‐Ghazali, 2020; Dan et al., 2018a, 2018b; Liu et al., 2015; Liu & Liu, 2016; Sönmez et al., 2021; Wang et al., 2019; Wu et al., 2022). Work environment, such as nurse participation in hospital affairs, collegial nurse–physician relations, and staffing and resources adequacy, was positively correlated with career success (Sönmez et al., 2021; Wang et al., 2019). Job resources, such as social support, colleague solidarity of nurses, structural empowerment, and transformational leadership, were positively correlated with career success (Al‐Ghazali, 2020; Dan et al., 2018a, 2018b; Liu et al., 2015; Liu & Liu, 2016; Wu et al., 2022).
5. DISCUSSION
The findings of this integrative review indicate seven themes that shape nurses' career success and three themes concerning antecedent requirements. In the following sections, we discuss how the findings of this review address our two aims. First, we mainly discuss the unique elements of career success in the nursing context and the factors that indicate career success in nursing. Second, we discuss the mechanism by which career success is enhanced through dynamics with antecedents, based on the conservation of resources (COR) theory that provides a valuable framework for explaining career success (Hobfoll et al., 2018; Spurk et al., 2019). Finally, we discuss the limitations and contributions of this review.
5.1. Elements that make sense of career success in nursing
The first aim was to identify the elements that indicate nurses' career success. To investigate what should be measured as career success in the nursing context, we reviewed career outcomes. Our review revealed seven themes that have shaped nurses' career success: satisfaction, positive attitude toward work, quality work in nursing, continuation of career and professional development, positive interaction at work, person–organization fit, and enrichment of an individual's life. Our findings are consistent with those of previous studies. In several previous studies on working adults worldwide, the definitions of career success have been identified as achievement, learning and development, work–life balance, positive relationships, positive impact, and satisfaction (Hupkens et al., 2021; Mayrhofer et al., 2016; Poon et al., 2015; Shockley et al., 2016). These overlapping elements of what it means to have career success are common career outcomes for the general worker.
The elements included in the theme of quality work in nursing were indicated as unique to nursing career success. Qualitative research conducted in the nursing context has shown that the most commonly reported elements of career success were the provision of quality care, reflected in patient‐centered care, and a high level of clinical competence and knowledge (Zamanzadeh et al., 2019). However, only two studies included in the review qualitatively explored career success for nurses, which still seem to be too few. The remaining potential to conduct qualitative research has been similarly noted in a review of career success in occupational psychology (Heslin, 2005). Further research is needed to analyze nurses' perceptions of career success from their narratives to explore the unique elements of their career success.
Person–organization fit may be an element of career success that distinguishes nursing from other professions. Mayrhofer et al. (2016) analyzed the career success of participants in various occupations in dozens of countries around the world and identified entrepreneurship as a factor in their career success. Hupkens et al. (2021) indicated that autonomy, which is characterized by personal ownership of one's career, such as setting up new projects and enterprises, includes subjective career success perceptions. The results of our review revealed that, in contrast to the findings of studies conducted in the industrial psychology field, the element of person–organization fit does constitute career success for nurses. In many cases, nursing care is provided in collaboration with others in the healthcare teams. Building relationships with colleagues and organizations in the healthcare team is an essential element for nurses because it promotes interprofessional collaborative practice (Wei et al., 2020). Thus, the ability to work while also building relationships with healthcare organizations is an important element of nurses' career outcomes.
5.2. Mechanism by which career success is enhanced through dynamics with antecedents
The second aim was to determine the factors that influenced nurses' career success. Our review revealed three themes that influenced nurses' career success: personal resources, positive behavior for nursing work and research, and job resources and environments.
The mechanisms that enhance nurses' career success can be explained by the concept of resource caravans, which was developed from the COR theory. The COR theory accounts for the tenet that individuals strive to obtain, retain, foster, and protect the things they centrally value (Hobfoll et al., 2018), which provides a valuable framework for explaining the achievement of career success (Spurk et al., 2019). Resources tend to evolve through the influence of both individuals and organizations, and such collaborations have been theorized as resource caravans (Hobfoll et al., 2018). In other words, resources tend to be a consequence of nurturing and adaptive learning and may be interrelated (Hobfoll et al., 2018). Research on career success in nursing has also shown that work and personal resources have influenced career success, which may prove that these resources are interrelated and enhance career success. Indeed, the quantitative studies included in this review reported that personal resources mediate the relationship between job resources and career success (Allen, 2011; Dan et al., 2018a, 2018b; Liu et al., 2015; Liu & Liu, 2016; Wu et al., 2022). It can thus be concluded that job and personal resources work together to enhance career success. Future research that investigates the mechanisms by which work and personal resources work together to enhance career success could establish novel findings.
5.3. Limitations
Our review yielded several insights; however, it also has several limitations. First, a few of the studies included in our review examined unique elements of nurses' career success, while the two qualitative studies we included examined the unique elements of nurses' career success. In other words, quality of work in nursing and person–organization fit were integrated from the findings of previous studies as unique aspects of nurses' career success; however, there may be other aspects of nurses' career success that are not yet fully understood. Second, all of the quantitative studies in our review had cross‐sectional study designs; however, cross‐sectional studies cannot ensure the rigor of the methods identifying causal factors influencing nurses' career success in our result. Third, we only considered studies published in English; therefore, any relevant studies of career success for nurses conducted in various other countries or languages were not included in our analysis. Despite these limitations, by integrating scientific findings on career success for nurses, we have developed a holistic understanding and gain insight into what shapes career success and how to achieve it for nurses.
5.4. Contribution to the literature and implications for practice
Our review makes two main contributions. First, we expand the literature by distinguishing the unique elements of nurses' career success from those that overlap with the general worker. It allows us to integrate our scientific findings with determining which outcomes are important in nursing careers. We can also specify a framework for measurement and evaluation. Further, we reveal that little qualitative research has been undertaken to investigate the unique aspects of nurses' career success, which continues to present challenges for future research. As career success is influenced by national culture (Briscoe et al., 2021), identifying the perspective of nurses' career success worldwide would greatly extend the nursing career literature.
Second, we contribute to nurses' professional development by illustrating research trends in nursing career success. Nurses may maintain and improve their nursing careers by applying the insights of our review. Finally, our findings may also contribute to the organizational management practices of nursing managers. Successful management of job and human resources can enhance staff career success, enabling the provision of quality nursing care.
6. CONCLUSION
We reviewed studies on nurses' career success, integrating seven themes that shape nurses' career success and three antecedent requirements that influence it. However, career success among nurses has not yet been adequately explored. Future research is needed to analyze nurses' perceptions of career success from their narratives to examine unique elements. Investigating how job and personal resources work together to enhance career success could establish novel findings.
AUTHOR CONTRIBUTIONS
MY, KA: Study design. MY: Data collection. MY, SS, NT: Data analysis. KA: Study supervision. MY: Manuscript writing. All authors have read and approved the submitted version of the manuscript.
FUNDING INFORMATION
The authors disclose receipt of the following financial support for the research and authorship of this article: This work was supported by JST, the establishment of university fellowships toward the creation of science technology innovation (grant number JPMJFS2102).
CONFLICT OF INTEREST STATEMENT
The authors have no conflicts of interest to declare.
ETHICAL APPROVAL
The present study utilized published literature and took great care to handle copyrights. As only published articles were used in this review, it did not require approval from an ethics committee.
ACKNOWLEDGEMENTS
We are grateful to all the scholars who have conducted research on nurses' career success.
Yamada, M. , Asakura, K. , Sugiyama, S. , & Takada, N. (2024). Insights from defining nurses' career success: An integrative review. Nursing Open, 11, e2040. 10.1002/nop2.2040
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.