Work Readiness among Nursing Diploma Students in a Higher Education Institution in Malaysia

This study investigated work readiness level among 140 Nursing Diploma students in a public university in East Malaysia. Work Readiness Inventory was used. There were six components in this instrument, namely responsibility, flexibility, skills, communications, self-view, and health and safety. The results indicated that the overall work readiness among Nursing Diploma students was high (M=138.10, SD 11.03). The highest work readiness was from the health and safety component (M= 26.90, SD = 3.14); and the lowest work readiness was from the self-view component (M=15.73, SD = 3.15). There was no significant difference in scores of work readiness for genders, t (138) =.299, p = .765. As for years of study and work readiness, there was also no significant difference, F (2,137) = .717, p = .490. In terms of work readiness and family income, there was also no significant difference, F (3,136) = 1.909, p =.131. This study implies that it is necessary to create more programmes to boost student self-confidence as well as help them to find out their real interest, so that they can put their efforts in and eventually be well prepared for work.


Introduction
Nursing is a challenging job in terms of mental and also physical requirements.Nurses need to interact with people who need help, handle medicines, and deal with sick people in life and death situations.Therefore, the nature of work in nursing requires high challenges.Nursing Diploma students enter nursing as young as 18 years old.At this young age they have to go through the routine as a nurse, and are exposed to real conditions and situations in hospitals to perform duties.The challenges of this high work demand, definitely are not easy.Work readiness will determine their attitude and motivation and their achievements in this field.Once individuals have work motivation, it will surely make them positive, interested in the nursing career and highly engaged in achieving career success (Zeng et al., 2022).

Statement of Problem
A career may start at an early stage when individuals decided to venture to a higher level after the Malaysian Certificate of Education examination (SPM, Sijil Pelajaran Malaysia).At this time, individuals will be looking for directions and opportunities that can help them to succeed in the future.Among the fields they could consider to enter is the Nursing Diploma Programme.These students are known as student nurses when they get into the Nursing Diploma Programme.In Malaysia, the programme participants will need 3 years to graduate.
The process of transitioning from a student who has just finished SPM and then entering the challenging nursing career is not easy.It takes time and willingness to understand and perform the role of a nurse.Work readiness is important in nursing because nurses deal with real patients.In order to be a successful nurse, the individual needs to be mentally and physically prepared to take on the responsibilities and work role.Nurses need to have a set of competencies such as knowledge and skills (Bastani et al., 2021) so that they could demonstrate soft skills, and effective communication while performing tasks.Work readiness, therefore, is important to increase professionalism among students to become registered nurses.
Some studies express concern about the work readiness in the nursing field.Usher et al (2015) stated that there were nurses entering the workplace not well prepared for the reality of the clinical environment.This type of concern extends throughout the world in countries such as Australia, Canada and the United Kingdom regarding work readiness; some participants in the studies stated that they lacked the required skills to allow them to register as a registered nurse.Therefore they were concerned about the qualifications they had (Morrell & Rigdway, 2014).
The profession of being a nurse is not an easy job.This profession combines "art" and "science" that helps individuals learn self-care at any time.At the same time, it helps other individuals when they are helpless to meet their own needs and self-care activities (Ministry of Health Malaysia, 2011).A nurse not only cares for and helps herself in life, but also helps and cares for other individuals who need help.In addition, the characteristics required in a nursing career are loving, energetic, polite, patient, honest, caring, able to communicate as well as having a positive attitude.These characteristics will help the individual to be a successful person and devoted to others when carrying out a career as a nurse.At the same time, nursing certainly requires a person with high vision, able to accept challenges and hold the trust given as best as possible.Therefore, this study was conducted to investigate the extent of work readiness level among student nurses by using the Work Readiness Inventory.Apart from learning in the classroom, student nurses also involve themselves in the real career setting of the hospital, where their scope of work is the same as that of a staff nurse.Are these Nursing Diploma students ready for their work in the future?This study is expected to provide some facts about the phenomenon.So far in Malaysia, studies related to work readiness in the nursing field are still very limited, especially regarding the work readiness during the Nursing Diploma Programme.This study investigated the difference in work readiness in terms of gender.This is because the nursing profession is not limited to females only, but it is also open to males.Investigating the work readiness between the sexes is important because since ancient times, the nursing career has been dominated by females.It is good to understand the work readiness among males too.
As the Nursing Diploma Programme takes 3 years in Malaysia, students from different years of study may show different work readiness level, such as third year students who have gone through 2 years of learning in the ward, while the first year students are still new and fresh from knowing the scope of work as a nurse.Therefore, this study can give some insight regarding the work readiness differences in terms of years of study.
One of the factors affecting an individual's work readiness is family income.This is because a well-to-do family background allows for more career exposure.Cedeño et al (2021) stated that poverty and lack of resources in a family will have bad consequences for the behaviour of teenagers, especially in career readiness.Therefore it is important to offer knowledge, skills and opportunities including learning and exposure to work to the poor so that inter-generational poverty will not persist.Abu Bakar and Noorsafarina (2011) found that the earlier the awareness of career choice, the higher the work readiness because individuals will have time to improve the weaknesses they face as they are still young.Students from affluent families have more opportunities to do so.Therefore, this study examines the difference work readiness level with family income.It is hoped that this study will be able to benefit all Nursing Diploma students from the six aspects of work readiness namely responsibility, flexibility, skills, communication, self-view, and health & safety that are measured in the Work Readiness Inventory (Brady, 2010 ).
For this study, the research questions to be answered are 1.What is the work readiness level among Nursing Diploma students?2. Is there any difference in the work readiness level between genders among Nursing Diploma students?3. Is there any difference in the work readiness level with the years of study among Nursing Diploma students?4. Is there any difference in the work readiness level with family income among Nursing Diploma students?

Work Readiness
Cabellero and Walker (2010) stated that readiness to work is having skills and attributes that ensure marketability to enable workplace success.Work readiness is needed to achieve and strengthen the ability to enter the world of work (Zaharim et al., 2010).Taylor and Govender (2013) stated that some important aspects of work readiness are being skilled and experienced, having good problem-solving skills, being able to overcome diversity, adapting in an unfamiliar environment, and the ability to work well with others.Walker (2013) stated that strategies and skills are factors that help or hinder the transition of graduates to the workplace.
A person who has sufficient work readiness is one that has the characteristics of preparing himself or herself to succeed in the knowledge and assessment skills required (Casey et al., 2011).According to Brady (2010), there are 6 components of work readiness namely responsibility, flexibility, skills, communication, self-view, and health and safety.
Responsibility is an important element to show an individual is ready for work.Having a career as a nurse requires great responsibility; this involves coming to work early so that handing over from the previous staff could be done before taking over the responsibilities.Responsibility also involves personal integrity, honesty, and trust (Gardner et al., 2001).Gardner et al (2001) found that more than two-thirds of workers in the industry perceive responsibility at work as an important matter.It is not only holding responsibility for themselves, but also being responsible for colleagues and the workplace, so that the workplace needs could be met (Gardner, 2007).Flexibility, on the other hand, is a resilience factor that allows individuals to adapt to change and accept reality in the workplace (Moorhouse & Caltabiono, 2007).Having the flexibility to adapt to change is seen as an important component in work readiness because the process of life in work is dynamic and not static (Brady, 2010).Flexibility is needed when adapting to new and changing work roles and situations.This is especially true for nurses who need high flexibility skills at work.Skills are related to jobs, intellectual level, and expertise that dominate knowledge (Freidman, 2005).These skills include micro skills as well as macro skills such as "learning how to learn" (Parker, 2008).The micro and macro skills are important for nursing students as they need to apply what they learn in the classrooms and to perform it on patients in the hospital.
Communication not only involved effective communication but also in terms of social exchange in daily life.This involves helping each other.A person who shows good communication skills has good social skills.This good social competence will lead to enhanced performance in the workplace (Harris et al., 2007).
Self-view includes self-concept, self-identity and self-efficacy (Brady, 2010).Selfconcept and self-efficacy continue to influence career planning and career decision making.Those who have a positive self-view tend to have good performance, besides being effective in their duties and roles (Brady, 2010).
Health and safety is a global concern.The International Labor Office (ILO, 2008) estimated that every year there are 337 million work-related injuries and 2 million workrelated illnesses worldwide.Therefore health and safety is important at work.Nurses need to have more concern over the use of drugs and their working environment to keep themselves and their patients safe.

Methodology
This is a quantitative study that uses questionnaires to collect data.This section discusses the sample and data collection methods and the instrument used.

Sample and Data Collection Methods
Nursing Diploma students were selected as a focused sampling to identify the work readiness level among them.Some 140 Nursing Diploma students participated in this study, 82.1% (115) students were females and 17.9% (25) students were males.
As for years of study, 25.7 % (36) students were in the first year; 36.4% (51) students were from the second year, and 37.9% (53) students were in the the third year of study.
Data collection is done physically with paper and pencil.The researcher used three weeks to involve all first, second and the third year Nursing Diploma students in a Faculty at a public university in East Malaysia.The approval was sought from the Dean of the Faculty.Collection in class was also carried out after getting approval from the class lecturers.

Research Instrument and Scoring
The research instrument used is the Work Readiness Inventory (Brady, 2010).Table 1 shows the 6 components and the respective items.6,12,18,24,30,36 6 This instrument requires students to answer on a 5-point Likert scale, with a score of 1 indicating not concerned to a score of 5 indicating very concerned.The higher level of concern indicates more readiness for work.
Table 2 shows the level of concern, score range for each component and total score range.The score range for each component was from 6 to 30, and the total score range is from 36 to 180.Cronbach's alpha for the instrument used in this study was .788.

Results
The results of this study are presented as follows:

Work Readiness Level among Nursing Diploma Students
The work readiness level among Nursing Diploma students is shown in Table 3. Overall the mean of work readiness for Nursing Diploma students was 138.10 (M=138.10,SD=11.03).This represented a high readiness for work.

Difference in Work Readiness between Genders among Nursing Diploma Students
There were 82.1% (115) female students, and 17.9% (25) male students in this study.t-test was used to investigate the work readiness difference between the genders among Nursing Diploma students.

Difference in Work Readiness with the Years of Study among Nursing Diploma Students
For this study, the total respondents for first year students was 25.7 % (36), the second year was 36.4% (51), and the third year was 37.9% (53).One-way ANOVA was used to investigate the difference in the work readiness with years of study among Nursing Diploma students.
Table 6 shows there was no significant difference in scores of work readiness between groups means as determined by one-way ANOVA with the years of study among Nursing Diploma students, F (2,137) = .717,p = .490.
Table 7 shows there was no significant difference in scores of work readiness between groups means as determined by one-way ANOVA for family income among Nursing Diploma students, F (3,136) = 1.909, p =.131.

Discussion
Work readiness had five levels, i.e. "very high," "high," "moderate,", "low," and "very low" levels.The results show that the overall work readiness among Nursing Diploma students was "high."This could be because this group of students have interest in becoming nurses.
Interest is one of the factors influencing readiness to choose a career in the field studied (Hartini, 2010).Interest makes students have more motivational force in dealing with work.Owen (1996) stated that motivation is not only a behaviour, but also an internal force that can influence an individual's behaviour.Robbins (2001) noted that motivation is the employee readiness to bring out abilities at a high level in achieving goals.Thus, work readiness is important in providing students efforts to further improve their work quality as employees.
Interest and motivational force keep students performing well and full of enthusiasm at work.At the same time, interest and motivational force help them to grab opportunities available and make plans to achieve them.In this study, as most of the students have just finished their SPM, they are starting to move away from tentative career preference towards a more specific vocational preference.Most of them enter the last stage of exploration, namely the implementation process (Super,1990).The Nursing Diploma Programme enables them to achieve their dreams.The high work readiness among the Nursing Diploma students directly helped them to determine their work identity as nurses, so as to make them have "high" work readiness.
As for each of the component of work readiness, the result also showed that Nursing Diploma students have the highest work readiness in the Health and Safety component.This component is important in the Ministry of Health because nursing is dealing with life.Safety procedures when using tools need to be handled with care and monitored by qualified nurses.According to Brady (2010), employers want employees who know how to keep the workplace safe, healthy and accident-free.Health and safety involves strong physical and mental awareness in the workplace.Therefore, the analysis of this study shows that nursing students are very concerned about health quality and safety of the hospital.As a future nurse, using the correct techniques such as bending or reaching for something is very important to avoid accidents.In addition, wearing the right clothes while providing treatment to patients is also a very important aspect for work as a nurse to avoid infection.Thus, out of all the components, this study shows that students are more prepared with the Health and Safety component.On the contrary, self-view is the least work readiness among the Nursing Diploma students.This shows that students are having low self-confidence.They are unaware of their capabilities.In other words, their self-efficacy needs to be upgraded.
The results of this study show that men and women have the same readiness for work.This result supported studies by (Lee and Hughey, 2001;Lau et al., 2011).Again, this result also implies that students applied for the Nursing Diploma Programme most likely based on interest, even for male students.Since most of the students have interest in the nursing field, this contributes to no significant difference in work readiness between genders.
Results also show no significant difference in work readiness in terms of years of study.This result is contrary to most of the studies stating that the senior students usually have more work readiness as they showed more career maturity (Brown & Rector, 2008).Brown and Rector (2008) also suggested that more occupational knowledge (which will be increased by years) would be positively related to work readiness.The results of this study show no significant difference among Nursing Diploma students in terms of years of study, probably because the students at this stage are still in the stages of completing their education and training before entering the world of work.Most of them have just finished their secondary schools with SPM results.At this level most of them are in the level of exploration, and still trying for work experience.Most of them are in the transitional and experimental stages, where they started from zero knowledge as nurses.This contributes to no significant difference among Year 1, 2 or 3 students.
As for the family income in relation to work readiness, this study revealed there was also no significant difference between family income category and work readiness.The results of this study were inconsistent with most of the previous studies.Previous studies found that parents of moderate and high income can afford to spend more on children's educational exposure (Alexander et al., 1994).This type of exposure will enable students to have more work readiness, if compared with students from a low income family (Johnstone, 2004;Wang, 2001).However, this study has a consistent result with the study of Bilal et al (2016) on a group of engineering students from a private university in Malaysia.This study has four groups of family income, but none of them has a significant difference in relation to work readiness.It is most likely because of the education system where the Malaysian government provides free education starting from primary school.In Malaysia, the majority of students, whether rich or poor, studied in the government funded schools until they finished SPM.These schools have the same syllabus for all the students throughout Malaysia.This implied that the students have the same exposure to various prospective careers in schools.Even though previous studies suggested that students from more affluent families will have an advantage in terms of work readiness, this study suggests that schools still play a major role in relation to work readiness.

Motivation and Contribution of This Study
The biggest contribution of this study is to emphasize that interest can provide readiness to an individual regardless of their gender, years of study and family income.It is one of the factors that provide motivation for individuals to go through the world of work and the field that has been chosen.Interest helps students determine their work identity while motivating them to learn about the opportunities available and try to make a career plan in a real job situation.
Interest will hone the talent and potential of students through solidification in the field of training and help them when working later.Interest will prepare students to go through many challenges.Active involvement will increase skills and experiences, further increasing self-sufficiency in competitiveness in the world of work, whether nationally or internationally.

Conclusion
"Choose a job you are interested in and you will never have to work a day in your life" (Adonis, 2018).This study shows that work readiness for Nursing Diploma students is high most likely because of interest.Interest plays an important role in making career decisions and eventually achieving life satisfaction.It is timely for policy makers to nurture students' interest even in primary schools, so that they know where their interest lies.If they have explored enough the kind of jobs they desire, they will have a very high readiness for their chosen career.In light of the results, hopefully the work readiness of students will upgrade to "very high" in the coming cohorts should proper steps be taken to help the young generation.
Results showed that students' self-confidence need to be upgraded.This study stressed that policy makers need to hire experts in designing programmes to boost student selfconfidence so that students have confidence in carrying out assigned tasks.Malaysia needs high-skilled workers with full confident to propel the country toward a high-income society so that they can contribute to economic development of the nation.

Table 1
The Component and Items of Work Readiness Inventory

Table 2
Score Range and Level of Concern

Table 3
Table4shows the mean for each component.The highest mean was from the health and safety component, with the value of 26.90 (SD= 3.14); and the lowest mean was self-view, at 15.73 (SD=3.15).

Table 5
Difference in Work Readiness between Genders among Nursing Diploma Students

Table 6
Difference in the Work Readiness with the Years of Study among Nursing Diploma Students

Table 7
Difference in the Level of Work Readiness with Family Income among Nursing Diploma