Sample records for nurse work environments
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Association of the nurse work environment with nurse incivility in hospitals.
Smith, Jessica G; Morin, Karen H; Lake, Eileen T
2018-03-01
To determine whether nurse coworker incivility is associated with the nurse work environment, defined as organisational characteristics that promote nurse autonomy. Workplace incivility can negatively affect nurses, hospitals and patients. Plentiful evidence documents that nurses working in better nurse work environments have improved job and health outcomes. There is minimal knowledge about how nurse coworker incivility relates to the United States nurse work environment. Quantitative, cross-sectional. Data were collected through online surveys of registered nurses in a southwestern United States health system. The survey content included the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index and the Workplace Incivility Scale. Data analyses were descriptive and correlational. Mean levels of incivility were low in this sample of 233 staff nurses. Incivility occurred 'sporadically' (mean = 0.58; range 0.00-5.29). The nurse work environment was rated highly (mean = 3.10; range of 1.00-4.00). The nurse work environment was significantly inversely associated with coworker incivility. The nurse manager qualities were the principal factor of the nurse work environment associated with incivility. Supportive nurse managers reduce coworker incivility. Nurse managers can shape nurse work environments to prevent nurse incivility. © 2017 John Wiley & Sons Ltd.
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Choi, Sandy Pin-Pin; Pang, Samantha Mei-Che; Cheung, Kin; Wong, Thomas Kwok-Shing
2011-10-01
The nursing work environment, which provides the context of care delivery, has been gaining increasing attention in recent years. A growing body of evidence points to an inseparable link between attributes of the nursing work environment and nurse and patient outcomes. While most studies have adopted a survey design to examine the workforce and work environment issues, this study employed a phenomenological approach to provide empirical evidence regarding nurses' perceptions of their work and work environment. The aim of this study was to advance our understanding of the phenomenon of increasing nurse turnover through exploring frontline registered nurses' lived experiences of working in Hong Kong public hospitals. A modified version of Van Kaam's controlled explication method was adopted. Individual semi-structured interviews were conducted with 26 frontline nurses recruited from ten acute regional, district and non-acute public hospitals in Hong Kong. Their perspectives in regard to their work and work environment, such as workload, manpower demand and professional values, were extensively examined, and a hypothetical description relating the nursing work environment with nurses' turnover intention was posited. Contemplation of nurses' experiences revealed the vulnerable aspects of nursing work and six essential constituents of the nursing work environment, namely staffing level, work responsibility, management, co-worker relationships, job, and professional incentives. These essential constituents have contributed to two sets of forces, stabilizing and destabilizing forces, which originate from the attributes of the nursing work environment. Nurses viewed harmonious co-worker relationships, recognition and professional development as the crucial retaining factors. However, nurses working in an unfavorable environment were overwhelmed by destabilizing forces; they expressed frustration and demonstrated an intention to leave their work environment. The nursing work environment is a complex entity comprising multiple constituents; its attributes affect nurses' perceptions of their work and work environment, which warrant special attention in addressing the phenomenon of increasing nurse turnover. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Effects of work environment on patient and nurse outcomes.
Copanitsanou, Panagiota; Fotos, Nikolaos; Brokalaki, Hero
2017-02-09
Several parameters of the nurse's work environment lead to fewer patient complications and lower nurse burnout. The aim of this systematic review was the analysis of research data related to the effect of nurses' work environments on outcomes for both patients and nurses. Medline was searched by using keywords: 'working conditions', 'work environment', 'nurses', 'nursing staff', 'patients', 'outcomes'. In total, 10 studies were included, of which 4 were cross-sectional and the remaining were descriptive correlational studies. Patients who were hospitalised in units with good work environments for the nurses were more satisfied with the nursing care than the patients in units with poor work environments. Nurses who perceived their work environment to be good experienced higher job satisfaction and lower rates of burnout syndrome. A good work environment constitutes a determinant factor for high care quality and, at the same time, relates to improved outcomes for the nurses.
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Desmedt, M; De Geest, S; Schubert, M; Schwendimann, R; Ausserhofer, D
2012-12-21
Magnet hospitals share nurse work environment characteristics associated with superior patient, nurse and financial outcomes. In Switzerland, however, it is uncertain how nurses appraise their work environments. To describe the quality of the nurse work environment in 35 Swiss acute care hospitals and to benchmark findings based on international Magnet hospital research. This study used two data sources: (1) the Swiss arm of the RN4CAST study; and (2) a structured literature review. Hospitals were categorised based on Magnet and non-Magnet data. Our outcome variable of interest was the quality of nurse work environment measured with the Practice Environment Scale of the Nurse Work Index (PES-NWI). We reviewed 13 American, Canadian, and Australian studies of acute-care hospitals. Three provided Magnet hospitals' nurse work environment data, and all included non-Magnet hospitals' data. Swiss hospitals' evaluations on nurse work environment quality varied widely, but 25% achieved scores indicating "Magnet nurse work environments". Swiss hospitals' average "Nursing manager ability" subscale scores fulfilled Magnet hospital criteria, although "Nurse participation in hospital affairs" and "Nursing staffing and resource adequacy" scores neared non-Magnet levels. On average, our results indicated high quality nurse work environments in Swiss hospitals. Implementing Magnet model organisational principles might be a valuable approach for Swiss acute-care hospitals to both improve mixed and unfavourable nurse work environments and to improve nurse and patient outcomes. National benchmarking of nurse work environments and other nurse-sensitive indicators may facilitate evaluating the impact of current developments in Swiss healthcare.
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Gormley, Denise K
2011-01-01
The purpose was to examine differences in perceptions of work environment and quality of care between nurse managers and staff nurses, and the relationship between nurses' perceptions of the work environment and intention to leave. It is important for managers to understand how staff nurses perceive the work environment as these perceptions may affect nurses' intention to leave the organization. Few studies have examined the perceptions of nurses compared with nurse manager/directors regarding the organizational influences on intention to leave. This study was a cross-sectional, non-experimental design. A total of 336 nurses and managers participated from two Midwestern hospitals. Participants completed the Perceived Nurse Work Environment Scale (PNWE), Anticipated Turnover Scale (ATS), and a researcher developed perception of quality scale. Data were analysed for descriptive statistics, Analysis of Variance, and Pearson's correlation. Significant differences were found between nurses and managers on perceptions of work environment. Managers rated work environment higher than staff on all subscales. Work environment was related to anticipated turnover. Managers and staff nurses are 'not on the same page' in perceptions of work environment. Nurse managers need to understand the organizational influences that may affect nurses' intention to leave. Strategies to improve the work environment are necessary to meet the needs of the staff nurse. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.
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The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units.
Baernholdt, Marianne; Mark, Barbara A
2009-12-01
The aim of the present study was to determine whether there are differences in hospital characteristics, nursing unit characteristics, the nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. Research in urban hospitals has found an association between the nurse work environment and job satisfaction and turnover rates, but this association has not been examined in rural hospitals. Rural and urban nursing units were compared in a national random sample of 97 United States hospitals (194 nursing units) with between 99 and 450 beds. Significant differences were found between hospital and nursing unit characteristics and the nurse work environment in rural and urban nursing units. Both nursing unit characteristics and the work environment were found to have a significant influence on nurse job satisfaction and turnover rates. Job satisfaction and turnover rates in rural and urban nursing units are associated with both nursing unit characteristics and the work environment. Both rural and urban hospitals can improve nurse job satisfaction and turnover rates by changing unit characteristics, such as creating better support services and a work environment that supports autonomous nursing practice. Rural hospitals can also improve the work environment by providing nurses with more educational opportunities.
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Hospital nurses' work environment, quality of care provided and career plans.
Hinno, S; Partanen, P; Vehviläinen-Julkunen, K
2011-06-01
In several European countries, the availability of qualified nurses is insufficient to meet current healthcare requirements. Nurses are highly dissatisfied with the rising demands of the healthcare environment and increasingly considering leaving their jobs. The study aims to investigate the relationships between the characteristics of hospital nurses' work environment and the quality of care provided, and furthermore to examine Dutch nurses' career plans. A cross-sectional, questionnaire survey of registered nurses (n = 334) working in the academic and district hospitals was conducted in 2005/2006. Previously validated questionnaires translated into the participants' language were used. Factor and regression analysis were used for data analysis. Overall, nurses rated their work environment rather favourably. Five work environment characteristics were identified: support for professional development, adequate staffing, nursing competence, supportive management and teamwork. Significant relationships were found between nurses' perceptions of their work environment characteristics and quality of care provided and nurses' career plans. When work environment characteristics were evaluated to be better, nurse-assessed quality of care also increased and intentions to leave current job decreased linearly. Study findings suggest that nurses' perceptions of their work environment are important for nurse outcomes in hospital settings. Further research is needed to explore the predictive ability of the work environment for nurse, patient and organizational outcomes in hospitals. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.
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Choi, Sandy Pin-Pin; Cheung, Kin; Pang, Samantha Mei-Che
2013-04-01
To examine how front-line registered nurses' perception of their work environment associates with and predicts nurse outcomes in terms of job satisfaction and turnover intention. Mounting evidence has pointed to an inseparable link between attributes of the nursing work environment and nurse outcomes. However, there is a paucity of research examining nurses' perception of their work environment beyond the Western context. This cross-sectional survey involved 1271 registered nurses working in 135 inpatient units in 10 public hospitals in Hong Kong. The instrument comprised items developed from in-depth interviews with front-line nurses that explored nurses' perception of their work environment. Factor analysis identified five dimensions (professionalism, co-worker relationship, management, staffing and resources, and ward practice) of the nursing work environment. Logistic regression analysis further identified professionalism, management and ward practice as significant factors in predicting nurses' turnover intention, and staffing and resources as an additional factor in predicting their job satisfaction. Attributes of the nursing work environment have a significant bearing on nurses' job satisfaction and intention to leave. Managerial effort should focus on improving nurses' work conditions through detailed resource planning, effective management and removal of work constraints that affect nursing practice. © 2012 Blackwell Publishing Ltd.
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Effects of nurse work environment on job dissatisfaction, burnout, intention to leave.
Nantsupawat, A; Kunaviktikul, W; Nantsupawat, R; Wichaikhum, O-A; Thienthong, H; Poghosyan, L
2017-03-01
The nursing shortage is a critical issue in many countries. High turnover rates among nurses is contributing to the shortage, and job dissatisfaction, intention to leave, and burnout have been identified as some of the predictors of nurse turnover. A well-established body of evidence demonstrates that the work environment for nurses influences nurse job dissatisfaction, intention to leave, and burnout, but there never has been a study undertaken in Thailand to investigate this relationship. To investigate how work environment affects job dissatisfaction, burnout, and intention to leave among nurses in Thailand. The study used a cross-sectional survey to collect data from 1351 nurses working in 43 inpatient units in five university hospitals across Thailand. The participants completed the Practice Environment Scale of the Nursing Work Index, the Maslach Burnout Inventory, and measures of job dissatisfaction and intention to leave. Logistical regression models assessed the association between work environment and nurse-reported job dissatisfaction, burnout, and intent to leave. Nurses working in university hospitals with better work environments had significantly less job dissatisfaction, intention to leave, and burnout. The nurse work environment is a significant feature contributing to nurse retention in Thai university hospitals. Improving the work environment for nurses may lead to lower levels of job dissatisfaction, intention to leave, and burnout. Focusing on these nurse outcomes can be used as a strategy to retain nurses in the healthcare system. Addressing the challenges of poor work environments requires coordinated action from policymakers and health managers. © 2016 International Council of Nurses.
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Association of the Nurse Work Environment, Collective Efficacy, and Missed Care.
Smith, Jessica G; Morin, Karen H; Wallace, Leigh E; Lake, Eileen T
2018-06-01
Missed nursing care is a significant threat to quality patient care. Promoting collective efficacy within nurse work environments could decrease missed care. The purpose was to understand how missed care is associated with nurse work environments and collective efficacy of hospital staff nurses. A cross-sectional, convenience sample was obtained through online surveys from registered nurses working at five southwestern U.S. hospitals. Descriptive, correlational, regression, and path analyses were conducted ( N = 233). The percentage of nurses who reported that at least one care activity was missed frequently or always was 94%. Mouth care (36.0% of nurses) and ambulation (35.3%) were missed frequently or always. Nurse work environments and collective efficacy were moderately, positively correlated. Nurse work environments and collective efficacy were associated with less missed care (χ 2 = 10.714, p = .0054). Fostering collective efficacy in the nurse work environment could reduce missed care and improve patient outcomes.
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Work environment, job satisfaction, stress and burnout among haemodialysis nurses.
Hayes, Bronwyn; Douglas, Clint; Bonner, Ann
2015-07-01
To examine the relationships among nurse and work characteristics, job satisfaction, stress, burnout and the work environment of haemodialysis nurses. Haemodialysis nursing is characterised by frequent and intense contact with patients in a complex and intense environment. A cross-sectional online survey of 417 haemodialysis nurses that included nurse and work characteristics, the Brisbane Practice Environment Measure, Index of Work Satisfaction, Nursing Stress Scale and the Maslach Burnout Inventory. Haemodialysis nurses reported an acceptable level of job satisfaction and perceived their work environment positively, although high levels of burnout were found. Nurses who were older and had worked in haemodialysis the longest had higher satisfaction levels, experienced less stress and lower levels of burnout than younger nurses. The in-centre type of haemodialysis unit had greater levels of stress and burnout than home training units. Greater satisfaction with the work environment was strongly correlated with job satisfaction, lower job stress and emotional exhaustion. Haemodialysis nurses experienced high levels of burnout even though their work environment was favourable and they had acceptable levels of job satisfaction. Targeted strategies are required to retain and avoid burnout in younger and less experienced nurses in this highly specialised field of nursing. © 2013 John Wiley & Sons Ltd.
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Establishing a Measurement Tool for a Nursing Work Environment in Taiwan.
Lin, Li-Chiu; Lee, Huan-Fang; Yen, Miaofen
2017-02-01
The nursing work environment is a critical global health care problem. Many health care providers are concerned about the associations between the nursing work environment and the outcomes of organizations, nurses, and patients. Nursing work environment instruments have been assessed in the West but have not been considered in Asia. However, different cultures will affect the factorial structure of the tool. Using a stratified nationwide random sample, we created a measurement tool for the nursing work environment in Taiwan. The Nursing Work Environment Index-Revised Scale and the Essentials of Magnetism scale were used to examine the factorial structure. Item analysis, exploratory factor analysis, and confirmatory factor analysis were used to examine the hypothesis model and generate a new factorial structure. The Taiwan Nursing Work Environment Index (TNWEI) was established to evaluate the nursing work environment in Taiwan. The four factors were labeled "Organizational Support" (7 items), "Nurse Staffing and Resources" (4 items), "Nurse-Physician Collaboration" (4 items), and "Support for Continuing Education" (4 items). The 19 items explained 58.5% of the variance. Confirmatory factor analysis showed a good fit to the model (x2/df = 5.99; p < .05, goodness of fit index [GFI] = .90; RMSEA = .07). The TNWEI provides a comprehensive and efficient method for measuring the nurses' work environment in Taiwan.
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Spence Laschinger, Heather K; Leiter, Michael P
2006-05-01
To test a theoretical model of professional nurse work environments linking conditions for professional nursing practice to burnout and, subsequently, patient safety outcomes. The 2004 Institute of Medicine report raised serious concerns about the impact of hospital restructuring on nursing work environments and patient safety outcomes. Few studies have used a theoretical framework to study the nature of the relationships between nursing work environments and patient safety outcomes. Hospital-based nurses in Canada (N = 8,597) completed measures of worklife (Practice Environment Scale of the Nursing Work Index), burnout (Maslach Burnout Inventory-Human Service Scale), and their report of frequency of adverse patient events. Structural equation modeling analysis supported an extension of Leiter and Laschinger's Nursing Worklife Model. Nursing leadership played a fundamental role in the quality of worklife regarding policy involvement, staffing levels, support for a nursing model of care (vs medical), and nurse/physician relationships. Staffing adequacy directly affected emotional exhaustion, and use of a nursing model of care had a direct effect on nurses' personal accomplishment. Both directly affected patient safety outcomes. The results suggest that patient safety outcomes are related to the quality of the nursing practice work environment and nursing leadership's role in changing the work environment to decrease nurse burnout.
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Liu, Ke; You, Li-Ming; Chen, Shao-Xian; Hao, Yuan-Tao; Zhu, Xiao-Wen; Zhang, Li-Feng; Aiken, Linda H
2012-05-01
This study examines the relationship between hospital work environments and job satisfaction, job-related burnout and intention to leave among nurses in Guangdong province, China. The nursing shortage is an urgent global problem and also of concern in China. Studies in Western countries have shown that better work environments are associated with higher nurse satisfaction and lower burnout, thereby improving retention and lowering turnover rates. However, there is little research on the relationship between nurse work environments and nurse outcomes in China. This is a cross-sectional study. Survey data were collected from 1104 bedside nurses in 89 medical, surgical and intensive care units in 21 hospitals across the Guangdong province in China. Stratified convenience sampling was used to select hospitals, and systematic sampling was used to select units. All staff nurses working on participating units were surveyed. The China Hospital Nurse Survey, including the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory, was employed to collect data from nurses. Statistical significance level was set at 0·05. Thirty-seven per cent of the nurses experienced high burnout, and 54% were dissatisfied with their jobs. Improving nurses' work environments from poor to better was associated with a 50% decrease in job dissatisfaction and a 33% decrease in job-related burnout among nurses. Burnout and job dissatisfaction are high among hospital nurses in Guangdong province, China. Better work environments for nurses were associated with decreased job dissatisfaction and job-related burnout, which may successfully address the nursing shortage in China. The findings of this study indicate that improving work environments is essential to deal with the nursing shortage; the findings provide motivation for nurse managers and policy makers to improve work environments of hospital nurses in China. © 2012 Blackwell Publishing Ltd.
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Liu, Ke; You, Li-Ming; Chen, Shao-Xian; Hao, Yuan-Tao; Zhu, Xiao-Wen; Zhang, Li-Feng; Aiken, Linda H
2012-01-01
Aims and objectives This study examines the relationship between hospital work environments and job satisfaction, job-related burnout and intention to leave among nurses in Guangdong province, China. Background The nursing shortage is an urgent global problem and also of concern in China. Studies in Western countries have shown that better work environments are associated with higher nurse satisfaction and lower burnout, thereby improving retention and lowering turnover rates. However, there is little research on the relationship between nurse work environments and nurse outcomes in China. Design This is a cross-sectional study. Survey data were collected from 1104 bedside nurses in 89 medical, surgical and intensive care units in 21 hospitals across the Guangdong province in China. Methods Stratified convenience sampling was used to select hospitals, and systematic sampling was used to select units. All staff nurses working on participating units were surveyed. The China Hospital Nurse Survey, including the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory, was employed to collect data from nurses. Statistical significance level was set at 0·05. Results Thirty-seven per cent of the nurses experienced high burnout, and 54% were dissatisfied with their jobs. Improving nurses’ work environments from poor to better was associated with a 50% decrease in job dissatisfaction and a 33% decrease in job-related burnout among nurses. Conclusion Burnout and job dissatisfaction are high among hospital nurses in Guangdong province, China. Better work environments for nurses were associated with decreased job dissatisfaction and job-related burnout, which may successfully address the nursing shortage in China. Relevance to clinical practice The findings of this study indicate that improving work environments is essential to deal with the nursing shortage; the findings provide motivation for nurse managers and policy makers to improve work environments of hospital nurses in China. PMID:22380003
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Yoo, Moon Sook; Kim, Kyoung Ja
2017-09-01
The aim of this study was to explore the influence of nurse work environments and patient safety culture on attitudes toward incident reporting. Patient safety culture had been known as a factor of incident reporting by nurses. Positive work environment could be an important influencing factor for the safety behavior of nurses. A cross-sectional survey design was used. The structured questionnaire was administered to 191 nurses working at a tertiary university hospital in South Korea. Nurses' perception of work environment and patient safety culture were positively correlated with attitudes toward incident reporting. A regression model with clinical career, work area and nurse work environment, and patient safety culture against attitudes toward incident reporting was statistically significant. The model explained approximately 50.7% of attitudes toward incident reporting. Improving nurses' attitudes toward incident reporting can be achieved with a broad approach that includes improvements in work environment and patient safety culture.
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Nurses' work environment: indicators of satisfaction.
Suliman, Mohammad; Aljezawi, Maen
2018-01-10
This study aimed to investigate nurses' perceptions of the nursing work environment in Jordanian hospitals. Previous research has indicated a strong relationship between nurses' work environment and their satisfaction at work. However, little is known about the situation in Jordan. A cross-sectional and descriptive design was used. A sample of 500 nurses was recruited. The study was conducted using the Individual Workload Perception Revised scale (IWPS-R). A sum of 382 out of 500 nurses from three health care sectors in Jordan responded to the questionnaires (response rate = 76.4%). The results indicate that nurses working in the public hospitals had significantly better perceptions about their work environment than nurses working in private and university hospitals. Older nurses with lower academic qualifications are more likely to be satisfied with their work. Furthermore, nurses who have good perceptions of support from their manager and peers, and a manageable workload are more likely to stay in their jobs. The public hospitals are currently considered a more suitable milieu for nurses in Jordan. Other health care sectors should work to enhance nurses' working conditions. Providing a supportive work environment with a manageable workload will encourage nurses to stay in their hospitals. © 2018 John Wiley & Sons Ltd.
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RN work engagement in generational cohorts: the view from rural US hospitals.
Sullivan Havens, Donna; Warshawsky, Nora E; Vasey, Joseph
2013-10-01
To describe staff nurse work engagement, identify predictors by generational cohort, present implications for nurse managers and suggest future research. A global nurse shortage looms. While an adequate supply of nurses is needed to ensure access to care, access to quality care may be enhanced by an adequate supply of highly engaged nurses-those who are dedicated, energized, and absorbed. Nurses have long reported the presence of energy depleting practice environments. Nurses practicing in professional practice environments may be more engaged. A non-experimental survey design was executed. Direct care Registered Nurses (n = 747) working in five rural acute care hospitals completed questionnaires to assess work engagement (Utrecht Work Engagement Scale-9), decisional involvement (Decisional Involvement Scale), relational coordination (Relational Coordination Survey) and the nursing practice environment (Practice Environment Scale of the Nursing Work Index). Descriptive, correlational and regression analyses examined work engagement and predictors by generational cohort. With the exception of the absorption component, no statistically significant differences in engagement emerged across generational cohorts. Predictors of engagement differed by cohort, however across all cohorts, professional nursing practice environments predicted nurse work engagement. Professional nursing practice environments are significantly associated with nurse work engagement. Enhancing nurse work engagement is a complex challenge. Generational cohorts may respond to different strategies to enhance engagement. © 2013 John Wiley & Sons Ltd.
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Wage, Work Environment, and Staffing: Effects on Nurse Outcomes
McHugh, Matthew D.; Ma, Chenjuan
2015-01-01
Research has shown that hospitals with better nurse staffing and work environments have better nurse outcomes—less burnout, job dissatisfaction, and intention to leave the job. Many studies, however, have not accounted for wage effects, which may confound findings. By using a secondary analysis with cross-sectional administrative data and a four-state survey of nurses, we investigated how wage, work environment, and staffing were associated with nurse outcomes. Logistic regression models, with and without wage, were used to estimate the effects of work environment and staffing on burnout, job dissatisfaction, and intent to leave. We discovered that wage was associated with job dissatisfaction and intent to leave but had little influence on burnout, while work environment and average patient-to-nurse ratio still have considerable effects on nurse outcomes. Wage is important for good nurse outcomes, but it does not diminish the significant influence of work environment and staffing on nurse outcomes. PMID:25121923
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Nonlinear Analysis to Detect if Excellent Nursing Work Environments Have Highest Well-Being.
Casalicchio, Giuseppe; Lesaffre, Emmanuel; Küchenhoff, Helmut; Bruyneel, Luk
2017-09-01
To detect potentially nonlinear associations between nurses' work environment and nurse staffing on the one hand and nurse burnout on the other hand. A cross-sectional multicountry study for which data collection using a survey of 33,731 registered nurses in 12 European countries took place during 2009 to 2010. A semiparametric latent variable model that describes both linear and potentially nonlinear associations between burnout (Maslach Burnout Inventory: emotional exhaustion, depersonalization, personal accomplishment) and work environment (Practice Environment Scale of the Nursing Work Index: managerial support for nursing, doctor-nurse collegial relations, promotion of care quality) and staffing (patient-to-nurse ratio). Similar conclusions are reached from linear and nonlinear models estimating the association between work environment and burnout. For staffing, an increase in the patient-to-nurse ratio is associated with an increase in emotional exhaustion. At about 15 patients per nurse, no further increase in emotional exhaustion is seen. Absence of evidence for diminishing returns of improving work environments suggests that continuous improvement and achieving excellence in nurse work environments pays off strongly in terms of lower nurse-reported burnout rates. Nurse staffing policy would benefit from a larger number of studies that identify specific minimum as well as maximum thresholds at which inputs affect nurse and patient outcomes. Nurse burnout is omnipresent and has previously been shown to be related to worse patient outcomes. Additional increments in characteristics of excellent work environments, up to the highest possible standard, correspond to lower nurse burnout. © 2017 Sigma Theta Tau International.
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Bullich-Marín, Ingrid; Miralles Basseda, Ramón; Torres Egea, Pilar; Planas-Campmany, Carme; Juvé-Udina, María Eulalia
A favourable work environment contributes to greater job satisfaction and improved working conditions for nurses, a fact that could influence the quality of patient outcomes. The aim of the study is two-fold: Identifying types of centres, according to the working environment assessment made by nurses in intermediate care units, and describing the individual characteristics of nurses related to this assessment. An observational, descriptive, prospective, cross-sectional, and multicentre study was conducted in the last quarter of 2014. Nurses in intermediate care units were given a questionnaire containing the Practice Environment Scale of the Nursing Work Index (PES-NWI) which assesses five factors of the work environment using 31 items. Sociodemographic, employment conditions, professional and educational variables were also collected. From a sample of 501 nurses from 14 centres, 388 nurses participated (77% response). The mean score on the PES-NWI was 84.75. Nine centres scored a "favourable" working environment and five "mixed". The best valued factor was "work relations" and the worst was "resource provision/adaptation". Rotating shift work, working in several units at the same time, having management responsibilities, and having a master degree were the characteristics related to a better perception of the nursing work environment. In most centres, the working environment was perceived as favourable. Some employment conditions, professional, and educational characteristics of nurses were related to the work environment assessment. Copyright © 2015 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.
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Kim, Kyoung-Ja; Yoo, Moon Sook; Seo, Eun Ji
2018-04-20
This study aimed to explore the influence of nurse work environment and patient safety culture in hospital on instances of missed nursing care in South Korea. A cross-sectional design was used, in which a structured questionnaire was administered to 186 nurses working at a tertiary university hospital. Data were analyzed using descriptive statistics, t-test or ANOVA, Pearson correlation and multiple regression analysis. Missed nursing care was found to be correlated with clinical career, nursing work environment and patient safety culture. The regression model explained approximately 30.3 % of missed nursing care. Meanwhile, staffing and resource adequacy (β = -.31, p = .001), nurse manager ability, leadership and support of nurses (β = -.26, p = .004), clinical career (β = -.21, p = .004), and perception on patient safety culture within unit (β = -.19, p = .041) were determined to be influencing factors on missed nursing care. This study has significance as it suggested that missed nursing care is affected by work environment factors within unit. This means that missed nursing care is a unit outcome affected by nurse work environment factors and patient safety culture. Therefore, missed nursing care can be managed through the implementation of interventions that promote a positive nursing work environment and patient safety culture. Copyright © 2018. Published by Elsevier B.V.
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Compassion Fatigue and the Healthy Work Environment.
Kelly, Lesly; Todd, Michael
2017-01-01
Burnout is a concern for critical care nurses in high-intensity environments. Studies have highlighted the importance of a healthy work environment in promoting optimal nurse and patient outcomes, but research examining the relationship between a healthy work environment and burnout is limited. To examine how healthy work environment components relate to compassion fatigue (eg, burnout, secondary trauma) and compassion satisfaction. Nurses (n = 105) in 3 intensive care units at an academic medical center completed a survey including the Professional Quality of Life and the American Association of Critical-Care Nurses' Healthy Work Environment standards. Regression models using each Healthy Work Environment component to predict each outcome, adjusting for background variables, showed that the 5 Healthy Work Environment components predicted burnout and that meaningful recognition and authentic leadership predicted compassion satisfaction. Findings on associations between healthy work environment standards and burnout suggest the potential importance of implementing the American Association of Critical-Care Nurses' Healthy Work Environment standards as a mechanism for decreasing burnout. ©2017 American Association of Critical-Care Nurses.
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Work environment for Chinese nurses in different types of ICUs: a multisite cross-sectional survey.
Bai, Jinbing; Zhang, Qing; Wang, Ying; Yu, Li-Ping; Pei, Xian-Bo; Cheng, Lei; Hsu, Lily
2015-05-01
To investigate the current nurse work environment, levels of job satisfaction and quality of patient care, and to identify intensive care units with a healthier work environment in mainland China. A healthy work environment is closely related to a higher nurse job satisfaction and a better patient care quality. The work environment has not been extensively explored among Chinese intensive care unit nurses. The Chinese version of the Essentials of Magnetism II was used to measure the nurse work environment and another two 0-10 single-item scales were used to assess nurses' overall job satisfaction and nurse-assessed quality of care. The study found that the eight essentials of Chinese version of the Essentials of Magnetism II were significantly correlated with each other and also correlated with overall job satisfaction and quality of care. Nurses from medical intensive care units had a healthier work environment with higher scores of overall job satisfaction and quality of care than other intensive care units, while surgical intensive care units showed the least healthy work environment with the lowest overall job satisfaction and quality of care scores identified. The essentials of Chinese version of the Essentials of Magnetism II, overall job satisfaction and quality of care were also correlated with nurses' work experience and their education level. Nurse administrators and health policy-makers should establish a healthy work environment for intensive care units nurses, especially for those from surgical intensive care units. © 2014 John Wiley & Sons Ltd.
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Hung, Jui-Tai; Lin, Ching-Wen; Wen, Wei-Chun; Lin, Esther Ching-Lan
2015-08-01
The nursing practice environment has been shown to wield significant influence on nursing retention and nursing quality of care. Because a large percentage of Taiwan nurses currently work at regional teaching hospitals, exploring the perception toward the practice environment of nurses working at this type of hospital is important. This study explored the perception of nurses working at a regional teaching hospital in central Taiwan toward their practice environment. A cross-sectional research design with a sample of 474 nurses from a regional hospital in central Taiwan was conducted. Instruments including the demographic data and the Chinese-version Practice Environment Scale-Nursing Work Index (CPES-NWI) were anonymously self-administered. Overall, participants were moderately satisfied with their practice environment, with the greatest dissatisfaction focused on staffing and resource adequacy. Work unit and nursing level, respectively, had significant impacts on perceptions regarding the practice environment. Furthermore, discriminant analysis identified two new compound variables: 1) adequate staffing resources and partnership in the workplace and 2) supportive administrative management environment. Participants who worked in medical and surgical units were significantly more dissatisfied with the adequacy of staffing resources and partnership in the workplace than participants who worked in acute/intensive and special units. Participants at the N2 level were significantly more dissatisfied with the supportive nature of the administrative management environment. These findings support that the nursing practice environment of regional hospitals may be improved using several measures, including: modifying the staffing and resource adequacy of nurses, fostering collaborative nurse-physician relationships, and further involving nurses in administrative management and decision-making.
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Wang, Shanshan; Liu, Yanhui
2015-04-01
This study aimed to investigate the influence of professional nursing practice environment and psychological empowerment on nurses' work engagement. Previous researchers have acknowledged the positive influence that nurse work environment and psychological empowerment have on engagement. However, less is known about the mechanisms that explain the links between them. A predictive, non-experimental design was used to test the model in a random sample of 300 clinical nurses from two tertiary first class hospitals of Tianjin, China. The Utrecht Work Engagement Scale, the Practice Environment Scale of the Nursing Work Index and the Psychological Empowerment Scale were used to measure the study variables. Structural equation modelling revealed a good fit of the model to the data based on various fit indices (P = 0.371, χ(2) /df = 1.056, goodness of fit index = 0.967), which indicated that both professional practice environment and psychological empowerment could positively influence work engagement directly, and professional practice environment could also indirectly influence work engagement through the mediation of psychological empowerment. The study hypotheses were supported. Psychological empowerment was found to mediate the relationship between practice environments and work engagement. Administrators should provide a professional nursing practice environment and empower nurses psychologically to increase nurse engagement. © 2013 John Wiley & Sons Ltd.
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Wu, Yan; Zheng, Jing; Liu, Ke; Baggs, Judith G; Liu, Jiali; Liu, Xu; You, Liming
2018-06-04
Occupational hazards (OHs) and occupational injuries (OIs) may contribute to nurses needing sick time and to a high financial burden for hospitals. There is little published literature about nurse-reported OHs/OIs and their relationships with work environments and working overtime in China. This study was designed to describe Chinese hospital registered nurses' OHs/OIs and to explore the associations between work environments, working overtime, and nurse-reported OHs/OIs. This cross-sectional study was conducted in Guangdong province in China in 2014. The sample included 1,517 nurses from 111 medical/surgical units in 23 hospitals. The Practice Environment Scale of the Nursing Work Index was used to measure work environment. Overtime was calculated by subtracting scheduled work hours from actual work hours. Six items were used to measure nurse-reported OHs/OIs. Descriptive statistics, Chi-square tests, and two-level logistic regression models were used to analyze the data. The percentages of nurses reporting OHs/OIs occurred in the year before the survey ranged from 47% to 80%. Nurses who worked in good (vs. poor) unit work environments were less likely to experience OHs/OIs (Odds ratio [OR] = 0.65-0.68, p < .05). Nurses who worked overtime (OR = 1.19-1.33, p < .05) and in Level 3 (largest) hospitals (OR = 1.45-1.80, p < .05) were more likely to experience OHs/OIs. We found that OHs/OIs were prevalent among hospital nurses in China. Better work environment and less nurse overtime were associated with fewer nurse OHs/OIs. © 2018 Wiley Periodicals, Inc.
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The rural nurse work environment and structural empowerment.
Krebs, Julianne P; Madigan, Elizabeth A; Tullai-McGuinness, Susan
2008-02-01
Rural health care organizations struggle to attract and retain nurses, yet much of the research has focused on characteristics of the nurse work environment or empowerment in urban hospitals. The purpose of this study was to examine the nurse work environment in rural areas across settings by describing the relationship between structural empowerment and characteristics of the nurse work environment. Nurses ( N = 97) working in home care agencies and hospitals were surveyed. Significant differences were found between the groups, with home care nurses having significantly higher empowerment scores than medical/surgical nurses. A strong correlation was found between characteristics of the nurse work environment and empowerment. Policy makers are using evidence to guide development of policies, but much of the research has been conducted in urban hospital settings. This study begins to provide evidence that differences exist between urban and rural areas and between practice settings.
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Aiken, Linda H.; Cimiotti, Jeannie P.; Sloane, Douglas M.; Smith, Herbert L.; Flynn, Linda; Neff, Donna F.
2011-01-01
Context Better hospital nurse staffing, more educated nurses, and improved nurse work environments have been shown to be associated with lower hospital mortality. Little is known about whether and under what conditions each type of investment works better to improve outcomes. Objective To determine the conditions under which the impact of hospital nurse staffing, nurse education, and work environment are associated with patient outcomes. Design, Setting, and Participants Outcomes of 665 hospitals in four large states were studied through linked data from hospital discharge abstracts for 1,262,120 general, orthopedic, and vascular surgery patients, a random sample of 39,038 hospital staff nurses, and American Hospital Association data. Main outcome measures 30-day inpatient mortality and failure-to-rescue. Results The effect of decreasing workloads by one patient/nurse on deaths and failure-to-rescue is virtually nil in hospitals with poor work environments, but decreases the odds on both deaths and failures in hospitals with average environments by 4%, and in hospitals with the best environments by 9 and 10% respectively. The effect of 10% more BSN nurses decreases the odds on both outcomes in all hospitals, regardless of their work environment, by roughly 4%. Conclusions While the positive effect of increasing percentages of BSN nurses is consistent across all hospitals, lowering the patient-to-nurse ratios markedly improves patient outcomes in hospitals with good work environments, slightly improves them in hospitals with average environments, and has no effect in hospitals with poor environments. PMID:21945978
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Impact of nurse work environment and staffing on hospital nurse and quality of care in Thailand.
Nantsupawat, Apiradee; Srisuphan, Wichit; Kunaviktikul, Wipada; Wichaikhum, Orn-Anong; Aungsuroch, Yupin; Aiken, Linda H
2011-12-01
To determine the impact of nurse work environment and staffing on nurse outcomes, including job satisfaction and burnout, and on quality of nursing care. Secondary data analysis of the 2007 Thai Nurse Survey. The sample consisted of 5,247 nurses who provided direct care for patients across 39 public hospitals in Thailand. Multivariate logistic regression was used to estimate the impact of nurse work environment and staffing on nurse outcomes and quality of care. Nurses cared for an average of 10 patients each. Forty-one percent of nurses had a high burnout score as measured by the Maslach Burnout Inventory; 28% of nurses were dissatisfied with their job; and 27% rated quality of nursing care as fair or poor. At the hospital level, after controlling for nurse characteristics (age, years in unit), the addition of each patient to a nurse's workload was associated with a 2% increase in the odds on nurses reporting high emotional exhaustion (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00-1.03; p < .05). Nurses who reported favorable work environments were about 30% less likely to report fair to poor care quality (OR 0.69; 95% CI 0.48-0.98; p < .05) compared with nurses who reported unfavorable work environments. The addition of each patient to a nurse's workload was associated with a 4% increase in the odds on nurses reporting quality of nursing care as fair or poor (OR 1.04; 95% CI 1.02-1.05; p < .001). Improving nurse work environments and nurse staffing in Thai hospitals holds promise for reducing nurse burnout, thus improving nurse retention at the hospital bedside as well as potentially improving the quality of care. Nurses should work with management and policymakers to achieve safe staffing levels and good work environments in hospitals throughout the world. © 2011 Sigma Theta Tau International.
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Nurse Outcomes in Magnet® and Non-Magnet Hospitals
Kelly, Lesly A.; McHugh, Matthew D.; Aiken, Linda H.
2011-01-01
The important goals of Magnet® hospitals are to create supportive professional nursing care environments. A recently published paper found little difference in work environments between Magnet and non-Magnet hospitals. The aim of this study was to determine whether work environments, staffing, and nurse outcomes differ between Magnet and non-Magnet hospitals. A secondary analysis of data from a 4-state survey of 26,276 nurses in 567 acute care hospitals to evaluate differences in work environments and nurse outcomes in Magnet and non-Magnet hospitals was conducted. Magnet hospitals had significantly better work environments (t = −5.29, P < .001) and more highly educated nurses (t = −2.27, P < .001). Magnet hospital nurses were 18% less likely to be dissatisfied with their job (P < .05) and 13% less likely to report high burnout (P < .05). Magnet hospitals have significantly better work environments than non-Magnet hospitals. The better work environments of Magnet hospitals are associated with lower levels of nurse job dissatisfaction and burnout. PMID:21934430
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Nurse Outcomes in Magnet® and Non-Magnet Hospitals
Kelly, Lesly A.; McHugh, Matthew D.; Aiken, Linda H.
2017-01-01
The important goals of Magnet® hospitals are to create supportive professional nursing care environments. A recently published paper found little difference in work environments between Magnet and non-Magnet hospitals. The aim of this study was to determine whether work environments, staffing, and nurse outcomes differ between Magnet and non-Magnet hospitals. A secondary analysis of data from a 4-state survey of 26,276 nurses in 567 acute care hospitals to evaluate differences in work environments and nurse outcomes in Magnet and non-Magnet hospitals was conducted. Magnet hospitals had significantly better work environments (t = −5.29, P < .001) and more highly educated nurses (t = −2.27, P < .001). Magnet hospital nurses were 18% less likely to be dissatisfied with their job (P < .05) and 13% less likely to report high burnout (P < .05). Magnet hospitals have significantly better work environments than non-Magnet hospitals. The better work environments of Magnet hospitals are associated with lower levels of nurse job dissatisfaction and burnout. PMID:22976894
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Wage, work environment, and staffing: effects on nurse outcomes.
McHugh, Matthew D; Ma, Chenjuan
2014-01-01
Research has shown that hospitals with better nurse staffing and work environments have better nurse outcomes-less burnout, job dissatisfaction, and intention to leave the job. Many studies, however, have not accounted for wage effects, which may confound findings. By using a secondary analysis with cross-sectional administrative data and a four-state survey of nurses, we investigated how wage, work environment, and staffing were associated with nurse outcomes. Logistic regression models, with and without wage, were used to estimate the effects of work environment and staffing on burnout, job dissatisfaction, and intent to leave. We discovered that wage was associated with job dissatisfaction and intent to leave but had little influence on burnout, while work environment and average patient-to-nurse ratio still have considerable effects on nurse outcomes. Wage is important for good nurse outcomes, but it does not diminish the significant influence of work environment and staffing on nurse outcomes. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
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Using evidence-based leadership initiatives to create a healthy nursing work environment.
Nayback-Beebe, Ann M; Forsythe, Tanya; Funari, Tamara; Mayfield, Marie; Thoms, William; Smith, Kimberly K; Bradstreet, Harry; Scott, Pamela
2013-01-01
In an effort to create a healthy nursing work environment in a military hospital Intermediate Care Unit (IMCU), a facility-level Evidence Based Practice working group composed of nursing.Stakeholders brainstormed and piloted several unit-level evidence-based leadership initiatives to improve the IMCU nursing work environment. These initiatives were guided by the American Association of Critical Care Nurses Standards for Establishing and Sustaining Healthy Work Environments which encompass: (1) skilled communication, (2) true collaboration, (3) effective decision making, (4) appropriate staffing, (5) meaningful recognition, and (6) authentic leadership. Interim findings suggest implementation of these six evidence-based, relationship-centered principals, when combined with IMCU nurses' clinical expertise, management experience, and personal values and preferences, improved staff morale, decreased staff absenteeism, promoted a healthy nursing work environment, and improved patient care.
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Zhang, Li-Feng; You, Li-Ming; Liu, Ke; Zheng, Jing; Fang, Jin-Bo; Lu, Min-Min; Lv, Ai-Li; Ma, Wei-Guang; Wang, Jian; Wang, Shu-Hong; Wu, Xue; Zhu, Xiao-Wen; Bu, Xiu-Qing
2014-01-01
The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave and to explore the relationship of work environment to nursing outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization and high levels of reduced personal accomplishment. Nearly one-fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported an intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nursing outcomes in Chinese hospitals. Copyright © 2014 Elsevier Inc. All rights reserved.
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Zhang, Li-feng; You, Li-ming; Liu, Ke; Zheng, Jing; Fang, Jin-bo; Lu, Min-min; Lv, Ai-li; Ma, Wei-guang; Wang, Jian; Wang, Shu-hong; Wu, Xue; Zhu, Xiao-wen; Bu, Xiu-qing
2014-01-01
The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave, and to explore the relationship of work environment to nurse outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization, and high levels of reduced personal accomplishment. Nearly one fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nurse outcomes in Chinese hospitals. PMID:24345617
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Johansen, Mary L; Cadmus, Edna
2016-03-01
To examine the conflict management style that emergency department (ED) nurses use to resolve conflict and to determine whether their style of managing conflict and a supportive work environment affects their experience of work stress. Conflict is a common stressor that is encountered as nurses strive to achieve patient satisfaction goals while delivering quality care. How a nurse perceives support may impact work stress levels and how they deal with conflict. A correlational design examined the relationship between supportive work environment, and conflict management style and work stress in a sample of 222 ED nurses using the expanded nurse work stress scale; the survey of perceived organisational support; and the Rahim organisational conflict inventory-II. Twenty seven percent of nurses reported elevated levels of work stress. A supportive work environment and avoidant conflict management style were significant predictors of work stress. Findings suggest that ED nurses' perception of a supportive work environment and their approach to resolving conflict may be related to their experience of work stress. Providing opportunities for ED nurses in skills training in constructive conflict resolution may help to reduce work stress and to improve the quality of patient care. © 2015 John Wiley & Sons Ltd.
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Factors influencing nurse-assessed quality nursing care: A cross-sectional study in hospitals.
Liu, Ying; Aungsuroch, Yupin
2018-04-01
To propose a hypothesized theoretical model and apply it to examine the structural relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care. Improving quality nursing care is a first consideration in nursing management globally. A better understanding of factors influencing quality nursing care can help hospital administrators implement effective programmes to improve quality of services. Although certain bivariate correlations have been found between selected factors and quality nursing care in different study models, no studies have examined the relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care in a more comprehensive theoretical model. A cross-sectional survey. The questionnaires were collected from 510 Chinese nurses in four Chinese tertiary hospitals in January 2015. The validity and internal consistency reliability of research instruments were evaluated. Structural equation modelling was used to test a theoretical model. The findings revealed that the data supported the theoretical model. Work environment had a large total effect size on quality nursing care. Burnout largely and directly influenced quality nursing care, which was followed by work environment and patient-to-nurse ratio. Job satisfaction indirectly affected quality nursing care through burnout. This study shows how work environment past burnout and job satisfaction influences quality nursing care. Apart from nurses' work conditions of work environment and patient-to-nurse ratio, hospital administrators should pay more attention to nurse outcomes of job satisfaction and burnout when designing intervention programmes to improve quality nursing care. © 2017 John Wiley & Sons Ltd.
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The link between leadership and safety outcomes in hospitals.
Squires, Mae; Tourangeau, Ann; Spence Laschinger, Heather K; Doran, Diane
2010-11-01
To test and refine a model examining relationships among leadership, interactional justice, quality of the nursing work environment, safety climate and patient and nurse safety outcomes. The quality of nursing work environments may pose serious threats to patient and nurse safety. Justice is an important element in work environments that support safety initiatives yet little research has been done that looks at how leader interactional justice influences safety outcomes. A cross-sectional survey was conducted with 600 acute care registered nurses (RNs) to test and refine a model linking interactional justice, the quality of nurse leader-nurse relationships, work environment and safety climate with patient and nurse outcomes. In general the hypothesized model was supported. Resonant leadership and interactional justice influenced the quality of the leader-nurse relationship which in turn affected the quality of the work environment and safety climate. This ultimately was associated with decreased reported medication errors, intentions to leave and emotional exhaustion. Quality relationships based on fairness and empathy play a pivotal role in creating positive safety climates and work environments. To advocate for safe work environments, managers must strive to develop high-quality relationships through just leadership practices. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
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Factors predicting quality of work life among nurses in tertiary-level hospitals, Bangladesh.
Akter, N; Akkadechanunt, T; Chontawan, R; Klunklin, A
2018-06-01
This study examined the level of quality of work life and predictability of years of education, monthly income, years of experience, job stress, organizational commitment and work environment on quality of work life among nurses in tertiary-level hospitals in the People's Republic of Bangladesh. There is an acute shortage of nurses worldwide including Bangladesh. Quality of work life is important for quality of patient care and nurse retention. Nurses in Bangladesh are fighting to provide quality care for emerging health problems for the achievement of sustainable development goals. We collected data from 288 randomly selected registered nurses, from six tertiary-level hospitals. All nurses were requested to fill questionnaire consisted of Demographic Data Sheet, Quality of Nursing Work Life Survey, Expanded Nursing Stress Scale, Questionnaire of Organizational Commitment and Practice Environment Scale of the Nursing Work Index. Data were analysed by descriptive statistics and multiple regression. The quality of work life as perceived by nurses in Bangladesh was at moderate level. Monthly income was found as the best predictor followed by work environment, organizational commitment and job stress. A higher monthly income helps nurses to fulfil their personal needs; positive work environment helps to provide quality care to the patients. Quality of work life and predictors measured by self-report only may not reflect the original picture of the quality of work life among nurses. Findings provide information for nursing and health policymakers to develop policies to improve quality of work life among nurses that can contribute to quality of nursing care. This includes the working environment, commitment to the organization and measures to reduce job stress. © 2017 International Council of Nurses.
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Van Bogaert, Peter; Timmermans, Olaf; Weeks, Susan Mace; van Heusden, Danny; Wouters, Kristien; Franck, Erik
2014-08-01
To investigate the impact of nurse practice environment factors, nurse work characteristics, and burnout on nurse reported job outcomes, quality of care, and patient adverse events variables at the nursing unit level. Nurse practice environment studies show growing insights and knowledge about determining factors for nurse workforce stability, quality of care, and patient safety. Until now, international studies have primarily focused on variability at the hospital level; however, insights at the nursing unit level can reveal key factors in the nurse practice environment. A cross-sectional design with a survey. In a cross-sectional survey, a sample of 1108 nurses assigned to 96 nursing units completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality of care, and patient adverse events. Associations between the variables were examined using multilevel modelling techniques. Various unit-level associations (simple models) were identified between nurse practice environment factors, nurse work characteristics, burnout dimensions, and nurse reported outcome variables. Multiple multilevel models showed various independent variables such as nursing management at the unit level, social capital, emotional exhaustion, and depersonalization as important predictors of nurse reported outcome variables such job satisfaction, turnover intentions, quality of care (at the unit, the last shift, and in the hospital within the last year), patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medications errors. Results suggested a stable nurse work force, with the capability to achieve superior quality and patient safety outcomes, is associated with unit-level favourable perceptions of nurse work environment factors, workload, decision latitude, and social capital, as well low levels of burnout. Nurses, physicians, nursing leaders, and executives share responsibility to create an environment supportive of interdisciplinary team development. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Authentic leaders creating healthy work environments for nursing practice.
Shirey, Maria R
2006-05-01
Implementation of authentic leadership can affect not only the nursing workforce and the profession but the healthcare delivery system and society as a whole. Creating a healthy work environment for nursing practice is crucial to maintain an adequate nursing workforce; the stressful nature of the profession often leads to burnout, disability, and high absenteeism and ultimately contributes to the escalating shortage of nurses. Leaders play a pivotal role in retention of nurses by shaping the healthcare practice environment to produce quality outcomes for staff nurses and patients. Few guidelines are available, however, for creating and sustaining the critical elements of a healthy work environment. In 2005, the American Association of Critical-Care Nurses released a landmark publication specifying 6 standards (skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership) necessary to establish and sustain healthy work environments in healthcare. Authentic leadership was described as the "glue" needed to hold together a healthy work environment. Now, the roles and relationships of authentic leaders in the healthy work environment are clarified as follows: An expanded definition of authentic leadership and its attributes (eg, genuineness, trustworthiness, reliability, compassion, and believability) is presented. Mechanisms by which authentic leaders can create healthy work environments for practice (eg, engaging employees in the work environment to promote positive behaviors) are described. A practical guide on how to become an authentic leader is advanced. A research agenda to advance the study of authentic leadership in nursing practice through collaboration between nursing and business is proposed.
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Relationship between nurses' practice environments and nursing outcomes in Turkey.
Topçu, I; Türkmen, E; Badır, A; Göktepe, N; Miral, M; Albayrak, S; Kebapçı, A; Serbest, Ş; Özcan, D
2016-06-01
This study aimed to understand nursing practice environment characteristics in Istanbul-area hospitals in Turkey, the relationship between these characteristics, nurse burnout levels and nurses' intentions to leave work. A well-known relationship exists in many countries between nursing practice environments and nurse burnout and intention to leave work. However, little is known about the relationship between practice environment characteristics and nursing outcomes in Turkey. This cross-sectional study was conducted among 2592 nurses in 20 Ministry of Health and 29 private hospitals in Istanbul, Turkey. A demographic questionnaire, Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory were used for data collection. Almost half of nurses suffered from high-level burnout related to emotional exhaustion and personal accomplishment, and one-third reported depersonalization and the intent to leave their jobs within a year. A poor nursing practice environment was the leading factor, increasing nurses' burnout levels in all subdimensions. Burnout related to emotional exhaustion, personal accomplishment and poor practice environment increased intention to leave. Permanent positions decreased intention. There was a relationship between poor practice environments and nursing outcomes in Turkey. The use of a survey data collection method is a potential study limitation. Quantitative and qualitative methods could be combined to obtain more detailed objective data about nursing practice environments. Poor practice environments, high-level burnout and intention to leave work are significant problems in Istanbul, Turkey. Favourable practice environments and job security should be provided to improve nursing outcomes. Policymakers and nurse managers should be aware of any negative issues regarding nursing practice environments and job security to improve nursing outcomes. © 2016 International Council of Nurses.
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The relationship between healthy work environments and retention of nurses in a hospital setting.
Ritter, Desiree
2011-01-01
The purpose of the present paper was to determine the effect a healthy work environment has on the retention of nurses in a hospital setting. There is a nursing shortage that has been ongoing and is expected to continue, resulting in challenges for the healthcare system in the United States. The significance of this issue is the impact the nursing shortage will have on healthcare organizations and patients. The present paper included an extensive review of the current literature. The literature reviewed encompassed scholarly peer-reviewed journal articles. This article focused on nurses, work environments and the impact of the work environments on retention. Important issues that emerged from this analysis were the dangers of an unhealthy environment, the impact a healthy work environment has on patient outcomes and retention, the Magnet link to healthy work environments and the manager's role in creating and sustaining a healthy work environment. The literature provided evidence of the link between healthy work environments and the retention of nurses in a hospital setting. The implications for management are to implement changes now to create a healthy work environment that will recruit and retain nurses to secure their position in the future. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.
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The environment of professional practice and Burnout in nurses in primary healthcare
Lorenz, Vera Regina; Guirardello, Edinêis de Brito
2014-01-01
OBJECTIVES: to assess how nurses perceive autonomy, control over the environment, the professional relationship between nurses and physicians and the organizational support and correlate them with burnout, satisfaction at work, quality of work and the intention to quit work in primary healthcare. METHOD: cross-sectional and correlation study, using a sample of 198 nurses. The tools used were the Nursing Work Index Revised, Maslach Burnout Inventory and a form to characterize the nurses. To analyze the data, descriptive statistics were applied and Spearman's correlation coefficient was used. RESULTS: the nurses assessed that the environment is partially favorable for: autonomy, professional relationship and organizational support and that the control over this environment is limited. Significant correlations were evidenced between the Nursing Work Index Revised, Maslach Burnout Inventory and the variables: satisfaction at work, quality of care and the intent to quit the job. CONCLUSION: the nurses' perceptions regarding the environment of practice are correlated with burnout, satisfaction at work, quality of care and the intent to quit the job. This study provides support for the restructuring of work processes in the primary health care environment and for communication among the health service management, human resources and occupational health areas. PMID:25517928
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Empowering a healthy practice environment.
Kushner, Jodi; Ruffin, Tasha
2015-03-01
This article provides frontline nurses a tool kit so they can advocate a healthy practice environment. The healthy nurse, healthy work hours, job satisfaction, adequate sleep, power naps at work, and balancing family/work are discussed. The overweight nurse, nurse fatigue, compassion fatigue, shift work sleep disorder, and role strain are discussed as barriers to a healthy practice environment. Case reports with analysis and recommendations are discussed to overcome these barriers. Resources are presented for frontline nurses to develop a tool kit for transforming their environment to a healthy practice environment and to empower them to become healthy nurses. Copyright © 2015 Elsevier Inc. All rights reserved.
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Kramer, Marlene; Halfer, Diana; Maguire, Pat; Schmalenberg, Claudia
2012-03-01
The objective of the study was to examine effects of nurse-confirmed healthy unit work environments and multistage nurse residency programs (NRPs) on retention rates of newly licensed RNs (NLRNs). Establishing a culture of retention and healthy clinical nurse practice environments are two major challenges confronting nurse leaders today. Nurse residency programs are a major component of NLRN work environments and have been shown to be effective in abating nurse turnover. Sample for this study consisted of 5,316 new graduates in initial RN roles in 28 Magnet® hospitals. There were no differences in retention rates by education or patient population on clinical unit. NLRN retention rate was higher in community than in academic hospitals. More than half of NLRNs were placed on units with very healthy work environments. Newly licensed RNs on units with work environments needing improvement resigned at a significantly higher rate than did other NLRNs. The quality of clinical unit work environments is the most important factor in NLRN retention.
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Cho, Eunhee; Sloane, Douglas M.; Kim, Eun-Young; Kim, Sera; Choi, Miyoung; Yoo, Il Young; Lee, Hye Sun; Aiken, Linda H.
2014-01-01
Background While considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea. Objective To examine the effects of nurse staffing, work environment, and education on patient mortality. Methods This study linked hospital facility data with staff nurse survey data (N=1,024) and surgical patient discharge data (N = 76,036) from 14 high-technology teaching hospitals with 700 or more beds in South Korea, collected between January 1, 2008 and December 31, 2008. Logistic regression models that corrected for the clustering of patients in hospitals were used to estimate the effects of the three nursing characteristics on risk-adjusted patient mortality within 30 days of admission. Results Risk-adjusted models reveal that nurse staffing, nurse work environments, and nurse education were significantly associated with patient mortality (OR 1.05, 95% CI 1.00–1.10; OR 0.52, 95% CI 0.31–0.88; and OR 0.91, CI 0.83–0.99; respectively). These odds ratios imply that each additional patient per nurse is associated with an 5% increase in the odds of patient death within 30 days of admission, that the odds of patient mortality are nearly 50% lower in the hospitals with better nurse work environments than in hospitals with mixed or poor nurse work environments, and that each 10% increase in BSN nurse is associated with a 9% decrease in patient deaths. Conclusions Nurse staffing, nurse work environments, and percentages of BSN nurses in South Korea are associated with patient mortality. Improving hospital nurse staffing and work environments and increasing the percentages of BSN nurses would help reduce the number of preventable in-hospital deaths. PMID:25213091
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Chen, Yu-Meng; Fang, Jin-Bo
2016-02-01
Nurse burnout and low job satisfaction are main reasons that cause nurses to leave their current position. Improving the nursing work environment may reduce the severity of job burnout and of job dissatisfaction and thus decrease the turnover intention of nursing staff. The aim of this study was to explore the correlation between the nursing work environment and the outcome variables of burnout, job satisfaction, and turnover intention in the western region of Mainland China. This is a cross-sectional descriptive study. Survey data were collected between February and December 2012 from 1,112 clinical nurses working at 83 medical, surgical, and intensive care units in 20 hospitals across the western region of Mainland China. Multistage sampling was conducted on some of the participants. The research instruments that were used included the Practice Environment Scale of the Nursing Work Index, Maslach Burnout Inventory, Nurse Job Satisfaction Scale, and the self-developed basic information and turnover intention questionnaire. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 19.0. The level of statistical significance was set at p<.05. Among the five dimensions of the nursing work environment, collegial nurse-physician relations earned the most favorable mean scores (3.57±0.68; total=4 points), whereas adequacy of staffing and resources earned the lowest (3.21±0.82). Over half of the participants (58.4%) reported experiencing a high level of emotional exhaustion (EE) burnout, 45.2% reported experiencing a high level of depersonalization (DP) burnout, and 24.6% reported experiencing a high level of personal accomplishment (PA) burnout. About 59% of the participants were satisfied with their work and 3.8% reported intention to leave. Participants in self-reported "favorable" work environments were less likely to report high burnout, less likely to report intention to leave, and more likely to report job satisfaction than their peers in self-reported "poor" work environments. The odds ratio (OR) values were 0.64 (EE), 0.66 (DP), 0.57 (PA), 0.19, and 2.26. The results of the present study support that the nursing work environment affects nurse burnout, job satisfaction, and turnover intention. Therefore, nursing managers should work to improve nursing work environments in order to reduce the turnover intent among their nursing staff.
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Rajacich, D; Freeman, M; Armstrong-Stassen, M; Cameron, S; Wolfe, B
2014-06-01
Nurse migration is of global concern for every country, and study of migration can provide critical information for managers concerned with nurse recruitment and retention. This mixed-methods research examined factors influencing registered nurses' (RNs') decisions to work in their home country, Canada, or to commute daily to a nursing position in the United States. Measures included nurses' feelings about their work environment conditions, work status congruence (the goodness of fit between employer expectations and their own regarding hours and times worked), professional development opportunities, and their perceptions of organizational support and autonomy (freedom and independence) in the workplace. All work environment variables were significantly higher for nurses working in Michigan. Qualitative results supported these survey findings, providing additional information about nurses' satisfaction. Nurses in our sample were more satisfied with all the work environment factors examined, even when stress from commuting out of country was experienced. The environmental issues examined in this study should be considered by nurse managers concerned with recruitment and retention of nurses. Copyright © 2014 Longwoods Publishing.
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Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik
2014-01-01
To explore the mechanisms through which nurse practice environment dimensions, such as nurse-physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Cross-sectional survey. Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Nurse practice environment dimensions predicted nurses' ratings of job outcome variables as well as quality of care. Features of nurses' work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses' perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services.
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Changes in hospital nurse work environments and nurse job outcomes: an analysis of panel data.
Kutney-Lee, Ann; Wu, Evan S; Sloane, Douglas M; Aiken, Linda H
2013-02-01
One strategy proposed to alleviate nursing shortages is the promotion of organizational efforts that will improve nurse recruitment and retention. Cross-sectional studies have shown that the quality of the nurse work environment is associated with nurse outcomes related to retention, but there have been very few longitudinal studies undertaken to examine this relationship. To demonstrate how rates of burnout, intention to leave, and job dissatisfaction changed in a panel of hospitals over time, and to explore whether these outcomes were associated with changes in nurse work environments. A retrospective, two-stage panel design was chosen for this study. Survey data collected from large random samples of registered nurses employed in Pennsylvania hospitals in 1999 and 2006 were used to derive hospital-level rates of burnout, intention to leave current position, and job dissatisfaction, and to classify the quality of nurses' work environments at both points in time. A two-period difference model was used to estimate the dependence of changes in rates of nurse burnout, intention to leave, and job dissatisfaction on changes in nurse work environments between 1999 and 2006 in 137 hospitals, accounting for concurrent changes in nurse staffing levels. In general, nurse outcomes improved between 1999 and 2006, with fewer nurses reporting burnout, intention to leave, and job dissatisfaction in 2006 as compared to 1999. Our difference models showed that improvements in work environment had a strong negative association with changes in rates of burnout (β=-6.42%, p<0.01) intention to leave (β=-4.10%, p<0.01), and job dissatisfaction (β=-8.00%, p<0.01). Improvements in nurse work environments over time are associated with lower rates of nurse burnout, intention to leave current position, and job dissatisfaction. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Fan, Yuying; Zheng, Qiulan; Liu, Shiqing; Li, Qiujie
2016-07-01
To explore the relationships among perceived work environment, psychological empowerment and job engagement of clinical nurses in Harbin, China. Previous studies have focused on organisational factors or nurses' personal characteristics contributing to job engagement. Limited studies have examined the effects of perceived work environment and psychological empowerment on job engagement among Chinese nurses. A cross-sectional quantitative survey with 923 registered nurses at four large university hospitals in China was carried out. Research instruments included the Chinese versions of the perceived nurse work environment scale, the psychological empowerment scale and the job engagement scale. The relationships of the variables were tested using structural equation modelling. Structural equation modelling revealed a good fit of the model, χ(2) /df = 4.46, GFI = 0.936, CFI = 0.957. Perceived work environment was a significant positive direct predictor of psychological empowerment and job engagement. Psychological empowerment was a significant positive direct contributor to job engagement and had a mediating effect on the relationship between perceived work environment and job engagement. Perceived work environment may result in increased job engagement by facilitating the development of psychological empowerment. For nurse managers wishing to increase nurse engagement and to achieve effective management, both perceived work environment and psychological empowerment are factors that need to be well controlled in the process of nurse administration. © 2016 John Wiley & Sons Ltd.
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Nursing practice environment, quality of care, and morale of hospital nurses in Japan.
Anzai, Eriko; Douglas, Clint; Bonner, Ann
2014-06-01
The purpose of this study was to describe Japanese hospital nurses' perceptions of the nursing practice environment and examine its association with nurse-reported ability to provide quality nursing care, quality of patient care, and ward morale. A cross-sectional survey design was used including 223 nurses working in 12 acute inpatient wards in a large Japanese teaching hospital. Nurses rated their work environment favorably overall using the Japanese version of the Practice Environment Scale of the Nursing Work Index. Subscale scores indicated high perceptions of physician relations and quality of nursing management, but lower scores for staffing and resources. Ward nurse managers generally rated the practice environment more positively than staff nurses except for staffing and resources. Regression analyses found the practice environment was a significant predictor of quality of patient care and ward morale, whereas perceived ability to provide quality nursing care was most strongly associated with years of clinical experience. These findings support interventions to improve the nursing practice environment, particularly staffing and resource adequacy, to enhance quality of care and ward morale in Japan. © 2013 Wiley Publishing Asia Pty Ltd.
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Cho, Eunhee; Sloane, Douglas M; Kim, Eun-Young; Kim, Sera; Choi, Miyoung; Yoo, Il Young; Lee, Hye Sun; Aiken, Linda H
2015-02-01
While considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea. To examine the effects of nurse staffing, work environment, and education on patient mortality. This study linked hospital facility data with staff nurse survey data (N=1024) and surgical patient discharge data (N=76,036) from 14 high-technology teaching hospitals with 700 or more beds in South Korea, collected between January 1, 2008 and December 31, 2008. Logistic regression models that corrected for the clustering of patients in hospitals were used to estimate the effects of the three nursing characteristics on risk-adjusted patient mortality within 30 days of admission. Risk-adjusted models reveal that nurse staffing, nurse work environments, and nurse education were significantly associated with patient mortality (OR 1.05, 95% CI 1.00-1.10; OR 0.52, 95% CI 0.31-0.88; and OR 0.91, CI 0.83-0.99; respectively). These odds ratios imply that each additional patient per nurse is associated with an 5% increase in the odds of patient death within 30 days of admission, that the odds of patient mortality are nearly 50% lower in the hospitals with better nurse work environments than in hospitals with mixed or poor nurse work environments, and that each 10% increase in nurses having Bachelor of Science in Nursing Degree is associated with a 9% decrease in patient deaths. Nurse staffing, nurse work environments, and percentages of nurses having Bachelor of Science in Nursing Degree in South Korea are associated with patient mortality. Improving hospital nurse staffing and work environments and increasing the percentages of nurses having Bachelor of Science in Nursing Degree would help reduce the number of preventable in-hospital deaths. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Changes in Hospital Nurse Work Environments and Nurse Job Outcomes: An Analysis of Panel Data
Wu, Evan S.; Sloane, Douglas M.; Aiken, Linda H.; Fagin, Claire M.
2013-01-01
Background One strategy proposed to alleviate nursing shortages is the promotion of organizational efforts that will improve nurse recruitment and retention. Cross-sectional studies have shown that the quality of the nurse work environment is associated with nurse outcomes related to retention, but there have been very few longitudinal studies undertaken to examine this relationship. Objectives To demonstrate how rates of burnout, intention to leave, and job dissatisfaction changed in a panel of hospitals over time, and to explore whether these outcomes were associated with changes in nurse work environments. Methods A retrospective, two-stage panel design was chosen for this study. Survey data collected from large random samples of registered nurses employed in Pennsylvania hospitals in 1999 and 2006 were used to derive hospital-level rates of burnout, intentions to leave current positions, and job dissatisfaction, and to classify the quality of nurses’ work environments at both points in time. A two-period difference model was used to estimate the dependence of changes in rates of nurse burnout, intentions to leave, and job dissatisfaction on changes in nurse work environments between 1999 and 2006 in 137 hospitals, accounting for concurrent changes in nurse staffing levels. Results In general, nurse outcomes improved between 1999 and 2006, with fewer nurses reporting burnout, intentions to leave, and job dissatisfaction in 2006 as compared to 1999. Our difference models showed that improvements in work environment had a strong negative association with changes in rates of burnout (β =−6.42%, p<0.01) intentions to leave (β =−4.10%, p<0.01), and job dissatisfaction (β =−8.00%, p<0.01). Conclusions Improvements in nurse work environments over time are associated with lower rates of nurse burnout, intentions to leave current positions, and job dissatisfaction. PMID:22902135
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Exploring work-life issues in provincial corrections settings.
Almost, Joan; Doran, Diane; Ogilvie, Linda; Miller, Crystal; Kennedy, Shirley; Timmings, Carol; Rose, Don N; Squires, Mae; Lee, Charlotte T; Bookey-Bassett, Sue
2013-01-01
Correctional nurses hold a unique position within the nursing profession as their work environment combines the demands of two systems, corrections and health care. Nurses working within these settings must be constantly aware of security issues while ensuring that quality care is provided. The primary role of nurses in correctional health care underscores the importance of understanding nurses' perceptions about their work. The purpose of this study was to examine the work environment of nurses working in provincial correctional facilities. A mixed-methods design was used. Interviews were conducted with 13 nurses and healthcare managers (HCMs) from five facilities. Surveys were distributed to 511 nurses and HCMs in all provincial facilities across the province of Ontario, Canada. The final sample consisted of 270 nurses and 27 HCMs with completed surveys. Participants identified several key issues in their work environments, including inadequate staffing and heavy workloads, limited control over practice and scope of practice, limited resources, and challenging workplace relationships. Work environment interventions are needed to address these issues and subsequently improve the recruitment and retention of correctional nurses.
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Lundgren, Dan; Ernsth Bravell, Marie; Börjesson, Ulrika; Kåreholt, Ingemar
2018-06-01
This study examines the association between nursing assistants' perceptions of their psychosocial work environment and satisfaction among older people receiving care in nursing homes and home care. Cross-sectional surveys were conducted among people receiving care ( N = 1,535) and nursing assistants ( N = 1,132) in 45 nursing homes and 21 home care units within municipal old-age care. Better psychosocial work environment was related to higher satisfaction in old-age care among the recipients. Significant and stronger associations were more common in nursing homes than in home care. Perception of mastery and positive challenges at work were associated with higher recipient satisfaction both in home care and in nursing homes: social climate, perception of group work, perception of mastery, and positive challenges at work only in nursing homes. Findings suggest that recipient satisfaction may be increased by improving the psychosocial work environment for nursing assistants, both in nursing homes and in home care.
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Wan, Qiaoqin; Li, Zhaoyang; Zhou, Weijiao; Shang, Shaomei
2018-06-01
To assess turnover intention among experienced nurses and explore the effects of work environment, job characteristics and work engagement on turnover intention. The nursing shortage is an urgent concern in China. A high turnover rate of experienced nurses could have serious effects on the quality of care, costs and the efficiency of hospitals. It is crucial to explore the predictors of turnover intention and develop strategies tailored to experienced nurses. A descriptive, cross-sectional survey design. A total of 778 experienced nurses from seven hospitals was surveyed on their work engagement, job characteristics, work environment and turnover intention in March-May 2017. Structural equation modelling was used to test a theoretical model and the hypotheses. The results showed that 35.9% of experienced nurses had high-level turnover intention. The final model explained 50% of the variance in experienced nurses' turnover intention and demonstrated that: (1) work environment was positively associated with higher work engagement and lower turnover intention and work engagement partially mediated the relationship between work environment and turnover intention; and (2) job characteristics were positively related to higher work engagement and lower turnover intention and work engagement fully mediated the relationship between job characteristics and turnover intention. The study confirms the intrinsic and extrinsic motivators on work engagement posited by job demands-resources model. Theory-driven strategies to improve work environment, enhance job characteristics and promote wok engagement are needed to address the nursing shortage and high turnover intention among experienced nurses. © 2018 John Wiley & Sons Ltd.
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Lacher, Stefanie; De Geest, Sabina; Denhaerynck, Kris; Trede, Ines; Ausserhofer, Dietmar
2015-09-01
Anticipating nursing shortages, the Swiss healthcare system recently introduced the position of allied healthcare assistant (AHA). However, indicators of AHAs' integration and stability, particularly their perceptions of their work environment quality and related outcomes (i.e., burnout, job satisfaction, and intention to leave), remain unclear. (a) To describe AHAs' ratings of the quality of the nurse work environment, job satisfaction, burnout, and intention to leave their workplaces; (b) to compare AHAs' and registered nurses' (RNs') work environment quality ratings and related outcomes; and (c) to assess links between AHAs' work environment quality ratings and related workforce outcomes. A secondary analysis of RN4CAST data (October 2009 to June 2010) on 61 AHAs and 466 RNs in 13 Swiss acute care hospitals. We used descriptive statistics to summarize data of AHAs and RNs on their units and hospitals. Via binary logistic regression models, we compared AHAs and RNs and identified associations between work environment ratings and workforce outcomes. AHAs' work environment quality ratings were significantly higher than those of RNs, and were associated with lower odds of burnout and intention to leave their current job and higher odds of reported job satisfaction. This study provides primary evidence linking AHAs' work environment quality ratings to burnout, job satisfaction, and intention to leave in acute care hospitals. Given the increasing importance of AHAs for nursing care provision, hospitals should assess the quality of nurse work environment and nurse outcomes from the perspective of all nurses. © 2015 Sigma Theta Tau International.
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Kudo, Yasushi; Kono, Keiko; Kume, Ryuko; Matsuhashi, Ayako; Tsutsumi, Akizumi
Registered nurses and licensed practical nurses have received professional education, but to enhance their work motivation it is necessary to create work environments in which they can concentrate on their jobs as specialists. One of the methods to develop such work environments is to use nursing assistants effectively. We investigated professional nurses' feelings toward nursing assistants and then examined the associations between those feelings and their work motivation. The analyzed subjects were 2,170 female nurses working in 25 hospitals with from 55 to 458 beds. The average age of the respondents was 38.0 (standard deviation, 10.6 years). Factor analyses extracted four factors of professional nurses' feelings toward nursing assistants: 1. knowledge related to healthcare, 2. nursing assistants' attitudes toward work, 3. human relations, and 4. distinguishing between professional nurses' work and nursing assistants' work. Using multiple linear regression analysis, our results revealed that scores of maintaining a high motivation to work thanks to nursing assistants became lower as the ages of the respondents increased. Scores of maintaining a high motivation to work thanks to nursing assistants became higher as professional nurses gained satisfaction from: knowledge related to healthcare, nursing assistants' attitudes toward work, and human relations. Hospital managers should consider these findings to improve working environments in which professional nurses can feel motivated to work.
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An exploratory study about meaningful work in acute care nursing.
Pavlish, Carol; Hunt, Roberta
2012-01-01
To develop deeper understandings about nurses' perceptions of meaningful work and the contextual factors that impact finding meaning in work. Much has been written about nurses' job satisfaction and the impact on quality of health care. However, scant qualitative evidence exists regarding nurses' perceptions of meaningful work and how factors in the work environment influence their perceptions. The literature reveals links among work satisfaction, retention, quality of care, and meaningfulness in work. Using a narrative design, researchers interviewed 13 public health nurses and 13 acute care nurses. Categorical-content analysis with Atlas.ti data management software was conducted separately for each group of nurses. This article reports results for acute care nurses. Twenty-four stories of meaningful moments were analyzed and categorized. Three primary themes of meaningful work emerged: connections, contributions, and recognition. Participants described learning-focused environment, teamwork, constructive management, and time with patients as facilitators of meaningfulness and task-focused environment, stressful relationships, and divisive management as barriers. Meaningful nursing roles were advocate, catalyst and guide, and caring presence. Nurse administrators are the key to improving quality of care by nurturing opportunities for nurses to find meaning and satisfaction in their work. Study findings provide nurse leaders with new avenues for improving work environments and job satisfaction to potentially enhance healthcare outcomes. © 2012 Wiley Periodicals, Inc.
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Using a social capital framework to enhance measurement of the nursing work environment.
Sheingold, Brenda Helen; Sheingold, Steven H
2013-07-01
To develop, field test and analyse a social capital survey instrument for measuring the nursing work environment. The concept of social capital, which focuses on improving productive capacity by examining relationships and networks, may provide a promising framework to measure and evaluate the nurse work environment in a variety of settings. A survey instrument for measuring social capital in the nurse work environment was developed by adapting the World Bank's Social Capital - Integrated Questionnaire (SC-IQ). Exploratory factor analysis and multiple regression analyses were applied to assess the properties of the instrument. The exploratory factor analysis yielded five factors that align well with the social capital framework, while reflecting unique aspects of the nurse work environment. The results suggest that the social capital framework provides a promising context to assess the nurse work environment. Further work is needed to refine the instrument for a diverse range of health-care providers and to correlate social capital measures with quality of patient care. Social capital measurement of the nurse work environment has the potential to provide managers with an enhanced set of tools for building productive capacity in health-care organisations and achieving desired outcomes. © 2013 John Wiley & Sons Ltd.
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Nursing work environment in Saudi Arabia.
Aboshaiqah, Ahmad E
2015-05-01
The purpose of this study was to assess the work environment as perceived by nurses in a large tertiary hospital in Saudi Arabia. The quality of patient care services has been associated with the quality of work environment of nurses. It is therefore important to assess the work environment in order to acquire baseline data and enable the institution to benchmark their status from established quality standards. This study used a descriptive survey with 1007 staff nurses across service units of a 1000-bed government-operated hospital. The American Association of Critical-Care Nurses (AACN) Healthy Work Environment Assessment Questionnaire was used for data collection. Scores were aggregated and interpreted. Effective decision making, authentic leadership, appropriate staffing, true collaboration, skilled communication and meaningful recognition were rated as good (mean range 3.53-3.76). Healthy work environments mutually benefit patients, nurses, nurse managers, health care providers, the health team, administration, the institution and the community at large. Valuable baseline data on the status of the work environment in this setting were generated. This should allow administrators and staff to work together in improving weaknesses and strengthening further whatever gains that are attained to ensure consistent provision of safe and quality patient care. © 2013 John Wiley & Sons Ltd.
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2011-01-01
Background The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. The aims of the present study were to investigate in what way different aspects of the ward atmosphere were related to the psychosocial work environment, as perceived by nursing staff working in psychiatric in-patient care, and possible differences between nurses and nurse assistants. Methods 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses. Results The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate. Conclusions The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways. PMID:21679430
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Swiger, Pauline A; Patrician, Patricia A; Miltner, Rebecca S Susie; Raju, Dheeraj; Breckenridge-Sproat, Sara; Loan, Lori A
2017-09-01
The Practice Environment Scale of the Nursing Work Index (PES-NWI) is an instrument, which measures the nursing practice environment - defined as factors that enhance or attenuate a nurse's ability to practice nursing skillfully and deliver high quality care. The purpose of this paper is to provide an updated review of the Practice Environment Scale of the Nursing Work Index's use to date and provide recommendations that may be helpful to nursing leaders and researchers who plan to use this instrument. A narrative review of quantitative studies. PubMed, EMBASE, and the Cumulative Index to Nursing & Allied Health Literature were searched to identify relevant literature using the search terms, Practice Environment Scale of the Nursing Work Index and PES-NWI. Studies were included if they were published in English between 2010 and 2016 and focused on the relationship between the Practice Environment Scale of the Nursing Work Index and patient, nurse, or organizational outcomes. Data extraction focused on the reported survey scores and the significance and strength of the reported associations. Forty-six articles, from 28 countries, were included in this review. The majority reported significant findings between the nursing practice environment and outcomes. Although some modifications have been made, the instrument has remained primarily unchanged since its development. Most often, the scores regarding staffing and resource adequacy remained the lowest. The frequency of use of this instrument has remained high. Many researchers advocate for a move beyond the study of the connection between the Practice Environment Scale and nurse, patient, and organizational outcomes. Research should shift toward identifying interventions that improve the environment in which nurses practice and determining if changing the environment results in improved care quality. Published by Elsevier Ltd.
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The work environment of haemodialysis nurses and its impact on patients' outcomes.
Prezerakos, Panagiotis; Galanis, Peter; Moisoglou, Ioannis
2015-04-01
The aims of this study were to assess haemodialysis nurses' work environment and investigate the correlation between work environment and patients' outcomes. A cross-sectional study was conducted at the 11 public hospital-based haemodialysis units of the 5th Regional Health Authority of Greece. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to assess work environment. Nurses were asked to report the frequency of a series adverse events and errors. Study population consisted of 133 nurses (response rate 89.3%). The overall PES-NWI scored just < 2.5 (Mean = 2.48, standard deviation = 0.34) indicating a non-favourable haemodialysis workplace. Nurse-physician Relations, nurse manager ability and nursing foundations for quality of care were the most favourable aspects of work environment. Multivariate logistic regression analysis identified that hypotension (odds ratio (OR) = 0.3, 95% confidence interval (CI) = 0.1-0.9, P = 0.03), venous needle disconnection (OR = 0.14, 95% CI = 0.03-0.65, P = 0.012) and patient fall (OR = 0.02, 95% CI = 0.001-0.51, P = 0.018) were associated with a non-favourable work environment. Findings have important implications for improvement of haemodialysis work environment and enhancement of patients' safety. © 2013 Wiley Publishing Asia Pty Ltd.
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Nurse work environment and quality of care by unit types: A cross-sectional study.
Ma, Chenjuan; Olds, Danielle M; Dunton, Nancy E
2015-10-01
Nursing unit is the micro-organization in the hospital health care system in which integrated patient care is provided. Nursing units of different types serve patients with distinct care goals, clinical tasks, and social structures and norms. However, empirical evidence is sparse on unit type differences in quality of care and its relation with nurse work environment. Nurse work environment has been found as an important nursing factor predicting nurse and patient outcomes. To examine the unit type differences in nurse-reported quality of care, and to identify the association between unit work environment and quality of care by unit types. This is a cross-sectional study using nurse survey data (2012) from US hospitals nationwide. The nurse survey collected data on quality of care, nurse work environment, and other work related information from staff nurses working in units of various types. Unit types were systematically classified across hospitals. The unit of analysis was the nursing unit, and the final sample included 7677 units of 14 unit types from 577 hospitals in 49 states in the US. Multilevel regressions were used to assess the relationship between nurse work environment and quality of care across and by unit types. On average, units had 58% of the nurses reporting excellent quality of care and 40% of the nurses reporting improved quality of care over the past year. Unit quality of care varied by unit types, from 43% of the nurses in adult medical units to 73% of the nurses in interventional units rating overall quality of care on unit as excellent, and from 35% of the nurses in adult critical care units to 44% of the nurses in adult medical units and medical-surgical combined units reporting improved quality of care. Estimates from regressions indicated that better unit work environments were associated with higher quality of care when controlling various hospital and unit covariates; and this association persisted among units of different types. Unit type differences exist in the overall quality of care as well as achievement in improving quality of care. The low rates of nurses reporting improvement in the quality of nursing care to patients suggest that further interventions focusing at the unit-level are needed for achieving high care quality. Findings from our study also suggest that improving nurse work environments can be an effective strategy to improve quality of care. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Analysis of the moral habitability of the nursing work environment.
Peter, Elizabeth H; Macfarlane, Amy V; O'Brien-Pallas, Linda L
2004-08-01
Following health reform, nurses have experienced the tremendous stress of heavy workloads, long hours and difficult professional responsibilities. In recognition of these problems, a study was conducted that examined the impact of the working environment on the health of nurses. After conducting focus groups across Canada with nurses and others well acquainted with nursing issues, it became clear that the difficult work environments described had significant ethical implications. The aim of this paper is to report the findings of research that examined the moral habitability of the nursing working environment. A secondary analysis was conducted using the theoretical work of Margaret Urban Walker. Moral practices and responsibilities from Walker's perspective cannot be extricated from other social roles, practices and divisions of labour. Moral-social orders, such as work environments in this research, must be made transparent to examine their moral habitability. Morally habitable environments are those in which differently situated people experience their responsibilities as intelligible and coherent. They also foster recognition, cooperation and shared benefits. Four overarching categories were developed through the analysis of the data: (1) oppressive work environments; (2) incoherent moral understandings; (3) moral suffering and (4) moral influence and resistance. The findings clearly indicate that participants perceived the work environment to be morally uninhabitable. The social and spatial positioning of nurses left them vulnerable to being overburdened by and unsure of their responsibilities. Nevertheless, nurses found meaningful ways to resist and to influence the moral environment. We recommend that nurses develop strong moral identities, make visible the inseparability of their proximity to patients and moral accountability, and further identify what forms of collective action are most effective in improving the moral habitability of their work environments.
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Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik
2014-01-01
Aim: To explore the mechanisms through which nurse practice environment dimensions, such as nurse–physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Background: Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Design: Cross-sectional survey. Method: Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Results: Nurse practice environment dimensions predicted nurses’ ratings of job outcome variables as well as quality of care. Features of nurses’ work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. Conclusion: The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses’ perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services. PMID:25431563
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A comparison of the nursing practice environment in mental health and medical-surgical settings.
Roche, Michael A; Duffield, Christine M
2010-06-01
To examine the differences between characteristics of the work environment of nurses working in mental health and general acute inpatient nursing settings. Secondary analysis of data collected on 96 randomly selected medical and surgical (general) wards and six mental health wards in 24 public acute general hospitals across two Australian states between 2004 and 2006. All nurses on the participating wards were asked to complete a survey that included the Practice Environment Scale of the Nursing Work Index (NWI-PES). Responses were received from 2,556 nurses (76.3% response rate). Using the five-domain structure, comparisons were made between mental health and general nurses. Across the entire sample of nurses, those working in mental health settings scored more highly in regard to nurse-doctor relationships and staffing adequacy. Nurses in general wards reported more participation in hospital affairs, stronger leadership, and the presence of more of the foundations of nursing quality care such as access to continued education. Differences between the groups on each of the domains was statistically significant at p=.05 or greater, but not for the composite practice environment scale. A wide range of responses was seen when data were aggregated to the ward level. The work environment of mental health nurses is different from that of their colleagues working in general settings. Specific areas of the mental health environment, such as participation in the hospital, leadership, and the foundations of quality, may be enhanced to improve nurses' job satisfaction and, potentially, other nurse and patient outcomes. Factors in the medical and surgical nursing practice environment have been established as significant influences on nurse and patient outcomes. It is important to understand the existence and potential impact of these factors in mental health inpatient settings.
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Measuring nurses' perception of work environment: a scoping review of questionnaires.
Norman, Rebecka Maria; Sjetne, Ingeborg Strømseng
2017-01-01
Nurses' work environment has been shown to be associated with quality of care and organizational outcomes. In order to monitor the work environment, it is useful for all stakeholders to know the questionnaires that assess or evaluate conditions for delivering nursing care. The aim of this article is: to review the literature for assessed survey questionnaires that measure nurses' perception of their work environment, make a brief assessment, and map the content domains included in a selection of questionnaires. The search included electronic databases of internationally published literature, international websites, and hand searches of reference lists. Eligible papers describing a questionnaire had to be; a) suitable for nurses working in direct care in general hospitals, nursing homes or home healthcare settings; and b) constructed to measure work environment characteristics that are amenable to change and related to patient and organizational outcomes; and c) presented along with an assessment of their measurement properties. The search yielded 5077 unique articles. For the final synthesis, 65 articles met inclusion criteria, consisting of 34 questionnaires measuring nursing work environments in different settings. Most of the questionnaires that we found were developed, and tested, for registered nurses in a general hospital setting. Six questionnaires were developed specifically for use in nursing home settings and one for home healthcare. The content domains covered by the questionnaires were both overlapping and unique and the terminology in use was inconsistent. The most common content domains in the work environment questionnaires were supportive managers, collaborative relationships with peers, busyness, professional practice and autonomy. The findings from this review enhance the understanding of how "work environment" can be measured by an overview of existing questionnaires and domains. Our results indicate that there are very many work environment questionnaires with varying content.
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Foley, Barbara Jo; Kee, Carolyn C; Minick, Ptlene; Harvey, Susan S; Jennings, Bonnie M
2002-05-01
The purpose of this aspect of a larger study was to describe characteristics of nurses and their work environment at two military hospitals. Few studies have explored characteristics among nurses who practice in military hospitals. There is reason to believe that differences exist between nurses who work in military and civilian hospitals, some of which are required educational level, leadership experience, officer status, and career development opportunities. A descriptive design was used to address how military and civilian nurses who work in military hospitals describe their autonomy, control over practice, nurse-physician collaboration, and clinical expertise and what relationships exist among these variables. Scores on autonomy, control over practice, and nurse-physician relationships all were above midpoint for all respondents as a group, indicating positive work environments in both of the military hospitals studied. Scores from the clinical expertise instrument were well above midpoint, indicating a desirable level of clinical expertise. These findings all reflect favorably on the military hospital work environment. This information will help to make a case for instituting or preserving those nursing processes that are effective and for identifying and working to change nursing processes that are not effective. Nurses will benefit by having a more collaborative work environment.
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Leadership styles of nurse managers in a multinational environment.
Suliman, Wafika A
2009-01-01
This is a descriptive study conducted at a multinational working environment, where 1500 nurses representing 52 nationalities are employed. The study aimed at exploring the predominant leadership style of nurse managers through self-evaluation and staff nurses' evaluation and the impact of working in a multinational environment on their intention to stay or quit. The value lies in its focus on leadership styles in an environment where national diversity among managers, staff, and patients is very challenging. The study included 31 nurse managers and 118 staff nurses using Bass and Avolio's (1995) Multifactor Leadership Questionnaire. The results showed that nurse managers and staff nurses reported transformational leadership as predominant with significant difference in favor of nurse managers. Participants' nationality and intention to stay or quit affected their perception of transformational leadership as a predominant style. The implications highlight the need for senior nursing management to set effective retention strategies for transformational nurse managers who work at multinational environments.
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Hayes, Bronwyn; Douglas, Clint; Bonner, Ann
2014-12-01
To test an explanatory model of the relationships between the nursing work environment, job satisfaction, job stress and emotional exhaustion for haemodialysis nurses, drawing on Kanter's theory of organizational empowerment. Understanding the organizational predictors of burnout (emotional exhaustion) in haemodialysis nurses is critical for staff retention and improving nurse and patient outcomes. Previous research has demonstrated high levels of emotional exhaustion among haemodialysis nurses, yet the relationships between nurses' work environment, job satisfaction, stress and emotional exhaustion in this population are poorly understood. A cross-sectional online survey. 417 nurses working in haemodialysis units completed an online survey between October 2011-April 2012 using validated measures of the work environment, job satisfaction, job stress and emotional exhaustion. Overall, the structural equation model demonstrated adequate fit and we found partial support for the hypothesized relationships. Nurses' work environment had a direct positive effect on job satisfaction, explaining 88% of the variance. Greater job satisfaction, in turn, predicted lower job stress, explaining 82% of the variance. Job satisfaction also had an indirect effect on emotional exhaustion by mitigating job stress. However, job satisfaction did not have a direct effect on emotional exhaustion. The work environment of haemodialysis nurses is pivotal to the development of job satisfaction. Nurses' job satisfaction also predicts their level of job stress and emotional exhaustion. Our findings suggest staff retention can be improved by creating empowering work environments that promote job satisfaction among haemodialysis nurses. © 2014 John Wiley & Sons Ltd.
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Fielding, J; Weaver, S M
1994-06-01
This study compares hospital- (n = 67) and community-based (n = 55) mental health nurses in relation to their perceptions of the work environment and also their psychological health. Measures include: the General Health Questionnaire, the Maslach Burnout Inventory and the Work Environment Scale. The data, obtained from self-returned questionnaires, show that community nurses rated their work environments higher for the dimensions of Involvement, Supervisor Support, Autonomy, Innovation and Work Pressure. Hospital nurses saw their environments as being higher in (managerial) Control. There were no differences between the groups for the dimensions of Peer Cohesion, Task Orientation, Clarity or (physical) Comfort. Furthermore, there were no overall differences between the two groups in relation to psychological health, although the pattern of factors associated with emotional well-being differed. Finally, analyses of the community data revealed that those nurses with 'flexitime' arrangements evaluated their work environments less positively and showed higher levels of psychological strain than did those working 'fixed-time' schedules. The findings suggest that the hospital and community environments make different demands on nursing staff, and that this should be considered when organizing nursing services if stress is to be avoided.
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Tavakkoli, Sodeh; Asaadi, Mohammad Mahdy; Pakpour, Amir H; Hajiaghababaei, Marzieh
2015-06-01
Environmental psychology as a science could be useful in understanding the dissociation between the man and the environment. The aim of this study was to compare mental health, job satisfaction and well-being of nurses who work in hospital environments with different designs. This was a quasi-experimental study, in which 250 nurses filled out the mental health, well-being and job satisfaction questionnaires. They were categorized into 3 groups randomly. Group1 included 63 nurses who worked in an environment without any natural elements; group 2 included 100 nurses who worked in an environment with natural elements and group 3 included 87 nurses who worked in an environment without any psychological and ergonomic design. The last group was only stimulated by demonstrating visual stimulus. Data were analyzed using the ANOVA and Tukey's pursuit statistical method. The nurses who were working in an environment without any natural elements reported significantly lower scores on mental health, well-being and job satisfaction compared to those who were working in other groups, with the exception of social functioning. Moreover, depression and anxiety were more common in nurses who were working in environments without any natural elements compared to those in the other groups (p<0.05). We can increase job satisfaction, and mental health and well-being of the nurses through the use of natural design and environmental psychology indexes in hospital buildings.
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How Nurse Work Environments Relate to the Presence of Parents in Neonatal Intensive Care.
Hallowell, Sunny G; Rogowski, Jeannette A; Lake, Eileen T
2017-09-25
Parental presence in the neonatal intensive care unit (NICU) is essential for families to participate in infant care and prepare them to transition from hospital to home. Nurses are the principal caregivers in the NICU. The nurse work environment may influence whether parents spend time with their hospitalized infants. To examine the relationship between the NICU work environment and parental presence in the NICU using a national data set. We conducted a cross-sectional, observational study of a national sample of 104 NICUs, where 6060 nurses reported on 15,233 infants cared for. Secondary analysis was used to examine associations between the Practice Environment Scale of the Nursing Work Index (PES-NWI) (subscale items and with a composite measure) and the proportion of parents who were present during the nurses' shift. Parents of 60% (SD = 9.7%) of infants were present during the nurses' shift. The PES-NWI composite score and 2 domains-Nurse Participation in Hospital Affairs and Manager Leadership and Support-were significant predictors of parental presence. A 1 SD higher score in the composite or either subscale was associated with 2.5% more parents being present. Parental presence in the NICU is significantly associated with better nurse work environments. NICU practices may be enhanced through enhanced leadership and professional opportunities for nurse managers and staff. Future work may benefit from qualitative work with parents to illuminate their experiences with nursing leaders and nurse-led interventions in the NICU and design and testing of interventions to improve the NICU work environment.
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Özer, Özlem; Şantaş, Fatih; Şantaş, Gülcan; Şahin, Deniz Say
2017-12-01
This study examines the association of nurses' perception of their work environment and communication satisfaction with their intention to quit. The implementation part of the study was conducted with nurses working in a public hospital in the city of Burdur, Turkey. Data were collected in January 2017 from 175 participants and then assessed. The analysis showed that perceptions of the work environment and communication satisfaction taken together explain the total variance of the intention to quit. While participants' perceptions of the work environment become increasingly positive, their communication satisfaction increases and their intention to quit decreases. The findings of this study suggest that making improvements to the nursing work environment and nurses' communication satisfaction will decrease their intention to quit. © 2017 John Wiley & Sons Australia, Ltd.
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Cho, Hyeonmi; Han, Kihye
2018-05-14
This study aimed to determine the relationships among the unit-level nursing work environment and individual-level health-promoting behaviors of hospital nurses in South Korea and their perceived nursing performance quality. This study used a cross-sectional design. Data were collected using self-reported questionnaires from 432 nurses in 57 units at five hospitals in South Korea. Nursing performance quality, nursing work environment, and health-promoting behaviors were measured using the Six Dimension Scale of Nursing Performance, Practice Environment Scale of the Nursing Work Index, and Health Promoting Lifestyle Profile-II, respectively. Nurses working in units with nurse managers who were characterized by better ability and by quality leadership, and who provided more support to nurses exhibited significantly greater health responsibility and physical activity. Nurses working with sufficient staffing and resources reported better stress management. Positive collegial nurse-physician relationships in units were significantly associated with more healthy eating among nurses. Nurses working in units with sufficient staffing and resources, and who had a higher level of spiritual growth and health responsibility, were more likely to perceive their nursing performance quality as being higher. To improve the quality of nursing practice, hospitals should focus on helping nurses maintain healthy lifestyles, as well as improving their working conditions in South Korea. Organizational support for adequate human resources and materials, mutual cooperation among nurses and physicians, and workplace health-promotion interventions for spiritual growth and health responsibility are needed. Organizational efforts to provide sufficient staffing and resources, boost the development of personal resources among nurses, and promote nurses' responsibility for their own health could be effective strategies for improving nursing performance quality and patient outcomes. © 2018 Sigma Theta Tau International.
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Bragadóttir, Helga; Gunnarsdóttir, Sigrún; Ingason, Helgi T
2013-05-01
This paper describes the development and piloting of electronic standardized measures on nursing work (e-SMNW) for rich data gathering on the work and work environment of registered nurses (RNs) and practical nurses (PNs). Efficient and valid methods are needed to measure nursing work to enhance the optimal use of the nursing workforce for safe patient care. The study combined human factors engineering (HFE) and nursing knowledge to develop electronic standardized measures for observational studies on nursing work in acute care. The work and work environment of RNs and PNs in acute care medical and surgical inpatient units was successfully measured using e-SMNW. With predetermined items of work activities and influencing factors in the work of nurses, and full use of computer technology, multi-layered rich standardized data were gathered, analysed and displayed. The combination of nursing knowledge, HFE and computer technology enables observational data collection for a rich picture of the complex work of nursing. Information collected by standardized and multi-layered measures makes it easier to identify potential improvements, with regard to influencing factors and management of the work and work environment of nurses. Further use of computer technology in health services research is encouraged. © 2012 Blackwell Publishing Ltd.
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Authentic leadership, organizational culture, and healthy work environments.
Shirey, Maria R
2009-01-01
The purpose of this article is to showcase the relationship among authentic leadership, organizational culture, and healthy work environments using a stress and coping lens. A qualitative descriptive study was conducted to determine what situations contribute to nurse manager stress, what coping strategies they utilize, what health outcomes they report, and what decision-making processes they follow to address stressful situations in their roles. A purposive sample of 21 nurse managers employed at 3 US acute care hospitals completed a demographic questionnaire and 14-question interview incorporating components of the Critical Decision Method. A secondary analysis of the data was conducted to identify differences in nurse manager narratives based upon differences in the organizational cultures where the managers worked. Of the 21 nurse managers studied, differences were evident in the organizational cultures reported. Nurse managers working in the positive organizational cultures (n = 12) generally worked in healthy work environments and engaged in more authentic leadership behaviors. Conversely, nurse managers working in the negative organizational cultures (n = 9) worked in unhealthy work environments and reported less optimism and more challenges engaging in authentic leadership practices. Organizational culture and leadership matter in creating and sustaining healthy work environments. Nurse managers play a pivotal role in creating these environments, yet they need supportive structures and resources to more effectively execute their roles.
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Zborowsky, Terri; Bunker-Hellmich, Lou; Morelli, Agneta; O'Neill, Mike
2010-01-01
Evidence-based findings of the effects of nursing station design on nurses' work environment and work behavior are essential to improve conditions and increase retention among these fundamental members of the healthcare delivery team. The purpose of this exploratory study was to investigate how nursing station design (i.e., centralized and decentralized nursing station layouts) affected nurses' use of space, patient visibility, noise levels, and perceptions of the work environment. Advances in information technology have enabled nurses to move away from traditional centralized paper-charting stations to smaller decentralized work stations and charting substations located closer to, or inside of, patient rooms. Improved understanding of the trade-offs presented by centralized and decentralized nursing station design has the potential to provide useful information for future nursing station layouts. This information will be critical for understanding the nurse environment "fit." The study used an exploratory design with both qualitative and quantitative methods. Qualitative data regarding the effects of nursing station design on nurses' health and work environment were gathered by means of focus group interviews. Quantitative data-gathering techniques included place- and person-centered space use observations, patient visibility assessments, sound level measurements, and an online questionnaire regarding perceptions of the work environment. Nurses on all units were observed most frequently performing telephone, computer, and administrative duties. Time spent using telephones, computers, and performing other administrative duties was significantly higher in the centralized nursing stations. Consultations with medical staff and social interactions were significantly less frequent in decentralized nursing stations. There were no indications that either centralized or decentralized nursing station designs resulted in superior visibility. Sound levels measured in all nursing stations exceeded recommended levels during all shifts. No significant differences were identified in nurses' perceptions of work control-demand-support in centralized and decentralized nursing station designs. The "hybrid" nursing design model in which decentralized nursing stations are coupled with centralized meeting rooms for consultation between staff members may strike a balance between the increase in computer duties and the ongoing need for communication and consultation that addresses the conflicting demands of technology and direct patient care.
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Hayes, Bronwyn; Bonner, Ann; Douglas, Clint
2015-01-01
Haemodialysis nurses form long term relationships with patients in a technologically complex work environment. Previous studies have highlighted that haemodialysis nurses face stressors related to the nature of their work and also their work environments leading to reported high levels of burnout. Using Kanters (1997) Structural Empowerment Theory as a guiding framework, the aim of this study was to explore the factors contributing to satisfaction with the work environment, job satisfaction, job stress and burnout in haemodialysis nurses. Using a sequential mixed-methods design, the first phase involved an on-line survey comprising demographic and work characteristics, Brisbane Practice Environment Measure (B-PEM), Index of Work Satisfaction (IWS), Nursing Stress Scale (NSS) and the Maslach Burnout Inventory (MBI). The second phase involved conducting eight semi-structured interviews with data thematically analyzed. From the 417 nurses surveyed the majority were female (90.9 %), aged over 41 years of age (74.3 %), and 47.4 % had worked in haemodialysis for more than 10 years. Overall the work environment was perceived positively and there was a moderate level of job satisfaction. However levels of stress and emotional exhaustion (burnout) were high. Two themes, ability to care and feeling successful as a nurse, provided clarity to the level of job satisfaction found in phase 1. While two further themes, patients as quasi-family and intense working teams, explained why working as a haemodialysis nurse was both satisfying and stressful. Nurse managers can use these results to identify issues being experienced by haemodialysis nurses working in the unit they are supervising.
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The health care work environment and adverse health and safety consequences for nurses.
Geiger-Brown, Jeanne; Lipscomb, Jane
2010-01-01
Nurses' working conditions are inextricably linked to the quality of care that is provided to patients and patients' safety. These same working conditions are associated with health and safety outcomes for nurses and other health care providers. This chapter describes aspects of the nursing work environment that have been linked to hazards and adverse exposures for nurses, as well as the most common health and safety outcomes of nursing work. We include studies from 2000 to the present by nurse researchers, studies of nurses as subjects, and studies of workers under similar working conditions that could translate to nurses' work environment. We explore a number of work organization factors including shift work and extended work hours, safety climate and culture, teamwork, and communication. We also describe environmental hazards, including chemical hazards (e.g., waste anesthetics, hazardous drugs, cleaning compounds) and airborne and bloodborne pathogen exposure. Nurses' health and safety outcomes include physical (e.g., musculoskeletal disorders, gastrointestinal, slips, trips and falls, physical assault) and psychosocial outcomes (e.g., burnout, work-family conflict). Finally, we present recommendations for future research to further protect nurses and all health care workers from a range of hazardous working conditions.
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Nursing practice environment and registered nurses' job satisfaction in nursing homes.
Choi, JiSun; Flynn, Linda; Aiken, Linda H
2012-08-01
Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs in nursing homes. The sample included 863 RNs working as staff RNs in 282 skilled nursing facilities in New Jersey. Two-level hierarchical linear modeling was used to account for the RNs nested by nursing homes. Controlling for individual and nursing home characteristics, staff RNs' participation in facility affairs, supportive manager, and resource adequacy were positively associated with RNs' job satisfaction. Ownership status was significantly related to job satisfaction; RNs working in for-profit nursing homes were less satisfied. A supportive practice environment is significantly associated with higher job satisfaction among RNs working in nursing homes. Unlike other nursing home characteristics, specific dimensions of the nursing practice environment can be modified through administrative actions to enhance RN job satisfaction.
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Using the Practice Environment Scale of the Nursing Work Index on Asian nurses.
Liou, Shwu-Ru; Cheng, Ching-Yu
2009-01-01
Researchers have used the Practice Environment Scale of the Nursing Work Index (PES-NWI) to examine the perception of practice environment among U.S. nurses in general; however, the scale has not been used to measure perceptions specifically among Asian nurses working in the United States, the largest group of international nurses in the nation. The purpose of this study was to test the reliability and the validity of the PES-NWI scale when applied to Asian nurses working in the United States. The study used a cross-sectional design with snowball sampling. Data from 230 Asian nurses who were born in Far Eastern countries and had worked at least 6 months in their current job at a U.S. hospital were analyzed, using Cronbach's alpha, item-total and interitem correlation, and factor analysis. The Cronbach's alpha for the PES-NWI was.96, and the item-total correlation coefficients ranged from.49 to.79. Five factors, which explained 59.12% of variance in the perception of practice environment, emerged: Nurse Participation and Development; Nurse Manager Ability, Leadership, and Support of Nurses; Nursing Foundations for Quality of Care; Staffing and Resource Adequacy; and Collegial Nurse-Physician Relations. Four derived factors were reconstructed, and one factor was renamed based on the meanings of scale items that were included in the factor. Study findings demonstrate that the PES-NWI is a reliable and a valid scale when applied to Asian nurses working in the United States. Findings also indicate that Asian nurses perceive practice environments differently than do American nurses, most likely due to dissimilar cultural beliefs. A better understanding of these differences may help develop more individualized support for Asian nurses as they adapt to working in the United States.
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Nursing leadership style and psychosocial work environment.
Malloy, Terry; Penprase, Barbara
2010-09-01
This study examines the relationship between leadership style and the psychosocial work environment of registered nurses. Research consistently supports the positive relationship between transformational leadership style and job satisfaction. There is less evidence, which identifies the relationship between leadership style and psychosocial work environment. The Multifactor Leadership Questionnaire 5× was used to identify the leadership style. The Copenhagen Psychosocial Questionnaire was used to measure psychosocial work environment dimensions. Statistical analysis included Pearson's r correlation between leadership style and psychosocial work environment and anova to analyse group means. There is a significant correlation between leadership style and 22 out of the 37 dimensions of the psychosocial work environment. This correlation was significant ranging from r = 0.88, P < 0.01 to r = 0.18, P < 0.05. Nurses divided into groups based on transformational leadership scores of the immediate supervisor report significant differences in their psychosocial work environment. This study supports the significant correlation between leadership style and psychosocial work environment for registered nurses. The results of this study suggest that there would be an improvement in the nursing psychosocial work environment by implementation of transformational and contingent reward leadership behaviours. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
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Adams, Joost; Verbeek, Hilde; Zwakhalen, Sandra M G
2017-01-01
The shift in nursing home care for patients with dementia from traditional task-driven environments towards patient-centered small-scale environments has implications for nursing practice. Information about its implications for nursing staff is lacking, and only a few studies have addressed staff perceptions. We sought to explore staff perceptions of required skills and to determine differences in job satisfaction, motivation, and job characteristics of staff working in both care settings. A secondary data analysis was conducted. The data source used was drawn from a larger study testing the effects of small-scale living (Verbeek et al., 2009). Nursing staff working on a permanent basis and who were directly involved in care were eligible to participate in the study. Data on job satisfaction, motivation, and job characteristics of nursing staff working in typical small-scale and traditional care environments were derived using a questionnaire. Data were analyzed using descriptive statistics. Differences between nursing staff job satisfaction, motivation, and job characteristics were tested using multilinear regression analysis. In total, 138 staff members were included (81 staff members working in traditional nursing home wards and 57 staff members working in small-scale nursing home wards). The findings showed that in typical small-scale nursing homes, job satisfaction and job motivation were significantly higher compared to those in typical traditional nursing homes. Job autonomy and social support were also significantly higher, while job demands were significantly lower in these small-scale nursing homes. Social support was found to be the most significant predictor of job motivation and job satisfaction in both types of typical nursing homes. Nursing staff working in traditional care environments more often expressed the intention to switch to small-scale environments. Based on the findings of this study, it can be concluded that nursing homes environments differ substantially in experienced job satisfaction and job motivation. To enable a balanced work environment for nursing staff, a clear understanding of the relation between living environments and experienced job satisfaction among nursing staff is required. Since social support seems to be one of the key contributors to a supportive beneficial work climate, managers should focus on enabling this in daily nursing home care. © 2016 Sigma Theta Tau International.
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Nursing leadership in intensive care units and its relationship to the work environment 1
Balsanelli, Alexandre Pazetto; Cunha, Isabel Cristina Kowal Olm
2015-01-01
AIM: To establish whether there is any relationship between the work environment and nursing leadership at intensive care units (ICUs). METHOD: Correlational study conducted at four ICUs in southern São Paulo (SP), Brazil. The study population was comprised of 66 pairs (nurses and nursing technicians) established by lottery. The nurses responded to three instruments: 1) characterization; 2) a validated Portuguese version of the Nursing Work Index Revised (B-NWI-R); and 3) Grid & Leadership in Nursing: ideal behavior. The nursing technicians responded to 1) characterization and to 2) Grid and Leadership in Nursing: actual behavior, relative to the corresponding randomly-assigned nurse. The data were analyzed by means of analysis of variance (ANOVA) at p ≤ 0.05. RESULTS: The work environment was not associated with actual nursing leadership (p = 0.852). The public or private nature of the institutions where the investigated ICUs were located had no significant effect on leadership (p = 0.437). Only the nurse-physician relationship domain stood out (p = 0.001). CONCLUSION: The choice of leadership styles by nurses should match the ICU characteristics. Leadership skills could be developed, and the work environment did not exert any influence on the investigated population. PMID:25806638
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McHugh, Matthew D.; Rochman, Monica F.; Sloane, Douglas M.; Berg, Robert A.; Mancini, Mary E.; Nadkarni, Vinay M.; Merchant, Raina M.; Aiken, Linda H.
2015-01-01
Background Although nurses are the most likely first responders to witness an in-hospital cardiac arrest (IHCA) and provide treatment, little research has been undertaken to determine what features of nursing are related to cardiac arrest outcomes. Objectives To determine the association between nurse staffing, nurse work environments, and IHCA survival. Research Design Cross-sectional study of data from: (1) the American Heart Association’s Get With The Guidelines-Resuscitation database; (2) the University of Pennsylvania Multi-State Nursing Care and and Patient Safety; and (3) the American Hospital Association annual survey. Logistic regression models were used to determine the association of the features of nursing and IHCA survival to discharge after adjusting for hospital and patient characteristics. Subjects A total of 11,160 adult patients aged 18 and older between 2005 and 2007 in 75 hospitals in 4 states (Pennsylvania, Florida, California, and New Jersey). Results Each additional patient per nurse on medical-surgical units was associated with a 5% lower likelihood of surviving IHCA to discharge (odds ratio = 0.95; 95% confidence interval, 0.91–0.99). Further, patients cared for in hospitals with poor work environments had a 16% lower likelihood of IHCA survival (odds ratio = 0.84; 95% confidence interval, 0.71–0.99) than patients cared for in hospitals with better work environments. Conclusions Better work environments and decreased patient-to-nurse ratios on medical-surgical units are associated with higher odds of patient survival after an IHCA. These results add to a large body of literature suggesting that outcomes are better when nurses have a more reasonable workload and work in good hospital work environments. Improving nurse working conditions holds promise for improving survival following IHCA. PMID:26783858
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The Integrality of Situated Caring in Nursing and the Environment
Jarrin, Olga F.
2012-01-01
Much emphasis has been placed on the importance of the environment as a determinant of health; however, little theoretical work in nursing has specifically articulated the importance of the nursing practice environment as a factor in patient outcomes. This work advances the unitary-transformative-caring paradigm by focusing on the concept of integrality and exploring the nursing meta-paradigm concepts (nursing, environment, human being, and health) through integral philosophical inquiry. PMID:22222236
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Ogata, Yasuko; Nagano, Midori; Fukuda, Takashi; Hashimoto, Michio
2011-06-01
The purpose of this study was to examine how the nursing practice environment affects job retention and the turnover rate among hospital nurses. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was applied to investigate the nurse working environment from the viewpoint of hospital nurses in Japan. Methods A postal mail survey was conducted using the PES-NWI questionnaire targeting 2,211 nurses who were working at 91 wards in 5 hospitals situated in the Tokyo metropolitan area from February to March in 2008. In the questionnaire, hospital nurses were asked about characteristics such as sex, age and work experience as a nurse, whether they would work at the same hospital in the next year, the 31 items of the PES-NWI and job satisfaction. Nurse managers were asked to provide staff numbers to calculate the turnover rate of each ward. Logistic regression analyses were carried out, with "intention to retain or leave the workplace next year" as the dependent variable, with composite and 5 sub-scale scores of the PES-NWI and nurse characteristics as independent variables. Correlation coefficients were calculated to investigate the relationship between nurse turnover rates and nursing practice environments. A total of 1,067 full-time nurses (48.3%) from 5 hospitals responded. Almost all of them were men (95.9%), with an average age of 29.2 years old. They had an average of 7.0 years total work experience in hospitals and 5.8 years of experience at their current hospital. Cronbach's alpha coefficients were 0.75 for composite of the PES-NWI, and 0.77-0.85 for the sub-scales. All correlation coefficients between PES-NWI and job satisfaction were significant (P < 0.01). In the logistic regression analysis, a composite of PES-NWI, "Nurse Manager's Ability, Leadership, and Support of Nurses" and "Staffing and Resource Adequacy" among the 5 sub-scales correlated with the intention of nurses to stay on (P < 0.05). The means for turnover rate were 10.4% for nurses and 17.6% for newly hired nurses. These rates were significantly correlated to the composite and some sub-scales of the PES-NWI. The working environment for nurses is important in retaining nurses working at hospitals. We confirmed the reliability and the validity of the PES-NWI scale based on the magnitude of the Cronbach's alpha coefficient and correlation coefficient between the PES-NWI scale and job satisfaction in this study.
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The Relationships of Nurse Staffing Level and Work Environment With Patient Adverse Events.
Cho, Eunhee; Chin, Dal Lae; Kim, Sinhye; Hong, OiSaeng
2016-01-01
The purpose of this study was to examine the relationships of nurse staffing level and work environment with patient adverse events. This cross-sectional study used a combination of nurse survey data (N = 4,864 nurses), facility data (N = 58 hospitals), and patient hospital discharge data (N = 113,426 patients) in South Korea. The three most commonly nurse-reported adverse events included administration of the wrong medication or dose to a patient, pressure ulcers, and injury from a fall after admission. Multilevel ordinal logistic regression was employed to explore the relationships of nurse staffing level (number of patients assigned to a nurse) and work environment (Practice Environment Scale of the Nursing Work Index) with patient adverse events after controlling for nurse, hospital, and patient characteristics. A larger number of patients per nurse was significantly associated with a greater incidence of administration of the wrong medication or dose (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 1.007-1.016), pressure ulcer (OR = 1.01, 95% CI = 1.007-1.016), and patient falls with injury (OR = 1.02, 95% CI = 1.013-1.022). A better work environment had a significant inverse relationship with adverse events; the odds of reporting a higher incidence of adverse events were 45% lower for administration of the wrong medication or dose (OR = 0.55, 95% CI = 0.400-0.758), followed by 39% lower for pressure ulcer (OR = 0.61, 95% CI = 0.449-0.834) and 32% lower for falls with injury after admission (OR = 0.68, 95% CI = 0.490-0.939). This study found that a larger number of patients per nurse and poor work environment increase the incidence of patient adverse events, such as administration of the wrong medication or dose to a patient, pressure ulcers, and injury from falling after admission. The findings suggest that South Korean hospitals could prevent patient adverse events by improving nurse staffing and work environment. Healthcare strategies and efforts to modify adequate nurse staffing levels and better work environments for nurses are needed to improve patient outcomes. © 2015 Sigma Theta Tau International.
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Differences in nursing practice environment among US acute care unit types: a descriptive study.
Choi, JiSun; Boyle, Diane K
2014-11-01
The hospital nursing practice environment has been found to be crucial for better nurse and patient outcomes. Yet little is known about the professional nursing practice environment at the unit level where nurses provide 24-hour bedside care to patients. To examine differences in nursing practice environments among 11 unit types (critical care, step-down, medical, surgical, combined medical-surgical, obstetric, neonatal, pediatric, psychiatric, perioperative, and emergency) and by Magnet status overall, as well as four specific aspects of the practice environment. Cross-sectional study. 5322 nursing units in 519 US acute care hospitals. The nursing practice environment was measured by the Practice Environment Scale of the Nursing Work Index. The Practice Environment Scale of the Nursing Work Index mean composite and four subscale scores were computed at the unit level. Two statistical approaches (one-way analysis of covariance and multivariate analysis of covariance analysis) were employed with a Tukey-Kramer post hoc test. In general, the nursing practice environment was favorable in all unit types. There were significant differences in the nursing practice environment among the 11 unit types and by Magnet status. Pediatric units had the most favorable practice environment and medical-surgical units had the least favorable. A consistent finding across all unit types except neonatal units was that the staffing and resource adequacy subscale scored the lowest compared with all other Practice Environment Scale of the Nursing Work Index subscales (nursing foundations for quality of care, nurse manager ability, leadership, and support, and nurse-physician relations). Unit nursing practice environments were more favorable in Magnet than non-Magnet hospitals. Findings indicate that there are significant variations in unit nursing practice environments among 11 unit types and by hospital Magnet status. Both hospital-level and unit-specific strategies should be considered to achieve an excellent nursing practice environment in all hospital units. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Nurse Burnout and Patient Satisfaction
Vahey, Doris C.; Aiken, Linda H.; Sloane, Douglas M.; Clarke, Sean P.; Vargas, Delfino
2010-01-01
Background Amid a national nurse shortage, there is growing concern that high levels of nurse burnout could adversely affect patient outcomes. Objectives This study examines the effect of the nurse work environment on nurse burnout, and the effects of the nurse work environment and nurse burnout on patients' satisfaction with their nursing care. Research Design/Subjects We conducted cross-sectional surveys of nurses (N = 820) and patients (N = 621) from 40 units in 20 urban hospitals across the United States. Measures Nurse surveys included measures of nurses' practice environments derived from the revised Nursing Work Index (NWI-R) and nurse outcomes measured by the Maslach Burnout Inventory (MBI) and intentions to leave. Patients were interviewed about their satisfaction with nursing care using the La Monica-Oberst Patient Satisfaction Scale (LOPSS). Results Patients cared for on units that nurses characterized as having adequate staff, good administrative support for nursing care, and good relations between doctors and nurses were more than twice likely as other patients to report high satisfaction with their care, and their nurses reported significantly lower burnout. The overall level of nurse burnout on hospital units also affected patient satisfaction. Conclusions Improvements in nurses' work environments in hospitals have the potential to simultaneously reduce nurses' high levels of job burnout and risk of turnover and increase patients' satisfaction with their care. PMID:14734943
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Gea-Caballero, Vicente; Castro-Sánchez, Enrique; Júarez-Vela, Raúl; Díaz-Herrera, Miguel Ángel; de Miguel-Montoya, Isabel; Martínez-Riera, José Ramón
Nursing work environments are key determinants of care quality. Our study aimed to evaluate the characteristics of nursing environments in primary care settings in the Canary Islands, and identify crucial components of such environments to improve quality. We conducted a cross-sectional study in primary care organisations using the Practice Environment Scale - Nursing Work Index tool. We collected sociodemographic variables, scores, and selected the essential items conducive to optimal care. Appropriate parametric and non-parametric statistical tests were used to analyse relations between variables (CI = 95%, error = 5%). One hundred and forty-four nurses participated. The mean total score was 81.6. The results for the five dimensions included in the Practice Environment Scale - Nursing Work Index ranged from 2.25 - 2.92 (Mean). Twelve key items for quality of care were selected; six were positive in the Canary Islands, two were mixed, and four negative. 7/12 items were included in Dimension 2 (fundamentals of nursing). Being a manager was statistically associated with higher scores (p<.000). Years of experience was inversely associated with scores in the 12 items (p<.021). Nursing work environments in primary care settings in the Canary Islands are comparable to others previously studied in Spain. Areas to improve were human resources and participation of nurses in management decisions. Nurse managers must be knowledgeable about their working environments so they can focus on improvements in key dimensions. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
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Verbal abuse from nurse colleagues and work environment of early career registered nurses.
Budin, Wendy C; Brewer, Carol S; Chao, Ying-Yu; Kovner, Christine
2013-09-01
This study examined relationships between verbal abuse from nurse colleagues and demographic characteristics, work attributes, and work attitudes of early career registered nurses (RNs). Data are from the fourth wave of a national panel survey of early career RNs begun in 2006. The final analytic sample included 1,407 RNs. Descriptive statistics were used to describe the sample, analysis of variance to compare means, and chi square to compare categorical variables. RNs reporting higher levels of verbal abuse from nurse colleagues were more likely to be unmarried, work in a hospital setting, or work in a non-magnet hospital. They also had lower job satisfaction, and less organizational commitment, autonomy, and intent to stay. Lastly, they perceived their work environments unfavorably. Data support the hypothesis that early career RNs are vulnerable to the effects of verbal abuse from nurse colleagues. Although more verbal abuse is seen in environments with unfavorable working conditions, and RNs working in such environments tend to have less favorable work attitudes, one cannot assume causality. It is unclear if poor working conditions create an environment where verbal abuse is tolerated or if verbal abuse creates an unfavorable work environment. There is a need to develop and test evidence-based interventions to deal with the problems inherent with verbal abuse from nurse colleagues. © 2013 Sigma Theta Tau International.
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Olds, Danielle M; Aiken, Linda H; Cimiotti, Jeannie P; Lake, Eileen T
2017-09-01
There are two largely distinct research literatures on the association of the nurse work environment and the safety climate on patient outcomes. To determine whether hospital safety climate and work environment make comparable or distinct contributions to patient mortality. Cross-sectional secondary analysis of linked datasets of Registered Nurse survey responses, adult acute care discharge records, and hospital characteristics. Acute care hospitals in California, Florida, New Jersey, and Pennsylvania. The sample included 600 hospitals linked to 27,009 nurse survey respondents and 852,974 surgical patients. Nurse survey data included assessments of the nurse work environment and hospital safety climate. The outcome of interest was in-hospital mortality. Data analyses included descriptive statistics and multivariate random intercept logistic regression. In a fully adjusted model, a one standard deviation increase in work environment score was associated with an 8.1% decrease in the odds of mortality (OR 0.919, p<0.001). A one-standard deviation increase in safety climate score was similarly associated with a 7.7% decrease in the odds of mortality (OR 0.923, p<0.001). However, when work environment and safety climate were modeled together, the effect of the work environment remained significant, while safety climate became a non-significant predictor of mortality odds (OR 0.940, p=0.035 vs. OR 0.971, p=0.316). We found that safety climate perception is not predictive of patient mortality beyond the effect of the nurse work environment. To advance hospital safety and quality and improve patient outcomes, organizational interventions should be directed toward improving nurse work environments. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Crilly, Julia; Greenslade, Jaimi; Lincoln, Cathy; Timms, Jo; Fisher, Andrew
2017-03-01
The emergency department (ED) is characterised by high workload and competing demands. This study describes ED nurses perceptions of their working environment with a sub group analysis for those who also worked at the local police watch house, where individuals are detained in custody. A cross-sectional pilot study was undertaken involving a survey of nurses working in one ED in Queensland, Australia. The Working Environment Score (WES-10) consists of four subscales: Self Realisation, Workload, Conflict, and Nervousness; and is used to measure stress and staff morale. This was administered at two time periods: T1: May 2013 and T2: July 2013; before and after 10 ED nurses worked in the watch house. Questionnaires were returned by 34 nurses at T1 and 41 nurses at T2. The perception of working environment differed between T1 and T2 for nurse respondents who worked at the local police watch house but not for nurse respondents who did not work in the watch house. Of the four sub-scales, workload was the factor that impacted most on working environment in both groups and was notably higher for those who worked in the watch house and responded at T2. This pilot study identified that for ED nurses' satisfaction with their working environment was relatively high, although certain areas (e.g., nervousness) were better than others (e.g., workload). The perception of workload was higher for T2 staff offered the opportunity to use their ED skills in a different setting, however further work with a larger sample size is required. Copyright © 2016. Published by Elsevier Ltd.
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Hinno, Saima; Partanen, Pirjo; Vehviläinen-Julkunen, Katri
2012-03-01
The working environment of nurses is receiving international interest, because there is a growing consensus that identifying opportunities for improving working conditions in hospitals is essential to maintain adequate staffing, high-quality care, nurses' job satisfaction and hence their retention. Thus, the aim of this study was to investigate the relationship between nurse work environment characteristics and nurse-reported job outcomes in hospital settings in Finland and the Netherlands and to compare these results. A comparative cross-sectional nurse survey was conducted. Data were collected from the two countries randomly sampling the countries' National Nurses Association' membership databases. In this paper, the results from Registered Nurses working in hospital settings are used. In total, 869 hospital nurses participated: 535 from Finland and 334 from the Netherlands with the response rate of 44.9 and 33.4%, respectively. Fifty-five items from the Nursing Work Index-Revised were used as a main tool for the practice environment. Exploratory factor analysis was used to identify a set of internally consistent subscales. Further, logistic regression analysis and T-tests were used. Three practice environment characteristics were identified: adequacy of resources, supportiveness of management and assurance of care quality via collaborative relationships. Favourable evaluations of the adequacy of resources and supportiveness of management were positively correlated with nurse-assessed quality of care and job-related positive feelings and negatively correlated with intentions to leave a unit, organization or the entire profession. In neither of the participating countries were adverse incidents affecting nurses related to nurses' evaluations of their current professional practice environment. Compared with Finland, in the Netherlands, RN appears to evaluate the majority of work environment characteristics more positively; nevertheless, to some extent, the results were uniform as adequacy of resources and supportiveness of management were main predictors for nurse-reported job outcomes considered. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.
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Nurse burnout and the working environment.
O'Mahony, Nuria
2011-09-01
This article examines levels of burnout experienced by emergency nurses and the characteristics of their work environment to determine if there is a relationship between the two. A literature review of recent articles on emergency nurses' burnout and contributing factors was undertaken. A quantitative study, in which nurses were asked to indicate the extent of their agreement with a series of statements on burnout and the working environment, was then undertaken, and the results were analysed to ascertain the extent to which the two topic are related. The results indicate that 52 per cent of nurses in an emergency department in Ireland experience high levels of emotional exhaustion and depersonalisation, which are significantly related to the nature of their work environment. Improvements to the environment and to education are required to reduce the risk of nurses developing burnout in the future.
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Leading change to create a healthy and satisfying work environment.
Sanders, Carolyn L; Krugman, Mary; Schloffman, Danielle H
2013-01-01
Nurse executives must take a leadership role in creating a healthy work environment for nurses and all disciplines. Engaging in partnerships and empowering clinical nurses to construct the solutions to barriers that may stand in the way of the goal of a satisfied and healthy workforce are important strategies toward success. This publication outlines many projects a 3-time Magnet-designated academic hospital has implemented, working with our shared leadership councils, to meet the standards for a healthy work environment. These initiatives, from the unit to the hospital level, included standardizing a culture change of uninterrupted meal breaks, the creation of intensive care unit Zen rooms, strategies to better manage increased patient volumes, best practices for facility design, enhancing physician-nurse relations, and a hospital wellness program. Data were benchmarked against national nurse and employee surveys to compare progress and report outcomes. Two important nursing organization structures that have contributed to the success of a healthy and satisfied nursing work environment include UEXCEL, a longstanding clinical nurse professional practice program, and the hospital's 11-year participation in the University HealthSystem Consortium/American Association of Colleges of Nursing National Post-Baccalaureate Nurse Residency Program. A highly engaged, well-educated, and committed nursing workforce, nurtured by a strong leadership team, has created a positive work environment characterized by low turnover and high retention.
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Work environments for healthy and motivated public health nurses.
Saito, Naoko; Yamamoto, Takeshi; Kitaike, Tadashi
2016-01-01
Objectives By defining health as mental health and productivity and performance as work motivation, the study aimed to identify work environments that promote the health and motivation of public health nurses, using the concept of a healthy work organizations, which encompasses the coexistence of excellent health for each worker and the productivity and performance of the organization.Methods Self-administered questionnaires were sent to 363 public health nurses in 41 municipal public health departments in Chiba prefecture. The questions were comprised of the 12-item General Health Questionnaire (GHQ-12) for mental health and the Morale Measurement Scale (5 items) for work motivation. Demographic data, workplace attributes, workload, and workplace environment were set as independent variables. The Comfortable Workplace Survey (35 items in 7 areas) was used to assess workers' general work environments. The "Work Environment for Public Health Nurses" scale (25 items) was developed to assess the specific situations of public health nurses. While aggregation was carried out area by area for the general work environment, factor analysis and factor-by-factor aggregation were used for public health nurse-specific work environments. Mental health and work motivation results were divided in two based on the total scores, which were then evaluated by t-tests and χ(2) tests. Items that showed a significant correlation were analyzed using logistic regression.Results The valid responses of 215 participants were analyzed (response rate: 59.2%). For the general work environment, high scores (the higher the score, the better the situation) were obtained for "contributions to society" and "human relationships" and low scores were obtained for "career building and human resource development." For public health nurse-specific work environments, high scores were obtained for "peer support," while low scores were obtained for "easy access to advice and training" and "organizational public health initiative." Mental health was found to be related to "contributions to society" (OR=2.86), "workload" (OR=3.00), and "organizational public health initiative" (OR=2.08). Work motivation was found to be related to "contributions to society" (OR=6.73) and "recognition of public health nurse's judgment and opinion" (OR=1.59).Conclusion Both mental health and work motivation were related to working environments where public health nurses can feel that their work is meaningful to society. It is therefore necessary to improve work environments so that objectives are clearly defined to raise aspirations and nurses' activities and achievements are recognized and shared.
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Nursing work environment, patient safety and quality of care in pediatric hospital.
Alves, Daniela Fernanda Dos Santos; Guirardello, Edinêis de Brito
2016-06-01
Objectives To describe the characteristics of the nursing work environment, safety attitudes, quality of care, measured by the nursing staff of the pediatric units, as well as to analyze the evolution of quality of care and hospital indicators. Methods Descriptive study with 136 nursing professionals at a paediatric hospital, conducted through personal and professional characterization form, Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and quality indicators. Results The professionals perceive the environment as favourable to professional practice, and consider good quality care that is also observed by reducing the incidence of adverse events and decreased length of stay. The domain job satisfaction was considered favourable to patient safety. Conclusions The work environment is favourable to nursing practice, the professionals nursing approve the quality of care and the indicators tended reducing adverse events and length of stay.
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Transplant Nurses' Work Environment: A Cross-Sectional Multi-Center Study.
Kugler, Christiane; Akca, Selda; Einhorn, Ina; Rebafka, Anne; Russell, Cynthia L
2016-09-01
BACKGROUND Numerically, nurses represent the largest healthcare profession, thus setting norms for the quality and safety of direct patient care. Evidence of a global shortage of nurses in all clinical practice settings across different healthcare systems and countries has been documented. The aims of the present study were: (1) to assess work environments in a sample of German transplant nurses, and (2) to compare their statements with a US-based sample. MATERIAL AND METHODS In a cross-sectional study, 181 transplant nurses from 16 German transplant centers provided information on their work environments. The translated version of the Job Design (JD) and Job Satisfaction (JS) survey showed satisfactory internal consistency for the JD (0.78) and JS (0.93) subscales. German nurses' work environments were compared with 331 transplant nurses from the US. RESULTS The majority of transplant nurses were female (81.8%), 55.4% were age 21-40 years, and 78.1% were employed full-time. German (versus US) transplant nurses reported their job design to be best for 'skill varieties' (p≤0.0002), and worst for 'autonomy' (p≤0.01). Job satisfaction was best with 'opportunities for autonomy and growth' (p≤0.0001), and 'pay and benefits' (p≤0.0001) was lowest. A higher professional degree (OR 1.57; p≤0.03; 95% CI 1.19-2.86), and longer time in transplant (OR 1.24; p≤0.001; 95% CI 1.11-1.38) showed a positive impact on German transplant nurses' perceptions of 'job satisfaction'. Nurses with time-dependent working contracts perceived more stress negatively affecting job satisfaction (OR 1.13; p≤0.009; 95% CI 1.02-12.82). CONCLUSIONS German specialty nurses working in the field of solid organ transplantation rate their work environments with respect to job design and job satisfaction as satisfactory. Institutions' investment into satisfactory nurse work environments and specializing nurses might increase the quality of care, thus improving patient outcomes.
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Numminen, Olivia; Ruoppa, Eija; Leino-Kilpi, Helena; Isoaho, Hannu; Hupli, Maija; Meretoja, Riitta
2016-01-01
To explore newly graduated nurses' (NGN) perception of their practice environment and its association with their self-assessed competence, turnover intentions and job satisfaction as work-related factors. The impact of practice environment on nurses' work is important. Positive practice environments are associated with positive organisational, nurse and patient outcomes. How this applies to NGNs needs further exploration. A cross-sectional descriptive correlation design was used. Data were collected with PES-NWI and NCS instruments from 318 Finnish registered nurses, and analysed statistically. Newly graduated nurses' perception of their practice environment was mainly positive. Most positive perceptions related to collegial nurse-physician relations, and the least positive to staffing and resource adequacy. Positive perceptions were also associated with higher professional competence, higher perceptions of quality of care and lower intentions to leave the job or profession. The findings revealed strong and significant associations between practice environment and work-related factors. Practice environment is an important element in supporting NGNs' competence, retention and job satisfaction. Nursing management should pay attention to NGNs' perceptions of their practice environment. Management's ability to create and maintain positive practice environments can foster NGNs' professional development and job satisfaction, and consequently retain them in the workforce. © 2015 John Wiley & Sons Ltd.
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Cummings, Greta G; MacGregor, Tara; Davey, Mandy; Lee, How; Wong, Carol A; Lo, Eliza; Muise, Melanie; Stafford, Erin
2010-03-01
Numerous policy and research reports call for leadership to build quality work environments, implement new models of care, and bring health and wellbeing to an exhausted and stretched nursing workforce. Rarely do they indicate how leadership should be enacted, or examine whether some forms of leadership may lead to negative outcomes. We aimed to examine the relationships between various styles of leadership and outcomes for the nursing workforce and their work environments. The search strategy of this multidisciplinary systematic review included 10 electronic databases. Published, quantitative studies that examined leadership behaviours and outcomes for nurses and organizations were included. Quality assessments, data extractions and analysis were completed on all included studies. 34,664 titles and abstracts were screened resulting in 53 included studies. Using content analysis, 64 outcomes were grouped into five categories: staffsatisfaction with work, role and pay, staff relationships with work, staff health and wellbeing, work environment factors, and productivity and effectiveness. Distinctive patterns between relational and task focused leadership styles and their outcomes for nurses and their work environments emerged from our analysis. For example, 24 studies reported that leadership styles focused on people and relationships (transformational, resonant, supportive, and consideration) were associated with higher nurse job satisfaction, whereas 10 studies found that leadership styles focused on tasks (dissonant, instrumental and management by exception) were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes. Our results document evidence of various forms of leadership and their differential effects on the nursing workforce and work environments. Leadership focused on task completion alone is not sufficient to achieve optimum outcomes for the nursing workforce. Efforts by organizations and individuals to encourage and develop transformational and relational leadership are needed to enhance nurse satisfaction, recruitment, retention, and healthy work environments, particularly in this current and worsening nursing shortage. Copyright 2009 Elsevier Ltd. All rights reserved.
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Nursing Practice Environment and Outcomes for Oncology Nursing
Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.
2012-01-01
Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101
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Validation of the professional practice environment scale in nurse educators in hospitals.
Sayers, Jan Maree; Salamonson, Yenna; DiGiacomo, Michelle; Davidson, Patricia Mary
2016-03-01
To report an assessment of the psychometric properties of the Professional Practice Environment (PPE) scale in a sample of Australian nurse educators in acute care hospitals. Although nurse educators are important in an enabling work environment, there has been no reported exploration of their satisfaction with work in acute care hospitals. The factor structure and internal consistency of the PPE scale were consistent with Erickson's eight-factor model of the items, indicating the appropriateness of the scale as an assessment tool to measure the PPE of nurse educators. The PPE scale is useful for monitoring the work environment of nurse educators in clinical practice and the environmental effects influencing their recruitment, retention and job satisfaction. This work may inform the development of integrated professional practice environments where the professional practice and workplace satisfaction of nurse educators are optimised, influencing safe, quality patient care.
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Leadership and the psychosocial work environment in old age care.
Lundgren, Dan; Ernsth-Bravell, Marie; Kåreholt, Ingemar
2016-03-01
To study leadership factors and their associations with psychosocial work environmental among nursing assistants who are engaged in old age care and to analyse (i) differences in the assessment of leadership factors and the assessment of psychosocial work environmental in nursing homes and home help services and (ii) the association between the psychosocial work environment and factors that are related to leadership in nursing homes and home help services. Leadership factors are an important element of the psychosocial work environment in old age care. The physical distance between leaders and nursing assistants is larger in home help services than in nursing homes. Therefore, it is important to study leadership separately in nursing homes and home help services. Assessments from 844 nursing assistants in nursing homes and 288 in home help services (45 nursing homes and 21 home help service units) were analysed. The data were analysed using linear regression. Age, gender, number of staff at the unit, number of years at the current working unit and educational level were controlled in Model 1. Summarised indexes that were based on all independent variables except the main independent variable were additionally controlled in Model 2. Psychosocial work environment was related to leadership factors, but stronger associations occurred more frequently in nursing homes than in home help services. Empowering leadership, support from superiors, the primacy of human resources and control over decisions were associated with higher assessments on all the variables that were related to the psychosocial work environment in both the nursing homes and home help services. Organisational differences in conducting leadership in old age care must be considered. Some leadership characteristics are better prerequisites for creating and maintaining a positive psychosocial work environment for nursing assistants in nursing homes and home help services. Due to the differences in organisational settings, it is important to consider the differences in prerequisites in conducting leadership. To influence nursing assistants' performance and to increase quality in old age care in the long term, appropriate leadership is necessary. © 2015 The Authors. International Journal of Older People Nursing Published by John Wiley & Sons Ltd.
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Gunnarsdóttir, Sigrún; Clarke, Sean P; Rafferty, Anne Marie; Nutbeam, Don
2009-07-01
To investigate aspects of nurses' work environments linked with job outcomes and assessments of quality of care in an Icelandic hospital. Prior research suggests that poor working environments in hospitals significantly hinder retention of nurses and high quality patient care. On the other hand, hospitals with high retention rates (such as Magnet hospitals) show supportive management, professional autonomy, good inter-professional relations and nurse job satisfaction, reduced nurse burnout and improved quality of patient care. Cross-sectional survey of 695 nurses at Landspitali University Hospital, Reykjavík. Nurses' work environments were measured using the nursing work index-revised (NWI-R) and examined as predictors of job satisfaction, the Maslach burnout inventory (MBI) and nurse-assessed quality of patient care using linear and logistic regression approaches. An Icelandic adaptation of the NWI-R showed a five-factor structure similar to that of Lake (2002). After controlling for nurses' personal characteristics, job satisfaction, emotional exhaustion and nurse rated quality of care were found to be independently associated with perceptions of support from unit-level managers, staffing adequacy, and nurse-doctor relations. The NWI-R measures elements of hospital nurses' work environments that predict job outcomes and nurses' ratings of the quality of patient care in Iceland. Efforts to improve and maintain nurses' relations with nurse managers and doctors, as well as their perceptions of staffing adequacy, will likely improve nurse job satisfaction and employee retention, and may improve the quality of patient care.
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Work experience, work environment, and blood exposure among home care and hospice nurses.
Leiss, Jack K
2012-01-01
Blood exposure rates among home care and hospice nurses (RNs) in the United States are markedly lower for nurses with more home care/hospice experience, whether or not they have more total years of nursing experience (i.e., in other work environments). This study examined whether the protective effect of home care/hospice experience was greater for nurses who worked under three types of circumstances that are typical of the home care/hospice work environment and conducive to blood exposure. A mail survey was conducted in 2006 among home care/hospice nurses in North Carolina, a largely rural state in the southeastern U.S. The adjusted response rate was 69% (n=833). Blood exposure rates were higher among nurses with ≤5 years' experience in home care/hospice. Contrary to expectations, the protective effect of more experience was greater among nurses who did not have limited access to safety devices/personal protective equipment, did not have to rush during home visits, and did not often visit homes with unrestrained pets, unruly children, poor lighting, or extreme clutter. These results suggest that characteristics of the home care/hospice work environment limit nurses' ability to use their experience to prevent blood exposure.
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Arnetz, J E; Hasson, H
2007-07-01
Lack of professional development opportunities among nursing staff is a major concern in elderly care and has been associated with work dissatisfaction and staff turnover. There is a lack of prospective, controlled studies evaluating the effects of educational interventions on nursing competence and work satisfaction. The aim of this study was to evaluate the possible effects of an educational "toolbox" intervention on nursing staff ratings of their competence, psychosocial work environment and overall work satisfaction. The study was a prospective, non-randomized, controlled intervention. Nursing staff in two municipal elderly care organizations in western Sweden. In an initial questionnaire survey, nursing staff in the intervention municipality described several areas in which they felt a need for competence development. Measurement instruments and educational materials for improving staff knowledge and work practices were then collated by researchers and managers in a "toolbox." Nursing staff ratings of their competence and work were measured pre and post-intervention by questionnaire. Staff ratings in the intervention municipality were compared to staff ratings in the reference municipality, where no toolbox was introduced. Nursing staff ratings of their competence and psychosocial work environment, including overall work satisfaction, improved significantly over time in the intervention municipality, compared to the reference group. Both competence and work environment ratings were largely unchanged among reference municipality staff. Multivariate analysis revealed a significant interaction effect between municipalities over time for nursing staff ratings of participation, leadership, performance feedback and skills' development. Staff ratings for these four scales improved significantly in the intervention municipality as compared to the reference municipality. Compared to a reference municipality, nursing staff ratings of their competence and the psychosocial work environment improved in the municipality where the toolbox was introduced.
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The validation and application of the Chinese version of perceived nursing work environment scale.
Zhao, Peng; Chen, Fen Ju; Jia, Xiao Hui; Lv, Hui; Cheng, Piao Piao; Zhang, Li Ping
2013-07-01
To improve the development of the Chinese version of Perceived Nursing Work Environment (C-PNWE) scale by examination and application and to explore the nurses' perception of their working environment in a hospital. The C-PNWE scale was translated and revised from the PNWE scale. The least of perfection is that the development of C-PNWE ignored that the psychometric properties of the PNWE instrument were established of critical care nurses and further application and testing of the PNWE in various patient care settings were recommended. This is a cross-sectional design. Nurses from different departments of a hospital were sampled by convenience sampling and investigated by self-administrated questionnaire. Data obtained through questionnaires were analysed by descriptive statistical analyses and profile analyses using the Statistical Package for the Social Sciences (SPSS) Chinese version 17.0 software. The coincident and level profile analyses indicated that these groups can merge into one group, and the profile of measurement result of this merged group would not exhibit flatness. Among six dimensions of C-PNWE scale, the Staffing and Resource Adequacy got the lowest average score. Among 41 items, 'Opportunity for staff nurse to participate in policy decisions' got the lowest mean. The C-PNWE scale shows good psychometric properties and can be used to explore nurses' perspectives of the nursing practice environment in China. And the situation of nurses' perceived working environment in China needs further study. Shaping nursing practice environments to promote desired outcomes requires valid and reliable measures to assess practice environments prior to, during and following efforts to implement change. The C-PNWE scale can be a useful measurement tool for administrators to improve the nursing work environment in China. © 2013 John Wiley & Sons Ltd.
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Djukic, Maja; Kovner, Christine; Budin, Wendy C; Norman, Robert
2010-01-01
The impact of personal, organizational, and economic factors on nurses' job satisfaction have been studied extensively, but few studies exist in which the effects of physical work environment--including perceptions of architectural, interior design, and ambient features on job satisfaction-are examined. The purpose of this study was to examine the effect of perceived physical work environment on job satisfaction, adjusting for multiple personal, organizational, and economic determinants of job satisfaction. A cross-sectional, predictive design and a Web-based survey instrument were used to collect data from staff registered nurses in a large metropolitan hospital. The survey included 34 questions about multiple job satisfaction determinants, including 18 Likert-type measures with established good validity (comparative fit index = .97, Tucker-Lewis index = .98, root mean square error of approximation = .06) and reliability (r ≥ .70). A response rate of 48.5% resulted in a sample of 362, with 80% power to detect a medium effect of perceived physical environment on job satisfaction. On average, nurses had negative perceptions of physical work environment (M = 2.9, SD = 2.2). Although physical environment was related positively to job satisfaction (r =.256, p = .01) in bivariate analysis, in ordered probit regression, no effect of physical work environment on job satisfaction was found. In future studies, this relationship should be examined in larger and more representative samples of nurses. Qualitative methods should be used to explore how negatively perceived physical work environment impacts nurses. Rebuilding of U.S. hospitals, with a planned investment of $200 billion without considering how physical environment contributes to nurse work outcomes, threatens to exacerbate organizational nurse turnover.
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Goh, Yong-Shian; Lopez, Violeta
2016-05-01
The aim is to examine the acculturation level of international nurses working in a multi-cultural society. The relationship between acculturation, working environment and quality of life of international nurses was also explored. A cross-sectional, correlational study using self-report questionnaire was conducted on 814 international nurses using stratified random sampling based on the nationality distribution of international nurses registered with the Singapore Nursing Board. Outcome measures included World Health Organisation Quality of Life-BREF (WHOQOL_BREF) and Practice Environment Scale of the Nursing Work Index-Revised (PES-NWI-R). Data were collected from June to December 2012. There were variations in the acculturation level among different nationality groups of international nurses. Acculturation levels were the lowest among Mainland Chinese international nurses (M=27.47, SD 5.23). A positive correlation was found between acculturation and quality of life whereas a lower perception of work environment was associated with lower acculturation level. Data obtained from this study can be utilized to develop interventions targeted at the unique needs of the international nurses as they migrate. Copyright © 2015 Elsevier Inc. All rights reserved.
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Urban, Ann-Marie; Wagner, Joan I
2013-12-01
Hospitals are situated within historical and socio-political contexts; these influence the provision of patient care and the work of registered nurses (RNs). Since the early 1990s, restructuring and the increasing pressure to save money and improve efficiency have plagued acute care hospitals. These changes have affected both the work environment and the work of nurses. After recognizing this impact, healthcare leaders have dedicated many efforts to improving the work environment in hospitals. Admirable in their intent, these initiatives have made little change for RNs and their work environment, and thus, an opportunity exists for other efforts. Research indicates that spirit at work (SAW) not only improves the work environment but also strengthens the nurse's power to improve patient outcomes and contribute to a high-quality workplace. In this paper, we present findings from our research that suggest SAW be considered an important component in improving the work environment in acute care hospitals.
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Workplace empowerment and nurses' job satisfaction: a systematic literature review.
Cicolini, Giancarlo; Comparcini, Dania; Simonetti, Valentina
2014-10-01
This systematic review aimed to synthesize and analyse the studies that examined the relationship between nurse empowerment and job satisfaction in the nursing work environment. Job dissatisfaction in the nursing work environment is the primary cause of nursing turnover. Job satisfaction has been linked to a high level of empowerment in nurses. We reviewed 596 articles, written in English, that examined the relationship between structural empowerment, psychological empowerment and nurses' job satisfaction. Twelve articles were included in the final analysis. A significant positive relation was found between empowerment and nurses' job satisfaction. Structural empowerment and psychological empowerment affect job satisfaction differently. A satisfying work environment for nurses is related to structural and psychological empowerment in the workplace. Structural empowerment is an antecedent of psychological empowerment and this relationship culminates in positive retention outcomes such as job satisfaction. This review could be useful for guiding leaders' strategies to develop and maintain an empowering work environment that enhances job satisfaction. This could lead to nurse retention and positive organisational and patient outcomes. © 2013 John Wiley & Sons Ltd.
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Kol, Emine; İlaslan, Emine; Turkay, Mehtap
2017-08-01
The objective of this study was to identify the satisfaction levels of nurses with positive environment initiatives and positive management strategies. In total, 235 and 259 nurses participated in the study before and after the application of the initiatives and strategies, respectively. Strategies adopted from the magnet model to create positive work environments and management styles were executed according to the forces of magnetism. Data related to satisfaction were collected twice, once before and once after the strategies to create positive working environments were implemented. The rates of working environment satisfaction in the nurses' department were 57.07% in 2011 and 69.01% in 2013. The rate of satisfaction with governance differed significantly between 2011 and 2013, especially in terms of the merit system, equity and equality, information flow between the administration and the employees, and the influence of the nursing managers on institutional decision making. This study showed that 24 months after the implementation of these strategies, nurse satisfaction with their work environment and management style increased significantly. © 2017 John Wiley & Sons Australia, Ltd.
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A Qualitative Study of the Work Environments of Mexican Nurses
Squires, Allison; Juarez, Adrian
2012-01-01
Background Studies of the nursing work environment are increasingly common in developed countries, but few exist in developing countries. Because of resource differences between the two contexts, researchers need to clarify what aspects of the work environments are similar and different. Objectives To study the perspectives of Mexican nurses about their work environments to determine similarities and differences to results from developed world studies. Design A secondary, directed content analysis of qualitative data from 46 Spanish language interviews using workplace-oriented themes Setting Purposively selected Mexican states from four regions of the country that reflect the country’s socioeconomic differences. Participants Practicing Mexican nurses with at least one year of clinical experience and currently working in nursing. Participants were recruited through convenience and snowball sampling techniques. Methods Initial data collection occurred in 2006 and 2008 during a broader study about professionalization processes that occurred in Mexican nursing between 1980 and 2005. The secondary, directed content analysis focused on an in-depth exploration of a central theme that emerged from the two original studies: The Workplace. The directed content analysis used themes from the global nursing work environment literature to structure the analysis: Professional relationships, organizational administrative practices, and quality of care and services. Results The three themes from the global literature were relevant for the Mexican context and a new one emerged related to hiring practices. By category, the same factors that created positive or negative perceptions of the work environment matched findings from other international studies conducted in developed countries. The descriptors of the category, however, had different conceptual meanings that illustrate the health system challenges in Mexico. Conclusions Findings from this study suggest that studies that seek to measure nursing work environments will most likely apply in Mexico and other Latin American or middle-income countries. Instruments designed to measure the work environment of nurses in these countries may prove relevant in those contexts, but require careful adaptation and systematic translations to ensure it. PMID:22386989
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Nurse work environment and job-related outcomes in Brazilian hospitals.
Dutra, Herica Silva; Cimiotti, Jeannie P; Guirardello, Edinêis de Brito
2018-06-01
It has been reported that a work environment that does not support nurses, and high levels of emotional exhaustion and job dissatisfaction are associated with nurses' intent to leave their job. The aim of this study was to determine if these work-related factors and job-related outcomes are common in Brazilian nurses. This cross-sectional study included a 2015 survey of nursing professionals who worked in 48 units of three Brazilian, acute care hospitals. Descriptive statistics were used to examine the sample and a series of logistic regression models were fit to examine two job-related outcomes of interest: job dissatisfaction and intent to leave during the next 12 months. A total of 450 completed surveys were available, where nurses reported high emotional exhaustion (26%), job dissatisfaction (28%), and an intent to leave (12%). Poor control over the work environment (OR = 2.19) and high emotional exhaustion (OR = 4.47) were associated with an increase in the odds of job dissatisfaction. Inadequate staffing (OR = 2.43), high emotional exhaustion (OR = 2.24) and job dissatisfaction (OR = 5.74) were associated with an increase in the odds that nurses would leave their job in the next 12 months. Features of the nurse work environment and high emotional exhaustion were associated with job dissatisfaction. Job dissatisfaction and inadequate staffing are likely to result in nurses leaving their job. It is imperative that hospital administrators provide a work environment that supports nursing and improves nurse outcomes and the quality of patient care. Copyright © 2018 Elsevier Inc. All rights reserved.
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Evaluation and comparison of health care Work Environment Scale in military settings.
Maloney, J P; Anderson, F D; Gladd, D L; Brown, D L; Hardy, M A
1996-05-01
The purpose of this study was to describe health care providers' perceptions of their work environment at a large U.S. Army medical center, and to compare the findings to other military medical centers. The sample (N = 112) consisted of the professional nursing staff working on the nine inpatient units. The Work Environmental Scale (WES) was used to measure perceptions of the workplace relative to gender, position (head nurses, staff nurses, and agency nurses), specialty nursing (intensive care unit [ICU] versus non-ICU), education (MSN, BSN, and ADN), and patterns of differences between the WES subscales of four military medical centers. Results of the study indicate that there were no significant gender differences. Head nurses, non-ICU nurses, and MSN nurses perceived their environment more positively. There were significant differences in the WES subscales between the military hospitals. Implications for nursing using the WES were recommended.
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Van Bogaert, P; Wouters, K; Willems, R; Mondelaers, M; Clarke, S
2013-10-01
Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n = 357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care. © 2012 John Wiley & Sons Ltd.
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Seeking Connectivity in Nurses' Work Environments: Advancing Nurse Empowerment Theory.
Udod, Sonia
2014-09-01
The purpose of this study was to investigate how staff nurses and their managers exercise power in a hospital setting in order to better understand what fosters or constrains staff nurses' empowerment and to extend nurse empowerment theory. Power is integral to empowerment, and attention to the challenges in nurses' work environment and nurse outcomes by administrators, researchers, and policy-makers has created an imperative to advance a theoretical understanding of power in the nurse-manager relationship. A sample of 26 staff nurses on 3 units of a tertiary hospital in western Canada were observed and interviewed about how the manager affected their ability to do their work. Grounded theory methodology was used. The process of seeking connectivity was the basic social process, indicating that the manager plays a critical role in the work environment and nurses need the manager to share power with them in the provision of safe, quality patient care. Copyright© by Ingram School of Nursing, McGill University.
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Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida; Greene, William H
2014-08-01
We explored direct and indirect influences of physical work environment on job satisfaction in a nationally representative sample of 1,141 early-career registered nurses. In the fully specified model, physical work environment had a non-significant direct effect on job satisfaction. The path analysis used to test multiple indirect effects showed that physical work environment had a positive indirect effect (p < .05) on job satisfaction through ten variables: negative affectivity, variety, workgroup cohesion, nurse-physician relations, quantitative workload, organizational constraints, distributive justice, promotional opportunity, local and non-local job opportunities. The findings make important contributions to the understanding of the relationship between physical work environment and job satisfaction. The results can inform health care leaders' insight about how physical work environment influences nurses' job satisfaction. © 2014 Wiley Periodicals, Inc.
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Prison Nursing: Formation of a Stable Professional Identity.
Choudhry, Khurshid; Armstrong, David; Dregan, Alexandru
The aim of this study was to analyze how working within prison environments can influence the self-identity and professional identity of nurses. The prison environment can be a difficult environment for nurses to deliver care within, with nurses having to carry out activities that seem to go against their professional role, while at the same time providing care to prisoners who have greater health needs than the general population. There is a lack of theoretical consideration of how prison nurses carry out their role in the face of such challenges. This study used a review of literature published over the last 11 years exploring nurses' beliefs, thoughts, and feelings toward delivering care within prison environment. With time, nurses working within prison environments develop specific skills to be able to deliver appropriate care to their patients. These skills include adapting to both the prison environment and the prison culture. Ultimately, adaptations lead to a change in identity allowing nurses to work effectively within prison. Providers of prison healthcare should ensure that induction (orientation) processes for new nurses are designed to address specific challenges that nurses face including the potential for cognitive dissonance. They should ensure that nurses receive training to develop and acquire the skills highlighted in this review. Ensuring that this training is in place may increase nurse retention.
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Linking Nurse Leadership and Work Characteristics to Nurse Burnout and Engagement.
Lewis, Heather Smith; Cunningham, Christopher J L
2016-01-01
Burnout and engagement are critical conditions affecting patient safety and the functioning of healthcare organizations; the areas of worklife model suggest that work environment characteristics may impact employee burnout and general worklife quality. The purpose was to present and test a conditional process model linking perceived transformational nurse leadership to nurse staff burnout and engagement via important work environment characteristics. Working nurses (N = 120) provided perceptions of the core study variables via Internet- or paper-based survey. The hypothesized model was tested using the PROCESS analysis tool, which enables simultaneous testing of multiple, parallel, indirect effects within the SPSS statistical package. Findings support the areas of worklife model and suggest that transformational leadership is strongly associated with work environment characteristics that are further linked to nurse burnout and engagement. Interestingly, different work characteristics appear to be critical channels through which transformational leadership impacts nurse burnout and engagement. There are several methodological and practical implications of this work for researchers and practitioners interested in preventing burnout and promoting occupational health within healthcare organizations. These implications are tied to the connections observed between transformational leadership, specific work environment characteristics, and burnout and engagement outcomes.
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Nurses' work environments, care rationing, job outcomes, and quality of care on neonatal units.
Rochefort, Christian M; Clarke, Sean P
2010-10-01
This paper is a report of a study of the relationship between work environment characteristics and neonatal intensive care unit nurses' perceptions of care rationing, job outcomes, and quality of care. International evidence suggests that attention to work environments might improve nurse recruitment and retention, and the quality of care. However, comparatively little attention has been given to neonatal care, a specialty where patient and nurse outcomes are potentially quite sensitive to problems with staffing and work environments. Over a 6-month period in 2007-2008, a questionnaire containing measures of work environment characteristics, nursing care rationing, job satisfaction, burnout and quality of care was distributed to 553 nurses in all neonatal intensive care units in the province of Quebec (Canada). A total of 339 nurses (61.3%) completed questionnaires. Overall, 18.6% were dissatisfied with their job, 35.7% showed high emotional exhaustion, and 19.2% rated the quality of care on their unit as fair or poor. Care activities most frequently rationed because of insufficient time were discharge planning, parental support and teaching, and comfort care. In multivariate analyses, higher work environment ratings were related to lower likelihood of reporting rationing and burnout, and better ratings of quality of care and job satisfaction. Additional research on the determinants of nurse outcomes, the quality of patient care, and the impact of rationing of nursing care on patient outcomes in neonatal intensive care units is required. The Neonatal Extent of Work Rationing Instrument appears to be a useful tool for monitoring the extent of rationing of nursing care in neonatal units. © 2010 Blackwell Publishing Ltd.
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Lin, Chiou-Fen; Lu, Meei-Shiow; Huang, Hsiu-Ying
2016-03-01
The nursing shortage in medical institutions in Taiwan averaged 9% in 2012, considerably higher than the 5% indicated in the literature. As a result, many hospitals have been forced to close wards or reduce beds. Despite the acute need, the percentage of registered nurses who are employed as nurses in Taiwan (60.4%) is considerably lower than those in Canada or the United States. This low rate may be because of the poor working environment for nurses in Taiwan. This study aimed to develop a set of nursing work environment quality indicators for Taiwan and to test the reliability and validity of the resulting survey tool. Multiple methods were used in this study. In Phase 1, we organized an expert panel, reviewed the literature, and conducted seven rounds of expert panel discussion and six focus group discussions with nursing directors. The goal was to draft indicators representing a quality nursing work environment to fit current conditions in Taiwan. In Phase 2, we conducted an expert review for content validity, held three public hearings, and conducted a survey. Four hundred twenty-seven questionnaires were sent out, with 381 returned. The goal was to test the content validity, construct validity, and internal consistency reliability. The study produced a set of indicators of a quality nursing work environment with eight dimensions and 65 items. The content validity index for importance and suitability dimensions were 1.0, whereas the internal consistency was 0.91. The eight dimensions were safe practice environment (16 items), quality and quantity of staff (four items), salary and welfare (seven items), professional specialization and teamwork (seven items), work simplification (five items), informatics (five items), career development (nine items), and support and caring (12 items). The overall load for the indicators was 77.57%. The developed indicators may be used to evaluate the quality of nursing work environments. Furthermore, the indicators may be used in hospital surveys to establish baseline conditions and for outcome research that measures improvement in nursing work environments after interventions.
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Moreno-Casbas, María Teresa; Alonso-Poncelas, Emma; Gómez-García, Teresa; Martínez-Madrid, María José; Escobar-Aguilar, Gema
2018-03-19
To describe nurses' perception in relation to the quality of care and their work environment, as well as to describe their quality of sleep. To analyze the relationship between ward and work shift with nurses' perception of their work environment, sleep quality and day time drowsiness. A multicentre, observational and descriptive study carried out between 2012-2014 in seven hospitals of the Spanish National Health System. Work environment, work satisfaction, sleep quality and quality of patient care were evaluated through validated tools. 635 registered nurses participated in the study. Eighty-three point seven percent perceived the quality of cares as good/excellent, and 55.1% rated the work environment of their hospital as good/excellent. PES-NWI classified 39% of hospitals as unfavourable and 20% as favourable. Fifteen point four percent of the nurses had a high level of burnout and 58.3% had low burnout. Sleep quality was 6.38 for nurses working on day shifts, 6.78 for the rotational shifts and 7.93 for night shifts. Significant differences were found between subjective sleep quality score, sleep duration, sleep disturbances and daytime dysfunction. In the provision of quality care services, there is a multitude of related factors such as shift, ward, satisfaction, and nurses' perceptions of patient safety and sleep quality. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.
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The role of work environment in keeping newly licensed RNs in nursing: a questionnaire survey.
Unruh, Lynn; Zhang, Ning Jackie
2013-12-01
In prior studies, newly licensed registered nurses (RNs) describe their job as being stressful. Little is known about how their perceptions of the hospital work environment affect their commitment to nursing. To assess the influence of hospital work environment on newly licensed RN's commitment to nursing and intent to leave nursing. Correlational survey. Newly licensed RNs working in hospitals in Florida, United States. 40% random sample of all RNs newly licensed in 2006. The survey was mailed out in 2008. Dependent variables were indicators of professional commitment and intent to leave nursing. Independent variables were individual, organizational, and work environment characteristics and perceptions (job difficulty, job demands and job control). Statistical analysis used ordinary least squares regressions. Level of significance was set at p<0.05. Job difficulty and job demand were significantly related to a lower commitment to nursing and a greater intent to leave nursing, and vice versa for job control. The strongest ranked of the job difficulties items were: incorrect instructions, organizational rules, lack of supervisor support, and inadequate help from others. Workload and other items were significant, but ranked lower. The strongest ranked of the job pressure items were: "having no time to get things done" and "having to do more than can be done well." The strongest ranked of job control items were "ability to act independent of others." Nurses with positive orientation experiences and those working the day shift and more hours were less likely to intend to leave nursing and more likely to be committed to nursing. Significant demographic characteristics related to professional commitment were race and health. Negative perceptions of the work environment were strong predictors of intent to leave nursing and a lower commitment to nursing among newly licensed RNs. These results indicate that retention of newly licensed RNs in nursing can be improved through changes in the work environment that remove obstacles to care-giving, increase resources and autonomy, and reduce workload and other job pressure factors. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Healthy work environments for the ageing nursing workforce.
Stichler, Jaynelle F
2013-10-01
The aim of this article is to describe the physical challenges that ageing nurses experience and the facility design features that can promote healthy work environments to motivate nurses to continue working. Older nurses are working longer and beyond the usual retirement age. They often experience chronic fatigue and the usual physical and cognitive changes associated with aging. Nursing is a physically demanding profession and many older nurses work in pain while providing direct patient care. The literature is replete with studies focusing on the organisational factors that retain older nurses, but little research addresses design factors that facilitate nurses working longer and more safely in direct patient care. Electronic databases in medicine, nursing, psychology, and architecture were searched and evidence-based, non-evidence-based, and review articles and government and organisational newsletters were evaluated. Hospital design can help address the physical work challenges that older nurses experience. Older nurses have a wealth of knowledge and expertise, and the design of nursing units can optimize their work experience. Nurse Managers must participate in design efforts and advocate designs that support aging nurses. © 2013 John Wiley & Sons Ltd.
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Kudchadkar, Sapna R; Beers, M Claire; Ascenzi, Judith A; Jastaniah, Ebaa; Punjabi, Naresh M
2016-09-01
The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P < .001). Monitors/alarms and staff conversations were the biggest factors that adversely influenced the environment for sleep promotion in both settings. Nurses were less annoyed by noise in single-patient rooms (33%) than in multipatient rooms (79%; P < .001) and reported improved exposure to sunlight. Use of single-patient rooms rather than multipatient rooms improved nurses' perceptions of the pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience. ©2016 American Association of Critical-Care Nurses.
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A narrative approach to understanding the nursing work environment in Canada.
McGillis Hall, Linda; Kiesners, Diana
2005-12-01
Narrative interviews were conducted with hospital nurses participating in a research study designed to provide support and assistance to hospitals as they addressed work life issues for nurses in an attempt to create quality work environments. The eight interviews were conducted in a sample of Canadian hospitals and generated themes relating to an imbalance between the effort that nurses put into their work and rewards attained from it. Seigrist's ((1996) Journal of Occupational Health Psychology, 1, 27-41, (2002) In: P.L. Perrewe & D.G. Ganster (Eds.), Historical perspectives on stress and health. Research in Occupational Stress and Well Being (vol. 2). Boston, MA: Jai Press) effort-reward imbalance model was used to frame this study. The nurses' narratives suggest that multiple factors constitute the nurses' work environment and their experiences and perceptions of it. Issues which surfaced repeatedly in the interviews related to changing needs of hospitalized patients in today's health care system and the associated workload, the widespread shortage of nurses, and the imbalance this creates for nursing work. A crucial finding is the extent to which the nurse is impacted by the adequacy of care they are able to provide. These narratives outline the tremendous burden of guilt and the overcommitment that nurses bear when factors in the work environment prevent them from providing complete, quality care. Nurses are experiencing frustration and stress that is impacting their worklife, family and home life, personal health, and possibly patient outcomes.
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Laschinger, Heather K Spence; Wong, Carol A; Cummings, Greta G; Grau, Ashley L
2014-01-01
Nursing leaders are indispensable in creating positive nursing work environments that retain an empowered and satisfied nursing workforce. Positive and supportive leadership styles can lower patient mortality and improve nurses' health, job satisfaction, organizational commitment, emotional exhaustion, and intent to stay in their position. The results of this study support the role of positive leadership approaches that empower nurses and discourage workplace incivility and burnout in nursing work environments. The findings also provide empirical support for the notion of resonant leadership, a relatively new theory of relationship-focused leadership approaches. This research adds to the growing body of knowledge documenting the key role of positive leadership practices in creating healthy work environments that promote retention of nurses in a time of a severe nursing shortage.
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Why work in perioperative nursing? Baby boomers and Generation Xers tell all.
Thompson, Julia A
2007-10-01
This quantitative and qualitative study explored factors that influence nurses of different age groups to choose to work in and remain in the specialty of OR nursing, including the effect of work environment perceptions. Baby boomer nurses (n = 130) and Generation X nurses (n = 117) were surveyed, and seven RNs from each group also participated in semistructured interviews. Results showed that nurses of both age groups were more alike than different in the factors that influence them to choose and remain in OR nursing and in their perceptions of their work environment. Baby Boomers indicated a higher level of commitment to their jobs than did Generation Xers.
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Hospital Magnet Status, Unit Work Environment, and Pressure Ulcers.
Ma, Chenjuan; Park, Shin Hye
2015-11-01
To identify how organizational nursing factors at different structural levels (i.e., unit-level work environment and hospital Magnet status) are associated with hospital-acquired pressure ulcers (HAPUs) in U.S. acute care hospitals. A cross-sectional observational study used data from the National Database of Nursing Quality Indicators®. Responses from 33,845 registered nurses (RNs) were used to measure unit work environments. The unit of analysis was the nursing unit, and there were 1,381 units in 373 hospitals in the United States. Unit work environment was measured by the Practice Environment Scale of Nurse Working Index (PES-NWI). Multilevel logistic regressions were used to estimate the effects of unit work environment and hospital Magnet status on HAPUs. All models were controlled for hospital and unit characteristics when considering clustering of units within hospitals. Magnet hospital units had 21% lower odds of having an HAPU than non-Magnet hospital units (95% confidence interval [CI], 0.64-0.98). With one unit increase of the PES-NWI score, units had 29% lower odds of having an HAPU (95% CI, 0.55-0.91). When including both hospital Magnet status and unit work environment in the model, hospital Magnet status no longer had a significant effect on HAPUs (odds ratio [OR] = 0.82; 95% CI, 0.66-1.02), whereas the significant effect of unit work environment persisted (OR = 0.73; 95% CI, 0.56-0.93). Both hospital and unit environments were significantly associated with HAPUs, and the unit-level work environment can be more influential in reducing HAPUs. Investment in the nurse work environments at both the hospital level and unit level has the potential to reduce HAPUs; and additional to hospital-level initiatives (e.g., Magnet recognition program), efforts targeting on-unit work environments deserve more attention. © 2015 Sigma Theta Tau International.
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Dos Santos Alves, Daniela Fernanda; da Silva, Dirceu; de Brito Guirardello, Edinêis
2017-01-01
To assess correlations between the characteristics of the nursing practice environment, job outcomes and safety climate. The nursing practice environment is critical to the well-being of professionals and to patient safety, as highlighted by national and international studies; however, there is a lack of evidence regarding this theme in paediatric units. A cross-sectional study, in two paediatric hospitals in Brazil, was conducted from December 2013 to February 2014. For data collection, we used the Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and the Maslach Burnout Inventory, and for analysis Spearman's correlation coefficient and structural equation modelling were used. Two hundred and sixty-seven professional nurses participated in the study. Autonomy, control over the work environment and the relationship between nursing and medical staff are factors associated with job outcomes and safety climate and can be considered their predictors. Professional nurses with greater autonomy, good working relationships and control over their work environment have lower levels of emotional exhaustion, higher job satisfaction, less intention of leaving the job and the safety climate is positive. Initiatives to improve the professional practice environment can improve the safety of paediatric patients and the well-being of professional nurses. © 2016 John Wiley & Sons Ltd.
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Van Bogaert, Peter; Kowalski, Christoph; Weeks, Susan Mace; Van Heusden, Danny; Clarke, Sean P
2013-12-01
To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment. Acute care hospitals face daily challenges to their efforts to achieve nurse workforce stability, safety, and quality of care. A body of knowledge shows a favourably rated nurse practice environment as an important condition for better nurse and patient outcome variables; however, further research initiatives are imperative for a clear understanding to support and guide the practice community. Cross-sectional survey. Grounded on previous empirical findings, a structural equation model designed with valid measurement instruments was tested. The study population was registered acute care nurses (N=1201) in two independent hospitals and one hospital group with six hospitals in Belgium. Nurse practice environment dimensions predicted job outcome variables and nurse ratings of quality of care. Analyses were consistent with features of nurses' work characteristics including perceived workload, decision latitude, and social capital, as well as three dimension of burnout playing mediating roles between nurse practice environment and outcomes. A revised model adjusted using various fit measures explained 52% and 47% of job outcomes and nurse-assessed quality of care, respectively. The study refines understanding of the relationship between aspects of nursing practice in order to achieve favourable nursing outcomes and offers important concepts for managers to track in their daily work. The findings of this study indicate that it is important for clinicians and leaders to consider how nurses are involved in decision-making about care processes and tracking outcomes of care and whether they are able to work with physicians, superiors, peers, and subordinates in a trusting environment based on shared values. The involvement of nurse managers at the unit level is especially critical because of associations with nurse work characteristics such as decision latitude and social capital and outcome variables. Further practice and research initiatives to support nurses' involvement in decision-making process and interdisciplinary teamwork are recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Taking leave from work: the impact of culture on Japanese female nurses.
Mizuno-Lewis, Satomi; McAllister, Margaret
2008-01-01
This paper provides an overview of nurses' working conditions in Japan, exploring tensions between nurses' rights to take leave from work to fulfil family and personal needs and their actual ability to take such leave. It also considers possible effects of being restricted from taking such leave. Little has been written on the specific needs of nurses who are mothers in the Japanese work environment. Research has focussed on the effects of heavy, stressful workloads and long working hours leading to burnout, death from overwork and suicides in Japanese culture. However, research that considers unique cultural and female issues in Japan affecting nursing work has not been published. Discursive. The paper shows that there are many overlapping, complex issues affecting nurses working in Japan and their needs need to be considered and addressed in order to promote a healthier work environment, as well as a more humanistic environment. Workplace issues are relevant to recruitment and retention and better conditions are likely to improve hospital functioning.
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Oshodi, Titilayo O; Crockett, Rachel; Bruneau, Benjamin; West, Elizabeth
2017-09-01
To explore the structure of the Essentials of Magnetism II (EOMII) scale using data from nurses working in England; and to describe the impact of different aspects of the nursing work environment on nurse-assessed care quality (NACQ). The EOMII Scale was developed in the United States to measure nursing work environments. It has been widely used in the United States and in a number of other countries, but has not yet been used in the UK. Cross-sectional study. Registered nurses (n = 247) providing direct patient care in two National Health Service hospitals in England completed the EOMII scale and a single-item measuring NACQ. Principal components analysis was used to assess the structure of the scale. Correlation and regression analyses were used to describe the relationships between factors and NACQ. A solution with explanatory variance of 45.25% was identified. Forty items loaded on five factors, with satisfactory consistency: (i) ward manager support; (ii) working as a team; (iii) concern for patients; (iv) organisational autonomy; and (v) constraints on nursing practice. While in univariate analyses, each of the factors was significantly associated with NACQ, in multivariate analyses, the relationship between organisational autonomy and NACQ no longer reached significance. However, a multiple mediation model indicated that the effect of organisational autonomy on NACQ was mediated by nurse manager support, working as a team and concern for patients but not constraints on nursing practice. Subscales of the EOMII identified in an English sample of nurses measured important aspects of the nursing work environment, each of which is related to NACQ. The EOMII could be a very useful tool for measuring aspects of the nursing work environment in the English Trusts particularly in relation to the quality of care. © 2017 John Wiley & Sons Ltd.
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Feather, Janice; McGillis Hall, Linda; Trbovich, Patricia; Baker, G Ross
2018-04-22
To rigorously review the literature on the prosocial workplace behaviours of nurses. Prosocial workplace behaviours, predominantly organisational citizenship behaviours have been theoretically and empirically found to promote individual and group level performance in various industries. However, little consensus exists in the literature regarding the impact of nurses' workplace behaviours on the work environment and organisational performance. An integrative literature review was conducted on studies between 1980 and 2016. Nineteen articles were included related to nurses' prosocial behaviours and performance. A positive relationship was noted between workplace behaviours and individual level performance and unit level performance. Albeit multifactorial, leadership and the social structure of the work environment are important factors contributing to the workplace behaviour-performance relationship. Prosocial behaviours influence the social functioning of the work environment and offer insights into the delivery of quality care. Nurse managers should recognize the influence of leadership style and characteristics in the work environment that encourage employee participation in prosocial behaviours. These additional voluntary efforts by nursing staff may improve organisational effectiveness and quality of care. Inclusion of these behaviours in performance reviews and as cultural norms may help to foster a more collaborative work environment. © 2018 John Wiley & Sons Ltd.
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Kirwan, Marcia; Matthews, Anne; Scott, P Anne
2013-02-01
Patient safety is a priority for health services in all countries. The importance of the nurse's role in patient safety has been established. Effective nurse staffing levels, nurse education levels, and a positive work environment for nurses are factors which are known to impact on patient safety outcomes. This study sought to explore the relationship between the ward environment in which nurses practice and specific patient safety outcomes, using ward level variables as well as nurse level variables. The outcomes were nurse-reported patient safety levels in the wards in which they work, and numbers of formal adverse events reports submitted by nurses in the last year. This cross-sectional quantitative study was carried out within a European FP7 project: Nurse Forecasting: Human Resources Planning in Nursing (RN4CAST) project. 108 general medical and surgical wards in 30 hospitals throughout Ireland. All nurses in direct patient care in the study wards were invited to participate. Data from 1397 of these nurses were used in this analysis. A nurse survey was carried out using a questionnaire incorporating the Practice Environment Scale of the Nursing Work Index (PES-NWI). Ethical approval was obtained from the authors' institution and all ethics committees representing the 30 study hospitals. Multilevel modelling was carried out to examine the impact of ward level factors on patient safety. These included proportions of nurses on the ward educated to degree level, and aggregated ward-level mean for PES-NWI scores. The study results support other research findings indicating that a positive practice environment enhances patient safety outcomes. Specifically at ward level, factors such as the ward practice environment and the proportion of nurses with degrees were found to significantly impact safety outcomes. The models developed for this study predicted 76% and 51% of the between-ward variance of these outcomes. The results can be used to enhance patient safety within hospitals by demonstrating factors at ward-level which enable nurses to effectively carry out this aspect of their role. The importance of ward-level nurse factors such as nurse education level and the work environment should be recognised and manipulated as important influences on patient safety. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Stalpers, Dewi; de Brouwer, Brigitte J M; Kaljouw, Marian J; Schuurmans, Marieke J
2015-04-01
To systematically review the literature on relationships between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals. The search was performed in Medline (PubMed), Cochrane, Embase, and CINAHL. Included were quantitative studies published from 2004 to 2012 that examined associations between work environment and the following patient outcomes: delirium, malnutrition, pain, patient falls and pressure ulcers. The Dutch version of Cochrane's critical appraisal instrument was used to assess the methodological quality of the included studies. Of the initial 1120 studies, 29 were included in the review. Nurse staffing was inversely related to patient falls; more favorable staffing hours were associated with fewer fall incidents. Mixed results were shown for nurse staffing in relation to pressure ulcers. Characteristics of work environment other than nurse staffing that showed significant effects were: (i) collaborative relationships; positively perceived communication between nurses and physicians was associated with fewer patient falls and lower rates of pressure ulcers, (ii) nurse education; higher levels of education were related to fewer patient falls and (iii) nursing experience; lower levels of experience were related to more patient falls and higher rates of pressure ulcers. No eligible studies were found regarding delirium and malnutrition, and only one study found that favorable staffing was related to better pain management. Our findings show that there is evidence on associations between work environment and nurse-sensitive patient outcomes. However, the results are equivocal and studies often do not provide clear conclusions. A quantitative meta-analysis was not feasible due to methodological issues in the primary studies (for example, poorly described samples). The diversity in outcome measures and the majority of cross-sectional designs make quantitative analysis even more difficult. In the future, well-described research designs of a longitudinal character will be needed in this field of work environment and nursing quality. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Work engagement and its predictors in registered nurses: A cross-sectional design.
Wan, Qiaoqin; Zhou, Weijiao; Li, Zhaoyang; Shang, Shaomei; Yu, Fang
2018-04-23
Nurses are key staff members of health-care organizations. Nurse engagement directly influences quality of care and organizational performance. The purpose of the present study was to understand the state of work engagement and explore its predictors among registered nurses in China by using a descriptive, cross-sectional survey design (n = 1065). Work engagement was measured with the Chinese version of the Utrecht Work Engagement Scale. The results showed that the average work engagement of Chinese nurses was 3.54 (standard deviation = 1.49), and that nurses' age (β = .16, t = 5.32), job characteristics (β = .33, t = 9.43), and practice environment (β = .23, t = 6.59) were significant predictors of work engagement. Thus, nurse leaders should be encouraged to shape motivational job characteristics and create supportive practice environment so as to increase nurses' work engagement. © 2018 John Wiley & Sons Australia, Ltd.
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Predictors of nurse manager stress: a dominance analysis of potential work environment stressors.
Kath, Lisa M; Stichler, Jaynelle F; Ehrhart, Mark G; Sievers, Andree
2013-11-01
Nurse managers have important but stressful jobs. Clinical or bedside nurse predictors of stress have been studied more frequently, but less has been done on work environment predictors for those in this first-line leadership role. Understanding the relative importance of those work environment predictors could be used to help identify the most fruitful areas for intervention, potentially improving recruitment and retention for nurse managers. Using Role Stress Theory and the Job Demands-Resources Theory, a model was tested examining the relative importance of five potential predictors of nurse manager stress (i.e., stressors). The work environment stressors included role ambiguity, role overload, role conflict, organizational constraints, and interpersonal conflict. A quantitative, cross-sectional survey study was conducted with a convenience sample of 36 hospitals in the Southwestern United States. All nurse managers working in these 36 hospitals were invited to participate. Of the 636 nurse managers invited, 480 responded, for a response rate of 75.5%. Questionnaires were distributed during nursing leadership meetings and were returned in person (in sealed envelopes) or by mail. Because work environment stressors were correlated, dominance analysis was conducted to examine which stressors were the most important predictors of nurse manager stress. Role overload was the most important predictor of stress, with an average of 13% increase in variance explained. The second- and third-most important predictors were organizational constraints and role conflict, with an average of 7% and 6% increase in variance explained, respectively. Because other research has shown deleterious effects of nurse manager stress, organizational leaders are encouraged to help nurse managers reduce their actual and/or perceived role overload and organizational constraints. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Lifestyle practices and the health promoting environment of hospital nurses.
Hope, A; Kelleher, C C; O'Connor, M
1998-08-01
Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.
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The influence of authentic leadership and areas of worklife on work engagement of registered nurses.
Bamford, Megan; Wong, Carol A; Laschinger, Heather
2013-04-01
To examine the relationships among nurses' perceptions of nurse managers' authentic leadership, nurses' overall person-job match in the six areas of worklife and their work engagement. Reports have highlighted the impact of demanding and unsupportive work environments on nurses' wellbeing, resulting in a need for strong nursing leadership to build sustainable and healthier work environments. A secondary analysis of data collected from a non-experimental, predictive design survey of a random sample of 280 registered nurses working in acute care hospitals was conducted. An overall person-job match in the six areas of worklife fully mediated the relationship between authentic leadership and work engagement. Further, authentic leadership, overall person-job match in the six areas of worklife and years of nursing experience explained 33.1% of the variance in work engagement. Findings suggest that nurses who work for managers demonstrating higher levels of authentic leadership report a greater overall person-job match in the six areas of worklife and greater work engagement. As nurse managers' play a key role in promoting work engagement among nurses, authentic leadership development for nurse managers focusing on self-awareness, relational transparency, ethics and balanced processing would be beneficial. © 2012 Blackwell Publishing Ltd.
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Chiang, Hui-Ying; Hsiao, Ya-Chu; Lee, Huan-Fang
Nurses' safety practices of medication administration, prevention of falls and unplanned extubations, and handover are essentials to patient safety. This study explored the prediction between such safety practices and work environment factors, workload, job satisfaction, and error-reporting culture of 1429 Taiwanese nurses. Nurses' job satisfaction, error-reporting culture, and one environmental factor of nursing quality were found to be major predictors of safety practices. The other environment factors related to professional development and participation in hospital affairs and nurses' workload had limited predictive effects on the safety practices. Increasing nurses' attention to patient safety by improving these predictors is recommended.
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Satisfaction with nursing education, job satisfaction, and work intentions of new graduate nurses.
Kenny, Patricia; Reeve, Rebecca; Hall, Jane
2016-01-01
In the context of predictions of future shortages of nurses, retaining new graduate nurses in the nursing workforce is essential to ensure sufficient nurses in the future. This paper investigates the links between satisfaction with nursing education and job satisfaction, and job dissatisfaction and intentions to leave a nursing job. It uses survey data from a cohort study of nursing students recruited through two Australian universities and followed after graduation and workforce entry. Structural equation modeling (SEM) was used to simultaneously estimate the impact of educational satisfaction (work preparation component) on job satisfaction and the impact of job satisfaction on the expectation of leaving the current job. Two job satisfaction sub-scales were identified: 1) work environment satisfaction and 2) work hours and wages satisfaction. Work preparation satisfaction was significantly and positively associated with both job satisfaction scales but only work environment satisfaction was significantly associated with the expectation to stay in the job; a one standard deviation increase in work environment satisfaction was associated with a 13.5 percentage point reduction in the probability of expecting to leave. The estimated effect of satisfaction with education on expecting to leave, occurring indirectly through job satisfaction, was small (reducing the probability by less than 3 percentage points for a 1 point increase in work preparation satisfaction). Participating in a graduate transition program had the largest effect, reducing the probability of expecting to leave by 26 percentage points, on average. The study results suggest policies which focus on improving satisfaction with the work environment would be more effective at retaining nurses early in their career than improvements to conditions such as work hours and wages. Investment in new graduate transition programs would potentially have the largest impact on retention. Copyright © 2015 Elsevier Ltd. All rights reserved.
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The culture contributing to interruptions in the nursing work environment: An ethnography.
Hopkinson, Susan G; Wiegand, Debra L
2017-12-01
To understand the occurrence of interruptions within the culture of the medical nursing unit work environment. Interruptions may lead to errors in nursing work. Little is known about how the culture of the nursing work environment contributes to interruptions. A micro-focused ethnographic study was conducted. Data collection involved extensive observation of a nursing unit, 1:1 observations of nurses and follow-up interviews with the nurses. Data were analysed from unstructured field notes and interview transcripts. The definitions of interruption and culture guided coding, categorising and identification of themes. A framework was developed that describes the medical nursing unit as a complex culture full of unpredictable, nonlinear changes that affect the entire interconnected system, often in the form of an interruption. The cultural elements contributing to interruptions included (i) the value placed on excellence in patient care and meeting personal needs, (ii) the beliefs that the nurses had to do everything by themselves and that every phone call was important, (iii) the patterns of changing patients, patient transport and coordination of resources and (iv) the normative practices of communicating and adapting. Interruptions are an integral part of the culture of a medical nursing unit. Uniformly decreasing interruptions may disrupt current practices, such as communication to coordinate care, that are central to nursing work. In future research, the nursing work environment must be looked at through the lens of a complex system. Interventions to minimise the negative impact of interruptions must take into account the culture of the nursing as a complex adaptive system. Nurses should be educated on their own contribution to interruptions and issues addressed at a system level, rather than isolating the interruption as the central issue. © 2017 John Wiley & Sons Ltd.
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Latham, Christine L; Hogan, Mikel; Ringl, Karen
2008-01-01
The hospital workforce environment has been recognized as an important factor for nurse retention and patient safety, yet there is ongoing evidence that inadequate communication, intraprofessional oppression, and lack of collaboration and conflict resolution continue to disempower nurses and hinder improvement of workforce conditions. A 3-year academic-hospital partnership developed and used a registered nurse (RN) mentor and advocacy program to improve the RN work environment and selected patient outcomes. The partnership initiated mentor-mentee teams and a Workforce Environment Governance Board, and obtained preliminary data on outcomes related to mentor-mentee teamwork, changes in the level of support within each unit, and the impact of improved working conditions on nurse and patient satisfaction, nurse vacancy and turnover rates, and 3 patient safety outcomes related to fall and pressure ulcer prevention and use of restraints. Dedicated mentors not only engaged in supporting fellow nurses but also assisted with enhancing the overall work environment for RNs. The partnership enhanced mutual respect between frontline RNs and managers, and allowed frontline RNs to improve the culture of support. The comprehensive approach to incorporating mentor-mentee teams changes the way fellow nurses and others perceive nurses, augments support by managers and coworkers, and improves patient care outcomes.
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Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa
2016-01-01
Objective The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. Methods This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. Results 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Conclusions Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The most common nursing care omissions reported were related to nursing care plans. For the Global Sleep Quality score, difference were found between day and night shift workers. PMID:27496241
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Factors influencing nurses' perceptions of occupational safety.
Samur, Menevse; Intepeler, Seyda Seren
2017-01-02
To determine nurses' perceptions of occupational safety and their work environment and examine the sociodemographic traits and job characteristics that influence their occupational safety, we studied a sample of 278 nurses. According to the nurses, the quality of their work environment is average, and occupational safety is insufficient. In the subdimensions of the work environment scale, it was determined that the nurses think "labor force and other resources" are insufficient. In the occupational safety subdimensions "occupational illnesses and complaints" and "administrative support and approaches," they considered occupational safety to be insufficient. "Doctor-nurse-colleague relationships," "exposure to violence," and "work unit" (eg, internal medicine, surgical, intensive care) are the main factors that affect occupational safety. This study determined that hospital administrations should develop and immediately implement plans to ameliorate communication and clinical precautions and to reduce exposure to violence.
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Sveinsdóttir, Herdis
2006-06-01
The aim of this study was to describe and compare the self-assessed quality of sleep, occupational health, working environment, illness experience and job satisfaction among female nurses working different combinations of shifts. Evidence from several studies indicates that there is an association between the disruption of the circadian cycle caused by shift work and adverse health effects. A cross-sectional design was used with a sample of 348 nurses drawn from the registry of the Icelandic Nurses' Association, representing 17% of the workforce of Icelandic nurses. A self-administered questionnaire, measuring occupational health, quality of sleep, the illness experience, job satisfaction and working environment was used. Data were analysed according to type of shift (days only, rotating days/evenings, rotating days/evenings/nights) by use of analysis of variance and chi-square. No difference was found between participants based on type of shift with regard to the illness experience, job satisfaction and quality of sleep. Nurses working rotating day/evening/night shifts reported a longer working day, more stressful environmental risk factors, more strenuous work and that they were less able to control their work-pace. In general, the nurses reported low severity of symptoms; however, nurses working rotating days/evenings shifts experienced more severe gastrointestinal and musculoskeletal symptoms when compared with others. This was explained by the short rest period provided for between evening and morning shifts. In general Icelandic nurses are satisfied with their work and their shift assignment does not seem to pathologically disrupt their circadian cycle. Nevertheless, nursing directors are advised to look more closely at the organization of nurses' work during night shifts, as well as the rest period for nurses changing from evening to day shifts.
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Doran, Diane; Clarke, Sean; Hayes, Laureen; Nincic, Vera
2014-09-01
Much has been written about interventions to improve the nursing work environment, yet little is known about their effectiveness. A Delphi survey of nurse experts was conducted to explore perceptions about workplace interventions in terms of feasibility and likelihood of positive impact on nurse outcomes such as job satisfaction and nurse retention. The interventions that received the highest ratings for likelihood of positive impact included: bedside handover to improve communication at shift report and promote patient-centred care; training program for nurses in dealing with violent or aggressive behaviour; development of charge nurse leadership team; training program focused on creating peer-supportive atmospheres and group cohesion; and schedule that recognizes work balance and family demands. The overall findings are consistent with the literature that highlights the importance of communication and teamwork, nurse health and safety, staffing and scheduling practices, professional development and leadership and mentorship. Nursing researchers and decision-makers should work in collaboration to implement and evaluate interventions for promoting practice environments characterized by effective communication and teamwork, professional growth and adequate support for the health and well-being of nurses.
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Kaunonen, Marja; Salin, Sirpa; Aalto, Pirjo
2015-07-01
To explore factors associated with nursing intensity, work environment intensity and nursing resources that may affect nurse job satisfaction and risk of dissatisfaction in outpatient care at one university hospital in Finland. Much research has been done to study how nursing intensity, work environment intensity and nursing resources are associated with nurse job satisfaction, but not in the context of outpatient care. This research used a cross-sectional design. The data were collected from the hospital information systems of outpatient units (n = 12) in autumn 2010. Management style showed a statistically significant association with job satisfaction. The risk of dissatisfaction increased when nursing staff had no influence over the design of their jobs, when conflicts and contradictions were not addressed in the workplace and when feedback was not processed. Nursing intensity and work environment intensity had no effect on nurse job satisfaction. Nursing resources and patient satisfaction, on the other hand, were important to nurses' job satisfaction. The results indicate that nursing management should involve nursing staff in the development of their jobs and the care delivery model. © 2013 John Wiley & Sons Ltd.
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Blake, Nancy; Leach, Linda Searle; Robbins, Wendy; Pike, Nancy; Needleman, Jack
2013-01-01
A healthy work environment can improve patient outcomes and registered nurse (RN) turnover. Creating cultures of retention and fostering healthy work environments are 2 major challenges facing nurse leaders today. Examine the effects of the healthy work environment (communication, collaboration, and leadership) on RN turnover from data collected from a research study. Descriptive, cross-sectional, correlational design. Pediatric critical care RNs from 10 pediatric intensive care units (PICU) completed the Practice Environment Scale of the Nursing Work Index Revised and a subscale of the Intensive Care Unit Nurse-Physician Communication Questionnaire. These staff nurses were asked whether they intend to leave their current job in the next 6 months. Statistical analysis included correlations, multiple linear regression, t tests (2-tailed), and 1-way analysis of variance. A total of 415 RNs completed the survey. There was a statistically significant relationship between leadership and the intent to leave (P < .05). There was also an inverse relationship between years of experience and intent to leave. None of the communication variables between RNs and among RNs and MDs or collaboration were significantly associated with PICU nurses' intention to leave. Effective leadership in the PICU is important to PICU RNs and significantly influences their decisions about staying in their current job.
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Surakka, Tiina
2008-07-01
The aim of the study was to describe and compare the characteristics of the nurse manager's work in different hospital environments and at different times. Business values and pressures for cost efficiency have become a reality in health care. The data comprised the diaries of 155 nurse managers working in one Finnish health district's hospitals in the 1990s and 2000s. In addition, focus group interviews were used as a data source. The data were subjected to qualitative and quantitative content analysis. The nurse manager's work comprises responsibility activities, accountability activities, and traditional bedside nursing. They also described the recognition of the underlying premises of their work and outcome orientation. Their descriptions of work varied between university and rural hospitals, between psychiatric and somatic nursing and between different wards. The work changed in the 2000s as the nurse manager's role changed from nurse to nurse leader. It appears that nurse managers have succeeded in integrating different leadership models into their daily work pattern. A new leadership model was devised based on an emerging nursing framework. Nurse leaders should assess who can assume leadership positions in health care and on what grounds.
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Magnet status and registered nurse views of the work environment and nursing as a career.
Ulrich, Beth T; Buerhaus, Peter I; Donelan, Karen; Norman, Linda; Dittus, Robert
2007-05-01
To compare how registered nurses view the work environment and the nursing shortage based on the Magnet status of their organizations. The upsurge in organizations pursuing and obtaining Magnet recognition provides increased opportunities to investigate whether and how registered nurses who are employed in Magnet organizations and organizations pursuing Magnet status perceive differences in the nursing shortage, hospitals' responses to the shortage, characteristics of the work environment, and professional relationships. A nationally representative sample of registered nurses licensed to practice in the United States was surveyed. The views of registered nurses who worked in Magnet organizations, organizations in the process of applying for Magnet status, and non-Magnet organizations were analyzed as independent groups. Significant differences were found. Although there is a clear Magnet difference, there are also identifiable differences that occur during the pursuit of Magnet recognition. Many organizations in the process of applying for Magnet status rated higher than Magnet organizations, indicating that there is much to do to maintain the comparative advantages for Magnet hospitals.
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Magnet status and registered nurse views of the work environment and nursing as a career.
Ulrich, Beth T; Buerhaus, Peter I; Donelan, Karen; Norman, Linda; Dittus, Robert
2009-01-01
To compare how registered nurses view the work environment and the nursing shortage based on the Magnet status of their organizations. The upsurge in organizations pursuing and obtaining Magnet recognition provides increased opportunities to investigate whether and how registered nurses who are employed in Magnet organizations and organizations pursuing Magnet status perceive differences in the nursing shortage, hospitals' responses to the shortage, characteristics of the work environment, and professional relationships. A nationally representative sample of registered nurses licensed to practice in the United States was surveyed. The views of registered nurses who worked in Magnet organizations, organizations in the process of applying for Magnet status, and non-Magnet organizations were analyzed as independent groups. Significant differences were found. Although there is a clear Magnet difference, there are also identifiable differences that occur during the pursuit of Magnet recognition. Many organizations in the process of applying for Magnet status rated higher than Magnet organizations, indicating that there is much to do to maintain the comparative advantages for Magnet hospitals.
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Cummings, Greta G; Tate, Kaitlyn; Lee, Sarah; Wong, Carol A; Paananen, Tanya; Micaroni, Simone P M; Chatterjee, Gargi E
2018-05-03
Leadership is critical in building quality work environments, implementing new models of care, and bringing health and wellbeing to a strained nursing workforce. However, the nature of leadership style, how leadership should be enacted, and its associated outcomes requires further research and understanding. We aimed to examine the relationships between various styles of leadership and outcomes for the nursing workforce and their work environments. The search strategy of this systematic review included 10 electronic databases. Published, quantitative studies that examined the correlations between leadership behaviours and nursing outcomes were included. Quality assessments, data extractions and analysis were completed on all included studies by independent reviewers. A total of 50,941 titles and abstracts were screened resulting in 129 included studies. Using content analysis, 121 outcomes were grouped into six categories: 1) staff satisfaction with job factors, 2) staff relationships with work, 3) staff health & wellbeing, 4) relations among staff, 5) organizational environment factors and 6) productivity & effectiveness. Our analysis illuminated patterns between relational and task focused leadership styles and their outcomes for nurses and nursing work environments. For example, 52 studies reported that relational leadership styles were associated with higher nurse job satisfaction, whereas 16 studies found that task-focused leadership styles were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes. The findings of this systematic review provide strong support for the employment of relational leadership styles to promote positive nursing workforce outcomes and related organizational outcomes. Leadership focused solely on task completion is insufficient to achieve optimum outcomes for the nursing workforce. Relational leadership practices need to be encouraged and supported by individuals and organizations to enhance nursing job satisfaction, retention, work environment factors and individual productivity within healthcare settings. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.
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Goh, Yong-Shian; Lee, Alice; Chan, Sally Wai-Chi; Chan, Moon Fai
2015-08-01
This study aimed to determine whether definable profiles existed in a cohort of nursing staff with regard to demographic characteristics, job satisfaction, acculturation, work environment, stress, cultural values and coping abilities. A survey was conducted in one hospital in Singapore from June to July 2012, and 814 full-time staff nurses completed a self-report questionnaire (89% response rate). Demographic characteristics, job satisfaction, acculturation, work environment, perceived stress, cultural values, ways of coping and intention to leave current workplace were assessed as outcomes. The two-step cluster analysis revealed three clusters. Nurses in cluster 1 (n = 222) had lower acculturation scores than nurses in cluster 3. Cluster 2 (n = 362) was a group of younger nurses who reported higher intention to leave (22.4%), stress level and job dissatisfaction than the other two clusters. Nurses in cluster 3 (n = 230) were mostly Singaporean and reported the lowest intention to leave (13.0%). Resources should be allocated to specifically address the needs of younger nurses and hopefully retain them in the profession. Management should focus their retention strategies on junior nurses and provide a work environment that helps to strengthen their intention to remain in nursing by increasing their job satisfaction. © 2014 Wiley Publishing Asia Pty Ltd.
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Nurses well-being in intensive care units: study of factors promoting team commitment.
Galletta, Maura; Portoghese, Igor; Coppola, Rosa C; Finco, Gabriele; Campagna, Marcello
2016-05-01
Intensive care units (ICUs) are challenging work environments because of the critical condition of patients, and ICU nurses frequently lament low job satisfaction and high staff turnover. Nevertheless, organizational and work characteristics, and the quality of relationships with staff can help to maintain nurses' enthusiasm and increase job satisfaction. The aim of this study was to analyse how nursing work environment factors affect identification and commitment among ICU nurses. A cross-sectional study was carried out in 12 ICUs from four Italian urban hospitals. A total of 222 nurses participated and completed a self-reported questionnaire. Results show that nursing work characteristics are directly related to team commitment, and that the nursing work characteristics and team commitment relationship was mediated by both perceived supervisor support and job satisfaction. Our findings may concretely contribute to literature and offer additional suggestions to improve nurses' work conditions and patient health in ICUs. © 2014 British Association of Critical Care Nurses.
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Van Bogaert, Peter; Adriaenssens, Jef; Dilles, Tinne; Martens, Daisy; Van Rompaey, Bart; Timmermans, Olaf
2014-11-01
To study the impact of role, job- and organizational characteristics on nurse managers' work related stress and well-being such as feelings of emotional exhaustion, work engagement, job satisfaction and turnover intention. Various studies investigated role-, job- and organizational characteristics influencing nurse-related work environments. Research on nurse managers' related work environments define influencing factors, but, a clear understanding of the impact of nurse-managers' work-environment characteristics on their work related stress and well-being is limited. A cross-sectional design with a survey. A cross-sectional survey (N = 365) was carried out between December 2011-March 2012. The questionnaire was based on various validated measurement instruments identified by expert meetings (e.g. staff nurses, nurse managers and executives and physicians). Hierarchical regression analyses were performed using emotional exhaustion, work engagement, job satisfaction and turnover intentions as outcome variables. Study results showed one out of six nursing unit managers have high to very high feelings of emotional exhaustion and two out of three respondents have high to very high work engagement. Hierarchical regression models showed that role conflict and role meaningfulness were strong predictors of nursing unit managers' work related stress and well-being, alongside with job- and organizational characteristics. Several risk factors and stimulating factors influencing nurse unit managers' work related stress and well-being were identified. Further challenges will be to develop proper interventions and strategies to support nursing unit managers and their team in daily practice to deliver the best and safest patient care. © 2014 John Wiley & Sons Ltd.
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Huddleston, Penny; Gray, Jennifer
2016-09-01
The American Association of Critical-Care Nurses (AACN) Healthy Work Environment Assessment Tool was developed as a simple screening tool to assess the characteristics of a healthy work environment (HWE) in critical care environments. The purposes of these 2 qualitative research studies are to explore the nurse leaders' and direct care nurses' perceptions of the meaning of a HWE, to describe the nurse leaders' and direct care nurses' perceptions of a HWE, and to define the characteristics of a HWE in acute care settings. Exploratory descriptive designs using focus groups and guided questions with tape-recorded interviews were used to define the characteristics of an HWE. The 6 original themes from AACN HWE standards and 2 new themes emerged as a result of the nurse leaders and direct care nurses defining the characteristics of a HWE, which included appropriate staffing, authentic leadership, effective decision making, meaningful recognition, skilled communication, true collaboration genuine teamwork, and physical and psychological safety. The qualitative statements from these 2 studies will be used in future studies to describe and develop HWE scales for nurse leaders and direct care nurses and to assess the psychometric properties of these new tools.
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El-Jardali, Fadi; Alameddine, Mohamad; Dumit, Nuhad; Dimassi, Hani; Jamal, Diana; Maalouf, Salwa
2011-02-01
The dual burden of nursing shortages and poor work environments threatens quality of patient care and places additional pressures on resource-stretched health care systems, particularly in the Eastern Mediterranean Region (EMR). There is a paucity of research in the EMR examining the quality of nurses' work environment and its association to nurses' intent to leave their jobs/countries. Systematically examine the characteristics of nurses' work environment and their relation to nurses' intent to leave their jobs within the context of Lebanon. A secondary objective is to assess the utility and validity of the NWI-R within the context of the EMR. A cross-sectional survey design was utilized to survey a total of 1793 registered nurses in 69 Lebanese hospitals. The survey instrument included questions on nurses' background, hospital characteristics, intent to leave, and the Revised Nurse Working Index (NWI-R). Data analysis included descriptive statistics for demographic characteristics, t-test and ANOVA to assess differences in agreement scores, and a multinomial logistic regression model to predict intent to leave. Thematic analysis of open-ended questions was utilized to extract themes that fit under issues relating to nurses' work environment in Lebanese hospitals. The NWI-R subscale with the lowest mean score related to control. Younger nurses had lower scores on organizational support and career development. Regression analysis revealed that for every 1 point score decrease on career development there was a 93% increase in likelihood of reporting intent to leave country. Likewise, for every 1 point score decrease on participation there was an observed 51% and 53% increase in likelihood of reporting intent to leave country and hospital, respectively. Findings show that hospital characteristics (size, accreditation status and presence of a recruitment and retention strategy) were significantly associated with NWI-R subscales. Participation, control and career development were key work environment challenges contributing to the attrition on nurses from Lebanese hospitals. Although some of the issues identified are country specific, others would certainly be relevant to other countries in the EMR. Addressing these challenges would require a strong and coordinated action from governments, professional bodies, policy makers and health managers. Copyright © 2010 Elsevier Ltd. All rights reserved.
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High-dependency care: experiences of the psychosocial work environment.
Rahman, Hanif Abdul; Naing, Lin; Abdul-Mumin, Khadizah
2017-11-23
to explore high-dependency care nurses' experiences of their psychosocial work environment. four focus groups were conducted with 23 emergency and critical care hospital nurses in Brunei. All sessions were recorded, transcribed verbatim and analysed using inductive-approach thematic analysis. three major themes were identified. 'Specialisation/specific skills' explained a fundamental requirement for the high-dependency care nurses to work effectively and efficiently in their workplace. 'Task completion' narrated the pressure they experienced to complete their tasks within time constraints exacerbated by a reduced number of staff. 'Acknowledgement' signified their need for fair and adequate reward for their hard work through career progression and promotion. this study facilitates the design of future interventions and policies that promote a healthy psychosocial work environment by ensuring nurses working in these areas have the required specialisation skills, there is a balance of workload and nurse-to-patient ratios, and they are offered fairness and equity in career progression and promotion.
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Self-assessed occupational health and working environment of female nurses, cabin crew and teachers.
Sveinsdóttir, Herdis; Gunnarsdóttir, Hólmfríethur; Friethriksdóttir, Hildur
2007-06-01
The aim of this study was to describe and compare the self-assessed occupational health among female nurses, cabin crew and teachers, in relation to their working environment. Similarities between the three occupations, i.e. predominantly female and service-oriented, render them interesting in comparison with respect to health and working environment. The participants were female Icelandic cabin crew, nurses and elementary school teachers. A questionnaire including items on socio-demographics, working environment (addressing work pace, job security, monotonous work, assistance, physically strenuous work and physical environmental factors) and a symptom list was used for data collection. Factor analyses on the symptom list resulted in five symptom scales: Musculoskeletal, Stress and exhaustion, Common cold, Gastrointestinal and Sound perception scale. A total of 1571 questionnaires were distributed. The response rate was 65.7-69%, depending on occupation. Data were collected in 2002. Cabin crew reported worse gastrointestinal, sound perception and common cold symptoms than nurses and teachers. Cabin crew and teachers reported worse symptoms of stress and exhaustion than nurses (p < 0.05). When compared with teachers and nurses cabin crew reported less job security and more physically strenuous and monotonous work. Nurses were likelier to seek assistance from co-workers or patients as well as to take care of an older relative than teachers and cabin crew. Regression analysis found that within each occupation distress from environmental factors resulted in higher score on all the symptom scales. Nurses experience less stress and exhaustion than teachers and cabin crew. In comparison with one or both of the other occupations nurses are more likely to assist each other with their work, experience job security, reporting physically complex work and take care of older relatives. This should be highlighted as positive aspects of nurses' work praised as displaying responsibility and interconnectedness of nurses'.
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Cultural Awareness Among Nursing Staff at an Academic Medical Center.
McElroy, Jennifer; Smith-Miller, Cheryl A; Madigan, Catherine K; Li, Yin
2016-03-01
The goal is to identify areas for targeted improvement in regard to cultural awareness and competence among nursing staff and in the work environment. Many facilities have initiated programs to facilitate cultural competence development among nursing staff; however, there has been little examination of the effect of these initiatives, assessment of experienced nurses' cultural awareness, or investigation of nurse leader's role in promoting cultural competence in the literature. In this cross-sectional descriptive study, a cultural awareness survey was modified and electronically distributed to all registered nurses and assistive personnel at an academic medical center. The modified survey instrument showed good reliability and validity among the study population. Most nursing staff exhibited a moderate to high level of cultural awareness and held positive opinions about nursing leadership and the work environment with regard to cultural issues. In increasingly diverse work environments, assessing the cultural awareness of nursing staff enables nurse leaders to evaluate efforts in promoting cultural competence and to identify specific areas in which to target staff development efforts and leadership training.
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Nowrouzi, Behdin; Lightfoot, Nancy; Larivière, Michael; Carter, Lorraine; Rukholm, Ellen; Schinke, Robert; Belanger-Gardner, Diane
2015-07-01
This article reports on a literature review of workplace interventions (i.e., creating healthy work environments and improving nurses' quality of work life [QWL]) aimed at managing occupational stress and burnout for nurses. A literature search was conducted using the keywords nursing, nurses, stress, distress, stress management, burnout, and intervention. All the intervention studies included in this review reported on workplace intervention strategies, mainly individual stress management and burnout interventions. Recommendations are provided to improve nurses' QWL in health care organizations through workplace health promotion programs so that nurses can be recruited and retained in rural and northern regions of Ontario. These regions have unique human resources needs due to the shortage of nurses working in primary care. © 2015 The Author(s).
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Pryse, Yvette; McDaniel, Anna; Schafer, John
2014-08-01
Those in nursing have been charged with practicing to the full extent of their education and training by the Institute of Medicine. Therefore, evidence-based practice (EBP) has never been more important to nursing than in the current healthcare environment. Frequently the burden of EBP is the responsibility of the bedside practitioner, but has been found to be a process that requires leadership and organizational support. A key underlying component of a strong EBP environment includes effective communications and collaboration among staff and nursing leadership. Developing measurement tools that examine the milieu and nursing leadership in which the staff nurse practices is an important component of understanding the factors that support or hinder EBP. The aim of this study is to report on the development and analysis of two new scales designed to explore leadership and organizational support for EBP. The EBP Nursing Leadership Scale (10 items) examines the staff nurses perception of support provided by the nurse manager for EBP, and the EBP Work Environment Scale (8 items) examines organizational support for EBP. Staff nurses who worked at least .5 FTE in direct patient care, from two inner city hospitals (n = 422) completed the scales. The scales were evaluated for internal consistency reliability with the Cronbach alpha technique, content validity using a panel of experts, and construct validity by The content validity index computed from expert rankings was .78 to 1.0 with an average of.96. Cronbach's alpha was .96 (n = 422) for the EBP Nursing Leadership Scale and .86 (n = 422) for the EBP Work Environment Scale. Factor analysis confirmed that each scale measured a unidimensional construct (p < .000). The EBP Nursing Leadership Scale and the EBP Work Environment Scale are psychometrically sound instruments to examine organizational influences on EBP. © 2014 Sigma Theta Tau International.
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AbuAlRub, Raeda; El-Jardali, Fadi; Jamal, Diana; Abu Al-Rub, Nawzat
2016-08-01
The aims of this study are to (1) examine the relationships between work environment, job satisfaction and intention to stay at work; and (2) explore the predicting factors of intention to stay at work among nurses in underserved areas. Developing and fostering creative work environment are paramount especially in underserved areas, where the work conditions present many challenges. A descriptive correlational design was utilized to collect data from 330 hospital nurses who worked in two underserved governorates in Jordan. A set of instruments were used to measure the variables of the study. The results showed a strong positive association between job satisfaction and work environment. The results of logistic regression indicated receiving housing, job satisfaction, and work environment were the predicting variables of the level of intention to stay at work. It is critical to improve work conditions and create a culture of supportive work environment in underserved area. Copyright © 2015 Elsevier Inc. All rights reserved.
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Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René
2015-10-01
To describe care worker-reported quality of care and to examine its relationship with staffing variables, work environment, work stressors, and implicit rationing of nursing care. Cross-sectional study. National, randomly selected sample of Swiss nursing homes, stratified according to language region and size. A total of 4311 care workers of all educational backgrounds (registered nurses, licensed practical nurses, nurse aides) from 402 units in 155 nursing homes completed a survey between May 2012 and April 2013. Care worker-reported quality of care was measured with a single item; predictors were assessed with established instruments (eg, Practice Environment Scale-Nurse Working Index) adapted for nursing home use. A multilevel logistic regression model was applied to assess predictors for quality of care. Overall, 7% of care workers rated the quality of care provided as rather low or very low. Important factors related to better quality of care were higher teamwork and safety climate (odds ratio [OR] 6.19, 95% confidence interval [CI] 4.36-8.79); better staffing and resources adequacy (OR 2.94, 95% CI 2.08-4.15); less stress due to workload (OR 0.71, 95% CI 0.55-0.93); less implicit rationing of caring, rehabilitation, and monitoring (OR 0.34, 95% CI 0.24-0.49); and less rationing of social care (OR 0.80, 95% CI 0.69-0.92). Neither leadership nor staffing levels, staff mix, or turnover was significantly related to quality of care. Work environment factors and organizational processes are vital to provide high quality of care. The improvement of work environment, support in handling work stressors, and reduction of rationing of nursing care might be intervention points to promote high quality of care in nursing homes. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
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Organizational commitment, work environment conditions, and life satisfaction among Iranian nurses.
Vanaki, Zohreh; Vagharseyyedin, Seyyed Abolfazl
2009-12-01
Employee commitment to the organization is a crucial issue in today's health-care market. In Iran, few studies have sought to evaluate the factors that contribute to forms of commitment. The aim of this study was to investigate the relationship between nurses' organizational commitment, work environment conditions, and life satisfaction. A cross-sectional design was utilized. Questionnaires were distributed to all the staff nurses who had permanent employment (with at least 2 years of experience in nursing) in the five hospitals affiliated to Birjand Medical Sciences University. Two hundred and fifty participants returned completed questionnaires. Most were female and married. The correlation of the total scores of nurses' affective organizational commitment and work environment conditions indicated a significant and positive relationship. Also, a statistically significant relationship was found between affective organizational commitment and life satisfaction. The implementation of a comprehensive program to improve the work conditions and life satisfaction of nurses could enhance their organizational commitment.
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Rathert, Cheryl; May, Douglas R
2007-01-01
Experts continue to decry the lack of progress made in decreasing the alarming frequency of medical errors in health care organizations (Leape, L. L., & Berwick, D. M. (2005). Five years after to err is human: What have we learned?. Journal of the American Medical Association, 293(19), 2384-2390). At the same time, other experts are concerned about the lack of job satisfaction and turnover among nurses (. Keeping patients safe: Transforming the work environment of nurses. Washington, DC: National Academy Press). Research and theory suggest that a work environment that facilitates patient-centered care should increase patient safety and nurse satisfaction. The present study began with a conceptual model that specifies how work environment variables should be related to both nurse and patient outcomes. Specifically, we proposed that health care work units with climates for patient-centered care should have nurses who are more satisfied with their jobs. Such units should also have higher levels of patient safety, with fewer medication errors. We examined perceptions of nurses from three acute care hospitals in the eastern United States. Nurses who perceived their work units as more patient centered were significantly more satisfied with their jobs than were those whose units were perceived as less patient centered. Those whose work units were more patient centered reported that medication errors occurred less frequently in their units and said that they felt more comfortable reporting errors and near-misses than those in less patient-centered units. Patients and quality leaders continue to call for delivery of patient-centered care. If climates that facilitate such care are also related to improved patient safety and nurse satisfaction, proactive, patient-centered management of the work environment could result in improved patient, employee, and organizational outcomes.
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How Nurses Experience Their Work as a Learning Environment
ERIC Educational Resources Information Center
Skår, Randi
2010-01-01
This article explores and illuminates the meaning of nurses' experiences with their work as a learning environment. A qualitative hermeneutic approach guided the research process and the analysis and interpretation of the transcribed interview-texts of eleven graduate nurses. Three core themes emerged from these informants' descriptions of their…
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Generational diversity: what nurse managers need to know.
Hendricks, Joyce M; Cope, Vicki C
2013-03-01
This article presents a discussion of generational differences and their impact on the nursing workforce and how this impact affects the work environment. The global nursing workforce represents four generations of nurses. This generational diversity frames attitudes, beliefs, work habits and expectations associated with the role of the nurse in the provision of care and in the way the nurse manages their day-to-day activities. An electronic search of MEDLINE, PubMed and Cinahl databases was performed using the words generational diversity, nurse managers and workforce. The search was limited to 2000-2012. Generational differences present challenges to contemporary nurse managers working in a healthcare environment which is complex and dynamic, in terms of managing nurses who think and behave in a different way because of disparate core personal and generational values, namely, the three Cs of communication, commitment and compensation. An acceptance of generational diversity in the workplace allows a richer scope for practice as the experiences and knowledge of each generation in the nursing environment creates an environment of acceptance and harmony facilitating retention of nurses. Acknowledgement of generational characteristics provides the nurse manager with strategies which focus on mentoring and motivation; communication, the increased use of technology and the ethics of nursing, to bridge the gap between generations of nurses and to increase nursing workforce cohesion. © 2012 Blackwell Publishing Ltd.
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Practice environment as perceived by nurses in acute care hospitals in Sharjah and North Emirates.
Al-Maaitah, Rowaida; AbuAlRub, Raeda F; Al Blooshi, Sumaya
2018-04-01
To explore nurses' perceptions of their practice environment in acute care hospitals in Sharjah and North Emirates in the United Arab Emirates (UAE). The health of the environment in which registered nurses' work is critical to nursing outcomes. The interest to examine the practice environment extended to the Gulf area which has a complex healthcare system including the UAE. The study used an exploratory descriptive design with a qualitative part using two focus group interviews. The sample size was 450 nurses selected through a random sampling method. A self-administered questionnaire including the Practice Environment Scale of Nursing Work Index (PES-NWI) was used. In addition, semi-structured interviews for two focus groups were done. The results showed that UAE practicing nurses reported favorable perceptions of most aspects of their practice environment. Unfavorable perceptions were only reported for Staffing and Resource Adequacy. The analysis of focus group discussions resulted in different emerged themes such as Lack of Recognition and Career Promotion, and Nurses' Workload due to Paper and Administrative Work. The findings of this study suggest that strategic interventions are needed to secure adequate staff and resources and implement an effective system for evaluation of performance. © 2018 Wiley Periodicals, Inc.
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Measuring Work Environment and Performance in Nursing Homes
Temkin-Greener, Helena; Zheng, Nan (Tracy); Katz, Paul; Zhao, Hongwei; Mukamel, Dana B.
2008-01-01
Background Qualitative studies of the nursing home work environment have long suggested that such attributes as leadership and communication may be related to nursing home performance, including residents' outcomes. However, empirical studies examining these relationships have been scant. Objectives This study is designed to: develop an instrument for measuring nursing home work environment and perceived work effectiveness; test the reliability and validity of the instrument; and identify individual and facility-level factors associated with better facility performance. Research Design and Methods The analysis was based on survey responses provided by managers (N=308) and direct care workers (N=7,418) employed in 162 facilities throughout New York State. Exploratory factor analysis, Chronbach's alphas, analysis of variance, and regression models were used to assess instrument reliability and validity. Multivariate regression models, with fixed facility effects, were used to examine factors associated with work effectiveness. Results The reliability and the validity of the survey instrument for measuring work environment and perceived work effectiveness has been demonstrated. Several individual (e.g. occupation, race) and facility characteristics (e.g. management style, workplace conditions, staffing) that are significant predictors of perceived work effectiveness were identified. Conclusions The organizational performance model used in this study recognizes the multidimensionality of the work environment in nursing homes. Our findings suggest that efforts at improving work effectiveness must also be multifaceted. Empirical findings from such a line of research may provide insights for improving the quality of the work environment and ultimately the quality of residents' care. PMID:19330892
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Medical surgical nurses describe missed nursing care tasks-Evaluating our work environment.
Winsett, Rebecca P; Rottet, Kendra; Schmitt, Abby; Wathen, Ellen; Wilson, Debra
2016-11-01
The purpose of the study was to explore the nurse work environment by evaluating the self-report of missed nursing care and the reasons for the missed care. A convenience sample of medical surgical nurses from four hospitals was invited to complete the survey for this descriptive study. The sample included 168 nurses. The MISSCARE survey assessed the frequency and reason of 24 routine nursing care elements. The most frequently reported missed care was ambulation as ordered, medications given within a 30 minute window, and mouth care. Moderate or significant reasons reported for the missed care were: unexpected rise in volume/acuity, heavy admissions/discharges, inadequate assistants, inadequate staff, meds not available when needed, and urgent situations. Identifying missed nursing care and reasons for missed care provides an opportunity for exploring strategies to reduce interruptions, develop unit cohesiveness, improve the nurse work environment, and ultimately leading to improved patient outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.
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Work Environment: A Profile of the Social Climate of Nursing Faculty in an Academic Setting.
ERIC Educational Resources Information Center
Doughty, Jana; May, Barbara; Butell, Sue; Tong, Vivian
2002-01-01
The perceptions of 15 full-time and 7 part-time nursing faculty regarding their work environment at a liberal arts college were gathered using the Moos Work Environment Scale. Scores were congruent in 7 of 10 social climate subscales. Widest discrepancies were in the areas of work pressures, physical comfort, and managerial control. (Contains 42…
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Nourry, Nathalie; Luc, Amandine; Lefebvre, François; Sultan-Taïeb, Hélène; Béjean, Sophie
2014-04-01
The association between depressive symptoms and psycho-organisational work environment has been established in the literature. Some studies have evaluated depressive symptoms in healthcare workers, but little research has been carried out among nurse managers. The aim of the study is to evaluate the depressive symptoms prevalence among nurse managers' population and work environment factors. A descriptive correlational research design was used. Data were collected from 296 nurse managers in five hospitals in the eastern area of France between 2007 and 2008. Health outcomes were evaluated by measuring depressive symptoms (CES-D scale), the exposure data by assessing psycho-organisational work environment with effort-reward imbalance-model of Siegrist. Multiple logistic regressions were used to describe the strength of the association between depressive symptoms and effort-reward imbalance adjusted for personal and occupational characteristics of the nurse managers. Among the nurse managers, a third had depressive symptoms, and 18% presented an effort-reward imbalance (ratio: ≥ 1). A significant association was found between depressive symptoms and effort-reward imbalance (OR = 10.81, 95% CI: 5.1-23, p < 10(-3)), and with esteem as a reward (OR = 3.21, 95% CI: 1.6-6.3, p < 10(-2)). In view of the hierarchical situation of nurse managers and their primary roles in hospitals, it is necessary to take prevention measures to improve their work environment and health.
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Assessing the professional development needs of experienced nurse executive leaders.
Leach, Linda Searle; McFarland, Patricia
2014-01-01
The objective of this study was to identify the professional development topics that senior nurse leaders believe are important to their advancement and success. Senior/experienced nurse leaders at the executive level are able to influence the work environment of nurses and institutional and health policy. Their development needs are likely to reflect this and other contemporary healthcare issues and may be different from middle and frontline managers. A systematic way of assessing professional development needs for these nurse leaders is needed. A descriptive study using an online survey was distributed to a convenience sample of nurse leaders who were members of the Association of California Nurse Leaders (ACNL) or have participated in an ACNL program. Visionary leadership, leading complexity, and effective teams were the highest ranked leadership topics. Leading change, advancing health: The future of nursing, healthy work environments, and healthcare reform were also highly ranked topics. Executive-level nurse leaders are important to nurse retention, effective work environments, and leading change. Regular assessment and attention to the distinct professional development needs of executive-level nurse leaders are a valuable human capital investment.
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Social support in the workplace: nurse leader implications.
Shirey, Maria R
2004-01-01
The state of the science as it relates to the stress-mediating role of social support in the health care work environment is explored. The ability to build a nursing leadership workforce is dependent upon a type of social support mechanism that mediates the inherent stress that comes along with managerial positions. Independent of the inevitable work-related stress associated with the nurse manager role, social support provided to current and aspiring nurse leaders is assumed to assist with coping and thriving in the work environment.
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Park, Mihyun; Lee, Ji Yun; Cho, Sung-Hyun
2012-09-01
The purposes of this study are to examine differences in job satisfaction among professional groups including nurses, allied hospital professionals, social workers, and elementary school teachers, and to identify specific characteristics of job satisfaction of nurses. The study design was a cross-sectional exploratory study using secondary data analysis with the 2009 Graduates Occupational Mobility Survey. The sample was female new graduates. The differences in job satisfaction among professional groups were analyzed using logistic regression (satisfied vs. not satisfied). Overall, 41.5% of nurses, 50.1% of allied hospital professionals, 58.2% of social workers, and 89% of elementary school teachers were satisfied with their job. Nurses were significantly less satisfied than the other professionals in 5 of the 11 job characteristics and had the lowest odds ratio (OR) when compared with elementary school teachers: work content (OR = 0.197, 95% CI [0.128, 0.304]), physical work environment (OR = 0.353, 95% CI [0.236, 0.529]), working hours (OR = 0.054, 95% CI [0.033, 0.088]), personal growth (OR = 0.242, 95% CI [0.160, 0.366]), and autonomy (OR = 0.188, 95% CI [0.123, 0.288]). Work content, physical work environment, interpersonal relationship, advancement system, and autonomy were significantly associated with the overall job satisfaction of nurses. Relatively dissatisfying job characteristics in nursing work environment that were significant predictors for nurses' job satisfaction should be improved. Newly graduated nurses are at risk for job dissatisfaction. This can result in high turnover rates and can exacerbate the nursing shortage. Efforts to improve the work environment are needed. Copyright © 2012. Published by Elsevier B.V.
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Investigating nurses' quality of life and work-life balance statuses in Singapore.
Kowitlawkul, Y; Yap, S F; Makabe, S; Chan, S; Takagai, J; Tam, W W S; Nurumal, M S
2018-04-06
To investigate the key determinants of nurses' quality of life and work-life balance statuses in a tertiary hospital in Singapore. Nurses' quality of life can directly and indirectly impact patients' safety and quality of care. Therefore, identifying key factors that influence nurses' quality of life is essential in the healthcare delivery system. A descriptive quantitative study design was adopted, and validated questionnaires were used. Data were collected in a period of 3 months (March to May 2014) at a 600-bed tertiary hospital in Singapore. One thousand and forty nurses participated in the study. Social support and sense of coherence were found to be significant predictors for high quality of life in all domains. Most nurses in this study spent more time on work than their private lives. However, there was no significant difference in job satisfaction among the four groups of nurses' proportions of percentages of actual time spent on work and private life. Cultivating social support from family, friends/colleagues and supervisors can help an individual cope with stress and enhance a nurse's quality of life. Even though nurses who spent more time at work were still satisfied with their job, they might need to be aware of their physical health and work environment. Nursing policy related to nurses' physical health and environment should be established. Health promotion programmes such as physical exercise and mindfulness interventions should be conducted to promote nurses' well-being and healthy workplace environments to enhance nurses' quality of life. © 2018 International Council of Nurses.
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Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa
2016-08-05
The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The most common nursing care omissions reported were related to nursing care plans. For the Global Sleep Quality score, difference were found between day and night shift workers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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The N2N instrument to evaluate healthy work environments: an Italian validation.
Palese, Alvisa; Dante, Angelo; Tonzar, Laura; Balboni, Bernardo
2014-02-01
The aims of the study were to (a) validate N2N Healthy Work Environment tool, (b) assess the healthiness of work environments as perceived by nurses themselves and (c) identify the factors associated with Italian nurses' perception of work environment healthiness. The linguistic and cultural adaptation of USA-N2N Healthy Work Environments was achieved through a process of forward/backward translation. Content validity was assessed by three expert nurses. The stability of the instrument was checked with a test/retest evaluation. The instrument psychometric properties, the confirmatory factor analysis as well the healthiness of the work environment and its determinant factors were evaluated with a sample of 294 nurses. The content and face validity of the N2N Healthy Work Environment instrument was confirmed. The instrument demonstrated good internal consistency (α of 0.82), excellent stability values (ρ > 0.70) and high levels of acceptability (response rate: 96.4 %). The confirmatory factor analysis has corroborated the existence of two factors as documented in the original instrument (Mays et al. in J Nurs Manag 19:18-26, 2011). Eighty-seven (29.6 %) nurses perceived the work environment where they work as "healthy". Working under a functional model of care delivery (χ(2) 24.856, p 0.000) and being responsible for one project or more (χ(2) 5.256, p 0.021) were associated with healthy environments. The instrument--valid and reliable, short in the number of items, easy to understand and based on international standards--allows a systematic assessment of the healthiness of the environment and might provide not only the opportunity to evaluate the effects of new organizational models and interventions, but also the possibility to activate a process of self-analysis and a process of ongoing review. The instrument can be used to systematically check the healthiness of Italian working environments, allowing for organizational diagnosis, targeted interventions and international comparisons.
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Improving Work Environment Perceptions for Nurses Employed in a Rural Setting
ERIC Educational Resources Information Center
Teasley, Susan L.; Sexton, Kathleen A.; Carroll, Cathryn A.; Cox, Karen S.; Riley, Michele; Ferriell, Kathleen
2007-01-01
Context: Effective recruitment and retention of professional nurses is a survival strategy for health care facilities, especially in rural areas. Purpose: This study examines the use of the Individual Workload Perception Scale to measure nurse satisfaction by a small rural hospital in order to make positive changes in the work environment for…
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Hallmarks of the Professional Nursing Practice Environment. AACN White Paper.
ERIC Educational Resources Information Center
Journal of Professional Nursing, 2002
2002-01-01
This white paper from the American Association of Colleges of Nursing depicts the current environment of nursing practice, including supply and demand. It describes work environments that support professional practice and outlines eight indicators for the practice environment. Contains 48 references and an appendix with suggested questions for…
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Gender segregation as a benefit - a qualitative study from Pakistan.
Rizvi Jafree, Sara; Zakar, Rubeena; Zakar, Muhammad Zakria
2015-11-01
To explore the possibility of exploiting gender segregation as a benefit for registered female nurses. Nursing is a highly gendered profession in Pakistan with 95% of nurses comprising females who suffer from low professional status, negative identity and unfavourable work environments. A qualitative research design was used to interview 12 nurses in management positions through purposive sampling. Face-to-face in-depth interviews were conducted to explore the views of female nurses on the benefits, if any, of gender segregation in the nursing profession. Content analysis identified three major categories of benefits of gender segregation for female nurses including: (1) demand for female nurses compared with demand for males, (2) resilience of female nurses in the face of difficult work environments and (3) comfort and safety of female co-workers in a male-dominated setting. Realising the benefits of gender segregation could mobilise nurse teamwork and union efforts in order to improve nurse identity, professional status and work environments. The present study highlights the nurse manager role in advancing knowledge of gender segregation benefits, team-building for gender solidarity, control of nurse supply, union mobilization and raising community awareness for women's health development. © 2014 John Wiley & Sons Ltd.
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[High-quality nursing health care environment: the patient safety perspective].
Tu, Yu-Ching; Wang, Ruey-Hsia
2011-06-01
Patient safety is regarded as an important indicator of nursing care quality, and nurses hold frontline responsibility to maintain patient safety. Many countries now face healthcare provider shortfalls, and recognize a close correlation between adequate manpower and patient safety. Many healthcare organizations work to foster positive work environments in order to improve health service quality. The active participation and "buy in" of nurses, patients and policymakers are critical to maximize healthcare environment quality and improve patient safety. This article adopts Donabedian's theoretical "Structure-Process-Outcome" model of quality (Donabedian, 1988) and presumes all high-quality healthcare environment indicators to be linked to patient safety. In addition to raising public awareness regarding the influence of healthcare environment quality on patient safety, this research suggests certain indicators for tracking and assessing healthcare environment quality. Future research may design an empirical study based on these indicators to help further enhance healthcare environment quality and the professional development of nurses.
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Influence of the Nursing Practice Environment on Job Satisfaction and Turnover Intention
Lee, Sang-Yi; Kim, Chul-Woung; Kang, Jeong-Hee; Yoon, Tae-Ho; Kim, Cheoul Sin
2014-01-01
Objectives: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. Methods: Among the 11 731 nurses who participated in the Korea Health and Medical Workers’ Union’s educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. Results: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses’ job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses’ turnover intention. Conclusions: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses’ job satisfaction. However, the nursing practice environment was not related to nurses’ turnover intention. PMID:25284197
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A study examining senior nursing students' expectations of work and the workforce.
Saber, Deborah A; Anglade, Debbie; Schirle, Lori M
2016-03-01
This study explored traditional and accelerated Bachelor of Science nursing students' expectations of nursing work and the workforce. Role transition difficulty is blamed for much of the 15-60% newly licensed registered nurse turnover in their first 3 years of employment. This qualitative study consisted of 14 focus groups (n = 98) to determine Bachelor of Science nursing students' expectations of work as newly licensed registered nurses. Two overriding themes for accelerated and traditional students emerged: stressors and coping strategies. Students believe four stressors will affect their progression into the newly licensed registered nurse role and have developed coping strategies. This study suggests that students have experienced stressors in the clinical environment and anticipate them in the newly licensed registered nurse role. During transition, strategies such as 'fitting in' and 'staying safe' will be employed to ensure work success. Younger generations value a healthy work-life balance and a positive working environment. These nurses will not tolerate positions that do not align with their values. With the aging of citizens in the USA and the predicted nursing shortage, nursing management needs to employ strategies to retain newly licensed registered nurses. © 2015 John Wiley & Sons Ltd.
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Phiri, Lindokuhle P; Draper, Catherine E; Lambert, Estelle V; Kolbe-Alexander, Tracy L
2014-01-01
Nurses have an increased risk for non-communicable diseases (NCDs), along with a high prevalence of obesity, poor eating habits and insufficient physical activity. The aim of this study was to determine the health concerns, health priorities and barriers to living a healthy lifestyle among nurses and hospital management staff from public hospitals in the Western Cape Metropole, South Africa. Participants were purposively sampled (n = 103), and included management personnel (n = 9), night shift (n = 57) and day-shift nurses (n = 36). Twelve focus groups (FGDs) were conducted with nursing staff to obtain insight into nurses' health concerns, lifestyle behaviours and worksite health promotion programmes (WHPPs). Seven key informant interviews (KII) were conducted with management personnel, to gain their perspective on health promotion in the worksite. Thematic analysis was used to analyse the data with the assistance of Atlas.ti Qualitative Data Analysis Software. Night shift nurses frequently identified weight gain and living with NCDs such as hypertension as their main health concerns. Being overweight was perceived to have a negative impact on work performance. All nurses identified backache and exposure to tuberculosis (TB) as occupation-related health concerns, and both management and nurses frequently reported a stressful working environment. Nurses frequently mentioned lack of time to prepare healthy meals due to long working hours and being overtired from work. The hospital environment was perceived to have a negative influence on the nurses' lifestyle behaviours, including food service that offered predominantly unhealthy foods. The most commonly delivered WHPPs included independent counselling services, an online employee wellness programme offered by the Department of Health and wellness days in which clinical measures, such as blood glucose were measured. Nurses identified a preference for WHPPs that provided access to fitness facilities or support groups. Public hospitals are a stressful work environment and shift work places an additional strain on nurses. The risk of NCDs and exposure to infectious disease remains a concern in this working population. Our findings highlight the need for WHPPs that support nurses in managing stress and transforming the work environment to facilitate healthy lifestyles.
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Skaalvik, Mari Wolff; Normann, Hans Ketil; Henriksen, Nils
2011-08-01
To measure nursing students' experiences and satisfaction with their clinical learning environments. The primary interest was to compare the results between students with respect to clinical practice in nursing homes and hospital wards. Clinical learning environments are important for the learning processes of nursing students and for preferences for future workplaces. Working with older people is the least preferred area of practice among nursing students in Norway. A cross-sectional design. A validated questionnaire was distributed to all nursing students from five non-randomly selected university colleges in Norway. A total of 511 nursing students completed a Norwegian version of the questionnaire, Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) evaluation scale in 2009. Data including descriptive statistics were analysed using the Statistical Program for the Social Sciences. Factor structure was analysed by principal component analysis. Differences across sub-groups were tested with chi-square tests and Mann-Whitney U test for categorical variables and t-tests for continuous variables. Ordinal logistic regression analysis of perceptions of the ward as a good learning environment was performed with supervisory relationships and institutional contexts as independent variables, controlling for age, sex and study year. The participating nursing students with clinical placements in nursing homes assessed their clinical learning environment significantly more negatively than those with hospital placements on nearby all sub-dimensions. The evidence found in this study indicates that measures should be taken to strengthen nursing homes as learning environments for nursing students. To recruit more graduated nurses to work in nursing homes, actions to improve the learning environment are needed. © 2011 Blackwell Publishing Ltd.
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Stories of Exemplary Hospital Registered Nurses: A Narrative Analysis
ERIC Educational Resources Information Center
Snelson, Donna Ayers
2010-01-01
Today the multidimensional global shortage of nurses is negatively impacting the work environment of hospital nurses and causing, in a cyclical fashion, decreasing work satisfaction, increasing nurse turnover, and decreasing patient outcomes. While strategies aimed at causation of the nursing shortage must be addressed, to support nursing until…
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Bruyneel, Luk; Li, Baoyue; Ausserhofer, Dietmar; Lesaffre, Emmanuel; Dumitrescu, Irina; Smith, Herbert L.; Sloane, Douglas M.; Aiken, Linda H.; Sermeus, Walter
2015-01-01
This study integrates previously isolated findings of nursing outcomes research into an explanatory framework in which care left undone and nurse education levels are of key importance. A moderated mediation analysis of survey data from 11,549 patients and 10,733 nurses in 217 hospitals in eight European countries shows that patient care experience is better in hospitals with better nurse staffing and a more favorable work environment in which less clinical care is left undone. Clinical care left undone is a mediator in this relationship. Clinical care is left undone less frequently in hospitals with better nurse staffing and more favorable nurse work environments, and in which nurses work less overtime and are more experienced. Higher proportions of nurses with a bachelor’s degree reduce the effect of worse nurse staffing on more clinical care left undone. PMID:26062612
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Bruyneel, Luk; Li, Baoyue; Ausserhofer, Dietmar; Lesaffre, Emmanuel; Dumitrescu, Irina; Smith, Herbert L; Sloane, Douglas M; Aiken, Linda H; Sermeus, Walter
2015-12-01
This study integrates previously isolated findings of nursing outcomes research into an explanatory framework in which care left undone and nurse education levels are of key importance. A moderated mediation analysis of survey data from 11,549 patients and 10,733 nurses in 217 hospitals in eight European countries shows that patient care experience is better in hospitals with better nurse staffing and a more favorable work environment in which less clinical care is left undone. Clinical care left undone is a mediator in this relationship. Clinical care is left undone less frequently in hospitals with better nurse staffing and more favorable nurse work environments, and in which nurses work less overtime and are more experienced. Higher proportions of nurses with a bachelor's degree reduce the effect of worse nurse staffing on more clinical care left undone. © The Author(s) 2015.
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Self-reported environmental health risks of nurses working in hospital surgical units.
Azizoğlu, F; Köse, A; Gül, H
2018-06-21
This study investigated the occupational health risk factors among nurses who work in public hospital surgical units. Nursing has a significant place in healthcare systems around the world. Surgical units are environments with certain risks, especially because of the possibility of exposure to various chemical, biologic or physical hazards. This study was conducted with 229 nurses who were working in the 11 surgery units of a big university hospital. In this cross-sectional study, a personal information form and an occupational risk factors scale were administered to respondents. We performed factor and reliability analyses for the scale; the overall reliability of the 41 items was α = 0.924, and the factor analysis found the scale was feasible. Biologic and psychological risk factor levels were found to be high. Physical, chemical, ergonomic and radiation risk factor levels were moderate. The general occupational risk factor score was moderate. Nurses working night duty were confronted with physical and psychological risk factors at a higher rate compared with those working in the daytime. Reported occupational health problems by nurses were correlated with the descriptive properties of the nurses including age, sex, marital status, education level, working hours, mode of working and status of occupational health and safety training. Nurses experience different occupational risks. If these risks are identified, healthier working environments can be provided to the nurses by taking necessary precautions. The health care provided by nurses who work in a healthy environment would be more efficient and of better quality, which will result in better economic and social outcomes for individual and communities. © 2018 International Council of Nurses.
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The impact of nurse empowerment on job satisfaction.
Ning, Sun; Zhong, He; Libo, Wang; Qiujie, Li
2009-12-01
This paper is a report of a study conducted to test Kanter's organizational empowerment theoretical model specifying the relationships among demographics, structural empowerment, and job satisfaction. Empowerment has become an increasingly important factor in determining nurses' job satisfaction in current restructured work environments in China. A correlational, cross-sectional design was used to test Kanter's organizational empowerment model with a sample of 650 full-time nurses employed in six Chinese hospitals in 2007, with a response rate of 92% (n = 598). The instruments used were the Demographic Data Questionnaire, Conditions of Work Effectiveness Questionnaire-II, and Job Satisfaction Scale. The three lowest scoring items for Conditions of Work Effectiveness Questionnaire-II were resources, opportunity and informal power. The job satisfaction items revealing most dissatisfaction were workload and compensation, professional promotion, amount of work responsibility, work environments, and organizational policies. A statistically significant positive correlation was found between empowerment and job satisfaction (r = 0.547, P < 0.01). The demographic factors influencing empowerment were work objectives and age. The influencing factors for job satisfaction were work objectives and education level. The results provide support for Kanter's organizational empowerment theory in the Chinese nurse population. Nurses who view their work environments as empowering are more likely to provide high quality care. Enhancing empowerment in a supportive environment would allow nurses to experience satisfaction with their jobs.
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Providing a healthy work environment for nurses: the influence on retention.
Cohen, Jayne; Stuenkel, Diane; Nguyen, Quyen
2009-01-01
Differences in registered nurses' (RNs) perceptions of their work environment were measured with the Insel and Moos' Work Environment Scale to identify factors in the work environment that may influence retention. Statistically significant differences for perceptions of supervisor support and innovation were found between those RNs who left their unit or hospital during a 24-month period and those who stayed. Implementing strategies to promote retention of RNs to ensure safe, quality patient care is essential.
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Groff-Paris, Lisa; Terhaar, Mary
2010-12-07
The strongest predictor of nurse job dissatisfaction and intent to leave is that of stress in the practice environment. Good communication, control over practice, decision making at the bedside, teamwork, and nurse empowerment have been found to increase nurse satisfaction and decrease turnover. In this article we share our experience of developing a rapid-design process to change the approach to performance improvement so as to increase engagement, empowerment, effectiveness, and the quality of the professional practice environment. Meal and non-meal breaks were identified as the target area for improvement. Qualitative and quantitative data support the success of this project. We begin this article with a review of literature related to work environment and retention and a presentation of the frameworks used to improve the work environment, specifically Maslow's theory of the Hierarchy of Inborn Needs and the National Database of Nursing Quality Indicators Survey. We then describe our performance improvement project and share our conclusion and recommendations.
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Home care nurses' experience of job stress and considerations for the work environment.
Samia, Linda W; Ellenbecker, Carol Hall; Friedman, Donna Haig; Dick, Karen
2012-01-01
Home care nurses report increased stress in their jobs due to work environment characteristics that impact professional practice. Stressors and characteristics of the professional practice environment that moderate nurses' experience of job stress were examined in this embedded multiple case study. Real life experiences within a complex environment were drawn from interviews and observations with 29 participants across two home care agencies from one eastern U.S. state. Findings suggest that role overload, role conflict, and lack of control can be moderated in agencies where there are meaningful opportunities for shared decision making and the nurse-patient relationship is supported.
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Kudo, Yasushi; Kido, Shigeri; Shahzad, Machiko Taruzuka; Shida, Kyoko; Satoh, Toshihiko; Aizawa, Yoshiharu
2010-03-01
Proper work environments are important for nurses to feel motivated. We examined the associations between work motivation and job satisfaction among Japanese nurses to improve their motivation. In Japan, relatively small and medium-sized private hospitals play a central role in the healthcare industry. In the present study, the subjects were nurses working in 23 small and medium-sized private hospitals that had 65 to 326 beds. We analyzed 1,116 registered and licensed practical female nurses (average age, 38.3 years; standard deviation, 11.3 years). Many nurses with their specialized nursing skills dedicate themselves to patient care. However, many of these nurses may not be interested in contributing to their hospitals. Nurses may have different opinions regarding dedication to patient care and contribution to their hospitals. Therefore, concerning work motivation, we produced these two different items, "Nurses' dedication to patients" and "Nurses' contribution to their hospitals." We also produced our own original new job satisfaction questionnaire. We found 7 facets of job satisfaction: "Work as specialists," "Workplace safety," "Relationships with superiors," "Work-life balance," "Relationships among nurses," "Communications with physicians," and "Salary." Multiple linear regression analyses show that both "Nurses' dedication to patients" and "Nurses' contribution to their hospitals" were significantly associated with "Work as specialists." Nurses feel their jobs of protecting people's lives and health are valuable. They do not feel motivated only by money. They value the intrinsic nature of their jobs. Creating proper work environments is important for nurses to be able to work as specialists.
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Work-engaged nurses for a better clinical learning environment: a ward-level analysis.
Tomietto, Marco; Comparcini, Dania; Simonetti, Valentina; Pelusi, Gilda; Troiani, Silvano; Saarikoski, Mikko; Cicolini, Giancarlo
2016-05-01
To correlate workgroup engagement in nursing teams and the clinical learning experience of nursing students. Work engagement plays a pivotal role in explaining motivational dynamics. Nursing education is workplace-based and, through their clinical placements, nursing students develop both their clinical competences and their professional identity. However, there is currently a lack of evidence on the role of work engagement related to students' learning experiences. A total of 519 nurses and 519 nursing students were enrolled in hospital settings. The Utrecht Work Engagement Scale (UWES) was used to assess work engagement, and the Clinical Learning Environment and Supervision plus nurse Teacher (CLES+T) scale was used to assess students' learning experience. A multilevel linear regression analysis was performed. Group-level work engagement of nurses correlated with students' clinical learning experience (β = 0.11, P < 0.001). Specifically, the 'absorption' and 'dedication' factors mostly contributed to enhancing clinical learning (respectively, β = 0.37, P < 0.001 and β = 0.20, P < 0.001). Nursing teams' work engagement is an important motivational factor to enhance effective nursing education. Nursing education institutions and health-care settings need to conjointly work to build effective organisational climates. The results highlighted the importance of considering the group-level analysis to understand the most effective strategies of intervention for both organisations and nursing education. © 2015 John Wiley & Sons Ltd.
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2014-01-01
Background Healthcare organisations monitor patient experiences in order to evaluate and improve the quality of care. Because nurses spend a lot of time with patients, they have a major impact on patient experiences. To improve patient experiences of the quality of care, nurses need to know what factors within the nursing work environment are of influence. The main focus of this research was to comprehend the views of Dutch nurses on how their work and their work environment contribute to positive patient experiences. Methods A descriptive qualitative research design was used to collect data. Four focus groups were conducted, one each with 6 or 7 registered nurses in mental health care, hospital care, home care and nursing home care. A total of 26 nurses were recruited through purposeful sampling. The interviews were audiotaped, transcribed and subjected to thematic analysis. Results The nurses mentioned essential elements that they believe would improve patient experiences of the quality of nursing care: clinically competent nurses, collaborative working relationships, autonomous nursing practice, adequate staffing, control over nursing practice, managerial support and patient-centred culture. They also mentioned several inhibiting factors, such as cost-effectiveness policy and transparency goals for external accountability. Nurses feel pressured to increase productivity and report a high administrative workload. They stated that these factors will not improve patient experiences of the quality of nursing care. Conclusions According to participants, a diverse range of elements affect patient experiences of the quality of nursing care. They believe that incorporating these elements into daily nursing practice would result in more positive patient experiences. However, nurses work in a healthcare context in which they have to reconcile cost-efficiency and accountability with their desire to provide nursing care that is based on patient needs and preferences, and they experience a conflict between these two approaches. Nurses must gain autonomy over their own practice in order to improve patient experiences. PMID:24923663
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ERIC Educational Resources Information Center
Hare, Jan; And Others
Burnout is a phenomenon in which the cumulative effects of a stressful work environment gradually overwhelm the defenses of staff members, causing them to psychologically withdraw. To understand the experience of professional and paraprofessional nurses suffering from burnout requires a close examination of the environments in which they function.…
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Organization of nursing and quality of care for veterans at the end of life.
Kutney-Lee, Ann; Brennan, Caitlin W; Meterko, Mark; Ersek, Mary
2015-03-01
The Veterans Health Administration (VA) has improved the quality of end-of-life (EOL) care over the past several years. Several structural and process variables are associated with better outcomes. Little is known, however, about the relationship between the organization of nursing care and EOL outcomes. To examine the association between the organization of nursing care, including the nurse work environment and nurse staffing levels, and quality of EOL care in VA acute care facilities. Secondary analysis of linked data from the Bereaved Family Survey (BFS), electronic medical record, administrative data, and the VA Nursing Outcomes Database. The sample included 4908 veterans who died in one of 116 VA acute care facilities nationally between October 2010 and September 2011. Unadjusted and adjusted generalized estimating equations were used to examine associations between nursing and BFS outcomes. BFS respondents were 17% more likely to give an excellent overall rating of the quality of EOL care received by the veteran in facilities with better nurse work environments (P ≤ 0.05). The nurse work environment also was a significant predictor of providers listening to concerns and providing desired treatments. Nurse staffing was significantly associated with an excellent overall rating, alerting of the family before death, attention to personal care needs, and the provision of emotional support after the patient's death. Improvement of the nurse work environment and nurse staffing in VA acute care facilities may result in enhanced quality of care received by hospitalized veterans at the EOL. Copyright © 2015 American Academy of Hospice and Palliative Medicine. All rights reserved.
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Stalpers, Dewi; Van Der Linden, Dimitri; Kaljouw, Marian J; Schuurmans, Marieke J
2017-06-01
To examine nurse-perceived quality of care, controlling for overall job satisfaction among critical care nurses and to explore associations with work environment characteristics. Nurse-perceived quality of care and job satisfaction have been positively linked to quality outcomes for nurses and patients. Much evidence exists on factors contributing to job satisfaction. Understanding specific factors that affect nurse-perceived quality potentially enables for improvements of nursing care quality. A multicentre survey study was conducted in three Dutch intensive care units. The Dutch version of the Essentials of Magnetism II questionnaire was used; including the single-item indicators: (i) nurse-perceived quality of care; (ii) overall job satisfaction; and (iii) 58 statements on work environments. Data were collected between October 2013 - June 2014. The majority of 123 responding nurses (response rate 45%) were more than satisfied with quality of care (55%) and with their job (66%). No associations were found with nurse characteristics, besides differences in job satisfaction between the units. After controlling for job satisfaction, nurse-perceived quality was positively associated with the work environment characteristics: adequacy of staffing, patient-centeredness, competent peers and support for education. Patient-centeredness and autonomy were the most important predictors for overall job satisfaction. Factors that contribute to nurse-perceived quality of care in intensive care units, independent from the effects of overall job satisfaction, were identified. Hereby, offering opportunities to maximize high quality of care to critically ill patients. Research in a larger sample is needed to confirm our findings. © 2016 John Wiley & Sons Ltd.
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Organization of Hospital Nursing and 30-Day Readmissions in Medicare Patients Undergoing Surgery.
Ma, Chenjuan; McHugh, Matthew D; Aiken, Linda H
2015-01-01
Growing scrutiny of readmissions has placed hospitals at the center of readmission prevention. Little is known, however, about hospital nursing—a critical organizational component of hospital service system—in relation to readmissions. To determine the relationships between hospital nursing factors—nurse work environment, nurse staffing, and nurse education—and 30-day readmissions among Medicare patients undergoing general, orthopedic, and vascular surgery. We linked Medicare patient discharge data, multistate nurse survey data, and American Hospital Association Annual Survey data. Our sample included 220,914 Medicare surgical patients and 25,082 nurses from 528 hospitals in 4 states (California, Florida, New Jersey, and Pennsylvania). Risk-adjusted robust logistic regressions were used for analyses. The average 30-day readmission rate was 10% in our sample (general surgery: 11%; orthopedic surgery: 8%; vascular surgery: 12%). Readmission rates varied widely across surgical procedures and could be as high as 26% (upper limb and toe amputation for circulatory system disorders). Each additional patient per nurse increased the odds of readmission by 3% (OR=1.03; 95% CI, 1.00-1.05). Patients cared in hospitals with better nurse work environments had lower odds of readmission (OR=0.97; 95% CI, 0.95-0.99). Administrative support to nursing practice (OR=0.96; 95% CI, 0.94-0.99) and nurse-physician relations (OR=0.97; 95% CI, 0.95-0.99) were 2 main attributes of the work environment that were associated with readmissions. Better nurse staffing and work environment were significantly associated with 30-day readmission, and can be considered as system-level interventions to reduce readmissions and associated financial penalties.
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Creating quality practice environments: not easy, but essential.
Winslow, Wendy
2004-01-01
Quality practice environments for registered nurses correlate positively with job satisfaction, productivity, recruitment, retention and client outcomes. However, when registered nurses work in environments that do not enable them to consistently meet their nursing practice standards, patient safety is jeopardized. This article describes the development of Canada's first guidelines for a quality practice environment for registered nurses in all practice environments. It is a tool healthcare leaders can use to improve the practice environment of all health professionals and to promote patient safety.
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Leader Empowering Behaviours and Work Engagement: The Mediating Role of Structural Empowerment.
Cziraki, Karen; Laschinger, Heather
2015-09-01
Reports of poor working conditions persist amid ongoing healthcare restructuring. Simultaneously, nursing shortage threats continue as the nursing population ages. Leadership strategies that create empowering working conditions are likely to retain nurses who are eligible to retire, and attract future nurses to the profession. Several studies have focused on leader behaviours and structural empowerment in recent years and how these impact the work environment and staff engagement. Correlations among leader empowering behaviours, structural empowerment and work engagement have been demonstrated (Laschinger et al. 1999; Peachey 2002); however, there is a gap in the empirical literature as to how leader empowering behaviours influence nurses' work engagement by creating structurally empowering work environments. Kanter's (1977, 1993) structural empowerment theory was used to test this proposition using data from a cross-sectional study of 322 Ontario staff nurses. Mediation analysis revealed that structural empowerment partially mediated the influence of leader empowering behaviours on work engagement. The implications for healthcare managers and leaders are discussed with a view to the recruitment and retention of nursing staff, by fostering greater work engagement. Copyright © 2015 Longwoods Publishing.
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Nurses' perceptions of their professional practice environment: a cross-sectional study.
Cao, Yingjuan; DiGiacomo, Michelle; Salamonson, Yenna; Li, Ye; Huai, Baosha; Davidson, Patricia M
2015-12-01
To describe nurses' perceptions concerning their professional practice environment in mainland China and identify factors associated with these views. Globally, the environments in which nurses work influence the quality of nursing practice and health care. A cross-sectional descriptive survey using both paper- and online-based delivery modes was used. A convenience sampling method was used. The survey questionnaire was composed of sociodemographic items and the 38-item Chinese version of Professional Practice Environment survey. The content of the paper-based questionnaire was identical to the online survey. Pearson's chi-square test was conducted to compare the demographic characteristics of these two data sets. Descriptive statistics analysis included frequency, percentage, mean and standard deviation. Multiple linear regression analysis using the Backwards method was applied to identify independent predictors of each subscale of the 38-item Chinese version of Professional Practice Environment. A total of 573 questionnaires were analysed. The mean score of each subscale of the 38-item Chinese version of Professional Practice Environment in this study ranged from 2·66-3·05. All subscales except work motivation (3·05, standard deviation: 0·44) scored less than 3·0. Areas rated as most in need of improvement included control over practice, interpersonal interaction, supportive leadership and handling conflict, and staff relationships with physicians and autonomy. This study has identified nurses' perspectives regarding their workplaces in contemporary China. These data have provided an important baseline for developing and implementing culturally appropriate strategies to improve the working environment of Chinese nurses. A supportive and enabling work environment promotes professional development and the safety and quality of health care. Addressing these factors is important in optimising work place environments. © 2015 John Wiley & Sons Ltd.
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Development and psychometric evaluation of the Core Nurse Resource Scale.
Simpson, Michelle R
2010-11-01
To examine the factor structure, internal consistency reliability and concurrent-related validity of the Core Nurse Resource Scale. A cross-sectional survey study design was used to obtain a sample of 149 nurses and nursing staff [Registered Nurse (RNs), Licensed Practical Nurse (LPNs) and Certified Nursing Assistant (CNAs)] working in long-term care facilities. Exploratory factor analysis, Cronbach's alpha and bivariate correlations were used to evaluate validity and reliability. Exploratory factor analysis yielded a scale with 18 items on three factors, accounting for 52% of the variance in scores. Internal consistency reliability for the composite and Core Nurse Resource Scale factors ranged from 0.79 to 0.91. The Core Nurse Resource Scale composite scale and subscales correlated positively with a measure of work engagement (r=0.247-0.572). The initial psychometric evaluation of the Core Nurse Resource Scale demonstrates it is a sound measure. Further validity and reliability assessment will need to be explored and assessed among nurses and other nursing staff working in other practice settings. The intent of the Core Nurse Resource Scale is to evaluate the presence of physical, psychological and social resources of the nursing work environment, to identify workplaces at risk for disengaged (low work engagement) nursing staff and to provide useful diagnostic information to healthcare administrators interested in interventions to improve the nursing work environment. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.
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Nurses who work outside nursing.
Duffield, Christine; Pallas, Linda O'Brien; Aitken, Leanne M
2004-09-01
The desire to care for people, a family history of professional health care work, and security in career choice are documented reasons for entering nursing. Reasons for leaving include workload, unsafe work environments and harassment. The relationship between these factors and the time nurses spend in the profession has not been explored. This paper reports a study with people who have left nursing, to investigate why they became a nurse, how long they stayed in nursing, and their reasons for leaving. A questionnaire was mailed to Registered Nurses currently working outside nursing, seeking respondents' reasons for entering and leaving nursing, and perceptions of the skills gained from nursing and the ease of adjustment to working in a non-nursing environment. Data analysis included descriptive statistics, exploratory and confirmatory factor analysis, correlational analysis and linear and multiple regression analysis. A model incorporating the factors 'altruistic reasons', 'default choice' and 'stepping stone' explained 36.2% of the variance in reasons for becoming a nurse. A model incorporating the factors 'legal and employer', 'external values and beliefs about nursing', 'professional practice', 'work life/home life' and 'contract requirements' explained 55.4% of the variance in reasons for leaving nursing. Forty-eight per cent of the variance in tenure in nursing practice was explained through personal characteristics of nurses (36%), reasons for becoming a nurse (7%) and reasons for leaving (6%). The reasons why nurses entered or left the profession were varied and complex. While personal characteristics accounted for a large component of tenure in nursing, those managing the nursing workforce should consider professional practice issues and the balance between work life and home life.
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Nursing Workload and the Changing Health Care Environment: A Review of the Literature
ERIC Educational Resources Information Center
Neill, Denise
2011-01-01
Changes in the health care environment have impacted nursing workload, quality of care, and patient safety. Traditional nursing workload measures do not guarantee efficiency, nor do they adequately capture the complexity of nursing workload. Review of the literature indicates nurses perceive the quality of their work has diminished. Research has…
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Melnyk, Bernadette Mazurek; Hrabe, David P; Szalacha, Laura A
2013-01-01
Although nurses are educated to take outstanding care of others, they themselves often have poor health outcomes, including high rates of depression and obesity, which are associated with stressful work environments. Furthermore, a high percentage of new graduate nurses leave their positions in the first year of employment, resulting in exorbitant costs to health care systems. The aim of this study was to determine the relationships among key variables that influence job satisfaction and healthy lifestyle behaviors of new graduate nurses, including workplace stress, work environment, lifestyle beliefs, and mental health. A descriptive correlational design was used with baseline data from 61 new graduate nurses attending the 2-day Nurse Athlete program, a workshop that focuses on nutrition, energy management, and physical activity. Higher levels of workplace stress were associated with higher levels of depression and anxiety as well as lower levels of resiliency, job satisfaction, and healthy lifestyle beliefs. Nurse leaders and managers must invest in creating healthy work environments for new and experienced nurses as well as provide mental health screening, resources, and intervention programs that focus on education and skills-building in health promoting behaviors, including emotional regulation of stress, anxiety, and depression.
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The work environment and empowerment as predictors of patient safety culture in Turkey.
Dirik, Hasan Fehmi; Intepeler, Seyda Seren
2017-05-01
As scant research based information is available regarding the work environment, empowerment and patient safety culture, this study from a developing country (Turkey) in which health care institutions are in a state of transition, aimed to investigate further the relationships between these three variables. A cross-sectional descriptive design was employed. The sample comprised 274 nurse participants working in a university hospital located in Izmir (Turkey). In data evaluation, descriptive statistics and hierarchical regression analyses were applied. The work environment and structural empowerment were related to the patient safety culture and explained 55% of the variance in patient safety culture perceptions. 'Support for optimal patient care', 'nurse/physician relationships' and 'staff involvement in organisational affairs' were the significant predictors. An enhancement of the work environment and providing access to empowerment structures may help health care organisations improve the patient safety culture. In light of the findings, the following actions can be recommended to inform health care leaders: providing necessary resources for nursing practise, encouraging nurses' participation in decision-making, strengthening communication within the team and giving nurses the opportunities to cope with challenging work problems to learn and grow. © 2017 John Wiley & Sons Ltd.
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Job satisfaction of overseas-qualified nurses working in Australian hospitals.
Timilsina Bhandari, K K; Xiao, L D; Belan, I
2015-03-01
The aims of this study were to explore factors associated with the job satisfaction of overseas-qualified nurses working in public hospitals in South Australia and to compare whether factors associated with job satisfaction of overseas nurses from English-speaking backgrounds differed from those from non-English-speaking backgrounds. Overseas-qualified nurses have become an essential part of the nursing workforce in Australia. Although this nurse population has different expectations and values in relation to their jobs when compared with local nurses, studies on job satisfaction among overseas nurses are scarce. A cross-sectional survey using the Job Satisfaction of Overseas-Qualified Nurses questionnaire was conducted in five major public hospitals in South Australia. One hundred and fifty-one overseas-qualified nurses completed the questionnaire. Four factors were found to influence job satisfaction: Supportive work environment, interpersonal relationships, communication in English, and salary and salary-related benefits. Communication in English was the predominant factor that was associated with job satisfaction in nurses from non-English-speaking backgrounds. This group of nurses also showed a negative correlation between length of stay in Australia and satisfaction with their work environment. Participants' responses to open-ended questions revealed issues relating to discrimination and racism. Supportive work environment, interpersonal relationships, communication in English, and salary and salary-related benefits were major factors associated with job satisfaction in overseas-qualified nurses in this study. Nurses from non-English-speaking backgrounds faced additional challenges in communication in the workplace and in dealing with issues of discrimination and racism. Nurses from non-English-speaking backgrounds need to be supported early in their employment, especially with their communication skills. Consideration also needs to be given to the education of local staff regarding cultural differences of overseas workers. © 2014 International Council of Nurses.
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Park, Mihyun; Cho, Sung-Hyun; Hong, Hyun-Ja
2015-01-01
To identify the prevalence and perpetrators of workplace violence against nurses and to examine the relationship of work demands and trust and justice in the workplace with the occurrence of violence. This study employed cross-sectional data from a 2013 nurse survey conducted at a university hospital in Seoul, South Korea. The study sample included 970 female nurses from 47 nursing units, including general, oncology, intensive care units (ICUs), operating rooms, and outpatient departments. The second version of the medium-sized Copenhagen Psychosocial Questionnaire (COPSOQ II) was used to measure work demands (i.e., quantitative demands, work pace, and emotional demands), trust and justice, and violence. Relationships among those variables were examined by conducting multiple logistic regression analyses with multilevel modeling. The 12-month prevalence of verbal abuse (63.8%) was highest, followed by threats of violence (41.6%), physical violence (22.3%), and sexual harassment (19.7%), but bullying had the lowest prevalence (9.7%). Physical violence, threats of violence, and verbal abuse occurred most frequently in ICUs, whereas sexual harassment and bullying were highest in operating rooms. The main perpetrators were patients, followed by physicians and patients' families. Nurses perceiving greater work demands and less trust and justice were more likely to have been exposed to violence. The prevalence and perpetrators of violence varied considerably among nursing units. Greater work demands and less trust and justice were associated with nurses' experiences of violence. Adequate work demands and a trusted and just work environment may reduce violence against nurses. In return, reduction of violence will contribute to creating a better nursing work environment. © 2014 Sigma Theta Tau International.
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Registered nurse job satisfaction and satisfaction with the professional practice model.
McGlynn, Karen; Griffin, Mary Quinn; Donahue, Moreen; Fitzpatrick, Joyce J
2012-03-01
This paper describes the initial assessment of job satisfaction and satisfaction with the professional practice environment of registered nurses working on units where a professional practice model was implemented and the relationship between these two variables. The nursing shortage has been linked to overall job satisfaction and specifically to nurses' satisfaction with the professional practice environment. Initiatives to increase retention and recruitment and decrease turnover have been linked to work satisfaction among nurses. A descriptive, cross-sectional design was used with participants (N = 101) from four patient care units; this represented a 55% response rate. The nurses were moderately satisfied with the professional practice environment but had overall low job satisfaction. There was a significant negative relationship between overall work satisfaction and satisfaction with the professional practice environment (P < 0.0001). The introduction of the professional practice model may have raised awareness of the components of job satisfaction that were not being met. Thus, the nurses may have become more knowledgeable about the potential needs in these areas. Nurse managers and leaders must recognize that job satisfaction consists of many dimensions, and each of these dimensions is important to nurse retention. Implementation of a professional practice model may heighten awareness of the missing components within a practice environment and lead to decreased overall satisfaction. A broader understanding of characteristics associated with increased satisfaction may aid in development of organizational change necessary to retain and attract nurses. © 2012 Blackwell Publishing Ltd.
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Leader empowering behaviours, staff nurse empowerment and work engagement/burnout.
Greco, Paula; Laschinger, Heather K Spence; Wong, Carol
2006-12-01
Efforts to improve nursing working conditions are critical to retaining nurses currently in the system and attracting newcomers to the profession (Laschinger et al. 2003b). The nurse leader's empowering behaviours can be pivotal in the way nurses react to their work environment. The purpose of this study was to test a model examining the relationship between nurse leaders' empowerment behaviours, perceptions of staff empowerment, areas of work life and work engagement using Kanter's theory of structural power in organizations. A cross-sectional correlational survey design tested the model in a random sample of 322 staff nurses in acute care hospitals across Ontario. Overall, staff nurses perceived their leaders' behaviours to be somewhat empowering and their work environment to be moderately empowering. Fifty-three percent reported severe levels of burnout. Leader empowering behaviour had an indirect effect on emotional exhaustion (burnout) through structural empowerment and overall fit in the six areas of work life. The final model statistics revealed a good fit (chi(2)=30.4, chi=3, chi=0.96, chi=0.95, chi=0.95). These findings suggest that the Leader's empowering behaviours can enhance person-job fit and prevent burnout. These findings have important implications in the current nursing shortage.
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Effects of hospital care environment on patient mortality and nurse outcomes.
Aiken, Linda H; Clarke, Sean P; Sloane, Douglas M; Lake, Eileen T; Cheney, Timothy
2009-01-01
The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. Staffing and education have well-documented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients. Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments. Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.
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Effects of hospital care environment on patient mortality and nurse outcomes.
Aiken, Linda H; Clarke, Sean P; Sloane, Douglas M; Lake, Eileen T; Cheney, Timothy
2008-05-01
The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. Staffing and education have well-documented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients. Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments. Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.
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Authentic leadership, empowerment and burnout: a comparison in new graduates and experienced nurses.
Laschinger, Heather K Spence; Wong, Carol A; Grau, Ashley L
2013-04-01
To examine the effect of authentic leadership and structural empowerment on the emotional exhaustion and cynicism of new graduates and experienced acute-care nurses. Employee empowerment is a fundamental component of healthy work environments that promote nurse health and retention, and nursing leadership is key to creating these environments. In a secondary analysis of data from two studies we compared the pattern of relationships among study variables in two Ontario groups: 342 new graduates with <2 years of experience and 273 nurses with more than 2 years of experience. A multi-group path analysis using Structural Equation Modelling indicated an acceptable fit of the final model (χ(2) = 17.52, df = 2, P < 0.001, CFI = 0.97, IFI = 0.97 and RMSEA = 0.11). Authentic leadership significantly and negatively influenced emotional exhaustion and cynicism through workplace empowerment in both groups. The authentic behaviour of nursing leaders was important to nurses' perceptions of structurally empowering conditions in their work environments, regardless of experience level, and ultimately contributed to lower levels of emotional exhaustion and cynicism. Leadership training for nurse managers may help develop the empowering work environments required in today's health-care organizations in order to attract and retain nurses. © 2012 Blackwell Publishing Ltd.
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Dhaini, Suzanne R; Denhaerynck, Kris; Bachnick, Stefanie; Schwendimann, René; Schubert, Maria; De Geest, Sabina; Simon, Michael
2018-06-01
Emotional exhaustion among healthcare workers is a widely investigated, well-recognized problem, the incidence of which has recently been linked to work environment factors, particularly work/family conflict. However, another environmental feature that may be equally influential, but that is more amenable to nurse manager action, remains less recognized: shift schedule flexibility. This study's main purposes were to assess variations in work schedule flexibility between Swiss acute care hospital units, and to investigate associations between psychosocial work environment (e.g. work schedule flexibility) and self-reported emotional exhaustion among registered nurses. This is a secondary analysis of data collected for the multi-center observational cross-sectional Match RN study, which included a national sample of 23 hospitals and 1833 registered nurses across Switzerland. Overall, self-reported work schedule flexibility among registered nurses was limited: 32% of participants reported little or no influence in planning their own shifts. Work schedule flexibility (β -0.11; CI -0.16; -0.06) and perceived nurse manager ability (β -0.30; CI -0.49; -0.10) were negatively related to self-reported emotional exhaustion. Work-family conflict (β 0.39; CI 0.33; 0.45) was positively correlated to emotional exhaustion. The study results indicate that managerial efforts to improve working environments, including special efforts to improve work schedule flexibility, might play an important role in promoting nurses' emotional health. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Brewer, Carol S; Kovner, Christine T; Obeidat, Rana F; Budin, Wendy C
2013-01-01
Verbal abuse in the workplace is experienced by registered nurses (RNs) worldwide; physicians are one of the main sources of verbal abuse. To examine the relationship between levels of physician verbal abuse of early-career RNs and demographics, work attributes, and perceived work environment. Fourth wave of a mailed national panel survey of early career RNs begun in 2006. RNs' perception of verbal abuse by physicians was significantly associated with poor workgroup cohesion, lower supervisory and mentor support, greater quantitative workload, organizational constraints, and nurse-colleague verbal abuse, as well as RNs' lower job satisfaction, organizational commitment, and intent to stay. RNs working in unfavorable work environments experience more physician abuse and have less favorable work attitudes. Causality is unclear: do poor working conditions create an environment in which physicians are more likely to be abusive, or does verbal abuse by physicians create an unfavorable work environment? Copyright © 2013 Elsevier Inc. All rights reserved.
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Gabriel, Allison S; Erickson, Rebecca J; Moran, Christina M; Diefendorff, James M; Bromley, Gail E
2013-12-01
Few researchers have examined how the components of the Practice Environment Scale of the Nursing Work Index (PES-NWI) relate to nurses' well-being at multiple organizational levels. The objective of the study was to perform a multilevel assessment of the relationships of the PES-NWI subscales with three nurse outcomes: job satisfaction, emotional exhaustion, and turnover intentions. Additionally, we tested the multilevel factor structure of the PES-NWI. In a sample of 699 full-time registered nurses in 79 units and 9 branches of a hospital system, relationships of the NWI with nurse outcomes were fairly consistent across levels of analysis. However, subscales contributed differently to the three outcomes, demonstrating the complexity of environmental influences on nurses' work experience. © 2013 Wiley Periodicals, Inc.
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Uchiyama, Ayako; Odagiri, Yuko; Ohya, Yumiko; Takamiya, Tomoko; Inoue, Shigeru; Shimomitsu, Teruichi
2013-01-01
Improvement of psychosocial work environment has proved to be valuable for workers' mental health. However, limited evidence is available for the effectiveness of participatory interventions. The purpose of this study was to investigate the effect on mental health among nurses of a participatory intervention to improve the psychosocial work environment. A cluster randomized controlled trial was conducted in hospital settings. A total of 434 nurses in 24 units were randomly allocated to 11 intervention units (n=183) and 13 control units (n=218). A participatory program was provided to the intervention units for 6 months. Depressive symptoms as mental health status and psychosocial work environment, assessed by the Job Content Questionnaire, the Effort-Reward Imbalance Questionnaire, and the Quality Work Competence questionnaire, were measured before and immediately after the 6-month intervention by a self-administered questionnaire. No significant intervention effect was observed for mental health status. However, significant intervention effects were observed in psychosocial work environment aspects, such as Coworker Support (p<0.01) and Goals (p<0.01), and borderline significance was observed for Job Control (p<0.10). It is suggested that a 6-month participatory intervention is effective in improving psychosocial work environment, but not mental health, among Japanese nurses.
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Siu, Heidi; Spence Laschinger, Heather K; Finegan, Joan
2008-05-01
The aim of this study was to examine the impact of nurses' perceived professional practice environment on their quality of nursing conflict management approaches and ultimately their perceptions of unit effectiveness from the perspective of Deutsch's theory of constructive conflict management. Rising reports of hostility and conflict among Canadian nurses are a concern to nurses' health and the viability of effective patient care delivery. However, research on the situational factors that influence nurses' ability to apply effective conflict resolution skills that lead to positive results in practice is limited. A nonexperimental, predictive design was used in a sample of 678 registered nurses working in community hospitals within a large metropolitan area in Ontario. The results supported a modified version of the hypothesized model [chi2(1) = 16.25, Goodness of Fit = 0.99, Comparative Fit Index = 0.98, Root-Mean-Square Error of Approximation = 0.15] linking professional practice environment and core self-evaluation to nurses' conflict management and, ultimately, unit effectiveness. Professional practice environment, conflict management, and core-self evaluation explained approximately 46.6% of the variance in unit effectiveness. Positive professional practice environments and high core self-evaluations predicted nurses' constructive conflict management and, in turn, greater unit effectiveness.
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Nursing from the casual pool: focus group study to explore the experiences of casual nurses.
FitzGerald, Mary; McMillan, Margaret; Maguire, Jane Margaret
2007-08-01
The use of flexible non-contract nursing staff is increasing in Australia and in other countries where there is currently a nursing shortage. There is sparse empirical evidence relating to the experience of these nurses. This focus group study with six groups of enrolled and registered nurses in one regional health authority in New South Wales reports on the challenges and rewards of working through the casual pool. The textual data were coded and reported in themes and subthemes; the overarching theme is balance of social and professional life, while subthemes are social politics, nursing work and professional performance. The results reveal that nurses who work from the casual pool have insight into the work environment and culture of clinical teams that is untapped formally. They have little or no chance to provide clinical teams with feedback or receive feedback on their own performance. The consequence of this study has been the development of a two-way performance intervention to promote high standards of care from nurses who work from the casual pool and the promotion of safe clinical environments and cultures.
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Warshawsky, Nora E; Havens, Donna S; Knafl, George
2012-09-01
This study tested the effects of interpersonal relationships on nurse managers' work engagement and proactive work behavior. An engaged workforce may help healthcare organizations improve performance. In healthcare, nurse managers are responsible for creating motivating work environments. They also need to be engaged, yet little is known about what influences nurse managers' performance. A self-administered electronic survey was used to collect data from 323 nurse managers working in acute care hospitals. Instruments included the Relational Coordination Scale, Utrecht Work Engagement Scale, and Proactive Work Behavior Scale. Interpersonal relationships with nurse administrators were most predictive of nurse managers' work engagement. Interpersonal relationships with physicians were most predictive of nurse managers' proactive work behavior. Organizational cultures that foster quality interpersonal relationships will support the job performance of nurse managers.
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Conflict resolution styles in the nursing profession.
Losa Iglesias, Marta Elena; Becerro de Bengoa Vallejo, Ricardo
2012-12-01
Managers, including those in nursing environments, may spend much of their time addressing employee conflicts. If not handled properly, conflict may significantly affect employee morale, increase turnover, and even result in litigation, ultimately affecting the overall well-being of the organization. A clearer understanding of the factors that underlie conflict resolution styles could lead to the promotion of better management strategies. The aim of this research was to identify the predominant conflict resolution styles used by a sample of Spanish nurses in two work settings, academic and clinical, in order to determine differences between these environments. The effects of employment level and demographic variables were explored as well. Descriptive cross-sectional survey study. Our sample consisted of professional nurses in Madrid, Spain, who worked in either a university setting or a clinical care setting. Within each of these environments, nurses worked at one of three levels: full professor, assistant professor, or scholarship professor in the academic setting; and nursing supervisor, registered staff nurse, or nursing assistant in the clinical setting. Conflict resolution style was examined using the standardized Thomas-Kilmann Conflict Mode Instrument, a dual-choice questionnaire that assesses a respondent's predominant style of conflict resolution. Five styles are defined: accommodating, avoiding, collaborating, competing, and compromising. Participants were asked to give answers that characterized their dominant response in a conflict situation involving either a superior or a subordinate. Descriptive and inferential statistics were used to examine the relationship between workplace setting and conflict resolution style. The most common style used by nurses overall to resolve workplace conflict was compromising, followed by competing, avoiding, accommodating, and collaborating. There was a significant overall difference in styles between nurses who worked in an academic vs. a clinical setting (p = 0.005), with the greatest difference seen for the accommodating style. Of those nurses for whom accommodation was the primary style, 83% worked in a clinical setting compared to just 17% in an academic setting. Further examination of the difference in conflict-solving approaches between academic and clinical nursing environments might shed light on etiologic factors, which in turn might enable nursing management to institute conflict management interventions that are tailored to specific work environments and adapted to different employment levels. This research increases our understanding of preferred approaches to handling conflict in nursing organizations.
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Atefi, N; Abdullah, K L; Wong, L P; Mazlom, R
2014-09-01
The purpose of this qualitative descriptive study was to explore factors related to critical care and medical-surgical nurses' job satisfaction as well as dissatisfaction in Iran. Job satisfaction is an important factor in healthcare settings. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care. A convenient sample of 85 nurses from surgical, medical and critical care wards of a large hospital was recruited. Ten focus group discussions using a semi-structured interview guide were conducted. Interviews were audio-recorded, transcribed verbatim and analysed using a thematic approach. The study identified three main themes that influenced nurses' job satisfaction and dissatisfaction: (1) spiritual feeling, (2) work environment factors, and (3) motivation. Helping and involvement in patient care contributed to the spiritual feeling reported to influence nurses' job satisfaction. For work environment factors, team cohesion, benefit and rewards, working conditions, lack of medical resources, unclear nurses' responsibilities, patient and doctor perceptions, poor leadership skills and discrimination at work played an important role in nurses' job dissatisfaction. For motivation factors, task requirement, professional development and lack of clinical autonomy contributed to nurses' job satisfaction. Nurse managers should ensure a flexible practice environment with adequate staffing and resources with opportunities for nurses to participate in hospital's policies and governance. Policy makers should consider nurses' professional development needs, and implement initiatives to improve nurses' rewards and other benefits as they influence job satisfaction. © 2014 International Council of Nurses.
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Sundberg, Fredrika; Olausson, Sepideh; Fridh, Isabell; Lindahl, Berit
2017-12-01
It has been known for centuries that environment in healthcare has an impact, but despite this, environment has been overshadowed by technological and medical progress, especially in intensive care. Evidence-based design is a concept concerning integrating knowledge from various research disciplines and its application to healing environments. The aim was to explore the experiences of nursing staff of working in an evidence-based designed ICU patient room. Interviews were carried out with eight critical care nurses and five assistant nurses and then subjected to qualitative content analysis. The experience of working in an evidence-based designed intensive care unit patient room was that the room stimulates alertness and promotes wellbeing in the nursing staff, fostering their caring activities but also that the interior design of the medical and technical equipment challenges nursing actions. The room explored in this study had been rebuilt in order to create and evaluate a healing environment. This study showed that the new environment had a great impact on the caring staffs' wellbeing and their caring behaviour. At a time when turnover in nurses is high and sick leave is increasing, these findings show the importance of interior design ofintensive care units. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Hospital Nurses' Work Environment Characteristics and Patient Safety Outcomes: A Literature Review.
Lee, Seung Eun; Scott, Linda D
2018-01-01
This integrative literature review assesses the relationship between hospital nurses' work environment characteristics and patient safety outcomes and recommends directions for future research based on examination of the literature. Using an electronic search of five databases, 18 studies published in English between 1999 and 2016 were identified for review. All but one study used a cross-sectional design, and only four used a conceptual/theoretical framework to guide the research. No definition of work environment was provided in most studies. Differing variables and instruments were used to measure patient outcomes, and findings regarding the effects of work environment on patient outcomes were inconsistent. To clarify the relationship between nurses' work environment characteristics and patient safety outcomes, researchers should consider using a longitudinal study design, using a theoretical foundation, and providing clear operational definitions of concepts. Moreover, given the inconsistent findings of previous studies, they should choose their measurement methodologies with care.
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Nursing Services Delivery Theory: an open system approach.
Meyer, Raquel M; O'Brien-Pallas, Linda L
2010-12-01
This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations. The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a 'black box' that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations. A search of CINAHL and Business Source Premier for the years 1980-2008 was conducted using the following terms: theory, models, organization, organizational structure, management, administration, nursing units, and nursing. Seminal works were included. The healthcare organization is conceptualized as an open system characterized by energy transformation, a dynamic steady state, negative entropy, event cycles, negative feedback, differentiation, integration and coordination, and equifinality. The Nursing Services Delivery Theory proposes that input, throughput, and output factors interact dynamically to influence the global work demands placed on nursing work groups at the point of care in production subsystems. THE Nursing Services Delivery Theory can be applied to varied settings, cultures, and countries and supports the study of multi-level phenomena and cross-level effects. The Nursing Services Delivery Theory gives a relational structure for reconciling disparate streams of research related to nursing work, staffing, and work environments. The theory can guide future research and the management of nursing services in large-scale healthcare organizations. © 2010 Blackwell Publishing Ltd.
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Turnover intention among hospital-based registered nurses in the Eastern Caribbean.
Lansiquot, Beverley Anne; Tullai-McGuinness, Susan; Madigan, Elizabeth
2012-06-01
Vacancy rates for nurses in the English-speaking Caribbean are estimated at 30% with turnover typically associated with migration. The purpose of this study was to describe the characteristics of hospital-based registered nurses (RNs) in the sub-region, their practice environment and turnover intention in two and five years, respectively, and to determine the relationships among practice environment characteristics and turnover intention. A descriptive correlational design was used with self-reported questionnaires from a convenience sample of 301 RNs working in hospitals in four English speaking Eastern Caribbean countries. Single-item visual analog scales (VAS) were used to measure turnover intention in 2 years and 5 years. The Practice Environment Scale of the Nursing Work Index (PES-NWI) measured the characteristics in the practice environment. The mean age of the nurses was 32.5 (SD = 6.75) years. Most nurses (58.8%) were single and 91.4% had relatives living abroad. Nurses scored three PES-NWI subscales < 2.5, indicating a less positive practice environment: resource adequacy, nurse participation in hospital affairs, and nurse managers' ability, leadership, and support. The subscale for collegial nurse-physician relations received the best rating (mean = 2.61, SD = .62). For 2-year intention to leave, the mean rating on the 100-mm VAS was 63.2, while that for the 5-year intention to leave was 65.6. No significant correlations were found among four of the five PES-NWI subscales and turnover intention in 2 and 5 years. The practice environment, while generally unfavorable, is not associated with the nurses' intention to leave their jobs. These findings support the current policy position that calls for managing turnover among nurses. Nursing and health system administrators should assess, plan, and implement workforce policies to slow the outflow of nurses. Initiatives to improve the work environment and the delivery of high-quality care are important to RNs in the Eastern Caribbean. Managing the negative impact of continuous outflow of nurses through turnover requires long-term coordinated policy and human resource development and management initiatives to sustain the supply of RNs in the subregion. © 2012 Sigma Theta Tau International.
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Carlson, Elisabeth; Idvall, Ewa
2015-07-01
The aging population is a globally recognized challenge for the health care service. The growing number of older people will probably lead to increased demands for nurses working in elderly care. Clinical practice has been shown to have an impact on how student nurses perceive a particular field of nursing. To compare perceptions of the clinical learning environment in nursing homes among students considering a career in aged care or not, and to examine the difference in age, gender and previous working experience as health care assistants in elderly care between the two groups. This was a cross-sectional study using the Swedish version of the Clinical Learning Environment and Nurse Teacher evaluation scale. Consecutive sampling was performed over three semesters from September 2011 to December 2012. The survey was conducted with 183 student nurses. Mann-Whitney U-test was used to examine differences in relation to two groups namely student nurses who did or did not consider to work in elderly care. A chi-square test of independence was performed to examine the difference in age, gender and previous working experience between the two groups. The analysis leaned towards an overall positive evaluation of the clinical learning environment with more positive values for students considering a career. There were no significant differences between younger students (18-23) and older students (24-50) regarding willingness to work in elderly care or not. Neither was any significant difference displayed between students, based on gender nor for previous work experience. Age, gender and previous work experiences as health care assistants did not impact on students' willingness to work in elderly care. Future studies need to acknowledge the complexity of why student nurses choose a particular pathway in nursing by longitudinal studies following cohorts of students during the course of the nursing programme. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Munnangi, Swapna; Dupiton, Lynore; Boutin, Anthony; Angus, L D George
Nurses are at the forefront of our health care delivery system and have been reported to exhibit a high level of burnout. Burnout and stress in trauma nurses at a safety-net hospital can negatively impact patient care. Safety-net hospitals are confronted with unique social, financial, as well as resource problems that can potentially make the work environment frustrating. The purpose of this study was to explore the levels of burnout, stress, and job satisfaction in nurses providing care to trauma patients at a Level I safety-net trauma center. A cross-sectional survey design was used to investigate principal factors including personal and professional demographics, burnout, perceived stress, and job satisfaction. Trauma nurses working at a Level I safety-net trauma center are stressed and exhibited moderate degree of burnout. The extent of emotional exhaustion experienced by the nurses varied with work location and was highest in surgical intensive care unit nurses. The level of job satisfaction in terms of opportunities for promotion differed significantly by race and the health status of the nurses. Satisfaction with coworkers was lowest in those nurses between the ages of 60-69 years. Female nurses were more satisfied with their coworkers than male nurses. In addition, the study revealed that significant relationships exist among perceived stress, burnout, and job satisfaction. Work environment significantly impacts burnout, job satisfaction, and perceived stress experienced by trauma nurses in a safety-net hospital. Nursing administration can make an effort to understand the levels of burnout and strategically improve work environment for trauma nurses in order to minimize stressors leading to attrition and enhance job satisfaction.
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Nurse managers describe their practice environments.
Warshawsky, Nora E; Lake, Sharon W; Brandford, Arica
2013-01-01
Hospital work environments that support the professional practice of nurses are critical to patient safety. Nurse managers are responsible for creating these professional practice environments for staff nurses, yet little is known about the environments needed to support nurse managers. Domains of nurse managers' practice environment have recently been defined. This is a secondary analysis of 2 cross-sectional studies of organizational characteristics that influence nurse manager practice. Content analysis of the free text comments from 127 nurse managers was used to illustrate the 8 domains of nurse managers' practice environments. Nurse managers valued time spent with their staff; therefore, workloads must permit meaningful interaction. Directors demonstrated trust when they empowered nurse managers to make decisions. Administrative leaders should build patient safety cultures on the basis of shared accountability and mutual respect among the health care team. The expectations of nurse managers have greatly expanded in the volume and complexity of direct reports, patient care areas, and job functions. The nurse managers in this analysis reported characteristics of their practice environments that limit their role effectiveness and may negatively impact organizational performance. Further research is needed to understand the effects of nurse managers' practice environments on staff and patient outcomes.
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Shao, Jing; Tang, Leiwen; Ye, Zhihong
For the stabilization of the nursing profession in mainland China, a valid and reliable nursing work environment instrument, grounded in China's context, should be developed to better provide rigorous evidence for policy makers. The purpose of the current research was to further develop a scale that could capture the characteristics of the nursing work environment in mainland China. A convenience sample of 542 nurses employed in a tertiary hospital of mainland China completed the 108-item Chinese Nursing Work Environment (C-NWE) Scale (1st ed.). Items that did not differentiate between respondents with the highest and lowest 27% of total scores and those that did not meet criteria for factor loadings were set aside. Exploratory factor analysis based on the maximum likelihood method was used to identify the structure of the scale. The chi-square test was used to evaluate model fit, and expert review was conducted to test content validity. Reliability was estimated using Cronbach's alpha coefficient. The revised C-NWE Scale, which consists of nine subscales and 47 items, is a simplified version of the C-NWE (1st ed.). Using exploratory maximum likelihood factor analysis, the normed chi-square fit index for a nine-factor solution was 1.97. The content validity index for the total scale was 0.93; Cronbach's alpha was .94. Initial evidence of the psychometric properties of C-NWE scores was presented. Further studies could be conducted in various settings to identify the C-NWE Scale's validity and reliability.
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Nursing Student Perceptions of Structural Empowerment.
Moore, Shelley C; Ward, Karen S
To meet role expectations for nurses, nurses must feel empowered. Faculty contributions to the learning environment for nursing students are critical. A descriptive analysis of student perceptions of empowerment within the learning environment was conducted using a form of Kanter's Conditions of Work Effectiveness Questionnaire; 203 participants from schools in 17 different states completed surveys. Subjects demonstrated moderate degrees of structural empowerment in their learning environment. This positive finding can be further investigated and used to fully prepare future nurses.
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Spence Laschinger, Heather K; Zhu, Junhong; Read, Emily
2016-07-01
To test a model examining the effects of structural empowerment and support for professional practice on new graduate nurses' perceived professional practice behaviours, perceptions of care quality and subsequent job satisfaction and career turnover intentions. The nursing worklife model describes relationships between supportive nursing work environments and nurse and patient outcomes. The influence of support for professional practice on new nurses' perceptions of professional nursing behaviours within this model has not been tested. Structural equation modelling in Mplus was used to analyse data from a national survey of new nurses across Canada (n = 393). The hypothesised model was supported: χ²(122) = 346.726, P = 0.000; CFI = 0.917; TLI = 0.896; RMSEA = 0.069. Professional practice behaviour was an important mechanism through which empowerment and supportive professional practice environments influenced nurse-assessed quality of care, which was related to job satisfaction and lower intentions to leave nursing. Job satisfaction and career retention of new nurses are related to perceptions of work environment factors that support their professional practice behaviours and high-quality patient care. Nurse managers can support new graduate nurses' professional practice behaviour by providing empowering supportive professional practice environments. © 2016 John Wiley & Sons Ltd.
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Copeland, Darcy; Chambers, Misty
2017-07-01
The purpose of this study was to determine what differences occurred in steps taken and energy expenditure among acute care nurses when their work environment moved from a hospital with centralized nurses' stations to a hospital with decentralized nurses' stations. Additional goals were to determine design features nurses perceived as contributing to or deterring from their work activities and what changes occurred in reported job satisfaction. Since design features can also affect patient outcomes, patient falls were monitored. The construction of a replacement facility for a 224-bed Level 1 trauma center provided the opportunity to compare the effects of centralized versus decentralized nurses' stations on nurses' experiences of their work environments. A pre-post quasi-experimental design was used. RN participants completed an open-ended questionnaire and recorded pedometer data at the end of each shift, working for 3-month pre-relocation and for 3-month post-relocation. Nine months passed between the move and post-relocation data collection. There were significant reductions in nurses' energy expenditure ( p < .001) and steps taken ( p = .041) post-relocation. Overall, nurses' job satisfaction was high and improved post-relocation, and patient falls decreased by 55%. Post-relocation, a number of the dissatisfiers associated with the physical environment were eliminated, and nurses identified more satisfiers (in general and related to the physical environment). Patients are safer post-relocation as indicated by a decrease in falls. This decrease is even more noteworthy when considering that the numbers of patient beds on each unit is higher post-relocation.
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Fallis, Wendy M; McMillan, Diana E; Edwards, Marie P
2011-04-01
Nurses working night shifts are at risk for sleep deprivation, which threatens patient and nurse safety. Little nursing research has addressed napping, an effective strategy to improve performance, reduce fatigue, and increase vigilance. To explore nurses' perceptions, experiences, barriers, and safety issues related to napping/not napping during night shift. A convenience sample of critical care nurses working night shift were interviewed to explore demographics, work schedule and environment, and napping/ not napping experiences, perceptions, and barriers. Transcripts were constantly compared, and categories and themes were identified. Participants were 13 critical care nurses with an average of 17 years' experience. Ten nurses napped regularly; 2 avoided napping because of sleep inertia. The need for and benefits of napping or not during night shift break were linked to patient and nurse safety. Ability to nap was affected by the demands of patient care and safety, staffing needs, and organizational and environmental factors. Nurses identified personal health, safety, and patient care issues supporting the need for a restorative nap during night shift. Barriers to napping exist within the organization/work environment.
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Practical ethical theory for nurses responding to complexity in care.
Fairchild, Roseanne Moody
2010-05-01
In the context of health care system complexity, nurses need responsive leadership and organizational support to maintain intrinsic motivation, moral sensitivity and a caring stance in the delivery of patient care. The current complexity of nurses' work environment promotes decreases in work motivation and moral satisfaction, thus creating motivational and ethical dissonance in practice. These and other work-related factors increase emotional stress and burnout for nurses, prompting both new and seasoned nurse professionals to leave their current position, or even the profession. This article presents a theoretical conceptual model for professional nurses to review and make sense of the ethical reasoning skills needed to maintain a caring stance in relation to the competing values that must coexist among nurses, health care administrators, patients and families in the context of the complex health care work environments in which nurses are expected to practice. A model, Nurses' Ethical Reasoning Skills, is presented as a framework for nurses' thinking through and problem solving ethical issues in clinical practice in the context of complexity in health care.
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AACN's healthy work environment standards and an empowering nurse advancement system.
Vollers, Dawn; Hill, Edie; Roberts, Cynthia; Dambaugh, Lori; Brenner, Zara R
2009-12-01
An empowering clinical nurse advancement system can facilitate institutional behaviors that embrace all of AACN's healthy work environment standards and thus serve as a building block for developing a flourishing health care environment. The results generate positive outcomes that are evident to health care professionals, patients, patients' families, and health care organizations. Patients benefit from highly satisfied employees who work in a culture of caring and excellence.
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Nakanishi, Miharu; Tei-Tominaga, Maki
2018-05-08
Background : Quality improvement initiatives can help nursing homes strengthen psychosocial work environments. The aim of the present study was to examine the association between supportive psychosocial work environment, and professional and organizational characteristics regarding quality improvement initiatives in dementia care. Methods : A paper questionnaire survey was administered to a convenience sample of 365 professional caregivers in 12 special nursing homes in Japan. Psychosocial work environment was assessed using the Social Capital and Ethical Climate at the Workplace Scale to calculate a score of social capital in the workplace, ethical leadership, and exclusive workplace climate. Variables for quality improvement initiatives included type of home (unit-type or traditional), presence of additional benefit for dementia care, and professionalism in dementia care among caregivers evaluated using the Japanese version of the Sense of Competence in Dementia Care Staff Scale. Results : Elevated professionalism and unit-type home were significantly associated with high social capital, strong ethical leadership, and low exclusive workplace climate. The presence of dementia care benefit was not associated with any subscale of psychosocial work environment. Conclusions : Quality improvement initiatives to foster supportive psychosocial work environment should enhance professionalism in dementia care with unit-based team building of professional caregivers in special nursing homes.
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Work engagement of older registered nurses: the impact of a caring-based intervention.
Bishop, Mary
2013-10-01
The aim of this evaluation research was to measure the impact of a caring-based intervention on the level of work engagement in older nurses. Every effort is needed to retain older nurses at the bedside by assisting them to revitalise the internal motivation and self- reward that brought them to nursing. A mixed method evaluation research approach using both qualitative and quantitative measurements was used to determine the impact of a caring-based programme on improving the work engagement scores of older Registered Nurses (RNs). The results of this study suggest that leadership strategies aimed at improving work engagement using caring theories have a significant positive impact. The findings contribute to our understanding of how work engagement can be enhanced through building work environments where there is a sense of belonging and teamwork, where staff are allowed time to decompress as well as build positive work relationships. Nurse Leaders (NLs) bear a responsibility to partner with older Registered Nurses (RNs) to build engagement in their work life while enhancing the quality of care. Successful leaders will find ways to meet these unique challenges by creating a healthy work environment. © 2013 John Wiley & Sons Ltd.
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Factors influencing work productivity and intent to stay in nursing.
Letvak, Susan; Buck, Raymond
2008-01-01
The researchers document the individual and workplace characteristics associated with decreased work productivity and intent to stay in nursing for nurses employed in direct patient care in the hospital setting. Factors associated with decreased work productivity were age, total years worked as a RN, quality of care provided, job stress score, having had a job injury, and having a health problem. Nurse leaders must place additional efforts on changes needed to improve the hospital workplace environment to decrease job stress, improve RNs' ability to provide quality care, and to assure the health and safety of nurses. Reducing job stress and providing adequate staffing so quality of care can be provided will enhance job satisfaction which will also encourage RNs to stay at the bedside. Improved work environments may delay older RNs' retirement from the workforce.
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Relationship between work-family conflict and a sense of coherence among Japanese registered nurses.
Takeuchi, Tomoko; Yamazaki, Yoshihiko
2010-12-01
Work-family conflict (WFC) refers to the conflict that arises between a person's work and family life. Previous studies have reported workload, job demands, and irregular working shifts as related to the WFC among nurses and have clarified that WFC is a predictor of job satisfaction, morale, and turnover intention. Very few studies have investigated WFC among Japanese nurses and no study has taken into consideration the sense of coherence (SOC) that helps nurses to cope with stress. The present study aimed to determine the relationship between WFC and SOC and to clarify how WFC and a SOC influence the mental and physical health of nurses in order to suggest ways of establishing work environments that enable nurses to achieve a balance between their work and family life. A self-report questionnaire survey of 388 Japanese female nurses was conducted. The data from 138 nurses who were a mother and/or wife were analyzed. Work-family conflict was significantly related to the SOC. It had a larger impact on the physical and mental health of nurses than their work and family characteristics. The SOC also had a major influence on the physical and mental health of nurses, while having a buffering effect on WFC with respect to depression. Our findings underscore the importance of taking organizational steps to create work environments that contribute to an enhanced SOC in order to reduce the WFC among nurses. © 2010 The Authors. Japan Journal of Nursing Science © 2010 Japan Academy of Nursing Science.
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Nurse Knowledge, Work Environment, and Turnover in Highly Specialized Pediatric End-of-Life Care.
Lindley, Lisa C; Cozad, Melanie J
2017-07-01
To examine the relationship between nurse knowledge, work environment, and registered nurse (RN) turnover in perinatal hospice and palliative care organizations. Using nurse intellectual capital theory, a multivariate analysis was conducted with 2007 National Home and Hospice Care Survey data. Perinatal hospice and palliative care organizations experienced a 5% turnover rate. The professional experience of advanced practice nurses (APNs) was significantly related to turnover among RNs (β = -.032, P < .05). Compared to organizations with no APNs professional experience, clinical nurse specialists and nurse practitioners significantly reduced RN turnover by 3 percentage points. No other nurse knowledge or work environment variables were associated with RN turnover. Several of the control variables were also associated with RN turnover in the study; Organizations serving micropolitan (β = -.041, P < .05) and rural areas (β = -.037, P < .05) had lower RN turnover compared to urban areas. Organizations with a technology climate where nurses used electronic medical records had a higher turnover rate than those without (β = .036, P < .05). The findings revealed that advanced professional experience in the form of APNs was associated with reductions in RN turnover. This suggests that having a clinical nurse specialist or nurse practitioner on staff may provide knowledge and experience to other RNs, creating stability within the organization.
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Wargo-Sugleris, Michele; Robbins, Wendie; Lane, Christianne Joy; Phillips, Linda R
2018-04-01
To determine the relationships between job satisfaction, work environment and successful ageing and how these factors relate to Registered Nurses' intent to retire. Although little studied, retention of older nurses by delaying early retirement, before age 65, is an important topic for research. Qualitative and quantitative studies have indicated that job satisfaction work environment and successful ageing are key motivators in acute care Registered Nurses retention and/or delaying retirement. This study was designed to provide information to administrators and policy makers about retaining older, experienced RNs longer and more productively. This was a correlational, descriptive, cross-sectional study. An online survey of acute care Registered Nurses (N = 2,789) aged 40 years or older working in Florida was conducted from September - October 2013. Participants completed items related to job satisfaction, work environment, successful ageing and individual characteristics. Hypotheses derived from the modified Ellenbecker's Job Retention Model were tested using regression analysis. Job satisfaction scores were high. Highest satisfaction was with scheduling issues and co-workers; lowest with advancement opportunities. Successful ageing scores were also high with 81% reporting excellent or good health. Work environment explained 55% of the variance in job satisfaction. Years to retirement were significantly associated with successful ageing (p < .001), age (p < .001) and income (p < .010). This study provides quantitative evidence that environment and successful ageing are important areas that have an impact on job satisfaction and delay of retirement in older nurses and further studies in these areas are warranted to expand on this knowledge. © 2017 John Wiley & Sons Ltd.
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[Evaluation and dimensions that define the labor environment and job satisfaction in nursing staff].
García-Pozo, A; Moro-Tejedor, M N; Medina-Torres, M
2010-01-01
To describe the dimensions with the greatest impact on the job satisfaction and work environment in the nursing staff in a tertiary hospital. Cross-sectional analytical and observational study, carried out in nurses with a full-time job. The instrument used was a questionnaire adapted from the satisfaction survey of the Basque Country (Spain) Outcome variables: global evaluation of work environment and job satisfaction. characteristics of individuals and organizations. An overall and by professional categories analysis has been made by a multivariate regression. 1676 questionnaires were received. Average age: 40.8 years (9.7) Seniority: Median: 12 years (IR: 4-20). The average overall evaluation of work environment was 5.9 (2) and of the job satisfaction 6.7 (2). The variables that explain the work environment are: physical conditions, training, satisfaction, promotion, organization, relationships with colleagues, knowledge of the directive objectives, adequacy of management decisions. Job satisfaction is defined by: use of the professional capacity, recognition, organization, satisfaction, information, knowledge of the directive objectives and receptiveness of nursing directive. The overall evaluation of work environment and job satisfaction is good/high overall and by categories, although the dimensions that determine the evaluation are different depending on each category. It is noted that the dimensions that define the work environment are more related to work environment and those which define job satisfaction are more related to individual factors. Copyright 2009 SECA. Published by Elsevier Espana. All rights reserved.
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Friis, Karina; Ekholm, Ola; Hundrup, Yrsa Andersen
2008-06-01
Denmark is facing a shortage of nurses and this trend is anticipated to worsen within the next decades. The major reason for this shortage is that only very few nurses remain employed until the general retirement age. Every year several nurses are expelled from the labour market prematurely which causes a problem not only for the disabled nurses but also because it can affect the morale and productivity among the remaining personnel while new staff members are hired and trained. The aim of the study was to analyse the relationship between lifestyle, working environment, socio-demographic factors and disability pension (DP) among nurses. The study was based on 12,028 nurses above the age of 44 who in 1993 completed a questionnaire. The survey information was combined with longitudinal data from a register compiled by Statistics Denmark. The follow-up period was from 1993 to 2002. Nurses with relatively low gross incomes were more likely to become disability pensioners compared to nurses with high incomes (hazard ratio, HR 1.33 and HR 2.17). Also, nurses who were singles had a higher probability of entering DP (HR 1.63). Nurses who worked fixed evening or night shifts had higher risks of DP than nurses who worked daytime exclusively (HR 1.51 and HR 1.45). Smoking, obesity and having a sedentary lifestyle were also risk indicators for DP (HR 1.42, HR 1.63 and HR 1.50). Furthermore, low influence and high physical demands at work increased the probability of entering DP (HR 1.39 and HR 1.22). DP among nurses is influenced by a number of factors. Nurses who have poor working environments and/or unhealthy lifestyles have higher risks of becoming disability pensioners. Also, nurses who are singles and/or have low gross incomes have higher probability of entering DP.
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Nursing casualization and communication: a critical ethnography.
Batch, Mary; Windsor, Carol
2015-04-01
The aim was to explore the relationship between nursing casualization and the culture of communication for nurses in a healthcare facility. Casualization, or non-standard work, is the use of temporary, contract, part-time and casual labour. An increase in casual labour has been part of a global shift in work organization aimed at creating a more flexible and cheaper workforce. It has been argued that flexibility of labour has enabled nurses to manage both non-work related needs and an increasingly complex work environment. Yet no research has explored casualization and how it impacts on the communication culture for nurses in a healthcare facility. Critical ethnography. Methods included observation, field notes, formal interviews and focus groups. Data collection was undertaken over the 2 years 2008-2009. The concepts of knowing and belonging were perceived as important to nursing teamwork and yet the traditional time/task work model, designed for a full-time workforce, marginalized non-standard workers. The combination of medical dominance and traditional stereotyping of the nurse and work as full-time shaped the behaviours of nurses and situated casual workers on the periphery. The overall finding was that entrenched systemic structures and processes shaped the physical and cultural dimensions of a contemporary work environment and contributed to an ineffective communication culture. Flexible work is an important feature of contemporary nursing. Traditional work models and nurse attitudes and practices have not progressed and are discordant with a contemporary approach to nursing labour management. © 2014 John Wiley & Sons Ltd.
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Madathil, Renee; Heck, Nicholas C; Schuldberg, David
2014-06-01
It is important to consider ways in which nurses can be protected from experiencing the effects of burnout. This study examined the relationships between leadership style of psychiatric nurse supervisors, work role autonomy, and psychological distress in relation to psychiatric nurse burnout. Eighty-nine psychiatric nurses from Montana and New York hospitals completed an online survey that assessed their work-related experiences. Overall, results of this study indicate that the participants were experiencing high levels of emotional exhaustion and depersonalization when compared to a normative sample of mental health workers. Results also showed that leadership style and work role autonomy are likely to be environmental factors that protect against burnout in nurses. Finally, it was shown that the relationship between depressive symptoms and the burnout component of personal accomplishment may be influenced by nurses' perceptions of the leadership style in their work environment. These findings are important because nurse supervisor leadership styles and amount of autonomy are characteristics of the work environment that may be amenable to change through training and intervention. Copyright © 2014 Elsevier Inc. All rights reserved.
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Leading a multicultural work environment: reflections on the next frontier of nurse leadership.
Washington, Deborah
2015-01-01
Nurses face the challenge of leading in a diverse society. Is the cross section of present-day nurse leaders prepared to meet the needs of patients and a work environment represented by a broader range of social backgrounds, cultural traditions, and languages? Fundamental to leaders' ability to meet diverse needs is a new framework for understanding the meaning of leadership, in which the issue of diversity is paramount. This article explores how the word leadership expresses a more complex system, when responsibility to address human needs is emphasized, and care for multilingual and multiethnic patients by a diverse, committed work environment is a focus. Under the umbrella of diversity, the necessary knowledge to create such a work environment may lack depth or may even be absent.
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Ergonomics and nursing in hospital environments.
Rogers, Bonnie; Buckheit, Kathleen; Ostendorf, Judith
2013-10-01
This study describes workplace conditions, the environment, and activities that may contribute to musculoskeletal injuries among nurses, as well as identifies solutions to decrease these risks and improve work-related conditions. The study used a mixed-methods design. Participants included nurses and stakeholders from five hospitals. Several focus groups were held with nurses, walk-throughs of clinical units were conducted, and stakeholder interviews with key occupational health and safety personnel were conducted in each of the five hospitals, as well as with representatives from the American Nurses Association, Veterans Health Administration hospital, and National Institute for Occupational Safety and Health. Several key contributing factors, including the physical environment (e.g., layout and organization of work stations), work organization and culture (e.g., heavy workload, inadequate staffing, lack of education), and work activities (e.g., manual lifting of patients, lack of assistive devices), were identified. Recommendations included the need for a multifaceted and comprehensive approach to developing a sound ergonomics program. Copyright 2013, SLACK Incorporated.
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Generational differences in acute care nurses.
Widger, Kimberley; Pye, Christine; Cranley, Lisa; Wilson-Keates, Barbara; Squires, Mae; Tourangeau, Ann
2007-01-01
Generational differences in values, expectations and perceptions of work have been proposed as one basis for problems and solutions in recruitment and retention of nurses. This study used a descriptive design. A sample of 8207 registered nurses and registered practical nurses working in Ontario, Canada, acute care hospitals who responded to the Ontario Nurse Survey in 2003 were included in this study. Respondents were categorized as Baby Boomers, Generation X or Generation Y based on their birth year. Differences in responses among these three generations to questions about their own characteristics, employment circumstances, work environment and responses to the work environment were explored. There were statistically significant differences among the generations. Baby Boomers primarily worked full-time day shifts. Gen Y tended to be employed in teaching hospitals; Boomers worked more commonly in community hospitals. Baby Boomers were generally more satisfied with their jobs than Gen X or Gen Y nurses. Gen Y had the largest proportion of nurses with high levels of burnout in the areas of emotional exhaustion and depersonalization. Baby Boomers had the largest proportion of nurses with low levels of burnout. Nurse managers may be able to capitalize on differences in generational values and needs in designing appropriate interventions to enhance recruitment and retention of nurses.
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Nowrouzi, Behdin; Lightfoot, Nancy; Carter, Lorraine; Larivière, Michel; Rukholm, Ellen; Schinke, Robert; Belanger-Gardner, Diane
2015-01-01
The aim of this study was to determine: 1) if quality of work life (QWL), location of cross-training, stress variables, and various demographic factors in nurses are associated with work ability, and 2) nursing occupational stress, QWL, and various associated factors are related with nurses' work ability. There is limited research examining the obstetrical nursing environment. Given the amount of time and energy people expend at the workplace, it is crucial for employees to be satisfied with their lives at work. This cross sectional study was conducted in 2012 in four hospitals in northeastern Ontario, Canada. A stratified random sample of registered nurses (n= 111) were selected. The majority of participants were female (94.6%) ranging in age from 24 to 64 years (M = 41.9, s.d. = 10.2). For the stress and QWL model, one variable: QWL (home-work support - see Methods for definition) (p= 0.015), cross-trained (see Methods for definition) nurses (p= 0.048), and having more than 4 patients per shift (p= 0.024) significantly contributed to the variance in work ability scores. In the logistic regression model, the odds of a higher work ability for nurses who received home-work support were estimated to be 1.32 (95% CI, 1.06 to 1.66) times the odds of a higher work ability for nurses who did not receive home-work support. Work ability in the work environment of obstetrical nursing is important. To be high functioning, workplaces should maximize the use of their employees' actual and potential skills.
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Eskandari, Fereidoun; Siahkali, Soheila Rabie; Shoghli, Alireza; Pazargadi, Mehrnoosh; Tafreshi, Mansoreh Zaghari
2017-03-01
The demanding nature of nursing work environments signals longstanding and growing concerns about nurses' health and job satisfaction and the provision of quality care. Specifically in health care settings, nurse leaders play an essential role in creating supportive work environments to avert these negative trends and increase nurse job satisfaction. The purpose of this study was to examine the relationship between structural empowerment and organizational commitment of nurses. 491 nurses working in Zanjan hospitals participated in this descriptive-correlational study in 2010. Tools for data collection were Meyer and Allen's organizational commitment questionnaire and "Conditions for Work Effectiveness Questionnaire-II" (CWEQ-II). Data was analyzed by SPSS16. The statistical tests such as variance analysis, t-test, pearson correlation coefficient and linear regression were used for data analysis. According to the findings, the perception of nurses working in hospitals on "Structural Empowerment" was moderate (15.98±3.29). Nurses believed "opportunity" as the most important element in structural empowerment with the score of 3.18 ±0.79. Nurses working in non-academic hospitals and in non-teaching hospitals had higher organizational commitment than others. There was a significant relationship between structural empowerment and organizational commitment. Generally, structural empowerment (relatively strong) correlates with nurses' organizational commitment. We concluded that a high structural empowerment increases the organizational commitment of nurses.
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Nursing Services Delivery Theory: an open system approach
Meyer, Raquel M; O’Brien-Pallas, Linda L
2010-01-01
meyer r.m. & o’brien-pallas l.l. (2010)Nursing services delivery theory: an open system approach. Journal of Advanced Nursing66(12), 2828–2838. Aim This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations. Background The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a ‘black box’ that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations. Data sources A search of CINAHL and Business Source Premier for the years 1980–2008 was conducted using the following terms: theory, models, organization, organizational structure, management, administration, nursing units, and nursing. Seminal works were included. Discussion The healthcare organization is conceptualized as an open system characterized by energy transformation, a dynamic steady state, negative entropy, event cycles, negative feedback, differentiation, integration and coordination, and equifinality. The Nursing Services Delivery Theory proposes that input, throughput, and output factors interact dynamically to influence the global work demands placed on nursing work groups at the point of care in production subsystems. Implications for nursing The Nursing Services Delivery Theory can be applied to varied settings, cultures, and countries and supports the study of multi-level phenomena and cross-level effects. Conclusion The Nursing Services Delivery Theory gives a relational structure for reconciling disparate streams of research related to nursing work, staffing, and work environments. The theory can guide future research and the management of nursing services in large-scale healthcare organizations. PMID:20831573
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Nursing unit managers, staff retention and the work environment.
Duffield, Christine M; Roche, Michael A; Blay, Nicole; Stasa, Helen
2011-01-01
This paper examined the impact of leadership characteristics of nursing unit managers, as perceived by staff nurses, on staff satisfaction and retention. A positive work environment will increase levels of job satisfaction and staff retention. Nurse leaders play a critical role in creating a positive work environment. Important leadership characteristics of the front-line nurse manager include visibility, accessibility, consultation, recognition and support. Secondary analysis of data collected on 94 randomly selected wards in 21 public hospitals across two Australian states between 2004-2006. All nurses (n = 2488, 80·3% response rate) on the selected wards were asked to complete a survey that included the 49-item Nursing Work Index-Revised [NWI-R] together with measures of job satisfaction, satisfaction with nursing and intention to leave. Subscales of the NWI-R were calculated. Leadership, the domain of interest, consisted of 12 items. Wards were divided into those reporting either positive or negative leadership. Data were analysed at the nurse level using spss version 16. A nursing manager who was perceived to be a good leader, was visible, consulted with staff, provided praise and recognition and where flexible work schedules were available was found to distinguish the positive and negative wards. However, for a ward to be rated as positive overall, nurse leaders need to perform well on all the leadership items. An effective nursing unit manager who consults with staff and provides positive feedback and who is rated highly on a broad range of leadership items is instrumental in increasing job satisfaction and satisfaction with nursing. Good nurse managers play an important role in staff retention and satisfaction. Improved retention will lead to savings for the organisation, which may be allocated to activities such as training and mentorship to assist nurse leaders in developing these critical leadership skills. Strategies also need to be put in place to ensure that nurse leaders receive adequate organisational support from nursing executives. © 2010 Blackwell Publishing Ltd.
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Building a healthy work environment: a nursing resource team perspective.
Vaughan, Leslie; Slinger, Trisha
2013-01-01
Leadership and staff from the London Health Sciences Centre (LHSC) Nursing Resource Team (NRT), including members of their Continuous Quality Improvement (CQI) Council, attended the first Southern Ontario Nursing Resource Team Conference (SONRTC), held March 2012 in Toronto. The SONRTC highlighted healthy work environments (HWEs), noting vast differences among the province's various organizations. Conversely, CQI Council members anecdotally acknowledged similar inconsistencies in HWEs across the various inpatient departments at LHSC. In fact, the mobility of the NRT role allows these nurses to make an unbiased observation about the culture, behaviours and practices of specific units as well as cross-reference departments regarding HWEs. Studies have documented that HWEs have a direct impact on the quality of patient care. Furthermore, the literature supports a relationship between HWEs and nurse job satisfaction. Based on this heightened awareness, the NRT CQI Council aimed to investigate HWEs at LHSC. The American Association of Critical Care Nurses (AACN) Standards for Establishing and Sustaining Healthy Work Environments was adapted in developing a survey for measuring HWEs based on the perceptions of NRT staff. Each of the departments was evaluated in terms of the following indicators: skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition and authentic leadership (AACN 2005). Ultimately, the Building a Healthy Work Environment: A Nursing Resource Team Perspective survey was employed with NRT nurses at LHSC, and data was collected for use by leadership and staff for creating HWE strategies aimed at improving the quality of patient care.
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Jaafarpour, Molouk; Khani, Ali
2012-12-01
Several researchers have described the nurses' work as stressful and that the incidence of the occupational stress-related burnout in the profession was high. The aim of this study was to establish the relationship between the nurses' satisfaction, their psychosocial work environment, the levels of their reported moral sensitivities and their well - being in Iran. This descriptive-correlation study was performed at the ILAM general hospitals, IR, during the year 2011. The research instruments which were used were the Psychosocial Work Environment (PWE), the Moral Sensitivity (MS) and the well-being profile of the nurses. A sample of 120 Registered Nurses (RN) were enrolled in the study by using a simple random sampling method. The descriptive statistics and the Pearson's correlation test were performed by using SPSS. The relationship of the nurses' satisfaction and their psychosocial work environment was moderate (M=106.5, SD= 7.2) . The nurses' moral sensitivity was moderate (M=112.3, SD= 11.2).This study found that there were significant correlations between the PWE factors score and the MS subscale (P< 0.05, p<0.01). In addition, significant correlations were found between the nurses' well-being and the PWE factors (P< 0.05, p<0.01). These findings proved that the nurses perceived their PWE as stressful. The supporting nurses may have a positive effect on their perceptions of well-being. The attending nurses reported less physical symptoms, reduced anxiety and fewer feelings of not being in control.
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Yu, Mi; Kang, Kyung Ja
2016-03-01
The turnover rate of new graduate nurses in Korea is twice that of all Korean nurses; job/work environment satisfaction is a known risk factor. The authors examined these factors in new graduate nurses at various transition periods. A cross-sectional survey was conducted using stratified sampling from nine regions of Korea, and 443 new graduate nurses were enrolled. Job/work environment satisfaction and turnover intention were measured. Stepwise multiple regression analysis identified the factors affecting turnover intention. The factors differed through the transition periods. At 0 to 6 months, the factors were work schedule, desired hospital, orientation duration, becoming part of a team, professional development, and practical support; at 7 to 12 months, the factors were work schedule and desired hospital; and at 13 to 18 months, the factor was professional development, which accounted for 31%, 22.9%, and 12.6%, respectively, of the reasons for turnover intention. Reducing turnover intention requires consideration of the influential factors at each transition period. Copyright 2016, SLACK Incorporated.
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Yan, Ping; Yang, Yi; Zhang, Li; Li, Fuye; Huang, Amei; Wang, Yanan; Dai, Yali; Yao, Hua
2018-01-01
Abstract We aim to analyze the correlated influential factors between work-related musculoskeletal disorders (WMSDs) and nursing practice environment and quality of life and social support. From January 2015 to October 2015, cluster sampling was performed on the nurses from 12 hospitals in the 6 areas in Xinjiang. The questionnaires including the modified Nordic Musculoskeletal Questionnaire, Practice Environment Scale (PES), the Mos 36-item Short Form Health Survey, and Social Support Rating Scale were used to investigate. Multivariate logistic regression analysis was used to explore the influential factors of WMSDs. The total prevalence of WMSDs was 79.52% in the nurses ever since the working occupation, which was mainly involved waist (64.83%), neck (61.83%), and shoulder (52.36%). Multivariate logistic regression analysis indicated age (≥26 years), working in the Department of Surgery, Department of Critical Care, Outpatient Department, and Department of Anesthesia, working duration of >40 hours per week were the risk factors of WMSDs in the nurses. The physiological function (PF), body pain, total healthy condition, adequate working force and financial support, and social support were the protective factors of WMSDs. The prevalence of WMSDs in the nurses in Xinjiang Autonomous Region was high. PF, bodily pain, total healthy condition, having adequate staff and support resources to provide quality patient care, and social support were the protective factors of WMSDs in the nurses. PMID:29489648
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Yan, Ping; Yang, Yi; Zhang, Li; Li, Fuye; Huang, Amei; Wang, Yanan; Dai, Yali; Yao, Hua
2018-03-01
We aim to analyze the correlated influential factors between work-related musculoskeletal disorders (WMSDs) and nursing practice environment and quality of life and social support.From January 2015 to October 2015, cluster sampling was performed on the nurses from 12 hospitals in the 6 areas in Xinjiang. The questionnaires including the modified Nordic Musculoskeletal Questionnaire, Practice Environment Scale (PES), the Mos 36-item Short Form Health Survey, and Social Support Rating Scale were used to investigate. Multivariate logistic regression analysis was used to explore the influential factors of WMSDs.The total prevalence of WMSDs was 79.52% in the nurses ever since the working occupation, which was mainly involved waist (64.83%), neck (61.83%), and shoulder (52.36%). Multivariate logistic regression analysis indicated age (≥26 years), working in the Department of Surgery, Department of Critical Care, Outpatient Department, and Department of Anesthesia, working duration of >40 hours per week were the risk factors of WMSDs in the nurses. The physiological function (PF), body pain, total healthy condition, adequate working force and financial support, and social support were the protective factors of WMSDs.The prevalence of WMSDs in the nurses in Xinjiang Autonomous Region was high. PF, bodily pain, total healthy condition, having adequate staff and support resources to provide quality patient care, and social support were the protective factors of WMSDs in the nurses.
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Beason, Charlotte F
2005-01-01
Experts in creative management recommend that managers routinely explore the practices of other disciplines to develop innovative strategies for their organizations. The author examines the provisions of the Sarbanes-Oxley Corporate Responsibility Act of 2002, designed to ensure sound corporate fiscal practices, and proposes a model using the same actions to radically transform the nursing work environment.
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Zhang, Yuan; Punnett, Laura; McEnany, Geoffry Phillips; Gore, Rebecca
2018-01-01
The effect of shift work on nurses’ sleep is well-studied, but there are other challenging aspects of health care work that might also affect the sleep of direct caregivers. This study examined the influence of the long-term care work environment on sleep quantity and quality of nursing assistants. A cross-sectional survey collected data from 650 nursing assistants in 15 long-term care facilities; 46% reported short sleep duration and 23% reported poor sleep quality. A simple additive index of the number of beneficial work features (up to 7) was constructed for analysis with Poisson regression. With each unit increase of beneficial work features, nursing assistants were 7% less likely to report short sleep duration and 17% less likely to report poor sleep quality. These results suggest that effective workplace interventions should address a variety of work stressors, not only work schedule arrangements, in order to improve nursing assistants’ sleep health. PMID:26384714
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Corchia, Carlo; Fanelli, Simone; Gagliardi, Luigi; Bellù, Roberto; Zangrandi, Antonello; Persico, Anna; Zanini, Rinaldo
2016-04-02
Neonatal units' volume of activity, and other quantitative and qualitative variables, such as staffing, workload, work environment, care organization and geographical location, may influence the outcome of high risk newborns. Data about the distribution of these variables and their relationships among Italian neonatal units are lacking. Between March 2010-April 2011, 63 neonatal intensive care units adhering to the Italian Neonatal Network participated in the SONAR Nurse study. Their main features and work environment were investigated by questionnaires compiled by the chief and by physicians and nurses of each unit. Twelve cross-sectional monthly-repeated surveys on different shifts were performed, collecting data on number of nurses on duty and number and acuity of hospitalized infants. Six hundred forty five physicians and 1601 nurses compiled the questionnaires. In the cross-sectional surveys 702 reports were collected, with 11082 infant and 3226 nurse data points. A high variability was found for units' size (4-50 total beds), daily number of patients (median 14.5, range 3.4-48.7), number of nurses per shift (median 4.2, range 0.7-10.8) and number of team meetings per month. Northern regions performed better than Central and Southern regions for frequency of training meetings, qualitative assessment of performance, motivation within the unit and nursing work environment; mean physicians' and nurses' age increased moving from North to South. After stratification by terciles of the mean daily number of patients, the median number of nurses per shift increased at increasing volume of activity, while the opposite was found for the nurse-to-patient ratio adjusted by patients' acuity. On average, in units belonging to the lower tercile there was 1 nurse every 2.5 patients, while in those belonging to the higher tercile the ratio was 1 nurse every 5 patients. In Italy, there is a high variability in organizational characteristics and work environment among neonatal units and an uneven distribution of human resources in relation to volume of activity, suggesting that the larger the unit the greater the workload for each nurse. Urgent modifications in planning and organization of services are needed in order to pursue more efficient, homogeneous and integrated regionalized neonatal care systems.
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Neonatal Intensive Care Unit Layout and Nurses' Work.
Doede, Megan; Trinkoff, Alison M; Gurses, Ayse P
2018-01-01
Neonatal intensive care units (NICUs) remain one of the few areas in hospitals that still use an open bay (OPBY) design for patient stays greater than 24 hr, housing multiple infants, staff, and families in one large room. This creates high noise levels, contributes to the spread of infection, and affords families little privacy. These problems have given rise to the single-family room NICU. This represents a significant change in the care environment for nurses. This literature review answers the question: When compared to OPBY layout, how does a single family room layout impact neonatal nurses' work? Thirteen studies published between 2006 and 2015 were located. Many studies reported both positive and negative effects on nurses' work and were therefore sorted by their cited advantages and disadvantages. Advantages included improved quality of the physical environment; improved quality of patient care; improved parent interaction; and improvements in nurse job satisfaction, stress, and burnout. Disadvantages included decreased interaction among the NICU patient care team, increased nurse workload, decreased visibility on the unit, and difficult interactions with family. This review suggests that single-family room NICUs introduce a complex situation in which trade-offs occur for nurses, most prominently the trade-off between visibility and privacy. Additionally, the literature is clear on what elements of nurses' work are impacted, but how the built environment influences these elements, and how these elements interact during nurses' work, is not as well understood. The current level of research and directions for future research are also discussed.
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Farag, Amany A; Tullai-McGuinness, Susan; Anthony, Mary K
2009-01-01
To describe and compare how nurses representing four age cohorts perceive their manager's leadership style and unit climate. The current workforce consists of nurses representing four generational cohorts. Nursing literature suggests that nurses from each age cohort think, behave and approach work differently. Limited empirical evidence, however, exists about how nurses from each age cohort perceive two aspects of their work environment: their managers' leadership style and unit climate. This cross-sectional, descriptive survey was conducted using a convenience sample of 475 registered nurses working in different inpatient units in three community non-magnet hospitals. Only nurses from Boomer and Gen-Xers had sufficient representation to be included in the data analysis. Nurses from the two main age cohorts did not differ in their perceptions of their manager's leadership style. Significant differences were found in two unit climate dimensions. The Gen-Xers had a less favourable perception of their unit climate related to warmth and belonging and administrative support. Nurse manager's might reflect on how they interact with different age cohorts; and to involve nurses from various age cohorts in the development of policies to create a flexible work environment.
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Karidar, Hakima; Åkesson, Helene; Glasdam, Stinne
2016-06-01
Children who have a parent with incurable cancer are in a vulnerable situation and the Swedish law tries to protect them. This article aims to explore the interactions between nurses and children of patients with incurable cancer from the nurses' perspective. Semi-structured interviews with nine nurses in palliative oncology in Southern Sweden. Latent content analysis was carried out, inspired by Lundmann and Graneheim. Parents are gatekeepers to the children's involvement and meetings with the healthcare professionals. Therefore the nurses were dependent on the parents for contact with their children. Additionally, nurses were subject to the structural frame of their working environment in terms of time, economy, resources and the medical logic ruling the priorities for nursing during their daily working day. The opportunities to pay attention to the children of patients were limited, despite good intentions, willingness and a favourable legal framework. Teenagers were regarded as a challenge, and per se they challenged the nurses' opportunities to gain control of the meetings and situations around the families. Often nurses did not see and acknowledge the children of the palliative patient. They knew that the children were there and that it was important that they were there, but they challenged the order in the working environment in relation to time-allocated tasks and working flow. In the working environment patients were prioritised over relatives. From the perspective of nurses, there is a gap between the intentions of the Swedish law and the interactions between nurses and children. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Farag, Amany; Blegen, Mary; Gedney-Lose, Amalia; Lose, Daniel; Perkhounkova, Yelena
2017-05-01
Medication errors are one of the most frequently occurring errors in health care settings. The complexity of the ED work environment places patients at risk for medication errors. Most hospitals rely on nurses' voluntary medication error reporting, but these errors are under-reported. The purpose of this study was to examine the relationship among work environment (nurse manager leadership style and safety climate), social capital (warmth and belonging relationships and organizational trust), and nurses' willingness to report medication errors. A cross-sectional descriptive design using a questionnaire with a convenience sample of emergency nurses was used. Data were analyzed using descriptive, correlation, Mann-Whitney U, and Kruskal-Wallis statistics. A total of 71 emergency nurses were included in the study. Emergency nurses' willingness to report errors decreased as the nurses' years of experience increased (r = -0.25, P = .03). Their willingness to report errors increased when they received more feedback about errors (r = 0.25, P = .03) and when their managers used a transactional leadership style (r = 0.28, P = .01). ED nurse managers can modify their leadership style to encourage error reporting. Timely feedback after an error report is particularly important. Engaging experienced nurses to understand error root causes could increase voluntary error reporting. Published by Elsevier Inc.
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Workplace violence against nurses: A cross-sectional study.
Zhang, Liuyi; Wang, Anni; Xie, Xia; Zhou, Yanhong; Li, Jing; Yang, Lijun; Zhang, Jingping
2017-07-01
Workplace violence is a serious problem for clinical nurses, as it leads to a series of adverse consequences. However, little information is available on the prevalence and influencing factors of workplace violence in China. To determine the prevalence of workplace violence against Chinese nurses, and its influencing factors. A multi-center, cross-sectional study. The seven geographical regions (i.e., northeast, north, central, east, south, northwest, and southwest) of China. Four thousand one hundred and twenty-five nurses. We randomly selected 28 hospitals, located in 14 cities over 13 provinces across the seven geographical regions. We distributed 4125 questionnaires between May 4 and September 23, 2014. The questionnaire included demographic information, the Workplace Violent Incident Questionnaire, the Jefferson Scale of Empathy-Health Professionals, and the Practice Environment Scale of Nursing Work Index. Workplace violence was assessed in terms of physical violence, non-physical violence, sexual harassment, and organized healthcare disturbances. We then performed descriptive analyses and logistic regressions on the collected data. The response rate was 92.97% (n=3835). Additionally, we obtained valid questionnaires from 3004 individuals. Of these, 25.77% reported experiencing physical violence, 63.65% non-physical violence, 2.76% sexual harassment, and 11.72% organized healthcare disturbances. A logistic regression analysis revealed that nurses who have less experience, work a rotating roster, work in emergency rooms and pediatrics departments, have low empathy levels, and who work in poor nursing environments have greater odds of experiencing violence. Experiences of workplace violence are prevalent among Chinese nurses, and several complex factors are associated with a greater risk of such violence, including nurses' personal characteristics, work settings, and work environments. Our results might help nursing managers understand their employees' work status. We recommend that nursing leaders provide and enhance education and support for high-risk groups to help protect Chinese nurses from workplace violence. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Job satisfaction of Malaysian registered nurses: a qualitative study.
Atefi, Narges; Abdullah, Khatijah L; Wong, Li P
2016-01-01
Job satisfaction is an important factor in health care settings. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care. However, there have not been any studies exploring the job satisfaction of Malaysian nurses. The main purpose of this qualitative descriptive study was to explore the factors related to feelings of job satisfaction as well as job dissatisfaction experienced by registered nurses in Malaysia. A convenient sample of 46 Malaysian nurses recruited from a large hospital (number of beds = 895) participated in the study. A total of seven focus group discussions were conducted with nurses from surgical, medical and critical care wards. A semi-structured interview guide was used to facilitate the interviews, which were audio-recorded, transcribed verbatim and checked. The transcripts were used as data and were analysed using a thematic approach. The study identified three main themes that influenced job satisfaction: (1) nurses' personal values and beliefs; (2) work environment factors and (3) motivation factors. Concerning the nurses' personal values and beliefs, the ability to help people made the nurses felt honoured and happy, which indirectly contributed to job satisfaction. For work environment factors, team cohesion, benefit and reward, working conditions play an important role in the nurses' job satisfaction. Motivation factors, namely, professional development and clinical autonomy contributed to job satisfaction. It is important for nurse leaders to provide more rewards, comfortable work environments and to understand issues that affect nurses' job satisfaction. Our findings highlight the importance of factors that can improve nurses' job satisfaction. The study provides basic information for hospital administrators in planning effective and efficient policies to improve nursing job satisfaction in order to increase the quality of patient care and decrease nursing turnover. © 2014 British Association of Critical Care Nurses.
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Early nurse attrition in New Zealand and associated policy implications.
Walker, L; Clendon, J
2018-03-01
To examine the factors contributing to nurses choosing to exit the nursing profession before retirement age. Population growth, ageing and growing demand for health services mean increased demand for nurses. Better retention could help meet this demand, yet little work has been done in New Zealand to understand early attrition. An online survey of registered and enrolled nurses and nurse practitioners who had left nursing was used. This study reports analysis of responses from 285 ex-nurses aged under 55. The primary reasons nurses left the profession were as follows: workplace concerns; personal challenges; career factors; family reasons; lack of confidence; leaving for overseas; unwillingness to complete educational requirements; poor work-life balance; and inability to find suitable nursing work. Most nurses discussed their intentions to leave with a family member or manager and most reported gaining transferrable skills through nursing. Nurses leave for many reasons. Implementing positive practice environments and individualized approaches to retaining staff may help reduce this attrition. Generational changes in the nature of work and careers mean that nurses may continue to leave the profession sooner than anticipated by policymakers. If the nursing workforce is to be able to meet projected need, education, recruitment and retention policies must urgently address issues leading to early attrition. In particular, policies improving the wider environmental context of nursing practice and ensuring that working environments are safe and nurses are well supported must be developed and implemented. Equally, national nursing workforce planning must take into account that nursing is no longer viewed as a career for life. © 2017 International Council of Nurses.
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Hallowell, Sunny G; Rogowski, Jeannette A; Spatz, Diane L; Hanlon, Alexandra L; Kenny, Michael; Lake, Eileen T
2016-01-01
Nurses are principal caregivers in the neonatal intensive care unit and support mothers to establish and sustain a supply of human milk for their infants. Whether an infant receives essential nutrition and immunological protection provided in human milk at discharge is an issue of health care quality in this setting. To examine the association of the neonatal intensive care unit work environment, staffing levels, level of nurse education, lactation consultant availability, and nurse-reported breastfeeding support with very low birth weight infant receipt of human milk at discharge. Cross sectional analysis combining nurse survey data with infant discharge data. A national sample of neonatal intensive care units (N=97), nurses (N=5614) and very low birth weight infants (N=6997). Sequential multivariate linear regression models were estimated at the unit level between the dependent variable (rate of very low birth weight infants discharged on "any human milk") and the independent variables (nurse work environment, nurse staffing, nursing staff education and experience, lactation consultant availability, and nurse-reported breastfeeding support). The majority of very low birth weight infants (52%) were discharged on formula only. Fewer infants (42%) received human milk mixed with fortifier or formula. Only 6% of infants were discharged on exclusive human milk. A 1 SD increase (0.25) in the Practice Environment Scale of the Nursing Work Index composite score was associated with a four percentage point increase in the fraction of infants discharged on human milk (p<0.05). A 1 SD increase (0.15) in the fraction of nurses with a bachelor's degree in nursing was associated with a three percentage point increase in the fraction infants discharged on human milk (p<0.05). The acuity-adjusted staffing ratio was marginally associated with the rate of human milk at discharge (p=.056). A 1 SD increase (7%) in the fraction of infants who received breastfeeding support was associated with an eight percentage point increase in the fraction of infants discharged on human milk (p<0.001). Neonatal intensive care units with better work environments, better educated nurses, and more infants who receive breastfeeding support by nurses have higher rates of very low birth weight infants discharged home on human milk. Investments by nurse administrators to improve work environments and support educational preparation of nursing staff may ensure that the most vulnerable infants have the best nutrition at the point of discharge. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Hallowell, Sunny G.; Rogowski, Jeannette A.; Spatz, Diane L.; Hanlon, Alexandra L.; Kenny, Michael; Lake, Eileen T.
2016-01-01
Context Nurses are principal caregivers in the neonatal intensive care unit and support mothers to establish and sustain a supply of human milk for their infants. Whether an infant receives essential nutrition and immunological protection provided in human milk at discharge is an issue of health care quality in this setting. Objectives To examine the association of the neonatal intensive care unit work environment, staffing levels, level of nurse education, lactation consultant availability, and nurse-reported breastfeeding support with very low birth weight infant receipt of human milk at discharge. Design and setting Cross sectional analysis combining nurse survey data with infant discharge data. Participants A national sample of neonatal intensive care units (N = 97), nurses (N = 5614) and very low birth weight infants (N = 6997). Methods Sequential multivariate linear regression models were estimated at the unit level between the dependent variable (rate of very low birth weight infants discharged on “any human milk”) and the independent variables (nurse work environment, nurse staffing, nursing staff education and experience, lactation consultant availability, and nurse-reported breastfeeding support). Results The majority of very low birth weight infants (52%) were discharged on formula only. Fewer infants (42%) received human milk mixed with fortifier or formula. Only 6% of infants were discharged on exclusive human milk. A 1 SD increase (0.25) in the Practice Environment Scale of the Nursing Work Index composite score was associated with a four percentage point increase in the fraction of infants discharged on human milk (p < 0.05). A 1 SD increase (0.15) in the fraction of nurses with a bachelor’s degree in nursing was associated with a three percentage point increase in the fraction infants discharged on human milk (p < 0.05). The acuity-adjusted staffing ratio was marginally associated with the rate of human milk at discharge (p = .056). A 1 SD increase (7%) in the fraction of infants who received breastfeeding support was associated with an eight percentage point increase in the fraction of infants discharged on human milk (p < 0.001). Conclusions Neonatal intensive care units with better work environments, better educated nurses, and more infants who receive breastfeeding support by nurses have higher rates of very low birth weight infants discharged home on human milk. Investments by nurse administrators to improve work environments and support educational preparation of nursing staff may ensure that the most vulnerable infants have the best nutrition at the point of discharge. PMID:26518107
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Work and personal well-being of nurses in Queensland: Does rurality make a difference?
Hegney, Desley; Eley, Robert; Osseiran-Moisson, Rebecca; Francis, Karen
2015-12-01
This study aims to ascertain if differences exist in the perception of the professional practice environment and personal well-being of nurses across different geographical areas in Queensland. This paper was performed on a prospective, self-report cross-sectional on-line survey. The study was conducted among the nurses employed in public and private health care settings: acute hospitals, community health and aged care in Queensland, Australia. Participants of this study were 1608 registered and enrolled nurses and assistants in nursing, current members of the Queensland Nurses Union in 2013 and who provided a workplace postcode. One thousand eight of these participants worked in major cities, while 382 in rural locations and 238 in remote areas. None. Scores of well-being as determined by the following scales: the Depression, Anxiety and Stress Scale, the Professional Quality of Life Scale version 5, the Connor-Davidson Resilience Scale and of the Professional Practice Environment using the Practice Environment Scale - Nursing Work Index Revised. Nurses employed in major cities perceived 'nursing foundations for quality care' more favourably than those from other settings. Remote area nurses had lower levels of secondary traumatic stress than nurses in major cities and rural areas. There was no difference between nurses across their geographical locations for stress, anxiety, depression, compassion satisfaction, burnout, resilience and the four other measures of the Practice Environment Scale. The study findings provide new data suggesting that, with the exception of secondary traumatic stress, the personal well-being of nurses does not differ across geographical settings. Similarly, with the exception of the subscale of 'nursing foundations for quality care' there was no difference in perceptions of the professional practice environment. As secondary traumatic stress is associated with burnout, this finding needs to be investigated further. © 2015 National Rural Health Alliance Inc.
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Closeness, chaos and crisis: the attractions of working in acute mental health care.
Deacon, M; Warne, T; McAndrew, S
2006-12-01
This paper makes a case for the attractiveness of acute mental health inpatient nursing (acute nursing) and argues that an altered perception of this work is essential if we are to provide the most acutely mentally ill and vulnerable people with a stable and expert nursing workforce. The discussion draws on an ethnographic study conducted in an inner-city psychiatric unit in England and the advantages of this method for understanding nursing work are described. Within our findings, we set out two overarching themes: the contextual realities of the contemporary acute ward and features of attraction that encourage nurses to work in the acute care setting. The former includes nurses' responsibility for the total ward environment and the latter the 'comfort of closeness' and 'surviving and thriving in chaos and crisis'. In conclusion, we argue that despite the unpopularity of the acute inpatient mental health environment, the highly sophisticated skills employed by acute nurses actually ensure the promotion of health for the majority of service users.
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The relationship between ethical climate at work and job satisfaction among nurses in Tehran.
Joolaee, Soodabeh; Jalili, Hamid Reza; Rafii, Forough; Hajibabaee, Fatemeh; Haghani, Hamid
2013-01-01
This study aimed to provide an understanding of the relationship between the ethical climate at the workplace and job satisfaction among nurses. 210 nurses working in selected wards in the Tehran University of Medical Sciences were asked to fill out questionnaires on their work environment and level of job satisfaction. The data collection tools included a questionnaire to obtain demographic data, the Olson moral climate questionnaire and Minnesota job satisfaction questionnaire. The data were analysed using SPSS software version 14. We found a significant positive relationship between the ethical climate and the level of job satisfaction among the nurses. Among the demographic variables, the working shift, income level and type of duties allocated had a significant relationship with job satisfaction. Hospital managements should pay attention to the factors influencing job motivation among nurses, including the ethical climate of the work environment.
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Perianesthesia Nurses Are My Second Family: A Qualitative Descriptive Study.
Seefeldt, Julanne; Wood, Stacey; Bolton, Pamela; Fitzpatrick, Tara; Stegenga, Kristin; Roberts, Cristine
2017-12-01
Identify the perceptions of perianesthesia nurses regarding behaviors that promote or detract from sustaining a safe, efficient, and satisfying work environment. Two focus groups and seven individual interviews (n=14) were conducted exploring the perceptions regarding team behavior of registered nurses in one pediatric perianesthesia unit. Qualitative descriptive data collection, inductive content analysis. Nurses described a responsive, engaged health care team whose leadership is available and directive when needed, as creating an effective, satisfying work environment. Primary themes that emerged were Leadership Sets the Tone, Playing Fair, No One Gets Hurt, and Why We Stay. This nursing team acknowledged that inattentive, distracted team members cause frustration, work inequities, and care delays, potentially undermining patient safety. Results demonstrate the need to create and sustain consistently respectful perianesthesia work cultures. Research focusing on unit specific approaches to work distribution, communication, leadership, and technology use is needed. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
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Aspects of the working life of women in the nursing profession in South Africa: survey results.
Erasmus, B J; Brevis, T
2005-05-01
This article reports on a survey done among nurses registered with the South African Nursing Council. The survey was carried out in the last quarter of 2003. The purpose of the survey was to investigate aspects of the working life of women in the nursing profession in South Africa and to make recommendations on how their working environment could be improved. The important findings were that pay-related issues dominate as the main problem at work. Improving pay scales and being paid according to extra experience, responsibilities and qualifications could improve the nurses' working environment. Furthermore, training opportunities, medical insurance and equal opportunities should be addressed as a matter of urgency. In general, respondents had a positive attitude towards their job, which leaves the impression that nurses still regard their jobs as something they do for the sake of a service to the community and not only for the money they earn.
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New Nursing Faculty and Incivility: Applying Mindfulness-Based Strategies.
Green, Cheryl
Workplace incivility remains a problem within the nursing profession. As nurse leaders, we must recognize and not ignore the complexity of cultures that have adapted incivility into the work environment. Nursing education is a discipline that requires collaborative team work, independent drive, and commitment. New nursing faculty experiencing incivility can use mindfulness-based meditation approaches to cope with uncivil behaviors experienced within the workplace. Nurse educators applying the concepts of mindfulness can learn how to provide themselves self-care by reducing stress, as enhanced daily awareness of peace and calm are incorporated into their lifestyle. Mindfulness provides a realization that control can only be given to other persons when an individual allows or accepts another's negative behaviors. Awareness of the value and importance of oneself can assist the nurse educator experiencing incivility to maintain his or her emotional, physical, and spiritual health despite the volatility of the work environment.
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Enns, Victoria; Currie, Shawn; Wang, JianLi
2015-01-01
The prevalence of major depression in Canadian nurses is double the national average for working women. The present study sought to delineate the role of professional autonomy, health care setting, and work environment characteristics as risk factors for depression and absenteeism in female nurses. A cross-sectional, secondary analysis was conducted on a large representative sample of female nurses working in hospitals and other settings across Canada (N = 17,437). Univariate and multivariate analyses were used to test the hypothesis that work environment factors are significant determinants of major depression and absenteeism in female nurses after accounting for other risk factors. Experiencing a major depressive episode in the past 12 months was significantly associated with lower autonomy (odds ratio [OR] = 0.93), higher job strain (OR = 2.2), being a licensed practical nurse (OR = 0.82), and working in a nonhospital setting (OR = 1.5). Higher absenteeism was associated with the same variables as well as having less control over one's work schedule. Efforts to increase autonomy of nurses and reduce job strain may help to address the high prevalence of major depression in this professional group. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.
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Job satisfaction in psychiatric nursing.
Ward, M; Cowman, S
2007-08-01
In recent years, mental health services across Europe have undergone major organizational change with a move from institutional to community care. In such a context, the impact of change on the job satisfaction of psychiatric nurses has received little attention in the literature. This paper reports on the job satisfaction of psychiatric nurses and data were collected in 2003. The population of qualified psychiatric nurses (n = 800) working in a defined geographical health board area was surveyed. Methodological triangulation with a between-methods approach was used in the study. Data were collected on job satisfaction using a questionnaire adopted from the Occupational Stress Indicator. A response rate of 346 (43%) was obtained. Focus groups were used to collect qualitative data. Factors influencing levels of job satisfaction predominantly related to the nurses work location. Other factors influencing job satisfaction included choice of work location, work routine, off duty/staff allocation arrangements, teamwork and working environment. The results of the study highlight to employers of psychiatric nurses the importance of work location, including the value of facilitating staff with choices in their working environment, which may influence the recruitment and retention of nurses in mental health services.
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A new practice environment measure based on the reality and experiences of nurses working lives.
Webster, Joan; Flint, Anndrea; Courtney, Mary
2009-01-01
To explore the underlying organizational issues affecting a nurses' decision to leave and to develop a contemporary practice environment measure based on the experiences of nurses working lives. Turnover had reached an unacceptable level in our organization but underlying reasons for leaving were unknown. In-depth interviews were conducted with 13 nurses who had resigned. Transcripts were analysed using the constant comparative method. Information from the interviews informed the development a new practice environment tool, which has undergone initial testing using the Content Validity Index and Chronbach's alpha. Two domains ('work life' and 'personal life/professional development') and five themes ('feeling safe', 'feeling valued', 'getting things done', 'professional development' and 'being flexible') emerged from the interviews. A content validity score for the new instrument was 0.79 and Chronbach's alpha 0.93. The new practice environment tool has shown useful initial reliability and validity but requires wider testing in other settings. The reality and experiences of nurses working lives can be identified through exit interviews conducted by an independent person. Information from such interviews is useful in identifying an organization's strength and weaknesses and to develop initiatives to support retention.
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Armellino, Donna; Quinn Griffin, Mary T; Fitzpatrick, Joyce J
2010-10-01
The aim of the present study was to examine the relationship between structural empowerment and patient safety culture among staff level Registered Nurses (RNs) within adult critical care units (ACCU). There is literature to support the value of RNs' structurally empowered work environments and emerging literature towards patient safety culture; the link between empowerment and patient safety culture is being discovered. A sample of 257 RNs, working within adult critical care of a tertiary hospital in the United States, was surveyed. Instruments included a background data sheet, the Conditions of Workplace Effectiveness and the Hospital Survey on Patient Safety Culture. Structural empowerment and patient safety culture were significantly correlated. As structural empowerment increased so did the RNs' perception of patient safety culture. To foster patient safety culture, nurse leaders should consider providing structurally empowering work environments for RNs. This study contributes to the body of knowledge linking structural empowerment and patient safety culture. Results link structurally empowered RNs and increased patient safety culture, essential elements in delivering efficient, competent, quality care. They inform nursing management of key factors in the nurses' environment that promote safe patient care environments. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
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Promotion of Nursing Student Civility in Nursing Education: A Concept Analysis.
Woodworth, Julie A
2016-07-01
Substantive research into the development of civility within nursing education is long overdue. Behaviors learned by nursing students while in the school of nursing transfer to the work environment and culture of nursing. This paper reveals a concept analysis of civility within nursing education using Rodgers' evolutionary concept analysis method. Civility is defined to provide clarity for the current terminology of civility within nursing education. Nurse educators must set socially acceptable behavioral expectations in the learning environment, establishing positive interpersonal relationships with students, maintaining moral and academic integrity, and role model civil behaviors. Suggestions are included to help nurse educators outline acceptable behaviors in the learning environment and promote the development of civility. The development of civil behaviors in nursing students will carry into professional practice after graduation. Civility is necessary to establish meaningful interpersonal relationships, supportive communication, and optimum learning environments to ensure quality patient care with optimum outcomes. Woodworth. © 2015 Wiley Periodicals, Inc.
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Cusack, Lynette; Smith, Morgan
2010-09-01
This article explores the power implications of implementing competency-based assessments within the nursing work environment from a manager's perspective. It discusses how the implementation of competency-based assessments for continuing education may affect workplace culture, in particular, the use of power, within the nursing team. The term "managers" for the purpose of this article is defined as "nurses in senior administrative and educational positions within a health care facility." This article adds to the discourse on competency-based models by emphasizing the effect of the nursing work environment on the competency-based assessment process. It concludes by identifying strategies that can be used by nursing management when designing and implementing an effective and fair competency-based assessment for the nursing workplace. Copyright 2010, SLACK Incorporated.
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Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René
2015-09-01
Implicit rationing of nursing care refers to the withdrawal of or failure to carry out necessary nursing care activities due to lack of resources, in the literature also described as missed care, omitted care, or nursing care left undone. Under time constraints, nurses give priority to activities related to vital medical needs and the safety of the patient, leaving out documentation, rehabilitation, or emotional support of patients. In nursing homes, little is known about the occurrence of implicit rationing of nursing care and possible contributing factors. The purpose of this study was (1) to describe levels and patterns of self-reported implicit rationing of nursing care in Swiss nursing homes and (2) to explore the relationship between staffing level, turnover, and work environment factors and implicit rationing of nursing care. Cross-sectional, multi-center sub-study of the Swiss Nursing Home Human Resources Project (SHURP). Nursing homes from all three language regions of Switzerland. A random selection of 156 facilities with 402 units and 4307 direct care workers from all educational levels (including 25% registered nurses). We utilized data from established scales to measure implicit rationing of nursing care (Basel Extent of Rationing of Nursing Care), perceptions of leadership ability and staffing resources (Practice Environment Scale of the Nursing Work Index), teamwork and safety climate (Safety Attitudes Questionnaire), and work stressors (Health Professions Stress Inventory). Staffing level and turnover at the unit level were measured with self-developed questions. Multilevel linear regression models were used to explore the proposed relationships. Implicit rationing of nursing care does not occur frequently in Swiss nursing homes. Care workers ration support in activities of daily living, such as eating, drinking, elimination and mobilization less often than documentation of care and the social care of nursing homes residents. Statistically significant factors related to implicit rationing of care were the perception of lower staffing resources, teamwork and safety climate, and higher work stressors. Unit staffing and turnover levels were not related to rationing activities. Improving teamwork and reducing work stressors could possibly lead to less implicit rationing of nursing care. Further research on the relationship of implicit rationing of nursing care and resident and care worker outcomes in nursing homes is requested. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Tanaka, Sachiko; Maruyama, Yukie; Ooshima, Satoko; Ito, Hirotaka
2011-01-01
The aim of this study was to examine the awareness of work-life balance (WLB) among the nursing personnel at a university hospital in Japan. Survey. A questionnaire was sent to 1236 nursing personnel working at a university hospital and 1081 (87·5%) responses received. The questions concerned the following: (1) respondent demographical characteristics, (2) living background, (3) wishes for working environments and (4) motivation to work and health condition. The data were analysed by simple and cross-tabulations. The results can be summarised as follows: (1) the concept and significance of WLB has not yet been established among nurses in Japan, (2) three factors were found, which nurses need as working environment, 1st quality-of-life benefits, 2nd flexible working style, 3rd lifelong learning and (3) nurses who reported good WLB also reported higher job satisfaction and job motivation. The concept and significance of WLB has not yet been established among nurses. Thus, it is needed to enlighten nurses on the concept and significance of WLB as well as how they should practise WLB. Approximately half of the nurses gave their jobs first priority in reality, although they had various needs for their private lives and household affairs, as well as jobs. WLB cannot be achieved only by individual attitudes; thus, organisational efforts are necessary. In the correlation between WLB and 'job satisfaction' and 'job motivation,' nurses who were satisfied with their job and those who were highly motivated showed higher WLB. There was a significant correlation between satisfaction and motivation. It is necessary that nurses understand and have any information about working policy to improve working conditions to get better conditions which they need. © 2010 Blackwell Publishing Ltd.
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Collegial relationship breakdown: a qualitative exploration of nurses in acute care settings.
Cowin, Leanne S
2013-01-01
Poor collegial relations can cause communication breakdown, staff attrition and difficulties attracting new nursing staff. Underestimating the potential power of nursing team relationships means that opportunities to create better working environments and increase the quality of nursing care can be missed. Previous research on improving collegiality indicates that professionalism and work satisfaction increases and that staff attrition decreases. This study explores challenges, strengths and strategies used in nursing team communication in order to build collegial relationships. A qualitative approach was employed to gather nurses experiences and discussion of communication within their nursing teams and a constant comparison method was utilised for data analysis. A convenience sampling technique was employed to access both Registered Nurses and Enrolled Nurses to partake in six focus groups. Thirty mostly female nurses (ratio of 5:1) participated in the study. Inclusion criteria consisted of being a nurse currently working in acute care settings and the exclusion criteria included nursing staff currently working in closed specialty units (i.e. intensive care units). Results revealed three main themes: (1) externalisation and internalisation of nursing team communication breakdown, (2) the importance of collegiality for retention of nurses and (3) loss of respect, and civility across the healthcare workplace. A clear division between hierarchies of nurses was apparent in how nursing team communication was delivered and managed. Open, respectful and collegial communication is essential in today's dynamic and complex health environments. The nurses in this study highlighted how important nursing communication can be to work motivation and how leadership fosters teamwork.
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Nurse knowledge, work environment, and turnover in highly specialized pediatric end-of-life care
Lindley, Lisa C.; Cozad, Melanie J.
2016-01-01
Objective To examine the relationship between nurse knowledge and work environment and Registered Nurse (RN) turnover in perinatal hospice and palliative care organizations. Methods Using nurse intellectual capital theory, a multivariate analysis was conducted with 2007 National Home and Hospice Care Survey data. Results Perinatal hospice and palliative care organizations experienced a 5% turnover rate. The professional experience of advanced practice nurses (APNs) was significantly related to turnover among RNs (β= −0.032, P< 0.05). Compared to organizations with no APNs professional experience, clinical nurse specialists and nurse practitioners significantly reduced RN turnover by 3-percentage points. No other nurse knowledge or work environment variables were associated with RN turnover. Several of the control variables were also associated with RN turnover in the study: organizations serving micropolitan (β= −0.041, P< 0.05) and rural areas (β= −0.037, P< 0.05) had lower RN turnover, compared to urban areas. Organizations with a technology climate where nurses used electronic medical records had a higher turnover rate than those without (β= 0.036, P< 0.05). Conclusions The findings revealed that advanced professional experience in the form of APNs were associated with reductions in RN turnover. This suggests that having a clinical nurse specialist or nurse practitioner on staff may provide knowledge and experience to other RNs, creating stability within the organization. PMID:27188758
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Canadian oncology nurse work environments: part II.
Bakker, Debra; Conlon, Michael; Fitch, Margaret; Green, Esther; Butler, Lorna; Olson, Karin; Cummings, Greta
2012-03-01
In the aftermath of healthcare restructuring, it is important to pay attention to nurses' perceptions of workplace and professional practice factors that attract nurses and influence their retention. Continuing constraints on cancer care systems make the issue of health human resources an ongoing priority. This paper presents the findings of a follow-up study of a cohort of Canadian oncology nurses that aimed to compare nurses' perceptions of their work environment, job satisfaction and retention over a two-year period. Participants of the follow-up survey represented 65% (397/615) of the initial cohort. Many similar perceptions about the work environment were found over two years; however, at follow-up a larger proportion of nurses reported an absence of enough RNs to provide quality care and a lack of support for innovative ideas. With respect to career status, only 6% (25/397) of the follow-up sample had left oncology nursing. However, the proportion of nurses declaring an intention to leave their current job increased from 6.4% (39/615) on the initial survey to 26% (102/397) on the follow-up survey. Findings suggest that decision-makers need to use both the growing body of workplace knowledge and the input from staff nurses to implement changes that positively influence nurse recruitment and retention. Future research should focus on the implementation and evaluation of strategies that address workplace issues such as nurse staffing adequacy, leadership and organizational commitment.
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Effective strategies for nurse retention in acute hospitals: a mixed method study.
Van den Heede, Koen; Florquin, Mieke; Bruyneel, Luk; Aiken, Linda; Diya, Luwis; Lesaffre, Emmanuel; Sermeus, Walter
2013-02-01
The realization of an organizational context that succeeds to retain nurses within their job is one of the most effective strategies of dealing with nursing shortages. First, to examine the impact of nursing practice environments, nurse staffing and nurse education on nurse reported intention to leave the hospital. Second, to provide understanding of which best practices in the organization of nursing care are being implemented to provide sound practice environments and to retain nurses. 3186 bedside nurses of 272 randomly selected nursing units in 56 Belgian acute hospitals were surveyed. A GEE logistic regression analysis was used to estimate the impact of organization of nursing care on nurse reported intention to leave controlling for differences in region (Walloon, Flanders, and Brussels), hospital characteristics (technology level, teaching status, and size) and nurse characteristics (experience, gender, and age). For the second objective, in-depth semi-structured interviews with the chief nursing officers of the three high and three low performing hospitals on reported intention to leave were held. 29.5% of Belgian nurses have an intention-to-leave the hospital. Patient-to-nurse staffing ratios and nurse work environments are significantly (p<0.05) associated with intention-to-leave. Interviews with Chief Nurse Officers revealed that high performing hospitals showing low nurse retention were--in contrast to the low performing hospitals--characterized by a flat organization structure with a participative management style, structured education programs and career opportunities for nurses. This study, together with the international body of evidence, suggests that investing in improved nursing work environments is a key strategy to retain nurses. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Dendaas, Nancy
2011-01-01
To describe the degree to which Environmental Congruence (EC) is present in sampled units and considered important/desirable by staff RNs; staff RNs' reported level of work-related stress (WRS); the perceived contribution of the physical environment to WRS; and the relationship between existing levels of EC and WRS. Few studies have focused on how the physical environment might contribute to nurses' WRS and chronic nursing shortages. The construct of EC can be used, within a Person Environment (PE)-Fit framework, to assess the fit among nurses, nursing work, the physical work environment, and WRS. EC was measured using investigator-developed, literature/criterion-based survey instruments. Staff RNs reported WRS variables by using two single-item self-report measures. The final convenience sample consisted of 471 staff RNs from 39 medical/surgical units from 12 hospitals in the upper Midwest. Data were collected over a 7-month period. The mean level of existing EC in the sample was roughly 70% percent of highest capacity and that of important/desired EC in the sample was 93%. Staff RNs' mean level of WRS was 6.7; the mean contribution of the physical environment to WRS was 5.8. Moderate negative correlations were found between EC and WRS (r = -.41, p < .05), and between physical environment contribution to WRS and EC (r = -.55, p <.001). Staff RNs in the sampled units wanted a significantly higher level of EC. They rated their WRS moderately high and the contribution of the physical environment to it as moderate. A moderately negative relationship was found between EC and WRS. EC may be a useful construct in research that attempts to improve hospital nursing work environments.
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Powell, Idona
2013-10-01
To report a study that explored the experiences of night-shift nurses, focusing on employee interrelationships and work satisfaction. Night-shift nurses are a critical component in hospital care making it essential to understand the experiences that give meaning to their work and understand how these nurses and the organization can benefit from their contribution to hospital care. A literature review revealed minimal research in this area. Qualitative case study. A qualitative case study using semi-structured interviews and self-completed diaries was conducted in 2010 in regional public hospitals in Australia. Participants were 14 nurses working nights half or more of their shifts in medical or surgical wards. Thematic analysis identified four major areas of concern: work relationships, work environment, work practices and lifestyle impact. Notably, work relationships were most meaningful for nurses on the same shift; night-shift nurses experienced working conditions inferior to their daytime counterparts including a perception of minimal leadership. Despite limited education opportunities, night shift provided opportunity for professional growth for some nurses with a slippage in skills for others; night shift provided flexibility for family and social activities, yet impeded these same activities, primarily due to pervasive fatigue. Night-shift nurses considered their role critical, yet believed that they were poorly regarded. The strong interpersonal relationships developed between night-shift workers need to be capitalized on whilst developing a more effective leadership model, improved work environment, more equitable professional development, and genuine recognition of the critical role of night nurses. © 2013 Blackwell Publishing Ltd.
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Workplace social capital in nursing: an evolutionary concept analysis.
Read, Emily A
2014-05-01
To report an analysis of the concept of nurses' workplace social capital. Workplace social capital is an emerging concept in nursing with potential to illuminate the value of social relationships at work. A common definition is needed. Concept analysis. The Cumulative Index to Nursing and Allied Health Literature, PubMed, PsychINFO and ProQuest Nursing. Databases were systematically searched using the keywords: workplace social capital, employee social capital, work environment, social capital and nursing. Sources published between January 1937-November 2012 in English that described or studied social capital of nurses at work were included. A total of 668 resources were found. After removing 241 duplicates, literature was screened in two phases: (1) titles and abstracts were reviewed (n = 427); and (2) remaining data sources were retrieved and read (n = 70). Eight sources were included in the final analysis. Attributes of nurses' workplace social capital included networks of social relationships at work, shared assets and shared ways of knowing and being. Antecedents were communication, trust and positive leadership practices. Nurses' workplace social capital was associated with positive consequences for nurses, their patients and healthcare organizations. Nurses' workplace social capital is defined as nurses' shared assets and ways of being and knowing that are evident in, and available through, nurses' networks of social relationships at work. Future studies should examine and test relationships between antecedents and consequences of nurses' workplace social capital to understand this important aspect of healthy professional practice environments better. © 2013 John Wiley & Sons Ltd.
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The nursing profession: public image, self-concept and professional identity. A discussion paper.
ten Hoeve, Yvonne; Jansen, Gerard; Roodbol, Petrie
2014-02-01
To discuss the actual public image of nurses and other factors that influence the development of nurses' self-concept and professional identity. Nurses have become healthcare professionals in their own right who possess a great deal of knowledge. However, the public does not always value the skills and competences nurses have acquired through education and innovation. Discussion paper. We identified 1216 relevant studies by searching MEDLINE, CINAHL and PsycINFO databases in the period 1997-2010. Finally, 18 studies met our inclusion criteria. The included studies show that the actual public image of nursing is diverse and incongruous. This image is partly self-created by nurses due to their invisibility and their lack of public discourse. Nurses derive their self-concept and professional identity from their public image, work environment, work values, education and traditional social and cultural values. Nurses should work harder to communicate their professionalism to the public. Social media like the Internet and YouTube can be used to show the public what they really do. To improve their public image and to obtain a stronger position in healthcare organizations, nurses need to increase their visibility. This could be realized by ongoing education and a challenging work environment that encourages nurses to stand up for themselves. Furthermore, nurses should make better use of strategic positions, such as case manager, nurse educator or clinical nurse specialist and use their professionalism to show the public what their work really entails. © 2013 John Wiley & Sons Ltd.
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The context of oncology nursing practice: an integrative review.
Bakker, Debra; Strickland, Judith; Macdonald, Catherine; Butler, Lorna; Fitch, Margaret; Olson, Karin; Cummings, Greta
2013-01-01
In oncology, where the number of patients is increasing, there is a need to sustain a quality oncology nursing workforce. Knowledge of the context of oncology nursing can provide information about how to create practice environments that will attract and retain specialized oncology nurses. The aims of this review were to determine the extent and quality of the literature about the context of oncology nursing, explicate how "context" has been described as the environment where oncology nursing takes place, and delineate forces that shape the oncology practice environment. The integrative review involved identifying the problem, conducting a structured literature search, appraising the quality of data, extracting and analyzing data, and synthesizing and presenting the findings. Themes identified from 29 articles reflected the surroundings or background (structural environment, world of cancer care), and the conditions and circumstances (organizational climate, nature of oncology nurses' work, and interactions and relationships) of oncology nursing practice settings. The context of oncology nursing was similar yet different from other nursing contexts. The uniqueness was attributed to the dynamic and complex world of cancer control and the personal growth that is gained from the intense therapeutic relationships established with cancer patients and their families. The context of healthcare practice has been linked with patient, professional, or system outcomes. To achieve quality cancer care, decision makers need to understand the contextual features and forces that can be modified to improve the oncology work environment for nurses, other providers, and patients.
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"The pure hard slog that nursing is . . .": a qualitative analysis of nursing work.
Bogossian, Fiona; Winters-Chang, Peta; Tuckett, Anthony
2014-09-01
To explore nurses' perceptions of the nature of nursing work as a factor that contributes to attrition from the profession. A nonpurposive sample of nurses from the Nurses and Midwives e-cohort Study in Australia, New Zealand, and the United Kingdom provided electronic responses about reasons for leaving the profession. Data were then subjected to qualitative content analysis. Nurses at the "coal face," that is, those who actually do the work of nursing, in real working conditions, express dissatisfaction in relation to hygiene factors relating to the nature of nursing work and attribute these to nurses leaving the profession: workload, shift work, violence, and financial remuneration. Nurses' satisfaction with work and motivation to work are being sorely tested. There is manifest tension between the core concepts of nursing-compassion and care-and a system of work that actively precludes nurses from being able to exhibit these virtues and fails to reward them. Workload, shift work, violence, and financial remuneration are drivers of attrition and need to be addressed. Implications from this study are fourfold: determination of nursing workload, mitigating the impact of shift work, providing safe work environments, and adequate financial remuneration. © 2014 Sigma Theta Tau International.
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Ishihara, Itsuko; Ishibashi, Yukie; Takahashi, Kiyomi; Nakashima, Mitsuyo
2014-07-01
The purpose of this study was to investigate intention to leave in relation to organizational factors and work environments among newly graduated nurses (NGN). A questionnaire was delivered to NGN (n = 762) from baccalaureate programs as well as diploma schools from 19 R-hospitals (R-hospitals were designated as "public medical institutions" by the 1951 Medical Law) in 2010. Spearman's rank correlation coefficients and Mann-Whitney U-test were used to test statistical significance. Only 148 questionnaires were returned for a return rate of 19.4%. The authors found that 8.1% of respondents had a highly to extremely likely desire to leave nursing. Intention to leave was significantly associated with Nursing Work Index total (P < 0.01), social support (P < 0.001), work barriers (P < 0.001), commitment to workplace (P < 0.001), job satisfaction (P < 0.001), and burnout (P < 0.001). Those who graduated from R-schools run by the R-organization had significantly positive impressions of their organizations and significantly lower intentions to leave compared to other graduates. The study results suggest that NGN intention to leave the workplace and nursing predict actual early intention to leave. In order to reduce burnout and turnover, support from colleagues and supervisors appears to be essential in organizational and psychosocial work environments for NGN to experience job satisfaction and be committed to their workplace. The results of this study also suggest that a longitudinal study is needed to reveal the long-term effects of organizational factors and work environments on NGN and how they impact role transition and adaptation of the NGN to professional practice roles. © 2013 The Authors. Japan Journal of Nursing Science © 2013 Japan Academy of Nursing Science.
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Dhaini, Suzanne R; Zúñiga, Franziska; Ausserhofer, Dietmar; Simon, Michael; Kunz, Regina; De Geest, Sabina; Schwendimann, Rene
2016-01-01
Previous studies have demonstrated poor health of care workers in nursing homes. Yet, little is known about the prevalence of physical and mental health outcomes, and their associations with the psychosocial work environment in nursing homes. (1) To explore the prevalence of physical and mental health outcomes of care workers in Swiss nursing homes, (2) their association with psychosocial work environment. This is a secondary data analysis of the cross-sectional Swiss Nursing Home Human Resources Project (SHURP). We used survey data on socio-demographic characteristics and work environment factors from care workers (N=3471) working in Swiss nursing homes (N=155), collected between May 2012 and April 2013. GEE logistic regression models were used to estimate the relationship between psychosocial work environment and physical and mental health outcomes, taking into account care workers' age. Back pain (19.0%) and emotional exhaustion (24.2%) were the most frequent self-reported physical and mental health. Back pain was associated with increased workload (odds ratios (OR) 1.52, confidence interval (CI) 1.29-1.79), conflict with other health professionals and lack of recognition (OR 1.72, CI 1.40-2.11), and frequent verbal aggression by residents (OR 1.36, CI 1.06-1.74), and inversely associated with staffing adequacy (OR 0.69, CI 0.56-0.84); emotional exhaustion was associated with increased workload (OR 1.96, CI 1.65-2.34), lack of job preparation (OR 1.41, CI 1.14-1.73), and conflict with other health professionals and lack of recognition (OR 1.68, CI 1.37-2.06), and inversely associated with leadership (OR 0.70, CI 0.56-0.87). Physical and mental health among care workers in Swiss nursing homes is of concern. Modifying psychosocial work environment factors offer promising strategies to improve health. Longitudinal studies are needed to conduct targeted assessments of care workers health status, taking into account their age, along with the exposure to all four domains of the proposed WHO model. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Emergency room nurses' pathway to turnover intention: a moderated serial mediation analysis.
Bruyneel, Luk; Thoelen, Tom; Adriaenssens, Jef; Sermeus, Walter
2017-04-01
The aim of this study was to explore the association between the quality of the work environment, job characteristics, demographic characteristics and a pathway of job satisfaction, emotional exhaustion and turnover intention among nurses in emergency departments and perform subgroup analyses. Turnover intention among nurses is high. Multiple causes have been described, mostly in large studies of nurses working on general wards, often without considering complementarity of conceptual models and showing scant interest in the consistency of associations across subgroups of nurses. Cross-sectional multicentre survey. Convenience sample of 294 nurses in 11 Belgian emergency departments during 2014-2015. Indirect effects in the form of mediation and serial mediation were estimated to assess the association between work environment (Magnet model), job characteristics (Job Demand Control Support model) and turnover intention via job satisfaction and emotional exhaustion. Consistency of these indirect effects across subgroups of nurses was examined using moderated mediation analysis (conditional indirect effects). Several Magnet and Job Demand Control Support dimensions were related to turnover intention, either via job dissatisfaction (mediation) or via job satisfaction and emotional exhaustion (serial mediation). In the case of social support from supervisor, these indirect effects were only significant for female nurses, among whom turnover intention was higher. Last, nurses with more years of experience were less likely to indicate turnover intention. To maximize prevention of turnover intention at emergency departments, interventions could target early career nurses, work environment and job characteristics. Female nurses in particular may also benefit from improved social support from their supervisor. © 2016 John Wiley & Sons Ltd.
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Critical thinking of nurse managers related to staff RNs' perceptions of the practice environment.
Zori, Susan; Nosek, Laura J; Musil, Carol M
2010-09-01
BACKGROUND INFORMATION AND SIGNIFICANCE: Critical thinking (CT) skills and the inclination to engage in critical thinking are essential for nurse managers to function as transformational leaders capable of influencing staff to align with organizational goals. In an extensive literature review, numerous studies were found examining the concept of CT in students and no studies were found exploring CT in nurse managers. Identifying the attributes, such as CT, that lead to success in the nurse manager role is useful when preparing nurse managers to lead effectively in the current healthcare climate. Is there a difference between nurse managers' CT dispositions and their respective staff nurses' perceptions of the practice environment? A convenience sample of 12 nurse managers and a random sample of 132 of their respective staff registered nurses (RNs) participated in this descriptive study. CT in nurse managers was measured by the California Critical Thinking Disposition Inventory (CCTDI). Staff RNs' perceptions of the practice environment were measured by the Practice Environment Scale (PES). The research question was answered using a t test. Significant (p < .001) differences were found between specific nurse managers' CCTDI scores for open-mindedness, analyticity, and critical thinking confidence, and significant differences (p < .01) were found for systematicity when compared with their respective staff RNs' mean subscale and overall PES scores. Results of the study support the positive relationship between strength in critical thinking dispositions of nurse managers and their respective staff RNs' perceptions of the practice environment. Nurse managers with stronger CT dispositions may be better able to create positive practice environments that are conducive to job satisfaction and thus the retention of staff RNs. Inclusion of strategies to support the development and use of CT in nurse managers is recommended. CT and other leadership attributes and skills including emotional and social intelligence and management of change through an appreciative inquiry process may provide opportunities to improve leadership effectiveness in nurse managers. Enhancing critical thinking skills and dispositions of nurse managers may help to create positive work environments for staff RNs. Staff RNs who work in an environment perceived to be positive may be in a better position to deliver high quality, safe patient care.
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Tourangeau, Ann; Saari, Margaret; Patterson, Erin; Ferron, Era Mae; Thomson, Heather; Widger, Kimberley; MacMillan, Kathleen
2014-06-01
Given the role nurse faculty have in educating nurses, little is known about what influences their intention to remain employed (ITR) in academic settings. Findings from a nurse faculty survey administered to test a conceptual model of factors hypothesized as influencing nurse faculty ITR are reported. A cross-sectional survey design was employed. We included colleges and universities in Ontario, Canada. The population of Ontario nurse faculty who reported being employed as nurse faculty with the College of Nurses of Ontario (Canada) was included. Of the 1328 nurse faculty who were surveyed, 650 participated. Participants completed a questionnaire with measures of work, work environment, job satisfaction, burnout and ITR. Regression analyses were conducted to test the model. Ten of 26 independent variables explained 25.4% of variance in nurse faculty ITR for five years. These variables included: proximity to retirement, quality of relationships with colleagues, being employed full time, having dependents, satisfaction with work-life balance, quality of education, satisfaction with job status, access to financial support for education from organization, access to required human resources and being unionized. Although not all influencing factors are modifiable, academic leadership should develop strategies that encourage nurse faculty ITR. Strategies that support collegial relationships among faculty, increase the number of full time positions, promote work-life balance, engage faculty in assessing and strengthening education quality, support faculty choice between full-time and part-time work, and ensure adequate human resources required to teach effectively will lead to heightened nurse faculty ITR. © 2013.
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Retaining nurses in metropolitan areas: insights from senior nurse and human resource managers.
Drennan, Vari M; Halter, Mary; Gale, Julia; Harris, Ruth
2016-11-01
To investigate the views of senior nurse and human resource managers of strategies to retain hospital nurses in a metropolitan area. Against a global shortage, retaining nurses is a management imperative for the quality of hospital services. Semi-structured interviews, thematically analysed. Metropolitan areas have many health organisations in geographical proximity, offering nurses choices in employer and employment. Senior nurse and human resource managers recognised the complexity of factors influencing nurse turnover, including those that 'pulled' nurses out of their jobs to other posts and factors that 'pushed' nurses to leave. Four themes emerged in retaining nurses: strategy and leadership, including analysis of workforce and leavers' data, remuneration, the type of nursing work and career development and the immediate work environment. In contexts where multiple organisations compete for nurses, addressing retention through strategic leadership is likely to be important in paying due attention and apportioning resources to effective strategies. Aside from good human resource management practices for all, strategies tailored to different segments of the nursing workforce are likely to be important. This metropolitan study suggests attention should be paid to strategies that address remuneration, progressing nursing careers and the immediate work environment. © 2016 The Authors Journal of Nursing Management Published by John Wiley & Sons Ltd.
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Characteristics of the Nursing Practice Environment Associated With Lower Unit-Level RN Turnover.
Nelson-Brantley, Heather V; Park, Shin Hye; Bergquist-Beringer, Sandra
2018-01-01
The aim of this study is to examine characteristics of the nursing practice environment associated with lower RN turnover. Identifying characteristics of the practice environment that contribute to lower RN turnover is important for meeting the national quality strategy priority of reducing healthcare costs. Data from 1002 adult care units in 162 National Database of Nursing Quality Indicators participating hospitals were analyzed using multivariate linear regression. The Practice Environment Scale of the Nursing Work Index was used to measure practice environment characteristics. RN turnover was measured at the unit level. Nursing units with higher overall ratings of the nursing practice environment had lower rates of RN turnover. Units with higher RN perceived staffing and resource adequacy experienced significantly lower RN turnover. Unit managers and hospital administrators should consider RN perception of staffing and resource adequacy and the overall practice environment when developing targeted strategies for decreasing RN turnover.
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Authentic leadership and nurse-assessed adverse patient outcomes.
Wong, Carol A; Giallonardo, Lisa M
2013-07-01
Our purpose was to test a model examining relationships among authentic leadership, nurses' trust in their manager, areas of work life and nurse-assessed adverse patient outcomes. Although several work environment factors have been cited as critical to patient outcomes, studies linking nursing leadership styles with patient outcomes are limited suggesting the need for additional research to investigate the mechanisms by which leadership may influence patient outcomes. Secondary analysis of data collected in a cross-sectional survey of 280 (48% response rate) registered nurses working in acute care hospitals in Ontario was conducted using structural equation modelling. The final model fit the data acceptably (χ(2) = 1.30, df = 2, P = 0.52, IFI = 0.99, CFI = 1.00, RMSEA = 0.00). Authentic leadership was significantly associated with decreased adverse patient outcomes through trust in the manager and areas of work life. The findings suggest that nurses who see their managers as demonstrating high levels of authentic leadership report increased trust, greater congruence in the areas of work life and lower frequencies of adverse patient outcomes. Managers who emphasize transparency, balanced processing, self-awareness and high ethical standards in their interactions with nurses may contribute to safer work environments for patients and nurses. © 2013 John Wiley & Sons Ltd.
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[Development and Testing of the Taiwanese Hospital Nurses' Job Satisfaction Scale].
Tzeng, Wen-Chii; Lin, Chiou-Fen; Lin, Lih-Ying; Lu, Meei-Shiow; Chiang, Li-Chi
2017-04-01
In the context of professional nursing, the concept of job satisfaction includes the degree to which a nurse is satisfied with the nursing profession, his/her personal adaptation to this profession, and his/her current working environment. No validated scale that addresses the job satisfaction of nurses working in hospitals currently exists in Taiwan. To develop a reliable and validated scale for measuring the job satisfaction of hospital nurses in Taiwan. A three-phase, cross-sectional study design was used. First, a literature review and expert focus group discussion were conducted to develop the initial scale items. Second, experts were invited to validate the content of the draft scale. Finally, convenience sampling was used to recruit 427 hospital nurses from 6 hospitals. These nurses completed the scale and the results were analyzed using item analysis, factor analysis, and internal consistency analysis. The 31-item Taiwanese hospital nurse job satisfaction scale developed in the present study addresses 5 factors, including supportive working environment, professional autonomy and growth, interpersonal interaction and collaboration, leadership style, and nursing workload. The overall Cronbach's α was .96. The results indicate that the developed scale provides good reliability and validity. This study confirms the validity and reliability of the developed scale. It may be used to measure the job satisfaction of nurses working in hospitals.
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Prentice, Dawn; Black, Margaret
2007-09-01
Aim. This paper reports on a qualitative study that explored the reasons why Registered Nurses (RNs) chose to work in nursing homes in Southern Ontario, Canada and what factors attracted them to remain. Background. There is a paucity of information about factors associated with the recruitment and retention of RNs within long-term care (LTC) in Canada. As the population of older people is growing in Canada and elsewhere, it is essential that we better understand what attracts RNs to work and remain in this setting. Design and method. A case study approach was used in this study of nine RNs working in three nursing homes. Data were collected through in-depth interviews. Findings. Six sub-themes were identified: 'Job of Choice', 'Job of Convenience', 'Caring for the Residents', 'A Supportive Environment', 'Heavy Workload' and 'Supervisory Role of the RN'. Conclusion. Nurses chose to work in the nursing home because it was a 'Job of Convenience'. However, characteristics of the organizational environment played a major role in their remaining. Also, the caring relationship with residents played a role in the nurses remaining in this setting. Relevance to clinical practice. Strategies are provided that nurse managers may consider when planning recruitment and retention activities for LTC settings.
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Estryn-Béhar, Madeleine; Van der Heijden, Beatrice I J M; Ogińska, Halszka; Camerino, Donatella; Le Nézet, Olivier; Conway, Paul Maurice; Fry, Clementine; Hasselhorn, Hans-Martin
2007-10-01
Europe's nursing shortage calls for more effective ways to recruit and retain nurses. This contribution aims to clarify whether and how social work environment, teamwork characteristics, burnout, and personal factors are associated with nurses' intent to leave (ITL). Our sample comprises 28,561 hospital-based nurses from 10 European countries. Different occupational levels have been taken into account: qualified registered nurses (n = 18,594), specialized nurses (n = 3957), head nurses (n = 3256), and nursing aides and ancillary staff (n = 2754). Our outcomes indicate that ITL is quite prevalent across Europe, although we have found some differences across the countries depending on working conditions and economic situation. Quality of teamwork, interpersonal relationships, career development possibilities, uncertainty regarding treatment, and influence at work are associated with nurses' decision to leave the profession across Europe, notwithstanding some country-specific outcomes. A serious lack of quality of teamwork seems to be associated with a 5-fold risk of ITL in 7 countries. As far as personal factors are concerned, our data support the hypothesized importance of work-family conflicts, satisfaction with pay, and burnout. A high burnout score seems to be associated with 3 times the risk of ITL in 5 countries. To prevent premature leaving, it is important to expand nurses' expertise, to improve working processes through collaboration and multidisciplinary teamwork, and to develop team training approaches and ward design facilitating teamwork.
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Psychosocial work environment and burnout among emergency medical and nursing staff.
Escribà-Agüir, V; Martín-Baena, D; Pérez-Hoyos, S
2006-11-01
The prevalence of burnout syndrome is increasing among doctors and nurses. The aim of this study was to analyse the relationship between the psychosocial work environment and burnout syndrome among emergency medical and nursing staff in Spain. A secondary aim was to determine if the effect of this psychosocial work environment on burnout was different for doctors and nurses. A cross-sectional survey was carried out by means of a mail questionnaire among 945 emergency doctors and nursing staff of Spain. The outcome variable was three dimensions of burnout syndrome [emotional exhaustion (EE), personal accomplishment (PA), depersonalisation (DP)]. The explanatory variable was that psychosocial work environment evaluated according to Karasek and Johnson's demand-control model. The adjusted odds ratios (OR) and their 95% confidence intervals were calculated by logistical regression. The probability of high EE was greater among those exposed to high psychological demands, OR 4.66 (2.75-7.90), low job control, OR 1.65 (1.04-2.63), and low supervisors' social support, OR 1.64 (1.01-2.59). Emotional exhaustion dimension was negatively influenced by low control only among doctors. Those exposed to low job control had a higher risk of low PA, OR 2.55 (1.66-3.94). There was no evidence of negative effect of psychosocial risk factors on the DP. Prevalence of EE and PA was higher among doctors and nurses. The presence of risk factors derived from work organisation within the work place (psychosocial risk factors) increases the probability of presenting burnout syndrome and, above all, EE.
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Productive work groups in complex hospital units. Proposed contributions of the nurse executive.
Sheafor, M
1991-05-01
The Fiedler and Garcia cognitive resources contingency model of leadership offers a new approach for nurse executives to influence the productivity of work groups led by nurse managers. The author offers recommendations toward achieving the relatively stress-free environment for nurse managers specified by the model using Schmeiding's application of Orlando's communication theory to nursing administration. Suggestions for incorporating these insights into graduate education for nursing administration follow.
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Workplace incivility and new graduate nurses' mental health: the protective role of resiliency.
Laschinger, Heather K; Wong, Carol; Regan, Sandra; Young-Ritchie, Carol; Bushell, Pamela
2013-01-01
The aim of this study was to examine the relationships between coworker, physician, and supervisor workplace incivility and new graduate nurses' mental health and the protective role of personal resiliency. Positive interpersonal relationships in healthcare work environments are important for new graduate nurses' career transition and commitment. Workplace incivility threatens new graduate nurses' health and well-being. Personal resiliency helps employees to recover from negative stressors and may protect new nurses from the negative effects of workplace incivility. We surveyed 272 new graduate nurses in Ontario to explore the influence of 3 forms of workplace incivility and personal resiliency on new nurses' mental health. All sources of incivility were related to poor mental health. Results suggest that personal resiliency may protect nurses from the negative effects of incivility. New nurses are experiencing workplace incivility from a variety of sources in their work environments, which have detrimental effects on their workplace well-being.
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In order to establish a safe environment for nurses and patients, the American Nurses Association (ANA) supports actions and policies that result in the elimination of manual patient handling. Patient handling, such as lifting, repositioning, and transferring, has conventionally been performed by nurses. The performance of these tasks exposes nurses to increased risk for work-related musculoskeletal disorders. With the development of assistive equipment, such as lift and transfer devices, the risk of musculoskeletal injury can be significantly reduced. Effective use of assistive equipment and devices for patient handling creates a safe healthcare environment by separating the physical burden from the nurse and ensuring the safety, comfort, and dignity of the patient.
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Cognitive work analysis to evaluate the problem of patient falls in an inpatient setting
Lopez, Karen Dunn; Cary, Michael P; Kanak, Mary F
2010-01-01
Objective To identify factors in the nursing work domain that contribute to the problem of inpatient falls, aside from patient risk, using cognitive work analysis. Design A mix of qualitative and quantitative methods were used to identify work constraints imposed on nurses, which may underlie patient falls. Measurements Data collection was done on a neurology unit staffed by 27 registered nurses and utilized field observations, focus groups, time–motion studies and written surveys (AHRQ Hospital Survey on Patient Culture, NASA-TLX, and custom Nursing Knowledge of Fall Prevention Subscale). Results Four major constraints were identified that inhibit nurses' ability to prevent patient falls. All constraints relate to work processes and the physical work environment, opposed to safety culture or nursing knowledge, as currently emphasized. The constraints were: cognitive ‘head data’, temporal workload, inconsistencies in written and verbal transfer of patient data, and limitations in the physical environment. To deal with these constraints, the nurses tend to employ four workarounds: written and mental chunking schemas, bed alarms, informal querying of the previous care nurse, and informal video and audio surveillance. These workarounds reflect systemic design flaws and may only be minimally effective in decreasing risk to patients. Conclusion Cognitive engineering techniques helped identify seemingly hidden constraints in the work domain that impact the problem of patient falls. System redesign strategies aimed at improving work processes and environmental limitations hold promise for decreasing the incidence of falls in inpatient nursing units. PMID:20442150
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Cognitive work analysis to evaluate the problem of patient falls in an inpatient setting.
Lopez, Karen Dunn; Gerling, Gregory J; Cary, Michael P; Kanak, Mary F
2010-01-01
To identify factors in the nursing work domain that contribute to the problem of inpatient falls, aside from patient risk, using cognitive work analysis. A mix of qualitative and quantitative methods were used to identify work constraints imposed on nurses, which may underlie patient falls. Data collection was done on a neurology unit staffed by 27 registered nurses and utilized field observations, focus groups, time-motion studies and written surveys (AHRQ Hospital Survey on Patient Culture, NASA-TLX, and custom Nursing Knowledge of Fall Prevention Subscale). Four major constraints were identified that inhibit nurses' ability to prevent patient falls. All constraints relate to work processes and the physical work environment, opposed to safety culture or nursing knowledge, as currently emphasized. The constraints were: cognitive 'head data', temporal workload, inconsistencies in written and verbal transfer of patient data, and limitations in the physical environment. To deal with these constraints, the nurses tend to employ four workarounds: written and mental chunking schemas, bed alarms, informal querying of the previous care nurse, and informal video and audio surveillance. These workarounds reflect systemic design flaws and may only be minimally effective in decreasing risk to patients. Cognitive engineering techniques helped identify seemingly hidden constraints in the work domain that impact the problem of patient falls. System redesign strategies aimed at improving work processes and environmental limitations hold promise for decreasing the incidence of falls in inpatient nursing units.
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Doran, Diane; Duffield, Christine; Rizk, Paul; Nahm, Sang; Chu, Charlene H
2014-01-01
The purpose was to describe the number, demographic characteristics, work patterns, exit rates, and work perceptions of nurses in Ontario, Canada, in 4 specialty classifications: advanced practice nurse (APN)-clinical nurse specialist (CNS), APN-other, primary healthcare nurse practitioner [RN(extended class [EC])], and registered nurse (RN) with specialty certification. The objectives were to (1) describe how many qualified nurses are available by specialty class; (2) create a demographic profile of specialist nurses; (3) determine the proportions of specialist and nonspecialist nurses who leave (a) direct patient care and (b) nursing practice annually; (4) determine whether specialist and nonspecialist nurses differ in their self-ratings of work environment, job satisfaction, and intention to remain in nursing. Employment patterns refer to nurses' employment status (eg, full-time, part-time, casual), work duration (ie, length of employment in nurses and in current role), and work transitions (ie, movement in and out of the nursing workforce, and movement out of current role). A longitudinal analysis of the Ontario nurses' registration database from 2005 to 2010 and a survey of specialist nurses in Canada was conducted. The setting was Canada. The database sample consisted of 3 specialist groups, consisting of RN(EC), CNS, and APN-other, as well as 1 nonspecialist RN staff nurse group. The survey sample involved 359 nurses who were classified into groups based on self-reported job title and RN specialty-certification status. Data sources included College of Nurses of Ontario registration database and survey data. The study measures were the Nursing Work Index, a 4-item measure of job satisfaction, and 1-item measure of intent to leave current job. Nurses registered with the College of Nurses of Ontario were tracked over the study period to identify changes in their employment status with comparisons made between nurses employed in specialist roles and those registered as general staff nurses. Analysis involved descriptive summaries, mean comparisons with independent-samples t test, and χ(2) tests for categorical data. Exit rates from direct practice were highest for APN-other (7.6%) and CNS (6.2%) and lowest for RN(EC) (1.0%) and staff nurses (1.2%). χ(2) Tests indicated yearly exit rates of both APN-other and CNS nurse groups were significantly higher than those of staff nurses in all years evaluated (α = .025). Every specialist employment group scored significantly higher than staff nurses on measures of work environment and satisfaction outcomes. We provided a description of specialist nurses in Ontario and examined the relationship between specialization and employment patterns of nurses to inform nurse retention strategies in the future. Employment in specialist nursing positions is significantly associated with differences in transitions or exits from nursing among the specialist and nonspecialist groups. Registered nurses (EC) displayed improved retention characteristics compared with staff nurses. Advanced practice nurse-other and APN-CNS exit rates from nursing practice in Ontario were comparable to staff nurses, but exit rates from direct clinical practice roles were higher than those of staff nurses. Targeted strategies are required to retain CNS and APN-other in direct clinical practice roles.
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The relationship between work complexity and nurses' participation in decision making in hospitals.
Bacon, Cynthia Thornton; Lee, Shoou-Yih Daniel; Mark, Barbara
2015-04-01
The aim of this study is to examine the relationship between work complexity and nurses' participation in decision making in hospital nursing units. Increasing nurses' participation in decision making has been used as a way to manage work complexity; however, the work of nurses in acute care hospitals has become highly complex, and strategies used to manage this complexity have not been fully explored. The relationship between work complexity and nurse participation in decision making was examined using data from the Outcomes Research in Nursing Administration project. The sample included 3,718 RNs in 278 medical-surgical units in 143 hospitals. When work complexity increased, nurses' participation in decision making decreased. When nurses have limited input into decision making, the information available to the care team may be incomplete. Barriers to nurses' participation in decision making should be explored and interventions developed so that nurses may be full participants in decision making affecting both patients and the work environment.
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Aitken, Leanne M; Burmeister, Elizabeth; Clayton, Samantha; Dalais, Christine; Gardner, Glenn
2011-08-01
Factors previously shown to influence patient care include effective decision making, team work, evidence based practice, staffing and job satisfaction. Clinical rounds have the potential to optimise these factors and impact on patient outcomes, but use of this strategy by intensive care nurses has not been reported. To determine the effect of implementing Nursing Rounds in the intensive care environment on patient care planning and nurses' perceptions of the practice environment and work satisfaction. Pre-test post-test 2 group comparative design. Two intensive care units in tertiary teaching hospitals in Australia. A convenience sample of registered nurses (n=244) working full time or part time in the participating intensive care units. Nurses in participating intensive care units were asked to complete the Practice Environment Scale-Nursing Work Index (PES-NWI) and the Nursing Worklife Satisfaction Scale (NWSS) prior to and after a 12 month period during which regular Nursing Rounds were conducted in the intervention unit. Issues raised during Nursing Rounds were described and categorised. The characteristics of the sample and scale scores were summarised with differences between pre and post scores analysed using t-tests for continuous variables and chi-square tests for categorical variables. Independent predictors of the PES-NWI were determined using multivariate linear regression. Nursing Rounds resulted in 577 changes being initiated for 171 patients reviewed; these changes related to the physical, psychological--individual, psychological--family, or professional practice aspects of care. Total PES-NWI and NWSS scores were similar before and after the study period in both participating units. The NWSS sub-scale of interaction between nurses improved in the intervention unit during the study period (pre--4.85±0.93; post--5.36±0.89, p=0.002) with no significant increase in the control group. Factors independently related to higher PES-NWI included intervention site and less years in critical care (p<0.05). Implementation of Nursing Rounds within the intensive care environment is feasible and is an effective strategy for initiating change to patient care. Application and testing of this strategy, including identification of the most appropriate methods of measuring impact, in other settings is needed to determine generalisability. Copyright © 2010 Elsevier Ltd. All rights reserved.
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Freeman, Michelle; Baumann, Andrea; Akhtar-Danesh, Noori; Blythe, Jennifer; Fisher, Anita
2012-12-01
Internationally, nurse migration in border cities has received little attention. Nurses who graduate from nursing programs in Canadian border communities have the option of working in Canada or the United States. They are able to cross the international border each day as commuter migrants returning to their home country after work. Despite recent investment by Canada to increase the number of nursing students, the migration intentions of graduating nurses and the factors influencing their decision making has not been explored. The objective of this study is to explore the migration intentions of a graduating class of baccalaureate nursing students in a Canadian border community and the factors influencing their decision making. An explanatory sequential mixed methods design was used. In the first quantitative phase, data was collected by a web-based self-report survey. In the qualitative phase, semi-structured interviews were conducted. Data collection took place between February and July 2011. The response rate to the survey was 40.9% (n=115). Eighty-six percent of graduates preferred to work in Canada although two thirds identified that they were considering migrating for work outside of Canada. Knowing a nurse who worked in the US (Michigan) influenced intention to migrate and living in a border community was a strong predictor of migration. Migrants had significantly higher expectations that their economic, professional development, healthy work environment, adventure and autonomy values would be met in another country than Canada. Evidence from the interviews revealed that clinical instructors and clinical experiences played a significant role in framing students' perceptions of the work environment, influencing their choice of specialty, and where they secured their first job. The value-expectancy framework offered a novel approach to identifying job factors driving migration intentions. The study offered a snapshot of the graduates' perception of the work environment before entering the workforce. The graduates doubted that their future work environment would meet many of their job expectations, a troubling finding requiring further investigation. Expectations influenced their migration intentions and may be relevant to their integration and retention in the workforce. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Nurse administrators' intentions and considerations in recruiting inactive nurses.
Yu, Hsing-Yi; Tang, Fu-In; Chen, I-Ju; Yin, Teresa J C; Chen, Chu-Chieh; Yu, Shu
2016-07-01
To understand nurse administrators' intentions and considerations in recruiting inactive nurses and to examine predictors of intent to recruit. Few studies have provided insight into employer intentions and considerations in recruiting inactive nurses. A census survey collected data from 392 nurse administrators via a mailing method. Overall, 89.0% of nurse administrators were willing to recruit inactive nurses. Stepwise regression analysis revealed that the only predictor of nurse administrators' intention to recruit was nurse turnover rate at the hospital. Nurse administrators perceived the most important recruiting considerations were inactive nurses' cooperation with alternating shifts, health status and nursing licence. The most frequent reasons for not recruiting were an inactive nurse's lack of understanding of the medical environment and poor nursing competence. Most hospital nurse administrators were willing to recruit inactive nurses. Inactive nurses who wish to return to work should be qualified, willing to work both day and night shifts, and in good health. Nurse administrators can reduce the nursing shortage by recruiting inactive nurses. Re-entry preparation programmes should be implemented that will provide inactive nurses with knowledge of the current medical environment and the skills required to improve their nursing competence. © 2016 John Wiley & Sons Ltd.
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McHugh, Matthew D.; Ma, Chenjuan
2013-01-01
Background Provisions of the Affordable Care Act that increase hospitals’ financial accountability for preventable readmissions have heightened interest in identifying system-level interventions to reduce readmissions. Objectives To determine the relationship between hospital nursing; i.e. nurse work environment, nurse staffing levels, and nurse education, and 30-day readmissions among Medicare patients with heart failure, acute myocardial infarction, and pneumonia. Method and Design Analysis of linked data from California, New Jersey, and Pennsylvania that included information on the organization of hospital nursing (i.e., work environment, patient-to-nurse ratios, and proportion of nurses holding a BSN degree) from a survey of nurses, as well as patient discharge data, and American Hospital Association Annual Survey data. Robust logistic regression was used to estimate the relationship between nursing factors and 30-day readmission. Results Nearly one-quarter of heart failure index admissions (23.3% [n=39,954]); 19.1% (n=12,131) of myocardial infarction admissions; and 17.8% (n=25,169) of pneumonia admissions were readmitted within 30-days. Each additional patient per nurse in the average nurse’s workload was associated with a 7% higher odds of readmission for heart failure (OR=1.07, [1.05–1.09]), 6% for pneumonia patients (OR=1.06, [1.03–1.09]), and 9% for myocardial infarction patients (OR=1.09, [1.05–1.13]). Care in a hospital with a good versus poor work environment was associated with odds of readmission that were 7% lower for heart failure (OR = 0.93, [0.89–0.97]); 6% lower for myocardial infarction (OR = 0.94, [0.88–0.98]); and 10% lower for pneumonia (OR = 0.90, [0.85–0.96]) patients. Conclusions Improving nurses’ work environments and staffing may be effective interventions for preventing readmissions. PMID:23151591
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Changes to nurses' practice environment over time.
Roche, Michael A; Duffield, Christine; Friedman, Sarah; Twigg, Di; Dimitrelis, Sofia; Rowbotham, Samantha
2016-07-01
To examine changes in the nursing practice environment, retention-related factors, unit stability and patient care tasks delayed or left undone, over two periods between 2004 and 2013. Positive nurse practice environments have been linked to nurse retention and care quality outcomes. The collection of the Practice Environment Scale of the Nursing Work Index, job satisfaction, intent to leave, unit instability and tasks delayed or not done at six acute-care hospitals across three Australian states, in two waves between 2004 and 2013; results from the two waves are compared. On average, practice environment scores declined slightly; nurses reported a greater difficulty in finding another nursing position, lower intent to leave their current job and greater instability in their current position. Rates of delayed tasks increased over the period, whereas rates of tasks left undone have decreased over the period. The decline in nurses' perceptions of the quality of the practice environment is disappointing, particularly given the protracted workforce shortages that have persisted. Significant organisational restructuring and turnover of nurse executives may have contributed to this decline. Managers need to apply existing evidence to improve nurse practice environments and manage instability. © 2016 John Wiley & Sons Ltd.
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Higgins, Linda W; Shovel, Judith A; Bilderback, Andrew L; Lorenz, Holly L; Martin, Susan C; Rogers, Debra J; Minnier, Tamra E
The aim of this project was to describe hospital nurses' work activity through observations, nurses' perceptions of time spent on tasks, and electronic health record time stamps. Nurses' attitudes toward technology and patients' perceptions and satisfaction with nurses' time at the bedside were also examined. Activities most frequently observed included documenting in and reviewing the electronic health record. Nurses' perceptions of time differed significantly from observations, and most patients rated their satisfaction with nursing time as excellent or good.
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Does Synergy Exist in Nursing? A Concept Analysis.
Witges, Kim A; Scanlan, Judith M
2015-01-01
The aim is to analyze the concept of synergy, particularly as the concept applies to teamwork, and determine if the concept has utility in improving the work environment for nurses. Tackling nursing shortages that result from a poor work environment is a priority for many nurse leaders. Producing synergy among teams may be an effective strategy in enhancing the work environment. However, the understanding of synergy and the ability to produce synergy among teams has been seldom highlighted or discussed within nursing literature. Walker and Avant's approach was used to guide this concept analysis of synergy. Literature searches involved databases (PsycInfo, Medline, Cumulative Index for Nursing and Allied Health Literature [CINAHL], and Scopus), Internet search engines (Google), and hand searches. The analysis suggests that synergy is an outcome of the successful collaboration of the following three attributes: group cohesion, the pursuit of a common goal, and the achievement of a positive gain, considerably more than what was thought possible by the group. The foundation for this accomplishment requires an underlying feeling of special importance, the acknowledgment of each member's role, and open communication and dialogue among members. Nursing leaders would benefit from a broader understanding of synergy, and the mindful application and utility of synergy as an outcome of effective teamwork among nurses. © 2014 Wiley Periodicals, Inc.
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The influence of factors of work environment and burnout syndrome on self-efficacy of medical staff.
Nowakowska, Iwona; Rasińska, Renata; Głowacka, Maria Danuta
2016-06-02
Conditions of a healthy, friendly and safe work environment and proper work organisation increase self-efficacy and decrease or eliminate the factors causing the occurrence of burnout symptoms, all of which have a decisive impact on increasing the quality of work. The aim of the study was to analyse and assess the influence of factors of work environment and burnout syndrome on the self-efficacy of medical staff. The study comprised randomly selected professionally-active nurses working on hospital wards (N=405) on the area of two provinces in Poland. The study used the Generalized Self-Efficacy Scale, Copenhagen Burnout Inventory and a questionnaire concerning the factors that influence the process of work organisation at nursing positions in hospitals. Lower scores for self-efficacy resulted in a worse assessment of development opportunities and promotion prospects (r=-0.11), participation in the decision-making process (r=-0.11) and teamwork (r=-0.10). Lower self-efficacy contributed to the occurrence of burnout symptoms r∈[-0.19 - -0.17]. Properly shaped and used organisational factors are stimulating for professional efficiency and effectiveness, and consequently, for the quality of nursing work. Negative assessment of the factors in the work environment contributes to the occurrence of burnout symptoms and decrease in self-efficacy. Nurses with lower self-efficacy more often experienced symptoms of burnout.
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Workplace bullying among nurses and their related factors in Japan: a cross-sectional survey.
Yokoyama, Mami; Suzuki, Miho; Takai, Yukari; Igarashi, Ayumi; Noguchi-Watanabe, Maiko; Yamamoto-Mitani, Noriko
2016-09-01
To explore the association between workplace bullying and workplace environment factors among nurses in Japan. Workplace bullying among nurses is increasing globally and occurs more frequently than among other professions. However, there is little information on the impact of workplace environment factors on nurse bullying in Japan. A cross-sectional survey using a self-administered questionnaire. Participants were 1152 nurses recruited at seminars or training courses outside of their workplaces in Tokyo. Workplace bullying was measured using the Negative Acts Questionnaire-Revised. Participants were considered to have been 'bullied' if they reported experiencing at least one negative act on a daily or weekly basis. Workplace environment factors were measured using the Practice Environment Scale of the Nursing Work Index, which comprises five domains: nurse participation in hospital affairs; nursing foundations for quality of care; nurse manager ability, leadership and support of nurses; staffing and resource adequacy; and collegial nurse-physician relationships. A total of 898 (78·0%) questionnaires were returned, of which 825 (71·6%) were analysed. Altogether, 153 (18·5%) nurses were considered 'bullied.' The three most frequent negative acts reported as occurring on a weekly or daily basis were 'someone withholding information which affects your performance' (6·7%), 'being exposed to an unmanageable workload' (4·4%) and 'being shouted at or being the target of spontaneous anger (or rage)' (3·6%). Logistic regression analysis indicated that 'bullied' were associated with low scores on two work environment domains: nurse manager ability, leadership and support of nurses and staffing and resource adequacy. Effective nurse manager leadership and support as well as appropriate staffing management may positively influence workplace bullying among nurses in Japan. Authentic leadership styles and allowing nurses to easily request days off might also be important. Nurse managers' leadership may influence nurses' workplace bullying. © 2016 John Wiley & Sons Ltd.
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Zander, Britta; Dobler, Lydia; Busse, Reinhard
2013-02-01
As other countries which have introduced diagnosis-related groups (DRGs) to pay their hospitals Germany initially expected that quality of care could deteriorate. Less discussed were potential implications for nurses, who might feel the efficiency-increasing effects of DRGs on their daily work, which in turn may lead to an actual worsening of care quality. To analyze whether the DRG implementation in German acute hospitals (as well as other changes over the 10-year period) had measurable effects on (1) the nurse work environment (including e.g. an adequate number of nursing staff to provide quality patient care), (2) quality of patient care and safety (incl. confidence into patients' ability to manage care when discharged), and (3) whether the effects from (1) and (2)--if any--impacted on the nurses themselves (satisfaction with their current job and their choice of profession as well as emotional exhaustion). Two rounds of nurse surveys with the Practice Environment Scale of the Nursing Work Index (PES-NWI), five years before DRG implementation (i.e. in 1998/1999; n=2681 from 29 hospitals) and five years after (i.e. in 2009/2010; n=1511 from 49 hospitals). The analysis utilized 15 indicators as outcomes for (1) practice environment, (2) quality of patient care and safety, as well as (3) nurses' satisfaction and emotional exhaustion. Multivariate analyses were performed for all three sets of outcomes using SPSS version 20. Aspects of the practice environment (especially adequate staffing and supportive management) worsened within the examined time span of 10 years, which as a consequence had significant negative impact on the nurse-perceived quality of care (except for patient safety, which improved). Both the aspects of the practice environment and the quality aspects impacted substantially on satisfaction and emotional exhaustion among nurses. The DRG implementation in Germany has apparently had measurable negative effects on nurses and nurse-perceived patient outcomes, however, not as distinct as often assumed. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Nursing leadership and management effects work environments.
Tomey, Ann Marriner
2009-01-01
The aim of this literature search was to identify recent research related to nursing leadership and management effects on work environment using the 14 forces of magnetism. This article gives some historical perspective from the original 1983 American Academy of Nursing study through to the 2002 McClure and Hinshaw update to 2009 publications. Research publications were given a priority for references. The 14 forces of magnetism as identified by Unden and Monarch were: '1. Quality of leadership..., 2. Organizational structure..., 3. Management style..., 4. Personnel policies and programs..., 5. Professional models of care..., 6. Quality of care..., 7 Quality improvement..., 8. Consultation and resources..., 9. Autonomy..., 10. Community and the hospital..., 11. Nurse as teacher..., 12. Image of nursing..., 13. Interdisciplinary relationships... and 14. Professional development....'. Correlations have been found among positive workplace management initiatives, style of transformational leadership and participative management; patient-to-nurse ratios; education levels of nurses; quality of patient care, patient satisfaction, employee health and well-being programmes; nurse satisfaction and retention of nurses; healthy workplace environments and healthy patients and personnel. This article identifies some of the research that provides evidence for evidence-based nursing management and leadership practice.
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Situational Transitions and Military Nurses: A Concept Analysis Using the Evolutionary Method.
Chargualaf, Katie A
2016-04-01
Situational transitions in nursing remain a significant issue for both new graduates and experienced nurses. Although frequently discussed in current nursing literature, nursing research has exclusively focused on the transition experience of civilian (nonmilitary) nurses. With differing role and practice expectations, altered practice environments, and the risk of deployment, the outcome of negative transition experiences for military nurses is significant. The purpose of this analysis is to clarify the concept of transition, in a situational context, as it relates to military nurses by investigating the attributes, antecedents, and consequences. Rodgers' evolutionary method served as the framework to this study. The sample included 41 studies, published in English, between 2000 and 2013. Data were retrieved from the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, ProQuest, Ovid, and PsycINFO databases. Antecedents of situational transitions include any change in work roles or work environments. Attributes of situational transitions include journey, disequilibrium, finding balance, conditional, and pervasive. Consequences of transition range from successful to unsuccessful. Additional research that investigates the specific needs and challenges unique to nurses practicing in a military environment is needed. © 2015 Wiley Periodicals, Inc.
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Cheng, Ching-Yu; Liou, Shwu-Ru; Tsai, Hsiu-Min; Chang, Chia-Hao
2015-08-01
Nurse graduates are leaving their first employment at an alarming rate. The purpose of this study was to explore the relationships between job stress, job satisfaction and related factors over time among these nurses. This study applied a longitudinal design with three follow-ups after nurse graduates' first employment began. Using convenience sampling, participants were 206 new graduates from a university. The Work Environment Nursing Satisfaction Survey and the Clinical Stress Scale were used in this study. Results indicated that job stress remained moderate across three time points. Participants working 12 h shifts exhibited less job stress. Job satisfaction significantly increased in the twelfth month. Participants working 12 h shifts had a higher degree of job satisfaction. Job stress was negatively correlated with job satisfaction. The 12 h work shifts were related to job stress and job satisfaction. These results implied that health-care administrators need to provide longer orientation periods and flexible shift schedules for new graduate nurses to adapt to their work environment. © 2014 Wiley Publishing Asia Pty Ltd.
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Quality management and work environment in Swedish oral and maxillofacial surgery.
Pilgård, Göran
2009-01-01
This thesis attempts to describe the opinion of the work with quality, quality management, and work environment among the employees at Oral and Maxillofacial Surgery (OMFS) clinics in Sweden. Analyse if the OMFS clinics in Sweden actively work with quality development and if so which systems they use. Explore the opinion of the employees about quality work. Describe how the employees of OMFS clinics in Sweden perceive good work, i.e., their image of the dimensions that the profession should contain to be really good work. Investigate whether there is a discrepancy between ideal and reality for this group. Describe how the employees of OMFS clinics in Sweden perceive their health. Analyse how work environment influenced attitudes to and knowledge of quality among employees of OMFS clinics in Sweden. The study was based on self-report questionnaires which in 2003 were sent to all OMFS clinics in Sweden. The response rate was 86%. Only at two clinics did all the respondents agree on their system. Surgeons rated intellectually stimulating work as most important, and the hazard-free work environment as least important. The nurses rated stimulating fellowship as most important, and the opportunity for career advancement as least important. The percentage unit differences between the ideal and the reality were largest for the item the work provides opportunities to have an influence on important decisions. There were significant differences between maxillofacial. surgeons and dental nurses and assistant nurses as to muscle- and joint trouble. The differences were also significant between men and women both as to muscle- and joint troubles and somatic trouble. Only work environment was significant for attitude towards quality work. Profession, gender, clinic size, and a factor for hard demand had significant associations to quality management system used or not. More than half of the respondents stated that they worked with a quality system. The dental nurses and assistant nurses had a much more positive view on the potential of quality work as a means to improve their work than had the maxillo-facial surgeons. For a majority of the dental nurses the working situation concerning the physical environment was more important than for the maxillo-facial surgeons. The employees emphasized free, influential, and intellectually stimulating work, but the dissonance between ideal and reality was rather wide concerning good work. OMFS employees are feeling unhealthy, but no worse than other high-risk-groups in human service working and better than female general practice dentists. The women of OMFS employees feel worse than the men.
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Barriers to work-life balance for hospital nurses.
Mullen, Kathleen
2015-03-01
Nurses are loyal to their patients and coworkers. They often put the needs of others before their own and sometimes even before the needs of their families. This concern for others can cause conflicts that manifest as stress. Of the more than 2 million nurses in the United States, more than 62% work in hospitals. Hospitals are known to be both rewarding and stressful places to work. Like most workers, nurses face the challenge of balancing demands and achievements of work with those in their private lives. Hospital leaders can facilitate improved work-life balance (WLB) for hospital nurses by using tools already in place. Equally important, nurses can use their knowledge and resources to nurse the nurse within, which can greatly improve their experience of WLB, independent of the demands of their work environment. © 2015 The Author(s).
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de Brouwer, B J M; Kaljouw, M J; Kramer, M; Schmalenberg, C; van Achterberg, T
2014-03-01
Translate the Essentials of Magnetism II© (EOMII; Dutch Nurses' Association, Utrecht, The Netherlands) and assess its psychometric properties in a culture different from its origin. The EOMII, developed in the USA, measures the extent to which organizations/units provide healthy, productive and satisfying work environments. As many healthcare organizations are facing difficulties in attracting and retaining staff nurses, the EOMII provides the opportunity to assess the health and effectiveness of work environments. A three-phased (respectively N = 13, N = 74 and N = 2542) combined descriptive and correlational design was undertaken for translation and evaluation validity and psychometric qualities of the EOMII for Dutch hospitals (December 2009-January 2010). We performed forward-backward translation, face and content validation via cross-sectional survey research, and semi-structured interviews on relevance, clarity, and recognizability of instruments' items. Psychometric testing included principal component analysis using varimax rotation, item-total statistics, and reliability in terms of internal consistency (Cronbach's α) for the total scale and its subscales. Face validity was confirmed. Items were recognizable, relevant and clear. Confirmatory factor analysis indicated that five of eight subscales formed clear factors. Three original subscales contained two factors. Item-total correlations ranged from 0.43 to 0.83. One item correlated weakly (0.24) with its subscale. Cronbach's α for the entire scale was 0.92 and ranged from 0.58 to 0.92 for eight subscales. Dutch-translated EOMII (D-EOMII) demonstrated acceptable reliability and validity for assessing hospital staff nurses' work environment. The D-EOMII can be useful and effective in identifying areas in which change is needed for a hospital to pursue an excellent work environment that attracts and retains well-qualified nurses. © 2013 International Council of Nurses.
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Generational differences in distress, attitudes and incivility among nurses.
Leiter, Michael P; Price, Sheri L; Spence Laschinger, Heather K
2010-11-01
The first research objective was to replicate the finding of Leiter et al. [(2008)Journal of Nursing Management, 16, 100-109.] of Generation X nurses (n=338) reporting higher levels of distress than Baby Boomer nurses (n=139). The second objective was to test whether Generation X nurses reported more negative social environments at work than did Baby Boomer nurses. Negative social environments can influence the quality of work and the experience of distress for nurses. Generational differences in the experience of distress and collegiality have implications for the establishment of healthy workplaces, recruitment and retention. A questionnaire survey of nurses was organized by generation. Analyses of variance contrasted the scores on burnout, turnover intention, physical symptoms, supervisor incivility, coworker incivility and team civility. The results confirmed the hypotheses of Generation X nurses reporting more negative experiences than did Baby Boomer nurses on all measures. The negative quality of social encounters at work contributes to nurses' experience of distress and suggest conflicts of values with the dominant culture of their workplaces. Proactive initiatives to enhance the quality of collegiality can contribute to retention strategies. Building collegiality across generations can be especially useful. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
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Conflict and professionalism: perceptions among nurses in Saudi Arabia.
Zakari, N M; Al Khamis, N I; Hamadi, H Y
2010-09-01
To examine the relationship between nurses' perceptions of conflict and professionalism. In Saudi Arabia, health-care sectors are constantly undergoing major changes because of social, consumer-related, governmental, technological and economic pressures. These changes will influence the nature of health-care organizations, such as hospitals' work environment. The ability of nurses to practise in a professional manner may be influenced by their work environment and conflict level. A cross-sectional design was conducted in this study. A simple random selection of three health-care sectors in Saudi Arabia was performed and 346 nurse managers, as well as bedside nurses participated to provide information about conflict levels and professionalism. The Perceived Conflict Scale was used to assess the level of conflict, and the Valiga Concept of Nursing Scale was used to assess the professionalism perception among nurses. The intragroup/other department type of conflict had a statistically significant correlation with the perception of professionalism. In addition, the findings point to a low perception among the participating nurses regarding their professionalism. A number of factors might explain the low level of perception of professionalism. These relate to the workplace itself, as well as to the personal background of the nurses, which includes the personal interest in the nursing profession, as well as the family's, society's and the consumers' views of the profession. Given the findings of this study, nurse managers are encouraged to create a work environment that supports professionalism and minimizes conflict.
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McCullagh, Marjorie C; Berry, Peggy
2015-08-01
Occupational health nursing focuses on promotion and restoration of health, prevention of illness and injury, protection from work-related and environmental hazards, and corporate profitability. Quality education about the relationship between work and health is critical for nurses' success regardless of work setting, and is consistent with Healthy People 2020 goals, but is lacking or limited in some programs. This report introduces an innovative occupational health nursing curriculum for students enrolled in baccalaureate nursing programs. The process of designing and pilot testing this novel curriculum, its alignment with nursing competencies, and its format and learning activities are described. Preparing professional nurses to understand the role of the occupational health nurse and the relationship between work and health is an essential curricular consideration for contemporary nursing education. © 2015 The Author(s).
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'I love my work, but ... ': the 'best' and the 'worst' in nurse educators' working life in Finland.
Harri, M
1996-06-01
The aim of this study was to investigate nurse educators' perceptions of the quality of their working life. Questionnaires were sent to 706 Finnish nurse educators and their spouses or other adult living with them. The results concerning the structured part of the questionnaire have been described in detail in an earlier paper (Harri 1995). This paper describes the data collected by means of semi-structured questions from 477 (68%) educators and 409 (58%) spouses) and open-ended questions (309 nurse educators and 167 spouses), analysed using content analysis. The seven categories that were identified as the best features of work were, in descending order of prevalence: students, freedom, challenges, teaching, miscellaneous, colleagues, and physical environment. Among the worst features of work, workload ranked first, followed by inadequacy of personal resources, administrative issues, changes, interpersonal relationships, miscellaneous, and physical environment. In the open-ended comments the nurse educators used 400 expressions to describe positive features of their working life, while they used 597 expressions to describe negative features. The spouses made 90 positive comments about the working life of their teacher spouse, and 425 negative comments. The importance of this kind of study was remarked on quite frequently both by nurse educators (22%) and their spouses (12%). The study provides important clues to understanding the present reality of nurse educators' working life. It is hoped that the findings of the study will help focus attention on ways of developing the quality of nurse educators' working life.
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Nursing perceptions of patient safety climate in the Gaza Strip, Palestine.
Elsous, A; Akbari Sari, A; AlJeesh, Y; Radwan, M
2017-09-01
This study was undertaken to assess the perception of nurses about patient safety culture and to test whether it is significantly affected by the nurses' position, age, experience and working hours. Patient safety has sparked the interest of healthcare mangers, yet there is limited knowledge about the current patient safety culture among nurses in the Gaza Strip. This was a descriptive cross-sectional study, administering the Arabic Safety Attitude Questionnaire (Short Form 2006) to 210 nurses in four public general hospitals. Job Satisfaction was the most highly perceived factor affecting patient safety, followed by Perception of Management. Safety culture varied across nursing position, age, work experience and working hours. Nurse Managers had more positive attitudes towards patients than frontline clinicians did. The more experience nurses had, the better their attitudes towards patient safety. Nurses who worked the minimum weekly required hours and who were 35 years and older had better attitudes towards all patient safety dimensions except for Stress Recognition. Nurses with a positive attitude had better collaboration with healthcare professionals than those without a positive attitude. Generalization is limited, as nurses who worked in private and specialized hospitals were excluded. Evaluation of the safety culture is the essential starting point to identify hindrances or drivers for safe patient care. Job Satisfaction, Perception of Management and Teamwork necessitate reinforcement, while Working Conditions, Stress Recognition and Safety Climate require improvement. Ensuring job satisfaction through adequate staffing levels, providing incentives and maintaining a collegial environment require both strategic planning and institutional policies at the higher administrative level. Creation of a non-punitive and learning environment, promoting open communication and fostering continuous education should be fundamental aspects of hospital management. A policy of mixing experienced nurses with inexperienced nurses should be considered. © 2017 International Council of Nurses.
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Armstrong, Kevin J; Laschinger, Heather
2006-01-01
Nurse managers are seeking ways to improve patient safety in their organizations. At the same time, they struggle to address nurse recruitment and retention concerns by focusing on the quality of nurses' work environment. This exploratory study tested a theoretical model, linking the quality of the nursing practice environments to a culture of patient safety. Specific strategies to increase nurses' access to empowerment structures and thereby increase the culture of patient safety are suggested.
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[Emotional labour of nursing care: an evolutionary concept analysis].
Truc, Huynh; Alderson, Marie; Thompson, Mary
2009-06-01
Caring is considered as the essence of nursing. Underpinning caring, the internal regulation of emotions or the emotional labour of nurses is invisible. The concept of emotional labour is relatively underdeveloped in nursing. A literature search using keywords 'emotional labour', 'emotional work' and 'emotions' was performed in CINAHL, psycINFO and REPERE from 1990 to January 2008. We analysed 72 papers whose main focus of inquiry was on emotional labour. We followed Rodgers' evolutionary method of concept analysis. Emotional labour is a process whereby nurse adopt a 'work persona' to express their autonomous, surface or deep emotions during patient encounters. Antecedents to this adoption of a work persona are events occurring during patient-nurse encounters, and which consist of three elements : organization (i.e.social norms, social support), nurse (i.e.role identification, professional commitment, work experience and interpersonal skills) and job (i.e.autonomy, task routine, degree of emotional demand, interaction frequency and work complexity). The attributes of emotional labour have two dimensions : nurses' autonomous response and their work persona strategies (i.e. surface or deep acts). The consequences of emotional labour include organizational (i.e.productivity, 'cheerful environment') and nurse aspects (i.e. negative or positive) the concept of emotional labour should be introduced into preregistration programmes. Nurses also need to have time and a supportive environment to reflect, understand and discuss their emotional labour in caring for 'difficult' patients to deflate the dominant discourse about 'problem' patients.
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Work engagement in nursing practice: a relational ethics perspective.
Keyko, Kacey
2014-12-01
The concept of work engagement has existed in business and psychology literature for some time. There is a significant body of research that positively correlates work engagement with organizational outcomes. To date, the interest in the work engagement of nurses has primarily been related to these organizational outcomes. However, the value of work engagement in nursing practice is not only an issue of organizational interest, but of ethical interest. The dialogue on work engagement in nursing must expand to include the ethical importance of engagement. The relational nature of work engagement and the multiple levels of influence on nurses' work engagement make a relational ethics approach to work engagement in nursing appropriate and necessary. Within a relational ethics perspective, it is evident that work engagement enables nurses to have meaningful relationships in their work and subsequently deliver ethical care. In this article, I argue that work engagement is essential for ethical nursing practice. If engagement is essential for ethical nursing practice, the environmental and organizational factors that influence work engagement must be closely examined to pursue the creation of moral communities within healthcare environments. © The Author(s) 2014.
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Spence Laschinger, Heather K; Nosko, Amanda; Wilk, Piotr; Finegan, Joan
2014-12-01
Recruitment and retention strategies have emphasized the importance of positive work environments that support professional nursing practice for sustaining the nursing workforce. Unit leadership that creates empowering workplace conditions plays a key role in establishing supportive practice environments that increase work effectiveness, and, ultimately, improves job satisfaction. To test a multi-level model examining the effect of both contextual and individual factors on individual nurse job satisfaction. At the unit level, structural empowerment and support for professional nursing practice (organizational resources) were hypothesized to be predictors of unit level effectiveness. At the individual level, core self-evaluation, and psychological empowerment (intrapersonal resources) were modeled as predictors of nurse job satisfaction one year later. Cross-level unit effects on individual nurses' job satisfaction were also examined. This study employed a longitudinal survey design with 545 staff nurses from 49 hospital units in Ontario, Canada. Participants completed a survey at two points in time (response rate of 40%) with standardized measures of the major study variables in the hypothesized model. Multilevel structural equation modeling was used to test the model. Nurses shared perceptions of structural empowerment on their units indirectly influenced their shared perceptions of unit effectiveness (Level 2) through perceived unit support for professional nursing practice, which in turn, had a significant positive direct effect on unit effectiveness (Level 2). Unit effectiveness was also strongly related to individual nurse job satisfaction one year later. At Level 1, higher core self-evaluation had a direct and indirect effect on job satisfaction through increased psychological empowerment. The results suggest that nurses' job satisfaction is influenced by a combination of individual and contextual factors demonstrating utility in considering both sources of nurses' satisfaction with their work in creating effective nursing work environments. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Dittman, Patricia W
2015-01-01
Chemical use and dependency is a prevalent problem in society and among the members of the nursing profession. Nursing students, as the novice representatives of the profession, may be particularly vulnerable to chemical use. Nursing leaders in both educational institutions and practice settings must recognize highly vulnerable individuals, which nursing activities are most vulnerable, and interventions to assist and support the vulnerable individual while assuring a safe practice environment. As nurses, it is our responsibility, both ethically and legally, to provide a safe working environment not only for our patients but also for ourselves by reporting the behaviors of nurses who may be impaired through the proper channels according to your state's Nurse Practice Act. Through a united approach, nurse leaders from both the academic and practice environments should provide a safe and effective rehabilitation approach.
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The Lived Experience of Black Nurse Faculty in Predominantly White Schools of Nursing.
Whitfield-Harris, Lisa; Lockhart, Joan Such; Zoucha, Richard; Alexander, Rumay
2017-03-01
This study explored the experiences of Black nurse faculty employed in predominantly White schools of nursing. High attrition rates of this group were noted in previous literature. Understanding their experiences is important to increase nurse diversity. Hermeneutic phenomenology was used to explore the experiences of 15 Black nurse faculty using interviews. Four themes were extracted as the following: cultural norms of the workplace, coping with improper assets, life as a "Lone Ranger," and surviving the workplace environment. The study provided insight to understand the meaning that Black faculty members give to their experiences working in predominantly White schools of nursing. Findings exemplify the need to improve culturally competent work environments and mentoring programs. Results suggest that better communication and proper respect from students, colleagues, and administrators are necessary. The limited research on this topic illustrates that Black nurse faculty remain under investigated; research is necessary to determine effective change strategies.
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Educator or Counselor? Navigating Uncertain Boundaries in the Clinical Environment.
Lane, Annette M; Corcoran, Lynn
2016-04-01
Nurse educators in the clinical environment experience great rewards and challenges in their work with undergraduate students. However, closely working with students can lead to the challenge of intervening with those who are emotionally distressed. How do nurse educators navigate the precarious and subtle territory between educating and counseling? This article briefly reviews how boundaries are explored in nursing. Two case studies are presented to demonstrate how nurse educators can determine when their support and education begins to move into the counseling role. Finally, future directions for nurse educators are suggested. Little research exists that examines how nurse educators navigate the boundaries between educator and counselor roles with students in clinical settings. Navigating between the educator and counselor roles with students experiencing emotional distress in clinical settings can be challenging for nurse educators. Copyright 2016, SLACK Incorporated.
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Impact of postgraduate education on advanced practice nurse activity - a national survey.
Wilkinson, J; Carryer, J; Budge, C
2018-03-22
There is a wealth of international evidence concerning the contribution post-registration master's level education makes to advancing the discipline of nursing. There are approximately 277 nurse practitioners registered in NZ, but they account for only a small portion of nurses who have undertaken master's level education. The additional contribution these nurses make to the work environment through advanced practice activities has not, hitherto, been documented. To report the extent of advanced practice nurse activity associated with various levels of nursing education in a sample of nurses working in clinical practice in New Zealand. A replication of recent Australian research was done via a national cross-sectional survey of 3255 registered nurses and nurse practitioners in New Zealand using an online questionnaire to collect responses to the amended Advanced Practice Delineation survey tool. In addition, demographic data were collected including position titles and levels of postgraduate education. A positive association was found between postgraduate education at any level and more time spent in advanced practice activities. Independent of level of postgraduate education, the role a nurse holds also effects the extent of involvement in advanced practice activities. There is an additional contribution made to the work environment by nurses with master's level education which occurs even when they are not employed in an advanced practice role. These findings are of significance to workforce policy and planning across the globe as countries work to sustain health services by increasing nursing capacity effectively within available resources. © 2018 International Council of Nurses.
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Röndahl, Gerd; Innala, Sune; Carlsson, Marianne
2007-01-01
Homosexual nursing staff (n = 21) from different parts of Sweden were interviewed about experiences from their psychosocial work environment and about what they consider important points to communicate about lesbians and gay men in nursing. The findings show that most of the informants were partly open about their sexual orientation at work, the women less so than the men. All informants spoke of the fear of being socially excluded. Reported negative experiences included being neglected, harassment, and verbal discomfort based on sexual prejudices. The informants regarded responsibility, the need for knowledge, the consequences of invisibility, and the lesbian's specific situation, important points to communicate regarding homosexuality and nursing.
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Pickering, Carolyn E Z; Nurenberg, Katie; Schiamberg, Lawrence
2017-10-01
This grounded theory study examined how the certified nursing assistant (CNA) understands and responds to bullying in the workplace. Constant comparative analysis was used to analyze data from in-depth telephone interviews with CNAs ( N = 22) who experienced bullying while employed in a nursing home. The result of the analysis is a multistep model describing CNA perceptions of how, over time, they recognized and responded to the "toxic" work environment. The strategies used in responding to the "toxic" environment affected their care provision and were attributed to the development of several resident and worker safety outcomes. The data suggest that the etiology of abuse and neglect in nursing homes may be better explained by institutional cultures rather than individual traits of CNAs. Findings highlight the relationship between worker and patient safety, and suggest worker safety outcomes may be an indicator of quality in nursing homes.
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Using Cognitive Work Analysis to Fit Decision Support Tools to Nurse Managers’ Work Flow
Brewer, Barbara B.; Logue, Melanie D.; Gephart, Sheila; Verran, Joyce A.
2011-01-01
Purpose To better understand the environmental constraints on nurse managers that impact their need for and use of decision support tools, we conducted a Cognitive Work Analysis (CWA). A complete CWA includes system analyses at five levels: work domain, decision-making procedures, decision-making strategies, social organization/collaboration, and worker skill level. Here we describe the results of the Work Domain Analysis (WDA) portion in detail then integrate the WDA with other portions of the CWA, reported previously, to generate a more complete picture of the nurse manager’s work domain. Methods Data for the WDA were obtained from semi-structured interviews with nurse managers, division directors, CNOs, and other managers (n = 20) on 10 patient care units in 3 Arizona hospitals. The WDA described the nurse manager’s environment in terms of the constraints it imposes on the nurse manager’s ability to achieve targeted outcomes through organizational goals and priorities, functions, processes, as well as work objects and resources (e.g., people, equipment, technology, and data). Constraints were identified and summarized through qualitative thematic analysis. Results The results highlight the competing priorities, and external and internal constraints that today’s nurse managers must satisfy as they try to improve quality and safety outcomes on their units. Nurse managers receive a great deal of data, much in electronic format. Although dashboards were perceived as helpful because they integrated some data elements, no decision support tools were available to help nurse managers with planning or answering “what if” questions. The results suggest both the need for additional decision support to manage the growing complexity of the environment, and the constraints the environment places on the design of that technology if it is to be effective. Limitations of the study include the small homogenous sample and the reliance on interview data targeting safety and quality. PMID:21862397
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Using Cognitive Work Analysis to fit decision support tools to nurse managers' work flow.
Effken, Judith A; Brewer, Barbara B; Logue, Melanie D; Gephart, Sheila M; Verran, Joyce A
2011-10-01
To better understand the environmental constraints on nurse managers that impact their need for and use of decision support tools, we conducted a Cognitive Work Analysis (CWA). A complete CWA includes system analyses at five levels: work domain, decision-making procedures, decision-making strategies, social organization/collaboration, and worker skill level. Here we describe the results of the Work Domain Analysis (WDA) portion in detail then integrate the WDA with other portions of the CWA, reported previously, to generate a more complete picture of the nurse manager's work domain. Data for the WDA were obtained from semi-structured interviews with nurse managers, division directors, CNOs, and other managers (n = 20) on 10 patient care units in three Arizona hospitals. The WDA described the nurse manager's environment in terms of the constraints it imposes on the nurse manager's ability to achieve targeted outcomes through organizational goals and priorities, functions, processes, as well as work objects and resources (e.g., people, equipment, technology, and data). Constraints were identified and summarized through qualitative thematic analysis. The results highlight the competing priorities, and external and internal constraints that today's nurse managers must satisfy as they try to improve quality and safety outcomes on their units. Nurse managers receive a great deal of data, much in electronic format. Although dashboards were perceived as helpful because they integrated some data elements, no decision support tools were available to help nurse managers with planning or answering "what if" questions. The results suggest both the need for additional decision support to manage the growing complexity of the environment, and the constraints the environment places on the design of that technology if it is to be effective. Limitations of the study include the small homogeneous sample and the reliance on interview data targeting safety and quality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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Björn, Catrine; Lindberg, Magnus; Rissén, Dag
2016-01-01
The aim was to examine significant factors for work attractiveness and how these differ from the current work situation among operating department nurses. A second objective was to examine the associations between age, gender, length of employment, work engagement, work ability, self-rated health indicators and attractiveness of the current work situation. The attractiveness of work is rarely taken into account in research on nurse retention. To expand this knowledge, it is relevant to examine factors that make work attractive and their associations with related concepts. Correlational, cross-sectional survey using a convenience sample. Questionnaires were answered by 147 nurses in four operating departments in Sweden. Correlation and regression analyses were conducted. The nurses rated the significance of all factors of work attractiveness higher than they rated those factors in their current work situation; salary, organisation and physical work environment had the largest differences. The most significant attractive factors were relationships, leadership and status. A statistically significant positive correlation between work engagement and attractive work was found. In the multiple regression model, the independent variables work engagement and older age significantly predicted work attractiveness. Several factors should be considered in the effort to increase work attractiveness in operating departments and thereby to encourage nurse retention. Positive aspects of work seem to unite work engagement and attractive work, while work ability and self-rated health indicators are other important dimensions in nurse retention. The great discrepancies between the significance of attractive factors and the current work situation in salary, organisation and physical work environment suggest ways in which work attractiveness may be increased. To discover exactly what needs to be improved may require a deeper look into the construct of the examined factors. © 2015 John Wiley & Sons Ltd.
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Managing work-related stress in the district nursing workplace.
Burke, Michelle
2013-11-01
This article aims to highlight the issue of work-related stress within the district nursing workplace. It will acknowledge how the management of work-related stress has previously been discussed within nursing literature and will consider the emerging relationship between staff working conditions, staff wellbeing and quality of patient care. It will reintroduce the Health and Safety Executive's (HSE's) Management Standards approach to tackling work-related stress, which provides management support to reduce environmental work stressors and encourage enabling work environments and a positive workplace culture.
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Skillman, Susan M; Palazzo, Lorella; Hart, L Gary; Keepnews, David
2010-01-01
Little is known about RNs who drop their licenses and their potential re-entry into the nursing workforce. The results of this study provide insight into reasons nurses leave their careers and the barriers to re-entry, all important indicators of the current professional climate for nursing. While representing only one state, these findings suggest that RNs who allow their licenses to expire do so because they have reached retirement age or, among those who do not cite age as a factor, because many are unable or unwilling to work in the field. Inactive nurses who might otherwise appear to be likely candidates for re-entry into the profession may not be easily encouraged to practice nursing again without significant changes in their personal circumstances or the health care work environment. Effective ways to address current and pending RN workforce shortages include expanding RN education capacity to produce more RNs who can contribute to the workforce across the coming decades, and promote work environments in which RNs want to, and are able to, practice across a long nursing career.
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Leineweber, Constanze; Chungkham, Holendro Singh; Lindqvist, Rikard; Westerlund, Hugo; Runesdotter, Sara; Smeds Alenius, Lisa; Tishelman, Carol
2016-06-01
Nursing turnover is a major issue for health care managers, notably during the global nursing workforce shortage. Despite the often hierarchical structure of the data used in nursing studies, few studies have investigated the impact of the work environment on intention to leave using multilevel techniques. Also, differences between intentions to leave the current workplace or to leave the profession entirely have rarely been studied. The aim of the current study was to investigate how aspects of the nurse practice environment and satisfaction with work schedule flexibility measured at different organisational levels influenced the intention to leave the profession or the workplace due to dissatisfaction. Multilevel models were fitted using survey data from the RN4CAST project, which has a multi-country, multilevel, cross-sectional design. The data analysed here are based on a sample of 23,076 registered nurses from 2020 units in 384 hospitals in 10 European countries (overall response rate: 59.4%). Four levels were available for analyses: country, hospital, unit, and individual registered nurse. Practice environment and satisfaction with schedule flexibility were aggregated and studied at the unit level. Gender, experience as registered nurse, full vs. part-time work, as well as individual deviance from unit mean in practice environment and satisfaction with work schedule flexibility, were included at the individual level. Both intention to leave the profession and the hospital due to dissatisfaction were studied. Regarding intention to leave current workplace, there is variability at both country (6.9%) and unit (6.9%) level. However, for intention to leave the profession we found less variability at the country (4.6%) and unit level (3.9%). Intention to leave the workplace was strongly related to unit level variables. Additionally, individual characteristics and deviance from unit mean regarding practice environment and satisfaction with schedule flexibility were related to both outcomes. Major limitations of the study are its cross-sectional design and the fact that only turnover intention due to dissatisfaction was studied. We conclude that measures aiming to improve the practice environment and schedule flexibility would be a promising approach towards increased retention of registered nurses in both their current workplaces and the nursing profession as a whole and thus a way to counteract the nursing shortage across European countries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Educational Planning for Establishing a Health-Promoting Workplace (HPW).
Russell, Sally S
2015-01-01
The Academy of Medical-Surgical Nurses (AMSN) has had an ongoing series of articles related to Healthy Practice Environments. The AMSN website (www.amsn.org) also has a number of articles and documents about initiatives that AMSN has undertaken to promote healthy practice environments in health care settings. This articles will focus on the educational work necessary for nurses who desire to increase the healthiness of their workplace. The work is not easy, but the end result could be one that leaves a lasting legacy for those who work in that environment.
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Israeli nurse practice environment characteristics, retention, and job satisfaction.
Dekeyser Ganz, Freda; Toren, Orly
2014-02-24
There is an international nursing shortage. Improving the practice environment has been shown to be a successful strategy against this phenomenon, as the practice environment is associated with retention and job satisfaction. The Israeli nurse practice environment has not been measured. The purpose of this study was to measure practice environment characteristics, retention and job satisfaction and to evaluate the association between these variables. A demographic questionnaire, the Practice Environment Scale, and a Job Satisfaction Questionnaire were administered to Israeli acute and intensive care nurses working in 7 hospitals across the country. Retention was measured by intent to leave the organization and work experience. A convenience sample of registered nurses was obtained using a bi-phasic, stratified, cluster design. Data were collected based on the preferences of each unit, either distribution during various shifts or at staff meetings; or via staff mailboxes. Descriptive statistics were used to describe the sample and results of the questionnaires. Pearson Product Moment Correlations were used to determine significant associations among the variables. A multiple regression model was designed where the criterion variable was the practice environment. Analyses of variance determined differences between groups on nurse practice environment characteristics. 610 nurses reported moderate levels of practice environment characteristics, where the lowest scoring characteristic was 'appropriate staffing and resources'. Approximately 9% of the sample reported their intention to leave and the level of job satisfaction was high. A statistically significant, negative, weak correlation was found between intention to leave and practice environment characteristics, with a moderate correlation between job satisfaction and practice environment characteristics. 'Appropriate staffing and resources' was the only characteristic found to be statistically different based on hospital size and geographic region. This study supports the international nature of the vicious cycle that includes a poor quality practice environment, decreased job satisfaction and low nurse retention. Despite the extreme nursing shortage in Israel, perceptions of the practice environment were similar to other countries. Policy makers and hospital managers should address the practice environment, in order to improve job satisfaction and increase retention.
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Factors associated with work-related fatigue and recovery in hospital nurses working 12-hour shifts.
Han, Kihye; Trinkoff, Alison M; Geiger-Brown, Jeanne
2014-10-01
Nurse fatigue threatens both nurse and patient safety; fatigue affects nurses' neurocognitive functioning and hinders their work performance. The authors assessed the association of work and non-work factors with acute and chronic fatigue and intershift recovery among hospital nurses working 12-hour shifts. This study used survey data from 80 nurses who provided full-time direct patient care on medical-surgical and critical care units in a large teaching hospital. Psychological job demands (e.g., work load and social support from supervisor or coworker) were significantly associated with acute and chronic fatigue and intershift recovery. Rotating shifts were significantly related to acute fatigue. Findings suggest the need for a comprehensive approach to fatigue management, including organizational support to provide healthful work schedules and favorable nursing work environments, fewer psychological and physical demands, and assistance to improve nurses' sleep quality and quantity. [Workplace Health Saf 2014;62(10):409-414.]. Copyright 2014, SLACK Incorporated.
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Li, Jian; Shang, Li; Galatsch, Michael; Siegrist, Johannes; Miüller, Bernd Hans; Hasselhorn, Hans Martin
2013-01-01
Many countries throughout the world are facing a serious nursing shortage, and retention of nurses also is a challenge. The aim of this study was to compare the predictive contribution of a broad spectrum of psychosocial work factors, including job strain, effort-reward imbalance, and alternative employment opportunity, to the probability of intention to leave the nursing profession. A total of 7,990 registered female nurses working in hospitals in eight countries (Germany, Italy, France, The Netherlands, Belgium, Poland, Slovakia, and China) were included in the one-year prospective study. A standardized questionnaire on job strain, effort-reward imbalance, employment opportunity, and intention to leave the nursing profession was used in the survey. Multilevel logistic regression modeling was used to analyze the data. Results showed that an imbalance between high effort and low reward (in particular, poor promotion prospects) and good employment opportunity at baseline were independently associated with a new intention to leave the nursing profession at follow-up. However, job strain appeared to have relatively less explanatory power. Findings suggest that interventions to improve the psychosocial work environment, especially the reciprocity experienced between effort and reward, may be effective in improving retention of nurses and tackling the international nursing shortage.
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Testing a theoretical model of clinical nurses' intent to stay.
Cowden, Tracy L; Cummings, Greta G
2015-01-01
Published theoretical models of nurses' intent to stay (ITS) report inconsistent outcomes, and not all hypothesized models have been adequately tested. Research has focused on cognitive rather than emotional determinants of nurses' ITS. The aim of this study was to empirically verify a complex theoretical model of nurses' ITS that includes both affective and cognitive determinants and to explore the influence of relational leadership on staff nurses' ITS. The study was a correlational, mixed-method, nonexperimental design. A subsample of the Quality Work Environment Study survey data 2009 (n = 415 nurses) was used to test our theoretical model of clinical nurses' ITS as a structural equation model. The model explained 63% of variance in ITS. Organizational commitment, empowerment, and desire to stay were the model concepts with the strongest effects on nurses' ITS. Leadership practices indirectly influenced ITS. How nurses evaluate and respond to their work environment is both an emotional and rational process. Health care organizations need to be cognizant of the influence that nurses' feelings and views of their work setting have on their intention decisions and integrate that knowledge into the development of retention strategies. Leadership practices play an important role in staff nurses' perceptions of the workplace. Identifying the mechanisms by which leadership influences staff nurses' intentions to stay presents additional focus areas for developing retention strategies.
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Nursing Faculty Experiences of Virtual Learning Environments for Teaching Clinical Reasoning
ERIC Educational Resources Information Center
Zacharzuk-Marciano, Tara
2017-01-01
Nurses need sharp, clinical reasoning skills to respond to critical situations and to be successful at work in a complex and challenging healthcare system. While past research has focused on using virtual learning environments to teach clinical reasoning, there has been limited research on the experiences of nursing faculty and there is a need for…
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Emotional labour underlying caring: an evolutionary concept analysis.
Huynh, Truc; Alderson, Marie; Thompson, Mary
2008-10-01
This paper is a report of a concept analysis of emotional labour. Caring is considered as the essence of nursing. Underpinning caring, the internal regulation of emotions or the emotional labour of nurses is invisible. The concept of emotional labour is relatively underdeveloped in nursing. A literature search using keywords 'emotional labour', 'emotional work' and 'emotions' was performed in CINAHL, PsycINFO and REPERE from 1990 to January 2008. We analysed 72 papers whose main focus of inquiry was on emotional labour. We followed Rodgers' evolutionary method of concept analysis. Emotional labour is a process whereby nurses adopt a 'work persona' to express their autonomous, surface or deep emotions during patient encounters. Antecedents to this adoption of a work persona are events occurring during patient-nurse encounters, and which consist of three elements: organization (i.e. social norms, social support), nurse (i.e. role identification, professional commitment, work experience and interpersonal skills) and job (i.e. autonomy, task routine, degree of emotional demand, interaction frequency and work complexity). The attributes of emotional labour have two dimensions: nurses' autonomous response and their work persona strategies (i.e. surface or deep acts). The consequences of emotional labour include organizational (i.e. productivity, 'cheerful environment') and nurse aspects (i.e. negative or positive). The concept of emotional labour should be introduced into preregistration programmes. Nurses also need to have time and a supportive environment to reflect, understand and discuss their emotional labour in caring for 'difficult' patients to deflate the dominant discourse about 'problem' patients.
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Yorke, Janelle; Prigmore, Sam; Hodson, Matt; Stonham, Carol; Long, Hannah; Bellhouse, Sarah; Fletcher, Monica; Edwards, Sheila
2017-01-01
The National Health Service currently faces significant challenges and must optimise effective workforce planning and management. There are increasing concerns regarding poor workforce planning for respiratory medicine; a greater understanding of the role of respiratory nurse specialists will inform better workforce planning and management. This was a survey study. Two surveys were administered: an organisational-level survey and an individual respiratory nurse survey. There were 148 and 457 respondents to the organisational and individual nurse survey, respectively. Four main themes are presented: (1) breadth of service provided; (2) patient care; (3) work environment; and (4) succession planning. The majority of work conducted by respiratory nurse specialists relates to patient care outside the secondary care setting including supporting self-management in the home, supporting patients on home oxygen, providing hospital-at-home services and facilitating early discharge from acute care environments. Yet, most respiratory nursing teams are employed by secondary care trusts and located within acute environments. There was evidence of multidisciplinary working, although integrated care was not prominent in the free-text responses. High workload was reported with one-quarter of nursing teams short-staffed. Respiratory nurses reported working unpaid extra hours and a lack of administrative support that often took them away from providing direct patient care. Nearly half of the present sample either plan to retire or are eligible for retirement within 10 years. This survey report provides a current snapshot of the respiratory nurse specialist workforce in the UK. This workforce is an ageing population; the results from this survey can be used to inform succession planning and to ensure a viable respiratory nurse specialist workforce in future.
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Yorke, Janelle; Prigmore, Sam; Hodson, Matt; Stonham, Carol; Long, Hannah; Bellhouse, Sarah; Fletcher, Monica; Edwards, Sheila
2017-01-01
Introduction The National Health Service currently faces significant challenges and must optimise effective workforce planning and management. There are increasing concerns regarding poor workforce planning for respiratory medicine; a greater understanding of the role of respiratory nurse specialists will inform better workforce planning and management. Methods This was a survey study. Two surveys were administered: an organisational-level survey and an individual respiratory nurse survey. Results There were 148 and 457 respondents to the organisational and individual nurse survey, respectively. Four main themes are presented: (1) breadth of service provided; (2) patient care; (3) work environment; and (4) succession planning. The majority of work conducted by respiratory nurse specialists relates to patient care outside the secondary care setting including supporting self-management in the home, supporting patients on home oxygen, providing hospital-at-home services and facilitating early discharge from acute care environments. Yet, most respiratory nursing teams are employed by secondary care trusts and located within acute environments. There was evidence of multidisciplinary working, although integrated care was not prominent in the free-text responses. High workload was reported with one-quarter of nursing teams short-staffed. Respiratory nurses reported working unpaid extra hours and a lack of administrative support that often took them away from providing direct patient care. Nearly half of the present sample either plan to retire or are eligible for retirement within 10 years. Conclusions This survey report provides a current snapshot of the respiratory nurse specialist workforce in the UK. This workforce is an ageing population; the results from this survey can be used to inform succession planning and to ensure a viable respiratory nurse specialist workforce in future. PMID:28912954
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Power sharing. A transformational strategy for nurse retention, effectiveness, and extra effort.
Trofino, Joan
2003-01-01
Power sharing with staff nurses is an essential strategy for organizational transformation. The current competitive health care environment requires a powerful team of participants, including staff at all levels, to provide health care in mutual partnership. The challenges of today's competitive and global environment call for collegial relationships among nurse executive leadership, middle nurse managers, and staff nurses. Research has demonstrated that middle nurse managers maintain primary responsibility for staff nurse retention. A higher retention rate was reported among nurses who were very satisfied with their nurse managers. Nurses considered favorably nurse managers who value staff contributions, promote information sharing, and exert influence for a stable work environment. Furthermore, as staff nurse satisfaction increased, effectiveness and extra effort also increased when staff nurses perceived transformational leadership strategies. Strategies for power sharing include serving as role models and mentors, energizing staff, resisting attitudes of staff ownership, reducing staff nurse stress of leader presence, and information sharing and commendations at meetings.
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ERIC Educational Resources Information Center
Tella, Susanna; Smith, Nancy-Jane; Partanen, Pirjo; Turunen, Hannele
2016-01-01
Learning to ensure patient safety in complex health care environments is an internationally recognised concern. This article explores and compares Finnish (n = 22) and British (n = 32) pre-registration nursing students' important learning events about patient safety from their work placements in health care organisations. Written descriptions were…
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Assessing and developing critical-thinking skills in the intensive care unit.
Swinny, Betsy
2010-01-01
A lot of resources are spent on the development of new staff in the intensive care unit (ICU). These resources are necessary because the environment in the ICU is complex and the patients are critically ill. Nurses need an advanced knowledge base, the ability to accurately define and change priorities rapidly, good communication and teamwork skills, and the ability to work in a stressful environment in order to succeed and give their patients quality care. Critical thinking helps the nurse to navigate the complex and stressful environment of the ICU. Critical thinking includes more than just nursing knowledge. It includes the ability to think through complex, multifaceted problems to anticipate needs, recognize potential and actual complications, and to expertly communicate with the team. A nurse who is able to think critically will give better patient care. Various strategies can be used to develop critical thinking in ICU nurses. Nurse leaders are encouraged to support the development of critical-thinking skills in less experienced staff with the goal of improving the nurse's ability to work in the ICU and improving patient outcomes.
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McCaughey, Deirdre; McGhan, Gwen; Walsh, Erin M; Rathert, Cheryl; Belue, Rhonda
2014-01-01
With estimates of a 51% growth in the number of nursing assistants needed by 2016, there is a critical need to examine workplace factors that negatively contribute to the recruitment and retention of nursing assistants. Studies have shown that high demands, physical stress, and chronic workforce shortages contribute to a working environment that fosters one of the highest workforce injury rates in the United States. The aim of this study was to explore the relationship between nursing assistant injury rates and key outcomes, such as job satisfaction and turnover intent, while exploring workplace environment factors, such as injury prevention training, supervisor support, and employee engagement, that can decrease the rates of workplace injury. Data from the 2004 National Nursing Assistant Survey were used to examine the negative effects of workplace injury on nursing assistants and the workplace environment factors that are related to the rate of worker injury. Nursing assistants who experience job-related injuries have lower levels of job satisfaction, increased turnover intentions, and are less likely to recommend their facility as a place to work or seek care services. It was also found that nursing assistant injury rates are related to employee ratings of injury prevention training, supervisor support, and employee engagement. NAs with multiple injuries (>2) were 1.3-1.6 times more likely to report being injured at work than NAs who had not been injured when supervisor support, employee engagement, and training ratings were low. Evidence that health care organizations can use to better understand how workplace injuries occur and insight into ways to reduce the current staggering rate of on-the-job injuries occurring in health care workplaces were offered in this study. The findings also offer empirical support for an extension of the National Institute for Occupational Health and Safety/National Occupational Research Agenda Work Organization Framework for Occupational Illness and Injury.
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Military Nursing Outcomes Database (MilNOD IV): Analysis & Expansion
2011-03-29
Nurse - Level Nurse job satisfaction, nursing staff education and experience, and the nursing work environment were assessed at...dissatisfies nurses . Our analysis did not show any effect of staffing on nurse job satisfaction. 4. Should the PES should be used for all skill levels ...and patient mortality, nurse burnout , and job dissatisfaction. Journal of the American Medical Association, 288,
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The impact of environmental factors on nursing stress, job satisfaction, and turnover intention.
Applebaum, Diane; Fowler, Susan; Fiedler, Nancy; Osinubi, Omowunmi; Robson, Mark
2010-01-01
The purpose of this study was to investigate relationships between environmental factors of odor, noise, light, and color and perceived stress, job satisfaction, and turnover intention. The physical work environment may positively or negatively influence nurses' stress, and stress may negatively impact their job satisfaction and intention to change jobs. The research questions were answered using a descriptive, correlational design. The sample (n = 116) consisted of medical-surgical nurses working in acute-care settings. A 36-item questionnaire addressed odor, noise, light, color, perceived stress, job satisfaction, and turnover intention. Significant relationships were found between noise and perceived stress, perceived stress and job satisfaction, job satisfaction and turnover intention, and perceived stress and turnover intention. Nurses tend to overlook their physical environment and "do their job." Common environmental stressors in the work environment can be stressful to staff and influence job satisfaction and, ultimately, intention to change jobs. Mitigating or eliminating these environmental factors has the potential to improve staff satisfaction and retention. Stress influences nursing job satisfaction and, ultimately, intention to change jobs.
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Work-related quality of life of Ugandan healthcare workers.
Opollo, J G; Gray, J; Spies, L A
2014-03-01
To describe perceived work-related quality of life of Ugandan healthcare workers. A secondary aim was to seek participant input on ways to improve work environments. Poor patient outcomes, decreased employee motivation and decisions to leave the organization have been linked to poor work conditions. Interventions to correct healthcare worker shortage in developing countries require information about work quality of life. Descriptive cross-sectional study conducted in health and educational settings in Uganda in July 2011. Participants completed the Biographical Information Scale demographic questionnaire and the validated 24-item Work-Related Quality of Life scale. Sample included 146 healthcare workers employed in various settings. Participants reported poorer quality of work life on the work conditions, control at work and home-work interface subscales. Participants perceived stress at work to be low and experienced higher job career satisfaction. There was a significant relationship between work-related quality of life, gender and hours worked. Participants' suggestions to improve work life ranged from simple no-cost suggestions to more complex system level interventions. Work-related quality of life was low in this convenience sample. Perceived stress at work was lower than expected, but may have been due to nurses' expectations of a normal work assignment. Predominantly women, the participants had significant caregiving responsibilities. Nurses must acquire a seat at the table where crucial decisions about nursing and its future are made. By advancing leadership skills, nurses can effectively advocate for organizational changes that address broad factors related to increasing job satisfaction, and retaining and attracting nurses. Nurses can influence work quality of life individually and collectively by identifying workplace concerns, demanding safe work environments, fostering teamwork and enhancing professional growth. © 2014 International Council of Nurses.
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Nursing work in NHS Direct: constructing a nursing identity in the call-centre environment.
Snelgrove, Sherrill Ray
2009-12-01
The introduction of nurse-led telephone helplines for patients to have access to information and advice has led to the development of a new kind of practise for nurses. This study focuses on the ways NHS Direct (NHSD) nurses construct a nursing identity and shape their work in a call-centre environment. The empirical findings are drawn from a study investigating the impact of NHSD on professional nursing issues that was part of a wider evaluation of the service in South Wales, UK. Data were gathered from responses to free text questions included in a questionnaire sent to nurses in three NHSD sites. Further data were collected from focus groups held with NHSD nurses. The nurses defend their identity as nurses rather than call-centre workers. The discourses of the nurses show a strong alignment with the traditional values of nursing, encompassing holistic and empathetic practise that has moved with the nurses across locales. We argue that the nurses frame a nursing identity in NHSD around the importance of previous experience and claim to practise holistic nursing. However, the development of new skills and adaptation of old skills in response to the demand of NHSD work challenges normative notions of traditional 'hands-on' models of practise and indicates a possible movement towards a cognitive model of nursing based upon knowledge, analytical and communication skills that reflects the transformative and dynamic nature of professional identity and boundaries.
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Learning Opportunities for Nurses Working within Home Care
ERIC Educational Resources Information Center
Lundgren, Solveig
2011-01-01
Purpose: The purpose of this study is to explore home care nurses' experience of learning in a multicultural environment. Design/methodology/approach: The study was based on qualitative research design. Data were collected through repeated interviews with registered home care nurses working in a multicultural area. The data were analyzed through a…
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New graduate RN work satisfaction after completing an interactive nurse residency.
Anderson, Teresa; Linden, Lois; Allen, Marsha; Gibbs, Elizabeth
2009-04-01
The aims of this study were to measure job satisfaction and engagement perceptions of new nurses after completing interactive residency modules and to test the reliability and validity of the Halfer-Graf Job/Work Environment Nursing Satisfaction Survey. US nursing shortages are estimated to increase to 36% by 2020, requiring emphasis on hiring new graduate nurses. Improved retention of new graduates through innovative orientations such as interactive nurse residencies is one option. This mixed qualitative and quantitative study compared perceived job satisfaction and employee engagement of 90 new graduate nurses completing an interactive nurse residency. Reliability and validity of the Halfer-Graf tool were supported. Qualitative analysis yielded trends related to satisfiers (patients, patient outcomes, and teamwork) and dissatisfiers (staffing/scheduling, lack of teamwork, and physician disrespect). Simulation scenarios, debriefing, and e-mail communication with peers ranked high as beneficial teaching strategies. Study findings support previous research. An interactive learning environment was perceived as beneficial. First and second year nurse retention was consistent with previous residency programming.
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Carlson, Elisabeth; Idvall, Ewa
2014-07-01
One major challenge facing the health care systems worldwide is the growing demand for registered nurses able to provide qualified nursing care for a vulnerable population. Positive learning experiences during clinical practice influence not only learning outcomes, but also how students reason in relation to future career choices. To investigate student nurses' experiences of the clinical learning environment during clinical practice in nursing homes, and to compare perceptions among student nurses with or without prior work experience as health care assistants in elderly care. A cross-sectional study was designed, utilising the Swedish version of the CLES+T evaluation scale. 260 student nurses (response rate 76%) who had completed a five week long clinical placement in nursing homes returned the questionnaire during the data collection period in 2011-2012. Data were analysed using descriptive statistics. Mann-Whitney U-test was used to examine differences in relation to students with or without prior experience of elderly care. Overall, the clinical learning environment was evaluated in a predominantly positive way. The sub-dimension Supervisory relationship displayed the highest mean value, and the lowest score was calculated for the sub-dimension Leadership style of the ward manager. Statistical significant differences between sub-groups were displayed for four out of 34 items. The supervisory relationship had the greatest impact on how student nurses experienced the clinical learning environment in nursing homes. It is therefore, of utmost importance that collaborative activities, between educational and nursing home settings, supporting the work of preceptors are established and maintained. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Dhaini, Suzanne; Zúñiga, Franziska; Ausserhofer, Dietmar; Simon, Michael; Kunz, Regina; De Geest, Sabina; Schwendimann, René
2016-01-01
Worker productivity is central to the success of organizations such as healthcare institutions. However, both absenteeism and presenteeism impair that productivity. While various hospital studies have examined the prevalence of presenteeism and absenteeism and its associated factors among care workers, evidence from nursing home settings is scarce. To explore care workers' self-reported absenteeism and presenteeism in relation to nursing homes' psychosocial work environment factors. We performed a cross-sectional study utilizing survey data of 3,176 professional care workers in 162 Swiss nursing homes collected between May 2012 and April 2013. A generalized estimating equation ordinal logistic regression model was used to explore associations between psychosocial work environment factors (leadership, staffing resources, work stressors, affective organizational commitment, collaboration with colleagues and supervisors, support from other personnel, job satisfaction, job autonomy) and self-reported absenteeism and presenteeism. Absenteeism and presenteeism were observed in 15.6 and 32.9% of care workers, respectively. While absenteeism showed no relationship with the work environment, low presenteeism correlated with high leadership ratings (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.01-1.48) and adequate staffing resources (OR 1.18, 95% CI 1.02-1.38). Self-reported presenteeism is more common than absenteeism in Swiss nursing homes, and leadership and staffing resource adequacy are significantly associated with presenteeism, but not with absenteeism. © 2015 S. Karger AG, Basel.
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Japanese professional nurses spend unnecessarily long time doing nursing assistants' tasks.
Kudo, Yasushi; Yoshimura, Emiko; Shahzad, Machiko Taruzuka; Shibuya, Akitaka; Aizawa, Yoshiharu
2012-09-01
In environments in which professional nurses do simple tasks, e.g., laundry, cleaning, and waste disposal, they cannot concentrate on technical jobs by utilizing their expertise to its fullest benefit. Particularly, in Japan, the nursing shortage is a serious problem. If professional nurses take their time to do any of these simple tasks, the tasks should be preferentially allocated to nursing assistants. Because there has been no descriptive study to investigate the amount of time Japanese professional nurses spent doing such simple tasks during their working time, their actual conditions remain unclear. Professional nurses recorded their total working time and the time they spent doing such simple tasks during the week of the survey period. The time an individual respondent spent doing one or more simple tasks during that week was summed up, as was their working time. Subsequently, the percentage of the summed time he or she spent doing any of those tasks in his or her summed working time was calculated. A total of 1,086 respondents in 19 hospitals that had 87 to 376 beds were analyzed (response rate: 53.3%). The average time (SD) that respondents spent doing those simple tasks and their total working time were 2.24 (3.35) hours and 37.48 (10.88) hours, respectively. The average percentage (SD) of the time they spent doing the simple tasks in their working time was 6.00% (8.39). Hospital administrators must decrease this percentage. Proper working environments in which professional nurses can concentrate more on their technical jobs must be created.
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Oncology nursing: Finding the balance in a changing health care system.
Bakker, Debra; Fitch, Margaret I; Green, Esther; Butler, Lorna; Olson, Karin
2006-01-01
Health care restructuring has resulted in significant changes in the workload and work environment for oncology nurses. While recent studies describe the impact of these changes on the general nursing workforce in several countries, there have been no published studies that have focused on worklife issues of Canadian oncology nurses. Therefore, a qualitative study was conducted to gain insight about how oncology nursing has changed over the past decade and how Canadian oncology nurses are managing these changes. Analysis of telephone interviews with 51 practising oncology nurses employed across Canada revealed three major themes. The first theme, "health care milieu", portrayed a picture of the cancer care environment and patient and professional changes that occurred over the past decade. The second theme, "conflicting demands", reflects how the elements of change and social forces have challenged professional oncology nursing practice. The third theme, "finding the way", describes the patterns of behaviour that nurses used to manage the changing health care environment and make meaning out of nurses' work in cancer care. Overall, the findings portray a picture of Canadian oncology nurses in "survival mode". They face many workplace challenges, but are able to keep going "for now" because they find ways to balance their responsibilities on a daily basis and because they know and believe that their specialized nursing knowledge and skills make a difference in patient care.
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Gifkins, Jane; Loudoun, Rebecca; Johnston, Amy
2017-12-01
The aim of this investigation was to compare perceptions of nurses exposed to short or longer term shift work and their experiences working under this type of scheduling. Shift work is a crucial component of nurses' working lives, ensuring continuous care for patients. This study fills a research gap around the personal experiences of shift working nurses and the strategies used to manage the impacts of shift work. Qualitative case study design. Constructivist methodology, including in-depth semi-structured interviews conducted in 2015, was used for the study. Iterative review and inductive analysis of transcripts from nine recently graduated nurses and twelve experienced nurses enabled identification and verification of key themes. Three main areas of difference between new and experienced nurses relating to shift work challenges in a nursing environment emerged: perceptions about the utility of working in shifts, coping strategies and social support at home and work. Most experienced nurses found shift work advantageous, especially those with dependents. Coping strategies included flexible shift arrangements in both groups. Experienced nurses detailed the importance of support from family and friends while inexperienced nurses described feeling disconnected from social supports. Experienced nurses cited a lack of support from nursing managers as problematic. Findings suggest shift selection mitigated challenges of shift work for both inexperienced and experienced nurses, indicating autonomous roster selection is critical. Similarly, social support at work from senior nurses and management and at home played an important role in nurses' coping. © 2017 John Wiley & Sons Ltd.
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Terry, Daniel; Lê, Quynh; Nguyen, Uyen; Hoang, Ha
2015-08-12
The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Terry, Daniel; Lê, Quynh; Nguyen, Uyen; Hoang, Ha
2015-01-01
Objectives The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client’s homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff. PMID:26270947
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Resilience and Coping After Hospital Mergers.
Russo, Cynthia; Calo, Oriana; Harrison, Georgia; Mahoney, Kathleen; Zavotsky, Kathleen Evanovich
The aim of this study was to explore the relationship between resilience and coping in frontline nurses working in a healthcare system that has recently undergone a merger. Hospital mergers are common in the current healthcare environment. Mergers can provide hospital nurses the opportunity to use and develop positive coping strategies to help remain resilient during times of change. An anonymous-survey, quantitative, exploratory, descriptive study design was used. Data were obtained from an electronic survey that was made available to all nurses working in a 3-hospital system located in the northeast. Overall, the results showed that, when nurses reported using positive coping strategies, they report higher levels of resilience. The levels of resilience also varied from campus to campus. The campus that has been through 2 recent mergers reported the highest levels of resilience. This study suggests that, during times of change in the workplace, if nurses are encouraged to use positive coping strategies, they may have higher levels of resilience. This changing environment provides the clinical nurse specialists/clinical nurse educators the opportunity to foster and support frontline nurses in the use of healthy coping strategies and to help improve and maintain a high level of resilience, which is critical in today's healthcare environment.
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Resilience of nurses who work in community mental health workplaces in Palestine.
Marie, Mohammad; Hannigan, Ben; Jones, Aled
2017-08-01
People in Palestine live and work in a significantly challenging environment. As a result of these challenges they have developed resilient responses which are embedded in their cultural context. 'Sumud', in particular, is a socio-political concept which refers to ways of surviving in the context of occupation, chronic adversity, lack of resources and limited infrastructure. Nurses' work in Palestine is an under-researched subject and very little is known about how nurses adjust to such challenging environments. To address this gap in the literature this study aimed to explore the resilience of community mental health nurses (CMHNs) who work in Palestine. An interpretive qualitative design was chosen. Fifteen face-to-face interviews were completed with participants. Thirty-two hours of observations of the day-to-day working environment and workplace routines were conducted in two communities' mental health centres. Written documents relating to practical job-related policies were also collected from various workplaces. Thematic analysis was used across all data sources resulting in four main themes, which describe the sources of resilience among CMHNs. These sources are 'Sumud and Islamic cultures', 'Supportive relationships', 'Making use of the available resources', and 'Personal capacity'. The study concludes with a better understanding of resilience in nursing, which draws on wider cultural contexts and social ecological responses. The outcomes from this study will be used to develop the resilience of CMHNs in Palestine. © 2016 The Authors International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd on behalf of Australian College of Mental Health Nurses Inc.
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Bachnick, Stefanie; Ausserhofer, Dietmar; Baernholdt, Marianne; Simon, Michael
2018-05-01
Patient-centered care is a key element of high-quality healthcare and determined by individual, structural and process factors. Patient-centered care is associated with improved patient-reported, clinical and economic outcomes. However, while hospital-level characteristics influence patient-centered care, little evidence is available on the association of patient-centered care with characteristic such as the nurse work environment or implicit rationing of nursing care. The aim of this study was to describe patient-centered care in Swiss acute care hospitals and to explore the associations with nurse work environment factors and implicit rationing of nursing care. This is a sub-study of the cross-sectional multi-center "Matching Registered Nurse Services with Changing Care Demands" study. We included 123 units in 23 acute care hospitals from all three of Switzerland's language regions. The sample consisted of 2073 patients, hospitalized for at least 24 h and ≥18 years of age. From the same hospital units, 1810 registered nurses working in direct patient care were also included. Patients' perceptions of patient-centered care were assessed using four items from the Generic Short Patient Experiences Questionnaire. Nurses completed questionnaires assessing perceived staffing and resource adequacy, adjusted staffing, leadership ability and level of implicit rationing of nursing care. We applied a Generalized Linear Mixed Models for analysis including individual-level patient and nurse data aggregated to the unit level. Patients reported high levels of patient-centered care: 90% easily understood nurses, 91% felt the treatment and care were adapted for their situation, 82% received sufficient information, and 70% felt involved in treatment and care decisions. Higher staffing and resource adequacy was associated with higher levels of patient-centered care, e.g., sufficient information (β 0.638 [95%-CI: 0.30-0.98]). Higher leadership ratings were associated with sufficient information (β 0.403 [95%-CI: 0.03-0.77) and adapted treatment and care (β 0.462 [95%-CI: 0.04-0.88]). Furthermore, higher levels of implicit rationing of nursing care were associated with lower levels of patient-centered care, e.g., adapted treatment and care (β -0.912 [95%-CI: -1.50-0.33]). Our study shows a negative association between implicit rationing of nursing care and patient-centered care: i.e.the lower the level of implicit rationing of nursing care, the better patients understood nurses, felt sufficiently informed and recognized that they were receiving highly individualized treatment. To improve patient-centered care, the nurse work environment and the level of implicit rationing of nursing care should be taken into consideration. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Nurse Managers Speak Out About Disruptive Nurse-to-Nurse Relationships.
Moore, Linda Weaver; Sublett, Cynthia; Leahy, Cathy
2017-01-01
The purpose of this study is to explore nurse managers' (NMs') perceptions regarding disruptive nurse-to-nurse relationships. Nurse managers play a pivotal role in creating and sustaining healthy practice environments. They must understand how to recognize and confront disruptive nurse relationships that can threaten the health of their units. A qualitative study design using researcher-participant interviews of 13 NMs from 5 institutions provided data regarding NMs' views on nurse relationships. Nurse managers reported how they became aware of disruptive nurse relationships, their strategies for dealing with those relationships, and the impact that confronting disruptive relationships had on them personally. Findings can be helpful to NMs who are faced with addressing disruptive nurse-to-nurse relationships as they endeavor to create and sustain healthy work environments.
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Shattell, Mona; Bartlett, Robin; Beres, Kyle; Southard, Kelly; Bell, Claire; Judge, Christine A; Duke, Patricia
2015-01-01
The inpatient environment is a critical space for nurses and patients in psychiatric settings. In this article, we describe nurses' and patients' perceptions of the inpatient environment both before the removal of a Plexiglas enclosure around a nurses' station and after its removal. Nurses had mixed feelings about the enclosure, reporting that it provided for confidentiality and a concentrated work space but also acknowledged the challenge of the barrier for communication with their patients. Patients unanimously preferred the nurses' station without the barrier, reporting increased feelings of freedom, safety, and connection with the nurses after its removal. It is important to consider the implications of environmental decisions in inpatient settings in order to promote a healthy workplace and healing environment for all community members. © The Author(s) 2015.
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Wang, Ying; Dong, Weizhen; Mauk, Kristen; Li, Peiying; Wan, Jin; Yang, Guang; Fang, Lyuying; Huan, Wan; Chen, Chun; Hao, Mo
2015-01-01
To examine the job satisfaction of nurses who are caring for older adults in healthcare settings in Shanghai, and to explore the underlying factors in order to explain and predict nurses' job satisfaction. China has the largest elderly population in the world, and its population is aging rapidly. Studies on job satisfaction of nurses providing care for the elderly in China can help to identify problem areas and develop strategies for the improvement of nurses' working conditions. However, to date, this subject matter has not been thoroughly studied in the Chinese context. Previous studies in other countries show that many factors impact nurses' job satisfaction, with the practice environment being a critical factor. There is a serious nursing shortage in China, especially in the big cities such as Shanghai. Given the increasing care demand of the aging population, learning about the job satisfaction level among nurses who are caring for older adults can provide essential information to help attract and retain nurses in this specialty area. A cross-sectional survey was conducted among 444 nurses in 22 elderly care institutions in Shanghai. The Chinese version of the Index of Work Satisfaction (IWS) and the Nursing Practice Environment Scale were instruments used. Inferential statistical tests used to analyze the data included Spearman correlation analysis, one-way analysis of variance, and hierarchical regression tests. The average overall IWS (part B) score was 135.21 ± 19.34. Personality, job and organizational characteristics were found to be the most influential factors, and the practice environment was identified as having the strongest impact on job satisfaction (Beta = 0.494). Job satisfaction level among nurses who are caring for older adults in Shanghai is moderate, but the data suggest that this could be greatly increased if the nursing practice environment was improved.
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Chen, Li-Chin; Lin, Chun-Chih; Han, Chin-Yen; Hsieh, Chun-Lan; Wu, Chiung-Jung Jo; Liang, Hwey-Fang
2018-03-01
This study aims to gain in-depth understanding of nurses' perspectives of working in an overcrowded emergency. Symbolic interactionism and Charmaz's construction of grounded theory were used. Purposive sampling at the start of the study and a further theoretical sampling by snowball technique were used to recruit 40 registered nurses (RN) to participate in in-depth, semi-structured interviews between May and November, 2014. Data analysis included analytic techniques of initial, focused and theoretical coding. Study findings showed searching for work role is derived by the themes of Finding the role of positioning in Emergency Department (ED), Recognizing causes of ED overcrowding, and Confined working environment. Nurses' work experience which represents the RNs not gained control over their work, as care actions influenced by the problematic overcrowded circumstance of the ED environment. The findings fill a gap in knowledge about how RNs experience their work role in the context of an overcrowded Emergency Department in Taiwan. Arising from the study result include taking account of nurses' perspectives when planning staff/patient ratios, strategies to reduce waiting time and ensure that clients receive appropriate care. Copyright © 2018. Published by Elsevier B.V.
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Job satisfaction and work related variables in Chinese cardiac critical care nurses.
Liu, Yun-E; While, Alison; Li, Shu-Jun; Ye, Wen-Qin
2015-05-01
To explore critical care nurses' views of their job satisfaction and the relationship with job burnout, practice environment, coping style, social support, intention to stay in current employment and other work-related variables. Nurse shortage is a global issue, especially in critical care. Job satisfaction is the most frequently cited factor linked to nurses' turnover. A convenience sample of cardiac critical care nurses (n = 215; 97.7% response rate) from 12 large general hospitals in Shanghai was surveyed from December 2010 to March 2011. Over half of the sample reported satisfaction with their jobs. Nurses with 10-20 years of professional experience and those who had taken all their holiday entitlement reported higher levels of job satisfaction. The independent variables of practice environment, intention to stay, emotional exhaustion, personal accomplishment and positive coping style explained about 55% of the variance in job satisfaction. Chinese cardiac critical care nurses' job satisfaction was related to work related variables, which are amenable to managerial action. Our findings highlight the imperative of improving intrinsic and extrinsic rewards, together with the flexibility of work schedules to promote job satisfaction and staff retention. A clinical ladder system is needed to provide promotion opportunities for Chinese nurses. © 2013 John Wiley & Sons Ltd.
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Kishi, Yuka; Inoue, Kumiyo; Crookes, Patrick; Shorten, Allison
2014-04-01
The purpose of the study was to investigate the experiences of Japanese nurses and their adaptation to their work environment in Australia. Using a qualitative research method and semistructured interviews, the study aimed to discover, describe, and analyze the experiences of 14 Japanese nurses participating in the study. A qualitative study. Fourteen Japanese registered nurses working in Australian hospitals participated in the study. Individual semistructured interviews were conducted from April to June in 2008. Thematic analysis was used to identify themes within the data. Analysis of qualitative open-ended questions revealed the participants' adaptation process. It consists of three themes or phases: seeking (S), acclimatizing (A), and settling (S), subsequently named the S.A.S. model. The conceptual model of the adaptation processes of 14 Japanese nurses working in Australia includes the seeking, acclimatizing, and settling phases. Although these phases are not mutually exclusive and the process is not necessarily uniformly linear, all participants in this study passed through this S.A.S. model in order to adapt to their new environment. The S.A.S. model of adaptation helps to describe the experiences of Japanese overseas qualified nurses working in Australian hospitals. Future research is needed to examine whether this model can be applied to nurses from other countries and in other settings outside Australia.
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"Towering genius disdains a beaten path" Abraham Lincoln.
Ferguson-Paré, Mary; Mitchell, Gail J; Perkin, Karen; Stevenson, Lynn
2002-01-01
We see nursing leadership existing at all levels in nursing...all nurses leading. Nurse executives within academic health environments across Canada will be influencing health policy directions and dialogue within the profession nationally. They will be contributing to the development of a national agenda for nursing practice, education, research and leadership. These nurse executives will lead in a way that makes an invigorating impact on human service in health care environments and they will be dedicated to preparing the nursing leaders of tomorrow. The Academy of Canadian Executive Nurses will connect with the Office of Nursing Policy, Canadian Nurses Association, Canadian Association of University Schools of Nursing, Association of Canadian Academic Health Care Organizations and others to develop position papers regarding key issues such as patient safety, health human resource planning and leadership in the Canadian health care system. Our definition of professional nursing practice, fully integrated with education and research, will be advanced through these endeavours. The end result of a strong individual and collective voice will be improved patient outcomes supported by professional nursing practice in positive practice environments. This paper is intended to stimulate dialogue among nursing leaders in Canada, dislodge us from a long and traditional path, and place us firmly in a new millennium of leadership for the profession and practice of nursing, a style of leadership that is needed, wanted and supported by nurses and the clients we serve. It is the responsibility of those of us who lead in academic health science centres to be courageous for the students we support, the puactitioners we lead and the renewal of the profession. We are the testing ground for nursing research, and need to be the source of innovation for nursing practice. It is incumbent on us to leap forward to engage a new vision of the professional practice of nursing with a reconfigured work design and work environment compatible with the new economy, workplace and workforce.
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Depressive symptoms among Chinese nurses: prevalence and the associated factors.
Gao, Yu-Qin; Pan, Bo-Chen; Sun, Wei; Wu, Hui; Wang, Jia-Na; Wang, Lie
2012-05-01
This article is a report of exploration of depressive symptoms and the associated factors among Chinese nurses working at public city hospitals. Hospital nurses are known to work in psychologically and physically demanding work environment, which may lead to depressive symptoms. However, little research has been done to address this problem in Chinese nurses. A cross-sectional survey was carried out in seven randomly selected city hospitals of Liaoning Province, northeast of China in 2009. Depressive symptoms of the nurses were measured with the Chinese version of the Center for Epidemiologic Studies Depression Scale. Job Content Questionnaire and the effort-reward imbalance, demographic features, life style and work conditions were measured as the related factors. A total of 1592 nurses participated in the study and the effective response rate was 79·5%. The prevalence of depressive symptoms among the nurses was 61·7% (n = 886), of whom 74·9% (n = 664) had mild depressive symptoms. Multivariate logistic regression analysis showed that lower job rank, higher over commitment, alcohol consumption, worse nurse-patient relationship and higher education background were positively associated with depressive symptoms, whereas supervisor support, taking regular meals, doing physical exercises, higher skill discretion and higher job satisfaction were negatively associated with depressive symptoms. More than half of the Chinese nurses had depressive symptoms. As depressive symptoms may adversely affect quality of life and quality of care, consultation for the nurses with healthy life styles, work stress coping techniques and advice to administrator to improve social aspects of the work environment might be helpful to reduce the depressive symptoms in nurses. © 2011 Blackwell Publishing Ltd.
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Nurses' role transition from the clinical ward environment to the critical care environment.
Gohery, Patricia; Meaney, Teresa
2013-12-01
To explore the experiences of nurses moving from the ward environment to the critical care environment. Critical care areas are employing nurses with no critical care experience due to staff shortage. There is a paucity of literature focusing on the experiences of nurses moving from the ward environment to the critical care environment. A Heideggerian phenomenology research approach was used in this study. In-depth semi structured interviews, supported with an interview guide, were conducted with nine critical care nurses. Data analysis was guided by Van Manen (1990) approach to phenomenological analysis. Four main themes emerged: The highs and lows, you need support, theory-practice gap, struggling with fear. The participants felt ill prepared and inexperienced to work within the stressful and technical environment of critical care due to insufficient education and support. The study findings indicated that a variety of feelings and emotions are experienced by ward nurses who move into the stressful and technical environment of critical care due to insufficient skills and knowledge. More education and support is required to improve this transition process. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Gyllensten, Kristina; Andersson, Gunnar; Muller, Helena
2017-01-01
There is a shortage of registered nurses in the European Union (EU), and job dissatisfaction and perceived high work-family conflict have been identified as causes of nursing staff turnover. Reducing work hours is an organisational intervention that could have a positive effect on nurses' and assistant nurses' job satisfaction, work-life balance, and willingness to stay in the job. An orthopaedic surgery department at a large hospital in Sweden introduced reduced work hours for nurses and assistant nurses in order to improve the working situation. The aim of the study was to investigate the experiences of reduced work hours and no lunch breaks among nurses and assistant nurses at an orthopaedic surgery department at a hospital in Sweden, with a particular focus on recovery and psychosocial working environment. A qualitative design was used in the study. Eleven nurses and assistant nurses working at the particular orthopaedic department took part in the study, and semi-structured interviews were used to collect data. The interviews were analysed by interpretative phenomenological analysis. Four main themes were developed in the analysis of the data: A more sustainable working situation, Improved work-life balance, Consequences of being part of a project, and Improved quality of care. Each theme consisted of subthemes. Overall, reduced work hours appeared to have many, mainly positive, effects for the participants in both work and home life.
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Threading needles in the dark: the effect of the physical work environment on nursing practice.
Simmons, Debora; Graves, Krisanne; Flynn, Elizabeth A
2009-01-01
Frequently, the most critical calculations, considerations, and preparations for patient care and medication administration are made in noisy, dimly lit, and chaotic areas of the nursing unit. Healthcare has begun to recognize the impact of the physical work environment plays in the ability of humans to perform reliably and safely. This article reviews the draft guidelines recently released by the United States Pharmacopeia for public comment for the physical environment to promote safe medication administration.
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The relationship between individualized care and the practice environment: an international study.
Papastavrou, Evridiki; Acaroglu, Rengin; Sendir, Merdiye; Berg, Agneta; Efstathiou, Georgios; Idvall, Ewa; Kalafati, Maria; Katajisto, Jouko; Leino-Kilpi, Helena; Lemonidou, Chryssoula; da Luz, Maria Deolinda Antunes; Suhonen, Riitta
2015-01-01
Previous research studies have found that the better the quality of practice environments in hospitals, the better the outcomes for nurses and patients. Practice environment may influence nurses' ability to individualize care but the detailed relationship between individualized care and the professional practice environment has not been investigated widely. Some evidence exists about the association of practice environments with the level of individualization of nursing care, but this evidence is based on single national studies. The aim of this study was to determine whether nurses' views of their professional practice environment associate with their views of the level of care individualization in seven countries. This study had an international, multisite, prospective, cross-sectional, exploratory survey design. The study involved acute orthopedic and trauma surgical inpatient wards (n=91) in acute care hospitals (n=34) in seven countries, Cyprus, Finland, Greece, the State of Kansas, USA, Portugal, Sweden, and Turkey. Nurses (n=1163), registered or licensed practical, working in direct patient care, in orthopedic and trauma inpatient units in acute care hospitals in seven countries participated in the study. Self-administered questionnaires, including two instruments, the Revised Professional Practice Environment and the Individualized Care Scale-Nurse (Individualized Care Scale-Nurse A and B) were used for data collection. Data were analyzed statistically using descriptive statistics, simultaneous multiple regression analysis, and generalized linear model. Two regression models were applied to assess the predictive validity of the Revised Professional Practice Environment on the Individualized Care Scale-Nurse-A and B. The results showed that elements of the professional practice environment were associated with care individualization. Internal work motivation, cultural sensitivity, control over practice, teamwork, and staff relationship with physicians were predictors of support (Individualized Care Scale-A) for and the delivery (Individualized Care Scale-B) of individualized care. The results of this study provide evidence that environment aspect could explain variations in care individualization. These findings support the assertion that individualized care needs to be understood in a broader context than the immediate nurse-patient relationship and that careful development of the care environment may be an effective way to improve care quality and outcomes. Copyright © 2014 Elsevier Ltd. All rights reserved.
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The Relationship Between Work-Family Conflict and Job Satisfaction Among Hospital Nurses.
AlAzzam, Manar; AbuAlRub, Raeda Fawzi; Nazzal, Ala H
2017-10-01
This study aimed to explore the incidence of work-family conflict and the association between work-family conflict and satisfaction level among Jordanian nurses. Self-administered questionnaires were used to collect data from a convenience sample of 333 Jordanian nurses using a descriptive, cross-sectional, correlational design. The results revealed that nurses were exposed to both subtypes of work and family conflict, but they experienced the work-to-family conflict more than the family-to-work conflict. Both subtypes of work and family conflict were correlated negatively with age and positively with the number of children. Being female and absence of child care facilities at workplace had positive effects on the occurrence of work-to-family conflict. Finally, the negative and significant relationship between the work and family conflict and the job satisfaction level was supported. Those findings imply that nurse administrators and policy makers should establish different strategies to support the balance between the nurses' family life and nurses' work life such as child care and elder care services and other fringe benefits. Hospitals have to promote themselves as work environments that support job satisfaction to attract nurses, hence increasing patients' satisfaction and quality of nursing care. © 2017 Wiley Periodicals, Inc.
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Milisen, Koen; De Busser, Tinne; Kayaert, Annelore; Abraham, Ivo; de Casterlé, Bernadette Dierckx
2010-06-01
We have previously examined the professional self-image of practicing nurses in Belgium and its association with various professional decisions, however there is limited knowledge about the professional self-image of nurses-to-be. Despite prior research on nursing students' perceptions of nursing or their self-esteem, students' professional image, defined as "the way students perceive themselves in their clinical practice environment and their anticipated work environment", has not been described nor compared to that of practicing nurses. To describe the professional nursing self-image among students in their final year of baccalaureate education. Cross-sectional survey. Nine geographically spread baccalaureate programs in the Flemish region of Belgium. 427 evaluable students from 455 recruited from 663 potential. Data collected in each school during regular hours using an adapted version of the BELIMAGE (Belgian professional self-image instrument for hospital nurses) including questions on personal demographics, education and competence, nursing care, team and practice environment. Voluntary participation with returned questionnaire deemed informed consent. Respondents identified several curricular components as contributing to their perceived competence. They also identified several skills deemed important to professional nursing, however did not feel competent in all of these. Important nursing care aspects included individualizing patient care, detecting care problems and potential complications, and promoting patient well-being; within a care environment with open interdisciplinary communication, where care problems could be discussed with nursing colleagues, where one cares for the same patient regularly, and led by a team leader with vision. Society's view of nursing was generally more negative than students'. Most students planned on working in nursing after their studies and many had thought about additional education at some point. Most were proud of becoming a nurse, would recommend nursing to others, and would choose nursing again as field of study. Students' evolving professional self-image was positive, rich, and enthusiastic; and higher than that observed in working nurses in a prior study. There is a significant gap between nursing care aspects deemed important and perceived competence in these areas, which has implications for both educators and future employers. Once employed, students are likely to experience differences in their perceptions of professional self-image with those of senior colleagues; another area of attention for employers. (c) 2009 Elsevier Ltd. All rights reserved.
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Substance abuse among registered nurses.
Epstein, Patricia M; Burns, Candace; Conlon, Helen Acree
2010-12-01
The stressful conditions under which nurses work, due in part to the nursing shortage, are among the risk factors that contribute to nurses' abuse of illicit drugs. Nurses differ from the general population in that they work in an environment where they not only have access to controlled substances, but also are exposed to death and dying, the stress of which can increase the risk of drug abuse. However, practicing while impaired places patients' lives at risk and decreases staff morale. Copyright 2010, SLACK Incorporated.
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Wong, Florence Mei Fung
2018-06-18
Small group work is an effective teaching-learning approach in nursing education to enhance students' learning in theoretical knowledge and skill development. Despite its potential advantageous effects on learning, little is known about its actual effects on students' learning from students' and educators' perspectives. To understand students' learning through small group work from the perspectives of students and educators. A qualitative study with focus group interviews was carried out. Semi-structured interviews with open-ended questions were performed with 13 undergraduate nursing students and 10 educators. Four main themes, "initiative learning", "empowerment of interactive group dynamics", "factors for creating effective learning environment", and "barriers influencing students' learning", were derived regarding students' learning in small group work based on the perspectives of the participants. The results showed the importance of learning attitudes of students in individual and group learning. Factors for creating an effective learning environment, including preference for forming groups, effective group size, and adequacy of discussion, facilitate students' learning with the enhancement of learning engagement in small group work. The identified barriers, such as "excessive group work", "conflicts", and "passive team members" can reduce students' motivation and enjoyment of learning. Small group work is recognized as an effective teaching method for knowledge enhancement and skill development in nursing education. All identified themes are important to understand the initiatives of students and group learning, factors influencing an effective learning environment, and barriers hindering students' learning. Nurse educators should pay more attention to the factors that influence an effective learning environment and reduce students' commitment and group dynamics. Moreover, students may need further support to reduce barriers that impede students' learning motivation and enjoyment. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Radiofrequency identification: exploiting an old technology for measuring nurse time and motion.
Jones, Terry L
2012-09-01
A national campaign is underway to increase the amount of time staff nurses spend at the bedside of hospitalized patients through redesign of the work environment. This kind of work redesign requires robust data depicting what nurses do and how they spend their time. Historically, these kinds of data have been difficult, costly, and time consuming to collect. Wireless capture of data on the movement of humans within the work environment (ie, time and motion) is now possible through radiofrequency identification technology. When small tracking devices the size of a quarter are affixed to their clothing, the movement of nurses throughout a patient care unit can be monitored. The duration and frequency of patient interaction are captured along with the duration of time spent in other locations of interest to include nurses' station, supply room, medication room, doctors' station, electronic documentation stations, family waiting rooms, and the hallway. Patterns of nurse movement and time allocation can be efficiently identified, and the effects of staffing practices, workflows, and unit layout evaluated. Integration of radiofrequency identification time and motion data with other databases enables nurse leaders to link nursing time to important cost and quality outcomes. Nurse leaders should explore the usefulness of radiofrequency identification technology in addressing data needs for nurse time and motion.
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Kim, MinYoung; Oh, Seieun
2016-01-01
The purpose of this study was to generate a substantive model that accounts for the explanatory social processes of communication in which nurses were engaged in clinical settings in Korea. Grounded theory methodology was used in this study. A total of 15 clinical nurses participated in the in-depth interviews. "Assimilating to the hierarchical culture" emerged as the basic social process of communication in which the participants engaged in their work environments. To adapt to the cultures of their assigned wards, the nurses learned to be silent and engaged in their assimilation into the established hierarchy. The process of assimilation consisted of three phases based on the major goals that nurses worked to achieve: getting to know about unspoken rules, persevering within the culture, and acting as senior nurse. Seven strategies and actions utilized to achieve the major tasks emerged as subcategories, including receiving strong disapproval, learning by observing, going silent, finding out what is acceptable, minimizing distress, taking advantages as senior nurse, and taking responsibilities as senior nurse. The findings identified how the pattern of communication in nursing organizations affected the way in which nurses were assimilated into organizational culture, from individual nurses' perspectives. In order to improve the rigid working atmosphere and culture in nursing organizations and increase members' satisfaction with work and quality of life, managers and staff nurses need training that focuses on effective communication and encouraging peer opinion-sharing within horizontal relationships. Moreover, organization-level support should be provided to create an environment that encourages free expression.
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Australian primary health care nurses most and least satisfying aspects of work.
Halcomb, Elizabeth; Ashley, Christine
2017-02-01
To identify the aspects of working in Australian primary health care that nurses rate as the most and least satisfying. The nursing workforce in Australian primary health care has grown exponentially to meet the growing demand for health care. To maintain and further growth requires the recruitment and retention of nurses to this setting. Understanding the factors that nurses' rate as the most and least satisfying about their job will inform strategies to enhance nurse retention. A cross-sectional online survey. Nurses employed in primary health care settings across Australia were recruited (n = 1166) to participate in a survey which combined items related to the respondent, their job, type of work, clinical activities, job satisfaction and future intention, with two open-ended items about the most and least satisfying aspects of their work. Patient interactions, respect, teamwork, collegiality and autonomy were identified as the most satisfying professional aspects of their role. Personal considerations such as family friendly work arrangements and a satisfactory work-life balance were also important, overriding negative components of the role. The least satisfying aspects were poor financial support and remuneration, lack of a career path, physical work environment and time constraints. National restructuring of the primary health care environment was seen as a barrier to role stability and ability to work to a full scope of practice. This study has identified a range of positive and negative professional and personal aspects of the primary health care nursing role, which may impact on staff recruitment and retention. Findings from the study should be considered by employers seeking to retain and maximise the skills of their primary health care workforce. Understanding the factors that nurses perceive as being the most and least satisfying aspects of the work is can open up dialogue about how to improve the working experience of nurses in primary health care. © 2016 John Wiley & Sons Ltd.
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Lovrić, Robert; Piškorjanac, Silvija; Pekić, Vlasta; Vujanić, Jasenka; Ratković, Karolina Kramarić; Luketić, Suzana; Plužarić, Jadranka; Matijašić-Bodalec, Dubravka; Barać, Ivana; Žvanut, Boštjan
2016-07-01
Clinical practice is essential to nursing education as it provides experience with patients and work environments that prepare students for future work as nurses. The aim of this study was to translate the "Clinical Learning Environment, Supervision and Nurse Teacher" questionnaire in Croatian language and test its validity and reliability in practice. The study was performed at the Faculty of medicine, Josip Juraj Strossmayer University of Osijek, Croatia in April 2014. The translated questionnaire was submitted to 136 nursing students: 20 males and 116 females. Our results reflected a slightly different factor structure, consisting of four factors. All translated items of the original constructs "Supervisory relationship", "Role of nurse teacher" and "Leadership style of the ward manager" loaded on factor 1. Items of "Pedagogical atmosphere on the ward" are distributed on two factors (3 and 4). The items of "Premises of nursing on the ward" loaded on factor 2. Three items were identified as problematic and iteratively removed from the analysis. The translated version of the aforementioned questionnaire has properties suitable for the evaluation of clinical practice for nursing students within a Croatian context and reflects the specifics of the nursing clinical education in this country. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Use of video-feedback, reflection, and interactive analysis to improve nurse leadership practices.
Crenshaw, Jeannette T
2012-01-01
The chronic shortage of registered nurses (RNs) affects patient safety and health care quality. Many factors affect the RN shortage in the workforce, including negative work environments, exacerbated by ineffective leadership approaches. Improvements in the use of relationship-based leadership approaches lead to healthier work environments that foster RN satisfaction and reduce RN turnover and vacancy rates in acute care settings. In this article, an innovative approach to reduce nurse turnover and decrease vacancy rates in acute care settings is described. Video feedback with reflection and interactive analysis is an untapped resource for nurse leaders and aspiring nurse leaders in their development of effective leadership skills. This unique method may be an effective leadership strategy for addressing recruitment and retention issues in a diverse workforce.
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Exploring the value of dignity in the work-life of nurses.
Lawless, Jane; Moss, Cheryle
2007-04-01
In this paper the authors draw attention to the value of nurse dignity in the work-life of nurses. How does the profession currently understand this as a concept and construct? How might the valuing of worker dignity in the workplace affect the wellbeing of the workforce? A review of nursing literature and a theoretical lens on worker dignity derived from recent work by Hodson (2001) was used to explore these questions. In the context of current and international workforce issues associated with recruitment and retention, analysis of the construct of worker dignity within the profession takes on a strong imperative. The large existing body of research into nursing workplace environments highlights concern that nurses have in understanding and improving work-life quality. Findings of this inquiry reveal that while there is a degree of coherence between the nursing research and elements of Hodson's (2001) research on worker dignity, the dignity of nurses, as a specific construct and as an intrinsic human and worker right has received little explicit attention. Reasons for this may lie partly in approaches that privilege patient dignity over nurse dignity and which rely on the altruism and self-sacrifice of nurses to sustain patient care in environments dominated by cost-control agendas. The value of dignity in the work-life of nurses has been under-explored and there is a critical need for further theoretical work and research. This agenda goes beyond acceptance of dignity in the workplace as a human right towards the recognition that worker dignity may be a critical factor in sustaining development of healthy workplaces and healthy workforces. Directing explicit attention to nurse dignity may benefit the attainment of both nurse and organisational goals. Hodson's (2001) framework offers a new perspective on dignity in the workplace and leads to new insights and a slightly different view of a 'road well travelled' in nursing literature.
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Clark, Cynthia M; Sattler, Victoria P; Barbosa-Leiker, Celestina
2016-10-01
Fostering healthy work environments that enhance job satisfaction and reflect high levels of employee engagement and productivity is imperative for all organizations. This is especially true for health care organizations where unhealthy work conditions can lead to poor patient outcomes. A convenience sample of 520 nursing faculty and practice-based nurses in the United States participated in a study to test the psychometric properties of the Healthy Work Environment Inventory (HWEI). A factor analysis and other reliability analyses support the use of the HWEI as a valid and reliable instrument to measure perceptions of work environment health. The HWEI is a 20-item psychometrically sound instrument to measure perceptions of the health of the work environment. It may be completed either as an individual exercise or by all members of a team to compare perceptions of work environment health, to determine areas of strength and improvement, and to form the basis for interviewing. [J Nurs Educ. 2016;55(10):555-562.]. Copyright 2016, SLACK Incorporated.
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Physician and nurse relationships, a key to patient safety.
Benner, Annalisa B
2007-04-01
A negative or intimidating relationship between a physician and a nurse can create a situation that puts the patient at risk. There are four areas in which communication between these groups affect patient safety and physician liability. Multiple studies have revealed that nurses who are intimidated by physicians do not contact the care provider as quickly for a patient condition change or consult with the physician as readily to clarify a medication order. Patients will be put at risk if there are not enough nurses to staff hospitals. The nursing shortage will become a greater issue as the current nursing workforce ages. The average age of a nurse in Kentucky is 44 years old. To avoid a serious nursing shortage there is a need to fill the open positions left by retiring nursing staff. Attracting the new graduates will require a positive, healthy working environment. If a course of treatment is challenged by the courts, a solid partner relationship between a physician and a nurse puts the physician in a stronger position. There are multiple organizations that have developed suggested actions that will encourage a healthy working relationship with better communication between physicians and nurses. Collaboration between physicians, nurses, and hospital administrators is the only way a healthy work environment will be attained. It is the responsibility of each group to begin the conversations that will improve this patient safety barrier.
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Influence of workplace culture on nursing-sensitive nurse outcomes in municipal primary health care.
Hahtela, Nina; Paavilainen, Eija; McCormack, Brendan; Slater, Paul; Helminen, Mika; Suominen, Tarja
2015-10-01
To explore the influence of workplace culture on sickness absences, overtime work and occupational injuries in municipal primary health care. The need to improve nursing sensitive outcomes has been highlighted. Therefore, an adequate understanding of the influence of workplace culture on nursing-sensitive nurse outcomes is essential for nurse managers to meet the requirements of improving nursing outcomes. A cross-sectional survey design was used to incorporating the data from 21 inpatient acute care units of nine organisations at the Finnish municipal primary health care system from 2011 to 2012. Findings emphasise in particular the importance of the practice environment as being an interpretative factor for nurses' absences owing to sickness, overtime work and occupational injuries. To ensure favourable nursing sensitive outcomes it is essential that there is a shared interest in the unit to invest in the creation of a supportive practice environment. Outcome improvements require a special focus on issues related to nursing management, adequate staffing and resources and intention to leave. © 2014 John Wiley & Sons Ltd.
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Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology
2011-01-01
Background Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care. Methods/Design A multi-country, multilevel cross-sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data). All staff nurses of a random selection of medical and surgical units (at least 2 per hospital) were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout) as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status) is collected to control the analyses for institutional differences. This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate the impact of changing different aspects of the nursing work environment on quality of care and satisfaction of the nursing workforce. Discussion RN4CAST is one of the largest nurse workforce studies ever conducted in Europe, will add to accuracy of forecasting models and generate new approaches to more effective management of nursing resources in Europe. PMID:21501487
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Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology.
Sermeus, Walter; Aiken, Linda H; Van den Heede, Koen; Rafferty, Anne Marie; Griffiths, Peter; Moreno-Casbas, Maria Teresa; Busse, Reinhard; Lindqvist, Rikard; Scott, Anne P; Bruyneel, Luk; Brzostek, Tomasz; Kinnunen, Juha; Schubert, Maria; Schoonhoven, Lisette; Zikos, Dimitrios
2011-04-18
Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care. A multi-country, multilevel cross-sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data). All staff nurses of a random selection of medical and surgical units (at least 2 per hospital) were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout) as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status) is collected to control the analyses for institutional differences.This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate the impact of changing different aspects of the nursing work environment on quality of care and satisfaction of the nursing workforce. RN4CAST is one of the largest nurse workforce studies ever conducted in Europe, will add to accuracy of forecasting models and generate new approaches to more effective management of nursing resources in Europe.
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Laschinger, H K; Finegan, J; Shamian, J
2001-01-01
A predictive, nonexperimental design was used to test Kanter's work empowerment theory in a random sample of 412 staff nurses selected from the professional registry list of a central Canadian province. Kanter argues that work environments that provide access to information, support, resources, and opportunity to learn and develop are empowering and influence employee work attitudes, productivity, and organizational effectiveness. Test results suggest that fostering environments that enhance perceptions of empowerment will have positive effects on organizational members and increase organizational effectiveness.
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Wolf, Lisa A; Perhats, Cydne; Clark, Paul R; Moon, Michael D; Zavotsky, Kathleen Evanovich
2017-09-22
The Institute of Medicine recognizes that the workplace environment is a crucial factor in the ability of nurses to provide safe and effective care, and thus interactions that affect the quality and safety of the work environment require exploration. The purpose of this study was to use situational analysis to develop a grounded theory of workplace bullying as it manifests specifically in the emergency care setting. This study used a grounded theory methodology called situational analysis. 44 emergency RNs were recruited to participate in one of 4 focus group sessions, which were transcribed in their entirety, and, along with field notes, served as the dataset. This grounded theory describes the characteristics of human actors and their reactions to conditions in the practice environment that lead to greater or lesser levels of bullying, and the responses to bullying as it occurs in U.S. emergency departments. Workplace bullying is a significant factor in the dynamics of patient care, nursing work culture, and nursing retention. The impact on patient care cannot be overestimated, both in terms of errors, substandard care, and the negative effects of high turnover of experienced RNs who leave, compounded by the inexperience of newly hired RNs. An assessment of hospital work environments should include nurse perceptions of workplace bullying, and interventions should focus on effective managerial processes for handling workplace bullying. Future research should include testing of the theoretical coherence of the model, and the testing of bullying interventions to determine the effect on workplace environment, nursing intent to leave/retention, and patient outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Hadi, Khatereh; DuBose, Jennifer R; Ryherd, Erica
2016-04-01
This study investigates the perception of nurses about their lighting environment at medical-surgical hospital units in order to understand areas of improvement for lighting at these units. The bulk of the research about nurses and lighting is focused on nighttime nursing, exploring the disruptions of nurses' circadian rhythm and maintaining alertness. The understanding of nurses' perception about lighting and its impact on nurses' task performance and patient examination remains imprecise. This study used an online survey to ask a set of questions about lighting in medical-surgical units at five key locations including centralized nurse stations, decentralized nurse stations (DCNS), patient bedsides, patient bathrooms, and corridors from 393 survey participants. It then explored the survey findings in more depth through conducting focus groups with eight volunteer nurses. Lighting conditions at patient besides and DCNSs were significantly less desirable for nurses compared to other locations. A significant relationship between nurses' access to lighting controls (switches and dimmers) and satisfaction about the lighting environment was found. No significant relationship was observed between the individual characteristics of nurses (such as age, years of experience, etc.) and findings of this study. Thoughtful design of the lighting environment can improve nurses' satisfaction and perception about their working environment. © The Author(s) 2015.
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Job-related stress in psychiatric nurses in Japan caring for elderly patients with dementia.
Yada, Hironori; Abe, Hiroshi; Lu, Xi; Wakizaki, Yuko; Omori, Hisamitsu; Matsuo, Hisae; Ishida, Yasushi; Katoh, Takahiko
2014-11-01
We investigated the specificity and structures of job-related stress in psychiatric dementia nurses (PDNs) caring for elderly patients with serious behavioral and psychological symptoms of dementia who required substantial assistance with activities of daily living, in order to obtain fundamental knowledge toward providing mental health care for these nurses. Subjects were 244 nurses [63 PDNs and 181 other psychiatric nurses (OPNs)] Analysis of covariance to examine the specificity of job-related stress in PDNs revealed physical workload and work environment to be more significant stressors, and irritability and anxiety to be more significant stress reactions in PDNs than in OPNs. An examination of PDNs' job-related stress structures established in a structural equation model with two stress reactions confirmed as specific outcomes for PDNs revealed a significant positive influence of work environment on irritability; utilization of techniques for anxiety and physical workload influenced both stress reactions. Our findings highlight the importance of reducing physical workload and environment and establishing a structure for nursing techniques in psychiatric dementia wards to improve the mental health of PDNs.
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Changes in Patient and Nurse Outcomes Associated with Magnet Hospital Recognition
Kutney-Lee, Ann; Stimpfel, Amy Witkoski; Sloane, Douglas M.; Cimiotti, Jeannie P.; Quinn, Lisa W.; Aiken, Linda H.
2015-01-01
Background Research has documented an association between Magnet hospitals and better outcomes for nurses and patients. However, little longitudinal evidence exists to support a causal link between Magnet recognition and outcomes. Objective To compare changes over time in surgical patient outcomes, nurse-reported quality, and nurse outcomes in a sample of hospitals that attained Magnet recognition between 1999 and 2007 with hospitals that remained non-Magnet. Research Design Retrospective, two-stage panel design using four secondary data sources. Subjects 136 Pennsylvania hospitals (11 “emerging” Magnets and 125 non-Magnets) Measures American Nurses Credentialing Center Magnet recognition; risk-adjusted rates of surgical 30-day mortality and failure-to-rescue, nurse-reported quality measures, and nurse outcomes; the Practice Environment Scale of the Nursing Work Index Methods Fixed effects difference models were used to compare changes in outcomes between emerging Magnet hospitals and hospitals that remained non-Magnet. Results Emerging Magnet hospitals demonstrated markedly greater improvements in their work environments than other hospitals. On average, the changes in 30-day surgical mortality and failure-to-rescue rates over the study period were more pronounced in emerging Magnet hospitals than in non-Magnet hospitals, by 2.4 fewer deaths per 1000 patients (p<.01) and 6.1 fewer deaths per 1000 patients (p=0.02), respectively. Similar differences in the changes for emerging Magnet hospitals and non-Magnet hospitals were observed in nurse-reported quality of care and nurse outcomes. Conclusions In general, Magnet recognition is associated with significant improvements over time in the quality of the work environment, and in patient and nurse outcomes that exceed those of non-Magnet hospitals. PMID:25906016
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Yu, Xi; Li, Ce; Gao, Xueqin; Liu, Furong; Lin, Ping
2018-04-20
To explore the relationship between the medication environment and the unsafe medication behavior of nurses and to analyze its influence path. Unsafe medication behavior is the direct cause of medication error. The organizational environment is the foundation of and plays a guiding role in work behavior. Whether the medication environment correlates with the unsafe medication behavior of nurses remains unclear. This study used a correlative design with self-administered questionnaires, and the SHEL model, an acronym of its elements of software, hardware, environment, and liveware, was used as the framework for the medication environment. A survey was conducted among 1012 clinical nurses from five tertiary hospitals in China using the nurse unsafe medication behavior scale (NUMBS) and the nurses' perceptions of the medication environment scale (NPMES). Data were collected from January to February 2017. Path analyses were used to examine the hypothesized model. The medication environment correlated negatively with unsafe medication behavior (r=-0.48, p<0.001). The path analysis showed that software, liveware and nurses' personal factors directly affected unsafe medication behavior. Software, hardware and the environment indirectly influenced unsafe medication behavior, and nurses' personal factors played a mediating role in the relationships of unsafe medication behavior with software, hardware, and the environment. The unsafe medication behavior of nurses should be further improved. The medication environment was a predictor of unsafe medication behavior. Care managers should actively improve the medication environment to reduce the incidence of unsafe medication behaviors. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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Naruse, Takashi; Sakai, Mahiro; Watai, Izumi; Taguchi, Atsuko; Kuwahara, Yuki; Nagata, Satoko; Murashima, Sachiyo
2013-12-01
The increasing number of elderly people has caused increased demand for home-visiting nurses. Nursing managers should develop healthy workplaces in order to grow their workforce. This study investigated the work engagement of home-visiting nurses as an index of workplace health. The aim of the present study was to reveal factors contributing to work engagement among Japanese home-visiting nurses. An anonymous, self-administered questionnaire was sent to 208 home-visiting nurses from 28 nursing agencies in three districts; 177 (85.1%) returned the questionnaires. The Job Demands-Resources model, which explains the relationship between work environment and employee well-being, was used as a conceptual guide. The authors employed three survey instruments: (i) questions on individual variables; (ii) questions on organizational variables; and (iii) the Utrecht Work Engagement Scale (Japanese version). Multiple regression analyses were performed in order to examine the relationships between individual variables, organizational variables, and work engagement. Nurse managers and nurses who felt that there was a positive relationship between work and family had significantly higher work engagement levels than others. The support of a supervisor was significantly associated with work engagement. Nurses in middle-sized but not large agencies had significantly higher work engagement than nurses in small agencies. Supervisor support and an appropriate number of people reporting to each supervisor are important factors in fostering work engagement among home-visiting nurses. © 2013 The Authors. Japan Journal of Nursing Science © 2013 Japan Academy of Nursing Science.
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[Influence of Nurses' Self-leadership on Individual and Team Members' Work Role Performance].
Kim, Se Young; Kim, Eun Kyung; Kim, Byungsoo; Lee, Eunpyo
2016-06-01
The purpose of this study was to examine correlations between nurses' self-leadership and individual work role performance and correlations between self-leadership in nursing units and team members' work role performance. Participants were 202 conveniently selected general nurses from 5 general hospitals in Korea. The study was carried out on 35 nursing units. Data were collected during February 2015 with self-report questionnaires. For factors affecting individual work role performance, self-expectation, self-goal setting, constructive thought, clinical career in the present nursing unit and marital status accounted for 44.0% of proficiency, while self-expectation, self-goal setting, constructive thought, and marital status accounted for 42.3% of adaptivity. Self-expectation, self-goal setting, constructive thought, self-reward, clinical career in the present nursing unit and position accounted for 26.4% of proactivity. In terms of team members' work role performance, self-reward and self-expectation in nursing units explained 29.0% of team members' proficiency. Self-reward and self-expectation in nursing units explained 31.6% of team members' adaptivity, and self-reward in nursing units explained 16.8% of team members' proactivity. The results confirm that nurses' self-leadership affects not only individual self-leadership but also team members' work role performance. Accordingly, to improve nurses' work role performance in nursing units of nursing organizations, improvement in nursing environment based on self-leadership education is necessary and nurses' tasks rearranged so they can appreciate work-autonomy and challenges of work.
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Nursing lives in the blogosphere: A thematic analysis of anonymous online nursing narratives.
Castro, Aimee; Andrews, Gavin
2018-02-01
The aim of this study was to explore the work-life narratives of nurses through a thematic analysis of the nursing accounts they post in their publicly accessible, anonymous blogs. Many nurses participate on social media. Blogs have been advocated as a self-reflective tool in nursing practice, yet as far as the authors are aware, no previous studies have explored nurses' individual blogs for their potential to reveal nurses' perceptions of nursing work. The research design was qualitative description. Between May-August 2015, Internet search engines were used to discover lists of nursing blogs recommended by organizations representing nurses' interests. Recommended blogs were purposively sampled. Four anonymous blogs written by nurses from different nursing specialties met the sampling criteria. All 520 of their entries from 2014 were read and copied into NVivo 10, where an inductive coding process was followed. Three major themes arose in these nurses' online discussions of their work lives: they truly care about and value their nursing work, but they are feeling stressed and burnt out and they are using their anonymous blogs to share factors that frustrate them in their nursing work. Three main areas of frustration were revealed: teamwork problems, challenging patients and families, and management issues. Anonymous nursing blogs offer valuable, longitudinal insights into nurses' perceptions of their work lives. Nursing blogs should be further explored for ongoing insights into nurses' experiences of nursing work, as well as nurses' recommendations for addressing issues causing them to feel frustrated in their work environments. © 2017 John Wiley & Sons Ltd.
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Internationally recruited nurses' experiences in England: A survey approach.
Alexis, Obrey
2015-01-01
Over the past few years, there has been an impetus to recruit internationally registered nurses to work in the National Health Service (NHS) to avert the labor shortage inherent in the United Kingdom. To determine internationally registered nurses' perception of discrimination, support, and their adjustment to a new environment in the NHS in England. A descriptive survey was used. Data were collected from 188 internationally recruited nurses using a questionnaire approach from 15 National Health Service hospitals in England. Data were analyzed using chi-square, Fisher exact, or Kruskal-Wallis tests. The study had a 21% response rate. There were 81.9% females and 18.1% males who participated in the survey. A mean score of 7.55 and standard deviation of 6.82 were calculated for the number of years of experience of working in the NHS. The findings revealed many statistical differences between the different ethnic groups used in the study. Generally, internationally recruited nurses from Africa, in particular, perceived discrimination to be evident in the workplace, the support they received was limited, and their adjustment to a new environment was the weakest in comparison with the other internationally recruited nurses from the different data sets. Although the needs of all internationally recruited nurses should be considered, it would appear that the needs of African nurses are the greatest because the study found that they experienced challenges in the working environment in the NHS. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.
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Assimilating to Hierarchical Culture: A Grounded Theory Study on Communication among Clinical Nurses
2016-01-01
The purpose of this study was to generate a substantive model that accounts for the explanatory social processes of communication in which nurses were engaged in clinical settings in Korea. Grounded theory methodology was used in this study. A total of 15 clinical nurses participated in the in-depth interviews. “Assimilating to the hierarchical culture” emerged as the basic social process of communication in which the participants engaged in their work environments. To adapt to the cultures of their assigned wards, the nurses learned to be silent and engaged in their assimilation into the established hierarchy. The process of assimilation consisted of three phases based on the major goals that nurses worked to achieve: getting to know about unspoken rules, persevering within the culture, and acting as senior nurse. Seven strategies and actions utilized to achieve the major tasks emerged as subcategories, including receiving strong disapproval, learning by observing, going silent, finding out what is acceptable, minimizing distress, taking advantages as senior nurse, and taking responsibilities as senior nurse. The findings identified how the pattern of communication in nursing organizations affected the way in which nurses were assimilated into organizational culture, from individual nurses’ perspectives. In order to improve the rigid working atmosphere and culture in nursing organizations and increase members’ satisfaction with work and quality of life, managers and staff nurses need training that focuses on effective communication and encouraging peer opinion-sharing within horizontal relationships. Moreover, organization-level support should be provided to create an environment that encourages free expression. PMID:27253389
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Keeping patients safe: Institute of Medicine looks at transforming nurses' work environment.
2004-01-01
In November 1999, the Institute of Medicine (IOM) released To Err Is Human: Building a Safer Health System, which brought to the public's attention the serious--and sometimes deadly--dangers posed by medical errors occurring in healthcare organizations. Exactly 4 years later, an IOM committee released a new report that focuses on the need to reinforce patient safety defenses in the nurses' working environments.
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Is anybody listening? A qualitative study of nurses' reflections on practice.
Huntington, Annette; Gilmour, Jean; Tuckett, Anthony; Neville, Stephen; Wilson, Denise; Turner, Catherine
2011-05-01
To explore nurses' perceptions of the reality of practice based on data from the Nurses and Midwives e-cohort Study which examined the workforce characteristics, work-life balance and health of nurses. Recruitment and retention of the nursing workforce is of international concern as demands increase due to demographic changes, political pressure and community expectations, in a climate of economic constraint. Qualitative analysis of data from a cohort of Australian, New Zealand and UK nurses. Of the 7604 participants in the electronic cohort, 1909 provided qualitative comments of which 162 related to nursing practice; thematic analysis resulted in four high order themes. The analytical discussion is structured around 'care' as the organising construct. Four themes emerged: 'embodied care' which discusses the impact of work on the nurse's physical and emotional health; 'quantity/quality care' which addresses increasing pressures of work and ability to provide quality care; 'organisational (non)care' raising the seeming lack of support from management; and '(un)collegial/self care' where bullying and professional relationships were raised. Issues raised by participants have been discussed in the nursing literature for several years yet nurses still experience these negative aspects of nursing. It appears there is a significant gap between what is known about the practice environment, recommendations for change and change occurring: the management equivalent of the theory-practice gap, resulting in nurses intending to leave the profession. Research demonstrates that a well-qualified, stable nursing workforce improves quality of health care and health outcomes. Changing the work environment and fostering a positive workplace culture seems fundamental to supporting the retention of nurses, that this is not occurring in some areas in the current climate is a concern for the profession and those responsible for the provision of care. © 2011 Blackwell Publishing Ltd.
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Use of aromatherapy to promote a therapeutic nurse environment.
Johnson, Kari; West, Toni; Diana, Shelly; Todd, Jodi; Haynes, Brianna; Bernhardt, Judy; Johnson, Roberta
2017-06-01
Workplace stress can affect nurse satisfaction. Aroma therapy as a therapeutic use of essential oil can be beneficial in reducing stress. Assess perceived stress pre-post introduction of Essential Oil Lavender among registered nurses, charge nurses, and patient care technicians in a trauma intensive care unit, surgical specialty care unit and an orthopedic trauma unit. Pre-post intervention with a quasi-experimental design. After a pre-survey, Essential Oil Lavender was diffused 24h per day over 30days in a designated nursing area that all nurses were not required to enter on each unit. Dependent sample t-test for "how often do nurses feel stressed a work in a typical week" revealed pre-survey mean 2.97 (SD=0.99) which was significantly higher than post-survey mean 2.70 (SD=0.92) with significance, t(69)=2.36, p=0.021, suggesting a difference in how often staff felt stressed at work in a typical week, trending down from "feeling stressed half of time" to "once in a while". There were no statistically significant differences in pre-post survey scores for TICU, TOU, or SSC as separate units. Use of essential oils to decrease work-related stress among nursing staff may improve retention, workplace environment, and increase nurse satisfaction. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Absence of response: a study of nurses' experience of stress in the workplace.
Olofsson, Brita; Bengtsson, Claire; Brink, Eva
2003-09-01
It has become clear that nursing is a high-risk occupation with regards to stress-related diseases. In this study, we were interested in nurses' experiences of stress and the emotions arising from stress at work. Results showed that nurses experienced negative stress which was apparently related to the social environment in which they worked. Four nurses were interviewed. The method used was grounded theory. Analysis of the interviews singled out absence of response as the core category. Recurring stressful situations obviously caused problems for the nurses in their daily work. Not only did they lack responses from their supervisors, they also experienced emotions of frustration, powerlessness, hopelessness and inadequacy, which increased the general stress experienced at work. Our conclusion is that the experience of absence of response leads to negative stress in nurses.
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The Impact of Entrepreneurial Leadership on Nurses' Innovation Behavior.
Bagheri, Afsaneh; Akbari, Morteza
2018-01-01
The purpose of this study was to examine the influence of entrepreneurial leadership on nurses' innovation work behavior and its dimensions. This cross-sectional study employed the 10-item Innovation Work Behavior Questionnaire and the 8-item Entrepreneurial Leadership Questionnaire to explore the impact of entrepreneurial leadership on the innovation work behavior of 273 nurses from public and private hospitals in Iran. Entrepreneurial leadership had a significant positive impact on nurses' innovation work behavior and most strongly improved idea exploration, followed by idea generation, idea implementation, and idea championing. Entrepreneurial leadership was effective in enhancing nurses' innovation work behavior. More attention needs to be focused on developing entrepreneurial leadership competencies and on developing nurse leaders. Healthcare policies and strategies are needed to facilitate the implementation of entrepreneurial leadership by providing healthcare leaders with the appropriate environment. © 2017 Sigma Theta Tau International.
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Nursing in a technological environment: nursing care in the operating room.
Bull, Rosalind; FitzGerald, Mary
2006-02-01
Operating room nurses continue to draw criticism regarding the appropriateness of a nursing presence in the operating room. The technological focus of the theatre and the ways in which nurses in the theatre have shaped and reshaped their practice in response to technological change have caused people within and outside the nursing profession to question whether operating room nursing is a technological rather than nursing undertaking. This paper reports findings from an ethnographic study that was conducted in an Australian operating department. The study examined the contribution of nurses to the work of the operating room through intensive observation and ethnographic interviews. This paper uses selected findings from the study to explore the ways in which nurses in theatre interpret their role in terms of caring in a technological environment.
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Hanson, Sarah E; MacLeod, Martha L; Schiller, Catharine J
2018-04-01
During both teacher-led clinical practica and precepted practica, students interact with, and learn from, staff nurses who work on the clinical units. It is understood that learning in clinical practice is enhanced by positive interactions between staff nurses and nursing students. While much is known about preceptors' experiences of working with nursing students, there is little evidence to date about staff nurses' perspectives of their interactions with students in teacher-led practica. To understand teacher-led clinical practica from the perspective of staff nurses. A qualitative descriptive approach answers the question: How do staff nurses perceive their contributions to nursing students' learning during teacher-led practica? Nine staff Registered Nurses (RNs) working within a regional acute care hospital in western Canada were interviewed using semi-structured interviews. Interview transcripts were analyzed using cross case analysis to discover themes and findings were checked by several experienced RNs. Analysis showed that nurses' interactions with nursing students are complicated. Nurses want to "train up" their future colleagues but feel a heavy burden of responsibility for students on the wards. This sense of burden for the staff nurses is influenced by several factors: the practice environment, the clinical instructor, the students themselves, and the nurses' understanding of their own contributions to student learning. Staff nurses remain willing to support student learning despite multiple factors that contribute to a sense of burden during teacher-led practica. Workplace environment, nursing program, and personal supports are needed to support their continuing engagement in student learning. Nurses need to know how important they are as role models, and the impact their casual interactions have on student nurses' socialization into the profession. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.
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Nowrouzi, Behdin; Giddens, Emilia; Gohar, Basem; Schoenenberger, Sandrine; Bautista, Mary Christine; Casole, Jennifer
2016-10-01
Workplace environment is related to the physical and psychological well-being, and quality of work life (QWL) for nurses. The aim of this paper was to perform a comprehensive literature review on nurses' quality of work life to identify a comprehensive set of QWL predictors for nurses employed in the United States and Canada. Using publications from 2004-2014, contributing factors to American and Canadian nurses' QWL were analyzed. The review was structured using the Work Disability Prevention Framework. Sixty-six articles were selected for analysis. Literature indicated that changes are required within the workplace and across the health care system to improve nurses' QWL. Areas for improvement to nurses' quality of work life included treatment of new nursing graduates, opportunities for continuing education, promotion of positive collegial relationships, stress-reduction programs, and increased financial compensation. This review's findings support the importance of QWL as an indicator of nurses' broader work-related experiences. A shift in health care systems across Canada and the United States is warranted where health care delivery and services are improved in conjunction with the health of the nurses working in the system.
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Influence of Teamwork Behaviors on Workplace Incivility as It Applies to Nurses
ERIC Educational Resources Information Center
Logan, Todd R.
2016-01-01
Workplace incivility, or bullying, experienced by nurses has been shown to have negative consequences on nurses and the care they provide patients. Nurses' roles are being challenged in the healthcare environment because of incivility in the workplace. These negative outcomes exist despite the support provided by teams on which these nurses work.…
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Johal, Sarbjit S; Mounsey, Zoe; Brannelly, Petula; Johnston, David M
2016-02-01
This report explores nurses' perspectives following the Canterbury (New Zealand) 2010-2011 earthquake sequence and the subsequent recovery process. Problem Little is known about the experiences of health care professionals during a disaster recovery process, and this research generates insights about the challenges faced. Qualitative semi-structured interviews were undertaken with 11 nurses from the Christchurch (New Zealand) area to explore the challenges faced by the nurses during and following the earthquakes. The interviews took place three years after the start of the earthquake experience to enable exploration of longer term aspects of the recovery process. The interview transcripts were analyzed and coded using a grounded theory approach. The data analysis identified that the nurses had faced a number of challenges and these were characterized as practical, emotional, and professional. While some of the challenges were short-lived in the aftermath of the earthquakes, some were long-lasting due to the extended nature of the recovery process. Dealing with house damage, insurance negotiations, and working in damaged environments had a negative impact on the nurses. The nurses experienced a range of emotions, both negative and positive, after the disaster, though many had needed time to elapse before feeling able to reflect on their experiences. The findings suggest that secondary stressors have a negative impact on the psychosocial recovery process. The nurses recognized that they received support from others and were also required to focus on others. Keeping busy appeared to be the most common coping strategy. This lack of reflection on their experiences may have resulted in delayed emotional responses. Some of the nurses changed their work role, hours, and responsibilities suggesting that working in this environment was having a detrimental impact. The research indicates the challenges faced by nurses in the initial impact of the earthquakes and during the longer term recovery process. There is a need to consider the psychosocial impact of working and living in a post-disaster context and to develop support packages to ensure the health and well-being of nurses in this environment.
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Predictors of Burnout Among Nurses in Taiwan.
Lee, Huan-Fang; Yen, Miaofen; Fetzer, Susan; Chien, Tsair Wei
2015-08-01
Nurse burnout is a crucial issue for health care professionals and impacts nurse turnover and nursing shortages. Individual and situational factors are related to nurse burnout with predictors of burnout differing among cultures and health care systems. The predictors of nurse burnout in Asia, particularly Taiwan, are unknown. The purpose of this study was to investigate the predictors of burnout among a national sample of nurses in Taiwan. A secondary data analysis of a nationwide database investigated the predictors of burnout among 1,846 nurses in Taiwan. Hierarchical regression analysis determined the relationship between predictors and burnout. Predictors of Taiwanese nurse burnout were age, physical/psychological symptoms, job satisfaction, work engagement, and work environment. The most significant predictors were physical/psychological symptoms and work engagement. The variables explained 35, 39, and 18 % of the emotional exhaustion, personal accomplishment, and depersonalization variance for 54 % of the total variance of burnout. Individual characteristics and nurse self-awareness, especially work, engagement can impact Taiwanese nurses' burnout. Nurse burnout predictors provide administrators with information to develop strategies including education programs and support services to reduce nurse burnout.
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Comparison of Reasons for Nurse Turnover in Magnet® and Non-Magnet Hospitals.
Park, Shin Hye; Gass, Stephanie; Boyle, Diane K
2016-05-01
The aim of this study is to compare rates and reasons for registered nurse (RN) turnover by Magnet® status. Although lower RN turnover rates in Magnet hospitals have been documented well in the literature, little is known about specific separation reasons for RN turnover and whether the reasons differ between Magnet and non-Magnet hospitals. This descriptive, correlational study analyzed unit-level 2013 National Database of Nursing Quality Indicators® turnover data (2,958 units; 497 hospitals). Poisson regression and Wilcoxon-Mann-Whitney test were used. Registered nurse turnover due to environment-related reasons was higher on units in non-Magnet hospitals than units in Magnet hospitals. Units in non-Magnet hospitals had 4.684 times higher turnover rates due to staffing/workload and 1.439 times higher rates due to work schedules than did units in Magnet hospitals. Nursing administrators in both Magnet and non-Magnet hospitals need to continually strive to improve unit work environments, particularly staffing and workload conditions and work scheduling.
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Workplace culture in psychiatric nursing described by nurses.
Kurjenluoma, K; Rantanen, A; McCormack, B; Slater, P; Hahtela, N; Suominen, T
2017-12-01
This study looks to describe the workplace culture from the viewpoints of stress, job satisfaction and practice environment. Data were collected from nurses (n = 109) using a web-based survey, The Person-Centred Nursing Index, from two purposefully selected hospital districts in Finland. Data were statistically analysed. Nurses described their workplace culture in slightly positive terms. Nurses only occasionally experienced stress (mean = 2.56, SD = 0.55) and were fairly satisfied with their job (mean = 4.75, SD = 0.66) and their practice environment (mean = 4.42, SD = 0.81). Demographic variables such as the nurses' age, length of time in nursing, time at their present hospital, working shifts and their use of patient restriction were more frequently associated with their perceived workplace culture. Older nurses and those with a longer work history in the nursing profession tended to be more satisfied with their workplace culture in psychiatric nursing. Young and/or newly graduated nurses felt more negatively on their workplace culture; this issue should be recognised and addressed with appropriate support and mentoring. Nurses who used restrictive measures were more often less satisfied with their workplace culture. Continuous efforts are needed to reduce the use of coercive measures, which challenge also the managers to support nursing practice to be more person-centred. © 2017 Nordic College of Caring Science.
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Effect of effort-reward imbalance and burnout on infection control among Ecuadorian nurses.
Colindres, C V; Bryce, E; Coral-Rosero, P; Ramos-Soto, R M; Bonilla, F; Yassi, A
2018-06-01
Nurses are frequently exposed to transmissible infections, yet adherence to infection control measures is suboptimal. There has been inadequate research into how the psychosocial work environment affects compliance with infection control measures, especially in low- and middle-income countries. To examine the association between effort-reward imbalance, burnout and adherence to infection control measures among nurses in Ecuador. A cross-sectional study linking psychosocial work environment indicators to infection control adherence. The study was conducted among 333 nurses in four Ecuadorian hospitals. Self-administered questionnaires assessed demographic variables, perceived infection risk, effort-reward imbalance, burnout and infection control adherence. Increased effort-reward imbalance was found to be a unique incremental predictor of exposure to burnout, and burnout was a negative unique incremental predictor of nurses' self-reported adherence with infection control measures. Results suggest an effort-reward imbalance-burnout continuum, which, at higher levels, contributes to reduce adherence to infection control. The Ecuadorean government has made large efforts to improve universal access to health care, yet this study suggests that workplace demands on nurses remain problematic. This study highlights the contribution of effort-reward-imbalance-burnout continuum to the chain of infection by decreased adherence to infection control of nurses. Health authorities should closely monitor the effect of new policies on psychosocial work environment, especially when expanding services and increasing public accessibility with limited resources. Additionally, organizational and psychosocial interventions targeting effort-reward imbalance and burnout in nurses should be considered part of a complete infection prevention and control strategy. Further study is warranted to identify interventions that best ameliorate effort-reward imbalance and burnout in low- and middle-income settings. © 2017 The Authors International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.
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Carthon, J Margo Brooks; Lasater, Karen B; Sloane, Douglas M; Kutney-Lee, Ann
2015-01-01
Introduction Threats to quality and patient safety may exist when necessary nursing care is omitted. Empirical research is needed to determine how missed nursing care is associated with patient outcomes. Aim The aim of this study was to examine the relationship between missed nursing care and hospital readmissions. Methods Cross-sectional examination, using three linked data sources—(1) nurse survey, (2) patient discharge data from three states (California, New Jersey and Pennsylvania) and (3) administrative hospital data— from 2005 to 2006. We explored the incidence of 30-day readmission for 160 930 patients with heart failure in 419 acute care hospitals in the USA. Logistic regression was used to assess the effect of missed care on the odds of readmission, adjusting for patient and hospital characteristics. Results The most frequently missed nursing care activities across all hospitals in our sample included talking to and comforting patients (42.0%), developing and updating care plans (35.8%) and educating patients and families (31.5%). For 4 of the 10 studied care activities, each 10 percentage-point increase in the number of nurses reporting having missed the activity was associated with an increase in the odds of readmission by 2–8% after adjusting for patient and hospital characteristics. However, missed nursing care was no longer a significant predictor of readmission once adjusting for the nurse work environment, except in the case of the delivery of treatments and procedures (OR 1.08, 95% CI 1.02 to 1.14). Conclusions Missed care is an independent predictor of heart failure readmissions. However, once adjusting for the quality of the nurse work environment, this relationship is attenuated. Improvements in nurses’ working conditions may be one strategy to reduce care omissions and improve patient outcomes. PMID:25672342
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Adams, Jeffrey M; Denham, Debra; Neumeister, Irene Ramirez
2010-01-01
The Model of the Interrelationship of Leadership, Environments & Outcomes for Nurse Executives (MILE ONE) was developed on the basis of existing literature related to identifying strategies for simultaneous improvement of leadership, professional practice/work environments (PPWE), and outcomes. Through existing evidence, the MILE ONE identifies the continuous and dependent interrelationship of 3 distinct concept areas: (1) nurse executives influence PPWE, (2) PPWE influence patient and organizational outcomes, and (3) patient and organizational outcomes influence nurse executives. This article highlights the application of the MILE ONE framework to a community district hospital's clinical documentation performance improvement projects. Results suggest that the MILE ONE is a valid and useful framework yielding both anticipated and unexpected enhancements to leaders, environments, and outcomes.
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Borim, Bruna Cury; Croti, Ulisses A; Silveira, Patricia C; De Marchi, Carlos H; Moscardini, Airton C; Hickey, Patricia; Jenkins, Kathy
2017-11-01
The nursing profession faces continuous transformations demonstrating the importance of professional continuing education to extend knowledge following technological development without impairing quality of care. Nursing assistants and technicians account for nearly 80% of nursing professionals in Brazil and are responsible for uninterrupted patient care. Extensive knowledge improvement is needed to achieve excellence in nursing care. The objective was to develop and evaluate a continuing education program for nursing technicians at a pediatric cardiac intensive care unit (PCICU) using a virtual learning environment entitled EDUCATE. From July to September 2015, a total of 24 nursing technicians working at the PCICU at a children's hospital located in the northwestern region of São Paulo state (Brazil) fully participated in the continuing education program developed in a virtual learning environment using Wix platform, allowing access to video classes and pre- and post-training theoretical evaluation questionnaires outside the work environment. The evaluation tools recorded participants' knowledge evolution, technological difficulties, educational, and overall rating. Knowledge development was descriptively presented as positive in more than 66.7%. Content and training were considered "excellent" by most participants and 90% showed an interest in the use of technological resources. Technical difficulties were found and quickly resolved by 40% of participants including Internet access, login, and lack of technical expertise. The continuing education program using a virtual learning environment positively contributed to the improvement in theoretical knowledge of nursing technicians in PCICU.
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Nurses in Practice: A Perspective on Work Environments.
ERIC Educational Resources Information Center
Davis, Marcella Z., Ed.; And Others
A major portion of the collection of 20 readings authored by practicing professionals consists of field observations presented both as raw data (field notes) and as analyzed and organized data. About the work of nurses in a variety of settings, a recurrent theme is that work behavior is greatly influenced by organizational and structural elements…
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[Clinical Work Experience of Korean Immigrant Nurses in U.S. Hospitals].
Seo, Kumsook; Kim, Miyoung
2016-04-01
The purpose of this qualitative study was to explore the meaning of the experience of Korean immigrant nurses working in US hospitals. Purposive sampling yielded 15 Korean immigrant nurses who had more than one year of clinical experience in US hospitals. Data were collected from March to August 2012 through in-depth interviews and thematic analysis was conducted using van Manen's hermeneutic phenomenological approach. The findings were classified into eight themes: 'struggling from staff at workplace being territorial to outsiders', 'feeling oppressed due to language barrier', 'accepting rational and horizontal relationships at work', 'staying alert in the environment where lawsuits are rife', 'feeling a sense of stability from the social system that values human dignity', 'maintaining self-confidence from prominent nursing practices and senior Korean nurses' professional reputation', 'performing essential comprehensive nursing care', 'promoting self-development to be equipped with professionalism.' The findings indicate that the Korean immigrant nurses were able to excel in their workplace when their clinical experience at US hospitals was combined with the lived space in US politics and environment, lived time of patience, lived body to be alert, and lived others with multi cultural characteristics.
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Yu, Mi; Lee, Haeyoung
2018-03-06
Nurses' turnover intention is not just a result of their maladjustment to the field; it is an organizational issue. This study aimed to construct a structural model to verify the effects of new graduate nurses' work environment satisfaction, emotional labor, and burnout on their turnover intention, with consideration of resilience and job involvement, and to test the adequacy of the developed model. A cross-sectional study and a structural equation modelling approach were used. A nationwide survey was conducted of 371 new nurses who were working in hospitals for ≤18 months between July and October, 2014. The final model accounted for 40% of the variance in turnover intention. Emotional labor and burnout had a significant positive direct effect and an indirect effect on nurses' turnover intention. Resilience had a positive direct effect on job involvement. Job involvement had a negative direct effect on turnover intention. Resilience and job involvement mediated the effect of work environment satisfaction, emotional labor, and burnout on turnover intention. It is important to strengthen new graduate nurses' resilience in order to increase their job involvement and to reduce their turnover intention. © 2018 Japan Academy of Nursing Science.
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Exploring nursing staffs communication in stressful and non-stressful situations.
André, Beate; Frigstad, Sigrun A; Nøst, Torunn H; Sjøvold, Endre
2016-03-01
To explore the factors that characterise the work environment, focusing on communication among nurses in stressful and non-stressful situations. Nursing is often described as a stressful occupation. Implementation of change may be an additional stress factor. Nurses and assistant nurses completed a questionnaire from two different perspectives, 'communication in non-stressful situations' and 'communication under stress'. The Systematising Person-Group Relations method was used to gather and analyse the data. When the two perspectives, 'communication in non-stressful situations' and 'communication under stress', were compared, there were significant differences in 8 of the 12 factors. The stressful situations were characterised by low values in task orientation, caring, criticism, loyalty, acceptance, engagement and empathy; only the factor creativity had higher scores. The stressful situations were characterised by creative and spontaneous behaviour, not by task orientation and engagement, indicating a potential patient safety risk. There is a need to help health-care workers develop more mature analytical and task-oriented behaviours related to both independent work and collaboration in stressful situations. Nursing leadership and organisation must focus on healthy work environments to promote engaged communication in stressful situations, ultimately increasing patient safety. © 2015 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.
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Tuckett, Anthony; Parker, Deborah; Eley, Robert M; Hegney, Desley
2009-12-01
Aim. The aim of this qualitative analysis - a component of a larger survey study, was to provide insights and understandings about intrinsic and extrinsic work values for nurses in aged-care. Background. Intrinsic and extrinsic work values impact on nurses' job satisfaction and ultimately nursing retention. This study contributes further to knowledge development in this area by building on a previous work values study in aged-care nursing. Methods. This paper presents the qualitative research findings from the final open-ended question from a survey of nurses employed in the aged-care sector in the State of Queensland, Australia in 2007. Data from a cohort of 105 aged care sector nurses was analysed relying on deductive content analysis. Findings. Two intrinsic work values emerged - low morale and images of nursing and two extrinsic work values emerged - remuneration and working conditions. The work value 'working conditions' comprised four aspects of aged-care work, specifically staff turnover, workplace violence, care team membership specifically the Assistants-in-Nursing and paperwork. A single social workplace value 'support by management' is discussed as identified as important to these nurses. Conclusion. Qualitative insights into aged-care nurses' intrinsic and extrinsic work values suggest that work satisfaction is low. Workforce policy makers and employers of nurses in aged-care need to comprehend the relationship between job satisfaction, retention and work values. Relevance to clinical practice. These findings have implications for recruitment, retention and workforce planning within the aged-care environment. © 2009 Blackwell Publishing Ltd.
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[Information and communication technologies in nursing].
Kern, Josipa
2014-03-01
The application of information and communication technologies (ICT) in nursing is an integral part of the educational curriculum at the university graduate level of nursing, but also part of scientific and professional meetings on nursing informatics. As part of seminars, students are obliged to choose e-health topics from their working environment, to show them and discuss with colleagues. The same is happening at meeting on nursing informatics. Selected papers on the issue are chosen to cover information literacy of nurses, examples of e-nursing, ICT infrastructure, the possible future developments and organizational aspects of e-health at healthcare institutions. Among others, special attention is paid to improving the quality of work in nursing.
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Lavander, Päivi; Meriläinen, Merja; Turkki, Leena
2016-11-01
This systematic review aimed to synthesise the existing evidence of working time use and the division of labour among nurses and health-care workers in hospital wards. The environment of nursing work is changing. Health systems are becoming more complex and costly, and highly skilled health-care professionals are transferring to new, more demanding tasks. Changes require a division of labour that is based on the efficient use of working time. Sixteen studies were identified for the final analysis through a systematic search. The use of working time was examined mainly through six categories: direct care, indirect care, documentation, unit-related work, personal time and non-nursing duties. The division of labour was examined from the perspective of different occupational groups. Despite nurses' different educational backgrounds, certain similarities could be observed. All working groups seem to spend less than half of their working time in direct patient care. Nurse managers could influence the increasing nursing workload by supporting the right division of labour and focusing the nurses' working time use so that it benefits the patient. © 2016 John Wiley & Sons Ltd.
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Parro Moreno, Ana; Serrano Gallardo, Pilar; Ferrer Arnedo, Carmen; Serrano Molina, Lucía; de la Puerta Calatayud, M Luisa; Barberá Martín, Aurora; Morales Asencio, José Miguel; de Pedro Gómez, Joan
2013-11-01
To analyze the perception of nursing professionals of the Madrid Primary Health Care environment in which they practice, as well as its relationship with socio-demographic, work-related and professional factors. Cross-sectional, analytical, observational study. Questionnaire sent to a total of 475 nurses in Primary Health Care in Madrid (former Health Care Areas 6 and 9), in 2010. Perception of the practice environment using the Practice Environment Scale of the Nursing Work Index (PES-NWI) questionnaire, as well as; age; sex; years of professional experience; professional category; Health Care Area; employment status and education level. There was a response rate of 69.7% (331). The raw score for the PES-NWI was: 81.04 [95%CI: 79.18-82.91]. The factor with the highest score was "Support from Managers" (2.9 [95%CI: 2.8-3]) and the lowest "Workforce adequacy" (2.3 [95%CI: 2.2-2.4]). In the regression model (dependent variable: raw score in PES-NWI), adjusted by age, sex, employment status, professional category (coefficient B=6.586), and years worked at the centre (coefficient B=2.139, for a time of 0-2 years; coefficient B=7.482, for 3-10 years; coefficient B=7.867, for over 20 years) remained at p≤0.05. The support provided by nurse managers is the most highly valued factor in this practice environment, while workforce adequacy is perceived as the lowest. Nurses in posts of responsibility and those possessing a higher degree of training perceive their practice environment more favourably. Knowledge of the factors in the practice environment is a key element for health care organizations to optimize provision of care and to improve health care results. Copyright © 2012 Elsevier España, S.L. All rights reserved.
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Hinno, Saima; Partanen, Pirjo; Vehviläinen-Julkunen, Katri; Aaviksoo, Ain
2009-12-01
The aim of the present study was to examine Estonian nurses' thinking with regard to how they perceive their autonomy, control over practice, teamwork and organizational support in regional, central and general hospitals. BACKGROUND; Despite the well-documented fact that there is a need to improve nurses' working environments in hospitals to promote safe patient care, in Europe broader studies on this topic have not received priority thus far. A nationally representative stratified random sample of 478 acute care hospital nurses was surveyed using the Nursing Work Index-Revised (NWI-R) instrument in 2005/2006. Nurses perceived their autonomy, control over practice and organizational support remarkably lower than nurse-physician relationships. Age and tenure were highly related to the nurses' perceptions. The Estonian nurses' ambivalent perceptions of the organizational attributes reflected the effects ascribed to hospital reforms. There is an urgent need for nurse managers to be particularly alert and attentive with regard to nurses who have been practising the profession for more than a decade. Support for their practice should be provided with the long-term goal of assuring the retention of those experienced nurses. Continuous monitoring of nurses' perceptions should be used systematically as a tool for staffing decisions at the hospital level.
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The Impact of Environmental Factors on Nursing Stress, Job Satisfaction, and Turnover Intention
Applebaum, Diane; Fowler, Susan; Fiedler, Nancy; Osinubi, Omowunmi; Robson, Mark
2014-01-01
Objective The purpose of this study was to investigate relationships between environmental factors of odor, noise, light, and color and perceived stress, job satisfaction, and turnover intention. Background The physical work environment may positively or negatively influence nurses’ stress, and stress may negatively impact their job satisfaction and intention to change jobs. Methods The research questions were answered using a descriptive, correlational design. The sample (n = 116) consisted of medical-surgical nurses working in acute-care settings. A 36-item questionnaire addressed odor, noise, light, color, perceived stress, job satisfaction, and turnover intention. Results Significant relationships were found between noise and perceived stress, perceived stress and job satisfaction, job satisfaction and turnover intention, and perceived stress and turnover intention. Conclusions Nurses tend to overlook their physical environment and “do their job.” Common environmental stressors in the work environment can be stressful to staff and influence job satisfaction and, ultimately, intention to change jobs. Mitigating or eliminating these environmental factors has the potential to improve staff satisfaction and retention. Stress influences nursing job satisfaction and, ultimately, intention to change jobs. PMID:20661062
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Empowerment in the interpersonal field: discourses of acute mental health nurses.
Lloyd, M
2007-08-01
Social policy greatly influences the working environment of mental health nurses but in practice can be difficult to translate. Empowerment of service users is one area that is constantly significant in policy, locally and nationally, yet quite difficult to define in practice. This ethnomethodological study explored the practice of 10 mental health nurses working in an acute admissions unit. Through semi-structured interviews, the nurses were asked to discuss the taken-for-granted methods of empowerment with individual service users, their families and with work colleagues. The results were thematically analysed and compared with international findings, which reflected an awareness among mental health nurses of empowering practice in four areas. These were: Working with mental illness, Making connections, Responsibility and Teamworking.
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Preparedness of final-year Turkish nursing students for work as a professional nurse.
Güner, Perihan
2015-03-01
To determine the preparedness levels of final-year Turkish nursing students starting their careers as professional nurses. The transition from nursing student to professional nurse is challenging. One of the ways to help facilitate this transition is to determine how well students are prepared to start work. There are limited, but conflicting, results on this topic. Mixed-methods study. Undergraduate nursing students (n = 4490) in their final year of study from 74 Turkish universities were eligible to participate in this study. Of these, 1804 total students participated from 38 randomly selected universities. Data were collected through an investigator-developed questionnaire (n = 1804) and focus group interviews (n = 57). Students felt highly prepared to start work (57·6%). Those who were older, male, graduates of a vocational high school or already working as a nurse felt most prepared. Students who felt that their education preparation and resources were adequate felt more prepared. Focus group interviews revealed that students felt confident in their knowledge of educational theory, but not in clinical skills. Students may have felt prepared to start work, but insufficient clinical experience probably contributed to a lack of confidence in their skills. The resources of the school, the quality of the education, and the clinical practice environments were considered most important for the students' perceived preparedness levels. An undergraduate education provides the foundation for successful nurse preparation. A good clinical environment along with a high-quality education programme can help give students more confidence in their skills when they join the nursing workforce. Internship or residency programmes may also facilitate this learning. This is extremely important for safe, high-quality patient care. © 2014 John Wiley & Sons Ltd.
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Workplace bullying in nursing.
Ovayolu, Ozlem; Ovayolu, Nimet; Karadag, Gulendam
2014-09-01
This research was designed to determine whether nurses are bullied by other staff members and the effects of such behaviors on the nurse victims. This study reports on nurses' interpersonal workplace relationships in a culturally unique environment. The study was conducted with 260 nurses working in three public hospitals. Data were collected using a questionnaire. The majority of nurses were female with bachelor's degrees and reported being assigned duties outside their usual responsibilities, held responsible for coworkers' mistakes, and criticized for job performance although they thought they had done their work properly. Most of the nurses who were bullied experienced health and sleep problems,did not want to go to work, and had communication problems with other staff members. Nearly all of the study nurses received psychological support to solve their problems and believed that the best way to prevent bullying was education.
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Clinical supervision of nurses working with patients with borderline personality disorder.
Bland, Ann R; Rossen, Eileen K
2005-06-01
Some nurses describe individuals diagnosed with borderline personality disorder (BPD) as among the most challenging and difficult patients encountered in their practice. As a result, the argument has been made for nursing staff to receive clinical supervision to enhance therapeutic effectiveness and treatment outcomes for individuals with BPD. Formal clinical supervision can focus on the stresses of working in a demanding environment within the work place and enable nurses to accept accountability for their own practice and development (Pesut & Herman, 1999). A psychiatric-mental health clinical nurse specialist can provide individual and/or group supervision for the nursing staff, including education about patient dynamics, staff responses, and treatment team decisions. A clinical nurse specialist also can provide emotional support to nursing staff, which enhances job satisfaction, as they struggle to maintain professional therapeutic behavior with these individuals.
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Nurse retention and satisfaction in Ecuador: implications for nursing administration.
Palmer, Sheri P
2014-01-01
This study explores the characteristics of professional nursing work environments that may affect nursing turnover and satisfaction within a large Ecuadorian hospital. Nursing turnover is a challenge and may compromise patient care. Work dissatisfaction contributes to high turnover. Improving nurse satisfaction can contribute to better patient outcomes. Eighty-eight nurses participated in a quantitative and qualitative survey focusing on nursing satisfaction, turnover and selected organisation characteristics. Issues that may affect nurse satisfaction and turnover were identified using questions from the Nursing Work Index: pay, insufficient number of nurses, undervaluing of nurses by public and the medical team, limited advancement opportunities, lack of autonomy and inflexibility in schedule. Other themes identified from qualitative data are reported. The top factor of decreased satisfaction was low pay as indicated by the Nursing Work Index. The qualitative results showed that low pay was the factor for nurse turnover. Additional factors related to nursing satisfaction can be addressed to improve nurse retention. Along with increasing nursing pay, strategies to consider in decreasing turnover and increasing satisfaction included: providing opportunities for nursing advancement, promoting the value of nursing, creating clinical protocols and enhancing autonomy. This study adds to knowledge about nursing needs and satisfaction in South America. © 2013 John Wiley & Sons Ltd.
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Nurses' work-related stress in China: a comparison between psychiatric and general hospitals.
Qi, Yun-Ke; Xiang, Yu-Tao; An, Feng-Rong; Wang, Jing; Zeng, Jiao-Ying; Ungvari, Gabor S; Newhouse, Robin; Yu, Doris S F; Lai, Kelly Y C; Ding, Yan-Ming; Yu, Liuyang; Zhang, Xiang-Yang; Chiu, Helen F K
2014-01-01
Little is known about the level of work-related stress in nurses in China.This study compared the level of work-related stress between female nurses working in psychiatric and general hospitals in China. A descriptive comparative cross-sectional design was used.A consecutive sample of nurses from two psychiatric hospitals (N = 297) and a medical unit (N = 408) of a general hospital completed a written survey including socio-demographic data and a measure of work-related stress (Nurse Stress Inventory). Compared to the nurses working in the general hospital, those working in the psychiatric setting had a higher level of stress in the domains of working environment and resources (p < .001) and patient care (p < .001), but lower workload and time (p < .001).Multivariate analyses revealed that college or higher level of education(b = .1, p < .001), exposure to violence in the past 6 months (b = .2, p < .001),longer working experience, and working in psychiatric hospitals were associated with high work-related stress (b = .2, p < .001). Considering the harmful effects of work-related stress, specific stress management workshops and effective staff supportive initiatives for Chinese nurses are warranted.
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Jones, Terry L.
2017-01-01
A national campaign is underway to increase the amount of time staff nurses spend at the bedside of hospitalized patients through redesign of the work environment. This kind of work redesign requires robust data depicting what nurses do and how they spend their time. Historically, these kinds of data have been difficult, costly, and time consuming to collect. Wireless capture of data on the movement of humans within the work environment (ie, time and motion) is now possible through radiofrequency identification technology. When small tracking devices the size of a quarter are affixed to their clothing, the movement of nurses throughout a patient care unit can be monitored. The duration and frequency of patient interaction are captured along with the duration of time spent in other locations of interest to include nurses’ station, supply room, medication room, doctors’ station, electronic documentation stations, family waiting rooms, and the hallway. Patterns of nurse movement and time allocation can be efficiently identified, and the effects of staffing practices, workflows, and unit layout evaluated. Integration of radiofrequency identification time and motion data with other databases enables nurse leaders to link nursing time to important cost and quality outcomes. Nurse leaders should explore the usefulness of radiofrequency identification technology in addressing data needs for nurse time and motion. PMID:22592451
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Presenteeism in nursing: An evolutionary concept analysis.
Rainbow, Jessica G; Steege, Linsey M
Presenteeism is an emerging concept in nursing that has been linked to increased health care costs, patient medication errors and falls, and negative nurse well-being. However, prior work has utilized various definitions and antecedents. Clarity on the significance, development, and consequences of presenteeism in nursing is needed. This concept analysis seeks to understand the application of presenteeism within nursing workforce literature and in the broader workforce context. Rodgers' evolutionary concept analysis method was used. The proposed definition of presenteeism as the act of being physically present at work with reduced performance can be attributed to multiple antecedents. These include nurse health, professional identity, work-life balance, and work environment. The prevalence of these antecedents with high rates of presenteeism among nurses and consequences point to the need for interventions. These findings can guide development of future interventions and policies that address the broader context of factors leading to presenteeism. Copyright © 2017 Elsevier Inc. All rights reserved.
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Compassion Satisfaction and Compassion Fatigue Among Critical Care Nurses.
Sacco, Tara L; Ciurzynski, Susan M; Harvey, Megan Elizabeth; Ingersoll, Gail L
2015-08-01
Although critical care nurses gain satisfaction from providing compassionate care to patients and patients' families, the nurses are also at risk for fatigue. The balance between satisfaction and fatigue is considered professional quality of life. To establish the prevalence of compassion satisfaction and compassion fatigue in adult, pediatric, and neonatal critical care nurses and to describe potential contributing demographic, unit, and organizational characteristics. In a cross-sectional design, nurses were surveyed by using a demographic questionnaire and the Professional Quality of Life Scale to measure levels of compassion fatigue and compassion satisfaction. Nurses (n = 221) reported significant differences in compassion satisfaction and compassion fatigue on the basis of sex, age, educational level, unit, acuity, change in nursing management, and major systems change. Understanding the elements of professional quality of life can have a positive effect on work environment. The relationship between professional quality of life and the standards for a healthy work environment requires further investigation. Once this relationship is fully understood, interventions to improve this balance can be developed and tested. ©2015 American Association of Critical-Care Nurses.
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Neonatal Intensive Care Unit Nurses Working in an Open Ward: Stress and Work Satisfaction.
Lavoie-Tremblay, Mélanie; Feeley, Nancy; Lavigne, Geneviève L; Genest, Christine; Robins, Stéphanie; Fréchette, Julie
2016-01-01
There is some research on the impact of open-ward unit design on the health of babies and the stress experienced by parents and nurses in neonatal intensive care units. However, few studies have explored the factors associated with nurse stress and work satisfaction among nurses practicing in open-ward neonatal intensive care units. The purpose of this study was to examine what factors are associated with nurse stress and work satisfaction among nurses practicing in an open-ward neonatal intensive care unit. A cross-sectional correlational design was used in this study. Participants were nurses employed in a 34-bed open-ward neonatal intensive care unit in a major university-affiliated hospital in Montréal, Quebec, Canada. A total of 94 nurses were eligible, and 86 completed questionnaires (91% response rate). Descriptive statistics were computed to describe the participants' characteristics. To identify factors associated with nurse stress and work satisfaction, correlational analysis and multiple regression analyses were performed with the Nurse Stress Scale and the Global Work Satisfaction scores as the dependent variables. Different factors predict neonatal intensive care unit nurses' stress and job satisfaction, including support, family-centered care, performance obstacles, work schedule, education, and employment status. In order to provide neonatal intensive care units nurses with a supportive environment, managers can provide direct social support to nurses and influence the culture around teamwork.
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[Nursing motivation leadership].
Chen, Ia-Ling; Hung, Chich-Hsiu
2007-02-01
The concept of "patients treated as guests" is emphasized in today's medical service and patient-center nursing care. However, with rapid changes in health insurance and hospital accreditation systems as well as increasing consumer awareness, the nurse manager must both efficiently relieve the working pressure of nurses and motivate them. However, it would be an extreme challenge for nurse managers to build a team in which each member works in a self-fulfilling work environment and achieves a high quality of care. This article presents several theories and techniques that relate to motivation strategies. These strategies can serve as a guide and a reference for nurse managers to inspire teamwork and raise morale. It can be expected that increasing nurse satisfaction, performance, and care quality will decrease turnover and desertion rates. Hopefully, this article will assist nurse managers to become better leaders and to achieve success in providing efficient services and good of nursing care quality.
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Working with difference: Thematic concepts of Japanese nurses working in New Zealand.
Healee, David; Inada, Kumiko
2016-03-01
The purpose of this study was to compare the differences experienced by Japanese nurses working in New Zealand from an organizational and personal perspective, using a qualitative approach. Interview data was analyzed using a thematic method to abstract increasing levels of themes until one main theme explained the data: finding a voice. This core theme demonstrated that Japanese nurses had to learn to accommodate difference while learning to speak up. Moreover, this needed to occur through a number of cultural filters. The principal conclusion was that migrant nurses face multiple personal and organizational challenges when working in a new environment. Finding a voice is the method in which nurses learn to communicate and work within new healthcare settings. Nurses use a number of filters to manage the transition. The host country needs to recognize these differences and accommodate them through orientation modules. © 2015 Wiley Publishing Asia Pty Ltd.
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Amarneh, Basil Hameed
2017-01-29
The concept of "work stressors" has been well studied. However, in the field of nursing, studies concerning social support behaviors are limited. The aim of this study was to compare nurse work stressors, social support behaviors, and predictors of these variables among nurses in Jordanian teaching and non-teaching hospitals. A convenience sampling technique and a comparative quantitative research design were used in the current study. Two hundred and ninety-one nurses were recruited from five teaching hospitals, and 172 were recruited from eight non-teaching hospitals in Jordan. The Nursing Stress Scale (NSS) and the Inventory of Social Supportive Behaviors (ISSB) were used to collect data. The studied variables differed across hospitals. In some subscales, as well as in some individual items of the scales, nurse work stressors and social support behaviors differed between teaching and non-teaching hospitals. In teaching hospitals, the work shift was the only predictor of nurses' work stressors, whereas the work shift and model of nursing care were predictors of social support behaviors. In non-teaching hospitals, the work shift, level of education, and model of nursing care were predictors of nurse work stressors. Predictors of social support behaviors were marital status, model of nursing, and organizational structure. Regardless of the type of hospital, nurse stressors should be assessed and, once identified, managed by providing various social support behaviors. By turning a work environment into a healthy workplace, researchers and nurse leaders believe that improvements can be realized in recruitment and patient safety and quality.
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Backhaus, Ramona; Rossum, Erik van; Verbeek, Hilde; Halfens, Ruud J G; Tan, Frans E S; Capezuti, Elizabeth; Hamers, Jan P H
2017-01-01
A lack of relationship between direct care staffing levels and quality of care, as found in prior studies, underscores the importance of considering the quality of the work environment instead of only considering staff ratios. Only a few studies, however, have combined direct care staffing with work environment characteristics when assessing the relationship with quality of care in nursing homes. To examine the relationship between direct care staffing levels, work environment characteristics and perceived quality of care in Dutch nursing homes. Cross-sectional, observational study in cooperation with the Dutch Prevalence Measurement of Care Problems. Twenty-four somatic and 31 psychogeriatric wards from 21 nursing homes in the Netherlands. Forty-one ward managers and 274 staff members (registered nurses or certified nurse assistants) from the 55 participating wards. Ward rosters were discussed with managers to obtain an insight into direct care staffing levels (i.e, total direct care staff hours per resident per day). Participating staff members completed a questionnaire on work environment characteristics (i.e., ward culture, team climate, communication and coordination, role model availability, and multidisciplinary collaboration) and they rated the quality of care in their ward. Data were analyzed using multilevel linear regression analyses (random intercept). Separate analyses were conducted for somatic and psychogeriatric wards. In general, staff members were satisfied with the quality of care in their wards. Staff members from psychogeriatric wards scored higher on the statement 'In the event that a family member had to be admitted to a nursing home now, I would recommend this ward'. A better team climate was related to better perceived quality of care in both ward types (p≤0.020). In somatic wards, there was a positive association between multidisciplinary collaboration and agreement by staff of ward recommendation for a family member (p=0.028). In psychogeriatric wards, a lower score on market culture (p=0.019), better communication/coordination (p=0.018) and a higher rating for multidisciplinary collaboration (p=0.003) were significantly associated with a higher grade for overall quality of care. Total direct care staffing, adhocracy culture, hierarchy culture, as well as role model availability were not significantly related to quality of care. Our findings suggest that team climate may be an important factor to consider when trying to improve quality of care. Generating more evidence on which work environment characteristics actually lead to better quality of care is needed. Copyright © 2016 Elsevier Ltd. All rights reserved.
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The contribution of hospital nursing leadership styles to 30-day patient mortality.
Cummings, Greta G; Midodzi, William K; Wong, Carol A; Estabrooks, Carole A
2010-01-01
Nursing work environment characteristics, in particular nurse and physician staffing, have been linked to patient outcomes (adverse events and patient mortality). Researchers have stressed the need for nursing leadership to advance change in healthcare organizations to create safer practice environments for patients. The relationship between styles of nursing leadership in hospitals and patient outcomes has not been well examined. The purpose of this study was to examine the contribution of hospital nursing leadership styles to 30-day mortality after controlling for patient demographics, comorbidities, and hospital factors. Ninety acute care hospitals in Alberta, Canada, were categorized into five styles of nursing leadership: high resonant, moderately resonant, mixed, moderately dissonant, and high dissonant. In the secondary analysis, existing data from three sources (nurses, patients, and institutions) were used to test a hypothesis that the styles of nursing leadership at the hospital level contribute to patient mortality rates. Thirty-day mortality was 7.8% in the study sample of 21,570 medical patients; rates varied across hospital categories: high resonant (5.2%), moderately resonant (7.4%), mixed (8.1%), moderately dissonant (8.8%), and high dissonant (4.3%). After controlling for patient demographics, comorbidities, and institutional and hospital nursing characteristics, nursing leadership styles explained 5.1% of 72.2% of total variance in mortality across hospitals, and high-resonant leadership was related significantly to lower mortality. Hospital nursing leadership styles may contribute to 30-day mortality of patients. This relationship may be moderated by homogeneity of leadership styles, clarity of communication among leaders and healthcare providers, and work environment characteristics.
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What implies the good work for registered nurses in municipal elderly care in Sweden?
Josefsson, Karin; Aling, Jenny; Östin, Britt-Louise
2011-08-01
The aim was to describe registered nurses' perceptions of what the good work implies to them in municipal elderly care. A descriptive design and a structured questionnaire specifically designed for this study were used. Sixty housing units for older people and 213 nurses participated, with a response rate of 62%. The good work included the following aspects: intellectually stimulating without guilt feelings; freedom and independence with the possibility to influence; having appreciative and pleasant fellow workers and a fair and understanding manager; a good physical and risk-free environment; work security and a steady income with the possibility of improving salary through work effort; work effort should be beneficial to others; innovative thinking and initiative should be highly valued; and pride in work without compromising personal values. Employers must take this into consideration to retain those nurses already employed and recruit nurses to municipal elderly care.
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The Different Facets of Work Stress: A Latent Profile Analysis of Nurses' Work Demands.
Jenull, Brigitte B; Wiedermann, Wolfgang
2015-10-01
Work-related stress has been identified as a relevant problem leading to negative effects on health and quality of life. Using data from 844 nurses, latent profile analyses (LPA) were applied to identify distinct patterns of work stress. Several sociodemographic variables, including nurses' working and living conditions, as well as nurses' reactions to workload, were considered to predict respondents' profile membership. LPA revealed three distinct profiles that can be distinguished by a low, moderate, and higher stress level. Being financially secure is positively related to the low stress profile, whereas working in an urban area and having low job satisfaction increases the chance of belonging to the higher stress profile. Our results can be used as a basis to develop interventions to create a healthy nursing home environment by supporting the balance between family and work, providing access to job resources and optimizing recovery opportunities. © The Author(s) 2013.
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Lin, Shou-Ju; Huang, Lain-Hua
2014-08-01
The practice environment for nurses has seen tremendous change over the past century due to the dedication and trailblazing work of nursing pioneers. This article describes how the nursing practice environment in Taiwan has evolved over this period. References used include nursing narratives, hospital accreditation standards, standard operating procedures, workplace safety standards, and worksite-related values and expectations. The efforts of the professional nursing community to realize a positive practice environment are further discussed. Over this century of change, the only thing that has remained unchanged is the commitment of nurses to "treat patients as one's own family". In the current as well as the previous periods of manpower shortages in nursing, the nursing community has managed to turn crisis into opportunity by using the situation to enhance pay and benefits. Nursing professionalism is widely respected and recognized throughout Taiwan society. The rapidly changing needs of the 21st century in aspects such as the advancement of high technology, the rapid growth of the elderly population, and the fast rate of social change seriously impact the development of the nursing profession. How to effectively apply high technology, simplify workflows, provide high quality and humanistic nursing care, build safe and quality workplaces, attract bright nursing students, and provide healthcare for the entire population will remain the responsibilities of nursing for generations to come.
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Leineweber, C; Chungkham, H S; Westerlund, H; Tishelman, C; Lindqvist, R
2014-05-01
The present shortage of registered nurses (RNs) in many European countries is expected to continue and worsen, which poses a substantial threat to the maintenance of healthcare in this region. Work-family conflict is a known risk factor for turnover and sickness absence. This paper empirically examines whether the nurse practice environment is associated with experienced work-family conflict. A multilevel model was fit with the individual RN at the 1st, and the hospital department at the 2nd level using cross-sectional RN survey data from the Swedish part of RN4CAST, an EU 7th framework project. The data analyzed here is based on a national sample of 8356 female and 592 male RNs from 369 hospital departments. We found that 6% of the variability in work-family conflict experienced by RNs was at the department level. Organizational level factors significantly accounted for most of the variability at this level with two of the work practice environment factors examined, staffing adequacy and nurse involvement in hospital affairs, significantly related to work-family conflict. Due to the design of the study, factors on ward and work group levels could not be analyzed, but are likely to account for additional variance which in the present analysis appears to be on the individual level, with private life factors likely explaining another major part. These results suggest that higher level organizational factors in health care have a significant impact on the risk of work-family conflict among RNs through their impact on the nurse practice environment. Lower level organizational factors should be investigated in future studies using hierarchical multilevel sampling. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Experiences of Iranian Nurses that Intent to Leave the Clinical Nursing: a Content Analysis
Valizadeh, Leila; Zamanzadeh, Vahid; Habibzadeh, Hosein; Alilu, Leyla; Gillespie, Mark; Shakibi, Ali
2016-01-01
Introduction: Despite the current shortage of nurses, it is important to know the reasons nurses want to leave the clinical setting. The purpose of this study was to explore the experiences of nurses who intend to leave clinical nursing. Methods: In a qualitative content analysis study, data obtained from 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to the Tabriz and Urmia University of Medical Sciences in Iran, selected through purposive sampling. A conventional content analysis was used for data analysis. Results: Four categories and eleven subcategories emerged during data analysis. The extracted categories and sub categories consisted of (I) Entry routes into nursing (implicitly entry, targeted entry), (II) Defects in dignity (lack of professional vision toward the nurses, social status of nurses), (III) Work in non-ideal working environment (lack of support, discrimination, conflict, lack of opportunities for advancement), and (IV) Dissatisfaction with working conditions (heavy workload, lack of power, unusual working hours). Conclusion: The findings of this qualitative study reflect professional turnover as a complex, ongoing, multidimensional process. By identifying the factors responsible, it could be possible to retain nurses in the field. PMID:27354981
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ERIC Educational Resources Information Center
Shugart, Kelli Palmer
2017-01-01
Because of the limited research on the perceptions of nursing faculty on horizontal violence, this convergent mixed method study investigated the phenomenon of bullying behaviors among nursing faculty and the faculty's intent to stay in academe following exposure to bullying. 300 nursing faculty members of the Nursing Educator Discussion list…
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Interventions aimed at improving the nursing work environment: a systematic review
2010-01-01
Background Nursing work environments (NWEs) in Canada and other Western countries have increasingly received attention following years of restructuring and reported high workloads, high absenteeism, and shortages of nursing staff. Despite numerous efforts to improve NWEs, little is known about the effectiveness of interventions to improve NWEs. The aim of this study was to review systematically the scientific literature on implemented interventions aimed at improving the NWE and their effectiveness. Methods An online search of the databases CINAHL, Medline, Scopus, ABI, Academic Search Complete, HEALTHstar, ERIC, Psychinfo, and Embase, and a manual search of Emerald and Longwoods was conducted. (Quasi-) experimental studies with pre/post measures of interventions aimed at improving the NWE, study populations of nurses, and quantitative outcome measures of the nursing work environment were required for inclusion. Each study was assessed for methodological strength using a quality assessment and validity tool for intervention studies. A taxonomy of NWE characteristics was developed that would allow us to identify on which part of the NWE an intervention targeted for improvement, after which the effects of the interventions were examined. Results Over 9,000 titles and abstracts were screened. Eleven controlled intervention studies met the inclusion criteria, of which eight used a quasi-experimental design and three an experimental design. In total, nine different interventions were reported in the included studies. The most effective interventions at improving the NWE were: primary nursing (two studies), the educational toolbox (one study), the individualized care and clinical supervision (one study), and the violence prevention intervention (one study). Conclusions Little is known about the effectiveness of interventions aimed at improving the NWE, and published studies on this topic show weaknesses in their design. To advance the field, we recommend that investigators use controlled studies with pre/post measures to evaluate interventions that are aimed at improving the NWE. Thereby, more evidence-based knowledge about the implementation of interventions will become available for healthcare leaders to use in rebuilding nursing work environments. PMID:20423492
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Understanding skill acquisition among registered nurses: the 'perpetual novice' phenomenon.
Wilson, Barbara; Harwood, Lori; Oudshoorn, Abe
2015-12-01
To determine whether the perpetual novice phenomenon exists beyond nephrology nursing where it was first described. The perpetual novice is a state in which nurses are unable to progress from a novice to an expert in one or more essential clinical skills which are used in their practice area. Maintaining clinical competence is essential to quality patient care outcomes. An exploratory, sequential, mixed methods design was used, comprised of a quantitative component followed by in-depth interviews. Registered nurses employed in one of four roles were recruited from two university-affiliated hospitals in London, Ontario, Canada: Clinical Educator, Clinical Nurse Specialist, Advanced Practice Nurse and Nurse Practitioner. Participants were first asked to complete and return a survey and demographic questionnaire. Following the return of the completed surveys, ten participants were interviewed to enhance the results of the surveys. The results of the surveys confirmed that the perpetual novice phenomenon exists across multiple nursing care areas. Four contributing factors, both personal and structural in nature, emerged from the interviews: (1) opportunities for education, (2) the context of learning, (3) personal motivation and initiative to learn and (4) the culture of the units where nurses worked. The perpetual novice phenomenon exists due to a combination of both personal factors as well as contextual factors in the work environment. The results assist in directing future educational interventions and provide nursing leaders with the information necessary to create work environments that best enable practicing nurses to acquire and maintain clinical competence. © 2015 John Wiley & Sons Ltd.
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Sustaining the rural workforce: nursing perspectives on worklife challenges.
Hunsberger, Mabel; Baumann, Andrea; Blythe, Jennifer; Crea, Mary
2009-01-01
Concerns have been raised about the sustainability of health care workforces in rural settings. According to the literature, rural nurses' work satisfaction varies with the resources and supports available to respond to specific challenges. Given the probable effects of stressors on retention, it is essential to understand the unique requirements of nurses in rural practice environments. To investigate whether nurses receive the resources and supports necessary to meet the challenges of rural practice. Semi-structured interviews were conducted with 21 managers and 44 staff nurses in 19 selected rural hospitals in Ontario, Canada. The interviews were taped and transcripts interpreted through a thematic analysis. Major worklife themes were identified and analyzed within a healthy work environment model based on the work of Kristensen. Three interrelated dimensions of the model were relevant to workforce sustainability: the balance between demands and the resources of the person, the level of social support, and the degree of influence. The availability of resources and supports affected whether the nurses perceived challenges as stimulating or overwhelming. Deficits interfered with practice and the well-being of the nurses and patients. The nurses felt frustrated and powerless when they lacked resources, support, and influence to manage negative situations. Strategies to achieve workforce sustainability include resources to reduce stress in the workplace, education to meet the needs of new and experienced nurses, and offering of employment preferences to the workforce. Addressing resources, support, and influence of rural nurses is essential to alleviate workplace challenges and sustain the rural nursing workforce.
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Nursing Unit Environment Associated with Provision of Language Services in Pediatric Hospices.
Lindley, Lisa C; Held, Mary L; Henley, Kristen M; Miller, Kathryn A; Pedziwol, Katherine E; Rumley, Laurie E
2017-04-01
Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1251 pediatric hospice agencies. Variable selection was guided by structural contingency theory, which posits that organizational effectiveness is dependent upon how well an organization's structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. The majority of hospices provided translation services (74.9 %) and interpreter services (87.1 %). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Findings indicate that nursing unit environment predicts provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staffs who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency and ultimately reduce ethnic disparities in end-of-life care for children and their families.
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Nursing unit environment associated with provision of language services in pediatric hospices
Lindley, Lisa C.; Held, Mary L.; Henley, Kristen M.; Miller, Kathryn A.; Pedziwol, Katherine E.; Rumley, Laurie E.
2016-01-01
Background Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Methods Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1,251 pediatric hospice agencies. Variable selection was guided by Structural Contingency Theory, which posits that organizational effectiveness is dependent upon how well an organization’s structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. Results The majority of hospices provided translation services (74.9%) and interpreter services (87.1%). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Conclusions Findings indicate that nursing unit environment predict provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staff who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency, and ultimately reduce ethnic disparities in end-of-life care for children and their families. PMID:27059050
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Ajeigbe, David O; McNeese-Smith, Donna; Leach, Linda Searle; Phillips, Linda R
2013-03-01
Teamwork is essential to safety. Few studies focus on teamwork between nurses and physicians in emergency departments (EDs). The aim of this study was to examine differences between staff in the interventional group EDs (IGEDs) and control group EDs (CGEDs) on perception of job environment, autonomy, and control over practice. This was a comparative cross-sectional study of the impact of teamwork on perceptions of job environment, autonomy, and control over practice by registered nurses and physicians (MDs) in EDs. Staff in the IGEDs showed significant differences compared with staff who worked in the CGEDs on staff perception of job environment, autonomy, and control over practice. Active teamwork practice was associated with increased perceptions of a positive job environment, autonomy, and control over practice of both nurses and physicians.
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Nurses' work role in the context of gender and Chinese culture: an online forum study.
Liu, Yi
2010-06-01
Nurses in Taiwan are seen as "angels in white." This image conveys that nurses are caring, kind, patient, and full of love. Another popular image of nurses is that of a candle, which implies that nurses bring light to others by sacrificing their "self." These images also reflect accurately the traditional role of women in the Chinese patriarchal society. Hence, gender and culture effects on nurses' perceptions of their work role cannot be ignored. The purpose of this article was to explore nurses' perceptions of their work role on the basis of the perspectives of Chinese gender role and culture. This study was conducted using a Web-based online forum for 4 weeks. Twenty nurses completed discussions of questions in four topic areas. Thematic analysis was used to analyze data. Three themes were identified: (a) gendered work, (b) low social status, and (c) tensions among nurses. Findings indicate that certain stereotypes regarding gender roles in Taiwanese society constrained the professional growth of nurses and nursing. The social status of nurses was found to be relatively low, and nurses were at a relatively high risk of developing powerless behaviors. Nursing leaders and administrators should understand the impact of gender and Chinese culture on nursing and pay attention to the situation of nurses to provide more gender-sensitive and positive work environments for nurses.
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Exploring Shared Governance for an Academic Nursing Setting.
Boswell, Carol; Opton, Laura; Owen, Donna C
2017-04-01
A beneficial work environment influences staff and employee satisfaction and contributes to enhanced organizational execution. This article communicates a literature review of the existing knowledge to describe the potential influence of job satisfaction, empowerment, and work engagement on a faculty and staff academic shared governance model and impact on the improvement of a healthy work environment. References from PubMed (from 1975 to 2014) and ERIC (from 2006 to 2016), along with manuscripts included in the reference lists of the selected articles, served as the basis of the review. Definitions and descriptions of shared governance in academic settings suggested the potential influence on the development of a faculty and staff shared governance model within a school of nursing on job satisfaction, empowerment, and work engagement, resulting in the maintenance of a healthy work environment. This shift is essential for the resilience of nursing academia and the building of novel, more inclusive approaches to innovation that tap into the talent and skill of all organizational members. [J Nurs Educ. 2017;56(4):197-203.]. Copyright 2017, SLACK Incorporated.
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Guevara, Edilma B; Mendias, Elnora P
2002-11-01
To identify changes in nursing practice and the nursing-practice environment that have occurred with implementation of health sector reform in five countries in the Americas. An exploratory study of selected settings in Argentina, Brazil, Colombia, Mexico, and the United States of America was conducted between 1997 and 1999 to collect narrative data from 125 professional nurses about their perceptions of nursing practice and changes in work environments. Descriptions of characteristics and trends in nursing practice in the study sites were also obtained. Reorganization of health services has occurred in all five of the countries, responding to health sector reform initiatives and affecting nursing practice in each country. Respondents from all five countries mentioned an emphasis on private enterprise, changes in payment systems for patients and providers, redistributions in the nursing workforce, changes in the personnel mix and nursing-practice functions, work shifting from the hospital to the community, and greater emphasis on cost control and prevention in practice settings. The study provides initial information about current nursing issues that have arisen as a result of health care reform initiatives. Regardless of differences in service models or phases of health sector reform implementation, in all the countries the participating nurses identified many common themes, trends, and changes in nursing practice. The driving forces for change and their intensity have been different in the five countries. Nurses maintain their core values despite increased work stress and greater patient care needs in all the countries as well as economic crises in the Latin American countries.
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Wang, Ying; Dong, Weizhen; Mauk, Kristen; Li, Peiying; Wan, Jin; Yang, Guang; Fang, Lyuying; Huan, Wan; Chen, Chun; Hao, Mo
2015-01-01
Aim To examine the job satisfaction of nurses who are caring for older adults in healthcare settings in Shanghai, and to explore the underlying factors in order to explain and predict nurses’ job satisfaction. Background China has the largest elderly population in the world, and its population is aging rapidly. Studies on job satisfaction of nurses providing care for the elderly in China can help to identify problem areas and develop strategies for the improvement of nurses’ working conditions. However, to date, this subject matter has not been thoroughly studied in the Chinese context. Previous studies in other countries show that many factors impact nurses’ job satisfaction, with the practice environment being a critical factor. There is a serious nursing shortage in China, especially in the big cities such as Shanghai. Given the increasing care demand of the aging population, learning about the job satisfaction level among nurses who are caring for older adults can provide essential information to help attract and retain nurses in this specialty area. Methods A cross-sectional survey was conducted among 444 nurses in 22 elderly care institutions in Shanghai. The Chinese version of the Index of Work Satisfaction (IWS) and the Nursing Practice Environment Scale were instruments used. Inferential statistical tests used to analyze the data included Spearman correlation analysis, one-way analysis of variance, and hierarchical regression tests. Results The average overall IWS (part B) score was 135.21 ± 19.34. Personality, job and organizational characteristics were found to be the most influential factors, and the practice environment was identified as having the strongest impact on job satisfaction (Beta = 0.494). Conclusion Job satisfaction level among nurses who are caring for older adults in Shanghai is moderate, but the data suggest that this could be greatly increased if the nursing practice environment was improved. PMID:26380980
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Amarneh, Basil Hameed
2017-01-01
Purpose: The concept of “work stressors” has been well studied. However, in the field of nursing, studies concerning social support behaviors are limited. The aim of this study was to compare nurse work stressors, social support behaviors, and predictors of these variables among nurses in Jordanian teaching and non-teaching hospitals. Design: A convenience sampling technique and a comparative quantitative research design were used in the current study. Two hundred and ninety-one nurses were recruited from five teaching hospitals, and 172 were recruited from eight non-teaching hospitals in Jordan. Methods: The Nursing Stress Scale (NSS) and the Inventory of Social Supportive Behaviors (ISSB) were used to collect data. Results: The studied variables differed across hospitals. In some subscales, as well as in some individual items of the scales, nurse work stressors and social support behaviors differed between teaching and non-teaching hospitals. In teaching hospitals, the work shift was the only predictor of nurses’ work stressors, whereas the work shift and model of nursing care were predictors of social support behaviors. In non-teaching hospitals, the work shift, level of education, and model of nursing care were predictors of nurse work stressors. Predictors of social support behaviors were marital status, model of nursing, and organizational structure. Conclusions: Regardless of the type of hospital, nurse stressors should be assessed and, once identified, managed by providing various social support behaviors. Clinical relevance: By turning a work environment into a healthy workplace, researchers and nurse leaders believe that improvements can be realized in recruitment and patient safety and quality. PMID:28146045
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Occupational stress, Type A behavior, and physical well being.
Ivancevich, J M; Matteson, M T; Preston, C
1982-06-01
In the context of a person-environment fit framework, organizational level and the Type A behavior pattern of managers were found to moderate the stressor, satisfaction, and physiology associations. For nurses, Type A behavior pattern was a much more significant moderator of the person-environment fit than were the nurses' specialty work activities.
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[Conflict management: challenges experienced by nurse-leaders in the hospital environment].
Amestoy, Simone Coelho; Backes, Vânia Marli Schubert; Thofehrn, Maira Buss; Martini, Jussara Gue; Meirelles, Betina Hörner Schlindwein; Trindade, Letícia de Lima
2014-06-01
This study aimed to understand the main conflicts experienced by nurses-leaders in the hospital environment, as well as the strategies adopted to face them.The study reflects a qualitative descriptive type approach, which was used in the case study as research strategy. The study included 25 nurses who worked in three hospitals in the city of Florianopolis, Santa Catarina. Information where obtained in the months of May to December of 2010 through semi-structured interviews, non-participant observation and dialogical workshops. Data were analyzed using the Thematic Analysis. The results demonstrated the predominant of interpersonal conflicts involving the multidisciplinary team, nurses and the nursing staff Adopting a participatory leadership, based on dialogue emerges as a strategy for coping with conflicts in the hospital environment.
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Is work stress in palliative care nurses a cause for concern? A literature review.
Peters, Louise; Cant, Robyn; Sellick, Kenneth; O'Connor, Margaret; Lee, Susan; Burney, Sue; Karimi, Leila
2012-11-01
Palliative care nurses are at risk of work stress because their role involves exposure to frequent deaths and family grieving. Little is known about their degree of stress or whether they suffer stress or burnout more than nurses in other disciplines. The aim of this paper is to critically examine the current literature concerning stress and burnout in palliative care nurses. Sixteen papers were included in the review. Although work demands were a common cause of stress in the studies reported, there was no strong evidence that palliative care or hospice nurses experienced higher levels of stress than nurses in other disciplines. Common causes of stress were the work environment, role conflict, and issues with patients and their families. Constructive coping styles appeared to help nurses to manage stress. Managers have a key role in providing education and training for palliative care nurses to support their personal development and to help reduce vulnerability to and the impact of stress in the workplace.
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Karsh, B; Booske, B C; Sainfort, F
2005-08-15
The purpose of this study was to examine whether job characteristics, the work environment, participation in quality improvement activities and facility quality improvement environment predicted employee commitment and job satisfaction in nursing homes, and whether those same predictors and commitment and satisfaction predicted turnover intention. A total of 6,584 nursing home employees from 76 nursing homes in a midwestern state participated. A self-administered questionnaire was used to collect the data. The results supported the hypotheses that job and organizational factors predicted commitment and satisfaction while commitment and satisfaction predicted turnover intentions. The implications for retaining nursing home employees are discussed.
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Exploration of the facilitators of and barriers to work engagement in nursing.
Freeney, Yseult M; Tiernan, Joan
2009-12-01
Engagement is couched as the opposite to burnout and while there have been numerous studies that have supported the relationship between organizational antecedents and employee engagement, nurse engagement is still inadequately understood. Recent papers in the nursing literature have called for more research on this construct to be conducted with nurses so that nurse leaders can be better informed about the impact of engagement on outcomes for the organization. To explore nurses' experiences of their work environments and to reveal factors in the workplace that may facilitate or act as barriers to nurse engagement. A qualitative methodology was employed with the data from focus groups with a total of 20 nurses working in both general and psychiatric nursing. Facilitators of and barriers to engagement center around six areas of organizational life, namely; workload, control, reward, fairness, community and values. Interventions aimed at fostering engagement are called for and through future research in the area of engagement, it is believed that nurses will gain more positive experiences from their work and subsequently a greater sense of well-being.
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We cannot staff for 'what ifs': the social organization of rural nurses' safeguarding work.
MacKinnon, Karen
2012-09-01
Rural nurses play an important role in the provision of maternity care for Canadian women. This care is an important part of how rural nurses safeguard the patients who receive care in small rural hospitals. This study utilized institutional ethnography as an approach for describing rural nursing work and for exploring how nurses' work experiences are socially organized. Rural nurses advocated for safe healthcare environments by ensuring that skilled nurses were available for every shift, day and night, at their local hospital. Rural nurses noted that this work was particularly difficult for the provision of maternity care. This article explores two threads or cues to institutional organization that were identified in our interviews and observations; namely staffing and safety standards, and the need for flexibility in staffing in small rural hospitals. Rural nurses' concerns about ensuring that skilled nurses are available in small rural hospitals do not enter into current management discourses that focus on efficiency and cost savings or find a home within current discourses of patient safety 'competencies'. © 2011 Blackwell Publishing Ltd.
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Evaluating the late career nurse initiative: a cross-sectional survey of senior nurses in Ontario.
Doran, Diane; Jeffs, Lianne; Rizk, Paul; Laporte, Daniel R; Chilcote, Autumn Marie; Bai, Yu Qing
2015-10-01
This study evaluated the impact of the late career nurse initiative on nurse perceptions of their work environment, workplace burnout, job satisfaction, organisational commitment and intention to remain. The Ontario Ministry of Health and Long-Term Care introduced the late career nurse initiative with the goal of improving the retention of front-line nurses aged 55 and over by implementing a 0.20 full-time equivalent reduction of physically or psychologically demanding duties, enabling nurses to engage in special projects for the improvement of their organisations and patient care. A sample of 902 nurses aged 55 and over from acute and long-term care facilities were surveyed using valid and reliable questionnaires. Nurses who had participated in the initiative did not differ significantly from those who had not in terms of workplace burnout, job satisfaction, length of service or intention to remain within their current organisation. The late career nurse initiative participants reported significantly higher perceptions of managers' ability, leadership and support and their level of participation in hospital affairs. The late career nurse initiative was associated with perceived differences in nurses' work environment but not outcomes. Leaders need to pay attention to how late career nurses are selected and matched to organisational projects. © 2014 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.
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Nowrouzi, B; Rukholm, E; Larivière, M; Carter, L; Koren, I; Mian, O
2015-01-01
Literature from the past two decades has presented an insufficient amount of research conducted on the nursing practice environments of registered practical nurses (RPNs). The objective of this article was to investigate the barriers and facilitators to sustaining the nursing workforce in north-eastern Ontario (NEO), Canada. In particular, retention factors for RPNs were examined. This cross-sectional research used a self-administered questionnaire. Home addresses of RPNs working in NEO were obtained from the College of Nurses of Ontario (CNO). Following a modified Dillman approach with two mail-outs, survey packages were sent to a random sample of RPNs (N=1337) within the NEO region. Logistic regression analyses were used to determine intent to stay (ITS) in relation to the following factor categories: demographic, and job and career satisfaction. Completed questionnaires were received from 506 respondents (37.8% response rate). The likeliness of ITS in the RPNs' current position for the next 5 years among nurses aged 46-56 years were greater than RPNs in the other age groups. Furthermore, the lifestyle of NEO, internal staff development, working in nursing for 14-22.5 years, and working less than 1 hour of overtime per week were factors associated with the intention to stay. Having an understanding of the work environment may contribute to recruitment and retention strategy development. The results of this study may assist with addressing the nursing shortage in rural and northern areas through improved retention strategies of RPNs.
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Insights from a national study.
Kulig, Judith C; Stewart, Norma J; Morgan, Debra; Andrews, Mary Ellen; MacLeod, Martha L P; Pitblado, J Roger
2006-04-01
Aboriginal registered nurses have been identified as an essential group in the delivery of health services in First Nations communities. Despite this, there is a lack of information about this group of nurses in Canada. This article presents information about this group taken from two components of a national study, The Nature of Nursing Practice in Rural and Remote Canada: documentary analysis and a national survey of nurses. The aboriginal nurse participants were predominantly female, between the ages of 40 and 49, diploma prepared and with licensure for less than 10 years. The survey data showed 41.4 per cent returned to their home communities to work. The participants noted how they enjoyed the challenges of rural and remote nursing and wanted to raise their families in these small communities. They have been able to create supportive work environments, particularly with their nursing colleagues. The nurses are committed to working in rural and remote communities.