Age, developmental, and job stage influences on nurse outcomes

This descriptive study surveyed 412 nurses in three hospitals and found that older nurses and nurses in more mature developmental stages showed greater job satisfaction, productivity, and organizational commitment. Job stages of entry, mastery, and disengagement were examined, and 24% of nurses reported being disengaged from their jobs, with lower satisfaction and commitment. Implications include the compelling need for nurses and organizations to do career planning together to avoid disengagement of nurses so critical to patient and organizational outcomes.

Job stages of entry, mastery, and disengagement among nurses

OBJECTIVE

To examine the phenomenon of job stages, particularly entry, mastery, and disengagement; to identify predictors of each stage; and to determine when disengagement occurs among nurses.

SUMMARY BACKGROUND DATA

Job or career stages have been conceptualized as an aspect of growth and development and also career growth and change. Graham identified job stages of entry, mastery, and disengagement and theorized that stages are related to time on the job, skill development, and attitudes. They are levels of identification of the self and ego with the job environment. Studies on burnout as well as hardiness were also examined because of their possible relations with job stages.

METHODS

This descriptive survey queried 412 RNs, selected by random sample from three hospitals, to determine their job stage. Demographic characteristics, role, years as a nurse, years in this hospital, years in this job, and job satisfaction, productivity, and organizational commitment were also measured. Data analyses provided frequencies and percentages, and logistic regression was performed to identify predictors of each job stage.

RESULTS

Forty-eight (13%) nurses reported being in the entry stage; 224 (62%) nurses were in mastery. Mastery was predicted by several variables, including U.S. education (negative) and organizational commitment (positive). Eighty-seven (24%) nurses reported being in disengagement, and this was predicted by years in this job and negatively predicted by organizational commitment.

CONCLUSIONS

Strategic planning for mastery and avoidance of disengagement were discussed, and implications for administrators and the profession were presented.

Nursing supply and characteristics in the nonmetropolitan areas of the United States: findings from the 1988 National Sample Survey of Registered Nurses

This study examines the supply and selected characteristics of nurses working in nonmetropolitan areas of the United States using the most recent data reported in the third national sample survey of registered nurses in 1988. Nursing supply is analyzed in terms of the ratio of registered nurses per 100,000 people for three standard nonmetropolitan census county size classifications and nine regional groupings of states. Seven dimensions relating to the educational background and current professional characteristics of registered nurses are studied. Findings indicate a notable difference in the ratio of nurses per population across county size and regions of the country. In terms of characteristics selected for this study, the educational background, salary gap, and time spent in various activities differentiate nurses in rural areas from those working in urban counties. Results of this study should be particularly relevant because a variety of educational, financial, and other incentives are being considered to address what is perceived to be a crisis in rural nursing availability.

Returns to nursing education: rural and nonrural practice

This study uses data from a national sample of registered nurses to compare earnings of nurses in rural and nonrural practice. The comparisons, conditioned by the nurses' education level, are analogous to the concept of "returns to human capital investment" used in labor economics. A general linear model is applied within a framework of labor economics analysis. Results show that nurses with more education receive less for their investment if they practice in rural areas. Work experience and employment setting are also related to lower annualized earnings for rural practice. One exception to the otherwise consistent findings is that returns to advanced practice nursing are higher in rural areas. Results and policy implications are discussed.

The national Healing Web partnership. An innovative model to improve health

The authors describe the Healing Web, a partnership between nursing service and education that encourages the best use of nurses education clinical experience and personal competencies. Based on differentiated practice and education of nursing students in multi-level roles the Healing Web partnership is demonstrating at multiple institutions, that education and nursing service can work collaboratively to position the profession of nursing for maximum effectiveness in the 21st century.

Professional classifications of American nurses, 1910 to 1935

Nursing's claim to professional status is debatable. The purpose of this historical study is to describe the official classifications of American nurses as professionals or nonprofessionals, from 1910 to 1935. Labor legislation before World War I, military decisions during that war, and federal mandates during the Great Depression resulted in differing professional classifications of nurses. Although nurse leaders aspired to traditional criteria of professionalism, such as individual responsibility and a deep, distinct body of knowledge, these criteria were subsumed by political, financial, and gender issues. This study demonstrates that professional status cannot be assured by attainment of professional criteria alone, but is defined by more diverse and complex issues.

Perioperative nurses' attitudes toward continuing education

The primary purpose of this study was to determine perioperative nurses' attitudes toward continuing education (CE) and selected demographic variables. The researcher developed and administered a Likert-type questionnaire to perioperative nurses. The first part of the questionnaire related to demographic variables, length of service at the facility as a registered nurse, and certification status. The second part of the questionnaire was a 30-item attitude scale related to perioperative nurses and CE. The null hypothesis was analyzed using a t-test at a .05 level of significance. Study findings revealed no differences in attitudes toward CE between certified perioperative nurses and noncertified perioperative nurses.

Breaking with tradition: the new groups in professional nursing

Chronic shortages of registered nurses (RNs) have stimulated interest in locating non-traditional sources of RNs. A statewide survey of 2,315 newly graduated RNs compared three non-traditional groups in nursing with their traditional counterparts, identifying differences that have implications for successful recruitment and retention. Second career nurses, former LPNs and minorities comprised 41.9% of the population. Compared to the traditional groups, more second career nurses, former LPNs and some minority groups were older, married and had children. Second career vs. first career nurses placed less emphasis on selecting schools at the highest levels of academic quality, holding out for the most lucrative jobs or working with the most "interesting" patients (i.e., the acutely ill). Former LPNs, compared to other RNs, placed greater value on easy access to schools and jobs. Compared to whites, minority RNs were more inclined to value nursing's socioeconomic rewards. However, compared to non-Asian minorities in nursing, Asian RNs had higher expectations for professional advancement and were less altruistic. Our results indicate that several of the new groups view nursing less as a "calling," finding the field appealing for practical socioeconomic reasons and accessibility.

Temporary alien workers seeking classification under the Immigration and Nationality Act--Immigration and Naturalization Service. Final rule

This final rule implements provisions of the Immigration Act of 1990 (IMMACT). Public Law No. 101-649, November 29, 1990, and the Armed Forces Immigration Adjustment Act of 1991. Public Law No. 102-110, October 1, 1991, as they relate to temporary alien workers seeking nonimmigrant classification and admission to the United States under sections 101(a)(15) (H), (L), (O), and (P) of the Immigration and Nationality Act (Act), 8 U.S.C. 1101. This rule also contains technical amendments which reflect the Service's operating experience under the H and L classifications. This rule will conform Service policy to the intent of Congress as it relates to these classifications, implement new nonimmigrant classifications and requirements established by Public Law 101-649 and Public Law No. 102-110, and clarify for businesses and the general public requirements for classification, admission, and maintenance of status.

Entry: a new approach

Despite all of the protections promised through grandfathering and pathways to educational mobility, the entry movement tends to be perceived by many to be "demoting" the lives and livelihoods of hundreds of thousands of RNs who do not possess the education to meet the proposed standard. Here is a proposal for a way out of the quagmire.

Nursing: just a job? Do statistics tell us what we think?

This study considers the value of classifying attitudinal statements given by nurses in a questionnaire by the statistical procedure of latent class analysis. It demonstrates with the use of qualitative data derived from in-depth interviews how precarious are the groups derived from statistical analysis. However, it is argued that the apparent discrepancies between responses 'objectively' derived by a statistical approach and those 'subjectively' declared by respondents may focus on different levels of meaning and may well provide a useful resource. Most importantly, it is stressed that a dynamic model is needed which recognizes change and the consequences of change.

Differentiated nursing practice: concepts and considerations

Those institutions that have implemented differentiated practice based on clinical competency have increased nursing staff retention and reduced recruitment costs. Less demonstrable are very real improvements in patient safety and care.