Factors influencing satisfaction and anticipated turnover for nurses in an academic medical center

The potential of patient-based nurse staffing - a queuing theory application in the neonatal intensive care setting

Faced by a severe shortage of nurses and increasing demand for care, hospitals need to optimally determine their staffing levels. Ideally, nurses should be staffed to those shifts where they generate the highest positive value for the quality of healthcare. This paper develops an approach that identifies the incremental benefit of staffing an additional nurse depending on the patient mix. Based on the reasoning that timely fulfillment of care demand is essential for the healthcare process and its quality in the critical care setting, we propose to measure the incremental benefit of staffing an additional nurse through reductions in time until care arrives (TUCA). We determine TUCA by relying on queuing theory and parametrize the model with real data collected through an observational study. The study indicates that using the TUCA concept and applying queuing theory at the care event level has the potential to improve quality of care for a given nurse capacity by efficiently trading situations of high versus low workload.

Modeling wellbeing for U.S. correctional nurses: A cross sectional survey

BACKGROUND

Nurses work in stressful environments, and this stress has negative consequences on health. Correctional nurses experience unique job stress in their roles. However, there has been limited research exploring how the correctional environment impacts nurse health and wellbeing.

OBJECTIVE

This study aimed to evaluate the relationship between the variables of organizational characteristics (i.e., job demands, job control, manager support, peer support, workplace relationships), job stress, and wellbeing levels in a sample of U.S. correctional nurses, while exploring socio-demographic covariates.

METHODS

Using a convenience sampling method, 270 U.S. correctional nurses completed a cross-sectional online survey. Informed by the Job Demands-Resources Theory, a conceptual model was created and tested in this sample. Analysis involved multiple linear regression and structural equation modeling.

RESULTS

The model significantly fit the data (CI: 0.71-0.83, CFI = 0.51, SRMR: 0.37, and RMSEA = 0.08) revealing the direct relationship between job stress, job demands, job control, and workplace relationships and wellbeing. This study also provided evidence that job stress mediates the relationship of job control and job demands with wellbeing.

CONCLUSION

Results underscore the opportunity for correctional organizations to consider targeting job demands, job control, workplace relationships, and job stress in future interventions to improve the correctional nursing work environment and support correctional nurse wellbeing.

TWEETABLE ABSTRACT

A recent study found evidence for a relationship between organizational characteristics & job stress and U.S. correctional nurse wellbeing.

The Healthcare Environment Survey: A multicountry psychometric evaluation of nurses' job satisfaction

AIM

To evaluate the properties of a reduced-item Healthcare Environment Survey measuring nurses' job satisfaction across eight countries.

BACKGROUND

There is currently no rigorously tested international measure of nurses' job satisfaction that can be used internationally to improve the nurse work environment.

METHODS

Nursing staff from 11 hospitals in eight countries participated in this study. The original 57-item, 11-facet Healthcare Environment Survey was evaluated for reliability, validity, and measurement invariance: Cronbach's alpha was used to test for reliability; construct, discriminate, and convergent testing were used to test validity; and invariance testing including configural, metric, and scalar tests were used to study measurement invariance between the countries.

RESULTS

2,046 nursing staff completed the survey. Reliability was established for all six subscales and the combined composite score. Both validity and measurement invariance were supported in every test conducted. An excellent model fit was found for the final 19-item, 6-facet Healthcare Environment Survey that explained 82% of the variance of nurses' job satisfaction.

CONCLUSIONS

Findings suggest the instrument is an efficient measure of nurses' job satisfaction across multiple countries. Longitudinal testing for invariance will be needed to ensure the model remains a good fit. Testing more countries will also verify model fit.

IMPLICATIONS FOR NURSING

The instrument can be used to measure nurse job satisfaction globally.

IMPLICATIONS FOR NURSING POLICY

The instrument can be used to assess interventions to improve the social (patient, unit manager, and coworker) and technical (professional rewards, autonomy, and professional growth) aspects of nurse job satisfaction.

Satisfaction, Stress, and Turnover: Comparing U.S. Intensivist Physicians Before and During the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic

To evaluate changes in work satisfaction, work-life balance (WLB) satisfaction, stress, and turnover intention among U.S. critical care physicians during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic of 2021-2022 compared with prepandemic levels in 2016.

DESIGN

A cross-sectional electronic survey.

SETTING

Critical care practices in the United States.

SUBJECTS

U.S. physician members of the Society for Critical Care Medicine.

MEASUREMENTS AND MAIN RESULTS

A total of 1,148 intensivists completed online surveys administered in two waves: in 2016 (693 respondents) and in the late 2021 to early 2022 (455 respondents). They reported demographic and practice characteristics, self-perceived levels of satisfaction, stress, health, and intention to leave their current job. U.S.-based critical care physicians in 2022 report significantly lower levels of job satisfaction compared with 2016. Frequency of work stress and turnover intention also increased, whereas WLB satisfaction has remained the same. Nearly two-thirds of intensivists wish they could work fewer hours, and this discontentment is correlated with decreased satisfaction, increased stress, and increased turnover, particularly in pandemic respondents. More than 25% of physicians rated their mental health as poor or fair, and 20% rated their physical health as poor or fair; these self-ratings correlated with decreased satisfaction and increased stress and turnover intention.

CONCLUSIONS

The SARS-CoV-2 pandemic has further burdened an already-strained critical care workforce. During the pandemic, job satisfaction fell, work stress became more frequent, and turnover intention increased for critical care physicians. They also have consistently low rates of WLB satisfaction. Work hours matter the most for physician satisfaction, stress, and turnover intention, and the desire to work fewer hours is negatively related to all outcomes. Many critical care physicians reported poor mental and physical health during the pandemic, which is strongly and negatively related to all outcomes. These results emphasize the importance of prioritizing the working preferences and the self-care of intensivist physicians.

Impact of Patient Safety Culture on Job Satisfaction and Intention to Leave Among Healthcare Workers: Evidence from Middle East Context

Background

The association between patient safety culture and staff outcomes remains unclear to date. This study aimed to identify the relationship between patient safety culture/job satisfaction and intention to leave among healthcare workers.

Methods

A cross-sectional study was conducted using an online survey. Multinomial logistic regression analysis was used to investigate the association between the safety culture dimensions and the outcomes in terms of job satisfaction and intention to leave.

Results

Majority were females (77.2%); age between (20-30) years were (66.1%). 1-5 years work experience was reported by (98.2%); nurses accounted for (75.7%). (62.1%) reported very good patient safety grade. (78.3%) of respondents had no intention to leave; (84.3%) reported they like their job, (70.5%) stated that working in this hospital is like being part of a large family. However, (38%) said the hospital is not a good place to work, and morale in their clinical area is low. The overall composite scores were highest for "teamwork within hospital units (81.4)", and "organizational learning (79.4)", while lowest for "communication openness (37)",staffing (26.5)", and "non-punitive response to error (22.1)". Females were two times more likely to leave their jobs compared to males (AOR: 2.36, 95% CI: 1.24-3.46); intention to leave was 3.35 (95% CI = 2.19-5.09). As for job satisfaction, ages between 31-40 years tend to like their job two times more than other age groups (AOR: 1.90, 95% CI = 1.02-3.55). The safety culture domains "staffing" and "hospital management support for patient safety" were linked to a higher odds ratio for job satisfaction.

Conclusion

Aside from gender and age, the dimensions of safety culture, including staffing, hospital management support, hospital handover, and transition, may have a signification impact on job satisfaction and intention to leave among healthcare workers.

Effects of workload and job stress on the shift work disorders among nurses: PLS SEM modeling

Nurses, as the largest forces in the health system, are always challenged with various work responsibilities such as long working hours, lack of manpower and death of patients. This study aimed at providing a model of the relationship between workload and physical and mental health, sleep disorders, and individual and family problems by the mediation role of job stress. The present study is a cross-sectional study that was conducted on 300 nurses in a specialty and sub-specialty hospital in Tehran. For this reason, various questionnaires including demographic, survey of shift workers (SOS) and job stress questionnaires were used to collect the desired data. The proposed model was presented using structural equation modeling method based on Smart-PLS and SPSS-20 software. The results show that workload has an effect on job stress (β=0.747), mental health (β=-0.291), Physical health (β=-0.253), sleep quality (β=-0.234) and personal and family problems (β=-0.206). Also the results of this study show that job stress has an effect on mental health (β=-0.295), Physical health (β=-0.349), sleep quality (β=-0.295) and Personal and family problems (β=-0.441). In conclusion, results showed that the data fitted well with the model and that workload is associated with physical and mental problems, sleep disorders and individual and family problems both directly and indirectly through job stress mediation.

The Hybrid Multiple-Criteria Decision-Making Model for Home Healthcare Nurses’ Job Satisfaction Evaluation and Improvement

Objectives: To investigate and evaluate the key factors related to job satisfaction performance of home healthcare nurses (HHNs).

Methods: A total of 31 HHNs from three community hospitals in Zhejiang province were invited to participate in the study. They completed a questionnaire survey based on the home healthcare nurse job satisfaction scale (HHNJS) from February to March 2022. Consistent fuzzy preference relation (CFPR) methods and important-performance analysis (IPA) were used to obtain the attribute weights and performance for HHNs job satisfaction.

Results: The results showed that the attributes of C₁₃, C₁₄, C₁₅, C₂₃, C₂₄, C₄₂, C₅₁, and C₅₂ were key factors influencing HHNs job satisfaction.

Conclusion: The hybrid multiple-criteria decision-making (MCDM) model can help home-healthcare-agency administrators better understand the key factors related to HHNs job satisfaction and establish reasonable improvement strategies.

A scoping review of strategies used to recruit and retain nurses in the healthcare workforce

AIMS

This article reports the results of a scoping review to identify initiatives for improving recruitment and retention of nurses in healthcare and ascertain their effectiveness.

BACKGROUND

The global shortage of nurses has results in greater competition for vacant posts and an increased need to retain existing post holders. While there are a large number of publications discussing ways to improve recruitment and retention, the effectiveness of these need to be established.

EVALUATION

Thirteen papers met the inclusion criteria. There was no literature identified focusing on recruitment and only one paper reported a formal evaluation of a retention initiative.

KEY ISSUES

Five themes summarised the initiatives for retaining nurses: leadership and support; ongoing professional development; recognition; work environment; and flexible scheduling.

CONCLUSION

While strategies have been proposed to retain nurses, there is a dearth of evidence supporting the effectiveness of these.

IMPLICATIONS FOR NURSING MANAGEMENT

Although there is a lack of evaluations of retention strategies, the review identified a number of initiatives that warrant consideration. With the launch of the National Health Service People Plan in England in 2021, which is recommending initiatives identified in this review without robust evidence, an integrated programme of research evaluating this is recommended.

Turnover intention and related factors among resident physicians in China under the standardised residency training programme: a cross-sectional survey

OBJECTIVES

This study aimed at examining the extent of turnover intention among the Chinese resident physicians who entered the newly established national standardised residency training programme (SRTP), and exploring factors associated with their turnover intention.

DESIGN

Cross-sectional survey.

SETTING

Ten institutions from five geographical areas in China.

METHODS

1414 residents were surveyed using paper-based questionnaires and scales regarding their demographics, work situation, attitudes towards SRTP, job satisfaction, psychological resilience, burnout and turnover intention in 2017. The turnover intention was described and compared between categorical groups. Linear regressions were used to select the factors associated with turnover intention. The structural equation model was used to capture the potential mediating effects.

RESULTS

The mean turnover intention score was 12.45 (SD=4.47). Nearly half (47.87%) of the residents had a high and very high level of turnover intention. Psychological resilience (β=0.066), burnout (β=0.141) and job satisfaction (β=0.022) were positively associated with turnover intention, while specialty (β=-0.135), year of training (β=-0.687), career in medicine (β=-2.191), necessity of training (β=-0.695) and satisfaction with income (β=-1.215) had negative associations with turnover intention. Working hours and nightshift interval indirectly were associated with turnover intention through the mediating effects of burnout. Career in medicine, necessity of training, satisfaction with income, and psychological resilience showed direct effects and indirect effects on turnover intention through burnout and job satisfaction as mediators.

CONCLUSIONS

The turnover intention among Chinese residents was prevalent and unignorable. Burnout was the major contributing factor, while year of training and positive attitudes towards training were protective factors. Burnout and job satisfaction also served as mediators. Interventions targeting these factors should be incorporated in the training programmes to keep a prosperous physician workforce.

The prevalence of turnover intention and influencing factors among emergency physicians: a national observation

BACKGROUND

Adverse consequences of physician turnover include financial losses, reduced patient satisfaction, and organizational instability. However, no study has reported the prevalence among emergency physicians. This study explore the rate and influencing factors of this community, which could provide a reference for preventing the loss of emergency physicians.

METHODS

A nationally representative cross-sectional survey of 15,243 emergency physicians was conducted in 31 provinces across China between July and September 2019. Multivariable logistic regression analysis was performed to identify predictors of turnover intention.

RESULTS

There were 49.75% of emergency physicians having turnover intention. Logistic regression analysis model showed that emergency physicians who were male (OR = 0.87) and older [> 37 and ≤ 43 (OR = 0.78) or > 43 (OR = 0.64)], worked in eastern China (OR = 0.88) and higher level of hospital [two-grade level (OR = 0.71) or three-grade level (OR = 0.56)], and had high (OR = 0.75) or middle (OR = 0.81) level income were not more likely to have less turnover intention, while those who had higher education level [bachelor degree (OR = 1.55) or master degree or higher (OR = 1.63)], long work tenure [> 3 and ≤ 6 (OR = 1.29) or > 6 and ≤ 11 (OR = 1.41) or > 11 (OR = 1.25)], poorer health status [fair (OR = 1.55) or poor (OR = 2.12)] and sleep quality [fair (OR = 1.16) or poor (OR = 1.43)], history of coronary heart disease (OR = 1.29), depression (OR = 2.77) and experienced the shift work (OR = 1.37) and workplace violence (OR = 1.78) were more likely to intend to leave.

CONCLUSION

Nearly half of emergency physicians in China have turnover intention. Targeted intervening measures should be taken to reduce the turnover intention, so as to avoid the shortage of physicians and thus hinder the supply of emergency medical services.

Perceived Organizational Support and Work Engagement of First-Line Managers in Healthcare - The Mediation Role of Feedback Seeking Behavior

BACKGROUND

First-line managers play a significant role in the management system of a health-care organization because they provide support and bridge for both senior management and their subordinates. Their work engagement becomes the foundation of facility functioning, encompassing both meeting organizational goals and the patient-centered care approach, but also meeting the expectations and needs of subordinate staff. The purpose of our study is to examine the relationship between perceived organizational support and work engagement of first-line health-care managers and the deeper mechanisms in the form of feedback seeking behavior that may positively influence this relationship.

METHODS

Data collection was carried out in the form of a questionnaire survey in the period February 2021. Respondents were first-level medical managers from different types of clinical areas and from all Slovak hospitals (221). The PLS-SEM method was used to analyze paths between variables and to analyze direct and indirect effects using SmartPLS 3.3 software.

RESULTS

The findings indicate a positive association of perceived organizational support and work engagement. Hypotheses about the mediation of the two components of feedback seeking behavior (monitoring and inquiring) have support in both their separate and joint mediation. At the same time, in joint mediation, a larger part of the indirect effect is transmitted by the feedback seeking behavior inquiring and thus represents a possible direction of interest for the top management of hospitals to strengthen the work engagement of their first-level managers not only for the purpose of their higher performance, but also of their job satisfaction.

CONCLUSION

Perceived organizational support enhances the work engagement of first-line managers. However, the total effect is significantly higher when feedback seeking behavior is involved not only in monitoring, but especially in inquiring.

Factors Influencing Retention Intention of Nurses at Long-Term Care Hospitals in Korea

The current study aimed to assess relationships among role conflict, nursing professionalism, nursing work environment, and retention intention of nurses at long-term care (LTC) hospitals. Participants comprised 183 nurses at nine LTC hospitals located in Busan, Korea. Data were collected using a structured self-report questionnaire and analyzed using descriptive statistics, t test, one-way analysis of variance, Pearson's correlation coefficient, and multiple linear regression. Retention intention had a signifi-cant positive correlation with nursing professionalism (r = 0.39, p < 0.001) and nursing work environment (r = 0.51, p < 0.001). Nursing work environment had a significant negative correlation with role conflict (r = -0.30, p < 0.001) and a significant positive correlation with nursing professionalism (r = 0.48, p < 0.001). In the final multiple regression analysis, factors influencing retention intention of participants included number of beds (β = -0.15 p < 0.026), nursing professionalism (β = 0.19, p = 0.007), and nursing work environment (β = 0.36, p < 0.001). The explanatory power of number of beds, nursing professionalism, and nursing work environment on retention intention was 34% (F = 16.66, p < 0.001). Improving nursing professionalism and nursing work environment of nurses at LTC hospitals will ultimately enhance their retention intention and positively impact the quality of gerontological nursing care. [Journal of Gerontological Nursing, 47(10), 44-53.].

Identifying Patterns of Turnover Intention Among Alabama Frontline Nurses in Hospital Settings During the COVID-19 Pandemic

Introduction

Current research about frontline nurse stress and turnover intention lacks context related to rural communities’ plight in providing organizational resources during the current COVID-19 pandemic. These implications have been particularly underexamined in the United States, whose regional differences may influence how frontline nurses perceive the access and utility of organizational resources. This study investigates if anxiety and stress while working during the current COVID-19 pandemic contribute to frontline nurses’ desire to leave their current position in Alabama hospital settings.

Material and Methods

A cross-sectional survey was developed and distributed as a Qualtrics survey to frontline nurses using social media and professional contacts. A total of 111 frontline nurse respondents within May 19–June 12, 2020 were included in this study.

Results

A significant correlation was found between gender (p= 0.002), marital status (p= 0.000) and seniority (p= 0.049) on turnover intention. A nurse’s perceived anxiety and stress related to their patients’ acuity (r= 0.257, p= 0.004), their personal health as a risk factor (r= 0.507, p= 0.000), their patient assignments (r= 0.239, p= 0.01), their personal protective equipment (r= 0.412, p= 0.000), and their psychological support (r= 0.316, p= 0.001) correspond to higher turnover intention among nurses working with patients infected with COVID-19.

Conclusion

Perceived resource loss in task autonomy, PPE, and psychosocial support increased turnover intention among frontline nurses in Alabama. Research is needed to understand how intrinsic motivations and social support influence individual nurse staff’s perceptions of resource loss and job demands. Further, more research is necessary to examine the implications of rurality and place in discussing turnover intention and organizational resources across multiple health systems.

Preferences for Indoor Environmental and Social Comfort of Outpatient Staff during the COVID-19 Pandemic, an Explanatory Study

While the pressure on hospital workers keeps growing, they are generally more dissatisfied with their comfort than other occupants in hospitals or offices. To better understand the comfort of outpatient workers in hospitals, clusters for preferences and perceptions of the indoor environmental quality (IEQ) and social comfort were identified in a previous study before the outbreak of the coronavirus disease 2019 (COVID-19) pandemic. This qualitative study explains the outpatient workers' main preferences for comfort during the COVID-19 pandemic. Semi-structured interviews and photo-elicitation were used. Contextual changes due to the COVID-19 pandemic were included. The questions in the interviews were based on the characteristics of the profiles, corresponding with the clusters. The data were analyzed with content analysis according to the steps defined by Gioia. Seventeen outpatient workers who had been part of the previous study participated. For some outpatient workers differentiation of preferences was illogical due to interrelations and equal importance of the comfort aspects. The main changes in perceptions of comfort due to the pandemic were worries about the indoor air quality and impoverished interaction. Because the occupants' preferences for comfort can change over time, it was suggested that further development of occupant profiles needs to accommodate changes.

Communication Skills and Transformational Leadership Style of First-Line Nurse Managers in Relation to Job Satisfaction of Nurses and Moderators of This Relationship

The job satisfaction of nurses is reflected in almost all organizational outputs of medical facilities. First-line nurse managers (FLNMs), who are directly related to subordinate nurses, have a great influence on this satisfaction. The aim of our paper is to examine the connection between communication skills and the transformation style of FLNMs management with the job satisfaction of nurses and to verify the influence of three moderators on the strength of this relationship. The chosen moderators-the practice of managing FLNMs, the degree of control (span of control) and psychosocial work-follow from theoretical studies. The moderating effect of the variable management practice is also significant from the point of view of Slovak legislation. The sample consisted of 132 FLNMs from five university hospitals in Slovakia. Data collection took place in the form of a questionnaire. All data were processed using the SPSS 24 software package. A series of regression analyzes were used to identify the proposed hypotheses. ANOVA analysis was used to analyze multiple dependencies. We worked at a 5% level of significance. The findings point to the strong direct effects of communication skills and the transformational leadership style of FLNMs on nurses' job satisfaction. Moderation effects are mild, but significant in the case of management and span of control practices. The lower values of both variables reinforce the positive relationships among the two predictors and the job satisfaction of nurses. The third moderator, psychosocial work factors, also have a significant moderating effect, which is negative, and the higher value of this moderator mitigates both positive direct effects.

Some health effects of work-related stress among nurses working in critical care units

Occupational stress is a major health problem among nurses. Critical care nurses appear to experience more stress at work compared to others. Stress is associated with multiple system disorders, hormonal, and immunological disturbances, and genetic effects. The aim of our study was the detection of health effects of work-related stress and to investigate the link between stress and immune response, alterations of hormones, and expression of micro-RNA (miRNA) among critical care nurses. An exposed 80 critical care nurses matched to 80 controls were involved in our study. Full history, psychological assessment using the General Health Questionnaire (GHQ12) and a complete clinical examination were done for both groups. Serum interleukin (IL)-6, IL-10, luteinizing hormone (LH), follicle-stimulating hormone, thyroid-stimulating hormone (TSH), free triiodothyronine, and free thyroxine (FT4) were measured by enzyme-linked immunosorbent assay, micro-RNA26, and 142 extractions. The exposed group had a mean age of 41 ± 10 years old and mean work duration of 22 ± 9.7 years, matched to 80 controls. The exposed group (32.5%) was associated with severe psychological distress (GHQ scores > 20) compared to only 5% among controls. In addition, the exposed group had a significantly higher level of miRNA 26, miRNA 142, TSH, LH, and IL-6 when compared to the control group. However, there a significantly lower level of FT4 among the exposed group compared to the control group, there were no statistically significant differences between the studied participants regarging FT3,FSH and IL-10 levels. Stress is prevalent among critical care nurses and is reflected on their psychological health with an increase in inflammatory cytokines and disturbances in endocrine functions.

Occupational identity, job satisfaction and their effects on turnover intention among Chinese Paediatricians: a cross-sectional study

Background

This study contributes to research on the paediatrician shortage by examining occupational identity, job satisfaction and their effects on turnover intention among paediatricians in China.

Methods

A multi-stage stratified random sampling method was employed to conduct a questionnaire survey. Of the 4906 survey recipients, valid data were collected from 4198 of the respondents (85.6%). The participants were from seven geographic regions of China (south, central, north, east, northwest, southwest, and northeast). Paediatricians who volunteered and provided written informed consent participated. All variables including basic socio-demographics and work-related characteristics, occupational identity, job satisfaction and turnover intention were based on available literature, and measured on a 5- point Likert scale. Statistical methods such as exploratory factor analysis (EFA), descriptive analysis, common method bias, one-way ANOVA test, Pearson correlation analysis and mediation analysis were used.

Results

Significant differences were observed among the respondents in terms of turnover intention based on age, education level, marital status, region, the type and grade of practice setting, professional title, years in practise, workload, rest days, and monthly income. Occupational identity and job satisfaction were both negatively related to turnover intention, and occupational identity was positively correlated with job satisfaction (r₁ = − 0.601, p < 0.01; r₂ = − 0.605, p < 0.01). The results also showed that job satisfaction played a mediating role in the association between occupational identity and turnover intention among Chinese paediatricians.

Conclusions

Work conditions, workload and salary are crucial factors of turnover intention among paediatricians in China. Therefore, we suggest that healthcare managers should increase investment in paediatrics, implement salary reforms and dedicate more attention to female and young paediatricians, thus reducing turnover intention among Chinese paediatricians.

Translation and validation of the anticipated turnover scale for the Portuguese cultural context

Aim

This study aimed to culturally and linguistically adapt the Anticipated Turnover Scale (ATS) for the Portuguese population.

Design

A cross-sectional study.

Methods

The ATS instrument was validated in a non-probabilistic sample of 259 nurses working at three hospitals in Portugal. The validity was assessed through factor analysis and structural equation modelling. Reliability was assessed using Cronbach's alpha, composite reliability and test-retest.

Results

The final scale is a one-factor scale consisting of 10 items and called "turnover intention." There are significant correlations among the scale items. Reliability and validity are acceptable. The ATS-Portuguese version, exhibited good psychometric properties for the Portuguese population.

Occupational Stress Among Nurses: A Factorial Study with Special Reference to Indore City

Nurses are a stressed group and this may affect their health and work performance. Occurrence of occupational stress among nurses is becoming common and this takes a toll on their health both in terms of physical and mental health. There is minimal research on reducing occupational stress. This study aimed to determine factors of occupation stress within nurses. The present study has been undertaken on 68 employees of hospitals to understand the factors affecting occupational stress. This article reports the major factors that are constituents for occupational stress among nurses of Indore region.

Pediatric Nurses' Turnover Intention and Its Association with Calling in China's Tertiary Hospitals

PURPOSE

To examine the turnover intention of Chinese pediatric nurses, its influential socio-demographic factors, and the association with calling and job satisfaction.

DESIGN AND METHODS

We randomly surveyed 10% of the nurses from 50% of the children's tertiary hospitals nationwide in China. Data were collected on nurses' turnover intention and associated factors such as age, income, skill level, working years, job satisfaction, and calling in 2017.

RESULTS

In total, 547 nurses were surveyed, and the response rate was 98.6%. More than a third of pediatric nurses had the intention to quit their current jobs. Influential factors associated with turnover intention included position, skill level, calling, and job satisfaction. Low job satisfaction of administration, workload, relationships with colleagues, work itself, and remuneration and benefits were negatively associated with turnover intention, with the odds ratio of high turnover intention in the lowest level of satisfaction ranging from 2.0-7.8 when compared with the medium level. However, calling was the strongest factor influencing turnover intention, and a weak calling may increase the risk of high turnover intention more than ten times, after adjusting for job satisfaction. Job satisfaction may partially mediate the relationship between calling and turnover intention.

CONCLUSION

The turnover intention of nurses was high in Chinese pediatric tertiary hospital. Calling may be the strongest influential factor of turnover intention.

PRACTICE IMPLICATIONS

To alleviate pediatric nurses' turnover rate, it may be helpful to develop interventions to increase job satisfaction and calling.

Stress and Health in Nursing Students: The Nurse Engagement and Wellness Study

BACKGROUND

Evidence suggests that behavioral, social, and environmental factors may modify the effects of life stress on health and performance of new nurses as they transition to hospitals.

OBJECTIVES

The aim of this study was to describe the methods of a project designed to investigate the role of social, behavioral, and environmental factors in modifying the adverse effects of stress on new nurses and to discuss demographic, health, and life stress characteristics of the cohort at baseline.

METHODS

A prospective cohort design was used to conduct a comprehensive assessment of health endpoints, life stress, behaviors, personal traits, social factors, indicators of engagement and performance, and environmental exposures in nursing students. Adjusted odds ratios and analyses of covariance were used to examine associations between these factors at baseline.

RESULTS

Health indicators in the cohort were comparable or better than in the broader United States population, and lifetime stress exposure was lower than among students from other majors. Exposure to more lifetime stressors was associated with greater risk for various health conditions, including hypertension, diabetes, and depression. Conversely, better social, environmental, behavioral, and personal profiles were associated with protective effects for the same health conditions.

DISCUSSION

These data comprehensively summarize the lives of predominately Hispanic nursing students and highlight risk and resilience factors associated with their health and well-being. The findings are timely, as the nursing field diversifies in preparation to care for a diverse and aging population. Comprehensively assessing stress-health relationships among student nurses ought to inform the policies, practices, and curricula of nursing schools to better prepare nurses to thrive in the often-strenuous healthcare environment.

Job satisfaction, work stress, and turnover intentions among rural health workers: a cross-sectional study in 11 western provinces of China

BACKGROUND

Health workforce turnover remains a global concern, particularly in rural and remote areas. Western rural areas are the least developed in China, where it faces the serious challenge on the rural health worker (RHW) management. This study aimed to investigate job satisfaction, work stress, and turnover intentions of RHWs, and to explore prominent factors associated with turnover intentions of RHWs in rural western China.

METHODS

From June to September 2013, based on a three-stage random sampling method, a cross-sectional survey was conducted among RHWs in 11 western provinces in China. A brief, structured questionnaire filled in by RHWs was used for data collection. A total of 5046 RHWs participated in the study. The response rate was approximately 93.1%. Exploratory factor analyses, Pearson's chi-squared tests, one-way ANOVA, binary logistic regression analyses, and mediating effect tests were performed for data analyses.

RESULTS

Approximately 29.1% of the 5046 RHWs indicated turnover intentions. Most of the RHWs disclosed low educational levels, income levels, and professional technical titles. The RHWs expressed slight job satisfaction (mean 3.20) and moderate work stress (mean 3.22). Age, income, medical institution, and job satisfaction (i.e., organizational management, reward, and occupation satisfaction) were significant predictors of the RHWs' turnover intentions. The RHWs, who were younger (less than 41 years), receiving an income of $326.8-$490.1 per month, working in township hospitals, and having low job satisfaction, were more likely to have turnover intentions. Work stress had an indirect and positive effect on RHWs' turnover intentions. Job satisfaction weakened the positive effect of work stress on turnover intentions of RHWs by playing a total mediating role. Reward satisfaction was the strongest mediator.

CONCLUSIONS

The turnover intentions of RHWs in western China are significantly associated with job satisfaction, work stress, age, income, and medical institution. Appropriate strategies should be implemented to improve RHWs' job satisfaction and reduce their work stress. Meanwhile, providing more attractive wages and non-monetary support, improving working conditions, etc. could be effective to reduction in RHWs' turnover intentions.

Medication Safety: A Need to Relook at Double-Checking Medicines?

Objective:

To present a structured evaluation process that provides evidence that the single-checking (SC) system is not only a viable option in reducing medication errors, but also has the added advantage of increasing staff satisfaction.

Methods:

The structured evaluation involved one work improvement process and conducting a survey establishing registered nurses’ (RNs’) attitude toward SC of medicines. The survey questionnaire included 12 questions with a 5-point Likert scale.

Results:

In spite of the increased number of patients, the number of medication errors actually reduced (P < 0.001; two-sample test of proportions) with the implementation of SC of medication for competent and experienced staff. A survey was conducted to establish RNs’ attitudes toward SC of medicines 3 years post SC implementation. RNs viewed the single-nurse checking protocol positively. In particular, the nurses considered single-nurse checking as an encouragement to update their drug knowledge and as a time-saving measure, enhancing the quality of patient care. Nonetheless, they also expressed concerns on single-nurse checking.

Conclusions:

The findings provide evidence that SC system is a viable way to reducing medication errors and also confer the added advantage of staff satisfaction. Assuring quality and safety involves the need to challenge the status quo based on revealed evidence.

Investing in human capital: exploring causes, consequences and solutions to nurses' dissatisfaction

Background

Human capital (employees) is the most important asset for healthcare. However, nurses experience some of the highest rates of burnout and dissatisfaction. In 2017, the Nursing and Midwifery Council reported that, for the first time since 2008, more nurses and midwives are leaving the profession in the UK than joining it.

Aims

The aim of this paper is to explore the literature regarding the importance of human capital within healthcare sectors in the UK, with a particular focus on nurses and job satisfaction.

Methods

A literature review was conducted with the focus on the aim, as stated above. Findings and conclusions have been summarised. Potential causes, consequences and solutions to job dissatisfaction are explored.

Results

Factors related to job satisfaction include pay, respect, security, workload, recognition, responsibility, environment, autonomy, personal growth, administrative bureaucracy and caseload. Investing and promoting 'organisational compassion' could be a key part of the solution.

Conclusions

More research using the same validated tools for measuring job satisfaction will help with consistency and comparability across hospitals. It is hoped this could provide information aiding recruitment and retention, which is a problem within both the NHS and independent sectors.

Choosing a women's health career

BACKGROUND

In 2005, in response to a decline in residency applications in obstetrics and gynecology (OB GYN), the American College of Obstetrics and Gynecology Presidential Task Force outlined strategies for attracting medical students to OB GYN. Application rates have increased since then, but little is known about which interventions are effective. We aimed to identify modifiable and nonmodifiable variables that may contribute to students choosing OB GYN for their careers; this information could be used to inform curriculum design, faculty development, and innovative exposures to women's health.

METHODS

This qualitative study received institutional review board approval. Eligible participants were students who applied or recently matched into OB GYN residency programs from the class of 2014-2016 at our institution. Students were interviewed with open-ended questions and a Likert-type survey. Thematic analysis was performed.

RESULTS

Ten qualitative interviews were completed and analyzed. Intrinsic themes such as the potential for a meaningful job in women's health, advocacy for women, or empowerment of women were identified as factors contributing to participant career choice. Extrinsic themes such as positive impressions during the clinical clerkship and welcoming teams were also identified. Most students indicated that the clerkship was the most influential experience.

CONCLUSIONS

Participants identified important events, including some that even preceded medical school that guided them toward OB GYN. The data guide us to consider the importance of emphasizing the unique combination of characteristics in OB GYN and improving the learning environment in the clerkship as a way to encourage student recruitment.

Communication With Physicians as a Mediator in the Relationship Between the Nursing Work Environment and Select Nurse Outcomes in Jordan

PURPOSE

To test whether communication mediated relationships among nurses' work environments and nurse outcomes of job satisfaction and intent to stay.

DESIGN

This study used a cross-sectional, quantitative survey design to query 650 nurses who worked in three hospitals in Jordan.

METHODS

We used Arabic versions of valid, reliable instruments measuring the nursing work environment, nurse perceptions of communication with physicians, intent to stay, and job satisfaction. Mediation analysis was used to test hypotheses.

FINDINGS

A total of 582 questionnaires were returned (89.5% response rate). Nurse perceptions of communication with physicians mediated the relationship between the nursing work environment and job satisfaction in medical, surgical, and critical care units. Nurse perceptions of communication with physicians mediated the relationship between the nursing work environment and intent to stay in all but maternity and "other" units.

CONCLUSIONS

Depending on the nurse outcome, communication was a significant mediator for various unit types. These results may be related to the type of work that is done in each unit and the influence of patient care. Communication is one of many mechanisms that can specify how a positive nursing work environment can contribute to nurses' job satisfaction and intent to stay.

CLINICAL RELEVANCE

A potential solution to the nursing shortage in Jordan emerges by identifying communication with physicians as a mediator in the relationship between the work environment and selected nurse outcomes.

HUMAN RESOURCES AND INNOVATIVE BEHAVIOUR: IMPROVING NURSING PERFORMANCE

This study examines, using the social exchange theory, the mediating effect of employees’ perception of wellbeing on the relationship between two human resource (HR) management factors (satisfaction with teamwork and satisfaction with training opportunities) and innovative behaviour of nurses working in Australian public and private hospitals. Current nurse shortages and limited budgets have increased the need for hospitals to improve their efficiency and cost-effectiveness. It is proposed that fostering innovative behaviour is one way that hospitals can improve the efficiency and effectiveness of nurses. A cross-sectional self-report survey was completed by 220 nurses working within Australian hospitals. The results show that an employee’s perception of their wellbeing completely mediated the relationship between satisfaction with training opportunities and their innovative behaviour and partially mediated the relationship between satisfaction with teamwork and innovative behaviour. The findings shed new light on how HR management factors can foster innovative behaviour. The results raise new implications for managers seeking to stimulate innovative behaviour, highlighting the importance of cultivating an organisational environment conducive to positive perceptions of wellbeing.

Factors affecting performance of public hospital nurses in Addis Ababa region, Ethiopia

BACKGROUND

Nurses have a major role to play in providing timely, quality health services in hospitals. It is important to identify factors influencing the performance of nurses to improve the quality of healthcare delivered in healthcare organizations. The objective of this study was to identify factors influencing job performance of nurses in public hospitals in Addis Ababa, Ethiopia.

MATERIALS AND METHODS

A cross-sectional survey was conducted from June 2010 to December 2010 in five public hospitals in Addis Ababa. Among 658 nurses meeting the inclusion criteria, the estimated sample size of 290 nurses was selected using a simple random sampling technique. Data were collected using self-administered questionnaire.

RESULTS

A total of 230 (80%) questionnaires were returned of the 290 questionnaires distributed to respondents. The results of the study indicated that nurses have rated the following as below average: job performance (mean=2.71, SD=0.48), job satisfaction (mean=2.55, SD=0.39), and organizational commitment (mean=2.45, SD=0.36). Organizational commitment (β=0.69, P<0.01), career development (β=0.39, P<0.01), payment (β=0.41, P<0.01), relationship with colleagues (β=0.32, P<0.01), work condition (β=0.21, P<0.05), and years of experience (β=0.27, P<0.05) have significant effect on nurses' job performance.

CONCLUSION AND RECOMMENDATIONS

This study highlighted that organizational commitment, job satisfaction, and work experience were significant predictors of nurses' job performance. Healthcare organization should give more attention to factors that contribute to job satisfaction and organizational commitments to improve nurses' job performance.

Employment retention of health care providers in frontier areas of Alaska

OBJECTIVES

The objectives of this study were to: describe the length of employment of health care providers in rural Alaska; assess whether there are differences in length of employment among community health aides, medical doctors, and nurses; and determine whether provider length of employment is significantly increased following implementation of telemedicine.

STUDY DESIGN

We conducted a prospective cohort study of length of employment among health professionals in rural Alaska, and identified the cohort based on current employment status of community health aides, medical doctors, and nurses.

METHODS

Employment data were collected from four Alaska Native regional health corporations. Kaplan-Meier product-limit survival analysis was used to assess employment length. The Mantel-Haenszel log-rank test was used to test the difference between retention (survival) curves among doctors, nurses, and community health aides for all four regional health corporations combined. Data included provider hire date, termination date, and position title. Fifty seven percent of the data points were right-hand censored.

RESULTS

The community health aides (median (Mdn) = 1186 days) were retained significantly longer than either the doctors (Mdn = 596 days), or the nurses (Mdn = 408 days), who were not significantly different from each other (log-rank chi2 (2, N = 996) = 68.30, p = 0.0001).

CONCLUSIONS

Our findings document that community health aides in the region retain their jobs significantly longer than doctors and nurses. Findings highlight the problem of providing an adequate health work force in rural areas.

Effects of nurse work environment on job dissatisfaction, burnout, intention to leave

BACKGROUND

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.

OBJECTIVES

To investigate how work environment affects job dissatisfaction, burnout, and intention to leave among nurses in Thailand.

METHODS

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.

RESULTS

Nurses working in university hospitals with better work environments had significantly less job dissatisfaction, intention to leave, and burnout.

CONCLUSION

The nurse work environment is a significant feature contributing to nurse retention in Thai university hospitals.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

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.

THE RELATIONSHIP BETWEEN ORGANIZATIONAL JUSTICE AND TURNOVER INTENTION OF HOSPITAL NURSES IN IRAN

Background:

Despite advances in science and technology, human resources are of the major capital for organizations. Workforce retention is required to improve organizational efficiencies.

Objective:

Therefore, in this study, the relationship between organizational justice (as one of the most influential factors) and turnover intention was investigated.

Methods:

This descriptive-analytic study was done in the Comprehensive Jame Women’s Hospital of Tehran in 2015. The statistical sample consisted of 135 nursing staff members. The data were collected using a questionnaire of Beugre’s organizational justice and analyzed by the use of Spearman’s and Anova statistical tests.

Results:

Averages of organizational justice was obtained to be 68.85 ± 7.67 . Among different sorts of organizational justice, the highest average score of 75.24 ± 16.68 was achieved relevant to interactional justice. A significant relationship was observed between organizational justice (r = -0.36), interactional justice (r = -0.38), and procedural justice (r = -0.36) and turnover intention, but no relation was found between turnover intention and systemic and distributive justice. Furthermore, there was no relationship between demographic variables, organizational justice, and turnover intention.

Conclusion:

Considering the prominent role of organizational justice in the personnel’s intention to stay or leave and due to the high costs of recruiting and training new staff, managers should pay especial attention to justice and provide their employees’ satisfaction and stability in their organizations by creating a positive mindset in them.

An Investigation of Nurses' Job Satisfaction in a Private Hospital and Its Correlates

Background:

Nurses’ job satisfaction and job stress are important issues regarding their turnovers. While there are some recent descriptive studies on job satisfaction in public hospitals, very limited research was found on this topic in private hospital setting. It is worth to examine the job satisfaction of nurses and its correlates in such a specific hospital context in Hong Kong, by which the findings can be compared with those in public hospitals, and across countries.

Aims:

To investigate nurses’ job satisfaction, job stress and intention to quit of nurses in a private hospital, and the correlates of the nurses’ job satisfaction.

Design:

A cross-sectional, descriptive survey study was conducted.

Methods:

By using stratified random sampling in terms of nature of wards/units and working ranks, 139 full-time nurses who were working in the 400-bed private hospital for at least 6 months and provided direct nursing care were recruited in this study. Data were collected by employing a set of self-administered structured questionnaires, consisting of the Index of Work Satisfaction (job satisfaction), Anxiety-Stress Questionnaire (job stress), Michigan Organizational Assessment Questionnaire (intention to quit), and socio-demographic data.

Results:

With a response rate of 74.3%, the results of the 139 respondents showed that the nurses in the private hospital had an overall moderate level of satisfaction with their work and rated the professional status as the highest satisfied domain. The nurses also reported moderate levels of job stress and intention to quit. The nurses’ job satisfaction was negatively correlated with their job stress and intention to quit; whereas, the nurses’ job stress was positively correlated with their intention to quit. The nurses with older in age and more post-registration experience and/or working experience in the private hospital indicated a higher level of job satisfaction, particularly with ‘Pay’ and ‘Autonomy’.

Conclusion:

The findings suggest that the nurses in the private hospital are moderately stressful and satisfied with their work environment and relationships. A few socio-demographic characteristics of these nurses such as their age and years of clinical experiences were associated with their levels of job satisfaction and/or stress. The findings provided information for private hospitals and healthcare organizations about the need and areas for improvement of nurse’s job satisfaction, thus strengthening their recruitment and retention.

Turnover intention among intensive care unit nurses in Alexandria, Egypt

BACKGROUND

Given the difficulty in recruiting new nurses, it is imperative to retain those already in the profession. This cross-sectional study explored the relationship of demographic and work-related factors, burnout, conflict management and relationship between nurses and physicians on turnover intentions among ICU nurses in eight major hospitals in Alexandria, Egypt.

SUBJECTS AND METHODS

Data on burnout, conflict management, nurse-physician communication, and turnover intention were collected by surveying 100 nurses in eight hospitals in Alexandria governorate. All nurses at the ICU of selected hospitals were approached (n=100) and a 47-item Likert scale questionnaire was administered to explore the factors affecting the turnover intention of ICU nurses in Alexandria.

RESULTS

ICU nurses exhibited a mean score for turnover intention of 3.23 (mean score percentage 65.0%). There was a moderately positive statistically significant correlation between turnover intention and emotional exhaustion (r=0.29, P<0.05), nurse-physician communication (r=0.25, P<0.05), and age (r=0.21, P<0.05). The predicting factors for turnover intention were emotional exhaustion and age.

CONCLUSION AND RECOMMENDATION

Nurses turnover intention at the ICU of the selected hospitals is high and is significantly associated with nurses' emotional exhaustion, poor nurse-physician communication, and nurses age.

Testing a theoretical model of clinical nurses' intent to stay

BACKGROUND

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.

PURPOSE

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.

METHODOLOGY

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.

RESULTS

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.

PRACTICE IMPLICATIONS

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.

Measuring professional satisfaction and nursing workload among nursing staff at a Greek Coronary Care Unit

Objective To explore potential associations between nursing workload and professional satisfaction among nursing personnel (NP) in Greek Coronary Care Units (CCUs). Method A cross-sectional study was performed involving 66 members of the NP employed in 6 randomly selected Greek CCUs. Job satisfaction was assessed by the IWS and nursing workload by NAS, CNIS and TISS-28. Results The response rate was 77.6%. The reliability of the IWS was α=0.78 and the mean score 10.7 (±2.1, scale range: 0.5-39.7). The most highly valued component of satisfaction was "Pay", followed by "Task requirements", "Interaction", "Professional status", "Organizational policies" and "Autonomy". NAS, CNIS and TISS-28 were negatively correlated (p≤0.04) with the following work components: "Autonomy", "Professional status", "Interaction" and "Task requirements". Night shift work independently predicted the score of IWS. Conclusion The findings show low levels of job satisfaction, which are related with nursing workload and influenced by rotating shifts.

Phenomenological Study on Burnout Experience of Clinical Nurses Who have Turnover Intention

PURPOSE

This study was aimed to understand the meaning and essentials of the experience of burnout for hospital nurses with turnover intention.

METHODS

The design was a qualitative research of phenomenological study. Participants: Seven hospital nurses who had worked over three years and had experiences of turnover intention in a hospital with over 400 beds were included.

RESULTS

Nine meaningful themes related to burnout experiences and four theme clusters of 1) battery warning sounds almost out; 2) the player who hit the drum and double-headed drum; 3) the target flying arrow without a break; and 4) the pendulum swaying to turn over. Registered nurses (RNs) felt burnout with an overload of work and by the thought that it was illegal action for registered nurses to receive insufficient rewards for their work. RNs also experienced there were no problem solving strategies to verbal violence by patient and medical team.

CONCLUSION

The findings show that burnout experiences for those who had turnover intention was developed from the insight that insufficient training to do work independently with over-load for nurses was not ethical. It suggests that it is necessary to rethink training systems for nursing and hospitals to relieve turnover intention.

Trends in job satisfaction among German nurses from 1990 to 2012

OBJECTIVE

Improving the job satisfaction of nurses is essential to enhance their productivity and retention and to improve patient care. Our aim was to analyse trends in German nurses' job satisfaction to enhance understanding of the nursing labour market and inform future policies.

METHODS

We used 1990-2012 German Socioeconomic Panel data for trends in nurses' job satisfaction. Comparisons were drawn with doctors, other health care workers, and employees in other sectors of employment. Analysis explored associations between job satisfaction trends and other aspects of employment, such as whether full time or part time and pay. To account for fluctuations across the period of analysis, linear trends were generated using ordinary least squares.

RESULTS

Over 23 years, job satisfaction of German nurses underwent a steady and gradual decline, dropping by an average 7.5%, whereas that of doctors and other health care workers increased by 14.4% and 1%, respectively. The decline for part-time nurses (13%) was more pronounced than that for full-time nurses (3%). At the same time, nurses' pay rose by only 3.8% compared to a 23.8% increase for doctors.

CONCLUSIONS

The steady decline in nurses' job satisfaction over the last two decades may be attributable to the multiple reforms and associated policy changes that generally disadvantaged nurses. Contributing factors to job satisfaction decline include lower pay and the demanding and strenuous work environment. Irrespective of the reason, health services researchers, leaders, and policy makers should investigate the reasons for this decline given the forecast growth in work load and complexity of care. Supportive policies for nurses would help enhance the quality and sustainability of German health care.

Job satisfaction in nursing: a concept analysis study

AIM

This study aims to undertake a concept analysis of job satisfaction in the nursing profession.

BACKGROUND

Around current global shortage of nurses, it is important to stabilize the nursing workforce. Nurses' job satisfaction has been found to be related to intention to leave.

INTRODUCTION

In the nursing profession, there is a lack of evidence to support the attributes of nurses' job satisfaction.

METHODS

Walker and Avant's approach of concept analysis was used.

RESULTS

The main attributes of job satisfaction from this study are (1) fulfillment of desired needs within the work settings, (2) happiness or gratifying emotional responses towards working conditions, and (3) job value or equity. These attributes are influenced by antecedent conditions like demographic, emotional, work characteristics and environmental variables. Additionally, the consequences of nurses' job satisfaction have a significant impact on both nurses and patients.

DISCUSSION

This study integrated both the content and process of motivational theories to generate the attributes of job satisfaction in nursing that overcome the limitation of the previous studies, which looked only at the definitions of nurses' job satisfaction based on content motivational theories.

CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY

The findings of this study can facilitate both nursing researchers to develop a cultural adaption instrument and policy makers to improve clinical nursing practice. This analysis provides nurse managers with a new perspective to deal with nurses' job satisfaction by taking into account all the attributes that influence it in the nursing field.

Developing nurse and physician questionnaires to assess primary work areas in intensive care units

The objective of the study was to develop instruments for describing and assessing some aspects of design of the primary work areas of nurses and physicians in intensive care units (ICUs). Separate questionnaires for ICU physicians and nurses were developed. Items related to individual- and unit-level design features of the primary work areas of nurses and physicians were organized using constructs found in the literature. Items related to staff satisfaction and staff use of time in relation to primary work area design were also included. All items and constructs were reviewed by experts for content validity and were modified as needed before use. The final questionnaires were administered to a convenience sample of 4 ICUs in 2 large urban hospitals. A total of 55 nurses and 29 physicians completed the survey. The Cronbach α was used to measure internal consistency, and factor analysis was used to provide construct-related validity. Convergent and discriminant validity were assessed through examining bivariate correlations between relevant scales/items. Analysis of variance was used to identify whether the between-group member responses were significant among the 4 units. The Cronbach α values for all except 3 preliminary scales indicated acceptable reliability. Factor analysis indicated that some preliminary scales could be partitioned into subscales for finer descriptions of the primary work areas. Correlational analysis provided strong evidence of convergent and discriminant validity of all the scales and subscales. The significance level of F-statistics showed that the units were significantly different from each other, providing evidence of more between-unit variance than within-unit variance. Therefore, the questionnaires developed in the study offer a promising departure point for rigorous description and evaluation of the primary work areas in relation to staff satisfaction and use of time in ICUs at a time when the importance of such studies is growing.

Job satisfaction and intent to leave among psychiatric nurses: closed versus open wards

PURPOSE

The aim of this study was to investigate: (a) the association between socio-demographic variables, job satisfaction and intent to leave among hospital psychiatric nurses, and (b) the differences in the above between psychiatric nurses working on closed and open wards.

PROCEDURES

After receiving ethical approval, a convenience sample of 52 (70% of total nursing staff) was drawn from psychiatric nurses in a large Israeli psychiatric hospital (95% response rate). The sample completed anonymously a self-administered structured questionnaire.

MAIN FINDINGS

A negative correlation was found between job satisfaction and intent to leave and between age, all categories of seniority, and intent to leave. Closed-ward nurses reported a higher intent to leave psychiatric nursing. Nurses under 35 reported a significantly higher intent to leave psychiatric nursing than nurses over 35. Job satisfaction was significantly higher among full-time nurses than part-time.

PRINCIPAL CONCLUSIONS

Psychiatric hospitals need to pay attention to all factors associated with workers' readiness to leave. Given the widespread shortage of nurses, it is especially important that they address the relatively low job satisfaction of both younger and part-time nurses, and the particular stresses that closed-ward nurses work under.