Home healthcare nurse retention and patient outcome model: discussion and model development

Alone and together: registered nurses' experiences of work satisfaction in municipal home healthcare

BACKGROUND

The need for advanced home healthcare (HHC) is expected to increase, with registered nurses (RNs) as key figures. Given the difficulties recruiting and retaining RNs in the HHC sector, understanding their work satisfaction is imperative.

AIM

This study aimed to explore RNs' experiences of work satisfaction in the municipal HHC.

METHODS

Individual interviews were conducted with RNs (n = 8) in four municipalities in Norway. The data were evaluated using qualitative content analysis.

RESULTS

Work satisfaction in HHC was organised into one theme 'alone and together' under four categories-the patient, the co-worker, the registered nurse, and the organisation-and 15 subcategories, including patient diversity, supportive co-workers and professional environment, appropriate workload and responsibilities, and provision of preconditions for self-management.

CONCLUSIONS

Patients, co-workers, and organisations were identified as crucial areas affecting RNs' work satisfaction in the municipal HHC. Awareness of these areas is essential to promote RNs' work satisfaction. Patients' diversity adds positively to RNs' work satisfaction. Notably, RNs working alone can affect their work satisfaction not only negatively but also positively.

Finnish Version of the Specialist Outcomes and Barriers Analysis Scale: Evaluation of Psychometric Properties

PURPOSE

To evaluate the psychometric properties of the Finnish version of the Specialist Outcomes and Barriers Analysis Scale.

DESIGN

This was a cross-sectional survey study.

METHODS

Cultural adaptation of the translation and content validity of the translated instrument were assessed by expert panelists (n = 5) using the content validity index. The construct validity was assessed with principal component analysis using the survey data of Finnish registered nurses (n = 60). Scale reliability was assessed with Cronbach's α values. All study phases were conducted in 2021.

RESULTS

The items (n = 59) of the scale were critically evaluated by the experts. The full-scale content validity was revealed as excellent (0.92). In terms of construct validity, the scale was analyzed separately for outcomes and barriers. The outcomes section revealed a 5-component structure with an overall Cronbach's α coefficient of .96, and the barriers section, a 2-component structure with an overall Cronbach's α coefficient of .82, indicating adequate reliability of the scale.

CONCLUSION

The Finnish version of the scale showed excellent content and construct validity. The Cronbach's α values represented adequate reliability of the Specialist Outcomes and Barriers Analysis scale when measuring nurses' perceived practice outcomes and barriers in the Finnish context.

Job demand and job resource factors explaining stress and job satisfaction among home care nurses - a mixed-methods sequential explanatory study

BACKGROUND

Increasing home care has been seen as a way to respond to the growing care needs of the aging population. To secure a sufficient number of nurses to provide home care, it is essential to identify and take into account the factors related to their well-being and job satisfaction. This study examined associations of both objective and subjective job demands and resources with stress and job satisfaction among nurses working in home care.

METHODS

This study used a mixed-methods sequential explanatory design. First, quantitative data was collected with a survey, followed by a qualitative survey with open-ended questions. Linear regression analyses and qualitative content analysis with an inductive approach were used to analyze the quantitative and qualitative data, respectively. Joint display in a form of a table was used to integrate the results.

RESULTS

Of the objectively measured job demands and resources, higher proportion of direct care time and higher number of interruptions were associated with higher stress in the fully adjusted models. Of the subjective measures, higher time pressure, role conflicts and disruptions were associated with higher stress. Higher time pressure, role conflicts, and disruptions in the workday were associated with lower job satisfaction, whereas higher care continuity and having more autonomy were associated with higher job satisfaction. The results of the qualitative study, in which the nurses described their experiences of their working week, partly explained and confirmed the results of the quantitative study but were also contradictory in some respects.

CONCLUSIONS

Many demands, both subjectively experienced and objectively measured in terms of work organization, may undermine home care nurses' well-being and enjoyment at work. A severe nursing shortage combined with a growing number of clients is the reality of home care, significantly increasing the risk of burnout and turnover among employees. Strategies must be developed urgently to ensure sufficient personnel in home care. For example, investments should be made in opportunities for autonomous planning of work, and promotion of good cooperation and functionality of work teams.

Examining the Predictors of Turnover Behavior in Newly Employed Certified Nurse Aides: A Prospective Cohort Study

Background

The turnover rate of nurse aides in Taiwan is high. However, the predictors of turnover behavior in the newly employed are still unclear.

Objective

To examine the predictors of turnover behavior in newly employed licensed nurse aides.

Methods

A longitudinal study design was used and subjects were newly employed certified nurse aides from a nurse aid training association in Taiwan. A total of five questionnaire surveys were conducted. The questionnaire was mainly used to collect information on turnover behavior, personal socioeconomic background, workplace psychosocial hazards, worker health hazards, and musculoskeletal disorders.

Results

A total of 300 participants were recruited in the study. Cox regression analysis results showed that short working experience (hazard ratio [HR] = 0.21, p < 0.01), work as non-home nurse aides (HR = 0.58, p = 0.01), low monthly salary (HR = 0.68, p < 0.01), high work mental load (HR = 1.01, p = 0.01), low workplace justice (HR = 0.97, p < 0.01), high workplace violence (HR = 1.60, p < 0.01), high burnout (HR = 1.01, p = 0.04), poor mental health (HR = 1.06, p = 0.04), and high total number of musculoskeletal disorder sites (HR = 1.08, p = 0.01) contribute to a higher risk of turnover.

Conclusion

The results indicated that employment period, work as a home nurse aide, monthly salary, work mental load, workplace justice, workplace violence, work-related burnout, mental health, and total number of musculoskeletal disorder sites are predictors of turnover behavior in newly employed certified nurse aides.

The development and validation of the Japanese version of job satisfaction scale: a cross-sectional study on home healthcare nurses

Objective

A reliable and valid tool is required to assess home healthcare nurses’ job satisfaction for evaluating and improving the work environment and clinical practice of home healthcare. This study aimed to develop and examine the Japanese version of the Home Healthcare Nurses’ Job Satisfaction Scale (HHNJS-J). The Home Healthcare Nurses’ Job Satisfaction Scale (HHNJS) was translated into Japanese; a backward translation was performed until equivalence between the original and the backward-translated HHNJS was confirmed. Subsequently, a mail survey was conducted among 409 home healthcare nurses from 154 home healthcare agencies in Japan. We evaluated construct validity through Confirmatory Factor Analysis (CFA), and criterion-related validity and internal consistency were also tested.

Results

The CFA revealed a second-order seven-factor structure and adequate internal consistency, although, the fit of the data to the factor structure was moderate. As per the goodness-of-fit indices of the final model of the CFA, the comparative fit index was 0.89 and root mean square error of approximation was 0.06. This newly translated scale can be used to assess the job satisfaction of home healthcare nurses within Japan. The HHNJS-J evaluated acceptable reliability and validity among Japanese home healthcare nurses and had application in clinical practice in Japan.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-022-06092-2.

The Home Healthcare Nurse: A Concept Analysis

The home healthcare nurse is a concept that has grown rapidly in the past two centuries, however, the role and meaning remain ambiguous. Continuous changes in the healthcare system have sparked confusion with patients and healthcare providers as to the essence of the home healthcare nurse. With the popularity and demand for home healthcare-based care on the rise, it is necessary to differentiate the concept of the home healthcare nurse from other related terms through a concept analysis. Using Walker and Avant's methodology, a literature search using Cumulative Index to Nursing and Allied Health Literature (CINAHL) along with dictionaries, encyclopedias, and professional organizations was performed to identify all the uses, attributes, and characteristics of the concept. Five defining attributes emerged during the analysis: autonomy, adaptability, person-centered holistic care, care coordination, and self-efficacy. Antecedents, consequences and empirical referents were identified. As a first step, this concept analysis brings clarity to the meaning and role of the home healthcare nurse from which arose an operational definition and proposed conceptual model. With the number of patients admitted to home healthcare accelerating, healthcare organizations and clinicians must distinctly understand the concept of the home healthcare nurse. Future research should include testing theoretical relationships between the home healthcare nurse and patient outcome variables to enhance nursing science and promote population health.

Turnover Intention Among Nurses in Nurse Managers, Directors, and Executives: Developing a Tool for Measuring Environmental Factors

Background and Purpose

Turnover among nurse managers, directors, and executives is associated with staff nurse retention and patient outcomes. The purpose of this article is to describe the development of an instrument to evaluate factors associated with intent to leave among these leaders within acute care facilities.

Methods

The Nurse Leader Environment Support Survey (NLESS) was developed and evaluated using exploratory factor analysis and reliability testing (Cronbach's α). Data was obtained as part of a large nationwide electronic survey (N = 1,903).

Results

Factors converged into three major themes (organizational culture, professional vulnerability, and workplace relationships) which were consistent across all three leadership groups. Factor subscales exhibited Cronbach's α > .7.

Conclusions

The NLESS is a useful tool in comparing reasons for turnover among nursing leadership groups. Future refinement may prove useful in identifying and clarifying foundational causes of turnover.

Nurses' job involvement and association with continuing current position-A descriptive comparative study

AIMS AND OBJECTIVES

The aim of the study is to examine nurses' job involvement and intentions to continue in their current position.

BACKGROUND

Globally, the supply of nurses fails to meet the labour markets' high demand. Compared to specialist health service, the community health service has the greatest challenge when it comes to nursing shortage. There is a lack of studies comparing nurses working in different parts of the healthcare system in research focusing on nurses' intentions to continue in their current position. Similarly, there has been relatively little research on nurses' job involvement, even less how it is associated with retaining the nurses, despite indications that job involvement may be the key to job-related motivated behaviour.

DESIGN

A descriptive comparative study with a cross-sectional design.

METHODS

The study comprises 297 nurses from the community health service and specialist health service, respectively. The relationships between nurses' intention to continue and participant characteristics were examined using binary logistic regression. Reporting followed the STROBE guidelines.

RESULTS

Nurses in the community health service are older, have more children under the age of 18 and hold more permanent positions than nurses in the specialist health service. Job involvement is the only variable associated with nurses' intention to continue in their current position regardless of whether the nurse works in the community health service or specialist health service.

CONCLUSIONS

The results indicate that the community health service has the same possibilities as the specialist health service to retain nurses in their current jobs.

RELEVANCE TO CLINICAL PRACTICE

The results indicate that nursing leaders/employers with a goal to retaining nurses are recommended to focus on improving the nurses' job involvement.

Stimulated by insight: Exploration of critical care nurses' experience of research participation in a recovery programme for intensive care survivors

AIMS AND OBJECTIVES

To explore critical care nurses' experiences of research participation during a one-year recovery programme for intensive care survivors.

BACKGROUND

Nurse-led postintensive care follow-up consultations have emerged to help patients to recover and overcome problems related to critical illness and admission at the intensive care unit (ICU). Previous research exploring post-ICU follow-up programmes have shown inconclusive evidence of their effectiveness on patient-reported outcome measurements, and provider evaluation is scarce. The context of this study is the Recovery and Aftercare in Postintensive care Therapy (RAPIT) trial.

DESIGN

A qualitative descriptive telephone interview study.

METHODS

Data were collected after completion of the RAPIT trial. Participants (n = 14) were trained intensive care nurses, who delivered the post-ICU recovery programme, representing nine out of ten sites from the RAPIT trial. Two focus group discussions were used to construct a semistructured interview guide. A thematic data analysis was performed using Braun and Clark's six-step method. This study conforms to the COREQ Research Reporting Guidelines for qualitative studies.

RESULTS

Our study indicated that nurses considered participation in research as a positive experience. The main finding "Stimulated by insight" described how nurses' engagement and professional growth was gained by reflection, patient feedback and research competencies acquired in the clinical setting. The research programmes stimulated to new knowledge, broaden their perspectives and enhanced critical reflection of ICU nursing practice.

CONCLUSIONS

The study indicates that nurses developed research competencies and enhanced their job satisfaction by using critical reflection and patient feedback. However, there is still a substantial need for support to strengthen nurses' competencies in collaboration with colleagues, managers and researchers.

RELEVANCE TO CLINICAL PRACTICE

This study can contribute to the development of recommendations supporting nurses doing research and to optimise implementation of clinical research.

Improving Retention of Home Health Nurses: Fostering Outcome Sustainability Through an Innovative Orientation and Mentorship Program

Home healthcare plays an increasingly vital role in contemporary postacute healthcare. Staffing instability and lack of perceived organizational support is a stimulus for nursing attrition from the organization with far-reaching impact on staff morale, patient care, agency budgets, and relationships with other healthcare settings. The purpose of this article is to describe a redesign of an agency's nursing orientation and the development of a mentorship program for newly hired home healthcare nurses within a large Midwestern integrated health system. During this time frame, 154 nurses completed the newly designed orientation program and, of those, 91 participated in the mentorship program. In this article, we evaluate 1-year new-hire nursing retention rates over a 4-year period, examine new-hire job satisfaction and perceptions of preceptors and mentors during their first year, and discuss issues of outcome sustainability. Agency-wide turnover rates for all home healthcare nurses decreased from 15.4% in 2016 to 10.1% in 2018, demonstrating the associated impact of these initiatives on staffing stabilization.

Work-related factors influencing home care nurse intent to remain employed

BACKGROUND

Health care is shifting out of hospitals into community settings. In Ontario, Canada, home care organizations continue to experience challenges recruiting and retaining nurses. However, factors influencing home care nurse retention that can be modified remain largely unexplored. Several groups of factors have been identified as influencing home care nurse intent to remain employed including job characteristics, work structures, relationships and communication, work environment, responses to work, and conditions of employment.

PURPOSE

The aim of this study was to test and refine a model that identifies which factors are related to home care nurse intentions to remain employed for the next 5 years with their current home care employer organization.

METHODOLOGY/APPROACH

A cross-sectional survey design was implemented to test and refine a hypothesized model of home care nurse intent to remain employed. Logistic regression was used to determine which factors influence home care nurse intent to remain employed.

FINDINGS

Home care nurse intent to remain employed for the next 5 years was associated with increasing age, higher nurse-evaluated quality of care, having greater variety of patients, experiencing greater meaningfulness of work, having greater income stability, having greater continuity of client care, experiencing more positive relationships with supervisors, experiencing higher work-life balance, and being more satisfied with salary and benefits.

PRACTICE IMPLICATIONS

Home care organizations can promote home care nurse intent to remain employed by (a) ensuring nurses have adequate training and resources to provide quality client care, (b) improving employment conditions to increase income stability and satisfaction with pay and benefits,

A Cyclic Model Describing the Process of Sustaining Meaningfulness in Practice: How Nurses Continue Working at One Home Care Agency

This study aimed to elucidate the experiences of home care nurses who had continued working a single agency, to gain insight into the prevention of premature turnover. We adopted a grounded theory approach to qualitative exploration of the experiences of 26 Japanese nurses working in a home care agency, using semistructured interviews and participant observation. Nurses' experience progressed through three phases: "encountering difficulty," "enjoying the fruitfulness," and "becoming dissatisfied." Nurses' cognitive rounding involving these phases was conceptualized as "cycle of sustaining meaningfulness." To move from encountering difficulty to enjoying the fruitfulness, nurses needed to discover the meaningfulness of practice, and to move from becoming dissatisfied to encountering difficulty, they needed to requestion their practice. During their time at the agency, nurses progressed through the phases of the cycle of sustaining meaningfulness repeatedly. Knowing the point at which nurses are in the cycle and assisting their further progress could aid in their retention.

[Opinions and nurse' satisfaction with INICIARE 2.0 scale: A qualitative study in a hospital setting]

OBJECTIVE

To know the opinions and satisfaction of nurses with the use of INICIARE, an instrument developed for assessment of nursing care needs in hospitalized patients. INICIARE is based on Virginia Henderson's conceptual model, and built up with indicators of Nursing Outcomes Classification (NOC) taxonomy.

METHOD

Exploratory qualitative study, using focus group technique for data collection. The sessions were recorded until saturation of information. A content analysis of syntactic, semantic and pragmatic levels of transcripts was performed. Participants' informed consent was obtained.

RESULTS

Three focus groups were developed; 24 nurses from two Public Hospitals in Andalusia (Southern Spain) participated; and four thematic categories were created to measure satisfaction with the instrument. INICIARE helped the nursing process. Its closed format, and items in NOC taxonomy streamline evaluation, facilitates its inclusion in Electronic Information Systems, and strengthens effective communication at all levels.

CONCLUSIONS

Nurses are satisfied with the use of INICIARE scale as a tool to enhance quality of care. It also has potential to be used as a tool for decision making in management of nursing care.

Job demands-resources predicting burnout and work engagement among Belgian home health care nurses: A cross-sectional study

BACKGROUND

A better knowledge of the job aspects that may predict home health care nurses' burnout and work engagement is important in view of stress prevention and health promotion. The Job Demands-Resources model predicts that job demands and resources relate to burnout and work engagement but has not previously been tested in the specific context of home health care nursing.

PURPOSE

The present study offers a comprehensive test of the Job-Demands Resources model in home health care nursing. We investigate the main and interaction effects of distinctive job demands (workload, emotional demands and aggression) and resources (autonomy, social support and learning opportunities) on burnout and work engagement.

METHODS

Analyses were conducted using cross-sectional data from 675 Belgian home health care nurses, who participated in a voluntary and anonymous survey.

RESULTS

The results show that workload and emotional demands were positively associated with burnout, whereas aggression was unrelated to burnout. All job resources were associated with higher levels of work engagement and lower levels of burnout. In addition, social support buffered the positive relationship between workload and burnout.

CONCLUSIONS

Home health care organizations should invest in dealing with workload and emotional demands and stimulating the job resources under study to reduce the risk of burnout and increase their nurses' work engagement.

How does collegial support increase retention of registered nurses in homecare nursing agencies? a qualitative study

Background

Collegial workplace support has been linked to higher registered nurse (RN) retention in various clinical settings. In Japan, homecare agencies experience high RN turnover. The purpose of this study was to develop a conceptual framework to describe how perceived support from colleagues affects RNs’ decision to remain in an agency.

Methods

A qualitative research method based on grounded theory was used. Participants were RNs with at least 4 years of experience at the same homecare agency. Participants were theoretically sampled via managers of 12 homecare nursing agencies. Semi-structured interviews and supplementary participant observations were conducted. Data were analyzed using a constant comparative technique, and the process of how workplace support affected participants’ decision to remain at their agency was clarified.

Results

In total, 26 RNs were interviewed, 23 of whom were observed in their practice setting. Participants’ perception of support from colleagues was framed as being “encouraged to grow in one’s own way”, which comprised practicing with protected autonomy in an insight-producing environment. Participants reported that they were able to practice with protected autonomy, receiving 1) mindful monitoring, 2) semi-independent responsibility, 3) help as needed, and 4) collegial empathy and validation. RNs also felt supported in an insight-producing environment by 1) enlightening dialogue, 2) being set for one’s next challenges, and 3) being able to grow at one’s own pace. Reportedly, these were defining characteristics in their decision to continue working in their agencies.

Conclusions

For RNs to willingly stay at a homecare nursing agency, it is essential that they are able to practice with protected autonomy in an insight-producing environment that encourages them to grow in their own way. Further research is needed to explore ways to create and enhance such environments to lower RN turnover.

Health Care Providers' Spirit at Work Within a Restructured Workplace

Spirit at work (SAW) research emerged as a response to care provider determination to maintain a healthy and productive health care work environment, despite restructuring. The aim of this descriptive mixed-methods research is to present the care provider's perceptions of SAW. SAW is a holistic measure of care provider workplace outcomes, defined as the unique experience of individuals who are passionate about and energized by their work. A mixed group of licensed and unlicensed care providers in a continuing care workplace were surveyed. Eighteen Likert-type scale survey questions were further informed by two open-ended questions. Results indicated that unlicensed continuing care providers' perceptions of SAW are lower than licensed care providers. Responses suggest that open discussion between managers and team members, combined with structured workplace interventions, will lead to enhanced SAW and improved patient care. Further research on SAW within the continuing care workplace is required.

Haemodialysis work environment contributors to job satisfaction and stress: a sequential mixed methods study

Background

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.

Methods

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.

Results

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.

Conclusions

Nurse managers can use these results to identify issues being experienced by haemodialysis nurses working in the unit they are supervising.

Primary care workforce shortages and career recommendations from practicing clinicians

PURPOSE

The success of efforts to bolster the primary care workforce rests in part on how these clinicians view their professions and their willingness to recommend their careers to others. The authors sought to examine career and job satisfaction, perceptions of workforce shortages, and willingness to make career recommendations among primary care physicians (PCPs) and primary care nurse practitioners (PCNPs).

METHOD

In 2012, the authors mailed a national survey concerning the issues above to 1,914 randomly chosen clinicians found on national databases: 957 PCPs and 957 PCNPs.

RESULTS

A total of 972 eligible clinicians (505 PCPs, 467 PCNPs) returned the survey. Using standard opinion research procedures, the authors estimated there were approximately 1,589 eligible clinicians in their sample (response rate, 61.2%). PCNPs and PCPs were more likely to recommend a career as a PCNP than as a PCP, despite the perception among all clinicians of a serious shortage of PCPs nationally and in their own communities. This finding held among PCNPs who reported low workplace autonomy and among PCPs reporting that they were satisfied with their own careers.

CONCLUSIONS

Efforts to solve the primary care workforce shortage that ignore the significant dissatisfaction of PCPs with their own careers are unlikely to be successful. Simply adding training slots and increasing reimbursement rates will do little to solve the problem if PCPs continue to view their own careers as ones they cannot recommend to others.

Predictors of the Intention to Resign Among Home-Visiting Nurses in Japan

Multivariate analysis was used to identify predictors of intention to resign in home-visiting nurses working for home-visit nursing agencies (VNAs) in Japan. Of the 214 participants, 56 (26.2%) intended to resign. Results showed that low job satisfaction (odds ratio [OR] = 2.24; 95% confidence interval [CI] = [1.49, 3.63]), working for a hospital-affiliated home-visit nursing agency (OR = 6.48; 95% CI = [1.84, 27.63]), and small allocation of service users per nurse (OR = 1.16, 95% CI [1.03, 1.34]) were significantly related to the intention to resign. Overall, approximately 30% of the nurses intended to resign. To prevent this, the number of service users assigned to a nurse should be flexible and measures should be taken to increase nurses’ job satisfaction. As autonomous organizations, hospital-affiliated home-visit nursing agencies should provide environments that encourage nurses to continue working.

Spirit at work and hope among the ruins: registered nurses' covenant of care

AIM

To explore registered nurses' (RNs) perspectives about the health care system, management/leadership, patients and spirit at work (SAW).

BACKGROUND

Researchers investigating RNs experiences of reduced job satisfaction and diminishing organisational commitment are looking carefully at spirit at work as a means to foster healthier workplaces.

METHODS

A descriptive, cross-sectional mixed methods design was used to measure and explore the relationships between spirit at work, job satisfaction and organisational commitment. A 2012 postal survey sent by the provincial licensing body to a random sample of 217 surgical and 158 home care registered nurses' in western Canada returned 179 surveys. Seventy-five respondents answered the open-ended survey question. Their responses warrant further content analysis and serve as the foundation of this article.

RESULTS

Participants noted that organisational structures and policies, combined with unsupportive leadership, were associated with a reduced sense of community, lack of trust and diminished accountability.

CONCLUSION

Spirit at work was described as sustaining registered nurses' and providing them with hope as they fulfilled their covenant of care with patients.

IMPLICATIONS FOR NURSING MANAGEMENT

Leadership attention to the advancement of SAW may support the covenant of care between the registered nurses and patient while fostering healthier workplaces.

Spirit at Work (SAW): fostering a healthy RN workplace

A cross-sectional mixed-method survey explored and measured relationships between spirit at work (SAW) concepts, experience, education, practice context, job satisfaction, and organizational commitment using LISREL 8.80 and 2012 survey data from a random sample of 217 surgical and 158 home care registered nurses (RNs) in western Canada. Qualitative data underwent content analysis using a priori coding categories based on established theory. Final model indices fit the observed data. SAW concepts of engaging work and mystical experience accounted for moderate to large amounts of model variance for both home care and surgical nurses, while significant positive relationships between SAW concepts, job satisfaction, and organizational commitment were also reported. Researchers concluded that SAW contributes to improved job satisfaction and organizational commitment while being sensitive to RN experiences across clinical contexts. As an holistic measure of RN workplace perceptions, SAW contributes essential information directed at creating optimal environments for both health care providers and recipients.

Procedural justice, supervisor autonomy support, work satisfaction, organizational identification and job performance: the mediating role of need satisfaction and perceived organizational support

AIM

To test a model linking procedural justice, supervisor autonomy support, need satisfaction, organizational support, work satisfaction, organizational identification and job performance.

BACKGROUND

Research in industrial and organizational psychology has shown that procedural justice and supervisor autonomy support lead to positive outcomes. However, very little research related to this subject has been conducted in healthcare settings. Moreover, few studies have examined mechanisms that could account for these positive relationships.

DESIGN

A cross-sectional correlational design was used.

METHOD

Convenience sampling was used and a sample of 500 nurses working in haematology, oncology and haematology/oncology units in France was surveyed in 2011. The final sample consisted of 323 nurses (64.6% response rate). The hypothesized model was tested using structural equation modelling.

RESULTS

Procedural justice and supervisor autonomy support significantly and positively influenced need satisfaction and perceived organizational support, which in turn positively predicted work satisfaction, organizational identification and job performance.

CONCLUSION

Organizations could deliver training programmes for their managers aimed at enhancing the use of fair procedures in allocating outcomes and developing their autonomy-supportive behaviours to improve nurses' work satisfaction, organizational identification and job performance.

Workplace empowerment and nurses' job satisfaction: a systematic literature review

AIMS

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.

BACKGROUND

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.

EVALUATION

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.

KEY ISSUE

A significant positive relation was found between empowerment and nurses' job satisfaction. Structural empowerment and psychological empowerment affect job satisfaction differently.

CONCLUSION

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.

IMPLICATION FOR NURSING MANAGEMENT

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.

Job satisfaction in mainland China: comparing critical care nurses and general ward nurses

AIM

To explore the level of nurses' job satisfaction and compare the differences between critical care nurses and general ward nurses in Mainland China.

BACKGROUND

Hospitals continue to experience high nurse turnover. Job satisfaction is a key factor to retain skilled nurses. The differences in job satisfaction among critical care nurses and general ward nurses are unknown.

DESIGN

A cross-sectional design was selected for this descriptive correlation study.

METHODS

Cross-sectional study of critical care nurses (n = 446) and general ward nurses (n = 1118) in 9 general hospitals by means of questionnaires that included the Chinese Nurses Job Satisfaction Scale and demographic scale. The data were collected from June 2010-November 2010.

RESULTS

Chinese nurses had moderate levels of job satisfaction, were satisfied with co-workers and family/work balance; and dissatisfied with pay and professional promotion. Critical care nurses were younger; less educated and had less job tenure when compared with nurses working on general wards. Critical care nurses were significantly less satisfied than general ward nurses with many aspects of their job.

CONCLUSION

Levels of nurses' job satisfaction can be improved. The lower job satisfaction of critical care nurses compared with general ward nurses should warn the healthcare administrators and managers of potentially increasing the critical care nurses turn over. Innovative and adaptable managerial interventions need to be taken to improve critical care nurse' job satisfaction and retain skilled nurse.