The relationship between healthy work environments and retention of nurses in a hospital setting

Qualitative assessment of nurse satisfaction in the paediatric cardiac ICU

The objective of this qualitative assessment, utilising the constant comparative method, was to identify satisfiers and dissatisfiers that influence paediatric cardiac ICU nurse retention and recognise areas for improvement. Interviews for this study were performed in a single, large academic children's hospital from March of 2020 through July of 2020. Each bedside paediatric cardiac ICU nurse underwent a single semi-structured interview. Among 12 interviews, four satisfiers were identified: paediatric cardiac ICU patient population, paediatric cardiac ICU care team, personal accomplishment, and respect. Four dissatisfiers were identified: moral distress, fear, poor team dynamics, and disrespect. Through this process of inquiry, grounded theory was developed regarding strategies to improve paediatric cardiac ICU nurse retention. Tactics outlined here should be used to support retention in the unique environment of the paediatric cardiac ICU.

Understanding Job Satisfaction and Occupational Stressors of Distinctive Roles in Zoos and Aquariums

For professionals caring for humans or non-human animals, many joys are to be found in working towards what an individual believes to be their calling, especially as they contribute to purposeful, meaningful work consistent with and intrinsic to their own values and beliefs. However, there can be downfalls. Empathic strain, conflict between co-workers, dissatisfaction with upper management, lack of opportunities to make positive changes, limited or no access to level and experience-appropriate professional development, and other stressors are all risks carried by organisations concerned with animal welfare. In the present study, a survey on job satisfaction and workplace stressors was completed by 311 zoo and aquarium professionals working in a range of roles from junior animal care staff to curator. Respondent profiles were created using Multiple Correspondence Analysis (MCA) and four distinct clusters were identified through Hierarchical Clustering on Principal Components (HCPC), highlighting common themes in different levels of experience and in job roles regarding stressors, satisfaction, and feelings about their work and workplaces. Overall, many zoo professionals were concerned with lacking the ability to feel empowered to do their best for animal welfare, and they described a link between the staff welfare and their perceptions of the welfare of the animals they cared for. Through identifying and understanding where organisations can better support their staff it is possible to target and reduce the number of common stressors faced by zoo professionals, leading to increased staff retention, higher job satisfaction, and an improved ability to perform at their best for animal welfare.

Factors related to a successful professional development for specialist nurses in surgical care: a cross-sectional study

BACKGROUND

A high level of competence among staff is necessary for providing patient-safe surgical care. Knowledge regarding what factors contribute to the professional development of specialist nurses in surgical care and why they choose to remain in the workplace despite high work requirements is needed. To investigate and describe the organizational and social work environment of specialist nurses in surgical care as part of studying factors that impact on professional development.

METHOD

This was a cross-sectional study with a strategic convenience sampling procedure that recruited 73 specialist nurses in surgical care in Sweden between October to December 2021. The study was guided by STROBE Statement and checklist of cross-sectional studies. The validated Copenhagen Psychosocial Questionnaire was used, and additional demographic data. Descriptive statistics were performed and the comparison to the population benchmarks was presented as the mean with a 95% confidence interval. To study potential differences among the demographic and professional characteristics, pairwise t tests were used with Bonferroni adjustment for multiple comparisons with a significance level of 5%.

RESULTS

Five domains were identified as factors related to success, as they received higher scores in relation to population benchmarks: quality of leadership, variation of work, meaning of work and work engagement as well as job insecurity. There was also a significant association between a having a manager with low nursing education and job insecurity (p = 0.021).

CONCLUSIONS

Quality of leadership is important for the professional development of specialist nurses in surgical care. Strategic work seems to include managers with a higher nursing education level to prevent insecure professional working conditions.

Nurse Leadership Development: A Qualitative Study of the Dutch Excellent Care Program

Aims. To understand how nurses perceived the contributions of the Dutch Excellent Care Program, the development of nurses’ leadership, and their ability to positively influence their work environment. Background. Research shows that the nursing work environment influences job satisfaction, retention, and quality of care. Many countries have created programs such as the Excellent Care Program to improve nurses’ leadership and facilitate a positive work environment. Methods. A descriptive qualitative study based on 17 semistructured group interviews (participants N = 52) and directed content analysis using thematic coding. Results. Four program processes contribute to leadership development: (1) nurses taking responsibility for their knowledge and skills development; (2) strengthening organizational structures to improve nursing governance; (3) challenging the status quo with quality-enhancing projects; and (4) enhancing awareness of the supportive role of the nurse manager. Conclusions. The program supported nurses’ leadership development for a positive work environment. The interrelatedness of the four processes enhanced the nurses’ ability to solve day-to-day problems and challenge the status quo that influenced working practices. Implications for Nursing Management. The findings support making improvements to healthcare organizational strategies to encourage nurses to show leadership in their work environment.

Nurses' perception of workplace discrimination

BACKGROUND

Discrimination and injustice are big obstacles in nurses' way to socialization and are among the major clinical challenges faced by nurses. Workplace discrimination is associated with such negative consequences as stress, fatigue, demoralization, loss of professional commitment, tension and conflicts at work, and resignation. A review of literature shows that not much research has been dedicated to workplace discrimination in nursing.

OBJECTIVE

This study aims to investigate nurses' perception of workplace discrimination.

METHOD

This cross-sectional study was conducted in the hospitals affiliated with a university of medical sciences in the largest city in the south of Iran in 2019. The participants consisted of 597 nurses who were selected through stratified random sampling. Data were collected using a researcher-made workplace discrimination questionnaire and analyzed in SPSS v. 21.

FINDINGS

The mean of the nurses' workplace discrimination scores was found to be 102.57 ± 14.5, which is considered as moderate. The nurses' mean scores for the dimensions of vertical and horizontal discrimination (44.53 ± 6.8), consequences of discrimination (20.52 ± 5.55), and unfair promotion (12.38 ± 2.44) were moderate. As for the two other dimensions of workplace discrimination, namely, gender discrimination (14.41 ± 3.28) and cultural-organizational discrimination (11.88 ± 2.99), the participants' mean scores were low. There was a significant relationship between the nurses' workplace discrimination mean score on the one hand and their employment status (p = 0.016) and work experience (p = 0.002) on the other. However, the nurses' workplace discrimination mean score was not found to correlate with their level of education (p = 0.65), marital status (p = 0.274), and gender (p = 0.479).

ETHICAL CONSIDERATION

This study has been approved by the ethics committee of the university. All the participants had signed the written informed consent form before participation.

CONCLUSION

Hospital managers should take measures to reduce discrimination and establish organizational justice to raise nurses' morale and improve the quality of their performance as caregivers.

Developing the nursing practice environment scale for home health care: A trial study in Japan

AIM

To develop the nursing practice environment scale in home health care (NPES-HHC), which measures the attractiveness of nursing practice environments in Japan.

DESIGN

Cross-sectional study.

METHODS

The answers of 1,050 mail surveys conducted for nurses at 421 home-visit nursing agencies in Japan were analysed. Exploratory and confirmatory factor analyses of the NPES-HHC's candidate items were performed. Relationships between the newly developed NPES-HHC and participants' intention to remain at the workplace, job satisfaction and quality of care were also tested.

RESULTS

A seven-dimensional model with 37 items was obtained by exploratory factor analysis (Cronbach's alpha: 0.77-0.92). Confirmatory factor analysis supported this model. NPES-HHC scores had significant positive relations with participants' intention to remain at the workplace, job satisfaction and quality of care (p < .01). The NPES-HHC is a reliable and valid instrument to assess the attractiveness of the practice environment for home-visit nursing agencies.

Work environment for hospital nurses in Japan: The relationships between nurses' perceptions of their work environment and nursing outcomes

AIM

To investigate nurses' perceptions of their work environment and to investigate the relationships between variables measuring the work environment (WE) and nursing outcomes (NOs ).

DESIGN

A 2-year prospective longitudinal survey (2013-2015).

METHOD(S)

Descriptive statistics of nurse demographics, organizational WE and NOs were calculated by position. The associations between Practice Environment Scale of the Nursing Work Index (PES-NWI) and NOs were examined for each unit.

RESULTS

The participants were 2,992 staff nurses, 137 nurse managers (NMs), and 8 chief nursing officers in Phase 1 and 7,849, 371 and 23 in Phase 2, respectively. The higher the job position, the better the WE was rated. The higher the PES-NWI scores, the better the outcomes. Descriptive statistics about organizational WEs and NOs and the statistically significant associations between the two were identified.

Licenced practical nurses' perceptions of their work environments and their intention to stay: A cross-sectional study of four practice settings

Aims and objectives

This study aimed to understand how licenced practical nurses perceive their work environments across different work settings and to analyse the association between these nurses’ perceptions of their work environments and their intentions to stay employed at their current nursing unit.

Design

A cross‐sectional descriptive survey was conducted with Licensed Practical Nurses in Alberta, Canada.

Methods

The study population consisted of 598 licenced practical nurses. Survey measures included demographic information, the Perceived Work Environment‐Nursing Work Index, and an intention to stay scale. Descriptive statistics were calculated and mean scores for perceptions about the work environment were compared by work setting. The associations between perceived work environment and intention to stay were analysed using linear regression.

Results

Overall, licenced practical nurses rated their work environment as mixed, with statistically significantly lower scores in acute care settings. Nurse manager ability and adequate staffing and resources were the highest contributing variables.

Newly graduated nurses' perceptions of work environment: A cross-sectional study in China

AIM

To assess the attitudes of newly graduated nurses in China toward their work environment and identify the factors affecting their perception.

BACKGROUND

Newly graduated nurses are the primary supply to cover the nursing shortage, but their stressful transition into clinical work has contributed to high turnover for decades. Although serving as a source of stress, the work environment can also be a source of support for new nurses.

METHODS

A total of 2361 new nurses at 31 tertiary hospitals in 20 provinces were surveyed from June to November 2018, using the Chinese version of the Practice Environment Scale-Nursing Work Index. Basic information and their perception about work environment were collected.

RESULTS

New nurses rated their work environment with an overall score of 84.67 (12.85). Multiple linear regression identified that education level, monthly income, hospital type and location, participation (or not) in standardized training programmes and having (or not) a mentor/preceptor were factors significantly associated with their perception of the work environment.

CONCLUSION

The perception of newly graduated nurses in China was mainly positive overall. Nursing managers may take full advantage of factors affecting the perception of work environment to support newly graduated nurses better, to help their retention and transition.

SUMMARY STATEMENT

What is already known about the topic? Newly graduated nurses experience transition shock at the beginning of their work. Supportive work environments can help successful transition. What this paper adds? Newly graduated nurses are not fully supported in their work environment. Staffing and resource inadequacy were the poorest environmental factors. Residency programmes had the most impact on the perceptions of newly graduated nurses about their work environment.

IMPLICATIONS FOR NURSING PRACTICE

These results can guide nursing managers to support the newly graduated nurses better in their transition process, thus helping retention of nursing human resource.

The value of intentional self-care practices: The effects of mindfulness on improving job satisfaction, teamwork, and workplace environments

BACKGROUND

Burnout rates among nurses have detrimental impact on job satisfaction, teamwork, and patient care. This costs millions of dollars in the healthcare system and challenges nurse leaders to address in order to keep up with the healthcare demands. Furthermore, burnout is especially relevant in our current healthcare climate, as frontline nurses have increased workload and multiple psychosocial stressors during the coronavirus disease (COVID-19) pandemic (Sultana, Sharma, Hossain, Bhattacharya, & Purohit, 2019). Literature also suggests that mindful self-care practices need to be reinforced in order to impact burnout long term (Chamorro-Premuzic & Lusk, 2017). Project7 Mindfulness Pledge© is an accessible and voluntary mindfulness tool that nurses can utilize in their individual practice to reduce burnout and does not require significant time commitment.

OBJECTIVE

To evaluate the effectiveness of intentional self-care practices on nurse burnout and workplace environment by measuring job satisfaction and teamwork among nurses.

METHODS

Comparisons between inpatient units on data from the National Database of Nursing Quality Indicators (NDNQI) with the Practice Environment Scale (PES), specifically on job enjoyment and teamwork, were done utilizing ANOVA.

RESULTS

Results show that nurses in an inpatient unit that implemented Project7 has significantly higher job satisfaction as compared to units that did not implement Project7.

CONCLUSIONS

This suggests that this tool provides an effective and accessible mindfulness framework managers and directors can utilize to improve job satisfaction, teamwork, and thereby reduce burnout to create healthier work environments.

Experiences of Nursing Professionals Working With Women Diagnosed With Opioid Use Disorder and Their Newborns: Burnout and the Need for Support

BACKGROUND

As the rate of opioid use in pregnancy escalates, there are a growing number of women diagnosed with opioid use disorder (OUD) and their newborns being cared for in inpatient settings.

PURPOSE

In this study, we sought to better understand the experiences of nurses and nursing assistants working with women diagnosed with OUD and their newborns. By identifying the needs of nurses and nursing assistants, the findings from this study may contribute to reductions in stigma and improved patient care.

METHODS

Nurses and nursing assistants were recruited from a postpartum unit at a large urban hospital in Utah. Participants (n = 30) attended up to 4 semistructured focus groups. We utilized Braun and Clarke's 6-phase approach to thematic analysis to analyze transcribed interviews.

FINDINGS/RESULTS

Themes identified during the data analysis process included negative feelings and reactions toward patients; preferential concern for the newborn over maternal well-being; and identification of organizational and training needs to overcome these challenges.

IMPLICATIONS FOR PRACTICE

These findings identify strategies for addressing challenges faced by nurses and nursing assistants in caring for women diagnosed with OUD and their newborns.

IMPLICATIONS FOR RESEARCH

Future research should examine the effectiveness of approaches to reduce behaviors influenced by stigma among nurses and nursing assistants working with women diagnosed with OUD and their newborns, as well as employee and patient satisfaction, and long-term health outcomes.

The Effect of Nurse Practice Environment on Retention and Quality of Care via Burnout, Work Characteristics, and Resilience: A Moderated Mediation Model

OBJECTIVE

The aim of this study was to explore the influence of nurse work characteristics, resiliency, and burnout on retention, and patient quality and safety.

BACKGROUND

With an ongoing nursing shortage, maintaining qualified nursing staff is critical. We explored the direct and indirect effects of practice environment, nurse work characteristics, and burnout on retention, and perceived quality and safety.

METHODS

Responses from 507 RNs were collected via an anonymous online survey. Theorized relationships were explored via path analysis and invariance testing.

RESULTS

Positive practice environment and favorable work characteristics lowered burnout and improved outcomes. The indirect effects of work characteristics and burnout were dependent upon individual level of resilience. Social capital minimized the effects of burnout for participants reporting below-average resilience.

CONCLUSIONS

Leader support was critical in shaping positive perception of the practice environment. A nurse leader's visibility and actions impact intent to stay. Results of this study may inform healthcare systems struggling to retain a robust, engaged nursing workforce.

Quality and Safety in Healthcare, Part LXXXI: Critical Care Nursing and the Beacon Award for Excellence

When the "Standards for Establishing and Sustaining Healthy Work Environments" set forth by the American Association of Critical-Care Nurses are met in a health care system, there is enhanced safety and quality care for the patient, better job satisfaction, and less turnover by the staff. The American Association of Critical-Care Nurses started the Beacon Award for Excellence not only to recognize those who have such high standards but also to encourage units who already have achieved this distinction or are applying for it to do better.

Sexual harassment of nurses by patients and missed nursing care-A hidden population study

AIM

To raise awareness of a patient-related antecedent of missed nursing care.

BACKGROUND

Missed nursing care is negatively associated with patient outcomes; accordingly, hospitals employ strategies to mitigate missed care. While antecedents of missed nursing care resulting from the work environment of nurses are recognized, sexual harassment by patients is not.

METHODS

This study is a hidden population study using respondent-driven sampling. We analysed data from thirty letters of frontline nurses from a tertiary Israeli hospital using the six steps of Aronson's thematic analysis.

FINDINGS

Six themes emerged. Nurses (a) felt objectified and that the sacred nurse-patient therapeutic space was desecrated; (b) felt a lack of support from ward managers; (c) felt unprotected, lonely, and alienated; (d) did not share the experience with managers; (e) coped with sexual harassment by ending treatment quickly and later realized they missed some tasks; and (f) considered leaving nursing.

CONCLUSION (S)

Policymakers are called upon to adopt the eight steps suggested for effectively coping with sexual harassment by patients and thus to reduce missed nursing care.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers are called upon to modify their management style and to provide support to nurses who experience sexual harassment in order to alleviate their stress, which is an also antecedent of missed nursing care.

Factors Determining Work Arduousness Levels among Nurses: Using the Example of Surgical, Medical Treatment, and Emergency Wards

Introduction

Staff shortages among nurses have been severely felt in most countries around the world for many years. In Poland, this problem is particularly visible due to the lowest nursing employment rate per 1000 inhabitants among 28 EU states and the high rate of leaving the profession. The average age of Polish nurses has been constantly growing for several years—in 2016 it was 50.79, while in 2008 it was 44.19. These data confirm that young nurses are the first to leave the profession. Diagnosis of the working conditions and psychosocial burden level among nurses should be subject to detailed analysis, so that leaving the profession will not additionally deepen the difficult staffing situation in health care.

Aim

The aim of the study was to identify factors affecting the assessment of work arduousness levels among nursing personnel.

Materials and Methods

The study was conducted among 573 nurses working on surgical, medical treatment, and emergency wards. A standardized job evaluation questionnaire was used to conduct the survey.

Results

(1) Stress levels depended on the ward in which the surveyed person worked. Nurses working in the emergency ward assessed their conditions the best, with the lowest stress. The average general result in this group was 38.1 points versus 46 and 45.7 points in the surgical and medical treatment wards, respectively. (2) At the level of the whole studied group, both the nurses' age and work experience did not differ statistically significantly in the total assessment of working conditions. Differences in the assessment of work arduousness in different age categories occurred at the level of individual wards. In the surgical ward, younger employees were characterized by higher stress levels, especially in the area of arduousness (p=0.0165). In the medical treatment wards, there was a similar age-to-stress ratio for the area of organizational uncertainty (p=0.0063). With age, employees of the emergency ward became more indifferent to stress related to unpleasant working conditions (p=0.0009), while stress related to organizational uncertainty increased (p=0.0495). (3) Nurses working in managerial positions assessed the overall stress related to their job higher than other nurses. They were particularly at risk for burdens related to haste, responsibility, and organizational uncertainty. The average overall assessment of work arduousness for this group was 44.6 points, while for surgical nurses it was 37.2 points. Correlations between the performed function and stress levels were found for almost all of the studied work characteristics (except for hazards). (4) Education had a statistically significant impact on the perception of working conditions in several dimensions. The people with the lowest education evaluated working conditions the best. The difference between people with a higher and those with a secondary education with a specialization was definitely smaller and often nonexistent. Education differentiated the work arduousness assessment depending on the ward. The most statistically significant correlations were obtained in surgical wards, and the least in medical treatment wards.

Conclusions

(1) The study results indicate the need to diagnose problems related to work conditions in the context of occupational stress within individual hospital wards. To limit employee turnover, nursing staff managers should approach the issue of improving working conditions individually for each ward, due to differences in the nature of the work and level of stressogenicity. (2) In each hospital ward, employees at different stages of their career are sensitive to the psychosocial burden resulting from different work characteristics. These areas should be thoroughly diagnosed and the burden minimized to prevent departures from the profession—at early stages of the professional career as well as among experienced personnel. (3) Nurses working in managerial positions should receive the necessary substantive support, due to the higher stress burden associated with greater responsibility.

Role of job satisfaction and work environment on the organizational commitment of nurses: a cross-sectional study

Background: Nursing shortage is a major global concern about healthcare. In this regard, nurses' organizational commitment is an important issue that should be focused on. Since limited data are available about the factors associated with nurse organizational commitment, further research is needed.Aim: This study aimed to examine the influence of job satisfaction and work environment on the organizational commitment of nurses.Design: A predictive design was employed.Methods: The sample comprised 595 nurses at a university hospital in Turkey. A hierarchical regression analysis applied to analyze the data.Results: Significant predictors identified as "self-realization", "nurses' participation in management and representative power", "nurse managers' attitudes and leadership qualities", "general quality", and "communication among physicians, nurses and colleagues".Conclusion: The development of strategies for increasing job satisfaction among nurses and creating positive work environments may lead administrators to increase organizational commitment in helping to the problem of nursing shortage.

Meaning of Courtesy and Respect: Nurse and Patient Experiences

BACKGROUND

Treating patients with courtesy and respect has quality, ethical, and fiscal ramifications.

PURPOSE

This qualitative study revealed meanings of nurse courtesy and respect as imbedded in nurse and patient stories.

METHODS

Audio-recorded interviews were collected from 15 registered nurses and 17 patients on a medical-surgical unit in a 377-bed, nonprofit, Magnet-recognized facility.

RESULTS

Six themes related to courtesy and respect emerged during descriptive content analysis by 2 researchers: (1) being attentive (with subthemes taking time, physical care, and proactive engagement); (2) giving empathetic support; (3) honoring culture and beliefs; (4) recognizing the family; (5) recognizing patient space; and (6) recognizing personhood (with subthemes of showing ordinary politeness and recognizing the individual and honoring choices).

CONCLUSIONS

Informants' stories contributed toward a better understanding of what it means to treat patients with courtesy and respect; and they created context for interpreting HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) numerical results. Further research is warranted.

The nursing work environment and quality of care: Content analysis of comments made by registered nurses responding to the Essentials of Magnetism II scale

AIM

To report a qualitative study of themes Registered Nurses raised spontaneously about their work environment, in a cross-sectional survey study when responding to the Essentials of Magnetism II (EOMII) scale.

DESIGN

Qualitative descriptive survey.

METHODS

At the end of the EOMII scale, a free form text section was included asking nurses to add comments about their ward/work environment. Of the 247 nurses who completed the EOMII scale, 30% (N = 75) provided comments. Inductive content analysis was used to analyse the textual information generated.

RESULTS

Three key themes emerged: "nurses need nurses to nurse"; working as a team and workplace environment. Participants described issues they were facing which comprised high turnover rates, inadequate staffing levels, increasing workload and high stress levels. Particular attention was drawn to the role of the ward manager in promoting a positive work environment, good teamwork and quality patient care.

Nurses' Participation in Clinical and Administrative Decisions in Different Types of Hospital Units

OBJECTIVE

This study explored the types of decisions and differences in decision making that nurses made in different types of hospital units.

BACKGROUND

The relationship between nurses' participation in decision making and the different types of hospital units where they work is not well understood.

METHODS

Nurses' participation in decision making was explored using the Participation in Decision Activities Questionnaire. The final sample included 307 nurses in 24 nursing units in 6 hospitals.

RESULTS

Nurses overall participated more in clinical than administrative decisions, and there were significant differences based on unit type. Critical care nurses had the highest and general care units the lowest levels of participation in decision making.

CONCLUSIONS

Nurses in critical care units participated in higher amounts and at higher levels of clinical decisions overall than either intermediate or general care units. Nurse leaders should determine barriers to decision making in general care units and explore mechanisms to increase participation by clinical nurses.

Empowering Nurses to Lead Interprofessional Collaborative Practice Environments Through a Nurse Leadership Institute

A year-long Nurse Leadership Institute (NLI) for emerging leaders in primary care clinics and acute care environments was developed, implemented, and evaluated. The NLI's goal was to foster empowerment in interprofessional collaborative practice environments for nurses in the three cohorts of NLIs. The NLI was framed around the Five Leadership Practices of modeling the way, inspiring a shared vision, challenging the process, enabling others to act, and encouraging the heart. To create a professional learning environment, foster community, and enhance leadership skills, the Lean In Circle materials developed by Sandberg were adapted for content reorganization and discussion. Minimal literature exists specifically addressing nursing leadership professionals' development based on Sandberg's Circle materials. The findings of the three NLI cohorts reported in this article begin to fill this existing knowledge gap. Participants reported a significant increase in leadership skills. Recommendations for refinement of future NLI offerings are provided. J Contin Educ Nurs. 2018;49(2):61-71.

Compassion Fatigue and the Healthy Work Environment

BACKGROUND

Burnout is a concern for critical care nurses in high-intensity environments. Studies have highlighted the importance of a healthy work environment in promoting optimal nurse and patient outcomes, but research examining the relationship between a healthy work environment and burnout is limited.

OBJECTIVE

To examine how healthy work environment components relate to compassion fatigue (eg, burnout, secondary trauma) and compassion satisfaction.

METHODS

Nurses (n = 105) in 3 intensive care units at an academic medical center completed a survey including the Professional Quality of Life and the American Association of Critical-Care Nurses' Healthy Work Environment standards.

RESULTS

Regression models using each Healthy Work Environment component to predict each outcome, adjusting for background variables, showed that the 5 Healthy Work Environment components predicted burnout and that meaningful recognition and authentic leadership predicted compassion satisfaction.

CONCLUSIONS

Findings on associations between healthy work environment standards and burnout suggest the potential importance of implementing the American Association of Critical-Care Nurses' Healthy Work Environment standards as a mechanism for decreasing burnout.

Investigation of the working conditions of nurses in public hospitals on the basis of nurse-friendly hospital criteria

Objective

This descriptive study reveals how nurses working in public hospitals rated their practice environments with respect to nurse-friendly hospital criteria.

Methods

This study was conducted on 460 nurses volunteering to participate this study among 735 nurses working in inpatient wards of three public hospitals. Data were collected using a personal information form and the Adapted Nursing Work Index–Revised. Numbers, percentages, means and standard deviations, t-test and one-way variance analysis were used to evaluate the data.

Results

Among the nurse-friendly hospital criteria, ‘control of nursing practice’, ‘middle management accountability’ and ‘quality initiatives’ had the highest mean scores, and ‘competitive wages’ had the lowest mean score. The assessments of the nurses presented statistically significant differences with respect to personal and occupational variables.

Conclusion

The nurses found most of the nurse-friendly hospital criteria adequate, but they believed that several areas needed improvement.

A Study Examining the Influence of Proximity to Nurse Education Resources on Quality of Care Outcomes in Nursing Homes

This examination seeks to determine the influence of proximal density to nurse education resources (nursing schools) on nursing home care quality outcomes in Alabama. Motivated by the social network theory, which highlights the influence of relational closeness on shared resources and values, we hypothesize that nursing homes that have higher levels of nursing education resources within a close proximity will exhibit significantly higher nursing home quality outcomes. As proximal density to nurse education resources increases, the opportunity for nursing homes to build closer, stronger ties increase, leading to higher quality outcomes. We examine this hypothesis via ordered logistic regressions of proximal density measures developed through geographic information systems (GIS) software, nurse education resource data from Johnson & Johnson’s Campaign for Nursing’s Future (n = 37), and nursing home quality outcome data from Centers for Medicare and Medicaid Services’s (CMS) Nursing Home Compare from 2016 (n = 226). The results find that increases in proximal density to nurse education resources have a negative and significant association with nursing home quality outcomes in Alabama. Additional sensitivity analysis, which examines the degree to which the nature of this relationship is sensitive to health care facilities’ location in high-density areas, is offered and confirms principal findings. Because nursing programs generally have stronger ties with hospitals, the findings suggest that the nursing homes in areas with higher nurse education resources may actually face greater competition for nurses.

Exploring generational cohort work satisfaction in hospital nurses

Purpose

Although extensive research exists regarding job satisfaction, many previous studies used a more restrictive, quantitative methodology. The purpose of this qualitative study is to capture the perceptions of hospital nurses within generational cohorts regarding their work satisfaction.

Design/methodology/approach

A preliminary qualitative, phenomenological study design explored hospital nurses’ work satisfaction within generational cohorts – Baby Boomers (1946-1964), Generation X (1965-1980) and Millennials (1981-2000). A South Florida hospital provided the venue for the research. In all, 15 full-time staff nurses, segmented into generational cohorts, participated in personal interviews to determine themes related to seven established factors of work satisfaction: pay, autonomy, task requirements, administration, doctor–nurse relationship, interaction and professional status.

Findings

An analysis of the transcribed interviews confirmed the importance of the seven factors of job satisfaction. Similarities and differences between the generational cohorts related to a combination of stages of life and generational attributes.

Practical implications

The results of any qualitative research relate only to the specific venue studied and are not generalizable. However, the information gleaned from this study is transferable and other organizations are encouraged to conduct their own research and compare the results.

Originality/value

This study is unique, as the seven factors from an extensively used and highly respected quantitative research instrument were applied as the basis for this qualitative inquiry into generational cohort job satisfaction in a hospital setting.

Effects of work environment on patient and nurse outcomes

BACKGROUND

Several parameters of the nurse's work environment lead to fewer patient complications and lower nurse burnout. The aim of this systematic review was the analysis of research data related to the effect of nurses' work environments on outcomes for both patients and nurses.

METHODS

Medline was searched by using keywords: 'working conditions', 'work environment', 'nurses', 'nursing staff', 'patients', 'outcomes'.

RESULTS

In total, 10 studies were included, of which 4 were cross-sectional and the remaining were descriptive correlational studies. Patients who were hospitalised in units with good work environments for the nurses were more satisfied with the nursing care than the patients in units with poor work environments. Nurses who perceived their work environment to be good experienced higher job satisfaction and lower rates of burnout syndrome.

CONCLUSIONS

A good work environment constitutes a determinant factor for high care quality and, at the same time, relates to improved outcomes for the nurses.

Nurses' perspectives on workplace mistreatment: A qualitative study

An accurate understanding of workplace mistreatment and its impacts on nurses is crucial to hospital managers. A qualitative approach using conventional content analysis was adopted in this study to describe the perspectives of a sample of Iranian nurses concerning workplace mistreatment. After analyzing the transcribed interviews, three main themes emerged: (i) Demand for a more humanistic and appreciative environment; this theme consisted of three categories: "incompetent management practice", "invisibility of nurses", and "unethical behaviors"; (ii) Unprofessional interpersonal encounters which included three categories: "poorly defined job characteristics", "nurses' poor performance", and "inefficient supportive means and structures"; and (iii) Inaction despite injury, consisting of two categories: "passive and ineffective ways of coping with mistreatment", and "personal and professional negative impacts". Findings from this study can guide further investigation within diverse populations of Iranian nurses, as well as worldwide, in order for firm conclusions to be drawn. Future research could compare the perspectives of other stakeholders - patients and relatives, physicians, and managers concerning workplace mistreatment.

Patient Violence Towards Counselors in Substance Use Disorder Treatment Programs: Prevalence, Predictors, and Responses

Workplace violence disproportionately impacts healthcare and social service providers. Given that substance use and abuse are documented risk factors for the perpetration of violence, SUD treatment personnel are at risk for patient-initiated violence. However, little research has addressed SUD treatment settings. Using data nationally representative of the U. S., the present study explores SUD counselors' experiences of violent behaviors perpetrated by patients. More than half (53%) of counselors personally experienced violence, 44% witnessed violence, and 61% had knowledge of violence directed at a colleague. Counselors reported that exposure to violence led to an increased concern for personal safety (29%), impacted their treatment of patients (15%), and impaired job performance (12%). In terms of organizational responses to patient violence, 70% of organizations increased training on de-escalation of violent situations, and 58% increased security measures. Exposure to verbal assault was associated with age, minority, tenure, recovery status, 12-step philosophy, training in MI/MET, and higher caseloads of patients with co-occurring disorders. Exposure to physical threats was associated with age gender, minority, tenure, recovery status, and higher caseloads of patients with co-occurring disorders. Exposure to physical assault was associated with age, gender, and sample. Implications of these findings for organizations and individuals are discussed.

Global Worker Migration

In an attempt to alleviate the shortage of nurses practicing within the United States (US), hospitals and other health care organizations have begun to recruit nurses from outside America’s borders. While these efforts may yield increased staffing levels in the US, they have also raised questions as to whether it is ethical to create nurse shortages in poor countries so that richer countries can enjoy full employee rosters. This recruitment of nurses serves to create what has been labelled as ‘brain drain’ for many developing countries. Within the US, professional nursing and hospital organizations and governmental legislation are attempting to address the issues of nursing shortages and help relieve some of the issues created by brain drain. Using game theory as a theoretical foundation, this article proposes the development of a win-win environment that may support adequate nursing levels in both developed and developing countries.

Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction

Efficient, accurate, and timely communication is required for quality health care and is strongly linked to health care staff job satisfaction. Developing ways to improve communication is key to increasing quality of care, and interdisciplinary care teams allow for improved communication among health care professionals. This study examines the patient- and family-centered use of structured interdisciplinary bedside rounds (SIBR) on an acute care for the elderly (ACE) unit in a 555-bed metropolitan community hospital. This mixed methods study surveyed 24 nurses, therapists, patient care assistants, and social workers to measure perceptions of teamwork, communication, understanding of the plan for the day, safety, efficiency, and job satisfaction. A similar survey was administered to a control group of 38 of the same staff categories on different units in the same hospital. The control group units utilized traditional physician-centric rounding. Significant differences were found in each category between the SIBR staff on the ACE unit and the control staff. Nurse job satisfaction is an important marker of retention and recruitment, and improved communication may be an important aspect of increasing this satisfaction. Furthermore, improved communication is key to maintaining a safe hospital environment with quality patient care. Interdisciplinary team rounds that take place at the bedside improve both nursing satisfaction and related communication markers of quality and safety, and may help to achieve higher nurse retention and safer patient care. These results point to the interconnectedness and dual benefit to both job satisfaction and patient quality of care that can come from enhancements to team communication.

Job satisfaction of Malaysian registered nurses: a qualitative study

BACKGROUND

Job satisfaction is an important factor in health care settings. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care. However, there have not been any studies exploring the job satisfaction of Malaysian nurses.

AIM

The main purpose of this qualitative descriptive study was to explore the factors related to feelings of job satisfaction as well as job dissatisfaction experienced by registered nurses in Malaysia.

METHOD

A convenient sample of 46 Malaysian nurses recruited from a large hospital (number of beds = 895) participated in the study. A total of seven focus group discussions were conducted with nurses from surgical, medical and critical care wards. A semi-structured interview guide was used to facilitate the interviews, which were audio-recorded, transcribed verbatim and checked. The transcripts were used as data and were analysed using a thematic approach.

FINDING

The study identified three main themes that influenced job satisfaction: (1) nurses' personal values and beliefs; (2) work environment factors and (3) motivation factors. Concerning the nurses' personal values and beliefs, the ability to help people made the nurses felt honoured and happy, which indirectly contributed to job satisfaction. For work environment factors, team cohesion, benefit and reward, working conditions play an important role in the nurses' job satisfaction. Motivation factors, namely, professional development and clinical autonomy contributed to job satisfaction.

CONCLUSION

It is important for nurse leaders to provide more rewards, comfortable work environments and to understand issues that affect nurses' job satisfaction.

RELEVANCE TO CLINICAL PRACTICE

Our findings highlight the importance of factors that can improve nurses' job satisfaction. The study provides basic information for hospital administrators in planning effective and efficient policies to improve nursing job satisfaction in order to increase the quality of patient care and decrease nursing turnover.

Anaesthetic nurse specialist role: leading and facilitation in clinical practice

Leadership and its effectiveness is becoming more prevalent within the nursing profession with anaesthetic nurse specialists showing their ability to lead, inspire and motivate others to work towards a shared vision in the rapidly changing peri-anaesthesia environment. Anaesthetic nurse specialists must therefore be aware of their personal leadership skills and continually develop these within clinical practice. They are also well placed regarding the facilitation of learning.

New graduate survey: factors that influence new nurses' selection of first clinical position

AIM

The aim was to survey nurses with 2 to 3 years' experience to determine what factors were involved in the choice of their first nursing position and if they were still in that position.

BACKGROUND

A false sense that the nursing shortage has ended has occurred with nurses delaying retirement until the economy improves. However, the turnover rate still shows 26% of registered nurses leaving their first hospital position within 2 years.

METHODS

New graduate nurses were surveyed to determine if nursing was what they expected, what led them to their first position, if they were still in their first position, and factors that may have influenced these decisions. The 159 respondents also commented on their intent to stay and gave free-text responses.

RESULTS

Significant difference was found between the current unit worked with both the unit wanted while in nursing school and the unit wanted upon graduation. Positive and negative narrative comments shed light on factors influencing intent to stay.

CONCLUSION

Nurses are concerned with ability to deliver safe care, supportive management, and teamwork.

IMPLICATIONS FOR NURSING MANAGEMENT

Recommendations were made for nursing management in creating an environment of continued learning and teamwork to support new graduate nurses.

Exploring physical health perceptions, fatigue and stress among health care professionals

Nurses, midwives, and paramedics are exposed to high degrees of job demand, which impacts health status and job satisfaction. The aim of this study was to explore the experiences and perceptions of health with a group of nurses, midwives and paramedics in Australia. Specifically, this paper reveals the findings related to the dataset on physical health. In this regard, the researchers sought to explore the relationship between physical health and job satisfaction, and the relationship between health status and stress levels. The study adopted a mixed methodology and used two methods for data collection: one-on-one interviews exploring the relationship between physical health and job satisfaction, and a survey questionnaire focusing on self-rated stress management. The individual interviews were conducted for further exploration of the participants’ responses to the survey. There were 24 health care participants who were drawn from metropolitan and regional Australia. The findings revealed participants: had a desire to increase their physical activity levels; had different perspectives of physical health from those recommended by government guidelines; and viewed physical health as important to job satisfaction, yet related to stress and fatigue.

Leading change to create a healthy and satisfying work environment

Nurse executives must take a leadership role in creating a healthy work environment for nurses and all disciplines. Engaging in partnerships and empowering clinical nurses to construct the solutions to barriers that may stand in the way of the goal of a satisfied and healthy workforce are important strategies toward success. This publication outlines many projects a 3-time Magnet-designated academic hospital has implemented, working with our shared leadership councils, to meet the standards for a healthy work environment. These initiatives, from the unit to the hospital level, included standardizing a culture change of uninterrupted meal breaks, the creation of intensive care unit Zen rooms, strategies to better manage increased patient volumes, best practices for facility design, enhancing physician-nurse relations, and a hospital wellness program. Data were benchmarked against national nurse and employee surveys to compare progress and report outcomes. Two important nursing organization structures that have contributed to the success of a healthy and satisfied nursing work environment include UEXCEL, a longstanding clinical nurse professional practice program, and the hospital's 11-year participation in the University HealthSystem Consortium/American Association of Colleges of Nursing National Post-Baccalaureate Nurse Residency Program. A highly engaged, well-educated, and committed nursing workforce, nurtured by a strong leadership team, has created a positive work environment characterized by low turnover and high retention.

Healthy work environments and staff nurse retention: the relationship between communication, collaboration, and leadership in the pediatric intensive care unit

BACKGROUND

A healthy work environment can improve patient outcomes and registered nurse (RN) turnover. Creating cultures of retention and fostering healthy work environments are 2 major challenges facing nurse leaders today.

SPECIFIC AIMS

Examine the effects of the healthy work environment (communication, collaboration, and leadership) on RN turnover from data collected from a research study.

METHODS

Descriptive, cross-sectional, correlational design. Pediatric critical care RNs from 10 pediatric intensive care units (PICU) completed the Practice Environment Scale of the Nursing Work Index Revised and a subscale of the Intensive Care Unit Nurse-Physician Communication Questionnaire. These staff nurses were asked whether they intend to leave their current job in the next 6 months. Statistical analysis included correlations, multiple linear regression, t tests (2-tailed), and 1-way analysis of variance.

RESULTS

A total of 415 RNs completed the survey. There was a statistically significant relationship between leadership and the intent to leave (P < .05). There was also an inverse relationship between years of experience and intent to leave. None of the communication variables between RNs and among RNs and MDs or collaboration were significantly associated with PICU nurses' intention to leave.

CONCLUSION

Effective leadership in the PICU is important to PICU RNs and significantly influences their decisions about staying in their current job.