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McCallum AM, Vandenberg HER, Penz KL. Help Wanted, Experience Preferred, Stamina a Must: A Narrative Review of the Contextual Factors Influencing Nursing Recruitment and Retention in Rural and Remote Western Canada from the Early Twentieth Century to 2023. Can J Nurs Res 2024; 56:134-150. [PMID: 37802101 PMCID: PMC11032004 DOI: 10.1177/08445621231204962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023] Open
Abstract
Rural and remote communities of Western Canada have struggled to recruit and retain nursing professionals since the turn of the twentieth century. Existing literature has identified the unique challenges of rural nursing due to the shifting context of rural and remote nursing practice. The objective of this narrative review is to explore the history of rural and remote nursing to better understand the contextual influences shaping rural nursing shortages in Western Canada. This narrative review compared 27 sources of scholarly and historical evidence on the nature of rural nursing practices and recruitment and retention methods following the First World War until 2023. The findings suggest that the complex nature of rural nursing practice is a consistent challenge that has intersected with the long-standing power inequities that are inherent in rural marginalization, political influences, the nursing profession, social structures, and organizational design, to perpetuate rural nursing shortages throughout the past century. Integration and collaboration are needed to reduce systemic marginalization and develop effective and sustainable solutions to reduce nursing shortages in rural and remote areas of Western Canada.
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Affiliation(s)
| | | | - Kelly L. Penz
- University of Saskatchewan College of Nursing, Saskatoon, SK, Canada
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2
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Lundberg A, Santamäki-Fischer R, Gyllencreutz L, Saveman BI, Boman E. Standing alone on the frontline. The meaning of being a nurse in the archipelago-A phenomenological hermeneutical study. Scand J Caring Sci 2023; 37:1048-1056. [PMID: 37130753 DOI: 10.1111/scs.13178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 03/10/2023] [Accepted: 04/16/2023] [Indexed: 05/04/2023]
Abstract
AIM The aim of this study was to illuminate the meaning of being a nurse in the archipelago. METHODOLOGICAL DESIGN AND JUSTIFICATION A phenomenological hermeneutical design was applied, as there is a need to understand the lifeworld and the meaning of being a nurse in the archipelago. ETHICAL ISSUES AND APPROVAL Approval was granted by the Regional Ethical Committee and local management team. All participants provided consent to participate. RESEARCH METHOD Individual interviews were conducted with 11 nurses (Registered Nurses or primary health nurses). The interviews were transcribed, and the text was analysed by means of phenomenological hermeneutical method. RESULTS The analyses ended in one main theme: Standing alone on the frontline, and three themes: 1. Combating sea, weather and the clock with the sub-themes: Fighting to give care to patients despite harsh conditions and Fighting against time; 2. Standing firm but wavering with the sub-themes: Embracing the unexpected and Calling out for support; and 3. Being a lifeline throughout the entire lifespan with the sub-themes: Having responsibility for the islanders and Having an intertwined private and work life. STUDY LIMITATIONS The interviews may be considered few, but the textual data were rich and assessed suitable for the analysis. The text may be interpreted differently, but we deemed our interpretation as more probable than others. CONCLUSION Being a nurse in the archipelago means standing alone on the frontline. Nurses, other health professionals and managers need knowledge and insight about working alone and the moral responsibilities thereof. There is a need to support the nurses in their lonely work. Traditional means of consultations and support could preferably be supplemented by modern digital technology.
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Affiliation(s)
- Anna Lundberg
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Nursing, Åland University of Applied Sciences, Mariehamn, Finland
| | | | | | - Britt-Inger Saveman
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Nursing, Åland University of Applied Sciences, Mariehamn, Finland
| | - Erika Boman
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Nursing, Åland University of Applied Sciences, Mariehamn, Finland
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Andreyeva E, David G, Griese E, Stansbury Ward C, Candon M. Nursing turnover in a large, rural health system. J Rural Health 2023; 39:246-250. [PMID: 35848792 DOI: 10.1111/jrh.12694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE Nursing turnover is a leading cause of inefficiency in health care delivery. Few studies have examined turnover among nurses who work in rural areas. METHODS We accessed human resources data that tracked hiring and terminations from a large health system operating in South Dakota, North Dakota, and Minnesota between January 2016 and December 2017. Our study sample included 7,634 registered nurses, 1,765 of whom worked in a rural community. Within the health system, there were 27 affiliated hospitals, 17 of which were designated critical access hospitals. We estimated nursing turnover rates overall and stratified turnover rates by available demographic and occupational characteristics, including whether the nurse worked in a community with an affiliated acute care hospital or critical access hospital. FINDINGS Overall, 19% of nurses left their position between January 2016 and December 2017. Turnover rates were associated with state, nurse gender and age, and occupational tenure, but were similar in urban and rural areas. Of note, turnover rates were significantly higher in communities without an affiliated acute care hospital or critical access hospital. CONCLUSION Between 2016 and 2017, nearly 1 in 5 nurses working in this health system left their position. Turnover rates differed based on nurse demographics and selected occupational characteristics, including tenure. We also found higher turnover rates among nurses who worked in communities without an affiliated hospital, which points to a potential but unexplored benefit of hospitals in rural areas.
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Affiliation(s)
- Elena Andreyeva
- Department of Health Policy and Management, Texas A&M University, College Station, Texas, USA
| | - Guy David
- Department of Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | - Molly Candon
- Department of Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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4
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Al Sabei SD, Labrague LJ, Al-Rawajfah O, AbuAlRub R, Burney IA, Jayapal SK. Relationship between interprofessional teamwork and nurses' intent to leave work: The mediating role of job satisfaction and burnout. Nurs Forum 2022; 57:568-576. [PMID: 35152423 DOI: 10.1111/nuf.12706] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/20/2021] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Reducing nurse turnover is a top priority for nursing management globally. While evidence has demonstrated that working in a favorable environment with greater interprofessional teamwork is essential in increasing nurse retention, few studies have explored the mechanism underlying this relationship. AIM To examine the direct and indirect effects of interprofessional teamwork on nurses' intentions to leave their jobs via the intermediary roles of job satisfaction and burnout. METHODS A cross-sectional study was conducted to collect data from 2113 nurses working in 21 hospitals in Oman. Data were collected using a survey questionnaire measuring teamwork, job satisfaction, burnout, and intention to leave. Logistic regression was used to investigate the direct effect of teamwork on intent to leave. A sequential mediation model was conducted to examine the mediating role of job satisfaction and burnout. RESULTS Interprofessional teamwork was directly associated with nurses' intentions to leave. The influence of teamwork on intention to leave was indirectly mediated by both job satisfaction and job burnout. CONCLUSION Findings illustrate the potential benefits of enhancing interprofessional teamwork in reducing nurses' intentions to leave. Interventions intended to foster teamwork could create satisfying workplaces, reduce perceived burnout, and ultimately contribute to organizational strategy for reducing nursing shortages.
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Affiliation(s)
- Sulaiman D Al Sabei
- Department of Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Leodoro J Labrague
- Department of Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Omar Al-Rawajfah
- Department of Adult and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
- Department of Adult, College of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Raeda AbuAlRub
- Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Ikram A Burney
- Medical Oncology, Women's Health Program, The Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat, Oman
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5
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Loes CN, Tobin MB. Does Empowerment Enhance Nurses' Organizational Commitment? J Nurs Manag 2022; 30:3123-3130. [PMID: 35761752 DOI: 10.1111/jonm.13725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 10/17/2022]
Abstract
AIM We examined whether psychological empowerment was significantly associated with the organizational commitment of licensed practical nurses. BACKGROUND Health-care organizations face unprecedented staffing challenges. This study provides insight into potential ways to ameliorate these issues. METHODS In early 2010, we distributed a 45-item questionnaire, based on established measures of psychological empowerment and organizational commitment, to the entire population of active, full-time licensed practical nurses throughout a Midwestern U.S. state. Our sample consisted of 1165 respondents. RESULTS The results of our data analysis suggest that even after controlling for a range of potentially confounding variables, three subscales (meaning, self-determination, and impact) were positively and associated with organizational commitment. However, one subscale (competence), was negatively related to the outcome. CONCLUSIONS The psychological empowerment dimensions of impact, meaning, and self-determination are associated with increased organizational commitment among licensed practical nurses. IMPLICATIONS FOR NURSING MANAGEMENT Considering the profound staffing challenges facing the nursing profession-exacerbated by the current global pandemic and retirements-our findings provide nurse administrators with critical information to use in stemming the wave of nurses leaving the profession.
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Affiliation(s)
- Chad N Loes
- Mount Mercy University, Cedar Rapids, IA, USA
| | - Mary B Tobin
- Iowa Wesleyan University, Mount Pleasant, IA, USA
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6
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Lei LP, Lin KP, Huang SS, Tung HH, Tsai JM, Tsay SL. The impact of organisational commitment and leadership style on job satisfaction of nurse practitioners in acute care practices. J Nurs Manag 2022; 30:651-659. [PMID: 35174563 DOI: 10.1111/jonm.13562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 11/28/2022]
Abstract
AIM To determine the main factors that affect nurse practitioners' job satisfaction, especially the relationship between organisational commitment and leadership styles in acute care practices. BACKGROUND There is little known about the influence of organisational commitment and leadership on NPs' job satisfaction within acute care hospitals. METHODS A cross-sectional design with a national online survey that enrolled 1,205 nurse practitioners from the Taiwan Association of Nurse Practitioners to identify potential variables associated with job satisfaction using the multiple regression model. RESULTS Organisational commitment (mean=59.47), job satisfaction (mean=173.47), and leadership style (mean ranged from 13.29 to 28) were at a moderate level. Organisational commitment, leadership style, patient load and nurse practitioner advancement levels explained 63% of the variance in nurse practitioners' job satisfaction. CONCLUSIONS Organisational commitment and leadership styles, such as idealised influence and individual consideration, are major factors that impact nurse practitioners' job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT Healthcare organisations should develop policies targeting organisational commitment and managers' leadership styles to improve nurse practitioners' job satisfaction.
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Affiliation(s)
- Lee-Pi Lei
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan
| | - Kuan-Pin Lin
- Department of Nursing, HungKuang University, Taichung, Taiwan
| | - Sheng-Shiung Huang
- College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - Heng-Hsin Tung
- School of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jung-Mei Tsai
- Department of Nursing, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Nursing, Mackay Medical College, Taipei, Taiwan
| | - Shiow-Luan Tsay
- College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
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7
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MacLeod MLP, Penz KL, Banner D, Jahner S, Koren I, Thomlinson A, Moffitt P, Labrecque ME. Mental health nursing practice in rural and remote Canada: Insights from a national survey. Int J Ment Health Nurs 2022; 31:128-141. [PMID: 34668279 PMCID: PMC9298219 DOI: 10.1111/inm.12943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 11/27/2022]
Abstract
Access to and delivery of quality mental health services remains challenging in rural and remote Canada. To improve access, services, and support providers, improved understanding is needed about nurses who identify mental health as an area of practice. The aim of this study is to explore the characteristics and context of practice of registered nurses (RNs), licensed practical nurses (LPNs), and registered psychiatric nurses (RPNs) in rural and remote Canada, who provide care to those experiencing mental health concerns. Data were from a pan-Canadian cross-sectional survey of 3822 regulated nurses in rural and remote areas. Individual and work community characteristics, practice responsibilities, and workplace factors were analysed, along with responses to open-ended questions. Few nurses identified mental health as their sole area of practice, with the majority of those being RPNs employed in mental health or crisis centres, and general or psychiatric hospitals. Nurses who indicated that mental health was only one area of their practice were predominantly employed as generalists, often working in both hospital and primary care settings. Both groups experienced moderate levels of job resources and demands. Over half of the nurses, particularly LPNs, had recently experienced and/or witnessed violence. Persons with mental health concerns in rural and remote Canada often receive care from those for whom mental health nursing is only part of their everyday practice. Practice and education supports tailored for generalist nurses are, therefore, essential, especially to support nurses in smaller communities, those at risk of violence, and those distant from advanced referral centres.
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Affiliation(s)
- Martha L P MacLeod
- School of Nursing, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Kelly L Penz
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Davina Banner
- School of Nursing, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Sharleen Jahner
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Irene Koren
- School of Nursing, Laurentian University, Sudbury, Ontario, Canada
| | - Alexandra Thomlinson
- Health Research Institute, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Pertice Moffitt
- Aurora Research Institute, Yellowknife, Northwest Territories, Canada
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8
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MacLeod MLP, Zimmer LV, Kosteniuk JG, Penz KL, Stewart NJ. The meaning of nursing practice for nurses who are retired yet continue to work in a rural or remote community. BMC Nurs 2021; 20:220. [PMID: 34742289 PMCID: PMC8571662 DOI: 10.1186/s12912-021-00721-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although much research has focused on nurses' retirement intentions, little is known about nurses who formally retire yet continue to practice, particularly in rural and remote settings where mobilization of all nurses is needed to assure essential health services. To optimize practice and sustain the workforce stretched thin by the COVID-19 pandemic, it is necessary to understand what it means for retired registered nurses (RNs) and licensed practical nurses (LPNs) to work after retirement. This study explored what nursing practice means for RNs and LPNs who have formally retired but continue to practice in rural and remote communities. METHODS A pan-Canadian cross-sectional survey conducted in 2014-2015 of nurses in rural and remote Canada provided data for analysis. Textual responses from 82 RNs and 19 LPNs who indicated they had retired but were occasionally employed in nursing were interpreted hermeneutically. RESULTS Retired nurses who continued to practice took on new challenges as well as sought opportunities to continue to learn, grow, and give back. Worklife flexibility was important, including having control over working hours. Nurses' everyday practice was inextricably tied up with their lives in rural and remote communities, with RNs emphasizing serving their communities and LPNs appreciating community recognition and the family-like character of their work settings. CONCLUSIONS Retired nurses who continue to work in nursing see retirement as the next phase in their profession and a vital way of engaging with their rural and remote communities. This study counters the conventional view of retaining retired nurses only to combat nursing shortages and alleviate a knowledge drain from the workplace. Rural and remote nurses who retire and continue working contribute to their workplaces and communities in important and innovative ways. They can be characterized as dedicated, independent, and resilient. Transitioning to retirement in rural and remote practice can be re-imagined in ways that involve both the community and the workplace. Supporting work flexibility for retired nurses while facilitating their practice, technological acumen, and professional development, can allow retired nurses to contribute their joy of being a nurse along with their extensive knowledge and in-depth experience of nursing and the community.
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Affiliation(s)
- Martha L P MacLeod
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, V2N 4Z9, Canada.
| | - Lela V Zimmer
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, V2N 4Z9, Canada
| | - Julie G Kosteniuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, S7N 2Z4, Canada
| | - Kelly L Penz
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 2Z4, Canada
| | - Norma J Stewart
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 2Z4, Canada
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9
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Wei W, Gan M, Liu Y, Yang M, Liu J. Mediating effects of nurses 'personal and organizational values between organizational commitment and turnover: Cross-sectional study. PLoS One 2021; 16:e0258387. [PMID: 34648546 PMCID: PMC8516302 DOI: 10.1371/journal.pone.0258387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/26/2021] [Indexed: 12/20/2022] Open
Abstract
Background The values of individuals and organizations are the core factors driving and guiding nurses’ decision-making and actions. Previous studies mainly focused on the impact of organizational commitment and other influencing factors on turnover intention. Aim To explore the mediating effect of personal and organizational values matching the relationship between organizational commitment and turnover intention of nursing staff. Methods A cross-sectional survey of 490 subjects in four tertiary hospitals in Tianjin was conducted by convenient sampling. Multivariate regression analysis and structural equation models were used to test each hypothesis. Results The results showed that there is a negative correlation between personal and organizational values, organizational commitment and turnover intention, and personal and organizational values played an indirect intermediary role between organizational commitment and turnover intention. Conclusions Organizational commitment reduces nurses’ turnover intention indirect through personal and organizational values paths. Leaders can improve nurses’ values as members of the organization, so as to participate in their own work more actively. Implications for nursing management Managers should effectively reduce the turnover rate and stabilize the nursing team by improving the organizational commitment and personal and organizational values of clinical nurses.
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Affiliation(s)
- Wentong Wei
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Mengxin Gan
- Nursing Department, Tianjin Union Medical Center Nankai University Affiliated Hospital, Tianjin, China
| | - Yanhui Liu
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- * E-mail: (YL); (JL)
| | - Mengyu Yang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jingying Liu
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- * E-mail: (YL); (JL)
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10
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Fukuzaki T, Iwata N, Ooba S, Takeda S, Inoue M. The Effect of Nurses' Work-Life Balance on Work Engagement: The Adjustment Effect of Affective Commitment. Yonago Acta Med 2021; 64:269-281. [PMID: 34429703 DOI: 10.33160/yam.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/17/2021] [Indexed: 11/05/2022]
Abstract
Background This study aimed to examine the effects of nurses' work-life balance (WLB), job demands and resources, and organizational attachment on their work engagement (WE). The second aim was to shed light on whether the relationships among WLB, job demands, resources, and WE are modulated by organizational attachment. Methods In total, 425 nurses working in a university hospital responded to the questionnaire. The primary statistical analysis method was hierarchical multiple regression with WE as the dependent variable. Results In the model in which all variables were applied, affective commitment (AC) (β = 0.41), family-to-work positive spillover (β = 0.25), and number of children (β = 0.13) were found to have a significant association with WE. Family-to-work negative spillover (FWNS) and AC had significant interaction effects. The result suggests that when AC was low, WE tended to decline further due to FWNS; however, when AC was high, WE did not change due to the effect of FWNS. Conclusion These results confirmed that to improve nurses' WE, hospital organizations should implement initiatives to facilitate WLB that considers nurses' household roles. Furthermore, high organizational attachment buffered the home's negative influence on work, thereby helping nurses work energetically.
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Affiliation(s)
- Toshiki Fukuzaki
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503 Japan
| | - Noboru Iwata
- Faculty of HealthCare, Kiryu University, Midori 379-2392 Japan
| | - Sawako Ooba
- Work-Life Balance Support Center, Tottori University Hospital, Yonago 683-8504 Japan
| | - Shinya Takeda
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503 Japan
| | - Masahiko Inoue
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503 Japan
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11
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Whiteing N, Barr J, Rossi DM. The practice of rural and remote nurses in Australia: A case study. J Clin Nurs 2021; 31:1502-1518. [PMID: 34396616 DOI: 10.1111/jocn.16002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/24/2021] [Accepted: 08/03/2021] [Indexed: 11/26/2022]
Abstract
AIM AND OBJECTIVE To delineate contemporary practice of registered nurses working in rural and remote areas of Australia. BACKGROUND Despite the implementation of strategies to address challenges reported by rural and remote nurses, concern remains over safety and quality of care, the well-being of nurses and retention of the nursing workforce. Twenty years on, geographically dispersed nurses still experience scarce human and material resources. DESIGN A multiple case study design was implemented. METHODS Nurses were recruited from 240 sites. The study comprised three phases of data collection. First, a content analysis of 42 documents relating to the context of nursing, specifically rural and remote nursing; second, a content analysis of an online questionnaire (n = 75); and third, a thematic analysis of semi-structured interviews (n = 20). COREQ reporting guidelines were used. RESULTS Each phase of data collection informed subsequent data collection and analysis within the study. Following triangulation of data from each phase of the study, the major themes reported are "a medley of preparation for rural and remote work"; "being held accountable"; "alone, with or without someone"; and "spiralling well-being." CONCLUSIONS Regardless of strategies, challenges of nursing in rural and remote areas persist. Issues of isolation, stress, burnout and a lack of organisational commitment to employees affect the retention of rural and remote nurses. While useful, professional development courses and graduate certificates are yet to make an impact on reducing these issues. RELEVANCE TO CLINICAL PRACTICE Registered nurses argue for more experience rather than more education to facilitate transition into this nursing area. The finding that experience is perceived as more valuable than education suggests the need for innovative ways to gain experience to practice in rural and remote nursing. Lack of organisational commitment requires attention to promote the well-being of nurses and patient safety.
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Affiliation(s)
- Nicola Whiteing
- Faculty of Health, Southern Cross University, East Lismore, NSW, Australia.,Central Queensland University, Brisbane, Qld, Australia
| | - Jennieffer Barr
- Central Queensland University, Brisbane, Qld, Australia.,Charles Darwin University, Brisbane, Qld, Australia
| | - Dolene M Rossi
- Central Queensland University, Rockhampton, Qld, Australia
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12
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Rodríguez-Fernández M, Herrera J, de las Heras-Rosas C. Model of Organizational Commitment Applied to Health Management Systems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4496. [PMID: 33922667 PMCID: PMC8122969 DOI: 10.3390/ijerph18094496] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/15/2021] [Accepted: 04/22/2021] [Indexed: 12/17/2022]
Abstract
In this paper, we try to build on the problems surrounding the management of human resources in health care organizations worldwide. After the analysis of the reviewed literature, we detected that the scientific community considers several recurring themes that need attention: stress, burnout, and turnover intention. Based on this, we developed a model of organizational commitment that aims to achieve performance and health quality, its main result the establishment of the appropriate management policies in order to avoid the abandonment of the organization through the search for commitment and job satisfaction. Amongst our main conclusions, we highlight the need to implement a human resources model for hospital administrators based on the relationships with "patients" not "clients" through the maintenance of a positive and strong atmosphere of staff participation. It is important to develop innovative practices related to clear job design that eliminate reasons for ambiguity and stress in executing the tasks of the healthcare system. Finally, we urge training programs in transformational leadership to promote the well-being and organizational commitment of employees.
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Affiliation(s)
| | - Juan Herrera
- Department of Economics and Business Administration, Universidad de Málaga, 29071 Málaga, Spain
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13
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Stewart NJ, MacLeod MLP, Kosteniuk JG, Olynick J, Penz KL, Karunanayake CP, Kulig JC, Labrecque ME, Morgan DG. The importance of organizational commitment in rural nurses' intent to leave. J Adv Nurs 2020; 76:3398-3417. [PMID: 33048386 PMCID: PMC7702146 DOI: 10.1111/jan.14536] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 06/24/2020] [Accepted: 07/29/2020] [Indexed: 01/21/2023]
Abstract
Aims To examine determinants of intention to leave a nursing position in rural and remote areas within the next year, for Registered Nurses or Nurse Practitioners (RNs/NPs) and Licensed Practical Nurses (LPNs). Design A pan‐Canadian cross‐sectional survey. Methods The Nursing Practice in Rural and Remote Canada II survey (2014–2015) used stratified, systematic sampling and obtained two samples of questionnaire responses on intent to leave from 1,932 RNs/NPs and 1,133 LPNs. Separate logistic regression analyses were conducted for RNs/NPs and LPNs. Results For RNs/NPs, 19.8% of the variance on intent to leave was explained by 11 variables; and for LPNs, 16.9% of the variance was explained by seven variables. Organizational commitment was the only variable associated with intent to leave for both RNs/NPs and LPNs. Conclusions Enhancement of organizational commitment is important in reducing intent to leave and turnover. Since most variables associated with intent to leave differ between RNs/NPs and LPNs, the distinction of nurse type is critical for the development of rural‐specific turnover reduction strategies. Comparison of determinants of intent to leave in the current RNs/NPs analysis with the first pan‐Canadian study of rural and remote nurses (2001–2002) showed similarity of issues for RNs/NPs over time, suggesting that some issues addressing turnover remain unresolved. Impact The geographic maldistribution of nurses requires focused attention on nurses' intent to leave. This research shows that healthcare organizations would do well to develop policies targeting specific variables associated with intent to leave for each type of nurse in the rural and remote context. Practical strategies could include specific continuing education initiatives, tailored mentoring programs, and the creation of career pathways for nurses in rural and remote settings. They would also include place‐based actions designed to enhance nurses' integration with their communities and which would be planned together with communities and nurses themselves.
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Affiliation(s)
- Norma J Stewart
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Martha L P MacLeod
- School of Nursing, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Julie G Kosteniuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Janna Olynick
- School of Nursing, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Kelly L Penz
- College of Nursing, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - Chandima P Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Judith C Kulig
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | | | - Debra G Morgan
- Rural Health Delivery, Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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