1
|
Chen Y, Zhou X, Bai X, Liu B, Chen F, Chang L, Liu H. A systematic review and meta-analysis of the effectiveness of social support on turnover intention in clinical nurses. Front Public Health 2024; 12:1393024. [PMID: 38903567 PMCID: PMC11187297 DOI: 10.3389/fpubh.2024.1393024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/17/2024] [Indexed: 06/22/2024] Open
Abstract
Background Nurse turnover has become a salient issue in healthcare system worldwide and seriously compromises patient outcomes. Social support is considered an effective contributor to alleviate nurse turnover intention (TI). However, the degree of correlation between social support and nurse TI remains elusive. Aims This study aims to evaluate the strength of the effectiveness of social support on TI among nurses as well as its potential moderators. Design This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Methods To obtained qualified studies, two researchers searched Embase, PubMed, Web of science, CINAHL, CNKI, WanFang, and Chinese Medical Journal Full Text Database from inception to January 6, 2024. Meta-analysis, publication bias, and sensitivity analysis were carried out on the included studies using CMA 3.0 software, and the moderating effect was verified through meta-analysis of variance (ANOVA). Results A total of 38 studies were obtained, involving 63,989 clinical nurses. The comprehensive effect size of the random effect model showed a significant medium negative correlation between social support and TI among nurses (p < 0.001). The sample size and TI measurement tools significantly moderated the correlation between social support and TI (p < 0.050). However, nurse department, gender, data collection time, and social support measurement tools did not moderate the correlation between the two variables. Conclusion Social support is negatively associated with TI in nurses. Nursing administrators and the medical community should fully recognize the importance of social support for nurses and take corresponding measures to enhance it, thereby reducing TI and ensuring the stability of the nursing team.
Collapse
Affiliation(s)
- Yan Chen
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xiang Zhou
- School of Sociology and Political Science, Shanghai University, Shanghai, China
| | - Xue Bai
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Beibei Liu
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Fengzhi Chen
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Lixia Chang
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Hongli Liu
- Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| |
Collapse
|
2
|
Suokonautio B, Kouvonen A, Nordquist H. Role identities of emergency medical services personnel and their associations with intention to leave the profession. BMC Emerg Med 2024; 24:96. [PMID: 38840088 PMCID: PMC11155154 DOI: 10.1186/s12873-024-01008-8] [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: 01/26/2024] [Accepted: 05/21/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND The scope of emergency medical services (EMS) has expanded from the urgent care of emergency patients to on-call healthcare services provided in the field with a holistic view of the patient's wellbeing. This challenges EMS to find solutions to cover all demands, while simultaneously setting high skill requirements for EMS personnel. Understanding personnel is a critical element in developing functional and resistant EMS. The aim of this study was to investigate how Finnish EMS personnel emphasize the Emergency Medical Services Role Identity Scale aspects of caregiving, thrill-seeking, duty, and capacity; and if these role identities are associated with intention to leave the profession. METHODS We conducted a cross-sectional survey (N = 616, 52% women, mean age 32.9 years). Data were collected through social media platforms and analyzed with means, standard deviations, Mann-Whitney U-tests, Kruskal-Wallis H-tests, and binary logistic regression analyses. RESULTS Our results indicate that capacity is the most emphasized aspect among EMS personnel, and at the same time, it increases intention to leave EMS. Capacity was followed by caregiving, with no association with intention to leave. Duty and thrill-seeking were the least emphasized and were negatively associated with intention to leave. Additionally, there were also other factors that were associated with emphasizing EMS-RIS aspect and intention to leave. CONCLUSION Capacity stands out most strongly in analysis being at the core of the role identity of EMS personnel and was associated with a higher likelihood of leaving intentions. Several other factors were also associated with the intention to leave. Future studies should examine the exact dimensions of capacity that are considered important among EMS personnel and why factors such as work experience are associated with intentions to leave.
Collapse
Affiliation(s)
- Beeda Suokonautio
- Faculty of Social Sciences, University of Helsinki, Helsinki, 00014, Finland.
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, 00014, Finland
- Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BA, Northern Ireland
| | - Hilla Nordquist
- Faculty of Social Sciences, University of Helsinki, Helsinki, 00014, Finland
- South-Eastern Finland University of Applied Sciences, Kotka, 48220, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, 00014, Finland
| |
Collapse
|
3
|
Subramony M, Vogus TJ, Chadwick C, Gowen C, McFadden KL. Workload, nurse turnover, and patient mortality: Test of a hospital-level moderated mediation model. Health Care Manage Rev 2024; 49:23-34. [PMID: 38019461 DOI: 10.1097/hmr.0000000000000390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND Hospitals are often tasked with improving patient care while simultaneously increasing operational efficiency. Although efficiency may be gained by maintaining higher patient volume per nurse (higher workload), high-quality patient care requires low levels of nurse turnover, which might be adversely affected by an increase in workload. PURPOSE Drawing upon job demands-resources theory, we hypothesized that hospital-level workload will predict nurse turnover and that nurse turnover will predict patient mortality, and that registered nurse hiring rates and human resource management practices will moderate (buffer) the positive relationship between nurse workload and nurse turnover, whereas quality care structures will moderate (buffer) the positive relationship between nurse turnover and patient mortality. METHODS We tested this model utilizing multiple sources of time-lagged data collected from a sample of 156 hospitals in the United States. RESULTS Our findings suggest that (a) nurse workload is associated with higher nurse turnover, (b) nurse turnover is positively associated with patient mortality, (c) nurse staffing buffers the workload-turnover relationship as a first-stage moderator, and (d) quality care structures act as a second-stage moderator that mitigates the effects of turnover on mortality. CONCLUSIONS/PRACTICE IMPLICATIONS The reduction of nurse turnover and patient mortality requires investments in adequate levels of nurse staffing and implementation of quality care structures.
Collapse
|
4
|
Xu JB, Zheng QX, Jiang XM, Zhuo Q, Nian JX, Wang JT. Mediating effects of social support, mental health between stress overload, fatigue and turnover intention among operating theatre nurses. BMC Nurs 2023; 22:364. [PMID: 37803427 PMCID: PMC10559401 DOI: 10.1186/s12912-023-01518-z] [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: 05/18/2023] [Accepted: 09/18/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND The high rate of nurses turnover and nursing staff shortage have been an ongoing concern issue and a challenge for global health systems. To explore the turnover intention among operating theatre nurses, and to test the hypothetical model for estimating the effects of stress overload and fatigue between social support, mental health and turnover intention. DESIGN a multi-center and cross-sectional online survey. METHODS This study was conducted from October 2020 to March 2021 comprised 1060 operating theatre nurses from 76 Chinese hospitals. The descriptive analysis, independent sample t test and one-way analysis of variance and Spearman correlation analysis were used to explore the relationships among variables by the SPSS software, and stepwise multiple linear regression analysis was utilized to identify influencing factors of turnover intention and its dimensions among operating theatre nurses. A structural equation model was analyzed by the AMOS software. RESULTS Social support, mental health, stress overload and fatigue were important predictors of turnover intention among operating theatre nurses. Besides, stress overload positively affected fatigue, mental health and turnover intention; fatigue negatively affected social support, however, fatigue positively affected mental health; social support negatively affected mental health and turnover intention; mental health positively affected turnover intention. Moreover, social support, mental health mediated between stress overload, fatigue and turnover intention among operating theatre nurses. CONCLUSION Social support, mental health mediated between stress overload, fatigue and turnover intention among operating theatre nurses.
Collapse
Affiliation(s)
- Jia-Bin Xu
- Nursing Department, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Street, Gulou District, Fuzhou City, Fujian Province, China
- Fujian Branch of Shanghai Children's Medical Center, Shanghai Jiaotong University school of Medicine, Fuzhou City, Fujian Province, China
- Fujian Children's Hospital, Fuzhou City, Fujian Province, China
| | - Qing-Xiang Zheng
- Nursing Department, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Street, Gulou District, Fuzhou City, Fujian Province, China
- Fujian Obstetrics and Gynecology Hospital, Fuzhou City, Fujian Province, China
| | - Xiu-Min Jiang
- Nursing Department, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Street, Gulou District, Fuzhou City, Fujian Province, China.
| | - Qing Zhuo
- Nursing Department, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Street, Gulou District, Fuzhou City, Fujian Province, China
| | - Jin-Xia Nian
- Nursing Department, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Street, Gulou District, Fuzhou City, Fujian Province, China
| | - Jie-Ting Wang
- Nursing Department, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Street, Gulou District, Fuzhou City, Fujian Province, China
| |
Collapse
|
5
|
Yu G, Kovner CT, Glassman K, Devanter NV, Ridge LJ, Raveis VH. The Impact of the Early COVID-19 Pandemic on Registered Nurses' Intent to Stay in Nursing. Policy Polit Nurs Pract 2023:15271544231160694. [PMID: 37128698 PMCID: PMC10159790 DOI: 10.1177/15271544231160694] [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: 05/03/2023]
Abstract
The COVID-19 pandemic has been difficult for registered nurses. Media reports, most of them anecdotal, have reported upticks in nurse resignations, and plans to resign and/or leave nursing due to COVID-19. This article reports findings from an online anonymous 95-item survey completed by about 1,600 nurses from a New York City metropolitan area health system's (HS) four hospitals and ambulatory care centers about their COVID-19 experience in the spring of 2020, their intent to stay at the HS, and their intent to stay working as a nurse. Conducted early in the pandemic, this survey addresses a major gap in the literature, as there was no timely evaluation of nurses' intent to leave during the "Great Attrition" wave or to stay during the "Great Attraction" trend. Among those nurses completing the survey, 85.7% reported that they planned to work as a nurse one year later and 77.9% reported that they planned to work at the HS one year later. Those nurses who obtained a master's or doctoral degree as their first professional degree in nursing, or had a high level of mastery, were less likely to report an intent to stay at the HS. Those with no children, those who thought the HS was more supportive, and those who thought that registered nurse-medical doctor relations were higher were more likely to intend to stay at the HS. Those nurses who reported worse communication with their nurse manager were less likely to report an intent to stay in nursing. Those who reported lower stress, who were unmarried and had no children were more likely to intend to work as nurses. Our findings on nurses' intent to leave their organization and their intent to leave nursing are much lower than reports in the popular press. Our data were collected early in the pandemic and it may not reflect the accumulated stress nurses experienced from witnessing the death of so many patients.
Collapse
Affiliation(s)
- Gary Yu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
- School of Global Public Health, New York University, New York, NY, USA
| | | | - Kimberly Glassman
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Nancy Van Devanter
- Rory Meyers College of Nursing, New York University, New York, NY, USA
- School of Global Public Health, New York University, New York, NY, USA
| | | | | |
Collapse
|
6
|
Rahnfeld M, Wendsche J, Wegge J. Job demands and resources as drivers of exhaustion and leaving intentions: a prospective analysis with geriatric nurses. BMC Geriatr 2023; 23:167. [PMID: 36959574 PMCID: PMC10037764 DOI: 10.1186/s12877-023-03829-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 02/16/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Nurses show a high prevalence of exhaustion and increased leaving intentions. With this study, we integrate established research about turnover intention with recent burnout literature and present a theoretical model that combines both. The aim of this study was to examine job demands (time pressure, social conflicts) and resources (job control, supervisor support, task identity, person-organisation fit) as drivers and health and age as moderators for the relationships between exhaustion and nurses' organisational and professional leaving intentions. METHODS We analysed data from a standardised paper-pencil questionnaire survey with a prospective, two-wave (12 months apart) study design. In total, 584 nurses participated at Time 1 (t1). The final sample at Time 2 (t2) was n = 222 nurses (38%; age: M = 41.1 years, SD = 11.0; 88% females). RESULTS We identified time pressure as job demand and job control, task identity, and person-organisation fit as resources that drive the relationships of exhaustion (mean between both times of measures) and organisational and professional leaving intentions. The relationships to organisational leaving intentions decreased with nurses' age and the relationships to professional leaving intentions increased for nurses who had poorer self-rated health. We found indirect effects of exhaustion for relationships between job demands and nurses' leaving intentions. Relationships to exhaustion remained significant after adjusting for depressive mood. CONCLUSION Insights from this study can be used both by employers and employees. Redesigning work might be a promising approach to improve nurses' well-being and retention in this profession. Geriatric care facilities should include the concept of person-organisation fit into their personnel selection process.
Collapse
Affiliation(s)
- Marlen Rahnfeld
- Faculty of Psychology, TU Dresden, Zellescher Weg 17, D-01069, Dresden, Germany
| | - Johannes Wendsche
- Federal Institute for Occupational Safety and Health, Fabricestraße 8, D-01099, Dresden, Germany
| | - Jürgen Wegge
- Faculty of Psychology, TU Dresden, Zellescher Weg 17, D-01069, Dresden, Germany.
| |
Collapse
|
7
|
Fewer Patients per Nurse Does Not Offset Increased Nurse Stress Related to Treatment Uncertainty and Mortality in the Neonatal Intensive Care Unit. Adv Neonatal Care 2022; 22:E152-E158. [PMID: 34743114 DOI: 10.1097/anc.0000000000000930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Many inpatient healthcare institutions' nurse staffing plans systematically assign fewer patients to nurses when patient acuity is high, but the impact of this strategy on components of nurse stress has not been thoroughly investigated. PURPOSE To examine the relationship between nurse-to-patient ratio assigned based on NICU patient acuity with the Nurse Stress Scale (NSS) subscales Death and Dying, Conflict with Physicians, Inadequate Preparation, Lack of Support, Conflict with Other Nurses, Work Load, and Uncertainty Concerning Treatment. METHODS A survey including the NSS tool items, demographic questions, and a question about nurse-to-patient ratio during the shift was administered. Cronbach's α, linear regression, and Spearman's correlation were used for data analysis. RESULTS Analysis of the 72 participating NICU nurses' survey responses showed fewer patients per nurse during the shift was negatively correlated with stress related to Death and Dying ( P < .001) and Uncertainty Concerning Treatment ( P = .002) subscale scores. This inverse relationship remained significant after controlling for education and years of experience. IMPLICATIONS FOR PRACTICE The observed higher stress can be inferred to be due to high patient acuity since fewer patients are assigned to nurses caring for high-acuity patients. Improvements in communication to nurses about patients' medical condition, treatment rationale, and information that should be conveyed to the family could reduce nurse stress from treatment uncertainty. Targeted education and counseling could help nurses cope with stress due to patient deaths. IMPLICATIONS FOR RESEARCH Interventions to reduce stress related to treatment uncertainty and death of patients among NICU nurses caring for high-acuity infants should be developed and evaluated.
Collapse
|
8
|
Zhang Y, El Ghaziri M, de Castillero ER. Synergistic effect of self-efficacy and social support on regular participation in leisure-time physical activity among nursing staff. Int J Nurs Pract 2022; 29:e13087. [PMID: 35929046 DOI: 10.1111/ijn.13087] [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: 02/22/2021] [Revised: 06/27/2022] [Accepted: 07/17/2022] [Indexed: 10/16/2022]
Abstract
AIMS This exploratory study, using mixed methods research, aimed to (1) examine the associations among self-efficacy, social support and regular leisure-time physical activity of nursing staff, and (2) identify motivators and barriers to leisure-time physical activity. BACKGROUND It is important to engage nursing staff in regular leisure-time physical activity as a countermeasure against high occupational stress and poor health. Limited research has examined nursing staff's participation in leisure-time physical activity and associated factors. METHODS Nursing staff employed at a community hospital in the northeastern United States were invited to participate in this cross-sectional survey with close- and open-ended questions in March 2016. RESULTS A total of 363 nurses and nursing assistants responded, among whom, 59.8% reported regular leisure-time physical activity. Poisson regression models suggested that self-efficacy and social support had an interactive association with increased prevalence of regular leisure-time physical activity. CONCLUSION Self-efficacy and social support have an important synergistic association with regular leisure-time physical activity of nursing staff. Effective interventions intending to facilitate nursing staff's leisure-time physical activity should consider improving their self-efficacy and social support. Qualitative comments suggested that work-out areas in the workplace with release time and organized activity may promote regular leisure-time physical activity of nursing staff.
Collapse
Affiliation(s)
- Yuan Zhang
- Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Mazen El Ghaziri
- Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Elizabeth Ronan de Castillero
- Division of Patient Care Services, Nursing Education Department, Lowell General Hospital, Lowell, Massachusetts, USA
| |
Collapse
|
9
|
A Conceptual Model of Nurses' Turnover Intention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138205. [PMID: 35805865 PMCID: PMC9266265 DOI: 10.3390/ijerph19138205] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/29/2022] [Accepted: 07/02/2022] [Indexed: 01/09/2023]
Abstract
The World Health Organisation predicts a lack of 15 million health professionals by 2030. The lack of licenced professionals is a problem that keeps emerging and is carefully studied on a global level. Strategic objectives aimed at stimulating employment, improving working conditions, and keeping the nurses on board greatly depends on identifying factors that contribute to their turnover. The aim of this study was to present a conceptual model based on predictors of nurses' turnover intention. Methods: A quantitative, non-experimental research design was used. A total of 308 registered nurses (RNs) took part in the study. The Multidimensional Work Motivation Scale (MWMS) and Practice Environment Scale of the Nursing Work Index (PES-NWI) were used. Results: The conceptual model, based on the binary regression models, relies on two direct significant predictors and four indirect significant predictors of turnover intention. The direct predictors are job satisfaction (OR = 0.23) and absenteeism (OR = 2.5). Indirect predictors that affect turnover intention via job satisfaction are: amotivation (OR = 0.59), identified regulation (OR = 0.54), intrinsic motivation (OR = 1.67), and nurse manager ability, leadership and support of nurses (OR = 1.51). Conclusions: The results of the study indicate strategic issues that need to be addressed to retain the nursing workforce. There is a need to ensure positive perceptions and support from managers, maintain intrinsic motivation, and promote even higher levels of motivation to achieve satisfactory levels of job satisfaction.
Collapse
|
10
|
Blytt KM, Bjorvatn B, Moen BE, Pallesen S, Harris A, Waage S. The association between shift work disorder and turnover intention among nurses. BMC Nurs 2022; 21:143. [PMID: 35668393 PMCID: PMC9169346 DOI: 10.1186/s12912-022-00928-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 05/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background Shift work disorder (SWD) is highly prevalent among shift-working nurses and has multiple negative health-related effects. There is a dearth of insight into career-related decisions made by nurses suffering from SWD, for instance in terms of their intention to quit work (turnover intention). In this study, we aimed to investigate the association between SWD and turnover intention among nurses, and the individual and work-related correlates of turnover intention. Method Data were derived from the ongoing longitudinal cohort study “SUrvey of Shift work, Sleep and Health (SUSSH)” among Norwegian nurses. An annual survey was initiated in 2008/2009 (N = 2965). The present study used data collected in year 2015 (wave 7) and 2016 (wave 8). Nurses were included if: 1) they were working as nurses in both 2015 and 2016, and 2) had completed a three-item scale adapted from the Michigan Organizational Assessment Questionnaire assessing turnover intention (in wave 8), and 3) did not only work day-shifts. SWD was measured in wave 7 with three questions based on the minimal criteria from the third edition of the International Classification of Sleep Disorders. Job demands, decision latitude, and social support at the workplace were measured with subscales of the Swedish Demand-Control-Support Questionnaire. Results Eight Hundred eighty-nine nurses were included. The results from the hierarchical linear regression showed that SWD predicted turnover intention one year later, i.e. from 2015 to 2016 (F1,835 = 6.00, p < 0.05; β = 0.084, p = 0.015). The findings remained significant when controlling for age, sex, organizational tenure, number of nights worked, shift work schedule and workplace social support, job demands and decision latitude. Conclusion This study showed that SWD is associated with turnover intention, even when controlling for individual and work-related variables.
Collapse
Affiliation(s)
- Kjersti Marie Blytt
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, P.O. Box 7030, 5020, Bergen, Norway.
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Bente E Moen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Optentia, the Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Siri Waage
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
11
|
Bergman A, Song H, David G, Spetz J, Candon M. The Role of Schedule Volatility in Home Health Nursing Turnover. Med Care Res Rev 2022; 79:382-393. [PMID: 34311619 PMCID: PMC9122113 DOI: 10.1177/10775587211034310] [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] [Indexed: 11/17/2022]
Abstract
Despite considerable research on nursing turnover, few studies have considered turnover among nurses working in home health care. Using novel administrative data from one of the largest home health care organizations in the United States, this study examined turnover among home health nurses, focusing on the role of schedule volatility. We estimated separation rates among full-time and part-time registered nurses and licensed practical nurses and used daily visit logs to estimate schedule volatility, which was defined as the coefficient of variation of the number of daily visits in the prior four weeks. Between 2016 and 2019, the average annual separation rate of home health nurses was over 30%, with most separations occurring voluntarily. Schedule volatility and turnover were positively associated for full-time nurses, but not for part-time nurses. These results suggest that reducing schedule volatility for full-time nurses could mitigate nursing turnover in home health care.
Collapse
Affiliation(s)
- Alon Bergman
- University of Pennsylvania, Philadelphia, PA, USA
| | - Hummy Song
- University of Pennsylvania, Philadelphia, PA, USA
| | - Guy David
- University of Pennsylvania, Philadelphia, PA, USA
| | - Joanne Spetz
- University of California, San Francisco, CA, USA
| | - Molly Candon
- University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
12
|
Thumm EB, Stimpfel AW, Squires A. Dimensions of being a Midwife and Midwifery Practice in the United States: A Qualitative Analysis. INTERNATIONAL JOURNAL OF CHILDBIRTH 2022. [DOI: 10.1891/ijc-2021-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BackgroundMidwives are a vital component of addressing maternal mortality crisis in the United States (US); however, there is scant understanding of the elements of midwifery practice that affect patient outcomes and the stability of the midwifery workforce in the country. This study investigates US midwives’ perceptions of factors influencing their practice and willingness to stay in the profession.MethodsWe applied a pragmatic qualitative design using summative content analysis techniques to code 1,035 comments from a national sample of 2,887 certified nurse-midwives and certified midwives. Two coders identified categories and themes of midwives’ perceptions of their practice environments, which were confirmed by an independent auditor.ResultsEight themes emerged from the data: I love midwifery but…; feeling valued and respected…or not; workload; time and its consequences; the multilevel geography of midwifery practice; changes at odds with quality midwifery care; midwives withdrawing from practice to cope; and the ambiguity of “I just want to practice like a midwife”.ConclusionMidwives readily identified aspects of their practice environment that negatively impact quality of care and stability of the midwifery workforce, including not valuing midwives, high workload, regulatory restrictions, and moral distress; however, respondents expressed strong commitment to the profession of midwifery. The findings also demonstrated the lack of a universally accepted definition of midwifery care within respondents’ professional communities and among respondents. Initiatives to increase integration of midwifery into the U.S. perinatal health system will benefit from taking these findings into consideration.
Collapse
|
13
|
Apaydin Cirik V, Gül U, Aksoy B. The image of nursing among nursing and other healthcare professional university students: A mixed-method study. Nurse Educ Pract 2022; 59:103293. [DOI: 10.1016/j.nepr.2022.103293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 11/29/2021] [Accepted: 01/08/2022] [Indexed: 10/19/2022]
|
14
|
Park SY, Kim H, Ma C. Factors associated with difficulty in adapting and intent to leave among new graduate nurses in South Korea. Health Care Manage Rev 2021; 47:168-178. [PMID: 34319282 DOI: 10.1097/hmr.0000000000000317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND New graduate nurses experience difficulty in adapting to a new environment, which affects intent to leave. However, data on the factors contributing to difficulty in adapting and intent to leave among new graduate nurses are insufficient. PURPOSE The aim of the study was to explore and compare factors associated with difficulty in adapting and the intent to leave among new graduate nurses in South Korea. METHODOLOGY This cross-sectional study used secondary data analysis. Primary data were obtained from the 2015-2016 Korean National Graduates Occupational Mobility Survey. Descriptive statistics, independent t tests, and chi-square statistics with weighted samples besides multivariate logistic regression analyses were conducted (N = 467). RESULTS Roughly 46% of nurses reported difficulty adapting, and 16% expressed their intent to leave. The factors linked to difficulty in adapting were working at large hospitals with rotating shifts, low person-job fit, and low satisfaction with personal competency; intent to leave was associated with high monthly salary and low satisfaction with the workplace (all ps < .05). Difficulty in adapting did not equate to their intent to leave. CONCLUSIONS There were high rates of difficulty in adapting and intent to leave among new graduate nurses. Although different factors were associated with difficulty adapting and intent to leave, workplace condition is a common factor. PRACTICE IMPLICATIONS Different strategies are needed to improve adaptation and intention of leaving among new graduate nurses. For better adaptation, developing training programs enhancing professional competency with a sufficient training period is required. In addition, providing staff and resources to reduce the intent to leave is crucial.
Collapse
Affiliation(s)
- Sun-Young Park
- Sun-young Park, MSN, RN, is Doctoral Student, College of Nursing, Yonsei University, and Associate Research Fellow, Division of New Health Technology Assessment, National Evidence-Based Healthcare Collaborating Agency, Seoul, South Korea. Heejung Kim, PhD, RN, is Associate Professor, College of Nursing, Yonsei University, and Principal Researcher, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea. E-mail: . Chenjuan Ma, PhD, MSN, RN, is Assistant Professor, Rory Meyers College of Nursing, New York University, New York
| | | | | |
Collapse
|
15
|
Kristoffersen M. Solidarity in a Community of Nursing Colleagues. SAGE Open Nurs 2021; 7:23779608211009514. [PMID: 33912674 PMCID: PMC8047943 DOI: 10.1177/23779608211009514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 03/22/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction Several concepts have been used to describe the qualities of communities of nursing colleagues. Nonetheless, few studies have shed light on nursing communities by drawing on the concept of solidarity. Objective To explore solidarity among a community of nursing colleagues. Methods A qualitative research design with a reflective life world approach was selected. This study reused data from a larger Norwegian empirical study. The data from the original study consisted of qualitative interviews and follow-up interviews with 13 nurses (RNs). The research context was municipality and specialist health services. A secondary data analysis was conducted. The study was based on the SRQR reporting guidelines. Results The results were formulated under two themes: 1) having indispensable relationships and 2) encountering a relative absence of sympathy. Conclusion A sense of community among nursing colleagues seems to rely on solidarity: whatever affects one nurse affects another. The solidarity that arose from the content of commonalities involved maintaining indispensable relationships with nursing colleagues by supporting and aiding them and simultaneously enduring a relative absence of sympathy. Solidarity among the community in this study was not a peripheral concept of the general notion of solidarity, implying that the commonalities within the collegial relationships were ambiguous and could shift from something good to something relatively good and vice versa. Such a shift was evidenced by nurses’ experiences of their community.
Collapse
Affiliation(s)
- Margareth Kristoffersen
- Department of Care and Ethics, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| |
Collapse
|
16
|
Aeschbacher R, Addor V. Competitive employer positioning through career path analysis: the case of the Swiss nursing sector. HUMAN RESOURCES FOR HEALTH 2021; 19:47. [PMID: 33823864 PMCID: PMC8025559 DOI: 10.1186/s12960-021-00586-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The global shortage of nurses has caused strategic employer positioning and strengthened employer branding to become progressively relevant addressing the increased competition in the recruitment of nurses. This study provides competition-oriented strengths-and-weaknesses profiles for nurse attraction and attrition for the major types of healthcare institutions to advise on competitive employer positioning. METHODS We applied bivariate weighted logistic regressions with cluster-adjusted standard errors to evaluate 4844 employer changes of 3011 nurses participating in the nurses at work study, whereby the reasons to quit (RQs) acted as both predictors of the former and the follow-up type of employer. For each employer type, we introduce a coordination system allocating each workplace criterion along its push and implicit pull characteristics, given through the specific odds ratios, to derive different strategic implications for an organisation's competitive nurse recruitment. RESULTS Depending on the employer type, workplace criteria were variously acting as push or pull factors in nurses' career decisions. CONCLUSIONS Nurses' career choices are affected by experienced and presumed workplace characteristics associated with specific employer types. Becoming aware of these associations and experiences, employers should leverage workplace criteria with relatively strong pull or/and weak push characteristics by intensified communication measurements and criteria with relatively weak pull or/and strong push characteristics should be enhanced to a competitive level.
Collapse
Affiliation(s)
- Remo Aeschbacher
- University of Fribourg (CH), Bd de Pérolles 90, 1700 Freiburg, Switzerland
| | - Véronique Addor
- University of Applied Sciences and Arts Western Switzerland (HES-SO), Genève, Switzerland
| |
Collapse
|
17
|
Green C. The hollow: A theory on workplace bullying in nursing practice. Nurs Forum 2021; 56:433-438. [PMID: 33350483 DOI: 10.1111/nuf.12539] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/11/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Incivility and bullying within the profession of nursing remains a problem within the workplace. As a result, healthcare workplaces can become unhealthy and difficult for nurses to function within. Work productivity is impacted and patients' healthcare is placed at risk when nurses are emotionally and physically affected by workplace incivility and bullying. Clinical nurse leaders (CNLs) applying theoretical reasoning and nursing competencies' in addressing bullying and incivility within the workplace, can provide an organized and effective organizational approach to addressing bullying and incivility in work environments. METHODS Theoretical reasoning and nursing competencies in addressing bullying and incivility within the workplace, will be examined as a means to identify nurses exhibiting signs and symptoms of bullying and incivility in work environments. The theory of The Hollow will identify the origins of affected nurses' behaviors and the physiological and psychological impact of bullying and incivility. The CNL role will be used as a facilitator of change at the microsystem level. And competencies for addressing behaviors associated with bullying and incivility will be addressed. APPROACH Innovation adapted from prior research and literature developed by the author, extrapolated from the literature on workplace bullying and incivility in nursing practice. OUTCOMES Bullying and incivility can be resolved in the workplace when competencies are set forth by nursing leaders to educate and empower nursing staff on expectations of healthy work environments. CONCLUSION Healthy workplaces are achievable when nurse leaders, such as CNLs, educate and empower nurses to have the expectation of healthy work environments not only for themselves, but for all nurses.
Collapse
Affiliation(s)
- Cheryl Green
- Southern Connecticut State University, New Haven, Connecticut, USA
| |
Collapse
|
18
|
Thumm EB, Meek P. Development and Initial Psychometric Testing of the Midwifery Practice Climate Scale. J Midwifery Womens Health 2020; 65:643-650. [PMID: 32893985 DOI: 10.1111/jmwh.13142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 02/28/2020] [Accepted: 04/02/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Perinatal care in the United States is plagued with a high maternal mortality rate and shortages of perinatal care providers. A supportive practice climate is a theoretically based and empirically demonstrated means of improving the quality of care and stabilizing the workforce; however, there has been limited research into the qualities and measurement of a supportive practice climate for midwives. METHODS We developed a self-report instrument, the Midwifery Practice Climate Scale, to measure midwives' perceptions of the supportiveness of their work environments. We tested content and face validity with 2 samples of content experts (n = 6 and n = 14, respectively). RESULTS Thirty-four items were created or adapted from nursing instruments. Two items that included language about physicians were removed based upon relevance and redundancy as a result of content and face validity testing. DISCUSSION The findings indicate that the Midwifery Practice Climate Scale is relevant to midwifery and addresses the intended concept of a supportive practice climate for midwives. Challenges of creating the scale identified were language regarding leadership and the varying relationships with physicians across diverse settings. The next stages in testing the Midwifery Practice Climate Scale will address these challenges, as well as test the reliability and construct validity.
Collapse
Affiliation(s)
- E Brie Thumm
- University of Colorado College of Nursing, Aurora, Colorado
| | - Paula Meek
- University of Colorado College of Nursing, Aurora, Colorado
| |
Collapse
|
19
|
McHugh MD, Aiken LH, Windsor C, Douglas C, Yates P. Case for hospital nurse-to-patient ratio legislation in Queensland, Australia, hospitals: an observational study. BMJ Open 2020; 10:e036264. [PMID: 32895270 PMCID: PMC7476482 DOI: 10.1136/bmjopen-2019-036264] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses. DESIGN Analysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data. SETTING Public hospitals in Queensland. PARTICIPANTS 4372 medical-surgical nurses and 146 456 patients in 68 public hospitals. MAIN OUTCOME MEASURES 30-day mortality, quality and safety indicators, nurse outcomes including emotional exhaustion and job dissatisfaction. RESULTS Medical-surgical nurse-to-patient ratios before implementation of ratio legislation varied significantly across hospitals (mean 5.52 patients per nurse; SD=2.03). After accounting for patient characteristics and hospital size, each additional patient per nurse was associated with 12% higher odds of 30-day mortality (OR=1.12; 95% CI 1.01 to 1.26). Each additional patient per nurse was associated with poorer outcomes for nurses including 15% higher odds of emotional exhaustion (OR=1.15; 95% CI 1.07 to 1.23) and 14% higher odds of job dissatisfaction (OR=1.14; 95% CI 1.02 to 1.28), as well as higher odds of concerns about quality of care (OR=1.12; 95% CI 1.01 to 1.25) and patient safety (OR=1.32; 95% CI 1.11 to 1.57). CONCLUSIONS Before ratios were implemented, nurse staffing varied considerably across Queensland hospital medical-surgical wards and higher nurse workloads were associated with patient mortality, low quality of care, nurse emotional exhaustion and job dissatisfaction. The considerable variation across hospitals and the link with outcomes suggests that taking action to improve staffing levels was prudent.
Collapse
Affiliation(s)
- Matthew D McHugh
- School of Nursing, Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Linda H Aiken
- School of Nursing, Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Carol Windsor
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Clint Douglas
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
- Metro North Hospital and Health Service, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Patsy Yates
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
20
|
Squires A, Miner S, Greenberg SA, Adams J, Kalet A, Cortes T. Graduate level health professions education: how do previous work experiences influence perspectives about interprofessional collaboration? J Interprof Care 2020; 35:193-199. [PMID: 32506976 DOI: 10.1080/13561820.2020.1732888] [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: 10/24/2022]
Abstract
Understanding how previous experiences with interprofessional education and collaboration inform health care provider perspectives is important for developing interprofessional interventions at the graduate level. The purpose of this study was to examine how previous work experiences of graduate level health professions students inform perspectives about interprofessional education and collaboration. Drawing from program evaluation data of two separate graduate level interprofessional education interventions based in primary care and home health care, we conducted a qualitative secondary data analysis of 75 interviews generated by focus groups and individual interviews with graduate students from 4 health professions cadres. Using directed content analysis, the team coded to capture descriptions of interprofessional education or collaboration generated from participants' previous work experiences. Coding revealed 173 discrete descriptions related to previous experiences of interprofessional education or collaboration. Three themes were identified from the analysis that informed participant perspectives: Previous educational experiences (including work-based training); previous work experiences; and organizational factors and interprofessional collaboration. Experiences varied little between professions except when aspects of professional training created unique circumstances. The study reveals important differences between graduate and undergraduate learners in health professions programs that can inform interprofessional education and collaboration intervention design.
Collapse
Affiliation(s)
- Allison Squires
- Rory Meyers College of Nursing, New York University, New York, NY, USA.,Division of General Internal Medicine, School of Medicine, New York University, New York, NY, USA
| | - Sarah Miner
- Wegman's School of Nursing, St. John Fischer University, Rochester, NY, USA
| | - Sherry A Greenberg
- Rory Meyers College of Nursing, New York University, New York, NY, USA.,Hartford Institute for Geriatric Nursing at Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Jennifer Adams
- Division of General Internal Medicine, School of Medicine, New York University, New York, NY, USA
| | - Adina Kalet
- Division of General Internal Medicine, School of Medicine, New York University, New York, NY, USA
| | - Tara Cortes
- Rory Meyers College of Nursing, New York University, New York, NY, USA.,Hartford Institute for Geriatric Nursing at Rory Meyers College of Nursing, New York University, New York, NY, USA
| |
Collapse
|
21
|
|
22
|
Zhang Y, ElGhaziri M, Nasuti S, Duffy JF. The Comorbidity of Musculoskeletal Disorders and Depression: Associations with Working Conditions Among Hospital Nurses. Workplace Health Saf 2020; 68:346-354. [PMID: 31959087 DOI: 10.1177/2165079919897285] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Musculoskeletal disorders (MSDs) are the leading cause of pain and disability among nurses and are frequently accompanied by depression. However, the association between the comorbidity of MSDs and depression and working conditions has not been studied, which was the aim of this study. Methods: In 2015, all nurses (n = 1,102) employed at a community hospital in the Northeast United States were invited to participate in this cross-sectional study. A survey was distributed in which participants were asked to report on MSDs, depressive symptoms, as well as subjective working conditions assessed including physical demands, psychological demands, decision authority, social support, and work-family conflict. Findings: 397 nurses responded (36%), and the prevalence of the comorbidity of MSDs and depression was 14.5%. Poisson regression (PR) models suggested that work-family conflict was associated with increased risk of the comorbidity (PR = 2.18; 95% confidence interval [CI] = 1.33-3.58), as was 8-hour night shift (PR = 2.77; 95% CI = [1.22, 6.31]) or 12-hour day shift (PR = 2.20; 95% CI = [1.07, 4.50]). Other working conditions were not directly associated with the comorbidity. Conclusions/Application to Practice: The comorbidity of MSDs and depression is prevalent among hospital nurses, and work-family conflict and working night shift or longer shifts were significantly associated with this. Effective workplace programs are needed to address nurses' working conditions to reduce their work-family conflict, thereby improving their musculoskeletal and mental health.
Collapse
Affiliation(s)
| | | | | | - Jeanne F Duffy
- Brigham Women's Hospital.,Harvard Medical School, Boston, MA, USA
| |
Collapse
|
23
|
Abstract
OBJECTIVE To examine and report burnout, secondary trauma, and compassion satisfaction in acute care nurse leaders through a large mixed-methods research study. BACKGROUND Although nurse leaders are removed from daily patient care activities, the pervasive challenges in the work environment create conditions for professional burnout. Nurse leaders must garner compassion satisfaction from different sources, including peer and staff interactions. METHODS The Professional Quality of Life scale was given to nurse leaders at 29 hospitals in 1 health system. Sixteen leaders from 2 hospitals participated in qualitative interviews. RESULTS Six hundred seventy-two nurse leaders from 29 hospitals reported similar levels of burnout across frontline, midlevel, and director-level leadership. Directors demonstrated higher levels of compassion satisfaction and lower levels of work-life balance. Four themes emerged representing areas of professional life that potentiate and alleviate compassion fatigue. CONCLUSIONS All levels of nurse leaders must address the risk of burnout and can do so through individual and organizational resiliency strategies.
Collapse
|
24
|
Kristoffersen M. Nurses' Remaining in Everyday Nursing Practice-A Comprehensive Model. SAGE Open Nurs 2019; 5:2377960819866343. [PMID: 33415248 PMCID: PMC7774426 DOI: 10.1177/2377960819866343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/30/2019] [Accepted: 07/06/2019] [Indexed: 11/29/2022] Open
Abstract
Previous theoretical and empirical models of nurses' remaining in everyday nursing practice are explained by elements such as intent to stay and desire to stay. This study provides a model that expands or expresses an increased understanding of the comprehensiveness of the issue by pointing to the qualitative worth of different desires. The aim of this study is to describe a comprehensive model of nurses' remaining in everyday nursing practice. This study was designed in three sequential stages: first, the empirical foundation of the model; second, the development of the model; and third, the description of the model. The described model is derived from a previous qualitative study's comprehensive understanding of empirical findings. That original study was based on a hermeneutical approach, the aim of which was to understand what is of significance for nurses to remain in everyday practice. The collected data consisted of qualitative interviews and qualitative follow-up interviews with 13 nurses. The research context was the primary and secondary somatic and psychiatric health service. The present comprehensive model is stated in a simple structure, which nonetheless provides a relevant framework for constituent elements of nurses' remaining in everyday practice. Horizons of identity and self-understanding have been identified as constituent elements or key concepts involved in remaining. By focusing on a deepened and broader understanding, the model highlights that remaining may be constituted through a process of identification and taking standpoints, which in turn has a potential to empower nurses to realize themselves.
Collapse
|
25
|
Pham TTL, Teng CI, Friesner D, Li K, Wu WE, Liao YN, Chang YT, Chu TL. The impact of mentor-mentee rapport on nurses' professional turnover intention: Perspectives of social capital theory and social cognitive career theory. J Clin Nurs 2019; 28:2669-2680. [PMID: 30938905 DOI: 10.1111/jocn.14858] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/01/2019] [Accepted: 03/23/2019] [Indexed: 01/30/2023]
Abstract
AIMS AND OBJECTIVES This study examines the impacts of mentor-mentee rapport on willingness to mentor/be mentored, self-efficacy, outcome expectations, career interest and subsequently on nurses' professional turnover intention. BACKGROUND Workplace relationships, whether positive or negative, influence nurse turnover within an organisation. Yet little is known about the effects of mentoring on nurses' intentions to leave the nursing profession. DESIGN A cross-sectional, survey-based research design was used to collect data from a large medical centre in Northern Taiwan. METHODS Study concepts were measured using scales from social capital theory (SCT), social cognitive career theory (SCCT) and the nursing literature. Partial least square structural equation modelling was used to test all study hypotheses. The STROBE statement was chosen as the EQUATOR checklist. RESULTS For mentors, rapport was positively related to willingness to mentor, which was positively related to outcome expectations, and further, positively related to career interest and negatively related to professional turnover intention. For mentees, rapport was positively related to willingness to be mentored, which was positively related to self-efficacy, outcome expectations and ultimately to career interest. Career interest was negatively related to professional turnover intentions. CONCLUSIONS Rapport between mentors and mentees may be an important means to retain nurses in the profession. RELEVANCE TO CLINICAL PRACTICE Managers should consider taking steps to enhance rapport between mentors and mentees. In doing so, managers improve nurse retention, a critical component of providing high-quality patient care.
Collapse
Affiliation(s)
- Thi Tuan Linh Pham
- Graduate Institute of Business and Management, Chang Gung University, Taoyuan City, Taiwan.,International School, Thai Nguyen University, Thai Nguyen, Vietnam
| | - Ching-I Teng
- Graduate Institute of Business and Management, Chang Gung University, Taoyuan City, Taiwan.,Department of Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Business and Management, Ming Chi University of Technology, Taipei , Taiwan
| | - Daniel Friesner
- College of Pharmacy, Nursing and Allied Sciences, North Dakota State University, Fargo, North Dakota
| | - Kai Li
- Business School, Nankai University, Tianjin, China
| | - Wan-Er Wu
- Department of Industrial and Business Management, Chang Gung University, Taoyuan City, Taiwan
| | - Yen-Ni Liao
- Department of Health Care Management, Chang Gung University, Taoyuan City, Taiwan
| | - Yin-Tzu Chang
- Department of Health Care Management, Chang Gung University, Taoyuan City, Taiwan
| | - Tsung-Lan Chu
- Quality Management Department, Administration Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| |
Collapse
|
26
|
Nurses’ Intention to Leave the Organization: A Mediation Study of Professional Burnout and Engagement. SPANISH JOURNAL OF PSYCHOLOGY 2018; 21:E32. [DOI: 10.1017/sjp.2018.30] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThe nature of the turnover process calls for the study of more complex relationships among variables beyond simple bivariate or multiple associations between predictors and turnover intentions. The present article aims to examine the predictive value of job demands and resources in the explanation of nurses’ intention to leave the organization and to test the mediating roles of professional burnout and engagement in these relationships, within a Portuguese nursing population. The research models were tested within the scope of the Registered Nurse Forecasting project. Data included the self-report questionnaires of 2,235 Portuguese nurses from 31 hospitals, collected through stratified random sampling procedures. The statistical analyses of the structural models showed that nurses’ participation in hospital affairs, a job resource at the work organization level, was the only significant predictor of nurses´ intention to leave the organization (β = –.45, p < .001). Analyses of the mediation models revealed that the emotional exhaustion symptoms of burnout (β = –.11, p < .001) and job engagement feelings (β = –.15, p < .001) were both significant mediators between nurses’ decisional involvement and their intentions to leave the organization. Results suggest that including nurses in decision-making processes regarding their professional practice policy and environment, and improving nurses’ professional well-being are two crucial strategies to reduce nurses’ turnover intentions.
Collapse
|
27
|
|
28
|
Perreira TA, Berta W, Herbert M. The employee retention triad in health care: Exploring relationships amongst organisational justice, affective commitment and turnover intention. J Clin Nurs 2018; 27:e1451-e1461. [PMID: 29322579 DOI: 10.1111/jocn.14263] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 12/21/2022]
Abstract
AIMS AND OBJECTIVES To increase understanding of the relationships between organisational justice, affective commitment and turnover intention in health care. BACKGROUND Turnover in health care is a serious concern, as it contributes to the global nursing shortage and is associated with declines in quality of care, patient safety and patient outcomes. Turnover also impacts care teams and is associated with decreased staff cohesion and morale. METHODS A survey was developed and administered to frontline nurses working in the Province of Ontario, Canada. The data were used to test a hypothetical model developed from a review of the literature. The relationships amongst the three constructs were evaluated using structural equation modelling and mediation analysis. RESULTS The hypothesised model was generally supported, although we were limited to considerations of interpersonal justice, affective commitment to one's organisation and turnover intention. Interpersonal justice is associated with affective commitment to one's organisation, which is negatively associated with turnover intention. Interpersonal justice was also found to be directly and negatively associated with turnover intention. Affective commitment to one's organisation was also found to mediate the relationship between interpersonal justice and turnover intention. CONCLUSIONS The examination of relationships within the "employee retention triad" in a single, comprehensive model is novel and provides new information regarding relational complexity and insights into what healthcare leaders can do to retain employees. RELEVANCE TO CLINICAL PRACTICE Reducing turnover may help to decrease some of the stressors related to turnover for clinical staff remaining at the organisation such as constant onboarding and orientation of new hires, working with less experienced staff and increased workload due to decreased staffing.
Collapse
Affiliation(s)
- Tyrone A Perreira
- Dalla Lana School of Public Health, Institute of Health Policy, Management and Evaluations, University of Toronto, Toronto, ON, Canada.,Ontario Hospital Association, Toronto, ON, Canada
| | | | - Monique Herbert
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
| |
Collapse
|
29
|
Eltaybani S, Noguchi-Watanabe M, Igarashi A, Saito Y, Yamamoto-Mitani N. Factors related to intention to stay in the current workplace among long-term care nurses: A nationwide survey. Int J Nurs Stud 2018; 80:118-127. [PMID: 29407345 DOI: 10.1016/j.ijnurstu.2018.01.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 01/13/2018] [Accepted: 01/16/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Keeping long-term care nurses employed is necessary to sustain the current and future demand for high-quality long-term care services. Understanding the factors relating to intention to stay among long-term care nurses is limited by the scarcity of studies in long-term care settings, lack of investigation of multiple factors, and the weakness of existing explanatory models. OBJECTIVE To identify the factors associated with long-term care nurses' intention to stay in their current workplace. DESIGN A cross-sectional questionnaire survey. SETTING Two hundred and fifty-seven hospitals with long-term care wards across Japan. PARTICIPANTS A total of 3128 staff nurses and 257 nurse managers from the long-term care wards of the participating hospitals. METHOD The questionnaire assessed nurses' intention to continue working in the current workplace as well as potential related factors, including individual factors (demographic data, reason for choosing current workplace, burnout, work engagement, somatic symptom burden) and unit factors (unit size, nurse-manager-related data, patients' medical acuity, average number of overtime hours, recreational activities, social support, perceived quality of care process, educational opportunities, feeling of loneliness, and ability to request days off). Multilevel logistic regression analysis was used to determine which variables best explained nurses' intention to stay in their workplace. RESULTS Only 40.1% of the respondents reported wanting to continue working at their current workplace. The regression analysis revealed that long-term care nurses' intention to stay was positively associated with nurses' age (odds ratio [95% confidence interval]: 1.02 [1.01-1.03]), work engagement (1.24 [1.14-1.35]), getting appropriate support from nurse managers (2.78 [1.60-4.82]), perceived quality of care process (1.04 [1.01-1.06]), educational opportunities (1.06 [1.0-1.13]), and various specific reasons for choosing their workplace (e.g., a good workplace atmosphere, being interested in gerontological nursing, and a high salary). By contrast, intention to stay was negatively associated with emotional exhaustion (0.93 [0.91-0.95]) and depersonalization (0.91 [0.89-0.93]). Intention to stay was associated with neither nurses' qualifications nor patient medical acuity. CONCLUSION Reason for choosing the workplace, work engagement, getting support from the nurse manager, and perceived quality of care process are significant predictors of long-term care nurses' intention to stay in the workplace. Promoting such nurses' work engagement, provision of high-quality care, and access to educational opportunities might augment long-term care nurses' intention to stay.
Collapse
Affiliation(s)
- Sameh Eltaybani
- Department of Gerontological Home Care and Long-Term Care Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan; Department of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Egypt.
| | - Maiko Noguchi-Watanabe
- Department of Gerontological Home Care and Long-Term Care Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-Term Care Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
| | - Yumiko Saito
- Department of Gerontological Home Care and Long-Term Care Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-Term Care Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
| |
Collapse
|
30
|
Halter M, Boiko O, Pelone F, Beighton C, Harris R, Gale J, Gourlay S, Drennan V. The determinants and consequences of adult nursing staff turnover: a systematic review of systematic reviews. BMC Health Serv Res 2017; 17:824. [PMID: 29246221 PMCID: PMC5732502 DOI: 10.1186/s12913-017-2707-0] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 11/07/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Nurses leaving their jobs and the profession are an issue of international concern, with supply-demand gaps for nurses reported to be widening. There is a large body of existing literature, much of which is already in review form. In order to advance the usefulness of the literature for nurse and human resource managers, we undertook an overview (review of systematic reviews). The aim of the overview was to identify high quality evidence of the determinants and consequences of turnover in adult nursing. METHODS Reviews were identified which were published between 1990 and January 2015 in English using electronic databases (the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS) and forward searching. All stages of the review were conducted in parallel by two reviewers. Reviews were quality appraised using the Assessment of Multiple Systematic Reviews and their findings narratively synthesised. RESULTS Nine reviews were included. We found that the current evidence is incomplete and has a number of important limitations. However, a body of moderate quality review evidence does exist giving a picture of multiple determinants of turnover in adult nursing, with - at the individual level - nurse stress and dissatisfaction being important factors and -at the organisational level - managerial style and supervisory support factors holding most weight. The consequences of turnover are only described in economic terms, but are considered significant. CONCLUSIONS In making a quality assessment of the review as well as considering the quality of the included primary studies and specificity in the outcomes they measure, the overview found that the evidence is not as definitive as previously presented from individual reviews. Further research is required, of rigorous research design, whether quantitative or qualitative, particularly against the outcome of actual turnover as opposed to intention to leave. TRIAL REGISTRATION PROSPERO Registration 17 March 2015: CRD42015017613 .
Collapse
Affiliation(s)
- Mary Halter
- Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, Cranmer Terrace, London, SW17 0RE UK
| | - Olga Boiko
- Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, Cranmer Terrace, London, SW17 0RE UK
- Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA UK
| | - Ferruccio Pelone
- Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, Cranmer Terrace, London, SW17 0RE UK
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regent’s Park, London, NW1 4RG UK
| | - Carole Beighton
- Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, Cranmer Terrace, London, SW17 0RE UK
| | - Ruth Harris
- Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA UK
| | - Julia Gale
- Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, Kingston Hill, Surrey, KT2 7LB UK
| | - Stephen Gourlay
- Department of Management, Faculty of Business & Law, Kingston University, Kingston Hill, Surrey, KT2 7LB UK
| | - Vari Drennan
- Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, Cranmer Terrace, London, SW17 0RE UK
| |
Collapse
|
31
|
Eileen M, Peter G, Bernadette J, Lindsay M, Christine B. Crossing professional cultures: A qualitative study of nurses working in a medical school. Contemp Nurse 2017; 53:633-646. [PMID: 29228876 DOI: 10.1080/10376178.2017.1416304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Leaving the nursing workforce is often seen as a loss. Some nurses maintain a current nursing registration and work within university schools of medicine. Little is known about their work. AIM To explore and describe the experiences of nurses who work in a New Zealand medical school. DESIGN Qualitative descriptive informed by autoethnography. METHODS Interviews with 14 nurses over a 12-month period in 2015. Data were inductively analysed. RESULTS The nurses were mid-to-late career with prior clinical experience and all held postgraduate qualifications. Five themes emerged. CONCLUSIONS Nurses chose to work in a medical school for a variety of reasons. They sought to maintain their nursing identity but the nursing profession often did not recognise them as nurses. Although individual colleagues recognised their value, organisationally, limited attention was afforded to the specific orientation, mentorship and development of nurses' careers within this setting.
Collapse
Affiliation(s)
- McKinlay Eileen
- a Department of Primary Health Care and General Practice , University of Otago , Wellington , New Zealand
| | - Gallagher Peter
- b Education Unit , University of Otago , Wellington , New Zealand
| | - Jones Bernadette
- c Department of Medicine , University of Otago , Wellington , New Zealand
| | - Macdonald Lindsay
- a Department of Primary Health Care and General Practice , University of Otago , Wellington , New Zealand
| | - Barthow Christine
- c Department of Medicine , University of Otago , Wellington , New Zealand
| |
Collapse
|
32
|
Zhang Y, Duffy JF, De Castillero ER. Do sleep disturbances mediate the association between work-family conflict and depressive symptoms among nurses? A cross-sectional study. J Psychiatr Ment Health Nurs 2017; 24. [PMID: 28635074 PMCID: PMC5585039 DOI: 10.1111/jpm.12409] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT Nurses are at a high risk for work-family conflict due to long and irregular work hours and multiple physical and psychosocial stressors in their work environment. Nurses report higher rates of depressive symptoms than the general public, leading to a high rate of burnout, absenteeism, and turnover. Work-family conflict is associated with negative consequences in nurses including physical illnesses and mental disorders. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE Past research on this topic has not examined the mechanisms for the effect of work family conflict on depression. Studies rarely examine the influence of health behaviors such as sleep in explaining this association. Our study identified significant association of sleep disturbances with both work-family conflict and depressive symptoms in nurses. Our main contribution is reporting the important role of sleep disturbances in translating the effect of work-family conflict on depressive symptoms among nurses. WHAT ARE THE IMPLICATIONS FOR PRACTICE Nurses need to receive training in best practices for maintaining their own sleep and mental health. Organizations should include sleep health education and training in workplace health programs. Evidence-based interventions to promote healthy sleep practices such as cognitive behavioral therapy and complementary and integrative approaches should be evaluated for their effectiveness in addressing the impact of work-family conflict on the mental health of nurses. Healthcare organizations should incorporate mental health services as part of their Employee Assistance Program for nurses and include psychological and sleep disorders screening, counseling, and follow-up. ABSTRACT Introduction Depression has been identified as the leading cause of disability worldwide. Nurses report higher rates of depression than the general public. Work-family conflict is challenging for nurses and may lead to depression and poor health. However, the mechanisms for the effect of work-family conflict on depression have not been well understood. Aim The objective is to use a cross-sectional design to examine the role of sleep disturbances in the association between work-family conflict and depressive symptoms in nurses. Methods Questionnaires, measuring working conditions, work-family conflict, sleep disturbances and depressive symptoms were collected from 397 nurses at a not-for-profit community hospital in the north-eastern United States. Results We observed a significant association between work-family conflict and depressive symptoms (β = 2.22, p < .001) among nurses. Sleep disturbances partially mediated this association by 40.54%. Discussion Sleep disturbances play an important role in translating work-family conflict into depressive symptoms. Implications Evidence-based interventions to promote healthy sleep practices should be evaluated for their effectiveness in addressing the impact of work-family conflict on mental health. Organizations should include sleep education and training as a component of workplace health promotion and employee assistance programmes to mitigate the effect of work-family conflict and promote overall health in nurses.
Collapse
Affiliation(s)
- Y Zhang
- Susan and Alan Solomont School of Nursing, University of Massachusetts Lowell, Lowell, MA, USA
| | - J F Duffy
- Division of Sleep and Circadian Disorders, Brigham Women's Hospital, Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|
33
|
Alameddine M, Bauer JM, Richter M, Sousa-Poza A. The paradox of falling job satisfaction with rising job stickiness in the German nursing workforce between 1990 and 2013. HUMAN RESOURCES FOR HEALTH 2017; 15:55. [PMID: 28851392 PMCID: PMC5576280 DOI: 10.1186/s12960-017-0228-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 08/07/2017] [Indexed: 05/30/2023]
Abstract
BACKGROUND Literature reports a direct relation between nurses' job satisfaction and their job retention (stickiness). The proper planning and management of the nursing labor market necessitates the understanding of job satisfaction and retention trends. The objectives of the study are to identify trends in, and the interrelation between, the job satisfaction and job stickiness of German nurses in the 1990-2013 period using a flexible specification for job satisfaction that includes different time periods and to also identify the main determinants of nurse job stickiness in Germany and test whether these determinants have changed over the last two decades. METHODS The development of job stickiness in Germany is depicted by a subset of data from the German Socio-Economic Panel (1990-2013), with each survey respondent assigned a unique identifier used to calculate the year-to-year transition probability of remaining in the current position. The changing association between job satisfaction and job stickiness is measured using job satisfaction data and multivariate regressions assessing whether certain job stickiness determinants have changed over the study period. RESULTS Between 1990 and 2013, the job stickiness of German nurses increased from 83 to 91%, while their job satisfaction underwent a steady and gradual decline, dropping by 7.5%. We attribute this paradoxical result to the changing association between job satisfaction and job stickiness; that is, for a given level of job (dis)satisfaction, nurses show a higher stickiness rate in more recent years than in the past, which might be partially explained by the rise in part-time employment during this period. The main determinants of stickiness, whose importance has not changed in the past two decades, are wages, tenure, personal health, and household structure. CONCLUSIONS The paradoxical relation between job satisfaction and job stickiness in the German nursing context could be explained by historical downsizing trends in hospitals, an East-West German nurse compensation gap, and an increase in the proportion of nurses employed on a part-time basis. A clearer analysis of each of these trends is thus essential for the development of evidence-based policies that enhance the job satisfaction and efficiency of the German nursing workforce.
Collapse
Affiliation(s)
- Mohamad Alameddine
- College of Medicine, Directorate of Strategy and Institutional Excellence, Mohammed Bin Rashid University of Medicine and Health Sciences, P.O. Box 505055, Dubai, United Arab Emirates
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Jan Michael Bauer
- Department of Management, Society and Communication, Copenhagen Business School, Porcelænshaven 18, 2000 Frederiksberg, Denmark
| | - Martin Richter
- Institute for Healthcare & Public Management (530A), University of Hohenheim, Fruwirthstr. 48, 70599 Stuttgart, Germany
| | - Alfonso Sousa-Poza
- Institute for Healthcare & Public Management (530A), University of Hohenheim, Fruwirthstr. 48, 70599 Stuttgart, Germany
| |
Collapse
|
34
|
Gifkins J, Loudoun R, Johnston A. Coping strategies and social support needs of experienced and inexperienced nurses performing shiftwork. J Adv Nurs 2017; 73:3079-3089. [PMID: 28677140 DOI: 10.1111/jan.13374] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2017] [Indexed: 01/21/2023]
Abstract
AIM The aim of this investigation was to compare perceptions of nurses exposed to short or longer term shift work and their experiences working under this type of scheduling. BACKGROUND Shift work is a crucial component of nurses' working lives, ensuring continuous care for patients. This study fills a research gap around the personal experiences of shift working nurses and the strategies used to manage the impacts of shift work. DESIGN Qualitative case study design. METHODS Constructivist methodology, including in-depth semi-structured interviews conducted in 2015, was used for the study. Iterative review and inductive analysis of transcripts from nine recently graduated nurses and twelve experienced nurses enabled identification and verification of key themes. FINDINGS Three main areas of difference between new and experienced nurses relating to shift work challenges in a nursing environment emerged: perceptions about the utility of working in shifts, coping strategies and social support at home and work. Most experienced nurses found shift work advantageous, especially those with dependents. Coping strategies included flexible shift arrangements in both groups. Experienced nurses detailed the importance of support from family and friends while inexperienced nurses described feeling disconnected from social supports. Experienced nurses cited a lack of support from nursing managers as problematic. CONCLUSIONS Findings suggest shift selection mitigated challenges of shift work for both inexperienced and experienced nurses, indicating autonomous roster selection is critical. Similarly, social support at work from senior nurses and management and at home played an important role in nurses' coping.
Collapse
Affiliation(s)
- Jane Gifkins
- Griffith University, Brisbane, Qld, Australia.,School of Natural Sciences, Griffith University, Nathan, Qld, Australia
| | - Rebecca Loudoun
- Centre for Research on Work, Organisation and Wellbeing, Griffith University, Nathan, Qld, Australia
| | - Amy Johnston
- Department of Emergency Medicine, Gold Coast Hospital and Health Service and Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
| |
Collapse
|
35
|
Fernet C, Trépanier SG, Demers M, Austin S. Motivational pathways of occupational and organizational turnover intention among newly registered nurses in Canada. Nurs Outlook 2017. [PMID: 28641867 DOI: 10.1016/j.outlook.2017.05.008] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Staff turnover is a major issue for health care systems. In a time of labor shortage, it is critical to understand the motivational factors that underlie turnover intention in newly licensed nurses. PURPOSE To examine whether different forms of motivation (the reasons for which nurses engage in their work) predict intention to quit the occupation and organization through distinct forms (affective and continuance) and targets (occupation and organization) of commitment. METHODS Cross-sectional data were collected from a sample of 572 French-Canadian newly registered nurses working in public health care in the province of Quebec, Canada. The hypothesized model was tested by structural equation modeling. FINDINGS Autonomous motivation (nurses accomplish their work primarily out of a sense of pleasure and satisfaction or because they personally endorse the importance or value of their work) negatively predicts intention to quit the profession and organization through target-specific affective commitment. However, although controlled motivation (nurses accomplish their work mainly because of internal or external pressure) is positively associated with continuance commitment to the occupation and organization, it directly predicts, positively so, intention to quit the occupation and organization. CONCLUSION These results highlight the complexity of the motivational processes at play in the turnover intention of novice nurses, revealing distinct forms of commitment that explain how motivation quality is related simultaneously to intention to quit the occupation and organization. Health care organizations are advised to promote autonomous over controlled motivation to retain newly recruited nurses and sustain the future of the nursing workforce.
Collapse
Affiliation(s)
- Claude Fernet
- Department of Human Resources Management, Université du Québec à Trois-Rivières, Québec, Canada.
| | | | - Mireille Demers
- School of Psychology, Université de Moncton, New Brunswick, Canada
| | - Stéphanie Austin
- Department of Human Resources Management, Université du Québec à Trois-Rivières, Québec, Canada
| |
Collapse
|
36
|
Yang H, Lv J, Zhou X, Liu H, Mi B. Validation of work pressure and associated factors influencing hospital nurse turnover: a cross-sectional investigation in Shaanxi Province, China. BMC Health Serv Res 2017; 17:112. [PMID: 28158979 PMCID: PMC5292011 DOI: 10.1186/s12913-017-2056-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 01/24/2017] [Indexed: 12/05/2022] Open
Abstract
Background Nurses' turnover is a major contributor to nursing shortages, strongly influenced by nurses’ intentions to leave. Several factors influencing the turnover intention have been well identified in Western countries and large cities in China. However, whether these factors also contribute to nurses' work stress in Midwest China are still unclear. The main purpose of this study was to examine the work pressure and associated factors influencing the nurses’ intent to leave. Methods A cross-sectional questionnaire-based survey with multistage sampling was conducted by recruiting 800 employed registered nurses with >1 year of work experience. Chi-square test and multi-factor logistic regression were applied to attain the relative comparisons. Sub-group analysis was conducted to explore the different turnover intention patterns in different age groups. Results The turnover intention was classified as strong/very-strong (19%), weak (62%), and very-weak (19%). Among the factors influencing the nurses’ desire to leave the profession, work pressure was the most prominent. The predominantly associated factors contributing the work stress were age, experience, and workload. However, the scale of income did not affect the intent to leave decision. Pediatrics was identified to be the highest tormented department with a significant (P < 0.05) turnover of nurses. Among different age sub-groups, 30–39 age group nurses in Secondary hospitals demonstrate a stronger intent to leave. Conclusion Nurses’ turnover intentions were associated with stress, age, job duty, and career commitment in Shaanxi Province. The intent to leave is dynamically multifactorial, and effective managements and supportive strategies are needed to reduce the nurses work stress accordingly.
Collapse
Affiliation(s)
- Huiyun Yang
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
| | - Jingwen Lv
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xi Zhou
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Huitong Liu
- Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| |
Collapse
|
37
|
Wendsche J, Hacker W, Wegge J. Understaffing and registered nurses’ turnover: The moderating role of regular rest breaks. GERMAN JOURNAL OF HUMAN RESOURCE MANAGEMENT-ZEITSCHRIFT FUR PERSONALFORSCHUNG 2017. [DOI: 10.1177/2397002216683880] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Current demographic and occupational changes call for new interventions to promote staff retention, especially in nursing where understaffing promotes turnover by increasing workload and strain. Based on previous research examining recovery at work, we investigated whether well-designed rest breaks can function as a resource that buffers adverse consequences of understaffing in nursing. We used a cross-sectional, multi-method study design and assessed understaffing of registered nurses, their regularity of rest breaks, and their annual turnover behaviour in 80 German geriatric nursing teams. As expected, understaffing positively predicted turnover only in work conditions with irregular rest breaks. Hence, implementing regularly scheduled rest breaks can be considered as an effective intervention for improving retention of nurses even in a situation of understaffing.
Collapse
|
38
|
Kristoffersen M, Friberg F. Remaining in the nursing profession: The relevance of strong evaluations. Nurs Ethics 2016; 25:928-938. [PMID: 28006967 DOI: 10.1177/0969733016684545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Why nurses remain in the profession is a complex question. However, strong values can be grounds for their remaining, meaning nurses evaluate the qualitative worth of different desires and distinguish between senses of what is a good life. RESEARCH QUESTION: The overall aim is to explore and argue the relevance of strong evaluations for remaining in the nursing profession. RESEARCH DESIGN: This theoretical article based on a hermeneutical approach introduces the concept strong evaluations as described by the Canadian philosopher Charles Taylor and provides examples of nurses' experiences in everyday nursing care drawn from a Norwegian empirical study. PARTICIPANTS AND RESEARCH CONTEXT: Data collected in the original study consisted of qualitative interviews and qualitative follow-up interviews with 13 nurses. The research context was the primary and secondary somatic and psychiatric health service, inside as well as outside institutions. ETHICAL CONSIDERATION: The article uses data from an original empirical study approved by the Norwegian Social Science Data Services. Information was given and consent obtained from the participants. FINDINGS: Remaining in the nursing profession can be understood as revolving around being a strong evaluator. This has been concretized in issues of being aware of different incidents in life and having capacities as a nurse. DISCUSSION: Why nurses remain is discussed in relation to how nurses have shaped themselves by reflecting on what is of significance in their life. However, being a strong evaluator cannot be seen as the casual condition for remaining. CONCLUSION: Remaining in the nursing profession is obviously not a contingent matter, rather it is a matter concerned with the qualitative worth of different desires and values. Nurses' awareness of a life choice impacts on whether they remain or not. Consequently, nurses may need to articulate and reflect on their priorities for remaining.
Collapse
|
39
|
International pediatric cardiac efforts. PROGRESS IN PEDIATRIC CARDIOLOGY 2016. [DOI: 10.1016/j.ppedcard.2016.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
40
|
Estimating and preventing hospital internal turnover of newly licensed nurses: A panel survey. Int J Nurs Stud 2016; 60:251-62. [DOI: 10.1016/j.ijnurstu.2016.05.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 05/02/2016] [Accepted: 05/04/2016] [Indexed: 11/17/2022]
|
41
|
Wendsche J, Hacker W, Wegge J, Rudolf M. High Job Demands and Low Job Control Increase Nurses’ Professional Leaving Intentions: The Role of Care Setting and Profit Orientation. Res Nurs Health 2016; 39:353-63. [DOI: 10.1002/nur.21729] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Johannes Wendsche
- Department of Psychology; TU Dresden, Germany
- Federal Institute for Occupational Safety and Health; Dresden Germany
| | | | - Jürgen Wegge
- Department of Psychology; TU Dresden; Dresden Germany
| | | |
Collapse
|
42
|
De Almeida Vicente A, Shadvar S, Lepage S, Rennick JE. Experienced pediatric nurses' perceptions of work-related stressors on general medical and surgical units: A qualitative study. Int J Nurs Stud 2016; 60:216-24. [PMID: 27297382 DOI: 10.1016/j.ijnurstu.2016.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 05/02/2016] [Accepted: 05/06/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Experienced pediatric nurses caring for increasingly sick and vulnerable children on medical and surgical units may be at particular risk for work-related stress. In view of their positive impact on quality of care, and the fact that they are particularly difficult to retain, it is imperative to understand the work-related stressors these nurses encounter in order to develop effective organizational interventions to minimize stressors and promote retention. OBJECTIVE To explore experienced pediatric nurses' perceptions of work-related stressors in medical and surgical units. DESIGN Qualitative descriptive design with semi-structured interviews. SETTING Medical and surgical units at a quaternary care pediatric hospital in Montreal, Canada. PARTICIPANTS Nurses recognized as experienced by the nursing leadership team as reflected by having been 'in charge' of the unit, or having trained junior staff, and who had been practicing full-time for three years or more on a general medical or surgical pediatric unit were eligible to participate. Purposive sampling was used, and nurses recruited until data saturation was reached (n=12). There were no refusals to participate. METHODS Semi-structured interviews were conducted between August and December 2013. RESULTS Nurses described a strong sense of responsibility for providing excellent patient care, and identified stressor that negatively impacted their ability to do so. Stressors are reflected in three themes: (1) "The kids are getting sicker and sicker": Difficulty ensuring excellent patient care to an increasingly vulnerable population, (2) Feeling powerless to provide quality care, and (3) Being a "Jack-of-all-trades": Struggling with competing demands. CONCLUSION Experienced pediatric nurses felt powerless to provide quality care to an increasingly acute and vulnerable population. Dealing with multiple and diverse responsibilities, and limited resources and support, were important stressors. Nurse Managers and educators could mitigate stressors and improve retention of experienced pediatric nurses by offering targeted continuing education to those newly responsible for additional roles, and building supportive working environments that encourage collaboration and empower experienced nurses.
Collapse
Affiliation(s)
- Alexandra De Almeida Vicente
- The Montreal Children's Hospital, McGill University Health Centre, 1001 boul. Decarie, Montréal, Québec, Canada H3A 3J1.
| | - Sanaz Shadvar
- The Montreal Children's Hospital, McGill University Health Centre, 1001 boul. Decarie, Montréal, Québec, Canada H3A 3J1.
| | - Stephanie Lepage
- Department of Nursing, The Montreal Children's Hospital, McGill University Health Centre, 1001 boul. Decarie, Montréal, Québec, Canada H3A 3J1.
| | - Janet E Rennick
- Department of Nursing and Department of Pediatrics, Division of Critical Care, The Montreal Children's Hospital, McGill University Health Centre, 1001 boul. Decarie, Room BS1.2566, Montréal, Québec, Canada H3A 3J1; Ingram School of Nursing and Department of Pediatrics, Faculty of Medicine, McGill University, Wilson Hall, 3506 University Street, Montreal, Québec, Canada H3A 2A7.
| |
Collapse
|
43
|
Rahnfeld M, Wendsche J, Ihle A, Müller SR, Kliegel M. Uncovering the care setting-turnover intention relationship of geriatric nurses. Eur J Ageing 2016; 13:159-169. [PMID: 28804376 DOI: 10.1007/s10433-016-0362-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
In times of global demographic changes, strategies are needed for improving nursing staff retention. We examined the association of care setting (nursing homes and home care) with geriatric nurses' intention to leave their job and their profession. Thus far, it is unclear why nurses' turnover intention and behaviour do not differ between care settings, although working conditions tend to be better in home care. We used the Job Demands-Resources model to explain indirect and buffering effects by job demands (time pressure, social conflicts) and resources (task identity, supervisor support, and co-worker support) via nurses' perceived health and job satisfaction on nurses' leaving intentions. The present cross-sectional questionnaire study was conducted with a sample of N = 278 registered nurses and nursing aides in German geriatric care. As expected, there was no direct relationship between care setting and leaving attitudes. Demands and resources predicted the intention to leave with job satisfaction as mediator. We found more demands in nursing homes but no differences in resources. Serial mediation effects of care setting on intentions to leave via demands/resources and health/job satisfaction as mediators were found only for time pressure and social conflicts. Unexpectedly, there were no clear differences between intention to leave the job and the profession. As hypotheses were only partly confirmed, other buffering and detrimental effects on leaving intentions are discussed. The present data suggest that detailed concepts for personnel and career planning in geriatric care are needed.
Collapse
Affiliation(s)
- Marlen Rahnfeld
- Department of Psychology, TU Dresden, Dresden, Germany.,Institute for Work and Health of the German Social Accident Insurance, Dresden, Germany
| | - Johannes Wendsche
- Department of Psychology, TU Dresden, Dresden, Germany.,Federal Institute for Occupational Safety and Health (BAuA), Dresden, Germany
| | - Andreas Ihle
- Department of Psychology, University of Geneva, Geneva, Switzerland
| | | | - Matthias Kliegel
- Department of Psychology, University of Geneva, Geneva, Switzerland
| |
Collapse
|
44
|
Chênevert D, Jourdain G, Vandenberghe C. The role of high-involvement work practices and professional self-image in nursing recruits' turnover: A three-year prospective study. Int J Nurs Stud 2015; 53:73-84. [PMID: 26421911 DOI: 10.1016/j.ijnurstu.2015.09.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 09/03/2015] [Accepted: 09/04/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND The retention of young graduate nurses has become a major management challenge among hospitals in Western countries, which is amplified in a context of aging of populations and an increasing demand for services from patients. Moreover, as it has been reported that 50% of experienced nurses do not recommend a career in nursing, it is likely that retention problems occur not only at the level of the organization, but also at the level of the nursing profession. Although research has identified some predictors of nurse turnover, it is unclear which factors influence nurses' turnover from the organization and from the profession and how these factors interrelate with one another over time. OBJECTIVE The present study extends previous research on nurse turnover by looking at the combined effects of nurses' pre-entry expectations, perceived high-involvement work practices, and professional self-image, on intended and actual turnover from the organization and the profession. DESIGN AND METHODS A prospective, longitudinal study of a sample of 160 graduated nurses affiliated with the Quebec Nurses' Association, Canada, was conducted. Participants were surveyed at three points in time, spread over a 3-year period. Graduated nurses' pre-entry expectations and professional self-image were surveyed at graduation (Time 1), while perceived high-involvement work practices, professional self-image, and intention to leave the organization and the profession were captured six months following nurses' entry into the labor market (Time 2). Finally, participants were surveyed with respect to organizational and professional turnover three years after the Time 2 survey (Time 3). Structural equations modeling was used to examine the structure of the measures and the relationships among the constructs. RESULTS Although pre-entry expectations had no effect, perceived high-involvement work practices were positively related to Time 2, professional self-image (controlling for pre-entry professional self-image). Moreover, high-involvement work practices exerted an indirect, negative effect on organizational and professional turnover through intention to leave the organization, and an indirect negative effect on intention to leave the profession through professional self-image. Nonetheless, professional self-image did not affect turnover. CONCLUSIONS The current study indicates that hospitals and nurse directors can take advantage of developing high-involvement work practices as these practices foster a stronger professional self-image among nurses, thereby contributing to their sense of value as care providers, and indirectly reduce intended and actual turnover from the organization and the profession.
Collapse
Affiliation(s)
- Denis Chênevert
- HEC Montréal, Department of Human Resources Management, 3000 chemin Côte Ste-Catherine, Montréal, Québec, Canada H3T2A7.
| | - Geneviève Jourdain
- HEC Montréal, Department of Human Resources Management, 3000 chemin Côte Ste-Catherine, Montréal, Québec, Canada H3T2A7.
| | - Christian Vandenberghe
- HEC Montréal, Department of Management, 3000 chemin Côte Ste-Catherine, Montréal, Québec, Canada H3T2A7.
| |
Collapse
|
45
|
Degen C, Li J, Angerer P. Physicians' intention to leave direct patient care: an integrative review. HUMAN RESOURCES FOR HEALTH 2015; 13:74. [PMID: 26350545 PMCID: PMC4563836 DOI: 10.1186/s12960-015-0068-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 08/18/2015] [Indexed: 05/25/2023]
Abstract
BACKGROUND In light of the growing shortage of physicians worldwide, the problem of physicians who intend to leave direct patient care has become more acute, particularly in terms of quality of care and health-care costs. METHODS A literature search was carried out following Cooper's five-stage model for conducting an integrative literature review. Database searches were made in MEDLINE, PsycINFO and Web of Science in May 2014. RESULTS A total of 17 studies from five countries were identified and the study results synthesized. Measures and percentages of physicians' intention to leave varied between the studies. Variables associated with intention to leave were demographics, with age- and gender-specific findings, family or personal domain, working time and psychosocial working conditions, job-related well-being and other career-related aspects. Gender differences were identified in several risk clusters. Factors such as long working hours and work-family conflict were particularly relevant for female physicians' intention to leave. CONCLUSIONS Health-care managers and policy-makers should take action to improve physicians' working hours and psychosocial working conditions in order to prevent a high rate of intention to leave and limit the number of physicians actually leaving direct patient care. Further research is needed on gender-specific needs in the workplace, the connection between intention to leave and actually leaving and measures of intention to leave as well as using qualitative methods to gain a deeper understanding and developing validated questionnaires.
Collapse
Affiliation(s)
- Christiane Degen
- Institute of Occupational Medicine and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
| | - Jian Li
- Institute of Occupational Medicine and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
| | - Peter Angerer
- Institute of Occupational Medicine and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
| |
Collapse
|
46
|
Factors associated with the self-perceived ability of nursing staff to remain working until retirement: a questionnaire survey. BMC Health Serv Res 2015; 15:356. [PMID: 26328791 PMCID: PMC4557922 DOI: 10.1186/s12913-015-1006-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 08/17/2015] [Indexed: 12/02/2022] Open
Abstract
Background It is important to learn how employers in European countries can prevent nursing staff from changing occupation or taking early retirement in order to counteract expected nursing shortages. However, to date research on nursing staff’s ability to remain working until retirement age has been limited. The purpose of this study was to gain insight into the associations between different job and organisational characteristics, job satisfaction, occupational commitment and the self-perceived ability to continue working in the current line of work until the official retirement age. Methods The questionnaire-based, cross-sectional study included 730 nursing staff members employed in Dutch hospitals, nursing homes, organisations for psychiatric care, homes for the elderly, care organisations for disabled people and home care organisations (mean age: 48; 89 % female). Linear and logistic regression analyses and mediation analyses were applied to test hypothesised associations. Results Reducing work pressure and increasing appreciation by senior management in particular have positive consequences for nursing staff’s self-perceived ability to continue working until the official retirement age. The job and organisational characteristics of autonomy, work pressure, supportive leadership, educational opportunities, communication within the organisation and appreciation of nursing staff by senior management together have substantial impact on nursing staff’s job satisfaction. Job satisfaction in turn is related to the self-perceived ability to continue working until the retirement age. However, job satisfaction mainly summarises the joint effect of job and organisational characteristics and has no supplementary effect on the self-perceived ability to continue working. Conclusion Employers should primarily focus on work pressure and the appreciation of nursing staff by senior management in order to retain nursing staff even as they get older. Electronic supplementary material The online version of this article (doi:10.1186/s12913-015-1006-x) contains supplementary material, which is available to authorized users.
Collapse
|
47
|
|
48
|
Chen IH, Brown R, Bowers BJ, Chang WY. Work-to-family conflict as a mediator of the relationship between job satisfaction and turnover intention. J Adv Nurs 2015; 71:2350-63. [PMID: 26043649 DOI: 10.1111/jan.12706] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2015] [Indexed: 12/11/2022]
Abstract
AIMS To investigate the mediating effect of work-to-family conflict on the relationship between job satisfaction and turnover intention among licensed nurses in long-term care settings. BACKGROUND The considerable research on turnover in long-term care has primarily focused on the impact of job satisfaction on turnover intention. Given the well-documented high turnover rate in nursing home staffing, dissatisfaction is expected to continue. Alternatives (e.g. reduction in work-to-family conflict) for reducing turnover under the circumstance of job dissatisfaction have not been investigated extensively. DESIGN A cross-sectional mailed survey. METHODS A convenience sample comprising 200 nurses from 25 private nursing homes in Central Taiwan was created. Data were collected from nurses about their level of turnover intention, job satisfaction and work-to-family conflict in 2012. A composite indicator structural equation model was used to examine the mediation model of this study. RESULTS Overall, 186 nurses (93%) returned the completed questionnaires. Consistent with published research from other countries, turnover intention in our study was significantly and negatively associated with job satisfaction and significantly and positively associated with work-to-family conflict. In addition, job dissatisfaction indirectly influenced turnover intention through high work-to-family conflict. CONCLUSION Findings from this study indicate the importance of work-to-family conflict to nurse turnover. While work setting has a strong, well-documented influence on job satisfaction, limiting job satisfaction efforts to work setting improvements may not yield the hoped-for results unless work-to-family conflict is also considered and addressed.
Collapse
Affiliation(s)
- I-Hui Chen
- Department of Nursing, Asia University, Taichung City, Taiwan
| | - Roger Brown
- Schools of Nursing, University of Wisconsin-Madison, Wisconsin, USA
| | - Barbara J Bowers
- Schools of Nursing, University of Wisconsin-Madison, Wisconsin, USA
| | - Wen-Yin Chang
- Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taiwan
| |
Collapse
|
49
|
Measures that matter. Nurs Manag (Harrow) 2015; 46:14-6. [PMID: 25692638 DOI: 10.1097/01.numa.0000461065.41660.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
50
|
Hewko SJ, Brown P, Fraser KD, Wong CA, Cummings GG. Factors influencing nurse managers' intent to stay or leave: a quantitative analysis. J Nurs Manag 2014; 23:1058-66. [DOI: 10.1111/jonm.12252] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Sarah J. Hewko
- Faculty of Nursing; University of Alberta; Edmonton AB Canada
| | | | | | - Carol A. Wong
- Arthur Labatt Family School of Nursing; Western University; London ON Canada
| | | |
Collapse
|