Profiling nurses' job satisfaction,acculturation, work environment,stress, cultural values and coping abilities: A cluster analysis

This study aimed to determine whether definable profiles existed in a cohort of nursing staff with regard to demographic characteristics, job satisfaction, acculturation, work environment, stress, cultural values and coping abilities. A survey was conducted in one hospital in Singapore from June to July 2012, and 814 full‐time staff nurses completed a self‐report questionnaire (89% response rate). Demographic characteristics, job satisfaction, acculturation, work environment, perceived stress, cultural values, ways of coping and intention to leave current workplace were assessed as outcomes. The two‐step cluster analysis revealed three clusters. Nurses in cluster 1 (n = 222) had lower acculturation scores than nurses in cluster 3. Cluster 2 (n = 362) was a group of younger nurses who reported higher intention to leave (22.4%), stress level and job dissatisfaction than the other two clusters. Nurses in cluster 3 (n = 230) were mostly Singaporean and reported the lowest intention to leave (13.0%). Resources should be allocated to specifically address the needs of younger nurses and hopefully retain them in the profession. Management should focus their retention strategies on junior nurses and provide a work environment that helps to strengthen their intention to remain in nursing by increasing their job satisfaction.     

Stress in telephone helpline nurses: research protocol for a study of theoretical determinants, physiological aspects and behavioural consequences

Title.  Stress in telephone helpline nurses: research protocol for a study of theoretical determinants, physiological aspects and behavioural consequences.
Aim.  This is a report of a research protocol to assess level, determinants and consequences of stress in NHS-24 telephone helpline nurses.
Background.  Nurses working in traditional hospital settings report high levels of occupational stress. Many nurses now work in call centres, environments with their own inherent stressors. Stress in nurses has been linked to reduced physical and psychological health, reduced job satisfaction, increased sickness absence and turnover, and poorer job performance. In this study, we will use multiple methods, including real time data collection to assess stress in telephone helpline nurses.
Design.  During 2008/09, NHS-24 nurses will (a) report general stress and call-by-call stress over two working shifts, (b) complete measures of theoretical determinants of occupational stress (demand, control, effort and reward), (c) have their concentration and attention tested before and after two shifts, (d) have their heart rate monitored over two shifts, (e) report job satisfaction, absenteeism and intended turnover and (f) allow the research team to retrieve related call data and performance indicators. Relationships between the variables will be assessed using regression and multi-level modelling.
Discussion.  Data will be analysed to examine the relationships between reported stress, physiological aspects of stress, call type, workplace attributes, cognitive performance, job satisfaction and absenteeism. The analysis will test models of occupational stress and assess the effects of stress on multiple work outcomes. The results will inform theoretical understanding of nurse stress, its determinants and possible methods of management. The practical challenges of conducting such a comprehensive study in a clinical environment are discussed.     

Implementation of an intravenous medication infusion pump system: implications for nursing

AIM: To assess perceptions of nurses regarding the implementation of intravenous medication infusion system technology and its impact on nursing care, reporting of medication errors and job satisfaction. BACKGROUND: Medication errors are placing patients at high risk and creating an economic burden for hospitals and health care providers. Infusion pumps are available to decrease errors and promote safety. METHODS: Survey of 1056 nurses in a tertiary care Magnet hospital, using the Infusion System Perception Scale. Response rate was 65.43%. RESULTS: Nurses perceived the system would enhance their ability to provide quality nursing care, reduce medication errors. Job satisfaction was related to higher ratings of the management team and nursing staff. Perceptions verified the pump was designed to promote safe nursing practices. CONCLUSIONS: It is important to consider relationships with job satisfaction, safe nursing practice and the importance of ratings of nursing staff and management teams when implementing infusion technology. IMPLICATIONS FOR NURSING MANAGEMENT: Infusion pumps are perceived by nurses to enhance safe nursing practice. Results stress the importance of management teams in sociotechnological transformations and their impact on job satisfaction among nurses.     

The relationship of body mass index (BMI) to job performance,absenteeism and risk of eating disorder among hospital-based nurses

Obesity has been linked to job absenteeism and decreased job performance. Additionally, shift work may be related to abnormal eating in nurses. This study examines the relationship between body mass index, job performance, absenteeism, and eating disorder risk among nurses. Registered Nurses (n = 63) participated in a survey that included the Work Limitations Questionnaire and the Eating Attitudes Test. Most participants were either overweight or obese. Significant correlations were noted between body mass index and job performance, and body mass index and risk of eating disorders. An understanding of how increased body mass index can affect a nurse's job performance and wellness warrants continued attention from the nursing profession.     

The task of nursing and risk of smoking

A survey of hospital nurses was conducted to determine whether certain aspects of nurses' working and living conditions could explain their smoking practices. Nurses (246) of all grades answered a questionnaire about their smoking practices, job characteristics, job satisfaction, life satisfaction and anxieties. The prevalence of regular smoking was low among first and second year student nurses but reached 22% among final year students and 27% among staff nurses. Those nurses who reported stress at work, high and low overall job satisfaction, low lifestyle satisfaction and high anxiety about patients were more likely to smoke. The importance of these factors was especially marked among final year students. It seems that the changes in the life and work routine of nurses during their final year of training appear to increase their risk of regular smoking.     

Barriers to participation in continuing education activities among rural and remote nurses

BACKGROUND: This article examines the barriers to participation in continuing education activities that are perceived by rural and remote registered nurses in Canada. METHODS: The data are drawn from a national survey that was part of a larger national project, "The Nature of Nursing Practice in Rural and Remote Canada." RESULTS: Perceived barriers to participation in continuing education activities include the isolation of rural nurses and time and financial constraints. Nurses who perceived barriers to participation were more likely to be middle-aged, unmarried, and working full-time than nurses who did not perceive barriers. They were also more likely to possess higher levels of nursing education and have children or dependents. The perception of barriers to participation was also associated with lower job and scheduling satisfaction. CONCLUSIONS: Rural and remote registered nurses have moderately high levels of participation in continuing education; however, participation and job satisfaction can be improved if some of the barriers identified are addressed.     

Lifestyle behaviours and weight among hospital-based nurses

Aims  The purpose of this study was to (i) describe the weight, weight-related perceptions and lifestyle behaviours of hospital-based nurses, and (ii) explore the relationship of demographic, health, weight and job characteristics with lifestyle behaviours.
Background  The obesity epidemic is widely documented. Worksite initiatives have been advocated. Nurses represent an important part of the hospital workforce and serve as role models when caring for patients.
Methods  A sample of 194 nurses from six hospitals participated in anthropometric measurements and self-administered surveys.
Results  The majority of nurses were overweight and obese, and some were not actively involved in weight management behaviours. Self-reported health, diet and physical activity behaviours were low, although variable by gender, age and shift. Reports of co-worker norms supported low levels of healthy behaviours.
Conclusions  Findings reinforce the need to address the hospital environment and culture as well as individual behaviours for obesity control.
Implications for nursing management  Nurse managers have an opportunity to consider interventions that promote a climate favourable to improved health habits by facilitating and supporting healthy lifestyle choices (nutrition and physical activity) and environmental changes. Such efforts have the potential to increase productivity and morale and decrease work-related disabilities and improve quality of life.     

护士职业认同感、工作压力和满意度及离职意愿调查

目的：了解北京市护士的职业认同感、工作压力和满意度及离职意愿状况。方法：采用方便抽样法抽取北京市19家不同级别医院的1272名护士,用自行设计的护士职业认同感、工作压力和工作满意度及离职意愿问卷对其进行调查。结果：1272名护士认为目前护士的社会地位平均分为36．5±19．7分（中位数为35．0）,27．8％的护士感觉患者对护士比较尊重或非常尊重,57．2％的护士认为工作压力较大或很大,压力来源主要为职业风险高、工作强度大、社会评价不高,30．7％的护士对工作比较满意或非常满意,不满意的原因主要为收入低、职业风险高、工作强度大;35．2％的护士表示不愿意继续从事护理工作,原因主要为收入低、职业风险高和工作强度大;多元线性逐步回归显示护士职业认同的影响因素有护龄和学历,工作压力的影响因素有婚姻状况和医院级别,工作满意度的影响因素有医院级别、职称和职务;Logistic回归显示护士离职意愿的影响因素为医院级别。结论：目前北京市护士的职业认同感评分低,工作压力大,工作满意度低,离职意愿强烈;相关管理部门应采取有效措施,减轻护士工作压力,提高护士工作满意度和职业认同感,减少有离职意愿护士的数量,以稳定护士队伍,保证临床护理质量。     

The relationship between supervisor support and registered nurse outcomes in nursing care units

Workplace social support is a major characteristic related to the Job Demand-Control model of job stress. Organizational and managerial support have an effect on nurse satisfaction and burnout. The relationships between perceived supervisor support and measures of nurse occupation-related outcomes were investigated in 3 nursing units within an academic medical center. Nurses with greater levels of perceived supervisor support experienced more positive job outcomes and less negative outcomes, including less occupational stress, than nurses with less perceived supervisor support. Implications for refocusing the role of the nurse supervisor and its effect on multiple nursing occupation-related outcomes are discussed.     

Perceived job stress, job satisfaction, and psychological symptoms in critical care nursing

This study tested the relationships among perceived job stress, job satisfaction, and psychological symptoms of critical care nurses. A self-administered questionnaire was sent to a sample of 180 critical care nurses from eight hospitals. The results supported the hypotheses that higher levels of perceived job stress are related to lower levels of job satisfaction (r = -.24, p = .001) and to higher levels of psychological symptoms (r = .33, p = .000). These effects remained even when years of experience in nursing and shift were controlled. Item analysis, however, showed that four of the five top-ranking stressors were not related to the outcome measures. A distinction between positive and negative stressors is proposed to explain the pattern of results.     

Teaching and community hospital work environments

The Institute of Medicine report suggests that nursing work environments experience threats to patient safety related to organizational management and workforce deployment practices, work design, and organizational culture. Organizational factors contribute to nursing and potentially patient outcomes, yet few studies have examined the differences in practices perceived by nurses employed in different settings. Nurses from 16 medical and surgical units in eight randomly selected acute care hospitals representing teaching and community organizations participated in this project. Nurses working in teaching hospitals reported lower levels of role tension, yet their perceptions of the quality of work, the work environment, nursing unit leadership, quality of care, and levels of job stress and job satisfaction were higher than their colleagues in the community sites. This study highlights some important differences between teaching and community hospitals that can inform nurse executives and policy makers of the unique work-life issues for different groups of nurses.     

Stress amongst district nurses: a preliminary investigation

This paper presents the results of a pilot study investigating stress among district nurses in the north-west of England. Nurses completed questionnaires covering job satisfaction, mental health, stress, Type A behaviour, health behavior, coping skills and demographic details. A specific measure of stress was developed following in-depth interviews with primary care professionals, including district nurses. A total of 79 district nurses took part in the study. The major sources of stress isolated by the district nurses related to: time pressure, administrative responsibility, having too much to do, factors not under their control, interruptions, keeping up with National Health Service (NHS) changes, and lack of resources. Factor analysis of stress questionnaire responses identified five major factors: demands of the job and lack of communication, working environment, problems with patients, work/home interface and social life, and career development. The highest levels of satisfaction were reported for the amount of variety in their job and the lowest level of job satisfaction was reported for chance of promotion. The results revealed that the mental wellbeing of the nurses was higher than that of the other population groups. Furthermore, multivariate analysis revealed three major stressors that were predictive of high levels of job dissatisfaction: demands of the job and lack of communication, working environment, and career development. The implications of the findings for further research are considered.     

Nursing staff mix models and outcomes

BACKGROUND: Recently, restructuring of the nursing workforce has been undertaken in a number of countries in an effort to provide efficient and cost-effective services to users. This often takes the form of the introduction of unregulated workers to carry out support roles with registered nurses. However, these changes have not been evaluated for efficacy or impact on nurses, patients or the health care system. PURPOSE: The purpose of this study was to determine the relationship between staff mix models comprising regulated staff (Registered Nurses and Registered Practical Nurses) or regulated and unregulated staff (Registered Nurses and unregulated workers), and nursing and quality outcomes. METHODS: This comparative correlational study was conducted in a random sample of 30 adult, acute care patient units within eight hospitals located in Toronto, Canada. Registered Nurses employed on 30 randomly selected hospital units, grouped by the two staff mix models (15 units per group), were surveyed using previously validated instruments to measure role conflict, role ambiguity, job satisfaction, perceived effectiveness of care and perceived quality of care. RESULTS: Results indicated that Registered Nurses in this study experienced high levels of role conflict, regardless of the type of staff mix model within which they worked. Registered Nurses on units employing both Registered Nurses and unregulated workers reported higher levels of job satisfaction. On units employing both Registered Nurses and unregulated workers, Registered Nurses perceived that the quality of care was lower. CONCLUSIONS: Staff mix model was related to Registered Nurses' perceptions of the quality of patient care. It was also evident that other variables within the work environment might have more influence on the outcomes examined than the independent variable of staff mix.     

Eating disorders. Highlights of nursing assessment and therapeutics

Nurses providing care for individuals with eating disorders should identify and test the effectiveness of various milieu factors and nursing therapeutics employed in the treatment of these often-debilitating disorders. Nurses offer presence, role modeling, surveillance, and emotional and physiologic support while guiding reluctant patients to explore and experiment with new behaviors. Nurses provide flexibility, empathy, and rational limit setting in response to the unique and shifting needs of each patient. This interpersonal dynamic is often extremely different from that experienced in the patient's family of origin and, thus, contributes to the essential "interpersonal conditions" that are necessary for the patient to engage meaningfully in treatment. The prevalence of eating disorders suggests that nurses are likely to encounter people with eating disorders in many settings. Nurses should be skilled at spotting disordered eating among an array of clinical presentations (e.g., amenorrhea, disturbed family relationships, athletic injuries) because people engaged in disordered eating are hesitant to volunteer such information. In addition to the shame associated with disordered eating is the stigma associated with psychiatric treatment. Seeking help from a nurse may be perceived as less stigmatizing than seeking care from a psychiatrist. Thus, nurses may serve as important points of entry for the hesitant patient. The initial contact is so essential in setting the stage for the continuation and denouement of therapy. Finally, nurses and patients with disordered eating share at least one commonality. Both groups are predominantly women. The prevailing culture has been implicated repeatedly as a major factor in contributing to the prevalence of disordered eating. Nurses experience the influences of paternalism in their professional practice and confront daily the pressures of socially constructed feminine ideals. These gender-sensitive ways of knowing, which nurses bring to the treatment relationship, should be further analyzed as substantive dimensions with treatment and preventive potential.     

Antecedents and consequences of intra-group conflict among nurses

almost j., doran d.m., mcgillis hall l. & spence laschinger h.k. (2010) Journal of Nursing Management 18, 981–992
Antecedents and consequences of intra-group conflict among nurses Aim To test a theoretical model linking selected antecedent variables to intra-group conflict among nurses, and subsequently conflict management style, job stress and job satisfaction. Background A contributing factor to the nursing shortage is job dissatisfaction as a result of conflict among nurses. To develop strategies to reduce conflict, research is needed to understand the causes and outcomes of conflict in nursing work environments. Method A predictive, non-experimental design was used in a random sample of 277 acute care nurses. Structural equation modelling was used to analyse the hypothesised model. Results Nurses’ core self-evaluations, complexity of care and relationships with managers and nursing colleagues influenced their perceived level of conflict. Conflict management style partially mediated the relationship between conflict and job satisfaction. Job stress had a direct effect on job satisfaction and core self-evaluation had a direct effect on job stress. Conclusion Conflict and its associated outcomes is a complex process, affected by dispositional, contextual and interpersonal factors. How nurses manage conflict may not prevent the negative effects of conflict, however, learning to manage conflict using collaboration and accommodation may help nurses experience greater job satisfaction. Implications for nursing management Strategies to manage and reduce conflict include building interactional justice practices and positive interpersonal relationships.