The relationship between nursing leadership and nurses' job satisfaction in Canadian oncology work environments

Background  Current Canadian oncology work environments are challenged by the same workforce statistics as other nursing specialties: nurses are among the most overworked, stressed and sick workers, and more than 8% of the nursing workforce is absent each week due to illness.
Aim  To develop and estimate a theoretical model of work environment factors affecting oncology nurses' job satisfaction.
Methods  The sample consisted of 515 registered nurses working in oncology settings across Canada. The theoretical model was tested as a structural equation model using LISREL 8.54.
Results  The final model fitted the data acceptably ( χ ² = 58.0, d.f. = 44, P  =   0.08). Relational leadership and physician/nurse relationships significantly influenced opportunities for staff development, RN staffing adequacy, nurse autonomy, participation in policy decisions, support for innovative ideas and supervisor support in managing conflict, which in turn increased nurses' job satisfaction.
Conclusions  These findings suggest that relational leadership and positive relationships among nurses, managers and physicians play an important role in quality oncology nursing environments and nurses' job satisfaction.
Implications for nursing management  Oncology nursing work environments can be improved by focusing on modifiable factors such as leadership, staff development and staffing resources, leading to better job satisfaction and hopefully retention of nurses.     

Workplace empowerment, incivility, and burnout: impact on staff nurse recruitment and retention outcomes

Aim  The aim of this study was to examine the influence of empowering work conditions and workplace incivility on nurses' experiences of burnout and important nurse retention factors identified in the literature.
Background  A major cause of turnover among nurses is related to unsatisfying workplaces. Recently, there have been numerous anecdotal reports of uncivil behaviour in health care settings.
Method  We examined the impact of workplace empowerment, supervisor and coworker incivility, and burnout on three employee retention outcomes: job satisfaction, organizational commitment, and turnover intentions in a sample of 612 Canadian staff nurses.
Results  Hierarchical multiple linear regression analyses revealed that empowerment, workplace incivility, and burnout explained significant variance in all three retention factors: job satisfaction ( R ² = 0.46), organizational commitment ( R ² = 0.29) and turnover intentions ( R ² = 0.28). Empowerment, supervisor incivility, and cynicism most strongly predicted job dissatisfaction and low commitment ( P  < 0.001), whereas emotional exhaustion, cynicism, and supervisor incivility most strongly predicted turnover intentions.
Conclusions  In our study, nurses' perceptions of empowerment, supervisor incivility, and cynicism were strongly related to job satisfaction, organizational commitment, and turnover intentions.
Implications for nursing management  Managerial strategies that empower nurses for professional practice may be helpful in preventing workplace incivility, and ultimately, burnout.     

'I love nursing, but..'- qualitative findings from Australian aged-care nurses about their intrinsic, extrinsic and social work values

Aim.  The aim of this qualitative analysis – a component of a larger survey study, was to provide insights and understandings about intrinsic and extrinsic work values for nurses in aged-care.
Background.  Intrinsic and extrinsic work values impact on nurses' job satisfaction and ultimately nursing retention. This study contributes further to knowledge development in this area by building on a previous work values study in aged-care nursing.
Methods.  This paper presents the qualitative research findings from the final open-ended question from a survey of nurses employed in the aged-care sector in the State of Queensland, Australia in 2007. Data from a cohort of 105 aged care sector nurses was analysed relying on deductive content analysis.
Findings.  Two intrinsic work values emerged – low morale and images of nursing and two extrinsic work values emerged – remuneration and working conditions. The work value 'working conditions' comprised four aspects of aged-care work, specifically staff turnover, workplace violence, care team membership specifically the Assistants-in-Nursing and paperwork. A single social workplace value 'support by management' is discussed as identified as important to these nurses.
Conclusion.  Qualitative insights into aged-care nurses' intrinsic and extrinsic work values suggest that work satisfaction is low. Workforce policy makers and employers of nurses in aged-care need to comprehend the relationship between job satisfaction, retention and work values.
Relevance to clinical practice.  These findings have implications for recruitment, retention and workforce planning within the aged-care environment.     

Measuring community nurses' job satisfaction: literature review

Title.  Measuring community nurses' job satisfaction: literature review
Aim.  This paper is a report of a review of the literature on community nurses' job satisfaction, including research using different scales and settings, what is known to date and directions for future research.
Background.  Job satisfaction is one of the strongest predictors of intent to stay and retention of nurses. An adequate understanding of the sources of job satisfaction and their importance can aid policymakers in the community nursing setting to cope with the growing demand for its services.
Data sources.  A database of papers was established using ISI Web of Knowledge. Cited references were used to expand the database. Journals adding to the database were scanned for related research. This technique was repeated until no additional papers could be found.
Findings.  Twelve job satisfaction scales were found, with striking differences in methodology, settings and sample characteristics of the studies concerned. A wide variety of job satisfaction and dissatisfaction sources is identified, but little is known on their relative importance. The Measure of Job Satisfaction and the Home Healthcare Nurses' Job Satisfaction Scale prove highly reliable and applicable.
Conclusion. Findings on the level and sources of community nurses' job satisfaction are ambiguous. Of all the scales reviewed, the Home Healthcare Nurses' Job Satisfaction Scale seems most promising for use in future research, based on its strong psychometric properties and its specificity for the community nursing setting.     

Workplace empowerment, job satisfaction and job stress among Italian mental health nurses: an exploratory study

Aim  The purpose of the present study was to investigate the relationship between staff nurses' structural empowerment, work stress and job satisfaction in two health care settings in Italy using Kanter's Empowerment Theory.
Background  With the current scarcity of economic resources and shortage of nurses, it is essential to empower nurses to perform at a high level to ensure high-quality patient care. Structural empowerment is a process that can optimize use of nursing skills and professional expertise, thereby increasing job satisfaction among nurses.
Method  A convenience sample of 77 nursing staff employed in the Department of Mental Health in central Italy was used in this study (return rate 64%).
Results  Structural empowerment was significantly related to their job satisfaction ( r  = 0.506, P  < 0.001), as was global empowerment ( r  = 0.62). Empowerment also had a significant negative relationship to nurses' work stress ( r  = −0.28, P  < 0.05).
Conclusion  The results of this study support Kanter's theory of structural empowerment in an Italian nursing sample – a previously unstudied population.
Implications for nursing management  Organizational administration must make every effort to create organizational structures and systems that empower nurses to practice according to professional standards and optimize the use of their knowledge and expertise.     

Career trajectories of nurses leaving the hospital sector in Ontario, Canada (1993–2004)

Title.  Career trajectories of nurses leaving the hospital sector in Ontario, Canada (1993–2004).
Aim.  This paper is a report of an analysis of the career trajectories of nurses 1 year after leaving hospitals.
Background.  Although hospitals are traditionally the largest employers of nurses, technological advances and budgetary constraints have resulted in many countries in relative shrinkage of the hospital sector and a shift of care (and jobs) into home/community settings. It has been often assumed that nurses displaced from hospitals will move to work in the other workplaces, especially the community sector.
Method.  Employment patterns were tracked by examining a longitudinal database of all 201,463 nurses registered with the College of Nurses Ontario (Canada) between 1993 and 2004. Focusing on the employment categories Active (Working in nursing), Eligible-Seeking nursing employment or Dropout from the nursing labour market, year-to-year transition matrixes were generated by sector and sub-sector of employment, nurse type, age group and work status.
Findings.  For every nurse practising nursing in any non-hospital job or in the community a year after leaving hospitals, an average of 1·3 and four nurses, respectively, dropped out of Ontario's labour market. The proportion of nurses leaving hospitals transitioning to the Dropout category ranged from 63·3% (1994–95) to 38·6% (2001–02). The proportion dropping out of Ontario's market was higher for Registered Practical Nurses (compared to Registered Nurses), increased with age and decreased with degree of casualization in nurses' jobs.
Conclusion.  Downsizing hospitals without attention to the potentially negative impact on the nursing workforce can lead to retention difficulties and adversely affects the overall supply of nurses.     

Job satisfaction in a Norwegian population of nurses: a questionnaire survey

BACKGROUND: Although job satisfaction is a factor that influences retention, turnover and quality of nursing care globally, there are few studies exploring these factors in European countries. OBJECTIVES: To describe job satisfaction among hospital nurses in Norway, to explore the relationship between nurses' job satisfaction and participation in a clinical ladder program and to explore relationships between several variables and intent to stay. A secondary purpose was to investigate the use of a job satisfaction instrument in a different culture than its origin. DESIGN: In a survey, 2095 nurses in four different hospitals answered a questionnaire that included demographic data, intent to stay and a job satisfaction instrument covering the importance of and actual satisfaction with different job factors. RESULTS: Interaction, followed by pay and autonomy were the most important job factors for Norwegian nurses. Actual job satisfaction was similar to nurses in other countries. There was no significant difference in job satisfaction between participants and non-participants in a clinical ladder. Nurses intending to stay more than a year were significantly more satisfied in their job. Further education and 1 day or more scheduled for professional development were factors that were positively related to intent to stay in the hospital. CONCLUSIONS: Norwegian nurses' views on the importance of different job factors mirrored views of the importance ascribed to working milieu in the Norwegian society. As such, the instrument used seemed sensitive to cultural differences. Nurses' actual satisfaction with their job was similar to respondents in many other countries and may imply that structures and content defining nurses' working situation are similar in many parts of the world. Participation in a clinical ladder did not increase nurses' overall job satisfaction. However, further education and the opportunity for professional development increased nurses' intention to stay in the organization.     

Work-home interference among nurses: reciprocal relationships with job demands and health

Title.  Work-home interference among nurses: reciprocal relationships with job demands and health.
Aims.  This paper is a report of a study with three aims: (i) to investigate whether emotional, quantitative and physical demands have a causal, negative impact on nurses' health; (ii) to examine whether work-home interference can explain this effect, by playing a mediating role; and (iii) to test the so-called loss spiral hypothesis claiming that nurses' health problems lead to even higher job demands and more work-home interference over time.
Background.  While many scholars have thought in terms of the stressor→work-home interference→strain model, the validity of a model that includes opposite pathways needs to be tested.
Method.  A questionnaire was completed twice, with a 1-year time interval by 753 (63·4%) Registered Nurses working in hospitals, 183 (15·4%) working in nursing homes, and 251 (21·1%) working in home care institutions. The first measurement took place between October 2002 and June 2003.
Findings.  Our findings strongly support the idea of cross-lagged, reciprocal relationships between job demands and general health over time. The reciprocal model with work-home interference as an intervening variable (including reciprocal relationships between job demands, work-home interference and general health) showed a good fit to the data, and proved to be superior to both the causality and reversed causation models.
Conclusion.  The higher nurses' job demands, the higher is their level of work-home interference and the more likely is a general health deterioration over time, in turn giving rise to higher job demands and work-home interference, which may even aggravate the nurses' general health, and so on.     

长沙市二级及以上医院护士职业承诺和工作满意度对留职意愿的影响研究

目的 调查长沙市二级及以上医院护士留职意愿现状,并分析其影响因素.方法 采用护士留职意愿问卷、护士工作满意度量表、职业承诺问卷,对长沙市医疗机构329名护士进行调查.结果 护士留职意愿总分为（19.64±4.12）分,护士工作满意度总分为（126.22±18.04）分,护士职业承诺总分为（70.74±13.59）分;分层回归分析结果显示年龄、工作职务、任职方式、情感承诺、规范承诺、经济成本承诺、机会承诺对护士留职意愿有预测作用（P＜0.01或P＜0.05）.结论 所调查长沙市医疗机构医院护士留职意愿呈中等水平,护理管理者应针对可控影响因素,制订稳定护理人才队伍的相应策略.     

临床护士职业满意度和专业认可度的调查分析

目的了解临床护士职业满意度和专业认可度，探讨其影响因素并分析专业认可度对职业满意度的影响。方法采用问卷法对100名护士进行职业满意度和专业认可度的调查。通过描述分析和回归分析处理所得数据。结果临床护士职业满意度处于中等水平，待遇、行政体系和自律性是导致护士满意度低的主要因素。护士专业认可度较高，护士的自我概念正确，对职业的认识度高。专业认可度对职业满意度有显著影响，社会对护理的认识是影响职业满意度最重要的方面。结论应对护士进行职业教育，采取人性化管理措施，提高护士的职业满意度和专业认可度。     

Personal characteristics and job satisfaction among nurses in Lebanon

OBJECTIVE: This study investigates the level of satisfaction of Lebanese nurses in their job and the influence of their personal characteristics. BACKGROUND: Given the current difficulties experienced by Lebanese hospitals in recruiting and retaining a sufficient number of nurses, the need to understand the reasons of nurses' dissatisfaction became urgent. Moreover, satisfaction at work is essentially a personal experience also affected by cultural factors. Therefore, it was necessary to study the links between personal characteristics and nurses' dissatisfaction. METHODS: The study included 421 registered nurses. A modified version of Measure of Job Satisfaction, developed by Taynor and Wade, was used to assess the effect of the personal characteristics, namely educational level, age, years of work experience, position, and marital and parental status, on 5 dimensions of satisfaction: personal satisfaction, workload, professional support, pay and prospect, and training. RESULTS: The findings suggest that personal characteristics have important influences on nurses' job perceptions. University graduate nurses reported more dissatisfaction with the quality of supervision and with respect and treatment they receive from their superiors. Nurses younger than 30 years and the technically trained were more dissatisfied with the available opportunities to attend continuing education courses. Results of staff nurses and unmarried nurses showed trends of more dissatisfaction than the married and nurses of higher positions. Moreover, the whole sample perceived that nursing provided a high level of personal satisfaction, but nurses were most dissatisfied with salary and lack of prospects for promotion. CONCLUSION: The results indicate the importance of personal characteristics on nurses' retention. Furthermore, intrinsic factors related to the nature and experience of nursing are more job satisfying than extrinsic factors.     

Retention of nurses in the primary and community care workforce after the age of 50 years: database analysis and literature review

Title.  Retention of nurses in the primary and community care workforce after theage of 50 years: database analysis and literature review.
Aim.  This paper is a report of a study conducted to explore strategies for retaining nurses and their implications for the primary and community care nursing workforce.
Background.  An ageing nursing workforce has forced the need for recruitment and retention of nurses to be an important feature of workforce planning in many countries. However, whilst there is a growing awareness of the factors that influence the retention of nurses within secondary care services, little is known about those that influence retention of nurses in primary and community care. Little is known about the age profile of such nurses or the impact of the ageing nursing workforce on individual nursing specialities in the England.
Methods.  Nursing databases were analysed to explore the impact of age on nursing specialities in primary and community care. The nurse retention literature was reviewed from 1995 to 2006.
Findings.  Workforce statistics reveal that primary and community care nurses have a higher age profile than the National Health Service nursing workforce as a whole. However, there are important gaps in the literature in relation to the factors influencing retention of older primary and community care nurses. Specific factors exist for older nurses within primary care that are unique. Implications for their retention are suggested.
Conclusion.  Particular attention needs to be paid to factors influencing retention of older nurses in primary and community care. These factors need to be incorporated into local and national policy planning and development.