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.     

Bullying among nurses and its relationship with burnout and organizational climate

Workplace bullying is one of the most common work‐related psychological problems. Bullying costs seem higher for organizations composed of health‐care workers who perform direct‐contact patients‐complex tasks. Only a few studies have been carried out among nurses in Italy and integrated models of bullying antecedents and consequences are particularly missing. The aim of this study was to develop a bullying model focused on the interaction between bullying and burnout in the setting of a climate–health relationship. Research involved 658 nurses who completed a survey on health, burnout, bullying and organizational climate. Structural equation modeling was used to test the hypothesis. Results suggest that workplace bullying partially mediates the relationship between organizational climate and burnout and that bullying does not affect health directly, but only indirectly, via the mediation of burnout. Our study demonstrates the key‐role of workplace bullying and burnout in the climate–health relationship in order to understand and to improve nurses’ health.     

Health consumers' experiences in Australian critical care units: postgraduate nurse education implications

Aim: To explore critical care patients and families experiences and seek their input into nurses' postgraduate educational preparation and practice. Background: There is an inconsistency in the expected standard of practice to ‘qualify’ Australian critical care nurses. There has also been a lack of health consumer input in the development of postgraduate course curriculum and content. Method: Following institutional ethics committee approval, purposive sampling was used to select participants for focus groups and individual interviews who had experienced intensive care or coronary care. Findings: Seventeen participants provided data which created two main thematic categories; the role of the critical care nurse and; minimum practice standards for postgraduate critical care course graduates. Both physical patient care and socio‐emotional support of patients and family were identified as important for the critical care nurse role. The level of socio‐emotional support provided by nurses was reported to be inconsistent. Components of socio‐emotional support included communication, people skills, facilitating family presence and advocacy. These components were reflected in participants' concepts of minimum practice standards for postgraduate critical care course graduates; talking and listening skills, relating to and dealing with stressed people, individualizing care and patient and family advocacy. Conclusion: Health consumers' views emphasize that socio‐emotional skills and behaviours need to be explicitly described in postgraduate critical care nursing course curricula and instruments developed to consistently assess these core competencies.     

The impact of organizational climate on nurse satisfaction. Management implications

The stresses and demands on nurses currently in practice and those who manage nursing environments are far greater than they were just a few years ago and will only escalate in the future. The purpose of this study was to examine the relationship of organizational climate dimensions on registered nurse job satisfaction. The sample consisted of 232 pediatric registered nurses who worked in all pediatric specialties. There was a statistically significant relationship between five climate dimensions and job satisfaction (p < .01-.001). Emphasis is placed on implications for nurse administrators and managers who can greatly impact the climate of the nursing unit and department. It is essential for nurse administrators and managers to plan and implement approaches that will meet the unique needs of their staff and institution in these particularly challenging times.     

Quality of care in Hunan Province nursing homes: relationship to staffing and organizational climate

Our objective was to examine the quality of care perceived by nursing staff and its relationship with the staffing and organizational climate in nursing homes. The participants in this cross-sectional study included 358 nursing staff from 26 nursing homes in Hunan Province, China. This study found that the interaction effect between nursing staff to resident ratio and physician to resident ratio exerted a significant effect on quality of care (p < 0.05). Higher scores on the relationships and communication scale (OR = 4.771, p = 0.002) and lower scores on the work stress scale (OR = 0.980, p = 0.050) were also associated with better quality of care. More work experience was related to lower quality of care (OR = 0.944, p = 0.048), and work experience was associated with relationships and communication (Beta = 0.172, p = 0.002) and work stress (Beta= = 0.259, p = 0.000). Staffing level, work experience, work stress, relationships and communication are key factors in providing higher quality of care in nursing homes.     

急危重症病学科护士职业倦怠干预的效果评价

目的 减轻急危重症病学科护士的职业倦怠感.方法 对急危重症病学科100名临床护士通过改善保健因素、应用激励机制、实施信息化管理和员工援助计划等方法进行系统干预,并应用职业倦怠量表进行干预前后评估比较.结果 情绪衰竭和去人格化两项指标得分下降,差异具有统计学意义(P<0.01或P<0.05).结论 急危重症病学科护士的职...     

Sleep deprivation in critical care units

Sleep deprivation is a significant problem for patients in critical care units. Sleep is a complex, active process that is divided into 4 stages of non-rapid eye movement (NREM) sleep, and rapid eye movement (REM) sleep. Noise, lights, discomfort, pain, medications, and stress all contribute to a patient's inability to sleep. Lack of knowledge about the sleep stages, nursing routines, and frequent nursing assessment and interventions also impact the critically ill patient's ability to sleep. Education about sleep deprivation needs to be integrated into critical care courses and orientation programs. Sleep deprivation should be addressed on the multidisciplinary care plan and in health team conference, and nursing care planned accordingly. Sleep medications and their effects should be evaluated for each patient, as well as identifying medications that might be preventing or disturbing sleep.     

护理组织氛围与护士职业价值观的相关研究

目的:了解医院护理组织氛围与护士职业价值观现状,探讨组织氛围与护士职业价值观的关系,为护理人力资源管理提供依据。方法:采用护理组织氛围量表和护士职业价值观量表对哈尔滨市4所三级甲等医院共695名注册护士进行调查。结果:护理组织氛围各个维度对护士职业价值观各个维度有显著的预测作用,结果具有统计学意义(P<0.01)。结论:营造良好的组织氛围有助于护士实现自身价值,从而促使其形成正确的职业价值观。     

Connection between organizational culture and climate and empowerment: The perspective of nurse managers

Health‐care organizations differ from other institutions due to their unique structure and management. Organizational culture and climate are the key constructs that compose the organizational social context, and might have an impact on employees, such as nurse managers, and the organization itself. The aim of this study was to analyze the connections between organizational culture and climate and work‐related empowerment, and also to present culture and climate profiles at team and organization levels. The research was carried out in Lithuania among 193 nurse managers in seven hospitals using a questionnaire that measured organizational culture and climate (Organizational Social Context instrument), and work‐related empowerment (Conditions for Work Effectiveness Questionnaire‐II and Work Empowerment Questionnaire). The findings showed that nurse managers were both structurally and psychologically empowered when the organizational culture was proficient and resistant, and the climate was engaged and functional. These results suggest that nurse managers are more likely to be empowered when there is an appropriate organizational culture and climate in the workplace. Creating an empowering work environment might have a positive impact on individual and organizational outcomes.     

The evolving role of the acute care nurse practitioner in critical care

PURPOSE OF REVIEW: The newest nurse practitioner role is the acute care nurse practitioner. This paper presents the latest data on the role from both a US and international perspective. RECENT FINDINGS: Now present in the USA for at least 15 years, the acute care nurse practitioner role has become well established in critical care settings and is moving into international healthcare. The few outcome studies conducted to date demonstrate the acute care nurse practitioner provides quality patient and family care, improves patient satisfaction, is cost effective, and is an answer to the hospital's shortage of medical residents with new restrictions on working hours. SUMMARY: The role of acute care nurse practitioners in critical care is increasing worldwide. Most countries are experimenting with this latest nurse practitioner as an extended-role healthcare provider with many potential benefits to patients and their families, as well as the healthcare system.     

Staff nurse turnover in neonatal intensive care units

The turnover rate and patterns in Neonatal Intensive Care Units (NICUs) were assessed and compared with adult Intensive Care Units (ICUs) and General Infant Care Units at the same hospitals for the year 1976. Thirty-five hospitals with NICUs participated in the study. The findings of this study disagree with the previous literature in three major ways: 1 The turnover rate of staff nurses was less than half that estimated by The National Commission on Nursing for 1970. 2 The turnover rates in ICUs and NICUs were not significantly higher than that for staff nurses in Non-Intensive Care Units. In addition, the pattern of turnover among leavers is identical for all three major types of unit. The variability pattern for neonatal units, however, is statistically significant; this is not so with the other units studied. 3 There is no evidence for a stabilization of turnover following the usual 'induction crisis period' (the first 3 to 6 months).     

Organ donation and the critical care nurse

CACCN supports the process of organ donation. Nurses working in critical care are in a privileged position to positively influence organ donation success; however, the process can be emotionally very difficult. Facility commitment, agency culture and medical practice are also crucial to the process of organ donation. Despite our commitment to support organ donation as an option, the critical care nurse's primary responsibility is to the potential donor and their family. Throughout the process, the critical care nurse must remain non-judgmental and supportive of the family, regardless of their decision. Ultimately, the nurse must balance organ donation with the needs of the family who is experiencing the tragic and untimely loss of a loved one. Finding this balance is never an easy task.     

Quality assurance and the critical care nurse

Care of the critically ill has become increasingly challenging due to demands from external sources to measure the quality and appropriateness of care provided. Quality assurance is the responsibility of every critical care nurse and requires vigilance as well as a knowledge of the principles of standards, monitoring and evaluation. Through quality assurance activities, the contribution of critical care nurses in the achievement of patient outcomes can be measured. Quality assurance challenges us to evaluate the way we practice, and assists us to continuously improve the way we provide care to critically ill patients.