The association of Chinese hospital work environment with nurse burnout,job satisfaction,and intention to leave

The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave and to explore the relationship of work environment to nursing outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization and high levels of reduced personal accomplishment. Nearly one-fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported an intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nursing outcomes in Chinese hospitals.     

Intensive care unit staff nurses: predicting factors for career decisions

Aims and Objectives. The aim of this study was to understand the factors related to intention to leave their job among intensive care unit (ICU) nurses in eastern Taiwan and to make between‐group comparisons between an intention to leave and an intention to stay as well as to predict the influencing factors that affect ICU staff nurses’ intention to leave. Background. Nurses’ intention to leave their job may have an important impact on the actual turnover of nurses. The issue has always been of concern to nursing executives. Only limited empirical studies in the area have been investigated in an Asian culture context and particularly the eastern Taiwan region. Methods. A cross‐sectional predictive study was performed during 2005 with 130 nurses recruited from two ICUs at a medical centre. A researcher‐designed questionnaire based on the Cooper's model with structured interviews was used to determine each nurse's characteristics and their intention to leave their job. Multiple logistic regression analysis was employed to investigate the various factors associated with this. Results. The overall response rate was 100%; 63 (48·9%) revealed that they intended to leave their jobs. The findings were that their self‐rated health status, the number of diseases, the level of happiness, the presence of depression, job satisfaction, sleep quality, type of license and their unit were significantly associated with an intention to leave (p = 0·05–0·001). Depression and sleep quality proved to be the most significant predictors of ICU staff nurses’ intention to leave their job. Conclusions. The findings suggest that there is a need to take steps to improve nurses’ health‐related quality of life and to develop effective strategies to improve nurse retention. Relevance to clinical practice. A succinct validated instrument would help identify the important factors that predict ICU nurses’ intention to leave their job, which may result in job disengagement. Predictors found in this study may be used as outcome variables for developing such an effective method of improving nurse retention in ICUs.     

A shared care model vs. a patient allocation model of nursing care delivery: Comparing nursing staff satisfaction and stress outcomes

Tran DT, Johnson M, Fernandez R, Jones S. International Journal of Nursing Practice 2010; 16 : 148–158
A shared care model vs. a patient allocation model of nursing care delivery: Comparing nursing staff satisfaction and stress outcomes This study compared nurse outcomes between the shared care in nursing (SCN) and patient allocation (PA) models of care. A quasi‐experimental design was used. Job satisfaction, stress and aspects of role were measured at baseline and 6 months after the implementation of the SCN model using validated instruments. Nurses in the PA (n = 51) and SCN (n = 74) units were comparable at baseline. Nurses from both groups were satisfied with their job and experienced clarity in their role despite some levels of pressure. ‘Satisfaction with co‐workers’ in the SCN group decreased, emphasizing the challenges of supervising staff. Matched pair sample sizes at follow‐up were small. The SCN represents an innovative model of care delivery that is responsive to increasing proportions of enrolled nurses and assistants in nursing within wards. Both models have been found to be supportive of nursing staff. Although difficulties with follow‐up data were experienced, this study represents the first Australian quasi‐experimental research, comparing two models with validated measures. New tasks such as negotiating with co‐workers might create some new challenges for nurses. Hospital administrators should consider the repertoire of care delivery models available.     

Attributes of nursing work environment as predictors of registered nurses’ job satisfaction and intention to leave

Aim To examine how front-line registered nurses’ perception of their work environment associates with and predicts nurse outcomes in terms of job satisfaction and turnover intention. Background Mounting evidence has pointed to an inseparable link between attributes of the nursing work environment and nurse outcomes. However, there is a paucity of research examining nurses’ perception of their work environment beyond the Western context. Methods This cross-sectional survey involved 1271 registered nurses working in 135 inpatient units in 10 public hospitals in Hong Kong. The instrument comprised items developed from in-depth interviews with front-line nurses that explored nurses’ perception of their work environment. Results Factor analysis identified five dimensions (professionalism, co-worker relationship, management, staffing and resources, and ward practice) of the nursing work environment. Logistic regression analysis further identified professionalism, management and ward practice as significant factors in predicting nurses’ turnover intention, and staffing and resources as an additional factor in predicting their job satisfaction. Conclusions Attributes of the nursing work environment have a significant bearing on nurses’ job satisfaction and intention to leave. Implications for nursing management Managerial effort should focus on improving nurses’ work conditions through detailed resource planning, effective management and removal of work constraints that affect nursing practice.     

Job control,work-family balance and nurses’ intention to leave their profession and organization: A comparative cross-sectional survey

BackgroundThe shortage of nurses is a problem in many countries. In Japan, the distribution of nurses across different care settings is uneven: the shortage of nurses in home healthcare and nursing homes is more serious than in hospitals. Earlier research has identified numerous factors affecting nurses’ intention to leave work (e.g., job control, family-related variables, work-family conflict); however, these factors’ levels and effect size may vary between nurses in hospitals, home healthcare, and nursing homes.ObjectivesThis study measured job control, family-related variables, and work-family conflict among nurses in hospitals, home healthcare, and nursing homes, and compared these variables’ levels and effect size on nurses’ intention to leave their organization or profession between these care settings.DesignThe research design was cross-sectional.MethodsParticipating nurses from hospitals, home healthcare facilities, and nursing homes self-administered an anonymous questionnaire survey; nurses were recruited from the Kyushu district of Japan. Nurses from nine hospitals, 86 home healthcare offices, and 107 nursing homes participated. We measured nurses’ intention to leave nursing or their organization, perceived job control, family variables and work-family conflict. We analyzed 1461 participants (response rate: 81.7%).ResultsThe level of job control, family variables, and work-family conflict affecting nurses varied between hospitals, home healthcare, and nursing homes; additionally, these variables’ effect on nurses’ intention to leave their organization or profession varied between these care settings. Work-family conflict, family variables, and job control most strongly predicted nurses’ intention to leave their organization or profession in hospitals, home healthcare, and nursing homes, respectively.ConclusionsInterventions aiming to increase nurse retention should distinguish between care settings. Regarding hospitals, reducing nurses’ work-family conflict will increase nurse retention. Regarding home healthcare, allowing nurses to fulfill family responsibilities will increase nurse retention. Regarding nursing home nurses, increasing nurses’ job control will increase nurse retention.     

Stress and coping in Singaporean nurses: A literature review

Stress is ubiquitous in the nursing profession and is also prevalent in Asian countries, particularly the “four tigers of Asia”: Singapore, Hong Kong, Taiwan, and South Korea. Based on the theoretical framework of Lazarus and Folkman (1984) , the present review of the nursing literature aims to identify sources and effects of stress in Singaporean nurses and the coping strategies they use. Nurses reported major stressors including shortage of staff, high work demands and conflict at work. Common coping strategies included problem orientation, social support and relaxation techniques. Several studies reported nurses' intent to leave the profession. Recommendations to minimize the impact of stress include in‐service programs to facilitate a problem‐solving approach to resolving work‐related issues such as conflict. Relaxation therapy and debriefing sessions may also help in reducing negative effects of work stressors. Finally, nurses' emotional coping can be enhanced by strengthening sources of social support, particularly from family.     

Faces of the nursing shortage: influences on staff nurses' intentions to leave their positions or nursing

OBJECTIVE: The objective of this study was to examine the relationship between organizational commitment, job satisfaction, and nurses' intention to leave their current position or nursing. BACKGROUND: Because retention of nurses is a critical issue for acute care institutions, study of the predictors of nurses' intention to leave (position or nursing) is essential. Of interest in predicting intention to leave are both organizational commitment and job satisfaction. METHODS: A mailed survey was conducted in which 787 respondents completed measures of satisfaction, organizational commitment, and personal and institutional demographics. All instruments had reliability estimates ranging from alpha = .76 to .92. RESULTS: Predictive relationships were found between financial status, organizational commitment, job and professional satisfaction, and intent to leave their current position (R = 0.42) and between financial status, professional satisfaction, and intention to leave nursing (R = 0.45) CONCLUSIONS: Organizational commitment has implications for nurses' intention to leave their current position but not nursing. Aspects of work and professional satisfaction predict both the intention to leave current position and nursing. Retention programs need to be focused on both organizational commitment and work and professional satisfaction.     

Impact of nurse staffing on intent to leave,job satisfaction,and occupational injuries in Korean hospitals: A cross‐sectional study

The purpose of this study was to examine nurse staffing in comprehensive nursing care units in Korea and examine the corresponding nurse outcomes, including intent to leave, job satisfaction, and occupational injuries. A total of 356 nurses working in comprehensive nursing care units at eight small‐medium sized Korean hospitals participated in this cross‐sectional study. In the day, evening, and night shifts, nurse staffing ranged from 9.00 to 24.82, 9.04 to 24.26, and 9.02 to 25.80, respectively. The nurse staffing on each shift did not have a significant impact on nurses? intent to leave, job satisfaction, and occupational injuries. However, workload had a strong relationship with intent to leave and job satisfaction. Voluntary overtime was related to occupational injuries. These findings demonstrate that workload is an important factor for intent to leave and job satisfaction among nurses working in comprehensive nursing care units. Improvements of the work environment, as well as rearrangement of nurse workload to account for patient acuity and nursing needs, are required for the future expansion of comprehensive nursing care services.     

Coping styles relate to health and work environment of Norwegian and Dutch hospital nurses: a comparative study

Nurses exposed to high nursing stress report no health complaints as long as they have high coping abilities. The purpose of this study was to investigate coping styles in relation to the health status and work environment of Norwegian and Dutch hospital nurses. This comparative study included a random sample of 5400 Norwegian nurses and a convenience sample of 588 Dutch nurses. Coping, health, and work environment were assessed by questionnaire in both samples and associations were investigated bivariately and multivariately. We found that active problem-solving coping was associated with the health and work environment of Norwegian nurses but not with the health and work environment of Dutch. Passive coping (avoiding problems or waiting to see what happens) was found to relate to poor general health, poor mental health, low job control, and low job support in both Norwegian and Dutch nurses. Improvements in the nursing work environment may not only result in better mental health, but may also reduce passive coping.     

Work climate perception and turnover intention among Korean hospital staff

Aim: To examine the impact of work climate perception (WCP) on turnover intention among public hospital personnel in Korea. Background: With increased competition and high staff turnover in hospitals, managers focus on human resource management. Positive work climate is considered as a strategy to retain valued staff, but previous studies have shown occupationally different relationships between turnover intention and work environment characteristics as perceived by staff. Methods: A cross‐sectional questionnaire survey was conducted of employees (n = 852) in four public hospitals in Korea to gather information about WCP, intention to leave and demographics. The work climate was measured by 32 items categorized into 13 factors in five dimensions. For each occupation, logistic regression analyses were performed to determine the significant factors of WCP that influenced turnover intention. Findings: Positive WCP inversely influenced turnover intention. For all occupations, the most significant factor was ‘workgroup friendliness and warmth’ (OR = 0.01–0.21). For the nursing group, an additional significant factor was ‘adherence to job standard’ (OR = 0.63). In contrast, there were different significant factors for other hospital staff: ‘workgroup esprit de corps’ (OR = 0.16) and ‘role clarity’ (OR = 0.19) for physicians, ‘adherence to job standard’ (OR = 3.08) and ‘role adaptation’ (OR = 2.23) for paramedicals, and ‘flexibility and innovation’ (OR = 0.14) and ‘interdepartmental cooperation’ (OR = 0.19) for administrators. Conclusions: Nurses with perceptions of work climate emphasizing ‘workgroup friendliness and warmth’ and ‘adherence to job standard’ had lower turnover intention. Physicians, paramedicals and administrators have different WCPs. To retain qualified personnel, hospitals should focus on human relations, maintaining a consideration for occupation‐specific characteristics.     

Low-perceived work ability, ageing and intention to leave nursing: a comparison among 10 European countries

AIM: This paper reports a study exploring nurses' perceived work ability and its associations with age and intention to leave nursing in a representative sample of registered nurses in 10 european countries. BACKGROUND: Throughout Europe, there is now a substantial shortage of Registered Nurses and unless steps are taken to reverse this trend, numbers are likely to decline further. A study exploring nurses' perceived work ability will provide baseline evidence, which may lead to improved working conditions and increased nursing retention. METHODS: A cross-sectional study design was employed. Questionnaire data were collected from 25,976 nurses in 10 member states of the European Union between October 2002 and June 2003. The response rate was 52.9% for the total investigation and varied between countries from 32.4% to 76.9%. Perceived work ability was assessed using the Work Ability Index. Intention to leave was measured by asking nurses how often they thought about leaving nursing. Data were examined using analysis of covariance and adjusted logistic regression. RESULTS: In all 10 European countries, scores on the Work Ability Index were significantly lower (P < 0.01) among older nurses (>or=45 years). Work ability varied among countries and differences between younger and older nurses were more pronounced in some countries. In all countries, there was a significant association between low Work Ability Index and intention to leave nursing (odds ratios between 1.98 and 21.46), especially among younger nurses. The association between work ability and intention to leave was most marked for those items on the Work Ability Index which explored subjective rather than objective aspects of work ability. CONCLUSION: Attempts to redress nursing shortages could include institutional policies to sustain work ability through better working conditions, improving quality of the working environment and finding suitable alternative nursing work for those no longer able to cope in their current post. These approaches should include nurses in all age categories.     

The relationships among turnover intentions, professional commitment, and job satisfaction of hospital nurses.

This study investigated the relationships among turnover intentions, professional commitment, and job satisfaction of registered nurses. A structured, self-administered questionnaire, including the Professional Commitment Scale, job satisfaction, turnover intentions, and demographic data, was distributed to 2,550 registered nurses. A total of 2,197 subjects completed the questionnaires with an 86.2 per cent response rate. All of the subjects were women. The mean age was 28.56 years. Seventy-two per cent of respondents had graduated with an associate's degree and 59 per cent were unmarried. There was a positive correlation between job satisfaction and professional commitment, intention to leave the organization, and between intention to leave the profession. The negative correlation was significant between professional commitment and turnover intentions, and between job satisfaction and turnover intentions. The discriminant analysis showed that 38.4 per cent of job satisfaction was correctly classified in predicting intention to leave the organization, and 30.5 per cent in predicting the intention to leave the profession. Thirty per cent of professional commitment was correctly classified in predicting intention to leave the organization, and 39.7 per cent in predicting the intention to leave the profession. The study suggests that there were different moderators that affect different turnover intentions of staff nurses.