Changes in hospital nurse work environments and nurse job outcomes: An analysis of panel data
ABSTRACT BACKGROUND: One strategy proposed to alleviate nursing shortages is the promotion of organizational efforts that will improve nurse recruitment and retention. Cross-sectional studies have shown that the quality of the nurse work environment is associated with nurse outcomes related to retention, but there have been very few longitudinal studies undertaken to examine this relationship. OBJECTIVES: To demonstrate how rates of burnout, intention to leave, and job dissatisfaction changed in a panel of hospitals over time, and to explore whether these outcomes were associated with changes in nurse work environments. METHODS: A retrospective, two-stage panel design was chosen for this study. Survey data collected from large random samples of registered nurses employed in Pennsylvania hospitals in 1999 and 2006 were used to derive hospital-level rates of burnout, intention to leave current position, and job dissatisfaction, and to classify the quality of nurses' work environments at both points in time. A two-period difference model was used to estimate the dependence of changes in rates of nurse burnout, intention to leave, and job dissatisfaction on changes in nurse work environments between 1999 and 2006 in 137 hospitals, accounting for concurrent changes in nurse staffing levels. RESULTS: In general, nurse outcomes improved between 1999 and 2006, with fewer nurses reporting burnout, intention to leave, and job dissatisfaction in 2006 as compared to 1999. Our difference models showed that improvements in work environment had a strong negative association with changes in rates of burnout (β=-6.42%, p<0.01) intention to leave (β=-4.10%, p<0.01), and job dissatisfaction (β=-8.00%, p<0.01). CONCLUSIONS: Improvements in nurse work environments over time are associated with lower rates of nurse burnout, intention to leave current position, and job dissatisfaction.
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- "Similarly Bartram et al.  found that perceived high performance work systems, which is a job resource for nurses, was the strongest predictor of intentions to leave the profession. Recent research by Kutney-Lee et al.  suggests that improvements in the working environments of nurses decreases not only burnout, but also their intentions to leave and their job dissatisfaction , while Van den Heede et al.  have found significant associations between staffing and work environment with intentions to leave the profession. A recent survey in Greece to investigate the impact of job stress on satisfaction among nurses has reported that heavy workload and conflicts were related to work stress which in turn affected negatively all job satisfaction dimensions . "
ABSTRACT: The recent global economic recession has affected nursing working conditions in terms of salary reductions, increased workload and staff shortages. Poor nursing working conditions are associated with higher levels of burnout. However in Greece this association has not yet been studied. The aim of this study was to explore financial crisis related changes in nurses' working conditions and their associations with burnout. A cross-sectional quantitative survey was conducted and data were collected through self-reported questionnaires from 299 Greek nurses from two Public Hospitals in 2012. Multiple linear regression analyses were used in order to find independent factors associated with burnout. The results showed that Greek nurses had high levels of burnout. Satisfaction from the job, quality of care and feeling equivalent with other professionals were independent predictors of lower emotional exhaustion. Workload increase and willingness to change career and work department were independent predictors of higher emotional exhaustion. Job satisfaction and satisfaction from care quality were independent predictors of lower depersonali-zation. Changes in working relationships and willingness to change career were independent pre-dictors of higher depersonalization. Higher personal accomplishments were independently associated with more years in nursing, satisfaction from the salary prior to reductions, better quality of care, feeling suitable for the job and being anxious about future career. Influence on nurse efficiency by income reduction was an independent predictor of lower personal accomplishments. In conclusion, Greek nurses were suffering from high levels of burnout which was independently associated with crisis related working conditions. Interventions are needed in order to reduce the A. Skefales et al. 549 burden of burnout among Greek nurses.Open Journal of Nursing 07/2014; 4(4):548-563. DOI:10.4236/ojn.2014.47058
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ABSTRACT: Nursing turnover continues to be a problem for healthcare organizations. Longitudinal research is needed in order to monitor the development of turnover intentions to leave the profession over time. The objectives were: (1) to investigate the prevalence of new graduates' intentions to leave the nursing profession, (2) to prospectively monitor the development of intention to leave during the first five years of professional life, and (3) to study the impact of sex, age, occupational preparedness and burnout (i.e. exhaustion and disengagement) on the development of intention to leave the profession. Longitudinal observational study. Participants were recruited from first-year nursing students at any of the 26 universities in Sweden offering nursing education. Of the 2331 student nurses who were invited to participate in the study, 1702 (73%) gave informed consent and thus constituted the cohort. This cohort was prospectively followed yearly (three times during education and five times post graduation) from late autumn 2002 to spring 2010. Of the 1501 respondents who continued to participate after graduating, 1417 worked as nurses at the time of data collection and responded to the items regarding intention to leave the nursing profession during at least one wave of measurement; these constituted the sample of the present longitudinal study. The outcome variable was intention to leave the nursing profession. This was measured using a scale of three items, covering thoughts of leaving the profession. The main predictor was burnout, and this was measured by the exhaustion and disengagement scale from the Oldenburg Burnout Inventory. Data were analysed using latent growth curve modelling. After five years, every fifth nurse strongly intended to leave the profession. The longitudinal analysis of change in intention to leave showed that levels increased during the first years of employment. High levels of burnout were related to an increase in intention to leave. It is important for organizations employing new graduates to pay attention to nurses who show early signs of burnout, and provide a resourceful work environment with a suitable workload, sufficient introduction, management support, satisfactory collaboration with colleagues, and role clarity.International journal of nursing studies 10/2013; 51(4). DOI:10.1016/j.ijnurstu.2013.09.012 · 2.25 Impact Factor
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ABSTRACT: To examine the effects of perceived workplace politics in hospitals on nurses' job satisfaction, commitment, exit intention, job neglect, absenteeism and performance. One of the factors contributing to nurses' poor advancement in clinical practice is the existence of petty politics, which has given rise to competing self-interest. However, little evidence exists to inform policy direction on the implication of politics on nurses' behaviour. A total of 610 nurses comprising associate and nursing professionals completed a structured questionnaire modelled on workplace politics and its outcome variables. Descriptive statistics and mean comparisons were used to analyse data. A multivariate regression model was computed to examine association between perceived politics and nurses' behavioural intentions. Perceived politics potentially leads to decline in job satisfaction, commitment and work performance. However, perceived workplace politics is associated with high intention to leave, negligent behaviour and absenteeism. Measures aimed at improving nursing management and health-care delivery should be directed at minimising the use of politics to promote self-interest. Evidence-based best practices in nursing management centred on the creation of an enabling environment for nurses to participate in decision-making should be given critical attention.Journal of Nursing Management 12/2013; 22(2). DOI:10.1111/jonm.12178 · 1.14 Impact Factor