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Promoting retention of nurses
Abstract
Background: Because the health care field is expected to be the fastest growing job field until 2020, an urgent need to focus on nurse retention exists. Purpose: The aim of this study was to examine the relationships between predictors of turnover (i.e., personal characteristics, role states, job characteristics, group/leader relations, organizational/environmental perceptions, attitudinal reactions) and turnover cognitions and intentions, as well as actual turnover among nurses, in an effort to determine the strongest predictors of voluntary turnover. Methodology: Meta-analysis was used to determine best estimates of the effect of predictors on turnover based on 106 primary studies of employed nurses. Meta-analyzed correlations were subjected to path analysis to establish the structural relationships among the study variables. Findings: Supportive and communicative leadership, network centrality, and organizational commitment are the strongest predictors of voluntary turnover based on meta-analytic correlations. Additional variables that relate to nurse turnover intentions include job strain, role tension, work-family conflict, job control, job complexity, rewards/recognition, and team cohesion. Practice Implications: The findings suggest that some factors, such as salary, are relatively less important in prediction of turnover. Administrators concerned about nurse turnover may more effectively direct resources toward altering certain job characteristics and work conditions in the effort to reduce voluntary turnover among nurses.
... On the other hand, a multiyear analysis of turnover determinants is also conducted in California, United States, which found family concerns, economic factors (salary), and stress [13]. Furthermore, a meta-analysis found that leadership style, network centrality, and organizational commitment were found to be strong determinants to turnover [14]. In Saudi Arabia, in 2017 an integrative review was conducted to synthesize the literature on nurse turnover in Saudi Arabia. ...
... Tis fnding is discordant with studies conducted in European countries where salary is not tackled nor identifed [12]. However, a meta-analysis study revealed that salary is a less important predictor of turnover [14]. Meanwhile, the World Health Organization still suggests that the remuneration should be commensurate to enhance retention [55]. ...
... In contrast, a systematic review reported that a positive leadership style, particularly ethical leadership, is efective in decreasing turnover intentions [56]. Te latter is supported by another meta-analysis study Nursing Forum 13 that found that supportive and communicative leadership is one of the strongest predictors of turnover [14]. ...
The turnover of nurses has been an ordeal for healthcare institutions not only locally but also globally. It ranges from changing unit or workplace to changing or leaving the nursing profession. High turnover rates affect care provision and organizational cost. Therefore, this review aims to identify the factors that influence nurse turnover in Saudi Arabia. An in-depth review of quantitative, qualitative, and mixed-method studies that includes all studies on nurses who intend to leave the job or profession (resigned or terminated) in any institution within Saudi Arabia was conducted. The grey literature and studies conducted outside of Saudi Arabia were excluded. PubMed, ScienceDirect, EBSCO Medline, ProQuest, and Web of Science were searched for relevant literature from inception to publication. MMAT (Mixed-Methods Appraisal Tool) is used to assess the risk of bias. A narrative synthesis of the findings is conducted and presented in a table. A total of 1286 articles were retrieved from the initial search and managed using Rayyan software. Out of 1102 articles screened, 44 articles were reviewed for eligibility yielding to 21 articles included in this study. Preliminary screening is performed by two authors by independently scrutinizing the title and abstracts followed by full-text screening. The data are carefully extracted by the author and validated by a second reviewer. The factors identified to influence nurse turnover in Saudi Arabia are classified into themes, namely, individual-related factors (demographic characteristics and psychological and personal aspects), work environment, and organizational factors. More studies are needed in all regions using more robust designs. The review protocol is registered in Prospero with ID no. CRD42023433406.
... 2022). Hoitajien työ koetaan kuormittavana, palkitseminen on puutteellista eikä työstä saada toivottavaa tunnustusta (Nei, Snyder & Litwiller 2015). Lisäksi kollegoiden tuen puute (Lyu ym. ...
Tiivistelmä
Artikkelissa tarkastelemme hoitoalan jättäneiden sairaanhoitajien kokemuksia alan jättämisen syistä ammatillisen toimijuuden murtumien näkökulmasta. Ammatillisen toimijuuden murtumalla viittaamme sairaanhoitajien työssään kokemiin ammatillisiin katkoksiin ja kriiseihin. Murtumat tekevät näkyviksi ammatillisia arvoja, käytäntöjä ja odotuksia, sekä nostavat esiin kokemuksellisia tekijöitä, jotka ovat ohjanneet sairaanhoitajia jättämään työnsä hoitoalalla. Tutkimuksessa kysymme, millaisia kokemuksia hoitoalan jättäneillä sairaanhoitajilla on ammatillisen toimijuuden murtumista sekä mitä ammatillista toimijuutta rakentavia arvoja, käytäntöjä ja odotuksia murtumakokemukset ovat rikkoneet. Tutkimusaineistomme koostuu 148 hoitoalan jättäneen sairaanhoitajan kirjoituksesta. Kertomusten analysoinnissa hyödynsimme tulkitsevaa fenomenologista analyysia. Tuloksina tunnistimme kolme toistuvaa pääteemaa, ammatillisen arvostuksen puute, hallinnan menetyksen kokemus sekä sosiaalisen tuen tarve. Näitä ammatillisen toimijuuden murtumia yhdistää ristiriita hoitajien ammatillista toimijuutta motivoivien arvojen, odotusten ja työarkea ohjaavien käytäntöjen välillä. Ammatillisen toimijuuden murtumat on hoitoalan jättäneiden sairaanhoitajien parissa toistuva ja alalta pois työntävä kokemus. Sen vuoksi ammatillisen toimijuuden tunnistaminen, tunnustaminen ja tukeminen on tärkeää arjen työssä ja joh-tamisessa. Hoitajia tulisi kohdella itsenäisinä ammatillisina toimijoina, ei hoitokoneiston osina.
Asiasanat: ammatillinen toimijuus, sairaanhoitajat, alanvaihto
Ring, M., Makkonen, T., Kaarakainen, M., & Maunu, A. (2024). Sairaanhoitajat: osaavia ja aktiivisia ammattilaisia vai käsipareja?. Focus Localis, 52(4), 49–60. Noudettu osoitteesta https://journal.fi/focuslocalis/article/view/145135
... There is a shortage of nurses in many developed countries around the world, including Australia (International Council of Nurses 2021). Understanding the effects of nurses' perceptions is important to promote retention and attract new nurses (Nei et al. 2015;Gregory et al. 2007). Key outcomes that drive nurse retention are health and attitudes, especially commitment, whether being committed to the organization and/or the overall profession of nursing (Wagner 2012). ...
Inconsistent findings regarding psychological contracts may be due to the variety of contexts studied. Sensemaking processes inform the psychological contract and may explain contextual differences. This study examines the psychological contract components of promises, fulfillment and breach, with negative affectivity, in relation to employee-level outcomes in two related but different contexts. Surveys were completed by 162 hospital nurses and 218 aged care nurses, in a situation where many potential contextual moderators were held relatively constant. Both fulfillment and breach were significant and predicted multiple outcomes in each context. Similar patterns of results for fulfillment and breach suggests there may simultaneously be two forms of discrepancy mechanism underpinning the impacts of the psychological contract: assessment of continuous discrepancy (fulfillment) and assessment of discontinuous discrepancy (breach). Negative affectivity appears to have prevented relationships, particularly between breach and stress, and should be included in future psychological contract research. The consistent relationships of fulfillment and breach with organizational and occupational commitment highlights the importance of career management. The main differences by context were the negative effects of breach and the lack of an effect for promises for aged care nurses, possibly due to prestige and other differences to be investigated in future research.
... The global analytics and organizational advisement group Gallup has demonstrated the positive impact of cultivating relationships between managers and subordinates and among coworkers on employee engagement and performance across sectors (Wagner & Harter, 2018). Research from education (Farinde-Wu & Fitchett, 2016), nursing (Nei et al., 2015), and child welfare (Benton, 2016) have also demonstrated a positive relationship between leadership and culture, such as employees being more likely to stay in their jobs when they feel supported and empowered by organizational leaders. ...
This study examined the impact of human service providers treating their employees with dignity, respect, and fairness on the quality of life of people with intellectual and developmental disabilities (IDD). We analyzed Personal Outcome Measures (n = 3,898 people with IDD) and Basic Assurances (n = 387 providers) data using multilevel logistic regressions. When providers treated their employees with dignity and respect, people with IDD were more likely to have the following outcomes present: health; continuity and security; realize goals; free from abuse and neglect; respect; decide when to share information; housing choice; fair treatment; rights; and choose services. How organizations treat their employees not only affects those employees, but also impacts the quality of life of people with IDD.
... Similarly, job satisfaction reflects global assessments across many working conditions such as flexible work, choice of working hours [8], ineffective supervisory relationships and poor opportunities for professional development [40]. In nursing, job satisfaction has been repeatedly found to predict intent to quit or remain [18,40,41], but few studies have investigated the utility of job satisfaction in predicting retirement behavior. ...
To retain nurses and prevent worsening the nursing shortage, a key opportunity is to better understand the drivers of complete and partial retirement of older nurses. This study investigates the characteristics that distinguish older nurses’ partial and complete actual retirement behavior, from those continuing to work, over a three-year period. A quantitative longitudinal design comprising 217 female Australian nurses aged 50 years or over, from two samples working at Time 1 (2012 and 2016), responding three years later (Time 2). Multinomial regression found two different patterns of drivers for each of completely retiring and partly retiring respectively. Age was the only variable distinguishing both partly and completely retired nurses from nurses who were not retired. The further variables distinguishing completely retired nurses were not being prosperous, having impaired work ability, being partnered, not stressed at work and working part-time. The only variable beyond age distinguishing partly retired nurses was having a casual contract. Offering flexible work options in terms of working hours and contracts that suit the nurse’s lifestyle and supporting nurses with health impairments to continue working are options that may lessen the number of nurses completely retiring and instead either remaining at work or partly retiring.
... Despite the high demand for nurses, there is still a considerable proportion of nursing staff with turnover intention, which refers to their psychological tendency to leave their current work environment. It predicts actual turnover actions and it can be either voluntary or involuntary (3). A New Zealand study (4) found an average . ...
Aim
The purpose of our study was to assess the turnover intention of nurses in China and examine the associated factors.
Background
Since the world population ages, the demand for nurses has kept growing, and the shortage of nurses and high turnover rates are concerned with the quality of care. Thus, understanding nurses' turnover intention and the relevant factors could provide nurse managers with strategies to address the modifiable factors to decrease the turnover rate of nurses.
Methods
A multi-center cross-sectional study was conducted on a total of 1,854 nurses working in 15 hospitals in China. Data were collected using a self-designed demographic questionnaire, the Turnover Intention Scale, the Job Satisfaction Scale, the Pay Level Satisfaction Scale, the Interpersonal Conflict at Work Scale, and a single question on the sense of belonging to the hospital.
Results
Most nurses (n = 1286, 69.4%) had a high level of turnover intention. Multilevel logistic regression analysis demonstrated that nurses being single (OR = 1.366, p < 0.05), with a junior college or below (OR = 0.381, p < 0.01), being a clinical nurse (OR = 1.913, p < 0.01), having higher pay level (OR = 0.596, p < 0.001), having higher job satisfaction (OR = 0.406, p < 0.001), having conflicts with colleagues (OR = 1.400, p < 0.05), and having a higher sense of belonging to the hospital (OR = 0.532, p < 0.001) proved to affect nurses' turnover intention.
Conclusion
This study extended the knowledge about the factors associated with nurses' intention to leave, which led to the turnover of nurses, and is one of the main contributors to the current shortage of nurses.
Implications for nursing management
This study provided new approaches to decreasing the turnover rate of nurses. Effective management strategies may mitigate nurses' turnover intention.
... An interesting result in our study concerns the mediating role of reassignment experience between lack of choice and both workplace well-being and intent to stay. In fact, perception of control over work, autonomy, or lack of choice are usually found to be directly associated with well-being, as proposed in the job-demand-control model [48] or with intent to stay [49]. Our results show that this association is mediated by HCWs' experience. ...
Our study aimed at investigating the way not having the choice to be reassigned was associated to a poorer experience of reassignment among health care workers (HCWs) during the first wave of the coronavirus disease 2019 (COVID-19), and indirectly to a lower workplace well-being and reduced intent to stay at the hospital. We also investigated the moderating role of the perceived hospital management responsiveness on these associations. A cross sectional survey was sent to all professionals from 11 hospitals and clinics in the French-speaking part of Switzerland, in July 2020. Out of 2811 professionals who completed the survey, 436 were HCWs reassigned to COVID-19 units during the first wave of the pandemic and constituted our analysis sample. Results indicated that hospital management responsiveness moderated the association between lack of choice and reassignment experience, indicating that the more HCWs perceived responsiveness, the less the lack of choice affected their experience of reassignment and thus their intent to stay and workplace well-being. Lack of choice during reassignments can reduce intent to stay and workplace well-being, in particular if hospital management is not perceived to be responsive during the crisis. Attempts by hospital management to find solutions, such as flexibility in working hours or extraordinary leaves, can alleviate the perceived constraints of reassignment and be considered signs of responsiveness from hospital management.
Employee retention is crucial for organizational success, particularly in healthcare. The nurse retention and shortage crisis in the U.S. is marked by turnover rates exceeding the national average, with 57% of nurses leaving within two years. High turnover disrupts organizational stability, exacerbates burnout, and compromises patient safety and care quality, thereby exposing organizations to financial, legal, regulatory, reputational, and clinical risks. The chapter identifies key factors driving the crisis, including an aging workforce, burnout, fewer new nurse graduates, and rising demand due to population health trends. These factors contribute to increased medical errors and adverse patient outcomes. Using AMG as a healthcare provider archetype, the chapter integrates the DMAIC problem-solving model, the COSO enterprise risk management framework, and Kotter's change management model to propose actionable retention strategies to address these challenges. The resulting recommendations aim to stabilize the nursing workforce, enhance patient outcomes, and mitigate enterprise risks.
Do fathers experience discrimination during pregnancy? YES! In this study, we explore the experience of fathers’ pregnancy discrimination (FPD), or the perceived unfavorable treatment of fathers in the workplace due to their wives expecting a baby. Applying the action regulation model of work–family balance, we examine FPD as a resource barrier that impacts both the father’s perceived work–family balance and the father’s and mother’s turnover. In a sample of 247 expectant fathers across four time periods using a newly developed and validated measure of FPD, we examine the four different action strategies that fathers might use in reaction to the resource barrier of FPD to attain work and family goals. Policy use (engagement strategy) was ineffective, but going the extra mile (changing strategy) was effective in achieving greater perceived work–family balance. For those who used disengagement strategies, the father’s desire for the mother to turnover (sequencing strategy) contributed to the mother’s turnover while the father’s turnover intention (revising strategy) contributed to the father’s turnover as avenues for goal attainment. This research provides an empirical examination of the four action strategies simultaneously invoked in response to a resource barrier (FPD) with implications for perceived balance and actual turnover.
Aim
To explore why registered nurses in Italy choose to resign from their positions in hospitals.
Background
In recent years, the work environment within hospitals has worsened, with increasing rates of burnout, stress, depression, compassion fatigue, and even suicide among nurses. This has prompted many nurses to either leave their current positions or exit the profession entirely. Previous research has indicated that nurse turnover, especially in hospital settings, poses a significant challenge for society and global healthcare, with insufficient nurse staffing associated with negative patient outcomes.
Methods
The study used a descriptive phenomenology design, conducting 30 semi‐structured interviews with nurses. The Consolidated Criteria for Reporting Qualitative Research have been followed in reporting the methods and findings.
Results
The average age of the participants was 32.8 years, the average length of hospital work experience was 5.7 years, and the majority of the participants were female ( n = 22). Thematic analysis revealed two main themes: individual factors, encompassing “quality‐of‐life threats” and “personal drive and ambitions”, and organizational factors, including “unsustainable working conditions” and “lack of support from employers.”
Implication for health policy
There is an urgent need for an evidence‐based approach to quality improvement to increase nurses' well‐being in the workplace. Organizations aiming to retain nursing staff should prioritize strategies such as promoting work flexibility and addressing concerns related to work–life balance. Effective management engagement and implementation of flexible working arrangements are essential, along with the promotion of organizational values aligned with professionalism to combat negative perceptions of the nursing profession.
Background
The global nursing shortage was a well-known issue before the Covid-19 pandemic, but the Covid-19 pandemic has exacerbated the current nursing workforce shortage and reduced nursing retention. This systematic review aimed to explore factors affecting retention of nurses.
Methods
The PubMed, Web of Science, Scopus and Proquest databases were searched for relevant primary studies published on nurses retention during Covid-19 pandemic. Finally, Google Scholar was searched for retrieving more related documents that may not be indexed in other searched databases. Inclusion criteria were research articles and gray literature related to nursing retention in Covid-19 pandemic, articles published in English, access to the full-texts, and without time limitation. Both qualitative and quantitative studies focusing on factors affecting the nurses retention were included. The Joanna Briggs Institute checklists were used for assessing quality of quantitative and qualitative studies. Qualitative and thematic content analysis methods based on Braun and Clark’s model were used to analyze the data.
Results
Eighteen studies were identified through a systematic search of the literature. The results showed that seven factors include personal, interpersonal, organizational, social media, educational, emotional, and protective factors are the factors affect the nurses retention.
Conclusion
The findings of this study showed that retention of nurse is complex and multi-factorial issue that factors from micro to macro-level affect it. Managers and health policy-makers based on the results obtained from this study can plan appropriate measures to increase the retention of nurses.
Purpose
This study aimed to determine the current turnover intention among workers at Centers for Disease Control and Prevention (CDCs) in Northeast China and to investigate the factors contributing to this phenomenon.
Materials and methods
The cross-sectional study was conducted in May 2023 across four northeastern provinces of China. The study included a total of 11,912 valid participants who were CDC workers selected using a stratified cluster sampling method. The study assessed demographics, turnover intention, work resources, work perceptions, and psychological support through online questionnaires. The binary logistic regression analysis identified the factors associated with turnover intention for CDC workers, while the Interpretative Structural Modelling (ISM) revealed the hierarchical relationship between the influencing factors.
Results
The study found that 28.8% of the respondents reported high turnover intention. The binary logistic regression suggested that the risk factors of turnover intention among employees included gender, age, education, and several work-related, organizational, and psychological factors. The work-related factors were daily working hours, job burnout, and role overload. The organizational factor was unit support for training, unit’s infrastructure conditions, leadership style, remuneration package and performance appraisal and promotion system. The psychological support factors were family support, professional identity, and organizational commitment. The ISM analysis results showed that the primary factors influencing CDC workers’ intention to leave were internally connected and grouped into four categories according to their level of impact: surface, transition, deep, and essential factors. Notably, the essential factors were professional identity and organizational commitment.
Conclusion
Nearly one-third of the respondents expressed a strong desire to resign from their employment. Turnover intention among CDC workers was subject to diverse influences. Early identification, detection, and targeted multidisciplinary interventions should be introduced to address the array of factors that affect staff, with particular emphasis on boosting the professional identity and organizational commitment of CDC workers.
Background
Worldwide growing shortages among health care staff are observed. This also holds true for medical assistants in Germany. Medical assistants mainly work in outpatient care and are the first point of contact for patients while performing clinical and administrative tasks. We sought to explore profession turnover among medical assistants, that is, in terms of the underlying decision-making process, the reasons for leaving the medical assistant profession and potential retention measures from the perspective of former medical assistants.
Methods
For this qualitative study, we conducted semi-structured telephone interviews with 20 former medical assistants between August and November 2023. Eligible for participation were medical assistants who (i) were of legal age, (ii) completed medical assistant vocational training and ii) were formerly employed as a medical assistant, but currently employed in another profession. The interviews were recorded, transcribed verbatim and content-analyzed.
Results
Former medical assistants expressed various, often interrelated reasons for leaving the profession. These were changes in priorities throughout their career (e.g., in terms of working hours and salary), a constant high workload, barriers to further training, poor career prospects, and poor interpersonal relationships particularly with supervisors, but also within the team and with patients as well as the perception of insufficient recognition by politics and society. Suggestions of former medical assistants to motivate medical assistants to stay in their profession included amongst others higher salaries, more flexible work structures, improved career prospects, and more recognition from supervisors, patients, and society.
Conclusion
Our study provides insights into the complex decision-making process underlying ultimate medical assistant profession turnover. In light of an already existing shortage of medical assistants, we suggest to further explore how the suggested interventions that aim at retention of working medical assistants can be implemented.
Background
The COVID-19 pandemic exposed nurses to new and more severe workplace stressors; exposure to these workplace stressors has exacerbated nurse turnover. Nurses working in mental health and substance use (MHSU) have also experienced the unique stressor of the overdose crisis in British Columbia (BC). MHSU nurses have been at the forefront of working to manage these dual emergencies. There is limited evidence related to the compounding effect of COVID-19 and the overdose crisis on nursing turnover. Understanding the unique conditions that MHSU nurses are currently experiencing and what factors influence a nurse's intention to stay in or leave a healthcare facility is essential in developing strategies to minimize turnover and maximize retention.
Purpose
To explore the factors that affect nurse turnover while working through the dual emergencies within a MHSU facility in BC, Canada.
Methods
A qualitative descriptive approach with an inductive, descriptive thematic analysis guided this quality improvement project.
Results
Findings were grouped into two main themes: reasons for leaving and reasons for staying. Reasons for leaving included workplace safety, seeking new opportunities, lack of support, and being short-staffed. Reasons to stay encompassed connections with clients, leaders and colleagues, support from colleagues and leaders, and feeling valued, safe, and heard.
Conclusions
Perceived personal safety and protection from workplace violence were found to increase the likelihood of intent to leave and turnover among nurses. Further, psychosocial safety and connection among nurses and health leaders were found to decrease the likelihood of turnover.
Hospital organizations are affected by the shortage of nurses across the United States. Hospital organizations must strategically plan to recruit and retain nurses. An average hospital will incur costs between 7.86 million due to RN turnover. In an outcome-focused healthcare environment, healthcare leaders must consider all perspectives involved in nurse manager leadership. The purpose of this phenomenological study was to describe nurses' lived experiences with nurse manager leadership on medical surgical units in Riverside County, California, USA.
Background
Aging populations and nursing workforce issues are causing challenges for long-term care globally, and therefore, improving the work-related wellbeing and retention of nurses is crucial. As such, gaining a further understanding of the factors that affect work strain in long-term care is important. Previously, the effect of job demands on the wellbeing of nurses has been researched principally by subjective instruments. In this study, we examined the relationship between indirectly measured workday characteristics and perceived stress and time pressure among nurses working in Finnish long-term care (assisted living facilities with 24-hour assistance).
Methods
A total of 503 nurses from 44 assisted living facilities across Finland completed time measurement surveys and wellbeing questionnaires. The data were linked with client characteristics from the Resident Assessment Instrument register. The relationships between the measured number of care events during the workday, clients’ care needs, and the amount of breaktime and perceived stress and time pressure were analyzed using multivariate logistic regression.
Results
Nurses who had more care events and clients with greater care needs were at higher odds of having high stress. More care events and reduced breaktime were associated with high time pressure. Disruptions during the workday were strongly associated with both high stress and time pressure. Last, nurses who were under high stress and time pressure worked more often in teams with lower team autonomy.
Conclusions
Our findings on indirectly measured job demands indicate that dividing the workload equally among nurses through better work division can help reduce the stress and time pressure of nurses in long-term care. In addition, ensuring sufficient breaktime and preventing unnecessary disruptions is important. To help recruit and retain the care workforce, fair management of work that accounts for varying client care needs and workload is needed. In addition, legislative and governance tools, such as staffing level regulation, and further consideration of job demands might aid in reducing the job strain of nurses.
Patient or public contribution
Patients or nurses were not involved in the design of the study, analysis, or interpretation of the results, or in the preparation of the manuscript.
Purpose: This study examines the interplay of psychosocial career pre-occupation, social connectedness, and organisational commitment in higher education and offers insights for academia and practitioners. It also explores the impact of gender, job level, and the moderating effect of psychosocial career pre-occupation on employees’ commitment in this sector.Design/methodology/approach: A purposeful sample of 288 senior academic and administrative staff, mostly married males aged 31–40 years, completed the Psychosocial Career Pre-occupation Scale (PCOS), Workplace Friendship Scale (WFS), and Organisational Commitment Scale (OCS).Findings/results: Significant relationships were found among psychosocial career pre-occupation, social connectedness, and organisational commitment in higher education. Moderated analysis revealed predictive roles of gender, job level, and psychosocial career pre-occupation on organisational commitment, and illuminating sector dynamics.Practical implications: For human resource managers and practitioners in Ghana’s public higher education, this study offers insights to boost workforce commitment and engagement, which is vital for national progress.Originality/value: By validating essential elements of career self-management practices, this research extends career construction theory, enriching understanding and fostering professionals’ careers in higher education. It contributes to practical applications and scholarly knowledge by providing a deepening insight into organisational dynamics in this sector.
Background
Working with research animals can be both rewarding and challenging. The rewarding part of the work is associated with understanding the necessity for animal research to improve the health of humans and animals and the knowledge that one can provide care and compassion for the animals. Challenges with animal research include witnessing stress/pain in animals necessitated by scientific requirements, end of study euthanasia, and societal stigmatization about animal research. These challenges could be compounded with more general workplace stresses, in turn, impacting job retention and satisfaction. However, these factors have yet to be formally evaluated. Therefore, the purpose of this survey was to comprehensively evaluate professional quality of life’s correlation with key workplace metrics.
Methods
Six institutions were recruited to participate in a longitudinal intervention trial on compassion fatigue resiliency. This manuscript reports key baseline metrics from this survey. A cross-sectional mixed methods survey was developed to evaluate professional quality of life, job satisfaction, retention, and factors influencing compassion fatigue resiliency. Quantitative data were analyzed via general linear models and qualitative data were analyzed by theme.
Results
Baseline data was collected from 198 participants. Personnel who reported higher compassion satisfaction also reported higher retention and job satisfaction. Conversely, personnel who reported higher burnout also reported lower job satisfaction. In response to open-ended questions, participants said their compassion fatigue was impacted by institutional culture (70% of participants), animal research (58%), general mental health (41%), and specific compassion fatigue support (24%).
Conclusions
In conclusion, these results show that professional quality of life is related to important operational metrics of job satisfaction and retention. Furthermore, compassion fatigue is impacted by factors beyond working with research animals, including institutional culture and general mental health support. Overall, this project provides rationale and insight for institutional support of compassion fatigue resiliency.
Background
Medical assistants (MA) constitute one of the largest professions in outpatient health care in Germany. The psychosocial working conditions of health care staff are generally believed to be challenging and to thereby increase the risk of poor mental health. A review of MA’s psychosocial working conditions and mental health is lacking, however. We aimed to systematically identify and summarize existing research on psychosocial working conditions and mental health of MA by addressing (1) Which methods, concepts, and instruments have been used to capture the psychosocial working conditions and mental health among MA in Germany? (2) What findings are available? and (3) What are the research gaps?
Methods
We systematically searched Medline, Scopus, CCMed and Google Scholar. Using the Population Concept Context (PCC)-framework, we applied the following eligibility criteria: (a) Language: English or German, (b) publication between 2002-2022, (c) original study, (d) study population: mainly MA (i.e., ≥ 50% of the study population), (e) concept: psychosocial working conditions and/or mental health, and (f) context: Germany. Two reviewers extracted data independently, results were compared for accuracy and completeness.
Results
Eight hundred twenty-seven sources were identified. We included 30 publications (19 quantitative, 10 qualitative, and one mixed methods study). Quantitative studies consistently reported high job satisfaction among MA. Quantitative and mixed methods studies frequently reported aspects related to job control as favorable working conditions, and aspects related to job rewards as moderate to unfavorable. Qualitative studies reported low job control in specific work areas, high demands in terms of workload, time pressure and job intensity, and a desire for greater recognition. Social interactions seemed to be important resources for MA. Few studies (n = 8) captured mental health, these reported inconspicuous mean values but high prevalences of anxiety, burnout, depression, and stress among MA. Studies suggested poorer psychosocial working conditions and mental health among MA during the COVID-19 pandemic.
Conclusions
Quantitative studies tend to suggest more favorable psychosocial working conditions among MA than qualitative studies. We suggest mixed methods to reconcile this alleged inconsistency. Future research should examine discrepancies between job satisfaction and unfavorable working conditions and if psychosocial working conditions and mental health remain changed after the COVID-19 pandemic.
Research problem: High turnover rates in long-term nursing facilities exacerbate the existing shortage of caregivers, a trend that will only worsen as the population of the United States ages. Part-time certified nursing assistants (CNAs) provide a significant amount of patient care in these facilities. CNAs also have high annual rates of turnover, which can harm health outcomes and increase the cost of care. In this study, we empirically analyze the effect of scheduling decisions on part-time CNA turnover. We explore three research questions that examine both how much and with whom a CNA is scheduled to work. We seek to empirically answer how (1) hours worked and (2) coworker variability influence turnover for part-time CNAs and if (3) coworker variability moderates the relationship between hours worked and CNA turnover. Methodology/results: Using novel data from one of the nation’s largest nursing home organizations, which includes data for 6,221 part-time CNAs at 157 facilities in the United States over a 26-month period, we identify two scheduling levers managers may be able to use to influence turnover. As hours worked increase, turnover first decreases and then increases, demonstrating a nonlinear U-shaped relationship between hours worked and turnover. We also find that high coworker variability increases turnover while also moderating the effects of hours worked on turnover. In post hoc analyses, we demonstrate that high CNA turnover has negative impacts on patient health. Managerial implications: These findings suggest that managers may be able to leverage part-time CNA scheduling to reduce turnover, improving both the quality and cost of care. Specifically, we demonstrate that managers can reduce CNA turnover by increasing hours worked, scheduling coworkers together consistently and doing both simultaneously.
Supplemental Material: The online appendices are available at https://doi.org/10.1287/msom.2021.0533 .
Concern is growing about financial stress among U.S. workers, many of whom experience financial insecurity (FIS) as they struggle to make ends meet, manage debt, and save. Benefits comprise almost a third of total compensation and affects hiring and retention, which is important with respect to the shortage of frontline healthcare workers (FHWs). We present results from a survey of 2321 FHWs, finding that FHWs without college degrees and working in home health and private duty settings have lower access to benefits and greater FIS compared to those with college degrees and who work in facility-based settings. Among all FHWs, access to benefits has a strong association with FIS, even while controlling for income. Our findings suggest that employers consider improving benefits to help address FIS and within healthcare, address issues of compensation equity based on educational attainment. Still, addressing worker FIS may take strengthening the public social safety net.
Background
It is critical to minimize nurse turnover to improve the quality of care and patient safety. In-depth investigation is required to better understand the factors related to nurses' turnover intentions.
Aim
This study aimed to determine the relationships between burnout, general wellbeing, and psychological detachment with turnover intention among nurses in China.
Methods
A cross-sectional survey using convenience sampling was conducted in one hospital in China between January 2023 and March 2023. A total of 536 nurses were surveyed using the General Wellbeing Schedule (GWB), the Maslach Burnout Inventory scale (MBI), the Psychological Detachment scale, and the Turnover Intention scale. The collected data were analyzed using SPSS 26.0 statistical software. The chi-square test and binary logistic regression analysis were used to explore the factors related to turnover intention.
Results
Our data demonstrated that the turnover intention scores were 13 (10, 15.75), with 56% of nurses exhibiting a high level of turnover intention. Binary logistic regression analysis results indicated that being on a contract (OR = 4.385, 95% CI = 2.196–8.754), working in the pediatrics (OR = 2.392, 95% CI = 1.267–4.514) or obstetrics (OR = 2.423, 95% CI = 1.145–5.126) department, and experiencing burnout (OR = 1.024, 95% CI = 1.008–1.041) were associated with a heightened level of turnover intention. Conversely, organizational satisfaction (OR = 0.162, 95% CI = 0.033–0.787) and general wellbeing (OR = 0.967, 95% CI = 0.946–0.989) were identified as factors that hindered the intention to leave.
Conclusions
Findings from this study suggest that nurses were employed on a contract basis, working in pediatric or obstetric departments, expressing dissatisfaction with the organization, reporting low general wellbeing, and experiencing high levels of burnout that require special attention. The identification of these risk factors can inform targeted interventions and support programs aimed at improving the wellbeing and retention of nurses in these settings.
Aims
To investigate which work‐related factors are associated with work–family conflict of care workers in nursing homes, this study aimed to: (a) describe the prevalence of work–family conflict of care workers in nursing homes and (b) assess the association of work‐related factors with work–family conflict.
Design
Cross‐sectional multicentre sub‐study based on data from the Swiss Nursing Homes Human Resources Project 2018.
Methods
Data were collected between September 2018 and October 2019. Work–family conflict of care workers was assessed with the Work–Family Conflict Scale (range 1–5). Prevalence was described in percentages. We used multilevel linear regression to assess the association of time‐based factors (working overtime or during one's free time, employment percentage, presenteeism, shift working) and strain‐based factors (staffing adequacy, leadership support) with work–family conflict.
Results
Our study sample consisted of 4324 care workers working in a total of 114 nursing homes. Overall, 31.2% of respondents stated to have experienced work–family conflict (>3.0 on the Work–Family Conflict Scale). The overall mean score of the study sample for work–family conflict was 2.5. Care workers experiencing presenteeism 10 or more days per year showed the highest scores for work–family conflict (mean: 3.1). All included predictor variables were significant (p < .05).
Conclusion
Work–family conflict is multifactorial. Possible intervention points to tackle work–family conflict could be strengthening care workers' influence in planning work schedules, enabling flexible planning to ensure adequate staffing, lowering presenteeism and implementing a supportive leadership style.
Impact
Care workers' jobs become less desirable when workplace demands interfere with family life. This study highlights the multifaceted nature of work–family conflict and suggests intervention options to prevent care workers from experiencing work–family conflict. Action is needed at nursing home and policy level.
Objectives
The shortage of healthcare staff is a global problem. UK mental health services have, on average, a higher turnover of staff than the NHS. Factors affecting retention of this staff group need to be explored in more depth to understand what is working for whom, for what reasons and in what circumstances. This review aims to conduct a realist synthesis to explore evidence from published studies, together with stakeholder involvement to develop programme theories that hypothesise how and why retention occurs in the mental health workforce and identify additional evidence to explore and test these theories thereby highlighting any persistent gaps in understanding. This paper develops programme theories that hypothesise why retention occurs and in what context and tests these theories thereby highlighting any persistent gaps in understanding.
Methods
Realist synthesis was used to develop programme theories for factors affecting retention of UK mental health staff. This involved: (1) stakeholder consultation and literature scoping to develop initial programme theories; (2) structured searches across six databases to identify 85 included relevant literature relating to the programme theories; and (3) analysis and synthesis to build and refine a final programme theory and logic model.
Results
Phase I combined findings from 32 stakeholders and 24 publications to develop six initial programme theories. Phases II and III identified and synthesised evidence from 88 publications into three overarching programme theories stemming from organisational culture: interconnectedness of workload and quality of care, investment in staff support and development and involvement of staff and service users in policies and practice.
Conclusions
Organisational culture was found to have a key underpinning effect on retention of mental health staff. This can be modified but staff need to be well supported and feel involved to derive satisfaction from their roles. Manageable workloads and being able to deliver good quality care were also key.
The pandemic has highlighted three critical nursing workforce issues: turnover, wellbeing, and equity. A comprehensive framework is needed to understand the interactions between these concepts. This paper proposes a model that allows for more inclusive understanding of professional outcomes for RNs, with attention not just to job outcomes, but also to equity for underrepresented groups in the workforce and individual wellbeing. The model highlights the importance of systems and societal elements, contextual elements, and individual responses to the dynamic conditions of work and life, and can be used to advance research and practice to create effective retention and support strategies.
Background
Nurses show a high prevalence of exhaustion and increased leaving intentions. With this study, we integrate established research about turnover intention with recent burnout literature and present a theoretical model that combines both. The aim of this study was to examine job demands (time pressure, social conflicts) and resources (job control, supervisor support, task identity, person-organisation fit) as drivers and health and age as moderators for the relationships between exhaustion and nurses’ organisational and professional leaving intentions.
Methods
We analysed data from a standardised paper-pencil questionnaire survey with a prospective, two-wave (12 months apart) study design. In total, 584 nurses participated at Time 1 (t1). The final sample at Time 2 (t2) was n = 222 nurses (38%; age: M = 41.1 years, SD = 11.0; 88% females).
Results
We identified time pressure as job demand and job control, task identity, and person-organisation fit as resources that drive the relationships of exhaustion (mean between both times of measures) and organisational and professional leaving intentions. The relationships to organisational leaving intentions decreased with nurses’ age and the relationships to professional leaving intentions increased for nurses who had poorer self-rated health. We found indirect effects of exhaustion for relationships between job demands and nurses’ leaving intentions. Relationships to exhaustion remained significant after adjusting for depressive mood.
Conclusion
Insights from this study can be used both by employers and employees. Redesigning work might be a promising approach to improve nurses’ well-being and retention in this profession. Geriatric care facilities should include the concept of person-organisation fit into their personnel selection process.
Background
The anticipated growth in number of older people with long-term health problems is associated with a greater need for registered nurses. Home care services needs enough nurses that can deliver high quality services in patients’ homes. This article improves our understanding of nurses’ career choices in home care services.
Methods
A qualitative study using individual semi-structured interviews with 20 registered nurses working in home care services. The interviews were audio-recorded, transcribed and thematically analyzed.
Results
The analysis resulted in three themes emphasizing the importance of multiple stakeholders and contextual factors, fit with nurses’ private life, and meaning of work. The results offer important insights that can be used to improve organizational policy and HR practices to sustain a workforce of registered nurses in home care services.
Conclusion
The results illustrate the importance of having a whole life perspective to understand nurses’ career choices, and how nurses’ career preferences changes over time.
Aims:
To explore and describe registered nurses' perceptions and experiences of work well-being extending from what inspired them to join the healthcare organization, what created a great day at work for them, through to what may have supported them to stay.
Design:
Qualitative descriptive study.
Methods:
Thirty-nine Australian nurses who resigned in 2021 from two metropolitan healthcare organizations in Victoria were interviewed in 2022, each for 30-60 min. The semi-structured interview transcripts were transcribed verbatim and analysed inductively and thematically.
Results:
Four themes were constructed for each of the key research questions. Inspiration to join the organizations transpired through organizational reputation, recruitment experiences, right position and right time, fit and feel. A great day at work was created through relationships with colleagues, experiences with managers, adequate resourcing and delivering quality care. Factors contributing to nurses resigning included COVID-19, uncertainty of role, workload and rostering, and finally, not feeling supported, respected and valued. Factors that may have supported the nurses to stay included flexible work patterns and opportunities, improved workplace relationships, workload management and support, and supportive systems and environments. Cutting across these themes were five threads: (1) relationships, (2) communication, (3) a desire to learn and develop, (4) work-life balance and (5) providing quality patient care.
Conclusions:
Novel ways of working and supporting individuals, teams and organizations are needed to maintain and sustain nurses. The nurses' inspiration, what created a great day at work, and support needed to stay highlighted the importance of workplace initiatives to build nursing career pathways, provide equitable opportunities for professional development, workload and roster flexibility and implement professional relationship-enhancing actions to foster authentic civility.
Impact:
This study contributes an in-depth exploration of the perceptions and experiences of nurses who resigned from two healthcare organizations and provides a description of (1) what inspired these nurses to initially join the organization, (2) what they perceived created a great day at work for them, (3) the factors contributing to their resignation and (4) what may have supported them to stay. The reasons nurses resign from an organization were identified as complex and multi-factorial, with opportunities for promoting nursing career pathways, addressing equity in opportunities and implementing professional relationship-enhancing actions. These contributions add both context and opportunity to strengthen organizational initiatives to attract, sustain and retain nurses.
Purpose:
This study aimed to examine effect sizes of leadership styles of nursing managers on turnover intention of hospital nurses.
Methods:
A systematic review and meta-analysis were conducted in accordance with the PRISMA and MOOSE guidelines. Participants were nurses working in hospitals. The intervention involved nursing managers' leadership styles; the outcome assessed was nurses' turnover intention. This was an observational study design. Eleven databases were searched to obtain articles published in Korean or English. Of the 14,428 articles reviewed, 21 were included in systematic review and meta-analysis. Comprehensive Meta-Analysis and R software programs were used.
Results:
The total effect size r (ESr) was -0.25 (95% confidence interval: -0.29 to -0.20). Effect sizes of each leadership style on turnover intention were as follows: ethical leadership (ESr = -0.34), transformational leadership (ESr = -0.28), authentic leadership (ESr = -0.23), transactional leadership (ESr = -0.21), and passive avoidant leadership (ESr = 0.13). Ethical leadership was the most effective style in decreasing turnover intention of hospital nurses.
Conclusion:
Positive leadership styles of nurse managers effectively decrease turnover intention of hospital nurses, and negative leadership styles of nurse managers effectively increase turnover intention of hospital nurses. The ethical leadership style is the most effective in decreasing turnover intention of hospital nurses; however, it requires careful interpretation as its effects are reported by only two studies. This study contributes to addressing the high turnover rate of hospital nurses and developing positive leadership styles of nurse managers in hospital settings.
Shortage of nurses on the ICU is not a new phenomenon, but has been exacerbated by the COVID-19 pandemic. The underlying reasons are relatively well-recognized, and include excessive workload, moral distress, and perception of inappropriate care, leading to burnout and increased intent to leave, setting up a vicious circle whereby fewer nurses result in increased pressure and stress on those remaining. Nursing shortages impact patient care and quality-of-work life for all ICU staff and efforts should be made by management, nurse leaders, and ICU clinicians to understand and ameliorate the factors that lead nurses to leave. Here, we highlight 10 broad areas that ICU clinicians should be aware of that may improve quality of work-life and thus potentially help with critical care nurse retention.
Nurses represent the highest proportion of healthcare workers globally and have played a vital role during the COVID-19 pandemic. The pandemic has shed light on multiple vulnerabilities that have impacted the nursing workforce including critical levels of staffing shortages in Canada. A review sponsored by the Royal Society of Canada investigated the impact of the pandemic on the nursing workforce in Canada to inform planning and implementation of sustainable nursing workforce strategies. The review methods included a trend analysis of peer-reviewed articles, a jurisdictional scan of policies and strategies, analyses of published surveys and interviews of nurses in Canada, and a targeted case study from Nova Scotia and Saskatchewan. Findings from the review have identified longstanding and COVID-specific impacts, gaps, and opportunities to strengthen the nursing workforce. These findings were integrated with expert perspectives from national nursing leaders involved in guiding the review to arrive at recommendations and actions that are presented in this policy brief. The findings and recommendations from this policy brief are meant to inform a national and sustained focus on retention and recruitment efforts in Canada.
Aim:
There has been growing concern about the nurses' turnover intention as well as life satisfaction during COVID-19 pandemic in Iran. The past research has provided evidence on the effect of organizational support on nurses' job satisfaction and turnover intention. However, little is known about the underlying mechanism behind these associations.
Design:
A cross-sectional survey was undertaken.
Methods:
An online survey was conducted in Iran from May to June 2020 through Google Docs Forms. In total, 305 nurses were participated and completed the online survey. Data were analysed using structural equation modelling through (AMOS). This study was checked with the STROBE checklist.
Result:
The results showed that nurses' perception of organizational support was positively related to their job satisfaction which in turn decreases the turnover intention. Likewise, the job satisfaction partially mediated the relationship between organizational support and nurses' life satisfaction.
Background:
This study aimed to investigate whether different types of changes in the work schedule of nurses working rotating shifts during the COVID-19 pandemic were associated with sleep duration, sleep quality, and turnover intention.
Methods:
Cross-sectional questionnaire data from 694 nurses participating in the SUrvey of Shift work, Sleep and Health (SUSSH) were collected between the first and the second wave of the COVID-19 pandemic in Norway. A total of 89.9% were female, and mean age was 44.6 years (SD = 8.6 years). Changes in the shift work schedule related to the pandemic comprised reports of more long workdays (>8 h), less days off between work periods, more night shifts, more quick returns (i.e., 11 h or less between two consecutive shifts), more day shifts, and more evening shifts compared to no change in the respective shift characteristics. Change in sleep duration, sleep quality, and turnover intention as well as demographics were also assessed. Logistic regression analyses were performed to investigate whether changes in the specific work schedules were associated with sleep duration, sleep quality, and turnover intention, controlling for sex, age, cohabitation, children living in household, percentage of full time equivalent and other changes in the work schedule.
Results:
A total of 17% reported experiencing one or more changes in their work schedule during the pandemic. Experiencing any change in the work schedule predicted worse sleep quality (OR = 2.68, p < 0.001), reduced sleep duration (OR = 4.56, p < 0.001), and higher turnover intention (OR = 1.96, p = 0.006) compared to experiencing no change in work schedule. Among the specific changes in work schedules, experiencing an increase in quick returns had the highest odds ratio for worse sleep quality (OR = 10.34, p = 0.007) and higher turnover intention (OR = 8.49, p = 0.014) compared to those who reported no change in quick returns. Nurses experiencing an increase in long workdays were more likely to report higher turnover intention (OR = 4.37, p = 0.003) compared to those experiencing no change in long workdays.
Conclusions:
Change in work schedule related to the pandemic was associated with worse sleep quality, reduced sleep duration, and higher turnover intention. Increase in quick returns emerged as especially problematic in terms of sleep quality and turnover intention, along with long workdays, which were associated with higher turnover intention.
Aims
This study investigated health problems, turnover intention, and actual turnover among shift work nurses. While turnover intention is often used as a proxy variable for turnover, the relationship between these variables requires clarification. This study tested for relevant associations using prospective longitudinal data with a time lag of 12 months. We also tested for associations between health problems (sleep disturbance, fatigue, and depression) and turnover intentions/turnover, with a focus on the mediating role of turnover intention.
Methods
This study conducted a secondary analysis of data from the Shift Work Nurses’ Health and Turnover project, which is a prospective longitudinal cohort study. We analyzed health problems, turnover intention, and actual turnover. The data were analyzed via descriptive statistics, the Pearson’s chi-squared test, independent t-test, univariable logistic regression, multiple logistic regression, and causal mediation.
Results
Participants included 491 shift work female nurses. Of these, 112 (22.8%) had turnover intention, while 38 (7.7%) left their jobs within the 12-month period of investigation. Of the 112 with turnover intention, 22 left their jobs (OR 5.68. 95% CI 2.84–11.36). The logistic regression analysis showed that sleep disturbance and fatigue were associated with turnover intentions and actual turnover, while depression was only associated with turnover intention. The causal mediation analysis showed that turnover intention mediated the relationship between health problems (sleep disturbance and fatigue) and actual turnover (sleep disturbance OR 1.31, 95%CI = 1.02–1.60; fatigue OR 2.11, 95%CI = 1.50–2.68); sleep disturbance had a natural direct effect on actual turnover (OR 2.66, 95%CI,2.07–3.21).
Conclusion
Turnover intention strongly predicted actual turnover. Sleep disturbances may result in turnover, even in cases without existing turnover intention. These findings highlight the need for early interventions aimed at preventing and alleviating sleep disturbances for shift work female nurses.
Background
During the COVID-19 pandemic, shortage of nursing staff became even more evident. Nurses experienced great strain, putting them at risk to leave their jobs. Individual and organizational factors were known to be associated with nurses’ turnover intention before the pandemic. The knowledge of factors associated with turnover intention during the pandemic could help to foster nurses’ retention. Therefore, this review aims to identify factors associated with nurses’ turnover intention during the COVID-19 pandemic.
Methods
After a systematic search of six databases, the resulting records were screened in a two-step process based on pre-defined inclusion and exclusion criteria. The included quantitative studies were synthesized qualitatively due to their methodological heterogeneity.
Results
A total of 19 articles were included in the analysis. Individual factors such as health factors or psychological symptoms and demographic characteristics were associated with nurses’ turnover intention. Organizational factors associated with turnover intention were e.g., caring for COVID-19 patients, low job control or high job demands, and moral distress. Resilience and supporting leadership could mitigate adverse associations with turnover intention.
Conclusions
The results help to identify high-risk groups according to individual factors and to develop possible interventions, such as trainings for nurses and their superiors, addressing individual and organizational factors. Future research should focus on longitudinal designs applying carefully defined concepts of turnover intention.
Background
Nurses’ intentions to leave their job are considered among the several difficulties encountered by any health system. Quality of nursing work life (QNWL) and job satisfaction are among the significant factors that impact this intention.
Purpose
To explore the relationship between quality of work-life job satisfaction and the intention to leave among registered nurses (RNs) in Jordanian hospitals.
Methods
A cross-sectional study using a self-administered questionnaire was conducted to collect data from 200 RNs from three hospitals in Jordan to measure the main variables from July 11 to 25,2020. Data were analyzed using descriptive and inferential statistics using SPSS version 25.
Results
A total of 193 RNs participated in the study and were moderately satisfied with their quality of work life and job satisfaction. QNWL correlated positively with job satisfaction (r = 0.579, p = 0.000) and negatively with intent to leave (rs = - 0.204, p-value = 0.002). Job satisfaction was negatively correlated with the intent to leave (rs = - 0.174, p-value = 0.008). Sociodemographic and work-related variables (hospital type, sex, educational level, and salary) showed significant differences and correlations with at least one of the main variables.
Conclusion
This study's results can be used by health care managers and policymakers to implement successful plans and policies to improve the QNWL and job satisfaction of RNs. This, in turn, may assist in enhancing individual and organizational performance; improving home and job environments; increasing nurses' commitment and increasing nursing retention. Further research is needed to develop effective measures for enhancing QNWL and job satisfaction among RNs.
To counteract the shortage of nurses in the workforce, healthcare organizations must encourage experienced nurses to extend their working lives. Intensive care (IC) has higher nurse-to-patient ratios than other settings, which includes a particular susceptibility to staff shortage. This qualitative study investigated how older IC nurses experienced their working life and their reflections on the late-career and retirement. Semi-structured interviews with 12 IC nurses in Sweden (aged 55–65 years) were analyzed using an interpretative phenomenological analysis approach. The results showed that nurses planned to continue working until the age of 65 and beyond. When reflecting on their late-career decisions, nurses considered nine areas covering individual, work, and organizational factors as being central to their ability and willingness to stay. Overall, the nurses had good health and were very satisfied and committed to their job and to the organization. They mentioned having both the job and personal resources required to cope with the physical and mental job demands, which were perceived as motivational challenges, rather than hinders. They also reflected on various human resource management practices that may promote aging-in-workplace. These findings may inform organizations aiming at providing adequate conditions for enabling healthy and sustainable working lives for IC nurses.
There is a shortage of registered nurses (RNs) who work in the specialty of Psychiatric-Mental Health (PMH). Attrition among Psychiatric-Mental Health Nurses (PMHNs) may be related to a lack of leadership empowerment which includes autonomy and access to professional development opportunities. The purposes of this study, guided by Kanter's theory of structural empowerment, were to determine (a) if there was a relationship between leadership empowerment behavior and PMH RNs' intent to leave within the first 2 years of practice in inpatient psychiatric settings and (b) if there was a relationship between leadership empowerment behavior and intent to leave among this population who are in their first 2 years of practice, based on RN demographics. The key variables were measured with the Leader Empowering Behavior Questionnaire and the Turnover Intention Scale. The study participants included 111 psychiatric RNs in their first 2 years of practice who were recruited via social media. Results showed an inverse relationship between leadership empowerment behavior and intent to leave. The RN demographic characteristics did not affect this relationship. The study findings could be used for social change by creating awareness for PMHN leaders to develop empowerment behavior as a strategy to mitigate new PMH RN turnover so that they can stay in practice and positively impact therapeutic and quality patient care delivery. Future studies using mixed methods and a larger sample size would be helpful to obtain an in-depth understanding of the role of leadership empowerment behavior and retention from the RN's perspective.
Objective:
To characterize the relationship between learning environments (the educational approaches, cultural context, and settings in which teaching and learning happen) and reliability enhancing work practices (hiring, training, decision making) with employee engagement, retention, and safety climate.
Data source:
We collected data using the Learning Environment and High Reliability Practices Survey (LEHRs) from 231 physicians, nurses, and technicians at 67 Veterans Affairs cardiac catheterization laboratories who care for high-risk Veterans.
Study design:
The association between the average LEHRs score and employee job satisfaction, burnout, intent to leave, turnover, and safety climate were modeled in separate linear mixed effect models adjusting for other covariates.
Data collection:
Participants responded to a web-only survey from August through September 2020.
Principal findings:
There was a significant association between higher average LEHRs scores and (1) higher job satisfaction (2) lower burnout, (3) lower intent to leave, (4) lower cath lab turnover in the previous 12 months, and (5) higher perceived safety climate.
Conclusions:
Learning environments and use of reliability enhancing work practices are potential new avenues to support satisfaction and safety climate while lowering burnout, intent to leave, and turnover in a diverse US health care workforce that serves a vulnerable and marginalized population.
Background
The serious shortage of human resources for primary health care (PHC) is a common issue in health reforms worldwide. China has proposed that it is an effective way to encourage and guide qualified medical personnel to work in primary health care institutions (PHCIs). However, few studies have been conducted on the willingness and influencing factors of medical personnel to seek employment at PHCIs.
Methods
Based on implicit theory and lexical approach, pre-investigation was conducted to collect the items that influence the medical personnel to seek employment at PHCIs from the perspective of guided objects. Through a three-phase investigation of 1160 doctors in 29 public hospitals in 9 cities, the items were categorized, and a structural equation model was established and verified to explore the interrelationship of influencing factors.
Results
A total of 6 factors were rotated, including Sense of Gain (SG), Internal Organization Development (IOD), Remuneration and Development (RD), Condition of the City Where the PHCI Is Located (CCPL), Job Responsibilities (JR) and Family Support (FS). The results of the model showed that IOD, RD, JR and FS had a significantly positive effect on the SG. In addition, the FS, RD and JR significantly mediated the relationship between the internal and external environment of PHCIs and SG. The values of the fit index indicated an acceptable-fitting model.
Conclusion
Family, remuneration, individual development, and job responsibility are closely related to the willingness of medical personnel to seek employment at PHCIs, and the internal and external environment of PHCIs is also an important factor. Therefore, the development of PHC providers can be promoted by paying attention to the family members of medical personnel, establishing a reasonable remuneration system, providing suitable development opportunities, arranging work rationally and improving the internal construction of PHCIs.
In China, the primary health care institutions (PHCIs) have difficulty winning the trust of residents because of the shortage of medical personnel and the low level of skills. The government has advocated encouraging qualified doctors to work in PHCIs, but no obvious results are achieved. Based on the theory of planned behavior (TPB), this paper explores the factors affecting medical personnel seeking employment in PHCIs and then putting forward measures to improve the human resources construction of PHCIs. A three-stage survey was conducted to obtain the factors and a structural equation modeling (SEM) was applied to examine the relationship of the factors. We found that the factors affecting medical personnel to work in PHCIs include the specific conditions and work contents of PHCIs, as well as the family life and regional factors. Besides, there is a significant correlation and indirectness between these factors. Therefore, targeted measures can be proposed to improve the intention of medical personnel seeking employment in PHCIs. This study provides theoretical support for encouraging medical personnel to work in PHCIs and improving the primary health care system.
This study reports the findings of a 2.5 year intervention project to reduce psychosocial risks and increase employee well-being in 15 emergency departments in the Netherlands. The project uses the psychosocial risk management approach “PRIMA” which includes cycles of risk assessment, designing and implementing changes, evaluating changes and adapting the approach if necessary. In addition, principles of participative action research were used to empower the departments in designing and implementing their own actions during the project. Next to determining overall effects, the study aims to assess potential moderators including the level of intervening (organization-directed or multilevel), process variables (the number and fit of actions to risk factors, communication and employee participation) and partaking in a Psychosocial Safety Climate intervention offered during the second half of the project. The results of linear mixed-model analyses showed that all job factors improved with the exception of autonomy, which did increase halfway the project but not when considering the entire timeframe. In addition, work engagement decreased and symptoms of burnout remained stable. Emergency departments that implemented more fitting actions, communicated better and involved their employees more in the process, had more favorable changes in job factors and more stable well-being. More activity (based on the number of actions implemented) and a multilevel approach regarding stress management did not lead to greater improvements. The Psychosocial Safety Climate intervention was effective in improving Psychosocial Safety Climate, but a longer follow-up period seems required to evaluate its effect on job factors and well-being. Overall, the project resulted in positive changes in most job factors, and its findings emphasize the importance of process variables in stress management interventions. Longer follow-up and higher quality multilevel interventions (including professional support for employees with stress-related complaints) seem essential to also improve well-being.
Aim
This study determined the relationships of satisfaction and frustration with basic psychological needs, organizational commitment, perceived authentic leadership, and turnover intention in nurses in South Korea.
Background
Minimizing nurse turnover is essential for improving the quality of nursing care and patient safety.
Methods
This was a cross-sectional, correlational pilot study of 216 nurses at a university hospital in South Korea. Data were collected with a self-report questionnaire, from September 1 to 15, 2020. Collected data were analyzed using SPSS 24.0.
Results
Multiple regression analysis revealed that clinical experience (3 to 5 years, β=2.35, p=.019; 5 to 10 years, β=2.23, p=.026), subjective workload (severe, β= 2.10, p=.036; extreme, β=2.84, p=.005), psychological needs frustration (β=0.35, p<.001), organizational commitment (β=-0.17, p=.011), and perceived authentic nurse leadership (β=-0.14, p=.030) were found to have significant effects on nurses’ turnover intention.
Conclusions
A strategy is needed for efficient nursing staffing management and reduction of nurses’ turnover intentions.
Implications for Nursing Management
This study offers a new approach to reducing nurses’ turnover. The results suggest that it is necessary to create a transparent work environment based on authentic leadership and consider individual frustrations with regard to basic psychological needs and organizational commitments.
Background
The values of individuals and organizations are the core factors driving and guiding nurses’ decision-making and actions. Previous studies mainly focused on the impact of organizational commitment and other influencing factors on turnover intention.
Aim
To explore the mediating effect of personal and organizational values matching the relationship between organizational commitment and turnover intention of nursing staff.
Methods
A cross-sectional survey of 490 subjects in four tertiary hospitals in Tianjin was conducted by convenient sampling. Multivariate regression analysis and structural equation models were used to test each hypothesis.
Results
The results showed that there is a negative correlation between personal and organizational values, organizational commitment and turnover intention, and personal and organizational values played an indirect intermediary role between organizational commitment and turnover intention.
Conclusions
Organizational commitment reduces nurses’ turnover intention indirect through personal and organizational values paths. Leaders can improve nurses’ values as members of the organization, so as to participate in their own work more actively.
Implications for nursing management
Managers should effectively reduce the turnover rate and stabilize the nursing team by improving the organizational commitment and personal and organizational values of clinical nurses.
Aim
to describe why registered nurses decide to leave their work and to investigate relationships between registered nurses’ working life and turnover (leaving the unit versus the profession).
Background
Much research has explored nurses’ intention to leave, while less research has looked at turnover and especially leaving the profession.
Methods
Data were collected using questionnaires and interviews.
Results
The three most common reasons for both groups (leaving the profession, n=40; leaving unit but not profession, n=256) were high workload, low salary and applied for and got a new job. Multivariate logistic regression analysis revealed statistically significant relationships between turnover and empowering structures, such as access to resources and informal power as well as the factor learning in thriving.
Conclusions
Structural empowerment, such as good access to resources and informal power, is important to keeping nurses in the profession, while learning seems to increase the risk of leaving the profession when variables such as vitality, resources, informal power and age are held constant.
Implications for Nursing Management
To counteract nurses leaving the profession, managers must provide nurses with good access to resources, informal power, such as networks within and outside the organization, and focus on nurses’ vitality.
Introduction:
Personal, community, and environmental factors can influence the attraction and retention of regional, rural, and remote health workers. However, the concept of place attachment needs further attention as a factor affecting the sustainability of the rural health workforce.
Objective:
The purpose of this rapid review was to explore the influence of a sense of place in attracting and retaining health professionals in rural and remote areas.
Design:
A systematic rapid review was conducted based on an empirical model using four dimensions: place dependence, place identity, social bonding and nature bonding. English-language publications between 2011 and 2021 were sought from academic databases, including studies relevant to Australian health professionals.
Findings:
A total of 348 articles were screened and 52 included in the review. Place attachment factors varied across disciplines and included (a) intrinsic place-based personal factors; (b) learning experiences enhancing self-efficacy and rural health work interest; (c) relational, social and community integration; and (d) connection to place with lifestyle aspirations.
Discussion:
This rapid review provides insight into the role of relational connections in building a health workforce and suggests that community factors are important in building attachment through social bonding and place identity. Results indicate that future health workforce research should focus on career decision-making and psychological appraisals including place attachment.
Conclusion:
An attachment to place might develop through placement experiences or from a strong rural upbringing. The importance of the relational interactions within a work community and the broader community is seen as an important factor in attracting, recruiting, and sustaining a rural health workforce.
The purpose of this study was to determine the job satisfaction among female workers in Korea and the association between health status and job satisfaction. The Korean Longitudinal Survey of Women and Families was used for this nationwide cross‐sectional study. Data from 1,570 female workers were analyzed to determine job satisfaction and examine the association between health status and job satisfaction, controlling for other variables such as personal characteristics, work attributes, job opportunities, and work conditions. Analyses included descriptive statistics, independent t‐tests, ANOVA, Pearson’s correlation, and multivariate regression. Subjective health status was positively related to job satisfaction. Diagnosed disease and depressive symptoms were negatively associated with job satisfaction. Monthly salary, work hours, fringe benefits, and geographical region were significantly related to female workers’ job satisfaction. Commute distance was related to job satisfaction with a small effect size. This study found that subjective health status, diagnosed disease, and depressive symptoms were related to female workers’ job satisfaction. Health promotion and supporting mental health among female workers may be important managerial strategies that may support increased job satisfaction in female workers.
Job satisfaction is a critical component of the professional work environment and is often ascertained through surveys that include structured or open-ended questions. Using data from 24,543 respondents to California Board of Registered Nursing biennial surveys, this study examines the job satisfaction of registered nurses (RNs) by applying clustering analysis to structured job satisfaction items and sentiment analysis to free-text comments. The clustering analysis identified three job satisfaction groups (low, medium, and high satisfaction). Sentiment analysis scores were significantly associated with the job satisfaction groups in both bivariate and multivariate analyses. Differences between the job satisfaction clusters were mostly driven by satisfaction with workload, adequacy of the clerical support services, adequacy of the number of RN staff, and skills of RN colleagues. In addition, there was dispersion in satisfaction related to involvement in management and policy decisions, recognition for a job well done, and opportunities for professional development.
Hospital organizations are affected by the shortage of nurses across the United States. Hospital organizations must strategically plan to recruit and retain nurses. An average hospital will incur costs between 7.86 million due to RN turnover. In an outcome-focused healthcare environment, healthcare leaders must consider all perspectives involved in nurse manager leadership. The purpose of this phenomenological study was to describe nurses' lived experiences with nurse manager leadership on medical surgical units in Riverside County, California, USA.
Improving nurses’ staff retention is highly needed since risks of turnover are high in this profession. Prior research uncovered job demands as important driver and job resources as protective factor for the development of nurses’ organizational leaving intentions. However, research on beneficial effects of rest break design as an important job resource on nurses’ leaving intentions is sparse and their interactions with present job demands have been widely neglected. Therefore, we aimed to examine if different rest break characteristics (i.e. break length, break disturbances, and social breaks) predict nurses’ organizational leaving intentions while also considering job demands (i.e. quantitative, cognitive, and emotional demands, and social conflicts) and other well-known person-related and work-related turnover antecedents. We conducted a cross-sectional paper-pencil survey study with 167 nurses from Germany. We found a positive relation between rest break disturbances and organizational leaving intentions even after adjusting for person-related and work-related confounders. Rest break length and the frequency of social breaks were no significant predictors when considering all rest break characteristics in combination. Moreover, high quantitative demands and high social conflicts at work related to higher leaving intentions. Fewer rest break disturbances increased the negative relation between cognitive demands and leaving intentions. In order to reduce nurses’ organizational leaving intentions and to improve staff retention, nursing management should prevent disturbances of nurses’ rest breaks in addition to other work design interventions such as reducing quantitative demands and social conflicts and especially when implementing cognitive challenging tasks.
In this study the authors compare career and work experiences of executive women and men. Female (n = 51) and male (n = 56) financial services executives in comparable jobs were studied through archival information on organizational outcomes and career histories, and survey measures of work experiences. Similarities were found in several organizational outcomes, such as compensation, and many work attitudes. Important differences were found, however, with women having less authority, receiving fewer stock options, and having less international mobility than men. Women at the highest executive levels reported more obstacles than lower level women. The gender differences coupled with women's lower satisfaction with future career opportunities raise questions about whether women are truly above the glass ceiling or have come up against a 2nd, higher ceiling.
Studied changes across time in measures of organizational commitment and job satisfaction as each related to subsequent turnover among 60 recently employed psychiatric technician trainees. A longitudinal study across a 101/2-mo period was conducted, with attitude measures (Organizational Commitment Questionnaire and Job Descriptive Index) collected at 4 points in time. Results of a discriminant analysis indicate that significant relationships existed between certain attitudes held by employees and turnover. Relationships between attitudes and turnover were found in the last 2 time periods only, suggesting that such relationships are strongest at points in time closest to when an individual leaves the organization. Organizational commitment discriminated better between stayers and leavers than did the various components of job satisfaction. (36 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
For structural equation models, a huge variety of fit indices has been developed. These indices, however, can point to conflicting conclusions about the extent to which a model actually matches the observed data. The present article provides some guide-lines that should help applied researchers to evaluate the adequacy of a given struc-tural equation model. First, as goodness-of-fit measures depend on the method used for parameter estimation, maximum likelihood (ML) and weighted least squares (WLS) methods are introduced in the context of structural equation modeling. Then, the most common goodness-of-fit indices are discussed and some recommendations for practitioners given. Finally, we generated an artificial data set according to a "true" model and analyzed two misspecified and two correctly specified models as examples of poor model fit, adequate fit, and good fit. In structural equation modeling (SEM), a model is said to fit the observed data to the extent that the model-implied covariance matrix is equivalent to the empirical co-variance matrix. Once a model has been specified and the empirical covariance matrix is given, a method has to be selected for parameter estimation. Different estimation meth-ods have different distributional assumptions and have different discrepancy functions to be minimized. When the estimation procedure has converged to a reasonable
Critically examines research over the past 10-12 yrs concerning factors related to turnover and absenteeism in work situations. On a general level, overall job satisfaction was consistently and inversely related to turnover. In an effort to break down the global concept of job satisfaction, various factors in the work situation were analyzed as they related to withdrawal behavior. 4 categories of factors, each representing 1 "level" in the organization, were utilized: organization-wide factors, immediate work environment factors, job-related factors, and personal factors. Several variables in each of the 4 categories were found to be related fairly consistently to 1 or both forms of withdrawal. An attempt is made to put the diverse findings into a conceptual framework centering around the role of met expectations. Methodological considerations and future research needs are also discussed. (83 ref.)
This study (a) compared the effect of perceived supervisor support (PSS) and perceived coworker support (PCS) on work attitudes; (b) examined the moderating role of gender, tenure, and job type in the support—attitude relationship; and (c) tested a theoretical model hypothesizing relationships among PCS, PSS, perceived organizational support, and work attitudes. In a meta-analysis, PSS was found to be more strongly related to job satisfaction (.52 vs. .37), affective commitment (.48 vs. .28), and turnover intention (—.36 vs. —.19) than was PCS. Further, job type (customer-contact vs. non-customer-contact jobs) was found to be a significant moderator. Finally, the proposed model received empirical support. Different forms of support were closely related to work attitudes and to each other. Implications for research on social support are discussed.
Data reported in labor market studies in which unemployment rates in a geographical area, industry, or time period are correlated with voluntary termination rates from work organizations support the hypothesized role of available alternatives in the satisfaction–quit process. Studies conducted at the individual termination-decision level support neither the theoretical propositions nor generalization of the results of analyses of aggregated data to individuals' decision to leave a job or organization. Three explanations for these inconsistencies are offered: (1) Different economies produce different work forces. (2) Job opportunities influence job satisfaction directly. (3) Job opportunities, not intentions, influence turnover directly. An integrated explanation based on the direct influence of economic/unemployment conditions of job affect, which is consistent with theoretical models of social attitudes and job affect formation as well as with empirical evidence, is presented. It is suggested that statements about the rationality of job-termination decisions must be made in view of the full range of factors that affect job utilities and utilities of alternative activities, including the utilities associated with being unemployed. (57 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The leader–member exchange (LMX) literature is reviewed using meta-analysis. Relationships between LMX and its correlates are examined, as are issues related to the LMX construct, including measurement and leader–member agreement. Results suggest significant relationships between LMX and job performance, satisfaction with supervision, overall satisfaction, commitment, role conflict, role clarity, member competence, and turnover intentions. The relationship between LMX and actual turnover was not significant. Leader and member LMX perceptions were only moderately related. Partial support was found for measurement instrument and perspective (i.e., leader vs. member) as moderators of the relationships between LMX and its correlates. Meta-analysis showed that the LMX7 (7-item LMX) measure has the soundest psychometric properties of all instruments and that LMX is congruent with numerous empirical relationships associated with transformational leadership. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This meta-analysis summarized youth, academic, and workplace research on the potential antecedents (demographics, human capital, and relationship attributes), correlates (interaction frequency, relationship length, performance, motivation, and social capital), and consequences (attitudinal, behavioral, career-related, and health-related outcomes) of protégé perceptions of instrumental support, psychosocial support, and relationship quality to the mentor or to the relationship. A total of 173 meta-analytic correlations were computed based on data from 173 samples and a combined N of 40,737. Among antecedents, positive protégé perceptions were most strongly associated with greater similarity in attitudes, values, beliefs, and personality with their mentors (ρ ranged from .38 to .59). Among correlates, protégé perceptions of greater instrumental support (ρ = .35) and relationship quality (ρ = .54) were most strongly associated with social capital while protégé perceptions of greater psychosocial support were most strongly associated with interaction frequency (ρ = .25). Among consequences, protégé perceptions of greater instrumental support (ρ = .36) and relationship quality (ρ = .38) were most strongly associated with situational satisfaction while protégé perceptions of psychosocial support were most highly associated with sense of affiliation (ρ = .41). Comparisons between academic and workplace mentoring generally revealed differences in magnitude, rather than direction, of the obtained effects. The results should be interpreted in light of the methodological limitations (primarily cross-sectional designs and single-source data) and, in some instances, a small number of primary studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Research into Leader-Member Exchange (LMX) theory has been gaining momentum in recent years, with a multitude of studies investigating many aspects of LMX in organizations. Theoretical development in this area also has undergone many refinements, and the current theory is far different from the early Vertical Dyad Linkage (VDL) work. This article uses a levels perspective to trace the development of LMX through four evolutionary stages of theorizing and investigation up to the present. The article also uses a domains perspective to develop a new taxonomy of approaches to leadership, and LMX is discussed within this taxonomy as a relationship-based approach to leadership. Common questions and issues concerning LMX are addressed, and directions for future research are provided.
This study examined whether structural, attitudinal, and behavioral variables of a relational nature were predictive of employee turnover. Participants were a sample of 176 health care employees from a large public medical center. Using survival analysis over a five-year time frame, we found that two such variables, network centrality and interpersonal citizenship behavior, predicted turnover. Implications of taking a relational perspective toward turnover and other withdrawal behaviors found in organizations are discussed. [ABSTRACT FROM AUTHOR] Copyright of Academy of Management Journal is the property of Academy of Management and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
The relationship between job satisfaction and turnover is significant and consistent, but not particularly strong. A more complete understanding of the psychology of the withdrawal decision process requires investigation beyond the replication of the satisfaction-turnover relationship. Toward this end, a heuristic model of the employee withdrawal decision process, which identifies possible intermediate linkages in the satisfaction-turnover relationship, is presented. Previous studies relevant to the hypothesized linkages are cited, and possible avenues of research are suggested. [ABSTRACT FROM AUTHOR] Copyright of Journal of Applied Psychology is the property of American Psychological Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Research on employee turnover since L. W. Porter and R. M. Steers's analysis of the literature reveals that age, tenure, overall satisfaction, job content, intentions to remain on the job, and commitment are consistently and negatively related to turnover. Generally, however, less than 20% of the variance in turnover is explained. Lack of a clear conceptual model, failure to consider available job alternatives, insufficient multivariate research, and infrequent longitudinal studies are identified as factors precluding a better understanding of the psychology of the employee turnover process. A conceptual model is presented that suggests a need to distinguish between satisfaction (present oriented) and attraction/expected utility (future oriented) for both the present role and alternative roles, a need to consider nonwork values and nonwork consequences of turnover behavior as well as contractual constraints, and a potential mechanism for integrating aggregate-level research findings into an individual-level model of the turnover process. (62 ref)
In this article, we summarize previous empirical studies that examined antecedents, correlates, and/or consequences of organizational commitment using meta-analysis. In total, 48 meta-analyses were conducted, including 26 variables classified as antecedents, 8 as consequences, and 14 as correlates. Statistical artifacts were found to account for the variance between studies in only one meta-analysis that used attendance. Type of organizational commitment (attitudinal vs. calculative) was proposed as a moderator variable and was found to account for significant between-study variance in 9 of 18 comparisons. Theoretical and methodological issues pertaining to the measurement of various forms of organizational commitment, its interrelations with other forms of attachments, and its role in causal models of behavior in organizations are reviewed. Directions for future research are highlighted.
Models of turnover specify important roles for both general labor market conditions and perceptions. There is consistent support for the role of general labor market conditions, but evidence on labor market perceptions is mixed. However, no empirical study has included both types of variables. Using a national sample of young adults, both types of measures were found to influence voluntary turnover, either directly or through other factors. However, the two constructs are not necessarily closely linked. For example, despite an intention to quit (based partly on perceived ease of movement), an employee may stay with the organization because general labor market conditions result in a generally low level of alternative job openings.
To synthesize studies that use structural equation modeling (SEM), researchers usually use Pearson correlations (univariate r), Fisher z scores (univariate z), or generalized least squares (GLS) to combine the correlation matrices. The pooled correlation matrix is then analyzed by the use of SEM. Questionable inferences may occur for these ad hoc procedures. A 2-stage structural equation modeling (TSSEM) method is proposed to incorporate meta-analytic techniques and SEM into a unified framework. Simulation results reveal that the univariate-r, univariate-z, and TSSEM methods perform well in testing the homogeneity of correlation matrices and estimating the pooled correlation matrix. When fitting SEM, only TSSEM works well. The GLS method performed poorly in small to medium samples.
Because measures of person-organization (P-O) fit are accountable to the same psychometric and legal standards used for other employment tests when they are used for personnel decision making, the authors assessed the criterion-related validity of P-O fit as a predictor of job performance and turnover. Meta-analyses resulted in estimated true criterion-related validities of .15 (k = 36, N = 5,377) for P-O fit as a predictor of job performance and .24 (k = 8, N = 2,476) as a predictor of turnover, compared with a stronger effect of .31 (k = 109, N = 108,328) for the more commonly studied relation between P-O fit and work attitudes. In contrast to the relations between P-O fit and work attitudes, the lower 95% credibility values for the job performance and turnover relations included zero. In addition, P-O fit's relations with job performance and turnover were partially mediated by work attitudes. Potential concerns pertaining to the use of P-O fit in employment decision making are discussed in light of these results.
Context The worsening hospital nurse shortage and recent California legislation
mandating minimum hospital patient-to-nurse ratios demand an understanding
of how nurse staffing levels affect patient outcomes and nurse retention in
hospital practice.Objective To determine the association between the patient-to-nurse ratio and
patient mortality, failure-to-rescue (deaths following complications) among
surgical patients, and factors related to nurse retention.Design, Setting, and Participants Cross-sectional analyses of linked data from 10 184 staff nurses
surveyed, 232 342 general, orthopedic, and vascular surgery patients
discharged from the hospital between April 1, 1998, and November 30, 1999,
and administrative data from 168 nonfederal adult general hospitals in Pennsylvania.Main Outcome Measures Risk-adjusted patient mortality and failure-to-rescue within 30 days
of admission, and nurse-reported job dissatisfaction and job-related burnout.Results After adjusting for patient and hospital characteristics (size, teaching
status, and technology), each additional patient per nurse was associated
with a 7% (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03-1.12)
increase in the likelihood of dying within 30 days of admission and a 7% (OR,
1.07; 95% CI, 1.02-1.11) increase in the odds of failure-to-rescue. After
adjusting for nurse and hospital characteristics, each additional patient
per nurse was associated with a 23% (OR, 1.23; 95% CI, 1.13-1.34) increase
in the odds of burnout and a 15% (OR, 1.15; 95% CI, 1.07-1.25) increase in
the odds of job dissatisfaction.Conclusions In hospitals with high patient-to-nurse ratios, surgical patients experience
higher risk-adjusted 30-day mortality and failure-to-rescue rates, and nurses
are more likely to experience burnout and job dissatisfaction.
The current study revisited the traditional dichotomy of part-time versus full-time employment and examined its efficacy in predicting job-related attitudes reflecting well-being (job satisfaction and organizational commitment) and emotional withdrawal (burnout and the intention to quit the workplace). In addition, we tested the impact of a continuous measure of actual work schedule as well as the psychological constructs (preferred work schedule and scheduling control) over these attitudes. Participants were 153 nurses in an Israeli hospital who had either full-time or part-time positions. Results showed that both the dichotomous and continuous measures of actual work schedule failed to explain any of the study criteria. Conversely, preferred work schedule and, especially, scheduling control were significant determinants of work attitudes. Implications for continued research are outlined.
Examined work and family influences on the decision to leave the field of public accounting. Ss were 195 male and 115 female members of the American Institute of Certified Public Accountants (AICPA) who were married or who had at least 1 child. Measures included work overload, career development opportunities, advancement expectations, family involvement, work–home conflict, and stress. Data regarding departure from public accounting was taken from AICPA records providing current job status of its members. Results indicate that women are more likely than men to depart public accounting. However, the reason for the sex difference in departure rate was not because women experienced greater family pressures than men, but rather because women had less of a desire to be promoted to partner than men. Moreover, women and men left public accounting for similar reasons, which were more likely to be work related than family related. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This article presents a comprehensive definition and conceptual model of person-organization fit that incorporates supplementary as well as complementary perspectives on fit. To increase the precision of the construct's definition, it is also distinguished from other forms of environmental compatibility, silch as person-group and person-vocation fit. Once defined, commensurate measurement as it relates to supplementary and complementary fit is discussed and recommendations are offered regarding the necessity of its use. A distinction is made between the direct measurement of perceived fit and the indirect measurement of actual person-organization fit, using both cross- and individual-level techniques, and the debate regarding differences scores is reviewed. These definitional and measurement issues frame a review of the existing literature, as well as provide the basis for specific research propositions and suggestions for managerial applications.
Reviewers often use regression models in meta-analysis (‘meta-regressions’) to examine the relationships between effect sizes and study characteristics. In this paper, we propose and illustrate the use of an index (R) that expresses the amount of variance in the outcome that is explained by the meta-regression model. The values of R2 obtained from the standard computer output for linear models of effect size in the meta-analysis context are typically too small, because the typical R2 considers sampling variance to be unexplained whereas in meta-analysis it can be quantified. Although the idea of removing the unexplainable variance from the estimator of variance accounted for in meta-analysis is not new (Cook et al., 1992; Raudenbush, 1994) we explicitly define four estimators of variance explained, and illustrate via two examples that the typical R2 obtained in a linear model of effect size is always lower than our indices. Thus, the typical R2 underestimates the explanatory power of linear models of effect sizes. Our four estimators improve upon typical weighted R2 values. Copyright © 2011 John Wiley & Sons, Ltd.
This paper presents an overview of a useful approach for theory testing in the social sciences that combines the principles of psychometric meta-analysis and structural equations modeling. In this approach to theory testing, the estimated true score correlations between the constructs of interest are established through the application of meta-analysis (Hunter & Schmidt, 1990), and structural equations modeling is then applied to the matrix of estimated true score correlations. The potential advantages and limitations of this approach are presented. The approach enables researchers to test complex theories involving several constructs that cannot all be measured in a single study. Decision points are identified, the options available to a researcher are enumerated, and the potential problems as well as the prospects of each are discussed.
Despite the substantial amount of useful prior work on turnover among nurses, our understanding of the causal mechanisms explaining why nurses voluntarily leave their jobs is limited. The purpose of this article is to promote the development of stronger conceptual models of the causes of voluntary turnover among nurses. The author compares the nursing-specific literature to research on voluntary turnover from the general management field over the past 30 years and examines the evolution of key theories used in the nursing literature. Results of this review comparing nursing research with that in the broader field suggest that, over time, nursing research has not kept pace with conceptualizations from general management explaining why people either remain at or quit their jobs. The author argues that conceptual models of turnover among nurses can benefit significantly from drawing more effectively on particular models and concepts available in general management studies of turnover.
The scope of the clinical nurse leader (CNL) is evolving in practice across the country. The preparation of this pivotal role in a complex healthcare environment has prompted the collaboration of nurse academics, nurse administrators, and clinicians to design unique educational experiences to maximize best practice. Knowledge attained regarding healthcare improvement and patient safety must not only be theoretical, but personal and application focused. Utilizing the American Association of Colleges of Nursing's CNL white paper and published resources faculty developed a clinical leadership course focused on active learning and reflection. Students explore concepts of improvement and quality related to business models of high functioning organizations including healthcare. Three key components of the course are described in detail; "quality is personal", executive interviews and the "5P" clinical microsystems assessment. Evaluation outcomes are discussed. Course content and innovative teaching/learning strategies for CNL are shared which may support the growth of CNL program development nationally.
A model is proposed that specifies the conditions under which individuals will become internally motivated to perform effectively on their jobs. The model focuses on the interaction among three classes of variables: (a) the psychological states of employees that must be present for internally motivated work behavior to develop; (b) the characteristics of jobs that can create these psychological states; and (c) the attributes of individuals that determine how positively a person will respond to a complex and challenging job. The model was tested for 658 employees who work on 62 different jobs in seven organizations, and results support its validity. A number of special features of the model are discussed (including its use as a basis for the diagnosis of jobs and the evaluation of job redesign projects), and the model is compared to other theories of job design.
This study assesses the relative influence of personal, attitudinal, and behavioral variables on behavioral intentions and voluntary turnover among nonsupervisory plant workers. Results show that personal variables have little direct effect on turnover; rather, their influence on turnover is channeled through their effects on behavioral intentions. Felt stress, organizational commitment, and behavioral intentions are found to be the strongest predictors of voluntary job termination. Weak support is found for absenteeism as a precursor of eventual turnover.
Diversity in the conceptualization and measurement of organizational commitment has made it difficult to interpret the results of an accumulating body of research. In this article, we go beyond the existing distinction between attitudinal and behavioral commitment and argue that commitment, as a psychological state, has at least three separable components reflecting (a) a desire (affective commitment), (b) a need (continuance commitment), and (c) an obligation (normative commitment) to maintain employment in an organization. Each component is considered to develop as a function of different antecedents and to have different implications for on-the-job behavior. The aim of this reconceptualization is to aid in the synthesis of existing research and to serve as a framework for future research.
Conducted a meta-analysis of 101 samples from studies relating perceived control variables to 19 employee outcome variables. For all studies combined, it was found that high levels of perceived control were associated with high levels of job satisfaction (overall and individual facets), commitment, involvement, performance and motivation, and low levels of physical symptoms, emotional distress, role stress, absenteeism, intent to turnover, and turnover. A similar pattern was found for the autonomy and participation studies analyzed separately, with one exception; participative decision making was not associated with absenteeism in the single study available. (35 ref) (PsycINFO Database Record (c) 2007 APA, all rights reserved)
Historically, researchers have sought to identify environmental causes of employee turnover. This paradigm has led to the underemphasis of individual differences as being an important cause of individuals' turnover decisions. The results of the meta-analysis show that personality traits do have an impact on individuals' turnover intentions and behaviors. The trait of Emotional Stability best predicted (negatively) employees' intentions to quit, whereas the traits of Conscientiousness and Agreeableness best predicted (negatively) actual turnover decisions. A theoretically developed path model showed important direct effects from personality to intentions to quit and turnover behaviors that were not captured through job satisfaction or job performance. These direct effects indicate that employees who are low on Emotional Stability may intend to quit for reasons other than dissatisfaction with their jobs or not being able to perform their jobs well. The direct effects on turnover suggest that individuals who are low on Agreeableness or high on Openness may engage in unplanned quitting. Personality traits had stronger relationships with outcomes than did non-self-report measures of job complexity/job characteristics. [ABSTRACT FROM AUTHOR] Copyright of Personnel Psychology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Despite arguments for a significant negative relationship, there have been ambiguous findings on the empirical relationship between procedural justice and turnover behavior. This study attempts to clarify these past findings by examining the effects of multiple dimensions of procedural justice on the voluntary turnover behavior of nurses in a work-scheduling context (N = 190). The advance notice and consistency dimensions were significantly and negatively correlated with turnover behavior. Two dimensions of procedural justice had divergent effects on actual turnover behaviors in a logistic regression model. Advance notice was negatively related to turnover, while representativeness of views was positively related to turnover. Copyright copyright 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR] Copyright of Journal of Organizational Behavior is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
This Study addresses the issue of whether positive employee attitudes and behaviors influence business outcomes or whether positive business outcomes influence positive employee attitudes and behaviors. We hypothesize that employee satisfaction, organizational citizenship behavior, and employee turnover influence profitability and customer satisfaction. Data were gathered from the units of a regional restaurant chain via employee surveys, manager surveys, customer surveys, and organizational records. Cross-lagged regression analyses show that employee attitudes and behaviors at Time 1 are related to organizational effectiveness at Time 2. Additional cross-lagged regression analyses show no significant relationship between organizational effectiveness at Time 1 and the employee attitudes and behaviors at Time 2. These results add to the evidence that HR outcomes influence business outcomes, rather than the other way around. [ABSTRACT FROM AUTHOR] Copyright of Personnel Psychology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
We tested the hypothesis that employee turnover and firm performance have an inverted U-shaped relationship: overly high or low turnover is harmful. Our analysis was based on economic performance data from 110 offices of a temporary employment agency. These offices had high variation in turnover but were otherwise similar, allowing control for important intervening variables. Regression analysis revealed a curvilinear relationship; high turnover was harmful, but the inverted U-shape was not observed with certainty. [ABSTRACT FROM AUTHOR] Copyright of Academy of Management Journal is the property of Academy of Management and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
We quantitatively integrated 169 samples ( N= 35,265 employees) that have been used to investigate the relationships of the following 7 work-related stressors with job performance: role ambiguity, role conflict, role overload, job insecurity, work–family conflict, environmental uncertainty, and situational constraints. Overall, we obtained a negative mean correlation between each job performance measure and each stressor included in our analyses. As hypothesized, role ambiguity and situational constraints were most strongly negatively related to performance, relative to the other work-related stressors. Analysis of moderators revealed that (a) the negative correlation of role overload and performance was higher among managers relative to nonmanagers; (b) publication year moderated the relation of role ambiguity and role overload with performance, although in opposite directions; (c) the correlations obtained for published versus unpublished studies were not significantly different; and (d) using the Rizzo et al. scale of role ambiguity and role conflict decreased the magnitude of the correlations of these stressors with performance, relative to other scales. Theoretical contributions, future research directions, and practical implications are discussed. [ABSTRACT FROM AUTHOR] Copyright of Personnel Psychology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Concerns related to the complex issue of nursing turnover continue to challenge healthcare leaders in every sector of health care. Voluntary nurse turnover is shown to be influenced by a myriad of inter-related factors, and there is increasing evidence of its negative effects on nurses, patients and health care organizations.
The objectives were to conduct a comprehensive review of the related literature to examine recent findings related to the issue of nursing turnover and its causes and consequences, and to identify on methodological challenges and the implications of new evidence for future studies.
A comprehensive search of the recent literature related to nursing turnover was undertaken to summarize findings published in the past six years.
Electronic databases: MEDLINE, CINAHL and PubMed, reference lists of journal publications.
Keyword searches were conducted for publications published 2006 or later that examined turnover or turnover intention in employee populations of registered or practical/enrolled or assistant nurses working in the hospital, long-term or community care areas. Literature findings are presented using an integrative approach and a table format to report individual studies.
From about 330 citations or abstracts that were initially scanned for content relevance, 68 studies were included in this summary review. The predominance of studies continues to focus on determinants of nurse turnover in acute care settings. Recent studies offer insight into generational factors that should be considered in strategies to promote stable staffing in healthcare organizations.
Nursing turnover continues to present serious challenges at all levels of health care. Longitudinal research is needed to produce new evidence of the relationships between nurse turnover and related costs, and the impact on patients and the health care team.
A meta-analytic study investigated the causal relationships among job satisfaction, behavioral intentions, and nurse turnover behavior. A theoretical model was proposed in which behavioral intentions were viewed as a direct antecedent to turnover behavior. Job satisfaction was expected to be indirectly related to turnover by virtue of the mediating role of behavioral intentions. Consistent with these expectations, a strong positive relationship was indicated between behavioral intentions and turnover; a strong negative relationship between job satisfaction and behavioral intentions; and a small negative relationship between job satisfaction and turnover. The results of the modifier analysis suggested that effect sizes are fairly robust to differences in study designs, response rates, and methods of measuring job satisfaction, but the manner in which behavioral intentions were operationalized appeared to moderate the relationship between behavioral intentions and turnover and job satisfaction. Of variables related to nursing job satisfaction, work content and work environment had a stronger relationship with job satisfaction than economic or individual difference variables.
The purpose of this study was to describe the magnitude of the relationships between nurses' job satisfaction and the variables most frequently associated with it. A meta-analysis of data from 48 studies with a total of 15,048 subjects revealed that job satisfaction was most strongly associated with stress (-.609) and organizational commitment (.526). Seven variables had correlations between .20 and .50: communication with supervisor, autonomy, recognition, routinization, communication with peers, fairness, and locus of control. Four other variables frequently included in these studies had low correlations (less than .20): age, education, tenure, and professionalization. The influence of employment site, date of study, and measures used on the size and consistency of estimates was described.
This review of the nursing literature aims to identify the factors with the greatest influence on turnover and absence of qualified nurses, possible common factors influencing both, and the relationship between absence and turnover. A hypothetical model grounded in the literature which depicts the expected relationships between these variables is presented for testing in an empirical study. The review identifies intent to stay in current employment as the variable with the greatest influence on turnover. Intent to stay is in turn most strongly associated with job satisfaction. Other variables are identified by single studies as having an influence on intent to stay, but are not supported by the results of other studies; exceptions are pay, opportunity for alternative employment and kinship responsibility, which are supported by the results of two studies. The relationship between job satisfaction and absence is unclear and requires further investigation. However, job satisfaction is identified as possibly influencing both absence and intent to stay and kinship responsibility is identified as a common antecedent of absence and intent to stay. Similarly, absence is identified as an antecedent to turnover. Thus, it is expected that absence would be positively related to turnover and negatively related to intent to stay. Understanding such relationships should allow identification of management strategies to reduce both turnover and absence.
A meta-analytic study was conducted to investigate the causal relationships among individual, organizational and environmental factors related to nurses' intention to stay at or leave their jobs in Taiwanese hospitals. A total of 129 studies related to nursing turnover from 1978-1998 were reviewed. A total of 4032 subjects were selected for the study. Data were integrated by estimation of parametric correlation coefficients, and analyzed using Friedman's two-way analysis of variance by ranks following weight adjustment of sample size and estimation of correlation effect on size of variables. The results of this study merit attention by nursing administrators in order to develop strategies for stabilizing the nursing work force.
Health care leadership continues to run under a transactional style that may be causing nurses to leave the system. Nurses no longer wish to stay in the profession perhaps because they struggle ideologically with the system in which they work. However, nurses may hold the key to transforming health care and dragging it into the 21st century in terms of work practices and reform. This is because nurses are visionary, creative, involved in decision making at patient level and have gender based qualities, and communication strategies that the health care sector needs. In contrast to transaction leadership, transformational leadership and team development has a positive affect on communication and team building. The later style is ideologically suited to nurses and may ensure the future of nurses and nursing in the health care sector. The case study described in this paper was an actual working environment and one that I came across all too often as a registered nurse and clinical educator.
The first few months of nursing have the potential to be the most challenging and stressful for new nursing graduates. The purpose of the present study was to examine sources of, and changes in, role stress 2-3 months after employment, and 11-12 months later in new graduate nurses. This study also investigated the relationship between job satisfaction and role stress. A factor analysis demonstrated that role ambiguity was the most salient feature of role stress in the first few months, while 10 months later, role overload was the most important factor explaining variance in role stress scores. There was no significant change in role stress scores over time. For the first survey, job satisfaction was significantly negatively correlated with role ambiguity and role stress. In the second survey there was still a significant negative correlation between role ambiguity and job satisfaction, but no significant correlation between role overload and job satisfaction. The findings are discussed in terms of implications for nursing education, practice and future research.
Nurse job dissatisfaction has been the primary predictor of intent to leave; however, although many predictors of job satisfaction have been identified, little is known about the influence of variable nurse attitudes, such as psychological empowerment and hardiness, on job satisfaction.
The purpose of this study was to investigate the relative influence of nurse attitudes, context of care, and structure of care on job satisfaction and intent to leave.
A nonexperimental, predictive design evaluated these relationships in a nonrandom sample of 90 registered staff nurses using instruments with known psychometric properties.
The major predictor of intent to leave was job dissatisfaction, and the major predictor of job satisfaction was psychological empowerment. Predictors of psychological empowerment were hardiness, transformational leadership style, nurse/physician collaboration, and group cohesion.
Results supported the influence of nurse attitude on job satisfaction relative to other contributing factors.
Stress perception is highly subjective, and so the complexity of nursing practice may result in variation between nurses in their identification of sources of stress, especially when the workplace and roles of nurses are changing, as is currently occurring in the United Kingdom health service. This could have implications for measures being introduced to address problems of stress in nursing.
To identify nurses' perceptions of workplace stress, consider the potential effectiveness of initiatives to reduce distress, and identify directions for future research.
A literature search from January 1985 to April 2003 was conducted using the key words nursing, stress, distress, stress management, job satisfaction, staff turnover and coping to identify research on sources of stress in adult and child care nursing. Recent (post-1997) United Kingdom Department of Health documents and literature about the views of practitioners was also consulted.
Workload, leadership/management style, professional conflict and emotional cost of caring have been the main sources of distress for nurses for many years, but there is disagreement as to the magnitude of their impact. Lack of reward and shiftworking may also now be displacing some of the other issues in order of ranking. Organizational interventions are targeted at most but not all of these sources, and their effectiveness is likely to be limited, at least in the short to medium term. Individuals must be supported better, but this is hindered by lack of understanding of how sources of stress vary between different practice areas, lack of predictive power of assessment tools, and a lack of understanding of how personal and workplace factors interact.
Stress intervention measures should focus on stress prevention for individuals as well as tackling organizational issues. Achieving this will require further comparative studies, and new tools to evaluate the intensity of individual distress.
The United Kingdom (UK), alongside other industrialised countries, is experiencing a shortage of nurses partly due to low retention rates. Job satisfaction has been highlighted as a contributing factor to intent to leave and turnover, yet this is a complex area with many elements affecting its measurement.
The aim of this paper is to explore the impact of job satisfaction components on intent to leave and turnover for hospital-based nurses in order to identify the most influential factors.
To achieve this, a systematic search of the literature was undertaken to identify relevant international research. Three databases (i.e. BNI, CINAHL and PsychInfo) were utilised, resulting in nine articles that met the inclusion criteria. Four recurrent themes were identified in the literature: leadership, educational attainment, pay and stress.
The key findings suggest that stress and leadership issues continue to exert influence on dissatisfaction and turnover for nurses. Level of education achieved and pay were found to be associated with job satisfaction, although the results for these factors were not consistent.
Investigating possible changes over time in sources of dissatisfaction revealed that factors related to the work environment rather than individual or demographic factors were still of most importance to nurses' turnover intentions. The differences found to occur across work settings necessitates analysis of job satisfaction at ward level, and the contribution of qualitative methods to develop more detailed insight is emphasised. The inconsistent findings over time associated with the effects of educational attainment and pay on intent to leave suggest that it is imperative that sources of job satisfaction are reassessed in the light of ongoing changes.
Although several variables have been correlated with nursing job satisfaction, the findings are not uniform across studies. Three commonly noted variables from the nursing literature are: autonomy, job stress, and nurse-physician collaboration. This meta-analysis examined the strength of the relationships between job satisfaction and autonomy, job stress, and nurse-physician collaboration among registered nurses working in staff positions. A meta-analysis of 31 studies representing a total of 14,567 subjects was performed. Job satisfaction was most strongly correlated with job stress (ES = -.43), followed by nurse-physician collaboration (ES = .37), and autonomy (ES = .30). These findings have implications for the importance of improving the work environment to increase nurses' job satisfaction.
In an effort to better understand turnover rates in hospitals and the effect of new nurses on them, this study sought to describe the characteristics and attitudes toward work of newly licensed RNs, a population important to both the nursing profession and the health care system.
A survey was mailed to a random sample of new RNs in 35 states and the District of Columbia. A total of 3,266 returned surveys met the inclusion criteria, for a response rate of 56%. RNs who qualified had completed the licensing examination and obtained a first license between August 1, 2004, and July 31, 2005. Data pertaining to four areas were collected: respondent characteristics, work-setting characteristics, respondents' attitudes toward work, and job opportunities. Respondents who were not working were asked to specify why.
Of the eligible newly licensed RNs, 58.1% had an associate's degree, 37.6% had a bachelor's degree, and 4.3% had a diploma or a master's or higher degree as their first professional degree. They were generally pleased with their work groups but felt they had only moderate support from supervisors. About 13% had changed principal jobs after one year, and 37% reported that they felt ready to change jobs. More than half of the respondents (51%) worked voluntary overtime, and almost 13% worked mandatory overtime. Also, 25% reported at least one on-the-job needlestick in a year; 39%, at least one strain or sprain; 21%, a cut or laceration; and 46%, a bruise or contusion; 62% reported experiencing verbal abuse. A quarter of them found it "difficult or impossible" to do their jobs at least once per week because of inadequate supplies.
This study provides descriptive evidence that a majority of newly licensed RNs are reasonably satisfied and have no plans to change jobs, but the group is not homogeneous. The negative attitudes expressed in response to some survey questions suggest that newly licensed RNs may not remain in the acute care settings where they start out. Investing in better orientation and management may be the key to retaining them in hospitals. The authors will be following these RNs for two years and will develop predictive models of turnover rates.
To investigate: (1) relationships between job stress, recognition of nurses' performance, job performance and intention to stay among hospital nurses; and (2) the buffering effect of recognition of staff performance on the 'stress-intention to stay at work' relationship.
Workplace stress tremendously affects today's workforce. Recognition of nurses' performance needs further investigation to determine if it enhances the level of intention to stay at work and if it can buffer the negative effects of stress on nurses' intention to stay at work.
The sample of the present study was a convenience one. It consisted of 206 Jordanian staff nurses who completed a structured questionnaire.
The findings of the study indicated a direct and a buffering effect of recognition of nurses' performance on job stress and the level of intention to stay at work.
The results of the study indicated the importance of recognition for outstanding performance as well as achievements. Implications for nursing management The results of this study support the need to focus on the implementation of recognition strategies in the workplace to reduce job stress and enhance retention.