Biomedical subjects
Publications and source records attributed to N Juhl.
In a national study of rural registered nurses, over 3,500 listed family or community-related reasons for practicing in rural areas. On the other hand, at least half stated that job-related factors would influence them to leave their present positions.
Researchers have demonstrated repeatedly the importance of the relationship linking job satisfaction to employee retention. In rural areas of the country, where a persistent maldistribution of nurses continues to hamper health care delivery, the potential benefits of bolstering retention via enhancements in job satisfaction are of utmost utility to administrators and providers alike. Data were gathered from a multistate survey of registered nurses (RNs) practicing in rural hospitals, skilled nursing facilities, and community/public health settings (N = 1,647; response rate = 40.3%). The investigators found that the use of tuition reimbursement corresponded significantly with increased levels of job satisfaction among nurses in all three practice environments, as did day care services for nurses in acute care settings. Also, among hospital-based RNs, level of nursing education was found to be a significant factor in the relationship between tuition reimbursement and job satisfaction, with the highest level occurring among diploma-prepared nurses.
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Death is a reality in the neonatal intensive care setting. This adds to the job stress nurses experience. Although the literature is replete with topics on death and dying, few of these articles are empirically based. The purpose of this study was to determine the stress associated with taking care of babies who die in NICU settings. The responses/coping mechanisms of NICU nurses were also identified. Fifty-nine nurses in an upper mid-western state participated in this study. Nurses reported feelings of helplessness and intense sorrow when a baby dies. As a result, they experienced the physio-emotional responses of chronic fatigue, decreased interest in exercise, irritability, and being overcritical. The greatest help in coping with grieving came through discussion with coworkers, a chaplain, the patient's family, and the nurse's own family. For some, attending the funeral or memorial services also helped. Implications for practice include fostering planned discussion sessions and continued education to improve counseling skills related to bereavement.
It has been suggested that in rural settings, the primary difficulty that faces nursing administrators is recruitment of registered nurses (RNs). This study examines the impact of recruitment strategies and barriers by comparing and contrasting corresponding RN full-time equivalent (FTE) vacancy rates. Data were gathered from a multistate telephone survey of directors of nursing (DONs) practicing in rural hospitals, skilled nursing facilities (SNFs), and public health settings (N = 556, response rate = 89.5%). The investigators found that DONs who perceived scheduling amenities and autonomy enhancements corresponded with RN FTE vacancy rates that were most reduced from the mean of the overall sample. Regarding recruitment barriers, geographic locale/isolation and job-related factors corresponded with RN FTE vacancy rates that were most elevated from the overall sample mean.
In rural practice settings where the task of recruiting new employees is exceedingly difficult, the first step in surviving the nursing shortage should begin with maintaining existing resources. Based on a survey of 2,488 staff registered nurses working in rural community hospitals, the authors compare personal, demographic, and practice characteristics of nurses by their self-reported intentions to stay in their present positions. Specific areas of job dissatisfaction that best distinguish those who anticipate leaving in 1 year from those committed to remaining in their present job for 5 years or more are identified.
This study compared the frequency of blood pressure elevation in a selected Native American and white population. Three hundred individuals participated: 87 Native Americans, 210 whites, and 3 others. Data were gathered using a questionnaire that addressed residence, sex, age, race, occupation, height, smoking, alcohol use, tea/coffee consumption, medications, and past or present illness. Weight and blood pressure were measured by the researchers at the time of data collection. The sample mean for systolic blood pressure (SBP) was 124 mm Hg (SD 14.78) and diastolic blood pressure (DBP) was 77 mm Hg (SD 10.13). One-way analysis of variance showed age groups and sex to affect blood pressure significantly (P = 0.0001). Stepwise multiple regression indicated weight significantly predicted blood pressure (SBP multiple R = 0.39, P = 0.001; DBP multiple R = 0.43, P = 0.00001). The interaction of age, sex, tobacco, alcohol, and caffeine influenced SBP and DBP. Obviously, these findings have limited generalizeability due to the sampling frame used in this study.
Based on Vroom's expectancy theory, this study was conducted to identify differences in job satisfaction between nurses working in public health settings, and staff nurses and administrators working in both settings. Questionnaires containing an adaptation of a job satisfaction scale were mailed to all 258 registered nurses practicing in public health and home health settings (response rate 57%) in a rural midwestern state. Respondents were asked to rate their satisfaction with various dimensions of their jobs, as well as how important each aspect was to them. Although both groups of nurses reported low satisfaction with salary, public health nurses were significantly less satisfied with their salaries than were home health nurses (F = 32.96, P < or = 0.001); home health nurses, however, were significantly less satisfied with benefits/rewards (F = 11.85, P < or = 0.001), task requirements (F = 8.37, P < or = 0.05), and professional status (F = 5.30, P < or = 0.05). Although administrators did not differ significantly from staff nurses on job satisfaction, they did perceive organizational climate (F = 4.50, P < or = 0.05) to be an important feature of satisfaction. These differences may be partially explained by divergent salaries, roles, and responsibilities between public health and home health nurses.
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Total blood cholesterol (TBC) levels and contributory risk factors in an adolescent population were investigated. Existing TBC screening records were reviewed on 452 10th grade students in two schools. The sample consisted of 52% males and 48% females whose mean age was 15.47 years. Blood samples were analyzed by the Reflotron. Risk factors investigated included age, gender, ethnicity, individual and family history of high cholesterol, history of high blood pressure, smoking tobacco products, and oral contraceptive use. The sample mean for TBC was 150.61. The only significant factors identified by ANOVA were gender and use of oral contraceptives. Females had higher TBC levels than males, and females who used oral contraceptives had higher TBC levels than nonusers.
A correlation between job satisfaction and employment longevity has been demonstrated by a number of researchers. However, the measurable aspects of job satisfaction only partially explain an individual's tenure at a particular job. Information about the relationship between job satisfaction and retention of community health nurses in a rural state was provided by 258 community health nurses in North Dakota who responded to a mailed questionnaire. Job satisfaction assessment included measures of autonomy, task requirements, salary, benefits, rewards, professional status, organizational climate, and interpersonal interactions. Job satisfaction was analyzed by taking into account the individual importance of each component. While the majority (61%) of the responding nurses indicated that they expected to stay in their current jobs for a period of five years or more, they were dissatisfied with various aspects of their jobs. The greatest factor influencing the nurses' choice of current position was job availability, followed by preferences for the particular health care agencies or communities. These findings indicate that retention of rural nurses should focus on strategies that go beyond improving job satisfaction.
This study examines the supply and selected characteristics of nurses working in nonmetropolitan areas of the United States using the most recent data reported in the third national sample survey of registered nurses in 1988. Nursing supply is analyzed in terms of the ratio of registered nurses per 100,000 people for three standard nonmetropolitan census county size classifications and nine regional groupings of states. Seven dimensions relating to the educational background and current professional characteristics of registered nurses are studied. Findings indicate a notable difference in the ratio of nurses per population across county size and regions of the country. In terms of characteristics selected for this study, the educational background, salary gap, and time spent in various activities differentiate nurses in rural areas from those working in urban counties. Results of this study should be particularly relevant because a variety of educational, financial, and other incentives are being considered to address what is perceived to be a crisis in rural nursing availability.
The costs and impacts associated with the recruitment and retention of nurses are substantial. In rural areas, these efforts are hampered by the recurring maldistribution of available nurses away from such environments. Based on a survey of 195 directors of nursing (DONs) practicing in rural community hospitals, the authors compare administrative assessments of recruitment and retention efforts of DONs practicing in various-sized rural facilities. Current full-time equivalent registered nurse staff vacancy rates are also reported in relation to these differing assessments.
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A number of researchers have suggested that nursing shortages are closely related to geographic maldistribution, specialty areas, and even individual shifts. As these findings have documented, the nursing shortage, as defined by the federal government, exists predominantly in rural areas of the country that are not adjacent to metropolitan areas. As a result, many of the economic, demographic, and health-related disparities that exist between rural and urban populations are mirrored in shortage and nonshortage counties. Higher unemployment rates and lower per capita incomes suggest an underlying relationship between economic vitality and the recruitment and retention of health care personnel. This suggests that a fundamental obstacle to staffing adequate numbers of qualified nurses in rural areas may not be a shortage of nurses, but economic barriers (domestic and health care related) deeply rooted in the rural settings themselves. In those states burdened with significant shortage areas, emphasis must be placed on easing the maldistribution of available nurses away from rural, often medically underserved settings. However, while the notion of producing appropriate "types" of nurses is well founded, the temptation to "solve" the problem simply by producing more providers should be resisted, since it will not markedly benefit those areas that are currently in greatest need. The time frame necessary for such "trickle down" approaches to affect rural areas could, when combined with other factors, render many health care delivery systems virtually unsalvageable. To address the persistent distribution problem, we could change how health professionals are educated.(ABSTRACT TRUNCATED AT 250 WORDS)