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The authors discuss the objectives of compensation programs--including direct and indirect forms of reward--and employee motivation. Job descriptions and job evaluations are also explored.
It is widely acknowledged that many critically ill patients are managed outside of designated critical care units. One strategy adopted in Australia and England to assess and manage risk in these patients is the intensive care unit (ICU) outreach or liaison nurse service. This article examines how ICU outreach/liaison roles in Australia and England operate in the context of Manley's theoretical framework for advanced nursing practice. Descriptive case study design using semi-structured interviews and job descriptions as sources of evidence. Findings of interviews with six Australian ICU Liaison nurses are already published; this study replicated the Australian study with four ICU Consultant Nurses in England and mapped interview and job description data from both countries onto Manley's conceptual framework for advanced practice/consultant nurse. Four themes emerged from the English data: patient interventions, support for ward staff, liaison between ward and ICU staff and hospital-wide impact. The first three of these comprised the core service common to the roles in both countries. Manley's four subroles (expert practitioner, consultant, educator and researcher) were present across both countries. However, the interview and job description data demonstrated that there were lower expectations in Australia that the roles would lead to staff development and build capacity across the hospital system. Similarly, formal education for ward staff such as ALERT and CRiSP courses were more developed in UK. Our data demonstrate that the role undertaken in England and Australia is sufficiently comparable to use as a research intervention in international studies across the two countries. However, the macro service level differs. Job descriptions across both countries emphasized the need to influence hospital policy; however, the ICU consultant nurses in England might be considered better placed to achieve this through role title and access to the hospital executive. In both countries, the roles would benefit from systematic evaluation of the impact on outcomes. This is particularly important for longer-term integration of the role in the health services in both countries.
THE JOB DESCRIPTION: Describes how the dentist wants to use that person in the practice, adapted by communication and the resourcefulness of the employee. A hygienist is trained with a particular philosophy. The practice philosophy is generally something that has developed without the help of the hygienist's philosophy, but none the less both need active manipulation and respect. The job description described here has changed rapidly and will continue to evolve as we communicate, educate and change to try to improve our overall service and delivery. THE CONTRACT: Now that an understanding has been reached as to both hygienist's's and dentist expectations, a contract for employment is required. The Employment Act in New Zealand has determined that this is essential. It is difficult to determine a contract without the job description. A contract should have a time-frame and be concise. It should be firm and binding whereas the job description should be flexible. The contract should have a clause which takes account of the flexibility and developing nature of the job description. The job description can be a baseline not only for the hygienist, but for the communication necessary to develop and improve team systems and programmes. The contract and its renewal is just one of those systems. The changes to a contract can only occur on renewal, but this doesn't mean to say you can't both tear it up and start again. The rapid changes that occur in modern dentistry cannot all be accounted for and there will always be the missing clauses. Your teamwork and communication will reduce these, and help promote a more satisfactory, comfortable and less stressful work environment.
This paper analyzes nursing job descriptions that compose a career ladder. These job descriptions, an ethnomodel of expertise, are compared to the Dreyfus model that describes five stages of skill acquisition. While the Dreyfus model posits the replacement of analytic reasoning with intuitive response as the characteristic of expert practice, the ideal posited in the nursing model places theoretical knowledge at the apex. Nursing job descriptions can best be understood in the context of this profession's search for greater power and legitimacy.
OBJECTIVE: THE PURPOSE OF THIS STUDY WAS TO DETERMINE: 1) demographics and professional credentials of recently hired athletic trainers, 2) the association between these characteristics and the high school, clinical, and collegiate setting, and 3) which of these factors best predicted salary. DESIGN AND SETTING: A survey was sent to all prospective employers. Of the 472 surveys sent, 282 (60%) were returned. SUBJECTS: Prospective employers who were listed on the NATA job vacancy notices from January 1, 1994 to October 1, 1994. MEASUREMENTS: Employers selected a job description for their position opening and indicated the characteristics of the people they hired. The job descriptions were placed into three categories. A chi-square analysis was used to determine the degree of association between applicant characteristics and job descriptions. Employee characteristics were coded and a stepwise multiple regression analysis was performed to determined which of the characteristics best predicted salary. Analyses of variance were performed to determine differences among the three practice settings and as follow-up analyses to the multiple regression. An analysis of variance was also performed to compare salaries based on job description and teaching responsibilities. RESULTS: No association was found between the employment setting and gender, ethnicity, marital status, educational route, physical therapy, credential, or EMT certification. There was an association between the CPR instructor's credential and employment setting and between highest degree attained and employment setting. CONCLUSIONS: The results suggest that these factors were most closely associated with employment in the collegiate setting. With regard to salary, it was determined that a doctoral degree, a master's degree, and marital status were the best predictors of salary.
BACKGROUND AND OBJECTIVE: The Centers for Disease Control and Prevention has published a new guideline on hand hygiene promoting the use of the alcohol-based handrub, but the technique was not addressed. The goal of this study was to evaluate the influence of technique on the efficacy of the alcohol-based handrub. PARTICIPANTS: Healthcare workers (HCWs) attending a course in hospital epidemiology. METHODS: A fluorescent dye was added to a hand antiseptic, and hands were checked under ultraviolet light after antiseptic cleansing. Data regarding the numbers of predefined fluorescent areas on the skin were collected in addition to demographic data such as age, gender, job description, and job experience. Results of the visualization test were compared with the data from microbiological samples before and after the procedure by the hand plate technique. RESULTS: Sixty HCWs were tested, 63% of whom had worked in infection control for more than 10 years. Sixty-six percent of all participants still had detectable bacteria after antisepsis. The mean log10 CFU reduction was 2.0 (range, 0-3.85). Twenty-five percent of all HCWs achieved less than 1.1 log10 CFU. Staphylococcus aureus was isolated from 13% (one of them being methicillin resistant) and gram-negative bacilli from 6.7%. After using the alcohol handrub, one subject still remained positive for S. aureus. Years of experience was the single most important factor predicting antimicrobial efficacy. CONCLUSIONS: Technique is of crucial importance in hand antisepsis. Major deficiencies were detected among even highly trained HCWs. Training should be provided before switching from handwashing to the alcohol handrub
BACKGROUND: This survey was conducted to obtain information about career and practice issues facing pediatric emergency medicine (PEM) physicians and general emergency medicine (GEM) physicians. We hypothesized that PEM physicians work fewer clinical hours and perform more teaching and research in their positions than GEM physicians. METHODS: Two surveys sponsored by the Future of Pediatric Education II Project were sent to 1545 emergency physicians identified by the American Board of Pediatrics, the American Academy of Pediatrics, and the American College of Emergency Physicians between October 1997 and February 1998. Data on demographics, job description, recent job changes, and career expectations were obtained and analyzed using Student t test or Welch analysis of variance for continuous variables and chi2 for categorical data. P values less than 0.05 were considered significant. Comparisons between PEM and GEM physicians were adjusted using analysis of covariance to control for the effect of medical school affiliation. RESULTS: Effective response rate was 934 (64%) of 1451. A total of 705 (75%) respondents identified themselves as a PEM physician, and 229 (25%) identified as a GEM physician. PEM physicians were younger (41.0 y vs 45.1 y) and more likely to be women (44% vs 15%, P < 0.0001 for both). Children younger than 18 years made up 80.9% and 28.6% of patients seen by PEM and GEM physicians, respectively (P < 0.001). Seventy-nine percent of PEM physicians and 42% of GEM physicians held an academic appointment (P < 0.0001). No differences were found for full-time equivalents per physician group (9.7 vs 9.1) or clinical hours spent in the emergency department (ED) (31.5 vs 32.7) when means were adjusted for academic appointment. During ED clinical activities, PEM physicians reported more time spent supervising trainees (34% vs 16%, P < 0.0001), and GEM physicians reported more time spent in direct patient care (77% vs 57%, P < 0.0001). Total clinical hours worked per week were greater for GEM physicians (37.9 vs 35.3, P < 0.05). PEM physicians spent more time than GEM physicians teaching (12% vs 8%, P < 0.005) and conducting clinical research (5% vs 2%, P < 0.0003). Of PEM and GEM physicians combined, 26% reported a job change in the past 3 years. Extended reduction of ED clinical duties occurred most commonly because of child care issues and was reported more commonly by women than men (53% vs 6%, P < 0.0001) irrespective of PEM or GEM practice. The likelihood of leaving emergency medicine practice within 5 years increased with age for both groups: 10% of PEM and GEM physicians under 40 years old anticipated leaving practice versus 30% of those older than 50 years (P < 0.0001). PEM physicians were more likely than GEM physicians to predict an increased need for additional pediatric subspecialists in general (60% vs 26%, P < 0.001) and for pediatric subspecialists in their discipline (54% vs 17%, P < 0.001). PEM subspecialists were twice as likely as GEM specialists to perceive competition in their subspecialty (60% vs 31%, P < 0.001). CONCLUSIONS: According to our sample, GEM and PEM physicians worked the same number of clinical hours in the ED but reported significant differences in how those hours are spent. Job changes and extended leaves were common in both groups. These results suggest that PEM and GEM physicians face similar vocational challenges, especially in the areas of balancing of family time, clinical hours, and academic productivity. These data also have important implications for workforce projection for the PEM physician supply, given the current estimated attrition rate, frequency of leave from clinical duties, and projection for increased need for PEM physicians in the future.
As hospitals convert from conventional image processing to picture archiving and communication systems (PACS) technology, new job opportunities arose for PACS analysts, PACS system administrators, PACS operators, and PACS trainers. To support a PACS, these positions require education in computer information systems and work experience in information technology. At Texas Children's Hospital, new roles for radiologic technologists (RT) in supporting the operation of PACS were not recognized until after implementation of the filmless system. A new position entitled PACS technologis was created, but roles and responsibilities largely were undefined. The inadequate job description contributed to problems with appropriate utilization of the PACS technologist. The primary role of the technologist was nebulous, and the priority of tasks was undefined. There was an excessive volume of information and technology to be mastered. The role represented a new paradigm, so no template for the job description was available that encompassed the array of functions to be performed. The result was a "morph" of the RT and PACS analyst job descriptions that was contrived and unworkable. The role of the PACS technologist is vital to the operation of the radiology department that uses PACS. There is a well-established need for cross training of RTs in PACS. PACS technology is not taught in RT training programs. There are recurrent communications problems between RT and Information Technology (IT) personnel. The PACS technologist can participate in a number of activities that improve the overall level of proficiency in the imaging operation, such as specialized PACS training for RTs, collection and analysis of quality control data, and planning for installations of PACS acquisition modalities. RTs have acquired knowledge of medical terminology and human anatomy, imaging modalities, and workflow. These qualifications constitute a common basis for communication with other RTs, physicians, and other health care providers. In addition the appropriate candidate for PACS technologist should have computer software and hardware knowledge, interpersonal skills, oral and written communications skills, and analytical skills to troubleshoot issues. This report will describe the evolution of a more accurate job description for the PACS technologist, the relationship between the PACS technologist and the RT supervisor, and specific tasks are appropriate for the PACS technologist to perform.
PURPOSE: This study was designed to create a job description for Korean geriatric care managers and examine performance frequency, importance, and difficulty of task elements. METHOD: The sample consisted of 38 geriatric care managers and professors who performed duties related to geriatric care management at community based-facilities in Korea. A survey method was used, and the questionnaire included frequency, importance, and difficulty of task elements in job descriptions using the DACUM method. Using SPSS WIN 10.0, descriptive statistics such as frequency distribution, means, and standard deviation were conducted to examine the subject's general characteristics, frequency, importance, and difficulties of task performance. RESULT: The job description of geriatric care managers revealed 10 duties, 34 tasks, and 105 task elements. On all ten duties, the average performance frequency, importance, and difficulty was 2.55, 2.21 and 2.43 respectively. CONCLUSION: The job description of geriatric care managers includes duty, task, and task elements and the definition of a completed job. Thus we recommend a data based trial to confirm and validate the information gathered.
PURPOSE: This study was designed to create the job description of Korean transplantation nurse practitioner and examine performance frequencies, criticality, and difficulties of task elements. METHOD: The sample consisted of 63 nurses and coordinators who performed duties related to transplantation at medical center in Korea. A survey method was used, and the questionnaire included frequencies, criticality, and difficulties of task elements in job description by the DACUM method. Using SPSS WIN 10.0, descriptive statistics such as frequency distribution, means, and standard deviations were conducted to examine the subject's general characteristics, the frequencies, criticality, and difficulties of task performance. RESULT: The job description of transplantation nurse practitioners revealed 5 duties, 22 tasks, and 85 task elements. On the all five duties, the averages of the performance frequency, criticality, and difficulty were 2.41, 3.38, and 2.78, meaning that the respondents rarely perform the 5 duties, but consider them critical and easy to perform. CONCLUSION: The job description of the transplantation nurse practitioner included duty, task, and task element and definition of job completed. Thus we recommended a data based trial to confirm and validate the information gathered.
There has been a growing recognition of work-related stress among nurses in Cameroon that has contributed to job dissatisfaction and high turnover. This study, which was conducted with 158 nurses in three major hospitals and three rural health centers in the Northwest Province of Cameroon, examined whether there were significant differences in job satisfaction between nurses in urban hospitals and rural community health settings in the six major components of the job: work, pay, promotions, supervision, co-worker relationships, and the job in general. A convenience sample of 158 staff nurses grouped into three categories (nurses' aides, registered nurses, and state registered nurses), volunteered to participate in this study. These nurses differ by level of educational preparation of 1, 2, and 3 years, respectively. The Job Descriptive Index questionnaires and the Job In General scales were used to measure job satisfaction. These data were analyzed with inferential statistics. Focus group interviews with 10 nurses were also done, and content analysis was used to analyze the data. The major findings indicated significant differences between job satisfaction and type of healthcare work setting, level of professional education, gender, years of service, and age group. These results are useful for nurse educators, administrators, and researchers in the formulation and implementation of effective health policies for nurses and health care organizations. This study also provided the groundwork for a future cross-cultural study of nurses in the United States and Cameroon.
This article reports the findings of a 3-year study that assessed the job satisfaction of nursing personnel in a rural nursing center that uses a differentiated practice model. Job satisfaction was measured using the Brayfield Job Satisfaction Questionnaire, the McCloskey/Mueller Satisfaction Survey, and the Job Descriptive Index. A high level of job satisfaction was found across all 3 years. Factors associated with job satisfaction are also described. The findings of this study add to the growing body of literature on the importance of differentiated practice in creating satisfying work environments.
This study was conducted to determine the possible influence of job characteristics on job satisfaction of pediatric nurses. Eighty-nine pediatric nurses working in the pediatric units of the Maternity and Children Hospital in Jeddah, Saudi Arabia comprised the subject of the present study. A questionnaire of three parts was synthesized for this study. Part I is a multifaceted measure of job satisfaction (Smith et al., 1969) and known as job Descriptive Index. Part II is a job Characteristics Inventory (J.C.I) of 30 items developed by (Sims et al., 1976) to determine nurses perception of six characteristics, namely, variety, autonomy, task identity, feed back, dealing with others, and friendship opportunities. Part III comprised five demographic items. The study revealed that the overall degree of satisfaction of pediatric nurses was found to be relatively low with a mean percentage score of only 58.52%. Regarding the five job satisfaction subscales, nature of work (nursing of children) showed the highest mean percentage score. The study illustrates a positive strong correlation between job characteristics and job satisfaction with variety, task identity, and feedback being the statistically significant individual characteristics.