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PubMed1997

A descriptive study of the role of the oncology nurse practitioner.

PURPOSE/OBJECTIVES: To describe the characteristics and activities of nurse practitioners (NP) with a focus in oncology. DESIGN: Descriptive. SAMPLE: 129 NPs employed in an oncology setting who completed on NP program and were functioning in the NP role. METHODS: Subjects completed an eight-page, self-administered questionnaire comprised of fixed-choice and open-ended questions. MAIN RESEARCH VARIABLES: Demographics, employment settings, populations served, advanced practice subroles, clinical functions, practice privileges, reimbursement issues, job descriptions, performance appraisals, job satisfaction, and facilitators/barriers to role implementation. FINDINGS: The majority of oncology NPs (ONPs) were located in the eastern United States in university-affiliated hospitals. The most common patient population served by the respondents was adults in the medical oncology outpatient setting. More than three-quarters of the respondents worked from protocols, almost two-thirds performed procedures traditionally performed by physicians, and approximately half had prescriptive authority. Few NP respondents reported that they obtained direct reimbursement for their services from third-party payors. Physicians were cited as the most facilitative of the NP role, and administrators were cited as the most frequent barrier. The vast majority of the respondents were satisfied with their roles. IMPLICATIONS FOR NURSING PRACTICE: The NP role in oncology is established and expanding. The scope of practice and more detailed characterization of the role is an area for future research. Data on the effectiveness of ONPs, particularly regarding cost-effectiveness, quality of care, and patient satisfaction, are needed to maintain their viability within the healthcare system.

Adult↗
PubMed1982

Some challenges in the management of community health education.

Health Educators are often expected to fill managerial roles yet are not always trained in management skills. The Health Educator's role is constantly changing but training has not always kept up, especially in the area of management. Job descriptions are often less than adequate and coordination between the jobs and the training institution could be better. Health Educators, due to frustration caused by inadequate role definition, may choose administration as a career as it is easier identified. Barriers to successful management can also be frustrating for the Health Educator, i.e., political constraints, lack of skills, etc. Planning should be a major activity of any Health Education program in order to ensure a successfully managed Health Education project.

Health Education↗
PubMed1998

Occupational chlorophenol exposure and soft tissue sarcoma risk among men aged 30-60 years.

To evaluate the association of chlorophenol exposure with soft tissue sarcoma risk independent of phenoxyherbicide exposure, the authors analyzed data from the Selected Cancers Study, a population-based case-control study that included 295 male soft tissue sarcoma cases, aged 32-60 years, from eight population-based cancer registries and 1,908 male controls. Chlorophenol exposure was assigned using both an intensity and a confidence estimate by an industrial hygienist based on verbatim job descriptions. Seventeen percent of the jobs rated as high intensity involved wood preservation, while 82% involved cutting oils. Soft tissue sarcoma risk, modeled using conditional logistic regression, was significantly associated with ever having high-intensity chlorophenol exposure (odds ratio = 1.79, 95% confidence interval 1.10-2.88). A duration-response trend was evident among more highly exposed subjects (p for trend < 0.0001). For subjects with 10 or more years of substantial exposure, the odds ratio was 7.78 (95% confidence interval 2.46-24.65). These results suggest that chlorophenol exposure independent of phenoxyherbicides may increase the risk of soft tissue sarcoma. Because of the large number of machinists in the exposed group and the complex composition of cutting fluids, it is possible that another exposure involved in machining is responsible for the observed excess risk.

Adult↗
PubMed1999

A comparison of job satisfaction among nursing assistants in nursing homes and the Program of All-inclusive Care for the Elderly (PACE).

Three hundred forty-nine full-time nursing assistants (NAs) in 5 PACE programs and their neighboring nursing homes were surveyed to assess job satisfaction. There were no significant differences between NAs in the two models of care with respect to demographics, job description, or importance placed on job elements. Job satisfaction, however, was higher among the PACE NAs. PACE NAs reported a significantly higher prevalence of the chance to form close relationships with patients, variety, respect for suggestions by people who make decisions about patient care, the chance to use one's own judgment, the chance to discuss patients with other team members, and respect for choices in assignment type.

Adult↗
PubMedDate not supplied

Nursing home administrators' level of job satisfaction.

Job satisfaction has been shown to have a direct relationship to the quality of work. Are nursing home administrators satisfied with their work? How do they compare with their counterparts in other industries? The results of this survey, using the Job Description Index (JDI) and the Job in General (JIG) scale as published by Bowling Green State University, indicate that nursing home administrators have a more compressed rate of job satisfaction than their counterparts in other industries. They focus their dissatisfaction on their coworkers and pay. They demonstrate dissatisfaction by rotating their positions at a rate of every 31 months. This suggests some significant problems in the development and maintenance of quality care and some areas that could be addressed to raise the level of satisfaction among nursing home administrators.

Data Collection↗
PubMedDate not supplied

Special considerations for hiring an office manager.

Medical practice office managers come in many varieties. They can be hired from the outside or promoted from within. They can have a great deal of experience working in medical practices or practically none. Which type of office manager is the best choice for your practice? This article will help you decide. It describes three types of office managers and considers the pros and cons of each. It explores the characteristics, advantages, and disadvantages of lay administrators hired from the outside, office managers promoted from the ranks, and "super-aides" who are asked to manage while doing their old jobs. This article also offers a list of 10 characteristics to look for in office manager candidates, as well as six areas of overall responsibility for your office manager. Finally, it includes a quick checklist of 20 required duties of typical medical practice office managers that can help you shape your office manager's job description.

Administrative Personnel↗
PubMedDate not supplied

Selecting the best to be the best: how to gain a competitive edge for your organization, Part I.

This article describes the benefits of good hiring and the costs of poor hiring in a health-care environment. The elements of an effective hiring process are delineated and discussed, including job descriptions; position specifications; the advantages and disadvantages of hiring from within or outside of the organization; and job application, résumé, and telephone screening. Part II will focus on compensation considerations; the selection interview; legal issues in hiring; letting candidates know the results; and orientation of new employees. Keys for success in each of these areas are provided. An outline of the steps in a selection interview as well as specific do's and don'ts in interviewing are provided. The point is made that the selection of a new employee is one of the most important processes in the effective management of any health-care organization. Yet, it is often done in haste, with a sense of urgency and with insufficient attention to the demands of the job, the specific nature of the organization, and the less tangible but critical aspects of the applicants.

Costs and Cost Analysis↗
PubMed1996

Work redesign: making it a reality.

Everyone involved in work redesign must recognize the need to plan for change, thus breaking the myth that new job descriptions primarily affect only the new worker. As part of redesign, specific questions regarding task analysis and job bundling need to be asked. Implementation of a new work design in a medical center applying these principles is described.

Hospital Restructuring↗
PubMed1995

A survey of job stress and job satisfaction among DSAs in the north-west of England.

This study was a survey of job stress and job satisfaction among DSAs in general practice in the north-west of England during 1993. The results suggest that severe overall job stress and dissatisfaction were not prevalent but do present an important problem for a minority. The chief sources of stress are ranked. Those which caused moderate to severe stress were: running behind time, feeling under-valued by the dentist and handling difficult patients. Those experiencing greater stress outside work were more likely to report stress within it. Having a regular staff meeting, an annual salary review and a clear job description were associated with significantly less job stress.

Adult↗
PubMed2004

School nurses: policies, working practices, roles and value perceptions.

BACKGROUND: In the UK, school nursing has recently been at the forefront of policy change, with school nurses being considered pivotal to child-centred public health practice. There is very little literature on this topic and, in particular, little that is written from a practitioner perspective. AIM: This paper reports a survey that examines the work of school nurses compared with the expectations of their first line managers and policy-makers in government, in order to discover any potential practical or ideological areas of conflict. METHODS: We first applied a theoretical framework of sensitizing concepts to the historical, political, cultural and contextual background of school nursing. Following this, 46 school nurses in the West Midlands region of the UK were randomly selected and asked to complete a questionnaire about their personal characteristics, experience, training and working practices. The 38 nurses who completed this were then interviewed. Job descriptions for school nurses and governmental job expectations were obtained from various official sources and compared with the self-reported practices of school nurses. FINDINGS: All the nurses met the work criteria of their local employers, except in respect of health needs assessment activities, which two nurses had not yet attempted. All 38 also carried out a range of additional work activities, including providing sexual health services and parental support clinics. They also had a diverse range of skills and qualifications relevant to supporting the needs of their local communities. Qualitative data from interviews provided a useful insight into nurses' feelings of being valued by their clients and by local and national employers, and feelings of professional undervaluing by their peers. They felt positive about role changes in the last few years, and that they supported the child-centred public health role advocated by public policy. CONCLUSIONS: The practice of the school nurses in this study covered what employers and policy-makers required, with the notable exception of health needs assessment, which nurses were uncomfortable and unconfident about. The theoretical framework used provides a useful starting point for examining how school nursing has developed into its current role.

Attitude of Health Personnel↗
PubMed2006

Determinants of staff job satisfaction of caregivers in two nursing homes in Pennsylvania.

BACKGROUND: Job satisfaction is important for nursing home staff and nursing home management, as it is associated with absenteeism, turnover, and quality of care. However, we know little about factors associated with job satisfaction and dissatisfaction for nursing home workers. METHODS: In this investigation, we use data from 251 caregivers (i.e., Registered Nurses, Licensed Practical Nurses, and Nurse Aides) to examine: job satisfaction scores of these caregivers and what characteristics of these caregivers are associated with job satisfaction. The data were collected from two nursing homes over a two and a half year period with five waves of data collection at six-month intervals. The Job Description Index was used to collect job satisfaction data. RESULTS: We find that, overall nursing home caregivers are satisfied with the work and coworkers, but are less satisfied with promotional opportunities, superiors, and compensation. From exploratory factor analysis three domains represented the data, pay, management, and work. Nurse aides appear particularly sensitive to the work domain. Of significance, we also find that caregivers who perceived the quality of care to be high have higher job satisfaction on all three domains than those who do not. CONCLUSION: These results may be important in guiding caregiver retention initiatives in nursing homes. The finding for quality may be especially important, and indicates that nursing homes that improve their quality may have a positive impact on job satisfaction of staff, and thereby reduce their turnover rates.

Adult↗
PubMed1992

A training project helps the poor. A rural healthcare facility offers job training, gains employees.

As poor Americans look for work, healthcare facilities face a shortage of workers. One facility, Saint Francis Medical Center in Grand Island, NE, found a way to help some of the area's financially disadvantaged persons receive technical training and employment as it eased its own personnel shortage. Saint Francis leaders assembled a team of representatives from the hospital's staff, the Greater Nebraska Job Training Program, Lincoln, and Central Community College, Grand Island, to establish the Rural Allied Medical Business Occupations program. The team reviewed several job descriptions to help it decide which jobs to include in the program and surveyed area hospitals to ensure the positions selected were experiencing shortages. The program received a grant as a demonstration project from the U.S. Department of Education. After identifying participants who had the aptitudes and interests for the jobs, the Rural Medical Allied Medical Business Occupations program arranged for participants' training and assistance with items such as tuition, child care, and transportation. Participants received training at Central Community College and at Saint Francis Hospital. Saint Francis Medical Center deemed the program a success. The hospital has hired seven healthcare workers who would not have been available if they had not been trained through this program. Moreover, the program provides yet another way for the hospital to help fulfill a major portion of its mission: to help the poor.

Allied Health Occupations↗
PubMed1978

The job satisfaction of allied health professionals.

The purpose of this study was to determine how allied health professionals felt about their jobs in general and about specific job facets in particular. Four groups were investigated: (1) medical dietitians; (2) physical therapists; (3) occupational therapists; and (4) medical technologists. When national norms were applied to the median scores obtained on the Job Descriptive Index (JDI), low levels of job satisfaction were revealed. Differences were found between professions.

Allied Health Personnel↗
PubMed1986

Development and validation of an instrument to measure pharmacists' satisfaction with their jobs and careers.

The development and validation of a survey questionnaire measuring pharmacists' satisfaction with their jobs and careers is outlined. The instrument was part of a 1983 study which surveyed pharmacists licensed and residing in Florida. The use of the pilot survey to arrive at a final survey instrument is outlined. Reliability of the instrument is assessed with tests of internal consistency reliability. Validity is judged through a test of concurrent validity utilizing the Job Descriptive Index, a standardized measure of job satisfaction. The delineation of this process is intended to aid other researchers in the development and validation of their surveys of job satisfaction and similar attitudinal measures.

Attitude of Health Personnel↗
PubMedDate not supplied

The effects of community, coworker and organizational support to job satisfaction of nurses in Cameroon.

This study examined the effects of community, co-worker and organizational support with the job satisfaction of nurses in Cameroon in six major components of the job namely; work, pay, promotion, supervision, co-worker relationships and the job in general. Each variable was examined separately. A convenience sample of 158 staff nurses, participated in this study. The Job Descriptive Index (JDI) questionnaire and the Job In General (JIG) scales were used to measure job satisfaction. Focus group interviews and a content analysis of major themes were conducted. Inferential statistics were used to test the effects of community, co-worker and organizational support and job satisfaction. Results showed significant, positive effects between perceived level of community support, coworker support and organizational support with components of job satisfaction sub-scales. These results are useful for nurse educators, and researches in the formulation and implementation of effective health policies for nurses and health care organizations.

Adult↗
PubMedDate not supplied

Temporary agency contracts: what should they include?

The AHRA Board committed to provide some tools to help our members with agency contracts. This article provides the sections for a contract and what they should include. Of course, the language will have to comply with your organization's requirements. To comply with HIPAA regulations for contracts, I've also included language for business associates. JCAHO requires that the following documentation be on file for all contracted personnel: 1. Hospital job description or formal contract outlining the job responsibilities. 2. All licenses, certifications and registrations are reviewed and a process is developed to ensure that they remain current. 3. Competency is evaluated and maintained. 4. Evidence that personnel received a general orientation. 5. Evidence that personnel received a departmental orientation. 6. Safety and infection control standards must be met. In order to aid with compliance when utilizing contracted personnel, my organization developed a Contractor Personnel Administrative Compliance Checklist, which identifies requirements for compliance, a reference for assistance, and places to record that the requirement has been met for each of the areas listed in the previous item. Our standard contract includes sections on general definition of engagement, credentials and work experience; health, including immunization and drug testing; corporation; JCAHO; terms of the contract; and, non-disclosure of information. A business associate agreement may be necessary to comply with HIPAA regulations. Using the template has made my job much easier than trying to read each contract that crosses my desk. If an agency refuses to sign our contract, then we do not conduct business with that company. If an agency requests changes to the contract, depending on the language, we may or may not agree to it. This information is not intended to be legal advice, but rather an educational overview. As with any contract, the reader should consult with legal counsel at his or her organization.

Contract Services↗