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PubMed2000

Nurses' job satisfaction and organizational climate in a dynamic work environment.

The infrastructure and organization of hospitals are changing rapidly as a result of major transitions in health care. Downsizing in hospitals has caused employees to have to take on new tasks and, often, multiple tasks with a decrease in available resources and an increase in job complexity. Naturally, such organizational changes have a profound effect on the nature and duration of patient hospitalization and on the job responsibilities and roles of inpatient staff. In many hospitals, there is a perception of chaos, sometimes resulting in frustration among the nursing personnel. The purpose of this study was to describe the relationship between nurses' job satisfaction and organizational climate.

Adult↗
PubMed1991

Nurse managers: role expectations and job satisfaction.

The purpose of the study was to assess the relationships among nurse managers' perceived job stress/job satisfaction, time allocation, and role expectations. The dependent variable was job satisfaction. The sample consisted of 72 nurse managers who responded to a self-administered questionnaire. It was found that nursing supervisors are satisfied with the actual time allocation of nurse managers, whereas physicians and nursing staff believe that more of the nurse managers' time should be given to direct patient care. When discrepancies occur about the allocation of nurse manager time, the nurse manager is apt to have lower job satisfaction.

Adult↗
PubMed1990

Data collection for an obstetric department.

A well-designed computerized data collection system allows an accurate, complete data-set to be compiled for all pregnant women. It should be able to produce all the documentation necessary for pregnancy care, with minimum delay, and avoid repetitive data entry. Data is stored on computer on the back of operational tasks so that it may be subsequently used for audit. In addition it may be used for research purposes. Patient care can be improved if the computer is programmed to react to certain items being entered by requesting further relevant data-items. This therefore acts as a teaching method. A further extension of this is to use the data to help reach a diagnosis and thus suggest a logical management. A computerized data collection system cannot bring order out of chaos. Before introducing one there must be well-stated objectives of what is required from it. It must be clearly stated what is to be collected by whom and for what purpose. Apart from the capital outlay there may be a need to set money aside for revenue purposes for additional staff involved in maintaining the system. If a large system is being introduced then this will have considerable implications with regard to the work done by some staff, and job descriptions may need renegotiation--an aspect usually overlooked.

Data Collection↗
PubMed1998

The role of advocacy in critical care nursing: a caring response to another.

With the aim of clarifying critical care nursing, six critical care nurses, working in a Swedish intensive care unit (ICU) were each asked to narrate a care situation with which they had been satisfied or dissatisfied. The stories were tape-recorded and analysed using a phenomenological-hermeneutic approach inspired by the philosophy of Ricoeur. The themes uncovered in the analysis describe the nurse's role of advocacy as: to build a caring relationship, to carry out a commitment, to empower, to make room for and interconnect, to be a risk-taker, to be a moral agent and to create a trusting atmosphere conducive to recovery. The meaning of the role of advocacy lies in a moral and existential response to another human being, an expression of caring. Advocacy rests on the patient-nurse relationship and occurs as an outspoken demand of another human being whose autonomy is threatened. The results are discussed from the ethical perspectives of Lögstrup, Watson's concept of care, and existential advocacy as expressed by Gadow.

Attitude of Health Personnel↗
PubMed1999

Role expansion in intensive care: survey of nurses' views.

The study described here is an investigation of intensive care unit (ICU) nurses' perceptions of how their role is expanding. Six specific skills were selected for consideration. A questionnaire was distributed to nurses working in ICUs in three different hospitals. Questions were based around issues such as education and assessment policies, the transfer of work between nurses and other groups of workers and the effects of ICU nurses accumulating additional skills. Completed questionnaires were received from 33 participants (68.75% response rate). The results showed that most of the nurses were carrying out the skills suggested. The training provided to underpin skill development was a balance of teaching and supervision. However, assessment practices varied. The majority of nurses felt that the existing training programmes were adequate. Data revealed that a range of duties could be released from their role and taken over by other workers, such as technicians and health care assistants. Participants suggested that the crucial element of the nursing role was the incorporation of many activities into the provision of continuous one-to-one total patient care. This was the aspect of work that was reported as being the most satisfying. It was perceived that patients benefited from nurses extending their role in the areas discussed.

Attitude of Health Personnel↗
PubMed1997

The work of accident and emergency nurses: Part 2. A & E maxims: making A & E work unique and special.

An ethnomethodological study was undertaken to explore the work of Accident and Emergency (A & E) nurses; the aim of which was to analyse the ordinary, taken for granted, everyday work of those practising A & E nursing. In this second paper on the work of A & E nurses, the specific rules or maxims of nursing work in A & E are introduced. From the analysis of materials gained: fieldwork notes, observations of nurses at work and conversations, a number of maxims of A & E nursing work were identified. Maxims direct, instruct and make nurses accountable for their work and the ways in which it gets done. That is, the presence of maxims underpinning A & E nursing work ensure that A & E nursing is seen and heard as a specific type of work with its own unique approach to talk and organization. Being aware of the maxims of A & E nursing work is not the concern of the nurse practising A & E nursing on a daily basis. Implicit and explicit reference to the maxims when talking about and doing the work provides nurses with impressions of who can do the job. Non-adherence by some nurses to the maxims of A & E nursing work often leads their colleagues to question their commitment to their choice of work setting. Maxims of A & E nursing account for the ways in which the work is seen, heard and talked about. Maxims direct the organization of work and its development within the A & E setting.

Clinical Competence↗
PubMed2002

Balancing values and imperatives: a study of nursing service in an ICU.

There has been significant attention from the managers and purchasers of health services regarding the economic advantages that result from changes to the patterns of health care delivery in the acute hospital setting. The impact of these changes, whilst often rendering advantage at the economic management level of health care, can have different consequences for the people who deliver and the people who receive health service. This paper reports on a study that was conducted with a group of nurses to investigate the practice milieu of a critical care unit in the context of changes to health service management. Interpretive methods were used to capture the perspective of the nurses and the way they interpret the multiple factors that influence their practice and their practice environment. The findings indicate that the nurses in the study setting interpret these factors according to the influences they have on the structure, the geography and the value of their work. Explication of these findings provides a research base to inform recommendations relating to improving the practice milieu of the critical care environment.

Adaptation, Psychological↗
PubMed2003

Assessing exposure to crystalline silica from farm work: a population-based study in the Southeastern United States.

PURPOSE: Farm workers are exposed to crystalline silica, but there are no established questionnaires to assess silica dust exposure from farm work in epidemiologic studies. This study examines aspects of farm work that were used to estimate potential silica dust exposure in a population-based study conducted in the southeastern United States. METHODS: We collected work and farming histories through in-person interviews with 620 participants in a population-based case-control study of systemic lupus erythematosus. A dust-exposure matrix was used to develop a telephone interview for 69 participants with potential medium- or high-level exposure, including questions on tasks, frequency, and farm location. Soil systems maps were used to infer soil type (sandy/other). Exposure indices were constructed based on tasks, frequency, and soil type. RESULTS: Thirty-six percent of study participants worked on a farm, but only 52 (8%) were classified in the high (n=16) or medium (n=36) exposure groups based on responses to follow-up interview questions. Exposure indices based on open-ended job descriptions in initial interviews correctly categorized 52% of participants who answered prompted questions on relevant dusty tasks in follow-up interviews. CONCLUSIONS: Specific questions on dusty tasks and frequency are needed to accurately assess silica exposure from farm work.

Adolescent↗
PubMed2000

A clinical teaching project. Evaluation of the mentor-arranged clinical practice by RN mentors.

This paper explores the relationship between nursing students and mentors and its influence on nursing students' development of professional knowledge during their clinical practice. The paper is based on an evaluation of a new initiative supplementing other clinical experiences for students of nursing, Mentor-Arranged Clinical Practice (MACP), by registered nurse mentors. Sixty-five (95.6%) mentors returned their questionnaires in a self-addressed envelope. Results of the study indicated that there were benefits and rewards for both students and mentors. The mentors felt that students gained more practicum time, confidence and independence in their practice, time management skills, rapport between staff and student, and better integration into the hospital environment. Mentors indicated that the most compelling reasons for becoming mentors were the opportunity to assist mentees to integrate into the nursing unit, to teach, share knowledge, promoting and improving the professional image of nurses, and gain job satisfaction from mentoring. The findings in this study suggest that there is a need for development of mentor relationships in the clinical setting of undergraduate nursing courses.

Attitude of Health Personnel↗
PubMed2004

Consumer involvement in the health technology assessment program.

OBJECTIVES: This study aims to describe a cycle of development leading to sustainable methods for involving consumers in the management of a program commissioning health technology assessment. METHODS: Staff time was dedicated to developing procedures for recruiting and briefing consumers to participate in prioritizing, commissioning, and reporting research. Resources and support were developed in light of early feedback from consumers and those working with them. These were piloted and amended before being used routinely. RESULTS: Over 4 years, procedures and resources have been developed to support six consumers attending seven to eight prioritization meetings a year; thirty to forty-five consumers each year commenting on research need for particular topics; thirty consumers a year commenting on research proposals, and twenty a year commenting on research reports. The procedures include clear job descriptions, induction and development days, clear briefing materials, payment for substantial tasks, and regularly seeking feedback to improve procedures. CONCLUSIONS: Explicit, inclusive, and reproducible methods for supporting consumer involvement that satisfy National Health Service policy recommendations for involving consumers in research require dedicated staff time to support a cycle of organizational development.

Community Participation↗
PubMed2006

Evaluation of the sustained implementation of a mental health learning initiative in long-term care.

BACKGROUND: This paper describes an innovative education program for the management of mental health problems in long-term care (LTC) homes and the evaluation of its longer-term sustainability. Since 1998, the "Putting the P.I.E.C.E.S. Together" learning initiative has been providing education sessions and related learning strategies aimed at developing the knowledge and skills of health professionals who care for older persons with complex physical and mental health needs and associated behaviors, in Ontario, Canada. A major focus of this province-wide initiative was the development of in-house Psychogeriatric Resource Persons (PRPs). Evaluation of this initiative included the completion of pre- and post-education questionnaires (over three data collection time periods) assessing learner confidence (N = 1,024 and 792, for pre- and post-education, respectively) and session evaluation questionnaires gathering feedback on the session (N = 2,029 across all sessions). A survey of LTC homes in Ontario (N = 439, 79% of the homes in the province) was conducted to assess longer-term sustainability. RESULTS: Ratings of the sessions indicated that they were relevant to learners' clinical practice. There were significant increases in ratings of ability to recognize and understand challenging behaviors and mental health problems, and in ability to use a variety of assessment tools. Few homes (15%) do not have a PRP; over 50% of the staff who completed the first session in 1999 continue to serve as a PRP and to apply learned skills. CONCLUSIONS: A learning initiative with supportive and reinforcing strategies can develop in-house PRPs to enhance the care of the elderly in LTC. Incorporation of PRP functions into job descriptions and management support contributed to the success of this initiative. This study highlights the importance of work environments that support and reinforce the use of learned skills to the success of continuing education and quality improvement initiatives in LTC.

Aged↗
PubMed2000

Role utilization of nurses in public psychiatry.

This study examined the professional, work and organizational characteristics, and the actual and preferred work activities of nurses employed by one state mental health agency. Findings include neutral ratings by this older and experienced group of nurses in relation to job satisfaction, work autonomy, and organizational commitment regardless of educational background or work setting. Specific activities of the nurses varied appropriately based on education, but differences emerged among functions performed by nurses in inpatient and community settings. All nurses preferred to increase their direct care activities and significantly reduce their clerical activities. Factors related to the appropriate utilization of public sector psychiatric nurses are analyzed.

Adult↗
PubMed1999

[Nurses with and without burnout: a comparison. Results of a quantitative longitudinal study and a qualitative depth study].

In 1995 a number of 2000 nurses received a questionnaire twice in a time scale of six months. Besides demographic variables the questionnaire measured nurses' scores on burnout, job characteristics, personality and coping behavior. In a more subject related way the phenomenon burnout was additionally examined in a qualitative study with 10 nurses. Nurses with low scores on burnout had a job with the following characteristics: low strain levels due to time pressure and responsibility, sufficient scope of action and little control, sufficient feedback and recognition, good relationships within the team and between doctors and nursing staff, satisfying working hours, sufficient wage rates and sufficient offers for job formation. In addition, nurses with low scores on burnout show a significantly stronger sense of coherence than their colleagues with high scores on burnout. There is also a trend for more idealism and will to help in this group. When there are problems in the job these nurses more often use instrumental modes of coping in a successful way than nurses with high scores on burnout.

Adaptation, Psychological↗
PubMed2001

Why do women suffer from sick building syndrome more often than men?--subjective higher sensitivity versus objective causes.

Office workers often report so-called sick building syndrome (SBS) symptoms affecting the skin, mucous membranes and nervous system. The recurring higher prevalence of SBS in women was investigated using questionnaire and ergonomic data from the German ProKlimA-Project. The hypothesis that working conditions and job characteristics for women are inferior to those of men was tested for groups of risk factors. Finally, gender-specific multiple logistic regression models were compared. It was found that 44.3% of women (n = 888) and 26.2% of men (n = 576) suffer SBS with significant differences between men and women for many variables. Considering sub-groups--supposing the same circumstances in psycho-social and work-related conditions--gender-specific SBS prevalence rates differ as for the whole sample, e.g. 35.9% of women with the most favourable job characteristic suffer SBS (men: 19.4%), 53.0% of women with the most unfavourable job characteristic suffer SBS (men: 33.3%). These results show that women suffer more SBS than men independent of personal, most work-related and building factors. Multiple logistic models define self-reported acute illness, job satisfaction, software quality and job characteristics as significant gender-independent risk factors. Number of persons/room, self-reported allergy and smoking are characteristic female risk factors. Age is a significant risk factor only in men.

Adult↗
PubMed1999

Efforts of health promotion teams to improve the psychosocial work environment.

This study evaluated the actions of 12 departmental "health promotion teams" and the means they used to improve the psychosocial work environment of a metal factory in a 3-year project. The teams included 80 members and were supported by organizational psychologists twice a year. A survey feedback process was applied in the beginning among all 773 employees, including management (response rate 94%). At the end, a questionnaire on perceived changes was filled out (response rate 94%). The teams guided the developmental process and initiated various activities in cooperation with the personnel. The planned activities were mainly directed at improving physical fitness and social climate. The majority of the personnel participated in these activities and were satisfied with them.

Community Participation↗
PubMed2000

Linear and nonlinear relations between psychosocial job characteristics, subjective outcomes, and sickness absence: baseline results from SMASH. Study on Musculoskeletal Disorders, Absenteeism, Stress, and Health.

This study investigates the demand-control-support (DCS) model by (a) using a more focused measure of job control, (b) testing for interactive and nonlinear relationships, and (c) further extending the model to the prediction of an objective outcome measure (i.e., company-administrated sickness absence). Hypotheses were tested in a heterogeneous sample of 1,739 employees from a 3-year prospective cohort study called SMASH (Study on Musculoskeletal Disorders, Absenteeism, Stress, and Health). Baseline results showed that a linear additive model was superior for job satisfaction, psychosomatic health complaints, and sickness absence, whereas a curvilinear model was superior for emotional exhaustion and depression. It is concluded that, first, there was no evidence of interactive effects. Second, it seems sensible to pay more attention to curvilinear relationships in future research. Finally, the DCS model was not supported using a more objective outcome measure.

Adolescent↗
PubMed2001

Justice, citizenship, and role definition effects.

A limitation of the organizational citizenship behavior (OCB) literature is that theory and empirical evidence suggest that some employees define OCBs as part of their job. A theoretical framework that addresses this problem is tested in this article. The framework focuses on 2 effects: a role enlargement effect (i.e., employees with more favorable attitudes define OCB as inrole behavior, which, in turn, results in greater citizenship) and a role discretion effect (i.e., the relationship between employees' attitudes and their citizenship will be stronger among employees who define OCB as extrarole behavior). In tests of this framework with 2 independent samples of supervisor-subordinate dyads, role definitions were found to moderate several relationships between procedural justice and OCB, providing support for the role discretion effect. Implications for OCB theory and research are discussed.

Adult↗