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PubMed2003

Primary care nurses' attitude to sickness absence: a study.

Nurses are under more pressure than ever before in a fast-changing NHS. Staff shortages and spiralling workload have led to escalating levels of stress in community care, while managers look to minimize the cost of sickness absence. However, the causes of sickness absence are complex and poorly understood. The authors report on a small-scale qualitative research study on the attitudes of primary care nurses to sickness absence. In-depth interviews were conducted with a small sample of volunteer nurses working in a west London primary care organization. Interviews were transcribed, coded and analysed into six main themes. It was found that psychological issues and values are very important but good management and the role of the team are also key factors in the decision to take sick leave. Workplace characteristics, personal issues, and local factors also play a very significant role.

Attitude of Health Personnel↗
PubMedDate not supplied

Maintaining nurses' job satisfaction and morale.

In this article those factors which influence the job satisfaction and morale of nurses are considered. It is suggested that action is needed if the profession is to continue to grow and develop.

Humans↗
PubMedDate not supplied

Developing nursing's future role. 2: Nurses' job satisfaction and morale.

This, the second of two articles, presents the results of a recent survey of nurses' job satisfaction and morale undertaken at the Northern General Hospital NHS Trust, Sheffield. The survey was conducted in order to provide a benchmark against which to gauge progress towards creating a work environment in which nurses are able to exercise maximum autonomy within a supportive and enabling culture. The results mirror recent national reports which highlight the increasing tension between workload pressures and the desire to provide holistic patient care. A number of factors were identified which suggest the need for remedial action across a range of fronts. Such factors are briefly described, together with the action taken to date to address the issues raised.

England↗
PubMedDate not supplied

Perceptions of tissue viability nurses of their current roles.

This qualitative and quantitative study was undertaken on a national scale. It identifies the perception of the role of the tissue viability nurse by its incumbents through the circulation of postal questionnaires sent to 173 identified tissue viability nurses, of which 87 responded. A constant comparative analysis of the responses identified the repetitive phrases and key words for the qualitative data. The quantitative responses were facilitated through the use of closed questions. The research facilitated four areas of discussion: role overview; perceived levels of education; positive/negative aspects of the role; types of wound contact and reasons.

Attitude of Health Personnel↗
PubMedDate not supplied

Nurses' perceptions of providing advice via a telephone care line.

The provision of advice over the telephone in the health service has become more common in the Western world and in Sweden this task is allocated to nurses. There are several million calls a year to the medical care telephone helpline. Nurses answer the calls, provide advice and direct the flow of patients to the most appropriate treatment level. The aim of this study was to describe how nurses perceive their job of providing telephone advice to patients. Interviews with 12 nurses were analyzed using a phenomenographic approach. The nurses perceived their work as stimulating, autonomous and challenging. They also felt exposed because extensive knowledge is required and there is a risk of being criticized, as they are in a front-line position. Nurses who are responsive, determined and not anxious about their prestige can carry out the work well, provided they have a good level of self-awareness. Personal qualities and the confidence of superiors make even an exposed position with considerable requirements manageable.

Adult↗
PubMed1998

Relationship between burnout and sense of coherence in health social workers.

The aim of this study was to determine whether a strong sense of coherence as a coping strategy affects burnout in health social workers. The research sample consisted of 31 social workers in the field of physical illness, 21 in the field of mental illness, and 29 in the field of the handicapped. The main finding indicates that health social workers who have a strong sense of coherence experience less burnout than those with a weak sense of coherence. More specifically, the findings indicate that the manageability component of sense of coherence predicts emotional exhaustion.

Adaptation, Psychological↗
PubMedDate not supplied

Arching the flood: how to bridge the gap between nursing schools and hospitals.

A gap persists between what nurses can do and what they are employed to do, between the education nurses obtain and the work design of hospitals. Despite agonizing over standardization, current nursing education reflects the pluralistic nursing workforce, and nurses hold accountability for it. But nurses have not been proportionately or effectively involved in restructuring the hospital workplace. The result is that nurses are both overworked and underused. Fortunately, this gap may be bridged with a number of short- and long-term policy solutions.

Benchmarking↗
PubMed2006

Long-term changes in the perception of job characteristics: results from the Belstress II--study.

The aim was to explore long-term changes in the perception of job characteristics--based on the Job Content Questionnaire (JCQ)--in view of the changing labor market in Western societies. A total number of 2,821 workers from nine companies were involved in the longitudinal Belstress-project. Data were gathered on two occasions with a mean time interval of 6.6 yr. At both times, participants completed the JCQ which measures the perception of job demands, job control and social support. In addition, the instrument contains questions regarding physical job demands, job insecurity and impact of world market competition (WMC). Changes over time in the perception of the different dimensions of the JCQ were evaluated within a sample of 2,490 respondents who remained in the same job. A statistically significant long-term stability of all JCQ scales was found. As far as intra-individual changes over time are concerned, the population showed a modest average increase in the perception of job demands, control and support of approximately 3%. Long-term changes in the other scales were larger, with an average increase of 10.3% in job insecurity and 15.5% in impact of WMC. Substantial variation in these two scales was found at the level of the company and in some socio-demographic factors. While perceived job characteristics remained relatively stable over an average period of 6.6 yr, a substantial increase was noted in job insecurity and the impact of WMC. These dimensions are becoming increasingly important within the context of economic globalization and labor market flexibility.

Adult↗
PubMed2003

Evaluation of a peer-reviewed career development and compensation program for physicians at an academic health science center.

OBJECTIVE: The Department of Pediatrics at the Hospital for Sick Children, which is funded by an alternative payment plan, has implemented a novel career development and compensation program (CDCP). Job activity profiles were used to more clearly define job expectations, benchmarks guided career development, and peer review was used to assess performance. The objective of this study was to evaluate the departmental pediatricians' satisfaction with the CDCP. METHODS: Pediatricians, all of whom had undergone CDCP annual reviews, could participate if they had undergone the in-depth triennial CDCP review. Each received a 5-point Likert scale-based questionnaire that asked how well the CDCP had conformed to the principles identified by the department during the development of the CDCP. Anonymous, confidential responses were collated and used to guide focus groups that discussed areas of greatest concern and attempted to identify solutions. Focus groups were led by external facilitators who were experienced in qualitative research. They audiotaped the sessions, transcribed the comments, and analyzed the data with the assistance of a qualitative analysis application. RESULTS: Sixty of the eligible 88 pediatricians participated, and 74% of their responses were that the CDCP had addressed the original principles "somewhat," "to a great extent," or "extremely well." The remainder indicated that some of the principles were either "not addressed" or "only to a small extent" by the CDCP. Results from the 11 focus groups (46 participants) indicated that the CDCP was an improvement over the previous method of career development and determination of the rate of remuneration. Most were also still in agreement with the purpose and design principles. Although they did not want the CDCP to undergo a major redesign, they identified areas that need improvement. Short-, medium-, and long-term action plans to address these areas are under way. CONCLUSION: Pediatricians at the health science center of the Hospital for Sick Children remain supportive of the CDCP.

Academic Medical Centers↗
PubMed1999

[Suffering and pleasure experienced by nurses working at an intensive care unit of a university hospital].

The purpose of this study is to grasp and to understand the nurses' social representations concerning their work in intensive care unit and the ways of expressing feelings of suffering and pleasure. Six nurses of the intensive care unit of medical, surgical and pediatric clinics were interviewed. The analysis of the social representations made possible the apprehension of the symbolic dimension of the work in the psycho-social (individual), social-dynamic (group) and institutional perspective. We verified that the work in intensive care unit brings pleasure to nurses despite of intense emotional constraint. This qualitative study allowed na in-depth reflection on the issue and made evident the need to deepen research. However, other investigations have to be carried out to deepen the subject on the subjective and symbolic dimension to subsidize the administration of human resources in nursing.

Attitude of Health Personnel↗
PubMed1998

[Ergonomic working conditions for the nursing team in a cardiology unit].

Aiming at finding out the ergonomics conditions of the nursing personnel in a hospital admission unit, the authors utilized as a methodological presupposition the search for a global experienced work situation through the analysis of some elements as: the man (nursing worker); the work activity (prescribed duty, real activities and work position) and the environment (temperature, noise and illumination). The authors selected the Cardiology admission unit for the site of their research. The results verified that the nursing workers the mentioned unit face problems related to salaries, work installations, relationship, work organization, levels of formation and the activities executed. The authors suggested some recommendations.

Cardiology↗
PubMed2002

Skin disease among staff in a large Korean nursing home.

Although previous studies have documented reasonably high rates of skin disease among nursing home staff, the prevalence among Korean workers is not well known. For this investigation we selected a large Korean nursing home and distributed a skin disease questionnaire to all staff. Questions included job title, job description, employment history, working hours, patient contact and the occurrence of skin disease over the past 12 months. Workers who reported a dermatological problem then underwent skin examinations conducted by specialist occupational physicians and a dermatologist. Contact dermatitis was the most common skin disease detected, with 4.8% of staff currently suffering from it and 6.0% reporting it in the previous 12-month period. Tinea pedis was another common condition, affecting 3.6% on our examination day. However, only two-thirds of them (2.4%) recounted a past history of tinea pedis. Scabies was diagnosed among 2.4% of staff and reported as a previous infection by 6.0%. Overall, the prevalence of dermatitis and scabies were quite low when compared to previous studies, while fungal infection rates were similar to other investigations. Further research into this growing occupational demographic is indicated.

Adult↗
PubMed1991

Superior-subordinate dyads: Dependence of leader effectiveness on mutual reinforcement contingencies.

Task contingencies were modeled from bureaucratic organizations in which vague job descriptions provide incomplete contingency specifications. Response rates within dyads were examined using two nonsocial, two social, and two control contingencies. In the first social contingency, responses by the superior produced monetary reinforcement for a subordinate while the superior received no reinforcement from his subordinate. A second social contingency was identical to the first except that the subordinate's rate of responding determined the rate of reinforcement delivered to his superior. Within this contingency, mutual reinforcement occurred whenever rates of superior and subordinate responding were correlated. Two control contingencies were identical to the second social contingency except that either the superior or the subordinate received a rate of response-independent reinforcement virtually identical to the rate received during the second social contingency. Leadership, in this context, was the difference between rates of subordinate responding produced by a nonsocial contingency and rates produced by each of the two social contingencies. The two nonsocial contingencies supported almost no responding among subjects. The first social contingency produced minimal levels of leadership within every dyad. The second social contingency produced high levels of leadership. Response-independent reinforcement generally reduced or eliminated responding.

Journal Article↗
PubMed2001

Biomechanical and psychosocial risk factors for low back pain at work.

OBJECTIVES: This study determined whether the physical and psychosocial demands of work are associated with low back pain. METHODS: A case-control approach was used. Case subjects (n = 137) reported a new episode of low back pain to their employer, a large automobile manufacturing complex. Control subjects were randomly selected from the study base as cases accrued (n = 179) or were matched to cases by exact job (n = 65). Individual, clinical, and psychosocial variables were assessed by interview. Physical demands were assessed with direct workplace measurements of subjects at their usual jobs. The analysis used multiple logistic regression adjusted for individual characteristics. RESULTS: Self-reported risk factors included a physically demanding job, a poor workplace social environment, inconsistency between job and education level, better job satisfaction, and better coworker support. Low job control showed a borderline association. Physical-measure risk factors included peak lumbar shear force, peak load handled, and cumulative lumbar disc compression. Low body mass index and prior low back pain compensation claims were the only significant individual characteristics. CONCLUSIONS: This study identified specific physical and psychosocial demands of work as independent risk factors for low back pain.

Adult↗
PubMed1989

Escalation of the nurse-physician conflict: registered care technologists and the economic crisis.

Rivalry between nurses and physicians has been escalating in recent years. The American Medical Association's (AMA's) recent proposal to deal with the nursing shortage by introducing a non-nurse bedside care technician to be called a registered care technologist has met with strong opposition from the American Nurses' Association (ANA). This article suggests that limiting the analysis of this debate to changes taking place within the health sector is problematic. The determining constraints are not endogenous to the health sector, but are located in the broader macroeconomic context. The object, herein, is to locate the AMA's proposal and the ANA's response in the light of the macroeconomic crisis that is forcing the U.S. economy, including the health sector, to restructure. This restructuring generates increasing rivalry and conflict as firms and workers vie to consolidate, and where possible, to expand their relative power in the face of generally declining and qualitatively changing circumstances.

Allied Health Personnel↗
PubMed1982

Blood pressure of male municipal employees: effects of job status and worksite.

Repeated measurements of resting blood pressure and heart rate were obtained at the worksite for a sample of 441 male municipal employees ranging widely in age (M = 41 yr.), job level, and education. As a result of unusually high diastolic values (M = 91), over-all uncontrolled hypertension rates were very high (33% of the men exceeding 160 systolic or 95 diastolic including those on medication). Higher rates were obtained for blue collar as opposed to white collar employees and for those plant workers in the Division of Water as opposed to Sewerage and Drainage. Net of age, weight, smoking, education, and anti-hypertensive medication use, higher systolic and diastolic mean values were obtained for supervisors who were primarily employed as foremen and clerical personnel. Inter-plant differences in blood pressure were also found for primarily blue collar Sewers and Drains employees, though whites' and blacks' values were nearly identical. Comparisons with national blood pressure data indicate significant effects for level of job and education which again disfavored supervisors and clerical employees and in addition men who had more education. Whites' and blacks' blood pressures deviated significantly from expected values, the differences favoring blacks. Social psychological mechanisms which may mediate these effects are discussed.

Adult↗
PubMed1994

Imitative suicide in a cohesive organization: observations from a case study.

Three suicides occurred within 3 years in a military unit of 35 individuals. This represented an annual rate 220 times the North American average. A clinical intervention was requested by medical authorities, the goal being to minimize the risk of further deaths. Group and individual therapy was conducted over 3 days and ongoing referrals were made as necessary. In addition, measures of anxiety, depression, and hostility were obtained from this unit and from a unit equivalent in size and job description to examine whether these constructs could be used diagnostically. Analysis of the data indicated that differences in mean scores between the units yielded potentially misleading information, although on an individual basis scores were useful in identifying clients at risk of suicide. When those who personally knew one or more of the decreased were compared with those who did not, variability of scores in conjunction with interviews was helpful in identifying relatively high-risk subgroups.

Adult↗