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Nurses and PAMs in innovative roles: job satisfaction and its contributing factors.
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Care of the community.
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Modernization: the role of ward sisters and charge nurses.
BACKGROUND: The nursing profession is being directed by the government to modernize alongside the NHS as an organisation (DoH 2000). The role of ward sister/charge nurse has taken the brunt of increasing managerialization and the reduction in junior doctors' hours. This article examines how the role has developed and explores future opportunities. CONCLUSION: The ward sister/charge nurse role is pivotal to the modernization of the NHS. However, unless the role, responsibilities and expectations of these experienced nurses are clearly defined, the position may cease to be a promotional aspiration of junior nurses. The negative consequences of this for standards of patient care and recruitment and retention of staff are likely to be significant.
Effects of stress in an NHS trust: a study.
This study of staff in an NHS trust tests two established models of occupational stress. Payne (1979) suggested that support at work can help to neutralise the strain of work demands, while Karasek (1979) suggested that staff whose jobs are characterised by high demands and low control are at greater risk of poor psychological wellbeing and ill health. Support is found for both models, and it is suggested that the two could usefully be combined.
The role of the clinical nurse specialist: a study.
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The role of the clinical nurse specialist.
AIM: To investigate the current work and role of the clinical nurse specialist. METHOD: Twenty semi-structured interviews were undertaken with clinical nurse specialists and analysed using the constant comparative approach of grounded theory. RESULTS: The clinical nurse specialists (CNSs) in this study identified the communicator-carer role as their key remit. This was perceived as being extremely effective and unique as well as providing the CNS with his or her main source of job satisfaction. Nonetheless, intrinsic desires and external demands create a considerable workload that therefore needs to be prioritised. In addition, the legitimacy of certain demands needs to be challenged to ensure appropriate demands are met and relevant opportunities realised. CONCLUSION: The pivotal role of the CNS might be under threat as it fails to fulfill its original extensive remit, specifically that of undertaking research.
Improving retention with a nurse rotational programme.
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Provider satisfaction in army primary care clinics.
The job satisfaction of physicians, nurse practitioners, and physician assistants was assessed during the course of a multicenter study of Army primary care clinics. All providers in nine clinics at three medical centers who were engaged in adult or family care were invited to participate in the study. Questionnaires on job satisfaction and other practice style variables were completed by 26 physicians, 19 nurse practitioners, and 13 physician assistants (46, 76, and 41% of eligible providers, respectively). Analysis revealed a broad range of job satisfaction in the sample. However, average levels of job satisfaction were not significantly different across the three groups of primary care providers. Autonomy and collaboration were significant predictors of job satisfaction. It is clear that changes in health care systems that reduce, or appear to reduce, the primary care provider's autonomy in clinical matters are likely to reduce provider satisfaction as well.
Developing employee ownership of the quality improvement process.
Developing true employee ownership of quality improvement is a process in itself. It begins with sending clear signals to employees that management fully supports the process and is committed to making it successful. It is reinforced when managers provide for the progressive education of all employees to ensure that job requirements are known and are achievable. Employee ownership of quality improvement continues to develop with ongoing management action that makes it clear that doing things right the first time is a part of the organizational culture. Encouraging the use of prevention--including quality improvement responsibilities in job descriptions and performance appraisals; the use of problem identification systems; and employee involvement in corrective action teams, quality improvement teams, and the management of the process--sends the message to employees that employee ownership of the process is a way of life in the organization. When success of the quality improvement effort is related to and understood as the key to the organization's success, as well as that of individual employees, and when each employee personally accepts the importance of his or her own role in making quality happen, the organization is well on its way to achieving its quality improvement objectives.
Case management: planning and coordinating strategies.
In summary, planning a case management system involves moving through sequenced stages; namely, (1) a developmental stage; (2) a phase-in stage; and (3) an operational stage. During the developmental stage, before processes have been formalized, attention is given to the political realities, the formation of a representative planning group, formulating goals and objectives, obtaining administrative support, information gathering, assessment of needs, resource procurement, program structure and design, selection of a case management model, participatory decision making, determining organizational fit, and beginning networking. During the phase-in or early implementation state, the formal stage of system introduction, attention is given to the establishment of interorganizational relationships, contracting for services, job descriptions, work assignments, training, problem solving, and conflict resolution. During the operational or full implementation stage, a period when the system should become more stabilized, attention needs to be given to managing movement of the client through the system, the flow of information, program updating, quality assurance, recordkeeping, resource management, evaluating, and system refurbishing. In practice, these stages will interact and overlap. Closure, if the system is to remain viable and open to change, should never occur.
Certification of laboratorians: an update.
More than a dozen national organizations certify clinical laboratory professionals. As regulations and job descriptions evolve, the debate over certification requirements continues.
Role of the management engineer in the patient-focused hospital.
Patient focused healthcare is coming. Based on the criteria John Nesbitt put forth in his book, MEGATRENDS, PFH is a TREND not a fad. By building on the principles of continuous quality improvement the PFH model strives to redesign hospitals and focus their operations on their customers, the patients. By doing this the PFH creates a stronger, more flexible organization that will be better able to respond to differing market demands. Improved quality, service, employee satisfaction and financial performance are early results reported by hospitals implementing the PFH model. MEs have the capability and motivation to play a major role in the conversion of traditional health care systems into PFH models. MEs must shift roles, create a new job description and get to work on the quality transformation.
Maximizing the results of new graduate orientation.
However, a word of caution seems appropriate. The administration at this hospital has long believed that no matter how good the orientation program, or the employee benefits package, or the employer's sensitivity to employees' intrinsic needs, the new nurse will be more likely to experience job satisfaction if she has, or obtains and accepts, a relatively realistic view of the job prior to accepting the position. Concerted efforts have been made to describe the role and the environment at the time the new graduate interviews for the position. Yet these nurses reported they had no real concept of the role until they were well into the orientation period. In effect, then, the importance of the preceptor's role in facilitating the process of transition cannot be over-emphasized.
Analysis of an organization's waste stream.
The steps involved in conducting a waste stream analysis for a health care organization have been described. The development of a corporate position on the organization's stewardship of its environment can be the major result of such an analysis. This position would communicate to the community the organization's commitment to the environment and would be used as policy guiding corporate decisions that affect the environment. As a result of the corporate policy, a health system waste management program could be developed. This program would consist of standardized policies and procedures, educational requirements for employees, roles and responsibilities' defined in job descriptions, public education programs, recycling programs, and capital equipment acquisition. Additionally, such a program would promote economies of scale. A waste stream analysis is only as good as the information it contains. Making it of sufficient priority within the organization ensures that adequate time and personnel are allocated to complete the analysis in a precise manner. A well completed analysis is a major component of the larger issue of an organization's responsibility to its environment.