Nursing Work Life in Acute Care

The effects of positive leadership on quality of work and life of family doctors: The moderated role of culture

Background

Quality of work and life (QWL) of family doctors is highly valued in improving access and equity of healthcare; however, the current low level of QWL in many countries and regions needs to be improved urgently.

Methods

This study explored the effect of positive leadership on the QWL of family doctors, as well as the moderating role of culture, via analysis of data from 473 valid questionnaires of family doctors in China as a sample using SEM, hierarchical linear regression, and a simple slope test.

Results

The empirical results show that positive leadership promoted the QWL of family doctors by improving their achievement motivation and coordinating supportive resources. In addition, our hierarchical linear regression analysis found that the interactive items of positive leadership and culture had a positive effect on achievement motivation (β(a)  = 0.192), QWL (β(b)  = 0.215) and supportive resources (β(c)  = 0.195). Meanwhile, culture had a moderated mediating effect on the relationship between positive leadership and QWL via the achievement motivation of family doctors and supportive resources.

Conclusion

These findings suggest that the interaction among multiple factors, including environmental factors, individual physiological features and culture, may influence the impact of positive leadership on the QWL of family doctors. The possible reasons of these findings and theoretical and practical implications are discussed in this study.

Quality of Nursing Work Life among Nurses in Saudi Arabia: A Descriptive Cross-Sectional Study

Background: Quality of working life (QWL) is a multidimensional concept that describes an employee's satisfaction with several work life elements. Quality of nurse working life is considered as a stepping stone for health services improvement, as it affects job satisfaction which, in turn, affects the performance of nurses. Understanding and investigating the nurses' quality of work life in Saudi Arabia is needed for improvement actions. Objectives: This study aimed to examine the quality of nursing work life (QNWL) among nurses working in Saudi Arabia and to determine the association between demographic variables and quality of work life among nurses. Methods: It was a cross-sectional design using Brooks' quality of nursing work life survey. It was distributed among nurses over the kingdom of Saudi Arabia. Results: There were 860 nurses participating in the study. The mean total score for the participants was 174.5+/- 30.3, indicating moderate to high QNWL. The highest score achieved by the nurses was for the work world context (4.29) while the lowest score was for work design dimension (3.92). The study revealed that nationality, income, and shift duration, having a dependent person, and having family accompany the nurse as significant factors affecting the quality of work life among the nurses. Conclusion: A novel contribution of the current study was that the demographic characteristics of the participants, including nationality, income, having family accompany the nurse, having an independent child, or spouse or parents, and shift duration, tended to have a statistically significant correlation with QNWL. The comprehensive results of this study have practical implications whereby authority bodies can create regulatory plans for enhancing satisfaction and performance over the sole utilization of job satisfaction measurements and can thereby improve nurses' retention and turnover rates.

Quality of Work Life of Magnetic Resonance Imaging Technologists: A Cross-Sectional Study

Quality of Work Life is a multi-dimensional discipline that is concerned with the quality of life in the workplace. This study aimed to assess quality of work-life level and identify the correlation between its dimensions and Job and Career Satisfaction. The study used the 32-item WRQoL-2 tool, a questionnaire consisting of 6 subscales: Job and Career Satisfaction, Control at Work, Home-Work Interface, General Wellbeing, Stress at Work, and Work Conditions, to assess for these correlations. 57 Magnetic Resonance Imaging Technologists (MRITs) (100%) responded to the questionnaire. The study found a high level of QWL among MRITs (66.2%, 3.31/5). The level of the JCS was high (71.6%, 3.59/5), with significant correlations between JCS and WCS, CAW, HWI, and GWB. An inverse relationship was noted between SAW and JCS. Further research on QWL is advised to diagnose and provide recommendation to resolve issues that may adversely affect the quality of healthcare service provision.

Quality of Work Life Among Nurses: A case study from Ad Dakhiliyah Governorate, Oman

Objectives

Quality of work life (QWL) is an important indicator of job-related satisfaction among nurses; however, there is little information regarding the QWL of nurses in Oman. Therefore, this study aimed to explore factors affecting QWL among nurses working in governmental health institutions in Ad Dakhiliyah Governorate, Oman.

Methods

This descriptive cross-sectional study was conducted between September and November 2018 at 29 governmental health institutions in Ad Dakhiliyah Governorate. A total of 374 nurses employed at these institutions were recruited via stratified random sampling. A demographic questionnaire incorporating Brooks’ Quality of Nursing Work scale was used to collect data.

Results

A total of 345 nurses participated in the study (response rate: 92.2%). The mean age was 33.3 ± 5.1 years and the majority were female (90.7%), married (88.7%), of Omani nationality (70.1%) and had a diploma degree (70.7%). Overall, the nurses demonstrated moderate levels of QWL (mean total score: 179.99 ± 24.17). Both job designation and nationality were found to be significant predictors of QWL (P = 0.041 and <0.001, respectively).

Conclusion

The findings of this study represent a baseline for further research on this important topic. As with all healthcare professionals, the QWL of nurses indirectly affects quality of patient care and associated health outcomes. As such, identifying areas of poor QWL among nurses can help in the development of initiatives to improve their professional satisfaction, thereby enhancing job performance and employee retention.

Systematic Review and Meta-analysis of Quality of Work Life in Iran (2011-2017)

BACKGROUND

Quality of work life (QWL) is considered as a universal concept in human resource management and organizational development, and its promotion is the key to the success of organizations' management. Therefore, the present study aimed to evaluate the QWL in Iran through systematic review and meta-analysis.

METHODS

In this study, all articles related to the QWL in Iran during the years 2011-2017 were systemically reviewed by searching national and international databases such as Science Direct, PubMed, Scopus, Web of Science, Springer, SID, Magiran, Barakat Knowledge Network System, Medlib, and the Google Scholar search engine using valid keywords. The results of the studies were combined using the random effects model. The heterogeneity of studies was studied using the I2 index. Data analysis was done using STATA ver 11.

RESULTS

The mean QWL score of 15,323 samples were 60.13, 36.80, 76.19, 58.90, 68.78, 50.69, 32.24, 8.01, 70.63, 39.70, and 44.41 based on Walton, Casio, Sirgy, Mirsepasi, SF-36, Ghasem zadeh, Dehghan, Dargahi, NIOSH, Venlar, Quality of nursing work life questionnaires, respectively. Meta-regression showed that the QWL of employees had no significant relationship with the sample size and years of research.

CONCLUSIONS

The mean score of QWL in Iranian employees was 56.90, with the highest and the lowest score for the questionnaire.

Relationship between occupational burnout and demographic variables among nurses in Jahrom, Iran

Introduction

Occupational burnout is a psychological syndrome caused by the accumulation of work-related stress and characterized by intolerance, high levels of emotional exhaustion, depersonalization, and the perception of low personal accomplishment. The present study aimed to evaluate the relationship between occupational burnout and all demographic variables among the nurses in Jahrom, Iran.

Methods

The present descriptive-analytical study was carried out during 2016 among nurses employed at Motahari Hospital and Peymanieh Hospital, both affiliated to Jahrom University of Medical Sciences (Iran). Based on the inclusion criteria, a total of 250 participants were selected. The data collection instruments included a demographic questionnaire and the Maslach burnout inventory. The data were analyzed using the SPSS statistical software (version 16.0) by descriptive statistics and Spearman's test.

Results

Among the participants, 223(89.2%) nurses suffered from a moderate to high level of occupational burnout. There was a significant correlation between personal accomplishment and age (r=0.21, P=0.002) and education level (r=-0.16, P=0.01). Additionally, income level had a significant correlation with emotional exhaustion (r=-0.38, P=0.001), depersonalization (r=-0.3, P=0.001), and personal accomplishment (r=0.35, P=0.001). A significant relationship was also found between sex and depersonalization (r=-0.15, P=0.02). However, there was no significant relationship between occupational burnout subscales and the number of children, type of hospital ward, type of employment, and marital status (P>0.05).

Conclusion

A significant positive correlation was found between the subscales of occupational burnout and younger age, low income, high education, and male nurses.

The relationship between quality of life and social support among nurses: A cross-sectional study

OBJECTIVE

This research was conducted with the aim of evaluating the quality of life (QoL) and its relationship with social support of nurses.

MATERIALS AND METHODS

This cross-sectional study was performed on 241 nurses working at Zanjan University of Medical Sciences. The instruments used in this study were the Persian SF-36 tool, McCain Marquin Social Interaction Questionnaire, and information on individual and job characteristics. The sampling method was cluster sampling with probability proportional to population size. The information was analyzed using SPSS version 18 and with proportional statistics.

RESULTS

Only 31.6% (67) of the nurses had high levels of social support. The average social support was 47/65 ± 93/6. The highest mean score of QoL 67.75 ± 25.023 was related to physical activity and the lowest score mean were related to dimensions of bodily pain (54.59 ±22.727) and role limitations because of physical health problems (59.60 ± 40.261). In the linear regression model with the Enter method, the adjustment of the effects of the variables of the three dimensions of general health, mental health and happiness, and QoL was associated with social support.

CONCLUSION

The majority of nurses have moderate social support and poor QoL for nurses. Therefore, considering the effects of nurse support, it is recommended to perform supportive interventions and plan for more well-being of nurses.

A cross-sectional study on workplace experience: a survey of nurses in Quebec, Canada

BACKGROUND

Nurses play a significant role in healthcare systems. Their workplace experience can have an impact not only on nurses themselves, but also on patients and organizations, particularly in terms of quality of care and performance. Despite the importance of this experience, it remains an ambiguous concept with varying interpretations. Current studies do not fully capture its complexity, as its multiple dimensions are often considered in isolation. As such, developing a portrait of nurses' workplace experience that integrates its multiple dimensions can provide decision-makers with better indications regarding what levers can be mobilized to generate positive results for nurses, patients, and organizations.

AIM

To identify profiles of nurses' workplace experience in Quebec, Canada.

DESIGN

Cross sectional.

METHODS

In April 2017, 891 nurses participated in this study by completing a self-administered questionnaire. Four dimensions of nurses' workplace experience were measured: resources available to them in their workplace, personal resources, demands (psychological and physical) placed on them, and outcomes associated with their work. Descriptive and factorial analyses were performed.

RESULTS

Three profiles of nurses' workplace experience emerged from the factorial analyses: nurses in distress, nurses in moderately positive situations, and nurses in positive situations.

CONCLUSION

The study identified profiles of nurses' workplace experience that were differentiated based on nurses' access to workplace resources, the demands of their work, and outcomes. Healthcare managers can use the results to improve the quality of nurses' workplace experience by improving access to structural work resources and alleviating psychological demands.

Health Literacy Status and Its Relationship with Quality of Life among Nurses in Teaching Hospitals of Shiraz University of Medical Sciences

BACKGROUND

Health literacy can be considered as a factor affecting healthcare providers' decision-making. The aim of this study was to investigate health literacy status and its relationship with quality of life among the nurses working in teaching hospitals affiliated with Shiraz University of Medical Sciences in Iran.

MATERIALS AND METHODS

This cross-sectional study was conducted in 2017. To this end, 185 nurses from hospitals were selected by stratified random sampling. The data collection instruments included the standardized Health Literacy Questionnaire and the 36-Item Short Form Health Survey. The data were analyzed through descriptive statistics as well as t test, analysis of variance, Pearson correlation coefficient, and multivariate linear regression analysis using SPSS23 (α = 5%).

RESULTS

The mean scores for health literacy and quality of life were 70.06 (12.98) and 60.86 (17.26), respectively. A significant relationship was observed between the health literacy and quality of life (p <0.001), Access (p = 0.004), reading skills (p = 0.004), understanding (p = 0.016), and application of health information (p = 0.012) as the dimensions of health literacy were identified among the predictors of quality of life. In addition, there was a significant relationship among age (r = 0.22, p = 0.008), work experience (r = 0.27, p = 0.002), and employment relationship (F = 3.89, p = 0.005) and the mean score for nurses' health literacy status.

CONCLUSIONS

A significant relationship was observed between health literacy and quality of life in nurses. Healthcare policy-makers are suggested to take measures to develop programs on promoting health literacy and related skills to improve the status of quality of life among nurses.

Development of an empowerment model for burnout syndrome and quality of nursing work life in Indonesia

Objectives

This study aimed to develop an empowerment model for burnout syndrome and quality of nursing work life (QNWL).

Methods

This study adopted a mixed-method cross-sectional approach. The variables included structural empowerment, psychological empowerment, burnout syndrome and QNWL. The population consisted of nurses who have civil servant status in one of the regional hospitals in Indonesia. The participants were recruited using multi-stage sampling measures with 134 respondents. Data were collected using questionnaires, which were then analysed using partial least squares. A focus group discussion was conducted with nurses, chief nurses and the hospital management to identify strategic issues and compile recommendations.

Results

Structural empowerment influenced psychological empowerment (path coefficient = 0.440; t = 6.222) and QNWL (path coefficient = 0.345; t = 4.789). Psychological empowerment influenced burnout syndrome (path coefficient = −0.371; t = 4.303), and burnout syndrome influenced QNWL (path coefficient = −0.320; t = 5.102). Structural empowerment increased QNWL by 39.7%.

Conclusion

The development of a structural empowerment model by using the indicators of resources, support and information directly influenced the psychological empowerment of the sample of nurses. As an indicator of meaning, psychological empowerment decreased burnout syndrome. In turn, burnout syndrome, as the indicator of personal achievement, could affect the QNWL. Structural empowerment directly influenced the QNWL, particularly within the workplace context. Further studies must be conducted to analyse the effects of empowerment, leadership styles and customer satisfaction.

Validation of the Chinese version of the Quality of Nursing Work Life scale

Quality of Nursing Work Life (QNWL) serves as a predictor of a nurse's intent to leave and hospital nurse turnover. However, QNWL measurement tools that have been validated for use in China are lacking. The present study evaluated the construct validity of the QNWL scale in China. A cross-sectional study was conducted conveniently from June 2012 to January 2013 at five hospitals in Guangzhou, which employ 1938 nurses. The participants were asked to complete the QNWL scale and the World Health Organization Quality of Life abbreviated version (WHOQOL-BREF). A total of 1922 nurses provided the final data used for analyses. Sixty-five nurses from the first investigated division were re-measured two weeks later to assess the test-retest reliability of the scale. The internal consistency reliability of the QNWL scale was assessed using Cronbach's α. Test-retest reliability was assessed using the intra-class correlation coefficient (ICC). Criterion-relation validity was assessed using the correlation of the total scores of the QNWL and the WHOQOL-BREF. Construct validity was assessed with the following indices: χ2 statistics and degrees of freedom; relative mean square error of approximation (RMSEA); the Akaike information criterion (AIC); the consistent Akaike information criterion (CAIC); the goodness-of-fit index (GFI); the adjusted goodness of fit index; and the comparative fit index (CFI). The findings demonstrated high internal consistency (Cronbach's α = 0.912) and test-retest reliability (interclass correlation coefficient = 0.74) for the QNWL scale. The chi-square test (χ2 = 13879.60, df [degree of freedom] = 813 P = 0.0001) was significant. The RMSEA value was 0.091, and AIC = 1806.00, CAIC = 7730.69, CFI = 0.93, and GFI = 0.74. The correlation coefficient between the QNWL total scores and the WHOQOL-BREF total scores was 0.605 (p<0.01). The QNWL scale was reliable and valid in Chinese-speaking nurses and could be used as a clinical and research instrument for measuring work-related factors among nurses in China.

Psychometric properties of the Chinese-version Quality of Nursing Work Life Scale

In this study, we developed and tested the psychometric properties of the Chinese-version Quality of Nursing Work Life Scale along seven subscales: supportive milieu with security and professional recognition, work arrangement and workload, work/home life balance, head nurse's/supervisor's management style, teamwork and communication, nursing staffing and patient care, and milieu of respect and autonomy. An instrument-development procedure with three phases was conducted in seven hospitals in 2010-2011. Phase I comprised translation and the cultural-adaptation process, phase II comprised a pilot study, and phase III comprised a field-testing process. Purposive sampling was used in the pilot study (n = 150) and the large field study (n = 1254). Five new items were added, and 85.7% of the original items were retained in the 41 item Chinese version. Principal component analysis revealed that a model accounted for 56.6% of the variance with acceptable internal consistency, concurrent validity, and discriminant validity. This study gave evidence of reliability and validity of the 41 item Chinese-version Quality of Nursing Work Life Scale.

Quality of work life as a predictor of nurses' intention to leave units, organisations and the profession

AIM

To examine the relationships between quality of work life (QWL) and nurses' intention to leave their unit (ITLunit), organisation (ITLorg) and profession (ITLpro).

BACKGROUND

The high turnover rate among nurses presents a major challenge to health care systems across the globe. QWL plays a significant role in nurses' turnover.

METHODS

A descriptive cross-sectional survey design was conducted via purposive sampling of 1283 hospital nurses and administering the Chinese version of the Quality of Nursing Work Life scale (C-QNWL), a three-ITL-type scale questionnaire, and a demographic questionnaire for individual- and work-related variables. Descriptive data, correlations, and ordinal regression models were analyzed.

RESULTS

QWL predicted ITLpro and ITLorg better than ITLunit. Three QWL dimensions (work arrangement and workload, nursing staffing and patient care, and work-home life balance) were significantly predictive of all three ITL measures. However, the dimension of teamwork and communication was only predictive for ITLunit, not for ITLorg and ITLpro.

CONCLUSIONS

Different patterns of QWL dimensions are predictive of ITLunit, ITLorg, and ITLpro.

IMPLICATIONS FOR NURSING MANAGEMENT

The study provides important information to nurse administrators about the aspects of QWL that most commonly lead nurses to leave their units, organisations, and even the profession itself.

Quality of work life among primary health care nurses in the Jazan region, Saudi Arabia: a cross-sectional study

BACKGROUND

Quality of work life (QWL) is defined as the extent to which an employee is satisfied with personal and working needs through participating in the workplace while achieving the goals of the organization. QWL has been found to influence the commitment and productivity of employees in health care organizations, as well as in other industries. However, reliable information on the QWL of primary health care (PHC) nurses is limited. The purpose of this study was to assess the QWL among PHC nurses in the Jazan region, Saudi Arabia.

METHODS

A descriptive research design, namely a cross-sectional survey, was used in this study. Data were collected using Brooks' survey of quality of nursing work life and demographic questions. A convenience sample was recruited from 134 PHC centres in Jazan, Saudi Arabia. The Jazan region is located in the southern part of Saudi Arabia. A response rate of 91% (n = 532/585) was achieved (effective response rate = 87%, n = 508). Data analysis consisted of descriptive statistics, t-test and one way-analysis of variance. Total scores and subscores for QWL items and item summary statistics were computed and reported using SPSS version 17 for Windows.

RESULTS

Findings suggested that the respondents were dissatisfied with their work life. The major influencing factors were unsuitable working hours, lack of facilities for nurses, inability to balance work with family needs, inadequacy of vacations time for nurses and their families, poor staffing, management and supervision practices, lack of professional development opportunities, and an inappropriate working environment in terms of the level of security, patient care supplies and equipment, and recreation facilities (break-area). Other essential factors include the community's view of nursing and an inadequate salary. More positively, the majority of nurses were satisfied with their co-workers, satisfied to be nurses and had a sense of belonging in their workplaces. Significant differences were found according to gender, age, marital status, dependent children, dependent adults, nationality, nursing tenure, organizational tenure, positional tenure, and payment per month. No significant differences were found according to education level of PHC nurses and location of PHC.

CONCLUSIONS

These findings can be used by PHC managers and policy makers for developing and appropriately implementing successful plans to improve the QWL. This will help to enhance the home and work environments, improve individual and organization performance and increase the commitment of nurses.

The relationship between quality of work life and turnover intention of primary health care nurses in Saudi Arabia

Background

Quality of work life (QWL) has been found to influence the commitment of health professionals, including nurses. However, reliable information on QWL and turnover intention of primary health care (PHC) nurses is limited. The aim of this study was to examine the relationship between QWL and turnover intention of PHC nurses in Saudi Arabia.

Methods

A cross-sectional survey was used in this study. Data were collected using Brooks’ survey of Quality of Nursing Work Life, the Anticipated Turnover Scale and demographic data questions. A total of 508 PHC nurses in the Jazan Region, Saudi Arabia, completed the questionnaire (RR = 87%). Descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression, and hierarchical multiple regression were applied for analysis using SPSS v17 for Windows.

Results

Findings suggested that the respondents were dissatisfied with their work life, with almost 40% indicating a turnover intention from their current PHC centres. Turnover intention was significantly related to QWL. Using standard multiple regression, 26% of the variance in turnover intention was explained by QWL, p < 0.001, with R² = .263. Further analysis using hierarchical multiple regression found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, p < 0.001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables.

Conclusions

Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes.

The nursing profession in Saudi Arabia: an overview

AIM

The study aims to provide an overview of the nursing profession in Saudi Arabia, including its history, educational development, workforce and professional practice.

BACKGROUND

Saudi Arabia is faced with a chronic shortage of Saudi nurses, accompanied by high rates of turnover. Expatriate nurses form a large proportion of the nursing workforce in Saudi healthcare facilities, with Saudis comprising only 29.1% of the total nursing workforce. Despite the fact that the proportion of Saudi nurses is very low in general, this rate is lower in the private health sector where local nurses comprise only 4.1% of the total.

METHODS

Data relating to the nursing profession in Saudi Arabia were extracted from published literature identified through search of a range of publically available databases such as Medline, CINAHL, Google Scholar, Saudi health databases, Saudi health journals, government reports and relevant texts. Obtained information was evaluated for relevance and grouped on a thematic basis.

CONCLUSION

The status of nursing in Saudi Arabia should be enhanced in order to make it a worthwhile career. The media should engage in helping to promote a positive image of the nursing profession. The education sector should reconsider the length of nursing training (5 years compared with 3 years in many developed countries) while maintaining competent and safe practice. Reducing the financial burden on the nursing student through provision of additional financial support would encourage more students. In particular, nurses should be paid a full salary during the intern year as currently occurs with medical students.

Job embeddedness and nurse retention

BACKGROUND

Nurse retention is a different way of conceptualizing the employer-employee relationship when compared with turnover. Job embeddedness (JE), a construct based on retention, represents the sum of reasons why employees remain at their jobs. However, JE has not been investigated in relation to locale (urban or rural) or exclusively with a sample of registered nurses (RNs). The purpose of this study was to determine what factors (JE, age, gender, locale, and income) help predict nurse retention.

METHODS

A cross-sectional mailed survey design was used with RNs in different locales (urban or rural). Job embeddedness was measured by the score on the composite, standardized instrument. Nurse retention was measured by self-report items concerning intent to stay.

RESULTS

A response rate of 49.3% was obtained. The typical respondent was female (96.1%), white, non-Hispanic (87.4%), and married (74.9%). Age and JE were predictive of nurse retention and accounted for 26% of the explained variance in intent to stay. Although age was a significant predictor of intent to stay, it accounted for only 1.4% of the variance while JE accounted for 24.6% of the variance of nurse retention (as measured by intent to stay).

CONCLUSIONS

Older, more "embedded" nurses are more likely to remain employed in their current organization. Based on these findings, JE may form the basis for the development of an effective nurse retention program.

Quality of Nursing Worklife

A critical appraisal of the construct of quality of nursing worklife is presented in an interview with Dr. Beth Brooks. Dr Brooks makes a strong case for better understanding of nursing worklife as essential to healthcare in the future.

The nature nursing quality of work life: an integrative review of literature

Studies that have examined the nursing quality of work life (QWL) have not been systematically reviewed in the recent years. Thus, the current study was aimed to identify the predictors of the nurses' QWL and determine the definitions of QWL for nurses. The authors used an integrative review of the literature and identified six themes as the major predictors of the nurses' QWL: leadership and management style/decision-making latitude, shift working, salary and fringe benefits, relationship with colleagues, demographic characteristics, and workload/job strain. Although different researchers had varied perspectives on the QWL in nursing, most viewed QWL as a subjective phenomenon that is influenced by personal feeling and perceptions. A closer review of definitions of QWL indicated that some authors considered QWL as an "outcome," whereas others saw it as a "process." Further research needs to be conducted to determine the relative importance of QWL predictors, and implementation programs to improve the QWL.

Nurses' Perceptions of Their Work Environment

Supervisor support is one factor contributing to a healthy work environment for registered nurses (RNs). This study explored differences in RNs' perceptions of their work environment by both years in the profession and current position. A statistically significant difference was found for RNs' perceptions of Supervisor Support based on number of years in current position. Those RNs with less than 2 years in their current position perceived the greatest Supervisor Support (X = 6.96; P = .03).

Assessing the quality of nursing work life

Traditionally, nursing has measured job satisfaction by focusing on employees' likes and dislikes. However, job satisfaction is an unsatisfactory construct to assess either the jobs themselves or employees' feelings about work sinceas much as 30% of the variance explained in job satisfaction surveys is a function of personality, something employers can do little to change. Based on socio-technical systems theory, quality of nursing work life (QNWL) assessments focus on identifying opportunities for nurses to improve their work and work environment while achieving the organization's goals. Moreover, some evidence suggests that improvements in work life are needed to improve productivity. Therefore, assessing QNWL reveals areas for improvement where the needs of both the employees and the organization converge. The purpose of this article was to assess the QNWL of staff nurses using Brooks' Quality of Nursing Work Life Survey.

Nurses' Narratives of Unforgettable Patient Care Events

PURPOSE

To explore the experience of registered nurses (RNs) caring for patients in contemporary hospitals.

DESIGN

The descriptive phenomenological study was based in the philosophical perspectives of Husserl and Merleau-Ponty.

METHODS

A purposive sample of 46 RNs employed in acute care hospitals in the southeastern United States (US) were recruited by network sampling. Data from unstructured interviews were analyzed in an interpretive group and themes were identified.

FINDINGS

Four themes were identified: (a) extraordinary caregiving events, (b) incomprehensibility, (c) questioning whether anything else could have been done, and (d) "alone or together," indicating the isolation nurses often experience while giving care as well as profound moments of connection, especially with patients.

CONCLUSIONS

Caregiving experiences resulted in an accumulating residue of moral distress which in turn became ground for future experiences in the everyday work life of RNs. Sometimes years later, participants were still trying to justify and understand the outcomes and perhaps to absolve themselves from blame. Participants were confronted with the limits of science and skill and plunged into the realm of existential questions for which they had no ready answers.

Said another way. Our obligation to float

TOPIC

Floating is one method that can help alleviate the burden and consequences of the nursing shortage.

PURPOSE

The devastating effects that occur as a result of the nursing shortage are discussed. As a result, floating is argued as a viable solution. The practice of floating is explored from an ethical approach.

SOURCES OF INFORMATION

Professional literature, electronic resources, nursing textbooks, from statements provided from the American Association of Colleges of Nursing, Joint Commission on Accreditation of Healthcare Organizations, Six Sigma, legal cases, and personal experience.

CONCLUSION

Although many nurses oppose the practice of floating, it remains not only necessary, but it is also our obligation. It is acknowledged that floating has its opposition, but the arguments posed are not justifiable when they are weighed against the consequences of not floating.