Implementing differentiated practice: personal values and work satisfaction among hospital staff nurses

A Differentiated Practice Model for School Nursing

School nursing is notable for autonomous practice and independent decision-making. School nurses practice within a complex school health services environment that is subject to constant change, the influence of multiple stakeholders, and a chronic state of uncertain resources. Other professional challenges faced by school nurses are a lack of standardized entry education requirement, inadequate theoretical research with practice application, and expanding role responsibilities. Administrative restructuring of school nursing services using a differentiated practice model could be a method to address the challenges of school nurse practice. A model of differentiated school nursing practice is proposed as a starting point for the national school nurse audience to consider this alternative to the master's entry requirement. School nurse role responsibilities are divided among three levels of practitioners: generalist, master's prepared, and school nurse policy analyst. Each level features an increased scope of responsibility based on higher educational attainment. Research regarding how differentiated practice has been implemented in other health care settings is described. Implications for the implementation of differentiated practice in school health services are discussed, including the need for cooperation among stakeholders, possible cost considerations, and how school nurse education might be affected.

Development and Psychometric Testing of the Mariani Nursing Career Satisfaction Scale

Background and Purpose: The Mariani Nursing Career Satisfaction Scale© (MNCSS) was developed to explore the influence of mentoring on career satisfaction of registered nurses (RNs). A review of the literature revealed no contemporary valid and reliable measure of career satisfaction. Methods: The MNCSS is a semantic differential of 16 opposite adjective pairs on which participants rate feelings about their nursing career. The MNCSS was used in a pilot study and three major studies exploring career satisfaction of RNs. Validity, reliability, and exploratory factor analysis (FA) were computed to explore the internal structure of the instrument. Results: The newly developed instrument had a content validity index (CVI) of .84 and Cronbach’s alpha internal consistency reliabilities of .93–.96 across three major studies. Exploratory FA (N = 496) revealed a univocal instrument with one factor that explains 57.8% of the variance in career satisfaction scores. Conclusions: The MNCSS is a valid and reliable instrument for measuring career satisfaction. FA of the combined data from three studies yielded one factor that measures the concept of career satisfaction.

The effect of mentoring on career satisfaction of registered nurses and intent to stay in the nursing profession

Mentoring is important in the career development of novice and experienced nurses. With the anticipated shortage in nursing, it is important to explore factors such as mentoring that may contribute to career satisfaction and intent to stay in the profession. This study explored the effects of mentoring on career satisfaction and intent to stay in nursing, and the relationship between career satisfaction and intent to stay in nursing. It was conducted through a mailed survey of RNs 55 years or younger currently in practice, education, administration, or research. Career satisfaction was measured through the use of the newly developed Mariani Nursing Career Satisfaction Scale. Findings revealed no statistically significant effect of mentoring on career satisfaction and intent to stay in nursing. There was a statistically significant relationship between career satisfaction and intent to stay in nursing. The majority of nurses reported participating in a mentoring relationship. Although the findings related to mentoring, career satisfaction, and intent to stay were not statistically significant, there was a prevalence of mentoring in nursing, thus suggesting the need for future research to identify outcomes of mentoring. In addition, the study contributed a newly developed instrument to measure the concept of career satisfaction in nursing.

A Reflective Model for Organizational Assessment and Interventions

A visionary academic medical center in Colombia, South America, engaged the Institute for Nursing Healthcare Leadership in a multifaceted project for the overall goal of strengthening the model of professional practice. The authors describe a reflective model for organizational assessment that steered the in-depth assessment of the organization. The model combines the constructs of culture, theory, patterns, and phenomenon with an iterative process. The organizational reflection process is applied to assessing key nursing roles and the nursing care delivery system. Recommendations and interventions that emerged from the assessment are included.