Carol Hall Ellenbecker

Job satisfaction, occupational commitment and intent to stay among Chinese nurses: a cross‐sectional questionnaire survey

AIMnThis study was designed to identify the level of nurses job satisfaction, occupational commitment and intent to stay among mainland Chinese nurses, to explore the relationship among them.nnnBACKGROUNDnu2002 Little is known about the magnitude of Chinese nurses intent to stay. Understanding the association among demographic characteristics and job satisfaction, occupational commitment and intent to stay among Chinese nurses is most important in a time of nurse shortages. Methods.u2002 A descriptive correlation design was used to examine the relationship among variables related to intent to stay. Data were collected by a self-administered survey questionnaire from 560 nurses working in four large hospital facilities in Shanghai in 2009.nnnRESULTSnThe mean scores for nurses job satisfaction, occupational commitment and intent to stay were 3·25(0·48), 3·11(0·40) and 3·56(0·65), respectively. Job satisfaction and occupational commitment were significantly related to intent to stay. A statistically significant positive correlation was found between occupational commitment and job satisfaction. Age and job position were significantly related to job satisfaction, occupational commitment and intent to stay.nnnCONCLUSIONnLevels of job satisfaction, occupational commitment and intent to stay reported by nurses in this study can be improved. Suggested strategies for improvement are: increasing salaries, decreasing workloads, modifying task structure, cultivating work passion and creating more professional opportunity for nurses personal growth development and promotion. Enhancing nurses job satisfaction and occupational commitment are vital to improve nurses intent to stay and for strategies to address the nursing shortage.

Predictors of Home Healthcare Nurse Retention

PURPOSEnTo examine the level of job satisfaction and test a theoretical model of the direct and indirect effects of job satisfaction, and individual nurse and agency characteristics, on intent to stay and retention for home healthcare nurses.nnnDESIGNnA descriptive correlation study of home healthcare nurses in six New England states.nnnMETHODSnHome healthcare nurse job satisfaction self-report data was collected with the HHNJS survey questionnaire & Retention Survey Questionnaire.nnnFINDINGSnBased on a structural equation model, job tenure and job satisfaction were the strongest predictors of nurse retention.nnnCONCLUSIONSnUnderstanding the variables associated with home healthcare nurse retention can help agencies retain nurses in a time of severe nurse shortages and increased patient demand.nnnCLINICAL RELEVANCEnPredicted nursing shortages and increasing demand have made the retention of experienced, qualified nursing staff essential to assure access to high-quality home healthcare services in the future.

What home healthcare nurses are saying about their jobs.

A troubling bit of evidence recently reported by Sochalski (2004a) is that among all groups of nurses, those working in home care are among the most dissatisfied with their jobs. This is a change from the past, when nurses working in home healthcare were believed to be the most highly satisfied group of nurses (Simmons et al., 2001). The source of nurses’ dissatisfaction has been attributed to the changing work environment in home care (Anthony & Milone-Nuzzo, 2005;Ellenbecker & Byleckie, 2005b) brought about by recent federal and state regulations. Requirements for the Outcome Assessment and Information Set (OASIS) and a capitated reimbursement system with incentives to limit the amount of contact nurses have with patients have increased nurses’ work demands (Anthony & Milone-Nuzzo; Smith-Stoner, 2004b). The changes made in organizational structures and policies to adapt to the changes in regulation and inadequate staffing have increased nurses’ workloads, job stress, and job dissatisfaction (Smith-Stoner, 2002, 2004;Sochalski, 2004b).

Home healthcare nurse retention and patient outcome model: discussion and model development

AIMnThis paper discusses additions to an empirically tested model of home healthcare nurse retention. An argument is made that the variables of shared decision-making and organizational commitment be added to the model based on the authors previous research and additional evidence from the literature.nnnBACKGROUNDnPrevious research testing the home healthcare nurse retention model established empirical relationships between nurse, agency, and area characteristics to nurse job satisfaction, intent to stay, and retention. Unexplained model variance prompted a new literature search to augment understanding of nurse retention and patient and agency outcomes.nnnDATA SOURCESnData come from the authors previous research, and a literature search from 1990 to 2011 on the topics organizational commitment, shared decision-making, nurse retention, patient outcomes and agency performance.nnnDISCUSSIONnThe literature provides a rationale for the additional variables of shared decision-making and affective and continuous organizational commitment, linking these variables to nurse job satisfaction, nurse intent to stay, nurse retention and patient outcomes and agency performance. Implications for nursing.u2002 The new variables in the model suggest that all agencies, even those not struggling to retain nurses, should develop interventions to enhance nurse job satisfaction to assure quality patient outcomes.nnnCONCLUSIONnThe new nurse retention and patient outcome model increases our understanding of nurse retention. An understanding of the relationship among these variables will guide future research and the development of interventions to create and maintain nursing work environments that contribute to nurse affective agency commitment, nurse retention and quality of patient outcomes.

Employer Retention Strategies and Their Effect on Nurses' Job Satisfaction and Intent to Stay

ABSTRACT Faced with a nursing shortage and anticipated increase in demand, home care agencies are implementing retention strategies with little knowledge of their effectiveness. The purpose of this study is to describe the strategies implemented and their effect on nurse job satisfaction and intention to leave. Data were collected from a random sample of 123 New England agencies during in-person interviews. Most agencies reported implementing multiple recruitment and retention strategies. Regression results suggest that the effects of employer retention strategy on nurses intent to stay are the indirect result of its effects on job satisfaction. The only retention intervention that made a statistically significant difference in job satisfaction was shared governance, and no retention strategy directly affected nurses intention to stay in their jobs.

Preparing the nursing workforce of the future.

Nurse shortages coupled with the need for national healthcare reform present a challenge. We are not preparing enough nurses nor are we preparing nurses with the right skills to fully participate in a reformed healthcare system. Historical forces in nursing education have resulted in multiple levels of entry into nursing practice and an inadequate nursing workforce. Today’s environment of expanding knowledge, the call for interdisciplinary healthcare delivery teams, and evidence of the relationship between nurse education and improved patient outcomes strongly indicate the need for nurses prepared at the baccalaureate level. Requiring a baccalaureate degree for entry into nursing practice, and as the initial degree of nursing education would prepare nurses earlier for graduate education and the much needed roles of educator, researcher and advanced practice nurse. The nursing profession should take the lead in advocating for educational policies that would adequately prepare the nurse workforce of the future.

Home Health Care Nurses’ Job Satisfaction: A System Indicator

The home health care industry has recently undergone tremendous change. How providers of care are adapting to the changes in their environment and the effect this has on nurses’ job satisfaction has not been explored. Nurses’ job satisfaction provides an indicator of a change in the system’s ability to deliver quality patient care and to attract and retain staff. The purpose of this study is to describe the level of job satisfaction of home health care nurses in three regions of the country. Neal’s theory of becoming a home health nurse was used as a framework for understanding the findings. Nurses in this study were satisfied with aspects of their job related to professional autonomy, relationships with patients and peers, and a sense that their work is worthwhile and important. They are less satisfied with their relationship to administration and their ability to effect changes in the system.

Agencies make a difference in home healthcare nurses' job satisfaction.

The purpose of this study was to explore the factors that contribute to variability in home healthcare nurses’ job satisfaction. Nurses completed the 30-item Home Healthcare Nurses Job Satisfaction Scale specifically designed to measure job satisfaction of home healthcare nurses. Results suggest that the greatest amount of variability in satisfaction for home healthcare nurses are salary and benefits, stress and workload, and organizational factors, that is, factors over which organizations and management have the most control.

Predictors of hospital nurses' intent to stay: a cross‐sectional questionnaire survey in Shanghai, China

Wang L., Tao H., Ellenbecker C.H. & Liu X.H. (2012) Predictors of hospital nurses intent to stay: a cross-sectional questionnaire survey in Shanghai, China. International Nursing Revie n nAim:u2002 To investigate predictors of hospital nurses intent to stay in the nursing profession. n nMethods:u2002 A cross-sectional survey design was adopted. Over 1000 nurses working in hospitals in Shanghai, China, were invited to complete a survey questionnaire between May and October 2009 and 919 nurses responded for an 82% response rate. n nFindings:u2002 Regression models explained 41.3% of variance in nurse intent to stay. Although the proposed model hypothesized 18 predictors of intent to stay, only seven were statistically significant factors of nurse intent to stay: normative commitment, economic costs commitment, age, limited alternatives commitment, praise/recognition, professional advancement opportunities and the hospital classification. Of these, the strongest predictors were normative commitment, economic costs commitment and age, which explained 37.3% of variance in nurse intent to stay. n nConclusion:u2002 Possible strategies to improve nurses intent to stay include employment practices that improve the work environment, increased wages and benefits, and greater professional opportunity for nurses personal growth development and promotion. Healthcare organizations should establish an asserting and nurturing environment for nurses and improve nurses normative commitment and economic costs commitment. Increased effort should be made to improve nurses conditions in primary and secondary hospitals where nurses report a lower level of intent to stay in nursing. n nStudy Limitations:u2002 Participants came from a limited number of hospitals in Shanghai. A larger sample from different hospitals in Shanghai and other districts in Mainland China could have enhanced the generalizability of the results and increased the power of the study.AIMnTo investigate predictors of hospital nurses intent to stay in the nursing profession.nnnMETHODSnA cross-sectional survey design was adopted. Over 1000 nurses working in hospitals in Shanghai, China, were invited to complete a survey questionnaire between May and October 2009 and 919 nurses responded for an 82% response rate.nnnFINDINGSnRegression models explained 41.3% of variance in nurse intent to stay. Although the proposed model hypothesized 18 predictors of intent to stay, only seven were statistically significant factors of nurse intent to stay: normative commitment, economic costs commitment, age, limited alternatives commitment, praise/recognition, professional advancement opportunities and the hospital classification. Of these, the strongest predictors were normative commitment, economic costs commitment and age, which explained 37.3% of variance in nurse intent to stay.nnnCONCLUSIONnPossible strategies to improve nurses intent to stay include employment practices that improve the work environment, increased wages and benefits, and greater professional opportunity for nurses personal growth development and promotion. Healthcare organizations should establish an asserting and nurturing environment for nurses and improve nurses normative commitment and economic costs commitment. Increased effort should be made to improve nurses conditions in primary and secondary hospitals where nurses report a lower level of intent to stay in nursing.nnnSTUDY LIMITATIONSnParticipants came from a limited number of hospitals in Shanghai. A larger sample from different hospitals in Shanghai and other districts in Mainland China could have enhanced the generalizability of the results and increased the power of the study.

A Nursing PhD Specialty in Health Policy: University of Massachusetts Boston:

This article describes the Nursing PhD Program specialty in health policy conceived and developed at the University of Massachusetts Boston. The rationale for a specialty in health policy is that nurses have valuable knowledge and a unique perspective of the health care system. Nurses belong to the largest group of health care providers and are the providers that spend the most time with patients. The nursing profession has a responsibility to help assure members of society have access to safe and effective quality health care. As a group, nurses need to be politically savvy to translate their knowledge and perspective to benefit society. Nurses need to direct their attention to understanding issues and policy arguments and to contribute to policy discussion with reasoned arguments and objectivity. The PhD program at the University of Massachusetts Boston prepares nurses as policy analysts, researchers, and educators who will positively contribute to the health of society.