Jaynelle F. Stichler

Nursing work environment and nurse caring: relationship among motivational factors

AIM This paper is a report of a study of the relationships among compassion satisfaction, nurse job satisfaction, stress, burnout and compassion fatigue to nurse caring. BACKGROUND Nurse caring is the most influential dimension of patient advocation and is predictive of patient satisfaction. Qualitative studies have indicated that nurse caring is a key motivational factor impacting recruitment and retention. METHODS A correlational study of nurses (N = 126) was conducted in 2008 at a single, academic medical center. The six variables of interest were operationalized using four valid and reliable research instruments: (1) the Mueller McCloskey Satisfaction Scale, (2) the Professional Quality of Life Scale, (3) the Stress in General Scale and (4) the Caring Behaviors Inventory. RESULTS Pearson Product-moment correlations showed statistically significant relationships between nurse caring and compassion satisfaction (r = 0.51, P < 0.001), nurse job satisfaction subscales (r = 0.16-0.28, P < 0.05), stress (r = -0.21, P < 0.05), and burnout (r = -0.22, P < 0.01). A statistically significant relationship was found between the nurse caring subscale of knowledge and skill and compassion fatigue (r = -0.22, P < 0.01). Hierarchical multiple regression analysis demonstrated that compassion satisfaction (R(2) = 0.287, beta = 0.536, P = 0.000) and nurse satisfaction with social interaction opportunities related to work (beta = 0.223, P = 0.032) explained variability in nurse caring. CONCLUSION Fostering compassion satisfaction and social interaction opportunities among nurses may improve nurse caring, potentially sustaining long-term improvements in patient.

Predictors of knowledge, attitudes, use and future use of evidence-based practice among baccalaureate nursing students at two universities

Nursing students are strategically positioned to influence adoption of evidence-based practice within the nursing profession. The purpose of this study was to identify the predictors of knowledge, attitudes, use and future use of evidence-based practice among baccalaureate nursing students at two universities. A cross-sectional survey design was used to study a convenience sample of 436 nursing students (response rate of 63.3%) enrolled at two baccalaureate nursing programs at the beginning of 2007 fall semester in the United States. The surveys included demographic questionnaire and knowledge, attitudes and behaviors questionnaire for evidence-based practice. EBP Knowledge, Attitudes toward EBP and Future Use of EBP subscales demonstrated statistically significant increase in mean scores with advancing academic levels. Confidence in clinical decision-making and clinical preparedness had moderate positive correlation with EBP Use and Future use of EBP. Simultaneous multiple regression analyses indicated that the clinical preparedness and confidence in clinical decision-making were statistically significant predictor variables for EBP use and Future use of EBP. Clinically well-prepared nursing students with high confidence in clinical decision-making are most likely to use evidence-based practice, both in the present and the future.

Faculty knowledge, attitudes, and perceived barriers to teaching evidence-based nursing.

This study measured the knowledge, attitudes, and perceived barriers to teaching evidence-based practice (EBP) among nursing faculty at two schools of nursing with baccalaureate and masters level programs in southwestern United States. Survey instruments included a demographic survey, the Evidence-Based Practice Questionnaire, and the BARRIERS to Research Utilization Scale. Descriptive statistics, Pearsons correlations, and hierarchical multiple regression procedures were employed to analyze the data. The results indicated that masters prepared faculty had significantly higher mean scores in the practice of EBP as compared with doctorally prepared faculty, and although faculty positively viewed EBP, their attitude toward EBP was more positive than their knowledge/skills and practice of EBP. One of the major findings in the study was that traditional research knowledge and skills among faculty does not necessarily translate to a supportive attitude or knowledge of the EBP process or skills in acquiring and appraising evidence. Understanding facultys knowledge, attitudes, and practice of teaching EBP is a critical step to successfully transforming the schools culture to an evidence-based framework for teaching nursing practice, integrating of EBP content into curricula, and ensuring student mastery and appreciation of EBP.

Predictors of nurse manager stress: A dominance analysis of potential work environment stressors

BACKGROUND Nurse managers have important but stressful jobs. Clinical or bedside nurse predictors of stress have been studied more frequently, but less has been done on work environment predictors for those in this first-line leadership role. Understanding the relative importance of those work environment predictors could be used to help identify the most fruitful areas for intervention, potentially improving recruitment and retention for nurse managers. OBJECTIVE Using Role Stress Theory and the Job Demands-Resources Theory, a model was tested examining the relative importance of five potential predictors of nurse manager stress (i.e., stressors). The work environment stressors included role ambiguity, role overload, role conflict, organizational constraints, and interpersonal conflict. DESIGN AND SETTINGS A quantitative, cross-sectional survey study was conducted with a convenience sample of 36 hospitals in the Southwestern United States. PARTICIPANTS All nurse managers working in these 36 hospitals were invited to participate. Of the 636 nurse managers invited, 480 responded, for a response rate of 75.5%. METHODS Questionnaires were distributed during nursing leadership meetings and were returned in person (in sealed envelopes) or by mail. RESULTS Because work environment stressors were correlated, dominance analysis was conducted to examine which stressors were the most important predictors of nurse manager stress. Role overload was the most important predictor of stress, with an average of 13% increase in variance explained. The second- and third-most important predictors were organizational constraints and role conflict, with an average of 7% and 6% increase in variance explained, respectively. CONCLUSION Because other research has shown deleterious effects of nurse manager stress, organizational leaders are encouraged to help nurse managers reduce their actual and/or perceived role overload and organizational constraints.

Succession Planning: Why Grooming Their Replacements is Critical for Nurse Leaders

Succession planning is an essential task for the effective nurse leader and is more important than ever, as a significant number of nurse leaders from the Baby Boomer generation are planning retirement in the next few years. The prowWe’re all so busy keeping up with our day-today responsibilities that few of us think about the end of our job, or plan for time when another person will take our place. But succession planning is an important thing to consider and is a hallmark of a true leader. The effective leader is one who can step out of the water and not leave a ripple. In fact, the time for causing ripples is when you’re influencing your team members to achieve their maximum potential, not when you’re leaving your job. The true leader effectively grooms, grows and nurtures Jaynelle F. Stichler, DNSc, RN, FACHE, FAAN

Healthy work environments for the ageing nursing workforce.

AIM The aim of this article is to describe the physical challenges that ageing nurses experience and the facility design features that can promote healthy work environments to motivate nurses to continue working. BACKGROUND Older nurses are working longer and beyond the usual retirement age. They often experience chronic fatigue and the usual physical and cognitive changes associated with aging. Nursing is a physically demanding profession and many older nurses work in pain while providing direct patient care. The literature is replete with studies focusing on the organisational factors that retain older nurses, but little research addresses design factors that facilitate nurses working longer and more safely in direct patient care. EVALUATION Electronic databases in medicine, nursing, psychology, and architecture were searched and evidence-based, non-evidence-based, and review articles and government and organisational newsletters were evaluated. KEY ISSUES Hospital design can help address the physical work challenges that older nurses experience. CONCLUSIONS Older nurses have a wealth of knowledge and expertise, and the design of nursing units can optimize their work experience. IMPLICATIONS FOR NURSING MANAGEMENT Nurse Managers must participate in design efforts and advocate designs that support aging nurses.

Developing collaborative relationships.

Most professionals want to work in a positive, supportive environment. In fact, most professionals spend more of their waking hours in the workplace than they do at home. A positive work environment is not only essential for physical and mental well-being, its also critical in ensuring a healthy outcome for patients. Collaborative relationships in the workplace can create a collegial and friendly foundation from which practice can be developed.

Developing Collaborative Relationships: Balancing Professional Power in the Health Care Environment

Most professionals want to work in a positive, supportive environment. In fact, most professionals spend more of their waking hours in the workplace than they do at home. A positive work environment is not only essential for physical and mental well-being, its also critical in ensuring a healthy outcome for patients. Collaborative relationships in the workplace can create a collegial and friendly foundation from which practice can be developed.

Predictors of Evidence‐Based Practice Implementation, Job Satisfaction, and Group Cohesion Among Regional Fellowship Program Participants

BACKGROUND A regional, collaborative evidence-based practice (EBP) fellowship program utilizing institution-matched mentors was offered to a targeted group of nurses from multiple local hospitals to implement unit-based EBP projects. The Advancing Research and Clinical Practice through Close Collaboration (ARCC) model postulates that strong EBP beliefs result in high EBP implementation, which in turn causes high job satisfaction and group cohesion among nurses. AIMS This study examined the relationships among EBP beliefs, EBP implementation, job satisfaction, group cohesion, and group attractiveness among the fellowship program participants. METHODS A total of 175 participants from three annual cohorts between 2012 and 2014 completed the questionnaires at the beginning of each annual session. The questionnaires included the EBP beliefs, EBP implementation, job satisfaction, group cohesion, and group attractiveness scales. RESULTS There were positive correlations between EBP beliefs and EBP implementation (r = 0.47; p <.001), as well as EBP implementation and job satisfaction (r = 0.17; p = .029). However, no statistically significant correlations were found between EBP implementation and group cohesion, or group attractiveness. Hierarchical multiple regression models showed that EBP beliefs was a significant predictor of both EBP implementation (β = 0.33; p <.001) and job satisfaction (β = 0.25; p = .011). However, EBP implementation was not a significant predictor of job satisfaction, group cohesion, or group attractiveness. LINKING EVIDENCE TO ACTION In multivariate analyses where demographic variables were taken into account, although EBP beliefs predicted job satisfaction, no significant relationship was found between EBP implementation and job satisfaction or group cohesion. Further studies are needed to confirm these unexpected study findings.Background A regional, collaborative evidence-based practice (EBP) fellowship program utilizing institution-matched mentors was offered to a targeted group of nurses from multiple local hospitals to implement unit-based EBP projects. The Advancing Research and Clinical Practice through Close Collaboration (ARCC) model postulates that strong EBP beliefs result in high EBP implementation, which in turn causes high job satisfaction and group cohesion among nurses. Aims This study examined the relationships among EBP beliefs, EBP implementation, job satisfaction, group cohesion, and group attractiveness among the fellowship program participants. Methods A total of 175 participants from three annual cohorts between 2012 and 2014 completed the questionnaires at the beginning of each annual session. The questionnaires included the EBP beliefs, EBP implementation, job satisfaction, group cohesion, and group attractiveness scales. Results There were positive correlations between EBP beliefs and EBP implementation (r = 0.47; p <.001), as well as EBP implementation and job satisfaction (r = 0.17; p = .029). However, no statistically significant correlations were found between EBP implementation and group cohesion, or group attractiveness. Hierarchical multiple regression models showed that EBP beliefs was a significant predictor of both EBP implementation (β = 0.33; p <.001) and job satisfaction (β = 0.25; p = .011). However, EBP implementation was not a significant predictor of job satisfaction, group cohesion, or group attractiveness. Linking Evidence to Action In multivariate analyses where demographic variables were taken into account, although EBP beliefs predicted job satisfaction, no significant relationship was found between EBP implementation and job satisfaction or group cohesion. Further studies are needed to confirm these unexpected study findings.

The Bottom Line: Financial Management Skills for Nurse Leaders

Managers work at the bidding of the organization and have vested positions to manage the resources of the organization, including the human, material and fi nancial resources, and to use those resources effectively in providing quality service, ensuring optimal patient tThe literature is full of articles outlining the critical competencies necessary to be a successful manager, including skills in articulating the vision to the organization (Hesselbein & Cohen, 1999), creating a positive work environment (Foley, Kee, Minick, Harvey, & Jennings, 2002), thinking strategically (Stichler, Noonan, Jones, Looker, & Weiss, 2001), empowering the workforce (Laschinger & Finegan, 2005; Laschinger & Wong, 1999), communicating effectively (Sherman, Bishop, Eggenberger, & Karden, 2007) and managing the resources of the organization (Kleinman, 2003; Sherman Jaynelle F. Stichler, DNSc, RNC, FACHE