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BACKGROUND: Emergency room (ER) nurses are frequently exposed to traumatic events (TE) at work. These events can lead to symptoms of post-traumatic stress disorder (PTSD). AIM: The goal of the present study was to describe the factors associated with PTSD symptoms. METHODS: A cross-sectional descriptive correlational design was used. The sample consisted of 35 nurses from an ER in Québec (Canada). Data were collected through self-administered questionnaires. RESULTS: TEs presenting a grief component (e.g. intentional injury to a child and patient suicide) are positively associated with peritraumatic distress (PD) in the days after the event. PD is positively associated with PTSD symptoms. Two personality traits (neuroticism and extraversion) should also be considered. Neuroticism is positively associated with PD whereas extraversion is negatively associated with PD and PTSD symptoms. CONCLUSION: The results are consistent with the literature, but some of these results are new to nurses. They suggest that in this population, TEs in the ER represent 'red flags'. Their occurrence should mobilise support structures. PD and its personality traits are also key factors to consider. IMPLICATION FOR NURSING MANAGEMENT: To provide adequate support for nurses, ER managers should be on the alert for these conditions. Interventions should be adapted to these findings.
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Enfermería de Urgencia , Enfermeras Especialistas/psicología , Enfermedades Profesionales/etiología , Trastornos por Estrés Postraumático/etiología , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/diagnóstico , Quebec , Factores de Riesgo , Trastornos por Estrés Postraumático/diagnósticoRESUMEN
This review of literature focuses on the influence of psychological work climate and job satisfaction on nurses' turnover intentions. More specifically, this review aims to explain the influence of the primary dimensions of psychological work climate - job characteristics, role characteristics, leadership characteristics, teamwork characteristics and organizational characteristics - on nurses' organizational and occupational turnover intentions. Furthermore, this review aims to explain the role of job satisfaction as a potential mediator in the relationship between psychological work climate dimensions and both organizational and occupational turnover intentions among nurses. More specifically, the mechanism by which an individual goes from having negative perceptions of psychological work climate to having turnover intentions is introduced. The review concludes by revealing evaluation and intervention practices that may facilitate the implementation of continuous improvement processes aimed to enhance nurses' perceptions of the psychological work climate and job satisfaction.
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Personal de Enfermería en Hospital/psicología , Estrés Laboral/diagnóstico , Estrés Laboral/terapia , Lugar de Trabajo/psicología , Actitud del Personal de Salud , Humanos , Satisfacción en el Trabajo , Enfermería del Trabajo/métodos , Reorganización del Personal , Encuestas y CuestionariosRESUMEN
AIM: This study tests a theoretical model where: (a) nurses' dispositional resistance to change is indirectly negatively related to behavioural empowerment through the mediating role of psychological empowerment; and (b) supervisors' empowering management practices buffer both the negative relationship between dispositional resistance to change and psychological empowerment and the indirect negative relationship between resistance to change and behavioural empowerment via psychological empowerment. BACKGROUND: Promoting a high level of empowerment among nursing personnel is important to ensure their effectiveness in the context of organizational change. It is thus essential to advance our current understanding of the factors that hamper nurses' psychological and behavioural expressions of empowerment and to clarify supervisor practices that can overcome such barriers. DESIGN: A cross-sectional research design. METHOD: We collected survey data during 2012 from a sample of 197 nurses from a Canadian hospital undergoing a major organizational change. RESULTS: Results from moderated mediation analyses provided evidence for an indirect negative relationship between dispositional resistance to change and behavioural empowerment through psychological empowerment, and for a moderating (buffering) effect of supervisors' empowering management practices on this mediated relationship. These findings provided support for our hypotheses. CONCLUSIONS: Supervisors' empowering management practices represent an important contextual buffer against the negative effects of dispositional resistance to change on nurses' empowerment. Organizations should develop empowering management skills among nurses' supervisors to counteract the detrimental effects of dispositional resistance to change and to sustain an empowered nursing workforce.
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Personal de Enfermería/psicología , Supervisión de Enfermería , Poder Psicológico , Adulto , Estudios Transversales , Investigación Empírica , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Although telehealth is a promising solution for healthcare professionals who work in remote and rural regions, the influence of specific telehealth applications on the nursing workforce remains unknown. This case study aimed to explore the potential influence of a teleassistance service in wound care (the acronym in French is TASP) on nursing practices and on nurse retention in peripheral areas. MATERIALS AND METHODS: We carried out an exploratory single case study based on 16 semistructured interviews with two promoters of TASP, five nursing managers, and nine nurses from three levels of expertise associated with this service. RESULTS: According to participants, the main positive influences of TASP were observed in quality of care, professional autonomy, professional development, and decrease of professional isolation. Participants mentioned increased workload associated with global patient data collection at first consultation as a negative effect of TASP. Finally, three possible effects of TASP on nurse retention were identified: none or minimal, imprecise, or mostly positive. CONCLUSIONS: This case study highlights the positive influence of TASP on several dimensions of nursing practice, in addition to its essential role in improving the quality of care. However, it is important to consider that the service cannot be considered as a solution to or replacement for the shortage of nurses.
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Servicios de Atención de Salud a Domicilio/organización & administración , Telemedicina/métodos , Heridas y Lesiones/enfermería , Adulto , Femenino , Humanos , Entrevistas como Asunto , Masculino , Personal de Enfermería/organización & administración , Quebec , Consulta Remota/métodos , Servicios de Salud Rural/organización & administración , Heridas y Lesiones/terapiaRESUMEN
BACKGROUND: Few studies link organizational variables and outcomes to quality indicators. This approach would expose operant mechanisms by which work environment characteristics and organizational outcomes affect clinical effectiveness, safety, and quality indicators. QUESTION: What are the predominant psychosocial variables in the explanation of organizational outcomes and quality indicators (in this case, medication errors and length of stay)? The primary objective of this study was to link the fields of evidence-based practice to the field of decision making, by providing an effective model of intervention to improve safety and quality. METHODS: The study involved healthcare workers (n = 243) from 13 different care units of a university affiliated health center in Canada. Data regarding the psychosocial work environment (10 work climate scales, effort/reward imbalance, and social support) was linked to organizational outcomes (absenteeism, turnover, overtime), to the nurse/patient ratio and quality indicators (medication errors and length of stay) using path analyses. RESULTS: The models produced in this study revealed a contribution of some psychosocial factors to quality indicators, through an indirect effect of personnel- or human resources-related variables, more precisely: turnover, absenteeism, overtime, and nurse/patient ratio. Four perceptions of work environment appear to play an important part in the indirect effect on both medication errors and length of stay: apparent social support from supervisors, appreciation of the workload demands, pride in being part of one's work team, and effort/reward balance. CONCLUSIONS: This study reveals the importance of employee perceptions of the work environment as an indirect predictor of quality of care. Working to improve these perceptions is a good investment for loyalty and attendance. In general, better personnel conditions lead to fewer medication errors and shorter length of stay.
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Enfermería Basada en la Evidencia/organización & administración , Hospitales Universitarios/organización & administración , Personal de Enfermería en Hospital/organización & administración , Personal de Enfermería en Hospital/psicología , Calidad de la Atención de Salud/organización & administración , Lugar de Trabajo/psicología , Absentismo , Canadá , Toma de Decisiones , Predicción , Humanos , Satisfacción en el Trabajo , Errores de Medicación , Modelos Organizacionales , Seguridad del Paciente , Reorganización del Personal , Psicología , Carga de TrabajoRESUMEN
AIM: The purpose of this study was to determine the potential impact of information and communication technologies (ICTs) on nursing practice and nurse retention in remote, intermediate and peripheral regions of Quebec, Canada. METHODS: A qualitative study using semi-structured interviews (n=21) was conducted among nursing managers from 16 health and social services centers (French acronym: CSSS) in the province of Quebec. RESULTS: The study found that a range of ICT applications are used, though not to the same extent in all organizations. The participants assessed the impact of computerization and telehealth applications on nursing practice and emphasized the relationships between telehealth and nurse retention, particularly through professional development. The participants also reported that ICTs can have different impacts on nurse retention (i.e. little or no impact, unclear impact, or indirect positive impact). CONCLUSIONS: The main findings indicate significant heterogeneity, both in terms of the nursing shortage and in terms of the integration of ICT in nursing practice. While focusing on a comparative approach, future research should further explore the impact of ICT on nursing practice and, indirectly, on nurse retention, which requires a contextual approach to ICT applications and workplaces and an analysis of staff characteristics.
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Informática Médica , Personal de Enfermería , Reorganización del Personal , Femenino , Humanos , Entrevistas como Asunto , Masculino , Quebec , TelemedicinaRESUMEN
BACKGROUND: In Canada, workforce shortages in the health care sector constrain the ability of the health care system to meet the needs of its population and of its health care professionals. This issue is of particular importance in peripheral regions of Quebec, where significant inequalities in workforce distribution between regions has lead to acute nursing shortages and increased workloads. Information and communication technologies (ICTs) are innovative solutions that can be used to develop strategies to optimise the use of available resources and to design new nursing work practices. However, current knowledge is still limited about the real impact of ICTs on nursing recruitment and retention. Our aim is to better understand how work practice reorganization, supported by ICTs, and particularly by telehealth, may influence professional, educational, and organizational factors relating to Quebec nurses, notably those working in peripheral regions. METHODS/DESIGN: First, we will conduct a descriptive study on the issue of nursing recruitment. Stratified sampling will be used to select approximately twenty innovative projects relating to the reorganization of work practices based upon ICTs. Semi-structured interviews with key informants will determine professional, educational, and organizational recruitment factors. The results will be used to create a questionnaire which, using a convenience sampling method, will be mailed to 600 third year students and recent graduates of two Quebec university nursing faculties. Descriptive, correlation, and hierarchical regression analyses will be performed to identify factors influencing nursing graduates' intentions to practice in peripheral regions. Secondly, we will conduct five case studies pertaining to the issue of nursing retention. Five ICT projects in semi-urban, rural, and isolated regions have been identified. Qualitative data will be collected through field observation and approximately fifty semi-structured interviews with key stakeholders. DISCUSSION: Data from both parts of this research project will be jointly analysed using triangulation of researchers, theoretical approaches, methods, and results. Continuous exchanges with decision makers and periodic knowledge transfer activities are planned to facilitate the dissemination and utilization of research results in policies regarding the nursing recruitment and retention.
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Enfermeras y Enfermeros/provisión & distribución , Selección de Personal , Encuestas y Cuestionarios , Telemedicina/organización & administración , Eficiencia Organizacional , Humanos , Entrevistas como Asunto , Enfermeras y Enfermeros/estadística & datos numéricos , Estudios de Casos Organizacionales , Reorganización del Personal/estadística & datos numéricos , Quebec , Análisis de Regresión , Proyectos de Investigación , Población Rural , Estudiantes de Enfermería , Recursos HumanosRESUMEN
Research has disregarded the processes and boundary conditions associated with the effects of job insecurity on innovative work behaviour. Combining the job demands-resources and the self-determination perspectives, the present study develops and tests a first-stage moderated mediation model that identifies intrinsic motivation as a key mechanism accounting for a negative effect of job insecurity on innovative behaviour and trait mindfulness as a buffer against the detrimental impact of job insecurity on intrinsic motivation and, indirectly, innovative work behaviour. Two time-lagged studies-a two-wave study of 138 employees from Canadian firms and a three-wave study of 157 employees from US firms-were conducted to test the hypothesized model. Supporting our predictions, intrinsic motivation mediated a negative relationship between job insecurity and innovative work behaviour. Moreover, high levels of trait mindfulness were observed to attenuate the negative relationship of job insecurity with intrinsic motivation and, indirectly, innovative behaviour. These findings contribute to the literature by disclosing the processes linking job insecurity with impaired work outcomes and help to elucidate how and when employee can keep their innovative potential alive in spite of insecure work conditions.
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Atención Plena , Motivación , Canadá , Empleo , Humanos , Satisfacción en el Trabajo , Autonomía PersonalRESUMEN
PURPOSE: This article describes and compares work climate perceptions and intentions to quit among three generations of hospital workers and nurses. BACKGROUND: Never before in history has the workplace comprised such a span of generations. The current workforce includes three main generations: Baby Boomers (born between 1946 and 1963), Generation X (born between 1964 and 1980), and Generation Y (born between 1981 and 2000). However, very little research has linked turnover among nurses and other healthcare workers to their generational profile. METHOD: A quantitative study with a correlational descriptive design was used. 1,376 hospital workers of the three generations (with 42.1% nurses, 15.6% support staff, 20.1% office employees, and 22.1% health professionals or technicians), employed in a university-affiliated hospital, completed a self-administered questionnaire. They answered the Psychological Climate Questionnaire and a measure of turnover intention. RESULTS: Generation Y hospital workers obtained a significantly lower score on the "Challenge" scale than did Baby Boomers. On the "Absence of Conflict" and "Warmth" scales, the opposite occurred, with Baby Boomers obtaining a significantly lower score than Generation Y respondents. If the nurse job category is taken separately, Generation Y nurses expressed a negative perception of the "Goal Emphasis" scale, compared with Baby Boomers. The proportion of Generation Y nurses who intend to quit is almost three times higher than that of other hospital workers from Generation Y. The main reason given by workers from Generations Y and X who intend to quit the organization is their own career advancement. The main reason given by Baby Boomers who intend to quit is retirement. CONCLUSIONS: Retention strategies that focus on improving the work climate are beneficial to all generations of hospital workers and nurses. If generation-specific retention strategies are developed, these should focus on the three areas identified to have intergenerational differences: challenges, absence of conflict, and warmth. CLINICAL RELEVANCE: New nurses will benefit from strategies aimed at supporting their career advancement in the workplace.
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Ambiente de Instituciones de Salud/organización & administración , Relaciones Intergeneracionales , Relaciones Interprofesionales , Personal de Enfermería en Hospital , Reorganización del Personal/estadística & datos numéricos , Lugar de Trabajo , Adulto , Factores de Edad , Actitud del Personal de Salud , Femenino , Hospitales Universitarios , Humanos , Intención , Masculino , Persona de Mediana Edad , Análisis Multivariante , Investigación en Administración de Enfermería , Investigación Metodológica en Enfermería , Personal de Enfermería en Hospital/organización & administración , Personal de Enfermería en Hospital/psicología , Cultura Organizacional , Crecimiento Demográfico , Quebec , Lugar de Trabajo/organización & administración , Lugar de Trabajo/psicologíaRESUMEN
This paper presents research results that offer answers to the "why," "what" and "how" of work climate measurement. It also submits to the scientific community a confirmatory cross-validation procedure applied to a new measurement tool, consistent with the works of Jones and James's (1979) and of Parker et al. (2003) on psychological climate. The results depict a good model fit for both the English and French versions of the questionnaire. This new instrument offers a comprehensive and manageable approach for the development of a healthy workplace.
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Ambiente de Instituciones de Salud/normas , Personal de Salud/psicología , Psicometría/instrumentación , Lugar de Trabajo/psicología , Actitud del Personal de Salud , Femenino , Investigación sobre Servicios de Salud , Hospitales Universitarios , Humanos , Masculino , Quebec , Encuestas y Cuestionarios , Análisis de SistemasRESUMEN
Exposure to workplace violence has been identified as a serious and universal issue facing modern organizations. The present study focuses more specifically on exposure to psychological violence, and its association with turnover intentions as mediated by workplace affective commitment. In addition, we also explore the moderating role of various facets of job demands (role stressors) and resources (social support) on the aforementioned relations. Data collected from 1,228 university employees indicated that experiencing psychological violence at work was associated with lower levels of workplace affective commitment and higher levels of turnover intentions, and that the relation between psychological violence and turnover intentions was partially mediated by commitment. Furthermore, role stressors and social support were found to moderate the negative relation between exposure to psychological violence and workplace affective commitment, as well as between commitment and turnover intentions, but not the direct relation between psychological violence and turnover intentions. Theoretical and research implications for the literature on psychological violence and practical suggestions for minimizing its damaging consequences are proposed.
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Intención , Reorganización del Personal/estadística & datos numéricos , Apoyo Social , Estrés Psicológico/psicología , Violencia Laboral/psicología , Lugar de Trabajo/psicología , Adulto , Canadá , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Violencia Laboral/estadística & datos numéricosRESUMEN
BACKGROUND: Stressed workers suffer from severe health problems which appear to have increased. Poor leadership is especially considered a source of stress. Indeed, supervisors might perceive their subordinates to be similar to them as far as stress is concerned and this might more widespread in organizations than previously thought. METHODS: The present research investigates the relationships between leaders' health, in terms of work-related stress, mental health, and workplace bullying and their evaluation of subordinates' stress. Five regression models were formulated to test our hypothesis. This is a cross-sectional study among 261 Italian leaders, using supervisor self-assessment and leaders' assessments of their subordinates. RESULTS: Leaders' health was related to their evaluation of staff stress. Job demand, lack of job control, and lack of support by colleagues and supervisors evaluated in their subordinates were particularly associated with the leaders' own health. CONCLUSION: Implications for developing healthy leaders are finally discussed.
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Using the theoretical perspectives offered by stressor-stress-strain framework and fairness theory, the authors propose that psychological climate will mediate the positive relationship between interpersonal aggression and employee burnout. Data from a survey of 1893 hospital employees suggested that psychological climate partially mediated the relationship between interpersonal aggression and two of the three dimensions of burnout, emotional exhaustion and depersonalization. The theoretical and practical implications of these findings and directions for future research are discussed.
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Agresión/psicología , Agotamiento Profesional/psicología , Relaciones Interpersonales , Medio Social , Estrés Psicológico/psicología , Lugar de Trabajo/psicología , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Salud Mental , Encuestas y Cuestionarios , Carga de Trabajo/psicologíaRESUMEN
OBJECTIVES: To identify factors that influence the initial plan and final decision to choose a rural area as first employment location in final-year nursing students or newly graduated nurses. DESIGN: We conducted a mixed-methods review of the literature, including both published and gray literature, using established criteria. Two reviewers performed data extraction of relevant information independently. DATA SOURCES: We retrieved empirical studies from the following databases: PubMED, Embase, CINAHL (EBSCO), Web of Science (SCI and SSCI), The Cochrane Library, Business Source Premier (EBSCO), ERIC, Proquest and PsychInfo. We also searched for empirical studies in the technical and gray literature and reviewed journals related to rural health. Additionally, we conducted searches in websites such as the Center for Health Workforce Planning and Analysis, as well as Google and Google Scholar search engines. RESULTS: Of the 523 studies thus screened, 15 were included for data extraction. We identified more than 40 factors associated with initial plans and final decision to settle in a rural area among nursing graduates. CONCLUSIONS: Only limited literature is currently available on the factors associated with the intention of nursing students or newly graduated nurses of practicing in rural areas and on the relationship between intention and effective behavior. This review highlights the needs for further research in this field.