More time where it matters: improving work environments in home healthcare nursing.

The nursing profession is currently experiencing a shift to community care, more complex clients and a shortage of human resources. Home healthcare organizations can increase job satisfaction and retention by better managing nurses' workloads and ensuring more time for direct client care. This project used innovative technology and dynamic methods to document nurses' work lives, identify areas for process improvements and increase time available for direct client care. This case study provides insight into ways in which organizations can streamline non-care activities and discusses implications for nursing leaders at the local and regional levels.

Developing and sustaining nursing leadership for healthy work environments.

The current nursing shortage and increasing demand for healthcare service in the home and community compound the urgent need for service providers to better attract and retain nurses. Nursing leaders can enhance recruitment and retention by promoting healthy work environments, and developing leadership can help service providers become a better place to work. This case study illustrates how one community healthcare organization successfully implemented healthy workplace strategies using the Registered Nurses' Association of Ontario (RNAO) Healthy Work Environments Best Practice Guideline, Developing and Sustaining Nursing Leadership. A detailed description of the process undertaken for project implementation and evaluation is provided, along with lessons learned and recommendations.

Developing a preceptorship/mentorship model for home health care nurses.

Preceptorship and mentorship programs are used in the health care sector to educate nurses, enhance their leadership skills, and improve their quality of work life. Recognizing the importance of these initiatives, Saint Elizabeth Health Care sought funding to create an innovative model of preceptorship/mentorship that meets the unique needs of home health care nurses. The methods utilized included focus groups, key informant interviews, and a workflow analysis. Factors that influence preceptorship such as nursing workload, preceptor training and remuneration were examined to develop a new model that offers career enhancement and leadership opportunities for preceptors and mentors, and promotes a welcoming environment for preceptees. Reward and recognition programs were created for preceptors to acknowledge their leadership contribution at the front line. This study demonstrates how evidence and innovation were used to create a preceptorship/mentorship model to develop community nursing leaders of the future.

Perceptions of empowerment and respect: effect on nurses' organizational commitment in nursing homes.

This study tested Kanter's theory of structural empowerment in a sample of nurses employed in nursing homes throughout Ontario by examining relationships between nurses' perceptions of structural and psychological empowerment, respect, and organizational commitment. A random sample of 79 RNs (response rate 64%) and 75 RPNs (response rate 60%) were used. Both groups reported moderate levels of empowerment, respect, and commitment. RNs perceived higher levels of empowerment and respect than RPNs. Access to opportunity was the most empowering factor for nurses in this study, and access to resources the least empowering. Structural empowerment, psychological empowerment, and respect explained 48% of the variance in affective commitment for RNs and 40% for RPNs. Results of this study provide support for the use of Kanter's theory in LTC nurse populations.