Assessment of Millennial Nurses' Job Satisfaction and Professional Practice Environment.

OBJECTIVE: The purpose of this study was to assess the relationship between demographic factors (age, gender, race, ethnicity, work status, and experience), the professional practice environment, and work satisfaction to increase understanding of millennial nurses. BACKGROUND: Millennials comprise 30% of the nursing workforce and are more likely to experience burnout, stress, high turnover, and less dedication to their workplace than other counterparts. Understanding how to retain these nurses is important to ensure work satisfaction and high-quality patient outcomes. METHODS: This descriptive study was a secondary analysis of data using the Professional Practice Work Environment Inventory survey. Descriptive statistics were used to describe the variables. Descriptive statistics and standard t tests were used. RESULTS: Demographics accounted for only 2.6% of the variance in work satisfaction, whereas supportive leadership accounted for nearly 63%. CONCLUSION: Findings demonstrate that supportive leadership is the primary factor contributing to millennial nurses' work satisfaction. This suggests that efforts to retain millennial nurses should focus on developing supportive leaders.

Development and Psychometric Evaluation of the Professional Practice Work Environment Inventory.

OBJECTIVE: The purpose is to examine the psychometric properties of the professional practice work environment inventory (PPWEI). BACKGROUND: Derived from the Professional Practice Environment (PPE) and the Revised PPE scales, the PPWEI was designed to measure 8 components of the PPE that can be used to assist nurse administrators in decision-making. METHODS: A psychometric evaluation was undertaken with 874 nurses who were providing direct care to patients at the Massachusetts General Hospital and who provided no missing data on the newly developed 72-item PPWEI. RESULTS: Cronbach's α internal consistency reliability of the total score was .93, with 61 items having factor loadings more than .50, the factor loading cutoff used to define the component subscales. Principal component analyses with varimax rotation and Kaiser normalization demonstrated 8 components, explaining 64.6% of variance. Cronbach's α reliability coefficients of the PPWEI subscales ranged from .82 to .93. CONCLUSION: The multidimensional PPWEI is a psychometrically sound measure of several components of the PPE in the acute care setting and sufficiently reliable and valid for use as independent subscales in healthcare research.

Characteristics of Nurse Directors That Contribute to Registered Nurse Satisfaction.

OBJECTIVE: The aim of this study was to explore RNs and nurse directors' (NDs') perceptions of leadership on units with high RN satisfaction scores. BACKGROUND: Identifying the characteristics of NDs that contribute to RN satisfaction is important in the recruitment and retention of RNs and in the selection and role development of NDs. METHODS: This study used a qualitative design using appreciative inquiry-guided data collection. RESULTS: Nine RNs and 9 NDs met the inclusion criteria. Each group identified 4 themes. CONCLUSIONS: Registered nurse and ND participants identified similar themes representative of leadership attributes and behaviors that contribute to RN satisfaction.

Benefits of a narrative culture.

LOOKING BACK over the past 20 years, the healthcare challenges we faced then are similar to those we face now. They may be heightened, but they still concern quality and safety, healthcare equity, cost constraints, and regulatory requirements.

Identification of the psychometric properties of the leadership influence over professional practice environments scale.

This study uses the qualitatively developed Adams influence model (AIM) and concepts from the psychometrically validated revised professional practice environment scale to guide the development of the leadership influence over professional practice environments scale. Nurse executives and others can use this scale individually or in conjunction with instruments targeting staff or patient perceptions of their influence as part of health services research, leadership development, and professional practice environment enhancement strategy.

Attending registered nurse: an innovative role to manage between spaces.

Massachusetts General Hospital embarked on the implementation of a new model that redesigned the role of selected staff nurses, advanced standardized processes, improved workflow, and introduced technology to enhance communication. These efforts included selecting 12 inpatient units to function as "Innovation Units". These units were specifically designated to support rapid change and test initiatives that would reduce costs and improve quality. The work of the Innovation Units allows nurse leaders to understand if the goals for improvement could be adopted by all inpatient units and beyond the walls of the hospital. The high-leverage intervention of introducing the role of the "Attending Nurse" in coordinating the work of the interdisciplinary team in addressing overuse, underuse, and misuse of services has been a significant staffing innovation. The Attending Nurse, while just one strategy, has placed the nurse at the center of the care team.

A multi-instrument evaluation of the professional practice environment.

This study identified organizational characteristics that are highly correlated with the work satisfaction of RNs using 2 practice environment measurement tools. In the sample, the organizational characteristics of autonomy, control over practice, and internal work motivation are critical to RNs' sense of work satisfaction. As care redesign efforts ensue, the need to preserve and strengthen the professional practice environment remains a priority for nurse executives.

Promoting a culture of international professional practice for nursing through a twinning relationship.

This article illustrates the impact of a twinning relationship between the nursing services of Huashan Hospital, Fudan University (HH), in Shanghai, China, and of Massachusetts General Hospital (MGH) in Boston, Massachusetts. Through twinning, the healthcare leaders and nursing staff at HH learned key concepts, skills, and methods from their MGH colleagues, enhancing the role, presence, and overall impact of nursing in their organization. Strategies to advance a nursing leadership development agenda included establishing twinning relationships and immersing nurse leaders into each other's practice arena via nurse visitation exchanges. This collaborative effort, although only 3 years old, begins the process of modeling twinning for replication among nurses and across organizations internationally. Improvements in nursing care delivery and patient care at both organizations are attributed to this project.

Professional practice model: strategies for translating models into practice.

In the current health care climate, economic and cultural conditions have created an optimal opportunity to envision a new direction for nursing as a profession. Nurses find themselves at the formative stages of charting this new direction. The articulation of a professional practice model provides a framework for setting this new direction and thus the achievement of exemplary clinical outcomes. In this article, the authors describe the evolution of the professional practice model at the Massachusetts General Hospital and how the model continues to be evaluated and modified over time by the nurses within the system.

Psychometric evaluation of the Revised Professional Practice Environment (RPPE) scale.

OBJECTIVE: The purpose was to examine the psychometric properties of the Revised Professional Practice Environment (RPPE) scale. BACKGROUND: Despite renewed focus on studying health professionals' practice environments, there are still few reliable and valid instruments available to assist nurse administrators in decision making. METHODS: A psychometric evaluation using a random-sample cross-validation procedure (calibration sample [CS], n = 775; validation sample [VS], n = 775) was undertaken. RESULTS: Cronbach alpha internal consistency reliability of the total score (r = 0.93 [CS] and 0.92 [VS]), resulting subscale scores (r range: 0.80-0.87 [CS], 0.81-0.88 [VS]), and principal components analyses with Varimax rotation and Kaiser normalization (8 components, 59.2% variance [CS], 59.7% [VS]) produced almost identical results in both samples. CONCLUSIONS: The multidimensional RPPE is a psychometrically sound measure of 8 components of the professional practice environment in the acute care setting and sufficiently reliable and valid for use as independent subscales in healthcare research.

Interdisciplinary Institute for Patient Care: advancing clinical excellence.

Healthcare leaders are searching for ways to create new synergies and efficiencies in today's complex health environments to enhance patient care, education, and research and nurture collaborative and rewarding professional practice environments. The authors discuss how the creation of a multidisciplinary Institute for Patient Care is an important innovation that is helping us achieve these aims.

Why not nursing.

Does nursing have an image problem that scares off potential nursing students? Here's what high-school students and adult career-switchers think about nursing as a potential career choice.

Development and psychometric evaluation of the Professional Practice Environment (PPE) scale.

PURPOSE: To describe the Professional Practice Environment (PPE) scale, its conceptual development and psychometric evaluation, and its uses in measuring eight characteristics of the professional practice environment in an acute care setting. DESIGN AND METHODS: The 38-item PPE Scale was validated on a sample of 849 professional practice staff at the Massachusetts General Hospital in Boston. Psychometric analysis included: item analysis, principal components analysis (PCA) with varimax rotation and Kaiser normalization, and internal consistency reliability using Cronbach's alpha coefficient. FINDINGS: Eight components were shown, confirming the original conceptually derived model's structure and accounting for 61% of explained variance. Cronbach's alpha coefficients for the eight PPE subscales ranged from .78 to .88. CONCLUSIONS: Findings showed the 38-item PPE Scale was reliable and valid for use in health outcomes research to examine the professional practice environment of staff working in acute care settings.

Mentoring the minority nurse leader of tomorrow.

Diversity is crucial to the future of nursing. And fortunately, a shift in the composition of the nursing workforce so that it more accurately mirrors the composition of America's patient population is already taking place. However, this emerging multiculturalism brings an important issue to the forefront-the leadership tier in healthcare organizations must also reflect the ethnic and cultural changes taking place. Movement in this direction makes prominent the importance of the mentor role in the life of the minority nurse seeking a leadership career path. Acknowledging the present demographics of the profession, it is most unlikely that the mentor and mentee will be a cultural or ethnic match. The good news is that this should not be viewed as an automatic barrier. This article describes the 5 Cs of mentoring a minority nurse professional, that is, candor, compromise, confidence, complexity, and champion-the specific competencies that promote a mentor-mentee relationship focused on career success.

The value of collaborative governance/staff empowerment.

OBJECTIVE: Collaborative governance is the decision-making process that places the authority, responsibility, and accountability for patient care with the practicing clinician. BACKGROUND: Collaborative governance was introduced as one of nine structures within the patient care services' professional practice model to facilitate communication and optimize staff participation in decision-making across disciplines. The concept of empowerment was used to evaluate the impact of the collaborative governance structure on members. METHODS: The purpose of the current study was to compare empowerment and power scores for both members and nonmembers of collaborative governance over a 3-year period. RESULTS: Initial survey data (baseline) from 136 staff from across disciplines was returned prior to beginning work on a committee. Study results were based on survey returns from 657 staff over a 3.5-year period. There were no significant differences between collaborative governance members and nonmembers on some demographic variables such as age, but there were significant differences on variables such as work status and education. All empowerment scores were significantly higher at the 2nd and 3rd measurement periods for collaborative governance members as compared to nonmembers. CONCLUSIONS: Findings suggest that membership on a collaborative governance committee increased staff sense of empowerment and fostered self-growth and organizational development.