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AIM: To examine predictors of Canadian new graduate nurses' health outcomes over 1 year. DESIGN: A time-lagged mail survey was conducted. METHOD: New graduate nurses across Canada (N = 406) responded to a mail survey at two time points: November 2012-March 2013 (Time 1) and May-July 2014 (Time 2). Multiple linear regression (mental and overall health) and logistic regression (post-traumatic stress disorder risk) analyses were conducted to assess the impact of Time 1 predictors on Time 2 health outcomes. RESULTS: Both situational and personal factors were significantly related to mental and overall health and post-traumatic stress disorder risk. Regression analysis identified that cynicism was a significant predictor of all three health outcomes, while occupational coping self-efficacy explained unique variance in mental health and work-life interference explained unique variance in post-traumatic stress disorder risk.
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INTRODUCTION: The need to be able to assess collaborative practice in health care teams has been recognized in response to the direction for team-based care in a number of policy documents. The purpose of this study is to report on further refinement of such a measurement instrument, the Assessment of Interprofessional Team Collaboration Scale (AITCS) first published in 2012. To support this refinement, two objectives were set: Objective 1: to determine whether the items from the data collected in 2016 load on the same factors as found for the 2012 version of the 37-item AITCS. Objective 2: to determine whether the items in the subscales of the AITCS could be reduced while retaining psychometric properties similar to those from the earlier versions of the AITCS. METHODS: Initially, the overall data sets of 1002 respondents from two hospitals and four community agencies were analyzed for demographics and scale and subscale mean values, SDs, and mean item scores. After deletion of respondents because of missing data, 967 respondents were available for the first analysis. An exploratory factor analysis was then conducted to determine the factor structure. All respondents with any random missing data were further removed to reduce the data set to 676 responses, followed by a confirmatory factor analysis to find a model fit resulting in an item reduction in the scale. RESULTS: The result was a 23-item AITCS-II for practitioners that retained acceptable levels of reliability and validity within 3 subscales-partnership (8 items), cooperation (8 items), and coordination (7 items). DISCUSSION: The shortened version of the AITCS-II is a valid and reliable instrument that can be used to assess collaboration in health care teams in practice settings.
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Conducta Cooperativa , Grupo de Atención al Paciente/normas , Proyectos de Investigación/normas , Adulto , Actitud del Personal de Salud , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ontario , Psicometría/instrumentación , Psicometría/métodos , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
Purpose This paper aims to test a model examining precursors and outcomes of nurses' leadership self-efficacy, and their aspirations to management positions. Design/methodology/approach A cross-sectional survey of 727 registered nurses across Canada was conducted. Structural equation modelling using Mplus was used to analyse the data. Findings Results supported the hypothesized model: χ2(312) = 949.393; CFI = 0.927; TLI = 0.919; RMSEA = 0.053 (0.049-0.057); SRMR 0.044. Skill development opportunities ( ß = 0.20), temporary management roles ( ß = 0.12) and informal mentoring ( ß = 0.11) were significantly related to nurses' leadership self-efficacy, which significantly influenced motivation to lead ( ß = 0.77) and leadership career aspirations ( ß = 0.23). Motivation to lead was significantly related to leadership career aspirations ( ß = 0.50). Practical implications Nurses' leadership self-efficacy is an important determinant of their motivation and intention to pursue a leadership career. Results suggest that nurses' leadership self-efficacy can be influenced by providing opportunities for leadership mastery experiences and mentorship support. Leadership succession planning should include strategies to enhance nurses' leadership self-efficacy and increase front-line nurses' interest in leadership roles. Originality value With an aging nurse leader workforce, it is important to understand factors influencing nurses' leadership aspirations to develop and sustain nursing leadership capacity. This research study makes an important contribution to the nursing literature by showing that nurses' leadership self-efficacy appears to be an important determinant of their motivation to lead and desire to pursue a career as a nurse leader.
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Aspiraciones Psicológicas , Movilidad Laboral , Liderazgo , Motivación , Enfermeras y Enfermeros/psicología , Autoeficacia , Adulto , Canadá , Estudios Transversales , Femenino , Humanos , Masculino , TutoríaRESUMEN
BACKGROUND: Extended lifespans and complex resident care needs have amplified resource demands on nursing homes. Nurse managers play an important role in staff job satisfaction, research use, and resident outcomes. Coaching skills, developed through leadership skill-building, have been shown to be of value in nursing. AIMS: To test a theoretical model of nursing home staff perceptions of their work context, their managers' use of coaching conversations, and their use of instrumental, conceptual and persuasive research. METHODS: Using a two-group crossover design, 33 managers employed in seven Canadian nursing homes were invited to attend a 2-day coaching development workshop. Survey data were collected from managers and staff at three time points; we analyzed staff data (n = 333), collected after managers had completed the workshop. We used structural equation modeling to test our theoretical model of contextual characteristics as causal variables, managers' characteristics, and coaching behaviors as mediating variables and staff use of research, job satisfaction, and burnout as outcome variables. RESULTS: The theoretical model fit the data well (χ2 = 58, df = 43, p = .06) indicating no significant differences between data and model-implied matrices. Resonant leadership (a relational approach to influencing change) had the strongest significant relationship with manager support, which in turn influenced frequency of coaching conversations. Coaching conversations had a positive, non-significant relationship with staff persuasive use of research, which in turn significantly increased instrumental research use. Importantly, coaching conversations were significantly, negatively related to job satisfaction. LINKING EVIDENCE TO ACTION: Our findings add to growing research exploring the role of context and leadership in influencing job satisfaction and use of research by healthcare practitioners. One-on-one coaching conversations may be difficult for staff not used to participating in such conversations. Resonant leadership, as expected, has a significant impact on manager support and job satisfaction among nursing home staff.
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Liderazgo , Cuidados a Largo Plazo/métodos , Tutoría/métodos , Enfermeras Administradoras/normas , Desarrollo de Personal/normas , Adulto , Canadá , Competencia Clínica/normas , Educación/normas , Femenino , Humanos , Cuidados a Largo Plazo/organización & administración , Masculino , Persona de Mediana Edad , Desarrollo de Personal/métodos , Encuestas y Cuestionarios , Lugar de Trabajo/psicología , Lugar de Trabajo/normasRESUMEN
BACKGROUND: Incivility has negative consequences in the workplace and remains a prevalent issue in nursing. Research has consistently linked incivility to nurse burnout and, in turn, to poor mental health and turnover intentions. To retain high-quality nurses, it is important to understand what factors might protect nurses from the negative effects of workplace mistreatment. PURPOSE: The aim of the study was to investigate the role of relational occupational coping self-efficacy in protecting nurses from workplace incivility and related burnout and turnover intentions. METHODOLOGY: A two-wave national sample of 596 Canadian nurses completed mail surveys both at Time 1 and one year later at Time 2. Structural equation modeling was used to test the hypothesized model. RESULTS: The model showed a good fit, and most of the hypothesized paths were significant. Overall, the results supported the hypothesized protective effect of relational occupational coping self-efficacy against incivility and later burnout, mental health, and turnover intentions. CONCLUSION: Relational occupational coping self-efficacy is an important protective factor against negative work behavior. PRACTICE IMPLICATIONS: Organizations should provide nurses with opportunities to build their coping strategies for managing job demands and difficult interpersonal interactions. Similarly, providing exposure to effective role models and providing meaningful verbal encouragement are other sources of efficacy information for building nurses' relational coping self-efficacy.
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Agotamiento Profesional/prevención & control , Incivilidad , Personal de Enfermería en Hospital/psicología , Autoeficacia , Lugar de Trabajo/psicología , Adulto , Agotamiento Profesional/psicología , Canadá , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Reorganización del PersonalRESUMEN
This study was an integrative literature review in relation to compassion fatigue models, appraising these models, and developing a comprehensive theoretical model of compassion fatigue. A systematic search on PubMed, EbscoHost (Academic Search Premier, E-Journals, Medline, PsycINFO, Health Source Nursing/Academic Edition, CINAHL, MasterFILE Premier and Health Source Consumer Edition), gray literature, and manual searches of included reference lists was conducted in 2016. The studies (n = 11) were analyzed, and the strengths and limitations of the compassion fatigue models identified. We further built on these models through the application of the conservation of resources theory and the social neuroscience of empathy. The compassion fatigue model shows that it is not empathy that puts nurses at risk of developing compassion fatigue, but rather a lack of resources, inadequate positive feedback, and the nurse's response to personal distress. By acting on these three aspects, the risk of developing compassion fatigue can be addressed, which could improve the retention of a compassionate and committed nurse workforce.
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Desgaste por Empatía/fisiopatología , Desgaste por Empatía/psicología , Satisfacción en el Trabajo , Modelos Teóricos , Enfermeras y Enfermeros/psicología , HumanosRESUMEN
BACKGROUND: Improving patient safety within health care organizations requires effective leadership at all levels. PURPOSE: The objective of this study was to investigate the effects of nurse managers' transformational leadership behaviors on job satisfaction and patient safety outcomes. METHODS: A random sample of acute care nurses in Ontario (N = 378) completed the crosssectional survey. Hypothesized model was tested using structural equation modeling. FINDING: The model fit the data acceptably. Transformational leadership had a strong positive influence on workplace empowerment, which in turn increased nurses' job satisfaction and decreased the frequency of adverse patient outcomes. Subsequently, job satisfaction was related to lower adverse events. CONCLUSION: The findings provide support for managers' use of transformational leadership behaviors as a useful strategy in creating workplace conditions that promote better safety outcomes for patients and nurses.
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Satisfacción en el Trabajo , Liderazgo , Enfermeras Administradoras , Personal de Enfermería en Hospital , Seguridad del Paciente , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Teóricos , Ontario , Poder Psicológico , Encuestas y Cuestionarios , Lugar de TrabajoRESUMEN
BACKGROUND: With increasing numbers of new graduate nurses from accelerated nursing programs entering the workforce, it is important to understand their transition experiences, as they may differ from those of traditional graduates. OBJECTIVES: The aim of this study was to describe and compare the intrapersonal resources, transition experiences, and retention outcomes of these two groups. DESIGN: A descriptive cross-sectional comparison study was conducted. PARTICIPANTS: A random sample of 3655 registered nurses with <3years of nursing experience were invited to participate from across Canada; 1020 responded (27.9%). The final sample included 230 nurses from accelerated programs and 768 from four-year programs (total n=998). METHODS: Following ethics approval, participants were mailed a questionnaire to their home address. One month later non-responders were sent a reminder letter, followed by a second questionnaire one month later (January to March, 2013). Descriptive statistics were conducted using SPSS. Group differences were assessed using independent samples t-tests for continuous variables and χ2 tests for categorical variables. RESULTS: Overall, there were few significant differences between new graduate nurses from accelerated and traditional programs. Nurses in both groups had high levels of intrapersonal resources, positive transition experiences, were satisfied with their jobs and their choice of nursing as a career, and their intentions to leave were low. CONCLUSIONS: All new graduate nurses need to have a strong educational preparation and transition support, regardless of their age and previous work and career experiences.
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Actitud del Personal de Salud , Bachillerato en Enfermería/métodos , Bachillerato en Enfermería/normas , Adulto , Canadá , Estudios Transversales , Bachillerato en Enfermería/estadística & datos numéricos , Femenino , Humanos , Capacitación en Servicio/normas , Satisfacción en el Trabajo , Masculino , Reorganización del Personal , Encuestas y CuestionariosRESUMEN
AIM: To describe new graduate nurses' transition experiences in Canadian healthcare settings by exploring the perspectives of new graduate nurses and nurse leaders in unit level roles. BACKGROUND: Supporting successful transition to practice is key to retaining new graduate nurses in the workforce and meeting future demand for healthcare services. METHOD: A descriptive qualitative study using inductive content analysis of focus group and interview data from 42 new graduate nurses and 28 nurse leaders from seven Canadian provinces. RESULTS: New graduate nurses and nurse leaders identified similar factors that facilitate the transition to practice including formal orientation programmes, unit cultures that encourage constructive feedback and supportive mentors. Impediments including unanticipated changes to orientation length, inadequate staffing, uncivil unit cultures and heavy workloads. CONCLUSIONS: The results show that new graduate nurses need access to transition support and resources and that nurse leaders often face organisational constraints in being able to support new graduate nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Organisations should ensure that nurse leaders have the resources they need to support the positive transition of new graduate nurses including adequate staffing and realistic workloads for both experienced and new nurses. Nurse leaders should work to create unit cultures that foster learning by encouraging new graduate nurses to ask questions and seek feedback without fear of criticism or incivility.
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Enfermeras Administradoras/psicología , Enfermeras y Enfermeros/psicología , Percepción , Factores de Tiempo , Canadá , Grupos Focales , Humanos , Satisfacción en el Trabajo , Liderazgo , Investigación CualitativaRESUMEN
BACKGROUND: Nurses' turnover has a costly impact on organizations, patients, and nurses. Numerous studies have highlighted the critical role of nursing leadership in enhancing new nurses' retention. PURPOSE: To examine the influence of authentic leadership on new nurses' job turnover intentions through their personal identification with the leader, organizational identification, and occupational coping self-efficacy. METHODS: Secondary data analysis of a cross-sectional national study of Canadian new graduate nurses was conducted using structural equation modeling. FINDINGS: Authentic leadership had a significant positive effect on nurses' personal identification with their leader and their organization. Personal identification mediated the relationship between authentic leadership and organizational identification. Organizational identification had a significant positive effect on occupational coping self-efficacy, which, in turn, had a negative effect on new graduate nurses' job turnover intentions. DISCUSSION: The findings demonstrate the vital role authentic leadership plays in retaining new graduate nurses. Authentic leaders foster personal and organizational identification among new graduate nurses, leading to increase in the confidence in their ability to manage work-related challenges, which subsequently results in positive outcomes in both new graduate nurses and the organization.
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Adaptación Psicológica , Agotamiento Profesional/psicología , Satisfacción en el Trabajo , Liderazgo , Personal de Enfermería en Hospital/psicología , Cultura Organizacional , Reorganización del Personal/estadística & datos numéricos , Adulto , Canadá , Estudios Transversales , Femenino , Humanos , MasculinoRESUMEN
AIM: To test a hypothesized model linking new graduate nurses' perceptions of their manager's authentic leadership behaviours to structural empowerment, short-staffing and work-life interference and subsequent burnout, job satisfaction and patient care quality. BACKGROUND: Authentic leadership and structural empowerment have been shown to reduce early career burnout among nurses. Short-staffing and work-life interference are also linked to burnout and may help explain the impact of positive, empowering leadership on burnout, which in turn influences job satisfaction and patient care quality. DESIGN: A time-lagged study of Canadian new graduate nurses was conducted. METHODS: At Time 1, surveys were sent to 3,743 nurses (November 2012-March 2013) and 1,020 were returned (27·3% response rate). At Time 2 (May-July 2014), 406 nurses who responded at Time 1 completed surveys (39·8% response rate). Descriptive analysis was conducted in SPSS. Structural equation modelling in Mplus was used to test the hypothesized model. RESULTS: The hypothesized model was supported. Authentic leadership had a significant positive effect on structural empowerment, which in turn decreased both short-staffing and work-life interference. Short-staffing and work-life imbalance subsequently resulted in nurse burnout, lower job satisfaction and lower patient care quality 1 year later. CONCLUSION: The findings suggest that short-staffing and work-life interference are important factors influencing new graduate nurse burnout. Developing nurse managers' authentic leadership behaviours and working with them to create and sustain empowering work environments may help reduce burnout, increase nurse job satisfaction and improve patient care quality.
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Agotamiento Profesional/etiología , Enfermeras y Enfermeros/psicología , Adulto , Canadá , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Admisión y Programación de Personal , Poder Psicológico , Calidad de la Atención de Salud , Lugar de Trabajo/psicologíaRESUMEN
The purpose of this study was to explore Rwandan nursing clinical instructors' (CIs) experiences of structural and psychological empowerment. CIs play a vital role in students' development by facilitating learning in health care practice environments. Quality nursing education hinges on the CI's ability to enact a professional role. A descriptive qualitative method was used to obtain an understanding of CIs empowerment experiences in practice settings. Kanter's Theory of Structural Power in Organizations and Spreitzer's Psychological Empowerment Theory were used as theoretical frameworks to interpret experiences. Interview data from 21 CIs were used to complete a secondary analysis. Most participants perceived the structural components of informal power, resources, and support while formal power and opportunity were limited, diminishing their sense of structural empowerment. Psychological empowerment for CIs stemmed from a sense of competence, meaning, impact and self-determination they had for their teaching roles and responsibilities in the practice setting.
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Educación en Enfermería/organización & administración , Docentes de Enfermería , Poder Psicológico , Autoeficacia , Curriculum , Humanos , Investigación en Educación de Enfermería , Autonomía Profesional , Investigación Cualitativa , Rwanda , Estudiantes de Enfermería/psicologíaRESUMEN
OBJECTIVE: This study examined the influence of authentic leadership, person-job fit with 6 areas of worklife, and civility norms on coworker incivility and burnout among new graduate nurses. BACKGROUND: New graduate nurses report experiencing high levels of workplace incivility from coworkers, which has been found to negatively impact their job and career satisfaction and increase their intention to leave. The role of civility norms in preventing burnout and subsequent exposure to incivility from coworkers has yet to be examined among new graduate nurses. METHODS: A cross-sectional mail survey of 993 new graduate nurses across Canada was conducted. RESULTS: The results supported the hypothesized relationships between study variables. CONCLUSIONS: Civility norms play a key role in preventing early career burnout and coworker incivility experienced by new graduate nurses. Leaders can influence civility norms by engaging in authentic leadership behaviors and optimizing person-job fit.
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Agotamiento Profesional/psicología , Satisfacción en el Trabajo , Liderazgo , Personal de Enfermería en Hospital/psicología , Adaptación Psicológica , Canadá , Estudios Transversales , Humanos , Relaciones InterprofesionalesRESUMEN
BACKGROUND: As the nursing profession ages, new graduate nurses are an invaluable health human resource. OBJECTIVES: The purpose of this study was to investigate factors influencing new graduate nurses' successful transition to their full professional role in Canadian hospital settings and to determine predictors of job and career satisfaction and turnover intentions over a one-year time period in their early employment. DESIGN: A national two-wave survey of new graduate nurses across Canada. PARTICIPANTS: A random sample of 3906 Registered Nurses with less than 3 years of experience currently working in direct patient care was obtained from the provincial registry databases across Canada. At Time 1, 1020 of 3743 eligible nurses returned completed questionnaires (usable response rate=27.3%). One year later, Time 1 respondents were mailed a follow-up survey; 406 returned a completed questionnaire (response rate=39.8%). METHODS: Surveys containing standardized questionnaires were mailed to participants' home address. Descriptive statistics, correlations, and hierarchical linear regression analyses were conducted using SPSS software. RESULTS: Overall, new graduate nurses were positive about their experiences and committed to nursing. However, over half of new nurses in the first year of practice reported high levels of emotional exhaustion and many witnessed or experienced incivility (24-42%) at work. Findings from hierarchical linear regression analyses revealed that situational and personal factors explained significant amounts of variance in new graduate nurses' job and career satisfaction and turnover intentions. Cynicism was a significant predictor of all four outcomes one year later, while Psycap predicted job and career satisfaction and career turnover intentions. CONCLUSIONS: Results provide a look into the worklife experiences of Canadian new graduate nurses over a one-year time period and identify factors that influence their job-related outcomes. These findings show that working conditions for new graduate nurses are generally positive and stable over time, although workplace mistreatment is an issue to be addressed.
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Educación en Enfermería , Personal de Enfermería , Adaptación Psicológica , Adulto , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Personal de Enfermería/psicología , Reorganización del Personal , Recursos Humanos , Adulto JovenRESUMEN
AIM: To test a model examining the effects of structural empowerment and support for professional practice on new graduate nurses' perceived professional practice behaviours, perceptions of care quality and subsequent job satisfaction and career turnover intentions. BACKGROUND: The nursing worklife model describes relationships between supportive nursing work environments and nurse and patient outcomes. The influence of support for professional practice on new nurses' perceptions of professional nursing behaviours within this model has not been tested. METHODS: Structural equation modelling in Mplus was used to analyse data from a national survey of new nurses across Canada (n = 393). FINDINGS: The hypothesised model was supported: χ²(122) = 346.726, P = 0.000; CFI = 0.917; TLI = 0.896; RMSEA = 0.069. Professional practice behaviour was an important mechanism through which empowerment and supportive professional practice environments influenced nurse-assessed quality of care, which was related to job satisfaction and lower intentions to leave nursing. CONCLUSION: Job satisfaction and career retention of new nurses are related to perceptions of work environment factors that support their professional practice behaviours and high-quality patient care. IMPLICATIONS: Nurse managers can support new graduate nurses' professional practice behaviour by providing empowering supportive professional practice environments.
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Actitud del Personal de Salud , Relaciones Interprofesionales , Enfermeras y Enfermeros/psicología , Percepción , Calidad de la Atención de Salud/normas , Adulto , Canadá , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Reorganización del Personal , Poder Psicológico , Práctica Profesional/normas , Lugar de Trabajo/psicología , Lugar de Trabajo/normasRESUMEN
AIM: The aim of this study was to examine the influence of structural empowerment, authentic leadership and professional nursing practice environments on experienced nurses' perceptions of interprofessional collaboration. BACKGROUND: Enhanced interprofessional collaboration (IPC) is seen as one means of transforming the health-care system and addressing concerns about shortages of health-care workers. Organizational supports and resources are suggested as key to promoting IPC. METHODS: A predictive non-experimental design was used to test the effects of structural empowerment, authentic leadership and professional nursing practice environments on perceived interprofessional collaboration. A random sample of experienced registered nurses (n = 220) in Ontario, Canada completed a mailed questionnaire. Hierarchical multiple regression analysis was used. RESULTS: Higher perceived structural empowerment, authentic leadership, and professional practice environments explained 45% of the variance in perceived IPC (Adj. R² = 0.452, F = 59.40, P < 0.001). CONCLUSIONS: Results suggest that structural empowerment, authentic leadership and a professional nursing practice environment may enhance IPC. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders who ensure access to resources such as knowledge of IPC, embody authenticity and build trust among nurses, and support the presence of a professional nursing practice environment can contribute to enhanced IPC.
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Relaciones Interprofesionales , Liderazgo , Percepción , Poder Psicológico , Lugar de Trabajo/normas , Adulto , Conducta Cooperativa , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Persona de Mediana Edad , Ontario , Cultura Organizacional , Lugar de Trabajo/psicologíaRESUMEN
AIM: To examine the relationships among the overall person-job match in the six areas of worklife, work-life interference, new nurses' experiences of burnout and intentions to leave their jobs. BACKGROUND: As a large cohort of nurses approaches retirement, it is important to understand the aspects of the nurses work-life that are related to turnover among new graduate nurses to address the nursing workforce shortage. METHODS: Secondary analysis of data collected in a cross-sectional survey of 215 registered nurses working in Ontario acute hospitals was conducted using structural equation modelling. RESULTS: The fit indices suggested a reasonably adequate fit of the data to the hypothesised model [χ(2) = 247, d.f. = 122, P = 0.001, χ(2) /d.f. = 2.32, Incremental Fit Index (IFI) = 0.954, Comparative Fit Index (CFI) = 0.953, Root Mean Square Error of Approximation (RMSEA) = 0.06]. Person-job match in six areas of worklife had a direct negative effect on burnout (emotional exhaustion and cynicism), which in turn had a direct positive effect on turnover intentions. Work-life interference also influenced turnover intentions indirectly through burnout. CONCLUSION: The study findings demonstrate that new graduate nurses' turnover intentions are a recurring problem, which could be reduced by improving nurses' working conditions. Retention of new graduate nurses could be enhanced by creating supportive working environments to reduce the susceptibility to workplace burnout, and ultimately, lower turnover intentions. IMPLICATIONS FOR NURSING MANAGEMENT: Managers must employ strategies to enhance workplace conditions that promote a person-job fit and work-life balance to improve retention of new graduate nurses, and, thereby, lessen the nursing shortage.
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Agotamiento Profesional/psicología , Intención , Satisfacción en el Trabajo , Enfermeras y Enfermeros/psicología , Personal de Enfermería en Hospital/psicología , Reorganización del Personal , Equilibrio entre Vida Personal y Laboral , Adulto , Actitud del Personal de Salud , Estudios Transversales , Femenino , Humanos , Masculino , Modelos Psicológicos , Modelos Estadísticos , OntarioRESUMEN
OBJECTIVE: This study explores correlates of new graduate nurses' experiences of workplace mistreatment. BACKGROUND: New graduate nurses' experiences of workplace mistreatment, such as bullying, coworker incivility, and supervisor incivility, negatively influence nurses' work and health. It is unclear whether these forms of workplace mistreatment have similar precipitating factors and outcomes. METHODS: We surveyed 342 new graduate nurses in Ontario to explore correlates of 3 forms of workplace mistreatment. RESULTS: Workplace incivility and bullying were significantly related to authentic leadership, structural empowerment, worklife fit, and psychological capital. Bullying was more strongly related to job satisfaction, emotional exhaustion, and mental and physical health outcomes than supervisor and coworker incivility. CONCLUSIONS: New graduate nurses' experiences of 3 types of workplace mistreatment are related to organizational and health factors, although bullying appears to have stronger negative effects.
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Actitud del Personal de Salud , Acoso Escolar/estadística & datos numéricos , Satisfacción en el Trabajo , Personal de Enfermería en Hospital/psicología , Estrés Psicológico/complicaciones , Lugar de Trabajo/normas , Adulto , Femenino , Estado de Salud , Humanos , Relaciones Interprofesionales , Liderazgo , Masculino , Salud Mental , Personal de Enfermería en Hospital/organización & administración , Personal de Enfermería en Hospital/provisión & distribución , Ontario , Cultura Organizacional , Reorganización del Personal/tendencias , Poder Psicológico , Distribución por Sexo , Estrés Psicológico/etiología , Encuestas y Cuestionarios , Lugar de Trabajo/psicología , Lugar de Trabajo/estadística & datos numéricosRESUMEN
BACKGROUND: The frontline clinical manager role in healthcare is pivotal to the development of safe and healthy working conditions and optimal staff and patient care outcomes. However, in today's dynamic healthcare organizations managers face constant job demands from wider spans of control and complex role responsibilities but may not have adequate decisional authority to support effective work performance resulting in unnecessary job strain. Prolonged job strain can lead to burnout, health complaints, and increased turnover intention. Yet, there is limited research that examines frontline manager job strain and its impact on their well-being and work outcomes. The substantial cost associated with replacing experienced managers calls attention to the need to address job strain in order to retain this valuable organizational asset. OBJECTIVES: Using Karasek's Job Demands-Control theory of job strain, a model was tested examining the effects of frontline manager job strain on their burnout (emotional exhaustion and cynicism), organizational commitment and ultimately, turnover intentions. DESIGN: Secondary analysis of data collected in an online cross-sectional survey of frontline managers was conducted using structural equation modeling. PARTICIPANTS: All 500 eligible frontline managers from 14 teaching hospitals in Ontario, Canada, were invited to participate and 159 responded for a 32% response rate. METHODS: Participants received an email invitation with a secure link for the online survey. Ethics approval was obtained from the university ethics board and the respective ethics review boards of the 14 organizations involved in the study. The model was tested using path analysis techniques within structural equation modeling with maximum likelihood estimation. RESULTS: The final model fit the data acceptably (χ(2)=6.62, df=4, p=.16, IFI=99, CFI=.99, SRMR=.03, RMSEA=.06). Manager job strain was significantly positively associated with burnout which contributed to both lower organizational commitment and higher turnover intention. Organizational commitment was also negatively associated with turnover intention and there was an additional direct positive relationship between job strain and turnover intention. CONCLUSIONS: Preliminary support was found for a model showing that manager job strain contributes to burnout, reduced organizational commitment and higher turnover intentions. Findings suggest that organizations need to monitor and address manager job strain by ensuring managers' role demands are reasonable and that they have the requisite decision latitude to balance role demands.
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Agotamiento Profesional/psicología , Enfermeras Administradoras/psicología , Reorganización del Personal , Estudios TransversalesRESUMEN
OBJECTIVES: A model linking authentic leadership, structural empowerment, and supportive professional practice environments to nurses' perceptions of patient care quality and job satisfaction was tested. BACKGROUND: Positive work environment characteristics are important for nurses' perceptions of patient care quality and job satisfaction (significant factors for retention). Few studies have examined the mechanism by which these characteristics operate to influence perceptions of patient care quality or job satisfaction. METHODS: A cross-sectional provincial survey of 723 Canadian nurses was used to test the hypothesized models using structural equation modeling. RESULTS: The model was an acceptable fit and all paths were significant. Authentic leadership had a positive effect on structural empowerment, which had a positive effect on perceived support for professional practice and a negative effect on nurses' perceptions that inadequate unit staffing prevented them from providing high-quality patient care. These workplace conditions predicted job satisfaction. CONCLUSION: Authentic leaders play an important role in creating empowering professional practice environments that foster high-quality care and job satisfaction.