... Engagement at work: A review of the literature Michelle R. Simpson * Center on Age and Community, College of Nursing, Cunningham Hall, 1921 East Hartford Avenue, University of Wisconsin-Milwaukee, Milwaukee, WI 53201-0413, United States Received 26 March 2008; received in revised form 20 May 2008; accepted 22 May 2008 Abstract Objectives: Engagement at work has emerged as a potentially important employee performance and organizational management topic, however, the definition and measurement of engagement at work, and more specifically, nurse engagement, is poorly understood. The objective of this paper is to examine the current state of knowledge about engagement at work through a review of the literature. This review highlights the four lines of engagement research and focuses on the determinants and consequences of engagement at work. Methodological issues, as identified in the current research, and recommendations for future nurse-based engagement research are provided. Design: A systematic review of the business, organizational psychology, and health sciences and health administration literature about engagement at work (1990–2007) was performed. Data sources: The electronic databases for Health Sciences and Health Administration (CINAHL, MEDLINE), Business (ABI INFORM), and Psychology (PsycINFO) were systematically searched. Review methods: Due to the limited amount of research that has examined engagement among the nursing workforce, published research that included...
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...Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction Grand Canyon University: NRS-433V 06-04-2016 PROBLEM STATEMENT: The broad research problem leading to this study is the belief that nursing shortage in facilities leads to patient safety issues. The review of available literature on this topic shows strong evidence that lower nurse staffing levels in hospitals are associated with worse patient outcomes. Some of these outcomes include very high patient to nurse ratio, fatigue for nurses leading to costly medical mistakes, social environment, nursing staff attrition from the most affected facilities. The study specifically attempts to find a way to understand how nurse staffing levels has an impact on patient outcomes and nurse retention in hospital practice. Purpose d Research Questions: With one of the most critical steps being the determination of the problem that will be studied in the research process. (Nieswiadomy, 2008, p.45). Linda H. Aiken et al states the research question as 1. Determine the association between patient-to-nurse ratio and patient mortality 2. Determine the association between patient-to-nurse ratio and failure-to-rescue (deaths following complications) among surgical patients 3. Determine the association between patient-to-nurse ratio and nurse retention/attrition. 4. Determine the association between patient-to-nurse and the facts that contributed to the stress that lead to nurse burnout The...
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...January 2016 Leadership and Management Executive Summary Nursing burnout is serious and in order to ensure that nurses are taken care of, the administration must implement incentives and policies that will provide nurses with the resources to maintain a healthy work life balance. Burnout accounts for many of the medication errors and patient injuries in healthcare facilities. Most nurses are overwhelmed because of the caseload and longer workdays necessary to complete charting. Many nurses are also disgruntled because of denied vacation requests that cannot be approved because of non-coverage. Research has shown that when employees are happy then there are less errors and injuries in the workplace. It’s ironic that nurses care for patients but they don’t feel as though the healthcare facility cares for them. Many things can be done to boost employee morale which in turn will increase the quality of care that the patients receive. Adequate coverage needs to be address and using temporary staffing is a way to fill chronic vacant positions so that float RN’s are available for PTO requests. Insurance credits and consumer discounts can be used as incentives for those employees that practice healthy living activities. Staff meetings held during work hours, discussion boxes, timeout rooms, and partnerships with massage clinics are all changes that can provide stress relief for nurses. These changes are not too costly for the facility, and in the end, will result...
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...S I N G E D U C A T I O N Nurse educators’ workplace empowerment, burnout, and job satisfaction: testing Kanter’s theory Teresa P. Sarmiento MScN RN College Nurse Educator, George Brown College, Toronto, Ontario, Canada Heather K. Spence Laschinger Canada PhD RN Professor and Associate Director Nursing Research, School of Nursing, The University of Western Ontario, London, Ontario, Carroll Iwasiw EdD RN Professor and Director School of Nursing, School of Nursing, The University of Western Ontario, London, Ontario, Canada Submitted for publication 22 May 2003 Accepted for publication 21 October 2003 Correspondence: Heather Spence Laschinger, School of Nursing, The University of Western Ontario, London, Ontario N6A 5C1, Canada. E-mail: hkl@uwo.ca SARMIENTO T.P., LASCHINGER H.K.S. & IWASIW C. (2004) Journal of Advanced Nursing 46(2), 134–143 Nurse educators’ workplace empowerment, burnout, and job satisfaction: testing Kanter’s theory Background. Empowerment has become an increasingly important factor in determining college nurse educator burnout, work satisfaction and performance in current restructured college nursing programmes in Canada. Aim. This paper reports a study to test a theoretical model specifying relationships among structural empowerment, burnout and work satisfaction. Method. A descriptive correlational survey design was used to test the model in a sample of 89 Canadian full-time college nurse educators employed in Canadian...
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...Patient Services/Intensive Care Nurses/Compassion Fatigue Intervention/BESt 173 Best Evidence Statement (BESt) Date: July 17, 2013 Title: Decreasing Compassion Fatigue* among Pediatric Intensive Care Nurses Using Self-Care Skills* and Compassion Fatigue Training* Clinical Question: P (Population/Problem) I (Intervention) C (Comparison) O (Outcome) Among pediatric intensive care nurses does functional knowledge of compassion fatigue and the practice of self-care skills, compared to not, demonstrate less compassion fatigue? Definitions for terms marked with * may be found in the Supporting Information section. Target Population for the Recommendation: Nurses working in pediatric intensive care settings who provide direct patient care Recommendation: It is recommended that nurses working in pediatric intensive care settings receive training that includes compassion fatigue awareness, coping strategies, stress management, relaxation techniques and self-care interventions to decrease the level of compassion fatigue experienced in the work environment (Marine, Ruotsalainen, Serra, & Verbeek (2009) [1a]; Gunusen, & Ustun (2010) [2a]; Kravits, McAllister-Black, Grant, & Kirk (2010) [4a]; Meadors & Lamson (2008) [4a]). Discussion/Synthesis of Evidence related to the recommendation: The evidence referred to a variety of concepts related to the manifestation of compassion fatigue, including burnout, emotional exhaustion, and workplace stress. The concepts...
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...of the Study Job satisfaction in registered nurses should be of great concern to any organization. Nurses hold the majority of positions in most health care settings, and replacement of licensed personnel is costly and time consuming. As newly graduated nurses, we have limited time but ample exposure to varying degrees of job satisfaction. What makes some so happy with their chosen profession, and others so unhappy? Aside from a change of career, is there a solution? With the current nursing shortage, and the anticipation of worsening conditions, we set out to investigate the sources of dissatisfaction in the health care setting. We reviewed several scholarly sources and withdrew pertinent information. Following the discussion of literature findings is a summary including suggestions for further research. In the article written by Fletcher, job satisfactions as well as dissatisfactions were investigated. Questionnaires were mailed to 5,192 registered nurses (RNs), 1,780 of which were returned and scored using several evaluation methods (Fletcher, 2001). Researchers looked at job satisfaction, patient satisfaction and safety, extrinsic work values, role of the immediate supervisor, and intent to stay in nursing. Job satisfaction was evaluated on several levels: Profits, Job performance, Intrinsic work values, and, Patient care issues. Profits referred not to personal financial gain, but to the organization’s profits. Many nurses responded feeling "devalued in their job" (Fletcher...
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...Occupational stress is a recognized problem in health care workers.1 Nursing has been identified as an occupation that has high levels of stress. In an investigation conducted by the National Institute for Occupational Safety and Health in the USA, nurses were found to be one of the occupations that had a higher than expected incidence of stress related health disorders.3 It was found that job stress brought about hazardous impacts not only on nurses’ health but also their abilities to cope with job demands. This will seriously impair the provision of quality care and the efficacy of health services delivery. In a study of job stress among hospital nurses, it was found that 27% of the subjects experienced psycho physiological symptoms of stress, and 38% reported consulting a doctor in the past 6 months. It has also been found that different nurses experience job stress different (Josef, 2003). In recent years there has been broad discussion on the nature of stressors experienced by members of “high risk” occupations and professions, for instance nursing and emergency workers, whose role is to support others through traumatic scenarios. Most people can cope with stress for short periods but Chronic stress produces prolonged changes in the physiological state.8 Effectiveness of coping behaviors depends on the situation in which they are used. Some coping behaviors may work well for some situations but not for others.9 In general terms, coping are a strategy that helps people reduce...
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...where they work hard but yet have fun while doing it. Furthermore they want to be recognized for the hard work that they are doing. People want to work in a place where there are not a lot of opposing personalities and egos. “Two studies of occupational stress and its relation with antecedent variables and job performance were completed by Stephan J. Motowidlo, John S. Packard, and Michael R. Manning. The first study, in which 104 nurses participated in group discussions and 96 nurses completed a questionnaire, identified 45 stressful events for nurses. In the second study, 171 nurses who completed another questionnaire were also rated by a supervisor and/or a co-worker. Ratings of interpersonal aspects of job performance (such as sensitivity, warmth, consideration, and tolerance) and cognitive/motivational aspects (such as concentration, composure, perseverance, and adaptability) correlated significantly with self-reported perceptions of stressful events, subjective stress, depression, and hostility. Models developed through path analysis suggest that the frequency and subjective intensity of the 45 events identified in Study 1 cause feelings of stress, which lead to depression, which, in turn, causes decrements in interpersonal and cognitive/motivational aspects of job performance (Motowidlo, Manning, & Packard, 1986, p. 1).”The tests resulted in several causes of stress with the top two being stress events such as case overload and individual characteristics such as people...
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...about is the shortage of nurses. This has been a long standing problem, even in the days of Ms. Florence Nightingale, when she and her nurses "used limited resources to address unlimited wants for healthcare (Cherry & Jacob, 2014)". They did the best they could and were able to improve the soldiers' condition dramatically. Agreeably, the situation is far better today. This topic is of great importance because, a shortage of nurses means that the ratio of patient to nurse increases and this can result in nurses being overwhelmed. It also affects the every aspect of patients’ care and it increases the risk of negative patients’ outcomes. It makes nurses apprehensive when they are going to work and that is not a good way to feel on a regular basis. Some of the reasons listed as causes of shortage of nurses include lack of good role models and early professional socialization, unrealistic workload, an aging workforce, negative work environment, retention problem, and insufficient nursing faculty staff. I chose the first article "Becoming a nurse: a meta-study of early professional socialization and career choice in nursing," because it attempts to deal with the issue of nursing shortage by investigating what motivates young people to choose nursing as a career and early professional socialization (Price, 2009). It highlighted the need to have good mentors, peers and role models, especially as new nurses are transitioning into the profession. A lot of new nurses report having negative...
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...MSN, RN, AOCNS®, FAAN Abstract Nurses have a longstanding history of witnessing the tragedy experienced by patients and families; however, their own reactions to profound loss and premature death have not been systematically addressed. There is a paucity of research describing interventions to prevent or minimize the ramifications of repeated exposure to traumatic events in the clinical workplace. Compassion fatigue is a contemporary label affixed to the concept of personal vicarious exposure to trauma on a regular basis. Yet this phenomenon of compassion fatigue lacks clarity. In this article, the author begins by describing compassion fatigue and distinguishing compassion fatigue from burnout. Next she discusses risk factors for, and the assessment of compassion fatigue. The need to support nurses who witness tragedy and workplace interventions to confront compassion fatigue are described. Citation: Boyle, D., (Jan 31, 2011) "Countering Compassion Fatigue: A Requisite Nursing Agenda" OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 1, Manuscript 2. DOI: 10.3912/OJIN.Vol16No01Man02 Key words: Compassion fatigue, nurse stress, work setting improvements, communication skills Nurses care for ill, wounded, traumatized, and vulnerable patients in their charge. This exposes them to considerable pain, trauma, and suffering on a routine basis (Coetzee & Klopper, 2010; Hooper, Craig, Janvrin, Wetzel, & Reimels, 2010). While many nurses perceive their work as a calling, few...
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...PROVIDING QUALITY CARE Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units Sung-Hyun Cho, Kyung Ja June, Yun Mi Kim, Yong Ae Cho, Cheong Suk Yoo, Sung-Cheol Yun and Young Hee Sung Aim. To examine the relationship between nurse staffing and nurse-rated quality of nursing care and job outcomes. Background. Nurse staffing has been reported to influence patient and nurse outcomes. Design. A cross-sectional study with a survey conducted August–October 2007. Methods. The survey included 1365 nurses from 65 intensive care units in 22 hospitals in Korea. Staffing was measured using two indicators: the number of patients per nurse measured at the unit level and perception of staffing adequacy at the nurse level. Quality of care and job dissatisfaction were measured with a four-point scale and burnout measured by the Maslach Burnout Inventory. Multilevel logistic regression models were used to determine the relationships between staffing and quality of care and job outcomes. Results. The average patient-to-nurse ratio was 2Æ8 patients per nurse. A fifth of nurses perceived that there were enough nurses to provide quality care, one third were dissatisfied, half were highly burnt out and a quarter planned to leave in the next year. Nurses were more likely to rate quality of care as high when they cared for two or fewer patients (odds ratio, 3Æ26; 95% confidence interval, 1Æ14–9Æ31) or 2Æ0–2Æ5 patients (odds ratio, 2Æ44; 95% confidence interval, 1Æ32–4Æ52), compared...
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...Examining experiences of WA nurses workload under the NHPPD staffing model. One of onus for practising nurses as highlighted by the ANMC code of ethics (2008) is that “Nurses value quality nursing care for all people”. This becomes significantly harder as several complexity or factors within the health system impedes on nurses ability to efficiently fulfil this role. One of such issues is safe and effective workload or the optimal nurse to patient ratio for providing quality nursing care. As Twigg et al. (2011) noted the implementation of nursing hours per patient day (NHPPD) staffing model in 2002, a landmark event for western Australian public hospitals was a result of nurses taking a stand to combat the unreasonable workload that was being undertaken. With evidence showing, mandated nursing staff levels having a significant impact on health outcomes, implementation of various staffing models to foster quality nursing care and improved patient outcomes in the health care setting has been widely utilised globally (Twigg et al. 2011). With prominent research done by Aiken and colleagues in the US, and with several other studies carried out internationally the gains achieved for patient outcomes through appropriate nursing staffing levels has been thoroughly highlighted. Aiken et al (2002) demonstrates the significant impact low staffing levels has on patient’s mortality rate. The study noted that wards that had the worst staffing ratios saw a 31% increase in death rates. Increases...
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...others so unhappy? Aside from a change of career, is there a solution? With the current employee’s shortage, and the anticipation of worsening conditions, the researcher of this study set out to investigate the sources of dissatisfaction in the hotel and restaurant settings. Most medium-sized enterprises realize that their effectiveness depend on the utilization of their human resources. Employees’ levels of burnout, job satisfaction and job performance give an indication of the effectiveness of an enterprise. The objective of this study was to determine the relationship between a dispositional variable (sense of coherence), burnout, job satisfaction and job performance. A once-off cross-sectional survey design was used.. The Orientation to Life Questionnaire, Maslach Burnout Inventory, Minnesota Job Satisfaction Questionnaire and Performance Appraisal Questionnaire were used as measuring instruments. Sense of coherence was related to the three subscales of burnout. Job satisfaction was found to be negatively related to burnout. The results showed that one component of burnout, namely low personal...
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...is vital that Congress preserve funding for nurse practitioners educational programs, traineeships, and Nurse Managed Clinics. Congress must reduce federal spending through the Division of Nursing in the Bureau of Health Professions of the Department of Health and Human Services. The American Academy of Nurse Practitioners (AANP) are advocates for nurse practitioners and patients. The AANP’s legislative team identify critical issues related to licensure, access to care, patient safety, health care reform, and reimbursement. They represent NPs on national committees and in health organization. Thus, the AANP is fighting Congress for sufficient funding for Nurse Education Programs (2015). The writer will introduce a new policy to improve the nursing shortage. Literature Review According to the American Association of Colleges of Nursing (AACN, 2014), a shortage of nursing school faculty is restricting nursing program enrolments. Nursing schools identified faculty shortages for rejecting qualified applicants. In 2012-2013, U.S. nursing schools rejected almost 80, 000 qualified applicants from undergraduate and graduate nursing programs due to insufficient number of faculty (2014). In addition to faculty shortages, clinical practice sites, classroom space, and clinical preceptors, and budget deficits also restricted enrollments (2014). The nursing shortage contributes to increase stress levels. As a result, there remains a high nurse turnover and vacancy rates (Littlejohn, Campbell...
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...Critical Incident Analysis: Burnout syndrome It was my 11th week of clinical in tertiary care hospital. On that day, I had experienced an incident that I would like to reflect upon. I was assigned to a female patient with diagnose of third stage breast cancer. After taking her interview, I came to know that patient and even their family member didn’t know any thing about the patient prognosis and they were too worried to know about. For that reason, I went to doctor and inquired that whether doctor had told them about the patient prognosis or not. In response to my question, doctor got irritated and replied in a very rude manner. He said, “you want me to tell patient that when he would gone to die? Or how much life is remaining for him… six month or less then that?” why should I be bothered? Let the family deal with it. I have other number of tasks. On hearing that comment, I got astonished and remained silent in front of him. After some time, he again probe that we don’t get enough time to explain each and every patient about their diagnosis and prognosis and if we take such type of tension related to patient’s health status, one day we get burst out. After coming across this situation, several kinds of feelings came in my mind. First of all, I felt very strange on hearing that discourteous response of doctor. I thought that being a professional, how he could talk in such a pathetic manner? Not only as a professional but also as a human...
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