Job satisfaction and retention

Disablednurse · Jun 8, 2003

Sounds like a good topic. The last place I worked, I was there for a little over 11 years. I worked under about 22 DONs and I was the DON for two years. The DON position is not a stable job by any stretch of the imagination. There is no support from management and the nursing assistants run the facility.

pickledpepperRN · Jun 8, 2003

I have friends who are nurse managers and supervisors. Their main conflict is being responsible for the quality of nursing care yet being evaluated on staying within a budget. All they can do is write proposals for the next years budget.

Trauma Columnist · Jun 8, 2003

I'm doing an ADN to MSN program through University of Phoenix online and like your idea. I too agree that mid-level managers are on the chopping block.

nightingale, RN · Jun 8, 2003

I remember hearing somewhere that nurses tend to average out and last about 5 years. From the sound of things, no wonder.

The only real job staisfaction I can cling to involves the dirent patient care.

Sad to say DisabledRN, I agree it is true. The NA have the longevity on many units and call the shots. Yuck!

gwenith, BSN, RN · Jun 8, 2003

The thread about "Patient who bit a nurses finger off" is so rich in all aspects related to job satisfaction that it would be a fantastic place to start. Might get a little big. The reactions of the nurses to the scenario give a good phenomenological study into the political reaction to a problem like this. Although you have got management support - have they given the nurse all the support she needs? There is the impact of not only lack fo professional support but threat of professional repurcussions since she has chosen to try to take action. There is the media actively promoting that violence to health care workers if OK - rich indeed. How does this impact on job satisfaction - Read through the threads - more than anything else the job dissatisfaction is not from hating the work itself but from the lack of security against workplace bullying and violence. Not just management on nurses and nurses on nurses but patient versus nurse. To care, and be abused for caring does not lead to good workplace environment.

Another area that may highlight what you are after is the prepponderance of nurses on this website who have been disabled with injuries from lifting. I am gobsmacked that so few American nurses have heard of "No Lift" policies and if you discuss it tell you "managment won't buy anything because it will cost money"

Here is a concrete way of increasing job satisfaction by taking the strain and risk of injury out of the workplace. Using this as a focus it would be possible to look at the factors preventing nurses from agitating for "No lift" i.e. "they already know about it" (when they may not) "They don't care" (they might do if it was put to them correctly) and "They won't spend money" ( We have it here because it proved to save money). Nurses seem not to know how to approach management to petition for change. Ah! Now! Research how to teach and encourage nurses to pettion for change effectively and we might see management cowering in a corner rather than standing over us with a big stick! LOL!!

SmilingBluEyes · Jun 9, 2003

Gwenith states it perfectly to me. I would take some of these thoughts and run with them. Good luck.

pickledpepperRN · Jun 9, 2003

Maybe this article will help. It is about direct care RNs, but help in retaining staff should help nurse managers too.

Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction

Linda H. Aiken, PhD, RN; Sean P. Clarke, PhD, RN; Douglas M. Sloane, PhD; Julie Sochalski, PhD, RN; Jeffrey H. Silber, MD,

PhD

Context The worsening hospital nurse shortage and recent California legislation mandating minimum hospital patient-to-nurse ratios

demand an understanding of how nurse staffing levels affect patient outcomes and nurse retention in hospital practice.

Objective To determine the association between the patient-to-nurse ratio and patient mortality, failure-to-rescue (deaths following

complications) among surgical patients, and factors related to nurse retention.

Design, Setting, and Participants Cross-sectional analyses of linked data from 10 184 staff nurses surveyed, 232 342 general,

orthopedic, and vascular surgery patients discharged from the hospital between April 1, 1998, and November 30, 1999, and

administrative data from 168 nonfederal adult general hospitals in Pennsylvania.

Main Outcome Measures Risk-adjusted patient mortality and failure-to-rescue within 30 days of admission, and nurse-reported job

dissatisfaction and job-related burnout.

Results After adjusting for patient and hospital characteristics (size, teaching status, and technology), each additional patient per

nurse was associated with a 7% (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03-1.12) increase in the likelihood of dying

within 30 days of admission and a 7% (OR, 1.07; 95% CI, 1.02-1.11) increase in the odds of failure-to-rescue. After adjusting for

nurse and hospital characteristics, each additional patient per nurse was associated with a 23% (OR, 1.23; 95% CI, 1.13-1.34)

increase in the odds of burnout and a 15% (OR, 1.15; 95% CI, 1.07-1.25) increase in the odds of job dissatisfaction.

Conclusions In hospitals with high patient-to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and

failure-to-rescue rates, and nurses are more likely to experience burnout and job dissatisfaction.

JAMA. 2002;288:1987-1993