Abstract

Nurses are the largest group of employees in the health care sector and play an important role in the delivery of high quality heath care. Unfortunately recent research has indicated that nursing staff in various countries have reported relatively modest levels of work satisfaction. Several countries are facing nursing shortages and the nursing profession has become a less attractive job and career prospect for young women and men. This investigation examines the relationship of six work experiences proposed by Leiter and Maslach (2005) as antidotes to burnout with various work and well-being outcomes in a sample of US nurses (N=289) whose hospitals were undergoing restructuring and budget cuts. The data indicated that high workloads and low levels of reward, control and value congruence were associated with greater nursing staff distress. Suggestions for addressing these job and work experiences are offered along with approaches to implementing restructuring and downsizing processes more likely to contribute to individual and hospital health.

Keywords

• Nursing staff, Work experiences, Work outcomes, Quality of Work Life, Psychological Well-being

Nursing Staff Work Experiences, Work Outcomes and Psychological Well-Being in Difficult Times: Implications For Improving Nursing Staff Quality Of Work Life and Hospital

Abstract

References

1. Aiken, L. H., & Fagin, C. M. (1997) Evalua- ting the consequences of hospital res- tructuring. 1-4.doi:10.1097/00005650-199710001- 00001 Care, 35,
2. Aiken, L. H., Sochalski, J., & Anderson, G.F. (1996) Downsizing the hospital nursing workforce. Health Affairs, 15, 88-92. d o i : 1 0 . 1 3 7 7 / h l t h a f f . 1 5 . 4 . 8 8 , PMid:8991258
3. Aiken, L.H., Smith, H. L., & Lake, E. T (1994) Lower medicare mortality among a set of hospitals known for good nursing care. Medical Care, 32, 771-787. doi:10.1097/00005650-199408000-00002
4. Aiken, L. H., Clarke, S. P., Sloane, D. M., & Sochalski, J. A. (2001) An international perspective on hospital nurses’ work environments: The case for reform. Po- licy, Politics and Nursing, 2, 255-263. doi:10.1177/152715440100200402
5. Armstrong-Stassen, M., Cameron, S. J., & Horsburgh, M. E. (1996) The impact of organizational downsizing on the job satisfaction of nurses. Canadian Journal of Nursing Administration, 9, 8-32. PMid:9016004
6. Bakker, A. B., & Leiter, M. P, (2010) Work en- gagement: A handbook of essential the- ory Psychology Press. New York:
7. Baumann, A., & Blythe, J. (2003) Restructu- ring, reconsidering, reconstructing: Im- plications for health human resources. International Journal of Public adminis- tration. doi:10.1081/PAD-120024411 1561-1580.
8. Baumgart, A. J., (1997) Health reform and nursing labor market trends in Canada. Medical doi:10.1097/00005650-199710001-00016 PMid:9339783 35, 124-131. 57, 1539-1546.

9. Buchan, J., Hancock, C., & Rafferty, A.M.(1997) Health sector reform and trends in the United Kingdom hospital workforce. Medical Care, 35,143-149. doi:10.1097/00005650-199710001-00018, PMid:9339785
10. Burke, R. J. 2004) Implementation of hospital res- tructuring and nursing staff perceptions of hospital functioning. Journal of Health Or- ganization and Management, 18, 279-289.
11. doi:10.1108/14777260410554287
12. Burke, R. J. (2003) Nursing staff attitudes fol- lowing restructuring: The role of per- ceived restructuring processes and stressors. International Journal of Family, 4, 49-62.
13. Burke, R. J., & Nelson, D. L. (1998) Downsi- zing, restructuring and privatization: A North American perspective. In M. K. Gowing, J. D. Kraft & J. C. Quick (eds.) The new organizational reality: Down- sizing, restructuring and revitalization. Washington, D. C.: American Psycholo- gical doi:10.1037/10252-001 pp. 21-54.
14. Cameron, K. (1994) Strategies for successful organizational downsizing. Human Re- sources Management, 33, 189-221. doi:10.1002/hrm.3930330204
15. Cameron, K., Freeman, S. J., Mishra,A. K. (1991) Best practices in white-collar downsizing: Managing contradictions. Academy of Management Executive, 5, 57-73
16. Cascio, W. F. (2002) Responsible restructu- ring: Creative and profitable alternati- ves Berrett0-Koehler. San Francisco:
17. Cascio, W. F, (1998) Learning from outco- mes: Financial experiences from 311 firms that have downsized. In M. K. Go- wing, J. D. Kraft & J. C Quick (eds.) The new organizational reality: Downsi- zing, restructuring and revitalization. Washington, D. C.: American Psycholo- gical doi:10.1037/10252-013 pp. 55-70.
18. Cascio, W. F. (1995) Whither industrial and organizational psychology in a chan- ging world of work? American Psycho- logist, doi:10.1037/0003-066X.50.11.928 928-939.
19. Cascio, W. F. (1993) Downsizing: What do we know>? What have we learned? Academy of Management Executive, 7, 95-104.
20. Derogatis, L.R., Lipman, R.S., Rickels, R. S., Uhlenhuth, E, H., & Covi, L. (1974) The Hopkins symptom Checklist (HSCL): A self-report symptom inventory. Beha- vioral d o i : 1 0 . 1 0 0 2 / b s . 3 8 3 0 1 9 0 1 0 2 PMid:4808738 19, 1-15.
21. Gowing, M. K., Kraft, J. D., & Quick, J. C. (1998) The new organizational reality: downsizing, restructuring and revitali- zation. Washington, D. C: American Psychological doi:10.1037/10252-000 Association. downside of downsizing. Human Rela- tions, doi:10.1177/001872679705000102 11-30.
22. Kovner, C., & Gergen, P. J., (1998) Nurse staf- fing levels and adverse advents following surgery in US hospitals. Image: Journal of Nursing Scholarship, 30, 3156-321. doi:10.1111/j.1547-5069.1998.tb01326.x
23. Laschinger, .H K. S., Sabiston, J.A., Finegan, J., Shamian, J. (2001) Voices from the trenches: Nurses’ experiences of hospi- tal restructuring in Ontario. Canadian Journal of Nursing Leadership 14, 6-13.
24. Leiter, M. P., & Maslach, C. (2005) Banishing burnout: Six strategies for improving your relationship with work. San Fran- cisco: Jossey-Bass.
25. Ludy, P. J. (2009) Profit building: Cutting costs without cutting people. San Fran- cisco: Berrett-Koehler.
26. Maslach, C., Jackson, S. E., & Leiter, M. P. (1996) The Maslach Burnout Inventory. 3rd ed. Consulting Psychologists Press. Palo alto, CA.
27. McKee, M., Aiken, L., Rafferty, A. M., & Soc- halski, J. (1998) Organizational change and quality of health care: An evolving international agenda. Quality in Health Care, 7, 37-41. doi:10.1136/qshc.7.1.37
28. Mesch, D. J., McGrew, J. H., Pescosolido, B. A., & Haugh, D. F. (1999) The effects of hospital closure on mental health wor- kers: An overview of employment, mental and physical health, and attitu- dinal outcomes. Journal of Behavioral Health Services and Research, 26, 305- 317. PMid:11571778
29. Muller-Mundt, G. (1997) trends in hospital restructuring and the impact on the workforce in Germany. Medical Care, 35, 132-142. doi:10.1097/00005650- 199710001-00017
30. Noer, D. (1993) Healing the wounds: Over- coming the trauma of layoffs and revi- talizing downsized organizations. San Francisco: Jossey-Bass.
31. O’Neill, H. M., & Lenn, J. (1995) Voices of survivors: Words that downsizing CEOs should hear. Academy of Mana- gement Executive, 9, 23-34.
32. Quinn, R. P., & Shepard, L. J. (1974) The 1972-73 Quality of Employment Survey. Institute for Social Research, University of Michigan, ann Arbor, MI>
33. Reinhardt, U. E., (1996) Spending more thro- ugh “cost control”: Our obsessive quest to gut the hospital. Health Affairs, 45, 145-154. doi:10.1377/hlthaff.15.2.145
34. Robertson, R., & Dowd, S. B. (1996) The ef- fects of hospital downsizing on staffing and quality of care. Health Care Super- visor. 12, 50-56.
35. Schaufeli, W. B., & Bakker, A. B. (2003) Ut- recht Work Engagement Scale: Prelimi- nary Psychology, Utrecht University, The Netherlands. Department of
36. Shanahan, M., Brownell, M. D. & Roos, N. P. (2001) The unintended and unexpected impact of downsizing: Costly hospitals become more costly. Medical Care, 37, 123-134.
37. Shortell, S. M., & O’Brien, J. L., & Carman, J. M.(1995) Assessing the impact of conti- nuous quality improvement/total qua- lity management: Concept versus implementation. Health /Services Re- search, 30, 377-401. PMid:7782222 PMCid:1070069
38. Sochalski, J., Aiken, L. H., & Fagin, C. M. (1997) Hospital restructuring in the Uni- ted States, Canada, and Western Eu- rope: An outcomes research agenda. Medical Care, 3, 13-25.
39. Woodward, C. A., Shannon, H.; S., Cun- ningham, C., McIntosh, J., Lendrum, B., Rosenblum, D. & Brown, J.(1999) The impact of re-engineering and other cost reduction strategies on the staff of a large teaching hospital. Medical Care, 37, 556-569 199906000-00005, PMid:10386568
40. Wright, B., & Barling, J. (1998) The executio- ner’s song: Listening to downsizers ref- lect on their experiences, Canadian Journal of Administrative Sciences, 15, 339-355. doi:10.1111/j.1936-4490.1998 .tb00176.x