Prevalence of, and risk factors for, physical disability among nurses in Europe

Aims and objectives: This study investigates possible causes of physical disability among European nurses, and deals with personal, physical and (social) work environment factors. Design: 39,898 (51.7%) nurses responded to our survey (6335 head nurses; 4933 specialized nurses; 24,142 state-registered nurses; and 4488 nursing aids). Methodology: First, the prevalence of physical disability among nurses in Europe was investigated. Second, multivariate analyses were performed to better understand the influence of possible risk factors for physical disability. A Strobe statement has been added. Results: In general, the risk of physical disability is positively associated with the amount of physical load and the nurses’ dissatisfaction with this, with a lack of teamwork quality, harassment by supervisors, colleagues not (quite) ready to help, not having lifting aids, a high quantitative work demand, and having to work in split shifts. The main moderating or buffering factors addressed in this study are having a part-time job, practice of sport and/or hobbies, and the nurses’ social work environment. Relevance to Clinical Practice: Today, there is a substantial shortage of nurses in Europe, and management in healthcare organizations that fails to improve physical working conditions and to provide adequate (career) support might suffer from, will experience growing levels of disability and dissatisfaction among nursing staff that might result in premature leave, reduced productivity or higher absenteeism

Job enrichment: Creating meaningful career development opportunities for nurses

© 2013 John Wiley & Sons Ltd. Aim: This paper presents an evaluation of a career development policy in South Australia which increased the number of senior staff nurse positions and provided senior registered nurses with time away from clinical duties to undertake agreed projects. We use Kanter's model of structural power and commitment theory to understand the dimensions of this policy. Background: Development strategies for experienced staff who wish to remain at the bedside are needed, especially in smaller health services with limited opportunities for horizontal or vertical mobility. Methods: Face-to-face semistructured interviews were conducted with 54 senior staff nurses who participated in the career structure arrangements. Results: The policy enhanced the structure of opportunity in three ways: by increasing the number of senior staff nurse positions, the ladder steps were improved; undertaking strategic projects developed new skills; and the job enrichment approach facilitated time out from the immediate pressures of ward work and challenged nurses in a different way. Conclusions: Through job enrichment, South Australia has found a novel way of providing meaningful career development opportunities for experienced nurses. Implications for nursing management: Methods of job enrichment need to be considered as part of career development policy, especially where movement between clinical facilities is limited and staff wish to remain at the bedside

Isolement, parcellisation du travail et qualité des soins en gériatrie

L’organisation du travail et l’espace déterminent fortement la manière dont les soignants peuvent réaliser leur tâche. Leur cœur de métier en gériatrie est de prodiguer des soins de base, techniques et relationnels à des résidents souvent très dépendants. Les expériences pilotes d’ergonomie participative présentées ont eu pour objectif la compréhension des déterminants des écarts entre travail prescrit et travail réel pour proposer des améliorations cohérentes pour tous.Les observations de 40 journées complètes de travail d’aides soignants (AS ; n = 26) et d’infirmiers (IDE ; n = 14) ont été menées par des ergonomes et des soignants en formation-action.On constate que les soignants ne peuvent rester auprès des résidents que de courts épisodes (AS moyenne 44 % du temps en 68 séjours et IDE 22 % en 51 séjours). Le peu de temps passé dans le poste de soins pour les AS (5,9 % versus 41,5 % pour les IDE) objective les faibles possibilités d’échanges AS /IDE (en moyenne les AS ont parlé 1,8 % de leur temps de travail avec une IDE), alors que ce sont les AS qui dialoguent le plus avec les résidents. Les constats des AS paraissent peu utilisés pour « reconsidérer régulièrement le projet de vie » de chaque résident.Les soignants peuvent rarement partager leur charge émotionnelle avec leurs collègues. Le risque de se retrouver dans une situation d’isolement et d’épuisement professionnel est majeur.Cette méthode permet de proposer, en groupe pluridisciplinaire, des améliorations des conditions de travail, de la coopération des personnels et de la prise en charge des résidents.The organisation of work and space have a major impact on how health workers do their job. The core of their occupation is to provide basic care for residents of nursing homes and patients in geriatric departments who are often very dependent. This participatory ergonomics analysis set out to understand why prescribed work does not always tally with actual work, with a view to suggesting improvements that will benefit both health workers and patients.A real-time task analysis of 40 full days worked by nursing assistants (NAs, n = 26) and registered nurses (RNs, n = 14) was carried out by ergonomists and health workers taking part in the research.In theory, the geriatric nurses and nursing assistants should be supporting and stimulating patients, often at the end of their lives, and giving them appropriate prescribed treatment. The real-time task analysis showed that they could only stay with patients for short periods (for NAs, 68 periods and 44 % of their working time ; for RNs, 51 periods and 22 % of their working time). NAs spend very little time at the nurses’ workstation (5.9 % compared to 41.5 % for RNs) which means they have few opportunities for discussion with RNs. On average, NAs spend only 1.8 % of their working time in discussion with RNs, even though it is the NAs who spend the most time talking to patients. Little use seems to be made of their observations in adapting the "life projects" of patients – in contradiction with the certification criteria.Moreover, they seldom have time to share their emotional burden with their colleagues.Because of the way health workers’ tasks are organised, they devote a large amount of time to indirect care such as preparation and cleaning. For the RNs, this means administrative tasks and walking from one ward to another. As a result, there is a danger of loneliness and a high risk of professional burnout.This method suggests improvements to working conditions, cooperation between the occupations concerned and the quality of patient care, as part of a multidisciplinary group

Congruency of resources and demands and their effects on staff turnover within the English health care sector

This study examines, at the organizational level, the congruency between job demands and resources and their effects on staff turnover within the English healthcare sector. Polynomial regression analyses conducted on 164 acute hospitals trusts found support for the predictions that organizations with congruent levels of resources and demands would have relatively low staff turnover whereas those with incongruent levels would have relatively high staff turnover. Overall the study indicates that individual job design should be considered within a broader organizational design perspective

Stress in nurses : stress-related affect and its determinants examined over the nursing day

Peer reviewedPostprin

Toward a mediation model for nurses' well-being and psychological distress effects of quality of leadership and social support at work

Contains fulltext : 169219.pdf (publisher's version ) (Open Access)Given the lack of active nurses in industrialized countries throughout the world, in combination with demographic changes, it is of utmost importance to protect nurses’ well-being and to prevent psychological distress, because of their strong association with premature occupational leave. The aim of this study was to investigate the effects of quality of leadership and social support at work on well-being and psychological distress of nurses and to determine whether nurses’ overcommitment mediates the relationship between the abovementioned determinants and the outcomes. A cross-sectional survey design was used to gather our data. This study utilized part of the database of the Nurses’ Early Exit Study. A total of 34,771 nurses (covering all nurse qualifications) working in hospitals, nursing homes, and home-care institutions in 8 European countries filled out a questionnaire (response rate?=?51.4%). For all model variables (job satisfaction, satisfaction with salary, positive affectivity, personal burnout, negative affectivity, quality of leadership, social support from immediate supervisor, social support from near colleagues, and overcommitment), psychometrically sound, that is, valid and reliable measures were used. Outcomes from testing a structural equation mediation model indicated that, respectively, positive and negative influences of leadership quality and social support from supervisor and colleagues on nurses’ well-being and psychological distress are partially mediated, that is, reduced, by nurses’ overcommitment. Social work environment is highly important in relation to nurses’ well-being and psychological distress.6 p

Impact of job demands and resources on nurses' burnout and occupational turnover intention towards an age-moderated mediation model for the nursing profession

Contains fulltext : 204955.pdf (publisher's version ) (Open Access

The effect of aggression management training programmes for nursing staff and students working in an acute hospital setting. A narrative review of current literature

BACKGROUND: Patient aggression is a longstanding problem in general hospital nursing. Staff training is recommended to tackle workplace aggression originating from patients or visitors, yet evidence on training effects is scarce. AIMS: To review and collate current research evidence on the effect of aggression management training for nurses and nursing students working in general hospitals, and to derive recommendations for further research. DESIGN: Systematic, narrative review. DATA SOURCES: Embase, MEDLINE, the Cochrane library, CINAHL, PsycINFO, pubmed, psycArticles, Psychology and Behavioural Sciences Collection were searched for articles evaluating training programs for staff and students in acute hospital adult nursing in a 'before/after' design. Studies published between January 2000 and September 2011 in English, French or German were eligible of inclusion. REVIEW METHODS: The methodological quality of included studies was assessed with the 'Quality Assessment Tool for Quantitative Studies'. Main outcomes i.e. attitudes, confidence, skills and knowledge were collated. RESULTS: Nine studies were included. Two had a weak, six a moderate, and one a strong study design. All studies reported increased confidence, improved attitude, skills, and knowledge about risk factors post training. There was no significant change in incidence of patient aggression. CONCLUSION: Our findings corroborate findings of reviews on training in mental health care, which point to a lack of high quality research. Training does not reduce the incidence of aggressive acts. Aggression needs to be tackled at an organizational level