Commitment in the workplace

PURPOSE
To determine the effect of hospital work environments on hospital outcomes across multiple countries.


DESIGN
Primary survey data using a common instrument were collected from separate cross sections of 98 116 bedside care nurses practising in 1406 hospitals in 9 countries between 1999 and 2009.


MAIN OUTCOME MEASURES
Nurse burnout and job dissatisfaction, patient readiness for hospital discharge and quality of patient care.


RESULTS
High nurse burnout was found in hospitals in all countries except Germany, and ranged from roughly a third of nurses to about 60% of nurses in South Korea and Japan. Job dissatisfaction among nurses was close to 20% in most countries and as high as 60% in Japan. Close to half or more of nurses in every country lacked confidence that patients could care for themselves following discharge. Quality-of-care rated as fair or poor varied from 11% in Canada to 68% in South Korea. Between one-quarter and one-third of hospitals in each country were judged to have poor work environments. Working in a hospital with a better work environment was associated with significantly lower odds of nurse burnout and job dissatisfaction and with better quality-of-care outcomes.


CONCLUSIONS
Poor hospital work environments are common and are associated with negative outcomes for nurses and quality of care. Improving work environments holds promise for nurse retention and better quality of patient care.

https://ir.ymlib.yonsei.ac.kr/bitstream/22282913/95019/1/T201105164.pdf

Importance of work environments on hospital outcomes in nine countries

Aim Using an interactionist perspective to test on-the-job embeddedness and off-the-job embeddedness as possible moderators for the predictive effects of job satisfaction and job stress on nurses' turnover intentions Background As turnover worsens nurse shortages across the globe, researchers needs to find ways to work out and reduce nurses' turnover intentions By exploring contributory factors, namely on-the-job and off-the-job embeddedness as two distinctive forms that both act as moderators, we add to the literature on effective nurse retention and highlight that incorporating off-the-job factors can provide a more realistic understanding of why people consider leaving their organization Design Survey of 361 nurses of the United Kingdom's (UK's) National Health Service, in 2016 Method We conducted hierarchical multiple regression and simple slope analyses Results Job satisfaction was negatively associated with turnover intentions, and this negative relationship was stronger when off-the-job embeddedness was high (vs low) Job stress was positively related to turnover intentions, yet high (vs low) off-the-job embeddedness buffered this relationship In contrast, when on-the-job embeddedness was high (vs low), the relationship between job stress and turnover intentions were even stronger Conclusion Results showed that using an interactionist perspective is useful in predicting nurse turnover Nursing management should be made aware of the importance of being embedded off-the-job to prevent nurse turnover This paper issues guidelines to form a more comprehensive staff retention programme for the healthcare sector

Job satisfaction, job stress and nurses' turnover intentions: The moderating roles of on-the-job and off-the-job embeddedness

Background The current COVID 19 pandemic brings into sharp focus the global necessity of having sufficient numbers of nurses and the dire impacts of nursing shortages throughout health systems in many countries. In 2020 retaining skilled experienced nurses continues to be a major global challenge. The dominant and consistent concentration of workforce research to date has focused on attitudinal factors including job satisfaction and burnout and there is limited research on how organisational commitment in combination with job satisfaction and burnout may explain what keeps nurses in nursing. Objectives To measure how organisational commitment in combination with job satisfaction and burnout relate to the intention of Registered General Nurses’ staying in nursing (ITSN). Design & Methods A quantitative descriptive design using a cross-sectional survey was utilised. A national postal survey of a representative sample of registered general nurses employed within the Republic of Ireland (ROI) health services was undertaken in 2010. A number of established valid and reliable instruments were used to measure attitudinal factors and their relationship with intention to stay (ITSN). Data were analysed using IBM SPSS version 24.0 and descriptive, correlational and multiple regression analysis were undertaken. Results A total of 756 registered nurses participated in this study. The strongest predictor of intention to stay in nursing was organisational commitment (β=0.32, p=.000) while burnout and job satisfaction had a significant relationship with ITSN. Conclusion Results reveal the complex and multidimensional nature of ITSN with the majority of nurses having a strong intention to stay in nursing. Organisational commitment and low burnout represented predictors which are influential in nurses remaining in nursing throughout their career lifespan. These results remain relevant in 2020 particularly in light of the ongoing pandemic when retention and recruitment of skilled and experienced nurses to the workforce will be critical to the management of health care, considering the increased nurse vacancy rates in many countries and the evident lack of resolution of the issues raised from this study.

How Organisational Commitment Influences Nurses' Intention To Stay In Nursing Throughout Their Career.

Purpose: This research adopts the perspective of Personal Construct Theory (PCT) to conceptualise employability. The study explores differences in the implicit employability theories of those involved in developing employability (educators) and those selecting and recruiting HE students and graduates (employers). 
Design/methodology/approach: A repertory grid technique (RGT) was employed to uncover the implicit theories of 22 employers and 14 educators across the UK. 
Findings: A total of 717 constructs were elicited. A differential analysis of data gathered demonstrated several areas of consensus among employers and educators (including; emotional management, confidence, professionalism), as well as divergence in representations of commitment, proactivity, interpersonal competencies, and vision to the conceptualisation of employability.
Practical implications: Findings from this analysis indicate a need to integrate group process assessments within undergraduate programmes and recruitment procedures.
Originality/value: This study represents a personal construct approach to employability, utilising the unique value of RGT to further inform our understanding of employability within a HE context. This study contributes to an understanding of employability as a continually re-constructed concept. Providing insights to its nature via two information rich cases that have extensive knowledge on the topic.

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A personal construct approach to employability: comparing stakeholders’ implicit theories

AIMS The aim of this study was to present a discussion and model depicting most effecting work-life experience contextual factors that influence commitment and turnover intentions for nurses in Sri Lanka. BACKGROUND Increasing demand for nurses has made the retention of experienced, qualified nursing staff a priority for healthcare organizations and highlights the need to capture contextual work-life experiences that influence nurses' turnover decisions. DESIGN Discussion paper. DATA SOURCES This discussion paper and model is based on our experiences and knowledge of Sri Lanka and represents an integration of classic turnover research and commitment theory and others published between 1958 - 2017, contextualized to reflect the reality faced by Sri Lanka nurses. IMPLICATIONS FOR NURSING The model presents a high-level view of intrinsic, extrinsic, personal and professional antecedents to nurse turnover where relevance can be used by researchers, policy makers, clinicians and educators to establish focused and limited scope models and examine comprehensive contexts. CONCLUSION This model emphasizes the role that work-life experiences play to fortify (or weaken) nurses' motivation to remain committed to their organization, profession, family, and country. Understanding of contextual work-life influences on nurses' intent to stay should lead to evidence-based strategies that result in a higher number of nurses wanting to remain in the nursing profession and work in the health sector in Sri Lanka.

Emerita Linda Ogilvie

Papers

A contextual work-life experiences model to understand nurse commitment and turnover.