The current nursing shortage, high hospital nurse job dissatisfaction, and reports of uneven quality of hospital care are not uniquely American phenomena. This paper presents reports from 43,000 nurses from more than 700 hospitals in the United States, Canada, England, Scotland, and Germany in 1998-1999. Nurses in countries with distinctly different health care systems report similar shortcomings in their work environments and the quality of hospital care. While the competence of and relation between nurses and physicians appear satisfactory, core problems in work design and workforce management threaten the provision of care. Resolving these issues, which are amenable to managerial intervention, is essential to preserving patient safety and care of consistently high quality.

These results provide initial support for an expanded model of organizational empowerment and offer a broader understanding of the empowerment process.

No abstract

No abstract

SummaryA longitudinal predictive design was used to test a model linking changes in structural and psychological empowerment to changes in job satisfaction. Structural equation modeling analyses revealed a good fit of the data from 185 randomly selected staff nurses to the hypothesized model. Changes in perceived structural empowerment had direct effects on changes in psychological empowerment and job satisfaction. Changes in psychological empowerment did not explain additional variance in job satisfaction beyond that explained by structural empowerment. The results suggest that fostering environments that enhance perceptions of empowerment can have enduring positive effects on employees.