BackgroundIn recent years, an increasing number of care procedures previously under the physician’s authority have been placed in the hands of registered nurses. The purpose of this study was to examine the attitudes of nurses towards expanding nurses’ authority and the relationships between these attitudes and job satisfaction facets, professional characteristics, and demographics.MethodA cross-sectional study was conducted between 2010 and 2011 in three major medical centers in Israel. Participants included 833 nurses working in 89 departments. Attitudes toward the expansion of nurses’ authority were assessed by self-report questionnaire, as well as job satisfaction facets including perception of professional autonomy, nurse-physician working relations, workload and burnout, perceptions of quality of care, and nursing staff satisfaction at work.ResultsNurses reported positive attitudes toward the expansion of nurses’ authority and moderate attitudes for interpretation of diagnostic tests in selected situations. The results of multivariate regression analyses demonstrate that the nurses’ satisfaction from professional autonomy and work relations were the most influential factors in explaining their attitudes toward the expansion of nurses’ authority. In addition, professionally young nurses tend to be more positive regarding changes in nurses’ authority.ConclusionsIn the Israeli reality of a nurse’s shortage, we are witnessing professional transitions toward expansion of the scope of nurses’ accountability and decision–making authority. The current research contributes to our understanding of attitudes toward the expansion of nurses’ authority among the nursing staffs. The findings indicate the necessity of redefining the scope of nursing practice within the current professional context.

Objective: To evaluate the effect of childbirth preparation courses on anxiety and self-efficacy levels in coping with childbirth. Methods: A study was conducted on a convenience sample of nulliparous women. The intervention groups consisted of 31 women who attended a 5-week childbirth preparation course and 39 women who attended a 2-week course. A control group included 32 women who did not attend any of the childbirth preparation courses. Levels of anxiety and self-efficacy were measured before and after childbirth preparation courses. The setting was a large teaching hospital in central Israel. Results: After completing the preparation courses the anxiety level dropped significantly in the long and short course groups (p = .04 and p = .01, respectively). The anxiety in both groups was significantly related to the self-efficacy for coping with childbirth (r = -0.26, p = .03 and r = -0.48, p = .001, respectively). Nonetheless, attending the preparation courses did not raise the level of self-efficacy in coping with childbirth. Anxiety and self-efficacy levels in the control group were not significantly different from those of the other groups. Conclusions: Preparation courses are expected to reinforce the self-efficacy of the parturient. The overall impact of the findings indicated that while they had no effect on self-efficacy, they did constitute an anxiety-reducing factor. Midwife postgraduate programs should include training in preparing women for coping with childbirth. These findings are an important contribution to the examination of current strategies of teaching and training of midwives in conducting childbirth preparation courses.

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