Health correlates of autonomy, control and professional relationships in the nursing work environment

Budge, Claire; Carryer, Jenny; Wood, Sue

doi:10.1046/j.1365-2648.2003.02615.x

Cited by 85 publications

(95 citation statements)

References 27 publications

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“…In August 2000, the Future Nursing Workforce Planning Group, comprising experts in nursing, hospital administration, human resources, and labor partners, was formed to evaluate the impact of the national nursing shortage on the VHA and to formulate strategies to ensure an adequate nursing workforce (Nursing Workforce Planning Group, 2002). Consistent with research on non-federal government settings (Aiken, Havens, & Sloane, 2000;Budge, Carryer, & Wood, 2003;Kramer & Hafner, 1989), the Planning Group concluded that characteristics of nurses' work environments, such as professional support, making decisions about patient care responsibilities, adequate compensation, and recognition as professionals, were key factors in attracting and retaining a qualified VHA nursing workforce.…”

mentioning

confidence: 83%

Measuring nurses' practice environments with the revised nursing work index: Evidence from registered nurses in the veterans health administration

Lake

Sales

et al. 2007

Research in Nursing & Health

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The Revised Nursing Work Index (NWI-R) is a widely used instrument for evaluating registered nurses' (RNs) practice environments. The existence of multiple subscale sets from the NWI-R raises questions about its generalizability. We tested the validity of the one-, three-, and five-subscale sets from the NWI-R and derived a short-form subscale set using a sample of RNs from the Veterans Health Administration (VHA). The prior sets do not have an excellent fit to these data. Results of exploratory factor analyses suggested a four-factor model with Opportunity for Advancement, Collegial Nurse-Physician Relations, Staffing Adequacy, and Nurse Manager Leadership as the most salient and parsimonious solution. Additional

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mentioning

confidence: 83%

Measuring nurses' practice environments with the revised nursing work index: Evidence from registered nurses in the veterans health administration

Lake

Sales

et al. 2007

Research in Nursing & Health

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“…The findings of this study indicate that a power imbalance between nurses and physicians could hinder this exchange of knowledge. However, the nurses reported that their authority with respect to holistic patient care and their capacity to protect patient needs positively influenced their cooperation with physicians and other professionals (Budge et al 2003;Skår 2009). …”

Section: Nurses Work As a Learning Environmentmentioning

confidence: 99%

“…According to Aamodt and Havnes (2008), job autonomy, co-worker support, and job commitment have a combined impact on job mastery in nursing. Within the hospital environment, autonomy and control over nursing care delivery have positive influences on nurses' interprofessional relationships (Budge et al 2003). Nevertheless, nurses show consideration for other members of the work community as they try to avoid conflicts (Duddle and Boughton 2007) and interrupt their activities to address the desires from other team members (Hedberg and Sätterlund Larsson 2004).…”

Section: Introductionmentioning

confidence: 99%

How Nurses Experience Their Work as a Learning Environment

Skår

2009

Vocations and Learning

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This article explores and illuminates the meaning of nurses' experiences with their work as a learning environment. A qualitative hermeneutic approach guided the research process and the analysis and interpretation of the transcribed interview-texts of eleven graduate nurses. Three core themes emerged from these informants' descriptions of their work as a learning environment: 'participation in the work community', 'to engage in interpersonal relations' and 'accessing important knowledge resources'. The study found that, for these informants, an understanding of work as a learning environment is connected to how the nurses elect to engage in their workplaces and how the workplaces regulate their participation in activities and interpersonal relations. The nurses were aware of their responsibilities for continuous learning at work, and to confirm, create and develop their practical and professional knowledge, they obtained support from knowledgeable co-workers and chose among accessible knowledge resources in their particular workplaces. Concurrently, workplace characteristics such as the community of workers, hierarchical structures, cultural practices, and personal relations influenced learning. This understanding of the learning environment in particular workplaces shows the importance of focusing on learning processes as part of professional development in an ever-changing health care system.

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“…[1][2][3] In intensive care units (ICUs), increased nursing autonomy is strongly linked with improved outcomes for patients 1,4,5 and nurses' health and well-being. 6,7 Exercising autonomy is a factor in supporting application of evidence-based practice 8 and in enhancing nurses' satisfaction and retention. 9 Increased autonomy for intensive care unit nurses is strongly linked with improved patient outcomes.…”

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confidence: 99%

Professional Autonomy, Collaboration With Physicians, and Moral Distress Among European Intensive Care Nurses

Papathanassoglou

Karanikola

Kalafati

et al. 2012

American Journal of Critical Care

191

262

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Background Discretionary autonomy is a key factor in enhanced patient outcomes and nurses' work satisfaction. Among nurses, insufficient autonomy can result in moral distress. Objectives To explore levels of autonomy among European critical care nurses and potential associations of autonomy with nurse-physician collaboration, moral distress, and nurses' characteristics. Methods Descriptive correlational study of a convenience sample of 255 delegates attending a major European critical care conference in 2009. Respondents completed a selfadministered questionnaire with validated scales for nurses' autonomy, nurse-physician collaboration, and moral distress. Results The mean autonomy score (84.26; SD, 11.7; range, and the mean composite (frequency and intensity) moral distress score (73.67; SD, 39.19; range, were both moderate. The mean collaboration score was 47.85 (SD, 11.63; range,. Italian and Greek nurses reported significantly lower nurse-physician collaboration than did other nurses (P < .001). Greek and German nurses reported significantly higher moral distress (P < .001). Autonomy scores were associated with nurse-physician collaboration scores (P < .001) and with a higher frequency of moral distress (P = .04). Associations were noted between autonomy and work satisfaction (P = .001). Frequency of moral distress was associated inversely with collaboration (r = -0.339; P < .001) and autonomy (r = -0.210; P = .01) and positively with intention to quit (r = 0.257; P = .004). Autonomy is defined as the freedom to make decisions within the domain of an individual's profession and to act accordingly. 10,11 The ability to make discretionary and autonomous decisions based on comprehensive knowledge, clinical expertise, and evidence-based findings is a hallmark of professionalism. In general, ICU nurses make 1 care decision every 30 seconds 12 and approximately 9 important patient-care decisions per hour, 13 suggesting that exercising judgment is a core nursing activity and influences the quality of care provided. Previous studies 11,[14][15][16] in European ICUs indicated that the levels of nurse autonomy differ between countries and that the decision-making capacity of these clinicians needs to be developed and strengthened. However, factors that may be associated with low autonomy among European ICU nurses have not been systematically studied. Although, presumably, poor nursephysician collaboration may limit a nurse's ability to implement care-and unit-related decisions, associations between these 2 constructs have not been investigated. Evidence of the association between nurse-physician collaboration and ICU nurses' moral distress is likewise scant. Although the design of the study we report here was unsuitable for exploring either causative factors or antecedents of autonomy-and inferences may be limited by differences in responders' context of practice-we wished to address autonomy, nurse-physician collaboration, and moral distress simultaneously in a sample of European ICU nurses to gain preliminary insigh...

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Health correlates of autonomy, control and professional relationships in the nursing work environment

Abstract: The study offers an insight into a New Zealand hospital environment and suggests the importance of good relationships with physicians and other departments for the health of nurses.

Cited by 85 publications

References 27 publications

Measuring nurses' practice environments with the revised nursing work index: Evidence from registered nurses in the veterans health administration

Measuring nurses' practice environments with the revised nursing work index: Evidence from registered nurses in the veterans health administration

How Nurses Experience Their Work as a Learning Environment

Professional Autonomy, Collaboration With Physicians, and Moral Distress Among European Intensive Care Nurses

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