Recruitment and retention of qualified nursing staff are vital to safe patient care and require the expertise of clinical educators to facilitate the nurses' professional development. However, organizational redesign has challenged clinical educators with role ambiguity, job stress, and decreased job satisfaction. This study used Kanter's Structural Theory of Organizational Behavior to examine the relationships between clinical educators' perceptions of empowerment, job tension, and job satisfaction. High levels of workplace empowerment were significantly related to low levels of job tension. In addition, the combination of high levels of empowerment and low levels of job tension was predictive of high levels of job satisfaction. Implications for staff development administrators are discussed.
The aim of this study was to test a multilevel model linking unit-level leader-member exchange quality and structural empowerment to nurses' psychological empowerment and organizational commitment at the individual level of analysis.
Few studies have examined the contextual effects of unit leadership on individual nurse outcomes. Workplace empowerment has been related to retention outcomes such as organizational commitment in several studies, but few have studied the impact of specific unit characteristics within which nurses work on these outcomes.
We surveyed 3,156 nurses in 217 hospital units to test the multilevel model.
A multilevel path analysis revealed significant individual and contextual effects on nurses' organizational commitment. Both unit-level leader-member exchange quality and structural empowerment had significant direct effects on individual-level psychological empowerment and organizational commitment. Psychological empowerment mediated the relationship between core self-evaluations and organizational commitment at the individual level of analysis.
The contextual effects of positive supervisor relationships and their influence on empowering working conditions at the unit level and, subsequently, nurses' organizational commitment highlight the importance of leadership for creating conditions that result in a committed nursing workforce.
We examined the impact of empowering work conditions on nurses' work engagement and effectiveness, and compared differences among these relationships in new graduates and experienced nurses.
As many nurses near retirement, every effort is needed to retain nurses and to ensure that work environments are attractive to new nurses. Experience in the profession and generational differences may affect how important work factors interact to affect work behaviours.
We conducted a secondary analysis of survey data from two studies and compared the pattern of relationships among study variables in two groups: 185 nurses 2 years post-graduation and 294 nurses with more than 2 years of experience.
A multi-group SEM analysis indicated a good fit of the hypothesized model. Work engagement significantly mediated the empowerment/effectiveness relationship in both groups, although the impact of engagement on work effectiveness was significantly stronger for experienced nurses.
Engagement is an important mechanism by which empowerment affects nurses feelings of effectiveness but less important to new graduates' feelings of work effectiveness than empowerment. Implications for nursing management Managers must be aware of the role of empowerment in promoting work engagement and effectiveness and differential effects on new graduates and more seasoned nurses.
Workplace empowerment is an important strategy for creating positive nursing work environments in a time of a severe nursing shortage. The purpose of this study was to test a model linking staff nurse perceptions of empowerment to their perceived fit with 6 areas of work life and work engagement/burnout using Kanter's work empowerment theory. We tested the model in a cross-sectional correlational survey design with a random sample of 322 staff nurses in acute care hospitals across Ontario. Overall, staff nurses perceived their work environment to be only somewhat empowering. Fifty-three percent reported severe levels of burnout. Overall empowerment had an indirect effect on emotional exhaustion (burnout) through nurses' perceived fit in 6 areas of work life. The final model fit statistics revealed a good fit (chi2 = 32.4, df = 13, GFI = 0.97, IFI = 0.97, CFI = 0.97, RMSEA = 0.07). These findings have important implications in the current nursing shortage.
Although nursing leadership roles have been greatly transformed as a result of dramatic changes within healthcare over the past decade, there is little research on the nature of nurse manager work life in current work environments. The purpose of this study was to test a theoretical model derived from Kanter's theory of organizational empowerment: linking nurse managers' perceptions of structural and psychological empowerment to burnout, job satisfaction and physical and mental health. A descriptive, correlational design was used in a sample of 286 first-line (n=202) and middle-level (n=84) hospital-based nurse managers obtained from a provincial registry. Ironically, managers reported high levels of burnout, but good mental and physical health. Middle managers were more empowered and satisfied with their jobs than first-line managers. In both groups, approximately 45% of the variance in job satisfaction and 18-52% of the variance in physical and mental health was explained by empowerment and burnout. Empowered work environments were associated with lower nurse manager burnout and better physical and mental health. The results suggest that creating work environments that provide access to empowerment structures may be a fruitful strategy for creating healthy work environments for nurse managers.
This study reports on a secondary data analysis undertaken to better understand the determinants of job satisfaction for hospital nurses. Both workplace and personal factors can contribute to job satisfaction.
Kanter's theory of structural empowerment and Spreitzer's theory of psychological empowerment explain logical outcomes of managerial efforts to create structural conditions of empowerment. Selected personal attributes were also considered.
Instruments used were 1) Conditions for Work Effectiveness Questionnaire; 2) psychological empowerment tool; 3) a mastery scale; 4) an achievement scale; and 5) a job satisfaction scale. The sample of 347 nurses (58% response rate) came from all specialty areas.
Structural and psychological empowerment predicted 38% of the variance in job satisfaction. Achievement and mastery needs were not significant. Other personal attributes can be found in future research to improve job satisfaction.
Through careful manipulation of the hospital environment, both structural and psychological empowerment can be increased, resulting in greater job and patient satisfaction and, ultimately, improved patient outcomes.
Unit-level leadership and structural empowerment play key roles in creating healthy work environments, yet few researchers have examined these contextual effects on nurses' well-being.
The aim of this study was to test a multilevel model of structural empowerment examining the effect of nursing unit leadership quality and structural empowerment on nurses' experiences of burnout and job satisfaction and to examine the effect of a personal dispositional variable, core self-evaluation, on these nurse experiences.
Nurses (n = 3,156) from 217 hospital units returned surveys that included measures of leader-member exchange, structural empowerment, burnout, core self-evaluation, and job satisfaction. Multilevel structural equation modeling was used to test the model.
Nurses' shared perceptions of leader-member exchange quality on their units positively influenced their shared perceptions of unit structural empowerment (Level 2), which resulted in significantly higher levels of individual nurse job satisfaction (Level 1). Unit-level leader-member exchange quality also directly influenced individual nurse job satisfaction. Unit leader-member exchange quality and structural empowerment influenced emotional exhaustion and cynicism differentially. Higher unit-level leader-member exchange quality was associated with lower cynicism; higher unit-level structural empowerment was associated with lower emotional exhaustion. At Level 1, higher core self-evaluation was associated with lower levels of both emotional exhaustion and cynicism, both of which were associated with lower job satisfaction.
This study provides a theoretical understanding of how unit leadership affects both unit- and individual-level outcomes.
The authors tested a model linking chief nurse executive (CNE) organizational structures (line and staff) to staff nurse perceptions of workplace empowerment in 2 large Canadian hospitals.
Kanter's theoretical constructs of empowerment (ie, access to information, support, resources and opportunity, and formal and informal power) were used to explore this phenomena. No published studies were found linking organizational structure to staff nurse empowerment.
Staff nurses (n = 256) were surveyed in 2 large teaching hospitals, one with a CNE in a line structure, the other with a CNE in a staff structure. Multiple regression analysis was used to test the proposed model.
Staff nurses with a CNE in a line structure felt significantly more empowered in their access to resources than nurses with a CNE in a staff structure. Kanter's empowerment structures explained 63% of the variance in nurses' global empowerment in a line structure and 42% in the staff structure. Access to information, resources, and formal power was an important predictor of nurses' global empowerment in the line hospital, whereas only access to support was a significant predictor in the staff hospital.
Support for the model tested in this study highlights the importance of the CNE in creating and sustaining healthy work environments for nurses.
To test whether incivility at work exacerbates the relationship between stressors and strain for hospital workers.
A climate of incivility and disrespect among colleagues was expected to heighten the impact of work stressors on the mental and physical health of care providers.
Members of 17 care-providing units from five hospital systems in Canada completed surveys, before and after a civility intervention (eight intervention vs. nine comparison units). Analyses tested whether (1) incivility moderated the stressor-strain relationship at baseline (n=478), and (2) the stressor-strain relationship decreased for the intervention units relative to comparison units 6 months later (n=361).
(1) Pre-intervention, individuals reporting more incivility on their unit showed a stronger stressor-strain relationship. (2) The negative relationship between work overload and mental health was mitigated among intervention group staff 6 months after the introduction of a colleague-based civility programme.
Besides being a stressor itself, incivility exacerbates the relationship between existing job role stressors and strain among health care workers.
Colleague civility and respect have an important ripple effect of buffering inevitable work stressors, helping health care providers respond to stress with greater health and resiliency.