The impact of nurses' work environment on satisfaction and job resignation.

摘要

The purpose of this study was to examine how clinical work environments influence nurses' satisfaction with their work and voluntary job resignation in hospital-based nursing practice. The work environment attributes examined included the adequacy of resources for patient care, the extent of collaborative relationships between nurses and physicians, the level of support nurses received from administrators and managers, the amount of control and recognition afforded to nursing, and opportunities for professional involvement in the work place and professional advancement.;The sample included 697 nurses from 40 units in 20 urban hospitals. Data sources included daily coupons the nurses completed during every shift over a 28-day period and a cross-sectional survey that included demographic data and nurses' reports of their work environments. The final sample represented 76% of the eligible participants.;Data were examined with frequencies and measures of central tendency. Analysis was conducted using ordered logit models, clustering the data at the nurse level, fixed effects models, ordinary least squares regression, and Cox proportional hazards regression to answer the range of questions posed in this study.;Nurses' assessments of their workloads were the strongest predictors of daily work satisfaction, above and beyond objective measures such as RN-to-patient ratios. Interactions between workload and attributes of the work environment were statistically significant, indicating a buffering effect of the work environment on the relationship between workload and work satisfaction such that nurses practicing in more supportive environments were less likely to be dissatisfied even when their workloads were assessed as heavy. Neither work satisfaction, its variability, nor daily work demands predicted voluntary job resignation; however, shorter unit tenure and less professional work environments were significantly related to job resignation.;These findings enrich a growing body of research about the effects of nurses' work environments on retention of nurses in hospital practice. This work suggests that work environments more supportive of professional nursing practice are more appealing to nurses (they have less of a tendency to resign from their jobs) and that a positive work environment may lessen the harmful effects of heavier than optimal workloads.