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To determine the impact of nursing support workers on nurses’ turnover intention and absenteeism, the practice environment, aggression, and registered nurses’ experience of working with support staff.
Methods:
Cross-sectional analysis of nurse survey and nurse interview data. Data were collected from ten sampled wards in public general acute care hospitals in Perth, Western Australia between March and October 2013: 5 wards with AINs and 5 without. Nurses were asked to complete a survey including questions on intention to leave their current position, absenteeism, aggression, together with demographic items. The survey also included the 31-item Practice Environment Scale (PES) (Lake, 2002) to measure nurse-doctor relationships, staffing and resource adequacy, leadership and support of nurses, and the foundations for quality care. Ethics approval was obtained from two universities and three hospitals. Responses to survey items and the practice environment were compared across AIN and non-AIN wards. Interview data were used to explore and describe perceptions and experiences of workload, delegation and outcomes in the presence of AINS.
Results:
Nurse surveys were returned from 154 respondents (response rate 35.4%), and 18 nurses were interviewed. Nurses on non-AIN wards reported a significantly more positive practice environment, in particular in regard to resource adequacy and nursing leadership. AINs wards reported substantially higher rates of physical assault and threats. A higher proportion of nurses on AIN wards were actively looking for a new job and there was higher absenteeism on AIN wards. Interviews suggested that AINs were important in reducing physical and emotional stress in registered nurses, and that they played a key role in freeing up time for registered nurses to complete necessary activities. Variation in the skills and scope of practice of AINs was also noted.
Conclusion:
Nursing support workers are perceived as supports to registered nurses and undertake tasks that require substantial amounts of interaction with patients. They display widely varied skills and may be associated with changes to the practice environment, turnover intent and absenteeism.