Quality of Nursing Worklife: A Review of the Science

Purpose: As the largest single employee group within hospitals, nurses are critical to the optimal functioning of the organization, and improving employee productivity continues to be a common theme in the health care literature. However, any increased productivity will be transitory if achieved at the expense of the quality of nurses’ work life (QNWL), since improvement in the QNWL is prerequisite to improved productivity. The purpose of this symposium is to review the theoretical and conceptual underpinnings of QNWL, list the various countries that have used the Brooks QNWL Survey to measure nursing worklife, and to describe two strategies to improve nursing worklife. These two strategies align with the assumptions of Socio-technical Systems theory (STS) which underlies the concept of quality of nursing worklife.

Method: Socio-technical systems theory is based on two underlying assumptions: (a) organizational performance can be improved by allowing lower level employees to assume more responsibility for their efforts, and (b) employees will become more responsible and self-directed as their positions offer opportunities to fulfill important psychological needs, such as learning, growth, self-esteem and significance in their working lives. An organization's internal environment has social and technical subsystems, as well as physical design and work settings, which act together to influence and produce the intended outcome (product or service). The social subsystem is comprised of the people who work in the organization and the relationships among them, whereas the technical subsystem of an organization consists of the tools, techniques, procedures, skills, knowledge, and devices used by members of the social subsystem to accomplish tasks of the organization. The major objective of the STS theory approach to organizational change is to optimize jointly the organizational goals and the needs of the employees—an approach significantly different from job satisfaction, which is based on employees’ likes and dislikes, a function of personality which employers can do little to change.

The network of relationships defined by STS theory and prior conceptualizations of QNWL implicitly define and identify characteristics of a quality work environment as defined by nurses for nurses (Attridge & Callahan, 1990). Leading to quality of nursing work life begins by being defined as the degree to which registered nurses are able to satisfy important personal needs through their experiences in their work organization while achieving the organization's goals (Brooks, 2001). The four dimensions that underlie QNWL are: 1) work life-homelife; 2) work design; 3) work context; and 4) work world (Baumann & O’Brien-Pallas, 1993; O’Brien-Pallas, Baumann, & Villeneuve, 1994).

Methods: These dimensions along with a synthesis of empirical referents gleaned from prior work resulted in the development of Brooks’ Quality of Nursing Worklife Survey. The survey has now been used in 30 countries and translated into five languages.

Results: This session will review the origins of the survey.

Conclusion: A number of Human Resources strategies can be used to improve the quality of nursing worklife in select countries.