Predictors of Nurse Managers' Health in Canadian Restructured Health Care Settings

Heather K. S. Laschinger, RN, PhD¹, Joan M. Almost, RN, MScN², Nancy Purdy, RN, MScN¹, and Julia Kim, RN, BScN¹. (1) School of Nursing, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada, (2) Faculty of Nursing, University of Toronto, Toronto, ON, Canada

Design: A predictive, non-experimental survey design was used to test the model. A random sample of 203 first line and 83 middle level hospital-based nurse managers selected from the provincial registry list participated in this study.

Measures: Conditions of Work Effectiveness-II (Laschinger, et al, 2000), Psychological Empowerment Questionnaire (Spreitzer, 1995), Pressure Management Indicator (Williams & Cooper, 2001), Maslach Burnout Inventory (Maslach, et al, 1996), and Global Job Satisfaction Questionnaire (Hackman & Oldman, 1975).

Methods: Nurse managers were sent questionnaires by mail using the Dillman method to increase survey response. Participants returned completed questionnaires in a researcher-addressed, stamped envelope (return rate= 65%). Data were analyzed using multiple regression procedures.

Findings: Nurse managers’ levels of structural and psychological empowerment were higher than those of staff nurses in previous research. Managers reported average levels of burnout but rated their mental and physical health as very good. Middle managers were significantly more empowered and satisfied with their jobs than first line managers. First line managers reported significantly less decision latitude, organizational support and personal power in their jobs. In both groups, structural and psychological empowerment explained 12% of the variance in physical health (energy level) and 13% of the variance in mental health (depressive symptomology). In both groups, approximately 45% of the variance in job satisfaction was explained by structural empowerment, psychological empowerment, and emotional exhaustion.

Conclusions: Empowered work empowerments tend to lower burnout levels of nurse managers and result in greater job satisfaction and better physical and mental health.

Implications: Creating work environments that provide access to empowerment structures is a fruitful strategy for creating healthy work environments for nurse managers in current restructured health care settings.

Learning Objective #1: Describe sources of pressure in nurse managers' work setting that have an impact on their physical and mental health
Learning Objective #2: Describe personal resources and environmental factors that protect nurse managers' health in restructured hospital settings