Paper
Thursday, July 22, 2004
Critical Characteristics of Practicing Nurses: Understanding the Components of a Coherent Work Environment
Rosanna F. DeMarco, RN, PhD, ACRN, School of Nursing, Boston College, Chestnut Hill, MA, USA and Patricia Reid Ponte, DNSc, RN, Nursing, Dana Farber Cancer Institute, Boston, MA, USA.
| Learning Objective #1: Identify the relationship between characteristics of practicing nurses and a coherent work environment |
| Learning Objective #2: Discuss ways nurse administrators may consider enhancing the practice environment to support hardiness, work excitement, and positive affectivity, and decrease silencing-the-self behaviors |
Objective: To describe the characteristics of newly employed registered staff nurses over time during hospital restructuring. Design: A descriptive design was used including focus groups and self-report instruments to assess attributes thought to impact on the ability to develop a sense of coherence. Variables included hardiness (using the Personal Views Survey), work excitement (measured by the Work Excitement Tool), positive affectivity (measured with the Positive and Negative Affect Scale), and self-advocacy (measured by the Silencing the Self Scale). Population, Sample, Setting: A convenience sample of newly employed RNs, (n=61) in a large teaching hospital in Boston, Massachusetts, USA (two cohorts of 35 and 26 RNs that were followed for 2 years). Methods: A mixed methods approach was used included thematic identification and descriptive analysis. Findings: Focus group data included difficulties in delivering quality patient care, diminished quality of work life, lack of team work and collaboration, deteriorating professional practice, and lack of consistent access to systems and supports for attaining and maintaining competency. Levels of hardiness fell below the reported average range. Responses on the work excitement measure revealed excitement about the high acuity of patients, the opportunity to be involved in research, the unit philosophy of care, and having the opportunity to foster the growth of other nurses. Data on affectivity scores showed a tendency toward a positive affect. Nurses in this sample showed a pattern of self advocacy behaviors. Conclusions: Over time RNs continued to be excited about their work especially related to fostering growth of other nurses and dealing with acutely ill patients despite system failures. Implications: A coherent work group is a critical component of a high-quality professional practice environment, and that attributes within individual nurses such as hardiness, work excitement, positive affectivity, and self-advocacy may impact the development of this coherence in a particular group.
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