A new practice environment measure based on the reality and experiences of nurses working lives

Webster, Joan, Flint, Anndrea and Courtney, Mary (2009) A new practice environment measure based on the reality and experiences of nurses working lives. Journal of Nursing Management, 17 1: 38-48. doi:10.1111/j.1365-2834.2008.00908.x


Author Webster, Joan
Flint, Anndrea
Courtney, Mary
Title A new practice environment measure based on the reality and experiences of nurses working lives
Journal name Journal of Nursing Management   Check publisher's open access policy
ISSN 0966-0429
Publication date 2009-01
Year available 2009
Sub-type Article (original research)
DOI 10.1111/j.1365-2834.2008.00908.x
Volume 17
Issue 1
Start page 38
End page 48
Total pages 11
Editor Melanie Jasper
Place of publication United Kingdom
Publisher Wiley-Blackwell Publishing Ltd
Collection year 2010
Language eng
Subject C1
321199 Nursing not elsewhere classified
111099 Nursing not elsewhere classified
920210 Nursing
Abstract Aims. To explore the underlying organizational issues affecting a nurses' decision to leave and to develop a contemporary practice environment measure based on the experiences of nurses working lives. Background. Turnover had reached an unacceptable level in our organization but underlying reasons for leaving were unknown. Method. In-depth interviews were conducted with 13 nurses who had resigned. Transcripts were analysed using the constant comparative method. Information from the interviews informed the development a new practice environment tool, which has undergone initial testing using the Content Validity Index and Chronbach’s alpha. Results. Two domains ('work life' and 'personal life/professional development') and five themes ('feeling safe', 'feeling valued', 'getting things done', 'professional development' and 'being flexible') emerged from the interviews. A content validity score for the new instrument was 0.79 and Chronbachs alpha 0.93. Conclusion. The new practice environment tool has shown useful initial reliability and validity but requires wider testing in other settings. Implications for nursing management. The reality and experiences of nurses working lives can be identified through exit interviews conducted by an independent person. Information from such interviews is useful in identifying an organizations strength and weaknesses and to develop initiatives to support retention.
Formatted abstract Aims
To explore the underlying organizational issues affecting a nurses' decision to leave and to develop a contemporary practice environment measure based on the experiences of nurses working lives.

Background
Turnover had reached an unacceptable level in our organization but underlying reasons for leaving were unknown.

Method
In-depth interviews were conducted with 13 nurses who had resigned.
Transcripts were analysed using the constant comparative method. Information from the interviews informed the development a new practice environment tool, which has undergone initial testing using the Content Validity Index and Chronbach’s alpha.

Results
Two domains ('work life' and 'personal life/professional development') and
five themes ('feeling safe', 'feeling valued', 'getting things done', 'professional
development' and 'being flexible') emerged from the interviews. A content validity score for the new instrument was 0.79 and Chronbach's alpha 0.93.

Conclusion
The new practice environment tool has shown useful initial reliability
and validity but requires wider testing in other settings.

Implications for nursing management
The reality and experiences of nurses working lives can be identified through exit interviews conducted by an independent person. Information from such interviews is useful in identifying an organization's strength and weaknesses and to develop initiatives to support retention.
Keyword personnel turnover
practice environment
qualitative research
questionnaires
References Aiken L.H. & Patrician P.A. (2000) Measuring organizational traits of hospitals: the Revised Nursing Work Index. Nursing Research 49 (3), 146–153. Barron D., West E. & Reeves R. (2007) Tied to the job: affective and relational components of nurse retention. Journal of Health Services Research & Policy 12 (Suppl. 1), S1-46–S1-51. Camerino D., Estryn-Behar M., Conway P.M., van Der Heijden B.I. & Hasselhorn H.M. (2008) Work-related factors and violence among nursing staff in the European NEXT study: a longitudinal cohort study. International Journal of Nursing Studies 45 (1), 35–50. Eriksen W., Tambs K. & Knardahl S. (2006) Work factors and psychological distress in nurses' aides: a prospective cohort study. BMC Public Health 6, 290. Erickson S. (1996) New trends in exit interviews. Recruitment, Retention & Restructuring Report 9 (5), 5–7. Farrell G.A., Bobrowski C. & Bobrowski P. (2006) Scoping workplace aggression in nursing: findings from an Australian study. Journal of Advanced Nursing 55 (6), 778–787. Faulkner J. & Laschinger H. (2008) The effects of structural and psychological empowerment on perceived respect in acute care nurses. Journal of Nursing Management 16 (2), 214–221. Gershon R.R., Stone P.W., Bakken S. & Larson E. (2004) Measurement of organizational culture and climate in healthcare. Journal of Nursing Administration 34 (1), 33–40. Glaser B.G. & Strauss A.L. (1967) . The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine Publishing Company, Chicago, IL. Gould D. & Fontenla M. (2006) Commitment to nursing: results of a qualitative interview study. Journal of Nursing Management 14 (3), 213–221. Gregory D.M., Way C.Y., LeFort S., Barrett B.J. & Parfrey P.S. (2007) Predictors of registered nurses organizational commitment and intent to stay. Health Care Management Review 32 (2), 119–127. Hegney D., Eley R., Plank A., Buikstra E. & Parker V. (2006) Workplace violence in Queensland, Australia: the results of a comparative study. International Journal of Nursing Practice 12 (4), 220–231. Hinrichs J.R. (1975) Measurement of reasons for resignation of professionals: questionnaire versus company and consultant interviews. Journal of Applied Psycholog, 69 (4), 530–532. Hutchinson M., Vickers M.H., Jackson D. & Wilkes L. (2006) They stand you in a corner; you are not to speak: nurses tell of abusive indoctrination in work teams dominated by bullies. Contemporary Nurse 21 (2), 228–238. Jurkiewicz C.L., Knouse S.B. & Giacalone R.A. (2001) When an employee leaves: the effectiveness of clinician exit interviews and surveys. Clinical Leadership & Management Review 15 (2), 81–84. King L.A. & McInerney P.A. (2006) Hospital workplace experiences of registered nurses that have contributed to their resignation in the Durban metropolitan area. Curationis 29 (4), 70–81. Kivimaki M., Elovainio M. & Vahtera J. (2000) Workplace bullying and sickness absence in hospital staff. Occupational and Environmental Medicine 57 (10), 656–660. Kramer M. & Hafner L.P. (1989) Shared values: impact on staff nurse job satisfaction and perceived productivity. Nursing Research 38 (3), 172–177. Lake E.T. (2002) Development of the practice environment scale of the Nursing Work Index. Research in Nursing and Health 25 (3), 176–188. Leahey M. & Henderson G. (1991) When nurses terminate: the exit interview/questionnaire. Nursing Economics 9 (5), 336– 342. Lefkowitz J. (1969) Validity of exit interviews. Personnel Psychology 22, 445–455. Lynn M.R. (1986) Determination and quantification of content validity. Nursing Research 35 (6), 382–385. Mapstone J., Elbourne D. & Roberts I. (2007) Strategies to improve recruitment to research studies. Cochrane Database of Systematic Reviews, 2007(2); MR000013. Melcher R.D. (1955) Getting the facts on employee relations. Personnel XXXl, 504–514. Moran E.J. (1956) The exit interview – an experimental study. Personnel Practices Bulletin (Melbourne) XII, 31–42. Morrell K., Loan-Clarke J., Arnold J. & Wilkinson A. (2008) Mapping the decision to quit: A refinement and test of the unfolding model of voluntary turnover. Applied Psychology 57 (1), 128–150. Neidermeyer E. & Neidermeyer A.A. (1987) The exit interview technique. Journal of Nursing Administration 17 (7–8), 8. O'Brien-Pallas L., Duffield C. & Alksnis C. (2004) Who will be there to nurse? Retention of nurses nearing retirement Journal of Nursing Administration 34 (6), 298–302. O'Shea M. & Kelly B. (2007) The lived experiences of newly qualified nurses on clinical placement during the first six months following registration in the Republic of Ireland. Journal of Clinical Nursing 16 (8), 1534–1542. Oztunc G. (2006) Examination of incidents of workplace verbal abuse against nurses. Journal of Nursing Care Quality 21 (4), 360–365. Polit D.F., Beck C.T.&Owen S.V. (2007) Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health 30 (4), 459–467. Siegrist J. (1996) Adverse health effects of high-effort/low-reward conditions. Journal of Occupational Health Psychology 1 (1), 27–41. Southwick D. (2005) Feeling valued. Nursing BC 37 (4), 9–10. Strauss A. & Corbin J. (1998) Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. 2. Sage Publications, Thousand Oaks, CA. Weissman J.S., Rothschild J.M., Bendavid E. et al. (2007) Hospital workload and adverse events. Medical Care 45 (5), 448–455. Whittemore A.D. (2007) The impact of professionalism on safe surgical care. Journal of Vascular Surgery 45 (2), 415–419. Yourman J. (1965) Following up on terminations: an alternative to the exit interview. Personnel 42, 51–55. Zangaro G.A. & Soeken K.L. (2007) A meta-analysis of studies of nurses' job satisfaction. Research in Nursing & Health 30 (4), 445–458.
Q-Index Code C1
Q-Index Status Provisional Code

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing and Midwifery Publications
 
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