The Journal of Continuing Education in Nursing, 2012
Nurse preceptors are vital linchpins, supporting the transition of new graduates to practicing re... more Nurse preceptors are vital linchpins, supporting the transition of new graduates to practicing registered nurses (RNs). This research clarifies similarities and differences among preceptors and nonpreceptors in an established statewide preceptor program. A secondary analysis of relicensure data from all nurses working in Vermont hospitals in two years (2005 and 2009) was undertaken. There were no statistical differences by basic degree type, highest degree, RN experience, years in the current job, job satisfaction, and intention to leave. Statistically significant differences that persisted over time included: (1) being less likely to be employed per diem; (2) work site population density; and (3) being more likely to be enrolled in nursing education programs. Given the lack of obvious identifiers, organizations would benefit from a systemized approach to preceptor identification and development. Regulators, who hold the clear social and legal mandate for patient safety, must also be an enabling force toward change.
The expected retirement of the largest cohort of nurses will push the RN workforce below projecte... more The expected retirement of the largest cohort of nurses will push the RN workforce below projected need by 2020. The challenges of managing a nursing workforce with the majority of nurses over 45 years of age are now necessitating attention to polices for recruitment and retention of older nurses, particularly in rural areas. This convenience sample study employed a mailed survey to investigate perceptions of nurses in 12 institutions (four hospitals, seven home health agencies, and one nursing home serving a small rural state). The goal was to explore rural RNs' perceptions of intent to stay in their current position, with their organization, and employment as a nurse; organizational and unit-level culture regarding older nurses in the workplace; importance of specific human resource practices/policies to their own intention to stay; and extent to which these human resource practices/policies are currently done. The results indicate that although there are similarities across a...
Journal of health and human services administration, 2011
Practical nurses (PNs) rated their general and emotional health and their employers' attentio... more Practical nurses (PNs) rated their general and emotional health and their employers' attention to their health and safety. These components were examined in relationship to work setting and intention to leave for the purpose of exploring workforce issues involving these important care providers of frail elders. A relicensure survey mailed to all PNs in one rural state included the Minimum Data Set for nurse workforce supply plus questions from the Health and Retirement Survey. Data were analyzed using Kruskal-Wallis nonparametric ANOVA, t-test, and chi-square tests. Of the state's working PNs, 813 responded, (71%) and 34% (n=269) reported nursing home employment. Overall, age and work role were not significantly associated with self-rated general health (p=0.14 and p=0.12). Males reported poorer general (p=0.09) and emotional (p=0.004) health. PNs working in nursing homes rated their general and emotional health lower than PNs in other settings (p<0.001). Of the PNs in nu...
A statewide study was conducted to examine the healthcare workforce from the perspectives of the ... more A statewide study was conducted to examine the healthcare workforce from the perspectives of the individual healthcare worker and employer as a basis for evidence-based workforce planning. The workforce minimum data set recommended by Colleagues in Caring was used to analyze job satisfaction, intention to leave current position, intention to leave profession, and reasons for such intentions in members of four professions (medical laboratorians, respiratory therapists, radiographers, and registered nurses) in a rural state. Statewide hospital vacancy and turnover rates for these disciplines also were analyzed. The study found that an aging workforce exists across these four healthcare disciplines. Despite relatively high satisfaction with their positions, a substantial proportion of this sample--over 20% for each profession--reported being "somewhat likely" or "very likely" to leave their position in the next 12 months. Top reasons for these intentions varied by p...
The entire population of inactive nurses in Vermont was surveyed to determine if a "shadow w... more The entire population of inactive nurses in Vermont was surveyed to determine if a "shadow workforce" exists. The notion that large numbers of nurses are available to return to work is not supported by this study. Desirable benefits for those wishing to return are discussed.
Current wisdom holds that health care is a business and "as such must abide by market princi... more Current wisdom holds that health care is a business and "as such must abide by market principles." Most nurses are not well enough versed in economic theories to credibly critique health care delivery decisions based on economic theories. The relationship of market principles to health care realities is described in basic terms to encourage nurses to "optimize patient care and influence health care policy." Physicians, who control all access points to the health care system, have enjoyed a 40-year market dominance that is "rapidly being replaced by insurance companies and for-profit investors." Providers' decisions to treat or not to treat are strongly influenced by whether the patient is in a fee-for-service or capitated payment environment.
Organizational life increasingly shapes and is shaped by the moral life of individual employees. ... more Organizational life increasingly shapes and is shaped by the moral life of individual employees. This paper offers a fresh approach to understanding the interactions among individual moral identity, the stated and unstated organizational values, and moral development of both the individual and the organization. A new theoretical framework, The Moral Cascade Model, posits that moral stress can have outcomes that enhance both the individual and the organization (moral eustress) or be a pernicious and destructive influence through a moral distress pathway that results in moral residue. The model provides new insights into why organizations would embrace moral dissonance as a means toward an increasingly virtuous organization. Implications for individual moral identity, including the intrapersonal experiences of moral prehension, moral stress, moral distress, and moral eustress are detailed, as are organizational manifestations and consequences. Avenues for further research are explored...
This article describes the centrality of the nursing leadership role in Vermont's statewide e... more This article describes the centrality of the nursing leadership role in Vermont's statewide efforts to combat the nursing shortage, particularly the establishment of a Blue-Ribbon Commission and an Office of Nursing Workforce Research, Planning, and Development. Recommendations by the Blue-Ribbon Commission along with its progress to date are presented. The role of the Office of Nursing Workforce Research, Planning, and Development is described in accomplishing the recommendations of the Blue-Ribbon Commission. These efforts have been cumulative, characterized by innovation and unprecedented collaboration between stakeholders representing nursing, public health, health care administration, education, and the political and private sectors. Lessons for replication are underscored.
Inactive nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; interest in volunteering for eme... more Inactive nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; interest in volunteering for emergency preparedness was examined. A mail survey was sent to the entire Vermont Board of Nursing list of in-state inactive and lapsed registered nurses (n = 3,682). A high rate of undeliverable surveys (60%) was found and 611 surveys were returned for a 20% response rate. Twenty-seven percent of the respondents were interested in volunteering. Those interested in participating in volunteer work as part of a national homeland security effort were significantly more likely to (a) be younger in age (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001); (b) identify themselves as &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;being a nurse&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; (p = 0.001); (c) be employed versus retired (p = 0.002); and (d) be currently volunteers (p = 0.001). Because 33% of the nation&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s nurses are over age 50, inactive nurses offer a potentially large pool of volunteers for emergency preparedness training and response in the years to come.
This study is a contribution to the small existing pool of state level research on Advanced Pract... more This study is a contribution to the small existing pool of state level research on Advanced Practice Registered Nurse (APRN) workforce supply. Data from four biennial surveys of Vermont APRNs from 2003, 2005, 2007, and 2009 (n = 1,538) were analyzed to produce descriptive statistics of one small state&amp;amp;amp;amp;#39;s APRN demographic, educational, employment, job satisfaction, intention to leave, and practice-setting characteristics. Survey results were then used to identify patterns or trends that existed in the data. There was a marked shift in the employment settings and a decrease time worked as an APRN, despite an aging APRN workforce. There was an increase in the aggregate education level of APRNs; however, the percentage educated at the doctoral level remained flat at 2%. Overall, APRNs were a satisfied segment of the health workforce; however, those intending to leave for dissatisfaction voiced more concern about job stress and less concern about salary and benefits over time. Implications for workforce planning and public policy are discussed.
... this workforce; and details predictors of intention to leave current position for reasons of ... more ... this workforce; and details predictors of intention to leave current position for reasons of career advancement, life situations, or ... negatively related to nurses&amp;amp;#x27; job satisfaction.[19]One meta-analytic study found work content and work environment variables ... [34]Among rural hospital ...
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home &amp;amp;gt; Current ...
Numerous articles have addressed the causes and implications of the current nursing shortage. Lit... more Numerous articles have addressed the causes and implications of the current nursing shortage. Little has been published, however, about how to measure the nursing workforce. This article presents (1) a review of definitions for common workforce indicators such as vacancy and turnover rates and the relationship between these indicators and the need for nurses, (2) a review of the calculation of vacancy and turnover rates in several statewide and national surveys, and (3) the results from the development and pilot test of a health care workforce survey for use in Vermont. The review indicates that in practice, no standard method is used despite attempts to standardize the calculation of vacancy and turnover rates. The Vermont pilot study results demonstrate that a richer profile of the health workforce can be obtained by using both standard workforce measures and more subjective questions to assess a statewide need for nurses.
Many strategies are currently needed to address a profound nursing shortage that is threatening h... more Many strategies are currently needed to address a profound nursing shortage that is threatening health care quality. One strategy is to increase the interest of youth in the profession of nursing. Middle school students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perception of nursing offers important clues toward successful recruitment of the next generation of nurses. The focus of this exploratory study was to compare a convenience sample of 301 male and female middle school students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of an ideal career versus a career in nursing. A post hoc analysis of variations by gender was also done. Perceptions of nursing and the ideal career were measured with an instrument developed by May, Champion, and Austin (1991), which has been assessed for reliability and validity in previous studies. Data were analyzed descriptively and inferentially, by using paired t tests and Bonferroni adjustments to control for multicolinearity. The respondents voiced statistically significant differences between nursing and the ideal career in key variables related to autonomy, respect, compensation, and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;busyness.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; When comparing boys with girls, however, there was more congruence between boys&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perception of nursing and ideal career than girls&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;. Implications for the development of timely and effective nursing recruitment campaigns targeting middle school students are offered.
The importance of the definition of nurse as a &amp;amp;amp;amp;quot;knowledge worker&amp... more The importance of the definition of nurse as a &amp;amp;amp;amp;quot;knowledge worker&amp;amp;amp;amp;quot; and the utility of knowledge as a recruitment policy for building a strong nursing workforce are discussed. The method used is the implementation of a statewide merit-based scholarship program targeting academically excellent students. At the University of Vermont, which educates roughly half of the state&amp;amp;amp;amp;#39;s nursing students, applications to the College of Nursing are up 83 percent, and entering class size is up 92 percent. Most significantly, Scholastic Assessment Test (SAT) scores have improved 4 percent, reversing an 8-year trend. In conclusion, merit scholarships are an effective means of building intellectual capacity and attracting academically stronger candidates to the nursing profession.
To compare job satisfaction and career retention in two cohorts of RNs, those whose highest degre... more To compare job satisfaction and career retention in two cohorts of RNs, those whose highest degrees were the associate degree (AD) or the bachelor's degree (BS) in nursing. Design: Survey. Methods: Instruments included a career satisfaction scale and questions based on the ongoing U.S. Health and Retirement Survey. Three-thousand nurses in the U.S. state of Vermont were surveyed with a resulting response rate of 56.7%. Of these respondents, 878 RNs fit the study criteria. Findings: BS RNs started their nursing careers earlier, were employed longer, had held more positions, and in the largest age cohort (age 40-54), were more likely to have been in their current positions at least 10 years. BS RNs scored significantly higher in job satisfaction related to: (a) opportunity for autonomy and growth, (b) job stress and physical demands, and (c) job and organizational security. AD and BS nurses were not significantly different in their satisfaction with supervision; career, continuing education, and promotion opportunities; or pay and benefits. Conclusions: These findings indicate support of bachelor's level education for individual and social return on investment, and they show that AD education might have unintended consequences. Implications for the nursing shortage and educational policy are discussed.
The Journal of Continuing Education in Nursing, 2012
Nurse preceptors are vital linchpins, supporting the transition of new graduates to practicing re... more Nurse preceptors are vital linchpins, supporting the transition of new graduates to practicing registered nurses (RNs). This research clarifies similarities and differences among preceptors and nonpreceptors in an established statewide preceptor program. A secondary analysis of relicensure data from all nurses working in Vermont hospitals in two years (2005 and 2009) was undertaken. There were no statistical differences by basic degree type, highest degree, RN experience, years in the current job, job satisfaction, and intention to leave. Statistically significant differences that persisted over time included: (1) being less likely to be employed per diem; (2) work site population density; and (3) being more likely to be enrolled in nursing education programs. Given the lack of obvious identifiers, organizations would benefit from a systemized approach to preceptor identification and development. Regulators, who hold the clear social and legal mandate for patient safety, must also be an enabling force toward change.
Performance measurement is an increasingly common element of the US health care system. Typically... more Performance measurement is an increasingly common element of the US health care system. Typically a proxy for high quality outcomes, there has been little systematic investigation of the potential negative unintended consequences of performance metrics, including metric-driven harm. This case study details an incidence of post-surgical metric-driven harm and offers Smith&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s 1995 work and a patient centered, context sensitive metric model for potential adoption by nurse researchers and clinicians. Implications for further research are discussed.
The Journal of Continuing Education in Nursing, 2012
Nurse preceptors are vital linchpins, supporting the transition of new graduates to practicing re... more Nurse preceptors are vital linchpins, supporting the transition of new graduates to practicing registered nurses (RNs). This research clarifies similarities and differences among preceptors and nonpreceptors in an established statewide preceptor program. A secondary analysis of relicensure data from all nurses working in Vermont hospitals in two years (2005 and 2009) was undertaken. There were no statistical differences by basic degree type, highest degree, RN experience, years in the current job, job satisfaction, and intention to leave. Statistically significant differences that persisted over time included: (1) being less likely to be employed per diem; (2) work site population density; and (3) being more likely to be enrolled in nursing education programs. Given the lack of obvious identifiers, organizations would benefit from a systemized approach to preceptor identification and development. Regulators, who hold the clear social and legal mandate for patient safety, must also be an enabling force toward change.
The expected retirement of the largest cohort of nurses will push the RN workforce below projecte... more The expected retirement of the largest cohort of nurses will push the RN workforce below projected need by 2020. The challenges of managing a nursing workforce with the majority of nurses over 45 years of age are now necessitating attention to polices for recruitment and retention of older nurses, particularly in rural areas. This convenience sample study employed a mailed survey to investigate perceptions of nurses in 12 institutions (four hospitals, seven home health agencies, and one nursing home serving a small rural state). The goal was to explore rural RNs' perceptions of intent to stay in their current position, with their organization, and employment as a nurse; organizational and unit-level culture regarding older nurses in the workplace; importance of specific human resource practices/policies to their own intention to stay; and extent to which these human resource practices/policies are currently done. The results indicate that although there are similarities across a...
Journal of health and human services administration, 2011
Practical nurses (PNs) rated their general and emotional health and their employers' attentio... more Practical nurses (PNs) rated their general and emotional health and their employers' attention to their health and safety. These components were examined in relationship to work setting and intention to leave for the purpose of exploring workforce issues involving these important care providers of frail elders. A relicensure survey mailed to all PNs in one rural state included the Minimum Data Set for nurse workforce supply plus questions from the Health and Retirement Survey. Data were analyzed using Kruskal-Wallis nonparametric ANOVA, t-test, and chi-square tests. Of the state's working PNs, 813 responded, (71%) and 34% (n=269) reported nursing home employment. Overall, age and work role were not significantly associated with self-rated general health (p=0.14 and p=0.12). Males reported poorer general (p=0.09) and emotional (p=0.004) health. PNs working in nursing homes rated their general and emotional health lower than PNs in other settings (p<0.001). Of the PNs in nu...
A statewide study was conducted to examine the healthcare workforce from the perspectives of the ... more A statewide study was conducted to examine the healthcare workforce from the perspectives of the individual healthcare worker and employer as a basis for evidence-based workforce planning. The workforce minimum data set recommended by Colleagues in Caring was used to analyze job satisfaction, intention to leave current position, intention to leave profession, and reasons for such intentions in members of four professions (medical laboratorians, respiratory therapists, radiographers, and registered nurses) in a rural state. Statewide hospital vacancy and turnover rates for these disciplines also were analyzed. The study found that an aging workforce exists across these four healthcare disciplines. Despite relatively high satisfaction with their positions, a substantial proportion of this sample--over 20% for each profession--reported being "somewhat likely" or "very likely" to leave their position in the next 12 months. Top reasons for these intentions varied by p...
The entire population of inactive nurses in Vermont was surveyed to determine if a "shadow w... more The entire population of inactive nurses in Vermont was surveyed to determine if a "shadow workforce" exists. The notion that large numbers of nurses are available to return to work is not supported by this study. Desirable benefits for those wishing to return are discussed.
Current wisdom holds that health care is a business and "as such must abide by market princi... more Current wisdom holds that health care is a business and "as such must abide by market principles." Most nurses are not well enough versed in economic theories to credibly critique health care delivery decisions based on economic theories. The relationship of market principles to health care realities is described in basic terms to encourage nurses to "optimize patient care and influence health care policy." Physicians, who control all access points to the health care system, have enjoyed a 40-year market dominance that is "rapidly being replaced by insurance companies and for-profit investors." Providers' decisions to treat or not to treat are strongly influenced by whether the patient is in a fee-for-service or capitated payment environment.
Organizational life increasingly shapes and is shaped by the moral life of individual employees. ... more Organizational life increasingly shapes and is shaped by the moral life of individual employees. This paper offers a fresh approach to understanding the interactions among individual moral identity, the stated and unstated organizational values, and moral development of both the individual and the organization. A new theoretical framework, The Moral Cascade Model, posits that moral stress can have outcomes that enhance both the individual and the organization (moral eustress) or be a pernicious and destructive influence through a moral distress pathway that results in moral residue. The model provides new insights into why organizations would embrace moral dissonance as a means toward an increasingly virtuous organization. Implications for individual moral identity, including the intrapersonal experiences of moral prehension, moral stress, moral distress, and moral eustress are detailed, as are organizational manifestations and consequences. Avenues for further research are explored...
This article describes the centrality of the nursing leadership role in Vermont's statewide e... more This article describes the centrality of the nursing leadership role in Vermont's statewide efforts to combat the nursing shortage, particularly the establishment of a Blue-Ribbon Commission and an Office of Nursing Workforce Research, Planning, and Development. Recommendations by the Blue-Ribbon Commission along with its progress to date are presented. The role of the Office of Nursing Workforce Research, Planning, and Development is described in accomplishing the recommendations of the Blue-Ribbon Commission. These efforts have been cumulative, characterized by innovation and unprecedented collaboration between stakeholders representing nursing, public health, health care administration, education, and the political and private sectors. Lessons for replication are underscored.
Inactive nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; interest in volunteering for eme... more Inactive nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; interest in volunteering for emergency preparedness was examined. A mail survey was sent to the entire Vermont Board of Nursing list of in-state inactive and lapsed registered nurses (n = 3,682). A high rate of undeliverable surveys (60%) was found and 611 surveys were returned for a 20% response rate. Twenty-seven percent of the respondents were interested in volunteering. Those interested in participating in volunteer work as part of a national homeland security effort were significantly more likely to (a) be younger in age (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001); (b) identify themselves as &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;being a nurse&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; (p = 0.001); (c) be employed versus retired (p = 0.002); and (d) be currently volunteers (p = 0.001). Because 33% of the nation&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s nurses are over age 50, inactive nurses offer a potentially large pool of volunteers for emergency preparedness training and response in the years to come.
This study is a contribution to the small existing pool of state level research on Advanced Pract... more This study is a contribution to the small existing pool of state level research on Advanced Practice Registered Nurse (APRN) workforce supply. Data from four biennial surveys of Vermont APRNs from 2003, 2005, 2007, and 2009 (n = 1,538) were analyzed to produce descriptive statistics of one small state&amp;amp;amp;amp;#39;s APRN demographic, educational, employment, job satisfaction, intention to leave, and practice-setting characteristics. Survey results were then used to identify patterns or trends that existed in the data. There was a marked shift in the employment settings and a decrease time worked as an APRN, despite an aging APRN workforce. There was an increase in the aggregate education level of APRNs; however, the percentage educated at the doctoral level remained flat at 2%. Overall, APRNs were a satisfied segment of the health workforce; however, those intending to leave for dissatisfaction voiced more concern about job stress and less concern about salary and benefits over time. Implications for workforce planning and public policy are discussed.
... this workforce; and details predictors of intention to leave current position for reasons of ... more ... this workforce; and details predictors of intention to leave current position for reasons of career advancement, life situations, or ... negatively related to nurses&amp;amp;#x27; job satisfaction.[19]One meta-analytic study found work content and work environment variables ... [34]Among rural hospital ...
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home &amp;amp;gt; Current ...
Numerous articles have addressed the causes and implications of the current nursing shortage. Lit... more Numerous articles have addressed the causes and implications of the current nursing shortage. Little has been published, however, about how to measure the nursing workforce. This article presents (1) a review of definitions for common workforce indicators such as vacancy and turnover rates and the relationship between these indicators and the need for nurses, (2) a review of the calculation of vacancy and turnover rates in several statewide and national surveys, and (3) the results from the development and pilot test of a health care workforce survey for use in Vermont. The review indicates that in practice, no standard method is used despite attempts to standardize the calculation of vacancy and turnover rates. The Vermont pilot study results demonstrate that a richer profile of the health workforce can be obtained by using both standard workforce measures and more subjective questions to assess a statewide need for nurses.
Many strategies are currently needed to address a profound nursing shortage that is threatening h... more Many strategies are currently needed to address a profound nursing shortage that is threatening health care quality. One strategy is to increase the interest of youth in the profession of nursing. Middle school students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perception of nursing offers important clues toward successful recruitment of the next generation of nurses. The focus of this exploratory study was to compare a convenience sample of 301 male and female middle school students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of an ideal career versus a career in nursing. A post hoc analysis of variations by gender was also done. Perceptions of nursing and the ideal career were measured with an instrument developed by May, Champion, and Austin (1991), which has been assessed for reliability and validity in previous studies. Data were analyzed descriptively and inferentially, by using paired t tests and Bonferroni adjustments to control for multicolinearity. The respondents voiced statistically significant differences between nursing and the ideal career in key variables related to autonomy, respect, compensation, and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;busyness.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; When comparing boys with girls, however, there was more congruence between boys&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perception of nursing and ideal career than girls&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;. Implications for the development of timely and effective nursing recruitment campaigns targeting middle school students are offered.
The importance of the definition of nurse as a &amp;amp;amp;amp;quot;knowledge worker&amp... more The importance of the definition of nurse as a &amp;amp;amp;amp;quot;knowledge worker&amp;amp;amp;amp;quot; and the utility of knowledge as a recruitment policy for building a strong nursing workforce are discussed. The method used is the implementation of a statewide merit-based scholarship program targeting academically excellent students. At the University of Vermont, which educates roughly half of the state&amp;amp;amp;amp;#39;s nursing students, applications to the College of Nursing are up 83 percent, and entering class size is up 92 percent. Most significantly, Scholastic Assessment Test (SAT) scores have improved 4 percent, reversing an 8-year trend. In conclusion, merit scholarships are an effective means of building intellectual capacity and attracting academically stronger candidates to the nursing profession.
To compare job satisfaction and career retention in two cohorts of RNs, those whose highest degre... more To compare job satisfaction and career retention in two cohorts of RNs, those whose highest degrees were the associate degree (AD) or the bachelor's degree (BS) in nursing. Design: Survey. Methods: Instruments included a career satisfaction scale and questions based on the ongoing U.S. Health and Retirement Survey. Three-thousand nurses in the U.S. state of Vermont were surveyed with a resulting response rate of 56.7%. Of these respondents, 878 RNs fit the study criteria. Findings: BS RNs started their nursing careers earlier, were employed longer, had held more positions, and in the largest age cohort (age 40-54), were more likely to have been in their current positions at least 10 years. BS RNs scored significantly higher in job satisfaction related to: (a) opportunity for autonomy and growth, (b) job stress and physical demands, and (c) job and organizational security. AD and BS nurses were not significantly different in their satisfaction with supervision; career, continuing education, and promotion opportunities; or pay and benefits. Conclusions: These findings indicate support of bachelor's level education for individual and social return on investment, and they show that AD education might have unintended consequences. Implications for the nursing shortage and educational policy are discussed.
The Journal of Continuing Education in Nursing, 2012
Nurse preceptors are vital linchpins, supporting the transition of new graduates to practicing re... more Nurse preceptors are vital linchpins, supporting the transition of new graduates to practicing registered nurses (RNs). This research clarifies similarities and differences among preceptors and nonpreceptors in an established statewide preceptor program. A secondary analysis of relicensure data from all nurses working in Vermont hospitals in two years (2005 and 2009) was undertaken. There were no statistical differences by basic degree type, highest degree, RN experience, years in the current job, job satisfaction, and intention to leave. Statistically significant differences that persisted over time included: (1) being less likely to be employed per diem; (2) work site population density; and (3) being more likely to be enrolled in nursing education programs. Given the lack of obvious identifiers, organizations would benefit from a systemized approach to preceptor identification and development. Regulators, who hold the clear social and legal mandate for patient safety, must also be an enabling force toward change.
Performance measurement is an increasingly common element of the US health care system. Typically... more Performance measurement is an increasingly common element of the US health care system. Typically a proxy for high quality outcomes, there has been little systematic investigation of the potential negative unintended consequences of performance metrics, including metric-driven harm. This case study details an incidence of post-surgical metric-driven harm and offers Smith&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s 1995 work and a patient centered, context sensitive metric model for potential adoption by nurse researchers and clinicians. Implications for further research are discussed.
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Papers by Betty Rambur