Category Archives: Job satisfaction
What drives “decision regret,” the negative cognitive emotion that occurs when an actual outcome differs from the desired or expected outcome? For nurses, fatigue is a big factor, according to a study in the current issue of the American Journal of Critical Care.
The study found that nurses impaired by fatigue, loss of sleep, daytime sleepiness, and an inability to recover between shifts are more likely than well-rested nurses to report decision regret. And while decision regret reflects previous decisions and adverse outcomes, it may also contribute to work-related stress and compromise patient safety in the future, the researchers found.
“Registered nurses play a pivotal role as members of the health care team,” lead author Linda D. Scott, RN, PhD, NEA-BC, FAAN, associate dean for academic affairs and an associate professor at the University of Illinois at Chicago College of Nursing, said in a news release. “Proactive intervention is required to ensure that critical care nurses are fit for duty and can make decisions that are critical for patients’ safety.”
The website Physicians Practice has released its annual Physician Compensation Survey, which for the third straight year shows that a majority of U.S. physicians view the income from their medical practice as “disappointing.” In 2013, 54 percent defined their net income this way, the same number as a year earlier, but 5 percent more than those who took the survey in 2011.
Physicians Practice surveyed 1,474 physicians and staff for the survey, asking about personal income, practice overhead, practice outlook, and other financial issues. For the first time, the survey acknowledged the shift from volume-based reimbursement to value-based reimbursement, asking respondents to share how much of their income is tied to factors other than the number of patients they see.
Thirty-three percent of respondents said a portion of their compensation is tied to value (quality and cost of care provided), with 8.5 percent of that group saying this was the only factor in their pay. Furthermore, 24 percent of respondents said a portion of their compensation was tied specifically to patient satisfaction.
However, productivity remained the dominant factor in physician compensation, with 28 percent of survey respondents saying that their entire compensation package was factored on productivity alone. Another 37 percent said it made up a portion of their annual pay.
Researchers at Loyola University Medical Center have conducted the first study of moral distress among nurses in an intensive care unit for burn patients, starting to address “a significant gap” in knowledge about responding to the painful feelings that arise in situations where people can’t act according to their ethical ideals, due to barriers such as lack of time and supervisory support, and policy and legal constraints.
Moral distress has been studied in various populations of health care providers, including neonatal ICU nurses, pediatric ICU nurses, genetic professionals, surgical residents, and medical residents. The Loyola study, published in the September/October issue of the Journal of Burn Care & Research, points out that the impact of moral distress on nurses during the provision of care, particularly in critical care settings, is well documented and can result in a wide variety of reactions, including depression, anxiety, emotional withdrawal, frustration, anger, and a variety of physical symptoms.
Peter Ubel, MD, is a physician and behavioral scientist. He is the Madge and Dennis T. McLawhorn University Professor of Business, Public Policy and Medicine at Duke University, an alumnus of the Robert Wood Johnson Foundation (RWJF) Generalist Physician Faculty Scholar program, and recipient of an RWJF Investigator Award in Health Policy Research.
During a break between classes, I offered some MBA students the chance to make a little extra money. Some would have a job of sitting in the classroom for five minutes doing nothing, absolutely nothing – no reading, no listening to music; just staring straight ahead. For this effortless job, they would receive $2.50.
Others would have the job of sitting in the same room for those same five minutes, but rather than staring into space they would be asked to solve word puzzles, forming four-word sentences out of five-word combinations. For example, the words “eagle apple majestic soars” could be turned into the sentence: the majestic eagle soars.
Michael Hochman, MD, MPH, is medical director for Innovation at AltaMed Health Services, a 43-site federally qualified health center in Southern California. He completed the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program at the University of California, Los Angeles, and the U.S. Department of Veterans Affairs in 2012. While a Clinical Scholar, Hochman co-led a primary care demonstration that was published last month in JAMA Internal Medicine. He recently published, 50 Studies Every Doctor Should Know.
Primary care in the United States is at a crossroads. As health care becomes increasingly disjointed and costs continue to rise, primary care providers face increasing pressure to take charge of the health system. Indeed, we know that health care systems with more developed primary care infrastructures are more efficient and of higher quality than those with a weaker primary care foundation.
But at the same time, more and more health care professionals are shying away from careers in primary care. Not only is the work challenging (late-night phone calls, numerous tests and studies to follow up on, ever-increasing regulatory requirements), but the pay is lower than in other fields of medicine.
One in three health care workers say they are likely to look for a new job in the next 12 months, according to a survey by Harris Interactive on behalf of the human resources and staffing company, Randstad Healthcare.
Among other findings from the survey:
- Fifty-four percent of health care workers believe they could find a new job in the next 12 months.
- About six in 10 health care workers “feel confident in the future of their employer,” and 81 percent feel secure in their jobs.
- More than a quarter of health care workers (26%) say the economy is getting stronger—a four percentage point increase from last quarter.
The survey includes online responses from 188 health care workers who are 18 or older.
Marni Storey, BSN, MS, is interim director of Clark County Public Health in Vancouver, Washington, chair-elect of the Washington State Association of Local Public Health Officials, and a Robert Wood Johnson Foundation Executive Nurse Fellow (2013-2016).
I am often asked if I recommend public health nursing as a career option. My enthusiastic answer is ABSOLUTELY! I have been a public health nurse for more than 25 years and am one of a very few Americans who wakes up every day believing I have the best job in the world. There are many reasons I enjoy this profession, but three important pillars of public health nursing have kept me engaged for more than 25 years, and will keep me enthusiastic for many years to come.
The first pillar is that public health nursing services—including nursing assessment, intervention, and evaluation—are focused on a population, not on individuals. Whether you are interested in women, children, ethnic or cultural groups, or if you are interested in conditions such as HIV/AIDS, communicable diseases or obesity, the strategies used by public health nurses affect entire communities. While challenging, this population focus is also rewarding because, as a public health nurse, you are developing an understanding of an entire group of people or community in order to effectively carry out your nursing duties. This is very different from the individual relationships you develop in other nursing fields. Also rewarding is the chance to witness community transformation as a result of the collective impact of communities working together.
Many physicians report flat or declining income, but few anticipate a career move in the short term, according to an annual survey from The Medicus Firm.
Fifty-four percent of physicians in training at the time of the survey indicated a preference for employment by a hospital or academic center.
When asked what limits their pay, many practicing physicians expressed frustration with the limits of hospital contracts and pay structures. They also cited time spent learning, using electronic medical records, and declining reimbursements.
“In an era when hospitals are competing on a national level for every physician they hire, practice preferences can be very helpful in composing a recruiting strategy and compensation package that will stand out and attract doctors," Medicus Firm President Jim Stone said in a news release about the survey. “With the majority of the nation's more than 5,000 hospitals currently recruiting doctors, physician recruiting trends impact the general patient population in addition to hospitals, as physicians choose where to settle and provide health care that is in higher demand than ever before.”
The survey also found that only 6.1 percent of physicians are open to practicing in a small town with fewer than 25,000 residents; nearly 60 percent prefer metropolitan or suburban locations.
The annual survey of more than 2,500 doctors was conducted by The Medicus Firm, a national physician recruiting firm based in Dallas and Atlanta.
A report released today by the Robert Wood Johnson Foundation (RWJF) finds the nation’s public health nurses report very high levels of job satisfaction and feel they are making a difference in their communities. But they also report concerns about job stability, compensation, and lack of opportunities for promotion in light of budget-tightening at many state and local health departments.
The findings come from the new report, Enumeration and Characterization of the Public Health Nurse Workforce: Findings of the 2012 Public Health Nurse Workforce Surveys. It was produced by the University of Michigan Center of Excellence in Public Health Workforce Studies and funded by RWJF. It is the first comprehensive assessment of the size, composition, educational background, experience, retirement intention, job function, and job satisfaction of nurses who work for state and local health departments.
The new study also finds that more than two in five public health departments report having “a great deal of difficulty” hiring nurses, and nearly as many state and local health departments report having insufficient resources to fill vacant nurse positions.
In 2003, the Institute for Healthcare Improvement and the Robert Wood Johnson Foundation launched Transforming Care at the Bedside (TCAB), a nationwide, nurse-focused effort to improve health care delivery. TCAB recognized that nurses often hold the key to making hospital care more effective, patient-centered and efficient. David Harrington, RN, BSN, CMSRN, has been a nurse at Providence St. Vincent Medical Center since 2006 and a TCAB leader there for two years. Erin Hochstein, RN, BSN, PCCN has been a staff nurse at Providence since 2010 and a TCAB leader for two years. This is part of a series of posts for National Nurses Week, highlighting how nurses are driving quality and innovation in patient care.
As nurses, we are with our patients and their families during some of the most pivotal moments in their lives, which is a true honor. Yet, with the ever-increasing demands of health care, the responsibilities of nurses have become greater, pulling us away from the bedside. To curb this trend we were given the opportunity, at Providence St. Vincent Medical Center, to adopt Transforming Care at the Bedside (TCAB), a program that gives bedside staff the chance to streamline care and improve patient outcomes.
By allowing us direct input on our workflow, we have the opportunity to develop rapid tests of change that we implement over the course of one shift. This adjustment in practice empowers frontline nurses to be catalysts of change for patient care, permitting us creative liberty in finding solutions to practice and system issues we face on a daily basis.
The Providence St. Vincent TCAB team began its journey in 2010 by visiting Prairie Lakes Hospital in Watertown, South Dakota, one of the original TCAB pilot sites, as part of an innovation grant provided by Providence Health & Services. Nurse representatives from three medical-surgical units along with hospital leaders were introduced to TCAB in action. As newly appointed TCAB leaders, we returned from the trip feeling motivated, inspired, and ready for change.