Kalisch Beatrice, Lee Kyung Hee
Innovation and Evaluation, School of Nursing, University of Michigan, Ann Arbor, MI, USA.
J Nurs Manag. 2014 May;22(4):465-71. doi: 10.1111/jonm.12012. Epub 2012 Nov 2.
The aim of this study was to examine the relationship between staffing and job satisfaction of registered nurses (RNs) and nursing assistants (NAs).
Although a number of previous studies have demonstrated the link between the numbers of patients cared for on the last shift and/or perceptions of staffing adequacy, we could find only one study that utilized a measure of actual staffing (opposed to perceptions of staffing adequacy) and correlated it with job satisfaction of registered nurses.
This cross-sectional study included 3523 RNs and 1012 NAs in 131 patient care units. Staff were surveyed to determine job satisfaction and demographic variables. In addition, actual staffing data were collected from each of the study units.
Hours per patient day was a significant positive predictor for registered nurse job satisfaction after controlling for covariates. For NAs, a lower skill mix was marginally significant with higher job satisfaction. In addition, the more work experience the NAs reported, the lower their job satisfaction.
Adequate staffing levels are essential for RN job satisfaction whereas NA job satisfaction depends on the number of assistive personnel in the mix of nursing staff.
Two implications are (1) providing adequate staffing is critical to maintain RN job satisfaction and (2) the NA job needs to be re-engineered to make it a more attractive and satisfying career.
本研究旨在探讨注册护士（RN）和护理助理（NA）的人员配备与工作满意度之间的关系。
尽管此前有多项研究表明上一班次护理的患者数量和/或人员配备充足感之间存在联系，但我们仅能找到一项研究使用了实际人员配备指标（而非人员配备充足感指标），并将其与注册护士的工作满意度进行了关联。
这项横断面研究纳入了131个患者护理单元的3523名注册护士和1012名护理助理。对工作人员进行了调查，以确定工作满意度和人口统计学变量。此外，从每个研究单元收集了实际人员配备数据。
在控制协变量后，每位患者每天的护理时长是注册护士工作满意度的显著正向预测因素。对于护理助理而言，较低的技能组合与较高的工作满意度略有显著关联。此外，护理助理报告的工作经验越多，其工作满意度越低。
充足的人员配备水平对注册护士的工作满意度至关重要，而护理助理的工作满意度则取决于护理人员组合中辅助人员的数量。
两点启示在于（1）提供充足的人员配备对于维持注册护士的工作满意度至关重要；（2）需要对护理助理的工作进行重新设计，使其成为更具吸引力和满意度更高的职业。
