Shoham-Yakubovich I, Carmel S, Zwanger L, Zaltcman T
Epidemiology and Health Services Evaluation Unit, Faculty for Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Soc Sci Med. 1989;28(12):1315-20. doi: 10.1016/0277-9536(89)90350-x.
This paper tests the hypothesis that structural changes in nurses' work settings, which allow nurses to autonomously exercise their knowledge and skills will lead not only to an enhanced feeling of professional autonomy, but also to an improvement in their professional self-image and to an increase in job satisfaction. An opportunity to test this hypothesis arose when physicians in Israel went on a strike which lasted 116 days. Primary care (PC) clinics were completely abandoned by physicians, leaving nurses to operate them on their own, while in hospitals, nurses continued to work as usual under physicians' supervision. The study compares the effect of the strike on head nurses in the two sectors. Data were collected by means of self administered questionnaires. The findings indicate that during the strike, PC head nurses expanded their activities and responsibilities and consequently felt more professional autonomy and job satisfaction, as well as an improvement in professional self-image. Hospital head nurses experienced significantly less changes in their work situation and, as expected, less change in all work related attitudes. It is suggested that, when given the opportunity to define for themselves roles where they can use their experience, knowledge and skills, senior nurses stand up to the challenge and consequently are more satisfied and their professional self-image improves.
护士工作环境的结构变化，即允许护士自主运用其知识和技能，不仅会带来职业自主性的增强，还会提升他们的职业自我形象，并提高工作满意度。当以色列的医生举行了为期116天的罢工，检验这一假设的机会出现了。基层医疗（PC）诊所被医生完全抛弃，由护士自行运营，而在医院，护士在医生的监督下继续照常工作。该研究比较了罢工对这两个部门护士长的影响。数据通过自填问卷的方式收集。研究结果表明，在罢工期间，基层医疗部门的护士长扩大了他们的活动和职责范围，因此感到职业自主性和工作满意度更高，职业自我形象也有所改善。医院护士长的工作状况变化明显较少，正如预期的那样，所有与工作相关的态度变化也较少。研究表明，当有机会为自己定义能够运用经验、知识和技能的角色时，资深护士能够迎接挑战，从而更加满意，职业自我形象也会得到提升。
