...States 8.5% to 14% with vacancy rates of over 14% in medical-surgical and critical care areas (American Hospital Association [AHA], 2004, 2006). Much of the employment growth of RNs employed in hospitals has been in nurses over age 50 (Buerhaus, Auerbach, & Staiger, 2007). However, 49% of hospitals surveyed stated it was more difficult to recruit RNs in 2005 than it was in 2004 (AHA, 2006). Hospital nurse staffing is a concern because of the effects a shortage has on patient safety and quality of care (Buerhaus, Donelan, Ulrich, Norman, & Dittus, 2005; Ulrich, Buerhaus, Donelan, Norman, & Dittus, 2005).

An aging workforce has contributed to the nursing shortage in the United States. The average age of a practicing RN is currently 46.8 years (Health Resources and Services Administration [HRSA], 2004) and it is predicted that by 2010 over 40% of the RN workforce will be over age 50 (Norman et al., 2005). Inconsistent information has been reported on job satisfaction in older versus younger nurses. Additionally, research is lacking on the capabilities, limitations, and needs of older workers, especially as they relate to the health and safety risks which may affect productivity and labor supply (Wegman & McGee, 2004).

While a shortage of practicing nurses is a significant issue, the work productivity of those nurses who remain at the bedside is just as important. Work productivity is not well understood and hospitals do not reliably report work productivity data, if they report it at all (O'Brien-Pallas, Meyer, & Thomson, 2004). Additionally, little is known about how workplace and individual characteristics affect productivity in nurses. Thus, the purpose of this study was to determine factors which influence the work productivity and intent to stay of hospital nurses employed in direct patient care in hospital settings.

Background

Recurrent nursing shortages have resulted in numerous studies of nurse retention and intent to stay. Nursing retention is directly associated with job satisfaction and workplace variables (Coomber & Barriball, 2007; Ulrich et al., 2005). Nursing is inherently stressful. Job stress can adversely affect employee health and well-being as well as worker turnover (Greiner, Krause, Ragland, & Fisher, 2004; Hall, 2004). According to one estimate, because of job stress, one in five nurses plan to leave the profession within the next 5 years, and almost 50% often think about leaving (Federation of Nurses and Health Professionals, 2001). Job stress is felt more severely by nurses employed in the hospital setting than in nurses employed outside of hospital settings (Sveinsdottir, Biering, & Ramel, 2006). The effect of job stress on the health of nurses is under-appreciated, and little research has been conducted on the effects of workplace stress on nurse turnover (McNeely, 2005).

Research has been conducted on perceived work ability in nurses. Fischer et al. (2007) conducted a descriptive study of factors impacting work ability among 696 nursing personnel (RNs and nurse aides) employed at a hospital in Brazil. Factors associated with decreased work ability included high home responsibilities (sole breadwinner, financial concerns, and raising children), poor working conditions (heat, poor work organization, and verbal abuse), and health concerns (high body mass index, sleep problems, and fatigue). Of note, in this study RNs were not separated as a group and 78% of the respondents were nurse aides. Camerino and colleagues (2006) conducted a cross-sectional study of 25,976 nurses in 10 European countries. While there were differing socio-demographic characteristics in nurses across countries, most of the respondents were employed in hospitals. Study findings demonstrated lower perceived work ability among older nurses. Importantly, a significant relationship was found between low perceived work ability and intent to stay in nursing, especially among younger nurses. AbuAlRub (2004) investigated the relationship between job stress and perceived job performance in an international sample of 303 nurses surveyed via the Internet. Respondents were all employed at the bedside in hospital nursing. Findings demonstrated that nurses with higher job stress had lower perceived job performance.

Most research on job productivity relates to absenteeism or perceived work ability and performance. However, productivity should include absenteeism, presenteeism (work effectiveness), work productivity loss (altered workload), and activity impairment (Reilly, 2005). Little is known about how specific workplace and individual variables, including worker health, impacts productivity in nurses when considering these factors. Thus, in this study, work productivity was examined by measuring other attributes of productivity, such as work effectiveness, altered workload, and activity impairment as determined by individual and workplace characteristics of RNs employed in direct patient care.

The Study

The purpose of this study was to...

NOTE: All illustrations and photos have been removed from this article.



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