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Improving Nurse Practitioner Job Satisfaction TATYANA ZAYTSEVA MS RN ANP-BC DOCTOR OF NURSING PRACTICE PROGRAM CHAMBERLAIN COLLEGE OF NURSING

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Page 1: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Improving

Nurse Practitioner

Job Satisfaction

TATYANA ZAYTSEVA MS RN ANP-BC

DOCTOR OF NURSING PRACTICE PROGRAM

CHAMBERLAIN COLLEGE OF NURSING

Page 2: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

This program has been developed solely for the purposes of

describing the level of nurse practitioner (NP) job satisfaction,

before and after participation in an online educational

intervention with a one-month practice-change follow-up. The

program is posted as a part of this project’s educational

intervention and is intended only for such use. The study has

been approved for this purpose by the Chamberlain College

of Nursing Institutional Review Board. Please find the link to

return to the survey at the end of the slides.

Page 3: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Objectives

By the conclusion of this presentation, participants will be able to:

1. Describe knowledge relating to nurse practitioner job satisfaction

2. Discern elements that most impact nurse practitioner job satisfaction

Interprofessional Collaboration / Collegiality

Challenge / Autonomy

Professional, Social and Community Interaction

Professional Growth

Factors related to Time

Benefits

3. Identify potential for improved practice-change relating to nurse practitioner job satisfaction

Page 4: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Rationale

Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept was published by Koelbel, Fuller, and Misener (1991). Subsequently, a tool to measure nurse practitioner job satisfaction was developed by Misener and Cox (2001) with psychometric properties again tested by Agosta (2009). The importance of job satisfaction in advanced practice nursing has been demonstrated nationally and internationally (Doran et al., 2014; Dunaway, & Running, 2009; Faris et al., 2010; Kacel, Miller, & Norris, 2005; Lamarche, & Tullai-McGuinness, 2009; O’Keeffe, Corry, & Moser, 2013; Schiestel, 2007). Moreover, the importance of job satisfaction in advanced practice nursing has been demonstrated across specialties and practice settings (Cheng, Kimball, & Van Cott, 2010; Cousins, & Donnell, 2012; De Milt, Fitzpatrick, & McNulty, 2011; Pron, 2013). However, despite substantial established evidence demonstrating the importance of job satisfaction in advanced practice nursing, the need to improve job satisfaction in nurse practitioner remains unabated (Bennett, Sawatzky, 2013; Pasaron, 2012; Shea, 2014; Wong, & Laschinger, 2013).

Page 5: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

At the organizational level interventions are often

intended to improve working conditions, for example,

enhancing collaboration between members of the

interprofessional team, especially APNs and

physicians.

Page 6: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

At the individual level, stress management and

prevention of burnout are aimed to help APNs

enhance their coping mechanisms in order to

successfully deal with the negative impact of

work-related problems.

Page 7: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Intrinsic factors Extrinsic factors

- Challenge/

Autonomy

- Professional Growth

- Intrapractice Partnership/ Collegiality

- Professional, Social & Community Interactions

- Time

- Benefits

Job Satisfaction

Page 8: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

FACTOR 1:

INTRAPRACTICE

PARTNERSHIP/COLLEGIALITY

INPUT INTO ORGANIZATIONAL POLICY

FREE TO QUESTION DECISIONS/PRACTICES

CONSIDERATION OF YOU OPINION

PROCESS OF CONFLICT RESOLUTION

CONSIDERATION GIVEN TO PERSONAL NEEDS

Page 9: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

FACTOR 1:

INTRAPRACTICE PARTNERSHIP/COLLEGIALITY

RESPECT FOR YOUR OPINION

OPPORTUNITY TO DEVELOP IDEAS

SUPERIOR RECOGNITION

EVALUATION OF PROCESS/PRACTICE

REWARD DISTRIBUTION

Page 10: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

FACTOR 1:

INTRAPRACTICE

PARTNERSHIP/COLLEGIALITY

IMMEDIATE SUPERVISOR

MONETARY BONUSES

ADMINISTRATIVE SUPPORT

COMPENSATION FOR SERVICES OUTSIDE NORMAL

Page 11: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

FACTOR 2:

CHALLENGE/AUTONOMY

LEVEL OF AUTONOMY

CHALLENGE IN WORK

PERCENTAGE OF TIME WITH PATIENT

SENSE OF ACCOMPLISHMENT

ABILITY TO DELIVER QUALITY CARE

Page 12: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

FACTOR 2:

CHALLENGE/AUTONOMY

EXPANDING SKILL LEVELS WITHIN SCOPE

VALUE OF WHAT YOU DO

OPPORTUNITY TO EXPAND SCOPE OF PRACTICE

VARIETY OF PATIENT LOAD

FLEXIBILITY IN PRACTICE PROTOCOLS

Page 13: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

FACTOR 3:

PROFESSIONAL, SOCIAL AND

COMMUNITY INTERACTION

SOCIAL WITH COLLEAGUES

PROFESSIONAL INTERACTION WITH OTHER DISCIPLINES

SOCIAL CONTACT AT WORK

STATUS IN COMMUNITY

Page 14: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

FACTOR 3:

PROFESSIONAL, SOCIAL AND

COMMUNITY INTERACTION

PEER RECOGNITION

ACCEPTANCE OF PHYSICIANS OUTS OF PRACTICE

INTERACTION OF OTHER NPs

QUALITY OF ASSISTIVE PERSONNEL

Page 15: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

FACTOR 4:

PROFESSIONAL GROWTH

EXPAND YOUR SCOPE AND EDUCATION

SUPPORT FOR CONTINUING EDUCATION

OPPORTUNITY FOR PROFESSIONAL GROWTH

TIME TO SERVE ON PROFESSIONAL COMMITTEES

INVOLVEMENT IN RESEARCH

Page 16: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

FACTOR 5:

TIME

TIME FOR REVIEW OF LAB

TIME FOR ANSWERING MESSAGES

TIME FOR SEEING PATIENTS

PATIENT SCHEDULING POLICIES

Page 17: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

FACTOR 6:

BENEFITS

BENEFIT PACKAGE

RETIREMENT PLAN

LEAVE POLICY

Page 18: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Increased job

satisfaction

• Increased job control

• Greater autonomy

• More holistic care

Work-related

stress

• Increased job demands

• Support issues

• Lack of recognition / Reward

Page 19: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

The components of building

patient relationships include the

following:

(a) maintaining nursing-based practice

and

(b) recognizing rewarding work.

Page 20: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Building therapeutic

relationships with patients

Preserving a

nursing-based

practice

Discovering

professional reward

in the provision of

care

Page 21: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Preserving a nursing-based

practice

spend more time w pts than doctors;

holistic approach (incorporating family and

psychosocial issues into the care of patients, as

well as taking time to talk with and listen to their

patients);

cost effective.

Page 22: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Strong nursing foundations, which emphasized

patient centrality, created the basis for this

emphasis on holistic patient care and nurtured

this drive to establish and maintain therapeutic

relationships. When patient care was

compromised, NP job satisfaction declined.

Page 23: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Discovering professional reward in

the provision of care

developing relationships with patients;

tremendous feeling and sense of reward when

you know that you have helped someone;

the establishment and preservation of

therapeutic patient relationships to provide

optimum health care

Page 24: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Struggling for acceptance

APNs can provide appropriate care to patients which is

widely documented in evidence-based practice

literature;

disseminate EBP knowledge re this issue in the

conferences, nursing week presentations and posters, in

organizational news letters

Page 25: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Struggling for acceptance

That will scientifically validate your ability to work as an

NP to fullest potential

Valued your nursing identity

Find your voice which stop APNs being marginalizes and

feeling exploited

Page 26: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Working conditions / Environment

APN can

modify

adapt

accept

Page 27: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Balancing the work environment

Work the system by creating stability in the work setting, for

yourselves and for your patients.

Live through changes in healthcare systems

increasing the number of patients seen daily would negatively

impact patient safety

Fight for services being capped: make an inquire to EBP literature,

collect data at your workplace, and present it to administration

Page 28: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Strategies to improve intrinsic

factors of job satisfaction

Seek for opportunities for continuing your education

which leads to professional growth

become active in NP state and national organizations

and associations

Serve on professional committees

Create infrastructure that support NP practice

Page 29: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Strategies to improve extrinsic

factors of job satisfaction

Develop better interprofessional partnership and collegial

relationships especially with medicine

Communication with and acceptance from peers and

members of other health disciplines to share patient

information

Teamwork and collaboration

ability to provide input into organizational policy and

evaluation process, respect for one’s opinion,

Page 30: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Strategies to improve extrinsic

factors of job satisfaction

Promote legislative initiatives regarding scope of

practice issues

communication with nursing leaders

participatory leadership in organizational

governance(decision-making opportunities, such as NPs

writing their own job descriptions or yearly evaluations)

Page 31: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Strategies to improve extrinsic

factors of job satisfaction

Seek for opportunities to develop and implement changes in

clinical practice and monetary issues

negotiate and procure resources and rewards for services

provided outside normal working hours in terms of time in lieu

and payments

Make a plan for developing managerial attributes such as

negotiation, emotional intelligence, budgeting and strategic

planning

Page 32: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Strategies to improve extrinsic

factors of job satisfaction

Promote visability of their role

Initiate and participate in mentorship programs for

novice NPs

promote the effective use of NPs advanced skills and

knowledge

Create mechanism of information dissemination (clubs,

in-services, news letters, meetings)

Page 33: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

improving inter-

professio-nal

collabora-tion

Joint responsibility

Sharing knowledg

e

Enhancing communica-

tion

Developing conflict

managing skills

Page 34: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Stress management interventions

enhancing coping skills and

equipping APNs with better ways of handling

stressful events.

Page 35: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Stress manage-

ment

applied relaxation

problem solving

time manage-

ment

cognitive restructu-

ring

meditation

Page 36: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

Providing APNs with resources for successfully

managing stressors and prevention of burnout

helps to improve their job satisfaction, their

commitment to the organization, and thereby

improve patient outcomes.

Page 37: Improving Nurse Practitioner Job Satisfaction · 2015-03-22 · Rationale Interest in nurse practitioner job satisfaction has been growing since an explanatory model of the concept

References Agosta, L. J. (2009). Psychometric evaluation of the nurse practitioner satisfaction survey (NPSS). Journal of Nursing Measurement, 17(2), 114-133.

Bennett, K., & Sawatzky, J. V. (2013). Building emotional intelligence: A strategy for emerging nurse leaders to reduce workplace bullying. Nursing

Administration Quarterly, 37(2), 144-151.

Cheng, C. E., Kimball, A. B., & Van Cott, A. (2010). A survey of dermatology nurse practitioners: Work setting, training, and job satisfaction. Journal of

the Dermatology Nurses’ Association, 2(1), 19-23. 27

Cousins, R., & Donnell, C. (2012). Nurse prescribing in general practice: A qualitative study of job satisfaction and work-related stress. Family Practice,

29, 223-227.

De Milt, D. G., Fitzpatrick, J. J., & McNulty, S. R. (2011). Nurse practitioners' job satisfaction and intent to leave current positions, the nursing profession,

and the nurse practitioner role as a direct care provider. Journal of the American Academy of Nurse Practitioners, 23(1), 42-50.

Doran, D., Duffield, C., Rizk, P., Hahm, S., & Chu, C. H. (2014). A descriptive study of employment patterns and work environment outcomes of specialist

nurses in Canada. Clinical Nurse Specialist, 28(2), 105-114. 27

Dunaway, L. J., & Running, A. (2009). Job satisfaction as self-care within a restrictive regulatory environment: Nevada's study. Journal of the American

Academy of Nurse Practitioners, 21(10), 557-564.

Faris, J. A., Douglas, M. K., Maples, D. C., Berg, L. R., & Thrailkill, A. (2010). Job satisfaction of advanced practice nurses in the Veterans Health

Administration. Journal of the American Academy of Nurse Practitioners, 22(1), 35-44.

Kacel, B., Miller, M., & Norris, D. (2005). Measurement of nurse practitioner job satisfaction in a Midwestern state. Journal of the American Academy of

Nurse Practitioners, 17(1), 27–32.

Koelbel, P. W., Fuller, S. G., & Misener, T. R. (1991). An explanatory model of nurse practitioner job satisfaction. Journal of the American Academy of

Nurse Practitioners, 3(1), 17-24.

Lamarche, K., & Tullai-McGuinness, S. (2009). Canadian nurse practitioner job satisfaction. Nursing Leadership, 22(2), 41–57.

Misener, T. R., & Cox, D. L. (2001). Development of the Misener nurse practitioner job satisfaction scale. Journal of Nursing Measurement, 9(1), 91–108.

O’Keeffe, A. P., Corry, M., & Moser, D. K. (2013). Measuring job satisfaction of advanced nurse practitioners and advanced midwife practitioners in the

Republic of Ireland: A survey. Journal of Nursing Management, 1-11.

Pasaron, R. (2012). Nurse practitioner job satisfaction: looking for successful outcomes. Journal of Clinical Nursing, 22(17/18), 2593-2604.

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References – cont’d Pron, A. L. (2013). Job satisfaction and perceived autonomy for nurse practitioner working in nurse-managed health centers. Journal of the Association

of Nurse Practitioners, 25, 213-221.

Rees Lyles, C., Harris, L., Le, T., Flowers, J., Tufano, J., Britt, D., . . . Ralston, J. (2011). Qualitative evaluation of a mobile phone and web-based

collaborative care intervention for patients with type 2 diabetes. Diabetes Technology and Therapeutics, 13(5), 1-7.

Schiestel, C. (2007). Job satisfaction among Arizona adult nurse practitioners. Journal of the American Academy of Nurse Practitioners, 19(1), 30–34.

Shea, M. L. (2014). Determined persistence: Achieving and sustaining job satisfaction among nurse practitioners. Journal of the American Association

of Nurse Practitioners, 1-8.

Summers, A., Confair, A., Flamm, L., Goheer, A., Karlene, G., Muindi, M., & Gittelsohn, J. (2013). Designing the healthy bodies, healthy souls church-

based diabetes prevention program through a participatory process. American Journal of Health Education, 44(2), 53-66.

Tabak, A., Herder, C., Rathmann, W., Brunner, E., & Kivimaki, M. (2012). Prediabetes: A high risk state for diabetes development. The Lancet, 379, 2279-

2290.

van Vugt, M., de Wit, M., Hendriks, S., Roelofsen, Y., Bilo, H., & Snoek, F. (2013). Web-based self-management with and without coaching for type 2

diabetes patients in primary care: Design of a randomized controlled trial. BMC Endocrine Disorders, 13(53).

Wong, C. A., & Laschinger, H. K. (2013). Authentic leadership, performance, and job satisfaction. Journal of Advanced Nursing, 69(4), 947-959.

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Thank you for participating in this project! Please slowly drag

your mouse over the live link below to activate and then

click on the URL to return to the post-test (you may need to

wait briefly for the link to connect):

https://www.surveymonkey.com/s/S2BC5LC