Review of the Literature Regarding the Nursing Work Environment: Implications for Public Health Nursing

Background and Issues:

Despite efforts by schools of nursing within the U.S. and abroad, the current nursing shortage is projected to grow at an alarming rate over the next two decades. Hospitals have long recognized the need to conduct research to identify optimal strategies for the recruitment and retention of nursing staff. A significant body of hospital research has demonstrated a critical link between positive work environments and positive outcome measures, such as enhanced organizational commitment, improved job satisfaction, and reduced turnover rates for nurses. There is a lack of work environment research within the public health setting. Given the vital role that public health nurses play in accomplishing core public health functions, such research is imperative.

Project Description:

The purpose of this poster is to describe how and why hospital-based work environment literature is applicable to the public health nursing work environment. Toward this end, a review of the published research literature has been conducted within the Medline and CINHAL data bases. A number of valid and reliable research instruments were identified. Three of the most well established instruments were evaluated to determine their applicability to the public health setting.

Lessons Learned:

Many of the items and subscales within well established hospital-based research instruments appear to have direct applicability to the public health setting. Unfortunately, significant modifications would be required with respect to a number of critical measures related to issues such as nursing management, control of practice, professional respect and communication. One recent, but unpublished study of the public health nursing work environment used a new instrument that may prove to be helpful in this regard.

Recommendations:

Additional work is needed to identify or develop an instrument to measure critical elements of the nursing work environment that are specific to the public health setting. With such data, management outcomes such as job satisfaction and intent to stay can be examined in relation to work environment information, thereby targeting areas for improvement related to optimal strategies for the recruitment and retention of public health nurses.