To score the Job Satisfaction Scale, a 5-point Likert-type scale ranging from 1 point (very dissatisfied) to 5 points (very satisfied) was used. Power analysis was used to calculate the appropriate sample size. AAOHN members have access to this journal as part of their membership. These comments suggest a complex interplay of different facets in relation to risk, including bravery, physical and psychological risk, and fear of losing their registration. This involved emotional factors, such as facing their fears, going into the unknown or feeling out of their comfort zone, and practical knowledge such as when to take themselves out of a situation. Google Scholar | Crossref Trufelli, DC, Bensi, CG, Garcia, JB ( 2008 ) Burnout in cancer professionals: A systematic review and meta-analysis . The traditional model of job satisfaction focuses on all the feelings that individuals have about their work (H. Lu et al., 2012). She also has worked as a nursing consultant in a medical center in Northern Taiwan. For appraisal in continuing one’s career, the data showed significant differences among participants by job level (F = 3.30, p < .05). This has implications for the retention of nurses who may need support, for example through guided reflection or clinical supervision (Rolfe 2002), to enable them to continue to face these challenges. By continuing to browse This finding is also consistent with results of a previous study, which reported on the influence of intrinsic and extrinsic job satisfaction on turnover among correction officers (Udechukwu, 2007). Login failed. Factors influencing job satisfaction and anticipated turnover among nurses in Sidama Zone public health facilities, South Ethiopia, Future intentions of registered nurses employed in the western New York labor market: Relationships among demographic, economic, and attitudinal factors, Career Commitment in human service professionals: A biographical study, Predictors of married female nurses’ health, The impact of children on women managers’ behavior and organizational commitment, Nurse empowerment, job-related satisfaction, and organizational commitment, Job attitudes and turnover intentions among professionals in different work settings, Applying non-synchronized E-learning to the nursing clinical ladder system, Reliability and validity of nurses’ job satisfaction scale and nurses’ professional commitment, The relationship of role-related variables to job satisfaction and commitment to the organization in a restructured hospital environment, Job satisfaction among hospital nurses revisited: A systematic review, Job satisfaction among nurses: A literature review, The relationships among turnover intentions, professional commitment, and job satisfaction of hospital nurses, The measurement of organizational commitment, Motivational factors of hospital employees: Evidence from North Cyprus, Work-related stress and associated factors among nurses working in public hospitals of Addis Ababa, Ethiopia: A Cross-Sectional Study, Job emotions and job cognitions as determinants of job satisfaction: The moderating role of individual differences in need for affect, Moderating effects of professional commitment on hospitals in Taiwan, Relationships among organizational commitment, job satisfaction, and turnover intention: A meta-analysis, The influence of intrinsic and extrinsic satisfaction on organizational exit (voluntary turnover): Evidence from a correctional setting, From nurse to nurse: The influence of age and gender on professional socialization and career commitment of advanced practice nurses, Impact of organizational structure on nurses’ job satisfaction: A questionnaire survey, The study on motivation attitude, job satisfaction and turnover intention for non-physician formal and temporary employees in a public hospital, American Association of Occupational Health Nurses, Exploring the Relationship Between Professional Commitment and Job Satisfaction Among Nurses, Kuokkanen, Leino-Klipi, & Katajisto, 2003. Based on surveys in one hospital, registered nurses expressed that significant differences were found between inner satisfaction and work sector and marital status. An effect size of 0.2, power of 0.8, and α less than .05 were adopted for this nursing study. The current challenges facing healthcare systems, in relation to the shortage of health professionals, necessitates mangers and leaders to learn from different leadership styles and staff empowerment strategies, so as to create a work environment that encourages nursing staff commitment to patients and their organization. THERE ARE FEW professions in which the ramifications of poor... We use cookies on this site to enhance your user experience. J Contin Educ Nurs 2015 ; 46(8): 349 – 355 . Barchard ,F., Sixsmith ,J., Neill ,S., & Meurier ,C.(2016).6Cs and ten commitments: nurses’ understanding and use of courage. Nursing & … The elephant in the room: nursing and nursing power on an interprofessional team. Based on a systematic review of 100 studies measuring the sources and effects of hospital nurses’ job satisfaction, H. Lu et al. (1985) Active listening in Nursing Intervention Treatment for Nursing Diagnosis (eds G. M. Bulechek and J. C. McCloskey), W. B. Saunders, New York. Nurses’ job satisfaction affects patient satisfaction and the quality of health services delivered (Asegid, Belachew, & Yimam, 2014). Constructionist grounded theory was used because of constructionism’s social, rather than individual, emphasis. Engagement in workplace activities focused on facilitating the business of the school of nursing and was measured with The Affective Commitment Subscale of the Organizational Commitment Questionnaire (Meyer et al., 1993). The impacts of career ladder system for nurses in hospital, Herzberg, F., Mausner, B., Snyderman, B. This is supported in Leading Change, Adding Value (Cummings 2016), the national framework for nursing, midwifery and care staff. P3 and P4, both community nurses with more than 30 years’ experience, said: ‘It’s having the courage to have a voice’, and ‘… having the courage to say “No” to them’. (2007) also suggested that professional commitment moderated the influence of burnout on job satisfaction. Participants suggested that being courageous could be considered as taking risks, and these risks could include losing their registration, opening themselves up to emotional distress, and being placed in the difficult position of having to ‘fight’ for something they believed in. Results Nurses discussed their understanding of courage in terms of being in a situation they do not want to be in, speaking up and taking risks. 14, 3, 213-221. Once finalised, it will be published in another article. As P6 noted: ‘You don’t necessarily always feel comfortable in what you’re doing… it is, again, it’s facing those fears.’. Conflict of InterestThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Aim This article reports the initial findings of a study that explored nurses’ understanding of courage, in the context of the 6Cs and the Leading Change, Adding Value framework. Speaking out revealed that nurses need courage to find their voice on a daily basis. Revalidation supports reflective practice, and could enhance retention if nurses use it to unpick some of the difficulties they face (NMC 2015b). Ethical concerns including anonymity, confidentiality, informed consent, withdrawal, briefing and debriefing, and protection from harm, were all addressed, ethical approval was granted, and recommendations were followed. However, literature reviews can be useful, for example in writing research proposals (Charmaz 2014), so a preliminary literature review was conducted in 2015 to determine if the subject had been explored. Wang et al. You can be signed in via any or all of the methods shown below at the same time. In today's ever changing and demanding healthcare environment, identifying and developing nurse leaders is one of the greatest challenges faced by the nursing profession. Gardner (1992) defined professional commitment in nursing as the intent to build a career that is a meaningful, lifelong pursuit and observed that this process … This finding suggests that individuals with higher willingness to make an effort, appraisal in continuing one’s career, and belief in goals and values are more likely to experience a higher level of job satisfaction. Google Scholar Yousef, D. A. The codes were refined into a series of themes, three of which are discussed below. Although the absence of these factors is not necessarily dissatisfying, when present, they can be a motivational force (Herzberg et al., 1959). In addition, appraisal in continuing one’s career correlated significantly and positively with belief in goals and values (r = .68, p < .01), inner satisfaction (r = .39, p < .01), and external satisfaction (r = .35, p < .01). According to Zeytinoglu et al., nurses with higher levels of career commitment showed statistically significantly lower levels of propensity to leave nursing []. Job satisfaction refers to individuals’ overall assessment of their jobs and is a popular topic of study because of its impact on the workplace (Teng et al., 2007). The researchers adopted a previously validated Job Satisfaction Scale by Yeh, Liu, Ke, and Chen (2004) for this study. Lean Library can solve it. The library of the University of Northampton, Nelson, CINAHL, Cochrane, EthOS, Medline and Ovid, Google Scholar and the internet were searched for research on courage in nursing. Exploring leadership styles Team nursing compared with other models. One of them (Gallagher 2010), which originated in the UK, discussed the concept of moral distress and courage, finding it to be an organisational, political and individual responsibility. Table 3. The four levels were N1 (responsible for basic nursing), N2 (critical care nursing), N3 (in charge of education and holistic nursing), and N4 (responsible for research and specialized nursing; Leu, Liao, Chang, & Su, 2010). External satisfaction describes the satisfaction employees garner that is not directly tied to the job itself, such as praise and positive working conditions. For inner satisfaction, results showed significant differences by nurses’ departments (F = 3.91, p < .01), but the relationship was too weak to demonstrate a significant post hoc difference by group. Career Commitment Career commitment in nursing is defined as the intent to build a career that is a meaningful part of a lifelong pursuit (Gardner, 1986). 14, 3, 213-221. It would be interesting to compare results with male nurse participants, and nurses from other disciplines and settings, to see if their experiences are similar. A significant difference was found among nurses’ willingness to make an effort by their marital status. Appraisal in continuing one’s career measures the degree to which employees feel that they should remain in their current jobs. P10, a community nurse with 25 years’ experience, said: ‘I think it’s, it’s perhaps, being very brave, taking risks, being out of comfort zone, prepared to take risks’, in the context of having difficult conversations with patients or their families. No significant differences were found between nurses’ demographic characteristics and external satisfaction (Table 3). The examples described in this article of how nurses confront and remain in difficult situations, speak out even when they fear the consequences (Francis 2013) and take risks are just some of the challenges they face in using courage. She used to work in Chang Gung Memorial Hospital as a head nurse. Journal of Nursing Management. Description of Age, Professional Commitment, and Job Satisfaction Subconcepts. A structured questionnaire was used to collect demographic data as well as data on the factors affecting professional commitment and job satisfaction among nurses. Finally, and crucially, commitment 8 states that ‘we will have the right education, training and development to enhance our skills, knowledge and understanding’. Therefore, professional commitment appears to be a crucial predictor of job satisfaction. The themes described above indicate something of nurses’ understanding of courage. Nurses’ professional commitment was strongly related to job satisfaction; aspects of professional commitment explained 32% of the variance in job satisfaction. However, it was found that simply increasing the salary is not the best method to resolve the problem of lacking nursing staff; it is necessary to focus on the impact of non-monetary factors. (, Kuokkanen, L., Leino-Klipi, H., Katajisto, J. The meaning of well-being and participation in the process of health and care- Women’s experiences following a myocardial infarction . Also, this study was cross-sectional with structured self-reported questionnaires, which may have been subject to respondent bias. By clicking any link on this page you are giving your consent for us to set cookies. Items in this section included statements such as, “the chance to work alone on the job” (Cronbach’s α = .90). This article outlines the initial results of a constructionist grounded-theory research study of the understanding of courage in the context of nursing. Among other limitations, the researcher inevitably brought herself into the interviews (Charmaz 2014), while race, culture and gender influence what is said and how it is said, and consequently what is found and written about. (, Lin, C. J., Wang, H. C., Li, T. C., Huang, L. C. (, Lu, H., Barriball, K. L., Zhang, X., While, A. E. (, Lu, K. Y., Lin, P. L., Wu, C. M., Hsieh, Y. L., Chang, Y. Y. No primary research UK studies were found but there were three from outside the UK. Method The study used unstructured interviews in a grounded-theory approach, in which a theory is constructed by analysing data, underpinned with epistemology of social constructionism, a theory that examines shared assumptions about reality. unstructured interviews. Relationships among willingness to make an effort, appraisal in continuing one’s career, belief in goals and values, inner satisfaction, and external satisfaction were evaluated by calculating Pearson’s product–moment correlations (Table 4). Teng, Shyu, and Chang (2007) investigated how professional commitment moderates the effects of burnout, providing nurse managers with strategies to reduce the impact of burnout on staff. Articles sought were in English and the field of nursing was not specified. Nurses’ job satisfaction is a significant issue because of its impact on patient satisfaction and health care quality (Willem, Buelens, & Jonghe, 2007). According to the 6Cs: ‘Courage enables us to do the right thing for the people we care for, to speak up when we have concerns and to have the personal strength and vision to innovate and to embrace new ways of working.’. Again, this relationship was too weak to demonstrate a significant post hoc difference by group. The specialties of Dr. Shih are in fibromyalgia and nursing education. The opening question was: ‘Could you tell me what’s your understanding of courage in nursing?’. The questionnaire’s Cronbach’s α value for this study was .83. Gallagher (2010) notes that moral distress affects nurses’ health and ability to provide care, which in turn affects job satisfaction, while Edmonson (2010) suggests that distress leads to burnout, desensitisation, and disengagement. Finally, inner satisfaction correlated significantly and positively with external satisfaction (r = .71, p < .01). The nature of the study means it was limited in terms of time and participant numbers, so it might be difficult to realise true theoretical saturation (Charmaz 2014). View or download all the content the society has access to. Sign in using your membership username and password. This study had several limitations, including a small sample size. Belief in goals and values measures the extent to which nurses had strong beliefs in and acceptance of the organization’s goals and values. Items in this section include statements such as, “the way my job provides for steady employment” (Cronbach’s α = .72). Find out about Lean Library here, If you have access to journal via a society or associations, read the instructions below. This site uses cookies. These include constraints within organisational cultures (Gallagher 2010), nurses’ characteristics such as resilience (Lindh et al 2010), experience and intuition in providing courageous care (Thorup et al 2012), and supportive working environments (LaSala and Bjarnason 2010). The purpose of this study was explained to each participant, and they were assured that their responses were anonymous and confidential. To increase the reliability and authenticity of findings, the study procedures are made clear and are repeatable. nursing management - Willingness to make an effort describes the extent to which nurses are willing to exert considerable effort on behalf of the organization. This finding supported the results of previous studies (Cherniss, 1999; Korabik & Rosin, 1996). There were 12 female participants, and their practice settings and other demographics are shown in Table 1. Study results may inform health care institutions about the importance of nurses’ job satisfaction and professional commitment so hospital administration can improve these aspects of organizational environment. Four more discussion and opinion papers that met the search criteria were identified. This research demonstrated that professional commitment influences both intrinsic and extrinsic job satisfaction. The specialties of Dr. Lin are in evidence-based nursing, Aboriginals, and nursing education. Given the paucity of research (Spence 2004, Lindh et al 2010, Murray 2010), this study aimed to explore nurses’ understanding of the concept. Table 2. This could help retain nurses in a profession of which they are immensely proud, but which can be challenging and have a personal cost. Six studies 8, 22, 23, 28-30 investigated job satisfaction among nurses implementing the team nursing model of care. Members of _ can log in with their society credentials below. Charmaz’s (2014) approach includes emphasis on action and coconstruction of meaning with the participants. She also works as an internship instructor in a medical center in the Junior College of Medicine, Nursing and Management. Reflexivity is central to the analysis, and to improve credibility an audit trail of detailed analysis articulates emergent theoretical concepts (Gasson 2004). Recently, a critical shortage of registered nurses has developed worldwide, and this shortage is expected to worsen (H. Lu, Barriball, Zhang, & While, 2012). Nursing is a dynamic and challenging profession requiring engaging and inspiring role models and leaders. As Lachman (2010) notes, courage is far from redundant, and is still relevant today as nurses encounter numerous situations that call for it. Twelve qualified nurses were interviewed in depth about their understanding of courage in professional practice. Perceived professional commitment was measured using a scale developed by the researchers after a systematic review of the literature (Lin et al., 2007; H. Lu et al., 2012; H. Lu, While, & Barriball, 2005; K. Y. Lu, Lin, Wu, Hsieh, & Chang, 2002). All participants in this study were volunteers. Many experienced nurses are leaving the field and young people are not selecting nursing as a potential career. The aim was to analyse rather than simply describe the data (Corbin and Strauss 2008). She previously worked in New York City as an assistant director in hospitals. A literature review was also undertaken. International Journal of Nursing Studies. A further 12 papers with only courage in the title and specific to nursing were identified in the same search (ten US, one European and one UK), and were a mix of opinion pieces and discussion articles. [PUBMED] [CROSSREF] [Google Scholar] Future studies could explore these settings separately. NVivo software, which encourages data analysis during collection (Bringer et al 2006, Bazeley 2007, Hutchinson et al 2010), was used.The 12 interviews raised 86 codes related to nurses’ understanding and use of courage. (2012) concluded that hospital nurses’ job satisfaction is closely related to working conditions and the organizational environment; job stress; role conflict, ambiguity, perception, and content; and organizational and professional commitment. Intrinsic factors are motivating factors (i.e., personal achievement, recognition, responsibility, advancement, growth, and the work itself). Article Google Scholar 4. A self-reported structured questionnaire was used to collect data. (2000). Three initial themes from analysis of the findings are presented and discussed below, and are applied in the context of Leading Change, Adding Value (Cummings 2016). Simply select your manager software from the list below and click on download. Correlations between professional commitment and job satisfaction were calculated using Pearson’s product–moment correlation, and a p value of less than .05 was considered statistically significant. The aims of the study were to explore how nurses’ understanding of courage can inform future practice, thus enabling preparation and support for nurses to use courage in practice settings, and to enhance understanding of adult nurses’ use of courage in everyday professional practice. A higher score indicated greater professional commitment. This finding confirmed the results of several previous studies (Brewer & Nauenberg, 2003; Kuokkanen et al., 2003; Lopopolo, 2002). (2014) found that low job satisfaction might lead to a decrease in service quality and an increase in patient care costs. This finding was congruent with results of a previous study, which showed that demographic variables do not significantly contribute to nurses’ job satisfaction (Oladotun & Öztüren, 2013). Organizational commitment: A mediator of the relationships of leadership behavior with job satisfaction and performance in a non-Western country. Lindh et al (2010) also found that courage was related to nurses’ willingness to expose themselves to risk, while Gallagher (2010) suggests that organisational, individual or cultural factors can influence this, and proposes that organisations need to embrace moral courage. This is also identified by Lindh et al (2010)’s review of research on courage, which found that remaining true to convictions is a struggle for nurses who may face losing their jobs if they speak out, and Lachman (2010), who suggests that nurses usually know what to say but may not do so because they fear embarrassment or punishment. This self-assessment scale includes 20 items addressing two subscales that measured inner satisfaction and external satisfaction. Compassion underpinned Florence Nightingale's depiction of the nursing character, and, in texts on nursing that followed, words associated with compassion (rather than this term itself) were employed—like virtuous, loving, kind). Unstructured interviews, consistent with constructionist grounded theory (Age 2011), took place in locations chosen by participants and lasted on average one hour. The aim was to explore how nurses’ understanding of courage can inform future practice, thus enabling preparation and support for nurses’ use of courage in practice settings, and to enhance understanding of their use of it in everyday professional practice. A total of 150 questionnaires were sent and 132 were returned, yielding a response rate of 88%. The majority of the 132 respondents was unmarried (62.1%) and had earned a college degree (58.3%); the nurses’ mean age was 28.8 years (SD = 4.38). Please check you selected the correct society from the list and entered the user name and password you use to log in to your society website. The specialties of Miss Lin are in evidence-based nursing, women’s health, and nursing education. She also works as a nursing consultant in a medical center in Northern Taiwan. Willingness to make an effort, appraisal in continuing one’s career, and belief in goals and values together explained 32% of the variance in inner and external satisfaction. Asegid et al. Results showed a significant difference between participating nurses’ willingness to make an effort by marital status (t = 1.98, p < .05). A larger sample would have strengthened the significance of the findings. Sign in here to access free tools such as favourites and alerts, or to access personal subscriptions, If you have access to journal content via a university, library or employer, sign in here, Research off-campus without worrying about access issues. Highly committed professionals are more responsive to advancing their professional value (Schlett & Ziegler, 2013; Teng et al., 2007). Szwedo , D. E., Mikami , … The 26 items addressed the three main categories of professional commitment: willingness to make an effort, appraisal of continuing one’s career, and belief in goals and values. Teng et al. In terms of nurses’ work life, 28.8% worked on surgical units, 73.5% worked shifts, and 40.9% were classified as N2 (Table 1). The three initial themes included here are as follows: being in a situation you do not want to be in, speaking up and taking risks. CMRPF 170091). She also said, as she recalled a patient who she felt emotionally distressed about 20 years after caring for them: ‘I don’t know; is compassion connected to courage? The results showed that married nurses had higher willingness to make an effort scores than unmarried nurses. Relationships Among Demographic, Professional Commitment, and Job Satisfaction Variables. P2 had a similar experience in an acute setting when two departments were being combined: ‘Nobody had the courage to speak up; everybody accepted what happened, why it happened; nobody had the courage to challenge it and, if they did challenge it, nobody had the courage to, to back them up and say we can’t do this anymore.’. A better understanding of nurses’ job satisfaction and professional commitment could aid hospital administrators in retaining nursing staff (Lin, Wang, Li, & Huang, 2007), thus improving patient outcomes. Adult nurses were recruited as the researcher is undertaking a professional doctorate and her area of practice is adult nursing. Data held were anonymised, password protected and securely stored. However, the implications for practice are becoming clear. Overall, this theme has depth and complexity, and implications for practice include supporting nurses to manage the risks they face. The interviews sought to reveal participants’ salient views and what meanings they attached to the word courage (Bowling 2009, Prescott 2009). P9 noted: ‘Courage is very closely linked to confidence, isn’t it, and experience; that, if you are confident in your knowledge and you’re confident in what you think is right, then you have the courage to shout about it.’. The demographic characteristics collected included age, marital status, education, work sector (department), work shift, and job level on a nursing proficiency ladder, a system with hierarchical structure that can be divided into four levels associated with an individual’s clinical abilities and proficiency growth. found that a higher level of occupational commitment was related to stronger intention to stay [ 41 ]. Furthermore, researchers have reported that the concept of professional commitment includes professional concerns, involvement, loyalty, relationships, recognition, beliefs, ethics, internal satisfaction, professional growth, and job involvement (Mowday, Steers, & Porter, 1979; Tsai, 2000). I have read and accept the terms and conditions, View permissions information for this article. This study suggests that even experienced nurses can find using courage demanding, and this should inform recruitment and retention policies.