This study tests a model that examines the effects of ethical climates and perceived organizational support on licensed nurses' intent to leave through job satisfaction and organizational commitment. A cross-sectional survey design was implemented. Three hundred and fifty nine skilled nursing facilities were selected in the midwestern United States. While a total of 110 facilities (31%) agreed to participate, responses were received from nurses representing 100 of those facilities (28%). A total of 656 usable questionnaires were returned of the 3,060 distributed-a 21.4% response rate. Descriptive statistics, Pearson correlation, and hierarchical regression analyses were used. The explained variance of intent to leave was 53%, with six major determinants: commitment, job satisfaction, years in facility, instrumental climate, age group, and facility ownership type. Commitment completely mediated the relationship between perceived organizational support and intent to leave. Findings suggest that organizational ethics and support may be used as means to generate positive outcomes such as retention.

This study examines the presence of ethical climates in skilled nursing facilities and identifies their antecedents (work group, job position, tenure). A cross-sectional survey design was implemented. A total of 359 facilities were selected in the Midwestern United States. Responses were received from nurses representing 100 of those facilities (28%). A total of 656 usable questionnaires were returned of the 3060 distributed (21.4% response rate). Descriptive statistics, confirmatory factor analysis, and multivariate and univariate analyses of variance were used. The results confirmed the presence of five ethical climates. Significant differences between registered and licensed practical nurses with regard to egoistic and independence ethical climates were found. Furthermore, nurses in management and non-management positions differed significantly in their perceptions of caring and egoistic climates. The results suggest incongruence in value perceptions and imply that researchers and practitioners have to direct efforts towards preventing and identifying reasons behind this.

OBJECTIVE: This study investigates the association of authentic leadership (AL) and perceived organizational support to workplace bullying among a sample of licensed practical nurses (LPNs). BACKGROUND: Workplace bullying is a serious problem in the workplace that harms nurses' physical and psychological well-being. METHODS: A cross-sectional survey design was implemented. A simple random sample of 855 was drawn from a population of 4306 LPNs in a single US Midwestern state. A total of 168 usable questionnaires were returned (19.65% response rate). RESULTS: Forty-three percent of nurses experienced at least 2 negative behaviors on a weekly/daily basis; 12% self-identified as a victim. The moral component of AL was a major determinant of overall workplace bullying (β = −.59), person-related bullying (β = −.70), and physical intimidation (β = −.58). Perceived support was a major determinant of work-related bullying (β = −.40). CONCLUSIONS: Organizational support initiatives and AL training for nurse leaders should be considered to reduce bullying.

The purpose of this study was to determine the levels of automation for 21 clinical functions and the benefits and barriers to electronic health records use in skilled nursing facilities in one of the Midwestern states in the US. A cross-sectional design was implemented. Data were collected from nursing home administrators using a mail and online survey approach. A total of 156 usable questionnaires of 397 distributed were returned, for a 39.30% response rate. While many facilities reported fully automated Minimum Data Set assessments, licensed nurse clinical notes, and care plans, there remained a predominant reliance on paper for functions, such as diagnostic tests and consults. Although many facilities had advanced toward using automation to produce quality reports, they were lagging behind in the use of automated clinical decision support and summary reports. The top two barriers included the amount of capital needed and the cost for hardware and infrastructure. Facilities with paper records were more likely to identify those barriers for functions, such as clinical notes and assessments. The top three benefits were quality patient care monitoring, management control of performance, and anywhere/anytime easier access to clinical data. The study concludes with recommendations to nursing home leaders and other stakeholders.

This study investigates ethical climates in government, nonprofit, and for-profit nursing homes and determines their similarities and differences. Surveys were collected from 656 (21.4%) licensed nurses who worked in 100 skilled nursing facilities in one Midwestern state. Shared law and code and caring ethical climates were identified across the 3 sector nursing homes. Those climates were also polarized. Important implications were drawn for consideration of ethical perceptions of each sector during negotiations and contract management.