The Effect of Nurse Practice Environment on Retention and Quality of Care via Burnout, Work Characteristics, and Resilience

Abstract

OBJECTIVE The aim of this study was to explore the influence of nurse work characteristics, resiliency, and burnout on retention, and patient quality and safety. BACKGROUND With an ongoing nursing shortage, maintaining qualified nursing staff is critical. We explored the direct and indirect effects of practice environment, nurse work characteristics, and burnout on retention, and perceived quality and safety. METHODS Responses from 507 RNs were collected via an anonymous online survey. Theorized relationships were explored via path analysis and invariance testing. RESULTS Positive practice environment and favorable work characteristics lowered burnout and improved outcomes. The indirect effects of work characteristics and burnout were dependent upon individual level of resilience. Social capital minimized the effects of burnout for participants reporting below-average resilience. CONCLUSIONS Leader support was critical in shaping positive perception of the practice environment. A nurse leader's visibility and actions impact intent to stay. Results of this study may inform healthcare systems struggling to retain a robust, engaged nursing workforce.

Nurses' resilience in the face of coronavirus (COVID‐19): An international view

“…Although strengthening an individual's psychological ability to handle emotionally challenging events is essential, organizational and community level factors must also be prioritized (Rieckert et al, 2021; Shih et al, 2009; Tan et al, 2020; Wei et al, 2019; Yıldırım et al, 2021). When nurses are respected and their health is protected, resilience can be built through increased trust in their colleagues and their leaders (Gensimore et al, 2020).…”

“…Others have described the influence on resilience of previous experiences, genetic factors, and environments (Kim‐Cohen & Turkewitz, 2012). A study of practice environment ( n = 507 nurses) found that a positive workplace environment (defined as leader support, unit management, collegial support, social capital among nurses, and a sense of accomplishment in work) was associated with high resilience to workplace stress and accounted for 24% of the variance in participant decisions to stay in their current position (Gensimore et al, 2020).…”

Nursing Moral Distress and Intent to Leave Employment During the COVID-19 Pandemic

“…The results of this study are in concordance with previous literature that highlights the importance of work environment in RN retention. 20 Specifically, through the support of coworkers and nurse leaders, direct care RNs can learn and grow professionally and develop a sense of belongingness at work. 11 A work environment where MD is minimized encourages RNs to feel united, share experiences, and learn coping strategies from each other and fosters an environment where the feelings of powerlessness shift and RNs begin to thrive.…”

Work Environment Characteristics and Emotional Intelligence as Correlates of Nurses’ Compassion Satisfaction and Compassion Fatigue: A Cross-Sectional Survey Study

“…These targeted assessments could occur on different levels, whether individual, departmental, and organizational, to investigate the prevalence of compassion fatigue and compassion satisfaction and the relative importance of their antecedents. Such assessments are highly relevant given the ever-increasing pressure and challenges in nursing work due to the ongoing worldwide pandemic, coupled with a nursing shortage and difficulty in retaining qualified nursing staff [ 27 , 68 ]. Our findings also suggest that compassion fatigue and compassion satisfaction are not influenced by the same factors and that further investigation into these phenomena using both qualitative and quantitative research approaches are warranted.…”