The purpose of this thesis was to conduct a systematic review of studies on critical care nurses’ job satisfaction. Specific research questions addressed were: 1) What are the conceptual definitions and theories of job satisfaction that are used in studies of critical care nurses?; 2) What instruments have been used to quantitatively measure and operationally define job satisfaction among critical care nurses?; 3) What is the level of job satisfaction among critical care nurses?; and 4) What factors are correlated to critical care nurses’ job satisfaction? Sixty-one studies were identified from five electronic databases. Definitions and theories of job satisfaction were inconsistent or absent in the literature. Forty-two different quantitative measures of job satisfaction were identified. The weighted mean job satisfaction score for critical care nurses was 56% and demonstrated a cyclical trend over time. Operating room and other (labour and delivery, pediatric, and neonatal) critical care, and undefined critical care nurses reported lower levels of job satisfaction compared to emergency and mixed critical care nurses. The following factors showed positive significant relationships to critical care nurses’ job satisfaction in four or more studies: shift worked, autonomy, personnel resources and staffing, and teamwork and cohesion. One factor, job stress showed a positive and negative significant relationship to critical care nurses’ job satisfaction depending on the study. Only one factor explored in the included studies (burnout emotional exhaustion) showed a negative significant relationship with job satisfaction. These factors hold promise as targets for critical care nurse job satisfaction interventions.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / The purpose of this descriptive study was to describe critical care nurses knowledge and experience regarding the acutely confused elderly. A questionnaire, developed by the investigator, was mailed to two hundred nurses who were members of the American Association of Critical Care Nurses (AACN). The questionnaire consisted of three parts; a case study and questions assessing the respondents' knowledge of acute confusion, questions about the respondents' past personal experiences with the elderly, and a section on demographics. The response rate was 45%. The essential findings were: 1) the mean score on the knowledge items was 60% correct 2) ICU nurses had limited personal experiences with confused elderly people 3) neither level of education nor years of nursing experience affected how well the respondents did on the knowledge items 4) ICU nurses tended to attribute the cause of acute confusion in an elderly patient to ICU psychosis. Further research needs to be done on the etiology and characteristics of acute confusion and on nursing actions and interventions concerning the acutely confused elderly patient. The concept of ICU psychosis needs to be further explored. / 2999-01-01

D.Cur. / The overall objective of this research study was to develop a model of emotional intelligence for the facilitation of wholeness in critical care nurses in South Africa. Critical care nurses often nurse three or more critically ill patients during one shift (Fiakus, 1998). The environment in the critical care unit is highly stressful, highly emotionally charged and emotionally demanding for the nurses that work there. This can lead to the nurse developing burnout (Coates, 2001 ). Burnout in a critical care nurse can have devastating consequences such as decreased well-being of the nurse, decreased quality of care, poor communication and increased costs to the employer related to absenteeism and high staff turnover (Poncet, Toullic, Papazian, Kentish-Barnes, Timsit, Pochard, Chevret, Schlemmer & Azoulay, 2006). In a study by Shipley, Jackson and Segrest (2004), it was found that staff with increased emotional intelligence enjoyed better emotional health and more satisfaction both at home and at work. The question that arose was what is the emotional intelligence of critical care nurses in South Africa. A theory-generative, exploratory, descriptive and contextual research design was used. The research study was carried out using a modification of the method of theory generation as described by Chinn and Kramer (1985). Step one dealt with the empirical phase in which the main concept was distilled from the results of the data analysis. The quantitative research design used for this phase was a typical descriptive survey design. The entire accessible population (N=380) consisted of registered nurses that attended the Critical Care Congress in 2009. They represented a wide range of registered nurses that worked or had worked in critical care in both the private and public health sectors in South Africa. The data collection instrument consisted of a biographical datasheet from which the sample (n=220) was divided into various context groups. Participation was voluntary and all participants signed a consent form. The second part of the data collection instrument consisted of the Trait Emotional Intelligence short form (TEIQue-SF). The data was analysed using SPSS. The sample consisted mainly of a group of mature, female and professionally experienced critical care nurses. They held a variety of job descriptions in critical care nursing. Nurses who are older and have more experience in critical care appear to have a higher range of emotional intelligence. This was also confirmed in a study by Shipley et al. (2004) in which emotional intelligence was associated with work experience. Based on the tests of normality, there was no significant difference in the emotional intelligence of the various context groups that were identified from the single sample (n=220). The exploratory factor analysis identified eight factors as having eigenvalues greater than 1. The statistical evidence pointed to concentrating on factors 1 and 2, and pragmatically these two factors became the focus of the model, as they form the central essence of emotional intelligence of the critical care nurse. The facilitation of inherent affective and mental resourcefulness and resilience was the main concept of the model. Step two comprised the definition and classification of the central and related concepts. This was achieved by finding dictionary meanings and their subject usage. The attributes identified were synthesised to form a definition in chapter five. Step three provided a description of the model. A visual application of the model was shown in chapter six, which highlighted the concepts as proposed by Dickoff, James and Wiedenbach (1968). Three stages of the process of facilitation of emotional intelligence were used to develop the inherent affective and mental resourcefulness and resilience of the critical care nurse. Step four entailed the description of guidelines for operationalising the model in practice to facilitate the emotional intelligence of the critical care nurse in South Africa. Evaluation of the model was undertaken according to Chinn and Kramer (1991 ). To ensure valid results a model of trustworthiness proposed by Guba (1981, in Krefting, 1999) was utilised for the macro argument for the total model. In this study ethical conduct was applied as described by Burns and Grove (2009). The limitations of the research study are highlighted in chapter seven and recommendations of the model for nursing practice, nursing research and nursing education are also made.

No description available.

Moral distress is a complex and challenging problem that may cause negative biopsycohosical and professional outcomes for critical care nurses. The purpose of this work was to explore the relationship between the ethical climate of the work environment and moral distress as experienced by critical care nurses; and to explore relationships among mediators of stress (nurse characteristics e.g. education (BSN, nonBSN), years certified as a critical care nurse, and tolerance of ambiguity) and their relationship with perceived stress, moral distress, health status and salivary alpha amylase. A descriptive correlational cross-sectional design was used for this pilot study of 100 critical care nurses working in adult intensive care units in one large academic medical center. Data were analyzed using descriptive statistics to characterize the sample and the model variables. Regression analysis using a stepwise regression model building technique was used to determine predictors of the study outcomes (moral distress, health status, and salivary alpha amylase). The findings demonstrate that the ethical characteristics of the work environment and perceived stress were predictive of moral distress, psychological/emotional outcomes and stress symptoms. Other variables thought to mediate these relationships were not significant. Future research is needed to find ways to prevent moral distress from occurring and to support nurses dealing with moral distress.

Background Nurses complete tasks during patient care to promote the recovery, or to maintain the health, of patients. These tasks can be routine or non-routine to the nurse. Non-routine tasks are characterized by unfamiliarity, requiring nurses to seek additional information from a variety of sources to effectively complete the tasks. Nurses’ perception of their problem-solving skills, as characterized by the attributes of personal control, problem-solving confidence, and avoidance-approach style, influences how information is sought. Objectives/Research Questions Guided by the information-seeking behaviour model, this study was designed to: (1) examine how the non-routineness of the task affects nurses’ information-seeking behaviour and the use of accumulated knowledge; and, (2) explore nurses’ perception of their problem-solving abilities. Methods An exploratory cross-sectional survey design was used. A random sample of critical care nurses who worked in a hospital setting were selected from the College of Nurses of Ontario (CNO) research participant database. Multiple regression analysis was used to examine the proposed relationships. Results Avoidance-approach style and, problem-solving confidence did not have a significant relationship with nurses’ information-seeking behaviour. None of the variables explained use of accumulated knowledge (F = 0.902, p > 0.05). Previous training (p = 0.008), Non-routineness of the task (p = 0.018), and Personal control (p = 0.040) had a positive relationship with information-seeking behaviour (Adjusted R2 = 0.136). Implications The study results provide evidence that problem-solving ability, and in particular the attribute of personal control, influences nurses’ information-seeking behaviour during the completion of nursing tasks. They reveal how information is sought from resources, and what specific information resources are necessary to promote access to, and use of, evidence-based information. The results also help direct efforts towards training nurses in issues related to problem-solving and information-seeking by targeting the development of personal control and retrieving evidence-based information.

Bakgrund: Sederade eller medvetslösa patienter kan inte verbalt kommunicera sin smärta. Smärta är svårt för sjukvårdspersonalen att bedöma om beteendebaserade smärtskattningsinstrument inte är implementerade. Forskning har visat att neurokirurgiska intensivvårdspatienter upplevt moderat till svår smärta under vårdtiden på intensivvårdsavdelningen och denna smärta har underbehandlats. Critical-Care Pain Observation Tool (CPOT) är ett smärtskattningsinstrument som nyligen validerats i Sverige för att kunna användas inom intensivvården på icke kommunikativa vuxna patienter, dock har neurokirurgiska intensivvårdspatienter exkluderats vid valideringen. Syfte: Syftet med denna studie var att undersöka intensivvårdssjuksköterskans uppfattning om CPOTs användbarhet inom neurokirurgisk intensivvård. Metod: Mixed-method enkätstudie. En implementering av ett beteendebaserat smärtskattningsinstrument. Resultat: Elva sjuksköterskor inom neurokirurgisk intensivvård deltog. Tio av elva sjuksköterskor ansåg det värt att implementera CPOT. Ingen av sjuksköterskorna använde något annat smärtskattningsinstrument än Visuell Analog Skala (VAS) vid studietillfället. I skattning på en skala från 0-10, om huruvida CPOT hjälpt sjuksköterskorna i deras bedömning och behandling av smärta, blev medianvärdet 5. Från de öppna frågorna identifierades sex kategorier: positivt, enkelt, bättre än VAS, utvärderingsmöjlighet, svårbedömt och okänsligt. Patienter i vila fick 0 – 5 CPOT poäng, med en median på 1. Vid nociceptiv procedur erhöll patienterna 0 – 7 poäng, med en median på 3. Maxpoängen i CPOT är 8. Slutsats: Intensivvårdssjuksköterskorna hade en positiv uppfattning av att använda CPOT inom neurokirurgisk intensivvård och de ansåg att CPOT är värt att implementera. CPOT gav högre poäng under nociceptiva procedurer än i vila. Klinisk betydelse: Studien kan leda till att CPOT implementeras. / Background: Sedated and unconscious patients cannot verbally communicate their pain. Pain assessment is difficult for health care professionals when behavioural pain assessment tools are not implemented. Science has shown that neurosurgical intensive care patients experienced moderate to severe pain during their stay in the intensive care unit and that this pain has been undertreated. Critical-Care Pain Observation Tool (CPOT) is a pain assessment tool recently validated in Sweden for use in the intensive care unit on uncommunicative adult patients, however, neurosurgical patients were excluded in the validation. Aim: The aim of this study was to investigate the critical care nurses perception of CPOT’s usefulness in neurosurgical intensive care. Method: Mixed-method questionnaire study. An implementation of a behavioral pain assessment tool. Result: Eleven nurses in a neurosurgical intensive care unit participated. Ten of the eleven nurses considered CPOT worth implementing. None of the nurses used any other pain assessment tool than Visual Analogic Scale (VAS) at the time of the study. Rating on a scale from 0-10, whether CPOT helped the nurses in their assessment and treatment of pain, the median score was 5. From the opened-ended question, six categories were identified: positive, simple, better than VAS, evaluation opportunity, difficult to assess and insensitive. Patients at rest scored 0-5 in CPOT, with a median of 1. In nociceptive procedures, the patients scored 0-7, with a median of 3. The maximum score in CPOT is 8. Conclusion: The critical care nurses had a positive attitude towards using CPOT in neurosurgical intensive care and they considered CPOT worth implementing. CPOT gave higher scores in nociceptive procedures than at rest. Clinical relevance: The study may result in the implementation of CPOT.

The focus of this study was on the regulation and management of emotions among professional nurses in a critical care unit in a private hospital in Gauteng. The aim of this project is to explore and describe the level of resilience of professional nurses, in this case specifically, critical care nurses. The background portrays a journey from emotions and emotional experiences as main focus. The main focus was transformed into sequential emotion regulation and management as precursors to emotional intelligence. An initial literature investigation into emotional intelligence among professional nurses in general indicated that: Much international and national research has been conducted on emotional intelligence among nurses; emotional intelligence is an essential aspect of nursing, as an emotion-laden profession; and emotional intelligence implies positive benefits for nurses. The purpose of this study was to enhance professional nurses‟ regulation and management of their emotions in a critical care unit in a private hospital in Gauteng in order to enhance the level of emotional intelligence. Methodology: A qualitative, phenomenological research design was most suitable for this research that was also explorative, descriptive and contextual and within a case study strategy, combined with the use of interviews. C purposive sampling (Botma, et al., 2010:126) was used to select participants. ASE records included incident reports; organisational records of employee satisfaction, as well as documents that portrayed the care rendered in the unit. Participants were informed about the research by means of a PowerPoint presentation. The sample size was established once the research by saturation of data (Botma et al., 2010:200). Participants were informed about the research by means of a slideshow. Conclusion The results re-confirmed the existence of emotional labour in the critical care unit, as well as the different emotions experienced in the critical care unit. Results reflect the strain critical care nurses need to cope with, and the different ways they use to regulate these emotions and emotional experiences. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013

The focus of this study was on the regulation and management of emotions among professional nurses in a critical care unit in a private hospital in Gauteng. The aim of this project is to explore and describe the level of resilience of professional nurses, in this case specifically, critical care nurses. The background portrays a journey from emotions and emotional experiences as main focus. The main focus was transformed into sequential emotion regulation and management as precursors to emotional intelligence. An initial literature investigation into emotional intelligence among professional nurses in general indicated that: Much international and national research has been conducted on emotional intelligence among nurses; emotional intelligence is an essential aspect of nursing, as an emotion-laden profession; and emotional intelligence implies positive benefits for nurses. The purpose of this study was to enhance professional nurses‟ regulation and management of their emotions in a critical care unit in a private hospital in Gauteng in order to enhance the level of emotional intelligence. Methodology: A qualitative, phenomenological research design was most suitable for this research that was also explorative, descriptive and contextual and within a case study strategy, combined with the use of interviews. C purposive sampling (Botma, et al., 2010:126) was used to select participants. ASE records included incident reports; organisational records of employee satisfaction, as well as documents that portrayed the care rendered in the unit. Participants were informed about the research by means of a PowerPoint presentation. The sample size was established once the research by saturation of data (Botma et al., 2010:200). Participants were informed about the research by means of a slideshow. Conclusion The results re-confirmed the existence of emotional labour in the critical care unit, as well as the different emotions experienced in the critical care unit. Results reflect the strain critical care nurses need to cope with, and the different ways they use to regulate these emotions and emotional experiences. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013

Background Nurses complete tasks during patient care to promote the recovery, or to maintain the health, of patients. These tasks can be routine or non-routine to the nurse. Non-routine tasks are characterized by unfamiliarity, requiring nurses to seek additional information from a variety of sources to effectively complete the tasks. Nurses’ perception of their problem-solving skills, as characterized by the attributes of personal control, problem-solving confidence, and avoidance-approach style, influences how information is sought. Objectives/Research Questions Guided by the information-seeking behaviour model, this study was designed to: (1) examine how the non-routineness of the task affects nurses’ information-seeking behaviour and the use of accumulated knowledge; and, (2) explore nurses’ perception of their problem-solving abilities. Methods An exploratory cross-sectional survey design was used. A random sample of critical care nurses who worked in a hospital setting were selected from the College of Nurses of Ontario (CNO) research participant database. Multiple regression analysis was used to examine the proposed relationships. Results Avoidance-approach style and, problem-solving confidence did not have a significant relationship with nurses’ information-seeking behaviour. None of the variables explained use of accumulated knowledge (F = 0.902, p > 0.05). Previous training (p = 0.008), Non-routineness of the task (p = 0.018), and Personal control (p = 0.040) had a positive relationship with information-seeking behaviour (Adjusted R2 = 0.136). Implications The study results provide evidence that problem-solving ability, and in particular the attribute of personal control, influences nurses’ information-seeking behaviour during the completion of nursing tasks. They reveal how information is sought from resources, and what specific information resources are necessary to promote access to, and use of, evidence-based information. The results also help direct efforts towards training nurses in issues related to problem-solving and information-seeking by targeting the development of personal control and retrieving evidence-based information.