Restructuring of health care has become widespread in hospitals across the United States. The emphasis on reducing healthcare costs has forced many organizations to redesign the roles and responsibilities of care givers. The American Hospital Association (1990) reported that 97% of hospitals were using unlicensed assistive personnel for care.The purpose of the study was to determine if registered nurses in central Indiana were utilizing delegation in the workplace and to determine if the use of unlicensed personnel affected nurse satisfaction with work. The theoretical framework was General Systems Theory.The population (N=292) was registered nurses working with unlicensed assistive personnel in a four-hospital network. The number of participants was 66 (23%). The questionnaire, who Helps You with Your Work?, was utilized. Participation was strictly voluntary and the identity of the participants was kept confidential.Data revealed that 95% of nurses who responded were utilizing unlicensed assistive personnel in the workplace. Delegation of certain tasks, such as bed making, weighing of delegation and the personnel should be broadened patients, and measuring and recording intake and output, was occurring. Nurses were not delegating more complex tasks, such as monitoring IV infusions or assisting physicians with examinations.Nurses, overall, were only slightly satisfied with work, as evidenced by a mean of 3.3 (3=neither satisfied or dissatisfied). Job satisfaction was not significantly related to utilization of unlicensed assistive personnel.Unlicensed assistive personnel were being utilized in hospitals in Central Indiana. Nurses were responsible for work delegated to unlicensed assistive personnel. Nurses should realize the importance of determining capabilities and limitations of unlicensed assistive personnel. Job satisfaction was not significantly related to utilization of unlicensed assistive personnel.Future research on the subject utilization of unlicensed assistive to include more than four hospitals. Job satisfaction needs to be measured using different staffing patterns and workload as well as the utilization of unlicensed assistive personnel. The data supported the need for further research on delegation, job satisfaction and the utilization of unlicensed assistive personnel. / School of Nursing

In balancing the divergent needs of staff, patients, families, support services and upper management, the nurse middle manager (NMM) in the acute care hospital faces daily stresses in dealing with the demands of the management role. The purpose of the study was to identify the relationship between hardiness, a stress resistance buffer, and coping effectiveness among NMMs. The conceptual framework used in the study was Lazarus' theory of stress and coping. The study was based on a descriptive correlational comparative design. The instruments used were: (a) the Health Related Hardiness Scale (HRHS), measuring hardiness; (b) the .Jalowiec Coping Scale (-JCS), measuring coping mechanisms and coping effectiveness; and (c) a demographic data form, describing the sample. A convenience sample of 201 (37.2X) NMMs representing 31 Indiana acute care hospitals participated in the study. Confidentiality of the subjects was maintained throughout the study. A Pearson r correlation, used to analyze the data of the HRHS and .JCS, indicated a weak: positive relationship at a significant level (r=.2S; p=':.OO1) between hardiness and coping effectiveness. Descriptive statistics wereused to determine that the most frequently used coping mechanisms were confrontive, optimistic, and self-reliant. No relationship was identified between hardiness and age (r=-.07; p=.33). No differences were identified between: (a) hardiness and present level of NMM educational preparation, and (b) hardiness and NMMs that reported 'adequate' and 'inadequate' social support (work and family). It was concluded that NMMs in the study had a high level of hardiness. A lower level of coping effectiveness (mean ;: effectiveness score, 3.30) indicated the use of a limited number of coping mechanisms, which may be the result of limitations in the work setting. The low correlation between hardiness with coping effectiveness may be the result of: (a) a low level of coping effectiveness, or (b) the use of a limited number of coping mechanisms resulting from limitations in the work setting. Confrontive, optimistic, and self-reliant coping mechanisms may be the most appropriate styles in the work setting for NMMs. The use of healthy coping mechanisms by the NMMs may be the result of the programs supporting the transition from clinician to manager provided by the participating hospitals. Organizations should plan strategies to help NMMs (both established and those new to the position) develop a sense of commitment to the organization, a feeling of challenge from the job demands, and a plan to provide control of the responsibilities of the position in order to sustain the present high levels of hardiness for the NMMs. / School of Nursing

The two purposes of the study were to investigate and compare job perceptions (satisfaction-dissatisfaction) of two groups of part-time nursing faculty teaching in Indiana associate and baccalaureate nursing programs and to recommend guidelines for increasing job satisfaction of part-time employees. Referent groups in the study included:1. part-time faculty surveyed in 1983 and 19872. administrators of nursing programs surveyed in 1983 and 1988A 12-item questionnaire containing 12 job satisfiers relating to current and restructured positions was used to gather perceptions from referent groups.Findings1. Achievement, autonomy, and responsibility motivators were ranked in that order as the three most important job satisfiers by the combined 1983 and 1987 part-time faculty respondents in current and restructured positions.2. Part-time faculty, 1983, ranked salaries as eighth most important job satisfier in current positions and sixth most important in restructured positions. Part-time faculty, 1987, ranked salaries as eighth most important job satisfier in current positions and third most important in restructured positions. Administrators in 1983 and 1988 ranked salaries as ninth most important job satisfier for part-time faculty in current positions and most important job satisfier in restructured positions.3. Administrators cited budget, most frequently, as the reason they employed part-time faculty. Part-time faculty frequently mentioned inadequate salary as the most dissatisfying facet of part-time teaching.4. Part-time faculty most often listed interaction with students as the most satisfying facet of their teaching.Conclusions1. The job satisfier, salaries, has become more important to job satisfaction for part-time nursing faculty.2. With the exception of salaries, part-time faculty respondents ranked job satisfiers classified as motivators as more important in the restructured positions than job satisfiers classified as maintenance factors.3. Part-time teaching offers qualified nurses an opportunity for job satisfaction due to the many motivators which are inherent in the position. / Department of Educational Leadership

Thesis (M.S.)--University of Michigan, 1978.

Thesis (M.S.)--University of Michigan, 1978.

Thesis (M.S.)--University of Michigan, 1980.

Thesis (M.S.)--University of Michigan, 1993.

Thesis (M.S.)--University of Michigan, 1980.

Thesis (M.S.)--University of Michigan, 1993.

The observed high turnover of nursing staff in some public hospitals in Luanda was assumed to give rise to staff shortages, resulting in work overload for the remaining nurses and poor service delivery. The aim of this study was to determine the reasons for the high turnover of nurses in public hospitals in the city of Luanda, and to determine the actual turnover over a two-year period. The researcher adopted a quantitative approach with an exploratory and descriptive design, using a questionnaire for data collection from a sample of 100 respondents consisting of the Directors of Nursing, Directors of Human Resources and Heads of Departments (ward/units) in seven public hospitals. The study found that the most common reasons for the resignation of nurses were retirement, ill health, and better remuneration and working conditions elsewhere. Lack of motivation could be ascribed to the perceived low remuneration, insufficient supplies and equipment, being overworked due to staff shortages, unsafe working environment and poor conditions of service. Recommendations were made to tackle these issues. It was however not possible to determine the actual extent of nurses resigning from the public hospitals. / Health Studies / M.A. (Health Studies)