Burn out (Psychology)--Prevention

It is estimated that there will be a 20% shortage of full time equivalent registered
nurses (RN) by 2015. Retention of nurses is a priority in health care, so a better
understanding of factors that contribute to job satisfaction and intent to leave is needed.
One possible factor is the quality of the interpersonal relationships that occur among
managers, peers, and nurses. A negative quality would be acts of hostility or horizontal
violence, which is nurse-to-nurse aggression. This is theorized to be a result of oppressed
group behavior. These behaviors may influence job satisfaction and the intent to stay on
the job and in the profession.
The overall purpose of the study was to explore relationships between horizontal
violence, oppressed group behavior, job satisfaction and intent to leave a position or
nursing in the next 12 months. This pilot study examined factors that influence registered nurses ' job satisfaction
and intent to leave a position or nursing. Convenience sampling was used to obtain the
sample of registered nurses from a BSN completion program and a Novice Nurse
Initiative Program (n=99). Written stories of conflict between nurses were obtained and
analyzed with linguistic analysis and word count (LIWC) software and various
standardized instruments were used including the Nurses Workplace Behavior Scale
(NWBS), the Organizational Climate for Caring Scale (OCCS), the Peer Group Caring
Interaction Scale (PGCIS), The McCloskey/Mueller Satisfaction Scale (MMSS) and two
visual analogue scales (VAS).
Significant relationships were found between job satisfaction and intent to stay in
a position and nursing (p<.01), oppressed group behavior and intent to stay in nursing
(p<.01), oppressed group behavior and job satisfaction (p<.01). Manager and peer caring
behaviors were related to intent to stay in a position and nursing (p<.01). Using stepwise
multiple regression, both manager and peer caring behaviors were found to influence the
relationship between job satisfaction and intent to stay in a position or nursing.
The findings of this study suggest that the quality of interpersonal relationships
between managers, peers and nurses can influence job satisfaction and intent to stay in a
position or nursing.

The nursing leader's challenging position in today's work environment may lead to an experience of stress, over-commitment, and overdoing. The purpose of this phenomenological study was to examine the meaning of caring for self by registered nurse leaders who had participated in a caring for self project in a community hospital setting. This group of 10 nursing leaders had participated in a caring for self project and had experience in nursing ranging from 18 to 32 years. One year after taking part in the caring for self project the 10 nursing leaders participated in individual taped interviews to explore the meaning of caring for self. Hermeneutic phenomenology (van Manen, 1990) was the method used for the interpretation of this research study. The depth of the lived experience of caring for self was described by each nursing leader. A metaphor of climbing a mountain to the peak of wisdom, being on the path and staying on the path regarding care of self, came from the words of the participants. In their words, the leaders communicate four common themes: Reflections on the Journey, Why Care for Self on the Journey, How to Care for Self on the Journey, and the Wisdom Learned Along the Path. Based on their reflections, recommendations include implementing creative ways to encourage care of self are for the hospital environment and educational methods to reinforce care of self for nurse leaders in the educational curriculum. A focus on care of self described by the leaders in this study may improve personal health, add to personal growth, assist in communication skills, allow for role modeling care of self to others, support setting priorities and boundaries, contribute to flexibility, and promote a work-life balance. These qualities would assist in creating a positive work environment and may influence the retention of nurses and contribute to recruiting new nursing leaders. Caring for self by nursing leaders is an important way for caring nursing theory to be brought to the practice setting. By role modeling a work-life balance nursing leaders bring the circle of caring out to others, beginning with care of self.