Professional Nursing Professional Nursing Values and Retention: Values and Retention:
Management and Staff Alignment?Management and Staff Alignment?
Paula F. Coe MSN, RN, NEA‐BCJennifer Brewer BSN, RN, CNRNNancy Woods PhD, MPH, CNM
Lauren Triplett BSN, RN
Presenter Disclosure InformationPresenter Disclosure InformationPresenter: Paula CoeTitle: Professional Nursing Values and Retention: Management and Staff Alignment
Financial Disclosure: None
Unlabeled/Unapproved Uses Disclosure: None
Learning ObjectivesLearning ObjectivesExplore relationships between values and retention
Examine the differences between staff nurse and leadership values and retention
Review and discuss significant findings to examine workforce development and retention strategies
BeginningsBeginningsNursing Leadership Journal Club
Employee Engagement Strategies
Journey to Excellence
Organizational Culture
Values and RetentionValues and RetentionNurses professional fulfillment
Nursing school beginnings
Organizational Ethics
Struggling with alignment
Perception vs Reality
ANA Code of EthicsANA Code of Ethics
Succinct statement of the ethical obligations
Nonnegotiable ethical standard
Nursing’s own understanding of it’s
commitment to society.
American Nurses Association (1995)
Themes: Code and ValuesThemes: Code and ValuesThe profession
The patient
Society
Yarbrough, S., Alfred, D., & Martin, P. (2008)
LiteratureLiterature ReviewReviewNurse administrators and staff nurses have essentially the same value priorities. Yarbrough, Alfred, and Martin (2008)
Level of education is positively related to more highly rated perceived professional values. Kubsch et al. (2008)
Nurse leaders view ethical issues essentially the same way as staff nurses. Cooper et al. (2004)
Design: non‐experimental, descriptive comparative study
Sample: convenience sample, 687 registered nurses18% response rate (N=125)
Setting: letter and survey were mailed to nurse’s home address; on‐line
Instrument: Nurses Professional Values Scale‐R
Approval: Holy Spirit Hospital IRB approved
Study ObjectivesStudy Objectives
To identify values held by nurses at Holy Spirit Hospital.
To identify the relationship between nursing values and retention.
To compare the values of staff nurses to those of management/leadership.
Demographics: RolesDemographics: Roles
94
11
113
11 1Staff Nurse
Charge Nurse
Nurse Manager
Director
Asst NurseManagerNurse Educator
Sample DescriptivesSample DescriptivesTable 1
Number Percent
Female 117 93.6%Gender
Male 8 6.4%
Diploma 20 15.9%
Associates 42 33.3%
BSN 53 42.1%
MSN 7 5.6%
Education
Other 4 3.2%
Demographics: ExperienceDemographics: Experience
< 6 months1%
5 – 10 yrs11%
10 – 20 yrs20%
20 or more yrs54%
2 – 5 yrs11%
6 – 24 months3%
Values of Holy Spirit NursesValues of Holy Spirit NursesObjective 1: To identify the values held by nurses at HSH
Maintain competency in area of practice (4.8)
Accept responsibility and accountability for own practice (4.7)
Act as patient advocate (4.7)
Safeguard patient’s right to privacy (4.6)
Maintain confidentiality of patient (4.6)
Values and Retention RelationshipValues and Retention RelationshipObjective 2: To identify the relationship between nursing
values and retention
There was no statistically significant relationship between values (low‐medium‐high) and retention
(10 years, 10‐20 years and . 20 years)
Tau= .049; p = .332
Values of Staff and ManagementValues of Staff and ManagementObjective 3: Objective 3: To compare the values of staff nurses to To compare the values of staff nurses to
those of management/leadershipthose of management/leadership
Staff nurses scored significantly lower in the following subscales:
The nurse acts to safeguard the client and the public when health care and safety are affected by the incompetent, unethical, or illegal practice of any person
Mean = 12.1 vs 13.2; t = ‐4.8, p = .000
The nurse participates in activities that contribute to the ongoing development of the profession’s body of knowledge Mean = 11.1 vs. 12.2; t = ‐2.4, p = .01
Values of Staff and ManagementValues of Staff and ManagementThe nurse participates in the profession’s efforts to implement and improve standards of nursing
Mean = 11.0 vs 12.1; t = ‐2.6, p = .01
The nurse collaborates with members of the health professions and other citizens in promoting community and national efforts to meet the health needs of the public
Mean = 14.5 vs 15.7; t = ‐2.8, p = .007
Total NPVS‐R score
Mean = 105.7 vs 110.8, t = ‐2.4, p= .02
Least important values to nursesLeast important values to nursesParticipate in peer review (3.5)
Participate in nursing research and/or implement research findings appropriate to practice (3.5)
Participate in activities of professional nursing associations (3.3)
Limitations of Data SetLimitations of Data SetNo differentiation between RN vs LPN in data set
No variable for retention at HSH
Years of experience collected as ordinal level of measurement rather than interval level (limits power)
Study based on previous work by Yarbrough et al. (2003).
No coding criteria for revised NPRS
Limitations of Sample:Limitations of Sample:Primarily white (98.4%)
Few male nurses in sample (8)
Sampling bias: nurses with low professional values may not remain in profession
Low response rate
ConclusionsConclusionsTop three values of entire sample:
Safe‐guarding privacyRespect for human dignityAssuming accountability and responsibility for actions.
Nurse administrators and staff nurses have essentially the same value priorities, but organizational ethics create challenges for both groups.
Yarbrough, et al. (2008), Cooper, et al. (2004)
ImplicationsImplications for Nurse Leadersfor Nurse LeadersAcknowledge the challenges of organizational culture
Support shared decision‐making
Improve communication
Understand and recognize the values of both staff and leadership
ReferencesReferencesAmerican Nurses Association (1995). Code of ethics for nurses with
interpretive statement. Retrieved August 28, 2009, from Nursing World: www.nursingworld.org/ethics/code/protected_nwcoe813.htm
Cooper, R.W., Frank, G.L., Hansen, M.M., Gouty, C.A., (2004). Key ethical issues encountered in healthcare organizations. Journal of Nursing Administration. 34(3), 149‐156.
Kleinman, C. (2004) The relationship between managerial leadership behaviors and staff nurse retention. Hospital Topics: Research and Perspectives on Healthcare. 82(4), 2‐9.
Kubsch, S., Hansen, G., Huyser‐Eatwell, V. (2008). Professional values: The case for RN‐BSN completion education. The Journal of Continuing Education in Nursing, 39(8), 375‐384.
ReferencesReferencesWeis, D., & Schank, M.J. (2002). An instrument to measure professional
nursing values. Journal of Nursing Scholarship. 32(2). 201‐204.
Weis, D., & Schank, M.J. (1997). Toward building an international consensus in professional values. Nurse Education Today, 17(5), 366‐339.
Wilson, A.A. (2005) Impact of management development on nurse retention. Nursing Administration Quarterly. 29(2) 137‐145.
Yarbrough, S., Alfred, D., & Martin, P. (2008). Research study: Professional values and retention. Nursing Management, 32(2), 201‐204.