DiversityNursing Blog

Quality of Nursing Worklife: Balancing work and life

Posted by Pat Magrath

Thu, Sep 29, 2016 @ 12:22 PM

CNR-Ad1.jpgWork/life balance has been on people’s minds for decades. As individuals and companies strive to improve work/life balance, we want to focus on work/life balance for Nurses. Are you familiar with Dr. Brooks Quality of Nursing Worklife Survey? If not, this article will help you and your place of employment.

Any discussion of quality of life would not be complete without addressing the concept of worklife and specifically nursing worklife, a critical element in healthcare delivery. Developing and retaining the nursing workforce is one of the biggest challenges facing health care employers today. Importantly, the quality of healthcare is frequently judged by the quality of nursing care. The overall quality of care and excellence in nursing is intimately tied to the quality of nurses’ worklife. Quality of nursing worklife is clearly essential to quality care and is an essential component in recruitment and retention of the nursing workforce. Here I make the case for measuring quality of nursing worklife, instead of job satisfaction. 

Historically nursing has focused on measuring job satisfaction and linking job satisfaction to patient outcomes. In practice settings one often hears “satisfied nurses make for satisfied patients.” The relationship between job satisfaction and organizational outcomes has been discussed for so long in the literature that a causal relationship is often inferred, when in fact studies have actually denounced the relationship (Bradfield & Crockett, 1955; Hom & Kinicki, 2001; Iaffaldano & Muchinsky, 1985; Judge, Thoresen, Bono, & Patton, 2001; Organ, 1988). The validity of the concept of job satisfaction and its relationship with organizational and performance outcomes has been questioned for decades (Brayfield & Crockett, 1955; Hom & Kinicki, 2001; Iaffaldano & Muchinsky, 1985; Judge et al., 2001; Organ, 1988). 

In fact, much nursing job satisfaction research linked to patient outcomes found only a correlational relationship not a causal one (Ma, Samuels, & Alexander, 2003). The questionable nature of this relationship might be in part due to questionnaire items (empirical referents) that do not have a strong theory base or unclear and ambiguous conceptual definitions of job satisfaction (Brown, 1999). This leads to inconsistent operational definitions that directly influence how job satisfaction is measured. On the other hand, quality of worklife, and in particular quality of nursing worklife, as the variable of interest does not suffer from the weaknesses in job satisfaction research in job satisfaction research.

Quality of worklife (QWL) has strong theoretical underpinnings that can be traced back to socio-technical systems theory. Socio-technical systems theory maintains one must co-optimize both social (people) and technical (equipment, the environment) subsystems to not only improve worklife, but to also improve the organization's productivity. In fact, going back as far as the 1950s Trist and Bamforth (1951) found a causal link between improved QWL and productivity. In addition, psychologists have found that as much as 30% of the variance in measures of job satisfaction measure personality something an employer has little influence over (Agho, 1993; Judge, 1993; Remus & Judge, 2003). Yet, employers continue to attempt to improve satisfaction in order to improve productivity.

There is increasing conceptual clarity around the construct of QNWL. My dissertation research synthesized years of empirical and conceptual research that studied QWL. A conceptual framework devised by nurse researchers at the University of Toronto was based on many of the principles underlying sociotechnical systems theory. Moreover, measures of QWL take into consideration the balancing act employees do between their worklife and home life. This too made sense for QNWL since nurses, like any employee, balance work and family. The strong theoretical underpinning from socio-technical systems theory (STS), the conceptual framework, and qualitative research exploring the worklife of nurses from the research unit became the basis of Brooks' Quality of Nursing Worklife Survey(C). Requests to use Brooks’ Quality of Nursing Worklife Survey have been received from graduate students and researchers in 30 countries from Greece to Estonia, Canada (Ontario, Quebec), India, Iran, Australia, Malaysia, Turkey, and Taiwan. And, my survey has been translated into 5 languages. 

It's important for organizations to look beyond job satisfaction when attempting to improve the work life of their employees, as well as the productivity of the organization.

Related Article: Nurses Practicing Self Care

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