Influence of organizational characteristics and caring attributes of managers on nurses' job enjoyment.

AIM: This paper is a report of a study to investigate the effect of organizational characteristics and perceived caring attributes of managers on nurses' job enjoyment. BACKGROUND: Job satisfaction was the outcome of several studies about organizational or professional practice environments. Study variables predicted 30-60% of the variance in job satisfaction. Job enjoyment, the affective dimension of job satisfaction and manager caring were not variables in previous studies. METHODS: We recruited a convenience sample of Registered Nurses (n = 731) employed by a large healthcare system in the mid-Atlantic region of the United States of America. Participants were primarily staff nurses, female, white, full-time employees and 41 years of age or older. Most had a baccalaureate degree in nursing and 4.5% had an advanced practice license. Participants were surveyed in 2005 using Lake's Practice Environment Scale of the Nursing Work Index, Nyberg's Caring Assessment Scale, the Job Enjoyment Subscale of the Atwood and Hinshaw Job Satisfaction Scale and a demographic data form. Descriptive statistics were used to explore the study variables. Data were analysed using multiple regression. RESULTS: Nursing foundations for quality of care, nurse manager ability, leadership and support of nurses, staffing and resource adequacy and collegial nurse-physician relations explained 30.6% of the variance in job enjoyment. Age, area of practice and job type explained an additional 5.4%. CONCLUSION: Quantitative measures did not identify a majority of the variables associated with job enjoyment. Research using a qualitative and quantitative methodology with different practice samples may reveal other variables that influence job enjoyment.

Clinical comparison of automatic, noninvasive measurements of blood pressure in the forearm and upper arm with the patient supine or with the head of the bed raised 45 degrees: a follow-up study.

BACKGROUND: Noninvasive measurement of blood pressure in the forearm is used when the upper arm is inaccessible and/or when available blood pressure cuffs do not fit a patient's arm. Evidence supporting this practice is limited. OBJECTIVE: To compare noninvasive measurements of blood pressure in the forearm and upper arm of medical-surgical inpatients positioned supine and with the head of the bed raised 45 degrees . METHODS: Cuff size was selected on the basis of forearm and upper arm circumference and manufacturers' recommendations. With a Welch Allyn Vital Signs 420 Series monitor, blood pressures were measured in the forearm and then in the upper arm of 221 supine patients with their arms resting at their sides. Patients were repositioned with the head of the bed elevated 45 degrees and after 2 minutes, blood pressures were measured in the upper arm and then the forearm. Starting position was alternated on subsequent subjects. RESULTS: Paired t tests revealed significant differences between systolic and diastolic blood pressures measured in the upper arm and forearm with patients supine and with the head of the bed elevated 45 degrees . The Bland-Altman procedure revealed that the distances between the mean values and the limits of agreement were from 15 to 33 mm Hg for individual subjects. CONCLUSIONS: Noninvasive measurements of blood pressure in the forearm and upper arm cannot be interchanged in medical-surgical patients who are supine or in patients with the head of the bed elevated 45 degrees .