Date of Award

2009

Degree Type

Dissertation

First Advisor

Mary C. Sullivan

Abstract

The environment of the Neonatal Intensive Care Unit is stressful for nurses, infants and families. Nurse job stress is related to burnout, workforce absenteeism, retention and turnover. The current national shortage magnifies the need to understand this critical care work environment in order to: retain and recruit nurses, improve job satisfaction, and improve patient outcomes. The study's purpose was to examine the relationships among the factors of nursing practice: professional practice environment, stress, and burnout; and maternal satisfaction in a 60 bed bay-style level III NICU. The conceptual framework was role stress. Role ambiguity and role conflict, forms of role stress, may play a significant role in determining burnout. This descriptive correlational study examined the data of NICU staff nurses 75) and mothers of NICU infants (n=26). Demographics, the Maslach Burnout Inventory-HSS, Expanded Nurse Stress Scale and the Professional Practice Environment Scale were completed by the staff nurses. Mothers completed the Press Galley NICU survey. Four hypotheses were tested in multivariate analyses. The practice environment factors of control over practice, leadership and autonomy in clinical practice and [total] professional practice environment mediated the effect of nurse stress on the burnout dimension of emotional exhaustion so that nurse stress contributes to the practice environment which influences the emotional exhaustion of NICU nurses. Workload and problems with supervisors were the most significant nurse stressors. Other significant nurse stressors included: uncertainty towards treatment, conflict with physicians, problems with peer support, and patients and families. There is also tentative evidence that nurse stress negatively affects NICU mothers' satisfaction. This study provides preliminary evidence that certain qualities of the practice environment, especially control over practice, contribute to and help explain the effect of nurse stress on the burnout dimension of Emotional Exhaustion. Additionally, this is one of the first studies to examine the factors of the nurse practice environment in neonatal intensive care. More study is needed to investigate potential linkages among the NICU practice environment with infant and parent outcomes.

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.