Nurses and Nurse Outcomes
Surveys were mailed in the spring of 1999 to a 50% random sample of registered nurses who were on the Pennsylvania Board of Nursing rolls and resided in the state. The response rate was 52%, which compares favorably with rates seen in other voluntary surveys of health professionals. Roughly one third of the nurses who responded worked in hospitals and included the sample of 10 184 nurses described here. No special recruiting methods or inducements were used. Demographic characteristics of the respondents matched the profile for Pennsylvania nurses in the National Sample Survey of Registered Nurses. Nurses employed in hospitals were asked to use a list to identify the hospital in which they worked, and then were queried about their demographic characteristics, work history, workload, job satisfaction, and feelings of job-related burnout. Questionnaires were returned by nurses employed at each of the 210 Pennsylvania hospitals providing adult acute care. To obtain reliable hospital-level estimates of nurse staffing (the ratio of patients to nurses in each hospital), attention was restricted to registered nurses holding staff nurse positions involving direct patient care and to hospitals from which at least 10 such nurses returned questionnaires. In 80% of the 168 hospitals in the final sample, or more nurses provided responses to our questionnaire. There were more than 50 nurse respondents from half of the hospitals. We examined 2 nurse job outcomes in relation to staffing: job satisfaction (rated on a 4-point scale from very dissatisfied to very satisfied) and burnout (measured with the Emotional Exhaustion scale of the Maslach Burnout Inventory, a standardized tool).