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The Impact of Role Discrepancy on Nurses’ Intention to Quit Their Jobs

The Impact of Role Discrepancy on Nurses’ Intention to Quit Their Jobs

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ISSUES IN CLINICAL NURSING
doi: 10.1111/j.1365-2702.2005.01508.x
The impact of role discrepancy on nurses\u2019 intention to quit their jobs
Miyuki TakaseRN, DipNurs, BNurs, MNurs, PhD
Research Fellow, Centre of Nursing Research, Deakin University, Malvern, Victoria, Australia
Phillip MaudeRN, DipMHN, BHSci, MNurs, PhD
Senior Lecturer, School of Nursing, University of Melbourne, Victoria, Australia
Elizabeth ManiasRN, BPharm, MPharm, MNursStud, PhD, CertCritCare
Associate Professor, School of Nursing, University of Melbourne, Victoria, Australia
Submitted for publication: 21 September 2004
Accepted for publication: 30 August 2005
Correspondence:

Miyuki Takase
Centre of Nursing Research
Deakin University
183 Wattletree Road

Malvern
Vic.
Australia

Telephone:\u00fe61 3 9244 6305
E-mail: m.takase@pgrad.unimelb.edu.au
TAKASE M, MAUDE P & MANIAS E (2006)
TAKASE M, MAUDE P & MANIAS E (2006)Journal of Clinical Nursing15, 1071\u2013
1080
The impact of role discrepancy on nurses\u2019 intention to quit their jobs
Aims and objective.The purpose of this study was to investigate the impact of role
discrepancy on nurses\u2019 intention to quit their jobs.
Background.Nurses experience role discrepancy, which refers to incompatibility

between the roles nurses desire and expect to take, and the roles they actually engage in at work. However, there is a paucity of information as to how this role dis- crepancy affects nurses\u2019 intention to quit their jobs.

Design.A correlational design was used to investigate the impact of role discrepancy
on nurses\u2019 intention to quit their jobs.
Methods.A total of 346 Australian nurses participated in this study by completing
questionnaires. The results were analysed byt-test, polynomial regression and
response surface analysis.
Results.Nurses tended to experience role discrepancy, in particular, in decision

making with hospital policies and provision of patient education. The overall results show that this role discrepancy contributes to nurses\u2019 intention to quit their jobs. Nurses\u2019 intention to quit their jobs also increased when they had a low desire to engage in nursing roles and when they only performed a few roles. When speci\ufb01c dimensions of nursing roles were examined, a role discrepancy in the use of nursing skills, such as participation in decision making and providing patient education and emotional support, had little impact on their turnover intention. On the contrary, a role discrepancy in task delegation practice showed a signi\ufb01cant association with nurses\u2019 intention to leave their jobs.

Conclusions.Role discrepancy has been experienced by many nurses, and this dis-
crepancy partially contributes to nurses\u2019 intention to quit their jobs.
Relevance to clinical practice.To reduce nursing turnover, it is important to create a
work environment where nurses are inspired to engage in various nursing roles and
their work desires are reinforced by existing work opportunities.
Key words:nurse roles, nurses, nursing, professional development, reality shock
\u00d32006 The Authors. Journal compilation \u00d32006 Blackwell Publishing Ltd
1071
Introduction

Nurses have been known to experience role discrepancy, which refers to the incompatibility between nurses\u2019 role conception and the actual roles they engage in at work. Role conception is de\ufb01ned as the roles nurses desire and expect to take as nursing professionals (Corwin 1961). Although experience of role discrepancy is prevalent, few studies have examined its effect on nurses.

Nurses experience a role discrepancy across various stages of their nursing career. For example, Yung (1996) indicated that nurses\u2019 experience of role discrepancy began as early as when they were nursing students. The study reported that degree programme nursing students tended to see they had fewer opportunities to engage in professional development and patient care in their clinical practice than they desired. On the contrary, nurses saw there were more organizational rules to follow in practice than they expected. Similar results are reported in studies that targeted newly graduated nurses (Ahmadiet al. 1987, Tayloret al. 2001). Experience with role discrepancy is also evident in nurses with wider clinical experience. By targeting nurses with diverse clinical experi- ence, Blegenet al. (1993) identi\ufb01ed that nurses tended to perceive they were less involved in policy making at the ward level than they desired.

The cause of role discrepancy is attributed to a gap
between nursing education and practice (Yung 1996, Taylor
et al.2001). Nurses internalize idealized roles of nursing such

as roles of decision making and they develop knowledge and skills according to these roles during the educational period. However, the roles nurses actually engage in at work are often controlled by bureaucratic rules, hospital hierarchy and cost-containment policies in organizational settings. Nurses\u2019 decision making is often constrained due to a lack of recognition of their knowledge and skills, coupled with a power asymmetry between nurses and physicians (Manias & Street 2001). The nursing role of caring also suffers in a hospital controlled by costs (Turkel 2001), as caring involves unobservable energy such as emotion and commitment and its outcomes are often undetected (Davies 1995). For instance, provision of emotional support by nurses helps to ease patient anxiety relating to their illness. Nevertheless, their contribution to patient well-being can be overshadowed by doctors\u2019 efforts to \ufb01nd a cure for the patient\u2019s condition, and this may lead to an inadequate allocation of hospital resources for nursing care.

While the states of role discrepancy in nursing have been examined, little is known as to how this discrepancy may affect nurses\u2019 attitudes toward their work. This is surprising considering several studies have investigated how other

dimensions of role-related problems in nursing, such as role expansion, role con\ufb02ict, role ambiguity and role overload, contributed to nurses\u2019 work attitudes including job dissatis- faction (Hindset al. 1998, Magenniset al. 1999, Chang & Hancock 2003) and burnout (Schmitzet al. 2000, Stordeur

et al.2001, Lee et al.2003). Understanding the impact of a

role discrepancy on nurses is important, as it provides nurse educators and managers with more meaningful approaches in dealing with role discrepancy. The aim of this study was, therefore, to investigate how the relationships between nurses\u2019 role conception and their perception of their actual roles contributes to nurses\u2019 work attitudes. In this paper, the impact of role discrepancy on nurses\u2019 turnover intention, which is de\ufb01ned as nurses\u2019 intention to quit their jobs, is explored.

Theoretical framework

The person\u2013environment \ufb01t theory was adopted to investi- gate the relationship between nurses\u2019 role conception, actual nursing roles and the turnover intention of nurses. In a broad sense, the person\u2013environment \ufb01t refers to a perceived compatibility or correspondence between employees\u2019 occu- pational needs and the characteristics of the environment where their job occurs (Dawis & Lofquist 1984, Mitchell

et al.2001). More recent studies tend to classify it into two

dimensions, a person\u2013organization \ufb01t and a person\u2013job \ufb01t. In general, a person\u2013organization \ufb01t refers to a perceived compatibility between employees\u2019 needs to obtain certain job outcomes (e.g. recognition, career advancement oppor- tunities and autonomy) and the organizational capability to reinforce such needs. On the contrary, a person\u2013job \ufb01t is characterized as compatibility between employees\u2019 occupa- tional abilities and the demands of their job, or between employees\u2019 role interests and the characteristics of a job undertaken. The interest of the present study lies in the latter dimension of the person\u2013job \ufb01t.

The person\u2013environment \ufb01t theory contends that the relationship between employees\u2019 occupational needs and the characteristics of the environment or job has an impact on employees\u2019 occupational behaviours. The occupational behaviours include occupational performance, job satisfac- tion and intention to quit a job (Dawis & Lofquist 1984, Walsh & Holland 1992, Lawet al. 1996, Dawis 2000). When employees perceive a \ufb01t between them, they tend to manifest favourable occupational behaviours. When they perceive a mis\ufb01t (i.e. incompatibility between their needs and the characteristics of their environment/job), employees may experience frustration and dissatisfaction with their job. This mis\ufb01t may lead to employees\u2019 intention to leave an

M Takaseet al.
1072
\u00d32006 The Authors. Journal compilation \u00d32006 Blackwell Publishing Ltd

organization or the occupation itself and to look for a more compatible environment or job (Dawis & Lofquist 1984, Walsh & Holland 1992, Dawis 2000). Based on the person\u2013 environment \ufb01t theory, the following hypothesis was derived. The mis\ufb01t between nurses\u2019 role conception and their percep- tion of the actual roles (i.e. role discrepancy) is positively related to increased turnover intention.

This hypothesized relationship is illustrated in Fig. 1. In this \ufb01gure, the score for the actual nursing roles is described along thex-axis, that of nurses\u2019 role conception along the

y-axis, and that of turnover intention along the z-axis, with

the larger scores indicating a greater degree of actual role engagement, nurses\u2019 stronger desires for role engagement, and their stronger intention to quit the jobs. The person\u2013job \ufb01t is represented by the straight line in the xy-plane. Along this line, the degree of the actual engagement in certain roles is congruent with the strength of nurses\u2019 desires or expecta- tions to engage in such roles. This straight line is termed

Y\u00bc Xline. Along the Y\u00bc Xline, nurses\u2019 turnover intention

is constantly low. The person\u2013job mis\ufb01t (i.e. role discrep- ancy) is illustrated along the dotted line in thexy-plane. Along this line, the strength of nurses\u2019 desires or expectations to engage in certain roles contradicts the degree of the actual involvement in the roles. This dotted line is termedY\u00bc\u00c0X line. Along theY\u00bc\u00c0X line, the surface illustrating turnover intention shows an upward curve. In other words, nurses\u2019 intention to quit their jobs becomes stronger, when they perceive a greater discrepancy between their role conception and their actual roles (Edwards & Parry 1993). This hypothesized model served as the framework to examine the impact of role discrepancy on nurses\u2019 turnover intention.

Methods

This study adopted a correlational survey design to test the hypothesis. Ethics approval from all the participating insti- tutions was obtained before data collection.

Sample

The target sample comprised 943 Registered Nurses who had completed a three-year nursing diploma or degree course. Participants were recruited from nurses, who were working in a metropolitan public hospital and a rural public hospital in Victoria, Australia, during May and June, 2003. In addition, Registered Nurses who were completing a postgra- duate diploma or certi\ufb01cate course in a university in Victoria were also invited to participate in the study. Recruitment of the university students enhanced the generalizability of the \ufb01ndings, as they were from diverse hospitals.

Instruments

Nurses\u2019 role conception and their perception of the actual role were measured by 10 selected items from the Jefferson Survey of Attitudes Toward Physician\u2013Nurse Inventory (Hojatet al. 1999) and the Staff Nurse Role Conception Inventory (R. L. Tavnton, unpublished research report). A six-point Likert scale was used on these items with higher scores indicating higher role conception and more actual involvement in their roles. Prior to the data collection, minor modi\ufb01cations were made to both instruments in accordance with the purpose of the study and the results of a judgemental panel review. The Index of Content Validity was used by the panel reviewto establish the relevancy of the instruments to the study purpose (Waltzet al. 1984). The questionnaire was then piloted with 16 Registered Nurse students in one university, who were not included in the main study. After the administration of the questionnaires to the main study sample, a principal-axis factor analysis with a varimax rotation was conducted by pooling the scores of nurses\u2019 role conception and the actual roles together. This procedure helped to obtain a mutual factor solution between the variables (Levine 1977). As a result, a two-factor solution emerged. The \ufb01rst factor, \u2018the use of nursing skills\u2019 consisted of eight items concerning participation in clinical and administrative decision making, providing patient education and providing emotional support. The second factor, \u2018task delegation\u2019 consisted of two items concerning delegation of basic patient care (i.e. assisting patients\u2019 daily activities and hygiene measures) to licensed practical nurses and patient care attendants. A reliability of 0\u00c662 was identi\ufb01ed for the

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Turnover
intention
(z-axis)
Actual roles
(x-axis)
Role conception
(y-axis)
Figure 1A hypothesized model illustrating the three-dimensional

relationship between nurses\u2019 role conception, the perception of their actual roles and their turnover intention. This \ufb01gure was created based on the work of Edwards and Parry (1993). The straight line in thexy-plane illustrates theY\u00bc X line, while the dotted line illus- tratesY\u00bc\u00c0X line.

Issues in clinical nursing
The impact of role discrepancy on nurses
\u00d32006 The Authors. Journal compilation \u00d32006 Blackwell Publishing Ltd
1073

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