Of the 1,339 potential participants, 402 nurses responded to the survey (30.0% response rate), with minimal demographic differences observed between respondents and non-respondents (16
). Two-hundred forty-two nurses had requisite data for analyses; they were employed by 106 practices. 67 % of these nurses worked in hospital or university-affiliated practices. Ninety-one percent were white, 74 % reported oncology certification, and 46 % reported holding a bachelor’s or higher degree. The majority (95%) of respondents were RNs and the remainder were LPNs.
One hundred ninety (80.9%) of respondents indicated they were satisfied or very satisfied with their current position. Compared with non-satisfied nurses (n = 45, 19.1%), satisfied oncology nurses reported higher scores on the revised PES-NWI subscales (). Scores differed the most on the staffing and resource adequacy subscale (3.73 for satisfied nurses versus 2.58 for dissatisfied nurses, p < .001). All subscales differed significantly at p < .01, with the exception of the difference in the medical assistant support scale. On the global assessment of the PE, the overwhelming majority of satisfied nurses reported favorable PEs (87.8% vs 12.2%, p < .001). The majority of dissatisfied nurses reported unfavorable or mixed PEs (67.4% vs. 32.6%, p < .001). Satisfied nurses reported significantly lower workloads on their last shift (8.29 patients versus 11.77 patients for dissatisfied nurses, p < .01). Job satisfaction did not differ by race, oncology certification, education, or years in practice.
Bivariate Relationships for Oncology Nursing Job Outcomes.
Intention to Stay in Current Position for 12 Months or Longer
The majority of nurse respondents (n=208, 87.4%) indicated they intend to stay in their current position for 12 or more months, compared with 30 nurses (12.6%) who reported intent to leave in > a year. Compared with the results on job satisfaction, fewer subscales on the revised PES-NWI differed significantly by nurses’ intention to stay (). Nurse participation in practice affairs, nurse manager leadership, ability, and support, and staffing and resource adequacy were significantly higher for nurses who intend to stay in their position. Once again, the staffing and resource adequacy subscale had the largest difference between groups (3.61 versus 2.70, p < .001). Perceived medical assistant support was higher in nurses who did not intend to stay for 1 year (3.80 versus 3.57), but the difference was not statistically significant. While workloads were lower for nurses who intend to stay (8.76 versus 10.18), the difference was not significant. White nurses, oncology certified nurses, and nurses with more years of practice reported intention to stay more frequently than their counterparts (all p < .05).
Multivariable Results on Job Outcomes
Results from 4 multivariable logistic regression models are displayed in . Two models are shown for each outcome: job satisfaction and intent to stay. The fully adjusted models use all study variables displayed in the table and parsimonious models use variables with reported odds ratios and 95% confidence intervals. Variables were removed from these models using stepwise backwards selection with a cutpoint of p > .15. All 4 models were adjusted for nurse clustering in practices using generalized estimating equations. Across all 4 models displayed, the strongest and most significant variable for the 2 job outcomes was staffing and resource adequacy. When nurses reported above the midpoint on the revised staffing and adequacy subscale from the PES-NWI, they were significantly more likely to report they were satisfied or very satisfied with their current position. They were also significantly more likely to report they intend to stay in the current position for at least 1 year. Related to staffing and resource adequacy, nurses who reported higher workloads were significantly less likely to report job satisfaction, Odds Ratio (OR) 0.92, 95% CI [.85, 1.00]. Nurses employed in practices owned by universities or hospitals were more likely to be satisfied in contrast to nurses employed in physician-owned or other private practice settings. Finally, nurses who reported above the midpoint on the revised nurse manager, leadership, and ability subscale were more likely to report job satisfaction.
Multivariable Logistic Regression Models for Oncology Nursing Job Outcomes
In addition to staffing and resource adequacy, 2 subscales were significantly associated with an increased likelihood to report intention to stay in the parsimonious model. Nurses who scored above the midpoint on the nurse participation in practice affairs were significantly more likely to report intention to stay, OR 3.08, 95% CI [1.01, 9.42]. Nurses who reported above the midpoint on the medical assistant support scale were less likely to report intention to stay, OR 0.21, 95% CI [.06, .72]. Finally, more years of nursing experience was significantly associated with an increased likelihood in intent to stay in both fully adjusted and parsimonious models.