Healthcare Quarterly

Healthcare Quarterly 6(4) June 2003 .doi:10.12927/hcq.2003.16764
Longwoods Review


Peggy Leatt


The Canadian healthcare system is in crisis when it comes to recruitment and retention of nurses! How many times have we heard that cry in the past decade? There still seem to be no straightforward answers or solutions to the problem. The prediction is that the situation will only get worse as more nurses reach retirement age and baby boomers reach the stage when they will need skilled nursing care.

Heather Spence Laschinger and her colleagues report on research they conducted to examine the work environments in which nurses generally carry out their daily activities. The research was designed to address the question of whether giving nurses greater control over their work enhances their feelings of empowerment, and subsequently decreases perceptions of burnout at a later time. The theory underlying the research was first hypothesized in corporate work by Kanter, who suggested that when employees feel they have power to make decisions and control their work environments they are more likely to feel satisfied with their work. In particular, Kanter hypothesized that where work environments are structured to aid and support people in carrying out their work, employees are likely to be more productive and feel greater rewards.

Applying these principles to the work of nurses, Laschinger and colleagues studied the relationship between empowerment of nurses and burnout in a sample of nurses working in urban tertiary care hospitals in Ontario. This research is unique in that it is longitudinal and incorporated follow up three years later. Not surprising to most healthcare managers, the researchers found that higher levels of structural empowerment can enhance feelings of psychological empowerment and consequently produce less burnout.

The real question then is what exactly can and should healthcare managers be doing to enhance nurses' empowerment and improve nurses' work environments? It is clear that much more should be done but the actual strategies are not clear. The U.S. Agency for Health Research and Quality recently released a comprehensive analysis of research on working environments and patient safety. Their conclusion - not enough definitive research has been done. So bravo! for the Canadian research team for moving forward with this important research.

About the Author(s)

Peggy Leatt, PhD


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