Using the Practice Environment Scale and Job Enjoyment Scale to Evaluate Laschinger's Nursing Work Life Model

Purpose:
The purpose of this study was to explore components of the Practice Environment Scale (PES) and Job Enjoyment Scale (JES) using unit level data from the 2011 RN Satisfaction Survey from the National Database for Nursing Quality Indicators (NDNQI®) to test Laschinger's Nurse Worklife Model (NWLM).

Background/Significance:
The practice environment has been identified as important to both nurse satisfaction and patient outcomes (Aikin, Clarke, Sloane, Sochalski, and Silber, 2002; Needleman, Buerhaus, Mattke, Stewart, and Zelevinsky, 2002). Practice environment component measures have been developed (Lake, 2002) but relationships have not been explored. Lachinger and Leiter (2006) posited the NWLM to explain how the elements identified are interrelated in the complex system of the nurse practice environment.

Methods:
Using 2011 NDNQI® RN satisfaction data, a secondary analysis was done to evaluate the Nurse Worklife Model (NWLM) pathways. PES subscales and JES served as proxy measures for the components of the NWLM. All PES subscales and the JES had demonstrated reliability ranging from .88 to .98. Hierarchical multiple regression was used to explore the mediation effects of the PES subscales (i.e., RN-MD Collaboration, Policy Involvement, Staffing Resources, and Foundations for Quality Nursing Care) between Nurse Manager Ability and Job Enjoyment controlling for unit type (medical, surgical, medical-surgical, step-down, and critical care). Mean unit scores (N = 3,583) for all measures were used.

Results:
Pathways in the NWLM were supported. However, Nurse Manager Ability was partially mediated by the subscales of the PES but also had a significant (p<.001) direct effect on JES (â = 0.24). In addition, Staffing Resources (â = 0.56), and RN-MD Collegiality (â = 0.10) had significant (p<.001) direct effects on JES. Controlling for unit type, the linear weighted combination of the PES subscales including Nurse Manager Ability accounted for 80% of the variance (p<.001) in JES. Nurse Manager Ability also was a significant (p<.001) positive predictor for RN-MD collaboration (â = 0.51), Policy Involvement (â = 0.61); Staffing Resources (â = 0.21); and Foundations for Nursing Quality (â = 0.18).

Conclusions and Implications for Practice:
This study adds to the understanding of the complex interaction of the components of the practice environment as depicted by the NWLM. While all of the components contribute to the over-all job enjoyment, the nurse manager plays a key role on the unit in staff nurse enjoyment of their job.