For the Multi-State Nursing Care and Patient Safety survey, we used a two-stage sampling design to collect information from registered nurses in California, Pennsylvania, New Jersey, and Florida. Our sampling frame was the state licensure lists for 2006–07. We surveyed nurses by mail at their homes.
Nurses who worked in hospitals were asked to provide the name of their employer, which allowed us to aggregate responses by hospital for the analysis of nurses’ reports and patient satisfaction. The response rate was 36 percent. To test for sample bias, we conducted a random-sample survey of nonrespondents from Pennsylvania and California, received a response rate of 91 percent, and found no response bias pertinent to this report.12 Further details on the sampling approach have been described elsewhere,9 (link) and are available in the Appendix.13 The survey included questions about the nurses’ employment status and, for working nurses, their setting, role, work environment, experience of burnout, and job satisfaction. As in other work,14 (link) we assessed burnout in terms of emotional exhaustion, which is the depletion of one’s emotional and physical resources due to work stress as measured on the nine-item emotional exhaustion subscale of the Maslach Burnout Inventory.6 (link) Burnout is common in human service occupations such as nursing, and it results in nurses’ distancing themselves emotionally and cognitively from their work.6 (link) Nurses were classified as burned out if their score was higher than the published average (27 or higher) for workers in health professions.15 ,16 Overall we measured job satisfaction and nurses’ satisfaction with specific aspects of their jobs—including salaries, benefits, opportunities for advancement, work schedules, independence, and professional status—on a four-point scale from “very satisfied” to “very dissatisfied.” Satisfaction measures were dichotomized so that nurses who reported being either “very dissatisfied” or “a little dissatisfied” were characterized as “dissatisfied.”
Nurses who worked in hospitals were asked to provide the name of their employer, which allowed us to aggregate responses by hospital for the analysis of nurses’ reports and patient satisfaction. The response rate was 36 percent. To test for sample bias, we conducted a random-sample survey of nonrespondents from Pennsylvania and California, received a response rate of 91 percent, and found no response bias pertinent to this report.12 Further details on the sampling approach have been described elsewhere,9 (link) and are available in the Appendix.13 The survey included questions about the nurses’ employment status and, for working nurses, their setting, role, work environment, experience of burnout, and job satisfaction. As in other work,14 (link) we assessed burnout in terms of emotional exhaustion, which is the depletion of one’s emotional and physical resources due to work stress as measured on the nine-item emotional exhaustion subscale of the Maslach Burnout Inventory.6 (link) Burnout is common in human service occupations such as nursing, and it results in nurses’ distancing themselves emotionally and cognitively from their work.6 (link) Nurses were classified as burned out if their score was higher than the published average (27 or higher) for workers in health professions.15 ,16 Overall we measured job satisfaction and nurses’ satisfaction with specific aspects of their jobs—including salaries, benefits, opportunities for advancement, work schedules, independence, and professional status—on a four-point scale from “very satisfied” to “very dissatisfied.” Satisfaction measures were dichotomized so that nurses who reported being either “very dissatisfied” or “a little dissatisfied” were characterized as “dissatisfied.”
