Table Of ContentBH 13 8
REPORT DOCUMENTATION PAGE
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MaJOR RRPORT,
THE RELATIONSHIPS AMONG IF FACTORS OF SATISFACTION AND
ANTICIPATED TURNDVI' OF Al FORCE CERTIFIED REGISTERED NURSI,
ANESTHETISIS:CO ACTIIOR CAPT CERISTINE MEVES
3 AUTHORS
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‘The Relationships Among the Factors of Satistaetion and Anticipated Ternover of
Air Force Cerfifled Registered Nurse Anesthetists
oresperdicg shor: Capin Crating L. Maves, NC, USAF
913 Weatgare Dr
Vacaville, CA 95687
0) 446.9974
acouif)sol.oom
20050125 149
AFCRNA Ieb Satisfaction J
Pages: 11
words: 2449
Tables and Figures 0
Photes: 0
Contact: Capt, Moves
(iuarantys: Capi, Ruch
‘The Relationships Among the Factors uf Sutisfuetion and Antlelpated Turnover of
Air Farce Centfied Registered Narse Anesthetists
Captain Donal @. Rush, NC, USAF; Captain Christine. Moves, NC, USAR; Jasob
Schmelz, PhD, RN; Jennifer A. Thimrtor, PRL
US Army Graduate Program in Anesthesia Nursing, University of Texas, Houston Health
Science Cenver; David Gract Medical Center, 10% Bocin Cr, ‘Travis Ave Pores
FaleLelé CA 94535
‘This muauseript was presented a6 apester at dae | Ariat Ameriuan Aasociation of
Nurse Anesthetists mecting iu Scans, WA, August 71, 2004
Key Words
Antvipsted Tumover
Nuuse Anesthtiet
Joh stisfhetion
AT CRNA lob Satisfaction 2
ABSTRACT
SAP} Conified Regignsrod Nine
ist (CRNA) creates both finane‘al aml mensle issues forthe Air Tonos, ‘The
[Purpose ofthis exploratory study was to identify the relaricnshe ninong factors of
fact
lon an wnilpated namaver OfUSAN CRNAs, Aweb-bined survey Was we for
dba oollsction, and al eetive duty Air Foroe CRNA were inl o paicipate
Sigoifcunt negative rletionships wero found between thre sos of Titers tas ascended
od jo rete factors (r= 332); pructos fms and sat soorded (2503
professanaXnscupetion! job section wc etiipated tumover (r~26"). In gered,
active duty Air Force CIRNAS experenes low fovea satifation and weiejpate
separating ftom the Air Forec bofore retirement, ‘Those who feel they deliver quality car,
he
equate tte 10 cel
Uva sae to parients, as well as enjoy thefrposicous wre Jess
likely to anticipate separating fron the Ade Perce before retireorent
AT CRNA Jeb Sutisiction’ 3
BACKGROUND AND PURPOSE,
‘The US Ais Foroc (AF) penvifles aussthesia services to aet've duty mnembars, their
<depenclomts,retitees, end othcr beneficiaris as well ar provid
nestresia personel is
the world. Tre AF baa
‘Support of wiltary and homaniarien mins threnghowt
‘stovieally cxperienced Nuctnations in anewthesia maupower, Cutrently, ocly 81% of tie
Available Centiied Nurse Anesthetists (CINNAS) positions i the AT are led, with ne
Projected change fr the upcoming year. The 2001 TriSarvice Working Group (TSW)
onsisting of anesthesia representatives Irom th Air Force, Army snuf Navy, was formed
1 identify reasons mlcary CRNAs scpaiacel fiora the servi
‘Whey alse uskod eurent
AK CRNAs, through a mailed tures, when shey intended to separate fm active day.
‘Mote than af ofthe respendents indicered ut ey pla
1o sepazate (34.494) or sere
undecided ahout separaring (20.9%) between 2002 and 2004, Between 1994 and 1998,
losses of AF CRNAs excetded asitaby ux CRNAs each year, The nilienide demand
‘lim and
fir CRINAS bs fueled sising civilian wages nd a widening gap be-ween
ailitary pay. The shoringe of CRNAs across the United States is expocind to
815,00
iby 2010, High ramnover of muse anesthetists eronts a flaanefal burden on the-OSAR.
Recruiting civilien CRNA hue bron wtsaly impossible since 1990, ie vast majority of
ow AF CRNAs coms from teining active duty critical cave ruses. This method of
supp"ying CRNAs for the AF is expensive. The costs inchude fil! salary and boncdis for
the stadent munse anesthetist for lwo anda half years, books, ution, and the cost of tice
permanent change vf station ‘nove foreach studsnt, Anus significant vost includes
filing the critica! care postions vacated hy the norees selected for auesthesie timing.
om,
Juang the isves relate to CRNA satisfuction is important in onder te ieplersert
AF CRNA fy Sat
‘who lewve before waching retirement
vofiens aimed at edveing she momber of acesth et
igibiicy aed tmprowng overell maqpewer availability
‘The patposs af this study’ was to: (a) i
ify she relationshéas smong the ‘actors of
satisfaction wed muvisipated tumovcr of Ale Fores CRNAR in order ro enkance the
Uunlerstending of reten‘on isanes; {h) augment the Fdings on jb satisfactiom of Air
ores CRNAs provided by the Txi-Service Working Group in 2001; (@) compare current
us wth earlier sry Fneings,
‘This exploratory scudy was based on w fou-atage misled of fatirs that ixfluence
Air Force CRNA job satstuerion wr anticipated Lamowcr. The nodal was slapred
(Cowan, 1. A196), The relationship betwim Navy anenihesia providers" job saviefeotion
se antslpaned tomo, Unpebiced master's eis, Arann State Univesity) thom eho
fivestagsthcorrea model of svieipate? removerumong ming aff dovekped by
‘Hinshaw and colleaguen ? In this austnge model, lastus fiom lower stagen ere preted
¢o nuence fetrsin te next highar age, Tho uence of factors from sage lo stage
cluinates in fevel af amtirpated trove Seago IV
‘Stage ts Init expovtadon ofssrvioe and mobi factors as the cormpanent of
Stage I. mployeos wo, when Fasthived, pan fo retin with an organization unt)
‘gible for vetiemem sre Jess Lely to ropart anticipated mumeverA sigoifiennt
70,
relationbip O13 hes been found betwoon Air Feros CRINAR Who, when thoy fa
Joined the Air Fore, planned tv stay unt retirement end those who stated, atthe ‘ime of
‘he survey, thot they sili anticipave retiring from the Air Force (Stamps, D. J, (1997), The
selutionships benween Ar Fores ansalbesin provider's job satisfaction aud anticipated
{nzcover, Unpublished master’s cheis, Uniformed Servioes University of the Heal
Sclonoes, Bethewd, MD). Similar Ecdings 2s support the telavoaship Betweom initial
AFCRNA Tob Saustnavon §
35,
‘ne ancipatedretitersenl ur United States Army CRNAS t
E01) (Grasso, 1.P, (1998), The Relat onsbip hetwean Arm CRNA. Job Setinfytion and
Tumoven, Unpublished masters tess, Unifomod Servors Levent ufcbe
Scienees, Bethesda, MD). For fhe prupose ifthe presen slur, iii] exposition of
service i defined asthe anticipation a the “ime of intl anployment as an Aie Peas
RNA, to vermin unt eticennt The ntl expovain of sevice is predicted
segatively influrace ancipsted tumor dred) ns well a influence Stage Ufc.
‘Mobility Sacton ave demographic factors of AMT CRNAs tal ure cxpested to
influence tumover. The twa mabil'yInton
sousldered fr ths present say ate mumber
of epenéects and lenth of mir se-vee. As fuity obligations increas and tine
toward rfteneut accrues within an organirativn, amuse is considered less mobile wiih
Is expecta: n negatively influence mipated warovor a well a influace Stage
‘tors?
Sage lt Satu xeon, jd rated facies, intenpersil relations ad prstice
fesuen are Ce primary components f Stage I. Sau aecorded Includes both professfua
stots and social status, Progestonal sins the perceived position one hold a he
‘orgnnizatioust hierarchy with respect to other healthcare profeysiousts. I indcated by
pay aad rewards such as premation, Social atatuy is how much one poteeives society
‘values his ar er accomplistinents and pasivian Stelos accorded is predicted to prsitvely
influence organizational work satisfetien and profess upational job satisfaction.
sticipated ummover? The TSG,
Increased status acconed baa hoon show, (9 tat uce
‘through a relephone inferviow with severly seperated CRNAs, identified inadequate pay.
sn] pone proucotion aaponiunties es the two Lop reasons Ait Forge CiUNA‘s identified far
separating froma the Air eres,
AF CRNA Job Satisantien 6
‘The jok re'nted factors ilu yuk itself, enjoyment, knowlege and stil, nd
competease, Werk itself includes she ruins adminissraive sks a5 wall as the acncal
anni ation of meshes, nossive cists tess can aegotvey inGuence
rofssionlloccupeiona! jo} saifeton. The TriScrvice Working Group feusid
ditional adiinistrative Cuties tobe ore ofthe tap seas for Ale Faroe CRNAS to
seprats tom the serve. Fajayac isthe aver evel ot happiness ne receives fon
worth
lasks, Ruowledge and ukils are the peasession of a noud base of professionat
Jmovledge and experience inte delivery af amestesia care, Compatenoe is the ability w»
deliver appropriate anesthesia eae, Yo’ telat fustorsinftuenae bow well CRNAS
they ean dn theit jobs as well as huw much they erjoy thee job, There factors ace aredioted
40 inflvonce professionaltacaupstions jc satisfaction.
Interpersonal relations incluls group cohesion, teatn super, and tear rape
Group cohesion is ths level of unity in which the anzs‘bes‘a care team performs. ‘Team
support is how well vie team encouages anil slp individnal mewibsts provide quality
anesthesia care, and team respect is how muuch mecsibers fee the. contributious are valued
Dy the teem, Interpeisonel rltions are prediocel te have a positive influence on Siage HI
Practice issues include the physical ervisonment, atonemy, coniro! over practice,
collaboration, und research. ‘The physical enviroment inclues safety of tne work area to
‘nctade noite levels, Tats includes tus availability of nacessury equipmerr and supplies
to perfiom nosessary wark cask, Avtomomy is the authority to setect au ancstkestu plan
bare end mache aller appropriate professicml decisions, Contre over practice is the
‘influence a CRNA. wil have in effecting practice onl wlsinistative changes.
Collaborator. isthe cooperative working relationship aetween the acasthssis teams, CRNA,
and soesthesiologist, Reseomh refers tothe level in which reseateh js porSosmed, er the
AE CRNA Job Satiafnchion 7
ream. Pr
level in sehicsreseomh resus ane uilived oy the anes! seu are
edict ly nflaence Stage TH fistre,
‘Stage IE: Organizational sonk satisfaction and peofesniemelsecupational job
satisfaction ars corpencats uf sige I. Organizational work autsfaction ix defined as ihe
CROA’S peceeption of joh in tonns of pay or zaward, administration yc,
professional status accorded, aud interactom with cetleayues *
Frofessioustioccupationsl job satisfaction was defined as “he anesthesia stats
‘opinion of the quality of the ear they delivered, time te conduct Meir cane activities, and
gencral enjoyment of thsi: position® Both types af satisfuction are predicted 0 negetively
influence ceticipated mmover.
‘Stage 1¥: The only factor nctadec in stage TV is anlivipated rorsoesr, ft és the
which ap Ait Force CRNA potsetven Ghat he oy she will separate from the AP
dege
before becoming eligible for retirement. Any active duty service vocnmlement mast be
‘oompleted betore che CRNA may sither nefits or soparaue fra the AF, meming they way
‘Wish tp separate bet ave unas todo o atthe present ime, Anticipated carmover has beet:
shown to eomtelate fo actual wnover in nursing persernc, Tie relaGonships emong factcs
affceting jo setisfaotion are comptes acd do not alway’ flow Lineatly from one tage vo
cons in Stage Tare
the vext, For instance, the initial expectation af service and snobility fe
predicted to negatively influence anticipated tumnaver direatly ax well ns Snfluenees rage 11
AP CRNA Tob Satisfuction 8
MryBOD
Samole
Ate te of sory disbution, the USAE cmuplayei #68 ative du'y CRNA
sulorizeé positions with 137 of those positions filed, AL! ative daty Ar CRVAe T=
157} wer oligile to patcipace in std. Individual Mobily Augmeatoos and
arcenfly on active duty, civil camtactons or any Department af Dedeuse
cemployces were not includee in the study. Active duty CRNAs with deliverabie duty’e-
nisl addresyes was invited 10 percipate (n* 116, 8296}. ‘The inital invitation to parigate
‘os sent via emul and feclnded a byperlik to the survey, A retrinder emil was sex twa
‘eck that resulod in an overall respnase tate ef 66% in=77),
Insument
‘The instrument consists oF twe-paxt queatfonnaize: a 15-quesdion demography
section and 2 46- Tikerestyle question gection, Hech Likert-tylo question relates to one of
tho factors Foon the thereon model. The prseotquestonnalt
‘Covransaiapison of he Nurse Tub Satisfaction Suu, he Wotk Session Seal and
{hs Anticipated Tumover Seale, Ske performs x prtet for he adaptation ofthe
jnvammeat, and sing multestnawiy seer analysin educed the numberof questions
thot 65.00 §7, The date ftom bes saly was computed using verimas rotcinaltecnigne
<onfinatory factor aegis, Tho umber of geetons was roduc Fntherto 37 due wy
innnatng all qnotions with fate loadings of es hun .$, Cconbech’s alpha foe
relat rele? inte followingcantoinated tuover 70, iil capectatons of ervice
60); iatempersonal relationships 88; joy related favors 76; organizationatiotk satisfaction
65; practioe in oscupat.onal jot suisfnetion 8 sta accorded
