THE EFFECTS OF UNIT SELF-MANAGEMENT ON HOSPITAL NURSES WORK PROCESS, WORK SATISFACTION, AND RETENTION

A number of innovative practice models have been introduced in an effo rt to resolve the hospital nursing shortage and improve the working co nditions and retention of registered nurses. This study examines the e ffects of a unit-level self-management model (including salaried compe nsation and gainsharing) in a number of clinical areas at The Johns Ho pkins Hospital in Baltimore, Maryland. In comparisons of nurses on sel f-managed and traditional nursing units, outcomes examined were nurses ' perceptions of their work process, nurses' work satisfaction levels, and nurses' retention. The self-management model is found to increase work satisfaction through effects on two work process variables: coor dination of care and effective team performance. The model is also ass ociated with higher retention. Nurses on self-managed units work longe r hours but earn increased pay; the effects of hours and pay on work s atisfaction and retention are discussed.