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Characteristics of Nurses and Hospital Work Environments That Foster Satisfaction and Clinical Expertise

Foley, Barbara Jo PhD, RN, FAAN; Kee, Carolyn C. PhD, RN; Minick, Ptlene PhD, RN; Harvey, Susan S. PhD, RN; Jennings, Bonnie M. RN, DNSc, FAAN

Journal of Nursing Administration: May 2002 - Volume 32 - Issue 5 - p 273-282

Objective The purpose of this aspect of a larger study was to describe characteristics of nurses and their work environment at two military hospitals.

Background Few studies have explored characteristics among nurses who practice in military hospitals. There is reason to believe that differences exist between nurses who work in military and civilian hospitals, some of which are required educational level, leadership experience, officer status, and career development opportunities.

Methods A descriptive design was used to address how military and civilian nurses who work in military hospitals describe their autonomy, control over practice, nurse-physician collaboration, and clinical expertise and what relationships exist among these variables.

Results Scores on autonomy, control over practice, and nurse-physician relationships all were above midpoint for all respondents as a group, indicating positive work environments in both of the military hospitals studied. Scores from the clinical expertise instrument were well above midpoint, indicating a desirable level of clinical expertise. These findings all reflect favorably on the military hospital work environment.

Conclusions/Implications This information will help to make a case for instituting or preserving those nursing processes that are effective and for identifying and working to change nursing processes that are not effective. Nurses will benefit by having a more collaborative work environment.

Author affiliations: University of North Carolina at Chapel Hill, (Dr Foley); Georgia State University, Atlanta (Dr Kee and Dr Minick); Queens College, Charlotte, NC (Dr Harvey); Office of the Assistant Secretary of Defense for Health Affairs/TRICARE Management Activity, Washington, DC (Col Jennings).

Corresponding author: Col (Ret) Barbara Jo Foley, PhD, RN, FAAN, 433 Carrington Hall, CB# 7460, Chapel Hill, NC 27599-7460 (

This report is from a study sponsored by the TriService Nursing Research Program, Uniformed Services University of the Health Sciences. The information or content and conclusions reflect the opinions of the authors although not necessarily representing the official position or policy of the TriService Nursing Research Program, the Uniformed Services University of the Health Sciences, the Army Medical Department, the Department of the Army, the Department of Defense, or the U.S. Government. No official endorsement of the aforementioned should be inferred.

© 2002 Lippincott Williams & Wilkins, Inc.