The authors describe a study that evaluated implementation of a professional development model in which nurses spend 80% of their salaried time in direct patient care and 20% of their salaried time on professional development. The professional development time includes focused learning about patient-centered practice guided by the human becoming nursing theory. A qualitative descriptive preproject-process-postproject method and a longitudinal, repeated measures, descriptive-comparative method were used to answer the research questions. Participants were 33 nurses, 11 other nurse leaders and health professionals, and 55 patients and family members. The findings show that on the study unit overtime hours decreased significantly, the education hours were sustained throughout the study period, workload hours per patient day increased significantly, sick time stayed low, patient satisfaction scores increased, staff satisfaction scores were significantly higher than for comparator groups, and turnover was non-existent among study participants in year 2. Average variable direct labor cost increased over time, but the increase was not significantly higher than on the control units. Themes from the interviews with participants are presented. Ongoing evaluation of the model and implications for future research are discussed.
Aiken, L.H., Clarke, S.P., & Sloane, D.M. (2002). Hospital staffing, organization, and quality of care: Cross-national findings. International Journal for Quality in Health Care, 14(1), 5-13.
Baumann, A., O'Brien-Pallas, L., Armstrong-Stassen, M., Blythe, J., Bourbonnais, R., Cameron, S., et al. (2001). Commitment and care: The benefits of a healthy workplace for nurses, their patients and the system. Ottawa, Ontario: Canadian Health Services Research Foundation.
4.
Bournes, D.A. (2002). Research evaluating human becoming in practice. NursingScience Quarterly, 15, 190-195.
5.
Bournes, D.A. (2006). Human becoming—guided practice. NursingScience Quarterly, 19, 329-330.
6.
Bournes, D.A., & Milton, C.M. (in press). Nurses' experiences of feeling respected-not respected . Nursing Science Quarterly.
7.
Canadian Institute for Health Information. ( 2002). New CIHI report reveals changes in Canada's nursing workforce: Fewer RNs per capita, more working full-time. Retrieved October 31, 2002, from the Registered Nurses Database on the Canadian Institute for Health Information Web site: http://secure.cihi.ca/cihiweb/en/media_18jun2002_fig4_e.html
8.
Canadian Nursing Advisory Committee. (2002). Our health, our future: Creating quality workplaces for Canadian nurses. Ottawa, Ontario: Health Canada.
9.
Ferguson-Paré, M. (2002). Giving voices to nurses at University Health Network. Unpublished manuscript, University Health Network, Toronto, Canada.
10.
Irvine, D.M., & Evans, M.G. (1995). Job satisfaction and turnover among nurses: Integrating research findings across studies. Nursing Research, 44, 246-253.
11.
Jenkinson, C., Coulter, A., & Bruster, S. (2002). The Picker patient experience questionnaire: Development and validation using data from in-patient surveys in five countries. International Journal for Quality in Health Care, 14, 353-358.
12.
Johnston, C.L. (1991). Sources of work satisfaction/dissatisfaction for hospital registered nurses. Western Journal of Nursing Research , 13, 503-513.
13.
Jonas, C.M. (1995). Evaluation of the human becoming theory in family practice. In R. R. Parse (Ed.), Illuminations: The human becoming theory in practice and research (pp. 347-366). New York: National League for Nursing Press.
14.
Jones, C.B. (1990). Staff nurse turnover costs: Part II, Measurements and results. Journal of NursingAdministration, 20(5), 27-32.
15.
Legault, F., & Daiski, I. (1993). Teaching baccalaureate nursing students Parse's theory of human becoming: An evaluation study. Unpublished manuscript, Ryerson Polytechnic University, School of Nursing, Toronto, Ontario, Canada.
16.
Legault, F., & Ferguson-Paré, M. (1999). Advancing nursing practice: An evaluation study of Parse's theory of human becoming. Canadian Journal of Nursing Leadership, 12(1), 30-35.
17.
Lowe, G.S. (2002, Summer). High-quality healthcare workplaces: A vision and action plan. Hospital Quarterly, 5(4), 49-56.
18.
Lynn, M.R., & Redman, R.W. (2005). Faces of the nursing shortage: Influence on staff nurses' intentions to leave their positions or nursing. Journal of NursingAdministration, 35, 264-270.
19.
McGillis Hall, L., Doran, D.I., Baker, G.R., Pink, G.H., Sidani, S., O'Brien-Pallas, L., et al. (2002). Nurse staffing and work status in medical, surgical and obstetrical units in Ontario teaching hospitals. Hospital Quarterly, 5(4), 64-68.
20.
Mitchell, G.J. (1995). Evaluation of the human becoming theory in practice in an acute care setting. In R. R. Parse (Ed.), Illuminations: The human becoming theory in practice and research (pp. 367-399). New York: National League for Nursing Press.
21.
Mitchell, G.J., Bournes, D.A., & Hollett, J. (2006). Human becoming—guided patient centered care: New perspectives transform nursing practice. Nursing Science Quarterly, 19, 218-224.
22.
Nicklin, W. (2001). “Thank you” isn't enough. Canadian Journal of Nursing Leadership, 14(3), 15-18.
23.
NRC+Picker Canada. (2006). Improving your workplace employee survey validation report. Available from NRC+Picker Canada, 7100 Woodbine Avenue, Suite 411, Markham, Ontario, Canada L3R 5J2.
24.
NRC+Picker Group. (2005). The confidence of knowing what's most important to her and the ability to deliver it. Retrieved August 20, 2005, from www.TheNRCPickerGroup.com
25.
Northrup, D.T., & Cody, W.K. (1998). Evaluation of the human becoming theory in practice in an acute care psychiatric setting. NursingScience Quarterly , 11, 23-30.
26.
O'Brien-Pallas, L., Doran, D.I., Murray. M., Cockerill, R., Sidani, S., Laurie-Shaw, B., et al. (2002). Evaluation of a client-care delivery model, Part 2: Variability in client outcomes in community home nursing. Nursing Economic$, 20, 13-36.
27.
O'Brien-Pallas, L., Thomson, D., Alksnis, C., & Bruce, S. (2001). The economic impact of nurse staffing decisions: Time to turn down another road?Hospital Quarterly, Spring, 42-50.
28.
Parse, R.R. (1998). The human becoming school of thought: A perspective for nurses and other health professionals. Thousand Oaks, CA: Sage.
29.
Parse, R.R. (2001). Qualitative inquiry: The path of sciencing. Sudbury, MA: Jones and Bartlett.
30.
Santopinto, M.D.A., & Smith, M.C. (1995). Evaluation of the human becoming theory in practice with adults and children. In R. R. Parse (Ed.), Illuminations: The human becoming theory in practice and research (pp. 309- 346). New York: National League for Nursing Press.
31.
Shields, M., & Wilkins, K. (2006). Findings from the 2005 national survey of the work and health of nurses. Ottawa, Canada: Statistics Canada and the Canadian Institute for Health Information.
32.
Tourangeau, A. (2006, March). The Ontario hospital nursing workforce . Paper presented at the Nursing Leadership Network of Ontario conference, Defining Our Future, Toronto, Canada.
33.
Williamson, G.J. (2000). The test of a nursing theory: A personal view. NursingScience Quarterly, 13, 124-128.
34.
Young-Mason, J. (1997). The patient's voice: Experiences of illness. Philadelphia: F. A. Davis.
