'You get used to it': Working with trauma in a burns unit of a South African children's hospital

I report here on the first stages of my work as a consultant clinical psychologist in a burns unit of a South African children's hospital. I show how the enormous trauma of the work leads inevitably to the adoption of defences on the part of staff against the pain and load of their work. I use the writing of Menzies Lyth and other authors as a basis for understanding staff defences in their daily work. I then describe the process whereby it has become possible to institute a form of group support for the staff. It has been important to think not only of the maladaptive but also of the helpful function of defences, and to recognize the staff's need for continuity and acceptance on the part of the consultant.     

Recruitment sources and organizational attraction: A field study of Belgian nurses

Previous research on recruitment sources has mostly focused on posthire instead of prehire outcomes and has typically applied a very rudimentary classification of sources on the basis of the formal–informal distinction. The present study relied on a theory-driven taxonomy to identify four major types of recruitment sources (recruitment advertising, recruitment events, publicity, and word of mouth) and applied a source credibility perspective to predict differential relationships of these sources with organizational attractiveness. In a sample of 184 job-seeking nurses in Belgium, characterized by a high labour market demand, it was found that job seekers who spent more time on receiving employment information through experiential recruitment sources such as events and word of mouth perceived this information as more credible. In addition, job seekers' exposure to word of mouth was strongly positively related to their attraction to organizations as an employer. This relationship was partially mediated by the perceived credibility of the received employment information. Therefore, the results of this field study suggest that to enhance their attractiveness as an employer for job seekers, especially those in high demand on the labour market, recruiting organizations should provide credible employment information and stimulate the use of word of mouth as a recruitment source.     

Amélioration de la qualité de vie au travail dans les unités de soins : la démarche ORSOSA

Improve the quality of working conditions is a major issue for healthcare workers who have to deal with productivity obligations and multiple procedures. Based on the magnet hospital concept, the ORSOSA study (prospective cohort study of 4000 helthcare workers) helped develop and validate a methodolody that allows to quickly diagnose the levels of psychological and organizational constraints (CPO) from the staff’s point of view / of the staff. The ORSOSA method relies on an organisational psychologist who launches a dynamic during the diagnostic feedback phase. He gets the team to appropriate the strengths and weaknesses and to rank their recommendations. This article presents an overview of the method and it the first stages of its evaluations.     

Représentations professionnelles,satisfaction au travail et choix de carrière des personnels infirmiers : le rôle des valeurs d’autonomie

We are interested in factors which can incite nurses to abandon their profession. In this frame, job satisfaction appears as a major explanatory factor, depending on the status granted to nurses’ “own role”. Besides, several studies show the importance of values concerning job satisfaction. Then, and in reference to the concept of professional representations, we consider that nurses’ job satisfaction depends on the importance of the own role in the representation of their function, all the more that Autonomy values are essential for them. A study, realized with regis tered and student nurses, confirm this approach, so underlining the crucial role of these values for the job satisfaction of nurses.     

Specific relationships between job demands, job resources and psychological outcomes and the mediating role of negative work-home interference

This study among 115 US and 260 Dutch nurses and nurse assistants tested a theoretically derived model of specific relationships between work characteristics and two theoretically distinct outcomes (i.e., emotional exhaustion and job satisfaction). Furthermore, the mediating role of negative work-home interference (NWI) in this context was examined. It was hypothesized that emotional exhaustion is related to job demands (i.e., psychological and emotional demands), and that job satisfaction is primarily associated with job resources (i.e., job control). Workplace social support was proposed to relate to both outcomes. In addition, we expected NWI to partially mediate the hypothesized relationships. Finally, we expected this pattern to be similar across the two samples. Structural equation modeling (LISREL) indicated (1) that our postulated model largely fitted to the data in both samples (same pattern), and (2) that NWI partially mediated the relationship between psychological job demands and emotional exhaustion in the Dutch sample. It can be concluded that the results supported our proposed pattern of specific relationships and, to a lesser extent, the partial mediating role of NWI. Practical implications and methodological limitations were discussed.     

Engaging in upward and downward comparisons as a determinant of relative deprivation at work: A longitudinal study

A longitudinal study was conducted among 93 nurses to determine the role of comparing one’s performance with that of one’s colleagues in the increase versus decrease of perceived relative deprivation at work over a period of one year. Relative deprivation at T2 had increased particularly among those high in social comparison orientation (Gibbons & Buunk, 1999) who at T1 (1) more frequently engaged in upward comparisons; (2) more frequently derived positive as well as negative feelings from such comparisons; and (3) more frequently derived negative feelings from downward comparison. Moreover, engaging in downward comparison also led to an increase in perceived relative deprivation at T2. This study is one of the few to find evidence for longitudinal effects of social comparison activity, and the first to find that such effects occur only for those high in social comparison orientation.     

Le burnout chez les infirmières en cancérologie : Une approche contextuelle du modèle exigences-contrôle-soutien

The current investigation, studying the burnout among oncology nurses, was guided by the Demand Control Support model (Karasek & Theorell, 1990). However, in accordance with scholars claiming for a context-specificity in occupational stress research, we first conducted 3 semi-structured focus groups to identify the specific sources of demands, control and support experienced by oncology nurses. The scale established from this analysis, (as well the other study variables), had been answered by 144 oncology nurses. Factorial analyses revealed 4 latent factors: “job demands”, “patient demands”, “support” and “control”. Then, hierarchical regression analyses indicated that job demands, control and support predicted significant proportions of burnout, in particular emotional exhaustion. We also observed a moderator effect of social support. Furthermore, the situation-specific stressors, that is, those relating to difficult relationships with patients, made significant contributions to burnout, supporting the claim of augmenting the components of the Demand Control Support model with stressors that are more situation- specific.     

Liens entre vécu au travail et bien-être subjectif des infirmier(ère)s : des effets réciproques

The purpose of the present study was to explore links between job perceptions (working conditions, intrinsic and relational aspects of job satisfaction) and subjective well-being (life satisfaction, global health, mental health). Two hundred and seventy-three nurses working in a provincial hospital answered to a questionnaire (open and closed questions). Results support globally the hypothesis of mutual influences between job perceptions and subjective well-being. These findings are discussed in relation to differences between participants, depending of workplaces (hospital services) and negative interferences between work and private life.     

Engaging Nurses in Genetics: The Strategic Approach of the NHS National Genetics Education and Development Centre

The UK government announced the establishment of an NHS National Genetics Education and Development Centre in its Genetics White Paper. The Centre aims to lead and coordinate developments to enhance genetics literacy of health professionals. The nursing program takes a strategic approach based on Ajzen’s Theory of Planned Behavior, using the UK nursing genetics competences as the platform for development. The program team uses innovative approaches to raise awareness of the relevance of genetics, working collaboratively with policy stakeholders, as key agents of change in promoting competence. Providing practical help in preparing learning and teaching resources lends further encouragement. Evaluation of the program is dependent on gathering baseline data, and the program has been informed by an education needs analysis. The challenges faced are substantial and necessitate international collaboration where expertise and resources can be shared to produce a global system of influence to facilitate the engagement of non-genetic nurses.     

Judgmental relativism as a validity threat to standardized psychiatric rating scales

Judgemental relativism is a threat to the replicability and validity of measures of client behavior from direct rating scales whenever raters are exposed to different levels of client functioning since the internal standards, or anchor points, used to judge dimensional continua may vary on the basis of prior experience. Traditional interrater reliability indexes fail to identify such effects. The influence of judgmental relativism on summated ratings from the Nurses Observational Scale for Inpatient Evaluation (NOSIE-30) for 1040 adult mentally ill clients was examined with clinical staff raters from 24 treatment units in which the Time-Sample Behavioral Checklist (TSBC) provided full-week objective measures of actual client functioning via hourly direct observational coding (DOC). Regression analyses found that the same level of objective performance received higher or lower ratings across treatment units dependent on the raters'exposure to client groups that differed in level of functioning. Analyses of rating errors found that clients with better levels of functioning relative to others within treatment units were rated even higher than performance warranted. The operation of halo and contrast effects is explored and guidelines are provided for determining when judgmental relativism may produce or nullify significant differences. DOC assessments should be used instead of retrospective ratings to support most decisions in residential settings. Specific recommendations for the application of rating scales and improving data quality are provided.This study was the basis of a master's thesis at the University of Houston by Betty E. Rich under the direction of Gordon L. Paul and Marco J. Mariotto. Richard M. Rozelle, to whom appreciation is expressed for helpful comments, served on the examination committee. This study was partially supported by grants to Gordon L. Paul from the National Institute of Mental Health, Public Health Service (MH-15353; MH-25464); the Illinois Department of Mental Health and Developmental Disabilities; the Joyce Foundation; the MacArthur Foundation; the Owsley Foundation; the Cullen Foundation; and the Center for Public Policy, University of Houston.