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Organizational climate, communication, and role strain in clinical nursing faculty
Climate, Communication, and Role Organizational Strain in Clinical Nursing Faculty BARBARA
PISCOPO,
This study examined factors contributing to role strain experienced by clinical nursing faculty while they oversaw the cllnical experiences of nursing students. Specifically, the study focused on differences between clinical nursing faculty’s perceptlons of organizational climate and communication within affiliating agencies and perceptions of these factors held by their respective nursing unit managers in the affiliating agencies. Perceptions of organkational climate and communication were related to role strain reported by clinical nursing faculty, and predictors of role strain in clinical nursing faculty were identified. The instruments used for data collection were the Organizational Climate Questionnaire, Communication Within Organizations Questionnaire, and Role Strain Questionnaire. Data were analyzed using independent Student’s f Tests, Pearson Product-Moment Correlation Coefficients, and stepwise multiple regression analysis. Significant differences in perceptions of organizational climate were not found; however, clinical nursing faculty and nursing unit managers differed significantly in their perceptlon of communication. There was a significant positive correlation between organizational climate, communication, and reported role strain In clinical nursing faculty, and a linear relationship was demonstrated between reported role strain in clinical nursing faculty, perceptions of communication, and length of time on the nursing unit In the affiliating agency. (Index words: Communication; Faculty practice; Organizational climate; Role strain) J Prof Nurse 70:773-779, 7994. CopyrIght 0 7994 by W.B. Saunders Company
A
LTHOUGH
the education
of nurses
was once
completely interwoven with nursing service, today the educational process occurs almost exclusively within higher education. This move into higher education was necessary if nursing was to advance as a profession. However, been
without
the move into higher problems.
Clinical
education
has not
nursing
faculty
*Chair and Professor, Department of Nursing, Western Connecticut State University, Danbury, CT. Address correspondence and reprint requests to Dr Piscopo: Department of Nursing, Western Connecticut State University, 181 White St, Danbury, CT 06810. Copyright 0 1994 by W.B. Saunders Company 8755-7223/93/1002-000X$03.00/0
Jozm.wl of Profarsional Nursing, Vol 10, No 2 (March-April),
EDD, RN*
(CNF) spend a majority a second organization. formally
part of the structure
university viduals
of their teaching Although
within
faculty
many
hours
organizations
are
the college
with which they are associated, spend
affiliating
in hospitals
or
these indiand/or
other
where they oversee the clini-
cal practice
of nursing
ulty
spend
some of their
with
members
majority
time within
nursing
students.
Although
working
time
of other organizations,
of their teaching
time within
most facinteracting
CNF spend
a
a second orga-
nization and as a result may experience role strain or “difficulty in meeting given role demands” (Goode, 1960, p. 485). Role strain cannot be fully understood without addressing concepts of role theory. Linton (196 1) describes the concept of status as a particular pattern, with the concept of role representing the dynamic aspect of status. The actualizing
of a status by a person
is the performance of a role (p. 202). Roles are not actualized in a vacuum; roles are interactional, identify relationships, sary to understand
and are reciprocal. It is not necesevery aspect of the reciprocal role;
however, the clearer the understanding of the reciprocal role and its rights and responsibilities, the smoother the relationship between persons occupying their respective roles. Merton (1957) further refines the concept of role by identifying the “role-set,” which is the “complement of role relationships in which persons are involved by virtue of occupying a particular social status” or role (p. 110). Therefore,
a person occupying
a role inter-
acts with many other persons who are members of their role-set. The role-set for CNF includes members of the affiliating agency used as the clinical practice setting for students. The role-set for nursing unit managers includes CNF and students, therefore, the role-set for both groups is multiple and diverse. Role expectations-or the rights, privileges, duties, and obligations (Sarbin, 1968, p. 497) of nursing faculty while they are in the clinical practice setting-are numerous and diverse. As a result, there may be difficulty in fulfilling these expectations. Therefore, the faculty person must decide how to bal1994: pp 113- 119
113
114
BARBARA PISCOPO
ante these role obligations bility
in the affiliating
The ability
without
sacrificing
nizational
climate
and flow of information
agency.
The climate
within
people’s perceptions
(Litwin,
over the climate
They may influence
the climate
faculty do
of an organiover the long
term; however,
in the short term they are required the organizational
counter
is
Hum-
function
within
the
of what it is
1978, p. 187). Nursing
not have direct control zation.
on the orga-
of the organization
like to work in a given environment” phrey, & Wilson,
to the role-
agency will depend
affiliating
“a way of measuring
munication
were related
CNF. Finally,
to clarify role expectations
ser in the affiliating
credi-
agency.
climate
to
as they en-
nizational
predictors
climate,
the affiliating unit,
and length
and
terms
of their
climate
Organizational process
climate
also influences
within
the organization.
studies on organizational
climate
is related to communication Payne & Pugh, 1976). Nursing
of time in
with
the nursing
nursing
unit
examined
managers
perceptions
and communication
were:
differ
in
of organizational within
the affil-
agency.
In CNF,
In CNF,
nication
length
by
orga-
were identified.
CNF
iating
reported in CNF,
of time on the nursing
of time working
perceptions and
correlated
Nursing faculty do not have direct control over the climate of an organization.
length
The specific research hypotheses
climate
it.
communication,
agency,
unit manager
to role strain of role strain
of both organizational
communication
are positively
with role strain. role strain is linearly
related
to the
predictor variables of organizational climate, communication, length of time in the affiliating agency,
length
of time on the nursing
unit, and length of time nursing unit manager.
working
with
the
Method
the commuPrevious
SUBJECTS
suggest that climate (Muchinsky, 1977; faculty communicate
Permission to undertake CNF who oversaw student
this study with full-time experiences in acute care,
with the nursing unit manager and nursing staff among others on the unit. In essence, the clinical experience for students is planned in advance by the
in-patient settings was requested in writing from deans of baccalaureate schools of nursing accredited by the National League for Nursing and located within
nursing unit manager and the faculty person, and rhe success of the clinical experience in part is dependent on adequate communication between these parties. As
the New York metropolitan area. After receiving permission to collect data, the researcher met with the
Katz and Kahn (1966) note, “Communication-the exchange of information . is the very essence of and . (the accomplishment of . . . organizations work) depends on communication between people” (p. 233). Role strain
may result
as CNF
address
questions
regarding the nurse educator’s role, adequate preparation and socialization into the role of nurse educator, ability to articulate the role to the role-set, ability
faculty at each institution Ninety-eight nursing schools of nursing
as a group. faculty from
and the nursing
whom they were working the study.
baccalaureate
unit manager
were asked to participate
with in
MATERIALS
After receiving an explanation of the study, faculty were given a nursing unit manager identification
to function within higher education, and need to spend a significant amount of time within another organization (Jnfante, 1983; O’Connor, 1978). This study explored selected factors contributing to role strain experienced by CNF. Specifically, the study
form, faculty data form, and the following instruments: Organizational Climate Questionnaire (Litwin & Stringer, 1968), Communication Within Organizations Questionnaire (Roberts & O’Reilly, 1974), and Role Strain Questionnaire (O’Shea, 1982). The Organizational Climate Questionnaire consists
focused on differences between CNF perceptions of organizational climate and communication within affiliating agencies and the perceptions of these factors held by nursing unit managers in the affiliating agencies. Perceptions of organizational climate and com-
of 47 items, uses a four-point Likert scale response format, and has a reported reliability of .74 (Muchinsky, 1976). This instrument was used to measure perceptions held by CNF and nursing unit managers of the organizational climate or atmosphere within the
CLIMATE,
COMMUNICATION,
affiliating tional
agency.
climate
A positive
was reflected
score, and a negative composite
AND ROLE STRAIN
response
115
to organiza-
in a higher
Likert scale response of .70.
perceptions within
response was reflected
format,
in a lower
This instrument
communication
reli-
was used to measure or flow of information
agency.
was reflected
score, and a negative
A positive
response
in a higher
response was reflected
to
composite in a lower
score.
The Role Strain tionnaire,
and has a reported
of communication
the affiliating
composite
Questionnaire
uses a five-point
is a 32-item
Likert scale response
strain.
Faculty were asked first to identify the nursing unit manager with whom they were working during the semester, the affiliating agency, and the nursing unit represented by the manager. Faculty were then asked to complete the remaining questionnaires, using the identified nursing unit manager, affiliating agency, and nursing unit and data form.
as reference
for the questionnaires
Nursing unit managers identified were sent a letter by the researcher describing the study, identifying the CNF person and college they represented from whom the researcher obtained their name, requesting them to participate in the study, and identifying data collection instruments. No faculty person was overseeing student therefore, tributed
experiences
on more than one nursing
each CNF-nursing
unit
manager
Characteristic Age (yr) Teaching
Range
Mean
SD
26-60
41
9
in a baccalaureate
program (yr) Present position (yr) Working in identified affiliating
l-23 l-17
agency (mo) Working on identified unit (mo) Working with identified unit manager (mo)
8.65 6.52
5.94 4 90
2-240
48.48
50 25
1-136
36.19
28 68
l-48
12.94
1197
nursing nursing
for-
faculty experienced while they were overseeing the clinical practice experience of nursing students. A higher score reflected less strain, and a lower score greater
Faculty Data for Age, Teaching in a Baccalaureate Program, Years in Current Position, and Current Affiliating Agency
ques-
mat, and has a reported reliability of .90. This instrument was used to measure the degree of difficulty
reflected
1.
score.
The Communication Within Organizations Questionnaire consists of 35 items, uses a seven-point ability
TABLE
composite
unit;
set con-
only one score to the data set.
Results The questionnaires from 3 1 faculty and their respective nursing unit manager were accepted for analysis. Faculty data regarding the affiliating agency and educational preparation are given in Tables 1 and 2. Faculty background data, including information related to the faculty member’s association with the current affiliating agency, are presented in Table 1. Specifically, faculty reported that they had been affiliated with the agency for an average of 48.48 months (SD = 50.25), they had been overseeing the clinical
practice of nursing students on the identified nursing unit for an average of 36.19 months (SD = 28.68), and they had been working with the identified nursing unit manager for an average of 12.94 months (SD =
11.97).
Faculty data related to educational preparation are presented in Table 2. Specificallyl 70% (22) of the TABLE
2.
Faculty Data for Rank, Education, Previous Teaching Experience, Orientation, and Clinical Practice Characteristic
Current rank Instructor Assistant professor Associate professor Professor Highest degree held Master’s in nursing Nonnursing master’s Doctorate in nursing Nonnursing doctorate Clinical practice as part of master’s preparation Yes No Preparation for teaching in master’s degree Yes No Other teaching experience by program Diploma Associate degree Diploma and associate degree Orientation to current affiliating agency was provided by the agency Yes No Currently engage in clinical practice Yes No
No.
2 5 13 11 21 1 5 4
22 9 2a* 3 9 11 3
8 13 19 11
*Of the 28, 23 indicated that their master’s program included a clinical practicum focusing on clinical supervision of nursing students.
116
BARBARA PISCOPO
faculty reported
that clinical
practice
was included
part of their master’s degree program, reported
that preparation
their master’s
(23) of the 28 faculty included
for teaching
degree program.
a clinical
practicum
was included
Seventy-five
indicated
managers
focusing
t Test
for the total
managers tional
between
were analyzed
scores.
climate:
t(6O) =
average score for nursing (SD = 16.28). unit managers
(SD = unit
Perceptions
nursing
(SD =
unit
managers
(Table
analysis
.54; P <
(Y
=
best predicted
to
was computed
mul-
(Table
(P <
29%
the de-
a stepwise
4).
.OOl) of the
unit along with communication
climate,
and the
time
with
time in the agency, tion, the predictive
was 122.55
explained
other variables, the nursing
eg, organizational unit
also were entered
manager,
and
into the equa-
value of these variables
were neg-
ligible.
held very different
Discussion The decision
and the average score for
was 170.48
Product-Moment
3) were computed
manager
by CNF,
explained
in CNF. Although
(SD =
17.58).
Correlation between
to examine
differences
in perceptions
between CNF and nursing unit managers was based on the premise that members and nonmembers of an organization nization. Significant
Perceptions held by CNF were neutral, but nursing unit managers held a more positive perception of communication. Pearson
related
climate did not differ.
unit managers
14.69),
.41; P <
=
36% (P < .002) of the variance in role strain reported
unit
perceptions of communication with the organization: t(60) = - 3.95 ; P < .O 1. The average score for CNF was 154.23
regression
the nursing
of organiza-
managers
(Y
variance among role strain scores in CNF, and time on
unit
held by CNF and nursing
of organizational
CNF and nursing
tiple
Student’s
20.98),
unit
manager
was positively
which variable
Communication
1.19; P > .05. The average
score for CNF was 128.22
time with the nursing To determine
climate
and nursing
perceptions
unit
time on the unit
gree of role strain reported
on the clinical
independent CNF
held very similar
.Ol) and, .OOl).
per cent
CNF and nursing
using
in
time with the nursing
that this preparation
supervision of nursing students. Differences in perceptions of organizational and communication
as
and 98% (28)
hold different differences
perceptions in perceptions
of that orgaof organiza-
tional climate between CNF and nursing unit managers were not found. These results were surprising in
Coefficients
the research vari-
ables organizational climate, communication, time in the agency, time on the unit, time with the nursing
that it was expected of the organization,
unit manager, and role strain for CNF. CNF did not report a high degree of role strain. Communication
perceptions than head nurses, who are organizational members. One possible explanation for the lack of
was positively related to organizational climate (Y = .43; P -=L.Ol) and role strain (Y = .54; P < .OOl);
differences in perceptions of organizational climate among CNF and head nurses may be that 19 of the 3 1
organizational climate was positively related to role strain (Y = .39; P < .Ol); and role strain was positively related to time on the unit (Y = .4 1; P < .O 1).
faculty respondents engage in clinical nursing practice at some time during the academic year. The experi-
As expected, time in the agency was positively related to time on the nursing unit (Y = .54; P < .OOl) and TABLE
3.
that CNF, who are nonmembers would be less positive in their
ences encountered during practice may have brought these faculty’s perceptions more in line with the perceptions held by the nursing unit manager.
Correlation Matrix for the Variables Communication, Organizational Time in Agency, Time on Unit, and Time with Nursing Manager
Climate, Role Strain, Time With
Organizational
Communication Organizational climate Role strain Time in agency Time on unit Time with nursing manager ‘P =S .Ol. tP c ,001. fP s .05.
Role
Time in
Time on
Communication
Climate
Strain
Agency
Unit
1.00
.43* 1.00
.54t .39’ 1.00
.19 .13 .26 1 00
.08 .16 .30* .54t 1.00
Nursing Manager - .22 .lO - 03 41* .57t 1.00
117
CLIMATE, COMMUNICATION, AND ROLE STRAIN
TABLE
4.
Regression Table: Summary for the Variables Communication, Time on Nursing Unit, Organizational Climate, Time with Nursing Manager, and Time in Affiliating Agency Variable
Pearson r
P
6 Change
F Increment
(P) of F
Communication Time on nursing unit Organizational climate Time with nursing unit manager Time in affiliating agency
.54 .30 .39 -.03 .26
,289 ,357 .378 389 ,393
,289 ,067 ,021 011 ,003
11.80 7 76 5 47 4 14 3.23
,001 ,002 ,004 .Oi .02
Abbreviation:
RSQ,
There was a significant communication
between
difference
ferences
than did nursing in perception
of
unit manof com-
ther. Given
The dif-
cision making
of communication
within
the
CNF are not part of the formal communication network. Also, CNF usually spend a specified number of hours within the affiliating agencies while they overexperiences,
related
both
care without
to student
the pace at which hospitals must
function,
use the least amount
time, and effort. As nonmembers
learning
compromising
eide-
of energy,
of the organization,
CNF may find such decision making difficult to accomplish, because the flow communication within the organization is not as familiar to the faculty person as it is to members. Information on which to make decisions
may not be readily
available
to the faculty
person.
and so they have few oppor-
tunities to engage in informal, unscheduled nications with organizational members.
commu-
There was a significant positive correlation between perceptions of organizational climate and role strain in CNF. Where perceptions
decisions
needs and to patient
perception
affiliating agency between CNF and nursing unit managers may be related to the following fact: because they are not formally members of the organization,
see student
making
unit managers.
agers. CNF held a more negative munication
in perceptions
CNF and nursing
of organizational
climate
by
CNF were positive, CNF reported less role strain. Where CNF perceive the organizational climate of agencies to be positive, they feel comfortable oversee-
There was a significant difference in perceptions of communication between CNF and nursing unit managers.
ing student experiences within the agency, because it allows more latitude in meeting responsibilities. As a result, faculty are better able to fulfill their primary
CNF are under stress while overseeing student experiences within the affiliating agency, because they
obligation, which is the education of students. In addition, faculty may be more comfortable in an en-
and for the learning needs of students. While on the nursing unit, CNF may need time to gather information that is vital to an existing situation, a situation
vironment that is more open and that welcomes input from both members and nonmembers. Faculty feel free to share their knowledge
and expertise
with or-
ganizational members as well as to bring information and knowledge to their focal agency, the College of Nursing. There was a significant positive correlation between the perception of communication and reported role strain in CNF. Where perception of communication was positive, faculty reported less role strain. Although communication pervades all organizations, essential or meaningful communication may not be available to nonmembers or may not be perceived by nonmembers, such nication is necessary role responsibilities Within the clinical
as CNF. for CNF without setting,
However, good commuif they are to fulfill their experiencing role strain. CNF are responsible for
are concerned
both for the well-being
of the patient
that could not tolerate misunderstandings. The CNFs’ responsibility, then, is to seek out relevant information from organizational members at whatever level is necessary and to communicate it to students or other members of the focal agency, the College or School of Nursing. A linear role strain
relationship was demonstrated between and perception of communication and
length of time on the nursing unit. Of the variance in reported role strain scores, 36% could be explained by the independent variables perceived communication and length of time on the nursing unit. Decreased role strain may be dependent on “clear and consistent feedback from those around us” (Katz & Kahn, 1978, p. 25). This feedback is available primarily from members of the specific nursing unit where faculty oversee
118
BARBARA PISCOPO
student
experiences.
ing unit, faculty
A longer association
with a nurs-
in terms of the period of time over which the member
may influence
has supervised the nature
students
and amount
on the unit, of feedback
or
communication. Increased
length
of time on the nursing
provides faculty with the opportunity obtain information role strain.
of the nursing
nonverbal
communication
derstanding
“this
nonverbal
familiarity
unit patterns
specialization
language
permits
sion of information between
to learn how to with the
role strain
should
be developed
opportunity
to remain
for nurs-
Both have the abil-
to help reduce the incidence
of
unit
and other
faculty
current
proare not
these programs
faculty
may have the
voluntarily.
administrators
of moving
Frequent
members, &
so that
education
the wisdom
terns
need to consider
CNF from agency to agency or
to nursing moving
unit
within
affiliating
of CNF means that faculty
meaningful
relationships
a task that eventually
communication with
different
patagency
takes its toll on the
in terms of role strain.
Nursing education is aware that faculty practice is not rewarded in academia; however, faculty practice may help to reduce role strain in CNF, keep their clinical skills current, and enrich student learning in both the classroom and clinical setting. Therefore, it may be up to nursing education to develop a means to reward and so encourage nursing faculty to engage in
in CNF.
clinical practice. Finally, CNF, nursing unit managers, and nursing staff must clearly understand the role and responsibilities of an educator. The role of the educator is to
an orientation should be provided by nursing service for the faculty person e . . . . .
The nursing
are available,
have to re-establish
(Tushman
practice
Where formal programs
yet resources
agencies.
misunderstanding
in clinical
and
by encour-
available
and
transmis-
expertise,
grams where available.
Un-
verbal
their clinical
to participate
and channels.
actors who share the language”
ity and responsibility
faculty
from nursing
an economical
education.
aging
and
Scanlon, 1981, p. 291). The results of this study have implications ing service and nursing
maintain
and of verbal of both
and minimizes
faculty
Nursing
that is helpful in terms of reducing
There is an increased
functioning
unit also
nursing
provide a basis for research and scholarship
literature
contains
no information
on
the orientation of CNF to an affiliating agency in which the faculty person is assigned to oversee the
provide for the education of nursing students. However, the education of students cannot be provided at the expense of patient care, nor can patient care be provided
at the expense
of student
learning.
CNF
clinical experiences of nursing students. Of the 3 1 CNF who participated in his study, only 8 indicated
must be able to articulate and clarify, as necessary, their role to colleagues within nursing service. The ability to articulate and clarify this role is best learned
that they were provided
throughout
with a formal orientation
to
the affiliating agency. In the interest of patients, faculty, and students, an orientation should be provided by nursing service for the faculty person to attend before assuming responsibilities in the institution. CNF need to seek out and participate in an orientation, to identify their own needs for an orientation, and to be willing
to spend
the time needed
to learn
the system. Knowledge of the system could improve communication and provide a supportive environment for the faculty person to carry out the role of educator. Nursing administration may help reduce the gap between nursing service and nursing education, help
graduate
education
where
instruction,
role modeling, and mentoring is provided in preparation for the nurse educator’s role (Infante, 1983, p. 8). This study supports
the need for clear and consis-
tent communication between CNF and members of the affiliating agencies, primarily the nursing unit manager, where faculty oversee student clinical experiences. It also supports the need to maintain stable faculty assignments whenever possible within affiliating agencies. Both would enhance the collaborative efforts between nursing education and nursing service.
References Goode,
W. J. (1960).
Sociological Review, 25,
A theory of role strain. American
Infante, M. S. (1983, March). Nurse vs. nurse educator: Conflicting roles for the teacher of nursing. Nme Educator’s Opportmitia
b Innovations,
1, 4-5,
R. L. (1966). Social psychology of York: Wiley. Katz, D., & Kahn, R. L. (1978). Social psychology of organizations (2nd ed.). New York: Wiley. Linton, R. (1961). Status and role. In T. Parsons, E.
Katz, D., & Kahn,
organizations.
483-495.
8.
New
CLIMATE,
COMMUNICATION,
AND ROLE STRAIN
Shils, K. D. Naegele, and J. R. Pitts (Eds.), Theories of society(pp. 202-208). New York: Free Press of Glencoe, Inc. Litwin, G. H., Humphrey, J. W., & Wilson, T. B. (1978). Organizational climate: A proven tool for improving performance. In W. W. Burke (Ed.), The cutting edge: &went theory and practice in organizational development(pp. 187-206). LaJolla, CA: University Associates. Litwin, G., & Stringer, R. (1968). Motivation and organizational climate. Cambridge, MA: Harvard University Press. Merton, R. K. (1957). The role set: Problems in sociological theory. British Jotirnal of Sociology, 8, lob- 120. Muchinsky, P. M. (1976). An assessment of the Litwin and Stringer Organizational Climate Questionnaire: An empirical and theoretical explanation of the Sims and LaFollette study. Personal Psychology,29, 37 l-392. Muchinsky, P. M. (1977) Organizational communication: Relationship to organizational climate and job satisfaction. Academy of ManagementJournal, 20, 592-607.
119 O’Connor, A. (1978). Sources of conflict for faculty members. Journal of Nursing Education, 17, 35-38. O’Shea, H. S. (1982). Role orientation and role strain in clinical nursing faculty in baccalaureate programs. Nursing Research, 31, 306-3 10. Payne, R., & Pugh, D. (1976). Organizational structure and climate. In M. D. Dunnette (Ed.), Handbook of industrial and organizational psychology (pp. 1125-l 173). Chicago: Rand McNally. Roberts, K. H., & O’Reilly, C. A. (1974). Measuring organizational communication. Journal of Applied Psychology, 59, 321-326. Sarbin, T. R., & Allen, V. L. (1968). Role theory. In G. Lindzey & E. Aronson (Eds.), The handbook of social psychology(Vol. 1, 2nd ed, pp. O-O). Reading, MA: Addison-Wesley. Tushman, M. L., & Scanlon, T. G. (198 1). Boundaryspanning individuals: Their role in information transfer and their antecedents. Academy of ManagementJournal, 24, 289295.
PISCOPO,
This study examined factors contributing to role strain experienced by clinical nursing faculty while they oversaw the cllnical experiences of nursing students. Specifically, the study focused on differences between clinical nursing faculty’s perceptlons of organizational climate and communication within affiliating agencies and perceptions of these factors held by their respective nursing unit managers in the affiliating agencies. Perceptions of organkational climate and communication were related to role strain reported by clinical nursing faculty, and predictors of role strain in clinical nursing faculty were identified. The instruments used for data collection were the Organizational Climate Questionnaire, Communication Within Organizations Questionnaire, and Role Strain Questionnaire. Data were analyzed using independent Student’s f Tests, Pearson Product-Moment Correlation Coefficients, and stepwise multiple regression analysis. Significant differences in perceptions of organizational climate were not found; however, clinical nursing faculty and nursing unit managers differed significantly in their perceptlon of communication. There was a significant positive correlation between organizational climate, communication, and reported role strain In clinical nursing faculty, and a linear relationship was demonstrated between reported role strain in clinical nursing faculty, perceptions of communication, and length of time on the nursing unit In the affiliating agency. (Index words: Communication; Faculty practice; Organizational climate; Role strain) J Prof Nurse 70:773-779, 7994. CopyrIght 0 7994 by W.B. Saunders Company
A
LTHOUGH
the education
of nurses
was once
completely interwoven with nursing service, today the educational process occurs almost exclusively within higher education. This move into higher education was necessary if nursing was to advance as a profession. However, been
without
the move into higher problems.
Clinical
education
has not
nursing
faculty
*Chair and Professor, Department of Nursing, Western Connecticut State University, Danbury, CT. Address correspondence and reprint requests to Dr Piscopo: Department of Nursing, Western Connecticut State University, 181 White St, Danbury, CT 06810. Copyright 0 1994 by W.B. Saunders Company 8755-7223/93/1002-000X$03.00/0
Jozm.wl of Profarsional Nursing, Vol 10, No 2 (March-April),
EDD, RN*
(CNF) spend a majority a second organization. formally
part of the structure
university viduals
of their teaching Although
within
faculty
many
hours
organizations
are
the college
with which they are associated, spend
affiliating
in hospitals
or
these indiand/or
other
where they oversee the clini-
cal practice
of nursing
ulty
spend
some of their
with
members
majority
time within
nursing
students.
Although
working
time
of other organizations,
of their teaching
time within
most facinteracting
CNF spend
a
a second orga-
nization and as a result may experience role strain or “difficulty in meeting given role demands” (Goode, 1960, p. 485). Role strain cannot be fully understood without addressing concepts of role theory. Linton (196 1) describes the concept of status as a particular pattern, with the concept of role representing the dynamic aspect of status. The actualizing
of a status by a person
is the performance of a role (p. 202). Roles are not actualized in a vacuum; roles are interactional, identify relationships, sary to understand
and are reciprocal. It is not necesevery aspect of the reciprocal role;
however, the clearer the understanding of the reciprocal role and its rights and responsibilities, the smoother the relationship between persons occupying their respective roles. Merton (1957) further refines the concept of role by identifying the “role-set,” which is the “complement of role relationships in which persons are involved by virtue of occupying a particular social status” or role (p. 110). Therefore,
a person occupying
a role inter-
acts with many other persons who are members of their role-set. The role-set for CNF includes members of the affiliating agency used as the clinical practice setting for students. The role-set for nursing unit managers includes CNF and students, therefore, the role-set for both groups is multiple and diverse. Role expectations-or the rights, privileges, duties, and obligations (Sarbin, 1968, p. 497) of nursing faculty while they are in the clinical practice setting-are numerous and diverse. As a result, there may be difficulty in fulfilling these expectations. Therefore, the faculty person must decide how to bal1994: pp 113- 119
113
114
BARBARA PISCOPO
ante these role obligations bility
in the affiliating
The ability
without
sacrificing
nizational
climate
and flow of information
agency.
The climate
within
people’s perceptions
(Litwin,
over the climate
They may influence
the climate
faculty do
of an organiover the long
term; however,
in the short term they are required the organizational
counter
is
Hum-
function
within
the
of what it is
1978, p. 187). Nursing
not have direct control zation.
on the orga-
of the organization
like to work in a given environment” phrey, & Wilson,
to the role-
agency will depend
affiliating
“a way of measuring
munication
were related
CNF. Finally,
to clarify role expectations
ser in the affiliating
credi-
agency.
climate
to
as they en-
nizational
predictors
climate,
the affiliating unit,
and length
and
terms
of their
climate
Organizational process
climate
also influences
within
the organization.
studies on organizational
climate
is related to communication Payne & Pugh, 1976). Nursing
of time in
with
the nursing
nursing
unit
examined
managers
perceptions
and communication
were:
differ
in
of organizational within
the affil-
agency.
In CNF,
In CNF,
nication
length
by
orga-
were identified.
CNF
iating
reported in CNF,
of time on the nursing
of time working
perceptions and
correlated
Nursing faculty do not have direct control over the climate of an organization.
length
The specific research hypotheses
climate
it.
communication,
agency,
unit manager
to role strain of role strain
of both organizational
communication
are positively
with role strain. role strain is linearly
related
to the
predictor variables of organizational climate, communication, length of time in the affiliating agency,
length
of time on the nursing
unit, and length of time nursing unit manager.
working
with
the
Method
the commuPrevious
SUBJECTS
suggest that climate (Muchinsky, 1977; faculty communicate
Permission to undertake CNF who oversaw student
this study with full-time experiences in acute care,
with the nursing unit manager and nursing staff among others on the unit. In essence, the clinical experience for students is planned in advance by the
in-patient settings was requested in writing from deans of baccalaureate schools of nursing accredited by the National League for Nursing and located within
nursing unit manager and the faculty person, and rhe success of the clinical experience in part is dependent on adequate communication between these parties. As
the New York metropolitan area. After receiving permission to collect data, the researcher met with the
Katz and Kahn (1966) note, “Communication-the exchange of information . is the very essence of and . (the accomplishment of . . . organizations work) depends on communication between people” (p. 233). Role strain
may result
as CNF
address
questions
regarding the nurse educator’s role, adequate preparation and socialization into the role of nurse educator, ability to articulate the role to the role-set, ability
faculty at each institution Ninety-eight nursing schools of nursing
as a group. faculty from
and the nursing
whom they were working the study.
baccalaureate
unit manager
were asked to participate
with in
MATERIALS
After receiving an explanation of the study, faculty were given a nursing unit manager identification
to function within higher education, and need to spend a significant amount of time within another organization (Jnfante, 1983; O’Connor, 1978). This study explored selected factors contributing to role strain experienced by CNF. Specifically, the study
form, faculty data form, and the following instruments: Organizational Climate Questionnaire (Litwin & Stringer, 1968), Communication Within Organizations Questionnaire (Roberts & O’Reilly, 1974), and Role Strain Questionnaire (O’Shea, 1982). The Organizational Climate Questionnaire consists
focused on differences between CNF perceptions of organizational climate and communication within affiliating agencies and the perceptions of these factors held by nursing unit managers in the affiliating agencies. Perceptions of organizational climate and com-
of 47 items, uses a four-point Likert scale response format, and has a reported reliability of .74 (Muchinsky, 1976). This instrument was used to measure perceptions held by CNF and nursing unit managers of the organizational climate or atmosphere within the
CLIMATE,
COMMUNICATION,
affiliating tional
agency.
climate
A positive
was reflected
score, and a negative composite
AND ROLE STRAIN
response
115
to organiza-
in a higher
Likert scale response of .70.
perceptions within
response was reflected
format,
in a lower
This instrument
communication
reli-
was used to measure or flow of information
agency.
was reflected
score, and a negative
A positive
response
in a higher
response was reflected
to
composite in a lower
score.
The Role Strain tionnaire,
and has a reported
of communication
the affiliating
composite
Questionnaire
uses a five-point
is a 32-item
Likert scale response
strain.
Faculty were asked first to identify the nursing unit manager with whom they were working during the semester, the affiliating agency, and the nursing unit represented by the manager. Faculty were then asked to complete the remaining questionnaires, using the identified nursing unit manager, affiliating agency, and nursing unit and data form.
as reference
for the questionnaires
Nursing unit managers identified were sent a letter by the researcher describing the study, identifying the CNF person and college they represented from whom the researcher obtained their name, requesting them to participate in the study, and identifying data collection instruments. No faculty person was overseeing student therefore, tributed
experiences
on more than one nursing
each CNF-nursing
unit
manager
Characteristic Age (yr) Teaching
Range
Mean
SD
26-60
41
9
in a baccalaureate
program (yr) Present position (yr) Working in identified affiliating
l-23 l-17
agency (mo) Working on identified unit (mo) Working with identified unit manager (mo)
8.65 6.52
5.94 4 90
2-240
48.48
50 25
1-136
36.19
28 68
l-48
12.94
1197
nursing nursing
for-
faculty experienced while they were overseeing the clinical practice experience of nursing students. A higher score reflected less strain, and a lower score greater
Faculty Data for Age, Teaching in a Baccalaureate Program, Years in Current Position, and Current Affiliating Agency
ques-
mat, and has a reported reliability of .90. This instrument was used to measure the degree of difficulty
reflected
1.
score.
The Communication Within Organizations Questionnaire consists of 35 items, uses a seven-point ability
TABLE
composite
unit;
set con-
only one score to the data set.
Results The questionnaires from 3 1 faculty and their respective nursing unit manager were accepted for analysis. Faculty data regarding the affiliating agency and educational preparation are given in Tables 1 and 2. Faculty background data, including information related to the faculty member’s association with the current affiliating agency, are presented in Table 1. Specifically, faculty reported that they had been affiliated with the agency for an average of 48.48 months (SD = 50.25), they had been overseeing the clinical
practice of nursing students on the identified nursing unit for an average of 36.19 months (SD = 28.68), and they had been working with the identified nursing unit manager for an average of 12.94 months (SD =
11.97).
Faculty data related to educational preparation are presented in Table 2. Specificallyl 70% (22) of the TABLE
2.
Faculty Data for Rank, Education, Previous Teaching Experience, Orientation, and Clinical Practice Characteristic
Current rank Instructor Assistant professor Associate professor Professor Highest degree held Master’s in nursing Nonnursing master’s Doctorate in nursing Nonnursing doctorate Clinical practice as part of master’s preparation Yes No Preparation for teaching in master’s degree Yes No Other teaching experience by program Diploma Associate degree Diploma and associate degree Orientation to current affiliating agency was provided by the agency Yes No Currently engage in clinical practice Yes No
No.
2 5 13 11 21 1 5 4
22 9 2a* 3 9 11 3
8 13 19 11
*Of the 28, 23 indicated that their master’s program included a clinical practicum focusing on clinical supervision of nursing students.
116
BARBARA PISCOPO
faculty reported
that clinical
practice
was included
part of their master’s degree program, reported
that preparation
their master’s
(23) of the 28 faculty included
for teaching
degree program.
a clinical
practicum
was included
Seventy-five
indicated
managers
focusing
t Test
for the total
managers tional
between
were analyzed
scores.
climate:
t(6O) =
average score for nursing (SD = 16.28). unit managers
(SD = unit
Perceptions
nursing
(SD =
unit
managers
(Table
analysis
.54; P <
(Y
=
best predicted
to
was computed
mul-
(Table
(P <
29%
the de-
a stepwise
4).
.OOl) of the
unit along with communication
climate,
and the
time
with
time in the agency, tion, the predictive
was 122.55
explained
other variables, the nursing
eg, organizational unit
also were entered
manager,
and
into the equa-
value of these variables
were neg-
ligible.
held very different
Discussion The decision
and the average score for
was 170.48
Product-Moment
3) were computed
manager
by CNF,
explained
in CNF. Although
(SD =
17.58).
Correlation between
to examine
differences
in perceptions
between CNF and nursing unit managers was based on the premise that members and nonmembers of an organization nization. Significant
Perceptions held by CNF were neutral, but nursing unit managers held a more positive perception of communication. Pearson
related
climate did not differ.
unit managers
14.69),
.41; P <
=
36% (P < .002) of the variance in role strain reported
unit
perceptions of communication with the organization: t(60) = - 3.95 ; P < .O 1. The average score for CNF was 154.23
regression
the nursing
of organiza-
managers
(Y
variance among role strain scores in CNF, and time on
unit
held by CNF and nursing
of organizational
CNF and nursing
tiple
Student’s
20.98),
unit
manager
was positively
which variable
Communication
1.19; P > .05. The average
score for CNF was 128.22
time with the nursing To determine
climate
and nursing
perceptions
unit
time on the unit
gree of role strain reported
on the clinical
independent CNF
held very similar
.Ol) and, .OOl).
per cent
CNF and nursing
using
in
time with the nursing
that this preparation
supervision of nursing students. Differences in perceptions of organizational and communication
as
and 98% (28)
hold different differences
perceptions in perceptions
of that orgaof organiza-
tional climate between CNF and nursing unit managers were not found. These results were surprising in
Coefficients
the research vari-
ables organizational climate, communication, time in the agency, time on the unit, time with the nursing
that it was expected of the organization,
unit manager, and role strain for CNF. CNF did not report a high degree of role strain. Communication
perceptions than head nurses, who are organizational members. One possible explanation for the lack of
was positively related to organizational climate (Y = .43; P -=L.Ol) and role strain (Y = .54; P < .OOl);
differences in perceptions of organizational climate among CNF and head nurses may be that 19 of the 3 1
organizational climate was positively related to role strain (Y = .39; P < .Ol); and role strain was positively related to time on the unit (Y = .4 1; P < .O 1).
faculty respondents engage in clinical nursing practice at some time during the academic year. The experi-
As expected, time in the agency was positively related to time on the nursing unit (Y = .54; P < .OOl) and TABLE
3.
that CNF, who are nonmembers would be less positive in their
ences encountered during practice may have brought these faculty’s perceptions more in line with the perceptions held by the nursing unit manager.
Correlation Matrix for the Variables Communication, Organizational Time in Agency, Time on Unit, and Time with Nursing Manager
Climate, Role Strain, Time With
Organizational
Communication Organizational climate Role strain Time in agency Time on unit Time with nursing manager ‘P =S .Ol. tP c ,001. fP s .05.
Role
Time in
Time on
Communication
Climate
Strain
Agency
Unit
1.00
.43* 1.00
.54t .39’ 1.00
.19 .13 .26 1 00
.08 .16 .30* .54t 1.00
Nursing Manager - .22 .lO - 03 41* .57t 1.00
117
CLIMATE, COMMUNICATION, AND ROLE STRAIN
TABLE
4.
Regression Table: Summary for the Variables Communication, Time on Nursing Unit, Organizational Climate, Time with Nursing Manager, and Time in Affiliating Agency Variable
Pearson r
P
6 Change
F Increment
(P) of F
Communication Time on nursing unit Organizational climate Time with nursing unit manager Time in affiliating agency
.54 .30 .39 -.03 .26
,289 ,357 .378 389 ,393
,289 ,067 ,021 011 ,003
11.80 7 76 5 47 4 14 3.23
,001 ,002 ,004 .Oi .02
Abbreviation:
RSQ,
There was a significant communication
between
difference
ferences
than did nursing in perception
of
unit manof com-
ther. Given
The dif-
cision making
of communication
within
the
CNF are not part of the formal communication network. Also, CNF usually spend a specified number of hours within the affiliating agencies while they overexperiences,
related
both
care without
to student
the pace at which hospitals must
function,
use the least amount
time, and effort. As nonmembers
learning
compromising
eide-
of energy,
of the organization,
CNF may find such decision making difficult to accomplish, because the flow communication within the organization is not as familiar to the faculty person as it is to members. Information on which to make decisions
may not be readily
available
to the faculty
person.
and so they have few oppor-
tunities to engage in informal, unscheduled nications with organizational members.
commu-
There was a significant positive correlation between perceptions of organizational climate and role strain in CNF. Where perceptions
decisions
needs and to patient
perception
affiliating agency between CNF and nursing unit managers may be related to the following fact: because they are not formally members of the organization,
see student
making
unit managers.
agers. CNF held a more negative munication
in perceptions
CNF and nursing
of organizational
climate
by
CNF were positive, CNF reported less role strain. Where CNF perceive the organizational climate of agencies to be positive, they feel comfortable oversee-
There was a significant difference in perceptions of communication between CNF and nursing unit managers.
ing student experiences within the agency, because it allows more latitude in meeting responsibilities. As a result, faculty are better able to fulfill their primary
CNF are under stress while overseeing student experiences within the affiliating agency, because they
obligation, which is the education of students. In addition, faculty may be more comfortable in an en-
and for the learning needs of students. While on the nursing unit, CNF may need time to gather information that is vital to an existing situation, a situation
vironment that is more open and that welcomes input from both members and nonmembers. Faculty feel free to share their knowledge
and expertise
with or-
ganizational members as well as to bring information and knowledge to their focal agency, the College of Nursing. There was a significant positive correlation between the perception of communication and reported role strain in CNF. Where perception of communication was positive, faculty reported less role strain. Although communication pervades all organizations, essential or meaningful communication may not be available to nonmembers or may not be perceived by nonmembers, such nication is necessary role responsibilities Within the clinical
as CNF. for CNF without setting,
However, good commuif they are to fulfill their experiencing role strain. CNF are responsible for
are concerned
both for the well-being
of the patient
that could not tolerate misunderstandings. The CNFs’ responsibility, then, is to seek out relevant information from organizational members at whatever level is necessary and to communicate it to students or other members of the focal agency, the College or School of Nursing. A linear role strain
relationship was demonstrated between and perception of communication and
length of time on the nursing unit. Of the variance in reported role strain scores, 36% could be explained by the independent variables perceived communication and length of time on the nursing unit. Decreased role strain may be dependent on “clear and consistent feedback from those around us” (Katz & Kahn, 1978, p. 25). This feedback is available primarily from members of the specific nursing unit where faculty oversee
118
BARBARA PISCOPO
student
experiences.
ing unit, faculty
A longer association
with a nurs-
in terms of the period of time over which the member
may influence
has supervised the nature
students
and amount
on the unit, of feedback
or
communication. Increased
length
of time on the nursing
provides faculty with the opportunity obtain information role strain.
of the nursing
nonverbal
communication
derstanding
“this
nonverbal
familiarity
unit patterns
specialization
language
permits
sion of information between
to learn how to with the
role strain
should
be developed
opportunity
to remain
for nurs-
Both have the abil-
to help reduce the incidence
of
unit
and other
faculty
current
proare not
these programs
faculty
may have the
voluntarily.
administrators
of moving
Frequent
members, &
so that
education
the wisdom
terns
need to consider
CNF from agency to agency or
to nursing moving
unit
within
affiliating
of CNF means that faculty
meaningful
relationships
a task that eventually
communication with
different
patagency
takes its toll on the
in terms of role strain.
Nursing education is aware that faculty practice is not rewarded in academia; however, faculty practice may help to reduce role strain in CNF, keep their clinical skills current, and enrich student learning in both the classroom and clinical setting. Therefore, it may be up to nursing education to develop a means to reward and so encourage nursing faculty to engage in
in CNF.
clinical practice. Finally, CNF, nursing unit managers, and nursing staff must clearly understand the role and responsibilities of an educator. The role of the educator is to
an orientation should be provided by nursing service for the faculty person e . . . . .
The nursing
are available,
have to re-establish
(Tushman
practice
Where formal programs
yet resources
agencies.
misunderstanding
in clinical
and
by encour-
available
and
transmis-
expertise,
grams where available.
Un-
verbal
their clinical
to participate
and channels.
actors who share the language”
ity and responsibility
faculty
from nursing
an economical
education.
aging
and
Scanlon, 1981, p. 291). The results of this study have implications ing service and nursing
maintain
and of verbal of both
and minimizes
faculty
Nursing
that is helpful in terms of reducing
There is an increased
functioning
unit also
nursing
provide a basis for research and scholarship
literature
contains
no information
on
the orientation of CNF to an affiliating agency in which the faculty person is assigned to oversee the
provide for the education of nursing students. However, the education of students cannot be provided at the expense of patient care, nor can patient care be provided
at the expense
of student
learning.
CNF
clinical experiences of nursing students. Of the 3 1 CNF who participated in his study, only 8 indicated
must be able to articulate and clarify, as necessary, their role to colleagues within nursing service. The ability to articulate and clarify this role is best learned
that they were provided
throughout
with a formal orientation
to
the affiliating agency. In the interest of patients, faculty, and students, an orientation should be provided by nursing service for the faculty person to attend before assuming responsibilities in the institution. CNF need to seek out and participate in an orientation, to identify their own needs for an orientation, and to be willing
to spend
the time needed
to learn
the system. Knowledge of the system could improve communication and provide a supportive environment for the faculty person to carry out the role of educator. Nursing administration may help reduce the gap between nursing service and nursing education, help
graduate
education
where
instruction,
role modeling, and mentoring is provided in preparation for the nurse educator’s role (Infante, 1983, p. 8). This study supports
the need for clear and consis-
tent communication between CNF and members of the affiliating agencies, primarily the nursing unit manager, where faculty oversee student clinical experiences. It also supports the need to maintain stable faculty assignments whenever possible within affiliating agencies. Both would enhance the collaborative efforts between nursing education and nursing service.
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COMMUNICATION,
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