Impact of Organization and Career Commitment on Clinical Nursing Competency.

Abstract

The majority of nurses are employed at medical institutions and acquire clinical competency through their work within their organization. Hands-on experience in the clinical setting is essential to enhance a nurse's clinical competence. The objective of this study was to determine the impact of commitment to the practical skills of nurses within Tottori prefecture. We studied data from 916 nurses employed at 7 publicly-funded medical facilities (national and other public institutions). Data on basic information, clinical nursing competence, and commitment were collected via an anonymous self-administered questionnaire. A total of 672 valid questionnaires were analyzed. Mean clinical nursing competence scores showed a tendency to increase with years of experience. Scores increased from years 1 to 4, and then tended to plateau or decrease slightly thereafter up to around year 9. Mean commitment scores decreased from 1 to 2 years of experience to 3 to 4 years of experience. Other than "normative factors," mean scores tended to increase after 5 to 10 years of experience. Multiple regression analysis showed that "job involvement" at 1 to 2 years; "overall job satisfaction" at 5 to 9 years; "career commitment" at 10 to 19 years; and "job involvement" and "career commitment" at ≥ 20 years impacted results. No factors appeared to have an influence on nurses in their 3rd to 4th year of experience. Based on the concepts described above, self-assessment of nursing competence scores tended to improve with years of experience. Mean commitment scores tended to decrease after 3 to 4 years of experience and thereafter plateaued or increased. Organizational commitment has not clearly been shown to affect nursing competency, but the factors that affect this parameter changed with the length of experience. Results suggest support is needed in the 1st and 2nd years to help nurses adapt to the organization while in years 5 through 9, support that takes work-life balance into consideration is needed. This indicates support should change to meet the needs of each stage in a nurse's career. In years 3 to 4, it was suspected that the nurses' relationship with the organization weakened. Helping nurses forge a good relationship with their organization is believed to be effective in improving clinical competency in nurses with 5 or more years of experience.