search, and evaluation task.
The literature exhibited particular gaps with regard to the initial problem that I was considering. For example, I began thinking about the difficulties of emergency room nursing care and the jeopardy to morale and job satisfaction that was just part of on-the-job exposure to the emergency room setting. Patients were often very badly hurt, but they were just as often in need of routine medical care for common, albeit uncomfortable conditions. Treating patients in emergency room settings often meant dealing with people who were violent toward those who were trying to care for them. In addition, much of the literature — for no apparent reason — was based on data and studies from non-American hospitals and emergency rooms. Dwindling resources in some locations meant fewer staff members to do the same amount of work in general hospitals and in emergency rooms. Physicians were often the focus of these studies rather than nursing staff. Balancing the preponderance of some kinds of studies and the dearth of others, I began to see a pattern that indicated a line of research: Job satisfaction of emergency room nurses in American hospitals. My search narrowed to the following key words: American hospital emergency rooms, emergency rooms, emergency room care, emergency care, emergency nurse, job satisfaction, job stress, job burnout, job fatigue, job turnover, workload, work engagement, and psychosomatic symptoms. Gradually, a mosaic of literature was compiled that illustrated the need for more research on job satisfaction and staff morale in nurses who practice in the emergency rooms of American hospitals.
B. Discuss the purpose of conducting a literature review of the chosen research topic.
The reasons for staff morale and job satisfaction for nurses working in the emergency rooms of American hospitals are not entirely clear. A considerable degree of generalization has occurred from nursing staff providing different types of care in a variety of settings to staff providing emergency room nursing care. Sweeping assumptions have been made about staff morale and job satisfaction of nursed which have tended to disregard the very different types of work that these nurses do, and the different types of practice demands they face in these several and distinct settings. This literature review was designed to gather research information about the different contributions made by settings that are both similar to and dramatically different from what is encountered in American hospital nursing room care.
C. Discuss at least two specific examples of how the literature review affected different components of a research proposal.
The relation between the hospital climate and job satisfaction was an unexpected finding. Of the several attributes that were associated with hospital climate, the one standout was having the opportunity for professional development. Some of the job dissatisfaction was expressed by CNAs and LPNs who do not experience many opportunities or avenues for professional betterment. An important aside was that registered nurses often expressed dissatisfaction with not being able to spend more time caring for patients, while the LPNs and the CNAs felt they were spending too much time on patient care with very few other alternatives, particularly opportunities for staff development. .
Experience with emergency room nursing care and the accuracy of concomitant work expectations led to higher job satisfaction. In other words, nurses who did not have accurate ideas about what emergency room nursing entailed were more likely to be dissatisfied with their jobs and to experience lower morale.
D. Explain how resource availability and selection limited the scope of your research topic.
Much of the research on job satisfaction of medical personnel focused on long-term care situations such as dialysis or acute care such as oncology. A body of research was also available on violence against nursing staff. One theme that was prevalent in the job satisfaction literature for hospital staff was shortages of staff and of beds. This theme did cross over into the emergency room nursing category since emergency rooms in some locations tend to be over-utilized by marginalized people who do not have medical insurance. The overarching problem was a dearth of literature specific to job satisfaction and morale in emergency room nursing staff.
E. Discuss how performing a literature review affects nursing practice in an emergency room setting.
The primary benefit to be derived from conducting a literature review of emergency room nursing care is that facets of the issue are made salient in the literature that were not initially viewed as contributing factors by the researcher. The result was a broader and deeper perspective about variables that impact job satisfaction and morale, and that have the potential to indirectly impact the quality of patient care Importantly, the process of doing a literature review can lead to discovery of new lines of research or perspectives that are wholly different from those of the researcher. Further, as the literature review is conducted, the relationship between the various studies becomes increasingly apparent. These insights would not be so readily available to the researcher were he or she not engaged in the process of considering each article against the other and more familiar studies.
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