[95% CI]
Note. PES-NWI=Practice Environment Scale of the Nursing Work Index; OR =odds ratio; CI=confidence interval. For interpretability, we report standardized coefficients. Unadjusted estimates are based on models evaluating the effect of a predictor variable, separately, without accounting for any other covariates. Adjusted models account for nurse gender, education level, unit type, years of experience, and hospital characteristics including market competition with the Herfindahl–Hirschman index, teaching status, number of beds, technology level, ownership, state, and urban–rural location.
Our results related to job dissatisfaction show that nurses working in hospitals with better work environments and better staffing have lower odds of job dissatisfaction. When we added wage to the models, the effect of wage was significant, but the effects of work environment and staffing remained essentially unchanged. Thus, an odds ratio ( OR ) of 0.70 (95% confidence interval [CI] [0.67, 0.72]) for work environment suggests that even when we account for wage and all other covariates, nurses working at hospitals at the 50 th versus the 16 th percentile or the 84 th versus the 50 th percentiles in terms of the work environment had 30% lower odds of job dissatisfaction. The OR for both staffing ( OR =0.91; 95% CI [0.86, 0.95]) and wage ( OR =0.91; 95% CI [0.86, 0.96]) suggests that a one standard deviation change in either average wage or average staffing was associated with 9% lower odds of nurses reporting job dissatisfaction. The same was true for our models that substituted Magnet status as an indicator of a good work environment. The odds of job dissatisfaction was 18% ( OR =0.82; 95% CI [0.72, 0.94]) lower in Magnet compared with non-Magnet hospitals, accounting for wage and all other covariates.
Our results related to burnout were similar to job dissatisfaction. The notable exception was that there was no statistically significant relationship between wage and burnout in our adjusted models with either the PES-NWI ( OR for wage=0.96; 95% CI [0.91, 1.02] in the PES-NWI model) or Magnet status ( OR for wage=0.97; 95% CI [0.90, 1.04] in the Magnet status model).
Work environment and staffing were significantly associated with intent to leave even when we accounted for average wage. The one caveat was related to models measuring the work environment with the PES-NWI—when we go from a model not including wage to one that includes wage, the relationship between staffing and intent to leave becomes statistically insignificant at the p =.05 level ( p =.058). The estimate, however, remained essentially unchanged ( OR =0.93; 95% CI [0.86, 0.99] in the PES-NWI model without wage; OR =0.93; 95% CI [0.87, 1.00] in the PES-NWI model with wage). The estimates for staffing in models using Magnet status, both with and without the inclusion of wage, were statistically significant. Interactions between the work environment and wage, Magnet status and wage, and staffing and wage were not significant.
The significant association between more favorable nurse work environments and nurse outcomes, net of wage effects, implies that wages are important, but they do not account for the better outcomes associated with the work environment and nurse staffing. This supports earlier findings that more favorable work environments are associated with lower burnout, job dissatisfaction, and intent to leave across a number of sectors, including nursing ( Aiken et al., 2008 ; Kovner et al., 2006 , 2009 ; Maslach & Jackson, 1982 ; Stone et al., 2007 ). Our findings are also consistent with the literature demonstrating that it requires more than good pay to attract nurses into hospital employment and keep them working there ( McCloskey, 1974 ; Stone et al., 2007 ).
Transforming the organizational culture to support and integrate a model of professional nursing practice can be a valuable investment for hospitals ( DeBaca, Jones, & Tornabeni, 1993 ; Mark, Lindley, & Jones, 2009 ; Needleman & Hassmiller, 2009 ; Zelauskas & Howes, 1992 ), but it requires organizational willingness and commitment. The Magnet Recognition Program is one approach offering a concrete model for creating a good work environment for nurses. When we substituted Magnet hospital status as an indicator of the work environment, our findings showed that—holding wage constant—Magnet recognition was associated with lower odds of burnout, job dissatisfaction, and intent to leave. The Magnet estimates are likely conservative given the low ratio of Magnet hospitals.
The finding that a higher patient-to-nurse ratio was associated with job dissatisfaction and burnout, regardless of average wage, supports previous research ( Aiken et al., 2002 ). An excessive workload exhausts workers’ energy and makes recovery impossible. Effective and gratifying work—the satisfaction that comes from providing good quality care to patients—becomes less attainable. Although hiring more nurses can be costly, some of these costs would be offset by increased productivity, a reduction in turnover and retraining costs, and, more importantly, better patient outcomes ( Dall, Chen, Seifert, Maddox, & Hogan, 2009 ; Jones, 2004 ; Needleman & Hassmiller, 2009 ; Rothberg, Abraham, Lindenauer, & Rose, 2005 ).
Our intent was not to discount the importance of wage; wages are an important tool for administrators to use to attract and expand their workforce ( Buerhaus, 2008 ). Our goal, however, was to evaluate whether, as we found, the effects of the work environment and staffing persisted when we accounted for wage. The wage effect, as one might expect, was still important—except in the instance of burnout. Wage may do little to compensate for the conditions leading to burnout. Reforming underlying work conditions at the root of emotional exhaustion may be key to reducing and preventing burnout.
Although nurses are paid relatively well in the United States, wages are compressed ( Greipp, 2003 ) and hospitals can set nurses’ wages below their value ( Staiger, Spetz, & Phibbs, 2010 ). This has not gone unnoticed. Nurses, particularly those in direct patient care roles in hospitals and nursing homes, have reported dissatisfaction with wages, as well as nonwage benefits such as health care, tuition reimbursement, and retirement benefits ( McHugh et al., 2011 ). Wage rates and distribution should match nurse skill level to encourage entry into the profession and retention within the institution. Competitive wages, combined with good benefits and nonpecuniary factors, may be necessary to recruit adequate numbers of nurses to meet the ongoing care demands of the upcoming decades and prevent cyclical shortages that have defined the past half century ( Spetz & Adams, 2006 ; Spetz & Given, 2003 ).
Researchers have estimated that California increased wages 12% higher than other metropolitan hospitals outside of California between 2000 and 2006 ( Mark, Harless, & Spetz, 2009 ). It has been suggested that this rise in wages was a consequence of California’s mandate that limited the number of patients that nurses could care for at a given time. We also find that California’s hospital wages were higher compared with hospitals in the other states in our analysis. However, our models estimating the effect of wage, work environment, and staffing on nurse outcomes account for differences by state.
There are limitations to our study. Foremost, the cross-sectional design limited our ability to draw causal inferences. The study, however, strengthens the basis for causal inference by accounting for an important potential confounder that had previously been omitted from most research.
Another limitation is that our survey and wage data predate the economic recession that began at the end of 2007. In an environment where any job is difficult to find, the financial downturn could have tempered perceptions of less desirable aspects of the work environment. A number of factors, however, limit our concern here. The first is that, over the many investigations examining the association between work environment and nurse outcomes, the relationships that we found have been consistently identified regardless of time ( Aiken et al., 2002 ; Aiken & Patrician, 2000 ; Hare & Skinner, 1990 ; Kelly et al., 2011 ; Kutney-Lee et al., 2009 ; Larrabee et al., 2003 ; McHugh et al., 2011 ). What is important about our findings is that we show that these relationships persist when we account for wages as a potential confounder.
Furthermore, although work environments may improve over time, evidence suggests that where changes occur, they are associated with changes in nurse outcomes, that is, if work environments and staffing improve, rates of burnout, job dissatisfaction, and intent to leave decrease ( Kutney-Lee, Wu, Sloane, & Aiken, 2013 ). Additionally, research showed that the percentage of direct care hospital nurses who were very satisfied with their present job in 2006 (prerecession) was 29% compared with 28% in 2008 (during the recession). The percentage of nurses who would rate the quality of the salary and benefits package in their current or most recent work setting as excellent or very good was not significantly different from 2006 (28%) to 2008 (30%). Researchers also suggested that the recession effects on the nursing workforce were temporary ( Staiger, Auerbach, & Buerhaus, 2012 ). We expect that if we repeated our study today, we would find the same relationships. Nevertheless, additional study is warranted.
Another consideration is that our outcomes were nurse-specific, but our wage data were not. Although nurse-level wage data might have allowed a more refined analysis of the association between individual wage and our nurse outcomes, we expect that the gains would have been marginal given wage compression. Additionally, some rural hospitals are not represented in our data because there were an insufficient number of nurses from small hospitals for reliable estimates. Many of such hospitals are Critical Access Hospitals, which are not paid under the Inpatient Prospective Payment System (IPPS) and, therefore, were not required to complete the survey that was the source of our wage data.
We also do not measure union presence or membership, although evidence varies regarding how much of a premium unions confer ( Ash & Seago, 2004 ). We do, however, include many covariates we expect would at least partially account for the variation associated with unionization, including state and urban–rural indicators, teaching status, ownership, and size.
Last, the relative impact of wage on nurse outcomes may vary in different countries. Some studies conducted outside the United States, for example, have shown that dissatisfaction with wage played the biggest role with nurse job dissatisfaction and turnover ( Fochsen, Sjogren, Josephson, & Lagerstrom, 2005 ; Klopper, Coetzee, Pretorius, & Bester, 2012 ; Palmer, 2014 ). These studies, however, also found that characteristics of the work environment were important contributing factors. Multihospital studies outside the United States and cross-national studies would be valuable.
Our findings suggest that better wages do not explain the relationship between working in well-staffed hospitals with good practice environments and nurse outcomes such as nurse burnout, job dissatisfaction, and intent to leave. Although good wages are important, interventions that improve the work environment and maintain reasonable staffing levels may be more critical to attracting and retaining satisfied nurses in the hospital workforce.
The authors thank Ms. Mikaella Hill and Ms. Myra Eckenhoff for their assistance with the preparation of this manuscript.
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Robert Wood Johnson Foundation Nurse Faculty Scholars program (to M. D. McHugh) and the National Institute of Nursing Research (R01-NR-004513 and P30-NR-005043; PI: L. Aiken).
Matthew D. McHugh , PhD, JD, MPH, RN, FAAN is The Rosemarie Greco Term Endowed Associate Professor in Advocacy at the Center for Health Outcomes & Policy Research at the University of Pennsylvania School of Nursing.
Chenjuan Ma , PhD is a post-doctoral fellow with The National Database of Nursing Quality Indicators, University of Kansas Medical Center.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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In 21 states, employers cannot ask job candidates about their salary histories, but employers can nonetheless make inferences based on whether candidates voluntarily disclose them.
I n response to claims that historical salary differences related to race, gender, or ethnicity may be perpetuated when job applicants are asked to disclose their salary histories, 21 US states have made it illegal for employers to ask prospective employees about their prior compensation. Job applicants in these states may voluntarily disclose previous earnings. Prospective employers may draw conclusions about candidates’ unobserved attributes and outside options based on whether they make such disclosures.
In Salary History and Employer Demand: Evidence from a Two-Sided Audit (NBER Working Paper 29460 ) Amanda Y. Agan , Bo Cowgill , and Laura K. Gee study how information on an applicant’s salary history shapes wage offers and hiring in the labor market for software engineers. They find that not disclosing salary history decreases salary offers for both men and women.
The researchers created 2,048 fictional job applications based on typical characteristics of software engineering candidates. All applicants were college graduates from roughly equivalent schools with four to six years of experience at well-known firms. Biographical details such as gender, employment at different firms, and whether applicants disclosed their previous salary even when prospective employers did not ask were randomized. The applicants were assigned previous salaries between the 75th and 25th percentile of their prior employer’s salary scale for software engineers, as given at Payscale.com in the headquarter cities. A gender wage gap mimicking real-world gaps was built into the applicants by setting female salaries 15 percent lower.
Using an intermediary firm to pose as an employer, the researchers hired 256 US-based recruiters to evaluate the job applications. Each recruiter was given eight applications and a detailed job description. They were asked to recommend whether to call a candidate for an interview, an amount for a take-it-or-leave-it salary offer, and the maximum amount that the firm should be willing to pay the applicant. They also estimated the number of competing offers a candidate would receive and the salary offer each candidate would accept. Recruiters were paid their standard hourly rate and received incentive bonuses.
Recruiters made negative inferences about nondisclosing candidates, especially male nondisclosing candidates. On average, recruiters inferred that candidates who did not disclose had salaries at or slightly below the 25th percentile. Applicants below this level were better off not disclosing their previous pay, in the sense that they received higher offers. The fictional applicants who disclosed received higher mean recommended salaries, $103,993 versus $96,521. Recruiters estimated their mean outside offers to be 9 percent higher than those for nondisclosers .
There are many ways to earn a higher salary; the experiment was designed to measure whether employers notice these distinctions and treat them differently. Some of the candidates came from firms with a high average wage. Some candidates came from lower-wage firms, but were well-paid within their firm’s distribution. Some candidates were simply beneficiaries of the gender wage gap.
Employers in the experiment noticed these distinctions and adjusted their beliefs and choices. An extra $1 of reported salary given to men through the gender wage gap increased recruiters’ estimated value of the applicant to the firm by only $0.42. By comparison, high salaries earned by working at a high-wage firm or being well-paid within an employer’s internal distribution increased recruiters’ value of the worker by $0.64 to $0.70 per $1 of salary. The employers in the experiment detected overpaid men and treated them less generously than others with the same salary. However, they did not completely eliminate the gender wage gap.
The researchers conclude that employers see disclosing salary as a positive signal of candidate quality. However, salary history is also a signal of strong competing offers. A disclosure could increase chances of a callback, but decrease chances of getting a high salary offer, conditional on a callback. Candidates, employers and policymakers may thus face tradeoffs using and regulating salary history information.
— Linda Gorman
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The paper will focus on bias detection and mitigation strategies within these models. [login to view URL] Review on Biases and Ethical Issues in AI Tasks: Identify and gather key research papers, articles, and books on biases in AI and ethical considerations. Read and summarize the main points from the literature. Create an annotated bibliography.
Cabanac, a research-integrity sleuth, has already created software to flag thousands of problematic papers in the literature for issues such as computer-written text or disguised plagiarism.
IBM's sales in China have steadily declined in recent years. In 2023, IBM's revenue in the country dropped 19.6 per cent compared to a 1.6 per cent rise in revenue across Asia-Pacific ...
A plan to cut CSIRO's annual costs by at least $100 million and reduce support staff by up to 500 will threaten the agency's ability to collaborate with industry and prosecute the government ...
¯ Rural residents reported an average of 3.8 days/week that their life activities were restricted by their physical health compared to 2.5 days in non-rural areas, and for mental health an ...
IBM IBM-0.20%decrease; red down pointing triangle is shutting down its China research and development department, the latest retreat from the country by top U.S. technology companies. The company ...
Vice President Kamala Harris, the Democratic presidential nominee, has warned Americans about "Trump's Project 2025" agenda — even though former President Donald Trump doesn't claim the ...
It also matters to consumers, as shown by new research conducted by the authors of this paper. A firm with a high (1000 to 1) ratio needs to offer a 50 percent discount in order to garner as favorable consumer impressions as a firm with a low (5 to 1) pay ratio.
research as it contextualizes and studies these different aspects of the labor market. In a regression comparing salary and non-monetary factors, only two out of 16 dummy variables are statistically significant. Both are positive work conditions, but Benefits (Positive) decreases salary and Long Hours (Positive) increases salary.
Using a sample size of 200 R&D employees, this paper examines the relationship between the current salary and starting salary, previous experience, education, employees' age and gender. The ...
effect of salary on work motivation. The results of the t test for variable X (salary) obtained the value of t count = 7.817 with a. significance level of 0.000. By using the 0.05 significance ...
PDF | In this paper, we undertake two primary tasks. First, we describe trends in pay → performance research since 1990. Examining 30+ years allows us... | Find, read and cite all the research ...
In 2008 to 2009, 97% of beginning teachers whose first-year base salary was $40,000 or more were teaching, versus 87% of those whose first-year base salary was less than $40,000; in 2011 to 2012, these shares (using the same base salary cutoff) were 89% versus 80% (based on the Beginning Teacher Longitudinal Study, for the United States).
the quality of working life is employees' perception that they want. to feel safe, relatively satis fi ed and get a chance to be able to grow. and develop properly human (Ari fi n, 2012). The ...
Firms are allowed to use aggregate data on market salaries to set pay, a practice known as salary benchmarking. Using national payroll data, we study firms that gain access to a tool that reveals market benchmarks for each job title. Using a difference-indifferences design, we find that the benchmark information reduces salary dispersion by 25%.
academia.edu is a platform for academics to share research papers. salary and performance ... uganda christian university-mukono faculty of business and administration a research proposal research topic: relationship between salaries and level of employee performance case study: ucu academic staff by kato andrew reg.no: s12b06/317 flield ...
Across sectors, salaries for research positions were highest in the private sector ($130,000). The median salary for psychologists in management positions was $110,000. Higher salaries were found for positions directly supervising 5-20 people ($110,000), or indirectly supervising
A joint research paper by . ACCA and Mercer. , 1-30. Lyon, ... (2019), salary is one of the payment obligations given by an organization or business to their employees, ...
The purpose of presented study is to develop a model that measures the degree of difference in salary satisfaction and its impact on job satisfaction in public sector organizations and private ...
Although salary inquiry bans are still relatively new and further research is needed on the effects of voluntary disclosure versus nondisclosure, initial research is showing that the outcomes of salary inquiry bans may be the opposite of that intended by the proponents of the bans. ... Evidence from a field experiment (CESifo Working Paper No ...
Manag. 22: 102147-66. [Google Scholar] Research on compensation and employee benefits has enjoyed a long and rich history. Energized by a new generation of scholars, changes in the broader workplace context, and developments in adjacent areas of inquiry, many classic theoretical tensions and research questions have begun to evolve in novel ...
In today's world, salary is the primary source of motivation for many regular employees, which makes salary prediction very important for both employers and employees. It helps employers and employees to make estimations of the expected salary. Fortunately, technological advancements like Data Science and Machine Learning (ML) have made salary prediction more realistic. In this paper, we ...
This study tend to bridge this gap by identifying salary increase and its impact on employees performance i.e. the study looks at how increase effect (employee effective, employee teamwork and employee creativity) with reference to Adamawa State University. The following research questions were formulated to guide this study;
4 PRACTICAL IMPLICATIONS AND FUTURE RESEARCH RECOMMENDATIONS. In this paper, we undertook two tasks. First, using over 30 years of articles in PP, JAP, and AMJ, we examined the current state of as well as trends in how research on compensation → performance is theorized, its most studied aspects, and designs/methodologies employed. Given that ...
PDF | On Jan 1, 2020, Sayan Das and others published Salary Prediction Using Regression Techniques | Find, read and cite all the research you need on ResearchGate
Abstract. Research has shown that hospitals with better nurse staffing and work environments have better nurse outcomes—less burnout, job dissatisfaction, and intention to leave the job. Many studies, however, have not accounted for wage effects, which may confound findings. By using a secondary analysis with cross-sectional administrative ...
The starting point of this article is to find a suitable method of salary prediction to find a job. Firstly, this paper will introduce the content and usage of different regression models in machine learning. After understanding the methodology that will be used, it is pointed out that the goal of this study is to find the correlation between the salaries of employees and different influencing ...
Here are 11 jobs involving research and analysis for you to consider when choosing a career: 1. Market research analyst. National average salary: $78,645 per year Primary duties: Market research analysts examine the conditions of the market to help companies decide on a target market and which products or services to offer them. They monitor ...
iven to the source.Myth or Measurement: What Does the New Minimum Wage Research Say about Minimum Wages and Job Loss i. David Neumark and Peter Shirley NBER Working Paper No. 28388 January 2021, Revised March 2022. o. J23,J38ABSTRACTThe disagreement among studies of the employment effects of minimum wages in the United S.
In Salary History and Employer Demand: Evidence from a Two-Sided Audit (NBER Working Paper 29460) Amanda Y. Agan, Bo Cowgill, and Laura K. Gee study how information on an applicant's salary history shapes wage offers and hiring in the labor market for software engineers. They find that not disclosing salary history decreases salary offers for ...