title: Linking the practice environment to nurses' job satisfaction through nurse-physician communication.
abstract: OBJECTIVE
  To investigate direct and indirect relationships among the practice environment, nurse-physician (RN-MD) communication, and job satisfaction, as is posited in the nursing role effectiveness model (NREM).
  
  
  METHODS
  Survey.
  
  
  METHODS
  Surveys were sent to a random sample of 500 hospital nurses throughout Michigan, and 332 (66%) responded. Main study instruments were the Conditions for Work Effectiveness Questionnaire-II (CWEQ-II), the Practice Environment Scale of the Nursing Work Index (PES-NWI), the ICU Nurse-Physician Questionnaire, and the Index of Work Satisfaction (IWS), Part B. Inferential statistical tests included multiple regression, t tests, and one-way analysis of variance.
  
  
  RESULTS
  Practice environment (PES-NWI) and empowerment (CWEQ-II) scales explained 20% of the variance in RN-MD communication. The combination of both environment scales (PES-NWI and CWEQ-II) and RN-MD communication explained 61% of the variance in nursing job satisfaction scores. RN-MD communication was also a significant mediating variable in the relationship between structure (practice environment and empowerment scales) and outcome (nursing job satisfaction).
  
  
  CONCLUSIONS
  Factors in the practice environment contributed both directly to nursing job satisfaction and also indirectly through RN-MD communication. Study findings showed that a practice environment favorable to nurses improved both nurses' perceptions of their communications with physicians and their job satisfaction.
authors.affiliation: University of Michigan, School of Nursing, Ann Arbor, MI 48109-0482, USA. mmanojlo@umich.edu
authors.forename: Milisa
authors.initials: M
authors.lastname: Manojlovich
mesh_terms: D000328:Adult; D005260:Female; D019538:Health Care Surveys; D006272:Health Facility Environment; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008824:Michigan; D008875:Middle Aged; D015999:Multivariate Analysis; D009741:Nursing Staff, Hospital; D019555:Physician-Nurse Relations; D012044:Regression Analysis