Attitudes toward expanding nurses' authority.
BACKGROUND
In recent years, an increasing number of care procedures previously under the physician's authority have been placed in the hands of registered nurses. The purpose of this study was to examine the attitudes of nurses towards expanding nurses' authority and the relationships between these attitudes and job satisfaction facets, professional characteristics, and demographics.


METHODS
A cross-sectional study was conducted between 2010 and 2011 in three major medical centers in Israel. Participants included 833 nurses working in 89 departments. Attitudes toward the expansion of nurses' authority were assessed by self-report questionnaire, as well as job satisfaction facets including perception of professional autonomy, nurse-physician working relations, workload and burnout, perceptions of quality of care, and nursing staff satisfaction at work.


RESULTS
Nurses reported positive attitudes toward the expansion of nurses' authority and moderate attitudes for interpretation of diagnostic tests in selected situations. The results of multivariate regression analyses demonstrate that the nurses' satisfaction from professional autonomy and work relations were the most influential factors in explaining their attitudes toward the expansion of nurses' authority. In addition, professionally young nurses tend to be more positive regarding changes in nurses' authority.


CONCLUSIONS
In the Israeli reality of a nurse's shortage, we are witnessing professional transitions toward expansion of the scope of nurses' accountability and decision-making authority. The current research contributes to our understanding of attitudes toward the expansion of nurses' authority among the nursing staffs. The findings indicate the necessity of redefining the scope of nursing practice within the current professional context.
Nursing Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Hana
H
Kerzman
Ben-Gurion University of the Negev, Negev, Israel.
Dina
D
Van Dijk
Nursing Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Limor
L
Eizenberg
Tel Aviv Sourasky Medical Center, Tel Aviv, Israel ; Nursing Division, Tel Aviv University, Tel Aviv, Israel.
Rut
R
Khaikin
Wolfson Medical Center, Holon, Israel.
Shoshi
S
Phridman
Gertner Institute for Epidemiology and Public Health Policy, Tel-Hashomer, Israel.
Maya
M
Siman-Tov
Nursing Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel ; Nursing Division, Tel Aviv University, Tel Aviv, Israel.
Shoshi
S
Goldberg
Acute hospital; Attitudes; Burnout; Expansion of nurses’ authority; Inter-professional cooperation; Job satisfaction; Professional autonomy; Workload