Larrabee’s Stress Resiliency Study June Larrabee’s study, Influence of Stress Resiliency on RN Job Satisfaction and Intent to Stay, attempts to demonstrate that stress resiliency and psychological empowerment has an influence on job satisfaction and nurse turnover, which greatly increases health care costs. This paper analyzes Larrabbee’s study, using Burns and Grove’s Critique Guidelines. The study is, for the most part, comprehensive and adds to the body of knowledge about nursing practices. Keywords: nursing, stress resiliency, job satisfaction, psychological empowerment, nurse turnover, health care, critique, study Larrabee’s Stress Resiliency Study According to June H. Larrabee (2010) of West Virginia University School of Nursing and her colleagues, nursing turnover is expensive and causes serious concerns to health care leaders (p. 81). This is how she articulates the study problem. Other studies have demonstrated that the average cost of nurse turnover is between $62,000 and $67,000, and can account for as high as 3.4% to 5.8% of a medical center’s administrative budget (p. 82). Larabee purpose of her study was to evaluate the influence of stress resiliency on job stress, psychological empowerment, job satisfaction, and intent to stay. She found that these things do indeed have an effect on nurse turnover. As is the practice with most studies, Larrabee begins her study with a literature review, which seems comprehensive and relevant to the study problem. She first presents the serious costs of excessive nurse turnover, and then states the obvious: …Intent to leave is the primary predictor of actual turnover (p. 82). She also uses the literature to support her theory that the above-mentioned elements, along with job satisfaction, are major precursors to low nurse turnover. One of the most interesting things the literature presents is that many studies demonstrate that experience is an indicator of low turnover. It seems that older, more experienced nurses, especially those who have been at their current job for more than ten years, tend to be happier with their jobs and intend to stay in them. Larrabee does a good job in her study of both summarizing and critiquing the literature. She points out that there are few studies that have investigated the effect of psychological empowerment, which is also her philosophical framework, on RN job satisfaction, thus the reason for conducting her study. Most of her sources, especially the studies she cites, are all relatively recently published. Larrabee describes psychological empowerment as an important mediator between one’s context or behavior, such as staying in or leaving a job (p. 82). This framework forms the basis of the entire study. Larrabee insists that it underpins job satisfaction, another major motivation for nurses to stay at their jobs, and stress. If a nurse has low stress on the job, for example, job satisfaction is high and turnover is low. Larrabee even includes a model in her discussion, called, the Stress Resiliency Model for Investigation (p. 86), which she connects directly to the nursing profession. Larrabee is also clear about the hypotheses of her study, and lists all three of them before describing the methodologies and research designs she uses to try and prove them. She and her graduate students used surveys distributed to nurses working in rural and urban West Virginia. She attempted to correct for confounding variables, but was unsuccessful in at least one way: not finding enough more mature nurses. She admitted that this was caused by her settings—hospitals in areas with a large student population, so many of her subjects were less experienced and in the field for a shorter time than she would have liked. Consequently, Larrabee recommended that this study be conducted in areas farther away from nursing training programs. The measurement strategies are described well in this study. Larrabee calls it a predictive nonexperimental study (p. 87). She uses measures of intent to stay, job satisfaction, job stress, psychological empowerment, and stress resiliency. These measures all seem reliable and valid, although is it possible that this study attempted to test for too many things. Larrabee was also thorough in the analysis of the data collected, which included descriptive and inferential statistics (correlation, ANOVA, casual modeling) and path analysis. Larrabee got a somewhat good response to her surveys, a 54.5% response rate. The typical nurse who responded to the survey was a 39-year old Caucasian female who had received her nursing training more than ten years ago, and had been in her current position as a medical/surgical nurse for over ten years, which demonstrates one of the weaknesses of this study. According to the Bureau of Health Professionals (2006), the mean age of nurses in the U.S. is 48.6. The data from the surveys were collected and analyzed by graduate students. Larrabee sets out her findings from this study systematically, even providing charts of each of the items she tested for. She was able to demonstrate that each of her three hypotheses is supported by the study. The study also supports the psychological empowerment models, as other studies in other disciplines had done, and provides the first evidence of the influence of stress resiliency had on psychological empowerment on a group of nurses. Low job stress has a high correlation with job satisfaction, and by extension, low nurse turnover. An unexpected outcome was that interpretative styles affected the nurses’ stress resiliency. The implications of Larrabee’s study is that in order to retain nurses at their jobs for a longer period of time, managers need to create a low-stress environment that psychologically empowers nurses. These things also create high job satisfaction, another indicator for low turnover. These findings are consistent with previous studies. Larabee recommended psychological empowerment training in nursing training programs and as a part of continuing education courses. She also recommended that this study be replicated to strengthen its findings, and that longitudinal studies be conducted to track the effects of establishing these training programs. This study is thorough in that it satisfies most of Burns and Grove’s Critique Guidelines (chapter 13?). As they state, this demonstrates the comprehensiveness of the study. For the most part, it was a well-run study, and provides insight into an important part of the nursing profession while leaving room for other investigators to add to it. It also is an important contribution to the field, and to the study of the practice of nursing. References Bureau of Health Professions. (2006). The registered nurse population: Findings from the March 2004 national sample survey of registered nurses. Rockville, Maryland: Dept. of Health and Human Services, Health Resources and Services Administration. Burns and Grove. ———. Larrabee, J.H., et al. (2010). Influence of stress resiliency on RN job satisfaction and intent to stay. Western Journal of Nursing Research, 32, 1, 81-102.