Abstract
Background:
Mattering is the feeling that a person makes a difference and is significant to others. Whether one matters to a loved one, friend, organization, or society, it is an essential psychological condition for thriving and flourishing and is endorsed by the U.S. Surgeon General as critical part of a healthy work environment. When employees matter at work they report increased productivity, engagement, intention to stay at their jobs, and are less likely to experience burnout and depression. Nurses need to know they matter, not only to their patients, but to their peers, physicians, administration, and the health care organization. Mattering is understudied among nurses and significant knowledge gaps prevent the integration of mattering into interventions to improve the health care work environment.
Purpose:
The purpose of this dissertation study was to explore mattering as a nurse within the health care work environment and identify aspects of the work environment such as the hospital ethical climate that play a role in how nurses perceive they matter.
Methods:
A convergent, parallel mixed-method study was conducted. Quantitative (survey questionnaire) and qualitative data (individual interviews) were collected concurrently and analyzed separately before they were converged to illustrate different ways that nurses expressed they mattered and what aspects of the work environment influenced these perceptions. Additionally, a systematic scoping review was completed to: synthesize the literature on mattering at work in general, identify key concepts and measurement methods of mattering within the context of work, and examine how mattering has been incorporated into work environments.
Mixed-method study results:
For the convergent, parallel mixed-method study, 243 registered nurses completed a Qualtrics survey and a sub-group of these nurses (n=22) participated in individual interviews. Significantly lower mattering scores were found in nurses who identified as a minority race other than Black or White (β= -3.03, p<.01), worked at small hospitals (< 100 beds; β= -2.26, p<.05), or at hospitals with nursing unions (β= -1.90, p<.05). Significantly higher mattering scores were found in nurses who worked at hospitals with formal award programs (β= 2.85, p<.01), and had nursing certifications (β= 1.56, p<.05). Mattering at work was significantly and positively correlated with the hospital ethical climate and its five factors: hospital, management, peers, patients, and physicians.
The following themes were inductively developed from nurses’ experiences of mattering within the health care work environment: 1) Support and resources necessary for mattering, 2) Leadership’s role in mattering, 3) Mattering when making a difference for patients, 4) Interprofessional relationships with peers affect mattering, 5) Mattering when collaborating with physicians.
Focusing specifically on aspects of the work environment that influenced nurses’ perceptions of mattering that can be targeted by interventions, the following themes were deductively developed from interviews: 1) Mattering as an individual, 2) Having a voice is important for mattering, 3) Recognition and appreciation support mattering, 4) Attending to well-being enhances mattering. Recommendations for workplace changes to enhance nurse mattering were made based on themes and participants’ suggestions.
Scoping review results:
A scoping review of the literature regarding mattering at work resulted in a total of 294 journal articles; 32 remained for full analysis after applying inclusion and exclusion criteria. Definitions, measurements, and characteristics of mattering at work were analyzed and implications for mattering among health care workers in the health care work environment were discussed.
Conclusion:
The feeling that one matters at work is essential for nurse well-being. Through mattering nurses are connected to the meaning of work, relationships with others, and their impact in society. While perceptions of mattering leads to enhanced engagement, belonging, resilience, and job satisfaction, the absence of mattering can lead to burnout, turnover, and depression. Mattering is an essential part of a healthy work environment. Nurses in this study discussed facets of the health care work environment that influenced how they felt valued as well as ways that they were able to add value. Health care organizations have a responsibility to address the well-being of their nurses and take steps to enhance perceptions of mattering within the health care work environment. Addressing these work environment elements may cause nurses to feel that they are valued members of the health care organization and lead to improvements in nursing burnout, turnover, and well-being.
