응급실 간호사와 의사의 팀워크인식이 재직의도에 미치는 영향

Abstract

본 연구는 응급실 의료 인력의 주축을 이루는 간호사와 의사의 팀워크를 측정하고, 팀워크가 재직의도에 미치는 영향을 확인하여 응급실 인적자원관리 방안 모색과 더불어 양질의 의료 인력 보유를 촉진하기 위한 기초자료를 제공하고자 시행된 서술적 상관관계 연구이다.

본 연구의 대상자는 서울시 소재 3차 병원중 기업병원 1곳, 대학병원 4곳 등 5곳의 병원 응급실에서 근무하는 간호사 112명, 의사 56명이었으며, 자료 수집은 2015년 11월 7일부터 14일까지 구조화된 자가 보고형 설문지를 이용하여 이루어졌다. 팀워크를 측정하기 위해 Larson & Lafasto (1989)가 개발하고, Loyd(2005)의 연구에서 사용된 설문을 김태백(2006)이 한국어로 번역하여 재구성한 측정도구를 연구대상자에 따라 일부 수정·보완 하여 사용하였다. 재직의도는 Cowin(2002)이 개발한 Nurses’ retention index(NRI)를 김민정(2006)이 한국어로 번역하여 사용한 도구를 연구대상자에 따라 일부 수정·보완 하여 측정하였다. 수집된 자료는 SPSS 19 프로그램을 이용하여 빈도, 백분율, 평균과 표준편차, t-test, ANOVA, Scheffe’s test, Pearson’s correlation coefficient, Multiple Linear Regression, Cronbach’s Alpha Coefficient를 사용하여 분석하였다.

본 연구의 주요 결과는 다음과 같다.

1. 본 연구의 대상자인 간호사의 일반적 특성으로 연령은 20대가 79명(70.5%), 성별에서 여자가 104명(92.9%), 결혼여부에서는 미혼이 87명(77.7%), 학력에서 대학졸업이 104명(92.9%)으로 가장 많았다. 간호사의 직무관련 특성으로는 일반 간호사가 87명(77.7%), 근무경력에서 보면 3년 미만이 43명(38.4%), 현재 병원 근무 경력 3년 미만이 45명(40.2%), 병원 유형별로는 기업병원 64명(57.1%), 응급실 근무 경력 3년 미만 52명(46.4%), 현재 병원 응급실 근무경력 3년 미만이 51명(45.5%), 1달 동안의 야간 근무 일 수는 5일 이상-10일 미만이 104명(92.9%)으로 가장 많았다. 의사의 일반적 특성은 연령에서 30대 이상이 39명(69.6%), 성별에서는 남자가 36명(64.3%), 미혼이 30명(53.6%), 대학졸업이 33명(58.9%)이었다. 의사의 직무관련 특성으로는 직위에서는 전공의가 40명(71.4%), 근무경력은 3년-5년 미만 18명(32.1%), 현재 병원 근무 경력 3년 미만 25명(44.6%), 병원 유형별로는 대학병원 32명(57.1%), 응급실 근무 경력은 3년 미만 30명(53.6%), 현재 근무병원 응급실 근무경력 3년 미만이 31명(55.4%), 1달 동안의 야간 근무 일 수는 10일 이상이 33명(58.9%)으로 가장 많았다.

2. 간호사의 팀워크는 5점 만점에 평균 3.55±0.59점으로 나타났다. 하위영역별 점수로는 목표공유 3.76±0.61점, 결과지향 3.65±0.64점, 팀워크 만족 3.54±0.84점, 상호협력 3.42±0.64점 순으로 나타났다. 의사의 팀워크는 5점 만점에 평균 3.37±0.73점으로 나타났다. 하위영역별 점수로는 목표공유 3.50±0.74점, 결과지향 3.46±0.81점, 팀워크 만족 3.36±0.88점, 상호협력 3.27±0.80점 순으로 나타났다.

3. 간호사의 재직 의도는 8점 만점에 평균 4.91±1.42점으로 나타났으며, 의사의 재직의도는 8점 만점에서 평균 6.44±1.18점으로 나타났다.

4. 간호사의 일반적 특성 및 직무관련 특성에 따른 팀워크 차이 분석 결과 목표공유는 연령(t=2.03, p=.045), 근무경력(F=4.59, p=.005), 현재 병원 근무경력(F=6.08, p=.003), 응급실 근무경력(F=4.16, p=.018)에 따라 통계적으로 유의한 차이가 있었고, 결과지향은 병원유형에서(t=-2.30, p=.023), 팀워크 만족에서도 병원유형에 따라(t=-2.34, p=.021) 유의한 차이가 있었다. 의사의 일반적 특성 및 직무관련 특성에 따른 팀워크 차이를 분석한 결과 팀워크 총점(F=9.32, p<.001), 목표공유(F=3.59, p=.034), 결과지향(F=8.18, p=.001), 상호협력(F=9.19, p<.001), 팀워크 만족(F=8.02, p=.001)에서 1달 동안 야간 근무일 수에 따라 통계적으로 유의한 차이가 있었다.

5. 간호사의 일반적 특성 및 직무관련 특성에 따른 재직의도 차이를 분석한 결과 근무경력(F=3.14, p=.028), 현재 근무 병원 경력(F=4.44, p=.014), 병원유형(t=-2.80, p=.006), 응급실 근무 경력(F=3.21, p=.044), 현재 응급실 근무 경력(F=3.62, p=.030), 1달 동안 야간 근무 일수(t=2.43, p=.017)에서 통계적으로 유의한 차이가 있었다. 의사의 일반적 특성 및 직무관련 특성에 따른 재직의도 차이 분석 결과 근무경력(F=3.38, p=.025)에서 통계적으로 유의한 차이가 있었다.

6. 간호사의 팀워크와 재직의도의 상관분석 결과, 팀워크의 하위영역 중 목표공유(r=0.35, p<.001), 결과지향(r=0.38, p<.001), 상호협력(r=0.33, p<.001), 팀워크 만족(r=0.41, p<.001)이 재직의도와 유의한 정적(+) 상관이 있는 것으로 나타났다. 의사의 경우 재직의도와 상관이 있는 팀워크의 하위영역 중 목표공유(r=0.40, p=.002), 상호협력(r=0.35, p=.008)이 재직의도와 유의한 정적(+) 상관이 있는 것으로 나타났다.

7. 간호사의 일반적 특성 및 직무관련 특성과 팀워크가 재직의도에 영향을 미치는 영향을 확인하기 위해 다중회귀분석을 실시한 결과 팀워크 만족이 높을수록(t=2.09, p=.039), 1달 동안의 야간 근무일수가 적을수록(t=-2.50, p=.014), 그리고 소속병원이 대학병원인 경우(t=2.05, p=.042) 간호사의 재직의도가 유의하게 상승하였음을 확인하였다. 회귀모형은 통계적으로 유의하였고(F=4.52, p<.001), 모형의 설명력은 24.1%였다. 의사의 일반적 특성 및 직무관련 특성과 팀워크가 재직의도에 영향을 미치는 요인을 알아보기 위해 다중회귀분석을 실시한 결과 의사의 재직의도에 유의한 예측변수는 확인되지 않았다.

본 연구 결과 팀워크는 응급실 간호사의 재직의도를 상승 시킬 수 있음을 확인하였다. 특히 팀워크 만족을 증가 시키는 것이 재직의도를 상승시킬 수 있음을 확인 하였으므로 응급실 간호사의 재직의도를 높이기 위해서는 팀워크 만족을 높이기 위한 팀워크 강화 훈련과 더불어 팀워크 중심 조직문화 형성을 촉진하는 전략 마련이 필요할 것으로 생각된다.| This is a descriptive correlation study which is designed to compare teamwork between nurses and physicians who are the main medical manpower, and the impact of the teamwork on retention intention. This study is aiming to seek for a method of human resource management for emergency room(ER) as well as to provide basic data in order to promote retention of quality medical manpower.

The subjects are 112 nurses and 56 physicians working at the ER in 1 industrial hospital and 4 university hospitals, and the data had been collected from November 7 to November 14 in 2015 by structured self-report questionnaires. The questionnaire used in this study to measure teamwork was developed by Larson & Lafasto (1989) and used by Loyd(2005) in his study. And it was translated into Korean and restructured by Kim(2006) but some parts were revised in this study depending on the subjects. The questionnaire to measure retention intention was developed by Cowin(2002) and standardized in Korean by Kim(2006). Some parts were also revised in this study depending on the subjects.

SPSS 19 was used to analyze collected data in order to calculate frequency, percentage, average, standard deviation, t-test, ANOVA, Scheffe’s test, Pearson’s correlation, Multiple Linear, Regression and Cronbach’s Alphas Coefficient.

The findings of this study are shown below.

1. Majority of the nurse participants are in their twenties(70.5%), female(92.9%), unmarried(77.7%) and university-graduated(92.9%). Majority of the nurse participants are general nurses(77.7%) and have less than 3 years tenure(38.4%) as well as less than 3 years tenure at their current hospitals(40.2%). 57.1% participants work for an industrial hospital and 46.4% participants have less than 3 years tenure at the ER. 45.5% of the participants have less than 3 year tenure at the ER of their current hospitals and 92.9% nurses do 5 to 10 days night shift per month. Majority of the physician participants are their thirties(69.6%) and 64.3% participants are male. 53.6% participants are unmarried and 58.9% are university-graduated. The majority of physician participants are residents(71.4%) and have 3 to 5 years tenure(32.1%). 44.6% of the participants have worked at the current hospitals for less than 3 years, and 57.1% participants work for university hospitals. 53.6% participants have less than 3 years tenure at the ER and 55.4% have worked at the ER of their current hospitals for less than 3 years. 58.9% of the participants do more than 10 days night shift per month.

2. Teamwork of the nurses shows average 3.55±0.59 out of 5. The sub-factors appear as shared goals 3.76±0.61, result-driven structure 3.65±0.64, teamwork satisfaction 3.54±0.84 and mutual cooperation 3.42±0.64.Teamwork of the physicians is average 3.37±0.73 out of 5. The sub-factors appear as shared goals 3.50±0.74, result-driven structure 3.46±0.81, teamwork satisfaction 3.36±0.88 and mutual cooperation 3.27±0.80.

3. Retention intention of the nurses shows average 4.91±1.42 out of 8, and the physicians’ retention intention appears 6.44±1.18.

4. As a result of teamwork analysis according to general and work-related features of the nurses, the difference of shared goals appears statistically significant depending on their age(t=2.03, p=.045), tenure(F=4.59, p=.005), tenure at the current hospitals(F=6.08, p=.003), tenure at the ER(F=4.16, p=.018). In addition, result-driven structure(t=-2.30, p=0.023) and teamwork satisfaction(t=-2.34, p=.021) statistically differs depending on hospital types. As a result of teamwork analysis according to general and work-related features of the physicians, the difference of teamwork(F=9.32, p<.001), shared goals(F=3.59, p=.034), result-driven structure(F=8.18, p=.001), mutual cooperation(F=9.19, p<.001) and teamwork satisfaction(F=8.02, p=.001) appears statistically significant depending on frequency of night shift per month.

5. As a result of retention intention analysis according to general and work-related features of the nurses, tenure(F=3.14, p=.028), tenure at their current hospital(F=4.44, p=.014), hospital type(t=-2.80, p=.006), tenure at the ER(F=3.21, p=.044), tenure at the ER of their current hospital(F=3.62, p=.030) appear significantly different depending on night shift per month(t=2.43, p=.017).The result of retention intention of the physicians according to their general and work-related features shows statistically significant difference depending on their tenure(F=3.38, p=.025).

6. The result of correlation analysis of teamwork and retention intention of the nurses shows that the sub-factors of teamwork, which are shared goals(r=0.35, p<.001), result-driven structure(r=0.38, p<.001), mutual cooperation(r=0.33, p<.001), teamwork satisfaction(r=0.41, p<.001), are positively(+) correlated with retention intention. In case of the physicians, shared goals(r=0.40, p=.002), mutual cooperation(r=0.35, p=.008) among the sub-factors of teamwork are positively(+) correlated with retention intention.

7. Multiple linear analysis had been conducted in order to analyse how general and work-related features of the nurses and teamwork effect on retention intention. The result shows positive(+) relationship between retention intention and teamwork satisfaction(t=2.09, p=.039) and negative(-) relationship between retention intention and night shift per month(t=-2.50, p=.014). In addition, university hospital(t=2.05, p=.042) significantly increases retention intention of the nurses. Regression model appears statistically significant(F=4.52, p<.001) and explanatory power of the model is 24.1%. Although multiple linear analysis had been conducted to analyse how general and work-related features of the physicians and teamwork effect on retention intention, no predictors have been found.

In conclusion, teamwork significantly increases retention intention of the nurses working at the ER. Especially because teamwork satisfaction is positively(+) related to retention intention, strategies to reinforce teamwork as well as to encourage teamwork-centered organizational culture are required in order to increase teamwork satisfaction that finally increases retention intention of the nurses.; This is a descriptive correlation study which is designed to compare teamwork between nurses and physicians who are the main medical manpower, and the impact of the teamwork on retention intention. This study is aiming to seek for a method of human resource management for emergency room(ER) as well as to provide basic data in order to promote retention of quality medical manpower.

The subjects are 112 nurses and 56 physicians working at the ER in 1 industrial hospital and 4 university hospitals, and the data had been collected from November 7 to November 14 in 2015 by structured self-report questionnaires. The questionnaire used in this study to measure teamwork was developed by Larson & Lafasto (1989) and used by Loyd(2005) in his study. And it was translated into Korean and restructured by Kim(2006) but some parts were revised in this study depending on the subjects. The questionnaire to measure retention intention was developed by Cowin(2002) and standardized in Korean by Kim(2006). Some parts were also revised in this study depending on the subjects.

SPSS 19 was used to analyze collected data in order to calculate frequency, percentage, average, standard deviation, t-test, ANOVA, Scheffe’s test, Pearson’s correlation, Multiple Linear, Regression and Cronbach’s Alphas Coefficient.

The findings of this study are shown below.

1. Majority of the nurse participants are in their twenties(70.5%), female(92.9%), unmarried(77.7%) and university-graduated(92.9%). Majority of the nurse participants are general nurses(77.7%) and have less than 3 years tenure(38.4%) as well as less than 3 years tenure at their current hospitals(40.2%). 57.1% participants work for an industrial hospital and 46.4% participants have less than 3 years tenure at the ER. 45.5% of the participants have less than 3 year tenure at the ER of their current hospitals and 92.9% nurses do 5 to 10 days night shift per month. Majority of the physician participants are their thirties(69.6%) and 64.3% participants are male. 53.6% participants are unmarried and 58.9% are university-graduated. The majority of physician participants are residents(71.4%) and have 3 to 5 years tenure(32.1%). 44.6% of the participants have worked at the current hospitals for less than 3 years, and 57.1% participants work for university hospitals. 53.6% participants have less than 3 years tenure at the ER and 55.4% have worked at the ER of their current hospitals for less than 3 years. 58.9% of the participants do more than 10 days night shift per month.

2. Teamwork of the nurses shows average 3.55±0.59 out of 5. The sub-factors appear as shared goals 3.76±0.61, result-driven structure 3.65±0.64, teamwork satisfaction 3.54±0.84 and mutual cooperation 3.42±0.64.Teamwork of the physicians is average 3.37±0.73 out of 5. The sub-factors appear as shared goals 3.50±0.74, result-driven structure 3.46±0.81, teamwork satisfaction 3.36±0.88 and mutual cooperation 3.27±0.80.

3. Retention intention of the nurses shows average 4.91±1.42 out of 8, and the physicians’ retention intention appears 6.44±1.18.

4. As a result of teamwork analysis according to general and work-related features of the nurses, the difference of shared goals appears statistically significant depending on their age(t=2.03, p=.045), tenure(F=4.59, p=.005), tenure at the current hospitals(F=6.08, p=.003), tenure at the ER(F=4.16, p=.018). In addition, result-driven structure(t=-2.30, p=0.023) and teamwork satisfaction(t=-2.34, p=.021) statistically differs depending on hospital types. As a result of teamwork analysis according to general and work-related features of the physicians, the difference of teamwork(F=9.32, p<.001), shared goals(F=3.59, p=.034), result-driven structure(F=8.18, p=.001), mutual cooperation(F=9.19, p<.001) and teamwork satisfaction(F=8.02, p=.001) appears statistically significant depending on frequency of night shift per month.

5. As a result of retention intention analysis according to general and work-related features of the nurses, tenure(F=3.14, p=.028), tenure at their current hospital(F=4.44, p=.014), hospital type(t=-2.80, p=.006), tenure at the ER(F=3.21, p=.044), tenure at the ER of their current hospital(F=3.62, p=.030) appear significantly different depending on night shift per month(t=2.43, p=.017).The result of retention intention of the physicians according to their general and work-related features shows statistically significant difference depending on their tenure(F=3.38, p=.025).

6. The result of correlation analysis of teamwork and retention intention of the nurses shows that the sub-factors of teamwork, which are shared goals(r=0.35, p<.001), result-driven structure(r=0.38, p<.001), mutual cooperation(r=0.33, p<.001), teamwork satisfaction(r=0.41, p<.001), are positively(+) correlated with retention intention. In case of the physicians, shared goals(r=0.40, p=.002), mutual cooperation(r=0.35, p=.008) among the sub-factors of teamwork are positively(+) correlated with retention intention.

7. Multiple linear analysis had been conducted in order to analyse how general and work-related features of the nurses and teamwork effect on retention intention. The result shows positive(+) relationship between retention intention and teamwork satisfaction(t=2.09, p=.039) and negative(-) relationship between retention intention and night shift per month(t=-2.50, p=.014). In addition, university hospital(t=2.05, p=.042) significantly increases retention intention of the nurses. Regression model appears statistically significant(F=4.52, p<.001) and explanatory power of the model is 24.1%. Although multiple linear analysis had been conducted to analyse how general and work-related features of the physicians and teamwork effect on retention intention, no predictors have been found.

In conclusion, teamwork significantly increases retention intention of the nurses working at the ER. Especially because teamwork satisfaction is positively(+) related to retention intention, strategies to reinforce teamwork as well as to encourage teamwork-centered organizational culture are required in order to increase teamwork satisfaction that finally increases retention intention of the nurses.