employment and nurses’ intention to leave the profession The role of support at work

Health Policy 99 (2011) 149–157

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Health

Policy

j o u r n a l h o m e p a g e :w w w.e l s e v i e r.c o m /l o c a t e /h e a l t h p o

l

Flexible employment and nurses’intention to leave the profession:The role of support at work

Isik U.Zeytinoglu a ,?,Margaret Denton b ,c ,Jennifer Millen Plenderleith b

a Human Resources and Management Area,DeGroote School of Business,McMaster University,1280Main St West,Hamilton,ON L8N 3Z5,Canada

b Gilbrea Centre for Studies in Aging,McMaster University,Hamilton,ON L8S 4M4,Canada c

Department of Health,Aging &Society,McMaster University,Hamilton,ON L8S 4M4,Canada

a r t i c l e i n f o Keywords:Nurses

Flexible employment Job insecurity

Intention to leave the profession

a b s t r a c t

Objectives:The objectives of this paper are to examine (1)the association between ?exible employment and nurses’intention to leave the profession,and (2)whether or not support at work mediates the association between ?exible employment and nurses’intention to leave the profession.Flexible employment is analyzed objectively using non-permanent contract,part-time employment status,casual employment status,involuntary hours and on-call work,and subjectively using job insecurity.Support at work refers to organizational,supervisor and peer support.

Methods:Data come from our survey of 1396nurses employed in three teaching hospitals in Southern Ontario.Descriptive statistics are provided.Bivariate correlations,hierarchical regression analysis and mediation tests are conducted.

Results:Compared to those in full-time employment,nurses in part-time employment do not intend to leave the profession.None of the other objective ?exible employment factors are associated with intention to leave the profession.Perceived job insecurity is associated with intention to leave the profession.Low support at work contributes to intention to leave the profession and mediates the association between job insecurity and intention to leave the profession.

Conclusions:The study provides evidence to health sector managers and policy makers that part-time employment,perceived job security and support at work are important factors to consider in efforts to retain nurses in the profession.

? 2010 Elsevier Ireland Ltd. All rights reserved.

1.Introduction

The objectives of this paper are to examine (1)the asso-ciation between ?exible employment and nurses’intention to leave the profession,and (2)whether or not support at work mediates the association between ?exible employ-ment and nurses’intention to leave the profession.Flexible employment is gaining importance globally in the health care sector since prescribed by the international ?nancial

?Corresponding author.Tel.:+19055259140x23957;fax:+19055218895.

E-mail address:zeytino@mcmaster.ca (I.U.Zeytinoglu).

institutions [1].The term ?exibility connotes both pos-itive and negative attributes.In the last three decades two streams of ?exibility literature emerged along these two opposing views [2].One stream of literature dis-cusses ?exibility as a strategic initiative of employers to enhance the business requirements of the ?rm.The other stream of literature discusses ?exibility as driven by employees demanding ?exibility for work-life balance interests.Research using national level data from the U.S.and Canada shows that ?exible employment is created for business reasons rather than meeting employee interests and needs [3,4].This study takes the perspective that ?exi-ble employment is primarily demand-driven and created for the interests and goals of the hospitals and hospital

0168-8510/$–see front matter ? 2010 Elsevier Ireland Ltd. All rights reserved.doi:10.1016/j.healthpol.2010.07.017

150I.U.Zeytinoglu et al./Health Policy99 (2011) 149–157

administrators.Nurse managers implement these hospital employment policies.Nurses respond to?exible job oppor-tunities created by the administration and attempt to?nd a good match between their interests and available jobs.

The health care sector in Canada and elsewhere experi-enced restructuring in mid-1990s and as a result hospital management introduced a number of?exible employment forms and involuntary hours with little job security[5–9]. Some nurses left the profession and others intend to leave [5,10].In2002,the year our study was conducted,only60% of nurses worked full-time[11,12].That year the provin-cial government initiated a policy to create more full-time jobs to keep nurses in the profession.Many of the nurses searching a full-time job found one,and many of the nurses working on a part-time basis chose to stay in part-time jobs. More investments were made to enhance the number of nurses working on a full-time basis.In addition,in the last few years,the provincial government guaranteed full-time employment to recent graduates,if they preferred.

Labour supply and demand imbalances in nursing are creating retention challenges[10,13–15].Decision-makers are noting that work environment issues are factors of con-cern for retention in health care sector[16]and generally in the labour market[17]making the topic of this paper important and timely.This study contributes to the liter-ature by examining a large number of objective?exible employment factors and a subjective?exible employment factor in the analysis,and by examining the role of support at work as a possible mediator of the relationship between these factors and intention to leave the profession.Findings can assist organizational level policy-making in hospitals. Findings can also inform decision-makers at national and intergovernmental organizations on retaining nurses in the profession.2.Turnover intention theory and the conceptual model

Retention and turnover are two sides of a coin[18]. Turnover is the ultimate decision preceded by the inten-tion to leave[19].The turnover theory shows that objective job circumstances and interpreted job circumstances affect an individual’s decision to leave or stay in the organization [20,21]or the profession[22].Nurses have a strong iden-ti?cation with their profession[23]and intention to leave the profession is a serious decision since it means leaving behind the training in nursing,a dedication to the profes-sion and possibly tenure in the profession.Thus,we focus on this ultimate decision for a nurse––the intention to leave the profession(see Fig.1).

Flexible employment is examined on objective and subjective dimensions similar to DeWitte and N?swall’s study of job insecurity[24].The objective?exible employ-ment dimensions of non-permanent contract,part-time employment status,casual employment status,involun-tary hours and on-call work are indicators that these jobs are in the periphery of the organizations with poor work-ing conditions and insecurity[3,25].Empirical research on employment statuses shows hierarchies within the periph-ery with part-time employment being in the near-core and providing some?exibility,and casual employment providing the most?exibility[25].Applying the the-ory of turnover intention to our study[20,21],nurses would examine the objective working conditions in their jobs in deciding whether to stay or leave the profes-sion.For a skilled profession like nursing,employment in non-permanent contracts,casual employment,involun-tary hours or on-call work may not be their preference after years of training for the profession.Considering that

these Fig.1.The conceptual model of the associations between employment?exibility,support at work and intention to leave the profession.

I.U.Zeytinoglu et al./Health Policy99 (2011) 149–157151

?exible employment dimensions show peripheral employ-ment conditions,we hypothesize that non-permanent contracts,casual employment status,involuntary hours and on-call work will be positively associated with nurses’intention to leave the profession.Acknowledging that regular part-time workers are in the near-core of the employment status hierarchy,and knowing that the part-time employment status in nursing is generally understood as regular part-time and a desirable form of employment for some nurses,we hypothesize that part-time employ-ment status will be negatively associated with nurses’intention to leave the profession.

A vast majority of studies that empirically investigate the relationship between job insecurity and turnover inten-tion have found either a signi?cant positive association [26,27]or partial support of the theorized relationship[13]. Although these studies are on intention to leave the organi-zation,it is possible that there can be a similar association for the intention to leave the profession.Thus,we hypothe-size that subjective employment?exibility of job insecurity will be positively associated with nurses’intention to leave the profession.

Work environment also affects intention to leave. Research on turnover shows that low support at work is associated with increased turnover intention[22,27,28]. About half of the nurses in Canada report low peer sup-port and about a quarter report low supervisor support [29].Laine et al.[13]study on European nurses suggest that support at work can be a buffering factor in reduc-ing the effects of job insecurity on intention to leave the profession.If nurses are employed in?exible employment or perceive job insecurity,then support at work may be crucial for their intention to leave or stay in the profession. Thus,we hypothesize that support at work will mediate the association between?exible employment and intention to leave the profession.

Research also shows that preference for a different employment status,heavy workload and the impor-tance of income to family are associated with increased turnover intention[22,27,30]and therefore these factors are included as control variables.

3.Data and methods

3.1.Data and respondent characteristics

This study was limited to a purposeful sample of nurses in three hospitals in Southern Ontario because it was known that these hospitals experienced restructuring.Two sample sites,i.e.hospitals,are the largest employers of nurses in their respective cities,and the third one is among the largest employers of nurses in that city.

The total population of nurses in three hospitals at the time of the survey was2684.The multivariate analysis we intended to conduct using a large number of independent and dependent variables requires a large sample size and thus all nurses were invited to participate in the survey. Prior to data collection ethics approval was received from the ethics board of each hospital.

Pilot testing of the questionnaire was conducted in April 2002.A mail out questionnaire was sent to all2684nurses in May–June2002.After sending a reminder card,a second mail out of the survey was conducted in June–July2002.

A total of1396nurses responded(52%response rate).We aimed for a good representation of respondents re?ecting the nursing population in the study hospitals.Thus,for each hospital,a comparison of respondents’demographic char-acteristics to the hospital’s averages was conducted.The majority of respondents(96%)were female.Average age was42,with an average of13years of tenure in the hospital and18years in the profession.Close to three-quarters were married/in a common-law relationship,and43%had chil-dren under12.These aggregate?ndings as well?ndings for each hospital indicated similarities between respondents and hospital averages with respect to demographic charac-teristics.Overall our sample’s demographic characteristics were similar to those of nurses at the national level[29].

3.2.Instrument and variables

The survey instrument was a self-completion question-naire on health and work life of nurses[31].Questions were either developed by the research team[31]or adapted from their previous survey[32].Some questions were adapted from other researchers’studies(as referenced below).Per-cent responses to each scale item are presented elsewhere [33].All scale items were measured on a?ve point scale with“1=strongly disagree”to“5=strongly agree”.Items were then summed to create a scale.Con?rmatory fac-tor analysis with‘varimax’rotation was conducted for the scales(except job insecurity as explained below).The Cron-bach’s alpha(?)was conducted for reliability of each scale.

The dependent variable is intention to leave the profes-sion.It was based on a single question from Fimian et al.

[34]and worded as“I am seriously considering leaving the nursing profession in the near future.”The indepen-dent variable is?exible employment.The questions for objective?exibility measures were:“Is your position per-manent or temporary”(1=non-permanent(temporary), 0=permanent).“What is your current employment sta-tus at this hospital?”Options to choose were“full-time”,“part-time”or“casual”and each were coded as“1=yes”,“0=otherwise”.“Involuntary hours”was asked in two questions.First nurses were asked“how many hours did you work in the last two weeks pay period?”,followed by“how many hours would you have preferred to work in the last two week pay period?”.If hours worked and preferred hours matched,then this variable was coded as “0=worked preferred hours”,if there was a discrepancy between responses then it was coded as“1=worked invol-untary hours”.For on-call work,nurses were asked“Does your position include being‘on-call’?”(1=yes,0=no). These were mutually exclusive questions and the pilot testing of the questionnaire showed that the respondents understood these as mutually exclusive employment types or schedules.

Subjective?exible employment factor of perceived job insecurity was developed based Cameron et al.[35]. Exploratory factor analysis(principal components factor analysis)with“varimax”rotation method to identify items composing our scale showed six items of job insecurity which included:“I am presently safe from dismissal at this

152I.U.Zeytinoglu et al./Health Policy99 (2011) 149–157

hospital(reversed);I am con?dent that this hospital will remain a steady place of employment for as long as I want to continue working here(reversed);I feel uneasy about the security in my present job;I feel I am likely to be laid off at this hospital;I am worried about my future with this hospital;and,I am worried about my job security”.The ?=.92.

Support at work is a work environment variable with three different types of support included as mediating https://www.wendangku.net/doc/9f10495249.html,anizational and supervisor support scales were each measured using six-items and peer support was measured using four-items from Denton et al.[36].

A sample item for each scale include:‘My hospital sup-ports me in time of personal crisis,illness or needing time off to help care for other family members”,“My supervi-sor appreciates my work”,“The people I work with take a personal interest in me”;?=.74,?=.94,and?=.80, respectively.

Control variables consist of work and individual charac-teristics variables.“Prefer a different employment status variable”was coded as1=yes prefer a different employ-ment status.0=no.The workload scale is a six-item scale from Denton et al.[36].A sample statement is“I have too much to do on this job”,?=.85.The only individual characteristic included was‘the importance of income to family’s economic well-being’and measured as a single item on a?ve-point scale,coded as“1=not at all important”to“5=very important”.Other individual characteristics such as education,position as a registered nurse or reg-istered practical nurse,tenure in the profession,gender, age,marital status,and children living with them who are under age12,were considered but the bivariate correlation tests showed that they were not signi?cantly associated with intention to leave the profession,and thus,were not included in the analysis.3.3.Analysis

Descriptive statistics,factor analysis and Cronbach’s alphas were conducted?rst.Next we examined the asso-ciation between variables using bivariate correlation tests. Two-tailed test of signi?cance was used.Following that, we proceeded to the hierarchical regression analysis.First control variables were entered in the analysis,and fol-lowed by the independent variables in the second step. Full-time employment status was the reference and part-time employment status was analyzed separately from casual employment status.To show the variance explained by these factors R2as well as Adjusted R2were con-ducted.Since the subjectively assessed variables may not be completely independent of each other,collinearity diag-nostics were conducted.Since collinearity was not found the results will not be reported.Mediation tests were con-ducted using the three-stage regression analysis method of Baron and Kenny[37].

4.Results

4.1.Descriptive statistics

As presented in Table1,about16%of the respondents indicated an intention to leave the nursing profession.A small percentage of nurses among our respondents were on non-permanent contracts(3%),many worked part-time (33%)and some worked as casual nurses(8%).Close to half had involuntary hours(48%),and more than one-in-?ve were on-call(14%).Only a few perceived job insecurity (5%,and the mean and standard deviation were M=13.6, S.D.=4.7).

Table1

Descriptive statistics of all variables:means(standard deviations)or percentages.

Variables N Mean(S.D.)%

Dependent variable

Intention to leave the profession1378 2.2(1.1)16 Independent variable

Flexible employment

Objective dimensions

Non-permanent contract1385 3.3 Full-time employment a138759.0 Part-time employment138733.3 Casual employment13877.7 Involuntary hours126648.3 On-call work138813.8 Subjective dimension

Perceived job insecurity139613.6(4.7)

Control variables

Prefer different status138321.3 Workload139620.6(4.4)

Importance of income to family1386 4.4(.85)

Mediating variable

Support at work1396

Organizational16.5(3.9)

Supervisor19.1(5.6)

Peer15.5(2.5)

a Full-time employment is not?exible employment but it is included in the table to show the distribution of full-time,part-time and casual employment statuses.

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Table2

Correlations between intention to leave the profession,?exible employment and support at work.

Variable1234567891011

1.Intention to leave the profession–

2.Perceived job insecurity.056*–

3.Non-permanent contract.045?.070**–

4.Full-time employment a.010?.029.014–

5.Part-time employment?.030?.003.061*?.847**–

6.Causal employment.034.059*?.135**?.347**?.204**–

7.Involuntary hours.038?.006.016?.041.035.013–

8.Work on-call?.017.022?.019?.109**.077**.064*.103**–

https://www.wendangku.net/doc/9f10495249.html,anizational support?.212**?.221**?.095**?.011?.015.046?.063*.041–

10.Supervisor support?.180**?.116**?.062*?.062*?.056*?.014?.038.011.532**–

11.Peer support?.161**?.169**?.021.038?.001?.068*?.021.032.217**.258**?

Note:The correlation table for all variables is available from the authors.

a Full-time employment is not?exible employment but it is included in the table to be consistent with the presentation of results in other tables.

*p<.05.

**p<.01.

4.2.Correlations

As presented in Table2,only the perceived job inse-curity,was signi?cantly and positively associated with intention to leave the profession(.056,p<.05).In the corre-lation analysis,none of the objective dimensions of?exible employment were associated with the intention to leave the https://www.wendangku.net/doc/9f10495249.html,anizational,supervisor,and peer sup-port were all signi?cantly and negatively associated with intention to leave the profession(?.212,p<.01;?.180, p<.01;?.161,p<.01,respectively)and job insecurity (?.221,p<.01;?.116,p<.01;?.169,p<.01,respectively). Organizational support was also signi?cantly and neg-atively correlated with non-permanent contract(?.095, p<.01)and involuntary hours(?.063,p<.05).Supervisor support was signi?cantly and negatively correlated with non-permanent contract(?.062,p<.05),signi?cantly and positively correlated with full-time hours(.062,p<.05) and signi?cantly and negatively correlated with part-time employment status(?.056,p<.05).For peer support the signi?cant correlation was only with casual employment status and that was a negative correlation(?.068,p<.05).

4.3.Regression results

Table3presents the second step of the hierarchi-cal regression results for variables associated with the three forms of support at work.Non-permanent contract was signi?cantly and negatively associated with orga-nizational support at the p<.001level and involuntary hours was signi?cantly and negatively associated with organizational support at the p=.029level.None of the other objective?exible employment variables were associ-ated with organizational support.Perceived job insecurity

Table3

Associations between?exible employment,control variables and support at work(hierarchical regressions,second step is shown).

Organizational support Supervisor support Peer support

B S.E.B S.E.B S.E.

Constant26.71.9726.62*** 1.5018.43***0.68 Independent variable

Flexible employment

Objective dimensions

Non-permanent contract?2.15***0.57?2.21*0.88?0.560.40 Full?time employment a(reference)––––––Part-time employment?0.010.22?0.530.34?0.080.15 Casual employment0.210.40?0.930.61?0.68*0.28 Involuntary hours?0.46*0.21?0.120.320.000.15 On-call work0.560.290.340.450.220.21 Subjective dimension

Perceived job insecurity?0.18***0.02?0.12***0.03?0.08***0.02 Control variables

Prefer different status?0.290.26?1.35**0.39?0.480.18 Workload?0.26***0.02?0.21***0.04?0.08***0.02 Importance of income to family?0.050.120.220.190.100.09 R20.160.060.06

Adjusted R20.160.050.05

N123612361236

a Full-time employment is not?exible employment but it is included with?exible employment variables to show that it is the reference for the employment status variable.

*p<.05.

**p<.01.

***p<.001.

154I.U.Zeytinoglu et al./Health Policy99 (2011) 149–157

Table4

Flexible employment and control factors associated with intention to leave the profession,with support at work included as a mediator(hierarchical regressions,second and third steps are shown).

Intention to leave the profession Intention to leave the profession with

support at work included

Columns12345

B S.E.B S.E.

Constant 1.48***0.30 3.51***0.43 Independent variable

Flexible employment

Objective dimensions

Non-permanent contract0.320.180.190.18

Full-time employment a(reference)––––

Part-time employment?0.130.07?0.13*0.07

Casual hours employment0.140.120.110.12

Involuntary hours0.060.070.040.06

On-call work?0.060.09?0.020.09 Subjective dimension

Perceived job insecurity0.01*0.010.000.01

Control variables

Prefer different status0.120.080.080.08

Workload0.05***0.010.03***0.01

Importance of income to family?0.16***0.04?0.15***0.04 Mediating variable

Support at work

Organizational support––?0.04***0.01

Supervisor support––0.010.01

Peer support––?0.04**0.01

R20.060.09

Adjusted R20.050.08

N12251225

a Full-time employment is not?exible employment but it is included with?exible employment variables to show that it is the reference for the employment status variable.

*p<.05.

**p<.01.

***p<.001.

showed a signi?cant and negative association with organi-zational support at the p<.001level.With control variables included the model explained16%of the variance in orga-nizational support.

For supervisor support,controlling for other factors, only non-permanent contract was signi?cantly and neg-atively associated at the p=.013level.None of the other objective?exible employment variables were associated with supervisor support.Perceived job insecurity showed a signi?cant and negative association with supervisor sup-port at the p<.001level.With control variables included the model explained6%of the variance in supervisor sup-port.

For peer support,controlling for other factors,the asso-ciation of the peer support with perceived job insecurity was also strongly signi?cant and negative at the p<.001 level.Of the objective?exible employment variables,only casual hours was signi?cantly and negatively associated with peer support and the signi?cance is at p=.014level. With control variables included,the model explained6%of the variance in peer support.

Table4columns2and3show that the hypothesis that objective employment?exibility will be positively associated with nurses’intention to leave the profession was not supported and none of the objective dimensions were signi?cant.The hypothesis that part-time employ-ment status will be negatively associated with nurses’intention to leave the profession was also not supported at this stage.On the contrary,the subjective dimension of job insecurity was signi?cantly and positively associ-ated with intention to leave the profession as hypothesized, with a signi?cance at the p=.032level.Overall,the model explained6%of the variance in intention to leave the pro-fession.

Next we conducted the mediation test for the hypoth-esis that perceived support at work will mediate the association between?exible employment and intention to leave the profession.Separate hierarchical regression anal-yses were conducted for each support at work variable but only the?nal model with the three support variables are shown in Table4columns4and5.In the separate analy-ses,each support at work variable showed full mediation. (Due to space limitations these results are not provided here,but are available from the?rst author.)As presented in Table4columns4and5,when support at work vari-ables were included in the analysis,controlling for other factors,organizational and peer support were signi?cantly and negatively associated with intention to leave the pro-fession(at p<.001and p=.001levels,respectively).The signi?cant effect of perceived job insecurity disappeared suggesting a full mediation effect.Part-time employment status became negatively signi?cant with intention to leave the profession(at p=.045level).All other objective?exi-ble employment variables were not signi?cantly associated with intention to leave the profession.Thus,there was par-tial support for the hypothesis.It is also important to note

I.U.Zeytinoglu et al./Health Policy99 (2011) 149–157155

that the signi?cance of supervisor support disappeared in the?nal model,due to its strong correlation with the orga-nizational support variable when examined in the same regression analysis.Overall the model explained9%of the variance in intention to leave the profession.

5.Conclusions and discussion

There is a general concern of retention in the nursing profession in Canada[10,16]and elsewhere[14,38–40]. This study found that16%of respondents are seriously con-sidering leaving the nursing profession.Though there are no national level data to compare our?ndings to the Cana-dian population of nurses,a study from Europe shows15% of nurses are intending to leave the profession[13].

In examining a variety of?exible employment in the nursing profession,our results showed that a small per-centage of nurses in our sample work in non-permanent jobs,in casual employment and on-call work.Part-time employment is more common among nurses in our study with about one-in-three working part-time.Part-time employment may re?ect more of the personal interest and needs of nurses as it allows nurses to stay in their occupa-tion while giving them the opportunity to attend graduate school or care for their families.Results showed that close to half of the respondents work involuntary hours sug-gesting a mismatch between hours interested to work and hours offered by the employing hospital.While we believe this is an important issue to consider in nurse retention, as we discuss below,this factor was not signi?cantly asso-ciated with intention to leave the profession.The analysis of the subjective employment?exibility dimension of job insecurity showed only a few of the respondents in this study perceived job insecurity.This?nding was due to labour shortages in the nursing labour market at the time data were https://www.wendangku.net/doc/9f10495249.html,ine et al.[13]found similar results and also suggested the labour market condition for their results.

We can conclude from the multivariate analysis that controlling for work and individual factors,only one of the objective?exible employment variables,part-time employment status was signi?cantly associated with nurses’professional labour market outcome.Nurses with part-time employment status,as compared to nurses with full-time employment status,were intending to stay in the occupation.This?nding is probably unique to the nurs-ing workforce employed in hospitals.In this predominantly female profession,some nurses employed in hospitals were interested in part-time employment as it may work well with their personal life interests,family responsibilities, and may assist in alleviating the demands of the heavy workload.It is also that these part-time jobs are‘good qual-ity’part-time jobs;they have some regularity in the hours and schedules,pay well,pay the same rate as full-time hours,and bene?ts are added as a percentage increase to the hourly rate.Thus for some nurses,particularly for those covered with their spouse’s bene?ts,this job is preferable. Hours are suf?ciently long to provide a good income and they have the right to refuse additional hours that nurse managers might demand from them.They can also specify their preferred work schedules in terms of days available,and day or night shift preference.Thus,the association of part-time employment with intention to stay in the pro-fession may be due to having more control over the hours of work and schedules.Part-time nurses can determine their hours of work on a bi-weekly basis whereas full-time nurses are given schedules about4months in advance.In terms of policy implications,this?nding suggests that cre-ating part-time employment in the nursing labour market may be a positive factor in keeping nurses in the pro-fession.For policy decisions,it is also important to note that other?exible employment factors of non-permanent employment,casual employment,involuntary hours or on-call work are not related to nurses’decision to either stay in or leave the profession.Thus,it is recommended that at the hospital and the sector levels part-time employment creation policy should be continued for nurses’retention in the profession.

A second conclusion of this study is that the subjective ?exible employment dimension of perceived job insecurity is associated with nurses’intention to leave the profession. It can only be expected that individuals faced with inse-curity in their employment,have seen many layoffs,and perhaps even experienced a layoff or two,may not be inter-ested in staying in the profession.This?nding is in line with the well-established theory and empirical literature on intention to leave the organization for workers in gen-eral[18–21]and for nurses[22].Our results suggest policy initiatives at the organization level for retention of nurses in the profession.It is the hospitals and hospital administra-tors along with nurse managers who can make a difference in nurses’perceptions to convince them to stay in the pro-fession.Nurses feel insecurity in their jobs;and as the job insecurity measure showed they are not con?dent that they will have continuous employment in their employing hos-pital.They also observe the developments in the sector and can see that the situation is not different elsewhere in other hospitals.They are worried about their future in this hospi-tal.This perceived insecurity contributes to their intention to leave the profession.Thus,it is crucial that,at the hospi-tal level,the perception of job security can be established as management policy and practiced as much as possible to keep nurses in the profession.Otherwise,they will con-tinue to say that they are‘treated as widgets’[41]and will leave the profession.

A third conclusion of our study is that all three forms of support at work–organizational,supervisor and peer–mediate the effect of perceived job insecurity on intention to leave the profession.However,it is important to note that organizational support absorbs the effect of supervisor support on intention to leave the profession.Nurses’sup-port to each other is also important in keeping them in the profession.Peer support can alleviate the negative effects of job insecurity.Thus,support at work is crucial for reten-tion of nurses in the profession.We recommend hospitals to show nurses that the hospital as their employer cares for them,considers their ideas or opinions as important for the hospital and for the sector,and share with them infor-mation about the future of the hospital and the sector.We recommend a supportive two-way communication policy to be established in hospitals.Hospitals are recommended to communicate to nurses that they are valued and essen-

156I.U.Zeytinoglu et al./Health Policy99 (2011) 149–157

tial components in the health care system.If this view can be conveyed at the organization level,it will trickle down and affect all levels of management behaviour,ultimately leading to nurses’perception that they are supported at work.This perceived support,in turn,can contribute to their intention to stay in the profession.

These results have signi?cant implications for health human resources policy as it applies to nursing.If nurses are to be retained in the health care profession,part-time work, perceived job security and support at work are impor-tant factors to consider.Except part-time work,it is not necessarily the objective dimension of?exible employ-ment that is associated with nurses’retention.It is the subjective dimension of perceived job security and feeling supported by their employing hospitals,administrators, nurse managers and co-workers that play decisive roles in nurses’intention to stay in the profession.Policy mak-ers are recommended to pay attention to nurses’current work and work environment factors and nurses’percep-tions of those work environments.Perceptions of work environment are real and important.Perceptions affect the attitude(of intention to leave the profession)and the atti-tude affects behaviour(decision to leave nursing).

It is important to note a few limitations of the study and suggest further research.First,the sample comes from only three organizations(hospitals)in one province(Ontario) in Canada.Although conducting the study focusing on a small number of organizations allowed us to examine the issues in-depth,we caution the readers in generalizing from our results.We suggest further studies on the topic, and ideally,a national or an international level analysis of these issues for generalizations.Second,our study is a cross-sectional analysis and thus,we are only able to show associations between variables and cannot discuss causal inferences.We recommend longitudinal studies on the impact of objective and subjective dimensions of ?exible employment on nurses’intention to leave the pro-fession to show causal relationships.It is possible that some variables that are not signi?cant here can become signi?cant in a longitudinal study and others may become insigni?https://www.wendangku.net/doc/9f10495249.html,stly,we recommend studies to examine nurses’actual decisions,i.e.leaving the profession,to fur-ther shed light on the topic.It is possible that once given the choice to leave,nurses might decide to stay even if they perceive job insecurity and low level of support at work.

Acknowledgements

The research for this paper is supported by a grant from the Social and Economic Dimensions of an Aging Popula-tion II Research Program funded by the Social Sciences and Humanities Research Council of Canada.Views expressed in this article are the authors’and do not necessarily re?ect the views of the granting organizations.Survey data were collected under Dr.Zeytinoglu and Dr.Denton’s manage-ment with funding from the Canadian Institutes of Health Research and Ontario Ministry of Health and Long-term Care operating grant to Dr.A.Bauman as the Principal Investigator and Drs.J.Blythe,I.U.Zeytinoglu,M.Den-ton and L.O’Brien-Pallas as Co-Investigators.We thank research project team members,S.Davies and A.Higgins for their assistance at various stages of this research. References

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商务英语信函的特点

摘要: 英国论文随着时代的发展, 使用简洁通俗的语言已成为现代商务英语, 尤其是商务英语信函的突出特点。本文从这一特点形成的根源简易英语运动出发, 分析了简易英语的定义, 遵循的原则, 最后在此基础上通过大量例证的对照比较, 总结了简易英语趋势在现代商务交际中的体现。 商务英语和法律英语一样, 通常被认为是充斥着技术性术语和诘屈聱牙语句的典型书面语。不可否认, 很长时间以来, 商务文书给人的印象确实如此。然而随着时代的发展, 这种情况已得到极大的改观, 商务交际用语渐趋简明易懂。使用简洁通俗的语言已成为现代商务英语的突出特点。我们可以比较一下下面的两句商务信函中的用语: 1. We beg respectfully to state that we are in receipt ofyour L/C in the amount of USD×××for which we thankyou. 2. We inform you that we have received your L/C forUSD×××. 可以看出, 这两句表达的意思完全相同, 但是第一句使用了beg respectfully to state, in receipt of, inthe amount of, 以及包括定语从句for which we thank you等表达极为繁杂的用语, 而第二句用语简洁明快, 但是它所包含的信息量较第一句而言没有丝毫的减少。现代商务英语正是提倡使用简单词语( plain words) , 而不用复杂的语句( complicated words) , 尤其是那些繁复老套的用语, 即我们所说的陈词滥调( cliché)。现代商务英语的这一显著特点, 其实与这些年来在英美等国出现的英语简化趋势, 尤其是在美国大张旗鼓推行的简易英语运动( Plain English Movement)有直接的联系。这一运动要求革除商业契约上的繁文缛节, 简化法律用语, 从而起到方便民众, 减少因繁复用语而引起不必要争端的作用。1978 年 3 月24 日, 当时的美国总统卡特更是签署了第12044 号行政命令, 要求联邦政府各部切实保证颁布的每项法令必须以简单易懂的英语撰写, 以便须依照有关法令办事的人都能看懂。这一法令理所当然受到普通老百姓的欢迎, 而简易英语运动在这一法令的推动之下也得到了更为蓬勃的开展[1]。 一、什么是“简易英语” 所谓简易英语( Plain English) , 美国学者考特兰?博维(Courtland Bovèe)和约翰?席尔( John Thill)认为简易英语是用简易的文字和结构写成的语句, 读者都能看懂, 很接近于我们的口语[2]。可见, “简易英语”是指书面表达中使用清晰正确的英语简明扼要而有效地传递信息。“简易英语”并不幼稚, 也并非过分简单化的英语。“简易英语”重视信息的传递。它并不堆积词藻, 而且不会不必要地使用行话、术语等难懂的表达。换句话说,“简易英语”彻底抛弃了繁文赘语和让人无所适从的表达。用“简易英语”书写的文件是为了让人们读懂, 因此所用的词语都是读者能够理解的。只要读者能够理解, “简易英语”用到技术性较强的专业术语也并非不可。比如,一篇医学学报上的论文面向的是医学专家, 使用专业术语是可以的, 因为这些读者能够理解。只要表达恰当, 这篇论文的语言仍然可被称为“简易英语”。当然, 如果这篇文章是出现在面向公众的通俗杂志上, 那么再包含很多专业术语就很可能出现普通读者无法理解的状况。这个时候, 只有使用普通大众能够理解的字眼那它才是“简易英语”。我们应该看到非常复杂的概念也是可以用“简易英语”加以解释的。许多法律文书, 比如合同和法令, 用“简易英语”改写后仍然能做到表达精确无误。 二、“简易英语”所遵循的原则 “简易英语”最重要的原则就是读者为先。即为读者着想, 考虑读者的需求。要“简易”, 就得好好考虑如下的问题:读者需要知道些什么? 他们对这个问题的理解程度如何? 怎样才能更好地把意思组织起来以便读者更好地理解? 要想有效传递你的信息, 首要的是要清楚什么样的人会阅读你写的东西。具体来讲, “简易英语”遵循如下的原则: (一)写作前做好规划起草文书之前, 首先得明确自己的写作目的。读者是谁? 他们对于所涉及的话题是非常了解, 了解一点还是一无所知? 他们想知道些什么? 找到这些问题的答案, 做到心中有数。一旦知道了读者是谁, 就应该尽可能从他们的角度来看问题, 来表达

2018高三英语常用动词短语搭配(完美版)

高考冲刺必备 高考常用动词短语搭配1.动词+about speak/talk about谈论 think about思考 care about关心,对...有兴趣bring about引起,使发生 set about 着手,开始 come about发生 hear about听说 worry about为...担心 2.动词+away throw away 扔掉 blow away吹走 carry away拿走,使入迷clear away清除掉,消散 die away逐渐消失 pass away 去世 wash away冲走 take away拿走 put away收拾起来,存起来give away背弃,泄露 wear away磨掉,消耗 break away摆脱 send away让走开 turn away把...打发走 3.动词+back keep back隐瞒,忍住 hold back控制住 call back回电话 look back回顾 give back归还 take back拿回,收回 4.动词+for run for竞选 ask for要求得到 wait for等候 long for渴望 care for关心,喜欢 search for查找 call for要求,需要 change for用...换 apply for申请 seek for寻找 stand for代表,表示 hope/wish for希望得到beg for乞求 look for寻找 hunt for寻找 charge for收费,要价 take for误以为...是 come for来拿,来取 5.动词+down break down 出毛病，分解，拆开 bring down 使下降，使倒下 burn down 烧毁 calm down平静下来 come down 下跌，落，降，传下 cut down 削减，砍倒 die down （炉火）渐熄 fall down 掉下，跌倒 get down to do 致力于，专心于 get down 下来，记下，使沮丧 go down 下沉，降低 hand down 传给，流传 hold down 控制，镇压 knock down 撞倒 look down upon 瞧不起 pass down 传下来 pass down…to 传给 pull down 往下拉，拆毁 put down 记下，写下，平息 set down 放下 settle down 安家 slow down慢下来 take down 记录，写下 tear down 拆除 turn down 调小，拒绝 6.动词+at come at 向...袭击 run at冲向,向...攻击 tear at用力撕 stare at凝视 glance at匆匆一瞥 knock at敲门,窗等 smile at冲某人笑 aim at向...瞄准 wonder at惊讶 shout at冲某人嚷嚷 work at干...活动研究 look at看,注视 glare at怒视 laugh at嘲笑 point at指向 strike at向...打击 shoot at向...射击 call at拜访地点 7.动词+from differ from与...不同 suffer from受...苦 hear from收到...来信 die from因...而死 keep/stop/prevent from不让...做 learn from向...学习 date from始于...时候 result from由于 separate from把...分离开 8.动词+of think of想到 consist of由...组成 approve of赞成 talk of谈到 complain of抱怨 dream of梦到 speak of 读到 die of死于 hear of听说 become of发生...情况,怎么啦 9.动词+off start off出发 set off出发 leave off''中断 show off炫耀 get off下车 see off送行 put off延期,推迟 cut off切断,断绝 keep off避开,勿走近 knock off把...撞落 pay off还清 get off脱下衣服等 trun/switch off关掉 take off脱下,起飞 ring off挂断电话 come off脱掉,褪色 fall off跌落,掉下 go off走开,消失,坏了 break off打断 carry off携走,带走 give off散发出 10.动词+on

todo与doing的区别

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（4）能够熟练掌握完整的业务流程，独立完成完整的业务磋商信函撰写。 2．知识目标 （1）掌握商务信函常用撰写格式及组成部分； （2）掌握商务英语信函撰写的特点及专业英语表达方式； （3）掌握各种外贸文件的翻译特点及相关外贸专业知识。 3．素质目标 （1）具备正确理解和掌握国家外交、外贸方针政策的能力； （2）持续学习，不断更新知识的意识； （3）具有从事商务活动的良好职业道德素质及行为规范； （4）具备国际商务礼仪知识，注重对外贸易交往的礼节； （5）踏实的工作作风和严谨的工作态度。 三、课程教学内容设计 （一）学习情境设计 《商务英语函电》课程选择“业务流程”为载体，共设置三个学习情境，各学习情境名称及学时分配情况如表所示：

常用英语动词短语固定搭配

常用英语动词短语 1. 动词 +about speak/talk about谈论 think about思考 care about 关心 , 对... 有兴趣bring about 引起 ,使发生 set about 着手 , 开始 come about 发生 hear about听说 worry about为...担心 2. 动词 +away throw away扔掉 blow away 吹走 carry away 拿走 , 使入迷clear away 清除掉 , 消散 die away 逐渐消失 pass away 去世 wash away 冲走 take away 拿走 put away 收拾起来 , 存起来give away 背弃 , 泄露 wear away 磨掉 , 消耗 break away 摆脱 send away 让走开 turn away 把 ... 打发走 3. 动词 +back keep back 隐瞒 ,忍住 hold back 控制住 call back 回电话 look back 回顾 give back 归还 take back 拿回 , 收回 4. 动词 +for run for竞选 ask for 要求得到 wait for等候 long for 渴望 care for 关心 , 喜欢 search for 查找 call for要求,需要 change for 用... 换 apply for申请 seek for 寻找 完美 .格式 .编辑 stand for 代表 , 表示 hope/wish for希望得到 beg for 乞求 look for 寻找 hunt for寻找 charge for收费,要价 take for误以为...是 come for 来拿 , 来取 5. 动词 +down burn down烧毁 take down记下,记录 cut down 削减 , 砍倒 pass down 传下来 calm down 平静下来 settle down安家 tear down拆毁,拆除 break down 坏了 , 垮了 ,分解turn down调小,拒绝 slow down 慢下来 put down 记下 , 写下 ,镇压bring down 使... 降低 , 使倒下come down 下落 , 传下 6. 动词 +at come at向...袭击 run at 冲向 , 向... 攻击 tear at用力撕 stare at 凝视 glance at 匆匆一瞥 knock at 敲门 , 窗等 smile at 冲某人笑 aim at 向 ... 瞄准 wonder at 惊讶 shout at 冲某人嚷嚷 work at 干... 活动研究 look at 看, 注视 glare at 怒视 laugh at 嘲笑 point at指向 strike at向...打击 shoot at 向 ... 射击 call at 拜访地点 7. 动词 +from differ from与...不同 suffer from受...苦

todoanddoing用法

加to do 的动词 attempt企图enable能 够 neglect忽视afford负担得 起 demand要求long渴 望 arrange安排destine注 定 mean意欲，打算begin开 始 expect期望omit忽略，漏 appear似乎，显得determine决定manage设 法cease停止 hate憎恨，厌恶pretend假装 ask问dread害 怕 need需要agree同 意

desire愿望love 爱 swear宣誓volunteer志愿 wish希望bear承 受 endeavor努力offer提 供 beg请求fail不 能 plan计划 bother扰乱；烦恼forget忘 记 prefer喜欢，宁愿care关心，喜欢happen碰 巧prepare准 备decide决 定learn学 习 regret抱歉，遗憾choose选择hesitate犹 豫profess表明

claim要求hope希 望 promise承诺，允许start开始undertake承 接want想要 consent同意，赞同intend想要refuse拒 绝decide决定 learn学习vow起contrive设法，图谋incline有…倾向propose提议seek 找，寻觅 try试图 2)下面的动词要求不定式做宾补：动词+宾语+动词不定式 ask要求，邀请get请，得 到 prompt促使allow允 许 forbid禁止prefer喜欢，宁愿announce宣 布force强

迫 press迫使bride 收 买 inspire鼓舞request请求 assist协助hate憎 恶 pronounce断定，表示advise 劝告exhort告诫，勉 励pray请求 authorize授权，委托help帮 助recommend劝告，推荐bear容 忍implore恳 求remind提醒 beg请求induce引 诱 report报告compel强 迫 invite吸引，邀请，summon传 唤command命 令intend想要，企

商务英语中的委婉表达及其翻译

最新英语专业全英原创毕业论文，都是近期写作 1 《大学英语》听力理解中的石化现象与对策 2 孔子与柏拉图的教育思想之比较研究 3 组织学习障碍及相应的对策 4 论《隐形人》中的象征主义 5 社会实践活动对大学生的重要性 6 英汉动物词汇文化内涵对比 7 浅谈象征在《了不起的盖茨比》中的运用 8 Cultural Connotation of Color Words in Chinese and Western Culture 9 《法国中尉的女人》中对维多利亚时代的批判 10 浅谈英语俚语 11 凯瑟琳安波特作品中的女性话语权威 12 从小说《百万英镑》中看对当今社会的讽刺意义 13 从女性主义视角解读《了不起的盖茨比》中的黛西 14 浅谈英语广告的特点及翻译 15 《白象似的群山》里的潜意识 16 写作教学中的范文教学 17 论奥斯卡王尔德唯美主义童话中的批判精神 18 浅析《了不起的盖茨比》中的象征主义 19 合作性学习在教学中的作用 20 合作原则在电影《暮光之城》人物心理分析中的应用 21 谈目的论视角下的商标翻译 22 试析《汤姆叔叔的小屋》中两个奴隶的性格和命运 23 从《马拉喀什》和《射象》看乔治?奥威尔散文的艺术风格 24 唐诗中比喻修辞格的翻译——以许渊冲英译本为例 25 英语谐音双关的语义特点及其不可译性 26 模糊语言的社会语用功能 27 从民族服饰角度看中美文化价值 28 浅析好莱坞英雄主义中的传统英雄和反英雄形象 29 美国拓荒运动中的新女性形象－－读威拉凯瑟《我的安东妮娅》 30 广告英语的语言特征 31 英美小说《傲慢与偏见》和《飘》中的女性主体意识比较分析 32 《太阳照常升起》中“迷惘的一代”人物分析 33 跨文化视角下的中美社交礼仪的对比研究 34 Using Maslow’s Hierarchy Needs Theory to Analyze Sister Carrie’s Destiny 35 女性人格的双重性——从心理学的角度对比分析凯瑟琳和简爱 36 从女性主义探讨托尼?莫里森笔下黑人妇女自我意识的觉醒 37 《宠儿》中塞丝的性格特征分析 38 论中美商务沟通中的跨文化意识 39 论爱丽丝·沃克《紫色》中西丽女性自我的缺失与重塑 40 汉英“甜”字隐喻用法对比 41 中西方婚礼习俗的差异 42 A Feministic Study of the Theme of “The Chrysanthemums”（开题报告+论文+文献综述）

初中英语常用动词词组及短语240个

初中英语常用动词词组及短语240个 由be构成的词组 1)be back/in/out 回来/在家/外出 2)be at home/work 在家/上班 3)be good at 善于，擅长于 4)be careful of 当心，注意，仔细 5)be covered with 被……复盖 6)be ready for 为……作好准备 7)be surprised (at) 对……感到惊讶 8)be interested in 对……感到举 9)be born 出生 10)be on 在进行，在上演，（灯）亮着 11)be able to do sth. 能够做…… 12)be afraid of (to do sth. that…) 害怕……(不敢做……，恐怕……) 13)be angry with sb. 生(某人)的气 14)be pleased (with) 对……感到高兴(满意) 15)be famous for 以……而著名 16)be strict in (with) (对工作、对人)严格要求 17)be from 来自……，什么地方人 18)be hungry/thirsty/tired 饿了/渴了/累了 19)be worried 担忧 20)be (well) worth doing (非常)值得做…… 21)be covered with 被……所覆盖…… 22)be in (great) need of (很)需要23)be in trouble 处于困境中 24)be glad to do sth. 很高兴做…… 25)be late for ……迟到 26)be made of (from) 由……制成 27)be satisfied with 对……感到满意 28)be free 空闲的，有空 29)be (ill) in bed 卧病在床 30)be busy doing (with) 忙于做……(忙于……) 由come、do、get、give、go、have、help、keep、make、looke、put、set、send、take、turn、play 等动词构成的词组 31)come back 回来 32)come down 下来 33)come in 进入，进来 34)come on 快，走吧，跟我来 35)come out出来 36)come out of 从……出来 37)come up 上来 38)come from 来自…… 39)do one's lessons/homework 做功课/回家作业 40)do more speaking/reading 多做口头练习/朗读 41)do one's best 尽力 42)do some shopping (cooking reading, cleaning)买东西(做饭菜，读 1文档来源为:从网络收集整理.word版本可编辑.