Evaluating primary nursing in hospitals: examination of effects on nursing staff

Despite widespread support in the nursing literature for the adoption of primary nursing as the optimal method of organizing hospital nursing care, little empirical evidence exists as to its effects on patients or nursing staff. This study compares units that have employed primary nursing for at least five months (N = 31) with nonprimary units (N = 20) in two large university-affiliated hospitals. Comparisons are made with respect to structural attributes of nursing units, nurses' perceptions of their jobs and units, and three outcomes: nurses' job satisfaction, absenteeism rates and resignation rates for the units. No significant differences are found between primary and nonprimary nursing with respect to measures of job satisfaction. Primary units at one hospital exhibit lower resignation and absenteeism rates than do nonprimary units. The adoption of primary nursing is discussed in light of these findings.