1. Ellenbecker, Carol Hall RN, PhD
  2. Boylan, Leslie Neal PhD, RN, FNP-C
  3. Samia, Linda RN, MSN


A troubling bit of evidence recently reported by Sochalski (2004a) is that among all groups of nurses, those working in home care are among the most dissatisfied with their jobs. This is a change from the past, when nurses working in home healthcare were believed to be the most highly satisfied group of nurses (Simmons et al., 2001). The source of nurses' dissatisfaction has been attributed to the changing work environment in home care (Anthony & Milone-Nuzzo, 2005;Ellenbecker & Byleckie, 2005b) brought about by recent federal and state regulations. Requirements for the Outcome Assessment and Information Set (OASIS) and a capitated reimbursement system with incentives to limit the amount of contact nurses have with patients have increased nurses' work demands (Anthony & Milone-Nuzzo; Smith-Stoner, 2004b). The changes made in organizational structures and policies to adapt to the changes in regulation and inadequate staffing have increased nurses' workloads, job stress, and job dissatisfaction (Smith-Stoner, 2002, 2004;Sochalski, 2004b).