Hospitalized patients' ability to identify licensed nurse versus unlicensed assistive personnel and prediction of patient satisfaction

Date of Completion

January 1999


Health Sciences, Nursing|Health Sciences, Health Care Management




To reduce costs, U.S. hospitals have hired unlicensed assistants to execute many bedside tasks formerly performed by nurses. Increasing task delegation decreases direct nurse-patient contact and limits the opportunity for nurses to establish quality interpersonal relationships with patients. Because patient satisfaction is largely influenced by the quality of the interpersonal relationships patients experience with their providers, reduced nurse-patient contact may negatively affect patients' satisfaction with their nursing care. This study investigated whether hospitalized patients can distinguish between licensed nurse and unlicensed assistive caregiver titles, and its relationship to patient satisfaction with nursing care. Travelbee's (1971) interpersonal theory linking knowledge of caregiver identity to attaining effective nurse-patient relationships provided a framework for this study. ^ Instruments included the LaMonica-Oberst Patient Satisfaction Scale, revised and an Employee Roster developed to measure patients' knowledge of nurse and unlicensed caregiver job titles. Using a multi-site descriptive correlational design, it was learned from 100 alert and oriented adult, hospitalized patients that 72% could correctly state the job title of a licensed nurse or an unlicensed assistant immediately after that employee left the patient's room. From the list of unit employees, patients were much more likely to recognize names of their nurses than their unlicensed assistants. In addition, patients were three times more likely to know the job titles of their nurses than of their unlicensed assistants. ^ Hierarchical regression revealed that correlations between patients' satisfaction with hospital nursing care and patients' ability to identify their licensed nurse or unlicensed assistants were insignificant after blocking the influence of age and length of stay. The ability to identify caregivers did not significantly predict patient satisfaction with nursing care scores. ^ Caregivers need to educate patients about their roles as well as their job titles. Future studies should explore what patients understand about the different training and capabilities of nurses and unlicensed assistants, and investigate the reasons why patients remember nurses' names more readily. Knowing whether patients believe it is important to know caregiver competencies or roles and how patients distinguish nurses from unlicensed caregivers would facilitate efforts to provide this essential information to patients. ^