Job satisfaction among hospital nurses: A literature review

Nurses' job satisfaction during the mass gathering of the Hajj 2018 in Saudi Arabia

AIM

To explore job satisfaction of nurses during the Hajj season 2018 in Saudi Arabia, determine predictors of nurses' job satisfaction and inform future healthcare provision and policy.

BACKGROUND

Mass gatherings of large numbers of people inevitably pose unique public health concerns and challenges for organizers. A mass gathering happens annually in Saudi Arabia during the Hajj pilgrimage. There was a paucity of evidence regarding nurses' experiences during Hajj. This gap in knowledge needed to be addressed.

METHODS

A cross-sectional survey was conducted in 198 nurses across 12 healthcare settings along the Hajj pilgrimage route. A 24-item Nurses' Job Satisfaction Questionnaire was developed exploring six domains: supervision, nature of work, retention, communication, workload and co-workers.

RESULTS

Nurses reported a high level of job satisfaction. All six domains were strong predictors of job satisfaction. Nurses reported the lowest level of job satisfaction when assessed against the items 'multiple policies and procedures that were perceived as complicating nursing work', 'incompetence of other people they work with' and 'too much burden at work'.

CONCLUSION

Job satisfaction levels for nurses during Hajj 2018 appeared higher than during previous Hajj pilgrimages, probably influenced by the additional healthcare measures put in place during Hajj 2018, such as improved technology.

IMPLICATIONS FOR NURSING POLICY AND PRACTICE

Hajj-specific skills training must be designed to enhance the knowledge, competencies and capabilities of nurses. Policies and procedures must prevent heavy workloads and avoid complicating nurses' work during Hajj. Improvements to the nurse work environment should focus on evidence-based interventions promoting effective resource planning, interprofessional relationships and communication, for instance via innovative, technological approaches. These findings can be shared with organizers of other mass gatherings worldwide.

Social support, role clarity and job satisfaction: a successful combination for nurses

AIM

To analyse the moderating effect of role clarity on the relationship between social support (supervisor and colleagues) and job satisfaction.

BACKGROUND

The social support of supervisors and co-workers and the clarity of roles are important antecedents of job satisfaction. According to the Conservation of Resources theory, the interaction of the instrumental nature of role clarity and social support would result in higher levels of job satisfaction in nursing.

METHODS

Through a convenience sample, a final sample of 191 participants (64.92% registered nurses, 35.08% nursing assistants) was obtained from a private hospital complex in Portugal. Hierarchical linear regression models were carried out to check the moderating function of role clarity.

RESULTS

Regression models showed the moderating effect of role clarity. Nursing staff with high social support from their supervisors and peers showed higher scores in job satisfaction when role clarity was high.

CONCLUSION

An adequate description of roles, through clear and detailed information regarding expected functions, responsibilities and behaviour, allows the effect of social support from supervisors and co-workers on job satisfaction to be stronger.

IMPLICATIONS FOR NURSING PRACTICE

Strategies such as defining responsibilities, setting clear expectations and role analysis allow a reduction in sources of uncertainty in jobs. Training in communication and feedback skills would improve the social support given by supervisors and colleagues.

IMPLICATIONS FOR NURSING POLICY

Hospital boards and nurse managers should be aware of the importance of clarifying roles, responsibilities, and functions of each professional category and hierarchical level for the provision of adequate quality of care.

The nurse outcomes and patient outcomes following the High-Quality Care Project

BACKGROUND

There have been many single cross-sectional studies on nurse or patient outcomes. However, long-term evidence on improving nurse and patient outcomes is still limited. The High-Quality Care Project is a national project in China for improving nurse and patient outcomes by implementing primary nursing.

AIM

(1) To assess the long-term changes in nurse and patient outcomes in the context of the High-Quality Care Project. (2) To explore the potential influences of primary nursing on nurse and patient outcomes based on this study and broader existing evidence.

METHODS

The data of two cross-sectional studies were used for analysis. The two cross-sectional studies were conducted before (2009) and after (2016) the High-Quality Care Project. A total of 1376 nurses and 904 patients from 40 units of 10 tertiary hospitals were surveyed. Reliable and validated instruments were used to measure nurse and patient outcomes. Multilevel modelling was the main method for data analysis.

RESULTS

Nurses in 2016 were more satisfied than nurses in 2009 with most dimensions of nurse work environment and job satisfaction. However, they were not more satisfied with burnout, global job satisfaction or intention to leave their job. Nurses in 2016 also reported better quality of patient care and patient safety while their patients reported higher patient satisfaction.

CONCLUSION

The analysis of our results based on existing evidence indicates that primary nursing could be considered as a potentially effective way to improve nurse work environment and patient outcomes. More studies with rigorous study design from micro perspectives would be useful to further explore the direct effects of primary nursing on nurse or/and patient outcomes.

IMPLICATIONS FOR NURSING AND NURSING POLICY

Policymakers, healthcare service leaders and nurse managers should make efforts to provide multi-level supports to cultivate an encouraging environment for nurses to practice primary nursing, because the implementation of primary nursing may improve the nurse work environment and patient outcomes. Furthermore, improving nurse participation in hospital affairs and developing nursing discipline and education for increasing nursing staff resource and nurses' capacity - which all need policy and management supports - are crucial to further improve nurse and patient outcomes.

The Association of Work Satisfaction and Burnout Risk in Endoscopy Nursing Staff-A Cross-Sectional Study Using Canonical Correlation Analysis

Background: Burnout is known to have detrimental effects on healthcare staff with regard to both personal and occupational matters. The association between burnout symptoms and work satisfaction in endoscopy nursing staff in Germany has not been studied previously. We aimed to investigate the association between work satisfaction and risk of burnout in endoscopy nursing staff in Germany and to extract predictors for burnout in the area of work satisfaction, which can inform the design of future interventions. Setting: All members of the German Association of Endoscopy Staff in Germany (Deutsche Gesellschaft für Endoskopiefachberufe e.V.—DEGEA) were invited to take part in an online survey. Methods: The total sample consisted of 674 endoscopy staff members. Of those, 579 were female (85.9%) and 95 were male (14.1%). The mean age of the participants was 44.3 years (SD 10.6), with a median age of 46 years, a minimum age of 20, and a maximum age of 64 years. We used confirmatory factor analyses to examine the Maslach burnout inventory (MBI) and, a questionnaire for assessing general and facet-specific job satisfaction (KAFA), regarding their postulated internal structure in our special sample. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy staff members. Results: We were able to replicate the factorial structures of the MBI and the KAFA, both showing an acceptable model fit. The canonical correlation analysis resulted in three canonical functions, with canonical correlations of 0.64 (p < 0.001), 0.32 (p < 0.001), and 0.17 (p < 0.001). The first canonical function revealed that KAFA scales for colleagues, professional development, payment, supervisor, and general job satisfaction were good predictors for less exhaustion, less depersonalization and lack of empathy, and higher personal accomplishment. Commonality analysis revealed that general job satisfaction was the most significant factor in explaining the squared canonical correlation. The second canonical function showed that occupational function and colleagues were good predictors for exhaustion and personal accomplishment. Conclusions: Interventions aimed at ameliorating symptoms of burnout in endoscopy staff should be tailored to address specific needs as experienced by the employees. Therefore, the results of this study could contribute to the design of various interventions, which could be employed to address the issue of work satisfaction and burnout in endoscopy staff most effectively.

Analyzing the Job Demands-Control-Support Model in Work-Life Balance: A Study among Nurses in the European Context

The balance of personal life with professional life is a topical issue that is increasingly worrisome due to globalization, the rapid introduction of new technologies into all areas of human life, the overlap between time between work and family, new organizational systems, and changes in the nature of work. This problem is accentuated by professions subjected to intense labor demands, as is the case of nurses. Adopting the Job Demand–Control–Support model, the main purpose of this research is to analyze how these factors lead to a greater or lesser degree of work–life balance. The research proposes a logistic regression model, which was constructed with a sample of 991 nursing professionals from the V European Working Conditions Survey. The results obtained confirm, on the one hand, that there is a significant effect of physical demands (but not psychological demands) on work–life balance. On the other hand, the moderating effects of job control are partially confirmed for psychological demands, and those of supervisor support (but not co-worker support) are partially confirmed for physical demands. In conclusion, the present research shows that effective management of nurses’ work context can decisively contribute to finding the difficult balance between personal and professional time.

A Multicenter Study into Burnout, Perceived Stress, Job Satisfaction, Coping Strategies, and General Health among Emergency Department Nursing Staff

Burnout is a major problem among nurses working in emergency departments and is closely related to a high turnover of personnel, nursing errors, and patient dissatisfaction. The aims of this study were to estimate burnout, perceived stress, job satisfaction, coping and general health levels experienced by nurses working in emergency departments in Spain and to analyze the relationships between sociodemographic, occupational, and psychological variables and the occurrence of burnout syndrome among these professionals. A cross-sectional study was conducted in four emergency departments in Andalusia (Spain) from March to December 2016. The study sample was composed of n = 171 nurses. An ad hoc questionnaire was prepared to collect sociodemographic and work data, and the Maslach Burnout Inventory, the Perceived Stress Scale, the Font–Roja Questionnaire, the Brief Cope Orientation to Problem Experience and the General Health Questionnaire were used. The prevalence of high burnout was 8.19%. The levels of perceived stress and job satisfaction were moderate. The most frequent clinical manifestations were social dysfunction and somatic symptoms, and problem-focused coping was the strategy most used by nurses. Lack of physical exercise, gender, years worked at an emergency department, anxiety, social dysfunction, and avoidance coping were significant predictors of the dimensions of burnout.

Predictors of nurses' turnover intention at one and five years' time

AIM

This study examined the role of job dimensions, job satisfaction, psychological stress and job burnout in predicting turnover intention at one and five years' time among professional nurses in the Philippines.

METHODS

A cross-sectional design was utilized in the study using a convenience sample of 549 registered nurses from six hospitals in the Central Philippines during the period of October 2018 to January 2019. Five self-report scales were used in this study.

RESULTS

Overall, 46.1% (n = 253) and 78.9% (n = 433) of nurses reported planning to leave the organization at one and five years' time, respectively. The type of hospital, job satisfaction and job burnout explained variances for turnover intention at one and five years' time. Separately, hospital bed capacity and job stress predicted turnover intention at five years' time. None of the job dimensions accurately predicted turnover intention in nurses.

CONCLUSION

Higher turnover intention results at one and five years' time were dependent on nurses' psychological stress, job burnout and job satisfaction.

IMPLICATIONS FOR NURSING PRACTICE AND POLICY

Organizational measures aimed at reducing stress and burnout and increasing job satisfaction in nurses are critically important to enhance the retention of nurses and ensure continued quality of nursing care.

The “service excellence chain”: an empirical investigation in the healthcare field

Purpose

The linkage between internal and external satisfaction is an understudied topic in the service field. This study aims to address this gap by proposing an original research model, the service excellence chain (SEC), that connects the internal and external perspectives by conjoining performance-excellence models and the service-profit-chain approach. Theoretical assumptions and quantitative measures are proposed by using advanced statistical techniques.

Design/methodology/approach

The SEC is investigated through an empirical study in the healthcare sector, focusing on an Italian hospital and involving two of its core units. Qualitative and quantitative approaches were used. First, internal and external customer satisfaction were separately tested through structural equation modeling. The linkage between internal and external satisfaction is then proposed by mathematically defining a synthetic index, the internal and external customer satisfaction index (IEGSI), modeled through Bayesian networks (BNs) and object-oriented BNs to provide an overall measure able to predict organizational improvement.

Findings

The distinct measured models show good internal validity and adequate fit both for patients' and employees' perspectives. The IEGSI allows rigorously connecting internal and external satisfaction by developing conjoint scenarios for organizational improvement.

Originality/value

This study proposes the SEC model as an innovative way to connect internal and external satisfaction. The findings can be useful both for private and public organizations and may provide several useful insights for healthcare managers as well as for policy-makers in relation to developing strategies for improving service quality.

Burnout among Healthcare Professionals in Ghana: A Critical Assessment

Health workers are prone to burnout, which can have an adverse effect on their person and the patients to whom care is offered. The goal of this paper was to assess the levels of burnout experienced by healthcare workers in Accra, Ghana. The study was conducted using the cross-sectional study design. Questionnaires were used to obtain data from 365 respondents who worked in 12 major healthcare facilities. Data obtained were analyzed with SPSS version 23. Majority of the respondents were females (56.7%) as against males (43.3%). The total score for all burnout variables among health worker groups ranged from good (71.50%), alarming (12.60%), acute crisis (6.02%), and burnout (9.90%). Among the health worker groups, nurses had the highest percentage score values for all burnout variables. There was an association between burnout and these sociodemographic characteristics: age (p < 0.001), gender (p = 0.003), educational qualification (p < 0.001), occupation (p < 0.001), years of work experience (p < 0.001), marital status (p < 0.001), and parenthood (having children) (p < 0.001). It is recommended that measures should be put in place in Ghanaian hospitals to assess stress and burnout levels to ensure people who are going through such situations are properly cared and supported.

Compassionate love, burnout and professional commitment in nurses

AIMS

To determine the effects of compassionate love on burnout and professional commitment in nurses.

BACKGROUND

Compassionate love as 'other-centred' love is referred to as altruistic love, unconditional love and unreciprocated love. Compassionate love has an important role among nurses in moderating burnout and increasing professional commitment.

METHODS

One-hundred ninety-four nurses working at two public hospitals in Turkey completed four self-report instruments: socio-demographics, the Compassionate Love Scale, the Burnout Measure-Short Version and the Nursing Professional Commitment Scale.

RESULTS

A statistically significant inverse relationship was found between Compassionate Love Scale and Burnout Measure-Short Version scores, while Compassionate Love Scale scores were significantly and positively associated with Nursing Professional Commitment Scale scores. Participants with children had higher Compassionate Love Scale scores while those participating in the arts had lower Burnout Measure-Short Version scores. Nurses with intensive care experience had higher Nursing Professional Commitment Scale scores.

CONCLUSION

There is a positive relationship between compassionate love and professional commitment, a negative relationship between compassionate love and burnout. Further research is needed to test compassionate love interventions.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers may use the results of this study in encouraging and rewarding acts of compassionate love towards colleagues and patients.

Paediatric nurses' general self-efficacy, perceived organizational support and perceived professional benefits from Class A tertiary hospitals in Jilin province of China: the mediating effect of nursing practice environment

Background

General self-efficacy is considered one of the most influential parameters affecting the quality of clinical practice and nurses’ perceived professional benefits (NPPB). Perceived organizational support (POS) is regarded as being central in understanding job-related attitudes, and it is important to enhance POS for nurses to maintain their current employment. NPPB can further reduce nurses’ job burnout and turn-over intention. Many studies have explored the relationships among general self-efficacy, POS, nursing practice environment (NPE) and NPPB. However, a moderating effect of NPE has not been fully explored in nurses, especially among paediatric nurses.

Methods

A descriptive cross-sectional study was conducted from July to October 2018 with 300 paediatric nurses from 3 Class A tertiary hospitals in Jilin Province. The respondents completed the General Self-Efficacy Scale, Perceived Organizational Support Scale, Practice Environment Scale and Nurses’ Perceived Professional Benefits Scale. The data were analyzed using path analysis and SPSS (version 23.0, IBM).

Results

General self-efficacy and POS were significantly positively associated with NPPB, which showed that the model had a good fit to the data. NPE was found to play a partial mediating role between POS and NPPB and also had a complete mediating role between general self-efficacy and NPPB.

Conclusions

The results suggest that general self-efficacy indirectly influences NPPB, and POS directly and indirectly influences NPPB by NPE. Effective measures should be taken to improve nurses’ practice environment in hospitals to raise nurses’ enthusiasm and confidence in their work.

Improving Nurses' Skills and Supporting a Culture of Evidence-Based Practice

Evidence-based practice is critical to hospitals achieving high quality performance measures, improving patient outcomes, and reducing mortality and costs. Nurses who perform evidence-based care report greater job satisfaction, which leads to less turnover or occupational burnout. Librarians play an essential role in establishing an evidence-based culture in their organizations and supporting the nursing staff so that they are not only competent, but also confident in meeting evidence-based competencies. Action steps librarians can take include augmenting their collections with evidence-based resources, collaborating with staff to help them find the best evidence, and assisting with the first four steps of the evidence-based practice model.

Factors Associated With Intent to Leave in Registered Nurses Working in Acute Care Hospitals: A Cross-Sectional Study in Ontario, Canada

Background: The work environment factors associated with nurses' intention to leave their jobs are not well understood because most studies have used non-probabilistic sampling methods, thus restricting the generalizability of the results. This study examined the relationship between work environment factors and intent to leave among nurses working in acute care hospitals in Ontario, Canada. Methods: This study included a random sample of 1,427 registered nurses who were part of a larger cross-sectional study and who responded to a mailed survey that included measures of resource availability, interprofessional collaboration, job satisfaction, and demographics. Results: Most of the respondents were female (94.8%), with an average age of 45.6 years, and 14.5 years of nursing experience at their current workplace, which included mostly urban (94.6%) and non-teaching hospitals (61.8%). In the multivariate model, we observed that the work environment variables explained 45.5% of the variance in nurses' intent to leave scores, F(9, 1362) =125.41, p < .01, with an R² of .455 or 45.5%. Job satisfaction (p < .01), flexible interprofessional collaborative relationships (p = .030), and resource availability (p < .01) were significantly associated with nurses' intent to leave scores. Conclusion/Application to Practice: Nurses who reported greater job satisfaction, flexible interprofessional relationships, and resource availability were less likely to express an intent to leave their hospital workplaces. Employers and health policy makers may use these findings as part of a broader strategy to improve the work environment of nurses. Occupational health nurses are ideally positioned to demonstrate leadership in promoting retention efforts in the workplace by advocating for the importance of job satisfaction, flexible interprofessional relationships, and resources.

Effect of Occupational and Personal Stress on Job Satisfaction, Burnout, and Health: A Cross-Sectional Analysis of College Teachers in Punjab, India

Aim:

This research is an attempt to gauge the effect of stress on job satisfaction, burnout and health that prevails among faculty members of select public and private colleges in Punjab, India.

Materials and Methods:

The study uses cross-sectional research methods to collect 412 samples by stratified random sampling. It uses scales like the socio-demographic questionnaire (SDQ), Chronic Burden Scale (CBS), Maslach Burnout Inventory Human Services Survey (MBI-HSS), and General Health Questionnaire (GHQ-28) to collect data. The data were analyzed using the IBM Statistical Package for the Social Sciences (SPSS) Statistics software, revealing that college teachers are facing the consequences of both occupational and personal stress.

Results:

The study revealed significant impact of occupational and personal stress on burnout, job satisfaction, and health of college teachers.

Conclusion:

The result of the study found that organizational environment significantly affects stress level in college teachers. Hence, it is suggested that a humane policy related to higher education is need of the hour to protect interests of teachers which share responsibility of carving out future of the country.

Unfinished nursing care in four central European countries

Aim

The main aim of the research was to describe and compare unfinished nursing care in selected European countries.

Background

The high prevalence of unfinished nursing care reported in recently published studies, as well as its connection to negative effects on nurse and patient outcomes, has made unfinished care an important phenomenon and a quality indicator for nursing activities.

Methods

A cross‐sectional descriptive study was undertaken. Unfinished nursing care was measured using the Perceived Implicit Rationing of Nursing Care questionnaire (PIRNCA). The sample included 1,353 nurses from four European countries (Croatia, the Czech Republic, Poland and Slovakia).

Results

The percentage of nurses leaving one or more nursing activities unfinished ranged from 95.2% (Slovakia) to 97.8% (Czech Republic). Mean item scores on the 31 items of the PIRNCA in the total sample ranged from 1.13 to 1.92. Unfinished care was significantly associated with the type of hospital and quality of care.

Conclusion

The research results confirmed the prevalence of unfinished nursing care in the countries surveyed.

Implications for Nursing Management

The results are a useful tool for enabling nurse managers to look deeper into nurse staffing and other organizational issues that may influence patient safety and quality of care.

The relationship between emotional labour and job satisfaction in nursing

AIM

To investigate the relationship between emotional labour strategies and job satisfaction among nurses in Turkey.

BACKGROUND

Nursing is one of the professions in which emotional labour is heavily used. The relationship between emotional labour strategies and job satisfaction has many different consequences in nursing.

INTRODUCTION

Although studies have focused on the relationship between emotional labour and job satisfaction among nurses abroad, no studies on the subject have been found in Turkey.

METHODS

A cross-sectional descriptive design was employed. The study was conducted with 281 nurses working in a university hospital and three public hospitals in Manisa, Turkey. Research data were collected using the Personal Information Form, Emotional Labour Scale and Minnesota Satisfaction Questionnaire. Descriptive statistics and Pearson correlation analysis were used in data evaluation.

RESULTS

Analyses showed that the type of emotional labour strategy most frequently exhibited by nurses was surface acting. In surface acting, behaviours do not reflect employees' true feelings. Job satisfaction of nurses was higher than the medium level. A negative correlation was found between deep acting and job satisfaction. In deep acting, employees try to feel the emotions appropriate to the behaviour expected of them.

DISCUSSION

Nurses' emotional labour may cause some undesirable consequences.

CONCLUSION

Nurses' emotional labour strategies are related to their job satisfaction levels.

IMPLICATIONS FOR NURSING POLICY

Managers should be aware of the emotional labour of nurses and its possible negative consequences. Management strategies that target the negative consequences of emotional labour are important not only for the well-being of nurses but also for the quality of patient care.

Nurse staffing and life expectancy at birth and at 65 years old: Evidence from 35 OECD countries

OBJECTIVE

To measure the possible magnitude of the role nurse staffing has on increasing life expectancy at birth and at 65 years old.

METHODS

The statistical technique of panel data analysis was applied to investigate the relationship from the number of practicing nurses' density per 1000 population to life expectancy at birth and at 65 years old. Five control variables were used as the proxies for the levels of medical staffing, health care financial and physical resources, and medical technology. The observations of 35 member countries of Organization for Economic Co-operation and Development (OECD) were collected from OECD Health Statistics over 2000-2016 period.

RESULTS

There were meaningful relationships from nurse staffing to life expectancy at birth and at 65 years with the long-run elasticities of 0.02 and 0.08, respectively. Overall, the role of nursing characteristics in increasing life expectancy indicators varied among different health care systems of OECD countries and in average were determined at the highest level in Japan (0.25), followed by Iceland (0.24), Belgium (0.21), Czech Republic (0.21), Slovenia (0.20) and Sweden (0.18).

CONCLUSION

A higher proportion of nursing staff is associated with higher life expectancy in OECD countries and the dependency of life expectancy to nursing staff would increase by aging. Hence, the findings of this study warn health policy makers about ignoring the effects nursing shortages create e.g. increasing the risk of actual age-specific mortality, especially in care of elderly people.

Understanding how nurse managers see their role in supporting ICU nurse well-being-A case study

AIM

To explore how nurse managers perceive and experience their role in supporting the well-being of intensive care nurses.

BACKGROUND

While it is known that nurse manager behaviours affect nurse well-being, literature indicates that intensive care nurses may not receive the support they require. Understanding how nurse managers see their role in supporting nurse well-being is crucial to offer recommendations for improvement.

METHODS

Qualitative multiple case study design. Twelve semi-structured, in-depth interviews were conducted with nurse managers from Australian intensive care unit settings. Data were analysed using thematic analysis.

RESULTS

Nurse manages felt unsure about what their supportive role involved, lacked training on how to support nurse well-being and called for organisational backup to carry out their role effectively. The study also provided insight into the strategies that enabled nurse managers to support nurse well-being.

CONCLUSION

There is currently no consensus on the role of the nurse manager in supporting nurse well-being resulting in inconsistencies and wide practice variations. Furthermore, nurse managers need support and training if they are required to support nurse well-being.

IMPLICATIONS FOR NURSING MANAGEMENT

A clear definition of the nurse manager supportive role describing the purpose and core functions involved in this role must be developed to support nurse well-being.