Predictors of job satisfaction in remote hospital nursing

Factors affecting nurses' job satisfaction in rural and urban acute care settings: A PRISMA systematic review

AIMS

This review aimed to systematically assess the findings of primary studies to identify the factors associated with nurse job satisfaction in rural and urban contexts while analysing the findings according to Herzberg's theory.

BACKGROUND

While there is evidence linking several factors to nurses' job satisfaction, gaps still exist in understanding the differences between factors affecting job satisfaction for nurses working in rural and urban settings.

DESIGN

Systematic review with narrative summary.

DATA SOURCES

Six databases were used to identify original studies that discuss the factors associated with the nurse's job satisfaction between 1998-2018.

REVIEW METHODS

Two authors independently reviewed each study using the Joanna Briggs Institute's critical appraisal checklists. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to report and examine the study biases systematically.

RESULTS

A total of 38 studies were selected for this review. Physical working environment and authority and freedom were the most frequently reported factors associated with nurses' job satisfaction. Several extrinsic, intrinsic, personal, and community factors were also found to be associated with nurses' job satisfaction. Urban studies tended to focus on extrinsic factors, whereas there was more balance between the two sets of factors in rural studies.

CONCLUSION

Both intrinsic and extrinsic factors play an essential role in nurses' job satisfaction. Future research should use more robust research methods and pay more attention to contrasting rural and urban contexts. Herzberg's theory can provide conceptual clarity when investigating the factors associated with nurses' job satisfaction.

IMPACT

This review discussed the factors associated with nurses' job satisfaction in rural and urban settings. The findings linked several extrinsic and intrinsic factors to nurses' job satisfaction. Nursing management should search for the perfect blend of intrinsic and extrinsic factors based on nurses' needs and organizational commitment to improve nurses' job satisfaction.

Job satisfaction of nurses in Jimma University Specialized Teaching Hospital, Ethiopia

BACKGROUND

In Ethiopia nurses have played a very important role in providing timely and quality health service in healthcare organizations. However, there is a limited literature in the area of nurses' job satisfaction in Ethiopian public hospitals. The objective of this research is to measure job satisfaction of nurses in Jimma University Specialized Teaching Hospital and to determine the influencing factors.

PARTICIPANTS AND METHODS

A cross-sectional survey was conducted from January 2012 to June 2012 in Jimma University Specialized Teaching Hospital. All full-time nurses with nonsupervisory management position and more than 1 year of work experience were invited to participate in the study. Minnesota Satisfaction Questionnaire was used to collect the data.

RESULTS

A total of 175 copies of the questionnaires were returned out of 186 copies distributed to the respondents. The results indicated that nurses were not satisfied by their job (mean=2.21, SD=0.52). Remuneration (r=0.71, P<0.01) and job advancement (r=0.69, P<0.01) were statically significant and strongly correlated with nurses' job satisfaction. Job security was associated with highest satisfaction (r=0.41, P<0.05) CONCLUSION AND RECOMMENDATIONS: Remuneration and job advancement were the most important factors for nurses' job satisfaction. Hospital administrators as well as health policy makers need to address the two major identified sources of nurses' job dissatisfaction in the study (i.e. remuneration and narrow opportunity of job advancement) and take appropriate measures to overcome their consequences.

Frontline registered nurse job satisfaction and predictors over three decades: a meta-analysis from 1980 to 2009

BACKGROUND

Frontline registered nurses' job satisfaction is important because it is tied to retention, organizational commitment, workforce safety, patient safety, and cost savings. The purpose of this study was to comprehensively, quantitatively examine the largest, moderate, and smallest predictors of frontline registered nurse job satisfaction from 1980 to 2009.

METHODS

A non-a priori meta-analysis was used to analyze studies that met inclusion.

RESULTS

Sixty-two studies and 27 job satisfaction predictors met inclusion for analysis. The largest effect sizes were found for task requirements (r = .61), empowerment (r = .55), and control (r = .52), and moderate effect sizes were found for 10 predictors. Fail-safe N indicates high reliability. Heterogeneity between studies was present in all of the 27 predictor analyses.

CONCLUSIONS

The largest predictors of job satisfaction for the frontline registered nurse may be different than previously thought. Supporting past research, autonomy and stress were found to be moderate predictors of satisfaction. Heterogeneity indicates study differences or moderator influence in studies.

Burnout in relation to specific contributing factors and health outcomes among nurses: a systematic review

Nurses have been found to experience higher levels of stress-related burnout compared to other health care professionals. Despite studies showing that both job satisfaction and burnout are effects of exposure to stressful working environments, leading to poor health among nurses, little is known about the causal nature and direction of these relationships. The aim of this systematic review is to identify published research that has formally investigated relationships between these variables. Six databases (including CINAHL, COCHRANE, EMBASE, MEDLINE, PROQUEST and PsyINFO) were searched for combinations of keywords, a manual search was conducted and an independent reviewer was asked to cross validate all the electronically identified articles. Of the eighty five articles that were identified from these databases, twenty one articles were excluded based on exclusion criteria; hence, a total of seventy articles were included in the study sample. The majority of identified studies exploring two and three way relationships (n = 63) were conducted in developed countries. Existing research includes predominantly cross-sectional studies (n = 68) with only a few longitudinal studies (n = 2); hence, the evidence base for causality is still very limited. Despite minimal availability of research concerning the small number of studies to investigate the relationships between work-related stress, burnout, job satisfaction and the general health of nurses, this review has identified some contradictory evidence for the role of job satisfaction. This emphasizes the need for further research towards understanding causality.

The first year: employment patterns and job perceptions of nursing assistants in a rural setting

AIM

The aim of this study was to follow rural certified nursing assistants (CNAs) (n=123) in the United States for 1 year post-training to identify retention and turnover issues in the long-term care (LTC) setting by exploring the CNAs' perceptions of the LTC work experience.

BACKGROUND

  Turnover among CNAs impacts the quality of care, imposes a financial burden on facilities and taxpayers, and creates increased stress and workloads on those who remain.

METHOD

A longitudinal survey design was used to track individuals completing CNA training for 1 year.

RESULTS

  At 1 year post-training, 53.7% of respondents currently worked in LTC, 30.9% worked in LTC and left, and the remaining 15.4% never worked in LTC.

CONCLUSION

While the training site does not appear to impact retention, the first 6 months of employment appear critical. The CNAs cited pay as a reason for leaving LTC, but better pay did not characterize the jobs taken by the CNAs who left. Implications for nursing management. This study highlights the importance of the first 6 months of employment to retention and provides practical information for nurse managers evaluating the resource-effectiveness of hosting training programmes. Additionally, the key issues influencing retention were identified and practical suggestions for nurse managers to improve retention are provided.

Impact and determinants of nurse turnover: a pan-Canadian study

AIM

As part of a large study of nursing turnover in Canadian hospitals, the present study focuses on the impact and key determinants of nurse turnover and implications for management strategies in nursing units.

BACKGROUND

Nursing turnover is an issue of ever-increasing priority as work-related stress and job dissatisfaction are influencing nurses' intention to leave their positions.

METHODS

Data sources included the nurse survey, unit managers, medical records and human resources databases. A broad sample of hospitals was represented with nine different types of nursing units included.

RESULTS

Nurses turnover is a major problem in Canadian hospitals with a mean turnover rate of 19.9%. Higher levels of role ambiguity and role conflict were associated with higher turnover rates. Increased role conflict and higher turnover rates were associated with deteriorated mental health. Higher turnover rates were associated with lower job satisfaction. Higher turnover rate and higher level of role ambiguity were associated with an increased likelihood of medical error.

CONCLUSION

Managing turnover within nursing units is critical to high-quality patient care. A supportive practice setting in which role responsibilities are understood by all members of the caregiver team would promote nurse retention.

IMPLICATIONS FOR NURSING MANAGEMENT

Stable nurse staffing and adequate managerial support are essential to promote job satisfaction and high-quality patient care.

Sustaining the rural workforce: nursing perspectives on worklife challenges

CONTEXT

Concerns have been raised about the sustainability of health care workforces in rural settings. According to the literature, rural nurses' work satisfaction varies with the resources and supports available to respond to specific challenges. Given the probable effects of stressors on retention, it is essential to understand the unique requirements of nurses in rural practice environments.

PURPOSE

To investigate whether nurses receive the resources and supports necessary to meet the challenges of rural practice.

METHODS

Semi-structured interviews were conducted with 21 managers and 44 staff nurses in 19 selected rural hospitals in Ontario, Canada. The interviews were taped and transcripts interpreted through a thematic analysis. Major worklife themes were identified and analyzed within a healthy work environment model based on the work of Kristensen.

FINDINGS

Three interrelated dimensions of the model were relevant to workforce sustainability: the balance between demands and the resources of the person, the level of social support, and the degree of influence. The availability of resources and supports affected whether the nurses perceived challenges as stimulating or overwhelming. Deficits interfered with practice and the well-being of the nurses and patients.

CONCLUSIONS

The nurses felt frustrated and powerless when they lacked resources, support, and influence to manage negative situations. Strategies to achieve workforce sustainability include resources to reduce stress in the workplace, education to meet the needs of new and experienced nurses, and offering of employment preferences to the workforce. Addressing resources, support, and influence of rural nurses is essential to alleviate workplace challenges and sustain the rural nursing workforce.

Predictors of Job Satisfaction for Rural Acute Care Registered Nurses in Canada

This study examines predictors of job satisfaction among rural acute care registered nurses. The data are from a cross-sectional national survey, which was part of a larger project, The Nature of Nursing Practice in Rural and Remote Canada. This analysis suggests that a combination of individual, workplace, and community characteristics are interrelated predictors of job satisfaction for rural acute care nurses. There were nine variables that accounted for 38% of the total variance in job satisfaction. Four variables alone (available and up-to-date equipment and supplies, satisfaction with scheduling and shifts, lower psychological job demands, and home community satisfaction) explained 33% of the variance. Recruitment and retention strategies in rural areas must acknowledge that rural nurses' work lives and community lives are inextricably intertwined. Attention to these issues will help ensure high-quality working environments and a continued commitment to quality nursing care in the rural hospital settings in Canada.

Jordanian Nurses' Job Satisfaction and Intent to Stay: Comparing Teaching and Non-Teaching Hospitals

The aims of this study were to identify variables of Jordanian nurses' job satisfaction and intent to stay, compare the phenomena of interest in teaching and non-teaching hospitals, and correlate the two concepts of nurses' job satisfaction and intent to stay. A convenience sample of 433 nurses was obtained from three teaching hospitals and two non-teaching hospitals. Nurses were "neither satisfied nor dissatisfied" and were "neutral" in reporting their intent to stay at their current jobs. Nurses who were working in non-teaching hospitals reported higher job satisfaction and intent to stay rates than those working in teaching hospitals. Nurses' job satisfaction and intent to stay were at the borderlines, which require the immediate attention of nursing and hospital administrators. Nurses' job satisfaction and intent to stay, particularly in teaching hospitals, have to be promoted; thus, interventions have to be effectively initiated and maintained at the unit and organizational levels.

A meta-analysis of studies of nurses' job satisfaction

Although several variables have been correlated with nursing job satisfaction, the findings are not uniform across studies. Three commonly noted variables from the nursing literature are: autonomy, job stress, and nurse-physician collaboration. This meta-analysis examined the strength of the relationships between job satisfaction and autonomy, job stress, and nurse-physician collaboration among registered nurses working in staff positions. A meta-analysis of 31 studies representing a total of 14,567 subjects was performed. Job satisfaction was most strongly correlated with job stress (ES = -.43), followed by nurse-physician collaboration (ES = .37), and autonomy (ES = .30). These findings have implications for the importance of improving the work environment to increase nurses' job satisfaction.

Job satisfaction among hospice workers: what managers need to know

The purpose of this study was to investigate the perception of job satisfaction among hospice interdisciplinary team members, which included social workers, nurses, spiritual care providers, and home health aides. Interdisciplinary team members (n = 72) from 4 hospice organizations in the Midwest participated in the study. Results of this study show that job satisfaction as defined by hospice workers includes having task significance, supervisory support, integration, distributive justice, positive affectivity, autonomy, routinization, no role overload, and high levels of work motivation. These same workers also stated that (1) working with patients and families and carrying out the hospice philosophy (task significance), (2) being comfortable with their level of knowledge and skills (competence), and (3) having good relationships with team members (integration) play a significant role in their degree of satisfaction on the job. These results have implications for managers in hospice organizations. Specifically, managers in health care organizations like hospices need to be apprised of what factors result in job satisfaction among employees.

Nurse job satisfaction and retention: comparing public to private hospitals in Jordan

AIMS

To identify variables of Jordanian nurses' job satisfaction and retention. Comparisons were performed between three public and two private hospitals.

BACKGROUND

There has been little research on nurse job satisfaction and retention in Jordan. Interest in nurse retention is renewed with each cycle of nursing shortage.

METHODS

A descriptive design using surveys guided this study through convenience sample of 438 nurses. Data were analysed using descriptive and inferential statistics.

RESULTS

Nurses reported that they were "moderately satisfied" in their jobs with "neutral" opinion about their retention. Nurses who work in private hospitals were more satisfied and intended to retain their jobs more than nurses in public hospitals.

CONCLUSION

Nurse job satisfaction and retention are related concepts; nurses who are satisfied in their jobs are likely to retain these jobs.

Nurses' autonomy: influence of nurse managers' actions

BACKGROUND

Autonomy plays an important part in nurses' job satisfaction and retention, but the literature shows that they are often dissatisfied with this aspect and want better working conditions and greater autonomy in decision-making.

AIMS

The aim of this study was to examine the role that nurse managers have in enhancing hospital staff nurses' autonomy.

METHODS

The study used a comparative descriptive survey design. Data collection took place over the Internet through the use of selective listservs in the United States of America (USA), Canada, and the United Kingdom. Of the 317 hospital nurses participating, 264 (83.3%) were from the USA. Differences relating to nurses, nurse managers, and hospital settings were controlled in the analysis.

RESULTS

Nurses were more autonomous in making patient care decisions than unit operational decisions, and they perceived their autonomy to be at a moderate level. Those who were autonomous in patient care decision-making were also likely to be autonomous in unit operation decision-making. Nurse managers' actions had a strong relationship with nurses' autonomy in deciding on patient care and unit operation decisions, and with total autonomy. The three important variables that were reported by staff nurses to increase their autonomy were supportive management, education and experience. The three most important factors that were reported to decrease nurses' autonomy were autocratic management, doctors and workload.

DISCUSSION

Technical issues such as the availability of listservs, valid e-mails, viruses, and familiarity with the Internet and its applications were the major limitations of this study. Nurses' autonomy over patient care and unit operations decisions needs to be enhanced, and nurse managers should promote this. Similarly, there is a role for nurse education, both in preregistration programmes and in continuing education for managers. Further research needs to explore the barriers that nurses face in autonomous decision-making and how nurses' participation in unit operational decisions can be promoted.

CONCLUSIONS

Hospital staff nurses have moderate autonomy which could be increased by more effective support from nurse managers. The use of electronic questionnaires is a promising data collection method.