JOB SATISFACTION AMONG NURSES.docx

JOB SATISFACTION AMONG NURSES

INTRODUCTION Organization comprises of people, it is their satisfaction which can make or mars the performance of an organization. Employee satisfaction is important in determining how far an organization achieves its goals. Job satisfaction leads to life satisfaction. Job satisfaction is generally regarded as an employee’s attitude toward the job and job situation. Spector (1997) defines job satisfaction simply as ―the degree to which people like their jobs.‖ Some people therefore enjoy work and consider it a central part of their lives while others do so only because they have to. Robbins (2005) defines job satisfaction as ―a collection of feelings that an individual holds towards his or her job.‖ This implies that a person with a high level of job satisfaction will hold positive feelings towards the job and a person who is dissatisfied will hold negative feelings about the job. Locke (1976) as cited by Cooper and Locke (2000) offers a further definition of job satisfaction as a ―pleasurable or positive emotional state resulting from the appraisal of one’s job or job experiences.‖ Job satisfaction is also defined in terms of equity. Robbins et al. (2003) define job satisfaction as ―the difference between the rewards employees receive and the reward they believe they should receive.‖ The higher this discrepancy, the lower will be the job satisfaction. Job dissatisfaction leads to absenteeism, labour turnover and negative publicity of the organization. Unsatisfied worker can prove to be a liability to any organization and on the other hand happy and satisfied worker is always a productive worker. Nurses contribute very important position in health care sector. Helping sick people and dealing with medical emergencies can be very stressful. Patients need 24 hrs care. Nursing duty is around the clock duty including night shifts. They often work nights, weekends and even on holidays. There is a considerable amount of health hazard from disease, infection and radiation. A nurse is responsible—along with other health care professionals—for the treatment, safety, and recovery of acutely or chronically ill or injured people, health maintenance of the healthy, and treatment of life- threatening emergencies in a wide range of health care settings. Nurses may also be involved in medical and nursing research and perform a wide range of nonclinical functions necessary to deliver health care. Thus, studying job satisfaction among nurses is important because it is necessary to distinguish between positive and negative aspects of job satisfaction. Hertzberg (1959) stated that (positive) satisfaction is due to good experiences, and that these are due to `motivators' i.e. achievement, recognition, the work itself, responsibility and

advancement. Dissatisfaction is due to bad experiences caused by `hygiene' factors i.e. supervisors, fellow workers, company policy, working conditions, and personal life (Hertzberg 1959)

NEED OF THE STUDY The present set up in government and private hospitals depicts that a massive work load with the greater deal of responsibilities are vested on the working nurses in their day to day activities. The role played by the working nurses is so significant in maintaining the basic purpose of the government and private hospitals that the question of their satisfaction from their job can never be ignored. Extensive research has been done on role stress among nurses but very few studies have been done on job satisfaction in nurses. So, the present study aims at measuring the level of job satisfaction among the nurses.

OBJECTIVE S OF THE STUDY Present study is conducted in Patiala as these areas contains maximum government and private medical institutes which caters to the needs of people from north-west region. These hospitals have state-of-art facilities and region is fast developing into a health care hub. Nurses are important constituent of health care industry and their level of job satisfaction is of extreme importance in delievering proper health care. Therefore the present study has been conducted in Patiala with the following objectives: 1. To compare the level of job satisfaction among nurses in government and private hospitals 2. To analyse the various factors influencing job satisfaction among nurses. 3. To suggest improvements needed to increase their job satisfaction.

UNIVERSE OF THE STUDY, SAMPLING DESIGN AND SAMPLE SIZE: A Descriptive study was carried out to have an in depth understanding of the job satisfaction level among nurses. Simple random sampling was adopted to select 100 nurses of all age group ranging from 22 to 58 years from the government hospitals and the private hospitals. The sample of nurses was selected on the basis of convenient sampling from Patiala. 50 nurses are taken as sample from the government hospitals and 50 from the private hospitals in order to draw a

comparison between the job satisfaction of nurses working in theses two sectors .A total of 7 hospitals from both areas were randomly selected from Patiala. The Government hospitals selected are Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, Government Medical College and Hospital, Sector 32, Chandigarh, Government Multispeciality Hospital, Sector 16, Chandigarh. And the Private hospitals selected are Mukat Hospital, Sector 34, Chandigarh, Inscol Hospital, Sector 34, Chandigarh, Fortis Hospital, phase 7, Mohali and IVY Hospital and cancer research institute, Sector 71, Mohali.

DATABASE: For the purpose of the present study, primary data has been used. The primary data was obtained through direct communication with the respondents through a structured questionnaire. The questionnaire contained both open ended as well as close ended questions. The questionnaire containing questions on various dimensions of job satisfaction were distributed. All possible efforts were made to make the nurses feel at ease and respond to the various questions with full concentration. The purpose of the study was explained to the respondents. They were informed that the results would be kept strictly confidential and efforts were made to get maximum cooperation of the nurses.

ANALYSIS OF DATA To analyze the perception of nurses towards their job, the data is analyzed by bringing raw data to measured data, summarizing the data and then applying analytical method to manipulate the data so that their interrelationship and quantitative meaning become evident. Other instruments used to analyze and interpret the collected data include pie charts, bar diagrams, tabulation and rank method.

LIMITATIONS OF THE STUDY: 1) The views of nurses were obtained from Patiala only. These views may not be attributed to the nurses of the whole country because of economic, social and cultural differences in the attitude and preferences. 2) The questionnaire method has the limitation of providing the limited information. 3) Due to constraints of resources, the study is limited to small sample size i.e. only 100 nurses.

ARTICLES

New Report: High Job Satisfaction Among Public Health Nurses, But Many State Health Departments Struggle to Fill Vacancies New surveys identify compelling need to advance education and training, increase diversity, and improve recruitment of public health nurses. Princeton, N.J.—Public health nurses play an essential role in improving the population’s health and delivering essential health services to communities, but the public health nursing workforce is facing significant challenges. More than two in five state health departments report having ―a great deal of difficulty‖ hiring nurses and nearly 40 percent of state and local health departments report having insufficient resources to fill vacant nurse positions. Those are among the findings of a report released today by the Robert Wood Johnson Foundation (RWJF), which provides the first comprehensive assessment of the size, composition, educational background, experience, retirement intention, job function, and job satisfaction of nurses who work for state and local health departments. Enumeration and Characterization of the Public Health Nurse Workforce: Findings of the 2012 Public Health Nurse Workforce Surveys, produced by the University of Michigan Center of Excellence in Public Health Workforce Studies and funded by RWJF, collected data from state and local public health departments and surveyed public health nurses themselves. It finds that public health nurses report concerns about job stability, compensation, and career growth in light of budget-tightening at many state and local health departments. Yet these nurses also report very high levels of job satisfaction and that they feel they are making a difference in their communities—factors that could bolster recruitment efforts. ―Capturing this data about public health nurses, who represent the largest professional sector of the public health workforce, gives us a clearer picture of the challenges before us,‖ said Pamela G. Russo, MD, MPH, RWJF senior program officer. ―It should be a high priority to address gaps and take steps to strengthen the public health nursing workforce. As health reform is implemented, and as public health agencies are transforming to a more population-healthoriented role in promoting health and protecting communities, public health nurses will need

additional training to keep pace with the changes. The size, makeup, and preparation of the public health nursing workforce greatly affect the ability of agencies to protect and improve the health of people in their jurisdictions.‖ The new report offers a snapshot of the current public health nurse workforce—estimated at 34,521 full-time equivalent RNs—and highlights the need for ongoing systematic monitoring in order to: inform competency, compliance and credentialing efforts; permit better alignment of academic resources with workforce needs; and allow for better understanding of the relationship between workforce infrastructure and population health outcomes. Among its findings: 

Nearly two in five respondents to the survey (39%) report that their highest nursing degree is a diploma/associate’s degree. Just 10 states require public health nurses to have BSN degrees.

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Providing clinical services is part of the work done by RNs in state and local health departments, but these nurses assume a wide variety of roles, including health promotion, disease surveillance, community health assessment, policy development, and more.

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The public health nursing workforce does not reflect the diversity of the communities it serves. Just 4 percent of public health nurses self-identify as Hispanic/Latino and 95 percent of those in leadership positions self-identify as White.

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The public health nurse workforce is aging; however, most RNs do not intend to retire within the next five years.

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Recruitment and hiring of RNs into public health nurses positions can be challenging, particularly for state health departments.

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Lack of promotion opportunities is a concern to both health departments and RNs.

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Public health nurses report extremely high levels of job satisfaction, despite reporting high levels of dissatisfaction with salaries. Recommendations in the report, created by the project’s advisory committee, include:

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Develop feasible opportunities for additional education and training for public health nurses.

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Improve the pipeline and intensify recruitment so public health nurses in health departments reflect the racial and ethnic composition of the communities they serve.

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Determine how changes in the functions of public health departments, due to health care reform and the transformation of public health agencies’ work, may affect the education public health nurses need.

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Identify options to address concerns about recruitment, compensation, and promotion opportunities.

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Conduct follow-up studies to monitor size, composition, capacity and functions of the public health nurse workforce over time, to help ensure this workforce is well-prepared to meet emerging needs. ―The nation depends on a strong public health nursing workforce, and these surveys identify clear challenges that federal, state, and local policy-makers, health agencies, and academic and philanthropic leaders can address,‖ said Matthew L. Boulton, MD, MPH, director of the Center of Excellence in Public Health Workforce Studies and associate professor at the University of Michigan School of Public Health (UMSPH). ―We shouldn’t overlook the importance of positive findings related to job satisfaction,‖ added Angela J. Beck, PhD, MPH, the Center’s associate director and research assistant professor at UMSPH. ―With 85 percent of public health nurses reporting job satisfaction and 90 percent reporting that they feel they make a difference in the health of their communities, we have a strong foundation to build on.‖ Several earlier national studies have attempted to count public health nurses in specific settings, but until now there has been little data collected on the characteristics of the public health nursing workforce as a whole. This limitation has made it difficult to determine the most strategic and sustainable approaches to providing training that will increase the skills and impact of this essential workforce. For this report, RWJF commissioned both organizational- and individual-level public health nurse workforce surveys, conducted by the University of Michigan Center of Excellence in Public Health Workforce Studies, to address these gaps in knowledge.

A public health nursing research agenda, established in 2010 by a collaborative working group of leaders in public health nursing, emphasized developing a better understanding of how metrics related to public health nursing impact population health. The Enumeration and Characterization of the Public Health Nurse Workforce report, released today,provides baseline data that can further this research agenda.

http://www.rwjf.org/en/about-rwjf/newsroom/newsroom-content/2013/06/new-report--high-jobsatisfaction-among-public-health-nurses--bu.html

Career, Job Satisfaction Rises Among Nurses, but Many Plan to Cut Back or Find New Job

Whether caused by improvements in the economy or improvements in their work-life isn’t clear, but nurses in 2012 are more willing than just a year ago to stay in the profession and continue working right where they are.

The 2012 Survey of Registered Nurses found 91 percent of responding nurses satisfied with nursing as a career and almost three-quarters of them (73 percent) said they were satisfied with their current job. That job and career satisfaction — the highest in the three years of the survey — may explain why 66 percent of the nurses intend to ―continue working as I am.‖

As the survey report itself says, ―The 2012 survey results show a much improved sense of satisfaction with both career and job.‖ Last year, only 74 percent of the nurses in the survey said they were satisfied with their choice of profession and only 55 percent of the nurses said they intended to ―continue working as I am‖; 24 percent planned to look for another job. In the 2012 survey, the percentage of nurses intending to change employers dropped to 17 percent. ―These large increases in career and job satisfaction,‖ notes the survey, ―could be indicative of the attention nursing is receiving since the publishing of the IOM report: The Future of Nursing. With a larger degree of focus on nursing and its future, nurses in general feel better about their profession.‖ That report on nursing’s future by the Institute of Medicine offered a number of recommendations and goals, one of which is that 80 percent of nurses have a Bachelor of Science in Nursing. However, the 2012 survey found only 17 percent intending to pursue their BSN. Another 23 percent are considering an advanced nursing degree. The percentages look a little better when the 2,931 respondents to the emailed survey are broken down by age. Few older nurses (those 55 and older) plan to pursue any nursing degree, while among those under 40, 25 percent intend to obtain their BSN, and an additional 43 percent will seek a Master’s or doctoral degree in nursing. Even as the 2012 survey results show nurses have brightened in their job and career satisfaction, a third of them admitted they ―often feel like resigning from my position. About the same percentage said that if they had their way they would ―not be working in this job in a year.‖ Coupled with the 17 percent who say they’ll be looking for another job in the year, and another 17 percent who say they’ll retire, leave nursing, or otherwise cut back on their hours, the survey suggests that individual facilities — if not the profession as a whole — may still face a nurse shortage.

Job Satisfaction of Nursres and identifying factors of job satisfaction in Solvenian Hospitals Mateja Lorber1 and Brigita Skela Savič2 Author information ► Article notes ► Copyright and License information ► Abstract Job satisfaction is determined by a comparison of one’s prior expectations about the job and the actual experience of the job (1). It has been found that job satisfaction relates to beliefs and emotions that individuals have about their work and their job (2). It has been described as an attitude with an affective and cognitive component (3). When establishing the level of job satisfaction, we should focus on how employees feel about their work and personal relationships in the workplace, and on how leaders influence employees’ satisfaction. Without a doubt, satisfied employees are the ultimate goal of every leader. On the other hand, the goal of every employee is to find the kind of work that matches their abilities and interests as closely as possible, enables them success, and provides them with opportunities for promotion. Satisfied employees tend to be more productive and committed to their employers, and a direct correlation has been shown between staff satisfaction and patient satisfaction in health care organizations (4,5). Even though research has shown different levels of job satisfaction for nurses, satisfaction predictors tend to be relatively similar, and include working conditions, relationships with coworkers and leaders, pay, promotion, security of employment, responsibility, and working hours (2,6-16). In Slovenia, no studies on the effects of leadership style, personality characteristics, and managerial competencies of leaders on job satisfaction have been conducted. There was only some research about leadership style in health care institutions (17-19). Also organizational climate and organizational culture in nursing have been studied as well as job satisfaction in some institutions (20-24). Experts in Slovenia (17,18,25-27) point to the problem of lack of knowledge of leaders about leadership. Because it affects not only quality of nursing but also patients’ satisfaction, the level of employees’ job satisfaction is very important for health care institutions. The aim of the study

was to determine the level of job satisfaction of employees in nursing and to determine the influence of leadership in job satisfaction. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3368291/ 1. Mihalič R. Increase satisfaction and loyalty of employees. Škofja Loka (Slovenia): Mihalič & Partner; 2008. 2. Lu H, While K, Bariball K. Job satisfaction among nurses: a literature review. Int J Nurs Stud.2005;42:211–27. doi: 10.1016/j.ijnurstu.2004.09.003. [PubMed] [Cross Ref] 3. Judge TA, Thoresen CJ, Bono JE, Patton GK. The job satisfaction-job performance relationship: A qualiative and quantitative review. Psychol Bull. 2001;127:376–407. doi: 10.1037/0033-2909.127.3.376.[PubMed] [Cross Ref] 4. Al-Almeri AS. Job satisfaction and organizational commitment for nurses. Saudi Med J.2000;21:531–5. [PubMed] 5. Tzeng HM. The influence of nurses’ working motivation and job satisfaction on intention to quit: an empirical investigation in Taiwan. Int J Nurs Stud. 2002;39:867–78. doi: 10.1016/S0020-7489(02)00027-5. [PubMed] [Cross Ref]

Nurse Job Satisfaction Improves Patient Outcomes, NDNQI Data Show When nurses enjoy their jobs and intend to stay in their positions long term, it can translate to improved patient outcomes, according to findings from NDNQI, a quality improvement program of the American Nurses Association. "NDNQI data show that positive patient outcomes are strongly tied to nurse satisfaction," says Marla J. Weston, PhD, RN, FAAN, chief executive officer of the American Nurses Association.

"For example, during a two-year time span, our RN survey data revealed that a 25% increase in

job enjoyment, and a 29% increase in intent to stay, associated with an overall quality of care increase of 5-20%." NDNQI data also showed that injury falls rate decreased by 17% in four years, hospital-acquired pressure ulcer rate decreased by 24-59% in two years, and infection rates decreased by 87% in two years. The ranges are reflective of the differences among nursing units and why reporting at the nursing unit level matters. NDNQI tracks up to 18 nursing-sensitive quality measures, providing actionable insights based on structure, process, and outcome data. For more information, visitwww.ndnqi.org. Download: ANA Inspired Care Infographic [168KB .pdf] NDNQI is a quality improvement solution of the American Nurses Association. Used by 2,000 hospitals nationwide, it is the largest provider of unit-level performance data to hospitals. NDNQI's measures reflect the structure, process and outcomes of nursing care, such as hospitalacquired pressure ulcers, patient falls and infections. NDNQI comparison data guides hospitals affecting quality improvements and examining the relationship between nurse staffing and patient outcomes

http://nursing.advanceweb.com/News/National-News/Nurse-Job-Satisfaction-Improves-PatientOutcomes-NDNQI-Data-Show.aspx

Nursing staff teamwork and job satisfaction

KALISCH BJ, LEE H & ROCHMAN M. (2010) Journal of Nursing Management 18, 938–947

Nurse practitioners’ job satisfaction and intent to leave current positions, the nursing profession, and the nurse practitioner role as a direct care provider Darcie G. De Milt, DNP, RN, NE-BC, ACNP-BC, GNP-BC1, Joyce J. Fitzpatrick, PhD, RN, FAAN (Elizabeth Brooks Ford Professor of Nursing)2, & Sister Rita McNulty, DNP, RN, CNP (Adjunct Assistant Professor)

Purpose: The purposes of this cross-sectional descriptive study were threefold: to describe job satisfaction among a national nurse practitioner (NP) sample; to examine differences in NP job satisfaction based on their intent to leave current positions, the nursing profession, and the NP role as a direct care provider; and to describe the relationship between job satisfaction and anticipated turnover. Data sources: Data were collected from 254 NPs who attended the 2008 American Academy of NPs (AANPs) 23rd National Conference. The Misener NP Job Satisfaction Scale (MNPJSS) was used to measure NP job satisfaction. The Anticipated Turnover Scale (ATS) was used to assess NP perception or opinion of the possibility of voluntarily terminating their present job. Intent to leave variables were measured with single-item questions. Conclusions: The NPs sampled were satisfied with benefits, challenge, and autonomy. They were minimally satisfied with professional growth, intrapractice partnership, and collegiality. Twenty-seven percent of NPs indicated intent to leave current positions; a small percentage (5.5%) indicated intent to leave the nursing profession and the NP role as a direct care provider (5.5%). There were significant differences in job satisfaction based on intent to leave current positions, and higher job satisfaction scores were significantly related to intent not to leave current positions. There was a significant negative relationship between job satisfaction and anticipated turnover. This study contributes to the current literature that has minimally addressed NP job satisfaction and has not addressed NPs’ intent to leave current positions, the nursing profession, or the NP role as a direct care provider. This is the first national NP study of job satisfaction, intent to leave, and anticipated turnover.

Implications for practice: This study will help bridge the gap in literature relating to NP job satisfaction, their intent to leave, and anticipated turnover. The results of this study could potentially assist employers in developing strategies for recruitment and long-term retention. These results may also give insight into how NPs can make their work environments more fulfilling. Additionally, these results may contribute to continued role adaption necessary for the constantly changing work environments in which NPs currently practice.

Job Satisfaction Of Certified Nurse Midwives: An Examination Health care providers face pressure to reduce costs and enhance patient satisfaction. One approach is to employ primary care providers such as nurse practitioners, physician assistants, and certified nurse midwives. Since there is a positive relationship between job satisfaction and patient satisfaction, positive job satisfaction on the part of providers, such as midwives, can translate into patient satisfaction. This research explores the degree of job satisfaction exhibited by certified nurse midwives. The data derives from a survey of 2000 CNM members of the American College of Nurse-Midwives. The survey captures job satisfaction factors, including interactions with physicians and nurses, job tasks, organization policies, pay, job autonomy, professional status, and job requirements and demographics. The findings reveal that the factors associated with overall job satisfaction are conditioned by midwives’ places of work. While levels of job satisfaction are high, those factors associated with it vary by workplace. Therefore, strategies designed to enhance job satisfaction for certified nurse midwives should relate to the locus of work and its environment.

Job Satisfaction and Midwives While there are numerous job satisfaction studies of health professionals, especially nurses and physicians, studies that explore CNM job satisfaction are limited in number, and they are dated. An early study found CNMs to be satisfied with their jobs (Collins, 1990). An Australian study found job satisfaction was associated with patient and colleague interactions (Watson, Potter & Donohue, 1999). A study of first-year CNMs found no relationship between job satisfaction and mentoring (Cuesta & Bloom, 1998).

Other inquires into CNM job satisfaction are limited in scope. Most focus on one or two aspects or primarily on overall job satisfaction. One investigation found that midwives who left and later returned to their practices did so because of previous high job satisfaction experiences (The University of Sheffield, 2006). Cattrell, Lavender, Wallymahmed, Kingdon, and Riley (2006) demonstrated that midwives gained considerable overall job satisfaction by continuity of care for patients. An examination of midwives in birth centers showed high levels of job satisfaction because the midwives felt their skills were needed and gave high satisfaction to patients (Bainbridge, 2006). Another inquiry conducted in Iran found that 49% of the midwives surveyed exhibited moderate levels of job satisfaction, 49% reported low satisfaction, and 2% conveyed high levels of job satisfaction (Mirmolaei, Dargahi, Kazemnejad, & Mohajerrahbari, 2005). Using correlation analysis, the study revealed no significant relationship between overall job satisfaction and various demographic variables, such as age, academic degree, and salary. A study of Estonian midwives found no significant association between job satisfaction and age, ethnicity, work abroad, or increased responsibility (Lazarus, Rasch & Liljestrand, 2005). A review of the literature on factors affecting the retention and turnover of midwives indicated that job aspects associated with job satisfaction, such as working hours, workload, and appreciation of contribution, received high ratings, and, consequently, are important factors for retention of midwives (Cox & McBride, 2004). An investigation of midwives in Turkey explored levels of work-related stress, burnout, and overall job satisfaction (Oncel, Ozer, & Efe, 2007). It was found that the level of work-related stress and levels for emotional exhaustion were moderate, while general work satisfaction was high. Another job satisfaction study of health care workers in Turkey, including general practitioners, nurses, technicians, and midwives, showed that midwives had the lowest overall job satisfaction scores (Bodur, 2002). The research reviewed leads to the conclusion that the findings are mixed and sometimes contradictory, and that more investigation of CNM job satisfaction is needed. This study examines the levels of CNM job satisfaction and the association of job satisfaction factors, demographics, and places of work, with overall job satisfaction.

Sample The certified nurse midwives surveyed were members of the American College of NurseMidwives. A random sample of 2000 certified nurse midwife names was acquired from this

association and the survey was mailed to each. Six hundred and eighty questionnaires were returned, resulting in 537 usable questionnaires. A comparison of the demographic characteristics of the sample with a membership survey indicates that the respondents were representative of ACNM members at large (Schulling, Sipe, & Fullerton, 2005).

Discussion and Implications This study provides insights into some of the factors that have an important effect in explaining the variation in overall job satisfaction of certified nurse midwives. One noteworthy finding is that the factors related to CNM overall job satisfaction are conditioned by their place of work or employment. An important implication is that healthcare managers and administrators need to realize that job satisfaction for CNMs is workplace specific and not generic. While levels of overall job satisfaction are high for CNMs, the factors associated with it vary by workplace. Therefore, strategies designed to enhance job satisfaction for CNMs must be related to the locus of work and its environment. Consistent with other research, a number of demographics, such as education level, marital status, and age, are not linked to overall job satisfaction (Collins, 1990). Also, and most interesting, is the notion that job autonomy, which is often viewed as defining the basis for work and enhancing the professional worth for nurse practitioners like the CNM, is not strongly supported by the findings of this study (Bruch & Capezuit, 1997). Only CNMs who are employed in a private practice view job autonomy as related to overall job satisfaction.

2012 Survey Of Registered Nurses JOB SATISFACTION, CAREER PATTERNS AND TRAJECTORIES

This study explores current career plans and trends, satisfaction levels and professional concerns for registered nurses (RNs). In the next one to three years a considerable number of nurses may pursue employment outside of nursing, shift to part-time roles, retire or otherwise modify their career paths in some way, according to this report. As the economy continues to recover, issues such as nursing retention and turnover within healthcare facilities, will be essential in planning for future nurse staffing. Therefore, it is important to know how nurses truly perceive their

profession. Their candid feelings, expressed in these survey results, may influence their peers and the next generation of nurses. AMN Healthcare conducted its annual 2012 Survey of Registered Nurses to answer these and related questions. The survey inquiries mirror those asked in the 2011 Survey of Registered Nurses, and include a few new components. Data from previous surveys conducted in 2010 and 2011 are compared to the 2012 data in this report, unveiling some remarkable findings. The 2012 survey offers a snapshot of current job satisfaction levels among nurses and also indicates how the economic recovery may affect future career trajectories. The data suggest how nurses currently view the quality of nursing care, and whether they believe healthcare reform will help address the predicted nursing shortage. These results are offered as an information resource for healthcare industry leaders, policy- makers, academics, staffing professionals, analysts, and others who follow clinical staffing and supply trends. The following data points provide background describing the current nursing supply and demand situation: • Nursing is the nation’s largest healthcare profession, with more than 3.1 million RNs nationwide. • Of all licensed RNs, 2.6 million or 84.8 percent are employed in nursing. That means about 500,000 licensed nurses don’t work in the nursing field, but potentially could do so. • The nation’s ability to train new nurses to replace retiring nurses is significantlycompromised by the limited number of faculty members at nurse training programs. • According to the American Association of Colleges of Nursing (AACN), U.S. nursing schools turned away 58,327 qualified applicants from entry-level baccalaureate nursing programs in 2011 (up from 52,115 in 2010) due to insufficient numbers of faculty, clinical sites, classrooms, clinical preceptors and budget constraints. • Almost two-thirds of the nursing schools cited faculty shortages as a reason for not accepting all qualified applicants.

• AACN reported that there was a 5.1 percent enrollment increase in entry-level baccalaureate programs in nursing in 2011, but this increase is not sufficient to meet the projected demand for nursing services.

• The Patient Protection and Affordable Care Act of 2010 is projected to provide 32 million Americans with access to healthcare services. • In July 2010, the Tri-Council for Nursing cautioned about declaring an end to the nursing shortage. The economic downturn led to an easing of the shortage in many parts of the country, but the Tri-Council noted that the limitations of the nation’s education system will slow the graduation of RNs. That, coupled with the passage of the Patient Protection and Affordable Care Act, is projected to increase demand for nursing services. • According to the projections released by the Bureau of Labor Statistics (BLS), registered nurses top the list of the 10 occupations with the largest projected job growth in the years of 2002-2012. Although RNs have ranked among the top 10 growth occupations in the past, this is the first time in recent history that RNs have ranked first. • The total job openings, which include job growth and the net replacement of nurses, will be more than 1.1 million. This growth, coupled with current trends of nurses retiring or leaving the profession and few new nurses, could lead to a nursing shortage of more than one million nurses by the end of this decade. (www.bls.gov/emp/#outlook) • Current projections for 2025 indicate a shortage of 260,000 registered nurses (Dr. Peter Buerhaus, ―The Recent Surge in Nurse Employment: Causes and Implications,‖ June 2009). A shortage of this magnitude would be twice as large as any nursing shortage experienced in this country since the mid-1960s. KEY FINDINGS AMN Healthcare’s 2012 Survey of Registered Nurses was conducted following an economic recession and in the midst of an economic upswing, albeit not an aggressive recovery. In

addition, the first parts of the Patient Protection and Affordable Care Act of 2010 were being implemented and more fully understood. The survey reflects how RNs modified career plans due to the recession and how they have begun to respond to the economic recovery. In addition, the survey addresses registered nurses’ perceptions of the impact of healthcare reform on the nursing shortage. • Less than one-fifth (17%) of nurses plan to seek a new place of employment as the economy recovers, a decline from the 24% who said they would seek a new place of employment in the 2011 survey. • RNs are still more likely to be employed by a hospital where there is permanent employment. However, down by 7% (total of 57%) from 2011. Thirty-one percent of nurses plan to take steps in the next one to three years that would take them out of nursing altogether (by retiring or seeking non-nursing jobs) or reduce the volume of clinical work they do (by switching to parttime or less demanding roles). • Sixty-six percent report that they will continue as they are, which is a significant rise from 55% last year. • A little less than half (40%) said they either would not recommend nursing as a career to young people or were not sure that they would. • Ninety-one percent of nurses are satisfied with their careers, up significantly from 2011. • Yet, 44% would either hesitate about becoming a nurse or choose another career entirely if they were making such a professional choice today. o 38% Age 19-39 in 2012 as opposed to 34% in 2011 o 44% Age 40-54 in 2012 as opposed to 49% in 2011 o 48% Age 50+ in 2012 as opposed to 45% in 2011 • Four percent plan to work as travel nurses in the next one to three years, compared to 14% who said that in 2011. • Forty percent of nurses will pursue further education in nursing in the next 1-3 years.

METHODOLOGY AMN Healthcare’s 2012 Survey of Registered Nurses was distributed via email to registered nurses nationwide. Email surveys were sent to 88,288 RNs who are registered with the Internet portals, NurseZone.com or RN.com. The survey was distributed to nurses in early April 2012, and responses were accepted through April 27, 2012. The charts on the following pages provide demographic information on those who completed the survey. AMN Healthcare www.amnhealthcare.com

Job satisfaction and its related factors: A questionnaire survey of hospital nurses in Mainland China Hong Lu_, Alison E. While, K. Louise Barriball King’s College London, Florence Nightingale School of Nursing and Midwifery, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, England, UK Received 26 January 2006; received in revised form 27 June 2006; accepted 13 July 2006

Background: The widespread nursing shortage is of concern in Mainland China and globally. Factors underpinning the increased mobility of the nursing workforce and their contribution to nurses’ turnover thus merit attention. Understanding nurses’ job satisfaction is important, as this is a key factor in nurses’ turnover. Objective: The study aimed to explore nurses’ views and experience regarding different components of their working lives in Mainland China. Methods: A cross-sectional survey design was selected and 512 nurses working in the medical and surgical departments in two teaching hospitals in Beijing completed questionnaires yielding a response rate of 81%. Results: More than half of nurses (53.7%; n ¼ 275) were satisfied or very satisfied with their jobs and 15% (n ¼ 77) felt moderate to extreme occupational stress. The majority of the sample

reported a high level of organizational commitment (63.7%; n ¼ 326) and professional commitment (85.9%; n ¼ 440) and only 5.9% (n ¼ 30) and 10.0% (n ¼ 51), respectively reported role conflict and role ambiguity often or very often. Nurses with a diploma or associate degree reported greater professional commitment and a lower level of role conflict than those with a bachelor degree (po0.05), but there were no significant differences in job satisfaction, organizational commitment, occupational stress and role ambiguity by educational programme (p40.05). Conclusions: Hospital nurses’ positive feelings regarding their working lives may be influenced by developments in the health care system and the nursing profession in Mainland China. Nurses’ educational level is an influencing factor on nurses’ views and experiences of their working lives with the findings suggesting the need to develop a clinical career ladder for nursing staff in Mainland China.

Factors influencing stress and job satisfaction of nurses working in psychiatric units: a research review. 1

2

Nakakis Konstantinos , Ouzouni Christina 1. Lecturer in Nursing, Technological Educational Institute of Lamia 2. Lecturer in Nursing, Technological Educational Institute of Lamia HSJ – HEALTH SCIENCE JOURNAL® VOLUME 2, ISSUE 4 (2008)

Background: Mental health nursing has been reported as a stressful speciality, with low job satisfaction. Method: An extensive literature search was performed aiming to identify and review research studies that investigate variables which influence stress and job satisfaction of nurses working in mental health settings. Results: This review shows that a variety of factors influence stress and job satisfaction of mental health nurses. Among these, clinical leadership and quality inter-professional collaboration between nurses and doctors and amongst nurses are particularly important. Nurses’ job satisfaction was found to be influenced primarily by psychological stress and the quality of clinical leadership.

Conclusions: The influence of the quality of collaboration amongst nurses and between nurses and doctors on nurses’ job satisfaction is uncertain. A strong negative relationship was found between clinical leadership, inter-professional collaboration, stress and job satisfaction. Although a positive relationship between clinical leadership and nurses' job satisfaction was found, the association between clinical leadership and quality of inter-professional collaboration is unclear. The association between these variables and job satisfaction is positive but tenuous. In addition, a positive but weak relationship was revealed between the clinical leadership and the quality of relationships amongst nurses. Organisational issues, lack of nursing staff and patient care were found to be related to ward type mental health nurses’ stress emerged as mediating variables between stress and job satisfaction. A hypothetical model of the relationships between these variables is presented for testing at a future study. Keywords: job satisfaction, stress, mental health nurses/nursing, psychiatric nursing/nurses.

Factors Which Influence Job Satisfaction in Nursing Assistants in Nursing Homes High turnover of nursing assisants in long term care facilities results in poor quality of care and decreased quality of life for nursing home residents. Turnover is related to job satisfaction and can be improved by improving job satisfaction. The purpose of this project was first to explore the relationships between job satisfaction and factors known to affect job satisfaction in an existing data set of 556 nursing assistants from 12 Maryland nursing homes. The second purpose of the project was to develop a guideline and user friendly tool to assist Directors of Nursing in improving job satisfaction in their own facilities. A multiple regression analysis was performed to identify the relationship between job satisfaction and facility, age, gender, education, years of experience, self-esteem, self-efficacy and outcome expectations for performance of restorative care activities, and observed performance of restorative activities. A step wise approach was used. Three variables entered the model, accounting for 7.1% of the variance in job satisfaction. The variables positively associated with job satisfaction were length of experience as a nursing assistant and performance of exemplary nursing care demonstrated through performance of restorative care. Self esteem was negatively associated with job satisfaction. The remaining variables did not enter the model.

An evidence based guideline for evaluating and improving job satisfaction and reducing turnover in nursing assistance was developed based on the study results and existing literature. Strategies for improving job satisfaction which were proven to be effective were included. A three step, checklist tool was developed from the guideline to assist administrative staff in the evaluation and improvement of job satisfaction and turnover in their facility. Enhancing job satisfaction and reducing turnover is a problem with multiple causes and multiple potential solutions. For Directors of Nursing, shifting through the potential interventions can be daunting. The guideline and tool can assist in addressing and resolving job satisfaction problems and, through more satisfied nursing assistants, improve quality of care and quality of life for long term care residents.

Factors Which Influence Job Satisfaction in Nursing Assistants in Nursing Homes The United States is currently experiencing a shortage of nursing assistants (Collier & Harrington, 2008). The average turnover of nursing assistants in nursing homes in the United States is high, averaging 93% (Bowers, Esmond, & Jacobson, 2003).Turnover results in high recruitment expenses, poor staffing ratios, and vacant positions in those facilities that care for our nations’ elderly. Those nursing assistants who leave nursing facility employment seem to do so due to poor job satisfaction. Over the last three decades, findings from numerous studies indicate that job satisfaction is significantly associated with job turnover among nursing assistants (Kennedy, 2005; Parsons, Simmons, Penn, & Furlough, 2003; Schur, Noelker, Looman, Whitlatch, & Ejaz, 1998; Secrest, Iorio, & Martz, 2005; Squillace et. al., 2006; Claudill & Patrick, 1989; Garland, Oyabu &Gipson, 1988). Job satisfaction in nursing assistants is also related to client satisfaction in nursing home patients and families (Tellis-Nayak, 2007; SikorskaSimmons, 2006; Chou, Boldy & Lee, 2003).

Background and Purpose The number of Americans in need of long term care is expected to double by 2050. Recruitment and especially retention of nursing assistants is a priority for long term care providers (Squillace, Remsburg, Bercovitz, Rosenoff, & Branden, 2006). Since nursing assistants are the members of the long term care healthcare team who provide direct assistance for the personal care needs of the patients, recruitment and especially retention of nursing assistants is a priority for long term

care providers (Squillace, Remsburg, Bercovitz, Rosenoff, & Branden). High turnover of nursing assistants results in a poor quality of care and decreased quality of life among nursing home residents (Castle, 2007; Collier, 2008; Castle, 2005; Schur, Noelker, Looman, Whitlatch, & Ejaz, 1998). Turnover and its relationship to quality of care could also be a factor in the relationship between job satisfaction and patient and family satisfaction with nursing home care. The issue of client and family satisfaction is becoming a crucial component in determining quality in the nursing home culture change movement. Researchers in and out of health care studying client satisfaction are finding correlation between client satisfaction and employee satisfaction (Hallowell, Schlesinger & Zornitsky, 1996). In nursing homes, less job satisfaction in larger nursing home units correlated with reduced quality of life measured by resident need for physical and psychosocial assistance (Pekkarinen, Sinervo, Perala & Elovainio, 2004). Better relationships and improved quality of life on units with nursing assistants satisfied with their jobs could positively influence reports of client and family satisfaction.

Job satisfaction trends during nurses' early career Trevor Murrells*, Sarah Robinson and Peter Griffiths

Background Job satisfaction is an important component of nurses' lives that can impact on patient safety, productivity and performance, quality of care, retention and turnover, commitment to the organisation and the profession. Little is known about job satisfaction in early career and how it varies for different groups of nurses. This paper investigates how the components of job satisfaction vary during early career in newly qualified UK nurses.

Methods Nurses were sampled using a combined census and multi-stage approach (n = 3962). Data were collected by questionnaire at 6 months, 18 months and 3 years after qualification between 1998 and 2001. Scores were calculated for seven job satisfaction components and a single item that measured satisfaction with pay. Scores

were compared longitudinally and between nursing speciality (general, children's, mental health) using a mixed model approach.

Results No single pattern across time emerged. Trends varied by branch and job satisfaction component. Rank order of job satisfaction components, from high to low scores, was very similar for adult and child branch nurses and different for mental health. Nurses were least satisfied with pay and most satisfied with relationships at 6 and 18 months and with resources (adult and child) and relationships (mental health) at 3 years. Trends were typically upwards for adult branch nurses, varied for children's nurses and downwards for mental health nurses.

Conclusion The impact of time on job satisfaction in early career is highly dependent on specialism. Different contexts, settings and organisational settings lead to varying experiences. Future research should focus on understanding the relationships between job characteristics and the components of job satisfaction rather than job satisfaction as a unitary construct. Research that further investigates the benefits of a formal one year preceptorship or probationary period is needed.

http://www.biomedcentral.com/1472-6955/7/7

The Job Satisfaction of Finnish Nursing Staff: The Development of a Job Satisfaction Scale and Survey Results Tarja Kvist,1 Raija Mäntynen,1,2 Pirjo Partanen,1 Hannele Turunen,1,2 Merja Miettinen,2,3 and Katri Vehviläinen-Julkunen1,2 1

Department of Nursing Science, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, 70211 Kuopio, Finland

2 3

Kuopio University Hospital, P.O. Box 1777, 70211 Kuopio, Finland University of Tampere, 33014 Tampere, Finland

Received 8 February 2012; Revised 17 July 2012; Accepted 25 July 2012 Abstract This paper describes the development of the Kuopio University Hospital Job Satisfaction Scale (KUHJSS) and the results of the survey. The scale was developed through a systematic literature review, and its validity and reliability were assessed using several psychometric properties including expert evaluation (), a pilot survey (), and exploratory factor analysis. The final version of KUHJSS included 37 items. A large sample psychometric evaluation was made by nursing staff (). The exploratory factor analysis revealed seven factors with modest internal consistency (0.64–0.92). The staff reported relatively high job satisfaction. The greatest satisfaction was derived from motivating factors associated with the work; the least, from the job's demands. Respondents who considered their working units to provide an excellent quality of care reported the highest job satisfaction in every subarea (). The KUHJSS proved to be a reliable and valid tool for measuring job satisfaction in hospital care.

Aims of the Study The aims of this study were to (1)develop a scale for assessing the job satisfaction of nursing staff and describe the process by which this was accomplished, (2)assess the job satisfaction of nursing staff using the newly-developed scale, (3)identify differences in the job satisfaction of nursing staff in relation to demographic variables. Discussion The first objective of this study was to develop a Job Satisfaction Scale for specialized health care nursing staff and to describe the process by which this was accomplished. The second was to use the newly developed scale to assess the job satisfaction of nursing staff, and the third was to identify relationships between background variables and nurses’ job satisfaction. Although a

number of studies on job satisfaction among nurses have previously been conducted (e.g., [1, 33, 34]) and a wide range of scales have been developed in recent decades [30, 39], developing of a Job Satisfaction Scale was useful in At Safe Hospital Project and it is giving reliable measurement and results for further research and development work.

Conclusions The objective of developing a reliable and valid Job Satisfaction Scale was achieved, and a 37item KUHJSS was developed. Responses to the scale provide an accurate and realistic picture of job satisfaction among Finnish nursing staff. Nursing staff are generally satisfied with their jobs, especially in terms of their motivation for work and their welfare at work. Job satisfaction was clearly related to nurses’ perception of the quality of care provided by their working unit. However, nursing leaders should pay more attention to nurse staffing levels and to providing opportunities for nurses to combine their work and personal lives.

Factors contributing to nurse job satisfaction in the acute hospital setting : a review of recent literature Hayes, Bronwyn, Bonner, Ann, & Pryor, Julie (2010) Factors contributing to nurse job satisfaction in the acute hospital setting : a review of recent literature. Journal of Nursing Management, 18(7), pp. 804-814. Aim To explore and discuss from recent literature the common factors contributing to nurse job satisfaction in the acute hospital setting. Background Nursing dissatisfaction is linked to high rates of nurses leaving the profession, poor morale, poor patient outcomes and increased financial expenditure. Understanding factors that contribute to job satisfaction could increase nurse retention.

Evaluation A literature search from January 2004 to March 2009 was conducted using the keywords nursing, (dis)satisfaction, job (dis)satisfaction to identify factors contributing to satisfaction for nurses working in acute hospital settings. Key issues This review identified 44 factors in three clusters (intra-, inter- and extra-personal). Job satisfaction for nurses in acute hospitals can be influenced by a combination of any or all of these factors. Important factors included coping strategies, autonomy, co-worker interaction, direct patient care, organizational policies, resource adequacy and educational opportunities. Conclusions Research suggests that job satisfaction is a complex and multifactorial phenomenon. Collaboration between individual nurses, their managers and others is crucial to increase nursing satisfaction with their job. Implications for nursing management Recognition and regular reviewing by nurse managers of factors that contribute to job satisfaction for nurses working in acute care areas is pivotal to the retention of valued staff.

http://eprints.qut.edu.au/45324/

The influence of nurses’working motivation and job satisfaction on intention to quit: an empirical investigation in Taiwan Huey-Ming Tzeng* Department of Nursing, I-Shou University, No. 1, Section 1, Hsueh-Chang Road, Ta-Hsu Hsiang, Kaohsiung County 840, Taiwan Received 21 August 2001; received in revised form 21 January 2002; accepted 22 April 2002

The present era of cost-containment pressures indicates that nursing executives have to ensure that, their nurses have a work environment with the work characteristics known to be linked to job satisfaction and good outcomes. The research hypothesis investigated here was: the higher nurses’levels on general job satisfaction, overall satisfaction with their professional role, and general job happiness, the lower their intention to quit would be. The controlling variables included demographic characteristics, working motivation, and nine job satisfaction subscales. This study was conducted in 3 hospitals located in southern Taiwan. All nurses working for these 3 hospitals were the target subjects. The overall response rate (648 completed questionnaires) was 82%. The nurses’Job Satisfaction and the perceptual degree of its importance questionnaire was used. Ordinal logistics regression analyses were utilized. General job satisfaction, general job happiness, satisfaction with salary and promotion, institution, educational background, and age of nurses’youngest child were proved to be significant predictors of nurses’ intention to quit. Suggestions for future studies and administrative strategies in decreasing nurses’intention to quit were discussed.r2002 Elsevier Science Ltd. All rights reserved.

Introduction A competitive healthcare market is indeed qualityoriented, and improving the quality of healthcare services is a continuing challenge to managers in the healthcare industry. Similar to the western societies, Taiwan’s healthcare industry became a cost-containing environment after the government implemented the National Health Insurance System in 1995.

Methods Subjects This study was conducted in 3 hospitals located in southern Taiwan. These hospitals’nursing administrators acted as members of the Human Subject Review committees. Committee members reviewed this research proposal for approval, and assured having appropriate human subject protection. The attached cover sheet indicated that all collected data would be used for research purposes only. Data would be kept confidential, and subjects’identification will be protected. These 3 hospitals were located in the same demographic area. One of them is a Christian teaching hospital (Hospital A), another one is a private-owned local hospital (Hospital B), and the other one is a local, veteran’s hospital (Hospital C). Data were collected during the period from December 1999 to March 2000. All the nurses working in these three institutions were the target population (including the ones with managerial responsibilities, and excluding physician assistants), for a total of 786 nurses. The questionnaire packages were sent to the nurse subjects through the hospitals’ nursing departments. This questionnaire packages (included a letter explaining the study purpose, a demographic information chart, a pre-stamped return envelope, and a gift for appreciating subjects’participation) were disseminated to all nurses through subjects’ managers. The completed questionnaire (in a sealed envelop) was returned to the principal investigator by mail or through their nursing departments. Subjects participated in this study voluntarily and anonymously. The overall response rate (648 completed questionnaires) was 82%, and the correspondent rate for each individual hospital ranged from 72% to 84%. The nurses’ job satisfaction and the perceptual degree of its importance questionnaire This questionnaire set was written in Mandarin, and only part of the items in this questionnaire was utilized. There were a total of 48 items for measuring the levels of the nine job satisfaction scales. Items were grouped into 9 scales: indirect working environment (6 items); direct working environment (7 items); salary and promotion (7 items); self-growth (3 items); challenge in work (6 items); interaction with and feedback from patients and family members (3 items); leadership style (7 items); working atmosphere (7 items); and family support and religion (2 items). Responses were given on a 5-point Likert scale: ranging from 1 (least satisfied) to 5 (most

satisfied), and 9 (not applicable). Three general perceptual factors (general job satisfaction, overall satisfaction with professional roles, general job happiness) were rated from very satisfied or very happy to very dissatisfied or very unhappy. The ordinal dependent variable, having intention to quit, was rated into five categories: (1) Least agreeable, (2) disagreeable, (3) neutral, (4) agreeable, and (5) most agreeable. For the consistency of the tool, a test-retest method (2 weeks apart) was used. A total of 46 fulltime nurses participated in this test. The test-retest correlation coefficients on items were ranged from 0.81 to 0.96. As for the reliability analyses, alpha coefficients were calculated using all the valid subjects. Except for the satisfaction scale of family support and religion (alpha coefficient=0.64), all the other alpha coefficients were ranged from 0.74 to 0.92. For each scale, the mean value was calculated by averaging the valid values of the grouped items.

Data analyses Data were entered and processed by using the statistical package for the social sciences (SPSS) software, English version 10.0. Descriptive information for all included variables was presented. Ordinal logistic regression analyses were utilized to develop a model of nurses’intention to quit. The demographic characteristics were entered into the regression model first, followed by nine job satisfaction scales, and three general job-related indicators at last. This procedure allowed us to observe the changes on coefficients when more explanatory variables were added into the equation.

Job satisfaction trends during nurses' early career Trevor Murrells*, Sarah Robinson and Peter Griffiths Published: 5 June 2008 BMC Nursing 2008, 7:7 doi:10.1186/1472-6955-7-7 Received: 24 September 2007 Accepted: 5 June 2008 This article is available from: http://www.biomedcentral.com/1472-6955/7/7

Background: Job satisfaction is an important component of nurses' lives that can impact on

patient safety, productivity and performance, quality of care, retention and turnover, commitment to the organisation and the profession. Little is known about job satisfaction in early career and how it varies for different groups of nurses. This paper investigates how the components of job satisfaction vary during early career in newly qualified UK nurses.

Methods: Nurses were sampled using a combined census and multi-stage approach (n = 3962). Data were collected by questionnaire at 6 months, 18 months and 3 years after qualification between 1998 and 2001. Scores were calculated for seven job satisfaction components and a single item that measured satisfaction with pay. Scores were compared longitudinally and between nursing speciality (general, children's, mental health) using a mixed model approach.

Results: No single pattern across time emerged. Trends varied by branch and job satisfaction component. Rank order of job satisfaction components, from high to low scores, was very similar for adult and child branch nurses and different for mental health. Nurses were least satisfied with pay and most satisfied with relationships at 6 and 18 months and with resources (adult and child) and relationships (mental health) at 3 years. Trends were typically upwards for adult branch nurses, varied for children's nurses and downwards for mental health nurses.

Conclusion: The impact of time on job satisfaction in early career is highly dependent on specialism. Different contexts, settings and organisational settings lead to varying experiences. Future research should focus on understanding the relationships between job characteristics and the components of job satisfaction rather than job satisfaction as a unitary construct. Research that further investigates the benefits of a formal one year preceptorship or probationary period is needed.

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