Factors influencing job satisfaction on specialty nursing units

In the midst of downsizing, restructuring, layoffs, hospital closures, mergers, and the beginning cycle of shortages in specialty units, nursing administrators must extend their understanding of the factors influencing job satisfaction and the implications these findings may have for nursing practice, in order to enhance the quality of worklife for nurses in a hospital setting and create competitive work environments. The Causal Model of Job Satisfaction for Nurses (Blegen & Mueller, 1987), including Leatt and Schneck's (1981) technology variable, was the conceptual framework used to look at the effect of the 14 variables (opportunity, routinization, autonomy, job communication, social integration, distributive justice, promotional opportunity, motivation, pay, workload, general training, kinship responsibility, unit size, technology) on job satisfaction. This study demonstrated a statistically significant positive correlation between autonomy, motivation and job satisfaction and a statistically significant negative correlation between routinization and job satisfaction.     

Work–family conflict, spouse support, and nursing staff well-being during organizational restructuring.

This study examined work and family conflict, spouse support, and nursing staff well-being during a time of hospital restructuring and downsizing. Data were collected from 686 hospital-based nurses, the vast majority (97%) women. Nurses reported significantly greater work–family conflict than family–work conflict. Personal demographic but not downsizing and restructuring variables predicted family–work conflict; downsizing and restructuring variables but not personal demographics predicted work–family conflict. Spouse support had no effect on work–family conflict but reduced family–work conflict. Both work–family conflict and family–work conflict were associated with less work satisfaction and greater psychological distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of health care reforms on job satisfaction and voluntary turnover among hospital-based nurses

OBJECTIVES: Among the consequences of downsizing and cost containment in hospitals are major changes in the work life of nurses. As hospitals become smaller, patient acuity rises, and the job of nursing becomes more technical and difficult. This article examines the effects of changes in the hospital environment on nurses' job satisfaction and voluntary turnover between 1993 and 1994. METHODS: Data were collected in a longitudinal survey of 736 hospital nurses in one hospital to examine correlates of change in aspects of job satisfaction and predictors of leaving among nurses who terminated in that period. RESULTS: Unadjusted results showed decline in most aspects of satisfaction as measured by Hinshaw and Atwood's and Price and Mueller's scales. Multivariate analysis indicated that the most important determinants of low satisfaction were poor instrumental communication within the organization and too great a workload. Intent to leave was predicted by the perception of little promotional opportunity, high routinization, low decision latitude, and poor communication. Predictors of turnover were fewer years on the job, expressed intent to leave, and not enough time to do the job well. CONCLUSIONS: The authors conclude that although many aspects of job satisfaction are diminished, some factors predicting low satisfaction and turnover may be amenable to change by hospital administrators.     

Job Stress in the Nursing Profession: The Influence of Organizational and Environmental Conditions and Job Characteristics.

The aim of the current study was to examine the influence of organizational and environmental work conditions on the job characteristics of nurses and on their health and well-being. The sample consisted of 807 registered nurses working in an academic hospital in Leiden (the Netherlands). The direct influence of work conditions on outcomes was examined. Mediation of job characteristics in the relationships between work conditions and outcomes was tested by means of regression analyses. The results indicated that job characteristics, such as demands and control, mediated the relationship between work conditions, such as work agreements/rewards, and outcomes. By managing organizational and environmental conditions of work, job characteristics can be altered, and these in turn influence nurses' job satisfaction and distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care utilization as a function of subjective health status, job satisfaction and gender among health care workers in Guangzhou, southern China

Job satisfaction, subjective health and health care utilization was studied on 72 doctors and 127 nurses working at two hospitals in Guangzhou in the People's Republic of China (P.R.C.), along with medication use and consultations with physicians over the 14 days preceding data collection. Female doctors were, on average, ten years older than male doctors. Nurses (all female) were comparable to male doctors in terms of age. Current and general subjective health, and job satisfaction differed between doctors and nurses. Nurses were less satisfied than doctors and reported poorer perceived health, until gender and age were controlled. Female doctors had poorer ratings of general and current subjective health and lower job satisfaction than their male colleagues. Path analysis tested whether lower job satisfaction leads to decrements in perceived current health which in turn increased consultation with a physician and medication use. When male and female subjects were examined separately, job satisfaction was inversely related to consultation behaviour among males and positively related to perceived current health in both genders. Among females job satisfaction and consultation behaviour related to current perceived health but were not related to each other. The hypothesized path was upheld for nurses. Lack of power prevented the same path being significant for male or female doctors. In combination, doctors showed significant relationships between the four main variables studied.     

Paid work, unpaid work and social support: a study of the health of male and female nurses

Paid work, unpaid work in the home and social support are important elements of the social production of health and illness, though their combined effects on both women and men have only recently become a focus of research. This paper examines their association with the health problems of nurses, presenting data from a survey of a proportional random sample of 2285 male and female nurses registered in the Province of Ontario. The data are first analysed for the full sample and then multiple regression analyses are run separately for male and female Registered Nurses. The demands of paid work (overload, exposure to hazards), unpaid work (time pressures, caring for a dependent adult) and overall stress in life are associated with greater health problems. There is also evidence of significant links between social support and health. A poor relationship with a supervisor is associated with health problems. On the other hand, enjoying a confiding relationship with a friend and having up to 4 children reduces the likelihood of experiencing health problems. The features of nursing associated with fewer health problems are challenge, statisfaction with work and working under 20 hours a week. Several common themes emerge in the analyses of women and men: overload, hazard exposure, satisfaction with work, having 3-4 children and level of overall stress in life. Yet the models are also very different and point to the need for further analyses of the social production of health problems in relation to gender. They also suggest that female nurses, in particular, may suffer the effects of restructuring in the health care sector. Workload issues are especially important for women. Younger women, those reporting time pressures and caring for a dependent adult are more likely to report health problems. Having a confiding relationship with a friend is associated with fewer health problems for women. Among men, those who dislike housework are more likely to experience health problems. Satisfaction with work and overall stress in life were associated with health problems for both men and women, though there may be gender differences in what generates satisfaction and stress.     

Secondary metabolites from marine microorganisms: bacteria, protozoa, algae and fungi. Achievements and prospects

To facilitate nurses' job satisfaction and reduce their psychological distress, it is useful for a nursing manager to know whether factors within the workplace provide greater prediction of these affective states than variables outside the domain of work, and whether there are common predictors of satisfaction and distress. The relative importance of occupational and nonoccupational variables in the prediction of job satisfaction and psychological distress was investigated in a survey of hospital nurses (N = 376). Perceived relations with the head nurse, coworkers, physicians, and other units/departments, along with unit tenure and job/nonjob conflict, were predictors of job satisfaction. Personal disposition (anxiety-trait), social integration, unit tenure, professional experience, position level, and job/nonjob conflict, along with the relations with the head nurse and physicians, were predictors of psychological distress. The relations with the head nurse and physicians, as well as unit tenure and job/nonjob conflict, were predictors of both satisfaction and distress. The prediction by unit tenure is noteworthy. Unit tenure had a negative relationship to satisfaction and a positive one to distress, whereas total experience had a negative relationship to psychological distress and none with job satisfaction. The role of unit tenure in nurses' affective experiences warrants more attention in future research, along with the role of job/nonjob conflict and other variables predictive of nurses' satisfaction and distress.     

The correspondence of patient satisfaction and nurse burnout

This study examined the relationships of nurse burnout, intention to quit, and meaningfulness of work as assessed on a staff survey with patient satisfaction with nursing care, physician care, information provided and coordination of care, and outcomes of the hospital stay assessed post-discharge. Sixteen inpatient units from two hospital sites formed the data base and included 605 patients and 711 nurses. Patients' perceptions of the quality of each of the four care dimensions corresponded to the relationships nurses had with their work. Patients on units where nurses found their work meaningful were more satisfied with all aspects of their hospital stay. Patients who stayed on units where nursing staff felt more exhausted or more frequently expressed the intention to quit were less satisfied with the various components of their care. Although nurse cynicism was reflected in lower patient satisfaction with interactions with nursing staff, the correlations between cynicism and other aspects of care fell below statistical significance. No significant correlations were found between nurse professional efficacy and any of the patient satisfaction components measured. The implications of the relationship between patient satisfaction and nurses' perception of their work is discussed.     

The Influence of Prior Commitment on the Reactions of Layoff Survivors to Organizational Downsizing.

Nurses (N := 179; Study 1) and managers (N = 154; Study 2) participated in 2 panel studies examining the relationship among prior commitment (affective and continuance commitment and perceived organizational support), coping strategies, and survivors' attitudes and perceptions during and following downsizing. In Study 1, perceived organizational support was significantly positively related to control-oriented coping, job satisfaction, and intention to remain and negatively related to perceived job insecurity and burnout 2 years later. In Study 2, coping mediated the relationship between the prior commitment variables and job alienation, health symptoms, and burnout following the downsizing. Control-oriented coping was associated with elevated levels of health symptoms and burnout following the downsizing, suggesting that control-oriented coping may have positive effects in the short term but potentially harmful effects in the long term. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A survey of job satisfaction, sources of stress and psychological symptoms among general practitioners in Leeds

BACKGROUND: The past seven years have seen rapid changes in general practice in the United Kingdom (UK), commencing with the 1990 contract. During the same period, concern about the health and morale of general practitioners (GPs) has increased and a recruitment crisis has developed. AIM: To determine levels of psychological symptoms, job satisfaction, and subjective ill health in GPs and their relationship to practice characteristics, and to compare levels of job satisfaction since the introduction of the 1990 GP contract with those found before 1990. METHOD: Postal questionnaire survey of all GP principals on the Leeds Health Authority list. The main outcome measures included quantitative measures of practice characteristics, job satisfaction, mental health (General Health Questionnaire), and general physical health. Qualitative statements about work conditions, job satisfaction, and mental health were collected. RESULTS: A total of 285/406 GPs (70%) returned the questionnaires. One hundred and forty-eight (52%) scored 3 or more on the General Health Questionnaire (GHQ-12), which indicates a high level of psychological symptoms. One hundred and sixty GPs (56%) felt that work had affected their recent physical health. Significant associations were found between GHQ-12 scores, total job satisfaction scores, and GPs' perceptions that work had affected their physical health. Problems with physical and mental health were associated with several aspects of workload, including list size, number of sessions worked per week, amount of time spent on call, and use of deputizing services. In the qualitative part of the survey, GPs reported overwork and excessive hours, paperwork and administration, recent National Health Service (NHS) changes, and the 1990 GP contract as the most stressful aspects of their work. CONCLUSIONS: Fifty-two per cent of GPs in Leeds who responded showed high levels of psychological symptoms. Job satisfaction was lower than in a national survey conducted in 1987, and GPs expressed the least satisfaction with their hours, recognition for their work, and rates of pay. Nearly 60% felt that their physical health had been affected by their work. These results point to a need to improve working conditions in primary care and for further research to determine the effect of any such changes.     

Immunocytochemical detection of advanced glycated end products in rat renal tissue as a function of age and diabetes

Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.     

Unlicensed assistive personnel in the perioperative setting

The present climate in health care, including a tendency toward more managed care and capitation systems, has caused hospital administrators and perioperative managers to reexamine traditional work systems and their associated costs. Some decisions around work redesign may be financially driven or based on the decreased availability of qualified professionals in the job market. The use of an increased number of unlicensed assistive personnel (UAP) in hospital settings has become a common redesign strategy to address both issues. In the perioperative setting, some traditional roles are well established for UAP. Today, changes associated with downsizing, cost containment, and increasing technology have opened up new opportunities to explore ways to integrate UAP roles into the perioperative setting.     

Intracellular signaling of osteogenic protein-1 through Smad5 activation

This research examines job satisfaction and need for autonomy of 190 registered nurses in Hong Kong using a cross-sectional survey design. The level of job satisfaction towards six job components (autonomy, professional status, pay, interaction, task requirements and organizational policies) was measured using the Index of Work Satisfaction. Results showed that the sample was dissatisfied more than satisfied, they valued the job components of autonomy, professional status and pay more than interaction, task requirements and organizational policies. In addition, comparisons were made between nurses working in different hospitals and also different nursing units within a hospital. The level of need for autonomy was assessed using the autonomy subscale of the Edwards Personal Preference Schedule. Results showed that the level of need for autonomy of this group of nurses was below the mid-score of the sub-scale and there was no significant relationship between their satisfaction with job autonomy and their individual need for autonomy.     

Burnout as a clinical entity--its importance in health care workers

Burnout, viewed as the exhaustion of physical or emotional strength as a result of prolonged stress or frustration, was added to the mental health lexicon in the 1970s, and has been detected in a wide variety of health care providers. A study of 600 American workers indicated that burnout resulted in lowered production, and increases in absenteeism, health care costs, and personnel turnover. Many employees are vulnerable, particularly as the American job scene changes through industrial downsizing, corporate buyouts and mergers, and lengthened work time. Burnout produces both physical and behavioural changes, in some instances leading to chemical abuse. The health professionals at risk include physicians, nurses, social workers, dentists, care providers in oncology and AIDS-patient care personnel, emergency service staff members, mental health workers, and speech and language pathologists, among others. Early identification of this emotional slippage is needed to prevent the depersonalization of the provider-patient relationship. Prevention and treatment are essentially parallel efforts, including greater job control by the individual worker, group meetings, better up-and-down communication, more recognition of individual worth, job redesign, flexible work hours, full orientation to job requirements, available employee assistance programmes, and adjuvant activity. Burnout is a health care professional's occupational disease which must be recognized early and treated.     

Impact of a CareMap and case management on patient satisfaction and staff satisfaction, collaboration, and autonomy

The purpose of this research was to evaluate the effect of a CareMap and nursing case management on patient satisfaction and staff job satisfaction, collaboration, and autonomy. The patients who had a CareMap and a nurse case manager were more satisfied with their care. The multidisciplinary staff who worked on the experimental unit had increased job satisfaction and nurses who applied and were selected for case management positions had higher levels of collaboration and increased autonomy. Multidisciplinary team members who developed the CareMap also had higher levels of collaboration than other multidisciplinary staff on the experimental unit and their job satisfaction with quality of care increased under this new care delivery system.     

Stress in nursing students and graduate nurses in inpatient psychiatry

This article deals with differences in work satisfaction, general state of well being, somatic complaints and work load of psychiatric student nurses and graduated nurses. Data were collected from a sample of 53 psychiatric student nurses and 145 graduated nurses. The graduated nurses reported an unexpectedly high job satisfaction of 70% compared to other working groups in hospitals. The student nurses were more content with their work and reported less somatic complaints. Furthermore the student nurses found in 20 cases certain duties less strenuous. In addition, the student nurses reported a more negative general state of well being.     

Work characteristics and employee well-being within a context of strategic downsizing.

Findings from this 4-year longitudinal study of strategic downsizing suggest that introducing deliberate work organization and change management strategies can combat the negative effects of reduced head count. Results showed that there was no overall decrease in well-being from before to after downsizing for the 139 employees remaining in an organization, despite an increase in work demands. The potential detrimental effect of demands appears to have been offset by improvement in work characteristics arising from initiatives introduced as part of the downsizing strategy. This interpretation is consistent with analyses at the individual level, which showed that high demands were associated with poorer well-being but that increases in control, clarity, and participation were associated with improved well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)