Job satisfaction among hospital nurses revisited: a systematic review

BackgroundThe current nursing shortage and high turnover is of great concern in many countries because of its impact upon the efficiency and effectiveness of any healthcare delivery system. Recruitment and retention of nurses are persistent problems associated with job satisfaction.ObjectiveTo update review paper published in 2005.DesignThis paper analyses 100 papers relating to job satisfaction among hospital nurses derived from systematic searches of seven databases covering English and Chinese language publications 1966–2011 (updating the original paper with 46 additional studies published 2004–2011).FindingsDespite varying levels of job satisfaction across studies, sources and effects of job satisfaction were similar. Hospital nurse job satisfaction is closely related to working conditions and the organizational environment, job stress, role conflict and ambiguity, role perception and role content, organizational and professional commitment.ConclusionsMore research is required to understand the relative importance of the many identified factors relating to job satisfaction of hospital nurses. It is argued that the absence of a robust causal model reflecting moderators or moderator is undermining the development of interventions to improve nurse retention.     

A model of job satisfaction of nurses: a reflection of nurses' working lives in Mainland China

AIM: This paper is a report of a study exploring nurses' views and experience regarding their working lives in Mainland China. BACKGROUND: The widespread nursing shortage and high turnover has become a global issue. Job satisfaction among nurses is a key factor in nurse turnover. Although several models of job satisfaction have been suggested in Western countries, these require further development and testing in Mainland China, where the social context of the labour market is different. METHOD: A survey design using questionnaires was adopted. A total of 512 hospital nurses in Beijing participated in the study in 2004, representing a response rate of 81%. FINDINGS: There was a negative relationship between nurses' job satisfaction and intention to leave their current hospitals, which was mediated by age (P < 0.05). About 40% of the variance in job satisfaction could be explained by the set of independent variables including organizational commitment, occupational stress, professional commitment, role conflict, role ambiguity, educational level, age and working years (R2 = 0.396). Organizational commitment had the strongest impact on job satisfaction, which explained 31.3% of the variance in this, followed by occupational stress and role conflict (5.5% and 1.9% respectively). In addition, both nurses' role perception and actual role content influenced job satisfaction as well as occupational stress, role conflict and role ambiguity (P < 0.05). Nurses' educational level was also a factor related to role perception, professional commitment and role conflict (P < 0.05). CONCLUSION: Nurses' job satisfaction could be increased through promoting organizational and professional commitment and reducing occupational stress, role conflict and role ambiguity.     

病房护士组织承诺及其影响因素的调查与分析

目的 了解护士组织承诺度现状,探讨其影响因素.方法 采用问卷调查法,对178名病房护士进行调查研究.结果 护士的组织承诺得分处于中等偏上水平,但也有将近一半的人只要工作性质相似就可以在其他医院工作;单因素分析结果显示:影响组织承诺的因素包括年龄、工作年限、科室、期望匹配度、对薪酬的满意度、角色冲突和角色模糊等.进一步多元分析显示,护士的角色模糊(β=-0.314)、角色冲突(β=-0.174)、对薪酬的满意度(β=0.169)、期望匹配度(β=0.344)和工作科室(β=0.300)等5个因素是护士组织承诺的主要影响因素.结论 护士的组织承诺总体较好;护理管理者应考虑角色认知变量和某些个体特征变量的影响,以进一步增强护士的组织承诺感.     

病房护士组织承诺及其影响因素的调查与分析

目的了解护士组织承诺度现状,探讨其影响因素。方法采用问卷调查法,对178名病房护士进行调查研究。结果护士的组织承诺得分处于中等偏上水平,但也有将近一半的人只要工作性质相似就可以在其他医院工作;单因素分析结果显示：影响组织承诺的因素包括年龄、工作年限、科室、期望匹配度、对薪酬的满意度、角色冲突和角色模糊等。进一步多元分析显示,护士的角色模糊（β=-0．314）、角色冲突（β=-0．174）、对薪酬的满意度（β=0．169）、期望匹配度（β=0．344）和工作科室（β=0．300）等5个因素是护士组织承诺的主要影响因素。结论护士的组织承诺总体较好;护理管理者应考虑角色认知变量和某些个体特征变量的影响,以进一步增强护士的组织承诺感。     

Job control,work-family balance and nurses’ intention to leave their profession and organization: A comparative cross-sectional survey

BackgroundThe shortage of nurses is a problem in many countries. In Japan, the distribution of nurses across different care settings is uneven: the shortage of nurses in home healthcare and nursing homes is more serious than in hospitals. Earlier research has identified numerous factors affecting nurses’ intention to leave work (e.g., job control, family-related variables, work-family conflict); however, these factors’ levels and effect size may vary between nurses in hospitals, home healthcare, and nursing homes.ObjectivesThis study measured job control, family-related variables, and work-family conflict among nurses in hospitals, home healthcare, and nursing homes, and compared these variables’ levels and effect size on nurses’ intention to leave their organization or profession between these care settings.DesignThe research design was cross-sectional.MethodsParticipating nurses from hospitals, home healthcare facilities, and nursing homes self-administered an anonymous questionnaire survey; nurses were recruited from the Kyushu district of Japan. Nurses from nine hospitals, 86 home healthcare offices, and 107 nursing homes participated. We measured nurses’ intention to leave nursing or their organization, perceived job control, family variables and work-family conflict. We analyzed 1461 participants (response rate: 81.7%).ResultsThe level of job control, family variables, and work-family conflict affecting nurses varied between hospitals, home healthcare, and nursing homes; additionally, these variables’ effect on nurses’ intention to leave their organization or profession varied between these care settings. Work-family conflict, family variables, and job control most strongly predicted nurses’ intention to leave their organization or profession in hospitals, home healthcare, and nursing homes, respectively.ConclusionsInterventions aiming to increase nurse retention should distinguish between care settings. Regarding hospitals, reducing nurses’ work-family conflict will increase nurse retention. Regarding home healthcare, allowing nurses to fulfill family responsibilities will increase nurse retention. Regarding nursing home nurses, increasing nurses’ job control will increase nurse retention.     

三级医院护理人员服务意识相关因素的调查分析

目的了解护理人员的服务意识现状及相关因素，为制定相应的措施提供理论依据。方法采用问卷调查法，调查258名三级医院护理人员的服务意识及其相关因素。结果81.01％的护理人员服务意识较好；与服务意识呈正相关的因素是组织承诺、专业认同、工作满意度，呈负相关的是角色模糊、工作压力、角色冲突；不同职称、是否有离职倾向的护士服务意识差异具有统计学意义（P〈0．01）；回归分析显示，组织承诺（P〈0．01）和角色模糊（P〈0.05）是服务意识的主要预测因素。结论护士的服务意识较好，影响服务意识的因素是多方面的，尤其是组织承诺和角色模糊，管理者应采用相应的措施来增强护理人员的服务意识，以提高护理质量。     

Job satisfaction and its related factors: a questionnaire survey of hospital nurses in Mainland China

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=275) were satisfied or very satisfied with their jobs and 15% (n=77) felt moderate to extreme occupational stress. The majority of the sample reported a high level of organizational commitment (63.7%; n=326) and professional commitment (85.9%; n=440) and only 5.9% (n=30) and 10.0% (n=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 (p<0.05), but there were no significant differences in job satisfaction, organizational commitment, occupational stress and role ambiguity by educational programme (p>0.05). 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.     

Evaluation of the effects of hospital nurse retention programs in Taiwan]

The purpose of the study was to examine the effectiveness of current nursing retention programs in hospitals in Taiwan and the relationships between job satisfaction and intention to stay. A proportional multi-stratified random sampling technique was used to recruit nurses who were working in accredited district and regional hospitals in the years 1996 to 1998. Data were collected through a structured questionnaire from 471 nurses with 2 years of nursing experience, and analyzed by non-parametric and logistic regression. The results showed that a majority of the respondents positively recognized the importance of the DOH retention policy and were satisfied with its implementation. Nurses whose working hospital had a retention program had higher job satisfaction and intention to stay than those without a retention program. Based on the findings, nursing and hospital administrators could develop retrievable data gathered during an ongoing organizational retention policy and develop strategic planning for stabilizing their clinical nursing workforce.     

北京市产科护士离职意愿影响因素的调查研究

目的 探讨影响产科护士离职意愿的相关因素及其在解释离职原因时的权重,为管理者提供理论依据.方法 按比例分层抽样的方法选取北京市10所三级综合医院252名产科病房护士进行问卷调查.结果 不同编制、职称的护士离职意愿得分不同(P<0.05);相关分析结果发现组织承诺度与离职意愿呈中度负相关(r=-0.451,P<0.01)...     

深圳市龙岗区护理人员工作满意度的影响因素分析

目的 探讨影响深圳市护理人员工作满意度的相关因素，为改善护理人员的工作满意度、提高护理质量、减少护理人员流失、完善护理人力资源管理制度提供依据。方法对在深圳市龙岗区医院工作的445名护理人员，采用一般资料问卷、明尼苏达满意问卷（MSQ）、组织承诺量表（OCQ）、离职意愿量表进行调查，分别以工作满意度量表、组织承诺量表、离职意愿量表总分为应变量，以护理人员的年龄、学历、婚姻、职称、职务、劳动关系、工龄、是否注册护士和其他两个量表总分为自变量进行多元逐步回归分析。结果护理人员工作满意度与组织承诺、年龄呈正相关，与劳动关系和离职意愿呈负相关（P〈0．001）。结论护理人员的工作满意度与组织承诺、年龄、劳动关系和离职意愿等因素关系密切。需采取有针对性的干预措施，提高护理人员的工作满意度。     

Intention to leave the profession: antecedents and role in nurse turnover

Title. Intention to leave the profession: antecedents and role in nurse turnover Aim. This paper is a report of a study to examine the relationship between intention to change profession and intention to change employer among newly graduated nurses. Background. Few studies of the worldwide nursing workforce shortage consider the contribution of changing professions to the shortage. Organizational behaviour research has identified that professional commitment and organizational commitment have an important role in organizational turnover and that professional commitment and intention to change professions may have a greater role in organizational turnover than is presently understood. Method. A model of the relationships between affective professional commitment job satisfaction, organizational commitment, intention to change professions and organizational turnover intention was developed through review of the organizational behaviour literature and tested using path analysis. The sample was drawn from all nurses in Queensland, Australia, entering the workforce for the first time in 2005. Results. The model was tested with a final sample size of 131 nurses in the initial period of exposure to the workplace. Affective professional commitment and organizational commitment were statistically significantly related to intention to change professions. Job satisfaction, organizational commitment and intention to change professions were statistically significantly related to intention to change employer. Conclusion. Turnover research in nursing should include intention to change professions as well as intention to change employer. Policies and practices that enhance the development of affective professional commitment prior to exposure to the workplace and support affective professional commitment, job satisfaction and organizational commitment in the workplace are needed to help reduce nurse turnover.     

Nurses' job satisfaction,organizational commitment,and career intent

OBJECTIVE: The objective of this survey was to define the characteristics of the nursing work force of a mixed urban/rural region of New York state and to determine the nurses' level of job satisfaction and commitment to the work setting. BACKGROUND: Recent investigations suggest nurses are highly dissatisfied with the demands of the healthcare environment and are expressing increased likelihood of leaving the work setting. These factors, in combination with the increasing age of the current nursing work force, are contributing to serious concerns about the future of patient care. METHODS: A random sample survey was mailed to registered nurses in the Finger Lakes Region of New York State in June 2000. Items in the questionnaire addressed nurse characteristics, reasons for leaving or staying with an employing agency, one- and five-year career intent, and level of job satisfaction and organizational commitment. RESULTS: Forty-six percent of the nurses returned completed questionnaires. Within this sample, most of the nurses were older, European American, and female. Personal and organizational characteristics contributed to differences in levels of job satisfaction, organizational commitment, and 1- and 5-year intent. In addition, many of the most satisfied and committed nurses reported their intent to leave nursing within the next 5 years. CONCLUSIONS: Findings of this investigation suggest the organizational environment, educational preparation, and personal characteristics of currently employed registered nurses affect their current job satisfaction, organizational commitment, and plans for continuing as a nurse.     

Job embeddedness: a theoretical foundation for developing a comprehensive nurse retention plan

OBJECTIVE: Using a new construct, job embeddedness, from the business management literature, this study first examines its value in predicting employee retention in a healthcare setting and second, assesses whether the factors that influence the retention of nurses are systematically different from those influencing other healthcare workers. BACKGROUND: The shortage of skilled healthcare workers makes it imperative that healthcare providers develop effective recruitment and retention plans. With nursing turnover averaging more than 20% a year and competition to hire new nurses fierce, many administrators rightly question whether they should develop specialized plans to recruit and retain nurses. METHODS: A longitudinal research design was employed to assess the predictive validity of the job embeddedness concept. At time 1, surveys were mailed to a random sample of 500 employees of a community-based hospital in the Northwest region of the United States. The survey assessed personal characteristics, job satisfaction, organizational commitment, job embeddedness, job search, perceived alternatives, and intent to leave. One year later (time 2) the organization provided data regarding voluntary leavers from the hospital. RESULTS: Hospital employees returned 232 surveys, yielding a response rate of 46.4 %. The results indicate that job embeddedness predicted turnover over and beyond a combination of perceived desirability of movement measures (job satisfaction, organizational commitment) and perceived ease of movement measures (job alternatives, job search). Thus, job embeddedness assesses new and meaningful variance in turnover in excess of that predicted by the major variables included in almost all the major models of turnover. CONCLUSIONS: The findings suggest that job embeddedness is a valuable lens through which to evaluate employee retention in healthcare organizations. Further, the levers for influencing retention are substantially similar for nurses and other healthcare workers. Implications of these findings and recommendations for recruitment and retention policy development are presented.     

Factors influencing job satisfaction of front line nurse managers: a systematic review

Aim The purpose of this study was to systematically review the research literature that examined the determinants of front line nurse managers’ job satisfaction. Background Front line managers are the vital link between senior management and clinical nurses. They influence organizational culture and outcomes for patients and staff so their job satisfaction and ultimately retention is of importance. Evaluations A review of research articles that examined the determinants of front line nurse managers’ job satisfaction was conducted. These managers supervise staff nurses and have direct responsibility for the management of a nursing unit or team in any type of healthcare facility. Fourteen studies were included in the final analysis. Key issues Evidence of significant positive relationships were found between span of control, organizational support, empowerment and the job satisfaction of front line nurse managers. Conclusion The review suggests that job satisfaction of front line managers may be improved by addressing span of control and workload, increasing organizational support from supervisors and empowering managers to participate in decision‐making. Implications for Nursing Management Healthcare organizations may enhance the recruitment, retention and sustainability of future nursing leadership by addressing the factors that influence job satisfaction of front line managers.     

Canadian cancer nurses' views on recruitment and retention

bakker d., butler l., fitch m., green e., olson k. & cummings g. (2009) Journal of Nursing Management  18, 205–214
Canadian cancer nurses' views on recruitment and retention Aim The purpose of this study was to explore oncology nurses’ perceptions about recruitment and retention. Background Competition among healthcare organizations to recruit and retain qualified nurses is a real-life challenge. Focusing attention on human resource planning in oncology is highlighted by both the worsening nursing shortage and cancer incidence. Methods A participatory action research approach was used and 12 focus groups with 91 cancer nurses were conducted across Canada to collect data about strategies that could improve recruitment and retention. Results Four themes emerged reflecting oncology nurses’ beliefs and values about organizational practices that attract and retain nurses and they are as follows: (1) recognizing oncology as a specialty, (2) tacit knowledge no longer enough, (3) gratification as a retaining factor, and (4) relationship dependent on environment. Conclusions Participants highlighted leadership, recognition and professional and continuing education opportunities as critical to job satisfaction and organizational commitment. Implications for nursing management Recruitment and retention were viewed as a continuum where organizational investment begins with a well-developed orientation and ongoing mentorship to ensure knowledge development. The challenge for nurse leaders is to use the evidence generated from this study and previous studies to develop professional practice environments that facilitate the cultural changes needed to build and sustain a quality nursing workforce.     

手术室护士工作压力、工作满意度与组织承诺的相关分析

目的探讨手术室护士工作压力、工作满意度与组织承诺的关系,为手术室管理提供切实可行的依据。方法选取201名手术室护士为研究对象,使用护士工作压力源量表、明尼苏达满意度问卷及组织承诺量表进行调查研究。结果手术室护士组织承诺的3个维度价值承诺、努力承诺、留职承诺及总分分别为（20．28±2．83）,（29．01±3．53）,（45．99±8．18）,（95．28±13．05）分;不同月平均夜班数、月收入护士组只承诺得分差异有统计学意义（P〈0．05）;手术室护士工作压力与组织承诺呈显著正相关（r=0．298,P=0．000）;工作满意度与组织承诺有显著的相关性,外在满意度与组织承诺之间相关性最为显著（t=9．780,P〈0．01）。结论手术室管理人员应注重缓解护理人员的工作压力,提高护理人员的满意度,提升护理人员的组织承诺。     

Faces of the nursing shortage: influences on staff nurses' intentions to leave their positions or nursing

OBJECTIVE: The objective of this study was to examine the relationship between organizational commitment, job satisfaction, and nurses' intention to leave their current position or nursing. BACKGROUND: Because retention of nurses is a critical issue for acute care institutions, study of the predictors of nurses' intention to leave (position or nursing) is essential. Of interest in predicting intention to leave are both organizational commitment and job satisfaction. METHODS: A mailed survey was conducted in which 787 respondents completed measures of satisfaction, organizational commitment, and personal and institutional demographics. All instruments had reliability estimates ranging from alpha = .76 to .92. RESULTS: Predictive relationships were found between financial status, organizational commitment, job and professional satisfaction, and intent to leave their current position (R = 0.42) and between financial status, professional satisfaction, and intention to leave nursing (R = 0.45) CONCLUSIONS: Organizational commitment has implications for nurses' intention to leave their current position but not nursing. Aspects of work and professional satisfaction predict both the intention to leave current position and nursing. Retention programs need to be focused on both organizational commitment and work and professional satisfaction.     

Organizational commitment as a predictor variable in nursing turnover research: literature review

AIM: This paper is a report of a literature review to (1) demonstrate the predictability of organizational commitment as a variable, (2) compare organizational commitment and job satisfaction as predictor variables and (3) determine the usefulness of organizational commitment in nursing turnover research. BACKGROUND: Organizational commitment is not routinely selected as a predictor variable in nursing studies, although the evidence suggests that it is a reliable predictor. Findings from turnover studies can help determine the previous performance of organizational commitment, and be compared to those of studies using the more conventional variable of job satisfaction. METHODS: Published research studies in English were accessed for the period 1960-2006 using the CINAHL, EBSCOHealthsource Nursing, ERIC, PROQUEST, Journals@OVID, PubMed, PsychINFO, Health and Psychosocial Instruments (HAPI) and COCHRANE library databases and Business Source Premier. The search terms included nursing turnover, organizational commitment or job satisfaction. Only studies reporting mean comparisons, R(2) or beta values related to organizational commitment and turnover or turnover antecedents were included in the review. RESULTS: There were 25 studies in the final data set, with a subset of 23 studies generated to compare the variables of organizational commitment and job satisfaction. Results indicated robust indirect predictability of organizational commitment overall, with greater predictability by organizational commitment vs job satisfaction. CONCLUSION: Organizational commitment is a useful predictor of turnover in nursing research, and effective as a variable with the most direct impact on antecedents of turnover such as intent to stay. The organizational commitment variable should be routinely employed in nursing turnover research studies.