Factors contributing to nurse job satisfaction in the acute hospital setting: a review of recent literature

hayes b, bonner a & pryor j (2010) Journal of Nursing Management 18, 804–814
Factors contributing to nurse job satisfaction in the acute hospital setting: a review of recent literature 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.     

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.     

Professionalism: the major factor influencing job satisfaction among Korean and Chinese nurses

Background:  The nursing shortage has become an internationally important issue. Nurses' professionalism and job satisfaction have been recognized as strong factors influencing their turnover. As international interchanges in nursing education are growing between Korea and China, understanding the commonalities and differences in factors associated with job satisfaction is critical to improving nurses' job retention.
Aim:  To compare the factors influencing job satisfaction among Korean and Chinese nurses.
Method:  A cross-sectional survey was conducted. The participants were comprised of 693 nurses at three general hospitals in Jinan, People's Republic of China and 593 nurses at two general hospitals in Seoul, Korea. A questionnaire was designed to measure the nurses' professionalism and job satisfaction. Stepwise multiple regression analysis was performed to identify factors related to job satisfaction.
Results:  Professionalism was the common factor influencing job satisfaction in Korean and Chinese nurses. Professionalism was positively related to job satisfaction in both groups. Additional factors associated with job satisfaction were demographics and job characteristics such as age, job position and department of work, which were significant only in Korean nurses.
Conclusions:  Professionalism was the most important factor influencing job satisfaction in both Korean and Chinese nurses. Enhancing nursing professionalism is recommended as a common strategy to improve nurses' job retention across different healthcare systems.     

Hospital RN job satisfaction and nurse unions

The objective of the study was to examine whether unionization is associated with job satisfaction among RNs in the United States using nationally representative surveys of RNs. Factors that predict job satisfaction for RNs in healthcare continue to be of great concern to nurse administrators and managers because job satisfaction remains an important aspect of nurse retention. In addition, the notion of having unions for RNs has also gained prominence on the national stage. The relationship between RN job satisfaction and having an RN union has rarely been studied, but in 2 studies, a paradox was found; hospitals with RN unions had higher job dissatisfaction but greater retention. This study will test the relationship between having an RN union and job satisfaction with data that are both more recent and nationally representative. We analyze the public-use data from the 2004 and 2008 National Sample Surveys of Registered Nurses. In both 2004 and 2008, union representation was negatively associated with job satisfaction, although this relationship was not statistically significant in 2008. Some nurse administrators and executives would not be surprised by this finding. However, although union nurses may express more dissatisfaction, they may also be more vocal and less fearful about voicing concerns. If managers can harness this ability of the nurses to be articulate and outspoken, working with unions and union nurses can be productive and satisfying.     

Job satisfaction in birth cohorts of nurses

klaus s.f., ekerdt d.j. & gajewski b. (2012) Journal of Nursing Management  20, 461–471 Job satisfaction in birth cohorts of nurses Aim The aim of the present study was to investigate which hospital, unit and individual characteristics predict job satisfaction in four age cohorts of registered nurses (RNs). Background Adequate supply of direct care nurses in hospitals is paramount to the provision of safe patient care. While recruitment is important, interventions to retain experienced nurses in the work force should also be undertaken. Methods Cross-sectional survey data from the 2004 National Database of Nursing Quality Indicators^® (NDNQI^®) RN Survey with Job Satisfaction Scales^© were used. The sample included 53 851 RNs age 20–59 years divided into four age cohorts. Data were analysed using three-level hierarchical linear modelling. Results Overtime demand and involuntary floating resulted in significantly lower job satisfaction in all age cohorts. The oldest two cohorts reported higher job satisfaction with increased unit tenure whereas the youngest cohort reported decreased job satisfaction with increased unit tenure. Higher job satisfaction was reported in all cohorts within Magnet hospitals; however, the relationship was only significant in 40–49 year olds. Conclusions Some factors are associated with job satisfaction in all age cohorts. Other factors differentially influence job satisfaction based on the cohort group. Implications for nursing management Nurse leaders should consider retention strategies congruent with the job satisfaction predictors of different age groups.     

Jordanian nurses' job satisfaction and intent to stay: comparing teaching and non-teaching hospitals.

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

Workplace stressors, coping, demographics and job satisfaction in Chinese intensive care nurses

Background: Prior research has suggested that certain workplace stressors, coping strategies and demographic characteristics are related to job satisfaction in nurses. Most of the research in this area has been conducted within western culture countries, with little research being carried out in Asian culture countries, especially China. It remains unclear if the findings of the research conducted in western culture countries are applicable to Chinese nurses, especially intensive care nurses. Aims and objectives: Therefore, the aims of this study were to examine, in Chinese intensive care nurses, the most often occurring workplace stressor; the most frequently used coping strategy; and the relationships among workplace stressors, coping strategies, demographic characteristics and job satisfaction. Design: The study design was a survey using four self‐report questionnaires. Methods: One hundred and two intensive care nurses, from four hospitals located in two major cities in central China, were administered four self‐report questionnaires. Results: Findings suggested that the most frequently cited workplace stressor was workload, while the most commonly used coping strategy was planning. Two hundred and twelve significant positive and negative correlations were found among the various workplace stressors, coping strategies, demographic characteristics and the different factors comprising job satisfaction. Conclusions: These findings identify factors that need to be considered when addressing workplace stress, coping strategies and demographic characteristics as they relate to job satisfaction in Chinese intensive care nurses. Relevance to clinical practice: It is important for both hospital and nursing administrators to address factors contributing to job satisfaction, so that retention of qualified ICU nurses, within the workforce, will be facilitated.     

Nurse migration and its implications for Philippine hospitals

BACKGROUND: 'Push' and 'pull' factors motivate Filipino registered nurses (RNs) to leave for employment in foreign countries making the Philippines the leading source country for nurses overseas. OBJECTIVE: To assess the current RN-staffing situation in Philippine hospitals. DESIGN: A self-administered survey was mailed to a sample of 200 Philippine hospital chiefs of nurses. RESULTS: According to respondents, the majority of RNs in their hospitals (73%) were aged 40 years and younger and female (85%); government hospital RNs earned higher wages than private hospital RNs; and on average, RN vacancy rates and RN turnover rates were lower in government hospitals than private hospitals. All respondents reported no difficulty recruiting RNs with less than 12 months of work experience. However, recruitment of more experienced RNs was somewhat or very difficult for private hospitals compared with government hospitals. Higher salaries, better benefits and good career opportunities were identified as most effective incentives for both recruitment and retention. CONCLUSIONS: RN staffing in government hospitals is more favourable than in private hospitals as measured by employment tenure, vacancy rates, turnover rates and ability to recruit and retain more experienced RNs. On average, respondents reported over half (59%) of total RN turnover was the result of nurse migration overseas.     

Factors associated with hospital retention of RNs in the New York City Metropolitan Area: an analysis of the 1996, 2000, and 2004 National Sample Survey of Registered Nurses

The nursing shortage is well documented, and government estimates indicate that shortfalls will worsen in the future. As the largest employer of registered nurses (RNs), hospitals are the most seriously affected by shortages, as they compete with other employment settings for limited nursing resources. Recruitment remains the primary avenue for ensuring staffing levels, but retention is increasingly important as applicant pools shrink because of demographic and employment trends. Effective retention strategies must address the factors that contribute to exodus of RNs from hospitals, as well as isolating the factors that enable RNs to remain in hospital employment. This secondary analysis of the 1996, 2000, and 2004 National Sample Survey of Registered Nurses examines the demographic, employment, and educational factors associated with working in hospitals, having full-time status, and holding patient care positions. The findings suggest that hospitals must address nonwork issues to retain nursing personnel. Relevant policy issues are examined and strategies for effective retention are offered.     

Theory Z as a framework for the application of a professional practice model in increasing nursing staff retention on oncology units

Recruitment and retention of nurses is the most significant issue facing nursing administrators, educators, researchers and clinicians in the ongoing nursing shortage in the United States today. It has been cited in the literature that American nurses feel that job satisfaction is a major issue in retaining qualified nurses in hospitals. Satisfaction occurs when nurse expectations are matched with the hospital's vision and values. It is for this purpose that the authors have chosen theory Z as a hospital management model to coincide with the institution of the Marker Professional Practice Model to increase job satisfaction (autonomy) in hospital-based nurses. There are four 'hidden' challenges in health care today. They are: (a) fundamental changes occurring within the profession and practice of nursing; (b) the expanded role of women in management; (c) ethical dilemmas related to advances in medical technologies; and (d) the difficulty for health care managers in the United States to make changes related to the above three challenges. The authors feel that it is inherent to the nursing profession to combine existing theories and models to enhance the retention of nurses to the profession.     

护理人员工作满意度、工作负荷与压力自我评价及其影响因素

目的了解医院护理人员对工作负荷、工作压力和满意度的自我认识与评价,探讨年龄、学历、工作年限等个人特征对工作负荷、工作压力和满意度的影响。方法采取整群抽样的方法,对2所三级医院10个科室260名正式在编护士进行问卷调查,内容包括护理人员年龄,学历,职称,从事护理工作年限,护理工作负荷及工作压力大小及原因,工作、收入满意度及原因等,并对调查资料进行统计学分析。结果护理人员认为工作负荷重的比例占83.7%,报告工作压力大的比例占80.5%;工作负荷重的原因主要是护理人员缺乏,工作压力大的原因主要是工作负荷重和担心人身安全;护理工作年限、学历和职称是影响护理人员对工作负荷评价的因素;护理人员对工作与收入满意度不高,且职称越高,工作满意度越低;工作满意度不高的主要原因是收入低、工作不受重视、个人才能难以发挥、职称晋升难。结论护理人员工作负荷重,工作压力大,工作满意度不高;有必要制定针对性的人力资源管理对策,合理配备与使用护理人员,减轻护理人员工作负荷与压力,提高护士的工作满意度。     

Education as a Determinant of Career Retention and Job Satisfaction Among Registered Nurses

PURPOSE: To compare job satisfaction and career retention in two cohorts of RNs, those whose highest degrees were the associate degree (AD) or the bachelor's degree (BS) in nursing. DESIGN: Survey. METHODS: Instruments included a career satisfaction scale and questions based on the ongoing U.S. Health and Retirement Survey. Three-thousand nurses in the U.S. state of Vermont were surveyed with a resulting response rate of 56.7%. Of these respondents, 878 RNs fit the study criteria. FINDINGS: BS RNs started their nursing careers earlier, were employed longer, had held more positions, and in the largest age cohort (age 40-54), were more likely to have been in their current positions at least 10 years. BS RNs scored significantly higher in job satisfaction related to: (a) opportunity for autonomy and growth, (b) job stress and physical demands, and (c) job and organizational security. AD and BS nurses were not significantly different in their satisfaction with supervision; career, continuing education, and promotion opportunities; or pay and benefits. CONCLUSIONS: These findings indicate support of bachelor's level education for individual and social return on investment, and they show that AD education might have unintended consequences. Implications for the nursing shortage and educational policy are discussed.     

Factors influencing satisfaction and anticipated turnover for nurses in an academic medical center

OBJECTIVES: The purpose of this study was to examine the relationships between work satisfaction, stress, age, cohesion, work schedule, and anticipated turnover in an academic medical center. BACKGROUND DATA: Nurse turnover is a costly problem that will continue as healthcare faces the impending nursing shortage, a new generation of nurses enter the workforce, and incentives provided to nurses to work for institutions increase. A variety of factors influence the retention of nurses in adult care settings, including work satisfaction, group cohesion, job stress, and work schedule. In general, previous research has documented positive relationships between work satisfaction, group cohesion, strong leadership, and retention rates and a negative relationship between stress, work schedule, and retention. In addition, age and experience in nursing are related to job satisfaction. METHODS: This study used a cross-sectional survey design in which nurses from 12 units in a 908-bed university hospital in the Southeast completed questionnaires on one occasion. The following factors were measured using self-report questionnaires: nurse perception of job stress, work satisfaction, group cohesion, and anticipated turnover. RESULTS: The more job stress, the lower group cohesion, the lower work satisfaction, and the higher the anticipated turnover. The higher the work satisfaction, the higher group cohesion and the lower anticipated turnover. The more stable the work schedule, the less work-related stress, the lower anticipated turnover, the higher group cohesion, and the higher work satisfaction. Job Stress, work satisfaction, group cohesion, and weekend overtime were all predictors of anticipated turnover. There are differences in the factors predicting anticipated turnover for different age groups. CONCLUSIONS: As healthcare institutions face a nursing shortage and a new generation of nurses enter the workforce, consideration of the factors that influence turnover is essential to creating a working environment that retains the nurse.     

军队传染病医院护士工作满意度调查分析及管理对策

目的了解军队传染病医院护士工作满意度的现状,并提出管理对策。方法应用Mueller／McCloskey满意度量表对随机抽取的193名军队传染病医院的护士进行问卷调查。结果军队传染病医院的护士对工作的满意度较低,其中对福利待遇及排班的满意度最低,不同年龄、学历、科室和编制的护士对工作不满意的程度不同。结论多种因素导致了军队传染病医院护士对工作的不满意,护理管理者应采取有针对性的管理对策和改进措施,提高护士对工作的满意度,进而提高护理质量,减少护理人员的大量流失。     

泉州市ICU护士工作满意度调查分析

目的调查泉州市ICU护士工作满意度现状及其影响因素。方法对泉州市12所医院的168名ICU护士进行了问卷调查。结果工作满意度总分（66．17±8．63）分,不同职称、月夜班次数及年龄的护士工作满意度比较差异有统计学意义（P〈0．05）。结论护士的工作满意度有待于进一步提高,医院管理者应在改善护士的工作环境、发展机会、薪酬及对护士政策落实的执行力上不断加强。