Analysis of the Relationship between Job Satisfaction and Dismissal of Nurses in the Intensive Care Unit - Essay Example

?Relationship between Job Satisfaction and Nurse’s Turnover in Intensive Care Unit Introduction: The shortage of healthcare professionals in general and of nursing professionals in particular is a big problem in many countries (Hayes, Bonner, & Pryor 2010). Research has shown that Western countries such as the USA, Britain, Germany and Australia and many others are recruiting nursing professionals from other countries overseas in order to keep their healthcare services in good shape. Acute hospitals have not been spared from this predicament as they often find it difficult to create a fine balance between job satisfaction and nurses’ turnover in the intensive care unit (ICU). Basically, ICUs have complex clinical areas such as emergency departments and critical care and the nurses working in these departments often face complex problems related to decision making, working long hours, shift work as well as high patient turnover. Thus, it is vital to retain highly skilled and specialised nurses working in this critical area and this can only be attained by ensuring that the nurses are satisfied with their work (Murrells et al. 2005). During the contemporary period, it can be noted that young adults are now better positioned to find better and lucrative employment opportunities in other fields as a result of the rapid changes such as technological innovations taking place in the environment in which we live. A concern of morality and ethics is rapidly diminishing when people consider their careers and it can be noted that the current generation of young adults are less motivated to join the nursing profession. Moreover, research has shown that the shortage of nurses in acute hospitals can be attributed to the element of little job satisfaction because of lack of job fulfilment and heavy workloads (Hayes, Bonner, & Pryor 2010). Against this background, the purpose of this paper is to review the literature available to learn more about the relationship between job satisfaction and nurse turnover in intensive care units. Methodology: The search for relevant literature used CINAHL and Pub med databases and examined articles from the period between 2001 and 2010. The aim of this review is to examine the relationship between job satisfaction by nurses working in the intensive care units and their turnover. The search of literature in this case is limited to research articles published in English and the search strategy is illustrated in table 1. The keywords used to collect relevant articles include the following: Factors effecting nursing job satisfaction. Job satisfaction among intensive care nurses. Nursing turnover. The articles were included if they met the following inclusion criteria: English language articles. Peer reviewed journals. Table 1 Research strategy Hits Nature of research Country Research methodology -factors affecting nursing job satisfaction in ICUs -dissatisfaction -nursing turnover in IC -The research is based on review of published research in ICU and healthcare. No actual research was conducted. -the paper focuses on Australia, USA and China. -the paper is based on qualitative method where published research in this area is critically analysed. About four articles will be reviewed. Review theme The specific theme of this review of research literature is to establish the relationship between nursing job satisfaction and turnover in the intensive care units. Literature review: The review of literature in this case is a combination of summary and explanation of the most current studies related to the topic. The qualitative method of analysing published literature which is employed in this paper is significant in that it gives a clear understanding of the subject area as well as insight into areas that may require further research. The understanding of current literature in this subject area reviewed is important because it provides a foundation upon which a researcher can build knowledge. Factors affecting job satisfaction: The concept of job satisfaction is complex in that there are many factors that affect it and these are not universal in all ICU scenarios. According to Hayes, Bonner, & Pryor (2010), the factors that affect job satisfaction can be divided into three categories namely: intrapersonal factors such as age, education and experience, interpersonal factors such as access to education, autonomy among others and extra personal factors which include job opportunities, pay as well as promotional incentives among others. Research has found that these factors affect the level of job satisfaction by the nursing staff in the ICU and the management must put strategic measures to ensure that the nurses are satisfied so that they will continue working in the ICU. On the other hand, research conducted among Chinese intensive care nurses shows that job satisfaction is influenced by factors such as demographic characteristics, job characteristics and work environment Li and Lambert (2010). In this case, it has been found that there are correlations between job satisfaction and nurses’ marital status, age has also been factored in to influence the level of job satisfaction and individual as well as demographic characteristics also have a bearing on the nurses’ job satisfaction (Moyle et al.,2003, as cited in Li and Lambert 2010). This research about nurses working in ICUs in China also suggests that job characteristics that affect job satisfaction include, but are not limited to autonomy, workload, task requirements, decision making and salary. When these factors are fulfilled, there are likely chances of the nurses staying longer at their work unlike when they are dissatisfied. Hwang et al, (2009) have also expressed similar opinions in their descriptive correlation design where they argue that satisfied nurses demonstrate more commitment towards their work. Nurses who are fortunate enough to have a better working environment may not leave the organization even if they are getting low salaries. These researches employed the use of a questionnaire as a tool to collect data on this particular subject. Questionnaires are seen as a more popular research method since each respondent is presented with similar questions that would likely to bring a reliable set of responses (Struwig and Stead 2004). To a greater extent, it can be noted that the findings of the researches conducted reflect that people who are satisfied with their job are likely to stay longer in the organisation. In their Ontario nurse survey strategy, Wilson et al, (2008), collected data from 6541 registered categorized as baby boomers based on their birth year and they expressed a similar opinion. Their findings reflect that nurses who are highly satisfied with their job are more likely to remain in the health care organisation and conversely, those who are dissatisfied are less likely to stay in their organisations. The level of job satisfaction possessed by the nursing staff in the ICU has a bearing especially on the period they will likely stay in the health care organisation. Thus, it is ideal for the nursing management to give the nursing staff in the ICU the autonomy to make decisions as a consolation for the complexity of their work. Wilson et al, (2008) suggest that providing younger nurses with the opportunity to self-schedule work hours within collective agreement terms may be one way to increase their overall job satisfaction. In their longitudinal research design, Suzuki et al, (2006) found that novice nurses often find it hard to form an accurate perspective of their profession and to obtain job satisfaction. Work life imbalances negatively impact on the level of job satisfaction by the healthcare professionals in particular. Many of the working professionals make complaints with respect to the work-life imbalances and in most cases, lose interest in the profession as they are often subjected to heavy workloads when they begin their career. This negatively impacts on their level of job satisfaction and may decide to leave the job which contributes to staff turnover in the ICU. The above mentioned factors can positively contribute towards the increase in the level of job satisfaction among nurses working in the ICU if a positive approach is taken by the nursing management. Job satisfaction among Intensive care nurses: Job satisfaction loosely refers to the level of happiness derived by an individual from the work he or she is doing. Aitken et al, (2010) conducted pre and post comparative design in two intensive care units located in two hospitals in a metropolitan area in Australia in a bid to establish the level of job satisfaction among registered nurses who were working full and part time shifts in the intensive care units. According to this research, nursing rounds are very important in building job satisfaction among nurses in the intensive care environment and is an effective strategy for initiating change to patient care (Aitken et al, 2010). Emergency and intensive care units have been facing stiff challenges in recent years because of the shortage of skilled nursing professionals. Moreover, different types of people visit emergency rooms and intensive care units which increase the burden on the nursing staff further. ICUs are staffed mainly to serve the victims of accidents or acute illnesses. Management of ICU patients is generally thought to be more difficult than the management of other patients. Thus, giving the nurses in the ICU the autonomy to make decisions may be very critical for the patient survival and this can positively contribute to their level of job satisfaction. However, the reliability of the findings of this study may be doubtful given that the pre-experimental design may be biased. The critical nature of work in the ICU is complex given that the nurses will also need to help the patients psychologically through provision of counselling services. In short, most of the ICU nurses on duty spend most of their time in challenging environments. Under such circumstances, strategies like nursing rounds will help the ICU nurses to be relieved from job related stress. Li and Lambert (2008) also point out in their study that after analysing 102 nurses working in a variety of ICUs in different parts of the intensive care unit, it was clear how stressful nursing life in this environment can be. They found that working in an ICU can be very stressful given that the pace and intensity of the required patient care and workplace tasks can be overwhelming. Chaboyera et al, (2001) have suggested that CC units are often large rooms whereby the nurses will be constantly under scrutiny by the doctors which can mean that they will not have enough time to relax. The thought that they are constantly under supervision of the doctors forces the nurses to be vigilant during the entire period of their duty in the ICU and it is quite difficult for a person to concentrate on one thing for prolonged periods. In order to improve job satisfaction of these people, nursing rounds are very important as they allow the others to have time to relax and pursue their private business. The element of work time balance plays a pivotal role in motivating the ICU nurses in particular to be committed to their job. Nurses’ turnover: In another cross sectional, comparative descriptive pilot study on the baccalaureate nurses who graduated from a university in north eastern Pennsylvania, Dimattio et al (2010) found that the nurses who have less educational qualifications are often less satisfied with their job than those who are highly educated and their chances of leaving their job are higher compared to those with higher qualifications. According to this study, factors that contribute to dissatisfaction and intent to leave are related to the practice environment and include job stress related to inadequate support from the management as well as lack of collaboration with the physicians. Less qualified nurses are often a source of inferiority complex whereby the nurses may be nervous to face particular tasks in their duties which may be challenging. For instance, (Li and Lambert 2010) suggest that nurses with higher qualifications are satisfied if they are given the autonomy to make decisions in their duties. Thus, when one is less educated, he or she may feel inferior to solve problems which can cause that person to leave the job. Kudo et al, (2006) suggest that there are various reasons for the increased turnover rate among nurses. Some of the factors that contribute to staff turnover are related to dissatisfaction among workers as a result of work hazards, bad relationship among co-workers, low salary and poor working conditions. All these factors contribute to nurses’ turnover given that they will not be satisfied with the working conditions they will be working under. In most cases, when there are no incentives to motivate the workers, their only option available is to move on in search of better opportunities. In the event that the nurses in the ICUs are forced to work for longer hours with very little rest, they will be stressed and may contemplate to leave the organisation. Nurses in the ICU are human beings like anyone else and they ought to be treated fairly in order for them to be motivated to stay in their jobs. The other reason that can contribute to nurses’ turnover in the ICU is the existence of conflicts with their co-workers. Given the complexity of their work, nurses in this department should not be involved in conflicts as this can lead to loss of morale. Someone who is disgruntled is less productive and can ultimately leave the organisation. In order to minimise the chances of high turnover of nurses in the ICU, a holistic approach must be taken to ensure that they are satisfied with their work. Job dissatisfaction: Dissatisfaction in a general sense is a psychological condition, or a reaction, that occurs in people after exposure to certain circumstances contrary to the expected ones. Some of the factors that contribute to turnover among nurses include dissatisfaction with professional growth opportunities, advancement opportunities, autonomy and professional commitment (Kudo et al, 2006). Career advancement is an important factor which often motivates a person to stay in a profession. However, nursing is a profession which offers fewer prospects for career growth and advancement. A nurse may become a head nurse or a nursing manager at best in a healthcare organization if he or she remains in that profession for a longer period (Li and Lambert, 2008). The structure of the health care profession is that the doctors and physicians are always above the rank of the nurses regardless of the experience and period of dedicated service by some of the nurses in the ICU. This can be a source of dissatisfaction among some nurses in the ICU as there will be limited chances available to them for career advancement. If the nurses are given the autonomy to make decisions, they will be satisfied with their job. According to Chaboyera et al, (2001), nurses and physicians have different perceptions about collaborative behaviour where the physicians believe that it exists to a greater extent than the nurses. Collaboration is necessary among nurses in order to succeed in their profession. For instance, Nurse-nurse relationships, nurse-physician relationship and nurse-hospital management relationships are extremely important in maintaining job satisfaction among nurses. Unfortunately, in most cases, none of the above three relationships, in the present situation, exist in any positive sense. In some cases, there is a tendency of insubordination of the nurses by the physicians which causes low morale. Thus, lack of collaboration or positive relationships among the nurses and physicians contribute heavily to dissatisfaction among nurses (Hayes, Bonner, & Pryor 2010). Conclusion: The study sought to establish the relationship between job satisfaction and nurses’ turnover in the intensive care unit departments in healthcare organisations through a critical analysis of published researches. The search methodology for relevant literature used CINAHL and Pub med databases and examined articles from the period between 2001 and 2010. The aim of this qualitative review was to examine the relationship between job satisfaction by nurses working in the intensive care units and nurses turnover in ICU as well. The search of literature in this case was limited to research articles published in English. The paper mainly focused on the following hits: Factors effecting nursing job satisfaction, job satisfaction among intensive care nurses, job dissatisfaction and nurses’ turnover. The findings suggest factors that need to be considered when dealing with job satisfaction and turnover. The concept of job satisfaction is complex in that there are many factors that affect it and these are not universal in all ICU scenarios. According to Hayes, Bonner, & Pryor (2010), the factors that affect job satisfaction can be divided into three categories namely: intrapersonal factors such as age, education and experience, interpersonal factors such as access to education, autonomy among others and extra personal factors which include job opportunities, pay as well as promotional incentives among others. On the other hand, research conducted among Chinese intensive care unit nurses shows that job satisfaction is influenced by factors such as demographic characteristics, job characteristics and work environment Li and Lambert (2010). This research about nurses working in ICUs in China also suggests that job characteristics that affect job satisfaction include, but are not limited to autonomy, workload, task requirements, decision making and salary. When these factors are fulfilled, there are likely chances of the nurses staying longer at their work unlike when they are dissatisfied. The paper found that if job satisfaction among the nurses working in the ICU is low, there will be little chances of retaining the highly skilled nurses in the organisation. Nurses who are satisfied with their job are more likely to stay in the organisation. Thus, it can be concluded that staff turnover in the ICU can be attributed to lower job satisfaction among the employees. Where job satisfaction among the employees is higher, there will be less chances of staff turnover. References Aitken L.M., Burmeister E., Clayton S., Dalais C., & Gardner G. (2010). The impact of Nursing Rounds on the practice environment and nurse satisfaction in intensive care: Pre-test post-test comparative study. International Journal of Nursing Studies doi:10.1016/ j.ijnurstu.2010.10.004 Chaboyera,W., Najmanb J., & Dunnc, S.(2001). Factors influencing job valuation: a comparative study of critical care and non-critical care nurses International Journal of Nursing Studies 38 (2001) 153±161 De Milt, D.G., Fitzpatrick, J.J., & Sister McNulty R. (2010). Nurse practitioners’ job satisfaction and intent to leave current positions, the nursing profession, and the nurse practitioner role as a direct care provider. Journal of the American Academy of Nurse Practitioners 00 (2010) 1–9 C _ 2010. doi: 10.1111/j.1745-7599.2010.00570.x Dimattio, M.J.K., Roe-Prior, P. & Carpenter, D.R., (2010). Intent to stay: A Pilot Study of Baccalaureate Nurses and Hospital Nursing. Journal of Professional Nursing, Vol 26, No. 5 (September–October), 2010: pp 278–286 doi:10.1016/j.profnurs.2010.06.005 Hayes B., Bonner A., and Pryor J. (2010). Factors contributing to nurse job satisfaction in the acute hospital setting: a review of recent literature. Journal of Nursing Management, 2010, 18, p.804–814 Hopkins. G.H., (2000). Quantitative Research Design. sportsci.org Journal . Hwang J.I., Lou F., Han S.S., Cao F., Kim W.O. & Li P. (2009) Professionalism: the major factor influencing job satisfaction among Korean and Chinese nurses. International Nursing Review 56, p.313–318 Kudo Y., Satoh T., Hosoi K., Miki T., Watanabe M., Kido S., & Aisawa Y. (2006). Association between intention to stay on the job and job satisfaction among Japanese nurse in small and medium sized private hospitals. Journal of Occupational health. 2006. 48: p.504-513 Li J. and Lambert V.A (2008). Workplace stressors, coping, demographics and job satisfaction in Chinese intensive care nurses. British Association of Critical Care Nurses, Nursing in Critical Care 2008 • Vol 13 No 1. Parahoo, S., (2006). Nursing Research: principle, process and issue (2nd Ed) London, Palgrave Macmillan. Polit, E., (2003). Nursing Research: Principle and Methods (7th Ed). New York. Lippincott Williams & Wilkins. Polit, E., (1989).Essentials of nursing research ( methods,appraisal and utilization) second edition.philadelphia:J.B Lippincott. Struwig F. W. and Stead G.B. (2004), Planning, Designing and Reporting Research, CT. Pearson Education. Suzuki E., Itominei., Kanoyay., Katsuk T., Horii S. and Sato C. (2006). Factors Affecting Rapid Turnover of Novice Nurses in University Hospitals. Journal of Occupational Health 2006; 48: p.49–61 Wilson B., Squires M., Widger K., Cranley L. & Tourangeau A. (2008) Job satisfaction among a multigenerational nursing workforce. Journal of Nursing Management 16, 716–723 Read More