Job Satisfaction and Nurses Turnover in Intensive Care Unit - Literature review Example

Job Satisfaction and Nurse’s Turnover in Intensive Care Unit Introduction The shortage of healthcare professionals in general and the nursing professionals in particular is a big problem in many of the countries. America, Britain, Germany and Australia like countries are recruiting nursing professionals from overseas countries in order to keep the healthcare services in proper shape. The problems associated with the nursing profession are too many. Most of the nurses forced to work around 16 hours daily because of the shortage of qualified nursing staffs. Even though such nurses are getting good salaries, they fail to achieve work-life balance. Failure to find enough leisure time for other activities force nurses to develop dissatisfaction over their profession. The responsibilities of nurses are complex and they are handling the most important thing in the world; the life of human. Any mistake arises during duties can end up in the loss of life of a patient which is unpardonable. The cases of nurses who are working in the intensive care units are even more complicated. These nurses are dealing with the patients in critical conditions and hence they forced to manage the end of life situations of the patients. Such frightening experiences may develop dissatisfaction among the ICU nurses. In short, because of the complexities of the duties and responsibilities, many of the nurses develop immense dissatisfaction about their profession which may end up in nurse’s turnover. Many of the nurses have given up their profession because of the lack of job satisfaction in their profession. This paper reviews the literature available to learn more about the relation between job satisfaction and nurse’s turnover in intensive care unit Relation between job satisfaction and nurse’s turnover in intensive care unit The shortage of nursing professionals is a big problem in many countries, and government can take it lightly because of the importance of nursing profession in saving the most valued thing in the world; the life of human being. In the current, rapidly developing world, youths are getting better opportunities in other fields. Morality and ethics are rapidly vanishing subjects in the world at present. In short, current youths are less motivated towards the nursing profession. Moreover, majority of the nurses in service are also not much satisfied over their profession because of lack of job satisfaction and heavy workloads. HAYES et al (2010) have pointed out that “job satisfaction is a complex and multifactorial phenomenon and collaboration between individual nurses, their managers and others is crucial to increase nursing satisfaction with their job” (HAYES et al, 2010, p.804). HWANG et al, (2009) have also expressed similar opinions. They argued that satisfied nurses demonstrate more commitment towards their organization. In their opinion, “job satisfaction is a complex phenomenon with many affecting components and is considered to be a set of attitudes towards various aspects of the job, including pay, workgroup, organizational factors and work environment” (HWANG et al, 2009, p.314). Many have the illusion that good salary may bring job satisfaction among professionals. In fact job satisfaction is not much connected with the salaries. There are many cases in which the nurses working even in poorly paid hospitals, only because of the good working environment there. For example, even if a nursing professional gets good salary from his organization, sometimes she/he will resign from that organization of the nursing managers or the management of the hospital blames or punishes him/her for unnecessary things. On the other hand, nurses who are getting better working environment may not leave the organization even if they are getting inadequate salaries. In short, job satisfaction is a multifaceted entity which is associated with many things. Job satisfaction is a concept that incorporates the employee’s personal beliefs, surroundings, individual characteristics, and expectations. Moreover satisfaction and dissatisfaction are unique to each individual and it depends on the extent to which employees or nurses like or dislike their work (De Milt et al, 2010, p.3). Wilson et al, (2008) also expressed similar opinions. In their opinion, “nurses who report a higher level of job satisfaction are more likely to remain employed in their current health care organization. Conversely, nurses who are less satisfied are less likely to remain employed in their current health care organization” (Wilson et al, 2008, p.717). Some nurses might have selected nursing profession only because of the circumstantial pressures. Getting employment is a big problem nowadays and hence many of the nurses selected nursing profession for employment purpose alone. Such nurses may have fewer commitments towards their profession and if they get another option or employment, they will easily leave the nursing profession. On the other hand, dedicated nurses will never leave their profession even if they face immense challenges in their profession. “Providing younger nurses with the opportunity to self-schedule work hours within collective agreement terms may be one way to increase satisfaction with scheduling and subsequent overall job satisfaction” (Wilson et al, 2008, p.721). Similar opinions were expressed by SUZUKI et al, (2006) also. In their opinion, “novice nurses find it hard to form an accurate perspective of their profession and to obtain job satisfaction. The process of acquiring the specialized skills of nursing is recognized to be valuable for novice nurses” (SUZUKI et al, 2006, p.49). Flexibility in working is the most important demand put forward by the employees in general and the healthcare professionals in particular. Many of the working professionals have the complaints with respect to the work-life imbalances. Younger nurses who start their careers in a heavy loaded work atmosphere may lose their passion for nursing profession quickly. Most of the fresh nurses do not have much idea about the different responsibilities of a nurse. They may have only the academic awareness about the nursing profession. The lesson learned from the nursing institutions and the real job experiences may have huge differences which may cause concerns among the fresh nurses about continuing in such heavy loaded work atmosphere. Many of the hospitals have the habit of giving extra workloads to the fresh nurses because of the shortage of nursing professionals. Such extra loads in fact result in resignations or turnovers. Aitken et al,(2010) have pointed out the importance of nursing rounds in building job satisfaction among nurses. In their opinion, “Implementation of Nursing Rounds within the intensive care environment is feasible and is an effective strategy for initiating change to patient care” (Aitken et al, 2010,p.1). 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 the emergency rooms and intensive care units which increase the burden of the nursing staffs further. ICU’s are staffed mainly to serve the victims of accidents or acute illness. Management of ICU patients is difficult than the management of the other patients. “The life threatening nature of patients' conditions in CC may influence nurses' sense of autonomy in that CC nurses may perceive their decisions to be more critical to patient survival” (Chaboyera et al, 2001, p.158). Moreover, the critical conditions will force the ICU patients to cause more troubles to the ICU nurses. Such patients may have anxiety over their future and apart from physical assistance; ICU nurses need to help the patients psychologically also. Giving counseling to the ICU patients is important in maintaining the emotional equilibrium of the ICU patients. In short, most of the ICU nurses are forced to spend their full duty time in challenging environments. Under such circumstances, strategies like Nursing Rounds will help the ICU nurses to release some of their job stresses. Li and Lambert, (2008) also pointed out the stressful nursing life in intensive care units. In their opinion; “working in a hospital setting can be very stressful, especially for nurses working in an intensive care unit (ICU). The pace and intensity of the required patient care and workplace tasks can be overwhelming” (Li and Lambert, 2008, p.12) Chaboyera et al, (2001) also expressed similar concerns. In their opinion, “majority of the CC units were ``open'' or large rooms with very few partitions and walls, meant that CC nurses could be readily scrutinised by their peers, their managers and the doctors” (Chaboyera et al, 2001, p.158). In other words, the presence of doctors or the observations of the doctors in ICU’s will be more than anywhere else in a hospital. Such heavy focus on ICU activities by the doctors, result in ICU nurses getting less time for relaxation. The thought about the supervision by doctors forces the nurses to be vigilant during the entire period of their duty in the ICU. It is difficult for a normal person to give 100% focus to a particular thing beyond certain limits. Such efforts will result in the development of mental fatigue among ICU nurses. On the other hand, nurses working in other units of the hospital may get better leisure times or relaxation times compared to the ICU nurses. In short, the work culture or atmosphere in ICU’s are extremely challenging which may develop dissatisfaction among ICU nurses. DIMATTIO et al (2010) have mentioned that “nurses who have less than a master's degree are less satisfied in their jobs than those with more education”. In their opinion, “factors contributing to dissatisfaction and intent to leave are related to the practice environment and include job stress related to patient acuity, inadequate staffing, inadequate support from management, and lack of collaboration with physicians” (DIMATTIO et al, 2010, p.280). Less qualification means less competent in profession. Higher education is always a blessing for any professional and in nursing profession, the importance of higher education is more evident. Nurses develop dissatisfaction over their work whenever they face unfamiliar situations or challenges in their profession. Higher education will make the nurses capable of dealing with the complicated situations in their profession. More over higher education will enhance their decision making abilities and hence they will become less worried when they face critical situations. Kudo et al, (2006) have mentioned various reasons for the increased turnover rate among nurses. In their opinion, “dissatisfaction regarding work hazards and relationships with the coworkers, low satisfaction regarding sleep, salary, welfare, etc” is some of the factors which increase the turnover (Kudo et al, 2006, p.505). Many of the nurses working in intensive care units were forced to work during night times. Even though they are getting day time for sleeping, it is difficult for a person to sleep during day time just like the night time. In other words, nurses who have night duties are not getting proper sleep. Proper sleep is necessary for maintaining the physical as well as mental health intact. Lack of sleep will create negative moods among nurses which will reflect in their dealings with the coworkers. Thus conflicts and clashes can develop among nurses not because of any real problems, but because of lack of sleep. Improper sleep can make a person mad. In fact, most of the psychological disorders are caused by lack of sleep and the medicines prescribed for psychological disorders include sleeping pills also. In short, sleep is as important as food for a human being in order to maintain psychological health. Lack of sleep always generates dissatisfaction among nurses and they will think that some other profession might be better suited to them. “Dissatisfaction with professional growth opportunities, advancement opportunities, autonomy and professional commitment are other factors of turnover among nurses” (Kudo et al, 2006, p.511). Career growth is an important factor which forces people to stay in a profession. However, nursing is a profession which offers fewer prospects for career growth. A nurse may become a head nurse or a nursing manager maximum in a healthcare organization if he/she remain in that profession for a prolonged period. A nurse will never become a doctor even if he/she acquires immense knowledge and experiences. In other words, even if a nurse acquires more knowledge than a junior doctor, he/she will never get the opportunity to treat a patient. Their knowledge and experiences will remain on papers alone. The inability to use the knowledge in proper ways may create dissatisfaction among nurses. Nurses will always work under the physicians or doctors. Autonomy is a distant dream for them. Thus lack of career advancement options and autonomy are contributing heavily to the dissatisfaction developing among the nurses. According to Chaboyera et al, (2001), “significant differences are there between the nurses' and physicians' perceptions of collaborative behavior, with physicians reporting that it existed to a greater extent than did nurses” (Chaboyera et al, 2001, p.154). Collaboration is necessary among nurses in order to succeed in their profession. Nurse-nurse relationships, nurse-physician relationship and nurse-hospital management relationships are extremely important in maintaining job satisfaction among nurses. Unfortunately, in most of the cases, none of the above three relationships are existing in a positive manner. Some doctors fire the nurses for unnecessary reasons whereas bullying and harassing destroy the relationships among the nurses. Thus lack of collaboration or relationships among the nurses and physicians contribute heavily to dissatisfaction among nurses. HAYES et al, (2010) also supported the claims of Chaboyera et al. in their opinion, “inter-personal interactions which exist between the nurse and colleague(s) and patient(s) contribute to nurse job satisfaction; it includes such factors as autonomy, providing direct patient care, professional relationships, rostering, leadership and professional pride” (HAYES et al, 2010, p.808) Professional pride is another factor which can motivate nurse to stick with their profession. But in many cases, professional pride is less among the nurses. Even though, the nurses are giving great services to the sustainment of human health, their contributions often overshadowed by the contributions of the doctors. When a patient escapes from a severe health condition, the credit is often given to the doctors rather than to the nurses even if the nurse did some wonderful things to save the life of that patient. Thus nurses have a feeling that even if they work hard, they are not getting the proper recognition from the society. References 1. 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 2. 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 3. 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 4. 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