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Nurses’ Satisfaction Dimensions and Intention to stay in Prince Sultan Cardiac Center Qassim

Kahkashan Sana Nursing Director Prince Sultan Cardiac Center Qassim


Job satisfaction is an important component of nurses' lives that can impact on patient safety, quality of care, retention, turnover, commitment to the organization, productivity and performance.


As part of staff retention plan in Prince Sultan Cardiac Center, a 50 bedded specialized care. This study was conducted to indentify the satisfaction and dissatisfaction indicators that lead to staff turnover and burnout.


Globally, major changes have taken place in all health care systems. These changes include shortened length of stay, increasing emphasis on cost effectiveness, and an increase of patients with acute and chronic diseases. These escalating changes in health care systems influence nurses’ job satisfaction (Curtin 2000; Kohles-Baker et al 2000; Mrayyan 2006).


Job satisfaction among nurses has long been recognized as a crucial indicator of nurses’ performance, cost savings, and quality of patient care.


The most correlate of work satisfaction is retention. Employees who are satisfied with their work tend to remain in their jobs. Studies have found strong evidence to support the positive relationship between work satisfaction and turnover behavior in nurses. Absenteeism, grievances, turnover, and reduced patient satisfaction are often the result of dissatisfaction and often translate into costs for the hospital (borda and norman 1997; lloyd et al 1998).


A study concluded that patients, who stayed on wards where nursing staff felt more exhausted or more frequently expressed their intention to quit, were less satisfied with their medical care. (Al–Aameri, 2000). This study confirmed the direct correlation between staff satisfaction and patient satisfaction in health care organizations (Al– Aameri, 2000).


Aiken and colleagues (2001) found that nurses reported decreasing standards of care and high levels of nurses’ burnout and job dissatisfaction.


According to Borda and Norman (1997) and Lu, While, and Barriball (2005), the retention and recruitment of nurses have shown that low wages and poor job satisfaction are the primary reasons why nurses leave their positions.


Many studies concluded that effective leadership is associated with better and more ethical performance (Loke, 2001; McNeeseSmith, 1995). Fletcher (2001), Friedrich (2001), Janney, Horstman, and Bane (2001), Kleinman (2003), Krairiksh and Anthony (2001), and Wynd (2003) found that the opinions of the employees’ immediate supervisor had more impact on the employee than overall company policies or procedures.


A leader’s behavior or leadership style may influence the subordinates’ level of job satisfaction. Studies have been carried out to determine how leadership behaviors can be used to influence employees for better organizational outcome.


The purpose of this study is focused on the predictive effects of organizational commitment, perceived organizational support, transformational leadership, professional communication, decision making, autonomy, level of professional development and accountability to the degree of job satisfaction of PSCCQ nurses.


Design A cross-sectional descriptive study. The study took place at PSCCQ, 50 bed center in the period between (October 29 – November 12, 2011). with total 120 nurses


All nurses employed in PSCCQ at the time of study A total of 120 nurses working in different units were surveyed A total of 120 questioners were distributed A total of 99 questioners were received.


A self-administered questionnaire items were developed for this study. The instrument consisted of two parts: 1- Demographic information which included: age, gender, marital status, educational degree, years of experience in PSCCQ. 2. Job satisfaction instrument constituted of a five-point Likert scale (1 = Strongly Disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly Agree).


The nurses were invited to participate voluntarily by an explanation, letter was given to the nurses with the survey. The questioners were distributed by the clinical instructors and head nurses to all nurse who were present during the time of this study, for day, evening and night staff.


Collection box was placed outside of the education department, and nurses were advised to place the questionnaire in a sealed envelope inside the collection box.


Statistical Package of the Social Science (SPSS) software was used for data processing. Analysis of Variance (ANOVA): For comparison of more than two groups of variables. 99/120 nurses respond to the questioners (96 females and 3 males).


The overall satisfaction score (from 500 point) was 352.6Âą85 for female and 349.2Âą 52 for male nurses.


High score was given quality of nursing care. Fair score was given to the autonomy and decision on patient care. Good score was given to the nursing tasks and accountability.


Transformational Leadership Nursing Management Scheduling Rewards / Recognition


High score was given to working 9 hours and low score was given to working 12hour shift. Good score was given to the support of Clinical Instructor and HNs Good score was given to the support of Nursing Administration High score was given to the competency based orientation program.


Good score was given to the team work between nurses and doctors and to the mutual respect between physicians and nurses. Low satisfaction score was given to the team work with the paramedics. High score given to the nurse to nurse interaction but they recommended more social interaction.


 Job Plans  Professional Status


Level of Professional Development


Nurses were proud of their profession and they were satisfied with the opportunities available within the center / region for professional development. Nurses were not supporting the transfer to any hospital if letter of no objection or transfer Iqama is afforded for them with the same salary.


Organizational Support and the Availability of Facilities


Low satisfaction scores were encountered mainly with regards salaries and accommodation facilities Good score given to the organization support.


16% of our nurses have intention to change and 84% of the nurses were planning to stay in the center if chance given to them.


Frequency and Percentage Distribution of Demographic Variables

Demographic Variables

Frequency

Percentage

1. Gender a) Male b) Female

3 96

3.0 97.0

2. Marital Status a) Single b) Married c) Widowed d) Divorced

40 58 0 1

40.4 58.6 0.0 1.0

3. Shift Working a) Day b) Evening c) Night d) All Shift

28 1 0 70

28.3 1.0 0.0 70.7

4. Level of Education a) BSN b) MSN c) Post RNG d) Midwifery e) Diploma

46 3 6 16 28

46.5 3.0 6.1 16.2 28.3

5. Age a) < =30 years b) 31 – 40 years c) 41 – 50 years d) > 50 years

63 33 3 0

63.7 33.3 3.0 0.0

6. Experience in own Country a) < 2 years b) 2 – 3 years c) 4 – 5 years d) 6 -7 years e) 8 – 9 years f) 10 years and above

10 37 28 15 4 5

10.1 37.4 28.3 15.2 4.0 5.1

7. Experience in PSCCQ a) < 2 years b) 2 – 3 years c) 4 – 5 years d) 6 -7 years e) 8 – 9 years f) 10 years and above

34 25 16 23 1 0

34.3 25.3 16.2 23.2 1.0 0.0

9. Intending to Change a) Yes b) No

16 83

16.2 83.8


Among demographic data, we found that the years of experience is the single item affecting overall satisfaction score (p= 0.05), with those who spent 4-5 years are the most satisfied.


Demographic Variables

Satisfaction score Frequency

Mean

S.D.

1. Gender a) Male b) Female

3 96

352.67 349.23

85.23 52.32

2. Marital Status a) Single b) Married

40 58

345.20 352.14

53.58 52.78

3. Shift Working a) Day d) All Shift

28 71

336.32 354.46

55.88 51.24

4. Level of Education a) BSN b) MSN c) Post RNG d) Midwifery e) Diploma

46 3 6 16 28

342.17 322.33 379.00 337.63 364.32

49.04 57.01 39.77 70.31 46.98

5. Age a) < =30 years b) 31 – 40 years c) 41 – 50 years

63 33 3

350.97 349.85 309.33

53.46 53.64 15.04

10 37 28 15 4 5

321.50 351.43 354.46 342.13 366.25 368.80

36.74 52.72 59.67 49.11 30.75 65.79

7. Experience in PSCCQ a) < 2 years b) 2 – 3 years c) 4 – 5 years d) 6 -7 years

34 25 16 24

357.44 341.12 372.88 330.71

51.53 50.25 42.99 58.09

8. Are you certified a) Yes b) No

29 70

347.79 349.97

60.89 49.75

9. Intending to Change a) Yes b) No

16 83

349.69 349.27

33.81 56.04

6. Experience in own Country a) < 2 years b) 2 – 3 years c) 4 – 5 years d) 6 -7 years e) 8 – 9 years f) 10 years and above

ANOVA test and P value F = 0.012, P= 0.912s (N.S) F = 0.407, P= 0.525 (N.S) F = 2.392, P= 0.125 (N.S) F = 1.678, P= 0.162 (N.S)

F = 0.886, P= 0.416 (N.S)

F = 0.884, P= 0.495 (N.S)

F = 2.689, P= 0.050 *

F = 0.034, P= 0.853 (N.S) F = 0.001, P= 0.977 (N.S)


Low Score was given to Autonomy, Decision Making, Nursing Management and Recognition Developed performance improvement project for enhancing their knowledge, skill and attitude. Provided qualified Clinical Instructors in each units. Conducted courses and workshops on Leadership and Management, Train the Trainer, Effective and Assertive Communication skills. Conducted the meetings with Head Nurses and Clinical Instructors. Conduct the meetings with Center Director regarding the retention plan implementation to evaluate the turn over for nurses.


Low Score was given to Autonomy, Decision Making, Nursing Management and Recognition Adjusted all nurses salary based on their years of experience and qualification. Project on housing and recreation improvement is still on-going. Recognition and motivation â&#x20AC;&#x201C; yearly GCC nurses day celebration with rewards for the best nurse of each unit and best clinical area. Conducts the meetings with Medical Director in on-going basis to enhance the team work among doctors, nurses and paramedics.


Review and update the nursing retention plan based on the study results. Discuss the study result with higher management to improve the dissatisfactory points. Conduct a similar study after one year of retention plan implementation to evaluate the turn over for nurses. Conduct similar study in all regional hospital to compare the results and generalize the results.


This study must be done in other hospitals to compare the results and to generalize the result and the retention plans.


The study result is good indicators for staff satisfaction, staff retention and performance improvement. The retention plan and staff satisfaction improve patient satisfaction and quality of nursing care. Retention plan reduce recruitment budget and cost.


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Hayes LJ, O'Brien-Pallas L, Duffield C, Shamian J, Buchan J, Hughes F, Spence Laschinger HK, North N, Stone PW: Nurse turnover: A literature review. International Journal of Nursing Studies 2006, 43(2):237-263. Lois H Thomas, Elaine McColl, Jonathan Priest, Senga Bond, and Richard J Boys: Newcastle satisfaction with nursing scales: an instrument for quality assessments of nursing care , Quality in Health Care 1996;5:67-72


Lu H, While AE, Barriball KL: Job satisfaction among nurses: a literature review. International Journal of Nursing Studies 2005, 42(2):211-227. Adams A, Bond S: Hospital nurses' job satisfaction, individual and organizational characteristics. Journal of Advanced Nursing 2000, 32(3):536-543.



SHA24/058006