The working environment as a factor of nurses' job satisfaction

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Introduction

The working environment forms a complex set of factors that act on nurses in the work process and influence its efficient functioning. They are subject to legal regulations and the internal policies of employers. They are influenced by employers' financial resources, organization of work, and management culture (Eliašová, Cuperová and colleagues 2016). Worsening working conditions and the environment of nurses can be a source of turnover, lack of interest in professional practice, or a cause of early departure from the profession. Experts agree that the working environment determines nurses' job satisfaction. This is confirmed by the study by Bujacz et al. (2021), from which it was found that the profiles of working conditions to which nurses were exposed are decisive for the continuous performance of the profession. Other authors believe that nurses' satisfaction in the profession is mainly conditioned, besides the work environment, by the ability of the organization to meet their basic needs. Meeting needs has strong motivational significance and is the decisive factor of overall nurse satisfaction (Katriňáková, 2022). Al-Hamdan et al. (2017) focused on the relationship between nurse satisfaction and nurses’ intention to stay in the profession. They found that favourable working conditions had a positive effect on nurses' decisions to remain in their current position. Heczková and Bulavá (2018) in their survey revealed that working conditions are, in the long term, the main source of nurses leaving employment. Llop et al. (2021) state that worsening working conditions for nurses represent a negative change that leads to migration, reduced interest in the profession, or a change of profession. The urgency of addressing this issue is due to the fact that nurse satisfaction should be a key aspect of personnel policy in every healthcare facility because nurses are the most significant part of the workforce in nursing. Sodeify and Habibpour (2021) focused on nurses' working conditions as a psychological factor of work motivation and workplace satisfaction. The results of their survey showed that nurses were motivated and satisfied when they felt support from colleagues and superiors. A similar study was conducted by Sodeify, Vanaki and Mohammadi (2013).

The findings of their in-depth interviews showed that a poor organizational climate, low social dignity, poor working conditions, and managers' lack of awareness were perceived as inhibitory factors of nurses' job satisfaction.

Objective The aim of our study was to assess nurses' job satisfaction.

Sample and Methodology A total of 285 nurses were included in the sample. Nurses were most represented in the age group 30 to 44 years (39 %). 143 nurses (50 %) had first-level higher education. 155 nurses (54 %) had specialization in one of the clinical specialties. 81 nurses (28 %) had worked in the profession for 6–15 years. 169 nurses (59 %) worked in state healthcare facilities. The data collection method used the Slovak version of a standardized questionnaire of nine domains of job satisfaction – Job Satisfaction Survey (Al Henami, Slezáková, 2022). The questionnaire contained 36 items and a six-point scale for evaluating satisfaction. It was administered electronically through the database of registered nurses in the Slovak Chamber of Nurses and Midwives (SKS a PA). Data collection was carried out in April and May 2022. For statistical analysis and data processing, we used SPSS for Windows version 21.0. We performed descriptive statistical analysis of data using frequencies (n), median (xm), mode (mod), arithmetic mean (x̄), standard deviation (sd), minimum (min.) and maximum (max.) values. Results and Discussion

Table 1. Job satisfaction scores of nurses by demographic characteristics

Legend: x̄ - arithmetic mean, xm – median, mod - mode, min.- minimum value, max.- maximum value

In general, job satisfaction among nurses varies considerably and is influenced by several factors that contribute to their so-called overall job satisfaction to different extents. In our sample (n=285), the determinants of overall job satisfaction were age, education, length of professional experience, and workplace (Table 1). We identified the highest average satisfaction score among nurses aged 45 to 59 years (x̄=114,42). Considering the highest obtained education, diplomed general nurses (x̄=114,04) and nurses with secondary education (x̄=113,77) were the most satisfied at work. The mean overall job satisfaction score of nurses with 26 to 35 years of practice is higher (x̄=115,49) than in other practice-length categories. Nurses in state healthcare facilities are generally more satisfied with working conditions (x̄=113,30). In the sample of 285 nurses, we assessed job satisfaction in nine areas (Table 2).

Table 2. Nurses' job satisfaction in individual areas

Legend: x̄ - arithmetic mean, xm – median, mod = mode, min.- minimum value, max.- maximum value, sd – standard deviation.

The working environment in which nursing care is provided comprises a number of factors that affect nurses' satisfaction in different ways and intensities. Lai and colleagues’ study (2021) also confirms this. Hierarchical multiple regression analysis showed that the nursing practice environment was a significant predictor of person-centred care (β=0,31, p<0,001). Our data analysis showed that the nature of work—person-centred care is the domain that on average most strongly influences nurses' job satisfaction (x̄ =18,41). Communication at the workplace (x̄ =17,23), relationships with colleagues (x̄ =16,29), and with superiors (x̄ =16,2) are other significant positive predictors of nurses' job satisfaction in our sample (n=285). Hulková and Meluš (2023) studied work condition factors that influence nurse turnover. In their sample (n=136), 63.2 % of nurses stated that conflicts with superiors or managers and poor workplace relations are perceived as causes of turnover. Their study findings also show that nurses’ decisions to end the employment relation would additionally be influenced by the work collective (43,4 %) and relationships with superiors (21 %). The domain “salary” is a factor with low average score in our sample (x̄ =7,65), and therefore it can be considered a source of dissatisfaction. Low average scores of job satisfaction were also identified in the domain of career growth (x̄ = 8,27) and recognition and rewards (x̄ =8,11). Hulková (2023) points to the importance of career growth. In a study on the prospects of Generation Z nurses in succession in nursing management, it was found that career growth is a decisive motivator (x̄ =4,725 out of 5; sd = 0,446) for Generation Z nurses. In our sample (n=285) we measured a lower average job satisfaction score in the domain of career growth (x̄ =8,27). Compared with the results of the study by Aslan et al. (2017), which was carried out in a university hospital in Istanbul, we note that in the area of recognition, appreciation, and responsibility for work, the job satisfaction score of our nurses is diametrically opposite—lowest. Kubišová's findings (2013) are opposite. In her study in Milosrdných Bratov Hospital in Brno, she found that up to 80 % of the nurses asked were overall satisfied with working conditions. In that of Mácsadyová (2013), more than two thirds of nurses (82 %) answered that they were satisfied with the established working conditions. An interesting finding is that with age and years of professional experience, nurses' satisfaction increases. Al-Hamdan et al. (2018) examined whether communication is a significant mediator of job satisfaction. In our survey, the average score in communication (x̄=17,23) demonstrates a positive relationship between job satisfaction and existing working conditions. Similarly, the results of Sypniewska's (2014) survey showed a positive relationship between job satisfaction and communication between staff and healthcare facility management. The effect of demographic factors on nurses' job satisfaction was investigated in several studies. Kožuchová and Vargová (2015) in their research found no statistically significant correlation between job satisfaction and demographic indicators (p = 0,907). The length of practice in their respondent sample did not increase job satisfaction scores (p = 0,106). In our survey, statistically significant average differences in satisfaction scores were confirmed between nurse groups with 6 to 15 years of practice (x̄ =17,9) and 16 to 25 years of practice (x̄ =16,5). Age and practice duration are areas showing correlations with nurses' job satisfaction also in the research by Horáková and Gurková (2012). They confirmed a weak positive correlation between total practice length and total MMSS score (p = 0,027). Similarly, between total length of professional practice and factors: planning and work schedule (p = 0,0001), praise and appreciation (p = 0,026), control and responsibility (p = 0,007). The finding in the area of praise and recognition is comparable to our results. It confirms the average job satisfaction score (x̄ =8,11).

Conclusion

Nurses' job satisfaction is an important indicator of the functioning of the healthcare system. It has a significant impact on the quality of care provided and nurses' retention in the profession. Studies have shown that nurses who are satisfied at work perform better, have their needs met, and stay with their employer. According to several authors, nurses' satisfaction can be influenced by aesthetic improvement of the workplace, optimization of healthcare technology and aids, maintaining a positive atmosphere at work, fair relationships with superiors and colleagues, and linking private and professional life. We believe that monitoring job satisfaction and implementing changes in working conditions and environment can be a tool to reduce nurses' economic mobility. Qualified professional nurses have ambitions to learn new procedures, to be motivated for performance, and to remain in the profession. Their decision to stay or leave, however, is in most cases in the hands of employers. The employer is the one who creates working conditions and an environment with many factors influencing nurses' decision-making processes.

Authors: prof. PhDr. Mária Kilíková, PhD., MPH PhDr. Tatiana Katriňáková

References

AL - HAMDAN, Z. − MANOJLOVICH, M. − TANIMA, B. 2017. Jordanian Nursing Work Environments, Intent to Stay, and Job Satisfaction. J Nurs Scholarsh. [online]. Jan 2017; 49(1):103-110. [cited 2022-03-30]. Available online: http s://pubmed.ncbi.nlm.nih.gov/27899008/

AL HENAMI, J. − SLEZÁKOVÁ, Z. 2022. Job satisfaction survey (JSS) - Slovak version. [online]. 2022, [cited 2022-03-30]. Available online: https://paulspector.com/assessments/pauls-no-cost-assessments/job-satisfaction-survey-jss/job-satisfaction-survey-translations/

ASLAN, M. 2017. Personality and Job Satisfaction among Nurses: The Mediating Effect of Contextual Performance. In International Journal of Caring Sciences. ISSN 1791-5201, 2017, roč. 10., č.1, s. 544-552.

BUJACZ, A. et al. 2021. Psychosocial Working Conditions of Shift-working Nurses: A Longitudinal Latent Transition Analysis. J Nursing Management. [online]. 26 July 2021; 29(8):2603-2610. [cited 2022-03-30]. Available online: https://pubmed.ncbi.nlm.nih.gov/34309949/

ELIAŠOVÁ, A., − CUPEROVÁ, J. et al. Backgrounds in Nursing. 2. Lipovce pri Prešove : A-print, 2016, p. 179. ISBN 978-80-89721-11-5.

HECZKOVÁ, J. − BULAVA, A. 2018. Reasons for Leaving the Profession. Urologie pro praxi. In Solen. [online]. XIX roč., č.2/2018. [cited 2022-03-19]. s. 95–98. Available online: https://www.urologiepropraxi.cz/pdfs/uro/2018/02/11.pdf˃ ISSN 1213-1768

HAROKOVÁ, S. − GURKOVÁ, S. 2013. Job Satisfaction as a Predictor of Nurses Staying at the Workplace - Literature Review. In Ošetřovatelství a porodní asistence. [online]. IV roč., č. 2/2013. [cited 2022-05-15]. s. 573-582. Available online: https://cejnm.osu.cz/artkey/cjn-201302-0004_pracovni-spokojenost-jako-prediktor-setrvani-sester-na-pracovisti-literarni-prehled.php?l=cz˃ISSN 1804-2740

HULKOVÁ, V. − MELUS, V. Nurse Turnover as an Indicator of the Level of Organizational Culture of a Healthcare Institution. In Prohuman [online]. 31 March 2023. [cited 2023-08-10]. Available online: https://www.prohuman.sk/osetrovatelstvo/fluktuacia-sestier-ako-ukazovatel-urovne-organizacnej-kultury-zdravotnickeho-zariadenia

HULKOVÁ, V. Perspectives of Generation Z Nurses in Succession in Nursing Management. In Prohuman [online]. 8 August 2023. [cited 2023-08-10]. Available online: https://www.prohuman.sk/osetrovatelstvo/perspektivy-generacie-sestier-z-v-nastupnictve-v-riadeni-osetrovatelstva.

KATRIŇÁKOVÁ, T. Working Conditions of Nursing Practice as a Motivator of Performance of the Nurse Profession: Thesis. Bratislava : Vysoká škola zdravotníctva a sociálnej práce sv. Alžbety, 2022, 112 s.

KOŽUCHOVÁ, M. – VARGOVÁ, A. 2015. Selected Factors of Slovak Nurses´ Job Satistfaction. Cent Eur J Nurs Midw. [online]. 30 September 2015; 6(2):260-266. [cited 2022-05-15]. Available online: https://cejnm.osu.cz/pdfs/cjn/2015/02/06.pdf

KUBIŠOVÁ, H. 2013. Motivation of General Nurses in the Performance of Their Profession: Bachelor's Thesis. Brno : Masaryková University, Faculty of Medicine. [online]. 2013, 83 s. [cited 2022-02-27]. Available online: ˂https://is.muni.cz/th/dxwvv/Motivace_vseobecnych_sester_pri_vykonu_jejich_povolani.pdf?info˃.

LAI, W. et al. 2021. Current Situation and Influencing Factors of Nursing Practice Environment in Five Tertiary General Hospitals in Shenzhen: A Cross-Sectional Study. Journal of Public Health. [online]. 5 March 2021 1(8). [cited 2022-03-30]. Available online: https://pubmed.ncbi.nlm.nih.gov/33717831/

LLOP, G. et al. 2021. Employment and Working Conditions of Nurses: Where and How Health Inequalities Increased during the COVID-19 Pandemic? Hum Resour Health. [online]. 16 September 2021; 19(1):112. [cited 2022-03-17]. Available online: https://pubmed.ncbi.nlm.nih.gov/34530844/

MÁCSADYOVÁ, G. 2013. Motivation in Stressful Work Positions Focused on Healthcare Workers in an Oncology Ward: Diploma Thesis. Trnava, Univerzita sv. Cyrila a Metoda v Trnave, Filozofická fakulta, Department of Psychology. [online]. 2013, 78 s. [cited 2022-04-04]. Available online: https://opac.crzp.sk/?fn=detailBiblioForm&sid=5D4D29B46C695A5DF59B193F1343

SODEIFY, R. − VANAKI, Z. − MOHAMMADI, E. 2013. Nurses' Experiences of Perceived Support and Their Contributing Factors: A Qualitative Content Analysis. Iran J Nurs Midwife Res. [online]. May-June 2013; 18(3):191-7. [cited 2022-03-21]. Available online: https://pubmed.ncbi.nlm.nih.gov/23983753/

SODEIFY, R. − HABIBPOUR, Z. 2021. Nurses' Perceptions of Co-worker Support in the Workplace: Qualitative Research. Enferm Clin (Engl Ed). [online]. November-December 2021; 31(6):355-362. [cited 2022-02-17]. Available online: https://pubmed.ncbi.nlm.nih.gov/34756239/

SYPNIEWSKA, B. 2014. Evaluation of Factors Influencing Job Satisfaction. In Contemporary Economics [online]. VIII roč., č.1/2014. [cited 2022-03-30]. s. 57-72. Available online: https://www.econstor.eu/handle/10419/105425˃ ISSN 2084-0845.