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Critical care unit is considered as a very hectic workplace in the hospital and the shortage of specialized nurses are the common issue at the international as well as at the national level. Level of job-satisfaction among critical-care units is directly associated with productivity and positive outcomes. A number of studies have been conducted in different countries but, limited studies are available in the Pakistani context.
The purpose of selection this topic is; being a critical-care practitioner I myself observe a lack of commitment to the work due to the low level of satisfaction among my colleagues. In future, my intention is to become a nurse manager. That’s why I have selected my subspecialty ‘critical care” in my MSN program. I want to highlight the factors affecting the level of job satisfaction among critical-care nurses working in Tertiary care hospital, Islamabad because limited evidence is available to examine the relationship of the factors with the level of job satisfaction in the Pakistani context. In the same way, I want to engage and motivate management to implement such steps to motivation and attaining the maximum level of satisfaction. This whole process will automatically enhance the level of patient care and hence their satisfaction.
The initial search was started from the database Google Scholar. Initial search words used Factors AND nursing; factors, affecting AND nursing OR nurse; factors affecting satisfaction, satisfaction level, AND nurs*. It shows 16,600 results on different articles. Additionally, search duration was limited from 2014-2019, the main focus was on original articles written in English and published in authentic journals. The database shows 235 articles. About 187 articles were excluded on the bases of title bases, and 36 articles were excluded on abstract bases, 12 articles were included for the literature review.
- What is the job satisfaction level of nurses working in critical care nurses?
- What are the factors affecting their satisfaction level?
The term “Satisfaction” is defined as per a sense of eagerness besides attraction of a person towards the job (Lu, Barriball, Zhang, & While, 2012). Job-Satisfaction is widely studied globally. According to Armstrong (2006), job-satisfaction is the interest and sensation through positive ecological support of an individual toward the work. Furthermore, rewards and enticements are very significant for the development of interest and attraction of the employees to work productively, similarly attractively (Statt, 2004). The discernment in addition to interest of workers about the profession, and professional tasks, the discernment towards the job could stay productive or just a task (Spector, 1997, p. 2).
A quantitative study from in Saudi Arabia has shown that the level of job satisfaction has a constructive association among salary, upgradation, enticements, team workers, working setting, and non-cooperative administration (Mari et al. (2018).
Another study conducted in Beijing, China has reported that rotating working shift and management, professional presentation, organizational commitment, effort and reward style has been recognized malingering behavior, illness, exhaustion, slow recruitment system, working abilities, in addition, resignation may affect the satisfaction-level of the critical-care nurses (Lu, Zhao, and While, 2019).
A descriptive study conducted in Sudan has highlighted that there is a direct association between level of job-satisfaction of critical-care nurses with individual and employed influences. Individual influences include advancing age, marriage, extra responsibilities of home and children. Employed influences include workload, insufficient staff, organization’s expectations, similar salary, and similar work responsibilities regardless education-level, limited advanced education opportunities, health-related risk, likewise promotions (Abduelazeez, Nouri, & Mukhtar, 2016).
Another study conducted in Ontario, Canada has shown that a number of influences that have a key impact upon the job-satisfaction of the nurses that includes job-related stress, work overload duties, turnover, shortage, staffing, lack of authority, non-cooperative hospital management, shifting duties, cooperation of team member, individual influences have shown the evidence of dis-satisfaction (Dilig-Ruiz, 2017).
A study conducted in China, revealed that there are a number of factors that cause dissatisfaction among nurses that include stressful working environment, autonomy, lack of fair appraisals, unfair salary distribution system regardless competencies, experience, and education level, lack of motivation and rewards, part-time jobs, although these all factors cause some nurses to leave the job but some nurses keep on doing their jobs, and the nurses who continue doing their jobs besides dissatisfaction shows the positive dedication as a productive member of the health care team for the organization. In both cases, whether the nurse leaves the organization or continues the job (Tao, Ellenbecker, Wang, & Li, 2015).
Critical care units demonstrate stressful working environment and work overload for the health care workers, a little help from the patients’ relatives may have a positive impact on nurses’ job satisfaction and psychologically effect on the recovery of the patients (Monroe & Wofford, 2017).
In edition of above studies, this study has also reported that the factors that affect the nurses work efficacy are lack of decision making, communication gaps, lack of independence, participation in decision making, working environment, work burden including total dependence of critical care upon nurses (Mousazadeh, Yektatalab, Momennasab, & Soroor Parvizy, 2018).
According to Oliveira, Barbosa, Andolhe, Eiras, & Padilha, (2017), that the factor that affects job satisfaction among nurses are the same as indicated by many researchers but the job satisfaction can be enhanced by the provision of the autonomy, participation in decision-making, healthy working environment, good interpersonal relationship and health communication among the management and health care professionals have a great impact on job satisfaction among health care professionals, and job satisfaction will increase productivity and also will have a great influence on patients’ recovery.
Moreover, another study has highlighted the factors affecting the motivation of the nurses towards their job and leads them to leave their job that includes hectic shifting work, interpersonal issues of nurses and their supervisors, inability to maintain balance in their life, participate in social activities, physical and mental tension due to stressful working environment (Khan, Jackson, Stayt, & 2018).
Furthermore, a study has reported that there are many motivational factors that increase the level job satisfaction of the nurses that include the healthy working environment that provides an opportunity to enhance critical thinking, participation in decision-making, learning environment, and supportive attitude of the management is very important for the intent of the nurses to work productively (Hoonakker et al., 2013).
A quantitative study conducted in Belgium has indicated that there is a positive association between good communication with higher authorities, job-satisfaction and job continuation (Vermeir et al., 2017).
A descriptive study conducted in Pakistan has indicated that hectic shift duties, work overload, low esteemed by seniors, patients, and their relatives, low salary, unfair promotions and designations, limited career opportunities, working environment, unplanned leaves, societal comportment all are the factors affecting satisfaction level of nurses (Sultana, Riaz, Mehmood & Khurshi, 2011).
The level of job-satisfaction has a constructive association among salary, upgradation, enticements, team workers, working setting, and non-cooperative administration (Mari et al. (2018). Rotating working shift, management, professional presentation, organizational commitment, effort, rewards, malingering behavior, illness, exhaustion, slow recruitment system, working abilities (Lu, Zhao, and While, 2019). Individual influences and employed influences affect the level of job satisfaction (Abduelazeez, Nouri, & Mukhtar, 2016). In edition, job-related stress, work overload, turnover, shortage, staffing, lack of authority, non-cooperative hospital management, shifting duties, the cooperation of team member are factors (Dilig-Ruiz, 2017). Lack of fair appraisals, unfair salary distribution system regardless competencies, experience, and education level, lack of motivation and rewards, part-time jobs are identified (Tao, Ellenbecker, Wang, & Li, 2015). Moreover, shortage, work overload, a little help from the patients’ relatives may have a positive impact on nurses’ job satisfaction (Monroe & Wofford, 2017). Additionally lack of decision making, communication gaps, lack of independence, participation in decision making, working environment, work burden affect satisfaction level (Mousazadeh, Yektatalab, Momennasab, & Soroor Parvizy, 2018; Oliveira, Barbosa, Andolhe, Eiras, & Padilha, 2017; Hoonakker et al., 2013). Furthermore, Factors include hectic shifting work, interpersonal issues of nurses and their supervisors, inability to maintain balance in their life, participate in social activities, physical and mental tension due to stressful working environment (Khan, Jackson, Stayt, & 2018). Furthermore, a positive association between good communication with higher authorities, job-satisfaction and job continuation (Vermeir et al., 2017). Hectic shift duties, work overload, low esteemed by seniors, patients, and their relatives, low salary, unfair promotions and designations, limited career opportunities, working environment, unplanned leaves, societal comportment are affecting satisfaction level of nurses (Sultana, Riaz, Mehmood & Khurshi, 2011).
Nurses level of satisfaction are similarly the same internationally and nationally, the factors that affect the level of satisfaction are work overload, shift duties, stressful working environment, lack of appreciation, rewards, unfair pay distribution system according to education, lack of appraisal, interpersonal relationship, communication gaps, limited opportunity for promotions and higher education, inability to balance work with personal routine life, physical and mental tension due to hectic work, staffing issues, lack of autonomy, lack of opportunity in decision-making, turnover, non-cooperative supervisors, and high managements’ demand. low satisfaction level leads to demotivation and ultimately either they leave their job or continue their job with lack of interest.
References
- Armstrong M. A handbook of human resource management practice. London: Kogan Page Publishing; 2006.
- Dilig-Ruiz, A. (2017). Job Satisfaction Among Critical Care Nurses: A Systematic Review of Contributing Factors, Individual and Organizational (Doctoral dissertation, Université d’Ottawa/University of Ottawa).
- Hoonakker, P. L., Carayon, P., McGuire, K., Khunlertkit, A., Wiegmann, D. A., Alyousef, B., … & Wood, K. E. (2013). Motivation and job satisfaction of Tele-ICU nurses. Journal of Critical Care, 28(3), 315-e13.
- Khan, N., Jackson, D., Stayt, L., & Walthall, H. (2019). Factors influencing nurses’ intentions to leave adult critical care settings. Nursing in critical care, 24(1), 24-32.
- Mari, M., Alloubani, A., Alzaatreh, M., Abunab, H., Gonzales, A., & Almatari, M. (2018). International Nursing: Job Satisfaction Among Critical Care Nurses in a Governmental Hospital in Saudi Arabia. Nursing administration quarterly, 42(3), E1-E9.
- MMN, A. E. A. A., & Job, H. M. E. H. M. (2016). Satisfaction and Related Factors among Intensive Care Nurses in Governmental Hospitals at Khartoum State—Sudan. J Comm Pub Health Nurs, 2, 1-5.
- Monroe, M., & Wofford, L. (2017). Open visitation and nurse job satisfaction: An integrative review. Journal of clinical nursing, 26(23-24), 4868-4876.
- Mousazadeh, S., Yektatalab, S., Momennasab, M., & Parvizy, S. (2018). Job satisfaction and related factors among Iranian intensive care unit nurses. BMC research notes, 11(1), 823.
- Oliveira, E. M. D., Barbosa, R. L., Andolhe, R., Eiras, F. R. C. D., & Padilha, K. G. (2017).
- Nursing practice environment and work satisfaction in critical units. Revista brasileira de enfermagem, 70(1), 79-86.
- Tao, H., Ellenbecker, C. H., Wang, Y., & Li, Y. (2015). Examining perception of job satisfaction and intention to leave among ICU nurses in China. International Journal of Nursing Sciences, 2(2), 140-148.
- Vermeir, P., Blot, S., Degroote, S., Vandijck, D., Mariman, A., Vanacker, T., … & Vogelaers, D. (2018). Communication satisfaction and job satisfaction among critical care nurses and their impact on burnout and intention to leave: A questionnaire study. Intensive and Critical Care Nursing, 48, 21-27.
- Yang, L. S., Yang, H. H., Chen, H. T., Chang, M. F., Chiu, Y. F., Chou, Y. W., & Cheng, Y. C. (2012). A study of nurses’ job satisfaction: The relationship to professional commitment and friendship networks. Health, 4(11), 1098.
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