Factors Affecting Job Satisfaction of Nursing Staff in Alberta, Canada
For many years, job satisfaction has been at the heart of organizational behavior and psychology. It is one of the most studied variables in the theory of organizational phenomena covering job design and supervision. Job satisfaction is the subject of serious studies because it focuses on mental and physical well-being of the employees both from an organizational psychology perspective, as well as from the point of organizational management, human resource management, and issues relating to formulation of management policies to enhance employee job satisfaction in an attempt to increase an organization’s profitability and productivity (Zeytinoglu et al., 2007). Today job satisfaction or dissatisfaction wholly depends on both the nature of the job and the expectations an employee has on what the job should offer. Job satisfaction in Alberta, Canada, has been a major issue. Nursing staff experienced low job satisfaction levels, which was associated with various factors. They include working environment that is characterized by abuse and violence, and working conditions characteristic of workloads and working overtime. In view of this, the current paper has discussed the issue of job satisfaction of nursing staff in Alberta, and how various factors contributed to increased and reduced job satisfaction.
Background, Definition, and Scope
Employee job satisfaction has been defined as gratification, enjoyment, and fulfillment that one gets from his/her work. This does not only include financial benefits, but the feelings an employee gets from the work itself. Scholars say it is a pleasurable emotional state that is a result of appraising one’s job experiences (Zeytinoglu et al., 2007). In other words, it is a degree to which an individual likes (satisfaction) or dislikes (dissatisfaction) his/her job.
With the recent development of the world’s economy, the level of healthcare has also increased. Nonetheless, job satisfaction among hospital personnel, especially nurses is relatively low. Studies indicate that nurses across the globe often experience physical, emotional, and psychological stress at work. Therefore, they feel dissatisfied, and their morale is lowered, which, in turn, affects the quality of health care and customer service provided. Job satisfaction in healthcare has attracted attention of many governments, since patients require enthusiastic and competent staff on which they can rely in health care settings. Many efforts have been made to study job satisfaction among nurses and possible ways of its improvement. However, factors influencing job satisfaction among nurses have not been fully studied.
Job satisfaction or dissatisfaction is a result of many factors. In Alberta in particular and Canada in general, the most notable contributing factors include working conditions (workloads and overtime), workplace violence, and abuse.
Workplace Violence and Abuse
Exposure to emotional, sexual, and verbal abuse is not uncommon for nurses in Canada. Apparently, healthcare givers in Alberta receive more assaults as compared to other working groups such as police officers. They are also more likely to be attacked at workplace than police officers or guards, for instance. As reported by the International Council of Nurses, about 72% of nurses feel unsafe as a result of assault, while 95% of them have been bullied at their at their workplace (Giovannetti, Estabrooks, & Hesketh, 2002).
Abuse in healthcare settings originates from interactions between nurses, patients, and their families, and also between managers, physicians, and co-workers. In a study carried out at the Vancouver Emergency Department, 68% of the workers stated there was increased violence over time, while 60% pointed out extreme severity of violence (Giovannetti, Estabrooks, & Hesketh, 2002). About 57% of the employees reported they had been assaulted, and 77% of them were afraid that their patients could get violent. 25% of the employees were found to take days-off as a result of violence. In general, 75% of the employees felt that violence had a negative impact on their job satisfaction (Giovannetti, Estabrooks, & Hesketh, 2002).
A more recent study by Giovannetti, Estabrooks, and Hesketh (2002), which was carried out on 43,000 nurses from five countries, indicated that Canadian nurses experience high levels of emotional abuse, threat, and physical assault. The researchers collected data on abuse from British Columbia and Alberta. The report was that about 40% of the respondents from Alberta had suffered emotional abuse during the last five shifts of their work. Irrespective of the efforts used to curb violence and punish offenders, little has been achieved (Giovannetti, Estabrooks, & Hesketh, 2002). In another study carried out in 1994 on 603 Canadian nurses, it was found out that 33% of the nurses had suffered abuse in the last week of their work. The report indicated that most nurses received verbal abuse from their patients (Duncan et al., 2001). Though most nurses from the five-country study confirmed that their employers had put measures to stop violence at their workplace, it is apparent that abuse continues at almost the same rate as it was reported about 10 years ago.
Shortly after the 1990’s budget cuts and staff reductions were instituted, a substantial increase in productivity was noted (Giovannetti, Estabrooks, & Hesketh, 2002). The job was done by fewer employees in a shorter period of time, thus many workplaces had been transformed to be more productive and efficient. However, reduction of total payroll remains the subject of debate. Studies in Canada indicate that understaffing increases the costs of employers, mainly through overtime expenses (Zeytinoglu et al., 2007). Additionally, nurses are forced to pay increased personal costs due to understaffing. Notwithstanding, the Canadian public sector suffers from higher costs, too in the form of increased costs and reduced quality of the services provided.
The registered nurses in Canada work 250,000 hours overtime per week. This is an equivalent of 7,000 full time jobs every year (Giovannetti, Estabrooks, & Hesketh, 2002). Doing the same work for many hours and with the same intensity, which is currently expected in the healthcare system, takes a toll on the nursing staff. Nurses both from part-time and full-time schedules suffer the same rates of sprains, strains, and back injuries. In a situation when patients must be moved by few nurses who have inadequate equipment and are tired or stressed, there is a great risk of musculoskeletal injuries. Contemporary studies indicate that there is a direct link between sick time and overtime. After all, overworking is exceedingly predictive factor of heightened lost-day injury claim rates among nurses.
The heightened levels of workload at workplace have resulted in staff overload. This has been an unwelcome feature in the field of nursing since the 1990’s, and it remains true in the new century (Zeytinoglu et al., 2007). Workload evidence is not hard to spot. Canadian nurses report that in many instances, they are expected to perform more than one task at a given time and be in multiple places at the same time. It is especially common when a critically ill patient is involved. The nurses complained that they were given more tasks during difficult time constraints. They described their working days as a rush and wanting need to catch up with the schedule. Most nurses reported about leaving the needs of their patients unaddressed because they had a lot of tasks to accomplish in the limited time provided. A study reported that extreme workload results in moral distress of nursing staff and administrators, especially when there is insufficient qualified personnel to deliver health care (Duncan et al., 2001).
Workload is a result of fewer nurses performing more jobs in a complex and more intense environment. It causes physical and mental strains resulting in high levels of injury, burnout, and illness that have impacted nursing employers over the last few years. According to studies, nurses experience the highest level of stress compared to other healthcare professionals.
As stated by Duncan et al. (2001), the problems resulting from the work and work environments of nurses such as heavy workloads, stress, injury, long hours, and unhealthy relations with colleagues can lead to physical and psychological health problems. Research carried out in other occupations indicate that long periods of job strain impact personal relationships and increase inefficiency, turnover, and sick time (Zeytinoglu et al., 2007). Work overload necessitates more overtime, especially where there is inadequate staff, and it often results in injuries and illnesses amongst nurses.
Most scholars exploring the state of nursing and nurses agree that overwork and desire to accomplish the job assigned correctly recurs over and over, which frustrates nurses. A study reported that some nurses worked for a minimum of eight hour shift nonstop in an attempt to complete their tasks, besides their regular overtime, and still felt frustrated (Duncan et al. 2001).
Benefits and Challenges
Ensuring job satisfaction is beneficial both to nursing staff and the healthcare system. Job satisfaction is positively correlated with staff motivation. When staff feels motivated and fulfilled, they identify themselves fully with an organization, performing their tasks in the best way possible (Zeytinoglu et al., 2007). This increases productivity and efficiency of the organization. Job satisfaction is linked with fair treatment, respect, physical health, and emotional well-being. It also results in employee behavior and impacts the functioning of the organization. Quality provision of care in the healthcare setting is considered the most significant factor since it is a reflection of how the facility is functioning. When nursing staff are satisfied, they are able to provide quality care. Developing quality systems in the healthcare setting requires the human resource management to pay attention to staff during the initial stages. This means that ensuring job satisfaction is a significant task of human resources management. In healthcare settings in Alberta, job satisfaction of nursing staff has been found to have a positive relation with patient satisfaction. A number of activities predict quality of care in a healthcare setting including comforting patients, routine teaching, backrubs, and preparation for discharge. These enhance better patient results in different settings encompassing reduction in anxiety and improvement of confidence.
Another benefit of increased job satisfaction is reduction in absenteeism. According to studies in Alberta, nurses who are satisfied with their job exhibit low rates of absenteeism (Giovannetti, Estabrooks & Hesketh, 2002). Nursing staff have passion to attend and accomplish their work. It also results in low turnover rates. Satisfied staff has no intention of terminating their employment. 82.5% of the surveyed nursing staff showed no intention of quitting their job in the next year (Giovannetti, Estabrooks & Hesketh, 2002). It reduces organizational distress in searching for qualified nurses. Job satisfaction results in positive publicity of the healthcare setting. A survey carried out by CBC News among Canadian registered nurses showed that Alberta nurses have a high rate of recommending other people into the healthcare settings (Hildebrandt, 2013). Human resource management should ensure that job satisfaction is one of the leading guiding principles when making healthcare decisions.
Failure to meet nurses’ needs results in high levels of dissatisfaction. Job dissatisfaction in Alberta is caused by various factors including poor working conditions, workplace violence, and abuse. Surveys conducted among nursing staff in Canada indicate concerns about safe staffing, requirement to work overtime, and workloads as the major causes of nurses’ dissatisfaction (Hildebrandt, 2013). Nursing staff in Alberta have a high level of job dissatisfaction. Working overtime and workloads have been highlighted as some of the factors resulting in job dissatisfaction. As a result of these, various challenges have been evidenced among nursing staff during their provision of care. Studies have shown that dissatisfied nurses are overwhelmed, stressed, fatigued, and burned out (Zeytinoglu et al., 2007). Nurses have reported that they have lost patience due to the failure of the government along with hospital management to take actions on the prevalent issues facing healthcare.
Work overload results in mental and physical strain. This leads to high levels of illness, injury, and burnouts among nursing staff (Hildebrandt, 2013). In the Canadian heath care setting, and Alberta in particular, nurses have been evidenced to experience the greatest degree of stress as compared to other healthcare professionals. Burnout entails feeling of being disrespected. Nurses who experience burnout lose their self-confidence of ever performing well in their roles. For most nurses, workloads and working environment challenge the value of their job. Nursing staff have reported having moral and ethical distress due to failure to offer the best nursing care as expected by patients. A study carried out by the Canadian Nurses Association (CNA) in 2010 indicated that fatigue impacts the capability of nursing staff to provide effective care (Canadian Nurses Association & Registered Nurses Association of Ontario, 2010). It affects their problem-solving and decision making capabilities, levels of engagement, as well as creativity. Various factors including workload, lack of professional development, overwork, and a decline in leadership were reported by nurses as the key factors causing fatigue. Job dissatisfaction results in increased turnover rates and absenteeism. This is caused by stress that nursing staff experience at their work. Dissatisfied staff have a high likelihood of providing inferior services because their mental, social, and physical well-being is affected by the degree of job satisfaction.
These benefits and challenges are in line with the literature that points out that turnover, burnout, fatigue, and absenteeism are frequent when nursing staff are dissatisfied with their job (Zeytinoglu et al., 2007). These issues should be addressed in order to enhance staff’s work life and the quality of care. Moreover, satisfied nurses are highly motivated, and they are an asset in their organizations.
Impact and Implications
Job satisfaction of nursing staff either makes or ruins an organization’s performance. Healthcare institutions should consider the degree of staff satisfaction as it is paramount in goal attainment. The significance of job satisfaction is perceived in the framework of two choices made by individuals regarding their job. These are the choice of belonging and the choice of performing. The former entails joining and remaining in an organization as a member, while the latter involves working hard in order to attain high degree of job performance (Zeytinoglu et al., 2007). In Alberta, some nursing staff has reported job satisfaction, while others have a feeling of dissatisfaction (Giovannetti, Estabrooks & Hesketh, 2002). This is due to different factors influencing job satisfaction and the degree of satisfaction among individuals (Duncan et al., 2001). The association between job satisfaction for nurses and quality of care offered to patients has been investigated. An examination of patient care outcomes conducted in healthcare setting among Canadian surgical oncologists revealed that negative and poor working environments resulted in increased mortality rates among patients (Duncan et al., 2001). They were also linked with reduced quality of care, as well as health complications for patients.
The impact of overtime and workload on the health of nurses is obvious. These factors result in burnout, injury or disease. The result is that over 7.4 percent of Registered Nurses miss work each week (Giovannetti, Estabrooks & Hesketh, 2002). The rate of absenteeism among Canadian nursing workforce is about 80 percent higher compared to the Canadian average (Giovannetti, Estabrooks & Hesketh, 2002).
Older nursing staff are the most affected as they are believed to fall sick more often. Absenteeism is linked with various economic implications. It has been demonstrated that healthcare settings lose over 16 million hours either due to illness or injury, which is equal to 9,000 nurses employed on a fulltime basis (Giovannetti, Estabrooks & Hesketh, 2002). Although it is not possible to eliminate injury and ill health, human resource management (HRM) should come up with strategies of reducing the rate of absenteeism. One of them is modifying the working conditions of the nursing workforce. It should be driven both by moral aspect, as well as the need to cut public cost by using money in a more effective manner.
The impact of burnout to the healthcare system is evidenced in terms of sick leaves as well as loss of the best workforce who prefer to quit their job. Patients are also harmed in the process considering that the nursing workforce happen to be disassociated with their work (Hildebrandt, 2013). They are dissatisfied with the achievement of their work and become dehumanized (Giovannetti, Estabrooks & Hesketh, 2002). This means that nurses generate pessimistic feelings towards their patients, and they perceive them as deserving their problems.
Although nurses are required to work for long hours, most of them are dissatisfied with the degree of care they provide to their patients. They are growingly turning into frustrations due to the non-nursing responsibilities that hinder them from providing high standard care. The implication of this is that nursing staff are torn between the key components and values of their responsibilities. They are unable to feel satisfied or have passion for their work, which is resulting in low productivity levels and organizational effectiveness. It is difficult for nurses to be passionate if the practice setting is not motivating.
HRM are charged with the overall responsibility of dealing with workforce in an organization. By understanding the significance of the factors influencing job satisfaction among nursing staff, HRM has a high probability of enhancing performance as well as the quality of care provided in the healthcare system. The needs and desires of nursing workforce should be met first so that they are able to meet patient’s needs. This implies that HRM is responsible for both patients and the workforce. Ensuring that the practice setting is favorable is the overall strategy that should be implemented in the healthcare system. This means good working conditions and work environments that are free of violence and abuse.
Job satisfaction is indicative of various behaviors such as turnover, productivity, job performance, and absenteeism (Zeytinoglu et al., 2007). Increased job satisfaction increases productivity and job performance, and reduces absenteeism and turnover rates. On the other hand, reduced job satisfaction leads to low productivity, poor performance, increased turnover and absenteeism (Zeytinoglu et al., 2007). The implication of this includes lost working hours by the hospital, poor quality care offered to patients, as well as mental and physical effects for nurses.
From the discussion, it is clear that job satisfaction in Alberta is the major issue. As a result, the government, HRM, together with other involved parties should implement strategies to combat job dissatisfaction among nursing staff. In line with the issues discussed, some of the recommendations which should be considered include the following.
The first recommendation involves creating a positive working environment free of abuse and violence. This is the responsibility of HRM who should make certain that the workplace is free of assault, attacks, violence, and bullying. A safe working environment means that nurses would feel safe while performing their responsibilities. Besides, HRM should ensure that healthy relationships are created between the nurses, patients and their families, as well as other colleagues. This would be constructive in keeping hospital settings an environment where nurses can thrive. Secondly, the management should develop and utilize frameworks to ensure that every nurse works to his/her full scope of practice and is appropriately utilized in providing patient focused care to all Albertans. Lastly, the government should employ more nursing staff in order to reduce workloads. Considering that workload has been outlined as the major factor causing job dissatisfaction, employing more nurses would mean reduced workloads, and in turn increased job satisfaction. In a nutshell, the nursing profession should come together as a community and solve the workforce issues to contribute meaningful health reforms and sustainability while ensuring positive nursing outcomes. These recommendations are also supported in the literature.
The issue of job satisfaction in the health care setting has been widely discussed. Many scholars have focused on establishing various factors which affect job satisfaction among hospital staff. The current paper has discussed the factors affecting job satisfaction of nursing staff in the healthcare setting in Alberta, Canada. It has been evidenced that job satisfaction in Alberta has been a matter of serious concern. Nurses have demonstrated a high rate of job dissatisfaction, which been caused by various factors including working environment that is characterized by violence and abuse, and working conditions characterized by work overloads and overtime work. This has resulted in increased absenteeism, burnout, fatigue and stress compromising the quality of care provided to patients. As a recommendation, the HRM should ensure favorable working environment that is free from violence and abuse. Besides, the government should also be involved in hiring more nurses in order to reduce workloads and working overtime.