FACTORS INFLUENCING JOB SATISFACTION AMONG NURSES IN NIGERIA
CHAPTER ONE
1.0 Background of the study
Nursing profession is the largest health care workforce in the healthcare system having more direct contact with patients. Nurses are therefore major determinant of overall quality of hospital care and patients’ outcome. To enable provision of standard care, nurses must be provided with an ideal professional practice environment where their job satisfaction is guaranteed. Nurses however, are faced with job dissatisfaction thereby threatening the effectiveness and efficiency of the nursing workforce (de Francisco, Meguid & Campbell, 2015). Job satisfaction is described as the major determinant of having good staff retention in the nursing workforce (Wang, Tao, Ellenbecker, & Liu, 2012).
In an ideal setting, employees’ welfare and satisfaction are imperative in attaining the organizational mission and vision. For instance, nurses are the safety net, ever present with their patient at the bedside, caring and detecting medication errors, addressing patients’ real need. Nurses are the first point of contact to clients in any healthcare facilities. Job satisfaction in the nursing workforce is therefore vital to quality care provision (Abualrub, El-Jardali, Jamal & Al- Rub, 2015; Alenius, Tishelman, Runesdotter, & Lindqvist, 2013; Saleh, Darawad, & Al‐Hussami, 2015). Job satisfaction thus, is the most important aspect of nurses’ lives which has positive influence on their morale, productivity, quality of care, patients’ safety, and retention (Ezeonwu, 2011; Aiken, et al., 2012).
Job satisfaction is the product of employee’s attitude to his/her job and job processes. Employee’s job satisfaction entails an outcome of job demands meeting employee’s expectations. It is “a
pleasurable or positive emotional state resulting from the appraisal of one’s job or job experiences” (Locke, 1969, p. 28). Job satisfaction is a consequence of people’s opinion and feeling about their job arising from intricately interwoven factors regarding the work itself and the work process. It is a function of the extent to which one values certain facets of work, such as the degree of autonomy, company policy, management style, promotion, pay, recognition, relationship among co-workers, work itself and working conditions. These are broadly grouped into extrinsic/hygiene and intrinsic/motivation factors by Herzberg (Herzberg, 1968; Asegid, Belachew, & Yimam, 2014).
Decline in job satisfaction is one of the major cause of shortage in nursing workforce globally. In the United States, Australia and Canada, poor job satisfaction has led to nurses quitting their organization and/or nursing profession leading to shortage in the nursing workforce (Bellasch, 2015). There is a projection of about 500,000 shortage of nurses by the year 2025 in the United State of America while that of Canada is anticipated to rise to 60,000 by 2022 (Buchan, O’May & Dussault, 2013; Trautman, 2015). Likewise, nurses from Germany, France, Poland, Italy, Netherlands, Belgium, Slovakia and China reported having poor job satisfaction and frustration with the nursing profession due to excessive work load coupled with poor recognition and remuneration (Li, Bruyneel, Sermeus, Van den Heede, Aiken & Lesaffre, 2013). Thus, Bellasch (2015) acknowledged that until adequate measures are taken to address decline in job satisfaction among nurses and halt the current high rate of nurse turnover, this shortage will continue to negatively impact the quality of healthcare systems across the globe.
The challenge of decline in job satisfaction among nurses and its associated consequences such as poor patient outcome, high turnover and attrition has become a global issue (Aiken et al., 2012). Indeed, the situation is more serious among the low and middle income nations such as Sub-
Saharan Africa of which Nigeria is one (Dolamo & Olubiyi, 2013). This health workforce crises accounts for the reason most African countries failed in meeting up with the Millennium Development Goals (MDGs) (Gupta, Bush, Dorsey, Moore, van der Hoof, & Farmer, 2015; De Francisco, Meguid, & Campbell, 2015). Additionally, retention problems in the nursing workforce in sub-Saharan Africa accounts for some of the reasons behind the high maternal and child mortality rate, poor response and ineffective management of infectious diseases and outbreak of epidemics (Sun & Larson, 2015). It is however, anticipated that when nurses are satisfied with their job, they would remain on their job and be committed to their organisation.
Nigerian healthcare system is under-resourced and overstretched owing to the rapid growing population, poor policy implementation and security challenges. This is further compounded with poor management of human resources for health such as mal-distribution of the nursing workforce and poor welfare packages (Green, 2016; Agboghoroma & Gharoro, 2015). Thus, the push and pull factors associated with global market forces such as poor working conditions, unattractive benefits and poor salary are forcing well trained and most competent Nigerian nurses to emigrate to high income nations in search of better remuneration and satisfactory working conditions. These are deepening the shortage in nursing workforce especially in terms of skill in Nigeria (Walani, 2015).
Nursing practice is more challenging in Nigeria, especially in the rural areas and the northern part of Nigeria plagued with terrorism (Innocent, Uche, & Uche, 2014; Adegoke, Atiyaye, Abubakar, Auta & Aboda, 2015). Nurses practicing in such areas are usually mandated by situation and empathy to go beyond their professional jurisdiction in patients’ care especially in the advent of epidemic outbreaks, such as Ebola, Lassa fever and meningitis as well as bomb-blasts. Nurses are thereby exposed to uncountable occupational-related stresses ranging from excessive workload,
dealing with death and dying patients (Green, 2016; Mosadeghrad, 2013). Most studies carried out on job satisfaction among nurses in other states of Nigeria reported decline in their job satisfaction due to poor salary, inadequate and sub-standard medical equipment and drugs, lack of opportunity for advancement and low self-esteem arising from being under-valued by their employers (Nwafor, Immanel & Obi-Nwosu, 2015; Edoho, Bamidele, Neji & Frank, 2015; Adegoke et al., 2015).
Without a stable nursing workforce, quality of care will continue to be compromised as nurses would demonstrate lack of commitment and competence to their work when they are not satisfied with their job. Having a satisfied nursing workforce in ABUTH which is the only tertiary healthcare facility in Kaduna State is therefore imperative. Anecdotal evidence though, shows a decline in job satisfaction among ABUTH nurses due to frequent industrial strikes, emigration and high nursing staff turnover.
To the best knowledge of the researcher, no study was found on job satisfaction among ABUTH nurses at the time of this study. In addition, other studies on job satisfaction among Nigerian nurses were conducted in other parts of Nigeria which have different cultural background and working conditions in contrast to ABUTH. The researcher therefore aimed at exploring factors influencing job satisfaction among ABUTH nurses. The findings will contribute to the existing knowledge on job satisfaction and will further enlighten the management of ABUTH on how to enhance job satisfaction among nurses so as to generally promote quality healthcare delivery.
Problem Statement
Nigeria is naturally endowed with both human and natural resources. Unfortunately, despite these leverages, the responsiveness of Nigerian’ healthcare system is inadequate. The Nigerian healthcare milieu is increasingly becoming volatile with unpleasant scenarios such as decreased
job satisfaction, incessant industrial strike actions among nurses, and deficient healthcare services. This has been observed to be the cause of massive exodus of Nigerians to access medical care abroad and poor health indicators such as increased rate of maternal and child mortality (Agbedia, 2012; Obansa & Orimisan, 2013; Green, 2016).
The healthcare system in Nigeria is faced with many challenges including unfair distribution of nursing workforce, increasing “brain drain” culminating into shortage of skilled and competent nursing workforce. Furthermore, poor human resources planning, mismanagement practices and structures, unsatisfactory working conditions, political crises, and terrorism among others are genuine challenges confronting the Nigerian healthcare system (Welcome, 2016; Obansa & Oriminsa, 2013).
Ogbolu, Johantgen, Zhu and Johnson (2015), described the nursing workforce as being deficient both in material and human resources which contributes to the inability of nurse leaders to achieve a healthy, adequate and stable nursing workforce. The frequent industrial strike actions among Nigerian healthcare workforce has resulted in unquantifiable losses, ranging from loss of lives, deformities and untold hardships among Nigerians especially the masses who cannot afford seeking care in private healthcare facilities or access medical care abroad due to financial incapability.
ABUTH has had its fair share of industrial strikes and upheavals among nurses due to job dissatisfaction. For instance, this year nurses in ABUTH participated in the general nurses’ strike in Nigeria. Nurses agitated against poor remuneration and lack of recognition among their peers especially, the promotion of nurses to executive positions. Thus, for two weeks, nurses stayed away from work while their leaders dialogue with government to resolve the impasse. ABUTH
though, has initiated some strategies to enhance job satisfaction among nurses, such as granting nurses study leave, a lot have to be done to build trust between management and nurses.
Additionally, partnership must be developed with stakeholders to mobilize resources to nurture and retain competent, confident and committed nursing workforce to effectively harness the material and human resources that will demystify these challenges. There must be adequate knowledge of the various variables either discouraging or encouraging job satisfaction among nurses. This study would therefore, explore the different variables influencing job satisfaction among nurses in ABUTH.
Purpose of the study
The purpose of this study is to describe the factors influencing job satisfaction among nurses in ABUTH.
Objectives of the Study
Specific objectives of the research are:
- To explore the influence of extrinsic factors (working conditions, salary, supervision, interpersonal relations and policy and administration) on job satisfaction
- To explore the influence of intrinsic factors (work itself, achievement, recognition, responsibility and advancement) on job satisfaction.
- To establish relationship between socio-demographic characteristics (marital status, gender, age and educational status) and job satisfaction.
Research Hypotheses - H1 – Extrinsic factors will influence nurses’ job satisfaction
- H1 – Intrinsic factors will influence nurses’ job satisfaction
- H1 – Nurses’ socio – demographic factors will influence their level of job satisfaction Research Questions
- What are the extrinsic factors that influence nurses’ job satisfaction?
- What are the intrinsic factors that are influencing nurses’ job satisfaction?
- How do nurses’ socio-demographic characteristics influence their job satisfaction?
Significance of the Study
The findings of the study when communicated to nurse leaders and management of ABUTH, would equipped them with adequate information to enable deal successfully with challenges of job dissatisfaction among nurses. It will also be relevant to the nursing profession by providing more insight that could herald policies that will ensure maximum support for nurses in their practice settings thereby leading to more stable and productive nursing workforce. The findings may also reveal other areas that would need further studies on variables associated with job satisfaction among nurses. The findings will also contribute to the existing knowledge on job satisfaction among nurses.