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Job satisfaction in critical care nurses Turner, Barbara Elly 1992

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JOB SATISFACTION IN CRITICAL CARE NURSESByBarbara Elly TurnerB.N., The University of Manitoba, 1981M.Sc.N., The University of British Columbia, 1992A THESIS SUBMITTED IN PARTIAL FULFILLMENT OFTHE REQUIREMENTS OF THE DEGREE OFMASTER OF SCIENCE IN NURSINGinTHE FACULTY OF GRADUATE STUDIES(School of Nursing)We accept this thesis as conformingto the required standardTHE UNIVERSITY OF BRITISH COLUMBIAApril 1992© Barbara Elly Turner, 1992In presenting this thesis in partial fulfilment of the requirements for an advanceddegree at the University of British Columbia, I agree that the Library shall make itfreely available for reference and study. I further agree that permission for extensivecopying of this thesis for scholarly purposes may be granted by the head of mydepartment or by his or her representatives. It is understood that copying orpublication of this thesis for financial gain shall not be allowed without my writtenpermission.(Signature) Department of SCA/V(96A^W+C(14 t\CThe University of British ColumbiaVancouver, CanadaDate ^A_}-(.k DE-6 (2/88)iiAbstractThis descriptive study was designed to explore jobsatisfaction among critical care nurses using an establishedconceptual framework of job satisfaction entitled the JobCharacteristics Model (Hackman & Oldham, 1980). Thestandardized measures of general job satisfaction and otherjob design variables were the Job Diagnostic Survey (Hackman& Oldham, 1980) and the Index of Job Satisfaction (Brayfield& Rothe, 1951). These were sent to a random sample of 300employed critical care nurses in British Columbia. 127usable questionnaires were returned and formed the basis forthe results. The nurses found task significance and skillvariety the strongest characteristics of motivatingpotential, task identity the lowest. The strongestrelationships were seen between general job satisfaction andmotivating potential of the job, meaningfulness of the work,and context satisfactions. There was also a significantrelationship between general job satisfaction and length ofnursing experience.iiiTable of ContentsPageAbstract^  iiTable of Contents^  iiiList of TablesList of Figures  viAcknowledgment  viiChapter One: Introduction ^1Problem Statement^  4Conceptual Framework  5The Purpose of the Study^  11Research Questions  12Definitions of Terms  12Assumptions^  14Limitations  14Significance of the Study^  14Chapter Two: Literature Review^  16Theories of Job Satisfaction  16Content Theories^  16Process Theories  18Job Satisfaction in Related Fields^  20Job Satisfaction in Nursing^  22Summary^  28Chapter Three: Methods  30Research Design^  30Subject Sample  30Subject Selection Criteria^  31Data Collection Procedure  31Instruments^  31Job Diagnostic Survey  32Index of Job Satisfaction^  33Nurse Characteristics Questionnaire^ 35Data Analysis^  35Protection of Human Rights  37Summary^  37ivChapter Four: Results and Discussion^  38Description of the Sample^  38Nurse Characteristics  38Educational Preparation^  39Years of Nursing Experience  42Maturity^  42Employment Tenure^  44Area of Practice  45Employment Status  45Research Questions^  48Research Question #1^  48Research Question #2  49Motivating Potential  49Critical Psychological States^  50Context Satisfactions^  52Pearson Product Moment Correlations^ 53Multiple Regression Analysis  55Research Question 13^  57Comparison of Study Sample with Other Studies^ 58Comparison of Study Sample with Normative Sample^ 60Summary^  63Chapter Five: Summary, Conclusions, and Implications... 65Summary^  65Conclusions  68Implications  69Implications for Nursing Administration^ 70Implications for Nursing Education  72Implications for Nursing Research^  73Summary^  75References  76Appendices:Appendix A - The Job Diagnostic Survey^ 83Appendix B - The Index of Job Satisfaction^ 90Appendix C - The Nurse CharacteristicsQuestionnaire^  92Appendix D - Information Letter for CriticalCare Nurses  93Appendix E - Revised Index of Job Satisfaction^ 94Appendix F - Sample Sizes, Means, StandardDeviations, and ANOCOVAs ofNurse Characteristics^  95TableList of TablesVPageTable 1 - Means and Standard Deviations of CoreJob Dimensions^ 50Table 2 - Means and Standard Deviations of CriticalPsychological States^ 51Table 3 - Means and Standard Deviations of ContextSatisfactions^ 53Table 4 - Pearson Product Moment Correlation Matrix 55Table 5 - Multiple Regression Analysis PredictingGeneral Job Satisfaction^ 56Table 6 - Pearson Product Moment Correlation Matrix ofGeneral Job Satisfaction, Work Experience,and Age^ 58Table 7 - Comparisons of the Study Sample and theNormative Group^ 62viList of FiguresFigure^ PageFigure 1 - The Job Characteristics Model^ 7Figure 2 - Motivating Potential Score Calculation^ 9Figure 3 - Educational Profiles of Nurses in ThreeCategories^  41Figure 4 - Age Distribution of Nurses in ThreeCategories  43Figure 5 - Employment Status of Nurses in ThreeCategories^  47viiAcknowledgementI would like to take this opportunity to thank allthose people who helped me through the long journey entitled"thesis". Thank you Sonia Acorn and Chris Bradley for allthe help, ideas, revisions, and edits which enabled thiswork to be a completed project. Thank you also must be saidto my friend and editor Lesley Forbes who spent manyevenings listening to me when I was feeling frustrated.Finally, thank you Brad, my husband, who has put up with themoods, tears, as well as the joys of completions throughoutthe years of my schooling. I couldn't have done it withoutany of you.1Chapter OneIntroductionThe health care industry is the fourth largest serviceindustry in Canada (Jenny, 1982). Increasingly, health carefacilities are growing in size and complexity. Hospitalsare feeling pressure resulting from technology, theexpectations of workers, and the demands made upon them froma complex environment (Kahn & Westley, 1984).Critical care units within hospitals are areas ofconcentrated technological, medical, and nursing care aimedprimarily at physiological monitoring and treatment ofseriously ill patients (Baggs, 1989). The development ofcritical care areas has helped to revolutionize health care(Allen, Jackson & Youngner, 1980). Patients who would nothave lived five to ten years ago are now being saved due totechnological advancement (Scherer, 1987). The servicessupplied to critically ill patients include closemonitoring, life support, and concentrated care,particularly nursing care (Lave & Knaus, 1989). Thisincreased sophistication with medical technology hasresulted in major changes in clinical services. Intensivecare beds service five percent of the patient population,but require fifty percent of the supply of nursing (Jenny,1982).The higher staffing ratio in critical care units compared2to elsewhere in the hospital is seen as consistent with thetechnological complexity and intensity of nursing needs forthe patient (Searle, 1988). Critical care areas needspecifically educated registered nurses, with many of theseareas requiring staffing ratios of one nurse per patient(Jenny, 1982).While technological advancement has increased the needfor highly specialized nurses to staff critical care areas(Penny, 1986), the number of registered nurses willing towork in critical care areas has not kept pace with theservice demands of the growing numbers of patients admittedto the units (Civetta, 1981). Searle (1988) estimated thatin 1988 there was a vacancy rate of 13.8% for critical carenursing positions in the United States. Furthermore, theannual turnover rate of critical care nurses was 23%, whilethe number of critical care beds was increasing (Searle,1988).The Canadian literature has little documentationregarding the supply and demand for critical care nurses.Critical care areas account for a large proportion ofregistered nurses in hospitals. Of the 21,012 registerednurses performing direct patient care, 29.6% are criticalcare nurses (Health Manpower Research Unit, 1989). Further,39% of all nurses employed within an acute care agencyconsist of critical care nurses (Registered NursesAssociation of British Columbia, 1989).3A survey of British Columbia hospitals found the averageannual turnover to be 32% of the registered nursingpositions (Health Services Research and Development, 1984).The vacancies reported by health care agencies in BritishColumbia averaged about 460/month, 30 percent from criticalcare (Registered Nurses Association of British Columbia,1988b). Another British Columbia study found that criticalcare areas have some of the highest number of difficult tofill vacancies in nursing (Health Manpower Research Unit,1988b). The Ministry of Health in British Columbia spent566,900 dollars to train additional nurses for understaffedcritical care settings in 1988 (Registered NursesAssociation of British Columbia, 1988b).Turnover has significant cost implications. There areexpenses due to the many costs incurred in recruiting andtraining replacement employees (Lawler, 1973). Theestimated cost of replacing a registered nurse ranged from3,000 dollars to one half of the first year's salary (BGIManagement Consultants, 1981).Many surveys in both Canada and the United States showthat staff nurse turnover rates are correlated with jobdissatisfaction (Canadian Nurses Association/CanadianHospital Association, 1990; Godfrey,1978a, b, c; Huckabay &Jagla, 1979; Huey & Hartley, 1988; Mendenhall, 1982;Wandelt, Pierce & Widdowson, 1981). In general, hospitalsseem to be less satisfying places to work, and nursing4discontent manifests itself with job dissatisfaction andturnover (Health Manpower Research Unit, 1988b). However,studies of intensive care nurses found inconsistent resultsregarding levels of job satisfaction and turnover whencompared to general duty nurses (Jacobson, 1983; McCloskey,1974; Nichols, Springford, & Searle, 1981; Wakefield, Curry,Price, Mueller, & McCloskey, 1988; Williams, 1990).In the light of high vacancy rates, high turnover rates,and the inconclusive results of research with respect to therelationship between turnover of critical care nurses andjob satisfaction, it seems prudent to focus research on whatsatisfies critical care nurses. One approach to this areaof study involves the area of work redesign. This methodexamines the various factors, such as autonomy and feedback,which lead to job satisfaction (Hackman & Oldham, 1980) aswell as general job satisfaction itself (Brayfield & Rothe,1951). By understanding which job factors correlatesignificantly to job satisfaction, job enrichment orredesign can be accomplished to yield increased jobsatisfaction.Problem StatementIn British Columbia, almost 30% of patient care nursesare critical care nurses (Registered Nurses Association ofBritish Columbia, 1988). Studies have revealed that thereare numerous staff vacancies as well as high turnover rates5in critical care areas. These positions are among thehighest in the "difficult to fill" vacancies. There arelimited Canadian studies on nurse job satisfaction; nonewere found focusing on critical care nurses. Comparinglevels of general job satisfaction with certain job factorswill assist in identifying what the significant jobcharacteristics are. The identification of these factorswill also assist in redesigning aspects of the job ofnursing thus promoting satisfaction, and consequentlyimprove productivity and retention.Conceptual FrameworkThe conceptual framework for this study is the JobCharacteristics Model of Hackman and Oldham (1980). Thebackground to the model stems from Herzberg's (1966)motivation-hygiene theory explaining job satisfaction.Herzberg's (1966) motivation-hygiene theory is based on thenotion that two distinct sets of factors affect a person atwork. These factors, satisfiers and dissatisfiers, are notseen as opposites but distinct affective states resultingfrom different employment factors.Herzberg's (1966) satisfiers are the challenging aspectsof the work itself and the opportunities for personalgrowth. They include the opportunity for advancement andachievement, recognition, and respect received in one's workrole. These intrinsic factors have the ability to motivate6people and contribute to job satisfaction.The dissatisfiers identified by Herzberg (1966) are pay,quality of supervision, working conditions, humanrelationships, and company policy and administration. Thesevariables are considered the extrinsic or hygiene factors.While satisfying these hygiene factors will not increase jobsatisfaction, their dissatisfaction with these factors aretheorized to cause frustration. The key to making a jobsatisfying is not simply eliminating the dissatisfiers, butalso providing satisfiers. Herzberg (1966) points to thedifference between these two sets of factors, whose themesare job content and the environment.Hackman and Oldham (1980) added two dimensions toHerzberg's theory. These concepts are: 1) individualdifferences with respect to job responses; and 2)quantification with respect to both the motivationalpotential of a particular job and the growth needs of theindividual performing that job. The merging of these ideasresulted in the Job Characteristics Model which sees corejob dimensions, critical psychological states, and personaland work outcomes in a causal relationship (Figure 1).7Figure 1Job Characteristics. ModelCORE JOB^CRITICAL PSYCHOLOGICAL^PERSONAL ANDDIMENSIONS STATES^ WORK OUTCOMESskill variety^experienced^high internaltask identity >>>^meaningfulness^work motivationtask significance of the workautonomyfeedbackA>>>^experiencedresponsibility^>>>for outcomes ofthe work>>>^knowledge of theactual results ofwork activitiesMODERATORShigh "growth"satisfactionhigh generaljobsatisfactionhigh workeffectivenessEmployee Growth Need StrengthKnowledge and SkillContext SatisfactionsHackman & Oldham, 1980, p.90.According to Hackman and Oldham (1980), this modelattempts to specify conditions under which individuals willbecome internally motivated to perform their jobseffectively. The focus of this model is on the interactionamong four groups of variables: the psychological statesthat must be present for internally motivated work behaviourto develop, the job dimensions that can create these states,the moderators or attributes of individuals which determinehow positively the person will respond to the job, and8personal and work outcomes. In general, the core jobdimensions prompt the critical psychological states which,in turn, lead to personal and work outcomes. The linksbetween these three dimensions are individual attributeswhich include individual growth need strength, knowledge andskill, and context satisfactions.Each group of variables in the Job Characteristics Modelwill now be described in more detail. The initial set ofvariables include the core job dimensions (Hackman & Oldham,1980):1. skill variety. The degree to which a job requires avariety of different activities in carrying out thework,involving the use of a number of different skillsand talents of the person (p.78).2. task identity. The degree to which a job requires acompletion of a "whole" and identifiable piece of work,that is, doing a job from beginning to end with a visibleoutcome (p.78).3. task significance. The degree to which the job has asubstantial impact on the lives of other people, whetherthose people are in the immediate organization or in theworld at large (p.79).4. autonomy. The degree to which the job providessubstantial freedom, independence, and discretion tothe individual in scheduling the work and indetermining the procedures to be used in carrying it9out (p.79).5. job feedback. The degree to which carrying out thework activities required by the job provides theindividual with direct and clear information about theeffectiveness of his or her performance (p.80).The five core job dimensions are used to determine theoverall motivating potential of a job, which prompt internalwork motivation on the part of job incumbents (Hackman &Oldham). The measure to determine the motivating potentialscore (MPS) was formulated by Hackman and Oldham (1980) asfollows:Figure 2Motivating^skill + task + taskPotential = variety identity signif X autonomy X jobScore (MPS) 3^ feedbackThe second set of variables is the critical psychologicalstates. These states are considered the major thrust of themodel. The critical psychological states refer to thepositive effects experienced when the individual learns thathe/she personally performed a meaningful task well.Hackman and Oldham (1980) define these states as follows:1. Experienced meaningfulness of the work. The degree1 0to which the individual experiences the job as onewhich is generally meaningful, valuable and worthwhile(p.256).2. Experienced responsibility for work outcomes. Thedegree to which the individual feels personallyaccountable and responsible for the results of the workhe or she does (p.256).3. Knowledge of results. The degree to which theindividual knows and understands, on a continuousbasis, how effectively he or she is performing the job(p.257).The third set of variables in this model is themoderators. These variables are the effect that theindividual's attributes have on a job.The first variable includes knowledge and skill. Forjobs high in motivating potential, people who havesufficient knowledge and skill to perform well willexperience much satisfaction from doing well. Those who arenot competent enough to perform well will experience a gooddeal of dissatisfaction from doing poorly. Conversely, forjobs low in motivating potential, the internal motivationwill be low, and personal satisfaction will not be affectedby how well one performs (Hackman & Oldham, 1980).The second variable relates to growth need strength.This variable measures how the individual reacts to theirwork. The premise is that an individual will respond more11positively to a job high in motivating potential if theyhave a high need for personal growth and development, thanan employee with a low growth need strength (Hackman &Oldham, 1976).Context satisfactions is the last variable in thissection. It deals with how satisfied individuals are withthe work conditions. This may affect their willingness orability to take advantage of the opportunities for personalaccomplishment provided by the job (Hackman & Oldham, 1980).The final set of variables presented in the JobCharacteristics Model is personal and work outcomes. Thesevariables include high internal work motivation, high"growth" satisfaction, high general job satisfaction, andhigh work effectiveness (Hackman & Oldham, 1980).Purpose of the StudyThe purpose of this study was to assess the level ofgeneral job satisfaction among critical care nurses. Therelationship among general job satisfaction, motivatingpotential, critical psychological states, and contextsatisfactions were also investigated. Finally, therelationships between general job satisfaction and personaland professional characteristics of critical care nurseswere examined.12Research Questions1. What is the level of general job satisfaction incritical care nurses?2. What is the relationship between general job satisfactionand the following variables: motivating potential,critical psychological states, and context jobsatisfactions?3. What is the relationship between general jobsatisfaction and selected personal and professionalcharacteristics of critical care nurses?Definition of TermsContext Job Satisfactions- the evaluation of conditions ofone's job, not the job itself. These include jobsecurity, pay, coworkers, and supervision (Hackman &Oldham, 1980).Critical Care Unit- a specialized unit which has been formedfor the patient population with a variety of lifethreatening illnesses or conditions. Examples includepatients in coronary care, emergency, and transplantunits, or medical/surgical, neonatal, neurological, andpediatric intensive care units within a hospital.13Critical Care Nurse- diploma or baccalaureate graduate nurseemployed at one of the above mentioned critical careunits.Critical Psychological States- the states created by thepresence of core job dimensions. These includeexperienced meaningfulness of work, experiencedresponsibility for outcomes of work, and knowledge of theactual results of work activities (Hackman & Oldham,1975, p.162).General Job Satisfaction- an overall measure of the degreeto which the employee is satisfied and happy with the job(Hackman & Oldham, 1975, p.162).Motivating Potential- the overall potential of a job toprompt internal work motivation on the part of jobincumbents as seen by the mathematical compilation of thecore job dimensions (Hackman & Oldham, 1976, p.258).Personal and Professional Characteristics of the Nurse-Characteristics include educational preparation, lengthof nursing experience in years, maturity in age,employment tenure, employment status, and area ofpractice.14Assumptions1. Registration information from the Registered NursesAssociation of British Columbia will accurately identifythose nurses currently employed in critical care areas inBritish Columbia.2. Subjects will provide frank and honest information tothe study questions.Limitations1. Organizational philosophies and practices of theparticipating hospitals are not considered.2. Subjects may not answer all of the questions on thequestionnaires.3. There are additional extraneous variables affecting jobsatisfaction, such as life situations, which are beyondthe scope of the study and are therefore not addressed.Significance of the StudyThe significance of this study for the nursing professionis to provide some insight into job satisfaction of criticalcare nurses. Practical solutions to enhance jobsatisfaction may result when correlating job characteristicsto job satisfaction. Using standardized measurement tools,various aspects of the job of critical care nursing areassessed. By studying job characteristics, identifyingaspects of the working conditions which contribute towards15both job satisfaction and lack of satisfaction will helpenhance nursing's knowledge base. This knowledge could beuseful in augmenting work through redesign to allow forincrease in job satisfaction. With increased jobsatisfaction, one may assume, according to the theory, thatthere would be an improvement in retention, recruitment, aswell as increase the motivation of all critical care nurses.16Chapter TwoLiterature ReviewIn order to understand job satisfaction in nursing, themain theories regarding job satisfaction will be explored.General job satisfaction will be discussed in order toascertain how individuals in various occupational categoriesview their respective levels of job satisfaction. Finally,job satisfaction will be examined within the field ofnursing to enable comparisons with different job classes aswell as understand the significant job related factorsspecific to nursing. Much of the original work on the firsttwo of these sections is from the 1940's through to the1970's and provides the basis for current thinking in thefield.Theories of Job Satisfaction Campbell, Dunnette, Lawler, and Weik (1970) dividedtheories of job satisfaction into two categories, contentand process theories.Content Theories Content theories account for the needs, values orexpectations which are important to individuals ininfluencing their job satisfaction (Gruneberg, 1979).Maslow's (1943) Needs Hierarchy Theory and its development17by Herzberg into the Two-Factor Theory of job satisfactionare the best known examples of this category.Maslow (1954) outlined a theory of human motivation whichhas been applied to work motivation. Maslow postulated thatman has five hierarchical need classes. In ascending orderthese needs are physiological, safety and security, social,esteem, and self-actualization. Only when lower order needsare satisfied, at least in part, will higher-level needsemerge.In applying this theory to work, many organizations meetthe physiological, safety and security, and social needs ofemployees through company policy and benefit packages.Therefore, they are no longer strong motivating forces.Needs such as recognition, status, and the opportunity forcreative expression then become of greater importance(Wassenaar, 1974).Herzberg, Mausner, and Snydermann (1959) developed theTwo-Factor theory which identified components of jobsatisfaction and dissatisfaction. These phenomena representtwo mutually exclusive domains, not existing as oppositeends of a bipolar continuum.Essentially, Herzberg's two categories compressed thefive level need hierarchy of Maslow (Munson & Heda, 1974).The motivators parallel Maslow's higher level needs, and thehygiene factors correspond to the lower level needs.Herzberg et al. (1959) postulate that since the hygiene18factors are related to basic needs they do not allow forpsychological growth and therefore do not fulfil employeeneeds relevant to job satisfaction.The motivators or intrinsic factors reflectingsatisfaction include achievement, recognition, the workitself, responsibility, and advancements. The hygiene orextrinsic factors indicating dissatisfaction, reflect theenvironment. These include company policy andadministration, supervision, salary, relationship with co-workers, and work conditions.Process Theories In contrast to the content theories, process theoriesspecify the types of variables (needs, values, andexpectations) causally relevant to work motivation, andexplain how these variables combine to determine overalllevels of job satisfaction (Locke, 1976). The expectancy,equity, and discrepancy theories are three of the mostpopular theories which fall into this category.Vroom's (1964) work on expectancy involves indirectmeasurement of focusing on variables that are assumed to beoutcomes of job satisfaction. He proposes that individualchoices of work behaviour are related to the value theyplace on the accompanying work-related rewards. Vroom(1970) contends that people compare the level of reward theyreceive with what they expect to receive as a result of19their occupancy of a work role. Satisfaction occurs whenthe actual reward equals or exceeds expectations and isdesired by the individual. However, if the reward is lessthan expected, or the person is indifferent to orexperiences aversion to the outcome, dissatisfactionresults. Negative worker attitudes result if the amount of avalued outcome is less than that received by a comparableother, or if the outcome is not valued.While expectancy theory incorporates job characteristics,equity theory centres on personal and organizationalvariables. Adams (1963) proposes that a major influence onjob performance and satisfaction exists in the degree ofequity that people perceive in their job. A state ofinequity exists when an individual perceives that the ratioof his job outcome to job inputs, in comparison with areference person's outcomes to inputs, is unequal. Inessence, the degree of job satisfaction is determined by thesimilarity between an individual's expectations and therewards offered by the job. The theory stresses thatexcessive reward causes feelings of guilt, while low rewardcauses feelings of unfair treatment (Lawler, 1973).Discrepancy theorists feel that satisfaction is"determined by the differences between the actual outcomes aperson receives and some other outcome level" (Lawler, 1973,p.66). In one example of this type of theory, Locke (1969,p.316) believes that "job satisfaction and dissatisfaction20are a function of the perceived relationship between whatone wants from one's job and what one perceives it isoffering". Locke emphasizes that the perceived discrepancy,not actual discrepancy, is the important feature determininggratification.In summary, there are two basic theoretical orientationsto the study of job satisfaction. The content theoriesidentify specific factors which can motivate employees. Onemajor criticism is that the importance of individualdifferences in expectations is not addressed with regards tosatisfaction (Gruneberg, 1979). Process theories attempt toexplain the cognitive variables and how they relate to workmotivation. However, a criticism here is that the researchdeals with job satisfaction as something static, not adynamic interaction between the individual and theenvironment (Gruneberg, 1979). Whatever the approachutilized, it appears that job satisfaction involves matchingindividual needs to the job environment.Job Satisfaction in Related Fields The research on the determinants of job satisfaction haslooked primarily at two relationships. These relationshipsare between satisfaction and the characteristics of the job,or satisfaction and the characteristics of the person(Lawler, 1973). The research shows that satisfaction isrelated to both the person and the environment (Lawler,211973).Originally, much of the interest in the study of jobsatisfaction was motivated by the assumption that itinfluenced performance. However, Vroom (1964) showed thatstudies had not found a strong relationship between the twovariables. At best, there was a very low positiverelationship. Better job performers were only slightly moresatisfied than poor performers.Srivastva et al. (1975), performed an extensiveliterature review on job satisfaction and productivity, andthe factors that influence these variables. The importanceof intrinsic motivation, of autonomy in work settings,organizational climate, democratic and supportivesupervisory style to job satisfaction was stressed.There has been a demonstrated inverse relationshipbetween satisfaction and turnover. There have been manycomprehensive reviews documenting this relationship(Brayfield & Crockett, 1955; Mobley, Griffeth, Hand, &Meglino, 1979; Porter & Steers, 1973; Vroom, 1964).In a multivariate analysis of age, education, job tenure,salary, job characteristics, and job satisfaction (Lee &Wilbur, 1985), it was found that job satisfaction increasedwith age. Younger employees were less satisfied overallwith their jobs while older employees were more satisfiedwith the extrinsic characteristics of the work. Age hasbeen shown to be related to job satisfaction in other22studies as well (Gibson & Klein, 1970; Herzberg, Mausner,Peterson & Capwell, 1957; Hulin & Smith, 1965; Rhodes,1983).Job Satisfaction in NursingJob satisfaction of nurses has been studied for sometime. Godfrey (1978) surveyed 17,000 nurses in Canada andthe United States. Responses indicated that jobsatisfaction was associated with opportunities forprofessional growth such as challenging work, the authorityto carry out that work, recognition and feedback, andadministrative support. Other studies showed similarfindings in nursing staff (McCloskey, 1974; Larson, Lee,Brown, & Shorr, 1984). In a survey of 3,500 nurses, Hueyand Hartley (1988) identified competent registered nursingstaff and authority to exercise nursing judgement in patientcare was associated with job satisfaction. In a review ofthe relevant literature, Jenny (1982) found that generalcategories contributing to job satisfaction were personnelpolicies, organizational climate, and nursing roles andfunctions.Roedel and Nystrom (1988) compared job satisfaction wtihjob characteristics as measured by the Job Diagnostic Survey(Hackman & Oldham, 1980) in 135 registered nurses. Whencomparing nurses' scores for job characteristics with thenormative data collected by Oldham, Hackman, and Stepina23(1976) they found the study nurses reported significantlyhigher skill variety and task significance, but lower taskidentity. Further, the ranking of both the study andnormative group from highest to lowest was satisfaction withcoworkers, supervision, the work itself, pay, andpromotional opportunities.Walker (1989) conducted a correlational study, using theJob Diagnostic Survey (Hackman & Oldham, 1980), on a sampleof 96 full time nurses in acute care hospitals in BritishColumbia. While the sample size was small for the number ofvariables, results indicated the nurses perceived their jobsrich in task significance, dealing with others, and skillvariety. They felt the job was poor in task identity andautonomy. The nurses in the study were less satisfied withthe general satisfaction, autonomy, and motivating potentialof their job when compared to other professionals.Studies focusing on job dissatisfaction have also beenconducted. Benton and White (1972) surveyed 565 nurses whofound the highest ranked job deficiencies to be lack of paydifferential for experience, inadequate personnel per shift,and lack of in-service training programs. Larson, et al.(1984) found factors related to employment issues such assalary and staffing, as least satisfying. Wandelt, Pierce,& Widdowson (1981) surveyed 3,500 Texas nurses to identifyfactors associated with nurse unemployment. A rank-order ofthe top 10 factors leading to dissatisfaction included24inadequate salaries, paperwork, inadequate administrativesupport, and insufficient opportunity for continuingeducation. Finally, Prescott and Bowen (1987) studied jobreactions and employment behaviours in over 1,000 staffnurses. Rank ordering of the results found inflexiblescheduling and insufficient administrative support as themost frequent reasons cited for terminating employment. Theprimary reasons for staying were a feeling of belongingnesswithin the organization and supportive relationships withadministrators and coworkers.The Canadian Nurses Association/Canadian HospitalAssociation (1990) compiled a review of 23 studies of nurseretention and quality of work life reports from acrossCanada. They found that the factors important in retentionwere: 1) work environment issues such as staffing, workloadstructure, non-nursing functions, scheduling, stafforientations, internships, and preceptorships; 2) educationin the use of technology, clinical and technical expertise,career opportunities; and 3) compensation in pay andbenefits.Researchers have compared job satisfaction within nursingto that of other professionals. Wright, McGill, and Collins(1990) compared a group of nurses with elementary schoolteachers and accountants, and found the three groups ratedmany aspects of their jobs similarly. However, nursesreported lower levels of satisfaction in salary and25opportunity for administrative participation when comparedwith accountants, and lower levels of satisfaction with jobsecurity when compared with teachers.Many studies found no significant correlation betweenpersonal and professional characteristics of the nurse andjob satisfaction (Sanger, Richardson, & Larson, 1985;Simpson, 1985). However, some studies have found significantresults. A survey of more than 2500 B.C. registered nursesfound a direct and indirect relationship between the levelsof job satisfaction and dissatisfaction to three types ofeducational preparation (Registered Nurses Association ofBritish Columbia, 1988a). The mixed findings suggest thatthere may be unexplored variables that must be assessed whencomparing satisfaction with educational preparation. Avariable such as job expectations could affect howbaccalaureate educated nurses view a job as compared todiploma educated nurses.Seybolt (1986) surveyed levels of job satisfaction usingthe Job Diagnostic Survey (Hackman & Oldham, 1980) andcompared 647 staff nurses according to length of tenure. Hefound that different job design variables were important tojob satisfaction when comparing length of tenure. In newentrants (less than 6 months) the critical factor to jobsatisfaction was feedback. Early career nurses (6 months to1 year) found performance-outcome links important. Mid-career nurses (1 to 3 years) indicated that autonomy and26role clarity were crucial. Advanced career nurses (3 to 6years) chose task significance and job feedback as criticalfactors, while later career nurses (over 6 years) desiredsupervisory feedback and role agreement. Turnoverintentions were highest for the early career nursesdecreasing with tenure, the exception being the entry levelnurse, whose turnover intentions were second lowest.Wetzel, Soloshy, and Gallagher (1990) studied the workattitudes of full time and part time registered nurses.They found there was no significant difference in the twogroups when measuring extrinsic or intrinsic jobsatisfactions. The only differences found between the twogroups were the full time nurses worked a greater number ofhours and claimed to have more job involvement.The relationship between job satisfaction and turnoverhas been documented (Mobley et al., 1978; Redfern, 1980).Further, the relationship between absenteeism andsatisfaction has been studied and confirmed within nursing.Myrtle and Robertson (1979) found that a high absenteeismrate within a nursing unit is related to deficiencies ineither the organizational climate, the work team, or thework content.Within the literature regarding critical care nurses,little was found regarding job satisfaction alone. Manystudies have found that both critical care and general staffnurses demonstrate low to moderate job satisfaction, with no2 7difference between the two groups (Nichols, Springford, &Searle, 1981; Williams, 1990).In contrast to the above studies, Joiner, Johnson,Chapman, and Corkrean (1982) found that there weredifferences in aspects of job satisfaction when comparingcritical care with ward nurses. The study looked atmotivating potentials of nurses as measured by Hackman &Oldham (1980). The motivating potential score for the studygroup was higher than all other job categories reported byHackman and Oldham. Overall, these nurses found their jobshigh in task significance and low in task identity whencompared to other professional jobs. This study went onfurther to study different groups of nurses includingcoronary care as well as many types of wards. The coronarycare nurses showed the highest motivating potential score.This was attributed to the high degree of task significanceand autonomy reported by this subgroup of nurses.Dear, Weisman, Alexander, and Chase (1982) utilized theJob Descriptive Index to compare job satisfaction andturnover between intensive care nurses and ward nurses.Results from the study suggest that it is not the intensivecare work per se that influences job satisfaction andturnover, but rather the personal factors of nurses and theorganizational climate of the institution. A survey of 567critical care nurses revealed that 62% of the staff nurserespondents had considered leaving critical care nursing28because of high levels of job dissatisfaction (Alspach,1987). The job dissatisfaction was due to stress,understaffing, work schedules, and low salary.Volk and Lucas (1991) studied the relationship ofmanagement style and anticipated turnover. The findingsfrom this study indicated that as nurses experiencedparticipative management style, they were less likely toanticipate leaving their critical care positions.Professional characteristics may play a role in jobsatisfaction within the realm of critical care as well. Ina study of critical care nurse preceptors, Bizek and Oermann(1990) found differences in job satisfaction related to thetype of unit in which the nurse worked, with emergency andintermediate care employees being more satisfied thanintensive care employees. Job satisfaction was inverselyrelated to tenure, and positively related to institutionalsupport for all nurses.SummaryIn this chapter, pertinent literature to job satisfactionhas been reviewed. Initially, the two main schools oftheories were discussed. Then general literature regardingjob satisfaction was surveyed. Finally, literature on jobsatisfaction within the field of nursing was examined.The factors contributing to job satisfaction ordissatisfaction appear to be diverse. When comparing and29combining themes within nursing, components frequentlyassociated with job satisfaction include those which promoteprofessional growth such as autonomy, recognition feedback,and supportive management. The components frequentlyassociated with job dissatisfaction include those relatingto the work environment such as inflexible scheduling, pay,interprofessional relationships, and poor administrativesupport.Personal and professional factors contributing to jobsatisfaction are still in the formative stages. Themajority of studies have failed to identify a relationshipbetween these factors and job satisfaction. However,correlations between nursing experience and employmenttenure with job satisfaction have been significant.Based on the literature review, the use of the JobCharacteristics Model (Hackman & Oldham, 1980) may assist inthe examination of job satisfaction in critical care nurses.The conceptual model looks at job satisfaction through therelationship of the person and job, and the significantvariables leading to general job satisfaction. Through theuse of the Job Diagnostic Survey (Hackman & Oldham, 1980),these significant variables can be measured and correlatedwith general job satisfaction (Brayfield & Rothe, 1951).The resulting information could be useful to administrationin designing critical care nursing jobs to enhance jobsatisfaction.30Chapter ThreeMethodsThis chapter includes a description of the researchmethods used and the specific procedures followed in thestudy.Research DesignThis descriptive correlational design used threestructured questionnaires for this study.Subject Sample A simple random sample of 300 subjects from the targetpopulation of 3,469 critical care nurses in British Columbia(Health Human Resources Unit, 1990) was used for the study.A list of registered nurses who fit the selection criteriawas produced by the Registered Nurses Association of BritishColumbia. The sample size was determined by the number ofvariables to be studied. In this study, the six variablesof motivating potential (a combination of the five core jobdimensions), experienced meaningfulness of the work,experienced responsibility for outcomes of the work,knowledge of the actual results of work activities, generaljob satisfaction, and context job satisfactions wereaddressed. Therefore, using Tabachnick and Fidell's (1983)rule of thumb of 20 participants per variable studied, 12031participants were needed. Assuming a return rate ofapproximately 40 percent and that several respondents whono longer met the inclusion criteria would have to beremoved, a mail out size was determined to be 300 subjects.Subject Selection Criteria Nurses who are:1. currently registered with the Registered NursesAssociation of British Columbia (RNABC); and2. currently employed in critical care units withinhospitals in British Columbia.Data Collection Procedure The questionnaires, subject information sheet,introduction letter, and postage paid return envelope weremailed to each selected subject. These packages were mailedfrom the RNABC in order to maintain anonymity, with thereturn mail sent to the researcher. While it was intendedthat reminder cards would be sent to those subjects who hadyet to return their questionnaires, the number of returnsmade this step unnecessary.Instruments Three instruments were mailed to the subject sample.These included the Job Diagnostic Survey (Hackman & Oldham,1980; Appendix A), the Index of Job Satisfaction (Brayfield32& Rothe, 1951; Appendix B), and the Nurse CharacteristicsQuestionnaire developed by the researcher (Appendix C).The Job Diagnostic SurveyThe Job Diagnostic Survey (JDS) was used to measure thefollowing variables: motivating potential; criticalpsychological states, which include experiencedmeaningfulness of the work, experienced responsibility foroutcomes of the work, and knowledge of the actual results ofwork activities; and context job satisfactions. Althoughvariables consist of only five of the 19 variables in theJDS, the instrument will be described in its entirety.The JDS is a data collection tool comprised of 83 itemsusing a Likert-type 7-point scale from low to high. The JDSprovides measures of variables relating to: a) core jobdimensions (combined to form motivating potential);b) critical psychological states resulting from thesedimensions; c) personal and work outcomes of employees tothe job and work setting; d) employee growth need strength;e) context job satisfactions.The JDS was developed over a two year period whichinvolved testing and revision. Empirical testing involvedapplication with over 1500 individuals working in more than100 jobs in approximately 15 organizations. The scales haveinternal consistency reliabilities that range from a high of.88 (growth need strength) to a low of .58 (task identity33and dealing with others). The results suggest that theinternal consistency reliability and discriminant validityof the items are satisfactory (Hackman & Oldham, 1975).Further testing involved 6930 subjects in 876 jobs from 56organizations which resulted in similar reports regardingthe instrument. Normative data for several job familieswere also developed using the JDS (Oldham, Hackman, &Stepina, 1979). Subsequent meta-analysis of the relation ofjob characteristics to job satisfaction showed a correlationbetween job characteristics and satisfaction to be .68 forpersons who are high on Growth Need Strength (GNS), and .38for those low on GNS (Loher & Noe, 1985).There are several cautions noted by Hackman and Oldham(1980). The job characteristics are not independent of oneanother. The validity of some JDS scales remainunestablished. The context satisfactions have few items andare meant only as a check of satisfaction in selectedaspects of the work environment. The evidence of validityof the growth need strength subscale is scattered andinconsistent.Index of Job SatisfactionThe second instrument used in this study to measuregeneral job satisfaction was the Index of Job Satisfaction(IJS, Brayfield & Rothe, 1951). The decision to use the IJSto assess this variable was made due to the limited number3 4of items assessing general job satisfaction in the JDS.While the JDS does assess general job satisfaction, thereare only five items assessing this variable, two whichdiscuss quitting. The IJS is an 18 item questionnaire whichutilizes a 7-point Likert-type scale from low of 1 to a highof 7. The score is calculated by summing the ratings fromthe 18 items.The construction of the IJS scale consisted of refiningjob satisfaction items developed by a group of students.Testing and retesting of the statements were then performedon two groups of workers. Finally, the IJS was administeredto a total of 322 employees at two separate times (Brayfield& Rothe, 1951).The reliability of the scale was computed by using theodd-even product moment reliability coefficient (.77), whencorrected by Spearman-Brown was .87. The validity of theitems were assessed by "face value" of 77 judges. Acomparison was made between the mean scores of a group of"satisfied" and "unsatisfied" students. Using the Fisherand Behrens' d-test, the difference between the means wasfound to be significant. Finally, the IJS was compared tothe job satisfaction index developed by Hoppock inthe early1930's. The product-moment correlation between scores onthe Hoppock questionnaire and on the IJS was .92.For the purpose of analyzing the findings from presentstudy, since Brayfield and Rothe (1951) did not discuss the35reverse coding of items a Principle Components Analysis withVarimax Rotation was performed on all 18 items. Themajority of the items loaded on the first factor eithernegatively or positively. Three items, numbers 40, 48, and49, loaded on another factor and were excluded. A furtheritem, number 55, appeared on all factors and was likewiseexcluded. Of the revised scale, an alpha coefficient of0.82 was determined (see Appendix E).Nurse Characteristics Ouestionnaire The third tool, the Nurse Characteristics Questionnaire(Appendix C) was developed by the researcher. This subjectinformation sheet included information on educationalpreparation, length of nursing experience in years,employment tenure, employment status, maturity in age, andarea of clinical practice. Upon the return of thequestionnaires it was noted that the "other" category wasfrequenty used in area of practice section. To moreaccurately reflect the respondents information for thepurpose of analysis, the groupings were changed toMedical/Surgical Intensive Care Unit, Coronary Care Unit,Intensive Care/Coronary Care Combined Unit, Emergency, andother.Data AnalysisData were analyzed using the computer program SYSTAT/PC36Version 5.1. Descriptive statistics included means andstandard deviations of all variables; percentages were alsoobtained for the nurse characteristics.Pearson product moment correlations were performed todetermine the magnitude and direction of the relationshipsof the six main variables including general jobsatisfaction, the critical psychological states (experiencedmeaningfulness of the work, experienced responsibilities foroutcomes of the work, knowledge of the actual results of thework activities), motivating potential, and contextsatisfactions. Multiple regression was used to determinethe extent, direction and strength of relationship betweenthese five key variables (predictors) and general jobsatisfaction (dependent). The level of significance was setat alpha = 0.05 for all tests.Finally, statistical tests were used to determinewhether the nurse characteristics were correlated withgeneral job satisfaction. Pearson product momentcorrelations were performed on maturity, years of nursingexperience, and general job satisfaction. Analysis ofcovariance using years of nursing experience as thecovariate, was used to assess whether general jobsatisfaction differed depending on education preparation,employment tenure, area of practice, or employment status.Nursing experience was used as a covariate because generaljob satisfaction and nursing experience showed a significant37positive relationship.Protection of Human Rights Protection of human rights was addressed in several ways.The proposal received approval from the University ofBritish Columbia Behavioural Sciences Screening Committeefor Research and Other Studies Involving Human Subjects.Second, the RNABC produced the randomized sample, issued acode number to ensure subjects' anonymity, and mailed outthe survey packages. Third, subjects were assured that theywere under no obligation to participate through the use ofan information letter. Subjects were also assured of thevoluntary nature of their participation, the confidentialityof their responses, the importance of their participation inthe study, as well as ability to access further information(Appendix D).SummaryThis descriptive survey used a correlational researchdesign. The instruments used included the Job DiagnosticSurvey (Hackman & Oldham, 1980), the Index of JobSatisfaction (Brayfield & Rothe, 1951), and the NurseCharacteristics Questionnaire. Data analysis of the 127usable questionnaires included descriptive statistics,Pearson product moment correlations, multiple regression,and ANOCOVAs.38Chapter FourResults and DiscussionThe results of this study are presented in thefollowing four sections. The first section presents adescription of the sample of critical care nurses. Thesecond section presents the findings which answer theresearch questions. The third section compares the studydata to other nursing research in the literature. The finalsection compares the study data to normative data providedby Hackman and Oldham (1980).Description of the SampleA total of 300 survey packages were mailed to currentlyemployed critical care nurses within British Columbia. Atotal of 134 (44.7%) of the packages were returned, of whichseven were excluded; one of the excluded packages was notfilled out, the other six did not meet inclusion criteria.A total of 127 (42.3%) questionnaires were used in theanalysis.Nurse Characteristics Data were collected on the nurse characteristics ofeducational preparation, years of nursing experience,maturity, employment tenure, area of practice, andemployment status.3 9Educational PreparationThe predominant educational preparation (40.9%) was adiploma in nursing and one or more post-basic courses. Thesecond most representative subgroup was a diploma educationexclusively (24.4%). Nurses with a baccalaureate degreepost-diploma certification consisted of 9.4% of the sample.The nurses with diploma education and some universitycourses towards a degree also consisted of 9.4% of thesample. Nurses with generic baccalaureate educationincluded 6.3% of the sample. Finally, the "other" subgroupincluded 9.4% of the nurses who did not fit in the abovecategories. The majority of this group included nurses witha diploma education and both post-basic and universitycourses, or with baccalaureate education and post-basiccourses.The educational profile for this sample is somewhatdifferent from nurses in Canada and British Columbia(Statistics Canada, 1990a). The category breakdown listedby Statistics Canada includes diploma education, diplomaeducation plus post-basic course certification,baccalaureate degree, master degree, or higher. Whencomparing the study group to national and provincial nurses,the study group's educational level is much higher. Of thestudy group, 40.9% had completed post-basic course work ascompared to 15.8% of Canadian hospital general duty nurses,and 33.8% for British Columbia. Only 33.8% of the study40population had a diploma certification as their highestlevel of education (combining the categories of diplomaeducation and diploma plus university course work) ascompared to 75.2% for Canada and 57.9% for B.C. Finally,the percentage of baccalaureate prepared nurses was alsohigher for the study group (15.7%) as compared to national(8.8%) and provincial (8.3%) statistics. Results arepresented on Figure 3.There are a few possible explanations for the discrepancyin level of education. Since the study group consists ofnurses in critical care areas, it is possible that a higherpercentage of this group would be motivated to attend post-basic courses as a prerequisite or corequisite ofemployment. An alternate reason is that most of the post-basic courses offered are within the critical care areas.The statistics used by Statistics Canada (1990a) include allpractising hospital employed general duty nurses.There are slightly different categories of education inthe Statistics Canada information. According to StatisticsCanada (1990a) only successfully completed post-basiccourses carrying a certificate or diploma are considered inthe "diploma and post-basic courses" category. In the studygroup, nurses with partial completion of post-basic coursework were included.MaccaIlaureate Degree1-1 Post Mask Dipllorna,R.N. DApIlorna41s6sFigure 3 - Educational Profiles of Nurses in Three Categories42Years of Nursing ExperienceNurses were asked to report the total number of yearsof nursing employment. The nurses of this group showed arange from two to 38 years, with a mean of 13 years, amedian of 12 years, and a standard deviation of 7.7 years.MaturityThe age range of nurses was from 24 to 63 years. Themean was 37 years, the median was 35 years, and the standarddeviation was 8.4 years.The results for the respondents showed a different agerange of nurses when compared to national and provincialfigures. The study sample was generally younger in age.Statistics Canada (1990b) reported that 18.6% of nursesemployed in Canada were were below age 30, 52.3% between theages of 30 and 44, and 19.9% over the age of 44. In BritishColumbia similar figures hold true; 15.1% of the nurses werebelow the age of 30, 51.5% between the ages of 30 and 44,and 33.3% above the age of 44. However, in the study group22% of the sample was below the age of 30, 63.8% in the 30to 44 year age group, and 14.2% above the age of 44. Thisindicates that the nurses in the study were younger, onaverage, than either the provincial or Canadian statistics.See Figure 4 for a comparison of results.30-55+M 50-5445-49Eg 40-4435-3930-34^ 25-29^ <254320-10 -0St1.16,1 essoIlipFigure 4 - Age Distribution of Nurses in Three Categories44Employment Tenure Following Seybolt's (1986) categories, employment tenurewas grouped into five time periods: less than 6 months, from6 months to 1 year, from 1 to 3 years, from 3 to 6 years,and over 6 years. The most represented group was nurseswith more than 6 years of tenure (37%). The second mostfrequently cited category was nurses with 1 to 3 yearstenure (30.7%). This was followed closely by the group with3 to 6 years tenure (26%). The lowest represented groupsincluded those nurses with 6 months to 1 year (4.7%) andless than 6 months (1.6%) respectively.The low number of respondents for the categories of lessthan 6 months and 6 months to 1 year may be that theinformation gathered by the Registered Nurses Association ofBritish Columbia (RNABC) which was used to obtain therandomized sample is updated on an annual basis at thebeginning of each year. Since this study was conducted inOctober, the data were eight months old. Therefore, it waslikely a coincidence that there were any respondents in theless than 6 months category. Furthermore, the category ofsix months to one year encompasses a much smaller time framewhen compared to the remaining categories, indicating alesser chance of respondents in the randomized sample.45Area of PracticeThe majority of nurses in this sample group (34.6%)practised in an Intensive Care Unit, including nursesworking in various types of Medical and/or SurgicalIntensive Care Units. The second highest group includednurses from the Emergency Unit (23.6%). IntensiveCare/Coronary Care Combined Units included 17.3% of thesample. The nurses working in Coronary Care Units consistedof 11.8% of the sample. Finally, 12.6% of the sampleincluded nurses who did not fit into the above categories.Examples of this group included nurses who worked in PostAnaesthetic Rooms or in multiple settings.Employment Status The largest percentage of respondents (49.6%) includednurses who were employed on a full time basis. The secondlargest group worked in a permanent part time position(35.4%). The casually employed nurses constituted 13.4% ofthe group. The "other" category (1.6%) included nursesemployed but currently on a leave of absence.The respondents' employment status resembles both thenational and provincial trends. Statistics Canada (1990b)documented the percentage of hospital employed nurses by thecategories of full time, part time, and not stated.Nationally, full time nurses contribute 58.1% of the hoursworked, part time nurses contribute 33.2% of the hours46worked. In British Columbia, full time nurses included57.6% of the total, part time nurses 31.5% of the group.When nurses in the study groups "casual" categories weredivided amongst the full time and part time nurses, thebreakdown was more consistent with the national andprovincial statistics. Changing the respondents' categoriesto correspond with those described in Statistics Canada(1990b), full time nurses included 54.3% of the totalsample, part time nurses constituted 44.1% of the total.Results are presented in Figure 5.IE Other^ Part TimeEI Full Time4760 -50-40-7:10q=, 30 -P-120--0IFigure 5 - Employment Status of Nruses in Three Categories48Research QuestionsResearch Question #1 What is the level of general job satisfaction incritical care nurses?In the revised Index of Job Satisfaction scale, theminimum possible satisfaction score is 14, and the maximumscore possible is 98. The mean general job satisfactionscore obtained by this sample was 68.11, with a standarddeviation of 10.59. Dividing the sample mean by the numberof items, the overall item mean was 4.87 out of a possiblescore of 7. The results suggest that the general jobsatisfaction of this sample of critical care nurses is abovethe median of 4 on the 7 point scale.Since the impetus for this study was the perceived lackof job satisfaction in the nursing literature and the highvacancy rates, it is interesting that the study nurses areabove the median in general job satisfaction scores. Themajority of nurses in this sample had over 6 years oftenure. Seybolt (1986) considers this group of nurses thepillars of the organization, and turnover is less likelythan at any other tenure time. Possibly, nurses with lowgeneral job satisfaction would have already found employmentelsewhere.49Research Question #2 What is the relationship between general jobsatisfaction and the following variables: motivatingpotential, critical psychological states, and context jobsatisfactions?Motivating Potential The mean scores of the five core job dimensions whichmake up the motivating potential vary from a mean high of6.03 to a mean low of 4.34 (Table 1). Task significanceshowed the highest mean score, which indicated the nursesquestioned felt that their work was very important and hadsubstantial impact on the lives of others. The secondhighest mean score was skill variety (5.79). This showedthat critical care nurses perceived their job as rich in theassortment of skills within the job. The next highest meanscore was autonomy (5.19), showing that nurses also felttheir job provided substantial freedom and independence.The lowest mean score was in the area of task identity(4.34) suggesting that the critical care nurses felt theyhad least satisfaction in breaking down their tasks intoidentifiable pieces with a visible outcome.The motivating potential of the study group wascalculated by a formula combining the core job dimensions(Figure 2). The mean score was 139, the standard deviation53.46. This score corresponds to 5.18 on the 7-point scale50used to measure all of the other variables.Table 1Means and Standard Deviations of Core Job DimensionsN=127 Mean SDSkill Variety 5.79 0.84Task Identity 4.34 1.14Task Significance 6.03 0.86Feedback from Job 4.87 1.03Autonomy 5.16 1.07Motivating 139.00 53.46PotentialNote: Rating scale ranges from 1 = low to 7 = highIn the case of Motivating Potential the lowestpossible score is 1, the highest is 343.Critical Psychological States The three critical psychological states of experiencedmeaningfulness of the work, experienced responsibility forthe outcomes of the work, and knowledge of the actualresults of work activities were all seen as important in thecritical care nurse's role (Table 2). The highest meanscore was in experienced meaningfulness of the work (5.86),which indicated that the nurses found their job important,valuable, and worthwhile. According to Hackman and Oldham(1980), the precursors to experienced meaningfulness of the51work are skill variety, task identity, and tasksignificance. When people engage in activities thatchallenge or stretch their skills and abilities, they willexperience the task as meaningful, and the more skillsinvolved, the more meaningful the work is likely to be(Hackman & Oldham, 1980). Likewise, when workers understandthat the work being done will have a substantial impact onthe physical or psychological well-being of other people, itwill be seen as meaningful. Clearly, when looking at theresults, nurses feel this way about the work of nursing.Table 2Means and Standard Deviations of Critical PsychologicalStatesN = 127 Mean SDMeaningfulnessof Work5.86 0.75Responsibility for 5.67 0.77Outcomes of WorkKnowledge of 5.21 0.91Results of WorkActivitiesNote: Rating scale ranges from 1 = low to 7 = high.52Context Satisfactions How satisfied workers are with the work context mayaffect their willingness or ability to take advantage of theopportunities for personal accomplishment provided byenriched work (Hackman & Oldham, 1980). The contextsatisfactions measured in this study included job security,pay, coworkers, and supervision. The highest mean score(5.61) was satisfaction with coworkers (Table 3). Thisindicates that the study nurses were appreciated by theircoworkers as people and as health care providers whenassessing the specific questionnaire items. This may impactthe satisfaction with the job as a whole, because some oftheir interpersonal needs are being met. Since nursing,particularly critical care nursing, involves many nursescaring for a relatively small number of patients, pleasantcollegial relationships are very important to the giving andreceiving of help.The lowest mean score in the entire study was in thearea of pay and fringe benefits (3.75). This indicates thenurses were least satisfied with the compensation aspect oftheir job. Pay was seen as the least satisfying aspect ofall the variables tested within the work of nursing. If notfeeling appropriately compensated, the critical care nurseswould be less willing to take advantage of the opportunitieswithin the job.53Table 3Means and Standard Deviations of Context SatisfactionsN = 127 Mean SDPay 3.75 1.52Security 4.97 1.59Co-workers 5.61 0.94Supervision 4.68 1.39Context 4.83 0.95SatisfactionsNote: Rating scale ranges from 1 = low to 7 = high.Pearson Product Moment Correlations Pearson product moment correlations were performed onthe six main study variables including motivating potential,the psychological states (experienced meaningfulness of thework, experienced responsibility for outcomes of the work,and knowledge of the actual results of the work activities),context satisfactions, and general job satisfaction (Table4). General job satisfaction correlated most strongly withexperienced meaningfulness of the work, context jobsatisfaction, and motivating potential. This suggests thatwhen nurses experience meaningfulness in their work, aresatisfied with the context satisfactions of pay,job security, coworkers, and supervision; and are internally54motivated with skill variety, task significance, and taskidentity, they are also more satisfied in their work.Further, nurses who feel their jobs have characteristicswhich are high in motivating potential, also seem to knowtheir performance level within the job itself. Finally,with experienced meaning in the work of nursing, therecoexists an inherent responsibility for the outcomes of thatwork.The weakest relationship was between experiencedresponsibility for the outcomes of the work and themotivating potential. This suggests the internal motivatingpotential of the core job characteristics have little effecton personal feelings of accountability for the job.55Table 4Pearson Product Moment Correlation Matrix1 2 3 4 5 6Motivating 1.000 0.375** 0.267* 0.471** 0.331** 0.419**PotentialMeaningfulnessof the Work1.000 0.465** 0.314** 0.347* 0.514**Responsibilityof the Work1.000 0.292** 0.272* 0.333**Knowledge ofthe Results1.000 0.335** 0.287**Context 1.000 0.458**SatisfactionsGeneral Job 1.000Satisfaction*p < .01**p < .001Multiple Regression Analysis A multiple regression analysis was performed todetermine which independent variables predicted general jobsatisfaction (Table 5). This approach examined the abilityof each independent variable to account for its uniquecontribution in predicting general job satisfaction afterall of the other independent variables had been partialedout of the equation. In this study, the strongest predictorof general job satisfaction was the experienced56meaningfulness of the work. Motivating potential andcontext satisfactions were also found to predict general jobsatisfaction. In total, 36% of the variance of general jobsatisfaction could be explained by the five independentvariables.Table 5Multiple Regression AnalysisPredicting General Job SatisfactionVariable DF T P(2 tail)Motivating 5 2.371 0.019*PotentialMeaningfulnessof the Work5 3.755 0.000**Responsibilityof the Work5 0.746 0.457Knowledgeof the Results5 -0.200 0.842Context 5 3.378 0.001**SatisfactionsAdjusted Squared Multiple R - 0.363*p < .01**p < .00157Research Ouestion #3 What is the relationship between personal andprofessional characteristics of critical care nurses andgeneral job satisfaction?Preliminary analysis was conducted on the nursecharacteristics to determine whether any significantcorrelations with general job satisfaction could be found.Pearson product moment correlations were performed betweengeneral job satisfaction, nursing experience, and age (Table6). Tabachnick and Fidell (1983) state that if a bivariatecorrelation is above .90 it suggests multicollinearity, andone of the two redundant variables must be deleted. Sincethe relationship between age and nursing experience was at.89 it was judged to suggest multicollinearity. Sincenursing experience was more strongly related to general jobsatisfaction, age was discarded. Experienced nurses likelyhave a greater knowledge base to work from, they mayperceive greater job satisfaction because they understandthe meaningfulness of their actions. Also, they may have agreater understanding of management concepts to rationalizethe functioning of the unit.Analysis of covariance using years of nursingexperience as the covariate, was performed on educationalpreparation, nursing tenure, area of practice, andemployment status to ascertain whether job satisfaction58differed according to these nurse characteristics. Nosignificant differences were seen. Sample sizes, means, andstandard deviations of the nurses characteristics are listedin Appendix F.Table 6Pearson Product Moment Correlation Matrix of General JobSatisfaction, Nurse Experience, and AgeJob SatisfactionNurse ExperienceAge11.00020.228**1.00030.227**0.887***1.000**p = .01***p = .00 (multicollinearity)Comparison of Study Sample with Other Studies The results of the present study support findings fromother studies measuring job characteristics within groups ofstaff nurses. In this survey, the highest mean scores ofcore job characteristics were found in the measures of tasksignificance and skill variety, the lowest in task identity.Joiner, Johnson, Chapman, and Corkrean (1982) reported thatthe staff nurses in their study showed highest scores inskill variety and task significance and lowest scores intask identity. When comparing the type of nursingassignment within their sample, Joiner et al. (1982) found59that the coronary care nurses had higher levels of autonomywhen compared to ward nurses. Similarly, Roedel and Nystrom(1988) and Walker (1990) found that their group of staffnurses had the highest mean scores in skill variety and tasksignificance, and the lowest mean score in task identity.When compared to nursing studies reported in the literature,the results from the present study found that these criticalcare nurses had the second lowest overall mean motivatingpotential score (139). Joiner et al. (1982) showed anoverall motivating potential mean of 155; the highest meanscore of 188 was found in the critical care group, thelowest being psychiatry nurses with a mean of 129. Roedeland Nystrom's (1988) study group of staff nurses showed amotivating potential mean score of 163. Walker (1990) foundthe staff nurses' motivating potential to have a mean of129.It was interesting that all the nursing studies foundtask significance and skill variety to have the highestscores, task identity the lowest as well. This finding wasconsistent, regardless of which area the nurses worked in.Therefore, it seems that nurses in all areas of practicefeel their work is important in effecting the well-being ofothers, and have a number of complex or high-level skills.These are crucial elements to the job of nursing per se, notto the area of practice chosen to be employed in.Nurses also uniformly had low scores in task identity.60The ability to see a task done from beginning to end was notpossible. Likewise, the nurse's job was seen ascontributing only a part in the overall service. Withfactors such as lengthy hospital stays of patients,multidisciplinary teams caring for patients, shift work,extended days off, one can see why the nurses are lesssatisfied in this area. If the task is defined as theoverall improvement of the patient, not specific proceduressuch as bed baths or dressing changes, one can see hownurses would feel this way.There is an indication that critical care nurses havehigher levels of satisfaction with autonomy than wardnurses. Autonomy in the job is seen as providingsubstantial freedom, independence, and discretion inscheduling the work, and in determining the procedures to beused in carrying it out (Hackman & Oldham, 1980). Adifference in feelings of autonomy may be due to the factthat critical care nurses have more standing orders, have alower patient-nurse ratios, and therefore feel empowered tobe more of an advocate for the patient and family.Comparison of Study Sample with Normative SampleA comparison of sample means with the normative dataprovided by Oldham, Hackman, and Stepina (1979) was alsoperformed. Since other nursing studies in the literaturecompared findings with the normative sample, it was felt61that comparison with the present study would giveconsistency. The normative sample comprise the result ofsurveys of nearly 7000 respondents in over 800 jobs in 56organizations.The job classification of professional/technical waschosen as the most representative of the nursing profession.Examples of other occupational titles found in thisclassification included engineers, physicians, and lawyers.However, notes of caution when comparing these data must bestated for several reasons. While the job classification ofprofessional/technical seems to be most closely related tonursing in the choices offered, we do not know whethernurses were included in the study or not. Also, the samplesize of the group was quite small (n = 72). Thirdly, thefindings are quite dated, the data were gathered sometimebefore 1979. Finally, we do not have a breakdown of gendertherefore it is possible that the majority of respondentswere male, while in the nursing studies the majority ofrespondents were female.While task significance and skill variety were seen assignificantly higher in importance in the study group whencompared with the normative group, the study group wassignificantly less able to identify tasks (Table 7). Thesefindings are consistent with those of Walker (1990) who alsofound the staff nurses showed significantly higher scores inskill variety and task significance, and significantly lower62Table 7Comparisons of the Study Samples and the NormativeGroup (Hackman & Oldham, 1980)Normative^Normative^NormativeGroup and Group and Group andPresent^Walker^Nystrom &Study (1990) Roedel(1988)t-value^z-score^t-valueCore Job DimensionsSkill Variety 3.27* 1.75* 4.28*Task Identity -4.30** -4.34* -3.31*Task Signif 3.15* 4.32* 6.50*Feedback -1.36 -0.60* 0.45Autonomy -1.23 -3.96* 1.38Motivating -1.90 -2.81* 1.15PotentialCritical Psychological StatesMeaningfulness 3.96** 0.45Responsibility -0.73 -0.88Knowledge 1.53 0.84Context SatisfactionsPay -2.94* -1.26Security 0.05 2.03*Co-workers 0.98 1.20Supervision -1.06 -0.10Context -0.72Satisfactions*p < .01**p < .001scores in task identity when compared with the normativegroup. However, Walker also found the staff nurses to be63significantly lower in autonomy than the normative group.Similarly, Roedel and Nystrom (1988) found their staffnurses to have significantly higher scores in skill varietyand task significance, and significantly lower scores intask identity than the normative group.When the mean scores of the critical psychologicalstates for the study sample were compared to the normativedata, only experienced meaningfulness of the work wassignificantly higher in importance. This seems to indicatethat the critical care nurses in the present study foundtheir jobs rich in value and worth. Walker (1990) found nosignificance in comparisons of critical psychological stateswith the normative group.When comparing context satisfactions mean scores, thepresent study group was significantly less satisfied withpay. Walker (1990) showed a significantly higher result injob security in her comparison with the normative group.SummaryThe findings of this study have been presented withrespect to the sample of 127 critical care nurses in BritishColumbia. The nurses in this study were found to havecharacteristics somewhat different to those reportedelsewhere. The level of education among the nurses in thissample was higher, and the age was generally younger thanthat noted in other reports. However, the employment status64seemed to be similar to that reported in the literature.The results of the statistical analysis of the dataindicated that the critical care nurses in this study weregenerally pleased with their work. In particular, theyfound meaningfulness in the task significance and skillvariety of the job. Further, The strongest predictors ofgeneral job satisfactions were the motivating potential ofthe job, experienced meaningfulness of the work, and thecontext satisfactions.65Chapter FiveSummary, Conclusions, ImplicationsSummaryThe nursing literature has identified problems relatedto job satisfaction in nursing for more than a decade.Through all of this research, little has been done toresolve the identified sources of job satisfaction and lackof job satisfaction in the general nursing population.Further, there is almost no research in this area pertainingto critical care nursing.This study was designed to explore the relationshipbetween general job satisfaction and job design variables incritical care nurses, using an established conceptualframework entitled the Job Characteristics Model (Hackman &Oldham, 1980). The tools used to collect data regardinggeneral job satisfaction and selected variables leading togeneral job satisfaction were the Index of Job Satisfaction(IJS, Brayfield & Rothe, 1951) and the Job Diagnostic Survey(JDS, Hackman & Oldham, 1980). A Nurse CharacteristicsQuestionnaire was prepared by the investigator to identifypersonal and professional characteristics of the studyrespondents. The research questions developed for the studyincluded: 1) What is the level of general job satisfactionin critical care nurses; 2) What is the relationship betweengeneral job satisfaction and the following variables:66motivating potential, critical psychological states, andcontext job satisfactions; and 3) What is the relationshipbetween general job satisfaction and selected personal andprofessional characteristics of critical care nurses?The questionnaires used for the study were mailed to arandomized list of critical care nurses compiled by theRegistered Nurses Association of British Columbia. A totalof 127 of the respondents met the established criteria. Thestatistical tests utilized included descriptive statistics,Pearson product moment correlation coefficient, multipleregression, and analysis of covariance.The findings related to the personal and professionalcharacteristics of the sample of nurses pertained toeducational preparation, experience in nursing, maturity,employment tenure, area of practice, and employment status.What emerged was a profile of critical care nurses themajority of whom were employed full time, had a mean age of36.8 years, an average of 13 years of nursing experience,employment tenure of over 6 years, held diploma education,had completed some post-basic coursework, and currentlyworked in an intensive care unit.The information obtained about this group of nursesregarding personal and professional characteristics variedin its compatibility with that reported by provincial andnational data. The educational level of this study'srespondents appeared to be much higher in the areas of post-67basic certification as well as baccalaureate education, andthe age distribution younger when compared to the provincialand national statistics. The employment status of the studygroup was similar to that reported by Statistics Canada(1990b). There was no documentation of national orprovincial statistics enabling the comparison of experience,employment tenure, or area of practice.The findings relating to the research questionsindicated that nurses perceived their work to be meaningful,and to provide variety and significance in terms of requiredskills. However, nurses also perceived their work not wellcompensated in terms of pay, and that the ability to work ona task from beginning to end was difficult. The strongestcorrelation was found between meaningfulness of the work andgeneral job satisfaction. Of the five variables regressedon general job satisfaction, motivating potential,experienced meaningfulness of the work, and contextsatisfactions were all found as significant predictorvariables. Finally, it was determined that both nursingexperience and age showed a positive relationship withgeneral job satisfaction. However, these nursecharacteristics demonstrated multicollinearity. Nursingexperience had the stronger relationship with general jobsatisfaction.68ConclusionsThe major conclusions arising out of this study dataare:1. The critical care nurses found their jobs rich in varietyand significance, and allowed for some autonomouspractice.2. The core job dimensions that contributed most to themotivating potential of critical care nurses were skillvariety and task significance.3. The core job dimension that contributed least to themotivating potential of critical care nurses was taskidentity.4. The results supported high positive correlations betweengeneral job satisfaction and: 1) motivating potential,2) experienced meaningfulness of the work, and3) knowledge of the actual results of the workactivities. Further high positive correlations were seenbetween motivating potential and knowledge of actualresults of work activities; as well as betweenexperienced meaningfulness of the work and experiencedreponsibility for the outcomes of the work.695. The results supported significant regressions betweengeneral job satisfaction and 1) motivating potential,2) experienced meaningfulness of the work, and 3) contextjob satisfactions.6. The results supported a significant positiverelationship between general job satisfaction and nursingexperience.7. Compared to other similar professionals reported innormative data, critical care nurses were more satisfiedwith the skill variety and task significance of thejob, and less satisfied with task identity.8. Compared to other professionals, critical care nursesfelt much more strongly about the experiencedmeaningfulness of the work and found their level of payless satisfying.9. Compared to other nurses, critical care nurses seemed tohave higher levels of autonomy than ward nurses.Implications The implications of this study are apply to nursingadministration, education, and nursing research. Nursingadministration guides the overall practice of nursing. It70is administration's ability and responsibility to developorganizational elements which affect nursing jobsatisfaction. Further, nursing educators can use theirunderstanding of job satisfaction variables to assist inhelping the bedside nurse. Finally, nursing research canguide theory development as well as testing before and afterimplementation of strategies to augment job satisfaction.Implications for Nursing AdministrationThe nurses in this study found the motivating potentialof the job to be a significant predictor of jobsatisfaction. Several core job dimensions were seen as veryimportant aspects of their work whether positive ornegative. The positive dimensions included skill varietyand task significance. The negative dimension included taskidentity. Nurse administrators should be aware that thesevariables are important in enhancing the work of nursing.Examples to incorporate this valuable information couldinclude assuring that critical care nurses are encouraged tohave challenge and variety in their assignments, which wouldencourage further skill variety. Another idea foradministrators is to allow willing nurses the chance to workin a number of critical care areas which would also promotefurther skill variety. Finally, allowing the bedside nursesto expand their role with patients and the respectivefamilies would enable further skill variety. Examples would71include the nurse to be responsible for the educationalpreparation and pre-hospital tours for the patient and thefamily he/she would be caring for. This would have theadded benefit of building nurse-patient rapport andtherapeutic relationship skills.Nurse administrators could be further guided by otherstudy findings including the lack of job satisfaction intask identity. People who complete an entire unit ofservice tend to see that task as more meaningful than whenthey are responsible for only a small part of the job(Hackman & Oldham, 1980). This characteristic could beredesigned to enhance improved job satisfaction. Nursescould be encouraged to follow patients throughout theirhospital stay to allow for increased knowledge of patientoutcome. Further, nurses could act as primary nurses forpatients if desired. Bedside nurses should be activemembers on committees such as Policy and Procedures, toaugment their understanding of the purpose of performingtasks in certain ways.Nurses should be encouraged to pursue autonomouspractice. With nurse administrators utilizing participativemanagement strategies, the autonomy of bedside nurses wouldbe further augmented by sharing the power of decision-makingwith these nurses. According to Bennett (1983), increasedparticpation in decisions that directly affect the nurses'work life results in higher productivity. Nurses should be72encouraged to voice their awareness of difficulties in theirwork environment as well as participate in the solving ofthese problems.Context satisfactions significantly predicted generaljob satisfaction. The context satisfactions measuredincluded job security, pay, co-workers, and supervision.There are ways nurse administrators could augment contextsatisfactions in nursing practice. One example ofaugmenting co-worker relations would be to establish aproper chain-of-command in conflict management which wouldensure fair solutions when disputes arise. As forsupervision, nurse administers must continue to assureadequate supervision for nurses on a day to day basis.Essential management practices necessary for the nurseadministrators include respect, fair treatment, support andguidance as needed. Pay, which was the characteristic withthe lowest level of satisfaction, is beyond the realm ofnurse administrators on a day to day basis.Implications for Nursing EducationThere are results from this study that can assistnursing education. The positive relationship between nurseexperience and general job satisfaction can be explored bynurse educators as well. Allowing those nurses with moreexperience to work closely with less experienced nurses inan organized fashion such as preceptorships not only assists73the novice to learn from the experienced nurse's skill andwisdom, but important attitudes of job satisfaction can befostered.Further, predictors of general job satisfaction areexperienced meaningfulness of the work and motivatingpotential. If novice nurses, while being educated, aretaught to understand and encorporate the core job dimensionsas important to them, they may experience increasedmeaningfulness of the work in general, and therefore haveimproved general job satisfaction.Implications for Nursing ResearchThere are several implications for nursing researcharising from the findings of job satisfaction of criticalcare nurses. One finding showed the importance of autonomyto general job satisfaction. Therefore, one area forresearch could include continued study into nurses'autonomy. Examples of research questions include "what doesautonomy mean to nurses?" and "how can nursing fosterautonomous practice within the health care system?". Theanswers could allow for innovative and useful ways ofaugmenting work satisfaction and job redesign.The respondents perceived the critical psychologicalstate of experienced meaningfulness of the work to beimportant in predicting general job satisfaction. Accordingto the Job Characteristics Model, the precursor core job74characteristics to the critical psychological states,experienced meaningfulness of the work, are skill variety,task identity, and task significance. The nurses also foundthese variables important, which is consistent with theconceptual framework. The importance of these variables isdocumented in other nursing studies, therefore thesevariables could be utilized in comparing groups of nursesfrom different areas or magnet wards and short-staffed wardsin regards to their job satisfaction. The collected datacould be used to enhance the wards where job satisfaction isfound to be at low levels.Further research could include continuing comparisonstudies between ward nurses and critical care nurses. Alimitation of the present study is the comparison betweenpresent results with the past results of other researchers.A study comparing job characteristics of two groups ofnurses in the same time frame, from the same geographicallocation would be preferable. A comparison study couldassist in the determination of whether these factorscontinue to be important through time. One could alsodetermine why certain factors are seen as negative in onegroup as opposed to the other. With this knowledge, nursingcould use the positive aspects of one area of nursing todevelop and implement a plan to enrich the work of theother.75SummaryThe findings of this study showed that critical carenurses in British Columbia were above the median in generaljob satisfaction scores. The job was considered rich interms variety and significance, and allowed for someautonomous practice. Nurses were least satisfied with payand benefits. The highest positive correlation andregression was seen between general job satisfaction and theexperienced meaningfulness of the work.The implications of this study advocate a supportiveadministration which enhances the positive aspects andreduces the negative characteristics of the work of nursing.The encouragement by nursing educators of relationshipsbetween senior and novice nurses would enable the learningof skills, transference of knowledge, and nurturance ofpositive attitudes. Finally, the conclusions of this studycould be used by nursing research to allow for furthercomparative studies within nursing practice.76ReferencesAdams, J.S. (1963). Toward an understanding of inequity.Journal of Abnormal Social Psychology, 67, 422-436.Allen, M., Jackson, D., & Youngner, S. (1980). Closing thecommunication gap between physicians and nurses in theICU setting. Heart and Lung, 9(5),836-840.Alspach, J.B. (1987). The shortage of critical care nurses:Readership survey results. Critical Care Nurse,8(3),14-23.Baggs, J. (1989). Intensive care unit use and collaborationbetween nurses and physicians. Heart & Lung. 18(4). 332-338.Bennett, A. (1983). Productivity and the quality of worklife in hospitals. Chicago: American HospitalAssociation.Benton, D., & White, H. (1972). Satisfaction of job factorsfor registered nurses. Journal of Nursing Administration,2(6), 55-63.BGI. Management Consultants (1981). Turnover of staff nursesin Nova Scotia: Causes and remedies. Halifax: Council ofTeaching Hospitals, Registered Nurses Association of NovaScotia, and Nova Scotia Department of Health.Bizek, K.S., & Oermann, M.H. (1990). Critical careeducation. Study of education experiences, support, andjob satisfaction among critical care nurse preceptors.Heart & Lung, 19(5),439-444.Brayfield, A., & Crockett, W. (1955). Employee attitudes andemployee performance. Psychological Bulletin, 52, 396-424.Brayfield, A., & Rothe, H., (1951). An index of jobsatisfaction. Journal of Applied Psychology, 35(5), 307-311.Campbell, J., Dunnette, M., Lawler, E., & Weik Jr., K.(1970). Managerial behaviour, performance, andeffectiveness. New York: McGraw-Hill Book Co.Canadian Nurses Association/Canadian Hospital Association(1990). Nurse retention and quality of worklife: Anational perspective. Ottawa: Author.77Civetta, J. (1981). Beyond technology: Intensive care in the80's. Critical Care Medicine, 9(11), 763-767.Dear, M.R., Weisman, C.S., Alexander, C.S., & Chase G.A.(1982). The effect of the intensive care nursing role onjob status and turnover. Heart and Lung, 11 (6) 560-565.Gibson, J., & Klein, S. (1970). Employee attitudes as afunction of age and length of service: Areconceptualization. Academy of Management Journal, 13,411-425.Godfrey, M. (1978a). Job satisfaction-or should it bedissatisfaction? How nurses feel about nursing. Part 1.Nursing 78, 8(4),14-25.Godfrey, M. (1978b). Job satisfaction-or should it bedissatisfaction? How nurses feel about nursing. Part 2.Nursing 78, 8(5),19-27.Godfrey, M. (1978c). Job satisfaction-or should it bedissatisfaction? How nurses feel about nursing. Part 3.Nursing 78, 8(6),65-73.Gruneberg, M. (1979). Understanding job satisfaction.London: The MacMillan Press Ltd.Hackman, R. & Oldham, G. (1975). Development of the jobdiagnostic survey. Journal of Applied Psvcholociv,60(2),159-170.Hackman, R. & Oldham, G. (1976). Motivation through thedesign of work: Test of a theory. Organizational Behaviour and Human Performance, 16(2)250-279.Hackman, R. & Oldham, G. (1980). Work redesign. Reading, MA:Addison Wesley.Health Human Resources Unit. (1990). Rollcall update 90.Vancouver: University of British Columbia, June.Health Manpower Research Unit. (1988a). The nurse manpowerstudy volume 1. Report of the nurse manpower advisorycommittee. Vancouver: University of British Columbia.Health Manpower Research Unit. (1988b). The nurse manpowerstudy volume 3. Influence of the workplace on nurse manpower supply in British Columbia. Vancouver:University of British Columbia.Health Manpower Research Unit (1989). Rollcall 89.Vancouver: The University of British Columbia, March.78Health Services Research and Development (1984). Vacancy turnover survey - October 1981 to April 1984. Universityof British Columbia.Herzberg, F., Mausner, B., Peterson, R., & Capwell, D.(1957). Job attitudes: Review of research and opinion.Pittsburgh: Psychology Services of Pittsburgh.Herzberg, F., Mausner, F., & Snydermann, B. (1959). Themotivation to work. New York: John Wiley & Sons Inc.Herzberg, F. (1966). Work and the motivation of man. NewYork: New American Library.Huckabay, L. & Jagla, B. (1979). Nurse's stress factors inthe intensive care unit. Journal of NursingAdministration, 9(2),6-9.Hulin, C., & Smith, P. (1965). A linear model of jobsatisfaction. Journal of Applied Psychology, 49, 209-216.Huey, F. & Hartley, S. (1988). What keeps nurses in nursing:35000 nurses tell their stories. American Journal of Nursing, 88 (2), 181-188.Jacobson, S.F. (1987). Stress and coping strategies ofneonatal intensive care unit nurses. Research in Nursingand Health, 6,3-9.Jenny, J. (1982). Issues affecting nurses' hospital employment in the 80's. Ottawa: Canadian HospitalAssociation.Joiner, C., Johnson, V., Chapman, J.B., Corkrean, M. (1982).The motivating potential in nursing specialties. TheJournal of Nursing Administration, 12(2), 26-30.Kahn, J., & Westley, W. (1984). The working environment inCanadian hospitals. Constraints and opportunities.Ottawa: Minister of Labour.Larson, E., Lee, P., Brown, M., & Shorr, J. (1984). Jobsatisfaction: Assumptions and complexities. The Journal of Nursing Administration, 14(1), 31-38.Lave, J.R., & Knaus, W.A. (1986). The economics of intensivecare units. In K. Benesch, N.S. Abramson, A. Grenvik, &A. Meisel (Eds.) Medicolegal aspects of critical care (pp.87-107). Rockville, Maryland: Aspen.Lawler, E.E. (1973). Motivation in work organizations.Monterey, California: Brooks/Cole Publishing Co.79Lee, R., Wilbur, E. (1985). Age, education, job tenure,salary, job characteristics, and job satisfaction: Amultivariate analysis. Human Relations, 38(8), 781-791.Locke, E.A. (1969). What is job satisfaction? OrganizationalBehaviour and Human Performance, 4(4)309-336.Locke, E.A. (1976). The nature and causes of jobsatisfaction. In M.D. Dunnette (Ed.) Handbook of industrial and organizational psychology (pp.1297-1350).Chicago: Rand McNally.Loher, B., & Noe, R. (1985). A meta-analysis of the relationof job characteristics to job satisfaction. Journal of Applied Psychology, 70(2), 280-289.Maslow, A.H. (1943). A theory of human motivation.Psychological Review, 50, 370-396.Maslow, A.H. (1954). Motivation and personality. New York:Harper and brothers.McCloskey, J. (1974). Influence of rewards and incentives onstaff nurse turnover rate. Nursing Research, 23(3), 239-247.Mendenhall, J. (1982). Factors affecting job satisfactionand dissatisfaction among critical care nurses. Focus onCritical Care, 9(5), 14-18.Mobley, W., Griffeth, R., Hand, H., & Meglino, B. (1979).Review and conceptual analysis of the employee turnoverprocess. Psychological Bulletin, 86(3), 493-522.Munson, F.C., & Heda, S.S. (1974). An instrument formeasuring nursing satisfaction. Nursing Research, 23(2),159-166.Myrtle, R., & Robertson, J. (1979). Determinants of jobsatisfaction in nursing care units. Journal of Long-termCare Administration, 7(4), 17-29.Nichols, K., Springford, V. & Searle, J. (1981). Aninvestigation of distress and discontent in various typesof nursing. Journal of Advanced Nursing, 6, 311-318.Oldham, G., Hackman, J., & Stepina, L. (1979). Norms for theJDS. Journal Supplement Abstract Service, 9(14), Ms. No.1819.Penny, M. (1986). Recruitment and retention of nurses incritical care. Nursing Management, 19(2), 72A-72V.80Porter, L., & Steers, R. (1973). Organizational work andpersonal factors in employee turnover and absenteeism.Psychological Bulletin, 80(2), 151-176.Prescott, P. & Bowen, S. (1987). Controlling nurse turnover.Nursing Management, 18(6), 60-66.Redfern, S. (1980). Hospital sisters: Work attitudes,perceptions, and wastage. Journal of Advanced Nursing,5(5), 451-466.Registered Nurses Association of British Columbia. (1988).Descriptive study of demographic characteristics and jobsatisfaction of B.C. registered nurses with threeeducational background. Vancouver: Author.Registered Nurses Association of British Columbia. (1988).Battling the nursing shortage. RNABC News, 20(5), 16-17.Registered Nurses Association of British Columbia. (1989).RNABC membership statistics. Vancouver: RNABC.Rhodes, S. (1983). Age-related differences in work attitudesand behaviour: A review and conceptual analysis.Psychological Bulletin, 93, 328-367.Roedel, R., Nystrom, P. (1988). Nursing jobs andsatisfaction. Nursing Management, 12(2), 34-38.Sanger, E., Richardson, J., & Larson, E. (1985). Whatsatisfies nurses enough to keep them? Nursing Management,16(19), 43-46.Scherer, P. (1987). When everyday is a saturday: Theshortage. American Journal of Nursing, 10, 1285-1290.Seybolt, J. (1986). Dealing with premature employeeturnover: It can be managed. Journal of NursingAdministration, 16(2), 26-32.Searle, L. (1988). The extent of nursing shortage incritical care. Heart & Lung, 17(6), 25A-29A.Simpson, K. (1985). Job satisfaction or dissatisfactionreported by registered nurses. Nursing AdministrationQuarterly, 9(3), 64-73.81Srivastva, S., Salipante, P., Cummings T., Notz, W.,Bigelow, J., & Waters J. (1975). Job satisfaction andproductivity, an evaluation of policy related research onProductivity, industrial organization and jobsatisfaction: Policy development and implementation.Cleveland: Dept of Organizational Behaviour, CaseWestern Reserve University.Statistics Canada. (1990a). Registered nurses managementdata 1990. Ottawa: Author.Statistics Canada. (1990b). Nursing in Canada 1988. Ottawa:Author.Tabachnick, B., & Fidell, L. (1983). Using multivariatestatistics. New York: Harper and Row.Volk, M., Lucas, M. (1991). Relationship of management styleand anticipated turnover. Dimensions of Critical Care Nursing, 10(1), 35-40.Vroom, H.V. (1964). Work and motivation. New York: JohnWiley & Sons.Vroom, H.V. (1970). Management and motivation. New York:John Wiley & Sons.Wakefield, D., Curry, J., Price, J., Mueller, C., &McCloskey, J. (1988). Differences in work unit outcomes.Job satisfaction, organizational commitment, and turnoveramong hospital nursing department employees. WesternJournal of Nursing Research, 10(1), 98-105.Walker, J. (1990). Job satisfaction among hospital-employednurses. Unpublished masters thesis. Vancouver: Universityof British Columbia.Wandelt, M., Pierce, P. & Widdowson, R. (1981). Why nursesleave nursing and what can be done about it. American Journal of Nursing, 81(1), 72-77.Wassenaar, D. (1974). Behavioural aspects of management: Anintroduction. San Jose, California: Lansford PublishingCo.Wetzel, K., Soloshy, D., Gallagher, D. (1990). The workattitudes of full-time and part-time registered nurses.Health Care Management Review, 15(3), 79-85.Williams, C. (1990). Job satisfaction: Comparing criticalcare and medical/surgical nurses. Nursing Management,21(7), 104A-H.82Woods, N. (1988). Sampling. In N.F. Woods & M. Catanzaro(Eds.). Nursing Research Theory and Practice (pp. 97-114). Washington: C.V. Mosby Co.Wright, V., McGill, J., Collins, J. (1990). Are nurses lesssatisfied than other workers? Nursing Economics, 8(5),308-313.83Appendix AThe Job Diagnostic Survey(Hackman & Oldham, 1980)This questionnaire was developed to study jobs and howpeople react to them. The questionnaire helps to determinehow jobs can be better designed, by obtaining informationabout how people react to different kinds of jobs.On the following pages you will find several differentkinds of questions about your job. Specific instructionsare given at the start of each section. Please read themcarefully. It should take no more that 15 minutes tocomplete the entire questionnaire. Please move through itquickly.The questions are designed to obtain your perceptionsof your job and your reactions to it.Please mail the completed postage paid form at yourearliest convenience.Thank you for your cooperation.SECTION ONEThis part of the questionnaire asks you to describe yourjob, as objectively as you can. Please circle the numberwhich most accurately reflects your answer.Please do not use this part of the questionnaire to show howmuch you like or dislike your job. Questions about thatwill come later. Instead, try to make your descriptions asaccurate and as objective as you possibly can.1. How much autonomy is there in your job? That is, to whatextent does your job permit you to decide on your own how togo about doing the work?1^2 3^4^5 6^7Very little; thegives me almostno personal "say"about how and whenthe work is done.Moderate autonomy;many things arestandardized andnot under mycontrol, but I canmake somedecisions aboutthe work.Very much; thejob gives mealmost completeresponsibilityfor deciding howand when the workis done.842. To what extent does your job involve doing a "whole" andidentifiable piece of work? That is, is the job a completepiece of work that has an obvious beginning and end? Or isit only a small part of the overall piece of work, which isfinished by other people or by automatic machines?1^2^3 4^5^6^7My job is only atiny part of theoverall piece ofwork; the resultsof my activitiescannot be seen inthe final productor service.My job is amoderate sizedchunk of the over-all piece of work;my own contribu-tion can be seenin the finaloutcome.My job involvesdoing the wholepiece of work,from start tofinish; theresult of myactivities areeasily seenin the finalproductor service.3. How much variety is there in your job? That is, to whatextent does the job require you to do many different thingsat work, using a variety of your skills and talents?1^-2^3 4^5^ 6 7Very little; the jobrequires me to dothe same routineover and over again.Moderate variety. Very much; thejob requires meto do manydifferentthings, using anumber of diff-erent skillsand talents.4. In general, how significant or important is your job?That is, are the results of your work likely tosignificantly affect the lives or well-being of otherpeople?1^2^3 4^5 6^7Not very signifi-^Moderatelycant; the outcomes significant.work are notlikely to haveimportant effectson other people.Highly signifi-cant; the of myoutcomes of mywork can affectother people invery importantways.855. To what extent does doing the job itself provide youwith information about your work performance? That is, doesthe actual work itself provide clues about how well you aredoing - aside from any "feedback" co-workers or supervisorsmay provide?1^2^ 3 4^5 6^7Very little; the jobitself is set up socould work foreverwithout finding outhow well I am doing.Moderately; some-times doing thejob provides"feedback" to me;sometimes it doesnot.Very much; thejob is set up Iso that I getalmost constant"feedback" as Iwork about howwell I amdoing.86SECTION TWOListed below are ten statements which could be used todescribe a job.You are to indicate whether each statement is an accurate oran inaccurate description of your job.Once again, please try to be as objective as you can indeciding how accurately each statement describes your job -regardless of whether you like or dislike your job.Write a number in the blank beside each statement, based onthe following scale:How accurate is the statement in describing your job?1^2^3^4^5^6^7Very Mostly Slightly Uncertain Slightly Mostly VeryInaccurate Accurate6. The job requires me to use a number of complex orhigh-level skills.7. The job is arranged so that I do not have the chanceto do an entire piece of work from beginning to end.8. Just doing the work required by the job providesmany chances for me to figure out how well I amdoing.9. The job is quite simple and repetitive.10. This job is one where a lot of other people can beaffected by how well the work gets done.11. The job denies me any chance to use my personalinitiative or judgement in carrying out the work.12. The job provides me the chance to completely finishthe pieces of work I begin.13. The job itself provides very few clues about whetheror not I am performing well.14. The job gives me considerable opportunity forindependence and freedom in how I do the work.15. The job itself is not very significant or importantin the broader scheme of things.87SECTION THREENow please indicate how you personally feel about your job.Each of the statements below is something that a personmight say about her or his job. You are to indicate yourown personal feelings about your job by marking how much youagree with each of the statements.Write a number in the blank for each statement, based onthis scale:How much do you agree with the statement?1^2^3^4^5^6^7Disagree Disagree Disagree Neutral Agree Agree^AgreeStrongly^Slightly^Slightly^Strongly16. It's hard, on this job, for me to care very muchabout whether or not the work gets done right.17. Most of the things I have to do on this job seemuseless or trivial.18. I usually know whether or not my work issatisfactory on this job.19. The work I do on this job is very meaningful to me.20. I feel a very high degree of personal responsibilityfor the work I do on this job.21. I often have trouble figuring out whether I'm doingwell or poorly on this job.22. I feel I should personally take the credit or blamefor the results of my work on this job.23. Whether or not this job gets done right is clearlymy responsibility.88SECTION FOURNow please indicate how satisfied you are with each aspectof your job listed below. Once again, write the appropriatenumber in the blank beside each statement.How satisfied are you with this aspect of your job?1^2^3^4^5^6^7Extremely^Slightly^Neutral^Slightly ExtremelyDissatisfied Satisfied24. The amount of job security I have.25. The amount of pay and fringe benefits I receive.26. The people I talk to and work with on my job.27. The degree of respect and fair treatment Ireceive from my boss.28. The chance to get to know other people while on thejob.29. The amount of support and guidance I receive from mysupervisor.30. The degree to which I am fairly paid for what Icontribute to this organization.31. How secure things look for me in the future in thisorganization.32. The chance to help other people while at work.33. The overall quality of the supervision I receive inmy work.89SECTION FIVENow please think of the other people in your organizationwho hold the same job you do. If no one has exactly thesame job as you, think of the job which is most similar toyours.Please think about how accurately each of the statementsdescribes the feelings of those people about the job.It is quite all right if your answers here are differentfrom when you described your own reactions to the job.Often different people feel quite differently about the samejob.Once again, write a number in the blank for each statement,based on this scale:How much do you agree with the statement?1^2^3^4^5^6^7Disagree Disagree Disagree Neutral Agree Agree AgreeStrongly Slightly Slightly^Strongly34. Most people on this job feel that the work isuseless or trivial.35. Most people on this job feel a great deal ofpersonal responsibility for the work they do.36. Most people on this job have a pretty good ideaof how well they are performing their work.37. Most people on this job find the work verymeaningful.38. Most people on this job feel that whether or not thejob gets done right is clearly their ownresponsibility.39. Most people on this job have trouble figuring outwhether they are doing a good or a bad job.90Appendix BAn Index of Job Satisfaction(Brayfield & Rothe, 1951)Now please indicate how you personally feel about your job.Again, each of the statements below is something that aperson might say about her or his job. You are to indicateyour own personal feelings about your job by marking howmuch you agree with each of the statements.Write a number in the blank for each statement, based onthis scale:How much do you agree with the statement?1^2^3^4^5^6^7Disagree Disagree Disagree Neutral Agree Agree AgreeStrongly Slightly Slightly^Strongly40. There are some conditions concerning my job thatcould be improved.41. My job is like a hobby to me.42. It seems that my friends are more interested intheir jobs.43. I consider my job rather unpleasant.44. I enjoy my work more than my leisure time.45. I am often bored with my job.46. I feel fairly well satisfied with my present job.47. Most of the time I have to force myself to go towork.48. I am satisfied with my job for the time being.49. I feel that my job is no more interesting thanothers I could get.50. I definitely dislike my work.51. I feel that I am happier in my work than most otherpeople.52. Most days I am enthusiastic about my work.53. Each day of work seems like it will never end.54. I like my job better than the average worker does.55. My job is pretty uninteresting.56. I find real enjoyment in my work.57. I am disappointed that I ever took this job.9192Appendix CNurse Characteristics Questionnaire58. EDUCATION PREPARATION. Please indicate the educationalpreparation that most closely describes your experience:Diploma (College or Hospital School).Diploma and one or more post-basic coursesDiploma and one or more university coursesBaccalaureate (basic program)Baccalaureate (post-R.N. program)Other (Please Specify)^59. EXPERIENCE IN NURSING. Please indicate the number ofyears that you have been employed in a nursing capacitysince the time of your original registration.Years of nursing experience since originalregistration.61. MATURITY. Please indicate your age on your lastbirthdate.Years of age.63. EMPLOYMENT TENURE. Please indicate the length of timethat you have been in your current employment. less than 6 monthsfrom 6 months to 1 yearfrom 1 to 3 yearsfrom 3 to 6 yearsmore than 6 years64. AREA OF PRACTICE. Please indicate the area in which youare presently working.Medical/Surgical ICU^Neonatal ICUCoronary Care Unit Pediatric ICUEmergency^ Other (Specify)70. EMPLOYMENT STATUS. Please indicate the amount of hoursthat you have worked over the past year.Full timePermanent part timeCasual (full time hours per year)Casual (less than full time hours per year)Other (Please Specify)^93Appendix DInformation Letter for Critical Care NursesDear Critical Care Nurse:My name is Barbara Turner. I am a graduate student innursing at the University of British Columbia, and I amcarrying out a research project for a Master's thesis. I amrequesting participants to complete a questionnaire in orderto assist me in learning more about job satisfaction of thecritical care nurse.This study is designed to assess the critical care nurses'reactions to various aspects of their work. The findings ofthis study will provide information that may be helpful inconsidering the nature of work for critical care nurses.As you are a registered nurse working in a critical careposition, I am asking for your participation in this study.To ensure anonymity, this questionnaire was mailed to you bythe RNABC after your name was randomly chosen by thecomputer. All costs incurred for this service are coveredby the researcher. You will not be required to identifyyourself anywhere on the questionnaire and all informationfrom the questionnaire will be kept confidential. After thequestionnaires are analyzed, they will be destroyed. Theseresults will be in the form of a research report so that noindividual response can be identified.The questionnaire will require approximately 10-15 minutesof your time. The completion of the questionnaire will betaken as your consent to participate in the study.Participation in this study is wholly voluntary. Anyrefusal to participate or to withdraw at any time will notin any way affect the participant's employment.I am available for any questions or concerns regarding thisstudy or your participation in it. Please feel free tocontact me at this address:(Personal data removed for reasons of privacy.)Sincerely,Barbara Turner, R.N., B.N.94Appendix ERevised Index of Job SatisfactionNow please indicate how you personally feel about your job.Again, each of the statements below is something that aperson might say about her or his job. You are to indicateyour own personal feelings about your job by marking howmuch you agree with each of the statements.Write a number in the blank for each statement, based onthis scale:How much do you agree with the statement?1^2^3^4^5^6^7Disagree Disagree Disagree Neutral Agree Agree AgreeStrongly^Slightly Slightly^Strongly1. My job is like a hobby to me.2. It seems that my friends are more interested in theirjobs.3. I consider my job rather unpleasant.4. I enjoy my work more than my leisure time.5. I am often bored with my job.6. I feel fairly well satisfied with my present job.7. Most of the time I have to force myself to go towork.8. I definitely dislike my work.9. I feel that I am happier in my work than most otherpeople.10. Most days I am enthusiastic about my work.11. Each day of work seems like it will never end.12. I like my job better than the average worker does.13. I find real enjoyment in my work.14. I am disappointed that I ever took this job.95Appendix FGeneral Job Satisfaction by Educational Preparation:Sample Size, Means, Standard Deviations and ANOCOVAsN^Mean^S.D.diploma^31^68.26^10.39diploma and^52^68.96^8.75post-basicdiploma and^12^70.75^10.30universitybaccalaureate^8^66.88^6.08basicbaccalaureate^12^61.75^19.40post-R.N.other^12^56.58^8.53ANOCOVASource^SS^DF MS^F-Ratio PNurs Exp^661.89^1^661.89^6.18^0.01Educ Prep^550.98^5^110.20^1.03 0.40Error^12848.26 120^107.07General Job Satisfaction by Tenure in Years:Sample Size, Means, Standard Deviations, and ANOCOVAsTenure N Mean S.D.<.5 2 67.00 2.83.5-1 6 61.33 13.051-3 39 66.74 12.213-6 33 66.49 8.22> 6 47 71.30 9.93ANOCOVASource SS DF MS F-Ratio PNurs Exp 207.19 1 207.19 1.93 0.17Tenure 389.60 4 97.40 0.91 0.46Error 13009.65 121 107.5296General Job Satisfaction by Area of Practice:Sample Size, Means, Standard Deviations, and ANOCOVASArea^N^Mean^S.D.Med/Surg ICU^44^67.39^11.04CCU^15 64.93 14.84ICU/CCU^22^69.46^7.04Emergency^30 68.33 10.14Other 16^70.81^9.86ANOCOVASource^SS^DF MS^F-Ratio PNurs Exp^732.52^1^732.52^7.78^0.01Area^331.85^4^82.96 0.77 0.55Error 13067.40 121^107.5297General Job Satisfaction by Employment Status:Sample Size, Means, Standard Deviations and ANOCOVASN^Mean^S.D.Full Time^63^68.22^9.26Part Time^45 68.73^11.41Casual 17^65.65^13.45Other^2 71.50 6.36ANOCOVASource^SS^DF MS^F-Ratio PNurs Exp^821.70^1^821.70^7.58^0.01Empl Stat^174.88^2*^87.44^0.81 0.50Error^13125.88 121^108.48*2 cases dropped from 'other' category98


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