Professional Settings and Improved Quality of Healthcare

¶ … Happy on the Job: Is Employment Satisfaction among Saudi Nurses necessary for working Suitably in the Professional Settings and Improved Quality of Healthcare.

When it comes to Saudi Arabia, nursing plays a major role in any health care system. Many evidences support the quality of nursing care and patient outcome. Patient interact with nurses more than any other health profession. Improved level of job satisfaction among Saudi nurses will be significant in the delivery of quality healthcare to the patients. Variable such as appropriate wages, effective facilities, healthy environment, professionalism, suitable working hours, and successful management will improve the level of job satisfaction among Saudi nurses. The correlation between impaired job satisfaction levels of nurses will affect their performance in the clinical settings, which will certainly result in the poor quality of healthcare. Thus, job satisfaction among Saudi nurses is necessary for working appropriately in the professional settings and improved quality of healthcare.

Table of Contents

Introduction 4

Problem Statement 5

Aims and Objectives 6

Research Questions 6

Questions for Nurses 6

Questions for Patients 7

Literature Review 7

Job Satisfaction 7

Reasons for Job Satisfaction 8

Major Consequence of Job Dissatisfaction 9

Nursing Shortage 9

Nurses' Burnout 10

Role of Stress in Job Dissatisfaction 11

Job Dissatisfaction and Quality of Healthcare 12

Job Satisfaction and Improved Healthcare Quality 13

Methodology 15

Study Design 15

Sample Size and Participants 15

Time Frame and Process 16

Ethical Consideration 17

Possible Limitations 17

Results 18

Discussion 18

Recommendations 19

Introduction

Nurses are considered to be one the most important healthcare workers, who are responsible for the delivery of health care. There are strong studies supporting nurses' role in improving patient clinical outcome. It is a fact that nursing professionals should develop necessary skills and capabilities for the proper regulation of healthcare processes. World Health Organization has also identified that nursing professionals are also responsible for improving the quality of life, in relation with the patients (World Health Organization, 2013).

Studies in different health care settings and countries strongly correlate nurse's job satisfaction with decrease turnover, cost effectiveness and high quality of care. Many of other factors include positive and constructive policies of the organization staff education level, leadership, healthy work environment and employee job satisfaction and performance.

Job satisfaction can be defined as a satisfactory feeling regarding the employment and organization. For the purpose of this study, we will explore the impact of job satisfaction on quality care in KSA.

In MOH health care setting, nurses are the largest workforce and interact the most with patients. Their role in health care delivery is a private role.

The WHO has concluded that nurses are also responsible for improving the quality of life in relation with the patients. The Institute of Medicine, define health care quality as a care in safe, effective, efficiency, and care that result in patient satisfaction. It is the goal of every health care facility to provide high quality care, to meet accreditation and credential standard. Health care quality will influence the organizational success (Cimine, 2014).

Problem Statement

Studies have identified that most nurses are not willing to work in unprofessional environments. It is also a fact that job dissatisfaction has resulted in the lack of qualified nursing professionals among the hospitals of Saudi Arabia. Some of the recent statistics have clearly identified that 19.8% of the nursing professionals have left their job because of discontentment on the job (Mitchell, 2009).

Especially in Saudi Arabia, where the governmental authorities and hospital administration are working hard for the implementation of advanced interventions. However, the level of satisfaction among nursing professionals of Saudi Arabia is extremely low (Mitchell, 2009). Therefore, the quality of healthcare is getting worse on a continuous basis. Majority of the patients are not satisfied with the quality of delivered hospital by nurses. Therefore, it is essential for the healthcare organizations to improve their level of satisfaction among the nursing professionals in order to enhance the quality of healthcare.

Purpose of the Study

The purpose of this study is to explore the impact of nurse's job satisfaction on quality care in KSA

Aims and Objectives

1. Explore the relationship between job satisfaction among nurses, and its impact on healthcare quality in hospitals of Saudi Arabia.

2. To identify factors that affect nurses' job satisfaction.

3. To make recommendations and advice strategies in regards to healthcare quality in KSA through improving nursing satisfaction.

Hypothesis

The higher the level of nurse satisfaction, the more likely the quality of care will be better.

Research Questions

This study will be funded by the following:

Questions for Nurses

Does your organization, care about your professional growth?

Do you consider your work environment healthy?

Are your co-workers supportive?

Do you experience work chronic stress / burnout?

Is your organization providing you with enough wages and facilities to fulfill your basic needs?

Are you satisfied with your job?

Do you want to quit this profession?

Do you feel attracted at work?

Are you pleased with your unit intuitive leadership style?

Questions for Patients

Were the nurses' behavior professional and appropriate?

Did anybody affect your self-esteem?

Did your nurse provide a safe care?

How did you rate the overall quality of care you received?

Are you satisfied with your assigned nurse?

Were you involved in your health care plan?

Literature Review

Job Satisfaction

A descriptive cross sectional study was conducted by Al Juhani & Kishk (2006), which focused on the factor of job satisfaction among the physicians and nursing professionals in the hospitals of Saudi Arabia. The study was conducted in Madinah, Saudi Arabia. The study sample included 445 health care providers with response rate of '85.4%. An affective orientation of the healthcare professionals towards their responsibilities is directly associated with the enhanced job satisfaction of the nursing professionals. The study assessed the levels of job satisfaction among the nursing professionals of the Saudi hospitals. The findings of the study mentioned that 67.1% of nursing professionals were not satisfied with working in the hospitals of Madina, a city of Saudi Arabia. Therefore, it can be said that most of the nursing professionals were not willing to continue their jobs as a nurses in the clinical settings.

Most of the nursing professionals have declared workload as the leading reason for job dissatisfaction. At the same time, lack of financial rewards was also identified as a major reason for decreased job satisfaction. The study has also shown that the quality of healthcare is continuously getting poor because of displeasure on the job. The nursing professionals did not work properly in the clinical settings because of their increased state of stress. Additionally, the study has shown that depressed mental status of the nursing professionals, further affected the recovery processes of the patients. Therefore, the study has concluded that the factor of job dissatisfaction is affecting the performance of nursing professionals, and quality of healthcare in negative way (Al Juhani & Kishk, 2006).

Reasons for Job Satisfaction

There are various reasons for the decreased level of job dissatisfaction among nursing professionals. The leading reason for the lessened level of job satisfaction is mismanagement or inappropriate hospital management. It is a fact that the nursing professionals require appropriate management for working effectively in the professional settings. Appropriate management of the hospitals will certainly result in the poor performance of nurses. Poor management of hospitals will not develop effective policies, which will affect the performance and satisfaction level of the nursing professionals (Kaur & Malik, 2012).

Stress and burnout are two significant reasons for the increased level of job dissatisfaction. It has been evaluated by various studies that stress and anxiety are responsible for the decreased satisfaction level among nurses which occur daily in the hospital settings. Job insecurity is another leading reason. The insecurity of the job has the capability to influence the mental state and proficiency of nurses. Lack of necessary skills is also considered as a major reason for the increased dissatisfaction among nurses, in relation with their professional responsibilities. It is a fact that lack of required skills among nurses will affect their performance, which will increase the level of dissatisfaction directly (Kaur & Malik, 2012).

An unpleasant co-worker is also identified as a serious reason for increased dissatisfaction among nurses. Impolite behavior among the co-workers will certainly result in the affected performance of the nursing professionals. Violence in the workplace is the final reason, which is closely associated with the increased level of job dissatisfaction. All of these reasons are barriers in the delivery of healthcare (De Milt, Fitzpatrick & McNulty, 2011).

Major Consequence of Job Dissatisfaction

As mentioned by certain studies, it has been evaluated that there are various consequences of job dissatisfaction. However, affected healthcare quality is considered as the most important consequence of job dissatisfaction. The factor of job dissatisfaction will increase the level of stress, anxiety, and burnout among nursing professionals. These minor consequences will affect the performance of nurses in the clinical settings, in relation with the patients. The patients have a close association with the nursing professionals; therefore, the patients will become affected because of inappropriate performance of the nursing professionals. The factor of burnout will also affect the thinking abilities of the nurses, which will influence their decision making abilities (McFarlin, 2014).

Nursing Shortage

Nursing shortage is considered to be the most important consequence of job dissatisfaction all over the world. A mixed study was conducted by Mitchell (2009) in Saudi Arabia, which showed job dissatisfaction as a factor among the nursing professionals will make a direct impact over the willingness to work in the clinical settings. Most of the nursing professionals have left their jobs because of dissatisfaction and burnout. Thus, this situation is affecting the workforce of nurses in the clinical settings. The study has clearly identified that decreased motivational level of nurses will affect their thinking and performance abilities in a negative way. Therefore, the study has clearly indicated that organizations need to focus on the different aspects of nursing professionals for improved satisfaction and encouragement (Mitchell, 2009).

The study also mentioned that the increased retention of nurses is affecting the quality of healthcare in the hospital settings. Statistics show that 80% of the nursing professionals have shown that inappropriate and low salaries are affecting their satisfaction level directly. The participants have declared that the healthcare organizations should increase wages of nursing professionals for getting better performance. Hectic environments have been reported by 50% of the participants. The participants of this study have declared that the organization and administration should maintain the environment of clinical settings appropriate for effective performance.

Nurses' Burnout

According to Vahey (2004) a cross sectional survey of 820 nurses and 621 patients from 40 units in 20 urban hospitals across United States was conducted by 86% response rate, which showed that the factor of burnout and stress play a major role in the increased level of job dissatisfaction. The study illustrated that the nursing professionals are working hard in the clinical settings for the delivery of healthcare to the patients. It is because of the greater workloads of the nurses that the 'hospital stays' of the nursing professionals are getting shorter. However, the burnout level of the nursing professionals are getting increased because of the greater workload. It has been evaluated by the study that most of the nursing professionals have experienced increased work related stress and burnout, which have affected their performance in the clinical settings. In addition to that, this study has also indicated that the level of job satisfaction and patients' satisfaction is also getting affected due to longer working hours.

The difference is that the satisfaction level of the nursing professionals has been affected negatively due to excessive working. However, the satisfaction level of the patients has been affected positively because of extreme working of the nurses. The findings of the study has shown that 96% of nurses were not satisfied with their organization's performance. Thus, decreased workforce of nurses will put extra burden on other workers, which will certainly result in the increased level of job dissatisfaction among nurses.

Role of Stress in Job Dissatisfaction

A quantitative study was conducted in two large and influential hospitals in southern Taiwan by Ho, et al., (2009) which showed that nurses developed serious level of stress and anxiety due to increased workloads. There were 650 copies of questionnaires with the response rate of 81.8%. Therefore, the study assessed the role of stress and anxiety in the decreased job satisfaction of the nursing professionals. The study has mentioned that every organization commits with the nursing professionals for fulfilling their personal and professional needs with the help of different opportunities. However, most of the organizations are unable to fulfill the basic demands of the nursing professionals, which result in the increased job dissatisfaction among the employees.

Ernst (2004) has also supported the findings of the study from above. The exploratory descriptive design surveys were distributed at a children hospital in the southeast where the sample was 534 nurses with response rate of 46%. The study mentioned that the factor of stress and burnout have the capability to influence the satisfaction level of nurses. Job related stress can develop due to three major reasons such as low salary, unprofessional behavior of the co-workers, and extensive workload. The study has shown that these three reasons will make a direct impact over the normal performance of nurses. A nurse will become less motivated, less encouraged, and stressful because of these reasons. Thus, it can be said that job dissatisfaction is totally dependent upon stress, anxiety, and burnout.

Another cross sectional study was conducted on nurses in Icelandic Nurse's Association. There were randomly selected, 522 nurses with a response rate of 42% by Sveinsdottir, Biering & Ramel (2006), which have shown that the major reason behind the increased job dissatisfaction of nurses is occupational stress. The study has described that occupational stress can affect the personal and professional behavior of a nurse. A nursing professional can develop the symptoms of burnout, confusion, loss of concentration, and weaker decision making skills due to occupational stress. All of these symptoms will make a direct impact on the professional performance of a nurse. It is also a fact that the factor of occupational stress will affect the abilities of critical thinking, which will directly affect the professional attitudes of the nursing professionals. Thus, it can be said that occupational stress has the capability to influence the performance of nurses, which will result in the increased level of job dissatisfaction.

Job Dissatisfaction and Quality of Healthcare

A cross sectional study was conducted by McHugh, et al. (2011) on 95499 nurses in four states in the United Stated, which has focused on the factors of burnout and frustration, in relation with the job dissatisfaction, limited workforce of the nursing professionals, and the quality of healthcare. The study has described that increased level of job dissatisfaction among the nursing professionals is emerging various health related problems for the patients. The patients are getting directly affected because of the decreased satisfaction level of the nursing professionals. The study has mentioned that nurses have a close relationship with their patients in the clinical settings. They are authorized and responsible to work for the improved health status of them. Most of the nursing professionals usually develop therapeutic relationship with the patients, which results in addressing the complications among them. However, the study has found that the factor of job dissatisfaction is directly associated with the disturbed therapeutic relationship with the patients.

This study further indicated that the shortage of nursing professionals is getting extremely common because of job dissatisfaction. Some of the statistical reports have mentioned that 29% of the nursing professionals left their professional responsibilities because of low salaries and unprofessional environment. Furthermore, this review has also described that most of the nursing professionals are not happy with the behavior of their co-workers, which is also affecting their satisfaction level and performance in the clinical settings. Therefore, it can be said that the quality of healthcare will become affected because of reduced satisfaction level of the nursing professionals (Zangaro & Soeken, 2007).

Job Satisfaction and Improved Healthcare Quality

A qualitative study was conducted in Germany and Austria on 534 nurses working in cancer care. The study involved 8 university hospitals and general hospitals with a response rate of 76.1% (Sehlen, 2009). The investigation illustrated that the factor of job satisfaction is directly associated with the improved quality of healthcare. It is a fact that the improved job satisfaction level of the nursing professionals has a direct relationship with the enhanced health care quality in the clinical settings. The study selected physicians and nursing professionals for the assessment of job satisfaction level. The research described that nursing professionals were less motivated and satisfied with their job compared to physicians. Additionally, the study has also shown that the quality of healthcare was also affected due to the decreased satisfaction level of nurses. Therefore, selected healthcare organizations increased their salaries for nursing professionals, and developed new opportunities for the increased satisfaction level of the nurses.

Another cross sectional study was conducted by Ahsan, et al. (2009) in the territories of Malaysia. The study focused on the factor of job satisfaction among the nursing professionals. The study described that enhanced level of satisfaction is strongly connected with the improved quality of healthcare processes. Moreover, the study described deprived autonomy, job length, and stress as factors that affect the job satisfaction and motivation of the nursing professionals. Increased level of occupational stress is strongly connected with the decreased level of job satisfaction. Therefore, the study has clearly indicated that the healthcare organizations should use appropriate strategies to improve the professional attitudes of nurses. It is also mentioned by the study that healthcare quality is strongly connected to the increased satisfaction level of the nursing professionals (Ahsan, et al., 2009). Therefore, the study has concluded that the organizations should work hard for reducing the level of occupational stress among the nursing professionals for improving the quality of nursing care.

Another descriptive cross sectional study was carried out by Mrayyan (2006), which have identified a major relationship between nurses' job satisfaction and quality of the healthcare. The study has described that the quality of nursing care is required by the organization to make a positive reputation in the community settings. It is a fact that ineffective performance of the healthcare professionals affect the reputation of the organization and its behaviors. The study selected 200 nurses, 510 patients, 26 head nurses for the identification of positive outcomes in Jordanian Educational Hospital. The outcomes of the study have described that the job satisfaction level of the nursing professionals are average because of appropriate strategies of the organization.

A similar study was conducted by Castle, Degenholtz & Rosen (2006), which focused on the satisfaction level of nurses. The study described that job satisfaction plays a major role in the management of nursing staff and other professionals. The rationale behind this statement is that the factor of job satisfaction is directly associated with the improved quality of the nursing care, and the enhanced motivation level of nurses. For the purpose of the investigation, the study selected 251 nursing professionals, which were evaluated on the basis of job satisfaction. The results of the nursing professionals mentioned that majority of the nurses were not motivated and satisfied with their job. Similarly, the outcomes have also mentioned that the satisfaction level of the patients was also impaired because of poor delivery of nursing care. Therefore, the study concluded that the improved satisfaction level of the nursing professionals is strongly associated with the improved health care quality.

Methodology

Study Design

The study will use a quantitative research method for the collection and analysis of the data. Two different questionnaires will be used for the collection of data. The first questionnaire will be comprised of nine questions, and will be distributed among the selected nurses. However, the second questionnaire will also be comprised of six questions, and will be distributed among the patients.

Sample Size and Participants

The study will select 60 nurses and 60 patients from three well-known hospitals of Saudi Arabia. There will be 20 nurses and 20 patients selected from a single selected hospital. The inclusion criteria for the selection of nursing are registered nurses (RN) who have a one year experience. All of the physicians, pharmacists, and other staff members will be excluded from the project. The patients, who received healthcare from the selected nurses, will be included in the project. If the patient will not participate in the study, then the respective nurse will also be dropped from the project.

Time Frame and Process

The study will be carried out in the time frame of two months. Permission will be taken from the administrations of three selected hospitals for the collection of data. The participants of the study will be selected in the initial 15 days. Then, the questionnaires will be distributed among the participants in the next 15 days. However, 5 days will be kept for the participants of single hospital. Then, the collected data will be entered in a computer software for the purpose of statistical analysis and appropriate outcomes. This step will then take 10 more days. The Final 20 days will be used for detailed and comprehensive analysis of the data with the development of proper research article.