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3. professional satisfaction b sc nsg stu

  1. 1. Professional Satisfaction among Pass-out B.Sc. NursingGraduates of B. P. Koirala Institute of Health Sciences Nepal *1Mehta RS, *2Yadav R. Email : ramsharanmehta@gmail.comAbstract:Professional Satisfaction is a measure of valuation or an inner estimation or judgment ofwhether the expectations are met from the profession or not. This study was conducted to findout the professional satisfaction among pass-out B.Sc. Nursing graduates from BPKIHS frombatches 1996 to 2004. Descriptive, cross-sectional study design was adopted to carry out thestudy. Using convenient and snowball sampling technique, out of 104 graduates, 50 wereincluded in the study. A pre-tested semi-structured questionnaire was used by selfadministration method to collect the information.Regarding satisfaction in different areas highest satisfaction was with status / security /respect (75%) and lowest with working condition (54%). The areas with decreasing value ofsatisfaction were growth and development, and interpersonal relationship (72%),achievement, recognition and accomplishment, salary, and supervision (70%), autonomy /challenging work / increased responsibility (69%). The majority of the respondents (54%)stated that there is job security in the profession and the opportunity to help others (52%) wasthe reason for their satisfaction, but 28% said that there is no updating of knowledge andthere is no autonomy (30%) in nursing profession.Based on this study we conclude that there is no difference in professional satisfaction of therespondents living in Nepal and abroad. Satisfaction is dependent upon age but not uponother independent variables. It is seen that though there are many problems and many areas ofdissatisfaction in nursing profession the respondents are satisfied to some extent with it andthe reason for brain drain among B.Sc. Nursing graduates were their personal interest.*1Ram Sharan Mehta, Associate Professor, Medical-Surgical Nursing DepartmentEmail: ramsharanmehta@hotmail.com, B. P. Koirala Institute of Health Sciences*2Ruby Yadav, B. Sc. Nursing, College of Nursing, B. P. Koirala Institute of HealthSciences
  2. 2. Introduction:The goal of nursing is to restore, maintain and advance the health of the patient. It is both ascience and an art. The science is the application of nursing knowledge and the technicalaspects of the practice. The art is the establishment of a caring relationship through which thenurse applies nursing knowledge and uses judgment in a compassionate manner. Both focuson the whole person, not just a particular health problem.According to the study conducted by Tzeng1, the level of job satisfaction among care workersis positively correlated with client satisfaction. Similarly Watanabe2 stated that jobsatisfaction and intention to turnover among care workers have been suggested as importantfactors determining the quality of services.Study conducted by Gleason3 stated that job satisfaction is a strong and significant predictorof worker’s intention to leave the job. Similarly another study conducted by Gaur4 stated thatthose who are not satisfied with their job are more likely to think about quitting their jobs.Even if they do not actually take the action, just having such thoughts may have a negativeimpact on the quality of care service.With reference to the behaviors of nurses that lead to mistakes in public practice, a studyconducted by Zhong5 in California, USA demonstrated that the majority of nurses were notdisciplined for system errors i.e. 70% of the cases reported in the study (N=207) wereunrelated to system errors. Instead, they resulted from misjudgment, misconduct, orincompetence. These violations threaten the public safety.According to Burton6, nurses perceive self-fulfillment and a sense of accomplishment orachievement as factors which contribute to job satisfaction. In addition, educationalopportunities, intellectual motivation and the occasion to develop new skills, rank high on thelist of job satisfiers.The study by Storey7 reported that flexibility or its absence in working arrangements appearto be a key factor influencing nurse’s decision to leave. Lack of autonomy, support andfeeling valued are also important while making the decision.According to Weisman8, job dissatisfaction is the main reason why nurses leave theirpositions, while the predominant issues associated with job dissatisfaction include nursingcontrol and career opportunities. Similarly a study conducted by Yamashita18 in studyingJapanese nurses, found that little opportunity for promotion negatively affected jobsatisfaction.The Murrells10 in his study in UK reported that the impact of time on job satisfaction in earlycareer is highly dependent on specialization. Different contexts, settings and organizationalsettings lead to varying experiences. Future research should focus on understanding therelationships between job characteristics and the components of job satisfaction rather thanjob satisfaction as a unitary construct. Research that further investigates the benefits of aformal one year preceptorship or probationary period is needed. We conclude that the impactof time on job satisfaction in early career is highly dependent upon specific jobs, even withinthe same profession. 2
  3. 3. Objectives1. To identify the professional satisfaction among pass-out B.Sc. Nursing graduates of BPKIHS from 1996 to 2004 batch.2. To compare the professional satisfaction of pass-out B.Sc. Nursing graduates working in Nepal and abroad.3. To find out the association between professional satisfaction and selected demographic variables (age, gender, current residence, marital status, duration of employment, living with and designation).Research Design and Methodology:A descriptive cross sectional research design was used to conduct the study. The research wasconducted among pass-out B.Sc. Nursing graduates from BPKIHS from 1996 to 2004 batchliving in Nepal and abroad and related to nursing profession. A convenient and snowballsampling technique was used to collect the data. Fifty subjects were included in the study. Aself prepared semi structured pre-tested questionnaire was used for data collection.Likert scale was used for rating the satisfaction in different areas. It consists of positive andnegative items. Positive items were rated as strongly disagree to strongly agree and thescoring was given accordingly (1, 2, 3, 4 and 5). Reverse scoring was given for negativeitems i.e. strongly disagree to strongly agree and scoring varied as 5, 4, 3, 2 and 1. Negativeitems included number 6, 21, 27, 28 and 29 and rest all was positive. Maximum obtainablescore was 190. Different items were included to assess the professional satisfaction in eacharea. Obtained scoring (overall and in specific areas) were converted into percentages andinterpreted by using median percentage and inter-quartile range.A list of pass-out B.Sc. Nursing graduates was obtained from Academic Section andcorresponding address collected from college of nursing, available friends and relatives. Forthe pass-out students who were in BPKIHS questionnaire was given directly. Postal, visiting,e-mailing was applied for those in eastern region of Nepal and Kathmandu and e-mailing wasdone for those working abroad for data collection. Convenient and snowball samplingtechnique was used for data collection. Data collection period was of from 10th January to10th June 2009.Results:Half of the respondents were of age group 22-25 yrs, 88% were females, 98% were Hindusand 50% were Brahmin / Chettri, 30% Newar, 56% were married, 58% living in Nepal andrest abroad (USA, Bangladesh, South Korea, Ireland, China, India and UK). With regards towork experience, 32% had 1-2 yrs of experience and 30% had > 3 yrs experience. Withregards to qualification 70% had not done any further study after B. Sc., 14% had done M.Sc. Nursing and 12% had done Masters in other nursing related fields.Majority of the respondents (44%) were working at the post of Nursing Instructor / Officer /Tutor / Sister and 18% are at Assistant Lecturer / Researcher. Among the ones living in Nepalmost (75.9%) were at officer level post and the rest were at the post higher than officer level.Among the ones living abroad majority (57.1%) were nursing students and 33.4% wereworking as RN / Staff Nurse.Majority of the respondents (56%) said that nursing is a noble profession because of itscaring nature and dedication to make a difference in others life (10%). Thirty percent of the 3
  4. 4. respondents did not answer to this question and 2(4%) of the respondents said that there isnothing to quote noble for nursing. In their view it is as respected as other professions.The majority of the respondents (36%) said that there is lack of autonomy and self sustainingpractices in this profession and 36% mentioned that there is no updating of knowledge andskills. Most of them (20%) quoted that there is a social stigma that nurses are assistant to thedoctors and ego problems of seniors which is also a problem of this profession. The majorityof the respondents (54%) said job security and 52% said opportunity to help as the majorreason for their satisfaction with nursing profession.Few respondents (20%) said that there is less reward and it is overshadowed by medicalprofession and 18% also said that there is social stigma attached with this profession which isthe reason for their dissatisfaction with nursing profession. The majority of the respondents(24%) said that one should respect and accept the profession and 16% said that the pass-outgraduates should aspire for higher studies as early as possible in order to improveprofessional satisfaction among pass-out B.Sc. Nursing graduates from BPKIHS.The majority of the respondents (44%) said that there should be adequate supervision andguidance especially in clinical posting and 18% said that updated information should begiven by nursing faculties in their related departments in order to improve nursing training inBPKIHS.Discussion:No significant difference was found between professional satisfaction and selectedindependent variables (p-value = 0.076 for gender, 0.074 for marital status, 0.342 for durationof employment, 0.341 for living with spouse and 0.764 for designation) and significantdifference was found between professional satisfaction and age (p-value = 0.039) whichshowed that with increasing age professional satisfaction was more (Spearman’s correlationcoefficient = +0.392. Hence, at 5% level of significance the researcher concludes that the nullhypothesis I is partially accepted.There was no significant difference between professional satisfaction of B. Sc. Nursinggraduates living in Nepal and abroad (p-value = 0.992 for overall satisfaction, 0.721 forachievement, 0.532 for recognition and accomplishment, 0.309 for autonomy, challengingwork and increased responsibility, 0.906 for growth and development, 0.441 for salary, 0.813for interpersonal relationship, 0.259 for status, security and respect and 0.876 forsupervision). Hence, at 5% level of significance the researcher concludes that the nullhypothesis II is not rejected meaning that professional satisfaction in not affected by thecountry of residence.Suggestion to improve professional satisfaction among B. Sc. Nursing graduates and nursingeducation at BPKIHS: They suggested for higher studies as soon as possible (16%) and thinkpositive (14%).They also suggested to improve nursing training in BPKIHS, majority of the respondents(44%) said that there should be adequate supervision and guidance especially in clinicalposting and 14% said that there should be continue training by nursing faculties in theirrelated departments. 4
  5. 5. Conclusion:This study concludes that there is no difference in professional satisfaction of the respondentsliving in Nepal and abroad. Also satisfaction is dependent upon age but not upon otherindependent variables like gender, current residence, marital status, living with anddesignation. It can be said that in spite of many problems and areas of dissatisfaction innursing profession the respondents are satisfied to some extent with it.References: 1. Treng HM, Ketefian S, Redman RW. Relationship of nurse’s assessment of organizational culture, job satisfaction, and patient satisfaction with nursing care. Int J Nurs stud 2001;22:3-14. 2. Watanabe RN. Effect of age on job satisfaction and intention to turnover among female nursing home care workers. Journal of Policy Studies. 2005 Mar; 19: 75-89. 3. Gleason WP, Mindel CH. A proposed model for predicting job satisfaction among nursing home social workers. J Geronto Soc Work 1999;32:65-79. 4. Gaur L, Chandler B, Burton B, Kolditz D. Institutional loyalty and job satisfaction among nurse aides in nursing homes. Journal of Aging and Health 1991; 3:47-65. 5. Mason D. Letters: Who’s watching nurses? Am J Nurs [Serial online] 2009 March [cited 2009 July 17] 14: Available from: URL: http://hinari_gw.who.int 6. Burton EC and Burton DT. Job expectations of senior nursing students. J Nurs Adm 1982;12(3):11-17. 7. Storey C, Cheater F, Ford J and Leese B. Retention of nurses in the primary and community care workforce after the age of 50 years: database analysis and literature review. J Adv Nurs 2009 Mar;65(8):1596-1605. 8. Weisman CS. Recruit from within: hospital nurse retention in the 1980’s. J Nurs Adm 1982;12(5):24-31. 9. Yamashita M. Job satisfaction in Japanese Nurses. J Adv Nurs 1995;22(1):158-164. 10. Murrells T, Robinson S, Griffiths P. Job satisfaction trends during nurses early career, BioMed Central 2008;(7)7. 11. Ruth HC, James DM. Job satisfaction of staff registered nurses in primary and team nursing delivery systems [serial online] 1981 Jan [cited 2009 July 17] Available from: URL:http://www3.interscience.wiley.com/journal/114081992/abstract 12. Fitzenberger B and Wunderlich, G. The changing life cycle patterns in female employment: A comparision of Germany and the UK. 2002; Discussion paper No. 02- 70. Mennheim: The Center for European Economic Research (ZEW). 13. Morinaga, Y. Work values and Career Patterns of Women College Graduates in Japan. Kobe College Studies 1999;46:133-148. 5
  6. 6. Table 1 Association between Percentage Satisfaction in Various Components of Profession and Residence Median percentage of Professional Remarks Satisfaction p-valueS.N. Item/ Particulars (IQR) Nepal Abroad n=29 n=21 1 Achievement 72 (60-82) 68 (60-76) 0.721 NS 2 Recognition and accomplishment 70 (60-80) 70 (62.5-80) 0.532 NS 3 Autonomy/Challenging work/ 71 (63-77) 63 (55.5-77) 0.309 NS Increased responsibility 4 Growth and development 72 (60-88) 72 (60-90) 0.906 NS 5 Salary 70 (60-70) 60 (60-75) 0.441 NS 6 Interpersonal relationship 72 (64-80) 76 (60-80) 0.813 NS 7 Working condition 52 (40-64) 64 (48-78) 0.068 NS 8 Status/Security/Respect 75 (65-85) 70 (57.5-77.5) 0.259 NS 9 Supervision 60 (50-80) 80 (40-80) 0.876 NS Mann Whitney U Test Key: S = Significant, NS = Not Significant Table2 Association between Professional Satisfaction and Selected Independent Variables n=50 Median percentage of S.N. Characteristics Categories p-value Remarks satisfaction (IQR) 1 Age <25 years 65 (58-71) 0.039 S >25 years 72 (66-77.5) 2 Gender Male 74.5 (71-77) 0.076 NS Female 67.5 (58.25-74.75) 3 Current residence Nepal 68 (60-75) 0.992 NS Abroad 68 (61-76) 4 Marital status Single 66.5 (58-72) 0.074 NS married 73 (65-77) 5 Duration of <1 yr 65.5 (57.75-77.25) 0.342 NS employment >1 yr 69 (64.25-75) 6 Living Alone 67.5 (58.25-71) 0.341 NS With spouse / family 68.5 (62-75.5) or others 7 Post / designation >officer level 74 (65.5-76.5) 0.764 NS <officer level 69 (64.25-77)Mann Whitney U Test Key: S = Significant, NS = Not Significant 6