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Satisfaction with the Quality Nursing Work Environment Among Psychiatric Nurses Working in Acute Care General Hospitals

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Satisfaction with the Quality Nursing Work Environment Among Psychiatric Nurses Working in Acute Care General Hospitals ORIGINAL ARTICLE The Journal of Nursing Research ▪ VOL. 28, NO. 2, APRIL 2020 Satisfaction With the Quality Nursing Work Environment Among Psychiatric Nurses Working in Acute Care General Hospitals Chiou-Fen LIN1 • Fu-Chih LAI2 • Way-Ren HUANG3 • Chung-I HUANG4 • Chia-Jung HSIEH5* shortages and high rates of turnover have become issues affecting ABSTRACT the nursing profession in many countries (Marć, Bartosiewicz, ń Background: The objective of this study was to investigate the Burzy ska, Chmiel, & Januszewicz, 2019). Although the impact on patient care quality of a positive, high-quality environ- reasons for these shortages are varied and complex, key ment that is tailored to the practice of nursing. This study en- reasons include unhealthy work environments and poor abled nurses to show their professional skills and knowledge, organizational climates, which characterize many work- which may help enhance job satisfaction. To date, little research places today (International Council of Nurses, 2007). In recent has been done to assess the relationship between the nursing decades, many countries have restructured, reorganized, and work environment and the job satisfaction of psychiatric nurses reengineered their healthcare systems, and as a result, posi- employed in acute wards of general hospitals. tive work environments for healthcare delivery have become Purpose: This study was designed to explain the relationship an important and powerful factor affecting nurses in clinical between job satisfaction and the perceived indicators of a qual- practice (Hinno, Partanen, Vehviläinen-Julkunen, & Aaviksoo, ity nursing work environment (QNWE) after adjusting for demo- 2009). A positive environment for nursing practice leads to graphic characteristics and work characteristics. higher quality patient care (Ward, 2011), may enable nurses Methods: A cross-sectional correlational design was em- to show their professional skills and knowledge (Currie, ployed, and a stratified random sample of 185 psychiatric Harvey, West, McKenna, & Keeney, 2005), and may foster nurses (99% response rate) working in acute wards in Taiwan self-actualization in nurses (Burtson & Stichler, 2010). A fur- was surveyed in 2013. Nurses were asked to complete a self- ther effect of a positive environment is an improved sense of administered questionnaire that included measures of per- job satisfaction (Lu, Barriball, Zhang, & While, 2012). Finally, ceived QNWE and job satisfaction and demographic variables. a positive work environment may help increase employee Results: A statistically significant, positive relationship was retention in a current workplace (Al-Hamdan, Manojlovich, found between perceived indicators of QNWE and job satisfac- & Tanima, 2017). Previous studies have found a negative tion (r =.813,p < .001). In the hierarchical multiple linear regres- relationship between job satisfaction and intent to leave sion model, for the subdimensions of QNWE, the variables (Alsaraireh, Quinn Griffin, Ziehm, & Fitzpatrick, 2014; Baum “perceived indicators of professional specialization and team- & Kagan, 2015). In addition, job satisfaction has been found ” “ ” work and support and caring showed a significant and pos- to mediate the relationship between organizational commit- itive association with job satisfaction, after adjusting for ment and intent to leave. Thus, for nurses, job satisfaction personal demographic characteristics. is associated with greater organizational commitment, re- Conclusions/Implications for Practice: Job satisfaction is re- ducing the percentage of nurses expressing intent to leave lated to the perception of nurses regarding their work environ- ment. Therefore, nursing managers should improve workplace 1 PhD, RN, Professor, School of Nursing, Taipei Medical University, and satisfaction by supporting and caring for nurses and creating Nursing Consultant, Department of Nursing, Shuang Ho Hospital, better career development and teamwork opportunities for Taipei Medical University • 2PhD, RN, Associate Professor, College of nurses through job training and planning. Nursing, Taipei Medical University • 3PhD, RN, Postdoctoral Research Fellow, Operations Center for Industry Collaboration, National Tsing Hua University • 4PhD, Deputy Director, Center for Management and KEY WORDS: Development, and Adjunct Assistant Professor, School of Health Care job satisfaction, nursing work environment, psychiatric nurse, Administration, Taipei Medical University • 5PhD, RN, Associate organizational support, teamwork. Professor, School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences. Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved. Introduction This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, Nurses are a critical part of the healthcare system and make up distribution, and reproduction in any medium, provided the original the largest segment of the healthcare workforce. However, work is properly cited. 1 The Journal of Nursing Research Chiou-Fen LIN et al. the current workplace (Shacklock, Brunetto, Teo, & Farr- satisfaction for nurses (Lu et al., 2012), empirical evidence in- Wharton, 2014). dicates the need for continued improvement. However, nurses A positive work environment has been defined as a work in different countries may hold different perceptions of what setting in which nurses are able to achieve organizational constitutes quality in the work environment (Lu et al., 2012). goals and to derive personal satisfaction from their work Previous studies have investigated the essential qualities (Lin, Lu, & Huang, 2016). Managerial strategies designed for nurses in the hospital environment, and other work has to reduce the negative effects of organizational complexity investigated important aspects of a healthy work environment on employee productivity, work quality, and retention have and nurses' work experiences (Budge et al., 2003; Milisen, emerged in a variety of industries and settings. Recent research Abraham, Siebens, Darras, & Dierckx de Casterle, 2006). has focused on “Magnet hospitals” because of their reputa- However, few studies have concentrated on the percep- tion for good work environments, success in attracting and tions of psychiatric nurses regarding their work environment retaining qualified nurses, and improved patient outcomes (Gardner, Thomas-Hawkins, Fogg, & Latham, 2007). Although (Friese, Xia, Ghaferi, Birkmeyer, & Banerjee, 2015). In the the psychiatric nursing shortage persists and the number of Magnet Recognition Program of the American Nurses Credential- individuals with mental health issues and psychiatric disorders ing Center, which identifies hospitals that epitomize nursing increases, empirical data on psychiatric nurses' perceptions re- excellence, using a win-win strategy for nursing and hospi- garding the quality of nursing work environments in acute inpa- tals was highlighted as an effective approach to achieving tient care are scarce. Psychiatric nursing is a stressful occupation, collaboration among healthcare institutions (Centrella-Nigro with potential effects on the health and job satisfaction of care et al., 2015); in other words, nursing managers must be able providers (Alsaraireh et al., 2014). One qualitative study indi- to create work situations that are assertive and cooperative cated that job satisfaction in the psychiatric workplace might with each other. Interest is growing regarding the perceptions influence the retention rate of nurses who work in mental of nurses toward their work and work environment to ad- health services (Ward & Cowman, 2007). dress current and potential future nursing workforce-related Minimal research has assessed the relationships among el- problems (Friese et al., 2015). As a result, understanding nurses' ements in the nursing work environment and job satisfaction perceptions of their work and work environment is critical to ef- in psychiatric nurses employed in acute wards. Moreover, to fective management. It is important to note associations among the knowledge of the investigative team, the correlation be- burnout, job satisfaction, and work environment (Khamisa, tween perceived QNWE and job satisfaction adjusted for per- Oldenburg, Peltzer, & Ilic, 2015). Research findings have linked sonal characteristics among psychiatric nurses in Taiwan is a burnout in nurses to several specific work environment fac- topic rarely considered in the literature. Therefore, this study tors, including high workload, poor collegial support, sense of was designed to fill a gap in understanding regarding psychi- coherence, and overall work-environment quality (Hanrahan, atric nursing in Taiwan and provide critical information to Aiken,McClaine,&Hanlon,2010;Levert,Lucas,&Ortlepp, human resource managers. 2000). Moreover, prolonged exposure to stressful work environ- The aims of this study were as follows: (a) to explore the ments diminishes job satisfaction (Khamisa et al., 2015). perceived QNWE from the perspective of psychiatric nurses using a nationwide survey, (b) to compare the differences in perceived indicators of QNWE between two groups of nurses Background with different levels of job satisfaction, and (c) to explain the The qualities of a positive nursing environment identified in relationship between job satisfaction and the perceived indi- previous studies include the leadership attributes of nursing cators
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