Practitioner Job Satisfaction Research Articles

Facets of job satisfaction of dental practitioners working in different organisational settings in England

Before April 2006, English dentists were either working as an NHS general dental service (GDS) practitioner (fee-per-item, no local contractual obligations); an NHS personal dental service (PDS) practitioner (block contract with the primary care trust (PCT)); a private practitioner (either fee-per-item or capitation-based, independent of the PCT); or in a situation where they were mixing their NHS work (either under the GDS or PDS arrangements) with private work. To a) investigate the extent of the mix of NHS and private work in English dentists working in the GDS and PDS, b) to compare global job satisfaction, and c) to compare facets of job satisfaction for practitioners working in the different organisational settings of PDS practices, GDS practices and practices where there is a mix of NHS and private provision. Method A questionnaire was sent to 684 practitioners, containing 83 attitudinal statements relating to job facets, a global job satisfaction score and questions concerning workload. Response rate was 65.2%. More PDS than GDS dentists were found to treat the majority of their patients under the NHS. GDS dentists working fully in the NHS were least likely to be satisfied with their job, followed by PDS practitioners and then GDS dentists working in mixed NHS/private practices. Private practitioners were the most satisfied. Differences between GDS, PDS and private practitioners were found in global job satisfaction and in the facets of job satisfaction related to restriction in being able to provide quality care, control of work and developing clinical skills.

Job Satisfaction Among Multiple Sclerosis Certified Nurses

Several studies document high levels of job satisfaction among certified nurses, but no study has examined job satisfaction and factors influencing job satisfaction of certified multiple sclerosis (MS) nurses. This study tested a theoretical model proposing that two organizational factors, colleague relationships and benefits, will predict job satisfaction. Job satisfaction was represented by four factors: autonomy, professional status, professional growth, and time efficiency. Participants included MS nurses certified for 6 months or more practicing mostly in three countries (Canada, Great Britain, and the United States) who anonymously completed the Misener Nurse Practitioner Job Satisfaction Scale, an overall job satisfaction rating, and demographic information. Findings indicate that colleague relationships and benefits significantly estimated organization structure and that autonomy, professional status, professional growth, and time efficiency significantly estimated job satisfaction; furthermore, organization factors such as colleague relationships and benefits significantly predict job satisfaction. Among the countries, several statistically significant differences were observed between job satisfaction factors as well as items in both organization and job satisfaction subscales. Average factor scores among the countries were mostly rated satisfactory. The International Organization of Multiple Sclerosis Nurses Executive Board plans to use the study findings to see how it needs to focus efforts as an organization toward enhancing and standardizing MS care and develop MS nurse professionalism worldwide.

Job satisfaction among Arizona adult nurse practitioners

A literature review for studies of job satisfaction among nurse practitioners (NPs) suggests that the true determinants of job satisfaction have not been discovered. The purpose of this study was to determine job satisfaction among adult health NPs (ANPs) practicing in Arizona. The Misener nurse practitioner job satisfaction scale was mailed to 329 Arizona ANPs who were certified by the Arizona State Board of Nursing (47% response rate). The mean overall satisfaction score was 4.69 out of a possible score of 6.0 for very satisfied. Differences in employer type, gender, annual income, membership in professional nursing organization, or full-time versus part-time employment status did not result in significantly different scores on the job satisfaction scale in this group. A deep and sustained nursing shortage, the exodus of experienced nurses from the profession, and a projected shortage of primary care providers have generated interest among professional groups, private and government healthcare commissions, and the healthcare industry in determining what factors may influence an individual to choose and remain active in nursing practice. Researchers, educators, employers, and the healthcare industry must look beyond well-worn assumptions about job satisfaction to explore what the individual NP finds satisfying about his or her role.

Supporting frail older people and their family carers at home using information and communication technology: cost analysis

This paper describes a cost analysis of a home-based support service for frail older people and their family carers in two municipalities in West Sweden and using information and communication technology. A key challenge facing nurse managers across Europe is an increasingly aged population, combined with reduced numbers of young adults of working age. New solutions are needed to provide quality, cost-effective community care services to frail older people and their family carers. A case study methodology involving five families was used, and included a detailed cost description of the technology-based service compared with usual services. Cost data were collected in June 2002. This work formed part of a larger project exploring the impact of a technology-based service known as, Assisting Carers using Telematics Interventions to meet Older Persons' Needs (ACTION). In addition to cost data, information was gathered on the quality of life of frail older people and their family carers, and the job satisfaction and work methods of nurses and other practitioners based in the community. The cost analysis comprised a description of the family and their caring situation, the perceived benefits of the telematic based support service and an assessment of its impact on the use of other care services. These analyses were carried out with the help of needs assessors who were known to the families, and nurses working in the ACTION call centre. All results were validated by the five participating families. Cost savings were achieved in all cases, and the benefits to older people and their carers were also considerable. As a result of the cost analysis and overall evaluation data, ACTION has been implemented as a mainstream service in the municipalities involved. Researchers, nurses, other practitioners and community care managers can work together with frail older people and their family carers to develop quality, cost-effective support services that reduce demands on staff whilst providing benefits to users.

Health care reform and job satisfaction of primary health care physicians in Lithuania.

BackgroundThe aim of this research paper is to study job satisfaction of physicians and general practitioners at primary health care institutions during the health care reform in Lithuania.MethodsSelf-administrated anonymous questionnaires were distributed to all physicians and general practitioners (N = 243, response rate – 78.6%), working at Kaunas primary health care level establishments, in October – December 2003.Results15 men (7.9%) and 176 women (92.1%) participated in the research, among which 133 (69.6%) were GPs and 58 (30.4%) physicians. Respondents claimed to have chosen to become doctors, as other professions were of no interest to them. Total job satisfaction of the respondents was 4.74 point (on a 7 point scale). Besides 75.5% of the respondents said they would not recommend their children to choose a PHC level doctor's profession. The survey also showed that the respondents were most satisfied with the level of autonomy they get at work – 5.28, relationship with colleagues – 5.06, and management quality – 5.04, while compensation (2.09), social status (3.36), and workload (3.93) turned to be causing the highest dissatisfaction among the respondents. The strongest correlation (Spearmen's ratio) was observed between total job satisfaction and such factors as the level of autonomy – 0.566, workload – 0.452, and GP's social status – 0.458.ConclusionTotal job satisfaction of doctors working at primary health care establishments in Lithuania is relatively low, and compensation, social status, and workload are among the key factors that condition PHC doctors' dissatisfaction with their job.

Measurement of nurse practitioner job satisfaction in a midwestern state

To describe the current level of job satisfaction of nurse practitioners (NPs) in one Midwestern state. This study utilized descriptive correlation design to examine factors that lead to job satisfaction and dissatisfaction among a randomized sample of licensed NPs from a Midwestern state. The sample of 147 NPs (63% return rate) completed self-administered questionnaires about various characteristics of their jobs. Descriptive statistics and correlations were used to analyze the data. The theoretical foundation for the study was Herzberg's Dual Factor Theory of Job Satisfaction. Overall job satisfaction of NPs was minimally satisfied to satisfied. NPs were most satisfied with intrinsic factors and least satisfied with extrinsic factors of their jobs. Factors NPs were most satisfied with were sense of accomplishment, challenge in work, level of autonomy, patient mix, and ability to deliver quality care. NPs were least satisfied with time off to serve on professional committees, reward distribution, amount of involvement in research, opportunity to receive compensation for services outside normal duties, and monetary bonuses available in addition to salary. NPs with 0-1 year practice experience were the most satisfied with their jobs, but satisfaction scores fell steadily with each additional year of experience, reaching a plateau between the 8th to 11th years of practice. Improving job satisfaction for NPs is critical to recruit and retain advanced practice nurses to enhance access to quality, cost-effective care for all patient populations. Satisfied NPs can potentially reduce healthcare costs associated with employee turnover. Employers must look at extrinsic factors such as compensation and opportunities for professional growth to enhance NP job satisfaction.

COLLABORATIVE PRACTICE BETWEEN REGISTERED NURSES AND MEDICAL PRACTITIONERS IN AUSTRALIAN GENERAL PRACTICE: MOVING FROM RHETORIC TO REALITY

Collaborative practice between medical practitioners and nurses is purported to improve patient access to services, improve health outcomes, provide a more ‘seamless service’, increase efficiency of care, reduce health care costs and improve practitioner job satisfaction. Therefore, it is important to understand what hinders and what facilitates this type of interdisciplinary functioning. This paper will examine these factors in the context of the Australian general practice setting. It is timely because recent Government financial incentives have been provided to increase the number of nurses employed in this sector and also to expand their role. Awareness of these factors may enable nurses in general practice, both individually and collectively, to better understand the dynamics of role expansion in order to move towards collaborative partnerships with their medical colleagues. Recommendations to advance collaborative practice are given and a model of practice proposed that identifies possible autonomous, collaborative and dependent functions for nurses in general practice.

Comments on “Primary nursing: an evaluation of its effects on patient perception of care and staff satisfaction”

This paper described a landmark small trial (Intervention group n 1⁄4 28; Control group n 1⁄4 31) which developed and tested earlier research regarding relational continuity of care in the acute hospital setting. Significantly higher levels of both patient and nurse satisfaction were reported where primary nursing was practised. The trial also highlighted the complexity of conducting trials in the natural setting of real acute hospital wards where control of extraneous variables is always a challenge but importantly the trial addressed key ongoing issues in healthcare namely: patient experience and job satisfaction of practitioners. While the authors acknowledged the limitations of their measurement tools, it could be argued that the patient satisfaction instrument was rather naive but reflected the extent of understanding at the time. Patient satisfaction was measured by a specially designed selfreport questionnaire comprising 11 items, 10 of which explored perceptions of nursing care received and one item recorded the recall of the number of nurses having contact during the last 24 h as a proxy for the number of nurses providing care. Patients were asked to rate their perceptions against a 3 point scale which may have encouraged response bias towards the median. Further, the measurement of patient satisfaction has been subject to much criticism over the years principally due to the lack of clarity surrounding the concept (Locker and Dunt, 1978; Fitzpatrick and Hopkins, 1993; Sitzia and Wood, 1997) with the inability of global statements to identify different levels of satisfaction relating to various aspects of care. Thus Question 5: ‘How well do you think the nurses understood you?’ did not permit study participants to consider differential experiences relating to the many aspects of nursing care received. The significant differences between the control and intervention groups must therefore be interpreted with caution. Similarly, the lack of expressed dissatisfaction by the control group was not surprising since the majority of patients consistently report high levels of satisfaction (Locker and Dunt, 1978). This research also highlighted the impact of the method of care delivery upon nurses’ job satisfaction. The nurses’ satisfaction instrument was more sophisticated utilising 7 and 4 point Likert scales and items drawn from previous work. The five items demonstrating significant differences between the control and intervention groups were associated with more autonomous clinical practice namely: ‘accomplishment of something worthwhile’, ‘opportunity to voice opinions’, participation in making decisions, speed of work, and setting own pace of work. These issues have resonance today and are regarded as issues of importance for the job satisfaction of nurses. However, the impact of this research and other similar work is evidenced by the change in nursing care delivery and the rejection of task oriented care delivery. Indeed, no hospital ward in United Kingdom now organises care along task lines rather the named nurse or team nursing are the norm although the reality at the bedside may result in little relational continuity with a single practitioner with the increasing use of health care assistants and temporary/agency nurses to make up the shortfall of permanent qualified nurses. Nonetheless, continuity of care including continuity of caregiver remain important aspirations within nursing provision and are often considered benchmarks of high quality healthcare. The universal reduction in the length of hospital in-patient stays has further highlighted the importance of relational continuity between patients and nurses if meaningful supportive relationships are to be developed between the cared for and professional carers. The current crisis in recruitment and retention of nurses has highlighted the job satisfaction of practitioners as an important policy and employment issue if healthcare delivery targets are to be met; neglect of job ARTICLE IN PRESS

Development of the Misener Nurse Practitioner Job Satisfaction Scale

The purpose of this study was to construct a reliable and valid instrument to measure job satisfaction among nurse practitioners (NP). The methodological approach consisted of a literature review and modification of an extant instrument (Mueller/McCloskey, 1990) to reflect primary care, followed by augmentation and validation of the items suggested by nurse practitioner faculty members and Master's prepared nurse practitioners. A 77-item scale was developed and mailed to 413 NPs recognized by the state boards of nursing in two states. Usable returns were received from 342 (83%) NPs. Items were reviewed for validity prior to field-testing the instrument. The 77 items were subjected to exploratory factor analysis to support construct explication using the maximum likelihood method of extraction and a promax rotation. An eigenvalue cutoff of 1.0 and item-to-factor loadings of at least .35 were criteria that guided item retention. Thirty-three items were deleted. The resultant six factors were named: (a) intra-practice partnership/collegiality; (b) challenge/autonomy; (c) professional, social, and community interaction; (d) professional growth; (e) time; and (f) benefits. The six factors (subscales) produced internal consistency reliability estimates of .94, .89, .84, .86, .83, and .79, respectively. The 44 retained items were used to create the final version of the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), with a possible maximum score of 264 using a 6-point Likert-type scale.

Gender differences in stress, satisfaction and mental wellbeing among general practitioners in England

This paper attempts to compare job stress, job satisfaction and mental wellbeing of male and female general practitioners (GPs) from a questionnaire study. Female GPs showed positive signs of mental wellbeing in contrast with a normative group. Conversely, male doctors showed significantly higher anxiety and depression scores than the norm. Although there was no significant difference between male and female GPs in the job satisfaction scale both genders were unhappy about their rate of pay, hours of work and amount of work they do. Multivariate analysis disclosed three job stressors that were predictive of high levels of job dissatisfaction for both male and female GPs; these were: time pressure/interruptions, working environment/communication, career and goal achievement. This finding suggests that specific stress management programmes for both male and female doctors need to be initiated and evaluated. There may be substantial benefit in providing a counselling service for male and female doctors who suffer psychological pressure from their work.

Perception of the Nurse Practitioner's Role and Job Satisfaction in the United States Navy

A few studies have specifically examined the role perception and job satisfaction of civilian nurse practitioners (NPs), but no data exist for U.S. Navy NPs. The purpose of this study was to describe the perceptions of the Navy NP's roles by commanding officers, directors of nursing services, physicians, and NPs, and the level of job satisfaction among Navy NPs. A total of 907 questionnaires investigating NP role and job satisfaction were mailed to 29 Naval hospitals and clinics in the United States and overseas. The sample size totaled 450 (50% response rate). Of the 450 respondents, 45 NPs also filled out the Measure of Job Satisfaction survey. There were measurable differences in NP role perception by the sample groups. Role conflict and ambiguity were shown. Autonomy, sense of accomplishment, and time spent in patient care were major satisfiers, whereas pay, overall staffing levels, time available to get through work, and the amount of time spent on administrative work were the major dissatisfiers.

A comparative study on occupational stress, job satisfaction and mental health in British general practitioners and Canadian family physicians

This paper attempts to compare job stress, job satisfaction and mental health of general practitioners (GPs) in England (n = 380) and family physicians in Toronto, Canada (n = 131) from a questionnaire study. British GPs experienced less job satisfaction, poorer mental health and significantly greater pressure at work than did their Canadian counterparts. British male GPs were more depressed and had higher levels of somatic anxiety than the Canadian doctors. It was also found that alcohol consumption by British GPs was higher in comparison with Canadian doctors. This finding suggests that specific stress management programmes for doctors need to be initiated and evaluated. The results should be interpreted with caution as the study is based on a small sample of Canadian doctors limited to the Toronto area only, which limits the generalizability of the findings. However, it does provide information which has important implications for the well-being of doctors.

Patients' choices and perceptions after an invitation to participate in treatment decisions.

Previous search indicates that treatment outcomes may be improved if patients perceive greater control over their treatment, but the practical implications of encouraging patients to take more control have not been investigated. The present study investigated responses of 143 patients in a cardiovascular risk management clinic to an invitation to make a decision about their treatment. Subjects' choices of the target behaviour for their behaviour-change treatment were highly predictable from their state of health, reasons for coming to the clinic, what behaviours they were told they were at risk from, and contacts with health workers. The degree of control that subjects reported they had over the decision varied considerably, being negatively related to blood pressure and positively related to the degree of control that subjects believed they had over their health in general. Issues such as time-demands, the practitioner's job satisfaction, and ethical implications of patient participation are discussed.

The Relationship Between Primary Health Care Practitioners?? Job Satisfaction and Characteristics of Their Practice Settings

Today, individuals spend much of their time at the workplace, and theorists argue that an individual's employment experience is an integral part of his or her social identity. Current research emphasizes the importance of job satisfaction to a person's entire life adjustment. Yet little data exists about the job satisfaction of nurses working in the advanced practice role of primary care. The purposes of this article's study were to describe those individual and situational factors that contribute to job satisfaction and dissatisfaction among nurse practitioners, and to explore the relationship between levels of job satisfaction and characteristics of primary health care practitioners' work/practice settings. The study results suggest that, overall, NPs demonstrate a high level of job satisfaction; only 9 percent reported overall dissatisfaction with their jobs. Autonomy, sense of accomplishment and time spent in patient care ranked as the top three factors contributing to job satisfaction. The highest ranked dissatisfier was salary. Differences in satisfaction existed according to several practice-setting characteristics. Fewer factors than initially expected were associated with overall job satisfaction. The correlates that were noted, however, identified number of years of experience and self-perceived skill levels as important variables contributing to overall job satisfaction. Implications of these findings for the early guidance of practitioners assuming the advanced-practice role and for the NP educational curriculum are discussed.

An Explanatory Model of Nurse Practitioner Job Satisfaction

Job satisfaction influences employee retention, worker productivity, and performance quality. To retain qualified nurse practitioners (NPs), health administrators must identify sources of job satisfaction and dissatisfaction. Herzberg's dual-factor theory of job satisfaction addresses extrinsic and intrinsic work-related factors. Expansion of the model to include global job satisfaction and individual differences provided a broad framework for the assessment of nurse practitioner job satisfaction. The expanded model was used to analyze the job satisfaction of 132 NPs registered with the South Carolina State Board of Nursing in 1988 (final response rate = 90%). Participants completed the Index of Job Satisfaction (IJS), the Minnesota Satisfaction Questionnaire-Short Form (MSQ-SF), and the Personal and Work Background Questionnaire (PWBQ). Although the NPs were moderately satisfied with their overall jobs, extrinsic factors were found to be major sources of dissatisfaction. The optimal combination of variables predicted by regression analysis to influence global job satisfaction were age, number of children, urban locations, achievement, company policies and practices, creativity, independence, and compensation. Implications for health administrators to improve the work environments of NPs are discussed.