Research Proposal on "ICU Job Satisfaction"

Research Proposal 7 pages (1933 words) Sources: 6

[EXCERPT] . . . .

ICU Job Satisfaction

Burnout Rate as a Determinant to Job Satisfaction among Intensive Care Unit (ICU) Nurses: A Mixed Method Approach

In today's service-oriented industries, healthcare servicing is one of the most demanding functions in both the business and social service domains. Healthcare service requires not only knowledge and skills, but also passion and commitment in order to provide the patients and their family quality care. This balance between competence and commitment is not an easy feat, as healthcare workers are often confronted with realities in their work that sometimes hamper their goal to provide quality care for each patient they care for. Understaffing and long work hours in the midst of high job demands could possibly lead to burnout, negatively affecting healthcare providers' satisfaction in their jobs.

This study will focus on the determinants that lead to job satisfaction, focusing particularly on burnout rate among nurses in healthcare institutions / organizations. Burnout rate as a determinant of job satisfaction was found to be critical among nurses, as they have identified factors relevant and critical to workload management and work environment, such as: "supportive work colleagues, a manageable workload with time to listen and talk to patients, and a pleasant working environment" (Ablett & Jones, 2007:737). These determinants, workload management and work environment, will be analyzed in relation to burnout rate; consequently, the relationship between burnout rate and job satisfaction will be explored in terms of its nature and strength.

Significance of the Study

Rationale for proposing this study is prompted by the increasing growth of health servicing in the country, with the increasing need for health services, particularly among the 'Baby Boomer' generation. Moreover, the influx of healthcare practitioners with different demographic characteristics -- race, gender, nationality, and culture -- made healthcare a dynamic sector in today's society. The increase in demand for healthcare and limited supply of practitioners is a reality that inevitably affects job satisfaction, and in effect, quality of care in healthcare institutions/organizations.

Research Objectives/Hypotheses

General Objective: To identify the determinants of job satisfaction among Intensive Care Unit (ICU) nurses.

Hypotheses:

There is a significant relationship between job satisfaction and kind of workload management.

There is a significant relationship between job satisfaction and work environment.

There is a significant relationship between workload management and burnout rate.

There is a significant relationship between work environment and burnout rate.

There is a significant relationship between job satisfaction and burnout rate.

Review of Related Literature

In understanding the occurrence of burnout and job satisfaction among nurses, it is essential to look first into these concepts as defined by the current literature.

Burnout is a concept explored in relation to workload management, specifically related to factors such as emotional exhaustion, depersonalization, and personal accomplishment, which were factors identified by the Maslach Burnout Inventory (MBI) as critical to determining burnout rate (Browning et. al., 2007:250). These findings were found to be most important in a survey among nurses, within three groups of nursing specialties: nurse practitioners, nurse managers, and emergency nurses. Results of the study showed that factors contributing to burnout differ among the three groups mentioned earlier. Emergency nurses, when compared against nurse practitioners, experienced more emotional exhaustion, more depersonalization, and less personal accomplishment. Nurse practitioners, meanwhile, experienced less depersonalization and more personal accomplishment, when compared to nurse managers.

This result demonstrates that workload management and work environment contribute differently to different nursing specializations. For emergency nurses, work environment is a critical factor that contributes to burnout.

Nurse practitioners and managers, meanwhile, are influenced more by workload management, as practitioners, who have lesser responsibilities than managers, were found to experience more personal accomplishment than their superiors. This study highlights the finding that apart from workload management and work environment, burnout is also a function of the roles and responsibilities that nurses assume within the healthcare institution/organization.

Delving further into the relationship between work environment and burnout, authors Nathan et. al. (2007) sought to determine the burnout rate among nurses working in a therapeutic environment (i.e., male and female wards in a medium secure unit). In their study, the authors found out that, using the MBI to measure burnout, "...burnout levels increased more for staff on the ward for female patients than for staff on the ward for male patients. This was evident...in terms of effect on emotional exhaustion, and in some indication...depersonalization" (346).

Further into this finding, results from the MBI showed that prior to the nurses' exposure to their respective wards (male and female wards), levels of emotional exhaustion and depersonalization were the same. After exposure to the male and female wards, nurses' reported burnout changed significantly, particularly for nurses assigned in the female ward, showing a big jump in emotional exhaustion and depersonalization, with a directionally lower sense of personal accomplishment after working in the women's ward for about 18 months (348). This increase in burnout among nurses in the women's ward than nurses in the men's ward is due to the "increased frequency of critical incidents, deliberate self-harm" that occur more often in women inpatients (350). This study highlighted the role of the work environment as a determinant of burnout, as shown in the nurses' experience as their reported feelings of burnout increased over time when they worked in a highly stressful ward (i.e., stressful work environment).

The studies just reviewed used the quantitative approach to generate descriptions of burnout as experienced by healthcare practitioners. Just as critical and important, however, are in-depth conceptualizations of burnout and its relationship to job satisfaction among health practitioners. Insights and deep understanding of burnout and its possible ramifications to job satisfaction is best reflected through the qualitative approach. Gustafsson et. al.'s (2008) study of 'meanings of becoming and being burnout' confirms findings from the quantitative studies discussed earlier.

Using the phenomenological-hermeneutic method in analyzing and interpreting the interviews of healthcare personnel, four (4) major themes were generated: (1) being torn between what one wants to manage and what one manages; (2) feelings of being a victim of circumstances; (3) being emotionally tormented; and (4) reaching an edge of overwhelming feebleness (523). All these themes are related to workload management and work environment, which this study posits as major determinants of burnout among healthcare practitioners. Moreover, these themes confirm concepts within the MBI, which are emotional exhaustion, depersonalization, and sense of accomplishment.

Combining both quantitative and qualitative approach to burnout will be most useful in the development of both the conceptual and operational definitions of burnout. Suggested additional sections for this review of related literature include further analysis of burnout in relation to job satisfaction.

Methodology

Research Design

This study will use both qualitative and quantitative approaches, using the exploratory and descriptive study designs. A mix of both approaches is recommended because of the advantages that they can contribute during the data gathering stage for this proposed topic.

The qualitative approach will be used to provide in-depth information on the concepts, attitudes, and perceptions of burnout and its relation to job satisfaction among healthcare practitioners, with focus on the nurses group. These concepts, attitudes and perceptions will be used for generating an overall definition for burnout and job satisfaction, suitable for the purpose of the study. Results from the quantitative study, in turn, will be used to provide a general profile (demographic and psychographic profiles) and description of the nature and dynamics of burnout and job satisfaction among nurses.

Methods

The qualitative approach will use the focus group discussion (FGD) method to generate insights and understanding of burnout as experienced by nurses, the participants who will be chosen for the study. The quantitative approach, meanwhile, will make use of the survey method, focusing on three concepts relevant to the study: (1) workload management, (2) work environment, and (3) reported job satisfaction.

Focus Group Discussion (FGD)

The FGDs will provide depth of information about burnout and job satisfaction, as applied in the healthcare servicing context. There will be six (6) mini-groups per segment, broken down into the following discussant types:

Group Type

Age group

Males

Nurse practitioners

ICU nurses

Emergency nurses

Females

Nurse practitioners

ICU nurses

Emergency nurses

Basis for the selection criteria of the discussants for the FGDs are based on the findings generated from the review of related literature, wherein it was found that nursing specialties influence the level of burnout experienced by nurses, wherein workload management and work environment are also significantly linked to these specialties (Browning et. al., 2007:250). For this study, nurse managers will be replaced in favor of ICU nurses, the nurse group that is of interest to the researcher. Furthermore, breaking down the groups between males and females will ensure that the discussants will be able to comfortably discuss the concepts without fear of being dominated, which could possibly happen in a mixed (male-female) group.

Survey

The survey method will make use of the multi-stage sampling, wherein respondents will be chosen randomly from a list of nurses in healthcare institutions / organizations. Quota sampling will be set, however, to control for the number of interviews… READ MORE

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