Research Proposal on "Satisfaction of Registered Nurses (Kovner, Brewer, Cheng"

Quoted Instructions for "Satisfaction of Registered Nurses (Kovner, Brewer, Cheng" Assignment:

Request for T.Lavinder!

THIS IS THE INSTRUCTIONS FOR THE RESEARCH CRITIQUE

NURS 225: RESEARCH

GUIDELINES FOR RESEARCH CRITIQUE

Directions for formatting the critique:

*****¢ Number all pages; title page will be page number 1 [see APA manual for format of title page, use of running head with page number, and proper citation of a journal article and book; use 12 pt. font, no bold print with APA]. Do not include an abstract with this assignment.

*****¢ For the body of this assignment you will not use a strict APA format. The form for the critique begins on page 2. Save this document as a Word file onto your desktop *****“ there is no need to *****re-type***** the form. Just type in your responses to each of the italicized bulleted questions/objectives. Your responses should be typed in regular font. Double-space your narrative response.

*****¢ Use main headings [i.e., Introduction; Problem/Purpose, etc.], then respond to each of the bulleted questions/objectives. Type your responses in regular font.

*****¢ Be sure to clearly explain answers, validate *****yes and no***** answers with at least a comment or two. Some of your narrative responses will be more detailed. Use proper grammar and proper sentence structure.

*****¢ The critique, including title and reference pages, should be about 8*****“10 pages. Do not be overly concerned about the length of the paper; just be sure to clearly respond to each of the questions/objectives.

NOTE: Refer to the points on critiquing research studies that are detailed throughout the textbook. Although it*****s not based on the guidelines above, you may find the example of an article critique helpful (see Module/Week 5 Additional Materials.

Points assigned to each component of critique are cited in parentheses [Total points possible: 225].

The form for the critique begins on page 2. Save this document as a word file onto your desktop *****“ then you may format as needed and type in your responses. Do not retype the form/information.

RESEARCH CRITQUE

Introduction (5)

*****¢ Does title fit well with the content of the article?

*****¢ Are the independent/dependent or variables of interest clearly defined?

*****¢ Discuss the content of the abstract, is it a good overview of the content, is it consistent with content?

Problem/Purpose (10)

*****¢ State the problem.

*****¢ Do the authors identify the significance of the problem?

*****¢ Do they provide adequate background information to support the problem?

*****¢ Do the authors explain the purpose or aim of the study?

Literature Review (10)

*****¢ Are relevant previous described?

*****¢ Are the references current? (number of sources in the last 10 years and in the last 5 years)

*****¢ Do the authors summarize their review of the literature to reveal what is known/not known *****“ and the need for further study?

Framework/Theoretical Perspective (10)

*****¢ Is the study based on a specific theory or theoretical framework?

*****¢ If the study is based on a specific theory, do the authors tie the framework/theory to their study *****“ concepts/variable of interest? If so, how is this accomplished?

List the Research Question(s) OR Hypotheses (10)

*****¢ Research hypothesis or hypotheses

*****¢ Research question(s)

Identify and Define Variables (10)

*****¢ Independent variables [*****intervention/treatment], identify and define variable(s), - what is the treatment or intervention and how is it implemented?

*****¢ Dependent variables [outcome of the treatment *****“ *****effect*****] define the dependent variable and describe how it is measured.

*****¢ If the study does not have and independent and dependent variable, identify and define and the study variables of interest.

Demographics of Sample (5)

*****¢ Were demographics of the sample included? If yes, provide a few examples of demographics, i.e. 50% male, 50% female, etc.

Research Design (15)

*****¢ Identify the research design and define the design, i.e. nonexperimental, descriptive survey, correlational, etc.

*****¢ Is the design used in the study the most appropriate design to obtain the needed data?

*****¢ If an experimental study, identify the treatment or intervention

*****¢ Were subjects assigned to groups? If so, how was this done?

*****¢ Did the researchers conduct a pilot study? If so, what did they have to say about it *****“ did they make changes based on the pilot study?

Sample/Setting (15)

*****¢ Sampling criteria *****“ this is usually referred to as *****inclusion criteria***** *****“ meaning what characteristics did participants need in order to be included in the study? i.e. *****“ female, 40-50 years of age, pregnant with 1st child, etc.

*****¢ Sampling method, how did researchers obtain participants, what kind of approach was used *****“ nonprobability [nonrandom] or probability [random]?

*****¢ Was informed consent obtained? Institutional Review Board mentioned?

*****¢ Identify the setting of the study *****“ did the setting fit well with the study*****s objectives?

Measurement, Methods & Instruments (15)

*****¢ Who developed the instruments used? The author, someone else?

*****¢ Identify the type of measurement used in the study [Likert scale, physiological measure, etc.] and the level of measurement used [remember basic stats *****“ nominal, ordinal, interval, or ratio]

*****¢ Discuss instrument development if applicable [some studies will use established instruments developed by other researchers/scientists if so note this]

*****¢ Did the authors discuss the reliability and validity of the instruments used?

Data Collection (10)

*****¢ How were data collected?

*****¢ Timing of data collection [one time [cross-sectional] collection, longitudinal?]

*****¢ Where were the data collected?

Data Analysis (10)

*****¢ Are data analysis procedures clearly described? Explain

*****¢ Are data analysis procedures appropriate for the type of data collected? Explain.

Statistical An*****s (15)

*****¢ What statistical measures were used to test or report reliability and validity of the measurement methods [usually refers to the instruments used] in the study?

*****¢ What statistical measures were used to analyze the data collected [the data that *****answered***** the research hypotheses or research questions]?

*****¢ Was the level of significance or alpha identified? If so indicate what it was [.05; .01; or .001. *****“ remember .05 means that the researchers are 95% confident that there was cause and effect or correlation b/w variables, .01 means that they were 99% confident, and .001 means that the researchers were 99.9% confident that their intervention was effective and directly related to the outcome *****“ of effect.

Limitations (10)

*****¢ What limitations were identified?

*****¢ Can you identify any other limitations?

Implication of Findings (10)

*****¢ What implications for nursing were described?

*****¢ Can you think of any implications that were not described?

*****¢ What were the suggestions for further study?

Generalization of Findings (5)

*****¢ Did the author(s) generalize the findings [did they apply the findings of their study beyond the sample studied *****“ and make application to the population in general? Remember that a random [probability] sample is considered to be generalizable whereas a nonrandom [nonprobability] sample is not.

Format (5)

*****¢ Did you discover any spelling, punctuation, or grammatical errors? What about sentence structure, organization, clarity?

Overall Evaluation (20)

*****¢ Were the steps of the research process logically linked together [did the authors***** research questions or hypotheses make sense based on the review of literature, did the methods employed, i.e., quantitative/qualitative fit well with the intent of the study, etc.?

*****¢ What are your impressions about the overall quality of the study?

*****¢ Your impressions regarding applicability of the study nursing practice and how it contributes to nursing knowledge

*****¢ Include any other points of *****critique***** or commentary as desired.

NOTE: Do not critique the article based on the information posted below; Quality of Work applies to the quality of your work on this critique assignment.

Quality of Work (20)

*****¢ Thoroughness

*****¢ Proper grammar and sentence structure

*****¢ Clear communication of ideas

*****¢ Depth of information

*****¢ Organization, APA formatted citation of reviewed article

THIS IS THE RESEARCH TO BE CRITIQUE

Health Policy & Systems

Factors Associated With Work Satisfaction of

Registered Nurses

Christine Kovner, Carol Brewer, Yow-Wu Wu, Ying Cheng, Miho Suzuki

Purpose: To examine the factors that influence the work satisfaction of a national sample of

registered nurses in metropolitan statistical areas (MSAs).

Design: A cross-sectional mailed survey design was used. The sample consisted of RNs randomly

selected from 40 MSAs in 29 states; 1,907 RNs responded (48%). The sample of

1,538 RNs working in nursing was used for analysis.

Methods: The questionnaire included measures of work attitudes and demographic characteristics.

The data were analyzed using ordinary least-squares regression.

Findings: More than 40% of the variance in satisfaction was explained by the various work

attitudes: supervisor support, work-group cohesion, variety of work, autonomy, organizational

constraint, promotional opportunities, work and family conflict, and distributive

justice. RNs who were White, self-perceived as healthy, and working in nursing education

were more satisfied. RNs that were more career ***** were more satisfied. Of the

benefits options, only paid time off was related to satisfaction.

Conclusions: Work-related factors were significantly related to RNs***** work satisfaction.

JOURNAL OF NURSING SCHOLARSHIP, 2006; 38:1, 71-79. C2006 SIGMA THETA TAU INTERNATIONAL.

[Key words: work satisfaction, nurses, work attitudes]

* * *

Nursing shortages have been widely reported in the

literature both regionally (Cushman, Ellenbecker,

Wilson, McNally, & Williams, 2001) and within

healthcare organizations (Buerhaus, Staiger, & Auerbach,

2003; Grumbach, Ash, Seago, Spetz, & Coffman, 2001).

Work satisfaction is an important issue for registered nurses

(RNs) and managers in part because of its reported relationship

with RN turnover (Davidson, Folcarelli, Crawford,

Duprat, & Clifford, 1997; Francis-Felsen et al., 1996;

Gurney, Mueller, & Price, 1997; Ingersoll, Olsan, Drew-

Cates, DeVinney, & Davies, 2002; Lake, 1998; Larrabee

et al., 2003; Prevosto, 2001; Shader, Broome, Broome,West,

& Nash, 2001, which can lead to organizational shortages

and absenteeism (Siu, 2002; Song, Daly, Rudy, Douglas, &

Dyer, 1997). Results from studies about determinants of RN

work satisfaction should be of interest to both administrators

and policy makers.

Background

A substantial body of literature exists about factors associated

with RN satisfaction with work (Stamps, 1997).

Various measures of satisfaction have been used, but many

are not based on a theoretical framework. Price (2004) and

Gurney et al. (1997) proposed an integrated theoretical

model of work satisfaction and voluntary turnover (intent

to leave) that combines economic, psychological, and sociological

theories with empirical findings about the determinants

of turnover. They theorized that a variety of

work-setting characteristics and attitudes toward work are

associated with satisfaction, resulting in intent to leave jobs.

Some empirical evidence for the model (Agho, Mueller, &

Price, 1993; Davidson, Folcarelli, Crawford, Duprat, &

Clifford, 1997; Gaerter, 1999; Gurney et al., 1997) has been

presented. A modification of Gurney et al.*****s model is shown

in the Figure.

Demographic characteristics have been associated with

RN work satisfaction (Blegen & Mueller, 1987; Ingersoll

Christine Kovner, RN, PhD, Upsilon, Professor, College of Nursing, New

York University, New York City; Carol Brewer, RN, PhD, Associate Professor,

School of Nursing; Yow-Wu Wu, PhD, Associate Professor, School

of Nursing; Ying Cheng, MA, Doctoral Candidate; all at University at Buffalo,

Buffalo, NY; Miho Suzuki, RN, MSN, Upsilon, Doctoral Candidate,

College of Nursing, New York University, New York City. This manuscript

was supported by the Agency for Healthcare Research and Quality, Grant

R01HS01132002. The authors of this article are responsible for its contents.

No statement in this article should be construed as an official position

of the Agency for Healthcare Research and Quality. Correspondence to Dr.

Kovner, College of Nursing, New York University, 246 Greene Street, Room

618E, New York, NY 10003. E-mail: ctk1@nyu.edu

Accepted for publication August 7, 2005.

Journal of Nursing Scholarship First Quarter 2006 71

RN Work Satisfaction

Job satisfaction

RN characteristics

Demographic

Health

Work setting

Social support and

integration to:

Work-to-family conflict

Family-to-work conflict

Job stress

Organizational constraints

Role overload

Promotional opportunities

Professional values

Autonomy

Routinization

Disposition and orientation

Work motivation

Career orientation

Direct patient care

Job hazards (injuries)

Pay (income, benefits)

Distributive justice

Movement constraints

MSA characteristics

Figure. Factors contributing to nurses***** job satisfaction. Based on Gurney, Mueller, & Price (1997). Adapted with permission.

et al., 2002; Langemo, Anderson, & Volden, 2002; Lum,

Kervin, Clark, Reid, & Sirola, 1998; Weisman, *****,

& Chase, 1980), and studies have indicated both a positive

relationship between autonomy and satisfaction (Acorn,

Ratner,&Crawford, 1997; Kramer&Schmalenberg, 2003)

as well as contradictory findings (Davidson et al., 1997;

Gurney et al., 1997; McNeese-Smith & Crook, 2003). The

relationship between variety and work satisfaction is equivocal

(Gurney et al., 1997; McNeese-Smith&Crook, 2003).

Findings are contradictory about the relationship between

distributive justice and work satisfaction (Gurney et al.,

1997; Taunton, Boyle, Woods, Hansen, & Bott, 1997),

workload, organizational constraint, and work satisfaction

(Adams&Bond, 2000; Davidson et al., 1997; Gurney et al.,

1997; Hoffman & Scott, 2003; Shaver & Lacey, 2003),

supervisor and mentor support, and satisfaction (Decker,

1997; Gurney et al., 1997; Larrabee et al., 2003; McNeese-

Smith & Crook, 2003).

Work-group cohesion, also termed integration, relationship

with coworkers, and peer support (Adams & Bond,

2000; Decker, 1997; Gurney et al., 1997; Larrabee et al.,

2003; Shader et al., 2001) and promotional opportunity

satisfaction (Gurney et al., 1997; Mills & Blaesing, 2000;

Taunton et al., 1997) have been related to work satisfaction.

Work-to-family conflict and family-to-work conflict are

related concepts that have been negatively related to work

outcomes, family outcomes, and employee physical and

mental health (Frone, 2003), but they were not included

in Price et al.*****s model. Family-to-work conflict (family conflicts

with work) has been positively related to job dissatisfaction,

work-related absenteeism, tardiness, and poor

job performance in various occupations (Bernas & Major,

2000; Frone, Russell, & Cooper, 1992; Frone, Yardley, &

Markel, 1997) and also among nurses (Decker, 1997). In

contrast, work-to-family conflict (work conflicts with family)

has been associated with intentions to quit one*****s job

and turnover (Greenhaus, Parasuraman, & Collins, 2001;

Kirchmeyer & Cohen, 1999).

Although not included in Price et al.*****s model, some

evidence exists that metropolitan statistical area (MSA)

characteristics affect nurses***** work participation behavior

(Buerhaus, 1993; Buerhaus & Staiger, 1996, 1997), but not

clear is whether these factors have any effect directly on

work satisfaction. For example, in areas with many inpatient

days, competition for RNs might be high. This competition

72 First Quarter 2006 Journal of Nursing Scholarship

RN Work Satisfaction

might force employers to improve working conditions,

which would improve RN work satisfaction. Similarly,

in areas with competition among healthcare providers, they

might compete in relation to quality or cost. If they compete

on quality, they might be satisfactory places to work. However,

if they compete on cost, they might be unsatisfactory

places to work. The purpose of the study reported here was

to empirically test the revised model shown in the Figure in

a national sample of working RNs to determine the factors

associated with RNs***** work satisfaction.

Methods

The target population for this study was all registered

nurses (RNs) in metropolitan statistical areas (areas around

and including metropolitan areas) in the United States.

About 78% of RNs live in MSAs (Spratley, Johnson,

Sochalski, Fritz, & Spencer, 2001). The sampling design included

a two-stage sample of RNs in MSAs. First, MSAs

were selected; then RNs were randomly selected from all

RNs in each MSA. Because of financial constraints for this

study, only 40 MSAs were randomly selected from the original

51 MSAs used by the Center for Studying Health System

Change in the Community Tracking Study (CTS) in 2000

(Metcalf, Kemper, Kohn, & Pickreign, 1996). The original

sampling strategy for the CTS was designed to result in a

nationally representative sample of RNs. RNs were sampled

from 29 states and the District of Columbia (AL, AR,

AZ, CA, CO, CT, FL, GA, IL, IN, KY, LA, MA, MD, DC,

MI, MO, NC, NJ, NV, NY, OH, OK, PA, SC, TN, TX, VA,

WV, and WA). The board of nursing in each area was contacted

to get an updated list of names and addresses for all

RNs. From these lists, 4,000 RNs were randomly selected

from the 40 MSAs with equal probabilities of selection. An

advantage of this method is that the statistical an*****s do

not require the use of sampling weights.

After the sample of 4,000 RNs was selected, each nurse

was sent a mailed questionnaire based on a seven-stage procedure

reported by Dillman (2000), including: (a) an alert

letter, (b) the first survey, (c) a postcard reminder, (d) a second

survey, (e) a third survey, (f) a follow-up phone call,

and (g) a fourth survey. Each selected RN received the first

survey with a $1.00 incentive and was eligible for one of

10 prizes of $100 in a drawing. These procedures resulted

in completed questionnaires being obtained from 1,906 of

the 4,000 sampled RNs. The overall response rate was 48%

and ranged across the 40 MSAs from 30% to 51%. Fortyfive

respondents were eliminated from the analytic sample

because they had moved to an area for which we could not

obtain MSA data, and 324 were eliminated because they

were not employed in nursing. Thus, the final sample was

1,538 nurses who were working in nursing.

Four types of variables were derived from the model: (a)

RNdemographic characteristics and health (age, sex, ethnicity,

race, marital status, highest degree in nursing, living with

children, years of experience in nursing, advanced certification,

partner*****s income, overall health status, current enrollment

in an educational program, and religious beliefs), (b)

MSA characteristics (medical, surgical, and other specialists

per 1,000 population, primary care practitioners per 1,000

population, index of competition, percentage of HMO hospital

services paid through fee schedules, inpatient days, and

RN-to-population ratios, unemployment rate in 2002, and

MSA, and (c) RN perceptions of the labor market that represented

movement constraints (local job opportunity and

outside job opportunity). The fourth group was work setting,

which included work attitudes (autonomy, variety, distributive

justice, work group cohesion, supervisory support,

mentor support, work-family conflict, family-work conflict,

promotional opportunity, organizational constraints, quantitative

workload, work motivation, career orientation,

partner*****s career orientation, and satisfaction) and characteristics

of the work (annual income, holding more than one

position for pay, work setting, position, work shift, transfer

of work unit, change in supervisor, needle sticks, strains and

back injury, paid time off benefit, medical insurance benefit,

retirement benefit, tuition reimbursement, importance of

benefits, and number of benefits). The full list of variables

is shown in Table 1.

Work attitudes were measured with scales used in previous

research (Carlson & Frone, 2003; Gurney, 1990; Quinn &

Staines, 1979; Spector & Jex, 1998). Satisfaction was measured

with the five-item Quinn and Staines*****s facet-free job

satisfaction scale (Quinn&Staines, 1979), but with slightly

altered response items.We expanded the number of options

in several cases, such as from the original three-response options

(strongly recommend, have doubts about recommending,

and advise the friend against) to four-response options

(strongly recommend, somewhat recommend, somewhat advise

against, and strongly advise against). The Cronbach

alpha coefficient was .86. Quinn and Staines reported that

these indicators of job satisfaction were correlated with less

role ambiguity (−.22), depressed mood at work (−.43), and

more facet-specific job satisfaction (.55), indicating evidence

of the validity of the scale (Cook, Hepworth, Wall, & Warr,

1981). All scales were Likert-type, varying in the number

of items from 3 (for work-family conflict) to 10 (for organizational

constraints). Table 1 shows the definition, mean,

standard deviation, actual range, Cronbach alphas, and the

number of items for all scales used in the analysis. Reliability

coefficients for the scales ranged from a low of .70 for variety

to .95 for supervisory support and distributive justice.

The one-factor structure of each scale using confirmatory

factor analysis was supported in all cases except organizational

constraint. After removing one item from that scale,

a one-factor solution was supported.

Partner*****s annual income was logged to normalize the distribution.

As for group two characteristics, all variables related

toMSAexcept unemployment rate were obtained from

InterStudy (2001). Unemployment rate was obtained from

the Bureau of Labor Statistics. Primary care practitioners are

physicians who provide primary care such as family practice

physicians. Index of competition is how competitive the

HMO marketplace is.

Journal of Nursing Scholarship First Quarter 2006 73

RN Work Satisfaction

Table 1. Definition, Reliability, Number of Items, Mean, Standard Deviation, and Actual Range of Work Attitude Scales (N=1,538)

Definition Alpha Number of items Mean (SD) Actual range

Local job opportunity Likelihood of obtaining jobs in local area as good, worse, or better

than current jobb

.88 2 2.95 (1.21) 1.00*****“5.00

Outside job opportunity Likelihood of obtaining jobs outside local area as good, worse, or

better than current jobb

.90 2 3.09 (1.15) 1.00*****“5.00

Supervisory support Degree to which supervisor supports and encourages employeeb .95 5 3.59 (1.03) 1.00*****“5.00

Mentor support Degree of adequacy of access to an appropriate experienced

professional to sponsorship, protectorship and professional

benefactorshipb

.91 6 3.00 (0.88) 1.00*****“5.00

Work group cohesion Degree to which employees have friends in the immediate work

environmentb

.90 4 3.81 (0.83) 1.00*****“5.00

Variety Degree to which job performance is repetitiveb .77 4 3.03 (0.71) 1.00*****“5.00

Quantitative workload Amount of performance required in a jobc .89 5 4.13 (1.16) 1.00*****“6.00

Autonomy Degree to which employees control their job performanceb .79 4 4.09 (0.73) 1.50*****“5.00

Organizational constraint Degree to which situations or things interfere with employees***** job

performancec

.89 10 2.41 (0.92) 1.00*****“6.00

Promotional opportunities Degree to which career structures within an organization are

available to its employeesb

.90 5 2.87 (0.92) 1.00*****“5.00

Work-to-family conflict Degree to which an employee*****s job interferes with family lifed .94 3 3.13 (1.40) 1.00*****“6.00

Family-to-work conflict Degree to which an employee*****s family life interferes with jobd .89 3 1.73 (0.90) 1.00*****“6.00

Work motivation Degree to which work is central to an employee*****s lifeb .83 4 2.08 (0.74) 1.00*****“5.00

Distributive justice Degree to which the an employee*****s rewards are related to

performance inputs into the organization b

.95 4 2.60 (0.98) 1.00*****“5.00

Job satisfactiona Employee*****s general affective reaction to the job without reference to

any specific job facete

.86 5 −.012 (0.80) −2.14*****“1.03

Note. aThe standardized score was used for job satisfaction because the number of items varied for each question. bGurney, Mueller, & Price (1997), c Spector & Jex (1998),

d Frone, Yardley, & Markel (1997), e Quinn & Stains (1979)

Findings

As shown inTable 2, working RNs were primarily women,

White, married, and only 14.2% had children under 6 years

old living with them. 19.1% had more than one position

for pay, 61% worked in hospitals, and a similar percentage

were in direct care positions. In addition to pay, the RNs had

a variety of noncompensation benefits: 85.2% had medical

insurance, 82.6% had retirement benefits, and 83.5% said

these benefits were somewhat to very important to them for

staying in the current position. At the same time 10.9% had

transferred to another work unit and 34.5% had a change in

the immediate supervisor in the last year. Table 3 shows that

the RNs had a mean age of 46.4, 18.8 years of experience,

and $49,940 annual income.

We used ordinary least squares (OLS) regression to estimate

the model, because the dependent variable was continuous

and we were testing a linear relationship. As shown in

Table 4, the model explains 54% of the variance in work

satisfaction, with most of the variation explained by the

work setting variables. Only the significant findings are included

in the table. No other variables were significantly

related to job satisfaction. Table 4 also shows the relationships

between the predictor variables and satisfaction.

Non-Hispanic Black RNs were less satisfied than were non-

Hispanic White RNs. RNs who were in poor or fair health

were less satisfied than were those with very good health,

but injuries did not influence satisfaction. Of the MSA characteristics,

only unemployment rate was significantly related

to satisfaction. Local job opportunity was related to satisfaction,

but nonlocal job opportunity was not. Of work setting

variables, the only benefit option related to satisfaction

was not having paid time off (e.g., vacation). RNs working

in nurse education were more satisfied than were those in

hospitals. Less career-***** RNs were less satisfied than

were those who were more career *****. RNs working as

managers or instructors were less satisfied than were RNs

providing direct care.

More than 40% of the variance in work satisfaction was

explained by the various attitude scales. High autonomy,

high distributive justice, high group cohesion, high promotional

opportunities, high supervisor support, high variety of

work, low work-to-family conflict, and low organizational

constraint, significantly contributed to satisfaction.

Discussion

Our sample is similar to the sample of working RNs from

the National Sample Survey of Registered Nurses (NSSRN;

74 First Quarter 2006 Journal of Nursing Scholarship

RN Work Satisfaction

Table 2. Demographic and Work-Related Characteristics of the Sample (N=1,538)

n (%)

Sex Female 1461 (95.0)

Male 77 (5.0)

Ethnicity Hispanic or Latino 38 (2.5)

Not Hispanic or Latino 1465 (97.5)

Race White 1306 (84.9)

Black 101 (6.6)

Asian 74 (4.8)

Other 57 (3.7)

Marital status Now married 1067 (69.5)

Unmarried 469 (30.5)

Live with children under age 6 Yes 219 (14.2)

No 1319 (85.8)

Live with children between age 6-11 Yes 269 (17.5)

No 1269 (82.5)

Live with children between age 12-17 Yes 415 (27.0)

No 1123 (73.0)

Live with children age over 18 Yes 480 (31.2)

No 1058 (68.8)

Overall health Poor or fair 137 (8.9)

Good 482 (31.5)

Very good 556 (36.3)

Excellent 356 (23.3)

Highest nursing degree Diploma 259 (17.1)

Associate 566 (37.3)

Baccalaureate 525 (34.6)

Master*****s/doctorate 167 (11.0)

Formal educational program Currently enrolled 129 (8.4)

Not currently enrolled 1409 (91.6)

Advanced certificate Yes 413 (26.9)

(National specialty or NP certification) No 1125 (73.1)

Nursing education in the US Yes 1448 (94.1)

No 90 (5.9)

Importance of religious beliefs Not at all/not very important 232 (15.3)

Moderately/very/extremely important 1283 (84.7)

MSA size Small (population <250,000) 181 (11.8)

Medium 402 (26.1)

Large (>1 million) 955 (62.1)

Position for pay More than one 293 (19.1)

Only one 1238 (80.9)

Work setting Hospital 938 (61.0)

Nursing home 86 (5.6)

Nursing education program 44 (2.9)

Home health care 126 (8.2)

Ambulatory care 218 (14.2)

Other 126 (8.2)

Position Manager 282 (18.9)

Consultant 26 (1.7)

Instructor 70 (4.7)

continued.

Journal of Nursing Scholarship First Quarter 2006 75

RN Work Satisfaction

Table 2. (continued)

n (%)

Direct care 943 (63.3)

Advanced practice nurse 100 (6.7)

Other 69 (4.6)

Work shift Day 890 (59.9)

Night 302 (20.3)

Other 295 (19.8)

Transfer of work unit Yes 167 (10.9)

No 1366 (89.1)

Change in supervisor Yes 529 (34.5)

No 1003 (65.5)

RN*****s career orientation Less than others 184 (12.0)

The same as others 755 (49.2)

More than others 594 (38.7)

Partner*****s career orientation Less than others 132 (8.7)

The same as others 534 (35.4)

More than others 435 (28.8)

No partner 409 (27.1)

Needle sticks Never 1153 (75.0)

One time 284 (18.5)

More than one time 101 (6.6)

Strains/back injury Never 839 (54.6)

One time 311 (20.2)

More than one time 388 (25.2)

Paid time off benefit Have it and used it 552 (35.9)

Have it but not used it 778 (50.6)

Do not have it 208 (13.5)

Medical insurance benefit Have it and used it 277 (18.0)

Have it but not used it 1033 (67.2)

Do not have it 228 (14.8)

Retirement benefit Have it and used it 122 (7.9)

Have it but not used it 1149 (74.7)

Do not have it 267 (17.4)

Tuition reimbursement Have it and used it 129 (8.4)

Have it but not used it 922 (59.9)

Do not have it 487 (31.7)

Importance of benefits to stay in the position Not at all/Not very important 254 (16.5)

Somewhat/Very important 1284 (83.5)

aSample sizes smaller than 1,538 indicate missing data.

Spratley et al., 2001) with the samples respectively, male (5%

vs. 6%), White (85.0% vs. 85.3%), and married (69.5%

vs. 70.4%) RNs. Although the mean age of the workingin-

nursing RN sample from the NSSRN was not available,

our sample (M=46.4) is similar to the mean age of the total

sample of the NSSRN that was 45.2 (Spratley et al.,

2001).

One of the issues in a study such as the one described

here is how meaningful the potential changes in satisfaction

are. Although the relationships might be significant,

the cost or effort to make a change (such as increasing variety

and autonomy) might not be related to a meaningful

change in satisfaction. In this study satisfaction scores were

standardized so the mean is approximately zero. A score of 1

is one standard deviation above the mean. What proportion

of a standard deviation would be meaningful? If a one unit

change in supervisory support is related to a.081 change in

satisfaction, that is unlikely to be meaningful. On the other

hand a one-unit change in career orientation that results in

a .183 change might be meaningful.

Working as an RN is often physically and emotionally

demanding. RNs with poor or fair health might find this

76 First Quarter 2006 Journal of Nursing Scholarship

RN Work Satisfaction

Table 3. Means and Standard Deviations of Continuous

Demographic Variables and Metropolitan Statistical Area

Characteristics (N=1,538)

M SD

Age 46.4 (10.5)

Years of experience in nursing 18.8 (11.1)

RN*****s annual income $49,940 (19,903)

Log of partner*****s annual income 7.98 (4.83)

Number of benefits 6.29 (2.61)

Medical, surgical, and other specialists 1.81 (0.65)

per 1000 population

Primary care practitioners per 1000 population 0.23 (0.08)

Index of competition 0.68 (0.21)

Percentage of HMO hospital services paid through 13.8 (11.0)

fee schedules

Unemployment rate in 2002 5.51 (0.97)

Inpatient days per 1000 population 0.98 (0.33)

RN size divided by corresponding MSA population 0.99 (0.25)

Note. Sample sizes for each variable may be smaller than 1,538 because of

missing values.

burden difficult, so that they are less satisfied than are RNs

with very good health. Why the non-Hispanic Black RNs

in our sample were less satisfied than were their White coworkers

is not clear, and Bush (1988) found race was not

related to satisfaction.

Regarding compensation, contrary to findings from some

other studies (Gurney et al., 1997; Ingersoll et al., 2002),

wages were not associated with satisfaction. However, dis-

Table 4. Ordinary Least Squares Regression Analysis of Significant Determinants of Job Satisfaction (N = 1,342)

Significant category for Unstandardized

Construct Variable (Reference Category) categorical variables coefficient R2 R2 change

Constant −.971∗∗

Demographic and Health Race/Ethnicity (Non-Hispanic White) Non-Hispanic Black −.204∗∗ .090 .090∗∗∗

Overall health status (Very good) Poor or Fair −.151∗

MSA market Unemployment rate 2002 −.040∗ .099 .009

Movement constraints Local job opportunity −.042∗ .135 .035∗∗∗

Work setting Supervisory support .081∗∗∗ .541 .407∗∗∗

Work-group cohesion .083∗∗

Work setting (Hospital) Nursing education program .355∗

Position (Direct care) Manager −.113∗

Instructor −.283∗

Variety .106∗∗∗

Autonomy .106∗∗∗

Organizational constraint −.154∗∗∗

Promotional opportunity .091∗∗∗

Work family conflict −.077∗∗∗

Career orientation Less than others −.219∗∗∗

(Same as others) More than others .183∗∗∗

Paid time off benefit Not have it .227∗∗

(Have it but not used it)

Distributive justice .087∗∗∗

∗p <.05, ∗∗p <.01, ∗∗∗p <.001.

tributive justice, which pertains to the fairness of pay, was

related to satisfaction. Interestingly, the only benefit associated

with satisfaction was paid time off. Possibly these other

benefits could directly affect turnover while not having an

effect on satisfaction.

Working shifts other than the day shift and shift length

were not related to satisfaction, consistent with findings

from other studies (Hoffman & Scott, 2003). The RNs*****

quantitative workload was not related to satisfaction. RNs

who perceived that they had high workloads were no more

or less satisfied than were those who perceived that they had

low workloads. This finding is contrary to some findings

(Davidson et al., 1997; Gaerter, 1999; Hoffman & Scott,

2003; Sheward & Hagen, 2005), and others have found

no relationship between workload and satisfaction (Gurney

et al., 1997; Shaver & Lacey, 2003). These contradictory

findings might be related to the samples or to instrument

used to measure satisfaction. None of these studies included

the measure of satisfaction used in our study. The study reported

here had a nationally representative sample, which

none of the above studies had. The difference might be related

to the perceived fairness (distributive justice) of the

workload rather than the actual workload. If everyone is

working hard, that might not affect satisfaction. However,

if some people have higher workloads or fewer days off,

the lack of justice could lead to dissatisfaction. Although

much has been written about the need for RNs to have support

from mentors (Prevosto, 2001), this variable was not

related to satisfaction in our sample. Supervisory support,

however, was related to RN work satisfaction, as was work

group cohesion, and both of these conditions might indicate

Journal of Nursing Scholarship First Quarter 2006 77

RN Work Satisfaction

support aspects of mentoring. These work setting factors

can be influenced by employers.

Conflicts between work and family have been reported to

be related to work satisfaction. We defined two concepts:

work-to-family conflict (work interferes with family) and

family-to-work conflict (family interferes with work). When

work interfered with family, the RN work satisfaction was

lower; however, when family interfered with work no relationship

to work satisfaction was found. Work-to-family

conflict was related to satisfaction in nonnursing samples

as well. Organizational and personal initiatives to reduce

work-to-family conflict would be particularly appropriate

targets to address (Frone, 2003).

Conclusions

The study reported here included a national random sample

of RNs in a variety of nursing positions and healthcare

organizations, unlike many other studies of work satisfaction

that were focused on only staff nurses in hospitals

(Adams & Bond, 2000). However, only the educational

work setting influenced satisfaction. Thus, differences in our

sample from studies focused on RNs in hospitals might account

for some differences in findings. On the other hand,

our model explained 54% of the variance inRNsatisfaction.

Thus, the model we tested, which included many variables

not analyzed in other studies, might account for some differences

from previously published studies.

Of particular interest to managers is what factors are mutable

by management or governmental policy in such a way

that they increase satisfaction. Considering the need to recruit

and retain minority nurses, managers should be particularly

sensitive to the concerns of non-Hispanic Black nurses

to determine how to increase their satisfaction. Organizational

characteristics such as paid time off, autonomy, variety,

distributive justice, supervisory support, promotional

opportunity, and organizational constraints are factors over

which organizations have a great deal of control. Interestingly

and contrary to economic literature, the amount of

wage was not significant but the fairness of the wage was

important, and this perception can be modified by employers.

Having paid time off as a benefit is a way employers

could reduce work-to-family conflict; e.g., flexibility in work

schedules might be an important factor in work satisfaction.

Work-to-family conflict and group cohesion might be improved

if organizations provide work environments that are

family friendly, with supervisors trained to foster activities

in work units that increase group cohesion. Improving those

organizational characteristics should lead to increased RN

satisfaction with work.

Future research should include studies with large enough

sample sizes to assess whether factors associated with satisfaction

vary by subgroup such as new graduates in the 1st

year of practice. Some measures that have been reported to

be related to satisfaction, such as communication with physicians

were not included in this study and should be included

in future research. This study was focused on individuals,

not organizations, and it included little information about

the organizations in which the RNs worked. We did not assess

organizational size or other characteristics, nor did we

include data about the dynamics of the work setting, such

as how care was organized.

Understanding satisfaction is important because it has

been linked inversely to turnover. Findings from this and

other studies indicate that organizations can do much to

increase RN satisfaction with work.

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