Job Satisfaction Among Registered Nurses in Institute Jantung Negara, Kuala Lumpur.

Chapter 1
1.0 Introduction

Job satisfaction among nurses related to their performance in healthcare and delivery of

quality nursing care. This study being a platform s to measure job satisfaction level among

registered nurse at private hospital and factors influencing their satisfaction and

dissatisfaction in nursing.

1.1 Background Information

According to International Council of Nurses (2012), it is being reported number of qualified

nurses has declined due to an increased in alternative job opportunities. The demands for

nurses in healthcare increased in response to ageing population and increased of chronic

diseases level Job satisfaction refer as strong element related to a nurse whether retain at

same healthcare or decided to leave (Zangaro and Soeken, 2007; Lu et al., 2008). A

teamwork at workplace as collaborative relationship between physician-nurses in patient care

decision making being a factor to determining job satisfaction level (Gardulf et al., 2008;

Wyatt and Harrison, 2010). Findings from Malaysia studies reported that relationship with

co-workers, salary, nursing management policy and inadequate support from superior refer as

components effects the job satisfaction level (Ahmad and Oranye, 2010; Masroor and Fakir,

2010). Besides, other studies reported inflexibility of working schedule, inadequate staff,

poor job security, heavy workloads and low clinical anatomy level affect the job satisfaction

among nurses (Al-Hussami, 2008; Mirzabeigi et al., 2009; Zarea et al., 2009).
1.2 Problem Statement

Nursing profession become as alternative choice rather than first choice. In era 1970s, a large

population of Malaysian young women went abroad like Australia and England to be trained

as nurses as those days limited opportunity available in Malaysia to be trained (Utusan,

2004).
At present time, although number of opportunity available in Malaysia but then the

popularity of nursing profession declined. Shortage of nurses not only happens in Malaysia

but worldwide experiencing the issues in healthcare. It been noticed that most of the

Malaysian trained nurses went abroad as they offered with high pay, for example Saudi

Arabia. During attending International Nurses Day 2007, our Prime Minister requested

Malaysian nurses to serve for nation despite for abroad to improve quality of healthcare

among Malaysian citizen to form healthy society (Bernama, 2007).

The basic element of a job satisfaction is employment fulfillment in which an employee

obtains the benefits through his or her job to secure their life ( Sarfaz, Afghan and Wagar,

2016). A healthy working environment is important to deliver quality output especially in

patient heath result. The main role of a nurse is to deliver good health practice to patients

which being essential factor for healthcare increase their turnover. By contributing poor

employment fulfillment such as low pay, inadequate staffing, inflexible schedule will directly

affect turnover rate of nurses. It is being reported that nurses turnover rate in Malaysia

increased from 400 to 1049 for those quit their job from 2005-2010 (Siew, Chitpakdee &

Chontawan, 2011). If the management aware about the factors influencing satisfaction and

dissatisfaction of nurses will allow them to improve working environment such as increment,

compensation and enrolling more staff to reduce the work load. It will improve nurse
 performance in work which contribute to good quality patient care (Newman, Maylor, &

Chansarkar, 2002).
1.3 Purpose/Objective/Hypothesis
The main reason of this study is to investigate identified elements of employment fulfillment

as well as displeasure experienced through work flow by nurses in private hospital based in

Kuala Lumpur.
The primary objective of this study is to:
To investigate identified elements of employment satisfaction experienced by nurse in private

hospital in Kuala Lumpur.

1.4 Research Question

a) What are the elements related with job satisfaction among nurses in a private hospital?
b) How do educational level affect nurses job satisfaction?
c) What are the difference in job satisfaction level between nurses in different unit?
d) Do demographic factors like age and years of experience give impact on nurse’s job

satisfaction?
e) How will be the level of job satisfaction if the nurses given flexible schedule?

1.5 Conceptual Definition

Job satisfaction
Job satisfaction refer to work fulfillment. It described about the level in which employees

love their job and it can be seen through their performance (Stamps, 1997).
Registered Nurses
A nurse who has been authorized by Board of Nursing in which they are suitable and trained

well to perform duty in healthcare (Merriam-Webster, 2016).

1.6 Significance of the Study
Nurses are referring as important group of pioneer in a healthcare setting. They play

important role to deliver good quality of healthcare and responsible for welfare of patient. In

present day, not only Malaysia but globally facing nursing shortages issues. The studies

found that the primary reason of this issue due to dissatisfaction of job. It is being proved

through study which shows gradual increase of turnover rate in nursing (Camerino et al.,

2006). This is because poor employment practice in which management fail to fulfill their

needs in terms of work. Nurses who are fulfilled has been shows good performance in their
 job. Vice versa, nurses who are not fulfilled expressed that poor compensation, heavy

workload and no profession openings to upgrade their skills. As result, poor nursing care

given to patient and rate of turnover increased. Nurses reported the desire to deliver nursing

care to patient is primary element that provoke their job satisfaction. Therefore, management

should identify the reason of dissatisfaction of job among nurses at all level and put effort to

overcome the issue. By improving the job satisfaction of nurses leads to improvement in

quality care of patient ((Newman, Maylor, & Chansarkar, 2002). By identifying and solving

the employment fulfillment will allow the nurses to retain at the healthcare. A pleasant

working environment motivate them to perform better which leading to better patient care

and resulting in patient satisfaction.

Chapter 2

Literature Review.

According to Zangaro and Soaeken (2007), nurses job satisfaction refers as essential component

to providing quality patient care which leading to patient satisfaction. Aiken et al (2001) reported

that 43,329 of nurses who dissatisfied with job found to be at five major countries like USA,

Canada, England, Scotland and Germany in a study carried throughout year 1998 to 1999. This

result associated with factors as lack of opportunities of advancement and education, low salary

and heavy workload.

In addition, numerous study reported that relationship with co-worker as well as collaboration

with physician, inflexibility of schedule, inadequate of staff, poor clinical autonomy and support

from superior were also refer as major factors associated with dissatisfaction of job among

nurses (Al-Hussami, 2008; Mirzabeigi et al., 2009; Zarea et al., 2009). Relationship between

physician and nurse is important in patient care decision-making and teamwork to determine the

level of work fulfillment of nurses ( Gardulf et al, 2008; Mirzabeigi et al, Zarea et al, 2009).

Based on Nursing Solution Inc report in 2003, nurses who working at critical care wards had low

salary (12.6%) compared with nurses who working at surgical/medical wards (16.8%) (Hwang et

al, 2009). The demands for nurses in healthcare increased in response to ageing population and

increased of chronic diseases level. But number of registered nurses declined globally including

Malaysia due to availability of alternative job opportunities with high salary offer. Malaysia

faced migration of 400 nurses to other countries per year (Barnett et al, 2010; Siew et al, 2011)

Therefore, nurse’s fulfillment in work is strong element in response to nurses retention (Lu et al,

2008).

A satisfied employee is who motivated employee. When a nurse being motivated, it will result in

delivery of sufficient effort and care within working environment. Otherwise, dissatisfaction of

nurse in job leading to uneven quality patient care, medical errors and at end impact on patient

satisfaction. A nurse should be motivated physically, mentally and emotionally as their services

rely on patient health care outcome.

Newman, Maylor and Chanskar (2002), expressed that capability of service, work fulfillment of

a nurse, nurse retention, patient care quality and satisfaction of patient are related each other into

a chain as follow:

As conclusion, the management system of healthcare plays a major role to support and upgrade

work fulfillment among nurses. Therefore, the management need to concern about employee

welfare and identify the dissatisfaction of employee on job time to time (Moody and Pesut,

2006).

Chapter 3

Methodology

3.1 Study Design

This is cross-sectional study which inquire focused on work fulfillment among registered

nurse in a private hospital Kuala Lumpur. A quantitative method used to measure job
 satisfaction by using Minnesota Satisfaction Questionnaire (Cook, Hepworth, Wall, Warr,

1981) to interpret the data. All registered nurses are invited to participate voluntarily in

response to obtain elements associated with job fulfillment among nurses.

3.2 Study Setting

This study will be conducted in a private cardiac specialist in Kuala Lumpur. This hospital

being chosen because well-known center for cardiac treatment and located at center of

capital. Here were number of registered nurses working and hence high chances to obtain

adequate information for study.

3.3 Sampling Plan

Target population of study would be 250 nurses whom are presently working at selected

location. Applicable sampling technique will be used such as questionnaire will be

distributed based on inclusion and exclusion criteria.

a) Inclusion criteria
Female and male registered nurses of all ethnicity.
b) Exclusion criteria
Nursing managers, clinic nurses, assistant nurses and medical aides.

3.4 Data Collection Procedures.

Research Instrument

Minnesota Satisfaction Questionnaire (Cook et al, 1981) which create by University of

Minnesota will be used throughout the study to interpret the data. This instrument depends on

reaction of human being towards nature of work.

 First segment of questionnaire will comprise of demographic information such as age,

gender, periods of employment and position in the stated hospital. Followed by second

segment of questionnaire associated with 20 thing enquiry’s a Likert type scale extending

from ‘Extremely Disappointed’ to ‘Extremely Satisfied’ which deals with cleanliness and

persuasive elements (Cook et al, 1981). Consent will be obtaining from the instrument

creator prior to utilization of this poll.

Operational Definition

Job satisfaction
In this study, work fulfillment is referring to how nurses being with his or her job. The work

fulfillment will be estimated with 20 things enquiry with Likert type scaling range from

“Extremely Disappointed” to “Extremely Satisfied” which deals with cleanliness and

persuasive elements (Cook et al, 1981).

3.5 Ethical Considerations

The exploration proposition will be submitted to the moral panel of International Medical

University in order to acquire authorization prior to continuing examination of study. The

consent will be obtaining from nursing executive of private cardiac hospital in Kuala

Lumpur. All participants will be educated on motivation about the study and the information

of participants will be kept confidentially. Each of the participants depends on deliberately

and the poll does not require basic information like name and unit in the document. Personal

information of participants would not be required as participants would remain anonymous.

3.6 Proposed Statistical Analysis

A descriptive statistic such as Statistical Package of Social Science (SPSS) version 18.0 will

be used for addressing insights in both segment 1 and 2. The insights comprised the

proportions of focal propensity including mean, middle, mode, standard deviation, normal

deviation and range.