Job satisfaction and retention of nurses in healthcare institutions in the U.S are vital since they determine the quality of care given to patients and their outcomes. When nurses are satisfied in their jobs, it impacts the patient’s safety, productivity, quality of care delivered, turnover, and retention rates (Drake, 2016). Although job satisfaction and nurse retention are directly related, retention of nurses is a challenge affecting diverse healthcare institutions in the U.S. A study conducted by Drake (2016) indicates that nurse retention is a global business problem that costs the healthcare sector in the U.S approximately $ 22,000-64,000 per year. Using the example of a small hospital in South-Eastern America, the author established that the retention of nurses/patient ratio was 5:1 (Drake, 2017). This is among the examples that suggest sufficient strategies need to be instituted to ensure that the retention rates of nurses are improved. When healthcare institutions in the U.S do not implement strategies for improving job satisfaction and retention among nurses, statistics indicate that 400,000 nursing positions will be left vacant towards the end of 2028, which will be twice that of the 1960s (Drake, 2017). A Shortage in the number of nurses negatively affects the delivery of care, leading to poor patient outcomes. This study, therefore, seeks to expound on the factors that can contribute to reduced job satisfaction and retention among nurses and offer recommendations on the effective strategies that healthcare institutions in the U.S and adopt to increase the satisfaction and retention of nurses.
Background and Factors that contribute to reduced Job Satisfaction and Retention
Nurse Managers play influential roles in ensuring that healthcare institutions in the U.S achieve their goals. Nurse Managers are expected to have skills that will enable them to managed finances effectively, negotiation skills, technological advancement, and leadership. According to the current statistics, the demand for nursing services is expected to increase from 2016-2026 by approximately 15 percent (Al Maqbali, 2015). The increase will be attributed to the increasing number of the older population that will need nursing services. Although it is the primary responsibility of nurse managers to ensure sufficient job satisfaction and retention among nurses, the numbers are still very low (Al Maqbali, 2015). The main factor contributing to nurses’ low satisfaction and retention is that nurse managers do not understand factors that contribute to satisfaction, hence the need to investigate more on this topic. Different factors are known to cause job satisfaction and retention among nurses. They include leadership behaviors by nurse managers, nurse autonomy, stress and burnout, financial burdens, patient quality of care, and staff interaction and relationships.
Leadership Behaviors of Nurse Managers
Leadership is an essential component of organizational success, including in the healthcare sector. Nurse managers’ leadership styles and skills need to be constantly evaluated to ensure that any deficiencies are identified and corrected. Monitoring the leadership styles of nurses also lays a foundation for increasing job satisfaction and retention among new graduate nurses hence reducing shortages in different hospitals (Kline, (2018). When a nurse manager is constantly engaging in abusive practices such as bullying or favoritism, it results in low job satisfaction among nurses, increasing their intention of quitting the nursing profession. However, nurses managers who adopt the transformational leadership style lead to positive outcomes, including high quality of care to patients and reduced intention for nurses to quit working in the healthcare sector (Kline, (2018).
According to a descriptive study conducted by Kline (2018) in a community-based hospital in the North Eastern United States, different leadership styles and other factors can be used to determine job satisfaction and retention among nurses, which in turn contribute to adequate retention rates. Organizational and leadership support by nurse managers is also an essential factor in increasing job satisfaction among nurses (Kline, 2018). When nurse managers are not supportive by failing to offer nurses sufficient resources to accomplish specific tasks, it makes them not have the morale to execute their duties. This may make them dissatisfied and develop the intention of moving to other healthcare facilities that may offer them better resources needed in care delivery (Kline, (2018).
Nurse Autonomy
Nurse Autonomy denotes the ability of nurses to have the authority of making decisions and acting per the nursing professional base. When new nurses begin working in different, they often have less experience; however, they have a higher level of autonomy when compared to the more experienced nurses. However, when new registered nurses work in a healthcare sector that does not give them the freedom to make decisions on specific issues effectively, it reduces their satisfaction. The absence of nurse autonomy in hospitals is among the main factors contributing to more nurses quitting hence leading to shortages. According to Drake (2016), shortage is a global problem primarily characterized by psychological and physical health consequences in the health sector. Proving n conducive working environment for nurses lays a foundation for enhancing the nursing psychological and physical effect. Nurse Managers who do not allow nurses to make decisions based on their professional knowledge lead to nurses not feeling valued and appreciated, leading to quitting the nursing profession (Drake, 2016).
Nurse turnover has a direct impact on the working morale of the remaining nurses in an institution. According to a study that was geared towards expounding on how nurse turnover impacts the work processes in a group, findings indicated that nurses who are constantly dissatisfied in their work environment exhibit a high turnover and increased attribution rate (Drake, 2016). An organization experiencing a high turnover suffers various challenges since the remaining nurses have to fill positions left by other nurses and execute operations that they are not familiar with. Such an aspect negatively affects the nursing team dynamics, including staff morale and team efficiency. In the long run, it leads to poor patient experience and patient health outcomes.
Staff Interaction and Relationship
The interactions and relationships that nurses and other members in an institution maintain are an important predictor of job satisfaction and retention. When nurses and physicians have a collaborative relationship, it directly influences job satisfaction and the quality of care delivered to patients. When a nurse faces challenges approaching a physician and seeking some crucial clarifications, their relationship significantly suffers, impairing the quality of patient care (Kline, (2018). Nurses are tasked with the responsibility of being patient advocates and ensuring that they have positive patient outcomes. When a nurse is working with a physician who has demeaning behavior and poor communication skills, it results in nurses having negative feelings concerning a given patient care issue. Such negative feelings in return translate to lower morale and dissatisfaction (Kline, (2018). Conversely, positive relationships between nurses and physicians increase nurses’ job satisfaction and desire to stay within a given health care institution. Less experienced nurses are often required to work in areas that they are less conversant. As a result, time exposure and working in certain high acuity areas are linked to negative emotions, leading to low satisfaction among the less experienced nurses (Kline, (2018).
Stress and Burn Out
Different studies have been conducted to ascertain the link between stress and burnout on the job satisfaction of nurses. According to a study by Milliken et al. (2017), stress and burnout among nurses lead to numerous challenges in the health sector. One of the common ones is poor patient outcomes due to an increase in medication errors (Boamah et al., 2016). Burnout is believed to arise due to adverse working conditions and a precursor of job dissatisfaction hence resulting in turnover. According to Boamah et al. (2016), increasingly heavy workloads, insufficient control over who should fulfill particular duties, and poor working relationships among staff members result in mental exhaustion among nurses, translating to burnout and stress. A stressed nurse cannot execute their duties effectively due to reduced morale and mental exhaustion (Boamah et al., 2016).
Impact Of Job Satisfaction and Retention of Nurses in the Healthcare Sector
Job satisfaction and retention is a critical component of various organizations in the U.S. Job satisfaction and retention is gaining recognition because failure to address it effectively may result to labor shortages hence negatively impacting patient outcomes. With the increasing number of the elderly population and lifestyle diseases, there is a need to understand the importance of job satisfaction of nurses (Perry et al., 2018). When nurses are satisfied in their jobs, they tend to have increased morale, leading to improved productivity and patient outcomes. Additionally, nurses who are satisfied with their jobs are likely not to quit the nursing profession.
On the other hand, nurses who are not satisfied with their jobs are likely to lose their working morale, leading to an increased urge to quit the nursing profession. Nurses are tasked with fulfilling various duties, including ensuring that patients do not experience falls and administering medications correctly (Perry et al., 2018). Nurses who are constantly dissatisfied with their jobs are likely to invest fewer resources needed to perform their duties effectively. Most of these types of nurses are likely to experience exhaustion and aversion of patients. Nurses who experience high exhaustion do not pay attention to their attention, leading to increased patient falls and medication errors (Perry et al., 2018). Based on the negative aspects related to poor job satisfaction and retention of nurses, effective strategies need to be adopted.
Strategies That Can Be Adopted to Increase Job Satisfaction and Retention of Nurses in the U.S
The existing statistics indicate that the retention of new nurses in the United States is still low. For instance, approximately 30 percent of new graduate nurses are likely to leave during their first year of practice, while 57 percent leave during their second year. Since the average turnover per nurse ranges from $ 37,700-58,400, healthcare institutions cannot continue losing their nurses. Instead, they should focus on adopting mechanisms geared towards enhancing job satisfaction and retention among nurses (Morton, 2018). Some of the strategies that can be adopted including establishing a nurse residency program, making career development among nurses a top priority, providing a flexible work schedule, and promoting a culture of learning among nurses (Morton, 2018). An organization that offers a nurse residency program is vital because it helps in fostering new connections and healthy collaborative work culture. The residency program also aids in enhancing nurse retention and instill confidence among new nurses. Nurses experience stress and burnout because they are not offered a flexible working schedule. Organizations should therefore strive to ensure that nurses do not experience such by reducing overtime work and allowing nurses to have time to engage in other life activities (Morton, 2018).
Conclusion
Job satisfaction and retention among nurses are essential since it determines organizational success and patient outcomes. Although job satisfaction and retention are directly related, nurse managers do not understand some of the causes of the factors contributing to dissatisfaction. Some of the coon causes of low job satisfaction and retention of nurses in the United States include leadership behaviors by nurse managers, nurse autonomy, stress and burnout, financial burdens, patient quality of care, and staff interaction and relationships. Therefore, the health sector needs to adopt strategies that will ensure that their retention rates are improved. The recommended strategies that can be helpful include offering a nursing residency program, setting time for career advancement, and offering a flexible working schedule.
References
Al Maqbali, M. A. (2015). Factors that influence nurses’ job satisfaction: a literature review. Nursing Management, 22(2). https://journals.rcni.com/nursing-management/factors-that-influence-nurses-job-satisfaction-a-literature-review-nm.22.2.30.e1297
Boamah, S. A., Read, E. A., & Spence Laschinger, H. K. (2017). Factors influencing new graduate nurse burnout development, job satisfaction, and patient care quality: a time‐lagged study. Journal of advanced nursing, 73(5), 1182-1195. https://onlinelibrary.wiley.com/doi/full/10.1111/jan.13215
Drake, R. M. (2017). Job satisfaction and retention of Registered Nurses at a small rural hospital in the Southeastern United States. Gardner-Webb University. https://www.proquest.com/openview/7740f5af656d5e0af8194a73116defbe/1?pq-origsite=gscholar&cbl=18750
Kline, B. N. (2018). Job Satisfaction and the Effects and Influences on Nurse Retention (Doctoral dissertation, Walden University). https://www.proquest.com/openview/aab16f5042d9a8d0889ea2c2f1c5a321/1?pq-origsite=gscholar&cbl=18750
Morton, I. R. (2018). Nurse Manager Job satisfaction and retention. Gardner-Webb University. https://www.proquest.com/openview/0c8aad9191053e4af749eb81819058cb/1?pq-origsite=gscholar&cbl=18750&diss=y
Perry, S. J., Richter, J. P., & Beauvais, B. (2018). The effects of nursing satisfaction and turnover cognitions on patient attitudes and outcomes: A three‐level multisource study. Health services research, 53(6), 4943-4969. https://onlinelibrary.wiley.com/doi/full/10.1111/1475-6773.12997
