WORK RELATED BARRIERS AND LEVELS OF

JOB SATISFACTION IN NURSING PRACTICE

OF MAYO HOSPITAL

1. RATIONALE

The nursing profession is considered as one of the main pillars in health

care systems all over the world . In the recent era, because of
shortage of nurses and high turnover , it has become a global issue
having a great impact on developing as well as developed countries. On
the international level many research projects have been carried out
particularly in the last decade to find out the main problems that nurses
face during their practice as well as to determine the factors that lead
to the shortage of nurses. According to WHO, the recommended ratio
of nurse to doctor has been set up to 4:1, those countries which have
any deviation from this level are said to have shortage of nursing
professionals.

Pakistan is one of those countries where nursing practice is at near to

the worst circumstances . As per the set level of WHO , in Pakistan , the
ratio of nurse to doctor is 1 nurse to 2.7 doctors which further worsens
the circumstances and ultimately leads to burnout of these health
professionals . The JOINT LEARNING INITIATIVE REPORT (2008) and
WORLD HEALTH REPORT (2012) listed Pakistan as one of the 57
countries with critical workfare deficiencies . Despite having 109
nursing schools and colleges , shortage of nurses is still a big concern
with approximately 44000 nurses registered all over the country. 965
largely urban based hospitals are facing problems of nurse shortage in
country .The fact that the nurse to patient ratio is 1:3043 itself speaks
of the level of shortage in the country.

This literature review analyses the previous researches performed at

national as well as international level to figure out the main barriers
faced during the nursing practice. The common points that are shared
by majority of the research projects 1,2,3,9 include hectic work routine of
nurses ,inadequate salary ,inadequate staff to cover duties,
inappropriate working conditions ,stress and depressive symptoms in
nurses leading to exhaustion and burnout and inappropriate behavior
of doctors and patients towards nurses .The ultimate depression and
burnout explained the lightest amount of variance in nurses mental
health status . These are known to compromise productivity as well as
performance and quality of patient care.

As in accordance with the facts given in1,2,3:

Poor attitude from doctors proved out to be the main cause of
stress in about 50 % of nurses . And 21% of nurses perceived poor
attitude from patients to be the main cause of stress .
Place of posting has an intimate association with stress . 43 % of
nurses working in ICU and emergencies were moderately
depressed while 2% of them were severely depressed .
 About 80% of nurses reported that they had no time for family
and 42% of them were moderate to severely depressed and 45 %
considered their job tiring and hectic .

Laschinger et al showed that manageable workplace factors play an

important role in influencing the positive attitude towards profession
among new nurse graduates and lessen their likelihood of leaving in the
first 2 years of graduation despite their motivation to work.
Similarly , Gardner identified job stress as the strongest predictor of
retention of new graduate nurses.

As mentioned , the second main focus of this review is to analyse the

results of research projects that determine the levels of job satisfaction
among nurses .Need fulfillment , that is , whether or not job met the
physical and psychological needs of the employee for the things within
the work situation (Worf , 1970) is job satisfaction.

As in accordance with 6,7,8,10 ,

1- Factors Promoting Job Satisfaction In Pakistan

Positive inter- personal relationships ( loyality,trust and

sharing of common values) .
 Quality of care
Clearly defined roles and responsibilities
Balanced workload

Reward for effort and positive feedback

Affiliation with standard body

2 - Factors Related To Job Dis - satisfaction In Pakistan :

High patient to nurse ratio ( 3043:1 )

Dis satisfaction with work quality
Poor leadership body
Inadequate work empowerment
Lack of money incentives
Lack of appreciation and negative feedback
Lack of professional latitude
Hectic work routine and stressful pattern
Continuous posting in emergencies and ICU departments
Inappropriate behaviour of doctor and patients towards nurses
Poor security provided by hospital administration
Ethical issues faced by nurses5,6
Communication barrier between nurses and patients

All the important factors mentioned above are the results that are
mentioned in the articles 1,,10 .Among these ,the points like
doctor and nurse inter relations , family time problems , . money
incentives , place of posting and work conditions are high yield
 issues and are emphasized by every second research project . But
there is need to highlight some othermain factors as well which
are at least in Pakistan cannot be ignored in the current
circumstances.

These are :

Behaviour of patients and attendants towards nurses

Security provided to nurses in hospitals
Appreciation and positive feedback
Career counselling of new graduates
Stressful place of posting / Minimum rotation

REFERENCES:

1 OCCURRENE OF DEPRESSIVE SYMPTOMS IN NURSES W

WORKING IN A FAMILY HEALTH PROGRAMS

2 - WORK RELATED STRESS,BURNOUT , JOB SATISFACTION

AND GENERAL HEALTH 0F NURSES

3 - OCCUPATIONAL STRESS AMONG STAFF NURSES

CONTROLLING THE RISK TO HEALTH
http://www.ncbi.nlm.nih.gov/ articles
4 - ETHICAL LEADERSHIP OUTCOMES IN NURSING
 5 ETHICAL ISSUES FACED BY NURSES IN DISTRICT LAYYAH
https://www.google.com.pk/url?sa=t&source=web&rct=j&u
rl=http://diversityhealthcare.imedpub.com/ethical-issues-
faced-by-nurses-during-nursingpractice-in-district-layyah-
pakistan.php%3Faid%3D10616&ved=0ahUKEwjP27HBneXSA
hWE6RQKHdW4B3wQFggwMAY&usg=AFQjCNFyi4xdEzHmYi
QIpNFxzw_zvideKQ

https://www.google.com.pk/url?sa=t&source=web&rct=j&url=
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2774771/&ve
d=0ahUKEwir5rvXneXSAhWJSBQKHZAEAPQQFggjMAA&usg=AF
QjCNEEvpH1YVLFwPz3VhvCatJm9Y3a8A

6 JOB SATISFACTION IN NURSES WORKING IN PUBLIC AND

PRIVATE HEALTH SECTOR
https://www.ncbi.nlm.nih.gov/articles
7 JOB SATISFACTION OF ADVANCED PRACTICING NURSES IN
VETERANS HEALTH ADMINISTRATION
8 FACTORS RELATED TO JOB SATISFACTION AMONG NURSES
9 COMMUNICATION BARRIER PERCEIVED BY NURSES AND
PATIENTS
10 JOB SATISFACTION FACTORS IN SOLVENION HOSPITALS
http://www.nursingworld.org/MainMenuCategories/ANAMark
etplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-
2014/No2-May-2014/Barriers-to-NP-Practice.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340164/#!po
=68.2432