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ANALYSIS OF JOB SATISFACTION OF PROFESSIONAL NURSES IN PUBLIC AND PRIVATE SECTORS IN ANAMBRA STATE, NIGERIA

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CHAPTER ONE

 

INTRODUCTION

 

Background to the Study

Output in terms of performance in any given organization is a function of many variables which job satisfaction is one of them.  Job satisfaction which is equally understood and sometimes referred to as “work satisfaction” has been variously defined in the literature.  Job satisfaction is the extent to which an employee expresses a positive orientation towards a job. It also describes how content an individual is with his or her job. Job satisfaction has also been defined as a pleasurable emotional state resulting from the appraisal of one’s job, an affective reaction to one’s job and an attitude towards one’s job (Chimanikire, Mutandwa, Gadzirayi, Muzondo, & Mutandwa, 2007; Thompson & Phua, 2012).  Job satisfaction is a worker’s sense of achievement and success on the job.  It is generally perceived to be directly linked to productivity as well as to personal well-being.  Job satisfaction implies doing a job one enjoys, doing it well and being rewarded for one’s efforts.  Job satisfaction further implies enthusiasm and happiness with one’s work.  Job satisfaction is the key ingredient that leads to recognition, income, promotion, and the achievement of other goals that lead to a feeling of fulfilment (Kaliski, 2007).

 

Job satisfaction has continued to be a major area of interest in the study of industrial and organizational psychology because of the presumed and common-sense linkages between satisfaction and other mainstream concepts like leadership, performance, reward system and group process (Poole & Warner, 2000).  Furthermore, job satisfaction has been an interesting construct for researchers in understanding employee behaviours and attitudes (Zurn, Dolea & Stillwell, 2005).  Despite the number of studies that dealt on different aspects of job satisfaction, Boles, Wood and Johnson (2008), stated that more studies are needed on job satisfaction because of several reasons.  According to them satisfaction with the job is directly related to organizational commitment, behaviours and actions.  To this end therefore job satisfaction among professional nurses should be of great importance and concern to any health organization, sector or nation given the pivotal role that nurses play in determining the efficiency, effectiveness and sustainability of health care delivery system. It is therefore imperative to understand what motivates nurses and the extent to which the organization and other contextual variables, add up to achieve satisfactory performance output in the overall health care delivery system. This is necessary going by the fact that job satisfaction is an essential part of ensuring high quality care and performance output (Lambert, Hogan & Barton, 2001; Mount, Ilies & Johnson, 2006). Job satisfaction does not necessarily concern the professional nurses only, but cuts across the entire system – patients and patients’ relations, hospital management as well as health sector, health organizations, and indeed the entire nation.  The inaction or inability of any organization to achieve a reasonable level of job satisfaction among her workforce will lead to dissatisfaction.

 

Job dissatisfaction generally, has been frequently cited as the primary reason for low/poor quality output, non-commitment, low productivity and high rate of staff turnover among others. Dissatisfied nurses not only give poor quality, less efficient care, there is also evidence of a positive correlation between professional nurse satisfaction and patient satisfaction and outcomes (Tzeng, 2002; Tsang, 2002, Takase, Maude & Manias, 2005). Nurses who were not satisfied at work were also found to distance themselves from their patients and their nursing chores, resulting in sub-optimal quality of care (Demorouti, Bekker, Nachreiner & Schaufeli, 2002).

 

The growing importance attached to studying job satisfaction especially among the professional nurses in recent times is not far-fetched. For instance, there is a growing need to strengthen health system in Nigeria to help meet the Millennium Development Goals (MDGs). It is widely believed that a key constraint to achieving the MDGs is the absence of a properly trained and motivated work force of which nurses are part and parcel, and improving the health workers working conditions is critical for health system performance (FMOH, 2007).  In addition, the HIV/AIDS epidemic is compounding the problem by creating a stressful environment for health workers through increased workload, exposure to infection and reduced morale.

 

The organization of the health care system in Nigeria is pluralistic and complex. It includes a wide range of providers, comprising the public health institutions and a large and equally growing private sector, made up of private-for-profit and private-for-non-profit providers, e.g. Non-Governmental Organizations (NGOs), Religious, Spiritual and Traditional Care Providers. This situation is equally the same in all the 36 States of the Federation including Anambra State.  Anambra State health care system consists of public sector health institutions that serve both the indigent and the affluent in the society, and the private health providers that specifically cater for the segment of the population that can afford their services.

 

Outside public health institutions, the private sector hospitals, maternity homes and clinics provide about 80 percent health services to Nigerians (Federal Ministry of Health, 2007).  Despite these remarkable contributions of the private sector to the overall health care need of the country, the sector are not very well supported (Kwahar & Ukeh, 2012).  Evidence from the literature, however, shows that the sector lags behind in training and refresher courses (Larbi, 2004).  With the exemptions of few non-governmental and mission hospitals, most private sector hospitals are privately owned and run by the physicians (doctors) who oversee the management of the hospitals on one man basis.  Most of the job satisfaction variables such as opportunity for advancement, recognition, job security, working conditions, interpersonal relationship, etc. are not regulated and policy driven in private sector as obtained in public health sector.  This situation, therefore, makes a critical evaluation of job satisfaction variables in the sectors worthwhile considering the rate of nurses’ turnover in both sectors.

 

Statement of the Problem

It is believed that the satisfied employee can provide good service while a low level of employee job satisfaction can result to difficulties in increasing service quality. To ensure the achievement of firm goals, organisations create atmosphere of commitment and cooperation for its employees through policies that facilitate employee satisfaction. However, Kwahar and Ukeh (2012) found that there has been a general lack of satisfaction with jobs in Nigeria.  Evidence from Ruggiero (2005) suggests that there is widespread lack of job satisfaction among nurses. Coupled with a critical shortage of registered nurses, this situation threatens the provision of safe healthcare. One way of ensuring optimum satisfaction of nurses in the health sector for maximum performance is to appraise the overall working conditions, job security, interpersonal relationship, recognition, advancement, etc of nurses. This requirement as suggested here is presumed on the premise that output in terms of performance in any organization is a function of many variables of which job satisfaction is inclusive.

 

Evidence from the literature shows that absence of job satisfaction leads to increased stress and frustration which result in physical, emotional and behavioural problems, lower productivity and abandonment of nursing profession (Kendrick, 2000; Robertson, Birch & Cooper, 2012), high turnover of nurses and increased rates of absenteeism (Larabee, 2003; Siu, 2002), as well as migration to other countries especially United States of America and United Kingdom, in search of better remuneration. These, nonetheless, are not healthy for the development of the health sector.  Hence, these unabating penchant and unhidden desires of many professional nurses to either move from private sector to public sector, or move from both sectors to outside the country for whatever reasons call for an in-depth empirical study.  This researcher therefore speculates that these unhidden desires and unabating penchant for the (intra and extra) movements might be because of the desire for better or improved job satisfaction. However, the unavailability of recent and empirical inter-sectoral research studies on professional nurses’ movements in Nigeria create a serious gap in the literature.  It is against these backdrops that this study is being carried out to analyse the job satisfaction of professional nurses in public and private hospitals in Anambra State, Nigeria.

 

Purpose of the Study

The main purpose of this study was to compare the job satisfaction of professional nurses in public and private health sectors in Anambra State. The study is also set to achieve the following specific purposes:

  1. To determine the level of satisfaction nurses derive from job security in public and private hospitals.
  2. To determine how recognition of nurses’ performances in public and private hospitals provide job satisfaction.
  3. To identify the extent to which opportunity for advancement guarantees job satisfaction to nurses in public and private hospitals
  4. To ascertain the level of satisfaction nurses derive from job control/responsibilities in public and private hospitals.

 

Research Questions

Based on the objectives, the following research questions are posed:

  1. What level of satisfaction do nurses derive from job security in public and private hospitals?
  2. How does recognition of nurses in public and private hospitals provide job satisfaction?
  3. To what extent does opportunity for advancement guarantees job satisfaction to nurses in public and private hospitals?
  4. What level of satisfaction do nurses derive from job control in public and private hospitals?

 

Research Hypotheses

The following Null hypotheses were formulated to guide the study.

  1. There is no significant difference in satisfaction from job security between nurses in the public and private hospitals
  2. There is no significant difference in satisfaction from recognition between nurses in public and private hospitals
  3. Opportunity for advancement does not significantly guarantee job satisfaction between nurses in public and private hospitals
  4. Job control does not have  significant effect on job satisfaction between nurses in public and private hospitals

 

Significance of the Study

The relevance and benefits of this study cut across different strata of the stakeholders and participants in the health sector.  It provides health sector managers some useful insights on the factors that would be addressed to achieve professional nurses’ job satisfaction towards delivering effective and efficient health care to the publics.  Consequently, government, organizations and non-governmental organizations that operate in the nation’s health sector through this study know where and what to contribute towards improving health care delivery.  Again, the study’s findings would guide the nurses in taking informed decisions that would guarantee their job satisfaction and fulfillment.  Finally, the study would guide health managers in handling health related issues as they concerned the nurses and industrial crisis within the health sector.  The society also will benefit from the study because, when nurses are satisfied with their job, they will render quality services to the society.

 

Scope of the Study

This study is delimited to professional nurses’ job satisfaction in both public and private health sectors of Anambra State.  As a comparative study, the job satisfaction variables considered in this study were; job security, opportunity for advancement, recognition and job control.

 

Operational Definition of Terms

 

Job satisfaction:  This is the degree of positive affective orientation an individual has toward a job.

 

Job satisfaction variables in this study refer to:

  • Job security: the nature and state of contractual agreement that guarantee steady or permanent employment, e.g. assurance of financial assistance, benefits and welfare in case of accident and disability arising from the job.
  • Status recognition: Refer to involvement in decision making, verbal or written award or commendation due to high performance as sources of inspiration and motivation.
  • Professional development opportunities: Refer to encouraging and sponsoring the nurses to national, regional, and international conferences, seminars, workshops and training that will boost their professional standing and status.
  • Ranking of job satisfaction variables: Refer to assignment of numbers from 1-7 to represent different values along the continuum in the scaling of job satisfaction variables.
  • Public health institutions: Publicly owned hospitals that depend on government subventions for its operations and are not strictly out to make profits, State teaching hospitals, medical centres, model health centres, general hospitals, etc.
  • Private health institutions: Privately owned hospitals that depend on the owner(s) for its financing and are strictly out to make profits. Mission hospitals, individually owned private hospitals, clinics, maternity homes.
  • Private health workers: This refers to nurses working private health institution.
  • Public health workers: This refers to nurses working in public health institution.

 

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