APPENDICIES
3.6. Job Satisfaction in the Context of Nursing
According to Asegid, Belachew and Yimam (2014), job satisfaction is related to the enjoyment, fulfilment and gratification that an employee derives from their work and is not only related to how much money or benefits an employee has as a result of their job. Human capital is considered to be the most vital asset for organisations today and especially for their organisational development (Khan, Nawaz, Aleem & Hamed, 2012). Getting the best out of human capital requires much skill by the organisation as well as its management. These skills are used to satisfy the needs of the workforce, where greater the levels of satisfaction among employees translate into higher returns for the organisation (Khan et al. 2012). Accordingly, job satisfaction remains one of the most extensively researched areas to date (Keung Fai, 1996).
South Africa has been facing a serious shortage of human resources within the public health care system for quite some time (Delobelle et al. 2011; Pillay, 2009). This shortage has been attributed to the migration of nurses to more developed countries, which offer incentives such as better living conditions, improved work conditions, better remuneration and
improved career path options (Buchan, Sochalski, Parkin, & WHO, 2003; Dovlo, 2007).
Migration does not only take place across borders, but also within the region itself, with nurses moving from public to private and from rural to urban areas in the hope of attaining better working conditions, better pay and a chance of an upward mobility career path.
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The shortage of nurses in South Africa not only impacts access to health care but also the success of health reforms such as the Re-Engineering of PHC which is largely nurse- driven. Public Health Care nurses work in teams in areas that do not enjoy ready access to doctors or specialists. Their roles within the community are to provide health care services at a primary level and sometimes extends beyond diagnosis to curative measures. While there are many reasons nurses choose to leave their jobs, low job satisfaction is by far the most frequently cited reason given. In order for the Re-Engineering of PHC to work and the groundwork to be lain for the rollout of a NHI scheme which is dependent on nurses, it is imperative that studies be conducted, policies developed and implemented, so as to increase job satisfaction among nurses working within the public sector.
3.6.1. Defining Job Satisfaction
According to Spector (1997) and Locke (1976), job satisfaction has primarily been defined by two approaches: a global approach and a faceted approach. For the purpose of identifying specific areas for improvement, the latter approach seems to be favoured as it emphasised employees’ attitudes towards individual aspects of their work (Coomber &
Barriball, 2007).
International research conducted in the field of nursing with relation to job
satisfaction among nurses has come to the conclusion that there is a growing dissatisfaction experienced by nurses around the world, including South Africa (Aiken et al. 2002; Hart, 2000; Pillay, 2009). The factors that they found to be the most important contributors to unhappiness included non-supportive environments and increased workloads (Sims, 2003;
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Healy & McKay, 2000). However, one of the key contributors linked to job satisfaction in nursing was that of professional development and recognition (Nolan, Nolan & Grant, 1995;
Lyon, 2003). These research results provide credibility that research in PsyCap and its development can lead to greater job satisfaction.
3.6.2. The High Turnover in Nursing
The literature reveals that job dissatisfaction has been the primary reason for the high turnover rate of nurses across the world (Delobelle, et al. 2011; Lambert, Hogan & Barton, 2001; Tzeng, 2002). In addition, it is the number one contributing factor to increased rates of absenteeism among nurses (Siu, 2002). This results in efficiency and effectiveness being impeded which in turn lowers the health care organisation’s capacity to provide good care and meet the needs of its patients (Shields & Ward, 2001; Tai, Barne & Robinson, 1998).
Research conducted by Pillay (2002), Borda and Norman (1997) and Cavanagh and Coffin (1992), found a decrease in morale among nurses. Low morale leads to increased turnover rates which not only affects the productivity level of an organisation, but also those nurses who remain behind. Similarly, Delobelle et al. (2011) found that nurses were
dissatisfied with their pay and work conditions and that half of the nurses in the study had considered leaving the organisation in the past two years.
3.6.3. The Relationship between Job Satisfaction and Organisational Outcomes
Nursing research has shown that satisfaction in work life correlates positively with patient satisfaction and outcomes (Tseng, 2002; Leiter, Harvie & Frizzell, 1998). Demerouti,
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Bekker, Nachreiner and Schaufeli (2000) found in their research that nurses who experienced dissatisfaction at work, seemed to distance themselves from their patients which ultimately resulted in poor quality of care. Buitendach and Moola (2011) conducted a study examining coping, occupational wellbeing and job satisfaction of nurses and found that job satisfaction was a good predictor of emotional exhaustion and cynicism which are components of burnout. Their research supports the fact that job satisfaction is regarded as one of the
outcomes of burnout. Similarly, Baxter (2002) found that satisfaction at work for nurses had a strong influence on the quality of care they provided to their patients. Consequently, if the DoH hopes to achieve its motto of “a healthy life for all,” they cannot ignore the
dissatisfaction that currently exists within the PHC setting.
The dissatisfaction of employees has adverse effects of the efficiency of any
organisation. Studying job satisfaction therefore remains one of the most important topics of enquiry in any organisation. The importance of job satisfaction can be realised by taking the recent strikes into consideration in South Africa (e.g. truck drivers, nurses, and teachers). The present research study therefore aims at exploring the current level of job satisfaction among nurses in South Africa with the hope of finding ways to help increase/improve job
satisfaction overall.