Academic journal article ABNF Journal

An Investigation of Job Satisfaction among Nurses in the Emergency Department

Academic journal article ABNF Journal

An Investigation of Job Satisfaction among Nurses in the Emergency Department

Article excerpt


ursing turnover is a recurring problem for healthcare facilities that is associated with high costs for the organization and lower safety and satisfaction of both patients and nurses (Jones & Gate, 2007). Nursing shortages are reaching crisis levels in North America and it is projected by 2020, there will be a shortage of one million nurses (Hunt, 2009). Specialty areas such as the Emergency Department (ED) are affected at a higher rate than other nursing areas. According to the 2014 National Healthcare & RN Retention Report, the overall rate of nursing turnover for bedside nurses is 14.2% while ED nurse turnover is 20.3% (Nursing Solutions, Inc. [NSI], 2014). A feeling of being overworked, lack of advancement opportunities, decreased recognition or respect, lack of role clarity, lack of trust in or collaboration with coworkers, and poor communication with management are factors that have been identified as most affecting this turnover (Hunt, 2009).

The ED has a unique work environment, in addition to an ever-growing increase in the number of patients being seen in the ED every year, there is also an increase in the average acuity with patients presenting sicker than in the past (Sawatzky & Enns, 2012, p.697). EDs with high nursing vacancy rates are more likely to be overcrowded, have longer wait times, and have an increased number of people leaving the facility without seeing a practitioner. Approximately 70% of the current nursing workforce will be at retirement age by 2025 and it has been found that older nurses prefer to work in areas that do not require shift work which further intensifies the negative effect of the aging workforce in areas such as the ED (Sawatzky & Enns, 2012).

Turnover of nurses has a huge impact on the quality of care being delivered. Healthcare organizations with high turnover rates (22%-44%) also had higher rates of risk-adjusted mortality and longer lengths of stay for patients (Jones & Gates, 2007). Patient satisfaction is often used as an indicator of quality of care and is affected by the cohesion of the staff in the unit. When nurse turnover is high, cohesion is low resulting in lower patient satisfaction (Bae, Mark, & Fried, 2010). Losing just one nurse can cost the organization twice the nurse's annual salary (Hunt, 2009) and according to Hairr et al. (2014) the cost to retrain an ED nurse is around $80,000 while retaining one nurse could save the organization $140,000.

Nurse turnover has a detrimental impact on the financial aspect of the organization, and also negatively impacts the existing nursing staff resulting in lower satisfaction (Ramoo, Abdullah & Piaw, 2013). A lower level of satisfaction exacerbates the negative impacts by causing additional nursing turnover, increased workloads for existing staff, and decreased patient satisfaction and quality of care (Sawatzky & Enns, 2012). Other detrimental effects of nurse turnover include decreased quality of care, increased staffing costs, loss of patients, increased turnover of ancillary staff, and increased rates of accidents and absenteeism (Hunt, 2009).

Job satisfaction has been identified as the most consistent predictor of nurses' intent to stay and is a complex element affected by many factors (Liu, Zhang, Ye, Zhu, Cao, Lu & Li, 2012). Information on job satisfaction specific to the ED is vital in helping nurse leaders develop strategies for retaining ED nurses. Ramoo et al. (2013) discuss that age, educational level, work experience, and gender are often linked to job satisfaction. For this reason, demographic factors related to job satisfaction were also explored in this study.

Research Problem/ Significance

Specialty areas such as the ED have unique working environments that cause increased nurse turnover rates and higher nurse vacancy rates which results in negative effects for the facility, its' employees and the patients they treat. With the number of patients being seen in the ED on the rise, the nursing shortage in the ED must be addressed (Sawatzky & Enns, 2012). …

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