Determinants of nurse job dissatisfaction - findings from a cross-sectional survey analysis in the UK

Abstract

Background A lower recruitment and high turnover rate of registered nurses have resulted in a global shortage of nurses. In the UK, prior to the COVID-19 epidemic, nurses’ intention to leave rates were between 30 and 50% suggesting a high level of job dissatisfaction. Methods In this study, we analysed data from a cross-sectional mixed-methods survey developed by the Royal College of Nursing and administered to the nursing workforce across all four UK nations, to explore the levels of dissatisfaction and demoralisation- one of the predictors of nurses’ intention to leave. We carried out logistic regression analysis on available data in order to determine what impacts job dissatisfaction. Results In total, 1742 nurses responded to questions about working conditions on their last shift. We found that nearly two-thirds of respondents were demoralised. Nurses were five times more likely (OR 5.08, 95% CI: 3.82–6.60) to feel demoralised if they reported missed care. A perceived lack of support had nearly the same impact on the level of demoralisation (OR 4.8, 95% CI: 3.67–6.38). These findings were reflected in the qualitative findings where RNs reported how staffing issues and failures in leadership, left them feeling disempowered and demoralised. Conclusion A large proportion of nurses reported feeling dissatisfied and demoralised. In order to reduce the negative impact of dissatisfaction and improve retention, more research needs to investigate the relationship dynamics within healthcare teams and how the burden experienced by RNs when unsupported by managers impacts on their ability to provide safe, good-quality care. These findings predate the current Covid-19 pandemic outbreak which may have had a further detrimental effect on job satisfaction in the UK and other nation’s nursing workforce.

COVID-Well: Evaluation of the Implementation of Supported Wellbeing Centres for Hospital Employees During the COVID-19 Pandemic

“…Many individuals with COVID-19 may have only mild symptoms, and therefore there is a risk of healthcare workers inadvertently increasing local transmission through being present at work in ill-health [39], possibly due to staff shortages and organizational culture setting norms against taking sick leave [40][41], or through a sense of dedication to their work, which was demonstrated in our study by high levels of work engagement in these hospital staff. Turnover intentions in this sample were concerning, but within ranges identified in a national study of UK nurses prior to the COVID-19 pandemic (30-50%), where intentions to leave have been associated with demoralisation, failures in leadership, and perceived lack of support from managers which was seen to impact on nurses' ability to provide safe, high quality care [42]. Although job stress was reported by many participants (as would be expected during a global pandemic), healthcare workers in this sample had higher job satisfaction (81%) than has been observed in other studies of public sector workers, although high levels of presenteeism (83%) were broadly comparable, e.g., social workers: 51% and 85% respectively, [43].…”

Distributed leadership as a predictor of employee engagement, job satisfaction and turnover intention in UK nursing staff*

“…As the UK health care staff consistently struggle with stress due to heavy workloads and feelings of being devalued (Senek et al., 2020), this study's findings are pertinent in addressing issues of disempowerment in the workplace. To address the increasing rates of burnout within the UK health care sector, it is recommended that organisations be transparent in their processes, increase engagement with their staff, increase management support and share information that will be helpful in facilitating staff work and enhance empowerment at the workplace.…”

COVID-Well: Evaluation of the Implementation of Supported Wellbeing Centres for Hospital Employees during the COVID-19 Pandemic

“…Another reason could be a sense of dedication to their work, which was demonstrated in our study by high levels of work engagement in these hospital staff. Turnover intentions in this sample were concerning, but within ranges identified in a national study of UK nurses prior to the COVID-19 pandemic (30–50%), where intentions to leave have been associated with demoralisation, failures in leadership, and perceived lack of support from managers which was seen to impact on nurses’ ability to provide safe, high quality care [ 47 ].…”