Health Science Journal

Keywords

Nurses; Job satisfaction; Organizational commitment

Introduction

Nurses satisfaction has been linked to and impacted on many issues in the health care system, such as the outcome of care, patient satisfaction and organizational commitment. Organizational commitment and job satisfaction are attitudes related to jobs that have received considerable attention from researchers worldwide. Nurse role considered as very important to provide health care for patient with respect the improving the quality of care in health institutions. Nurses, as the main and large group of health care providers [1-4] their job performance is affected by job satisfaction and organizational commitment, engaged and satisfied nurses usually perform highly and contribute to organizational efficiency and success [1-3].

Job satisfaction is important when its absence often leads to reduced organizational commitment. In the healthcare environment where nurse’s satisfied is expected to increase beyond its, provide quality care and commitment, maintaining a committed staff is a strong advantage and critical to organizational success [1,2]. Job satisfaction defines as "a pleasurable or positive emotional state resulting from the appraisal of one's job or job experiences". Nurse job satisfaction is show to what extent the nurse’s assurance with their job or not, such as their satisfaction with work place, nature of work or leaders [5-8]. Simply job satisfaction is how content an individual is with his or her job; whether he or she likes the job or not [9,10]. Studied show that nurses employed at magnet hospitals experienced higher levels of empowerment and job satisfaction due to greater involvement to work empowerment structures because they seeking to provide higher levels of job satisfaction and empowerment for staff nurses when compared with non-magnet hospitals [1].

A high-quality work environment for nurses described as “a place where the needs and expectations of the nurses are met as an individual and also where the patients achieve their targets regarding their own health” [11-15]. The Institute of Medicine highlighted that the work environment was important for nursing care quality [16]. The International Community of Nurses again identified its 2006 theme as “Safe Environment- Safe Employment” while the 2007 theme focused on “Positive Implementation-Work Environment” [17].

Nurse job satisfaction effect by many factors such as workload, incentives, job security, relationships with managers and social issues. Studies shown that these are two dimensions of satisfaction: first is extrinsic satisfaction with little aspects to do with the job tasks or content of the work itself; second intrinsic satisfaction refers to the job tasks themselves [1]. The elements accounting for differences in empowerment and job satisfaction scores included: (1) greater accessibility of magnet nurse leaders, (2) better support of clinical nurse autonomous decision making by magnet nurse leaders, and (3) greater access to work empowerment structures such as opportunity, information, and resources at magnet hospitals [12].

Organizational commitment influences the effectiveness of an organization in provides quality services [11] is having several positives in job outcomes including reduced absenteeism and turnover, work effort, and job performance [1]. There are threedimensional components of commitment [2]. First, dimension affective commitment which know as emotional attachment to an organization; Second, continuance commitment reflects the perceived costs-benefit evaluation of maintaining organizational membership; Third, normative commitment reflects the feelings of obligation to remain with the organization [1,2].

Engagement and retention of sufficient and well-committed nurses are needed for providing safe and effective health care [1]. Leaders should always take into consideration cultural differences in, job satisfaction and commitment of staff nurse while framing policies. Nursing leaders must be equipped with the information needed to contribution in making a workplace attract the new nurses, retain the nurses it already has and searching for ways to reâ€Âengineer the healthcare system particularly by providing supportive environment to staff empowerment, job satisfaction and commitment [3,4].

Challenges among nurses internationally are several such as suffering from absenteeism, high turnover rate with low commitment as well as Kingdom of Saudi Arabia. The health care organizations need to study the factors effecting on the job satisfaction to implement nurse retention plan. This study aimed to assess the relationship between nurse's job satisfaction and organizational commitment in Saudi hospitals.

Research Design and Methods

A quantitative descriptive correlational survey of registered nurses (RNs) in Riyadh region

The data collection tools: Satisfaction Questionnaire developed by researcher (Crombach alpha reliability above 0.75) and the Organization Commitment Questionnaire [1]. This study aimed to assess the relationship between nurse's job satisfaction and organizational commitment in Saudi hospitals. The study conducting in five hospitals around Riyadh reign, the participant were 199 staff nurses.

Data collection procedures and ethical issues

The approvals of conduct the study were granted from the Ethical Review Committees of the Ministry of Health in Saudi Arabia. The purpose and significance of the study were explained to all participants. They were informed that their participation was voluntary, their responses were confidential, and that refusing to participate would not negatively affect them. Participants were asked to complete the questionnaires and submitted. Data analysis used the statistical package of social sciences (SPSS) version 20 for data analysis. Descriptive statistics, Pearson's correlation, and logistic regression were utilized to analyze the data. The significance level for the study variables was set at 0.05.

Results

Table 1 shows the characteristics of the sample. The total number of participants were (n=199). With mean age of participants was between 31-40 years. (78.9%) were females, and the majority (69.8%) of them were married. (72.4%) with bachelor degree and the total years of nursing experience were 54.3% from 0 to 10 years and all of participants. More than half were staff nurses and work in patient departments with full-time.

Table 1: Frequency distribution of nurses characteristics of the sample N=199.

Characteristics	Frequency	Percent
Gender
Male	42	21.1
Female	157	78.9
Age
20-30	69	34.7
31-40	100	50.3
41-50	25	12.6
51-60	2	1
Marital Status
Married	139	69.8
Single	57	28.6
Other	3	1.5
Experience in nursing
0-10	108	54.3
11 20	75	37.7
21-30	10	5
31-40	3	1.5
41-50	2	1
Experience in hospital
0-10	139	69.8
11 20	54	27.1
31-40	5	2.5
41-50	1	0.5
Experience in current position
0-10	170	85.4
11-20	26	13.1
31-40	3	1.5
Nationality
Saudi	75	37.7
Non-Saudi	124	62.3
Work Place
In patient medical/surgical unit	53	26.6
Critical care unit( ICU, CCU ,NICU,PICU,MICU)	30	15.1
Emergency department	27	13.6
Operation room	9	4.5
Delivery room	4	2
Pediatric unit	5	2.5
Maternity (ante-natal, post-natal )	10	5
Outpatient unit	20	10.1
Administration position	41	20.6
Position
Staff nurse	111	55.8
Charge nurse	26	13.1
Head nurse	27	13.6
Nursing supervisor	35	17.6

Table 2 display the mean of the 4 elements that were measured through the questionnaire shows that nurses were satisfied and committed to their organization. The mean of each statement is presented in Table 2 and shows that nurses are highly satisfied with the orientation program of their hospital, the support of nursing directors and the team work. On the other hand, they face difficulties with the technology, low satisfaction about facilities and rest areas.

Table 2: Job Satisfaction mean of each statement of sample N=199.

Statements	Mean	SD
There is effective communication with higher administration in the institution	3.75	.978
Nursing Director is Supportive & knowledgeable	3.89	.984
My Job Requirements is more than my Abilities	3.59	1.064
Hospital Department orientation program was helpful	3.99	.820
Workload is equally distributed	3.41	1.181
My Work Place Provide me with ample opportunities to learn & develop my skills	3.76	.939
I feel frustrated from my work	3.44	1.135
I receive regular feedback on my performance from my manager or supervisor	3.55	.941
My spouse/Family satisfied from my job	3.70	.995
I feel problem in adaptation with rapidly changing technology	3.13	1.128
I face difficulties in getting my leaves and OFF days according to my needs.	3.47	1.158
My Performance evaluation is done fairly	3.83	.888
I face difficulties in working with opposite gender	2.86	1.213
I am satisfied about the facilities & rest areas	3.27	1.179
There is teamwork among staff to accomplish the work	3.86	.959

Table 3 present the correlations between nurse's job satisfaction and each dimension of organizational commitment were examined using the Pearson Correlation Coefficient. The correlation between nurse's job satisfaction and Affective commitment was positive and significant (r=0.636), Continue commitment (r=0.654) and Normative commitment (r=0.723) with (p<0.0) which means that nurses who are satisfied with their job have organizational commitment. Table 3 displays the means of each statement in every dimension of organizational commitment. In first dimension affective communication nurses felt that their organization has a great deal of personal meaning for them but they do not feel like "part of the family" at organization. In continuous commitment nurses feel that staying with the organization is a matter of necessity as much as desire and that too much of their life would be disrupted if they decided to leave their organization. In normative dimension nurses owe a great deal to their organization.

Table 3: Organizational commitment mean of each statement of sample N=199.

Statements	Mean	SD
Affective Commitment
I would be very happy to spend the rest of my career with this organization.	3.44	1.028
I really feel as if this organization's problems are my own.	3.54	1.019
I do not feel a strong sense of "belonging" to my organization	3.27	.988
I do not feel "emotionally attached" to this organization.	3.19	1.059
I do not feel like "part of the family" at my organization.	3.12	1.055
This organization has a great deal of personal meaning for me.	3.57	.929
Continues Commitment scale
Right now, staying with my organization is a matter of necessity as much as desire.	3.81	.841
It would be very hard for me to leave my organization right now, even if I wanted to.	3.60	1.014
Too much of my life would be disrupted if I decided I wanted to leave my organization now.	3.42	1.079
I feel that I have too few options to consider leaving this organization	3.44	.998
If I had not already put so much of myself into this organization, I might consider working elsewhere.	3.58	.872
One of the few negative consequences of leaving this organization would be the scarcity of available alternatives.	3.45	.988
Normative Commitment scale
I do not feel any obligation to remain with my current employer.	3.47	.947
Even if it were to my advantage, I do not feel it would be right to leave my organization now.	3.47	.926
I would feel guilty if I left my organization now.	3.37	1.074
This organization deserves my loyalty.	3.57	.906
I would not leave my organization right now because I have a sense of obligation to the people in it.	3.60	.958
I owe a great deal to my organization	3.65	.951

This study showed that nurses were satisfied and committed to their organization with a positive correlation between job satisfaction and commitment which goes with the same line of other conducted studies that stated A strong positive correlation between job satisfaction and organizational commitment which indicate that satisfied nurses tend to have a higher degree of commitment [13]. Therefore, nurse leaders could increase commitment among nurses' staff through ensuring their satisfaction with their job. Another study results showed that affective and normative commitments are found to influence job satisfaction, whereas job satisfaction has a strong effect on job performance, which suggest that the job satisfaction of nurses plays a critical role as a mediator in the relationship between organizational commitment components and job performance. Job satisfaction considered a complex and collaboration between individual nurses, their managers and others is critical to increase nursing satisfaction through empowering and open work environment and to elevate their commitment to the organization [18-22].

Table 4 present the correlations between nurse's job satisfaction and each dimension of organizational commitment were examined using the Pearson Correlation Coefficient. The correlation between nurse's job satisfaction and Affective commitment was positive and significant (r=0.636), Continue commitment (r=0.654) and Normative commitment (r=0.723) with (p<0.0) which means that nurses who are satisfied with their job have organizational commitment.

Table 4: Relationship between organizational commitment and job satisfaction.

Organizational commitment dimensions		Job satisfaction
Affective commitment	Correlation	.636**
	Sig.	0.000
	N	199
Continue commitment	Correlation	.654**
	Sig.	0.000
	N	199
Normative commitment	Correlation	.723**
	Sig.	0.000
	N	199

**Correlation is significant at the 0.01 level.

Conclusion

Nurses who are satisfied with their job have organizational commitment. The nurses were satisfied and committed to their organization with a positive effect on job performance, Job satisfaction considered a complex and collaboration between individual nurses, their managers and others، is critical to increase nursing satisfaction through empowering and open work environment.

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