Abstract
We aim to identify associations that may help support strategies to increase job satisfaction and reduce unscheduled time off work for nurses. Given current concerns regarding nursing workforce and retention, it is vital we identify strategies and factors which maintain job satisfaction, support staff retention and reduce unscheduled time off work. As part of a quality improvement project, we conducted and distributed an online anonymous survey. Likert scales were used to measure job satisfaction, perceived quality of care, wellbeing, and unscheduled time off work. We explored participation in project work of any kind in the preceding 12 months, and captured nursing experience and current area of practice (inpatient/outpatient). A total of 350 complete responses were analysed. Nurses engaged in research or Quality Improvement Projects (QIPs) were more likely to have higher perceived levels of patient care (p = 0.0001), wellbeing (p = 0.0001) and job satisfaction (p = 0.0001) and reported lower levels of unscheduled time off work (p = 0.0001). Nurses engaged in research or quality improvement projects reported higher levels of job satisfaction, wellbeing, perceived higher levels of care in their workplace, and had lower levels of unscheduled time off work. We suggest that involving nurses in research/QIPs may improve workforce instability and job satisfaction.
Background
In 2018, NHS England reported a shortfall of over 40,000 qualified nurses, accounting for 10% of the total nursing workforce.1,2 Despite government strategies to address these shortages, 2018 was the second year in a row in which the number of applications and acceptances for pre-registration nursing degrees declined. 3 This drop in enrolment resulted in a 0.5% overall increase in nursing staff in England, compared with a 2.3% increase in other allied health professionals for the same period. 3 One analysis of NHS staff has shown a staff stability index of 81% between 2017 and 2018 (that is, only 19% of staff employed at the beginning of the year remained in their role by the end of the year). 4 Given this current level of NHS staffing crisis, it is vital we identify strategies and factors which maintain job satisfaction, support staff retention and reduce unscheduled time off work within our nursing teams. High levels of sickness is recognised as a contributing factor in chronic staff shortages, 5 with many studies suggesting that healthy workplace interventions can improve health and wellbeing in healthcare staff. 6
Aim/hypothesis
Our aim is to identify associations which may help support or develop strategies to increase job satisfaction and reduce unscheduled time off work. We hypothesise that nurses who are actively engaged in research or Quality Improvement Projects (QIPs) are happier at work, have perceived higher levels patient care, and have reduced levels of unscheduled time off work.
Method
As part of a quality improvement project we conducted an online anonymous survey. We used Likert scales ranging from 0 to 5 to measure levels of job satisfaction, perceived quality of patient care at current workplace (i.e. how high they value the quality of care in their area of work), levels of wellbeing at work and unscheduled time off work. Respondents were asked to record if they participated in any of the following activities: audits, service evaluation projects, individual projects or research, presentations for conferences or nursing forums, published literature or been involved in other project work of any kind in the previous 12 months. Number of years nursing experience and current area of practice (inpatient/outpatient) were also captured. All incomplete surveys and responses from non-nurses were excluded before evaluation. The survey was distributed by the study team to colleagues and friends shared via social media using snowball sampling between March and April 2019.
Results
A total of 350 complete responses from nurses were analysed; 177 reported currently practising in out-patient units and 173 from in-patient settings. Of 350, 232 (66%) had more than ten years of nursing experience, and 45 (12%) had less than five years nursing experience. Using Likert scales, nurses who are engaged in research or QIPs are significantly more likely to report higher perceived levels of patient care (3.8 vs. 2.6: p < 0.01), higher levels of wellbeing at work (2.9 vs. 2.1: p < 0.01), and higher levels of job satisfaction (3.1 vs. 2.0 p < 0.01), and less likely to report unscheduled time off work (1 period vs. 3–5 periods: p < 0.01) (Figure 1). Nurses who felt supported with their professional development are more likely to be engaged in research and QIPs (X2=52.2: p < 0.001). Outpatient nurses reported feeling more supported with their professional development than nurses working in in-patient settings (120/177 (68%) vs. 93/173 (54%) p < 0.001), and reported higher levels of engagement in research and QIPs (p = 0.007).
Nurses engaged with research/QIP and work-related factors.
Significance
Nurses who are engaged in research or quality improvement projects have higher levels of job satisfaction and well-being, have higher perceived levels of care in their workplace and have less unscheduled time off work. Although we have shown that nurses engaged in research and QIP have significantly higher job satisfaction, greater wellbeing, higher perceived levels of care and lower unscheduled times off work, we could not control for confounding factors as they were not investigated in this pilot survey. We recommend further research with regression analysis be conducted to validate these findings. We suggest that, paradoxically, involving nurses in research or QIP in addition to their clinical work may improve workforce instability and job satisfaction. Healthcare institutions should provide sufficient time and resources in order to promote engagement in research and QIP.
Footnotes
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
