Effect of Burnout on Job Satisfaction among Registered Nurses Article

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[. . .] Kazanjian, Green, Wong & Reid (2005) conducted a systematic review of studies linking nursing work environment characteristics to patient mortality. The authors concluded based on the evidence from 27 studies revealed a link between inpatient mortality and variables that include autonomy, good nurse/physician relationships, reasonable workloads, care based on nursing standards, positive manager attributes, and professional development opportunities.

Aikens et al. (2008) research was the first study to link nursing work environments to patient outcomes revealing that nurses in the Magnet hospitals have lower levels of burnout, greater job satisfaction and lower turnover intentions because these hospitals support professional nursing practice by ensuring nurse autonomy, control over the practice setting, and strong nurse/ physician relationships. Job satisfaction and turnover rates in the rural and urban nursing units are associated with both nursing unit characteristics and the work environment (Bernholdt & Mark, 2009).

A large body of literature describes burnout as a consequence of organizational factor, a driver of suboptimal well-being and productivity. The dominant approach in this field has been to model simple sets of relationships whereby practice environment factors are hypothesized to influence outcomes through unspecified or untested mechanisms. (Kazanjian, Green, Wong & Reid, 2005). Moreover, work environments associated with high burnout are those that demand high personal adherence to work through restrictions of worker freedom or flexibility, de-emphasize planning and efficiency for the task at hand. Other work environments related to higher levels of burnout are those in which job expectations are vague or ambiguous, where management imposes extensive rules and regulations, and in which support and encouragement for new ideas and procedures are low. Maslach et al. (1996) suggested that a reduced stability on the organizational level is likely to have an impact on burnout. According to Maslach et al. (1996), organizational settings that undermine staff members' autonomy reduce their potential for significant accomplishments and increase their tendency to become cynical and distant from their work. The most commonly cited sources of pressure found in the study where lack of resources followed by work overload, bureaucracy and management.

Typically, burnout is increasingly being recognized as being a serious problem affecting many people, particularly those in the human service industry. Job burnout is a prolonged response to chronic emotional and interpersonal stressors on the job. In the multidimensional, there are three key dimensions to the burnout phenomenon. These include exhaustion, the feeling of cynicism, detachment from the job, a sense of ineffectiveness and lack of accomplishment. According to Maslach, Jackson, & Leiter (1996), burnout differs from occupational stress in that it is specific to work that requires intense involvement.

Burnout has been associated with absenteeism, ineffectiveness, interpersonal conflicts, lower productivity, job dissatisfaction, reduced organizational commitment, and turnover. The emotional exhaustion component of burnout has been associated with stress-related health outcomes. Emotional exhaustion predicts an increased rates of illness, fatigue, substance misuse, depression, anxiety, and irritability (Ducharme et al. 2008). Turnover among human service occupations has adverse implications not only for the organization, but also for the clients. Clients may suffer setbacks such as loss of trust when their clinical services are disrupted by their therapists. Turnover can intensify stress among the remaining therapists whose caseloads increase making the organization to hire temporary staff or newer less-experienced to fill the vacant positions (Ducharme et al.2008). Replacing staff is time-consuming and costly. There are costs associated with recruitment, training, and supporting new employees until their performance reaches a satisfactory level. Turnover causes a disruption in service provision and in the client-provider relationship.

Evidence suggests that a good work environment is an important factor in the recruitment and retention of health workers. Furthermore, the work environment can influence the quality of care and patient safety. As a working definition, an attractive and supportive workplace in this case can be described as an environment that attracts individuals into the health professions, encourages them to remain in the health workforce and enables them to perform effectively.


3.1. Research Design

This study uses a quantitative descriptive-correlation to determine the impact of work environment on a quality of care, intent to leave, burnout and job satisfaction among Registered Nurses in Saudi Arabia.

3.2. Sample and Population

After obtaining the IRB approval from the hospitals, a convenience sampling method was used to recruit Registered Nurses working in the different departments in the hospitals. A total of 545 Registered staff nurses in three governmental hospitals in Riyadh Saudi Arabia with more than one-year work experience consented to participate in the study. This sample size is based on a 0.05 margin of error and a 95% confidence interval.

3.3. Instrument

Registered nurses were asked to fill out a form to provide their demographic characteristics such as age, gender, civil status, the highest degree of education, area of assignment and employment status.

3.3.1. Nurse work environment.

Nurse work environment will be assessed by the Practice Environment Scale of the Nursing Work Index (Lake, 2002), which is the most widely reported measure used to gauge the quality of nursing practice environment. The PES-NWI is composed of 31 items that have been organized into five subscales: nurse participation in hospital affairs; nursing foundations for quality of care; nurse managerial ability, leadership, and support for nurses; staffing and resource adequacy; and collegial nurse-physician relations. The potential scores ranged from 1 (strongly disagree) to 4 (strongly agree) on a 4-point Likert scale. Higher scores indicated more agreement that the subscale items were present in the current job. Nurse responses in each item will be aggregated for each subscale to create a hospital-level mean of the subscales. The Cronbach's α coefficient of the PES-NWI in subscales 1 to 5 are 0.87, 0.90, 0.87, 0.91, and 0.85, respectively. Its discriminant validity has been shown in its ability to detect differences in the nurse practice environments of hospitals.

3.3.2. Job Outcomes

The categories that measure nurses' job outcome are job satisfaction, intention to leave, burnout and nurse-assessed quality of care. Job satisfaction is measured by a single item that asked nurses' perception about their satisfaction with their present jobs. The response categories ranged from 1 (very satisfied) to 4 (very dissatisfied) on a Likert scale. Higher scores indicate that nurses are dissatisfied with their current job. Reliability of published tests for a single item of nurse job satisfaction was in the range of 0.70 (Wanous, Reichers, &Hudy, 1997).

Burnout will be measured with the Maslach Burnout Inventory-Human Service Survey (MBI) (Maslach et al.,1996), using 20 items tapping three separate dimensions: emotional exhaustion (8 items), depersonalization (5 items) and personal accomplishment (7 items). Respondents are rated based on the frequencies with which they experience various job-related feelings on a 7-point scale ranging from 0 ('never experienced such a feeling') to 6 ('experience such feelings every day'). High scores on emotional exhaustion and depersonalization and low scores on personal accomplishment scale are considered indicative of burnout. Reliability coefficients are .88 for Emotional Exhaustion (EE), .70 for Depersonalisation (DP), and .83 for Personal Accomplishment (PA).

Regarding "intention to leave," nurses will be asked the following question: "Are you planning to leave your present job in the next year?" "Yes" is graded as 1; "No" is graded as 2. (Stone, Mooney-Kane, Larson, et al. 2007)

The variable of "nurse-assessed quality of care" is measured by a single item that asked nurses' perception about the quality of nursing care delivered to their unit. The response categories ranged from 1 (excellent) to 4 (poor) on a Likert-scale, with higher scores indicating poorer levels of quality. This single-item measure has been used extensively in international work and has established predictive validity (Aiken, Clarke, & Sloane, 2008) with Cronbach's coefficients in the range of 0.92 to 0.94. Single item measurements are useful when the construct is unambiguous (Wanous, Reichers, & Hudy, 1997) or when a holistic impression is informative. Single item measures are used because of their convenience, and are useful when participants are busy or perhaps dismissive of the academic pedantry that multiple item measures manifest (Wanous, Reaches, & Hudy, 1997).

3.4. Data Collection Procedures

After the Institution Review Board (IRB) approval the questionnaires were distributed and explained to the target respondents with a consideration of the inclusion and exclusion criteria. All data collected were coded and entered in the Excel software for the analysis.

3.5. Data Analysis methods

The statistical Program for Social Sciences (SPSS, Version 17) was used for the data analysis. The simple percentage was used to present the demographic profile of the respondents such as age, gender, civil status, educational attainment, the area of assignment and length of hospital experience. Chi-square test was used to establish the relationship among variables of the study.


Number of participants (N=545) were female (n=483/545; 88.62%) while males comprised 11% (n=62/545). The majority of the participants were married (n=374/545; 68.62%) while less than one-third (n=171/545; 32%) were single. The majority of the participants were BSN degree holders (n=491/545; 90%). Those with BSN graduates and post graduate studies are 10% (54/545). More than half of the participants have… [END OF PREVIEW] . . . READ MORE

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Effect of Burnout on Job Satisfaction among Registered Nurses.  (2016, November 9).  Retrieved January 28, 2020, from https://www.essaytown.com/subjects/paper/effect-burnout-job-satisfaction/7438101

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"Effect of Burnout on Job Satisfaction among Registered Nurses."  Essaytown.com.  November 9, 2016.  Accessed January 28, 2020.