ANALYSIS OF JOB SATISFACTION OF PROFESSIONAL NURSES IN PUBLIC AND PRIVATE SECTORS IN ANAMBRA STATE, NIGERIA

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TABLE OF CONTENTS                                                                    Page

Title Page                                ….               ….              ….                     i

Approval Page                       ….               ….              ….                    ii

Certification                            ….               ….              ….                  iii

Dedication                              ….               ….              ….                   iv

Acknowledgements                 ….               ….              ….                    v

Table of Contents                   ….               ….              ….                  vii

List of Tables                          ….               ….              ….                            xi

Abstract                                  ….              ….              ….                  xii

CHAPTER ONE:  INTRODUCTION

Background to the Study                           ….              ….              ….          1

Statement of the Problem                            ….              ….              ….          4

Purpose of the Study                        ….              ….              ….          6

Research Questions                           ….              ….              ….          6

Research Hypotheses                        ….              ….              ….          7

Significance of the Study                             ….              ….              ….          7

Scope of the Study                                      ….              ….              ….          8

Operational Definition of Terms       ….              ….              ….          8

CHAPTER TWO:  LITERATURE REVIEW 

Introduction                                                ….              ….              ….        10

Overview of Nigeria’s Health System        ….              ….              ….        10

Component Issues in the Nigeria Health System ….              ….        13

Conceptual Issues on Job Satisfaction and Motivation           ….        21

Theoretical Review on Job Satisfaction               ….              ….        29

Maslow’s Hierarchy of Needs Theory                           ….              ….        29

Frederick Herzberg’s two Factor Theory             ….              ….        31

Edwin Locke’s Range of Affect Theory               ….              ….        32

Timothy Judge’s core Self-Evaluation Model      ….              ….        32

Conceptual Framework on Nurses’ Job Satisfaction              ….        33

Empirical Studies on Professional Nurses’ Job Satisfaction   ….        35

Summary of the Literature Review                                          ….        41

CHAPTER THREE:    RESEARCH METHOD

Research Design                                ….              ….              ….        43

Area of Study                                    ….              ….              ….        43

Population of the Study                    ….              ….              ….        44

Sampling Procedure                          ….              ….              ….        45

Instrument for Data Collection                   ….              ….              ….        45

Validity of Instruments                     ….              ….              ….        46

Reliability of Instruments                           ….              ….              ….        46  

Ethical Consideration                       ….              ….              ….        46

Procedure for Data Collection           ….              ….              ….        47

Method of Data Analysis                           ….              ….              ….        47

CHAPTER FOUR:  DATA PRESENTATION AND ANALYSIS

Presentation of Results                      ….              ….              ….        48

Research Question One                     ….              ….              ….        49

Research Question Two                    ….              ….              ….        50

Research Question Three                            ….              ….              ….        51

Research Question Four                     ….              ….              ….        52

Hypotheses Testing                           ….              ….              ….        53

Hypothesis One                                 ….              ….              ….        53

Hypothesis Two                                ….              ….              ….        53  

Hypothesis Three                              ….              ….              ….        54

Hypothesis Four                               ….              ….              ….        55

CHAPTER FIVE:  DISCUSSION OF FINDINGS, CONCLUSIONS

AND RECOMMENDATIONS

Discussion of Findings                      ….              ….              ….        56

Nurses’ Satisfaction from Job Security                ….              ….        56

Nurses’ Satisfaction from Recognition                          ….              ….        57

Nurses’ Satisfaction from Opportunity for Advancement                ….        57

Nurses’ Satisfaction from Job Control/Responsibilities                    ….        58

Difference in satisfaction from job security between nurses

in Public and Private Hospitals                   ….              ….     ….        58

Difference in satisfaction from recognition between nurses

 in Public and Private Hospitals                 ….              ….     ….        58

Opportunity for Advancement and Job Satisfaction                        ….        58

Effect of Job Control on Job Satisfaction             ….              ….        59

Conclusion                                                           ….              ….        59

Implications of the Study                                               ….              ….        60

Limitations of the Study                                                ….              ….        60

Recommendations                                                          ….              ….        61

Contribution to knowledge                                  ….              ….        62  

Suggestion for further studies                              ….              ….        62

References                                                            ….              ….       64

Appendices                                                          ….              ….       73

Appendix A                                                                   ….              ….       74

Appendix B                                                                   ….              ….       75

Appendix C                                                                   ….              ….       79

Ethical Approval Letter                                       ….              ….       84

List of Tables

Table 1:      Study Sample                                                       ….           47

Table 2:      Sex and Age Distribution                                              ….          51

Table 3:      Mean Analysis of Satisfaction Derived from Job Security     51

Table 4:      Mean Analysis of Satisfaction Derived from Job Security     52

Table 5:      Mean Analysis of Satisfaction Derived from

Opportunity for Advancement                                                      53

Table 6:      Mean Analysis of Satisfaction Derived from Job Control            54

Table 7:      t-test Analysis of Nurses’ Response on Satisfaction

with Job Security                                                                           55        

Table 8:      t-test Analysis of Nurses’ Response on Satisfaction

with Recognition                                                                  56

Table 9:      t-test Analysis of Nurses’ Response on Satisfaction with

Opportunity for Advancement                                                      56

Table 10:    t-test Analysis of Nurses’ Response on Satisfaction

Job Control                                                                          57

ABSTRACT

This study investigated the job satisfaction of professional nurses in public and private health sectors in Anambra State.  A survey design was employed and a study population of 5903 comprising all professional nurses in private and public hospitals was used. Proportionate stratified random sampling technique was used in selecting a sample of 375 nurses for the study. Instrument for data collection was a structured questionnaire. Data collected were analyzed using mean and standard deviation statistical tool to answer the four research questions and t-test statistical tool was used to test the four hypotheses. Findings showed that nurses in public hospitals were satisfied from job security unlike nurses in private hospitals. Nurses in public and private hospitals were satisfied from job control/ responsibilities. Also, it was found that opportunity for advancement guarantees job satisfaction to nurses in public and private hospitals. Based on the findings, it was recommended that hospital management should create a work environment that is free from dissatisfiers in order that nurses would carry out their duties effectively towards the actualization of organization’s goal.  Few relevant areas that the present study did not cover were suggested for further investigation.

CHAPTER ONE
INTRODUCTION

Background to the Study

Output in terms of performance in any given organization is a function of many variables which job satisfaction is one of them.  Job satisfaction which is equally understood and sometimes referred to as “work satisfaction” has been variously defined in the literature.  Job satisfaction is the extent to which an employee expresses a positive orientation towards a job. It also describes how content an individual is with his or her job. Job satisfaction has also been defined as a pleasurable emotional state resulting from the appraisal of one’s job, an affective reaction to one’s job and an attitude towards one’s job (Chimanikire, Mutandwa, Gadzirayi, Muzondo, & Mutandwa, 2007; Thompson & Phua, 2012).  Job satisfaction is a worker’s sense of achievement and success on the job.  It is generally perceived to be directly linked to productivity as well as to personal well-being.  Job satisfaction implies doing a job one enjoys, doing it well and being rewarded for one’s efforts.  Job satisfaction further implies enthusiasm and happiness with one’s work.  Job satisfaction is the key ingredient that leads to recognition, income, promotion, and the achievement of other goals that lead to a feeling of fulfilment (Kaliski, 2007).

Job satisfaction has continued to be a major area of interest in the study of industrial and organizational psychology because of the presumed and common-sense linkages between satisfaction and other mainstream concepts like leadership, performance, reward system and group process (Poole & Warner, 2000).  Furthermore, job satisfaction has been an interesting construct for researchers in understanding employee behaviours and attitudes (Zurn, Dolea & Stillwell, 2005).  Despite the number of studies that dealt on different aspects of job satisfaction, Boles, Wood and Johnson (2008), stated that more studies are needed on job satisfaction because of several reasons.  According to them satisfaction with the job is directly related to organizational commitment, behaviours and actions.  To this end therefore job satisfaction among professional nurses should be of great importance and concern to any health organization, sector or nation given the pivotal role that nurses play in determining the efficiency, effectiveness and sustainability of health care delivery system. It is therefore imperative to understand what motivates nurses and the extent to which the organization and other contextual variables, add up to achieve satisfactory performance output in the overall health care delivery system. This is necessary going by the fact that job satisfaction is an essential part of ensuring high quality care and performance output (Lambert, Hogan & Barton, 2001; Mount, Ilies & Johnson, 2006). Job satisfaction does not necessarily concern the professional nurses only, but cuts across the entire system – patients and patients’ relations, hospital management as well as health sector, health organizations, and indeed the entire nation.  The inaction or inability of any organization to achieve a reasonable level of job satisfaction among her workforce will lead to dissatisfaction.

Job dissatisfaction generally, has been frequently cited as the primary reason for low/poor quality output, non-commitment, low productivity and high rate of staff turnover among others. Dissatisfied nurses not only give poor quality, less efficient care, there is also evidence of a positive correlation between professional nurse satisfaction and patient satisfaction and outcomes (Tzeng, 2002; Tsang, 2002, Takase, Maude & Manias, 2005). Nurses who were not satisfied at work were also found to distance themselves from their patients and their nursing chores, resulting in sub-optimal quality of care (Demorouti, Bekker, Nachreiner & Schaufeli, 2002).

The growing importance attached to studying job satisfaction especially among the professional nurses in recent times is not far-fetched. For instance, there is a growing need to strengthen health system in Nigeria to help meet the Millennium Development Goals (MDGs). It is widely believed that a key constraint to achieving the MDGs is the absence of a properly trained and motivated work force of which nurses are part and parcel, and improving the health workers working conditions is critical for health system performance (FMOH, 2007).  In addition, the HIV/AIDS epidemic is compounding the problem by creating a stressful environment for health workers through increased workload, exposure to infection and reduced morale.

The organization of the health care system in Nigeria is pluralistic and complex. It includes a wide range of providers, comprising the public health institutions and a large and equally growing private sector, made up of private-for-profit and private-for-non-profit providers, e.g. Non-Governmental Organizations (NGOs), Religious, Spiritual and Traditional Care Providers. This situation is equally the same in all the 36 States of the Federation including Anambra State.  Anambra State health care system consists of public sector health institutions that serve both the indigent and the affluent in the society, and the private health providers that specifically cater for the segment of the population that can afford their services.

Outside public health institutions, the private sector hospitals, maternity homes and clinics provide about 80 percent health services to Nigerians (Federal Ministry of Health, 2007).  Despite these remarkable contributions of the private sector to the overall health care need of the country, the sector are not very well supported (Kwahar & Ukeh, 2012).  Evidence from the literature, however, shows that the sector lags behind in training and refresher courses (Larbi, 2004).  With the exemptions of few non-governmental and mission hospitals, most private sector hospitals are privately owned and run by the physicians (doctors) who oversee the management of the hospitals on one man basis.  Most of the job satisfaction variables such as opportunity for advancement, recognition, job security, working conditions, interpersonal relationship, etc. are not regulated and policy driven in private sector as obtained in public health sector.  This situation, therefore, makes a critical evaluation of job satisfaction variables in the sectors worthwhile considering the rate of nurses’ turnover in both sectors.

Statement of the Problem

ANALYSIS OF JOB SATISFACTION OF PROFESSIONAL NURSES IN PUBLIC AND PRIVATE SECTORS IN ANAMBRA STATE, NIGERIA