PRE-PANDEMIC CLIMATE AND JOB SATISFACTION OF NURSING STAFF IN AN EMERGENCY SERVICE

Objetivo: Determinar la relación entre clima laboral o ambiente de trabajo y satisfacción laboral del personal de enfermería en el servicio de emergencia del Hospital Vitarte. Métodos: Investigación cuantitativa, descriptivo correlacional y transversal. La población muestra estuvo conformada por 70 miembros del personal de enfermería del servicio de emergencia. Previo consentimiento informado de cada participante, a través de una encuesta, se aplicaron dos cuestionarios validados en otros estudios. Resultados: El personal de enfermería participante estaba principalmente entre


INTRODUCTION
Besides, job satisfaction, a set of emotional responses, positive or negative attitudes perceived by the workers of an institution, is essential because it is linked to organizational behavior and, in turn, is an indicator of ( 6 ) the quality of work.service .In the nursing professional, it is an indicator of personal growth with (7) respect to the relationship with their co-workers .The importance of job satisfaction for nurses in caring for patients is essential in the daily life of the workforce; low satisfaction will in uence the quality of service (8) provision and commitment to organizations .
Job satisfaction and organizational climate are variables linked to well-being, as well as to the quality of life of individuals within their workplace, and, therefore, (9) have an impact on their performance .These are two factors of work environments that are of great importance, since they are related to the performance (10) of workers and the effectiveness of organizations .Nursing staff, who work in an institution, are affected by various factors that affect their effectiveness.The values of the establishment and each person affect the work The World Health Organization (WHO) estimates that there are 59.2 million paid health workers globally.However, it also identi es the density of the minimum health personnel to achieve the M illennium Development Goals (MDG) and indicates that 57 countries have a de cit of 2.4 million doctors and nurses (1) .International organizations such as the International Council of Nurses (ICN), the WHO, and the International Labor Organization (ILO) are periodically evaluating the situation of health personnel in each country with the aim of enabling decisions that optimize the management of people in the health system.Organizations today must join the global demands for quality and competitiveness, whose adaptation requires the provision of motivated and satis ed (2) people .
Nursing staff may show discomfort in their work (3) environment related to their professional satisfaction .The work climate, also called organizational climate or work environment, is a series of characteristics within (4) an organization .It refers to the work environment, whose perception awakens, in the worker, a fundamental element, because it will have an impact on (5) work behavior .

METHODS
The study is quantitative, with a descriptive, crosssectional and correlational design.The population and sample consisted of 70 nursing staff who work in the Emergency service of the Hospital de Vitarte.The sampling was census, since all met the selection criteria of accepting to participate in the study.
The variables studied were work environment and job satisfaction.The instruments used were two validated.(13) The work environment questionnaire consists of 50 items, grouped into the dimensions: supervision, communication, working conditions, self-actualization and involvement.It is designed on a Likert scale from 1 to 5 where 1 is considered the lowest and 5 the highest.The rating is: very unfavorable (50 to 89 points), unfavorable (90 to 129 points), medium or moderately favorable (130 to 169 points), favorable (170 to 209 points) and very favorable (210 to 250 points).The Job (14) Satisfaction Questionnaire (SL-SPC) consists of 36 items grouped into the following dimensions: physical and/or material conditions, labor and/or remunerative bene ts, administrative policies, social relations, personal development, task development, and relationships with authority.Likert-type responses from 1 to 5, where 1 is the lowest and 5 is the highest.The rating modality is as follows: very dissatis ed (92 points), dissatis ed (93 to 111 points), medium or moderately satis ed (112 to 148 points), satis ed (149 to 167 points) and very satis ed (168 to 180 points).
The technique applied was the survey, carried out in a meeting held by the nursing staff and, later, in the shifts held by those who did not attend said event.
environment; if they are not adequate, they create a tense and ambiguous climate that decreases the effectiveness of staff activities, which affects the quality (11) of care provided .Nursing needs an environment that develops or enhances their work skills; This is given by the harmony of two factors: the rst, a personal motivator that integrates personal expectations with development at work, and the second, aspects provided by the work environment to improve (12) conditions in their actions .
The aim of the research was to determine the relationship between work environment and prepandemic satisfaction in the nursing staff of the Emergency service of a national hospital.

Procedures
Pre-Pandemic climate

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In the descriptive analysis, absolute and relative f r e q u e n c i e s w e r e c a l c u l a t e d .To a p p l y t h e questionnaires (13,14), a pilot test was previously carried out on 30 nurses and nursing technicians who did not participate in the study, and a Cronbach's Alpha of 0.932 was obtained for the work environment and 0.922 for the of job satisfaction, considered acceptable.For statistical inference, the Chi-Square test of independence (X2) was used at 95% reliability (α= 0.05).

Statistical analysis
The Ethics and Research Committee of the Hospital de Vitarte authorized the study with Provided No. 029-2016.Informed consent was requested from each study

RESULTS
participant.Ethical principles in research in humans were considered, and the data obtained was only used for research.
The average age of the participants was 37.5 +-6.6 years, the age group of 30 -39 years was the most numerous (75.7%), there was a female predominance (62.9%), the occupational group of nursing technicians was equal to the professional, with a slight predominance of hired personnel (51.4%).The average years of service was 8.8 + -6.3 years and the majority had a service time between 5 and 9 years: 44.3%.(Table 1)     The nursing staff, overall, found the work environment to be moderately favorable (48.57%) and job satisfaction to be moderately satisfactory (42.86%) (Table 4).

Unsatis ed
Moderately satis ed

Unsatis ed
Moderately satis ed

Unsatis ed
Moderately satis ed

Unsatis ed
Moderately satis ed

Unsatis ed
Moderately satis ed

Unsatis ed
Moderately satis ed

Unsatis ed
Moderately According to the sociodemographic characteristics and job satisfaction results, no p value is less than 0.05; therefore, the null hypothesis is not rejected.Therefore, there is not enough evidence to say that there is an association between any of the characteristics and job satisfaction.The work climate has dimensions that can be measured in an organization that in uence behavior, by directly affecting the satisfaction and per formance of (19) individuals .A study raises nine dimensions: structure, responsibility, reward, challenge, relationships, cooperation, standards, con ict, and identity .Although our study does not use that classi cation, but rather ve dimensions: self-actualization, work involvement, supervision-communication, and work condition, they can be related to responsibility, challenge, standards-relationships, and reward.
For almost half of the par ticipants, the work environment is perceived as moderately favorable, and a third, unfavorable; this was somewhat lower than the nursing staff of a medical service where they found it between fair (78.6%) and low (21.4%) and none found it (17) good .Regarding job satisfaction, it was obtained that for four out of ten participants it was moderately satisfactory and only for two out of ten participants, satisfactory; the latter varies with the results of Méndez C, in which no nurse from the Medicine service of the (18) Hospital Belén de Trujillo is satis ed .

DISCUSSION
In the study, a relationship was found between the work environment and the satisfaction of the nursing staff of the Emergency service at Hospital de Vitarte (p=0.023).
These results agree with Manosalvas V , who states that it is possible to directly relate the work environment with satisfaction depending on the instruments used.Ortiz S and Aguirre MH also nd a relationship between these two variables.
In the study, the self-realization dimension was quali ed mainly as moderately favorable (81.4%), since their work allows them to learn, develop, and ful ll their work, but the achievements would be valued little, although there are opportunities to progress.Cortés J f o u n d t h a t n u r s e s p e r c e i v e t h e m s e l v e s a s accomplished, but they lack incentives, such as training, that allow them to develop personally .
Regarding the dimensions of job satisfaction, the assessment of moderately satisfactory to developing tasks, social bene ts and relationships with authority was notorious.To the extent that the tasks are interesting and offer learning opportunities, job satisfaction, acceptance of responsibilities and promotion opportunities are activated; on the other hand, camaraderie among employees impacts on the attitude towards job satisfaction, which is valued with process theory, which is composed of equity and expectation.
According to Torres S (22), dissatisfaction would be the result of the perception of absent equity.Another aspect that stands out is that nine out of 10 participants expressed job dissatisfaction regarding physical conditions.The infrastructure that is expected for an adequate service would be a spacious and comfortable environment due to the number of patients served.
Working in an environment with poor lighting, poor ventilation, inappropriate temperature, noise that increases stress, an inaccessible location that facilitates the rapid transfer of the patient to other services, insufficient distribution of personnel that can provide care and overcome difficulties are factors that must be taken into account to overcome them and achieve a

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Practically, nine out of 10 participants were moderately satis ed with the social bene ts; this could be due to the difference between the salary received by professional nursing staff and technical staff or the status of appointed or contracted staff.The latter do not receive the same economic incentives and bene ts.To this is added the time of service, since the more years worked, the payment is higher, as well as those who have specialized studies: they receive an additional bonus.
The salary symbolizes the economic compensation for (24) the activities carried out ; it is expected to be fair and meet personal expectations and demands.This would be re ected in greater job satisfaction by motivating workers and, even, in their behavior towards achieving (25) the objectives of the institution .In a study carried out on nurses, in a social security hospital in Peru, it was found that 75.5% presented sufficient performance; 66.7%, a service time greater than or equal to six years ( 2 6 ) and 96.2% have a specialty .Eight out of 10 participants were dissatis ed or moderately satis ed satisfactory work environment.Furthermore, another factor to observe is the materials and equipment available, which are sometimes de cient and scarce, as well as biosafety conditions, which are essential to guarantee the staff's health and the patient's wellbeing.Regarding the work schedule, which is related to the quality of care, work efficiency, and the physical and mental exhaustion of the staff, there is a similarity with the study by Gonzales P, who mentions that the care staff is dissatis ed with the conditions environment, infrastructure, and resources, which would be working (23) conditions .
with the administrative policies, which could be due to a poor link between the vision and mission of the institution and the service and, also, to not having a very clear operational and strategic activity plan.that guides towards the achievement of objectives.Most of the nursing staff would not know all the norms or guidelines of the institution, since they become more involved w i t h c a re wo r k a n d l e ave m a n a g e m e n t a n d administration aside.Brunet L points out that the behavior acquired by workers is directly due to administrative behavior and the organizational realities that they appreciate; therefore, it is asserted that the reaction will be de ned by the perception.This result is similar to the study by Bautista C, in which the nurses expressed dissatisfaction in the political-administrative (28) dimension .
A positive relationship was found between the work environment and job satisfaction of the nursing staff of the Emergency Service of the Hospital de Vitarte (p=0.023).
The limitation of this study was the waiting time to apply the instrument to the entire sample since it depended on the shift and available time of the participants.However, it was possible to survey everyone, and the ndings show that hospital management needs to implement strategies and make additional efforts to improve the climate and job satisfaction of its nursing staff; for example, generate assertive communication and promote courses, develop training workshops in order to have trained personnel, improve physical conditions, provide inputs and equipment; This will result not only in the quality of care provided to the patient, but also in the well-being of the staff, who would feel motivated and more committed to the institution.

CONCLUSION
Authorship Contribution: MLCP and MDPM have participated in the article's conception, the data collection, writing, and approval of the nal version.MEMZ performed the data analysis and nal revision of the manuscript, and AOM and MQS, the discussion of the article, as well as the nal revision of the manuscript.

TablE 1 .
Sociodemographic data of the nursing staff in the emergency department.
Source: Survey applied to the nursing staff of the emergency department.

Table 2 .
Work environment according to its dimensions in the nursing staff.

Table 3 .
Job satisfaction according to its dimensions in nursing staff.
Source: Survey applied to emergency department nursing staff.

Table 4 .
Overall results of the level of work environment and job satisfaction.

Table 5 .
Socio-demographic characteristics and job satisfaction * Anova test † Fisher's exact test.

Table 6 .
Correlation between work environment and job satisfaction.