ABSTRACT

Objective: To determine the relationship between work environment and job satisfaction of nursing staff in the emergency service of Hospital de Vitarte. Methods: Quantitative, correlational and cross-sectional research. The population and sample consisted of 70 members of the nursing staff of the emergency service. With the prior informed consent of each participant, two questionnaires validated in other studies were applied through a survey. Results: The participating nursing staff was mainly between 30 and 39 years old (50%), was female (62,9%), with the same number of professionals and technicians, with a slight predominance of contracted (51,4%) and had between 6 to 10 years of service. The dimensions of the work environment: self-realization (81,4%), work involvement (82,9%), supervision (82,9%) and communication (54,3%) were considered moderately favorable; working conditions were unfavorable (42,9%). The dimensions of satisfaction: physical conditions - materials (81,43%), administrative policies (72,86%) were unsatisfactory; while in social benefits – remuneration (87,14%), social relationships (47,14%), personal development (65,71%), task development (72,86%) and performance beyond the position (80%) were moderately satisfactory. The work environment was considered moderately favorable (48,57%) and job satisfaction was moderately satisfactory (42,86%). Conclusions: A statistically significant relationship was found between work environment and job satisfaction (p=0,023) in the nursing staff in the emergency service of the Hospital de Vitarte.

Keywords: Working conditions, job satisfaction, nurses, Emergency Service, Hospital.

RESUMEN

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 30 a 39 años de edad (50%), era femenino (62,9%), con la misma cantidad de profesionales y técnicos, con ligero predominio de contratados (51,4%) y tenía entre 6 a 10 años de servicio. Las dimensiones del clima laboral: autorrealización (81,4%), involucramiento laboral (82,9%), supervisión (82,9%), comunicación (54,3%) fueron consideradas medianamente favorable; y las condiciones laborales fueron desfavorables (42,9%). Las dimensiones de la satisfacción: condiciones físicas – materiales (81,43%), políticas administrativas (72,86%) fueron insatisfactorias; mientras que en beneficios sociales – remunerativos (87,14%), relaciones sociales (47,14%), desarrollo personal (65,71%), desarrollo de tareas (72,86%) y desempeño más allá del puesto (80%) fueron medianamente satisfactorias. El clima laboral fue considerado medianamente favorable (48,57%) y la satisfacción laboral fue medianamente satisfactorio (42,86%). Conclusiones: Se halló relación estadísticamente significativa entre clima laboral y satisfacción laboral (p=0,023) en el personal de enfermería en el servicio de emergencia del Hospital de Vitarte.

Palabras clave: Ambiente de trabajo, satisfacción en el trabajo, enfermeras, Servicio de Urgencia en Hospital.

INTRODUCTION

The World Health Organization (WHO) estimates that there are 59.2 million paid health workers globally. However, it also identifies the density of the minimum health personnel to achieve the Millennium Development Goals (MDG) and indicates that 57 countries have a deficit 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 satisfied people. ⁽²⁾.

Nursing staff may show discomfort in their work environment related to their professional satisfaction ⁽³⁾. The work climate, also called organizational climate or work environment, is a series of characteristics within an organization ⁽⁴⁾. It refers to the work environment, whose perception awakens, in the worker, a fundamental element, because it will have an impact on work behavior ⁽⁵⁾.

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 the quality of work. service ⁽⁶⁾. In the nursing professional, it is an indicator of personal growth with respect to the relationship with their co-workers ⁽⁷⁾. The importance of job satisfaction for nurses in caring for patients is essential in the daily life of the workforce; low satisfaction will influence the quality of service provision and commitment to organizations ⁽⁸⁾.

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, have an impact on their performance ⁽⁹⁾. These are two factors of work environments that are of great importance, since they are related to the performance of workers and the effectiveness of organizations ⁽¹⁰⁾.

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 environment; if they are not adequate, they create a tense and ambiguous climate that decreases the effectiveness of staff activities, which affects the quality of care provided ⁽¹¹⁾. Nursing needs an environment that develops or enhances their work skills; This is given by the harmony of two factors: the first, a personal motivator that integrates personal expectations with development at work, and the second, aspects provided by the work environment to improve conditions in their actions ⁽¹²⁾.

The aim of the research was to determine the relationship between work environment and pre-pandemic satisfaction in the nursing staff of the Emergency service of a national hospital.

MATERIALS AND METHODS

Design and study population

The study is quantitative, with a descriptive, cross-sectional 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.

Variables and instruments

The variables studied were work environment and job satisfaction. The instruments used were two validated. The work environment questionnaire ⁽¹³⁾ 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 Satisfaction Questionnaire (SL-SPC) ⁽¹⁴⁾ consists of 36 items grouped into the following dimensions: physical and/or material conditions, labor and/or remunerative benefits, 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 dissatisfied (92 points), dissatisfied (93 to 111 points), medium or moderately satisfied (112 to 148 points), satisfied (149 to 167 points) and very satisfied (168 to 180 points).

Procedures

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.

Statistical analysis

In the descriptive analysis, absolute and relative frequencies were calculated. To apply the 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).

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 participant. Ethical principles in research in humans were considered, and the data obtained was only used for research.

RESULTS

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 work climate perceived by the nursing staff in the dimensions of self-actualization (81.4%), work involvement (82.9%), supervision (82.9%), communication (54.3%) were considered moderately favorable; however, working conditions were predominantly unfavorable (42.9%) (Table 2)

No participant was satisfied with the physical-material conditions of their work environment; few were satisfied with the social-remunerative benefits (1.4%) and with the administrative policies (2.9%); on the other hand, more than 70% were dissatisfied with the physical-material conditions (81.4%) and administrative policies (72.9%). Over 70% were moderately dissatisfied with the social-remunerative benefits (87.1%), performance beyond the post, personal development (60%) and tasks (72.9%) (Table 3).

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).

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.

Table 6, shows a significant relationship between climate and job satisfaction, since the p values (p=0.023) are less than 0.05; therefore, the null hypothesis is rejected, having sufficient evidence to say that there is an association between climate and job satisfaction. Those who indicated feeling job dissatisfaction also reported having an unfavorable work environment (55.6%). Likewise, the majority of those who indicated that they were satisfied at work would have a medium (46.1%) or favorable (30.8%) work environment.

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. ⁽¹⁵⁾ , who states that it is possible to directly relate the work environment with satisfaction depending on the instruments used. Ortiz S ⁽¹⁶⁾ and Aguirre MH ⁽¹⁷⁾ also find a relationship between these two variables.

For almost half of the participants, 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 good ⁽¹⁷⁾.

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 Hospital Belén de Trujillo is satisfied ⁽¹⁸⁾.

The work climate has dimensions that can be measured in an organization that influence behavior, by directly affecting the satisfaction and performance of individuals ⁽¹⁹⁾. A study raises nine dimensions: structure, responsibility, reward, challenge, relationships, cooperation, standards, conflict, and identity ⁽²⁰⁾. Although our study does not use that classification, but rather five dimensions: self-actualization, work involvement, supervision-communication, and work condition, they can be related to responsibility, challenge, standards-relationships, and reward.

In the study, the self-realization dimension was qualified mainly as moderately favorable (81.4%), since their work allows them to learn, develop, and fulfill their work, but the achievements would be valued little, although there are opportunities to progress. Cortés J found that nurses perceive themselves as accomplished, but they lack incentives, such as training, that allow them to develop personally ⁽²¹⁾.

Regarding the dimensions of job satisfaction, the assessment of moderately satisfactory to developing tasks, social benefits 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 satisfactory work environment. Furthermore, another factor to observe is the materials and equipment available, which are sometimes deficient and scarce, as well as biosafety conditions, which are essential to guarantee the staff's health and the patient's well-being

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 dissatisfied with the conditions environment, infrastructure, and resources, which would be working conditions ⁽²³⁾.

Practically, nine out of 10 participants were moderately satisfied with the social benefits; 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 benefits. 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 the activities carried out ⁽²⁴⁾ ; it is expected to be fair and meet personal expectations and demands. This would be reflected in greater job satisfaction by motivating workers and, even, in their behavior towards achieving the objectives of the institution ⁽²⁵⁾. 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 and 96.2% have a specialty ⁽²⁶⁾.

Eight out of 10 participants were dissatisfied or moderately satisfied 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 with care work and leave management and administration aside.Brunet L ⁽²⁷⁾ 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 defined by the perception. This result is similar to the study by Bautista C, in which the nurses expressed dissatisfaction in the political-administrative dimension ⁽²⁸⁾.

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 findings 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

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).

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