Differences in job satisfaction of nurses based on type of hospital: An analytical study from India

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Submitted: 20 April 2023
Accepted: 23 August 2023
Published online: 2 January, TAPS 2024, 9(1), 54-57
https://doi.org/10.29060/TAPS.2024-9-1/SC3048

Atul Kumar1, Amol Gawande1, Meghana Bhilare2, Vishal Wadajkar2, Indrajit Ghoshal3 & Shirish Raibagkar4

1Dr.D.Y. Patil B-School, Pune, India; 2Dr.D.Y. Patil Institute of Management and Research, Pune, India; 3Faculty of Computer Science and Engineering, Poornima University, Jaipur, India; 4Savitribai Phule Pune University, Pune, India

Abstract

Introduction: The purpose of this study is to carry out a comparative analysis of the job satisfaction of nurses working in India based on the different types of the hospital they are working with. The study tests the null hypothesis that the job satisfaction of nurses from India across different types of hospitals is the same.

Methods: Four hundred nurses divided into 100 each for four popular types of hospitals – (1) Educational; (2) Government; (3) Charitable Trust; and (4) Private, from all over India were surveyed. Two ANOVA tests were performed. The first one was performed, taking overall job satisfaction as the dependent variable. The second ANOVA was performed by taking the monetary and compensation factors, work environment and management support, and job-related factors as the dependent variables.

Results: The overall mean of job satisfaction was -0.73 (SD 0.60). Overall, 65 percent of the variability of the dependent variable, job satisfaction, is explained by the type of hospital and is statistically significant (p<0.0001).

Conclusion: Monetary and compensation factors, work environment and management support, and job-related factors impact nurses’ job satisfaction. These factors vary with the type of hospital, and hence it can be concluded that due to variation in these factors depending on the type of hospital, the job satisfaction of nurses varies. Implications of our study are for the educational, government, and charitable trust hospitals to improve their work culture, management, and work environment so that nurses will have higher job satisfaction.

Keywords:           Nurses, Job Satisfaction, India, Hospitals, Government, Private, Charitable Trust, Educational 

I. INTRODUCTION

India’s ratio of nurses per 1000 population is only 1.96 as against the WHO norm of 3 per 1000 population. Another 4.3 million more nurses are required by India by the year 2024 to meet the World Health Organization (WHO) standard of 3 nurses per 1000 population (Business Standard, 2021). Job satisfaction of nurses assumes significance given the huge gap between its current ratio of nurses per 1000 and the WHO norm. But studies investigating linkages between types of hospitals (legal structure of the hospital) and their impact on the job satisfaction of nurses are relatively low. Different types of hospitals can be found in India – Educational, Government, Charitable Trust, Private, Military, Missionary, Railway, and a few more. A sizable amount of literature is available which suggests that factors like organisational culture matters in the job satisfaction of nurses (Rahnavard et al., 2018). But there are few studies correlating these factors with the type of hospital. The association between the factors and the type of hospital remains unexplored. This research attempts to provide empirical evidence supporting the association of the factors influencing job satisfaction and the type of hospitals. The study expects to generate valuable insights for nurses and their employers of different types. It is based on a survey of 100 nurses each from the four most popular types of hospitals – (1) Educational; (2) Government; (3) Charitable Trust; and (4) Private owned.

II. METHODS

The size of the Indian population of nurses is more than 3 million. At a 95 percent confidence interval, the sample size for this population works out to 384, which we rounded off to 400, giving an equal representation of 100 nurses each from the four types of hospitals – educational, government, charitable trust, and private owned. The task of collecting 100 responses for each type of hospital was distributed among the authors. Convenience and purposive sampling method were used. However, to make the study group more inclusive, the sample included nurses from all regions and parts of India – urban, semi-urban, and rural. The questionnaire was administered through Google Forms. The survey was conducted in March 2023. Express written consent for participation was obtained from each respondent.

The study got ethics committee approval number DYP202301, from the Dr.D Y Patil (Deemed to be) University, Pune, India, and Dr.Ajeenkya D Y Patil University, Pune, India.

A scale developed by Chang et al. (2017) to measure the job satisfaction of healthcare workers was largely referred to while designing our scale, which was duly tested for validity and reliability (Cronbach Alpha 0.96). We spoke to a few senior nurses who advised us to consider monetary and compensation factors while assessing the job satisfaction of nurses. Monetary benefits are important for any working human in any part of the world. Studies on job satisfaction (conducted in developed, developing, and underdeveloped countries) include monetary benefits as a parameter. Based on our discussion with the senior nurses and the existing literature, we identified three main factors as determinants of job satisfaction for Indian nurses – monetary and compensation factors, work environment and management support, and job-related factors. monetary and compensation Factors included items like “The salary pay-scales are satisfactory”, “Benefits like provident fund, and gratuity are duly given”, and others. work environment and management support included items like “The management of this organization is supportive of me”, “The management makes changes based on my suggestions and feedback”, and others. job-related factors included items like “I receive the right amount of support and guidance from my direct supervisor”, “I am provided with all trainings necessary for me to perform my job”, and others.

III. RESULTS

Some of the distinctive features of the profile information include a relatively high concentration of respondents in the work experience groups of 10-15 years (158 respondents representing 40 percent of the sample), very low representation of postgraduate educational qualification (10 respondents representing 3 percent of the sample); very low representation of hospitals with a standing of <10 years (11 respondents representing 3 percent of the sample). All these 11 hospitals with a standing of <10 years were private hospitals.  The data that support the findings of this study are openly available at https://www.openicpsr.org/ openicpsr/project/190042/version/V1/view  (Bhilare, 2023).

A. Descriptive Statistics

Table 1 shows descriptive statistics of the sample.

Type

Total

Monetary

Work Env.

Job related

Mean

SD

Mean

SD

Mean

SD

Mean

SD

Educational

-0.22

0.86

-0.21

0.87

-0.27

0.89

-0.19

0.90

Govt.

-1.55

0.40

-1.53

0.39

-1.60

0.47

-1.54

0.44

Trust

-1.57

0.46

-1.51

0.47

-1.65

0.50

-1.53

0.50

Private

0.42

0.68

 0.39

0.74

0.39

0.68

 0.48

0.71

Total

-0.73

0.60

-0.71

1.05

-0.78

1.09

-0.70

1.09

Table 1. Descriptive statistics of the sample

The overall job satisfaction mean scores of the hospitals were -0.22 (0.86) for educational hospitals, -1.55 (0.40) for Government hospitals, -1.57 (0.46) for Trust hospitals, and 0.42 (0.68) for private hospitals. For all the 400 respondents taken together, the mean job satisfaction score was -0.73 (SD 0.60).

In the case of educational hospitals, all three factors of job satisfaction were negative – monetary and compensation factors (M= -0.21, SD 0.87), work environment and management support (M= -0.27, SD 0.89), and Job-related factors (M= -0.19, SD 0.90). The same was the case with government hospitals which reported negative job satisfaction for all three factors – monetary and compensation factors (M= -1.53, SD 0.39), work environment and management support (M= -1.60, SD 0.47), and Job-related factors (M= -1.54, SD 0.44).

Further, charitable trust hospitals too reported negative job satisfaction for all three factors – monetary and compensation factors (M= -1.51, SD 0.47), work environment and management support (M= -1.65, SD 0.50), and job-related factors (M= -1.53, SD 0.50). However, private hospitals were the only type of hospitals that reported positive job satisfaction for all three factors – monetary and compensation factors (M= 0.39, SD 0.74), Work environment and management support (M= 0.39, SD 0.68), and job-related factors (M= 0.48, SD 0.71).

B. Testing of the Hypotheses

Two ANOVA tests were performed. The first one was performed, taking overall job satisfaction as the dependent variable (R2 0.65, p<0.0001). The second ANOVA was performed by taking the monetary and compensation factors (R2 0.62, p<0.0001), work environment and management support (R2 0.64, p<0.0001), and job-related factors (R2 0.64, p<0.0001) as the dependent variables.

IV. DISCUSSION

The overall job satisfaction score of the entire sample size of 400 respondents is -0.73 (SD 0.60), which is close to -1, indicating somewhat dissatisfied. Thus, on an overall basis, Indian nurses have reported job dissatisfaction. An important reason for this is the mismatch between the guidelines of the Nursing Council about the working conditions and the actual working conditions at the various hospitals. The analysis shows that for all the three factors, namely, the Monetary and compensation factors, the work environment and management support factors, and job-related factors the scores are range-bound. This indicates a close relationship between these three factors.

However, when we look at the analysis by the type of hospitals, major variations are seen. Three out of the four types: educational hospitals, government hospitals, and charitable trust hospitals, show negative job satisfaction, whereas only one type, the private owned hospitals, show positive job satisfaction. This is because private hospitals offer a much better and more professional work culture leading to higher job satisfaction among the nurses (Srimulyani & Hermanto, 2022). Interestingly, there is not much difference between the job satisfaction scores of government hospitals and charitable trust hospitals. The standard deviations associated with these two high negative scores are also similar. Scores of government hospitals and charitable trust hospitals can be taken as lying between somewhat dissatisfied and strongly dissatisfied ratings, pointing out a big gap between the prescribed norms of working conditions and the actual working conditions. The score of -0.22 indicates relatively much lesser job dissatisfaction in the case of educational hospitals (as compared to government and charitable trusts). It indicates that the control over educational hospitals is better as compared to the other two types of hospitals. The positive score of 0.42 in the case of private hospitals lies between neutral and somewhat satisfactory pointing a positive and professional work culture.

An important observation that emerges from the analysis is that for each of the four types of hospitals, there is little variation in the three factors of job satisfaction or dissatisfaction. This is because the three factors are closely related to each other.

V. CONCLUSION

Indian nurses, on an overall basis, are somewhat dissatisfied with their jobs. However, when we look into different types of hospitals, it is concluded that nurses working in private hospitals are moderately satisfied, those working in educational hospitals are moderately dissatisfied, and those working in government and charitable trust hospitals are highly dissatisfied. monetary and compensation factors, work environment and management support, and job-related factors impact nurses’ job satisfaction. These factors vary with the type of hospital, and hence it can be concluded that due to variation in these factors depending on the type of hospital, the job satisfaction of nurses varies. This impact is strong on an overall basis, as well as for the three factors (monetary and compensation Factors, work environment and management support, and job-related factors) separately. Interestingly there is a strong correlation among the three factors that we have used for measuring the job satisfaction of nurses. We conclude that positive and relatively higher job satisfaction among nurses working in private hospitals (Srimulyani & Hermanto, 2022) can be attributed to professional working culture, better monetary and compensation factors, better co-worker relationships, and other factors.

Notes on Contributors

Dr. Atul Kumar contributed to the conceptualization of the entire study. Dr. Amol Gawande contributed in designing methods for the study. Dr. Meghana Bhilare contributed to data collection. Dr. Vishal Wadajkar contributed to data analysis. Dr. lndrajit Ghoshal contributed in deducing findings and writing the discussion. Dr. S S Raibagkar contributed in writing the full paper including the conclusion. All the authors have read and approved the final manuscript.

Ethical Approval

The study got ethics committee approval number DYP202301, from the Institutional Review Boards of Dr.D Y Patil (Deemed to be) University, Pune, India, and Dr.Ajeenkya D Y Patil University, Pune, India.

Data Availability

All 400 responses were collated in a data set that has been deposited in a repository and can be accessed at https://www.openicpsr.org/openicpsr/project/190042/version/V1/view

Funding

No external funding was used for the study.

Declaration of Interest

We declare that there is no conflict of interest or competing interest of any sort with any individual or organization.

References

Bhilare, M. (2023). Data set Nurses Job Satisfaction (ICPSR 190042; Version V1) [Data set]. ICPSR. https://www.openicpsr.org/openicpsr/project/190042/version/V1/view

Business Standard. (2021, September 2). India in need of 4.3 mn more nurses by 2024 to meet who norms: Nurse org. Retrieved March 29, 2023, from https://www.business-standard.com/article/ current-affairs/india-in-need-of-4-3-mn-more-nurses-by-2024-to-meet-who-norms-nurse-org-121090201448_1.html

Chang, E., Cohen, J., Koethe, B., Smith, K., & Bir, A. (2017). Measuring job satisfaction among healthcare staff in the United States: a confirmatory factor analysis of the Satisfaction of Employees in Health Care (SEHC) survey. International Journal for Quality in Health Care, 29(2), 262-268. https://doi.org/10.1093/intqhc/mzx012

Rahnavard, F., Sadati, A. K., Hemmati, S., Ebrahimzade, N., Sarikhani, Y., Heydari, S. T., & Lankarani, K. B. (2018). The impact of environmental and demographic factors on nursing job satisfaction. Electronic Physician, 10(4), 6712. https://doi.org/10.19082%2F6712

Srimulyani, V. A., & Hermanto, Y. B. (2022). Organizational culture as a mediator of credible leadership influence on work engagement: empirical studies in private hospitals in East Java, Indonesia. Humanities and Social Sciences Communications, 9(1), Article 274. https://doi.org/10.1057/s41599-022-01289-z

*Shirish S Raibagkar
Savitribai Phule Pune University,
Ganeshkhind, Pune, India
Email: ssrssr696@gmail.com

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