Sources of satisfaction in hospital nursing practice. A guide to effective job design

As the healthcare system restructures, changes are being made that appear to influence nurses' jobs and satisfaction, yet little is known about effects on job characteristics and related outcomes. The authors present findings from a research project designed to identify links between specific aspects of hospital staff nurse (SN) practice and perceived job characteristics and psychological states, thought to have motivational consequences.

The Job Characteristics Model (JCM) is the dominant paradigm in contemporary job design theory and research. Although generally well-supported, the JCM has limitations that constrain its usefulness: first, the Job Diagnostic Survey used to assess perceived characteristics does not indicate the specific aspects of activities that lead to these perceptions, and second, the JCM, based primarily on manufacturing research, does not include interpersonal job characteristics that seem important in human service jobs.

Two studies were conducted using a similar methodology. Focus groups of SNs were held to identify links between specific activities and characteristics and sources of satisfaction in SNs' job content. The Staff Nurse Job Characteristics Index (SNJCI) was developed to assess the presence of certain elements and activities in a nurse's job. An initial sample of 63 and a second sample of 146 SNs from Medical/Surgical and Coronary Care units completed the SNJCI, the JDS, and a demographic form through a mail survey.

Internal consistency reliabilities (Cronbach's alpha) for eight of the nine SNJCI scales were acceptable. Correlation analysis indicates that job characteristics are meaningfully related to psychological states and job satisfaction. Findings support the hypothesis that specific aspects of SNs' jobs are reliably related to characteristics.

Aspects of SNs' jobs important to their satisfaction include continuity in nurse-patient relationships, authority to initiate independent nursing actions, individual accountability for clinical outcomes, and regular performance feedback from managers.