Hegney 2006
Hegney 2006
Hegney 2006
1 2
DESLEY HEGNEY BA, PhD, RN, FRCNA , ASHLEY PLANK MSc, PhD, Dip T and VICTORIA PARKER BHSc, RN,
3
MN, MRCNA
1
Director, Centre for Rural and Remote Area Health, Faculty of Sciences, University of Southern Queensland and
Faculty of Health Sciences, University of Queensland, Toowoomba, and 2Statistics Coordinator, SimStat,
Department of Mathematics and Computing, Faculty of Sciences and 3Lecturer, Department of Nursing, University
of Southern Queensland, Toowoomba, QLD, Australia
ª 2006 The Authors. Journal compilation ª 2006 Blackwell Publishing Ltd 271
D. Hegney et al.
(Edwards 2001, Zungolo 2001, Aiken et al. 2002, & Adams 1999, Adams & Bond 2000, Edwards et al.
Valentino 2002). 2000, Healy & McKay 2000, Stordeur et al. 2001,
Satisfaction with employment is influenced by the Tummers et al. 2002). Some authors note that
environment in which the nurse is employed and the increasing stress related to increased workloads results
personal attributes of the nurse (Wheeler 1997, Taylor in nurses being exhausted at the completion of shifts
et al. 1999, Tovey & Adams 1999, Adams & Bond (McNeese-Smith 1999). Consequently, several authors
2000). There is a substantial body of published litera- have linked the stressors arising from the nature of
ture linking the variables influencing job satisfaction nursing work to poor job satisfaction (Taylor et al.
with retention in the nursing workforce (Adams & 1999, Stordeur et al. 2001). As would be expected,
Bond 2000, Aiken et al. 2002, Ingersoll et al. 2002). other studies associate low levels of morale to poor job
However, no study has linked these variables to the satisfaction (Farrell & Dares 1999, Taylor et al. 1999,
model of intrinsic and extrinsic work values. Edwards et al. 2000). The significance of remuneration
Some authors note that nurses who are required to is unclear with the suggestion that remuneration is only
expand and extend their role may find this enhances relevant if nurses perceive a discrepancy between their
their job satisfaction, whereas other nurses may own remuneration and those of other professionals
experience a lessening of job satisfaction when role (Tovey & Adams 1999).
expansion is accompanied by a lack of career Whilst many of the aforementioned studies demon-
advancement (Adams et al. 1998, Furlong & Glover strate that job satisfaction in the workplace is largely
1998). Linked to this role expansion is an increasing determined by the interaction between personal and
autonomy of practice, also associated with job environmental characteristics (Lewin 1951 cited in
satisfaction (Adams & Bond 2000, Stordeur et al. 2001, Taris & Feij 2001), they rarely segregate the variables
Tummers et al. 2002). Additionally, there is some impacting upon nursing job satisfaction according to
evidence that the job level of the nurse influences job these characteristics. In the wider literature, the con-
satisfaction with nurses in more senior management gruence or fit between a person and the work environ-
positions experiencing greater satisfaction (Adams & ment (P–E fit) is considered to be an important predictor
Bond 2000). Further, the increasing need to use tech- of job satisfaction (Taris & Feij 2001). Further, within
nical resources has been linked to job satisfaction the P–E fit literature, several types of fit are identified
(Stordeur et al. 2001, Tummers et al. 2002), as has the including Kristof’s (1996) person–organization fit, per-
personal development opportunities of the nurse (Tovey son–vocation fit, person–group fit and person–job fit.
& Adams 1999, Adams & Bond 2000). An important category of person variables studied in
Flat organizational structures involving a nursing person–organization fit research is work values (Locke
director with a strong position in the management 1976 cited in Taris & Feij). These values are defined as
executive, decentralized decision-making, good com- Ôenduring beliefs that a specific mode or conduct or end-
munication between peers and medical colleagues, state is preferable to its opposite, thereby guiding the
positive leadership qualities of the ward manager and individual’s attitudes, judgements and behavioursÕ
good rostering practices have all been linked with (Taris & Feij 2001, p. 3). With regard to work values, a
improved job satisfaction (Hart & Rotern 1995, commonly used differentiation in this domain is in-
Morrison et al. 1997, Adams & Bond 2000, Healy & trinsic and extrinsic work values. Intrinsic work values
McKay 2000, Hegney & McCarthy 2000, Rosenstein Ôrefer to the degree to which employees value imma-
2002). In contrast, poor management practices terial aspects of their jobs that allow for self-expression
including lack of support and feedback and poor as important, for example, job variety and autonomyÕ
supervision (Taylor et al. 1999, Edwards et al. 2000, (Taris & Feij 2001, p. 3). Extrinsic work values Ôrefer to
Healy & McKay 2000, Hegney et al. 2002a,b) and the degree to which employees value material or
lack of pride in the quality of services delivered instrumental work aspects, such as salary and oppor-
(Adams & Bond 2000) have been associated with job tunity for promotion, as importantÕ (Taris & Feij 2001,
dissatisfaction. p. 3).
Job dissatisfaction is consistently linked to high levels The variables affecting job satisfaction in nursing
of stress, burn-out or mental and physical exhaustion could therefore be re-arranged into intrinsic work
(Blegen et al. 1993, Adams & Bond 2000, Aiken et al. values (the satisfaction of nursing work, being able to
2002, Tummers et al. 2002), high workloads, inap- complete the tasks during working hours) and extrinsic
propriate skills-mix and increasing complexity of care work values (remuneration and career progression).
caused by high patient acuity (Taylor et al. 1999, Tovey The importance of re-assessing the nursing job
272 ª 2006 The Authors. Journal compilation ª 2006 Blackwell Publishing Ltd, Journal of Nursing Management, 14, 271–281
Extrinsic and intrinsic work values
satisfaction literature using these work values is high- the fee-for-service private sector who were employed in
lighted by the results of studies suggesting that job for-profit and not-for-profit acute-care hospitals. The
satisfaction decreases when intrinsic work values are third sample was comprised of nurses employed in the
not met (Taris & Feij 2001). aged-care sector, which included both public and pri-
Further, these authors suggest that extrinsic work vate providers. The sampling frame was restricted to
aspects and social relations at work not only affect job financial members of the QNU to reduce the number of
satisfaction, but also intention to leave the current non-active nurses selected.
position. For example, Taris and Feij (2001) suggest The nurses who were surveyed included Registered
that an employee’s intention to leave decreased until the Nurses (RNs), enrolled nurses (ENs) and assistants-in-
employee’s valued level for this extrinsic value was nursing (AINs). In Australia, the work of RNs and ENs is
reached. If the extrinsic supply was increased over the controlled by State/Territory-based regulating authorit-
valued level then an employee was more likely to leave ies. Assistants-in-Nursing, whilst completing a technical
the company rather than stay (Taris & Feij 2001). This college qualification, are considered to be unregulated
finding was not apparent for intrinsic work values. care providers. The RNs in Australia are employed at
different pay levels, which reflect their level of manage-
ment and clinical responsibility. Level 1 nurses form the
Method major part of the nursing workforce and could be des-
cribed as providing direct patient care. Level 2 and level 3
Aim
nurses have management responsibilities and/or are
The study aimed at identifying the intrinsic and employed as clinical nurse specialists. Level 4 and level 5
extrinsic work values that were perceived by the mem- nurses have traditionally been referred to as Assistant
bers of the Queensland Nurses Union (QNU) in Directors of Nursing (level 4) and Directors of Nursing
Queensland, Australia, to influence job satisfaction. For (level 5), although all of these classifications are related
the purpose of this study, job satisfaction was defined as to industrial awards and do change over time.
the degree of positive affect towards a job or its com- A pilot study involving random samples of 40 nurses
ponents (Adams & Bond 2000). from each sector was carried out to disclose potential
problems with the protocol of the main study and with
the survey instrument and to provide information
Procedure
concerning response rates and variability in key
This study involved a postal survey questionnaire of measures. A total sample size of 2800, equally divided
members of the QNU in October, 2001. One follow-up among the three sectors, was determined to be ade-
mailing to non-respondents was made 2 weeks after the quate to achieve a precision in key measures of ±0.05
initial mailing. in population proportions at 95% confidence and of
Ethics approval was obtained from the University of better than 90% power for differences in proportions
Southern Queensland. To ensure anonymity of the of 0.10 across the sectors at the 5% level of
survey participants, codes were generated by the QNU significance.
to identify each participant and the QNU posted the Of these 2800, the total number of completed surveys
surveys to the participants. These codes were used by returned for analysis was 1477. This represented a
the project team to identify non-respondents and to response rate of 53%. After eliminating 41 cases where
notify the QNU to post a reminder package to them. As the work sector could not be precisely determined and
a result of this coding individual participants cannot be adjusting for differences in identification of work sector
linked to responses. between the QNU database and the survey itself (about
5% of cases), the final sample sizes and response rates in
the main study were: 441 aged care (47%); 497 public
Sample and sampling design
acute care (56%); and 498 private acute care (56%).
The Queensland Nurses Union (QNU) provided the
database of nurse participants from which the samples
The survey instrument
were drawn. There were three employment sectors of
nurses included in the random sample. First, the public While the questionnaire addressed a wide range of is-
sector nurses employed in acute hospitals and commu- sues, this paper focuses upon the participantsÕ level of
nity health. The public sector provides free health ser- agreement with 16 of the 17 positive or negative
vices. The second sample involved nurses employed in statements concerning their experiences in nursing
ª 2006 The Authors. Journal compilation ª 2006 Blackwell Publishing Ltd, Journal of Nursing Management, 14, 271–281 273
D. Hegney et al.
Table 1
Work is emotionally challenging Work is not emotionally challenging
Questions asked of respondents
Workload is heavy (not included in this paper) Workload is light (not included in this paper)
The work is physically demanding The work is not physically demanding
Pay rate is good Pay rate is poor
Work hours are inconvenient Work hours are convenient
Career prospects are good Career prospects are limited
Skills and experience are not rewarded Skills are experience are rewarded
Nursing is seen as a high status career Nursing is seen as a low status career
Work stress is high Work stress is low
Lacks teamwork and support from colleagues Good teamwork and support from colleagues
Workplace is safe Workplace is unsafe
Autonomy is encouraged Autonomy is discouraged
Nursing staff morale is good Nursing staff morale is poor
Nursing staff morale is deteriorating Nursing staff morale is improving
Workplace is well equipped/supplied Workplace is poorly equipped/supplied
Nursing work is valued by the community Nursing work is not valued by the community
Nursing work is valued within the health system Nursing work is not valued within the health system
(Table 1). Workload issues have been the subject of a bership database revealed no differences of significance
separate paper (Hegney et al. 2003). Responses were among the private and public sector respondents in
elicited according to a seven point ordinal scale, ranging terms of gender balance and job designation. A dis-
through Ôextremely positiveÕ, Ôquite positiveÕ, Ôslightly crepancy was apparent in the distribution of nurse types
positiveÕ, Ôneither positive nor negativeÕ Ôslightly negat- in the aged-care sector. Compared with the QNU
iveÕ, quite negativeÕ to Ôextremely negativeÕ. All ques- membership in this sector, RNs are significantly over-
tions were examined for relevance, potential for bias, represented while AINs are significantly under-repre-
appropriateness of scales of response and so on. Fol- sented among respondents. Also, the mean age of
lowing this development, the questionnaire was pre- respondents (weighted across sectors) at about 43 years
tested among 15 nurses to assess its content validity is higher than that of the QNU membership at just
before being piloted. above 41 years. This can be explained by the over-
The 16 items dealing with job satisfaction were representation of RNs compared with AINs in the aged-
divided into those primarily concerned with intrinsic care sector.
work values and those primarily concerned with An assessment of the effect of the apparent imbalance
extrinsic work values. A rotated factor analysis of these in the sample across nurse designation in the aged-care
items confirmed these two groupings as comprising the sector has been made on the results reported in this
dominant factors within each sector. The results were paper. At most the impact is a difference of 3% points
consistent across sectors with an explained variance in estimated percentages. On 12 of the 16 items des-
ranging between 35% and 37% of the total. The reli- cribed the impact is >1% point. The reported levels of
ability of responses was further assessed using Cron- significance are unaffected.
bach’s alpha. Satisfactory values of 0.70 or better were It should be emphasized that the samples used in this
obtained in each sector for each of the intrinsic and study are not necessarily representative of all Queens-
extrinsic sets of items. land nurses working in the public, private or aged-care
sectors during October 2001 since QNU membership
may not be representative of all nurses in these sectors.
Limitations
Because the most recent population figures were 5 years
The response rates for each sector were relatively high old at the time of this study (Australian Institute of
for a study of this type. Nonetheless, there is still con- Health and Welfare 1998), and AINs are not included in
siderable potential for non-response bias if the attitude these statistics, comparisons between the available data
of respondents and non-respondent differ markedly on describing QNU and Queensland nursing populations
particular issues. No systematic trends in the time order may not be valid. For information purposes, however, it
of receipt of the surveys are present with respect to the is estimated that between 65% and 75% of nurses active
responses that are the focus of this paper. A comparison in Queensland are members of the QNU and a com-
between the samples and QNU membership on the parison on demographic variables including job classi-
demographics variables available on the QNU mem- fication, age and gender suggest that the samples used in
274 ª 2006 The Authors. Journal compilation ª 2006 Blackwell Publishing Ltd, Journal of Nursing Management, 14, 271–281
Extrinsic and intrinsic work values
Percentage
40
respective Queensland populations.
30
20
Data analysis
10
Quantitative data were analysed using SPSS for
Windows, SPSS Inc., Chicago, IL, USA (Release 10.0.5). 0
To protect against Type I errors, in view of the con- Extremely Slightly Slightly Extremely
challenging challenging unchallenging unchallenging
siderable number of extant comparisons, only results
that were significant at the 1% level (two-sided) are Figure 1
reported except where an otherwise non-significant The emotionally challenging nature of nursing work: a comparison
between sectors (n[aged] ¼ 373, n[pub] ¼ 442, n[pvt] ¼ 450).
effect is significant at the 1% level in one of the other
sectors. In these cases, a threshold of 5% is used. Sig-
nificant differences in the distribution of percentages very strong evidence of differences across the sectors
across the seven-point scale for the various populations [v2(12) ¼ 84.0, P < 0.001], with a higher proportion of
of nurses were identified using the chi-square test of nurses from the aged-care sector perceiving nursing
independence. Categories were collapsed to ensure work to be extremely physically demanding than nurses
sufficient numbers in each cell of the analysis. Differ- from the other sectors (Figure 2). Differences exist
ences in median responses on each of the 16 items among job level and designation with regard to per-
across the three sectors were assessed using the Kruskall ceptions of the physical demands of nursing work. With
Wallis test. Measures such as means and percentages decreasing designation level (from RN to EN to AIN)
aggregated across the three sectors are weighted to the physical demands of nursing work are perceived to
reflect QNU membership across the three sectors. These increase in the aged care [H(5) ¼ 40.1, P < 0.001) and
weighting are 19.6, 63.2 and 17.2% for the aged-care, public sectors [H(3) ¼ 28.7, P < 0.001]. In the private
public and private sectors respectively. sector, the physical demanding nature of nursing work
Qualitative data from the questionnaire were tran- decreases with seniority of RN [H(3) ¼ 20.3,
scribed verbatim and subsequently analysed separately P < 0.001].
by two members of the research team for prominent
themes according to work sector and the designation of Work stress and morale
the nurse. Consultation following the initial analysis There was strong evidence of a difference between the
allowed for corroboration of the themes arising from sectors with respect to the level of work stress
these data that are presented in this paper. [v2(12) ¼ 57.2,P < 0.001]. In particular, the proportion
50
45 Aged care
Results 40 Public
35
Intrinsic work values
Percent
30 Private
25
The emotional challenges of nursing work 20
15
Averaged across the three sectors, 81% of nurses be- 10
lieved that nursing was extremely or quite emotionally 5
0
challenging (Figure 1). There were differences,
ng
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ª 2006 The Authors. Journal compilation ª 2006 Blackwell Publishing Ltd, Journal of Nursing Management, 14, 271–281 275
D. Hegney et al.
Percent
Private
extremely or quite poor (Figure 4). In the private sector,
15
there was strong evidence of a difference in the per-
10
ceived levels of staff morale by job designation
5
[H(3) ¼ 17.3, P ¼ 0.001]. For example, on average,
ENs and levels 3–5 RNs perceived a higher level of staff 0
ng
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morale than level 1 and level 2 RNs.
t in
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Overall, 45% of nurses believed that nursing staff
im
er
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te
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t
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ly
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morale was extremely or quite deteriorating and this
el
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ly
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ig
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m
was consistent across all sectors (Figure 5). In the
ig
Ex
tre
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Ex
private sector, there was strong evidence of
differences in perception regarding morale deterior- Figure 5
ation between level 3 and level 5 RNs, level 1 and Deteriorating nursing staff morale: a comparison between sectors
level 2 RNs and ENs (H(3) ¼ 21.2, P < 0.001). (n[aged] ¼ 381, n[pub] ¼ 447, n[pvt] ¼ 453).
On average, levels 3–5 RNs perceived less deteriora-
tion in staff morale than ENs and level 1 and level 2
RNs.
60
Aged care
Autonomy
50 Public
There was weak evidence of a difference across the
Private
40 sectors with respect to the perceived level of encour-
Percent
er
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20 25 Private
Percent
20
15 15
10 10
5
5 0
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Figure 4 Figure 6
Perceptions of the level of nursing staff morale: a comparison Autonomy in nursing practice: a comparison between sectors
between sectors (n[aged] ¼ 387, n[pub] ¼ 446, n[pvt] ¼ 451). (n[aged] ¼ 352, n[pub] ¼ 439, n[pvt] ¼ 440).
276 ª 2006 The Authors. Journal compilation ª 2006 Blackwell Publishing Ltd, Journal of Nursing Management, 14, 271–281
Extrinsic and intrinsic work values
The value of nursing work work to be more highly valued than levels 1, 2 and 3
Responses were elicited regarding nursesÕ perceptions of RNs.
the value placed upon their work by the community and
the health system. There was evidence of a difference
Extrinsic work values
across sectors with respect to the respondentsÕ percep-
tion of the value the community place upon nursing Remuneration
work [v2(12) ¼ 27.8, P ¼ 0.006]. Nurses in the aged The data provide strong evidence of differences across
care (12%, n ¼ 47) and public sectors (12%, n ¼ 53) the sectors [v2(12) ¼ 68.9, P < 0.001] with over 53% of
were more likely to perceive that nursing was extremely nurses from the aged-care sector believing their pay rate
or poorly regarded by the community than those in the was extremely or quite poor. Nurses in the private sector
private sector (7%, n ¼ 34). In the private sector, there were less satisfied with their pay rates than nurses in the
was also strong evidence of a difference in the perceived public sector, with 178 (40%) stating it was extremely or
value of nursing work by the community between RNs quite poor, compared with the 127 (29%) of public
and ENs [H(3) ¼ 17.8, P < 0.001] with ENs perceiving sector nurses. This difference between the sectors was
their work to be more valued than RNs. evident in the qualitative data, where nurses in the aged
With regard to the perception of the value placed care and private sectors were also more likely to spon-
upon nursing work by the health system, there was taneously report dissatisfaction with pay rates. Dis-
strong evidence of a difference across the sectors satisfaction centered upon the lack of parity between the
[v2(12) ¼ 43.1, P < 0.001], with a higher proportion of public sector (which is paid at a higher rate) and the
nurses in the aged-care sector believing nursing was private sector. In addition to lack of parity between
valued within the health system than nurses from the nurses in the public and private sectors, respondents
other sectors (Figure 7). Further, in the aged-care sector noted that other similarly educated and accountable
there was evidence of difference according to job des- professions, such as teaching are paid at a higher rate
ignation [H(2) ¼ 10.0,P ¼ 0.007] with, on average, than nurses. As one private sector nurse commented:
ENs perceiving higher values than AINs, who perceive a
Ô…Why should Queensland nurses be paid less
higher value upon their work than RNs. This evidence
than nurses in New South Wales etc? Why also
was further supported by analysis of the public
should the private acute sector nurses be paid less
[H(4) ¼ 15.5, P ¼ 0.004] and private sectors
than the public sector?Õ
[H(3) ¼ 22.8, P < 0.001], where ENs were more likely
to perceive their work was valued by the health system The public sector data differed from the other two
than RNs. There was also some evidence that level 4 sectors in one significant regard; the length of time spent
and level 5 RNs in the public sector perceive nursing in nursing was associated with the level of satisfaction
with pay rates [H(5) ¼ 20.6, P ¼ 0.001], with the
newest recruits to the public sector less satisfied with
30 remuneration than those who had been there longer.
Aged care health sector
25 Public health sector Rewards for skills and experience
20
Private health sector The data suggested that nurses perceived their skills and
Percent
ly
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el
ly
l
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th
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Sl
tre
m
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tre
Ex
Sl
ª 2006 The Authors. Journal compilation ª 2006 Blackwell Publishing Ltd, Journal of Nursing Management, 14, 271–281 277
D. Hegney et al.
Percent
15
22%) were more likely to perceive working hours as
10
extremely or quite inconvenient compared with nurses
in the aged care (n ¼ 67, 17%) and private (n ¼ 71, 5
16%) sectors.
0
There was evidence of a difference across the sectors
od
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od
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d
d
with respect to the perceived level of colleague support
ite
ite
ite
th
go
go
go
lim
ei
lim
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and teamwork in nursing (v2(12) ¼ 27.7, P ¼ 0.006).
te
N
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tre
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Overall, 38% of nurses believed that collegial support
ig
Sl
tre
Sl
Ex
Ex
and teamwork were quite or extremely evident in their
workplace. Perceptions of poor collegial support and Figure 8
teamwork were more evident in the aged-care sector Perceptions of nursing career prospects: a comparison between
than in the other two sectors (aged care n ¼ 110, 29%; sectors (n[aged] ¼ 377, n[pub] ¼ 449, n[pvt] ¼ 453).
278 ª 2006 The Authors. Journal compilation ª 2006 Blackwell Publishing Ltd, Journal of Nursing Management, 14, 271–281
Extrinsic and intrinsic work values
according to job level, job designation and employment when they perceive there is lack of parity between sec-
sector. tors and other professionalsÕ, such as teachers (Tovey &
Work stress, which was high, and morale, which was Adams 1999). A further finding of this study is that
low and decreasing in this study, have also previously length of employment can influence nursesÕ perceptions
been reported to influence job satisfaction (Blegen et al. of the adequacy of remuneration. This finding is
1993, Adams & Bond 2000, Aiken et al. 2002). Tyler important as it was the newly employed nurses who
and Cushway’s (1995) finding that high job levels in were most dissatisfied. Retention of the nursing work-
nursing have higher work stress was not confirmed by force, particularly newly recruited nurses, should be a
this study. An important finding, however, was the priority for all employers.
difference in perception of morale between nurses in Previous studies have suggested that role extension or
this study, with nurse managers having different per- expansion can decrease job satisfaction (Adams & Bond
ceptions of morale than nurses who provide Ôhands-onÕ 2000), particularly if this occurs in the absence of
clinical services. professional recognition and career development
Autonomy has also been linked to job satisfaction opportunities (Furlong & Glover 1998). In this study,
(Adams & Bond 2000, Tummers et al. 2002). No pre- whilst perceptions differed between sectors, it was
vious studies have reported the difference in levels of apparent that many nurses believed they were poorly
autonomy across employment sectors between job rewarded for their skills and experience (Queensland
designation and job level of nurses. The results suggest Health 1999, Adams & Bond 2000).
that, with the exception of the ENs in the aged care Working hours are influenced by rostering practices
sector, autonomy increases with increasing seniority of and the data from this study suggest that the public
the nurse. As levels 3–5 RNs do not normally provide sector nurses were those most likely to perceive their
clinical care, the data suggest that the nurses who are working hours to be unsatisfactory. It is possible that
providing clinical care report less autonomy, partic- this difference can be explained by the high level of
ularly in the public sector. continuous shift workers (55%) from the public sector
The differences across the sectors in perceptions of in this study. Working hours and rostering practice
how the community and health sector value nursing have both previously been linked to job satisfaction
work as well as the differences between the job desig- (Hegney & McCarthy 2000, Silvestro & Silvestro
nation and job level of the nurse have not previously 2000, Senate Community Affairs References Commit-
been reported. All of these intrinsic work factors have tee 2000).
the potential to influence job satisfaction and the Whilst there were differences across sectors, only
intention to leave employment. The intrinsic work value 20% of participants identified a lack of teamwork and
results in this study indicate a workforce in crisis (Senate collegial support. This finding is supported by other
Community Affairs References Committee 2002). studies that suggest that relationships with colleagues
are the best predicators of job satisfaction (Tovey &
Adams 1999, Adams & Bond 2000, Healy & McKay
Extrinsic work values
2000).
Similarly, many of the extrinsic work values in this This study, however, does support previous research
study have been the focus of previous studies into job indicating that the prospect of career advancement is
satisfaction (McNeese-Smith 1999, Queensland Health important to nursesÕ job satisfaction (Dodds et al.
1999, Tovey & Adams 1999, Adams & Bond 2000, 1991). Whilst this study did not specifically ask nurses if
Adams & Bond 2000, Healy & McKay 2000, Hegney career advancement was important to them, it did
& McCarthy 2000, Silvestro & Silvestro 2000). ascertain that the nurses in this study believed that their
Differences across sectors, and/or job designation career prospects were limited rather than good. The
and/or job level were apparent in perceptions of the rate respondentsÕ perceptions of how nursing is perceived as
of pay, rewards for skills and experience, the con- a career in addition to its correlation with low job
venience of working hours, collegial support and satisfaction, are also consistent with previous studies
teamwork, the safety of the workplace, nursing career (Adams & Bond 2000).
prospects and the status of nursing as a career. The only
variable not exhibiting differences across sectors is how
Conclusion
well the workplace was equipped.
With regard to remuneration, it was apparent that At a time of international shortages of nurses, it is
nurses report dissatisfaction with pay rates particularly apparent that the intrinsic and extrinsic work values
ª 2006 The Authors. Journal compilation ª 2006 Blackwell Publishing Ltd, Journal of Nursing Management, 14, 271–281 279
D. Hegney et al.
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Acknowledgement 135.
We wish to thank the Queensland Nurses Union (QNU) for Hegney D., McCarthy A., Rogers-Clark C. & Gorman D.
funding this study and for their invaluable assistance during (2002b) Why nurses are attracted to rural and remote practice.
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