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Are you satisfied?
Pay raises and promotions rank high for nurses
Compensation can make demands of job seem less taxing
Lisette Hilton
Lisette Hilton is a freelance writer.
What do nurses rank as most important to job satisfaction? According to's salary survey
the list includes pay increases, advancement opportunities, regular merit increases, tuition reimbursement and overtime opportunities – in that order. The survey represents responses from 4,522 RNs from all 50 states.
But when one drills down, the findings take on a new meaning. Salary was by far the most important aspect of job satisfaction, with 72% of nurses ranking it first. Benefits ranked No. 1 for 15% of those responding, with 6% saying advancement opportunities were most important, followed by 5% ranking merit increases important and 1% indicating tuition reimbursement or overtime opportunities were most important. The findings suggest employers need to offer fair-market salaries when hiring nurses, but the survey suggests most nurses are not entirely satisfied with their pay. The survey reveals about 46% of nurses are only somewhat satisfied with what they’re earning, ranking the level of satisfaction with their salaries as three or four out of five, with five being very satisfied. Slightly more than one in 10% indicated they were very satisfied with their salaries.
Given the demanding and stressful nature of their work and the educational requirements nurses may be inclined to seek other types of employment if they are not compensated adequately.”
— Ginger Hanson, PhD
“Compensation and benefits are certainly important to nurses’ job satisfaction,” Ginger C. Hanson, PhD, assistant professor of community public health nursing at Johns Hopkins School of Nursing, wrote in an email to “Given the demanding and stressful nature of their work and the educational requirements nurses may be inclined to seek other types of employment if they are not compensated adequately.” Hanson suggests employers go beyond offering fair nursing salaries. “I would also suggest that in order to stay competitive nursing employers conduct benefit reviews to make sure that nurses benefits are in line with white collar employees of similar educational backgrounds,” she said. “Keeping experienced nurses at the bedside will require an investment in nurses and the work they do.” “Nurse satisfaction with pay and benefits is important not just so hospitals can retain experienced staff but to prevent nursing strikes, which can be costly to hospitals and risky for patients affecting mortality rates and risk for readmission,” Hanson continued.
Let’s look at factors that lead to nurse dissatisfaction
“In 2004, the state of California legislated staffing ratios for nurses in hospitals. California lowered the number of patients in the nurses’ workload,” she said. “Following the staffing mandate, nurses reported greater satisfaction with their work and less burnout. Addressing staffing ratios is an important consideration for administrators looking to improve nurse satisfaction.” “Our research has found that 40% of nurses say that on their last shift, they didn’t have time to talk with patients,” Lasater continued. “This is evidence that nurses are over-extended and frequently don't have the time and resources to provide even basic nursing care.” One way employers can transition to more satisfying work environments, according to Lasater, is to pursue Magnet status for their facilities. “Magnet hospitals actually emerged out of the necessity of hospitals needing to recruit and retain nurses during a nursing shortage in the 1980s,” she said. “What we find in research about Magnet hospitals is that nurses in Magnet hospitals enjoy better work environments and have more management nurse-to-patient ratios and they’re more engaged in their work, which is important for job satisfaction. Nurses at Magnet hospitals are more likely to feel satisfied with their jobs and less likely to feel burned out.” Nurses want to work in environments where they feel respected for their knowledge and skills and have positive relationships with colleagues, Lasater said. These needs tie into the findings of the survey, she said. “The way I think about it is that the work environment – the culture of the hospital – is kind of this underlying foundation upon which everything else happens,” she said. “So, you might be dissatisfied with your benefits, but other things at work are good and you feel supported and acknowledged and respected for the work that you do.” “So the dissatisfaction with your benefits or wages is lessened by the fact that you work in a place that respects and acknowledges your work,” Lasater said “If you don’t have the foundation of a healthy work environment, these other things are more problematic.”
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Research shows nurses’ job dissatisfaction is multifactorial, according to Karen Lasater, PhD, RN, assistant professor at the University of Pennsylvania School of Nursing and senior fellow at the school’s Center for Health Outcomes and Policy Research. “I think the major finding across all the research that we have done is that dysfunctional teams, over-extended nurses and disempowered nurses are the primary contributors of job dissatisfaction,” Lasater said. It’s important that nurses feel like they have some control over clinical care. Nurses are highly skilled and knowledgeable and need to be included in the decision-making process from the patient to organizational levels, Lasater said. “But what we find is that nurses often express that other clinicians don’t value their professional knowledge,” Lasater said. “And with healthcare becoming increasingly more interdisciplinary, this dysfunctional teamwork is problematic for nurses’ satisfaction with their work.” When nurses feel over extended with work it often is a result of managing high workloads, such as when patients are sicker and their care increasingly more complicated than in the past. These factors that impact job satisfaction among nurses are not only problems for hospital administrators, but also for patients, Lasater said. Empowering nurses, fostering good working relationships and providing nurses with the time and resources to care for patients is easy to implement and has been shown to increase job satisfaction, Lasater said.
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