Correlates of Job Satisfaction among Public Health Nurses in Six Local

Health Departments

L. Michele Issel, PhD, RN, Hilary Kirk, MPH, Kathy Baldwin PhD, RN, Curt Fenton, MPH, RN, Sarah

Buller Fenton, MS, RN & Betty Bekemeier, PhD, RNAPHA Annual Meeting,

Washington, DC 1 November 2011

1KRISP Project

Presenter Disclosures

The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months:

L. Michele Issel, Kathleen Baldwin, Curtis M. Fenton,

Sarah Buller Fenton

No relationships to disclose.

KRISP: A Name and an Acronym

K Keeping Knowledge accessR RNs to Redesign job and work

environmentI Improve Innovate to improveS Strength

enScope and competency based practice

P Population Health

Population focused care

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Intervention

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Background re RN Job Satisfaction

Hospital vs PHNPHNs = largest professional group in public health

Lack evidence of correlation between level of satisfaction & intention to stay

Social justice rather than pay

Model of PHN Job Satisfaction

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Job Satisfaction

Centralized Decision Making

Distributive Justice

Communication Openness, Accuracy,

Timeliness

Formalization

Hypothesis for PHNsDegree of job satisfaction varies withdegree of :◦centralized decision making◦distributive justice◦communication openness, accuracy, and timeliness

◦formalization of the workKRISP Project 6

Purposes: Among public health nurses ~

To quantify the level of overall job satisfaction

To determine the relationships among overall job satisfaction and:◦Centralized decision-making◦Distributive justice ◦Communication openness, accuracy,

and timeliness, &◦Formalization of the work

MethodsInstrumentation: standardized, evidence-

based scales◦Job satisfaction scale: McCloskey-Mueller

Satisfaction Scale, 1990◦Centralization scale: “hierarchy of authority,”

Richard Hall in 1963◦Formalization scale: Odham and Hackman,

1981◦Distributive Justice Index: Price & Meuller,

1986◦Communication scales: Shortell, 1991 survey

examining different dimensions of communication among RNs

Survey Monkey

Sample6 LHDs in 6 KRISP Counties (IL & WA) (N=68) in rural, urban, suburban areasParticipation rates

◦IL = 55.8%◦ WA = 41.1%

Demographic characteristics (N=62)Female= 98.4%Caucasian= 95.2%

Sample (cont’d)Education:96.8% had highest degree in

nursing;75.8% of those were Baccalaureate

Year highest degree earned:< 1980 30%1981- 2000 47%> 2000 23%

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AnalysesDescriptive statistics on each

scale◦Estimated Cronbach’s alpha

Correlation across scales using Pearson for significance at 0.01 level

ResultsOverall scores on each scale used

in relation to KRISP and benchmark

All scales on 1-5 Likert scale for ease of comparison◦Generally higher is more of the concept

is present

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Job Satisfaction (higher=higher)KRISP Benchmar

kMean (Std. Dev.) Mean

Extrinsic 3.3 (0.7) 2.3

Scheduling 4.1 (0.7) 3.8

Work/Life Balance 3.1 (0.7) 1.7

Co-Workers 4.2 (0.7) 1.2

Interaction 3.5 (0.6) 2.7

Professional Opportunities 3.2 (0.6) 2.7

Recognition 3.6 (0.9) 2.9

Control 3.0 (0.9) 4.3

Scales: KRISP vs Benchmark KRISP Benchmar

kMean (SD)

Distributive Justice (higher=more job fairness) 3.5 (1.2) 3.5

Centralized Decision Making (higher=more centralized in managers)

2.5 (0.7) 3.7

Formalization (higher=more written policies and procedures)

3.8 (0.7) (Not available)

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Scales: KRISP vs Benchmark

CommunicationDimensions

KRISP Benchmark

Mean (SD)

Openness 3.4 (0.8) 4.3

Accuracy 3.3 (0.8) 3.8

Timeliness 3.6 (0.7) 3.9

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Correlations among Scales1 2 3 4 5 6 7

1- Job Satisfaction Total ---2- Distributive Justice .75**

3- Centralized Decision Making

-.64**

-.45**

4- Formalization .26 .01 -.085- Communication Openness

.76** .56** -.30 .40**

6- Communication Accuracy

.63** .48** -.30 .26* .77**

7- Communication Timeliness

.60** .47** -.34**

.27* .61** .56** --

Alpha 0.92 0.95 0.94 0.78 0.85 0.84 0.85KRISP Project 16* p<.05, ** p<.01

Study LimitationsVariations in numbers of total

staff & PHN staff at each LHDBudget constraints to

participationWake of emergency

preparedness trainingsSmall sample size and

convenience sample of LHDs reduces generalizability

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DiscussionMost scores similar to benchmarksControl & Decision-Making scores

low indicating more staff involvement

Formalization seems high◦Prescriptive programming◦Incident command system structure enacted months preceding survey

◦Brings into question the degree of professionalism that exists for public health nurses

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Practice Implications Potential for increased job satisfaction◦Introduce shared governance practices◦Build population-focused nursing skills

Work on improving communication◦Has benefits on job satisfaction and work outcomes

◦Improve communication with more written procedures

Use scales to assess effect of changes to work environment, advocate for public health nursesKRISP Project 19

Recommendations for Further StudyLongitudinal study with larger

sample size

Examine relationships between population-focused skills (PHN competencies) & job satisfaction, particularly centralization, formalization, and control

Examine feasibility of implementing shared governance principles in LHD’s

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Thank You!http://krispproject.wordpress.com/

Funded by HRSA Bureau of Health Profession, Division of Nursing, under the Nurse Education, Practice and Retention Program, grant number D11HP14605

KRISP Related Publications Issel, L. M, Ashley, M., Kirk, H. & Bekemeir, B.

(2011, in press). Public Health Nursing Job Descriptions: Are they Aligned with Professional Standards? Journal of Public Health Management and Practice.

Issel, L. M., Bekemeier, B., Baldwin, K. (2011). Three population patient indicators for public health nursing: Results of a consensus project. Public Health Nursing, 28: 24-34.

Issel, L. M., Bekemeier, B. (2010). Safe practice of population-focused nursing care: Development of a public health nursing concept. Nursing Outlook. 58, 226-232.

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