Finally, nurses were not very satisfied with their pay. There is a high discrepancy between importance and satisfaction with pay. According to Stamps and Piedmont (1986), this identifies the need for improvement in this dimension. The possibilities to increase nurses pay depend on national social security budgets and making pay a political issue partly beyond hospitals’ possibilities.
Considering the importance of pay, the clear dissatisfaction with pay and the impact this has on intention to quit, work motivation, and patient care, policy makers must recognize the importance of nurses’ pay as an important factor to maintain high-quality medical services.
The large impact of pay on satisfaction among nurses is not unique to America; previous studies in other parts of the world, such as Asia and the U. S. , have reached the same conclusion (e. g. , Seo et al. , 2004).
Increasing pay will take away the discontent in the medical and care sectors; however, increasing nurses’ work motivation should be attained by improving other dimensions of job satisfaction.
Once an acceptable level of pay is reached, dimensions (such as autonomy, status, and task requirements) related to higher-order motivators (such as recognition) become more important. Our study indicates that a number of other dimensions of job satisfaction are also low.
These dimensions are related more to structural issues and can be adjusted or influenced by management. Limitations to our study are based in our sample, which was a sample of nurses working in three American hospitals that provide general medical services. The limited geographical scope and number of hospitals impedes generalization towards other more specialized hospitals.
Furthermore, the study was cross-sectional with the usual limitations of such methods. Longitudinal research would allow assessment of evolution of satisfaction over time. Conclusion
There have been a number of studies on sources and dimensions of work satisfaction but the relationship with organizational structure is yet unclear. This study contributes by including the three major organizational-structure variables, centralization, specialization, and formalization, in the discussion on nurses’ job satisfaction. The study resulted in several findings. Firstly, specialization is positively related to nearly all dimensions of Stamps and Piedmont’s Index of Work Satisfaction. Secondly, a large part of nurses’ satisfaction is dominated by pay.
Thirdly, nurses’ satisfaction is not endangered by more formalization; our data suggest that formalization does not impede nurses’ involvement in decision-making in hospitals. Furthermore, the importance of decentralization to make employees, and nurses in particular, satisfied is supported. Hence, hospital managers can influence the quality of their services through an increase in nurses’ job satisfaction by more decentralization, restructuring for more specialization, and even increasing formalization.
Finally, interaction between doctors and nurses or interaction among nurses is perceived differently and is influenced by different variables. Therefore, this study contributes to measuring satisfaction by pointing to the necessity to extend Stamps and Piedmont’s model by distinguishing between these two kinds of interaction.
References
A. Adams and S. Bond, (2000) “Hospital nurses’ job satisfaction, individual and organizational characteristics”, Journal of Advanced Nursing 32 (3), pp. 536–543. M. A. Blegen, (1993) “Nurses job-satisfaction: a meta-analysis of related variables”, Nursing Research 42 (1), pp. 36–41.
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