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Nurses; Job satisfaction; Public hospital; Maternity; Safety

In the technology driven era, both public and private health care facilities have been undergoing significant transformations and changes all over the world [1]. These changes caused health care organizations to continuously redesign and restructure health care systems to survive in a highly.

Competitive health care marketplace. Nurses are the frontline care giver and the quality of their work services plays a significant role of the organization to survive in the competitive market. A study revealed that job satisfaction of nurses plays a vital role for quality care, patient safety, productivity and performance, retention and turnover in the work place as well as professional and organizational commitment [2]. According to a WHO enumeration conducted on January 10, 2022, male and female nursing personnel participation in Bangladesh is 10 percent and 90 percent respectively [3]. Therefore, the importance of recognizing female staff nurses job satisfaction is immense and it is essential to identify the cause and effect of its presence in a health care facility. Job satisfaction is generally defined refers to person feelings of satisfaction on the job, which acts as a motivation to work.

A study defined job satisfaction as a perception of the job by the job holder, who determines level of satisfaction based upon physiological and psychological need [4]. As per Maslow’s hierarchy the human needs ranges between physiological needs and self-actualisation where job satisfaction represents the important component [5]. Job satisfaction is complex phenomenon with multi facets and influenced by the factors like salary, working environment, autonomy, communication and organizational commitment [6]. It can be defined as the integrated set of psychological, physiological and environmental conditions that encourage employees to admit that they are satisfied or happy with their jobs [7]. A study agreed that job satisfaction is very important because most of the people spend a major of their life at their work place. Job satisfaction among nurses has been identified as a key factor in nurses’ recruitment and retention, however, a comprehensive understanding of nurses’ job satisfaction and its related factors remains elusive [8]. The health care providers' satisfaction is directly associated with client satisfaction [9]. A study established that low job satisfaction is the main basis of employee’s turnover among health care service workers [10]. Nursing care is emphasized in the 45th world health assembly in line with 'health strategies for all' and it is stated that providing appropriate working conditions, motivating more nurses will improve nursing services quality [11]. Furthermore, the concept of satisfaction for health care employees has described as a positive feeling of contentment that individuals obtain from their job while working for a corporate organisation. In the context of Bangladesh, there are many studies have been conducted to assess the job satisfaction of nurses in public health facilities. However, the present study is focused on the factors that affecting the job satisfaction of female staff nurses in public health facilities. The study discovered 47.8% female nurses are medium satisfied about supportive activities of the organization. In addition, more than half of respondents (54.6%) are medium satisfied regarding relationship with supervisors and associate colleagues. Furthermore, 36% nurses are dissatisfied with the working environment of the institute. After analysing the factors associated with results, the present study recommends that organization should conduct leadership training and development program for supervisors, superintends and department in charge so that they can practice the right leadership style effectively to alleviate the communication gap between nurses. Furthermore, administrator must review the retention policy of employee as well as follow the govt labour law to maintain the work life balance of female staff nurses so that they can deliver quality full working services to the patients and institutes.

A descriptive cross sectional study was conducted in this study among the female nurses and midwives working at government hospitals. They work as direct patient care providers. A pre tested, semi structured questionnaire was developed. Questionnaires were designed and developed in REDCap software, and a link was provided to the female nurses and midwives at the government hospital. Data were collected through online, self-reported questionnaires. A formal request for respondents to take part in this study and the study questionnaire were placed on the Directorate General of Nursing and Midwifery (DGNM) website. Pre-testing was done by the senior staff nurses of Bangabandhu Sheikh Mujib Medical University (BSMMU). The duration of the study and survey was one month (01-30 November 2022). The survey study questionnaire consisted of three parts:

• Demographic questionnaire.
• Job satisfaction related questionnaire.
• Work environment related questionnaire.

Demographic questionnaire

• The demographic section includes:
• Designation.
• Age.
• Marital status.
• Number of children.
• Professional educational qualification.
• Working hospital location, etc.

Job satisfaction includes:

Factor's affecting job satisfaction: Satisfaction about the duty roster and relationships with colleagues, the departmental in charge, nursing supervisors and the nursing superintendent.

Organization supportive activities affect job satisfaction: Satisfaction with the working department, feeling safe and secure (working in your organization, on night duty, nursing supervisors supervise your work on night duty).

The work environment includes: Female employees have a dress changing room at work. Hand washing station at the workplace, separate toilet facilities at the workplace, separate room for treatment in case of illness, problems with getting weekends off, the problem with getting your leisure leave and allowance, problems in getting maternity leave, problem getting work instructions from supervisors, meetings with supervisors at your workplace.

After completing the online survey, the data were downloaded, cleaned, organized, and analyzed. The incomplete and widely valued data were excluded. Finally, the 1991 participants’ data were analyzed using the SPSS program. Descriptive statistics, including frequency and percentage, were used to describe the participants’ demographic, job satisfaction and work environment responses.

Socio demographic profile of respondents

According to socio demographic characteristics indicated in Table 1, 71.5% of respondents are between the ages of 25 and 34, which indicates that the nursing sector is very popular with younger women in Bangladesh. A smaller number of nurses were very young in their age range of 20–24 years, which was only 1.6%. On the other hand, the percentage of senior nurses was quite minimal, at 17.7%. This indicates that the nursing sector is suffering from the low retention of efficient and senior nurses, which may impact the quality of nursing services. The overall mean and standard deviation are 32.5 ± 7.59, according to the age of the nurses. Table 1 also depicts that 57.1% of respondents have the diploma in nursing science and midwifery. However, there was a lack of higher educated nurses in this sector, as only 2.2 percent of respondents had a master's in nursing. While it is clearly depicted that 89.1% were holding the designation of senior staff nurse, that means there is a huge possibility of senior staff nurses who do not have higher education in nursing. There are 86.1% of married nurses having only one child, which is 44.1%. On the other hand, 32.3% had more than one child, and 23.7% had no child among them. 43.7% of nurses worked in the private sector, while 24.3%worked for the government. In addition, business owners are also interested in nursing jobs in Bangladesh, which is 27.3%. Also, 4.6% were from other contexts and 0.2% were housewives. In the case of working districts, half of the nurses reported that 60.5% were comfortable working in their own or their husband's district. 30.1% of the rest worked in other districts and 9.3% worked i n their husband's other districts. Almost half of the nurses worked in the medical college hospital, followed by 24.4% in the district headquarters/general hospital. The rest worked in Upazila health complex (16.9%), specialized hospital (15.3%), union sub center (for midwives) (1.2%) and other hospitals, which is 0.5%.

Table 1: Socio demographic characteristics of the respondents (n=1,991).

Job satisfaction of respondents based on organizational factors

Table 2 clearly shows that more than one fourth (57.8%) are moderately satisfied with the rostering duty service. Most of them (64.6%) are satisfied with their nursing superintendent in terms of having good communication. There is a communication gap with the colleagues and departmental in charge as well, for it shows medium satisfaction, yielding 42.9% with colleagues and 48.9% with the departmental in charge. The working environment has effects on employee satisfaction. According to the organization's supportive activities, half of the nurses (51.9%) are very satisfied with their current working environment. Safety and security of the working environment might be the reason behind this, as it is showing a 40.1% low satisfaction rate among respondents. More than half of the respondents (54.2%) did not feel safe at all on night duty. The result also shows that 57.4% of respondents are satisfied with the nursing supervisors’ supervision of their work on night duty.

Table 2: Factor’s affecting job satisfaction.

Job satisfaction of respondents based on work environmental factors

Table 3 shows the statistics of job satisfaction of respondents affected by their work environment. The results show the dress changing room at the workplace is available in almost all facilities, which is 97.1%. However, 2.9% of nurses did not have this facility, and 10% did not have a separate toilet. In addition, two twenty (11%) respondents don’t have a handwashing station at their workplace, which indicates that some institution itself is not conscious enough about the hygiene matter. The result of the health care facility for the nurses is shocking. Table 3 shows that in the event of illness among nurses, more than half, or 1,024 (51.4%), do not have a separate treatment room at their workstation. The results show that nurses are facing a massive problem getting their weekdays off as well as leisure leave and allowance. Majority of the nurses (84.4%) and (74.5%) were facing difficulty in this regard. Despite the fact that maternity leave is a labor right for all female employees, the results show that 1,028 respondents, or 61.7%, are denied this opportunity. On the other hand, some supervisors are reluctant to provide instructions to the nurses in some facilities. For, the result shows one hundred and eighty seven, or 9.4%, were not getting proper instruction from their supervisor. In addition, four three eight nurses, or 22%, were experiencing a communication gap in terms of meeting with supervisors in their workplace.

Table 3: Work environmental factors affecting job satisfaction.

The purpose of this study is to identify the job satisfaction of female nurses of Bangladesh. To achieve this objective, the present study used descriptive analysis of female staff nurses working in the government health facilities. After analysis of socio demographic statistics, the study found that 71.4% of nurses are at the young age of 24-34 years old. The overall mean and standard deviation are 32.5 ± 7.59. According to the result of organizational factors and working environment, the person job fit crisis, person organization fit crisis and lack of work-life balance is being revealed which is explicitly connected to employee’s job satisfaction. Person Job (P-J) fit and Person Organization (P-O) fit that are interdependent constructs that influence employees’ work attitudes and behaviours in special ways [12]. Moreover, person-organization fit is related to higher job satisfaction in other work contexts as well [13]. On the other hand, the quality of work life is an extent to which that job performer is satisfied with his/her personal and working needs through participating in the workplace while achieving the goals of the organization [14]. In addition, the quality of work life is expressed as the improvement of working conditions by taking into account not only physical but mental, psychological and social needs of the person. This study also revealed that most of the nurses 59.1% were being less communicative with their supervisors and 64.6% nurses having a poor relationship with their nursing superintendent. Moreover, one hundred eight seven (9.4%) were not getting proper instruction from their supervisor. A study revealed that with good and effective supervision, employees’ satisfaction level was high whereas with poorer communication ability, dissatisfaction level among employees was high. The communication style, relationship between superiors, subordinates and co-workers are strongly connected with the social work environment of an organization which is well defined as hygienic factor of motivational framework. When hygienic variables are not available (like job security, interpersonal interactions, business supervision, oversight level and style, working environment and compensation), the likelihood of employee discontent increases [15]. The current study revealed that 84.4% and 74.5% nurses are dissatisfied regarding getting weekends off, leisure leave and allowance. In addition, 61.7%nurses are facing trouble having maternity leave which might be a reason for employee drop out and can negatively impact the employee’s retention policy of the institute. A study revealed that wages, working time, employee autonomy, organizational structure, and employee management relationships are all elements that significantly affect job satisfaction.

Study of Job satisfaction of nurses has got significant interest to the researchers now a day. However, the factors that are explicitly correlated to the job satisfaction of female staff nurses in Bangladesh are needed to be more focused. The present study discovered that the communication among nurses, supervisors and superintendent is not satisfactory enough which resulting them demotivated regarding serving quality full working services. Also, the female staff nurses are facing complexity having maternity leave, leisure and allowance leave which is one of the main reasons of being dissatisfied and make them inefficient to show their potentiality in an effective mode. In addition, most of the respondents are not feeling safe at night duty in their work station and supervisors were quite reluctant to supervise their work at right time.

The present study suggests that hospitals should follow the labor laws of the Bangladesh government regarding maternity leave and provide associated facilities to female staff nurses. In addition, the administrator must review the retention policy about general leave and allowance of all employees to get an effective and efficient result in the long run. Furthermore, the hospital should provide a leadership training and development program to the supervisors, superintendent and associate employees so that the communication gap between nurses and supervisors can be mitigated. With proper guidance, two way fair and effective communication, and proper maintenance of government policy, the factors that affect the job satisfaction of female staff nurses can be significantly reduced, which may turn them into motivated, efficient, and satisfied female staff nurses in Bangladesh.

Evana Yasmin contributed to conceptualization, database search, analysis, and writing the original paper. Md. Al-Amin Bhuiyan contributed to the database search, analysis, editing, and revision of the original paper. Mohammad Abbas Uddin contributed to the database search, analysis, and writing of the original paper. Naima Siddika RN contributed to conceptualization, review, and supervision. Kabir Hossen contributed to the database search, analysis, writing of the original paper, and editing and revision.

This research did not receive any specific grants from funding agencies (in the public, commercial, or not-for-profit sectors).

All the authors mentioned in the manuscript have agreed to be authors, have read and approved the manuscript, and have given consent for its submission and subsequent publication. The order of authorship was agreed upon by all authors before submission.

This article has undergone peer review.

The authors declare no conflict of interest.

The data sets that support the findings of this study are available on request from the corresponding author. The data is not publicly available due to privacy.

We are grateful to the Directorate General of Nursing and Midwifery (DGNM), Ministry of Health and Family Welfare (MOHFW), Government of the people’s Republic of Bangladesh.

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