Research Into Job Satisfaction Among Nurses

Research Into Job rapture Among NursesNurses in more or less wellness shell out facilities be possessed of some of the highest levels of direct enduring contact of whatsoever employees. Nursing force plays an essential role in achieving organizational goals and providing high quality fright to the community. Hospitals ar important health care and social system where nurses are the cornerstones for their frameiveness and efficiency. Many of the nurses even take on the responsibilities of the medical supervisors or the doctors in command, and this makes them a very(prenominal) important commence of the medical system (Inter issue Council for Nurses, 200) Devoid of people, organizations set up non reach their goals. (Drucker, 1999). risque nurse disorder can impact negatively on an organizations capacity to find patient pauperisations and issue quality care (Gray and Phillips, 1996 Tai et al., 1998 Shields and Ward, 2001). At the nurse unit level, high turnover affects the morale of nurses and the productivity of those who remain to provide care while new staff members are hired and orientated (Cavanagh and Cofn, 1992 Sofer, 1995). Jones (1990a, b) dened breast feeding turnover as the process whereby nursing staff leave or transfer within the hospital setting. This denition Includes intentional and unintentional, as well as internal and external turnovers. Voluntary and involuntary turnovers are not always peremptory in studies because costs are incurred regardless of whether staffs resign or are requested to leave. According to L.J. Hayes et al(2008) turnover is a product of bloodline enjoyment and commitment and can lead to nursing shortage.Nursing shortage and high rates of nurses turnover has become a prevalent global issue (Kingman, 2001). The nursing shortage has a vital effect on healthcare system because of its negative impact on both preventive and curative care. For example, in evolution countries, fewer nurses have been lendable for providing immunizations and prenatal care. Hospitals in many industrialized and developing countries have been forced to close units when nursing staff has not been procurable (Oulton, 2006,cited in sianze,Malvarez (2008).Shortages can be a symptom of low theorise satisfaction, piteous management and lack of organizational support (Zurn et al., 2005). Shortages are resulting in laboured field of studyload, which is a precursor to excogitate render, and burnout, which have excessively been linked to low phone line satisfaction. Nurses job satisfaction is an elusive concept, which is defined within its extrinsic and innate determine (Cowin, 2002 cited in Masroor A.M., Fakir M. J 2010). Job satisfaction is an essential element that has strong effects on patient safety, productivity, and performance, quality of care, retention and turnover (Cavanagh and Cofn, 1992 Blegen, 1993 Irvine and Evans, 1995, Murrells, T., et al, 2007). Job satisfaction refers to over altogether po sitive feelings towards a job. It is defined as, Pleasurable or positive emotional state resulting from the appraisal of ones job experiences (Locke, 1976). What in foothold of job satisfaction counts the attitude of an employee towards his job? Attitude is a point of view of an idiosyncratic towards an object. The object whitethorn be anything, such as, an organization, a manager, a colleague or a job. What is important about attitude is that people make decisions based on their attitudes.When employees are satisfied with their job, they slant to stay in their job. On the other hand, people who are not satisfied with their job tend to take a decision of submitting their workplace. Workers with positive attitude are probable to be productive and useful in the organization whereas those with negative attitude have wretched performance and ultimately less productive (Abu Ajamieh, A. R, 1996). Satisfied employees tend to be more productive, creative, and committed to their indu stry, and recent studies have shown a direct relation amidst staff satisfaction and patient satisfaction in health care organizations (Al-Aameri, 2000). The entire employee wants to be satisfied at their job no matter what activities they are engaged in or have the allow for to admit out. The significance of job satisfaction arises from the fact that the nurses whom job satisfaction is positive are not only pleased and happy within themselves but in any case affecting the quantitative and qualitative outcomes of the health organization in a positive way. Quite the opposite, the dissatisfied nurses are not peacefully pleasured resulting in hapless performance, increased absenteeism, tardiness, burnout, turnover and qualitative and quantitative negative outcomes for the health care system.Nurses shortage and Job satisfaction should be of primary concerns to the health managers because nurses take the debt instrument of many positions in the hospital and their turnover would have great impact on the employers and the patients as well. The shortage of nurses has been well recognized and extended to the long-term care services (Fletcher, 2001 Mark, 2002 Mitchell, 2003) Cited in MH 2008. In response population harvest, health care organizations are facing problems in finding and keeping skillful nurses (Gohen Van Nostrand, 1995 Kassner Bertel, 1998). High nurse turnover and vacancy rates are affecting access to health care (Best Thurston, 2004) Cited in MH 2008. Continuously hiring new staff is costly and recurrent turnover influence the morality of nurses and vitiates patient care (Sofie, Belzar, Young, 2003) Cited in MH 2008. The increasing rate of turnover resulted in unfavorable physical and emotional effects on nursing home residents, leading to a greater incidence of falls, medication errors, fear and anxiety, and feelings of hopelessness (Best Thurston, 2004 Sofie, Belza, Young, 2003).Background and significanceThere are five governmental school s of nursing spread overall the United Arab Emirates (UAE). Three of them are called Institutes of Nursing (IONs) governed by the Ministry of Health (MOH). The IONs offer a Diploma layer and cover the Yankee Emirates. bit the Higher College of Technology and the Institute of Applied Technology which are controlled by the Ministry of Higher Education in both of Abu-Dhabi and Al-Ain graduate nurses holding Bachelors degree of nursing science. The period of sight in the IONs is three years. All of the graduates are female Emiratis and expatriates and the number of graduates in the northern emirates is relatively higher that of Abu-Dhabi and Al-Ain cities.Despite all such number of graduates, the UAE like the other countries is in severe shortage of nurses relate to high rate of turnover. The UAE is need for 30,000 nurses and midwives, only 23000 are available which agent that the shortage is 7000 (Underwood, M, 2010). According to the MOH-secretary of the Nursing and Midwifery Co uncil, low remuneration, low status and limited career development are all factors influencing the shortage. Therefore, the UAE must hire up to 25 to 30 per cent 7000 nurses to overcome the shortage of nursing staff. Dr. Rifaai (2010), the Head of Federal Nursing Department, referred the shortage of nurses and midwives in the UAE to the perceived low status of the profession. The Emirati nurses key only 4% of the total population (UAE-MOH, cited Underwood, M, 2010) which does not run in parallel with the demographics population of the country.The serious nursing shortage has prompted the MOH-UAE to start a national call for to identify the factors that could lead to a better workplace at the governmental hospitals. This study was in response to a previous buffer study funded by the Ministry of Health called Thinking Magnetism which revealed that low wages and Lack of autonomy to make decisions are the primary reason for nurses dissatisfaction (Khaleej Times, 23 November 2009). Th e outcomes of the study cloud the government to start looking carefully after these phenomena particularly when the pilot study, the magnet indicators showed very low scores for ministry hospitals as contrastd with the States magnet hospitals. The indicators canvass nursing contribution in hospital affairs nursing foundation of quality of care ability of nurse manager, leadership staffing resources and nurse-physician relationship. Among the 14 urgent requirements identified, the pilot study recommended part- beat jobs flexible recruitment promotion policies, and competitive salaries. Involvement in decision-making and encouragement of a healthy nurse-physician relationship was also suggested. Expatriate nurses working in the government hospitals demanded equal treatment with UAE nationals and placements according to qualifications. Suliman, A.B., (2006), stated in his study that staffs perceptions of fairness are largely based on comparison. For instance, employee may compare t heir payment, working hours, and incentives. If the comparison is positive, they are likely to feel positive toward their organization. Conversely, if the result is negative, they will react negatively toward the system and may challenge and oppose it. Consequently, the employees may intent to forsake their job.The finding of this study may help the health care managers and policy makers to develop and institutionalize targeted nurse recruitment and retention strategies by taking into consideration the prognosticators of nurses dissatisfaction and turnover.The significance of the problem and the absence of related researches and statistical data about the level of nurses satisfaction, and the factors that contribute to turnover give the urge to study these phenomena.Statement of PurposeThe aim of this research is to Explore the relationship between job dissatisfaction and turnover among registered nurses in the governmental hospitals of UAE.Find relationship between private/ dem ographic variables and job satisfaction among the registered nurses in the Governmental hospital in the UAE.Give the nursing managers in the UAE hospitals clear indicators towards improving the nurses job satisfaction, retention and lessening of turnover rates.Research questionsThis research is intended to answer the following questionsWhat is the relation between dissatisfaction factors to turnover?What is the relationship between demographic variables and job satisfaction? literary works ReviewTheoretical FrameworkJob satisfaction is multi-faceted with many definitions and theoretical frames. According to Spector (1997), Job satisfaction is the most important variable that is frequently canvass in organizational behavior research. In addition, the fundamental variable in both research and theory of organizational phenomena were ranging from job design to supervision. Moreover, the traditional copy of job satisfaction focuses on all the feelings that an individual has about his/ her job. Yet, being satisfied or dissatisfied does not rely on the type of the job only but also on the expectations of the individuals from their job.In another definition, Job satisfaction is defined as the degree to which employees enjoy their jobs (McCloskey McCain 1987). Job satisfaction is an pleasant affecting state resulting from the consideration of ones job (Locke, 1976 cited in Brief, A. P., Weiss, H. M. (2001) cited in Wikipedia), an emotional response to ones job (Cranny, Smith Stone, 1992 cited in Weiss, H. M. (2002) cited in Wikipedia) and an sentiment towards ones job (Brief, 1998 cited in Weiss, H. M. (2002) cited in Wikipedia).Researchers usually relate job satisfaction to motivation. Motivation can be defined as an internal process that activates, guides and maintains behaviour over time (Pintrich 2003 Schunk 2000).There are several theories of motivation .The most important theories are Maslows hierarchy of needs, Hertzbergs dual factor theory, and. Vrooms ex pectancy theory. Unfortunately, none of these theories have gained adequate support or shown to be valid as job satisfiers. Nevertheless, they are based on satisfying human needs that address motivation.Maslows theory1954Maslow suggested a hierarchy of needs and connect these needs to motivation. Maslow divided human needs into three categories, the deficiency needs (physical and psychological well being) , growth needs(knowing, appreciating, and catch), and self actualization (ones potential). Maslow pointed out that individuals will not be motivated to the second need until the demands of the first need have been satisfied. Based on Maslows theory, job satisfaction has been approached by some researchers from the perception of need fulllment (Kuhlen, 1963 Worf, 1970 Conrad et al., 1985). The fulfillment of job related needs lead to increase satisfaction as individual moves up in the hierarchy to the highest level. An individual who reaches the self-realization will continue in h is job and becomes more efficient and productive, whereas unfulfilled needs will lead to slimy performance less productivity, work related idiom and eventually job dissatisfaction which might result in turnover.Herzberg Motivation-Hygiene theory (1959)Herzberg presented a dual factor theory. He uses the needs satisfaction to explain job satisfaction. He believed that satisfaction and dissatisfaction were separate and unrelated. Intrinsic factors called motivators (i.e. related to the character and experience of performing work) were found to be job satisers and included achievement, recognition, work itself and responsibility and similar to the growth needs of Maslows hierarchy. Extrinsic factors called hygiene factors were found to be job dissatisers and included organizational policy, administration, supervision, salary, inter ain relations and working conditions to the deficiency needs of Maslow. However, the distinction between motivators and hygiene was not supported by many researches (Cronin-1977 Everly and Falcione, 1976 Gangadhraiah, et al.1990 Hutto Davis, 1989 Joiner, Johnson Crokrean, 1981 Koelbel, 1988 Munro, 1983 Simpson, 1985).Cavanagh (1992 cited in Burnard et al., 1999) noted that these theories attempt to specify particular needs that must be met or values that must be attained (p. 705) if an individual is to be satisfied at work.Figure 1 (Maslows and Herzbergs Ideas Compared, cited in Tiffany Jordan, undated)Vrooms Expectancy Theory of Motivation (1964)Vroom predicts that endeavor lead to increased performance (Expectancy), and performance lead to valued rewards (Instrumentality) and then these values are placed on outcomes (Valence), all three are needed for positive motivation. If either of these factors were absent, performance will be altered to zero (Suliman, 2001). However several researches have supported the principles of the theory (Campbell Pritchard, 1976, Hollenback, 1979, Mitchell, 1974). However, questions remain to whi ch extent an employee can increase his/her efforts about the corresponding organizational structure and decision making processes needed to fulfill the expectations of workers.(Expectancy Theory of Motivation (Undated), cited in Arrod, http//www.arrod.co.uk/archive/concept_vroom.php)Definitions of Job Satisfaction based on the theoriesJob satisfaction is the affective orientation that an employee has towards his or her work (Price, 2001). Specter (1997) summarized the following facets of job satisfaction appreciation, communication, co-workers, fringe benets, job conditions, nature of the work itself, the nature of the organization itself, an organizations policies and procedures, pay, personal growth, promotion opportunities, recognition, security and supervision.DentitionsRelated TheoryThe individual matching of personal needs to the perceived potential of the channel for satisfying those needs (Kuhlen, 1963)Maslows human needs theory (Maslow, 1954Need fulllment, that is, whether or not the job met the employees physical and psychological needs for the things within the work fact (Worf, 1970)A match between what individuals perceive they need and what rewards they perceive they receive from their jobs (Conrad et al., 1985)A function of satisfaction with the different elements of the job (Herzberg 1959)Herzberg motivation-hygiene theory (Herzberg, 1959)All the feelings that an individual has about his job (Gruneberg, 1976)Focus on cognitive process (Spector, 1997)The affective orientation that an employee has towards his or her work (Price, 2001)(Table 1, Dentitions of job satisfaction, Hong Lu, While, A., Barriball, K.,(2004)C. previous(prenominal) Research ReviewC. Previous Research ReviewLocke (1976) defined job satisfaction as a pleasurable or positive emotional state resulting from the appraisal of ones job or job experience. That is, it is the discrepancy between what an employee values and what the situation provides. Job satisfaction is a complex p henomenon. The current global shortage of nurses places of interest the magnificence of understanding the effect and interrelationships of the factors that contribute to nurses dissatisfaction and consequently turnover so that healthcare organizations may implement strategies that help to retain nurses.Sources of nurses job satisfactionSatisfaction has been found to be related to performance within the work environment (Landeweerd and Boumans, 1988, cited in Burnard et al., 1999), so it is not amazing that the notion of job satisfaction has gained much attention. Researchers have assay to identify the different variables of job satisfaction, measure the significance of each variable and examine what effect these variables have on the productivity of the employee (Burnard et al., 1999). A variety of quantitative and qualititative studies have been done on the sources of job satisfaction among nurses and here are the most important findingsAiken et al. (2001) found in his global stu dy in a sample of 43,329 nurses working in adult acute hospitals that job dissatisfaction among nurses was highest in the United States (41%) followed by Scotland (38%), England (36%), Canada (33%) and Germany (17%). One third of nurses in England and Scotland and more than one fth in the United States have intent to quit their job within 12 months of data collection. More striking, however, was that 27-54% of nurses less than 30 years of age intended to quit within 12 months of data collection in all countries. Opportunities for the development were the reason behind the satisfaction of the nurses in Germany (61%) while salary was the satisfier for the nurses in USA (57%) and Canada (69%).Similarly, Adamson et al. (1995) found that British nurses were more dissatised than Australian nurses. He pointed that the wretched insight of master key status, insufficient relationship with hospital management system and indecorous working environment, were found in British more than Austra lian nurses. Professional organization and work design, conict between the newly gained experience during training and the available one. Furthermore, lack of communication between nurses and physicians, feeling of being not respected by other related health professionals, hospital managers and physicians were a concern to the British nurses. Nevertheless, the perception of autonomy by the Australian and British nurses was nearly the same.Eventually Tovey and Adams (1999) came up with the main sources of nurses dissatisfaction working interactions, mainly those with administration, shortage of staff, professional concerns about poor standards of care and external work pressure. Nolan et al. (1998) found that level of job satisfaction had remained stable. They further found in a sample of 518 nurses that 35% of nurses reported simplification in their level of satisfaction and 69% drop in their morality. Price (2002), using the satisfaction scale of Mueller and McCloskeys (1990a, b) in a sample of 141 nurses found that (58%) were loosely satised with their job. Highest satisfaction was related to co-workers and extrinsic rewards and most dissatisfaction was with the amount of control and responsibility they had and with professional opportunities. Nurses were most satised with annual leave, nursing peers and hours worked (79%, 78% and 76% of respondents) and dissatisfied with compensation for working weekends and control over work conditions and childcare facilities (55%, 55% and 46% of respondents. Using the same scale, Wang (2002) found that Chinese nurses were mostly dissatised with pay and job promotion.Finally, nurses job satisfaction is very essential to organizations as levels of job satisfaction would globally impact the nursing workforce. Sources of job satisfaction are relatively similar, e.g., physical working setting, relations with fellow workers and managers, salary, promotion, job security, responsibility, the recognition from managers and workin g hours.Effects of job satisfaction of nurses on absenteeism, burnout, turnover and intention to quitResearchers have generally found that satisfied employees are more productive and committed to their jobs, whereas dissatisfied ones experience absenteeism, grievances and turnover (Smith 1996, cited in Alamri, 2001).Matrunola, (1996) did not find any signifi pretense relationship between job satisfaction and abscentism in a small sample of 34 nurses which makes its generalization difficult. Borda and Norman (1997) noted a signicant positive relationship between job satisfaction and intent to stay and negative relationships between job satisfaction and frequency of 1 day absence and short-term absence. Sius (2002) indicates that job satisfaction was an important predictor of abscentism. Job dissatisfaction is consistently linked to high levels of stress, burn-out or mental and physical exhaustion (Blegen et al. 1993, Adams Bond 2000, Aiken et al. 2002). wobble (1993) cited in Tzeng 2002), indicated that burnout affects mainly nurses, physicians, social workers and teachers. Burnout seems to be caused by stressful working conditions, disproportional-high efforts (time, emotional involvement, and empathy) and dissatisfaction with jobs. For the goals of lowering professional stress and change satisfaction, social support and improved team cooperation could protect nurses against burnout.There is a vast body of the literature linking job satisfaction in nursing and turnover.Job dissatisfaction has been frequently identied as the reason why nurses leave their jobs (Lum et al., 1998 Tzeng, 2002). Tzeng (2002) has also noted that factors such as indirect working environment (hospitals policies, benets, leisure activities, housing, parking, and vacation policy), salary and promotion as very important but strongly dissatisfying and indicated that job satisfaction is a predictor of turnover. A study conducted in the United States revealed that dissatisfied nurses wer e 65% more likely to have intent to quit compared to their satisfied colleagues (Shields Ward, 2001 cited in Masroor A.M., Fakir M. J., 2010).Gray and Philips (1994) Examined turnover rates and relationship to age and length of service in 342,000 employees from nine staff groups in National Health Service (NHS) and explored that annual turnover rate among all NHS staff 13.6% higher turnover among full-time than odd-job(prenominal) turnover declines with age, are high in rst year of service, remains high in second year before declining. Leveck and Jones (1996) indicated that experience on unit and professional job satisfaction were predictors of staff nurse retention job stress and clinical service were predictors of quality of care. The variable contributing the most was management style. While Davidson et al (1997) in a sample of 736 hospital nurses cited that intent to leave predicted by perception of little promotion, high routinization, low decision latitude and poor communica tion. Lum et al (1998) found among 361 RNs in neonatal and pediatric Intensive Care Unit that Job satisfaction has indirect and organizational commitment has direct effect on intent to quit. Boyle et al (1999) recognized that managers position power and inuence over work coordination had direct link to intent to stay. Instrumental communication, autonomy, and group ropiness decreased job stress and thus increased job satisfaction. Job satisfaction was directly linked with intent to stay. Furthermore, Hemingway and smith (1999) discovered that high work pressure was predictive of greater role conict and role ambiguity, and of more stress from heavy workload. In addition, poor supervisor support was signicantly related to greater stress from heavy workload, and lack of autonomy was related to higher role ambiguity. Larabee et al (2003) proposed that major predictor of intent to leave was job dissatisfaction, and the major predictor of job satisfaction was psychological empowerment. P redictors of psychological empowerment were hardiness, transformational leadership style, nurse/ physician collaboration, and group cohesion. Strachota et al (2003)identified the following reasons hours worked better job opportunity family poor pay and benets poor staffing unsupportive management unacceptable work environment work stress no opportunity for advancement. Duffield et al (2004) added the following causes leaving related to work aspects, structural aspects, professional issues, team support, salary and prestige, employer care, and legal concerns. Turnover has many consequences such as mean cost per RN turnover was $10,198, ranging from $6,886 to $15,152(Jones, 1990b, Waldman et al, 2004)), poor patient satisfaction, risk of infection increased almost 30% and the risk of hospitalization increased more than 80% (Zimmerman et al, 2002). Leiter et al. (1998)cited in Tzeng,2002) concluded that patients, who stayed on wards where nursing staff felt more exhausted or more frequ ently expressed their intention to quit, were less satised with their medical care. This study conrmed the importance of understanding nurses job satisfaction and intention to quit as both concepts, which would contribute to patient outcomes. Moreover, both nurses job satisfaction and patient satisfaction have been identied in the Nursing Report Card for Acute Care (American Nurses Association, 1995) as two of the important nursing quality outcome indicators. Lee et al.s (2003) showed that the most common reasons for nurses turnover were work overload, rotating shifts and conict in interpersonal relationships. A total of 24%, 15% and 35% of variance regarding depersonalization, emotional exhaustion and personal accomplishment, respectively, was explained by the individual characteristics, job stress and personal resources were explained by the predictor variables.Turning to, Cavanagh (1990) indicated that job satisfaction was the determining factor of turnover which could be predict ed by kinship responsibility, promotion, pay and influential communication skills. Wu et al (2000), found a positive and momentous relation between the job stress and intention to quit. This was also confirmed in Yin and Yangs (2002) meta-analysis who revealed that the strongest factors for nurse turnover were job satisfaction, autonomy, advancement opportunity, job stress, pay, group cohesion, marital status and educational level.To sum up, researches from various countries indicate that job satisfaction is a signicant predictor of nursing absenteeism, burnout, turnover and intention to quit the organization and nursing profession.Related factors to job satisfaction of nursesBlegens (1993) meta-analysis found a strong connection between job satisfaction, stress and organizational commitment. Seven variables had strong correlations communication with supervisor, autonomy, recognition, routinization, communication with peers, fairness and locus of control and four variables had very weak correlations age, years of experience, education and professionalism. A causal position of job satisfaction has been tested in the studies of Chu et al.s (2003) among 308 Taiwanese nurses and Seo et al.s (2004) among 353 South Korean nurses, respectively. In this model 11 independent variables included job involvement, positive affectivity, negative affectivity, autonomy, distributive justice, procedural justice, job stress (role ambiguity, role conict, and workload and resource inadequacy, pay, promotional chances, routinization and social support .Moreover, four of twelve structural variables (workload, supervisory support, routinization, and pay) were found to have signicant net effects on satisfaction. Chu et al. (2003) found that six variables had significant impact on job satisfaction routinization, positive affectivity, involvement, negative affectivity, role ambiguity, supervisor support which explain 45% of the variance in satisfaction. Whereas Seo et al. (2004) foun d sevener variables had statistically signicant effects on job satisfaction positive affectivity, supervisory support, pay, routinization, negative affectivity, workload and job opportunity and he found commonsensible fit between the casual model and data all the variables explained 53% of the variance.Interestingly, Packard and Motowidlo (1987) correlated job satisfaction with depression, hostility, subjective stress, frequency of stressful events, intensity of stressful events and anxiety. Knoop (1995) indicated that organizational commitment is positively related to job satisfaction among nurses, satisfaction with work, promotion opportunity, supervision, co-workers and pay among Canadian nurses. Organizational commitment refers to identication with and loyalty to the organization and its goals (Blau and Boal, 1987) which Mowday et al. (1979). consignment is characterized by three factors a strong belief in and an acceptance of the organizations goals and values a willingness to exert considerable effort on behalf of the organization and a strong desire to maintain membership in the organization (Blegen, 1993 Al-Aameri, 2000). Fang, (2001) agreed with the studies of (Blegen, 1993 Al-Aameri, 2000) and cited that job satisfaction was significantly and positively related to organizational commitment, professional commitment, and negatively related to job stress. Organizational commitment has an incremental effect on a professionals intention to leave the organization (Blau and Lunz, 1998). Enhancing professional commitment in nursing has the potential to produce benets for both the individual and their organization (Cohen, 1998 Cohen, 1999). Furthermore, professional commitment is positively related to the job satisfaction of nurses (Lu et al., 2000 Jones, 2000).Lu et al., (2002) indicates that professional commitment is more effective in predicting intention to leave the nursing profession than intention to leave the organization at 9.2 %. Lu et al., (2002 ) added that Job satisfaction was more effective in predicting intent to leave the organization than intention to leave the nursing profession at 8 %. Moreover, role conict and ambiguity are signicantly related to job stress, organizational commitment, job satisfaction and intentions to leave the nursing profession (Rosse and Rosse, 1981).Dailey (1990) found that most signicant predictor of intention to quit was experienced job generate stress symptoms. However, Mitchells (1994) in United State study found that there was not a signicant linear association between a nurses job satisfaction and the correlation between work role values and actual work roles. Yet, the nding that workload has the second largest impact emphasizes the relative importance of job stress in determining levels of nurses job satisfaction. This nding is consistent with the results obtained in other empirical studies which have shown that the job stress variables have negative impacts on job satisfaction (Mathie u, 1990, 1991