An Investigation On Nurses' Burnout, Job Satisfaction And Intent To Leave In Jiaxing Area

Background:Shortage of nurse is a worldwide problem. It was reported that there is an increasingly serious shortage of registered nurses in USA, predicted the demand for nursing services will exceed the supply by nearly 30% in 2020; UK is also experiencing a serious shortage of nurses. Canada, Germany, and even New Zealand and other developed countries, are suffering the same issue. In China, National statistical report from the Ministry of Health offered by the Center for Health Development in China 2003-2007 briefing pointed out that registered nurses per thousand population rose from 1.00 people to 1.12 in mainland China, by 2007 the average ratio of nurses and beds was 0.38:1, however, have not yet reached the standard of the Ministry of Health in 1978.Nursing resources are insufficient in Jiaxing area too. By the end of 2007 the total number of registered nurses was 5583,1.66 nurses per thousand people, the ratio of nurses and beds was about 0.34:1. The shortage of nurses to a certain extent affects the quality of care and patient satisfaction, restricts the further development of the nursing profession. What is the reason caused nurses to leave? The current focus for nursing administrators is to improve nurse satisfaction and reduce nurse turnover. It is expected that based on this study, strageties for further intervention might be proposed so as to improve physical and mental health, alleviate the nursing burnout, enhance the job satisfactionand reduce nurse turnover.Objectives:To investigate the status of nurses'health functioning, burnout, job satisfaction and intent to leave in GradeⅡLevelⅠhospitals in Jiaxing area, and analyze the relationship among job satisfaction, burnout and intent to leave, and to analyze factors influencing job satisfaction and intent to leave.Methods:A total of 2010 nurses from 11 GradeⅡLevelⅠhospitals were investigated by questionnaire which including Medical Outcomes Study Short From(SF-8), Maslach Burnout Inventory(MBI), Warr Job Satisfaction Scale of nurses and Michael Intent to leave Questionnaire(ILQ). The Statistical Package for Social Sciences (SPSS15.0) software was used to analyse the data, including descriptive analysis, t-test, one way ANOVA, Pearson correlation analysis, Binary logistic regression analysis and multiple linear stepwise regression analysis.Results:The findings showed that nurses health functioning score was 74.41±11.51, With 86.4% nurses reporting varied degrees of body pain,50.1% had affected social activities,79.8% reported different levels of emotional distress that affected their daily work, study or activities, 64.7% of nurses have different levels of sleep disorder problems (difficulty falling asleep, early awakening or more awake, etc).The emotional exhaustion score of nurses was 22.08±11.47, depersonalization was 6.81±5.71, reduced personal accomplishment was 29.64±10.30. It showed moderate levels of Emotional Exhaustion and Depersonalization, and low levels of Personal Accomplishment.The results also showed that the total score of job satisfaction was 48.40±7.88, with working condition subscore as 30.31±5.94, Work relationships 18.08±2.65.78.5% of nurses satisfied with relationship of colleagues,71.5% satisfied with their direct supervisor,53.6% satisfied with the relationship between leadership and subordinate, however only 13.4% satisfied with nursing income. About 39% of the variance in job satisfaction could be explained by the set of independent variables including burnout, health functioning and personal characteristics of nurses(R2=0.388). Emotional exhaustion had the strongest impact on job satisfaction, which explained 28.5% of the variance, followed by health function and low sense of accomplishment (6.4% and 1.9% in respectively).The total score of intent to leave was 14.74±3.24, the value of index was 61.42%; The highest scores were intent to leaveⅢ(possibility of receiving other job), the index value reached 69.5%, followed by intent to leaveⅠ(possibility of resign) andⅡ(motivation of searching for other job opportunity). About 11.4% of the nurses often considered resigned from current job,19.4% of the nurses were seeking other job opportuneities. About 30% of the variance in intent to leave could be explained by the set of independent variables including burnout, job satisfaction health functioning and personal characteristics of nurses(R2=0.303). Emotional exhaustion had the strongest impact on intent to leave, which explained 15.7% of the variance, followed by work experience and job satisfaction (7.3% and 4.9% respectively). The main reason of considering leaving nursing job was the high working risk, followed by low pay, unsatisfied working conditions and health reasons and so on.Conclusions:Health functioning among nursing staff in Jiaxing area was low, burnout and depersonalization was in the moderate, Nurses perception of achievement from work was generally at a low level, Job satisfaction was at a medium level. The important influencing factors were burnout, health functioning and shift work. The intent to leave rate was on a relatively high level, thus nursing team was in an unstable state; Factors affecting intent to leave rate including personal and professional characteristics, burnout, job satisfaction and health functioning. The higher job burnout, the higher turnover rate. The lower job satisfaction, the higher turnover rate; Health functioning of nurses was also an important variable affecting intent to leave.The possible top four reasons for nurses leaving were high working risks, low rewards, unsatisfactory working conditions and health reasons. For the nursing staff job satisfaction, intent to leave rate status and influencing factors, effective intervenetions should be taken, such as strengthening the nursing manpower allocation; improving the economic and social treatment of nurses; emphasizing supernumerary nurse team-building; establishing security mechanisms to control nursing risks; training specialist nurses, providing professional development opportunities for practice, bringing into full play the enthusiasm of the work of nurses; emphasizing physical and mental health of nurses to improve nursing job satisfaction, so as to reduce turnover rate, stable nursing team, ensure nursing quality and safety of care.