The Nursing Practice Environment and Job Outcomes in Saudi Hospitals

The nursing shortage is a challenging problem globally. In Saudi Arabia, the nurse shortage continues to be a critical problem in all healthcare sectors. International nursing research has shown strong relationships between poor practice environments and unfavorable nurse job outcomes, including job dissatisfaction, burnout, and intention to leave, which often precedes turnover, a leading cause of shortage. However, there is scarcity in this area of research in Saudi Arabia. This study aims to describe and compare the nursing practice environments and nurse job-related outcomes of nurses in two types of hospitals in Saudi Arabia. Additionally, the study aims to test a model that links the nursing practice environment to nurse job outcomes using path analysis. A comparative cross-sectional design was employed to examine a sample of nurses (n=404) from inpatient units in a public and a teaching hospital. A survey instrument was designed that included the Practice Environment Scale of the Nursing Work Index, the Emotional Exhaustion subscale of the Maslach Burnout Inventory, and questions related to job dissatisfaction and intention to leave. Results showed that the nursing practice environment and nurse job outcomes in the teaching hospital were more favorable than those in the public hospital. In the entire sample, approximately half (52.7 %) of the participants had a high level of burnout, 38.7% were dissatisfied, and 25.8% intended to leave within a year. In the public hospital, the percentages were 80.8% burned out, 64.7% dissatisfied, and 33.2 intended to leave as compared to 26%, 15.8%, and 19.2% respectively in the teaching hospital. The results of path analysis showed that both nursing practice environments and hospital type (public vs. teaching) have significant effects on burnout and job dissatisfaction, which in turn increase the intention to leave. Hospital type has also a direct effect on intention to leave. This study presents a good- fitted model that provides a better understanding of the relationship between nursing practice environment and nurse job outcomes in Saudi hospitals. This knowledge will help nurse leaders and policy makers develop retention strategies to improve nursing practice environments and job-related outcomes and to reduce turnover