Factors influencing nurses\u27 job satisfaction and retention in public sector tertiary care hospital Karachi

Hospitals are encountering serious dilemma in provision of quality care due to prevailing shortage of nurses. Literature suggests that poor work environment, spoiled working relationships, nursing management support, workload, inadequate autonomy and unstructured organizational policies are the major reason for nurses\u27 job dissatisfaction cited in different studies. A study conducted about nurses job satisfaction identified that the nurses\u27 work satisfaction, patients\u27 satisfaction and quality of care are influenced by global dynamics of healthcare systems. Other studies conducted in developed countries explored that a substantial proportion of nurses in many countries have reported job dissatisfaction, stress and quality care deficits as factors influencing their intention to quit. The findings of one of a comparative study conducted in private and public sectors of Pakistan depict that although nurses are not satisfied with their job but the level of satisfaction and factors for grievances vary. This study is embarking upon an exploration of factors influencing job satisfaction of nurses at a public sector tertiary care hospital in Karachi. Methods: The study was conducted through qualitative exploratory design. The duration of the study was from July to September, 2016 with active data collection in a public sector tertiary care hospital of Karachi through purposive sampling. Study participants were nurses, providing direct patient care .and head nurses in different units of hospital. Data collection was carried out through Focus Group Discussions with staff nurses; Indepth Interviews with head nurses, Key Informants interview with Human Resource professional and HR policy documents were also reviewed. Study Findings: The key findings of the study identified were lack of promotion and career opportunities, lack of in-service education and trainings, professional discrimination between physicians and nurses, high work load and patient load and shortage of staff. Moreover, nurses expect recognition for their work and respect from their working relationships like physicians and supervisors in addition from patients and their families/relatives. Workload and hectic work schedule due to shortage of staff emerged as another key reason for nurses\u27 job dissatisfaction. As most of the time they had to work extra hours due to staff shortage and high patient load but unfortunately, are not rewarded accordingly. Conclusion and policy implications: Factors related to job satisfaction and retention are context specific and varies according to organizational working environment but the factors such as workload and lack of promotion and career opportunities are the common perceived factors for job dissatisfaction. This study has identified some of the significant reasons resulting in nurses\u27 job dissatisfaction and turnover with potential implications for the whole of public sector hospitals in Karachi. The study findings would help policy and health systems stakeholders including those at Federal and organizational level to initiate effective strategies to alleviate these factors leading to reduced shortage and improved retention of nurses