Job satisfaction among nurses working in the private and public sectors: a qualitative study in tertiary care hospitals in Pakistan

Abstract

BackgroundMany low and middle income countries lack the human resources needed to deliver essential health interventions. A health care system with a limited number of nurses cannot function effectively. Although the recommended nurse to doctor ratio is 4:1, the ratio in Pakistan is reversed, with 2.7 doctors to one nurse.MethodsA qualitative study using narrative analysis was undertaken in public and private tertiary care hospitals in Pakistan to examine and compare job satisfaction among nurses and understand the factors affecting their work climate. Interactive interviews were conducted with nurses working with inpatients and outpatients.ResultsAll of the respondents had joined the profession by choice and were supported by their families in their decision to pursue their career, but now indicated that they were dissatisfied with their jobs. Three types of narratives were identified, namely, “Working in the spirit of serving humanity”, “Working against all odds”, and “Working in a functional system and facing pressures of increased accountability”. Nurses working in a public sector hospital are represented in the first two narrative types, whereas the third represents those working in a private sector hospital. The first narrative represents nurses who were new in the profession and despite hard working conditions were performing their duties. The second narrative represents nurses working in the public sector with limited resources, and the third narrative is a representation of nurses who were working hard and stressed out despite a well functioning system.ConclusionThe study shows that the presence of a well trained health workforce is vital, and that certain aspects of its organization are key, including numbers (available quantity), skill mix (health team balance), distribution (urban/rural), and working conditions (compensation, nonfinancial incentives, and workplace safety). This study has identified the need to reform policies for retaining the nursing workforce. Simple measures requiring better management practices could substantially improve the working environment and hence retention of nurses.

The Impact of Training Program on Organizational Effectiveness: A Case Study of Healthcare Organization in Karachi-Pakistan

“…Besides, their knowledge about system running in clinical area would be less than others. Therefore, a study also indicated that trained healthcare working force is crucial in tertiary care hospitals of Pakistan [15].…”

Unpacking the curvilinear relationship between negative affectivity, performance, and turnover intentions: The moderating effect of time-related work stress

“…Overall, the lack of facilities and resources of organizations in Pakistan creates a highly stressful work environment. Especially in view of the country's very high unemployment rates, employees are expected to cope with highly stressful situations in order to survive and thrive (Hamid et al, 2014). As a result of these extreme environmental work conditions, our findings may be somewhat more pronounced than if the study had been conducted in a Western context.…”

“…For example, all four hospitals were public sector nonprofit institutions. In comparison with public sector hospitals in more developed countries, the work context of public sector hospitals in Pakistan is highly stressful because of the scarce resources and high workload (Hamid, Malik, Kamran, & Ramzan, 2014). In addition to surveying public sector hospitals, we also targeted medium-sized companies from the manufacturing and engineering sectors because these sectors play an important role in the provision of employment in Pakistan (Ministry of Finance Pakistan, 2014).…”

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“…Poor salary packages with low fringe benefit also hinder the job satisfaction. As Hamid [6] study identified that the private sector attracts nurses from the public sector as they offering better pay and better working conditions. Salary should be similar for people who performing their work in similar profession and it should be determined through comparing it with the market pay rates.…”

“…Strategy to deal with this problem team comprised of well balance way in term of experience and quantity as well which will help the team to work efficiently. A study done by Hamid [6] shows that "The presence of a well-trained health workforce is vital, and that certain aspects of its organization are key, including numbers (available quantity), skill mix (health team balance), and distribution (urban/rural).…”