Nurses’ Attitudes Towards Their Job in Outpatient HIV Facilities in Namibia: A Qualitative Descriptive Study

Abstract

Background Nurse attitudes such as job satisfaction and burnout affect nurses’ ability to do their job well. Positive nurse attitudes have been associated with better patient outcomes, while negative job attitudes have been associated with increased nurse turnover and negative patient outcomes. The Job Demand Resource Model theorized that job attitude mediates the relationship between a job’s demands and resources and organizational outcomes. In Namibia’s outlying located hospitals, health centers and clinics, nurses are key prescribers and managers of antiretroviral therapy. It is vital to understand nurses’ job attitudes, factors that contribute to nurses’ job attitudes and how nurses perceive the impact of their job attitudes, in order to best understand how policy makers can empower nurses to do their jobs well. This paper seeks to examine: 1) factors that contribute to nurses’ job attitudes, and 2) how nurses’ job attitudes affect their ability to do their jobs well. Methods This study is a qualitative descriptive study of 18 semi-structured interviews with nurses working in outlying located hospitals, health centers, and clinics in northern Namibia. Interviews were analyzed using directed content analysis, with codes derived from the Job Demand Resource Model. Results Job factors that influence job attitudes included support from coworkers, workload, access to material resources, access to information, and patient rapport. Personal resilience factors included spirituality and emotional awareness. Patient outcomes were reported to shape nurses’ job attitudes by increasing the drive to learn more at work, improve patients’ satisfaction, decrease mistakes, decrease peer conflicts, increase the drive to coach patients on medication adherence, increase focus while at work, and decrease missed nursing care. Conclusions This study’s finding support the importance of investing in factors that promote positive nurse attitudes such as making investments when feasible in human resources (improving support form coworkers), providing material resources, facilitating positive patient relations, and supporting nurses by providing opportunities to increase their knowledge. This study also highlights the importance of nurse resilience against negative job attitudes, coming from intrinsic factors amongst nurses helping them to deal with stress at work.