Demystifying job satisfaction in long-term care: The voices of licensed practical nurses
Open Access
- Author:
- Knecht, Patricia
- Graduate Program:
- Nursing
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- February 05, 2014
- Committee Members:
- Paula F Milone Nuzzo, Dissertation Advisor/Co-Advisor
Judith E Hupcey, Committee Member
Lisa Ann Kitko, Committee Member
Janice L Dreachslin, Committee Member - Keywords:
- job satisfaction
job dissatisfaction
LPN
licensed practical nurse
long-term care
nursing home
focus group
nursing staff - Abstract:
- Background. Licensed Practical Nurse (LPN) job satisfaction is a critical issue facing any stakeholder concerned with advancing the health of the nation’s elderly. Increasing job satisfaction and decreasing job dissatisfaction has been found to improve staff retention and ultimately result in improved patient outcomes. Given the aging United States population, the projected nursing (RN and LPN) shortage, predominance of LPNs as the primary licensed nurse in long-term care settings, and the lack of LPN workforce research it is essential to understand the key attributes of LPN job satisfaction and job dissatisfaction in long-term care settings. Purpose. The goal of this study is to examine the attributes of long-term care LPNs’ job satisfaction and dissatisfaction. Methods. A qualitative, focus group study was conducted at six long-term care institutions in the Philadelphia metropolitan area. A purposive sample of 4 to 12 LPNs in each of the six focus groups (n = 37) participated in a 90-minute focus group session. Herzberg’s motivation/hygiene theory (1959) provided the theoretical basis for the conceptual framework for this qualitative study. The focus group methodology allowed the researcher to utilize the collective power of individual and group discussion, resulting in rich data. Data analysis began immediately following completion of the first focus group session and included open coding, condensation, and abstraction. Utilization of member checks, expert verification, and maintenance of an audit trail contributed to trustworthiness. Results. Four themes including value (sub-themes: value of the “work” itself and recognition), real connection, empowerment (sub-themes: role identity and voice), and growth contributed to LPN job satisfaction and one theme, working conditions (sub-themes: unrealistic workload and equipment) contributed to LPN job dissatisfaction. The dissatisfier, working conditions, was also found to potentially impact the LPNs’ ability to experience job satisfiers, thus preventing improved LPN job satisfaction. Conclusions: This study contributes to the literature by providing job satisfaction and job dissatisfaction data specific to the LPN in the long-term care setting. The four key attributes (value, real connection, empowerment, and growth) of LPN job satisfaction in long-term care settings are congruent with other research findings specific to RN, overall nursing staff, and direct care worker (DCW) populations, and align with some of Herzberg’s (1959) intrinsic motivators. In addition, the job satisfaction attributes identified in this study align with the major tenets of transformational leadership, referred to as the 4 I’s, inclusive of idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration. The depth of understanding of these attributes is enhanced; providing specific details to assist administrators and staff in addressing concepts such as LPN role identity and empowerment and providing opportunities in addition to the RN career path (i.e. specialty certification), thus contributing to LPN job satisfaction. In contrast to Herzberg (1959), only one dissatisfaction attribute, working conditions, was identified. Working conditions, inclusive of unrealistic workload and equipment can impact the LPNs’ ability to achieve overall LPN job satisfaction. The four attributes constitute four pieces of the LPN job satisfaction experience. The job dissatisfaction attribute, working conditions, can prevent the LPN from experiencing job satisfaction. Thus, it will be essential for supervisors/administrators to address issues related to working conditions, allowing job satisfaction to prevail, potentially improving LPN retention, and positively impacting patient outcomes. This is critical to meet the current and future health care needs of the United States’ elderly in long-term care settings.