Dept. of Nursing, Sahmyook Univ. Hwarang-ro 815, Nowon-gu, Seoul, Korea * Corresponding author:

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1 , pp Comparison of the Influence of Work satisfaction and Job stress on the Turnover intention of Nurses in the General ward and the Comprehensive Nursing Service ward Myung Suk Koh 1, Nam Suk Lee 1, Hyeon Cheol Jeong 1* 1 Dept. of Nursing, Sahmyook Univ. Hwarang-ro 815, Nowon-gu, Seoul, Korea * Corresponding author: love2hc@syu.ac.kr Abstract. The This study has been conducted with the aim of providing baseline data for the enhancement of this policy by identifying the influences inflicted on the turnover intention by the level of work satisfaction and job stress of the nursing in Comprehensive Nursing Service ward, and the General ward. The subjects, the nurses in these wards, 2 hospitals in Seoul and 1 in Gyeoggi region, were given a survey in a self-administered questionnaire form. The study discovered no significant disparities between the variables between the two groups, in terms of the level of work satisfaction, job stress and the turnover intention. In both groups, the level of work satisfaction and job stress had significant influences on the turnover intention. Keywords: Job Stress, Turnover Intention, Work Satisfaction, Comprehensive Nursing Service 1 Introduction The nursing force, which plays a highly influential role in a patient s recovery of health, takes up the largest proportion of the workforce within a hospital, of 30-40%, and are the group with direct influences on the reputation of a hospital and customer evaluation, as they are responsible for many aspects of the medical service. Also, the nursing profession involves being in direct contact with medical consumers and is a critical contributing factor in the quality of service [1]. However the realities of the medical field these days present high severity of diseases even in the General ward and development of new medical technology and equipment has contributed to placing additional pressure, ironically resulting in decrease in work satisfaction and therefore, creating a vicious cycle of increasing turnover rate. Consequently, the nursing force management is coming to the fore in the area of hospital administration. The high turnover rate of nurses places heightened workload upon the remaining nursing force. As a result, the medical organization suffers from many issues ISSN: ASTL Copyright 2015 SERSC

2 including financial loss, fall in quality of patient nursing, low morale among coworkers and decline in the organization s efficiency and productivity[2]. Meanwhile, social changes have occurred and the shifts of structures in population and industry have led to contraction of family size. Such changes in the social structure have led to transformation of method in terms of taking care of ill family member. From family taking care after the patient, to more frequent hiring of a personal nurse and this transition has revealed a number of issues [3]. The Ministry of Health and Welfare, aware of such social issues, launched a prototype service model and began the test operation of the Comprehensive Nursing Service ward from July Despite the initial expansion of the nursing force, in hospitals that have adopted this test operation system, workload of nurses have continuously increased in the process of taking exclusive responsibility for the treatment, inevitably leading to increase in job stress and an upward trend in the turnover rates[4]. Thus this study has been conducted as an attempt to provide baseline data for systematic and stabilized future policy enhancement by identifying the General ward/the Comprehensive Nursing Service ward nurses the level of work satisfaction, job stress and the turnover intention comparing and analyzing the aforementioned factors. 2 Methods 2.1 Subjects of the study This study explained the purpose of the study to nurses working in 3 hospitals which operate the Comprehensive Nursing Service ward, and selected ward nurses who submitted their written consents to participate in the study, with understanding of its purpose. Data collection took place between the dates of December 1 st, 2013 and January 10 th, questionnaires were distributed with elimination rate under consideration, and the final number of subjects for analysis was Tools The level of work satisfaction Work satisfaction was measured using the Index of Work Satisfaction developed by Slavitt, Stamps, Piedomont & Hasse, translated by Kim[5]. The index is a Likert 4 point scale questionnaire consisted of a total of 33 questions and 6 subdivisions. Job stress Measuring of job stress was conducted by a tool developed by Kim and Gu [6], consisted of a total of 43 questions and 9 subdivisions. 134 Copyright 2015 SERSC

3 The turnover intention The turnover intention was measured by the score calculated with the tool developed by Weisman and adapted by Park [7], consisted of a total of 3 questions. 2.3 Date analysis methods The collected data was analyzed using SPSS Ver. 21 program in the following ways. To determine the disparities between the work satisfaction, job stress and the turnover intention of each hospital, independent t-test was utilized in the analysis. Multiple linear regression was applied to the influence of the nurses level of work satisfaction and job stress on their the turnover intention. 3 Results 3.1 Disparity in the level of work satisfaction, job stress and the turnover intention per type of ward Work satisfaction scored an average of 2.43(0.27) for the General ward nurses and 2.43(0.25) for the Comprehensive nursing service ward nurses, displaying no significant disparity. Job stress scored an average of 2.34(0.52) for the General ward nurses and 2.41(0.47) for the Comprehensive nursing service ward nurses, displaying no significant disparity. The turnover intention scored an average of 2.60(0.77) for the General ward nurses and 2.56(0.71) for the Comprehensive nursing service ward nurses, displaying no significant disparity. Table. 1 The differences of variable according to ward types Variables General Ward n=112 M(SD) Comprehensive Nursing Service Ward n=107 t p M(SD) Work satisfaction 2.43(0.27) 2.43(0.25) Job Stress 2.34(0.52) 2.41(0.47) Turnover Intention 2.60(0.77) 2.56(0.71) Copyright 2015 SERSC 135

4 3.2 The influence of work satisfaction and job stress on their turnover intention When multiple linear regression was carried out in the General ward, work satisfaction (t = -5.50, p <.001) and job stress (t = -3.10, p =.002) had significant influences on turnover intention, the dependent variable. This means that the higher the work satisfaction level (B = ) or job stress level (B = -.379), the lower the turnover intention. The explanatory power of these variables, indicating the extent to which they accounted for the dependent variable, was 34.7% (adjr 2 =.347). In the case of the Comprehensive Nursing Service ward, work satisfaction (t = , p <.001) and job stress (t = -3.23, p =.002) also had a significant influence on turnover intention, the dependent variable. This means that the higher the work satisfaction level (B = ) or job stress level (B = -.404), the lower the turnover intention. The explanatory power of these variables, indicating the extent to which they accounted for the dependent variable, was 35.5% (adjr 2 =.355)<Table4>. Table 2. The influence of work satisfaction and job stress on their turnover intention Ward type Variables B SE β t p VIF (constant) <.001 General ward Work satisfaction < Job Stress adjr 2 =.347, F=30.52, p<.001 (constant) <.001 Comprehensive nursing care ward Work satisfaction < Job Stress adjr 2 =.355, F=30.12, p< Discussion and Conclusion The level of work satisfaction in both wards were at 2.43, and was slightly lower compared to nurse practitioner at 2.61 and nurse anesthetist at 2.56 [8]. The low level of work satisfaction displayed in this study might be attributed to the fact that the subject hospitals being public hospitals and the fact that the Comprehensive Nursing Service ward business is a new government project, prone to maladjustment to the 136 Copyright 2015 SERSC

5 administrative system. Thus further pursuit of this issue is recommended in future studies. The level of job stress was at an average of 2.34 in and at an average of 2.14 at the Comprehensive Nursing Service ward. This figure is lower than the one deduced from the study conducted on emergency room nurses, at 2.67 [9]. Such results may be due to the fact that with the introduction of the Comprehensive nursing service, and responsibilities previously performed by the patients guardians were transferred onto the nurses in the ward, and expansion of the workforce was insufficient to prepare for the increase in the work pressure. The turnover intention displayed the score of an average of 2.60 the General ward and an average of 2.56 in the Comprehensive Nursing Service ward. In the study conducted by Park[10], surveying general hospital nurses, the score was at 2.46 displaying a similar result. This trend seems to reflect the gloomy economic climate throughout the society and consequent lack of jobs to move into. Analysis of the influence of work satisfaction and job stress on the turnover intention indicates that in wards, higher work satisfaction or higher job stress results in lower the turnover intention. In particular, institutional remedial measures to prevent nurses in this ward from transferring, is crucial in order for explanatory power for the Comprehensive Nursing Service ward to heighten and the newly introduced system to become well-established For the system to be implemented as an effective health care management system for patients in the future, the nurses work satisfaction and job stress must be taken into account and the system should be developed towards a direction which can satisfy both the patients and their families and the nurses. References 1. Jun, Y. J., Han, G. S., Lim, J. Y., Kim, I. A.: The effects of empowerment on job satisfaction; focusing on followership style. Journal of Korean Academy of Nursing Administration, 11, (2005) 2. Kim, M. J., Park, S. A.: Experiences of Hospital nurses` turnover: Determinants of factors affecting turnover intention, Journal of militry nursing research, 28(1), (2010) 3. You, S. J.: Increasing the use of Nursing staff in Hospitals instead of Relying on Family members` assistance. Research Institute of Nursing Science, Seoul National University, 6(1), (2009) 4. Healthkoreanews, May. 06, Kim, S. N.: A Study of Duty Satisfaction of the Nurses in a University Hospital. Unpublished masters theses, Kyunghee University. (1998) 6. Kim, M. J., Gu, M. O.: The Development of the Stresses measurement tool for Staff nurses working in the Hospital, Journal of Korean Academy of Nursing. 14(2), (1984) 7. Park, S. H.: A Study of the Nurses' Intention of Leaving the Job in General Hospital. Unpublished masters theses, Kyunghee University. (1998) 8. Kim, K. J.: Job satisfaction of Clinical nurse Specialist. Unpublished masters theses, Kyungpook National University. (2004) Copyright 2015 SERSC 137

6 9. Lee, K. M.: Study on Relationship of Work Stress, Fatigue, and Job Satisfaction of Emergency Room nurses. Unpublished masters theses, Chonnam National University. (2003) 10. Park, S. R.: The Relationship between Job stress, Job satisfaction and Turnover of Nurse in General hospital, Unpublished master s thesis, Hnalim University. (2005) 138 Copyright 2015 SERSC