Nurses experience two kinds of satisfaction: compassion satisfaction and job satisfaction. Both kinds of satisfaction are said to be multifaceted. They are interconnected by several concepts and highly influenced by various factors that determine the over-all satisfaction, retention, and turnover of nursing professionals in the Philippines whether employed in private or government hospital/community health care facilities.
Compassion Satisfaction, as defined by Stamm (2005), is the pleasure one experiences from being able to do his or her work well. It is feeling positive about one’s own work performance, interaction with colleagues and the satisfaction of contributing to the work force and even to the greater society. Moreover, he also stated that one who has higher compassion satisfaction is found to be more satisfied with his or herself in providing quality care.
Filipino nurses are very much compassionate about their work putting the welfare of their patients above their own. Most Filipino nurses find satisfaction in providing compassionate and high quality nursing care to their patients. Satisfaction mainly relies on the affect, work resources, and self-care which are the primary factors affecting one’s positivity-negativity ratio (Radey & Figley, 2007). In a recent study focusing on the Professional Quality of Life of Staff Nurses in a local tertiary hospital, it was found that majority of the Filipino nurses are highly satisfied with themselves in providing quality care to their patients and maintaining harmonious nurse-patient relationships. Cashevelly (2008) revealed that nurses experience higher satisfaction with good patient relationships. Aklema, Linton & Davis, in a 2008 study, has shown that compassion satisfaction increases as nurses perform their own forms of self-care strategies such us talking with others, engaging in physical activities, and participating in spiritual activities.
Most private hospitals in the Philippines provide for the utmost satisfaction of their patients, a patient satisfaction-centered approach to providing health care services. Public hospitals, on the other hand, rely on government subsidy to maintain hospital operations. Even though the bulk of the government’s budget is devoted to social services, there is still a perceived lack of government subsidy for most state-run hospitals. This, in return, results to inadequate resources, insufficient staffing, perceived lack of support, and poor working conditions. These factors greatly influence nurses’ job satisfaction. Nurses’ job satisfaction has been frequently used as a predictor of retention and has been previously directly linked to turnover rates. One cannot deny then that the Philippines is not one of those countries that equally promote a good practice or healthy work environment.
The Philippines has more than enough nurses, a surplus as Congresswoman Leah Paquiz puts it, which cannot be accommodated because there were never enough job opportunities. The said ‘surplus’ is an upshot of the mushrooming of nursing schools stemming from the great demand of nurses overseas in the recent decades. In the Philippines, jobs are made available not because of the need for such but because there are enough resources to keep the workers in the workforce.
The Philippine General Hospital, the National University Hospital, is but a concrete example as to how the aforementioned factors correlate with job satisfaction and retention. The average nurse-patient ratio is at 1:15, significantly higher than the ideal. Some of the nurses leave primarily not due to compassion fatigue but in search of better opportunities abroad; a mark of job dissatisfaction.
There have been numerous studies linking occupational and personal stress to burnout and job satisfaction (Braithwaite, 2008; Ernst et al., 2004) in nurses. Previous reports revealed that effective personal coping strategies together with the establishment of healthy workplaces can significantly reduce burnout and hence, greatly improve job satisfaction. But in the Philippines, Filipino nurses are adept in utilizing effective personal coping strategies. Ineffective coping hasn’t been a commonly identified problem among Filipino nurses.
In a retrospective study conducted by Kutney-Lee, Wu, Sloane, & Aiken (2013), it was known that a positive work environment (e.g. adequate staffing and support of nurses) has been associated with lower nurse job burnout, intention to leave, and job dissatisfaction. Blegen & Mueller (1987), on one hand, revealed that more promotional opportunities correlate positively with job satisfaction. In general, hospitals that invest in positive work environment for nurses can increase job retention (Van den Heede et al., 2013). In 2005, the International Council of Nurses (ICN) has promoted the positive practice environment, linked to job satisfaction and good patient outcomes, as one of the top priorities to stem the global nursing shortage. Threats to this positive work environment include work-related stress, burnout, and job dissatisfaction. These are not uncommon hazards for nurses and can result in high turnover.
The Two-Factor Theory suggests that satisfaction is related to motivation (e.g. achievement, recognition, advancement, growth, and responsibility) and dissatisfaction is related to hygiene factors (e.g. company policy and administration, supervision, interpersonal relationships, working conditions, pay, status, and job security). The Philippines, since time immemorial, is geared towards providing patient-centered care setting aside the need to improve nurses’ job satisfaction.
The means to resolving the problem lies in the recognition of both motivation and hygiene factors as key determinants to improving job satisfaction and decreasing turnover rates. Philippine hospitals, whether private or government, should work towards the satisfaction of their employees by creating a healthy work environment that promotes advancement, growth, and trusting relationships through the improvement of policies and administrative measures and working conditions, providing just compensation, and ensuring job security. The attainment of these objectives can only be made possible through the collaboration of the different sectors of society in coming up with legislations (including budget allocation) and policies that seek to weave patient and health care professional satisfaction.
The challenge in today’s modern Philippine society is to bridge the gap between compassion satisfaction and job satisfaction wherein both have been previously identified as factors that determine retention and turnover as well as the quality of nursing care that determines patient care outcomes. With a determined workforce, this dream is not far from becoming the reality.
Thank you very much. – Reiner Lorenzo Jarabe Tamayo, College of Nursing, UP Manila
The Philippine Star 8 June 2015