Nursing culture, communication rules and job satisfaction in geriatric long stay wards
Shaw, Fiona E.
An exploratory, descriptive questionnaire survey was conducted in wards providing continuing care for elderly people, to describe nursing staff perceptions of ward culture and its relation to job satisfaction. The study was designed to answer three principal research questions: 1. To what extent are management practices in geriatric long stay wards perceived as participative (open) by nursing staff? 2. Is the degree of ward openness positively associated with nursing staff levels of job satisfaction? 3. Are perceptions of ward openness and levels of job satisfaction related to nursing staff grade? Study participants were recruited from 79 wards in two mainland health boards to provide a stratified random sample of 474 nursing staff, comprising first level nurses, second level nurses and nursing auxiliaries. The study was based on a communication rules approach to understanding organisational culture. Likert's (1961) description of a hypothetical 'participative group' management system, where there was free flow of information, participative decision-making and high job satisfaction levels was used to develop a 30-item 'Communication Rules' questionnaire to assess nursing staff perceptions of management 'openness' in geriatric long stay wards. Quinn and Staines' (1979) Facet Free Job Satisfaction Test was used to assess levels of job satisfaction among ward nursing staff and the relationships between staff grade, perceptions of openness and job satisfaction were explored. Ward members mean 'openness' and mean 'job satisfaction' scores were used to provide simple indices of 'ward openness' and 'ward satisfaction' in order to explore differences among wards. The majority of wards were perceived as open; the score differences between those wards with the highest and those with the lowest openness indices were statistically significant. A positive association was found between ward openness and staff job satisfaction. Further, ratings of openness and levels of job satisfaction correlated positively with respondents' reports of the frequency of 'good days', negatively with 'bad days'. Openness ratings and levels of job satisfaction were also associated with nursing staff grade. Through advances in organisation theory that include 'culture' concepts, the 'communication rules approach' provided new insights about nursing staff perceptions of ward openness and its relation to levels of job satisfaction. Further, in-depth research on the relationship between ward openness and nursing staff job satisfaction is recommended. The implications of the study for information sharing, decision-making, change management, education and nursing practice are considered. It is recommended that the findings should be used to guide future approaches to nursing management and skill development in the nursing care of elderly people in long stay wards.