How Satisfied are Medical Workers with Their Jobs: A Psychometric and Psychoanalytic X-Ray

This reserach study investigated how satisfied medical workers comprising of doctors, nurses and hospital administrators were with their jobs and roles in the hospital setting. The research specifically sort to unveil whether doctors were more satisfied


INTRODUCTION
Locke [3] observed that job satisfaction is an important area in medical work because of the humanitarian values of the profession and the nature of medical work practice which deals with helping patients in stressful situations.
Nevertheless, within the profession of medical work, there is less research on job satisfaction as conceptualized by [3]. This explains why job satisfaction is particularly relevant for the present day medical employees working in government hospitals.
Between the years of 2010 to 2014, doctors and nurses in Nigeria have embarked on several strike actions that have crippled medical care in the government hospitals and left patients stranded and several lives lost due to the failure of government to improve pay, working conditions and other incentives which are the pivot and indices that drives job satisfaction.
[4] discussed 10 ways to end doctors' strikes in Nigeria (www.vanguardngr.com) Wilde [5] studied Job -satisfaction and Burnout among intensive care unit nurses and physicians. The samples for the study comprised of 16 physicians and 129 nurses drawn from an intensive care hospital facility. The result revealed that mean job satisfaction among nurses was 43.9% while the mean job satisfaction of physicians was 51.6%. From the findings of the study it was obvious that the medical doctors were more satisfied with their jobs than the nurses.
Unni et al. [6] carried out a research on predictors of job satisfaction among doctors, nurses and auxiliaries working in 11 Norwegian Hospitals. The total N of the samples was 1,814 while a linear regression model was used for data analysis. Results of the research showed that professional development was the most important source of job satisfaction for doctors, support and feedback from superiors was the most important source of job satisfaction for nurses, and professional development was the most important source of job satisfaction for auxiliaries and local leadership. Persefoni [7] worked on motivation and job satisfaction among medical and nursing staff in a Cyprus public General Hospital. The participants in the study were 67 doctors/dentists and 219 nurses. From the findings, the medical doctors/dentists showed statistically significant lower job satisfaction compared to the nursing staff.
[8] carried out a research on Nurse-Physician relationships: Impact on nurse satisfaction and retention. The sample for the study was 1,200 respondents made up of nurses, physicians and hospital executives. The result of the study revealed that daily interactions between nurses and physicians strongly influenced nurses' morale and satisfaction. Nurses were least satisfied with their jobs compared to the physicians and the hospital executives.
Adams and Bond [9] used a sample of 834 nurses in England for their study. It was discovered that individual nurse characteristics were found not to be associated with job satisfaction. Also a weak association was found between grade and job satisfaction. Duanne et al. [10] utilized a sample of 2,220 health workers in their research. Participants completed a 10 item job satisfaction scale, multiple regression was used to identify significant predictors of job satisfaction and intent to leave. The results showed that there were statistically significant differences in job satisfaction and intention to leave between the three countries. 52.1% of health workers in South Africa were satisfied with their jobs compared to 71% from Malawi and 82.6% from Tanzania.
Alison [11] reported a staff care survey of 222 NPs on behalf of the American Nurse Practitioner Foundation (ANPF). The results showed that 100% of those questioned said they have positive feeling about being a NP, and 99% said they are positive and optimistic about the future of their profession. When rating their professional morale, 98% said it was positive. Those results are significantly higher than what physicians have reported in similar surveys. In a merit Hawkins survey, only 13% of physicians said they feel optimistic about the future of medicine and only 32% said that they feel positive about their profession. [12] used a sample of 438 nurses in the research. Data was analysed using descriptive and inferential statistics. Nurses reported that they were "moderately satisfied" in their jobs with "neutral" opinion about their retention.i.e not bordered if they are retained or not.
Shaher [13] studied a sample consisted of 181 nurses from all mental hospitals in Jordan. Data was collected with the Burnout Inventory and analysed using the correlation design. Results showed that scores of job satisfaction and social support were slightly higher than the midrange. Significant correlations were found among burnout categories, job satisfaction, social support and work related variables. Patricia [14] studied the nursing staff of a hospital on the relationship of nurses job satisfaction to their professional practice. Results showed that recruitment and retention of staff nurses was determined to a large extent by nurse satisfaction with work. Professional practice, positive interactions with physicians, autonomy, and strong manager and peer support were highly satisfying to the nurses. Control and shared governance highly correlated with job satisfaction.
Valda [15] assessed the differences in job satisfaction of nurses employed in magnet and non-magnet hospitals, using a sample of 305 nurses. The results showed that nurses employed in the magnet hospitals experienced higher job satisfaction than those employed in other US hospitals. Buerhaus et al. [16] carried out a health survey in England, Canada, Scotland and Germany. The results of the research revealed that 41% of hospital nurses were dissatisfied with their jobs, 22% planned to leave due to over work, verbal abuse and lack of administration's concerns Buch [17] sampled 252 health workers (36 doctors, 216 nurses and technicians, 74% females and 26% males) and examined the factors associated with their job satisfaction. Results showed that respondents were least satisfied with salary and incentives = 24%, benefit packages = 25.1%, equipment = 35.7%, environment = 41.8%. The average satisfaction score was moderate across the four domains. Medical doctors had more satisfaction than nurses and technicians.
From the literature examined, it becomes obvious that in some findings, doctors were more satisfied than nurses with their jobs while in some other studies, nurses were more satisfied than doctors. Furthermore, the researches carried out in this area were mainly from European and Asian countries. The dearth of research in this domain in African and Nigerian Health facilities therefore makes this research effort imperative. The objective of this study and the questions this study will attempt to answer is to discover whether doctors in Nigeria are more satisfied with their jobs than nurses and hospital administrators or vice versa.

HYPOTHESIS
There will be statistically significant differences in the levels of job satisfaction of doctors, nurses and hospital administrators employed in a hospital setting.

Participants
The subjects utilized in this research were (120) medical personnel consisting of doctors, nurses and hospital administrators drawn from a University Teaching Hospital facility in Southern Nigeria. The breakdown of the subject were as follows: doctors -40, nurses -40, hospital administrators -40. The mean age of participants was 47 while there were 62 males and 58 females. All participants were married and volunteers from a population of 50 medical doctors, 135 nurses and 60 administrators (245 medical workers)

Instrument
The instrument used for measuring job satisfaction was the Job Descriptive Index developed by [1]. This scale was chosen because of its demonstrated reliability and its wide use in measuring job satisfaction in Nigeria and abroad. The reliabilities of the scale were r = .83 [1] and r.93 [2]. The scale is made up of 72 items, layed out in five sections: the work, supervision, promotion, pay and co-workers. The instrument has a two point scale of Yes or No, and any question answered right attracts a score of 1 while a question answered wrongly attracts a score of 0. The highest score in the scale is 72 i.e high satisfaction and the lowest score 0 i.e low satisfaction.

Procedure
The subjects were selected through simple random sampling and the instrument administered to them at their work locations.

Design
The design employed in the analysis of data was the TxS ANOVA design.

Statistics
The statistics employed in the analysis of the data was the one -way ANOVA for equal sample sizes. The F-test was used for the purpose of the interpretation of the results.

RESULTS
From the results in Table 1 above, it could be seen that the finding is statistically significant [F(2,117) = 13.9, p<.05]. This means that there is low job satisfaction amongst the medical workers generally. More specifically however, the findings revealed that nurses had a higher level of job satisfaction than the doctors and the administrators. Furthermore, the level of job satisfaction of doctors was higher than that of hospital administrators who recorded the lowest level of job satisfaction.  The job satisfaction levels of doctors, nurses and administrators were made vividly clear from the table of Means. It could be seen that nurses had the highest level of job satisfaction, followed by the doctors, while the administrators had the lowest level of job satisfaction.

DISCUSSION
The results of this study has shown that nurses derive more satisfaction from their jobs than doctors. This could be as a result of the fact that nurses are trained as care givers. Since this is the fundamental principle behaind the nursing profession, the nurses naturally find fulfilment in caring for others as their roles since all about medical practice is care giving and helping the sick to recover. The findings of this study is in line with the findings of [9,15].
On the other hand, many take to the medical profession as doctors, as a symbol of status and prestige and not necessarily because they care about saving lives. In Nigeria, medicine is one of the most competitive courses to gain admission into Universities, the motive being to qualify and answer a doctor, earn better than other medical workers and be accorded high respect.
The hospital administrators reported the lowest level of job satisfaction because they find it difficult adapting to the hospital as their daily working environment.

CONCLUSION/RECOMMENDATION
In conclusion, the implication of this study is that anybody coming in to work in the hospital setting as nurses and doctors or hospital administrators should first see themselves as care givers helping the sick through their various roles to get well. The development and use of appropriate psychological tests to identify this motive during recruitment should be the mind stay of psychologists all over the world. This is important because any hospital full of medical workers without job satisfaction can never give their best to the sickly and dying who are in dire and critical need of help.

CONSENT
It is not applicable.

ETHICAL APPROVAL
It is not applicable.