What are some societal problems in nursing

Hospitals: what makes nurses dissatisfied

Little time for patients, no appreciation for work: many nurses and carers are frustrated. If hospitals want to attract and retain specialist staff, they have to make working conditions more attractive.

According to current projections by the Federal Statistical Office, there will probably be a shortage of around 112,000 full-time nurses in 2025 in order to be able to cover the need for professional care for the elderly and the sick in Germany. The growing shortage of skilled workers in the nursing sector is already a serious problem for many hospitals. The consequences of understaffing in nursing are usually far-reaching for the hospitals concerned. On the one hand, the cost of recruiting increases. On the other hand, personnel bottlenecks increase dissatisfaction among the remaining nursing staff. This also increases the willingness to change jobs, because the nursing staff in the facilities concerned often have to compensate for understaffing over a long period of time.

Doctors are also directly affected by the shortage of nurses. In day-to-day business, you are responsible for patient care, hand in hand with nursing staff. There is therefore an urgent need for action in German hospitals to counter the shortage of nursing staff with suitable concepts.

Against this background, how can successful personnel management and marketing be designed to attract and retain qualified nursing staff? To answer this question, the Münster University of Applied Sciences carried out a large-scale study in summer 2010 with the support of the Malteser Association and other hospitals. The nursing staff in hospitals and trainees in health and nursing care were interviewed. This was intended to provide insights into job-related needs, satisfaction with the work situation and the behavior of these groups when choosing a job.

Around 3,145 nurses and 740 trainees from the hospital sector took part in the study. They represent a good cross-section of the professional group. The evaluation of the answers paints a complex, sometimes very thought-provoking picture.

Only a third would recommend the nursing profession to others

When asked about the general satisfaction with the decision to have become a nurse, the picture is initially quite positive: Of the nurses surveyed from the hospital sector, around 70 percent are basically satisfied with their career choice; 80 percent identify with their job. Also, 85 percent generally enjoy doing their work; however, only about a third of those questioned would recommend the nursing profession to others.

If you look at the specific job satisfaction, the results of the study paint a negative picture: only about half of the respondents agree with the statement that they are all in all satisfied with their own job and that they consider it to be very attractive overall. But where does this dissatisfaction come from? Where are the starting points for improvement? For this purpose, the respondents were asked to rate their job satisfaction based on central criteria, which can usually be important when choosing and job satisfaction. They should also assess how important these criteria are to them. This shows:

  • On average, 13 out of 38 criteria express specific dissatisfaction. This is greatest with regard to the importance and appreciation of the nursing staff in the hospital (62 percent), the stress (56 percent) and the number of colleagues working on shifts (63 percent). (Table)
  • In relation to the individual job, the most important criteria are: an open-ended employment contract (88 percent), a secure job (88 percent) and good personal contact with patients (89 percent). The denominational orientation of a house, on the other hand, is considered to be the least important (9 percent).

A comparison of the average importance and satisfaction with the individual central characteristics of a job shows that the greatest pressure to act to improve job satisfaction lies in the following characteristics:

  • Earning opportunities
  • Work-life balance
  • personal contact with patients / time for people, shift staffing / staff coverage
  • Appreciation of performance / recognition by superiors
  • The importance and appreciation of the nursing staff in the hospital - and the positioning of the nursing professional group in the company's decision-making bodies.

A further examination showed that the average levels of importance and satisfaction hardly differ between the functional and ward duty.

The majority feel stressed and exhausted

With a view to the perceived everyday working life, more than 50 percent of the nurses surveyed said that they often felt mentally and physically stressed or exhausted from work in the hospital. More than two thirds of the respondents complained that they did not have enough time to complete the tasks and to look after the patient and that the work could hardly be done in the time allotted. The clear majority of those surveyed feel well prepared for their job. Nonetheless, around 40 percent of those questioned complained that they were not well supported by their employer and line manager and that their professional development was not encouraged.

Looking at future expectations, a bleak picture emerges. 70 percent of those surveyed are concerned that they will no longer be able to physically do their job from the age of 55 and assume that they will then be out of work. Except for the development of job security, the respondents generally rate the future of their nursing profession very pessimistically and classify it as unattractive (graphic).

In addition to the nursing staff, 740 trainees were also asked about the most important reasons for the decision to train as a nurse. This should provide clues with regard to specific job requirements and a targeted approach to the next generation. It was shown here that the most important reasons for the trainees are working on people, the opportunity to provide assistance and the interest in medical topics. Recommendations from parents or the continuation of a family professional tradition were viewed as comparatively unimportant.

When asked about the importance of the individual central properties of a job, the trainees showed that a secure job, good personal contact with patients / time for people and a reliable duty roster that enables good planning are of central importance . The job demands of the young generation are therefore close to those of the respondents who are already in the job.

With regard to the possible implications of the study results for the recruitment and retention of nursing staff in the hospitals, it becomes clear that the current situation shows some pressure to act, but also some options for the individual hospitals.

First of all, it can be stated that the respondents' satisfaction with the career choice “caregiver” is largely high. The interviewees have a very positive view of the job profile as such. Unfortunately, the assessment of the individual workplace is much more negative. Against the background of the expected further intensification of competition for nurses on the labor market, there is a clear need to improve job satisfaction in many hospitals. This is the only way for the clinics to protect the existing staff against migration and poaching of competitors from home and abroad. Attractive employers also improve their chances of attracting qualified nurses.

In this regard, the results of the study indicate several concrete starting points with the help of which the satisfaction of the nursing staff can be specifically and specifically optimized. It is by no means just a matter of checking the level of income. Although this has a strong influence on job satisfaction and is currently a frequent topic of public discussion, it is more the social aspects of everyday working life that have a lasting effect on job satisfaction in many hospitals. There are decisive design options for employers in order to successfully attract and retain nursing staff. It is of central importance that the nurses have enough time to care for the individual patient (for example by introducing social hours, reading hours, mentoring models for those in need of care).

Employees are motivated by praise and appreciation

The nursing staff can also be specifically relieved of administrative and non-nursing work, such as sorting materials. The appreciation of the work of the nursing staff in general and their recognition at the day-to-day level must be improved (for example via commendations in everyday life, quarterly employee interviews during the year, gratuity proofs). The hospitals can also ensure the compatibility of work and family - for example through flexible part-time and duty roster models as well as childcare offers.

If the hospitals improve the working conditions and thus the satisfaction of the nursing staff along the identified problem areas and respond to the needs of the employees, their chances of retaining qualified nursing staff increase. This would also have a positive effect on the medical work and the quality of patient care.

  • How this article is cited:
    Dtsch Arztebl 2011; 108 (17): A 946-8

Author's address
Prof. Dr. rer. pole. Holger Buxel
Professorship for service and
Product marketing, Münster University of Applied Sciences
Corrensstrasse 25, 48149 Münster
[email protected]