Objective:To examine the differences between critical care and medical-surgical nurses on work satisfaction related to autonomy, decision-making, and nurse-physician interaction.
Design: A correlational design was used for a secondary analysis of nurse satisfaction data previously collected by the National Database of Nursing Quality Indicators.
Population, Sample, Setting: The sample was comprised of 1,528 registered nurses (RNs) from 21 acute care hospitals located across the United States.
Variables: The dependent variables used in this study were RN satisfaction with job-related autonomy, decision-making, and nurse-physician interaction. Independent variables included unit type and hospital size in addition to education, years of experience on the current patient care unit, years of experience as an RN, and age.
Methods: Descriptive statistics were used to describe the sample. Pearson correlation identified relationships among the three work satisfaction variables in addition to the demographic variables. The hypotheses were related to associations between the respective work satisfaction variables, and both type of unit and hospital size were tested using analysis of variance procedures.
Findings: Across the sample nurses were moderately satisfied on all three work satisfaction variables. RNs who worked on critical care units were significantly less satisfied than those who worked on surgical, medical, or combined medical-surgical units. Scores on the work satisfaction variables were associated with hospital size and both subjects' experience and age. There were no interaction effects on work satisfaction by type of nurse with the demographic variables or hospital size.
Conclusions: Compared to medical surgical units, the work environment on critical care units is less effective in meeting nurses' expectations of their jobs.
Implications: Given the increasing shortage of nurses, the job dynamics around autonomy, participation in decision-making, and physicians' interaction with nurses are important factors in the work environment. Propositions for action are suggested for staff nurses, administrators, and researchers.
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