Introduction
Nurses face numerous challenges at work; in fact, working in a hospital is more stressful than any other work environment, according to a study of 95,499 nurses (McHugh, Kutney-Lee, Cimiotti, Sloane, and Aiken, 2011). Challenges nurses face contribute to job dissatisfaction, burnout, and turnover, which, in turn, effect patient care. For example, McHugh et al. observed patient satisfaction was lower in hospitals where nurses were dissatisfied or burned out. Some healthcare organizations are focusing on spirituality at work and how spirituality of staff affect patient and work-related outcomes (e.g., Beehner, 2016). This study examines sanctification, a facet of spirituality that refers to the sacred meaningfulness ascribed to something (Pargament & Mahoney, 2005), in the context of work to measure how the sanctification of work among nurses impacts nurse and patient outcomes. Specifically, the aim of this study is to determine the relationship between sanctification of work and work-related outcomes (job satisfaction, employee engagement, organizational commitment, job burnout, and turnover intention) among licensed and unlicensed nursing personnel. Evidence about how nurses’ sanctification of work impacts such important outcomes can potentially inform and improve nursing care and retention.
Background
Healthcare organizations continually face the challenges of having engaged, committed, and satisfied staff. Job dissatisfaction, burnout, and employee turnover often threaten nursing staff. These nurse outcomes, in turn, effect patient outcomes. Yet if healthcare organizations can employ satisfied and engaged nurses, it can support them to have a competitive advantage and financial gain (Rich, LePine, & Crawford, 2010). Thus, the construct of sanctification of work--recognized in psychology, but not yet in nursing, provides promise. In the findings from the few studies examining sanctification of work, positive associations were observed between it and work outcomes. For instance, Walker, et al. (2008), Hall, et al. (2012), and Carroll, et al (2014) found associations in different work groups between sanctification of work and organizational commitment, job satisfaction, and turnover intention. This study will not only measure a previously unstudied phenomenon in nursing (i.e., sanctification of work) to determine its prevalence in a sample of hospital nursing staff, but also examine how it explains nurse and patient outcomes.
Methods
A quantitative, descriptive, cross-sectional, correlational research design allowed the researchers to address the research aim. Sample was recruited at a 353-bed, not-for-profit, faith-based, teaching hospital in urban Southern California. Participants were recruited during regular staff meetings or daily huddles. They were incentivized with a $10 gift card. After consenting, participants completed an 82-item “paper and pencil” type questionnaire comprised of eight previously psychometrically supported measures and demographic items. These instruments included the Duke University Religion Index (DUREL), Sanctification of Work Scale, Overall Job Satisfaction Scale, Employee Engagement Scale, Affective Commitment Scale, abbreviated Maslach Burnout Index, and Turnover Intention Scale. Patient satisfaction was assessed through Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data obtained from the hospital’s Organizational Performance Department.
Results/Findings:
The participants included 463 licensed and unlicensed nursing personnel (435 was determined to achieve a power of 80%; response rate was 58%). Of these, 60% were Roman Catholic, 81% were female, and nearly 45% had worked at least five years in the organization. The mean age of the participants was 42. Participants’ rated sanctification of work, on average, as 5.7 on a 7-point scale, suggesting a fairly strong sense of sanctification of work. The linear regression results indicated that sanctification of work significantly and independently explained job satisfaction, employee engagement, organizational commitment. In addition, female respondents tended to perceive work as more sanctified than male respondents.
Implications:
Given findings substantiated that the sanctification a nurse ascribes to work does impact both nurse work and patient outcomes, these results suggest salient implications for nurse clinicians, administrators, and educators. Clearly, how to promote nurses’ sanctification of work must be considered. What interventions, work climates, and educational methods best create within a nurse a sense of sanctification for work? How does a clinician daily or hourly maintain this perception of nursing care as sanctified work? Might nurse recruiters screen potential employees for this quality? Whereas future research and evidence-based practice projects can address such questions, these study findings provide isolated, yet strong evidence that the sanctification of work among nurses does contribute to the critical and continually pursued outcomes of job satisfaction, employee engagement, organizational commitment.
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