In largest survey of its kind, nurses say they enjoy interactions with peers the most, pay the least -

In one of the largest samples of its kind exploring various components of job satisfaction among registered nurses (RNs), just over half of respondents indicated they "enjoy" their work (53 percent), while nearly two-thirds (63.3 percent) said they are satisfied with their jobs, a survey by the American Nurses Association (ANA) has found.

In the RN Satisfaction report, conducted through ANA's National Database of Nursing Quality Indicators (NDNQI), registered nurses (RNs) report the highest levels of satisfaction with regard to interactions with other RNs (67 percent), their professional status (65 percent) and career development opportunities (61 percent), and moderate levels of satisfaction with all other job aspects of their jobs, the report noted.

The respondents reported moderate levels of satisfaction regarding interactions with doctors (58 percent), nursing management (56 percent), nursing administration (54 percent), decision-making (47 percent), tasks (47 percent) and pay (40 percent).

Levels of job satisfaction for each category varied somewhat, depending on the unit in which the nurses worked. For example, maternal-newborn and pediatric RNs reported higher levels of job enjoyment than their counterparts working in medical-surgical, critical care, step-down and emergency rooms.

The RN Satisfaction report was based on input from 76,000 RNs from hospitals across the country. The survey was divided into several sections using adaptations of established indexes of work satisfaction and job enjoyment scales.

In addition to measuring job satisfaction, the report contained data regarding quality of care and the management staffing practices of having nurses work overtime and "floating" nurses to other units outside their areas of expertise. Also collected was information regarding nurses' job plans for next year.

In the category of nursing care, participants in general rated the quality of care provided on their unit as "good to excellent." Quality of care was rated higher in critical care, maternal-newborn, pediatric and surgical service departments.

Meantime, 82 percent of RNs reported working overtime, with most respondents reporting that overtime had increased on their unit during the past year, and the highest increases being reported in maternal-newborn units and emergency departments. And, 26 percent of nurses reported being "floated" to hospital units within the past two weeks.

The findings of the ANA study may be useful in developing strategies that increase retention of RNs. Retention strategies are key to stemming the growing shortage of nurses in the United States. A report released in July 2002 by the federal Bureau of Health Professions indicates that if the nursing shortage goes unchecked, the demand for RNs is expected to grow to 2.8 million by 2020 from two million in 2000 (resulting in a 29 percent shortage, up from 6 percent). According to a Hospital & Healthcare Compensation Service survey conducted in 2003, the turnover rate for RNs is 14.6 percent.

The RN Satisfaction report is offered to NDNQI member hospitals primarily through a Web-based response mechanism. The average unit response rate was 64 percent. Participants included RNs in 5,188 nursing units in 206 hospitals located in 44 states. Hospitals ranged in size from less than 100 beds to greater than 500 beds and included non-teaching, teaching and academic medical centers. Forty-three percent of hospitals participating in the RN satisfaction survey have achieved Magnet designation by the American Nurses Credentialing Center (ANCC).

The Magnet Recognition Program was developed to recognize health care organizations that provide the very best in nursing care and uphold the tradition within nursing of professional nursing practice. The program also provides a vehicle for disseminating successful practices and strategies among nursing systems. Magnet status is determined based on quality indicators and standards of nursing practice as defined in the ANA's Scope and Standards for Nurse Administrators (2003).

ANA's NDNQI, a repository for nursing-sensitive indicators, is a program of ANA's National Center of Nursing Quality (NCNQ). NCNQ is the overarching entity that includes a number of projects focused on patient safety, nursing care quality, nurse safety and quality of work life, and the factors that affect these areas. NDNQI is the only national database of nursing-quality indicators containing data collected at the nursing-unit level. In addition to RN satisfaction, other nursing-sensitive indicators being collected for analysis by the NDNQI database include patient falls, patient bedsores, nursing hours per patient day, staff mix, unit type, number of staffed beds, urban vs. rural facilities and others. Currently, more than 700 hospitals, located in the 50 states and the District of Columbia, participate in NDNQI.

For further information please visit the database.

The American Nurses Association is the only full-service professional organization representing the nation's 2.7 million Registered Nurses (RNs) through its 54 constituent member associations. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.