Exploring the Relationships between Job Burnout, Job Satisfaction, and Missed Nursing Care Among Staff Nurses

Background: Job satisfaction in nursing is associated with increased nurse retention, better organizational performance, and lower reports of staff nurses’ job burnout. Burnout staff nurses are at greater risk of making mistakes, which can involve mistakes that arise from missing or delayed nursing care. Missed nursing care is a factor that has been related to job satisfaction. Aim: To explore the relationships between job burnout, job satisfaction, and missed nursing care among staff nurses. Methods: Descriptive correlational design. This study was included a convenience sample of 124 staff nurses who were providing nursing care at emergency hospital Mansoura University. Three scales were utilized for data collection namely; Maslach burnout inventory, job satisfaction scale, and missed nursing care scale. Results: The majority of staff nurses had a high level of job burnout regarding emotional exhaustion and depersonalization, but regarding personal accomplishment, the majority of staff nurses had a low level of job burnout. In addition to a moderate level of job satisfaction and a low level of missed nursing care. Conclusion: There was a statistically significant negative relationship between staff nurses’ job burnout and job satisfaction, but staff nurses’ job burnout was correlated positively with their perception of missed nursing care. Recommendations: Nursing managers should develop training programs that will help staff nurses to utilize effective coping strategies toward work stress and burnout, create a safe and healthy work environment with adequate staff and resources to avoid the occurrence of job burnout, missed nursing care, as well as improve job satisfaction among staff nurses. Keyword: Job Burnout, Job Satisfaction, Missed Nursing Care, Staff nurses. Tanta Scientific Nursing Journal( Print ISSN 2314 – 5595 ) ( Online ISSN 2735 – 5519 ) Vol. 21 No. 2 May, 2021 98 Introduction Nursing is a demanding career concerned with extreme facets of health and illness inhuman beings. Consequently, nursing's stressful nature will inevitably contribute to job burnout. Burnout is a mental illness described as the reaction of the body to the failure of the coping mechanisms that people usually use to relieve work stress. Stress accumulation exhausts staff nurses to the point that their energy resources are inadequate to try to overcome the stress of a situation (8,9) . Burnout includes three key aspects; (i) Emotional exhaustion, which refers to the state of physical and emotional exhaustion due to job stress, which is associated with low energy, fatigue, depression, hopelessness and helplessness. (ii) Depersonalization, meaning the interpersonal component of burnout that manifests in unfeeling, hostile attitudes towards others and detachment from treatment and instructions. (iii) Low personal achievement that has been identified as the state of negative evaluation (27) . Burnout is occurring due to prolonged imbalance between a nurse and at least one of the following six dimensions of work; first, workload; unreasonable workload and requirements. Second, control; staff nurses do not have adequate control over the services required to complete or perform their job. Third, reward; the incentives may be economical, social and intangible without enough incentive for the job done. Fourth, community; staff nurses do not experience a sense of supportive relationships with their peers and administrators, contributing to frustration and decreasing the probability of social support. Fifth, equity; staff nurses who experience occupational unfairness, workload inequity, and compensation. Finally, values; staff nurses feel constrained by their work to behave against their own values and expectations or when contradictions between the values of the organization are experienced (10,13) . Burnout described as physical and emotional exhaustion that occurs from exposure to continuous stress. Emotional exhaustion can associate with physical exhaustion. Burnout may be harmful to the staff, organization and patients. Exhausted staff nurses are risk for health problems, psychological damage, a decrease in the sense of personal achievement and work dissatisfaction. Negative outcomes of burnout syndrome on personal level are high blood pressure, and cholesterol, tachycardia, abdominal Tanta Scientific Nursing Journal( Print ISSN 2314 – 5595 ) ( Online ISSN 2735 – 5519 ) Vol. 21 No. 2 May, 2021 99 disorders, cold and exhaustion, physical and psychological symptoms, decline in trust and self-respect, unhappiness, work dissatisfaction, depression, anxiety, agitation, failure in communication and family related issues. Organizational effects caused by burnout syndrome include a decrease in service quality, absenteeism, poor morale, desire to leave work, and increased nursing errors (33) . Job satisfaction is defined as the affective response of staff nurses to a job based on contrasting real results with desired results and is a multi-faceted construct that involves both intrinsic and extrinsic work factors. Extrinsic variables include observable aspects of the job, such as wages and benefits, while intrinsic variables include opportunities for personal and professional growth and recognition. Also, job satisfaction is conceptualized as the feelings associated with a job based upon fulfillment of expectations and needs within the working environment (26) . Job satisfaction of the nurses refers to the degree to which staff nurses like and appreciate their jobs. It can refer to the general attitude or perceptions of staff nurses towards their job. The degree of work satisfaction may be dependent on the degree of importance that staff nurses have put on their workplace incentives and/or benefits. Staff nurses indicate that the rewards of his / her work and greater job satisfaction resulted in good emotional states, quality and continuous patient care (40) . Job satisfaction improves the development of positive attitude, which establishes the relationship between nursing staff, improves peer interactions, staff nursespatients relationship, and the trust among staff nurses. Subsequently, job satisfaction by collaborative and partnered patient care will enhance teamwork and thereby increase patient satisfaction with care. There are many factors that impact job satisfaction, such as interpersonal relationships, interaction, burnout avoidance, professionalism, career growth, organizational policy, autonomy, and pay (3, 12) . Job burnout and job dissatisfaction linked to missing nursing care, in other words, enhancing job satisfaction and avoiding job burnout is crucial to preventing missed nursing care among staff nurses (40) . Missed nursing care means as any lapse in essential patient care. Moreover, missed nursing care is defined as any aspect of standard, required nursing care, not provided to the patient. For instance, a failure to ambulate an older adult patient Tanta Scientific Nursing Journal( Print ISSN 2314 – 5595 ) ( Online ISSN 2735 – 5519 ) Vol. 21 No. 2 May, 2021 100 can contribute to muscle deconditioning and functional decline. These losses can subsequently extend hospitalization, increase mortality and increase the risk of hospital-acquired conditions, post-hospital rehabilitation and nursing home placement (32) .Furthermore, it refers to nursing task incompletion, care left undone or implicit rationing of nursing care may represent a form of cognitive prioritization that occurs during external influence. This form of prioritization may be based upon immediate and direct patient care needs, such as medication administration and mandatory nursing tasks such as documentation (30,41) . Nursing care is considered missed if staff nurses reported that one or more activities undone. These tasks include: proper patient supervision, mouth care, administration of medication timely , skin care, pain control, ambulation /or range of motion, proper reporting, coordination of care, patient comfort, discharge planning for patients and families, development or / updating care plans, patient and family teaching (32) . There are many reasons for missing nursing care, such as labor resources ( e.g. number and types of nursing staff, level of nursing staff competency, staff qualifications and experience; material resources (e.g. availability of required medications, supplies and equipment); and resources for coordination and communication (among members of the patient care team, between staff nurses and physicians, between staff nurses). Staff nurses must priorities their care activities when one or more of these services are absent from an agency or during a working period, and the stage is set for delayed or omitted nursing care (15) . Significance of the study Staff nurses are performed critical roles in achieving patient safety and quality because they provide most of the bedside care and are well-positioned to recognize and prevent patient harm. However, nursing care for patients may not be reliable or amply provided; care tasks can be missed, and care omissions can lead to adverse patient outcomes to date, efforts to improve healthcare quality and safety have intentionally emphasized the reduction of omission errors such as administering the wrong dose of medication to a patient because they are easier to detect and more frequently reported (32) . Health care managers seek to maintain quality of patient care through avoid missing nursing care by identifying factors that contributes to missing nursing care, these factors may be staff nurses’ burnout and job dissatisfaction. Therefore the present study Tanta Scientific Nursing Journal( Print ISSN 2314 – 5595 ) ( Online ISSN 2735 – 5519 ) Vol. 21 No. 2 May, 2021 101 will be conducted to explore the relationships between staff nurses’ job burnout, job satisfaction, and missed nursing care among staff nurses. Aim of the study The present study aims to explore the relationships between job burno