Job_Satisfaction_Survey_2008_Report

JOB SATISFACTION

AND JOB RETENTION

ISSUES

2009 A Survey of RNs, LPNs, and RCWs on Prince Edward Island

Job Satisfaction and Job Retention Issues

Page 1

Table of Contents

ACKNOWLEDGEMENTS ............................................................................................................... 2

BACKGROUND .............................................................................................................................. 3

EXECUTIVE SUMMARY ................................................................................................................. 4

SURVEY METHODOLOGY ............................................................................................................ 6

Outline ........................................................................................................................................... 6

Limitations ..................................................................................................................................... 6

Sample .......................................................................................................................................... 7

Interpretation ................................................................................................................................. 7

RESULTS ........................................................................................................................................ 8

Statistics ........................................................................................................................................ 8

Sites Represented ...................................................................................................................... 8

Years in Practice ........................................................................................................................ 8

Work Schedule ........................................................................................................................... 8

Work Environment ......................................................................................................................... 9

Communications ......................................................................................................................... 9

Interaction with Colleagues ...................................................................................................... 10

Confidence in Management ..................................................................................................... 11

Physical Environment ............................................................................................................... 12

Wages ...................................................................................................................................... 13

Respect ....................................................................................................................................... 13

Quality in the Workplace ............................................................................................................. 16

Continuing Education ............................................................................................................... 17

Performance Reviews .............................................................................................................. 17

Scope of Practice ........................................................................................................................ 18

Retirement ................................................................................................................................... 19

DISCUSSION ................................................................................................................................ 19

Supervisors/Management vs. Staff ............................................................................................. 19

Acute Care vs. Long-term Care .................................................................................................. 20

Computer Use ............................................................................................................................. 22

Generational Differences ............................................................................................................ 23

Staying in Healthcare and Staying in PEI ................................................................................... 23

Suggestions for Future Data Analysis......................................................................................... 24

Subpopulations ......................................................................................................................... 24

Hours of Work ........................................................................................................................... 25

Work Environment .................................................................................................................... 25

Respect .................................................................................................................................... 25

Quality in the Workplace .......................................................................................................... 26

Should I Stay or Should I Go? .................................................................................................. 26

Scope of Practice ..................................................................................................................... 26

The Burden of Working in Health Care .................................................................................... 27

Appendix A - Job Satisfaction and Retention Survey - Overview ............................................... 28

Comprehensive Job-satisfaction and Retention Survey ............................................................. 30


Page 2

Job Satisfaction and Job Retention Issues A S u r v e y o f R N s , L P N s , a n d R C W s o n P r i n c e E d w a r d

I s l a n d

ACKNOWLEDGEMENTS

The conclusion of the survey questionnaire development, the focus testing of and the design for

the web and paper-based versions of the survey were done by Consultant, Vicki Bryanton in

conjunction with an Advisory Committee consisting of Betty Bailey (former Executive Director of the

PEI Health Sector Council - PEIHSC), Mark DeMone (Human Resource Advisor), and James

McClean (current Executive Director of the PEI Health Sector Council). Additional input and

support was received from the PEIHSC Board Members.

Special thanks go to the RNs, LPNs, and RCWs who participated with enthusiasm and candor in

the focus group sessions. Successful distribution of the promotional materials and paper surveys

was made possible through the efforts of Muriel Steele (LPN), Anne Dunphy (LPN), Lynn Parker

(RCW) and Sheila Gallant (RN). Thanks also goes out to Julie Murphy, Administrative Assistant

for the PEIHSC, who made special rounds to low responding areas to ensure good distribution of

the surveys.

The PEI Health Sector Council is funded by the Canada / Prince Edward Island Labour Market

Development Agreement (www.lmda.pe.ca). The opinions and interpretations presented in this

report are those of the authors and do not necessarily reflect those of the Government of Canada

or the Government of Prince Edward Island.

http://www.lmda.pe.ca/


Page 3

BACKGROUND

The PEI Health Sector Council Inc. (PEIHSC) is an independent organization which has been

developed to provide a neutral and sector-wide forum for the discussion, identification, validation

and resolution of health human resource issues. In fulfilling its role as a sector-wide representative

organization, the PEIHSC Board of Directors is composed of individuals from the public, private

and charitable/not-for-profit arms of the sector. The resolution of health human resource issues

also requires that the PEIHSC establishes open and ongoing dialogue with relevant educational

institutions, government departments and community organizations.

The Job Satisfaction & Job Retention Survey was developed to acquire information from a wide

range of Prince Edward Island Registered Nurses, Licensed Practical Nurses and Resident Care

Workers on their perspectives on issues of job satisfaction and retention.

Survey data will be used to establish baseline measures for other project objectives or other key

desired results, and/or to better understand the socio-demographic and work-related factors

associated with different aspects of job satisfaction and retention issues.


Page 4

EXECUTIVE SUMMARY

This report provides an analysis of job satisfaction and retention issues among the Registered

Nurse (RN), Licensed Practical Nurse (LPN) and Resident Care Worker (RCW) occupational

groups on Prince Edward Island. The frame work and initial questions for the survey were

provided by the Health Sector Council in consultation with organizations represented on the Board,

focus group analysis and input from Service Canada. The survey was conducted online and in

paper format. It was promoted through partner organizations and direct distribution of promotional

materials and paper surveys.

Four hundred and seventy six (476) people responded to the survey, including 220 RNs, 127 LPNs

and 129 RCWs. The survey asked questions regarding place of work, years in practice, work

schedule, work environment including communication and interaction with co-workers, supervisors

and managers, quality of the physical work environment, wages, feelings of respect among

colleagues and other health workers, scope of practice, performance review and retirement.

The research draws attention to a number of points.

The survey supports national statistics indicating an aging workforce of RNs, LPNs and

RCWs – 41% of respondents have been in practice for over 20 years and 21% have been in

practice for over 30 years. Only 19% of respondents have been in practice for less than 5

years;

Much of the workforce is employed part-time – only 50% of the respondents reported full-

time employment;

The majority of respondents were satisfied regarding interaction and level of communication

with both colleagues and supervisors;

Staff morale seems to be an issue requiring attention with 45% of respondents indicating

some level of dissatisfaction with staff morale. Perhaps linked to staff morale, 40% of

respondents were not satisfied that leaders in the workplace were making good decisions

and 44% were dissatisfied with the physical environment at their place of work;

The majority of respondents were satisfied with overall job security and wage levels;

Respondents working in acute care settings (versus those working in long-term care

facilities) were more satisfied regarding most workplace issues, including communications

with supervisors, staff morale and job security;

When questioned about ‗respect‘, the majority of respondents felt that both their opinion and

work was respected by all occupational groups identified, although there was some

variation between occupational groups;

Bullying in the workplace is an emerging health and safety issue that is becoming more

widely recognized as a form of workplace violence. Respondents to this survey reported

low incidences of workplace bullying overall, but perceptions of bullying did vary according

to occupational group. The following results have not been tested for statistical significance

(refer to pages 13-15 for a discussion on workplace bullying):

o 19% of RCWs and 17% of LPNs felt bullied by RNs

o 12.8% of RNs felt bullied by Physicians, and 11.8% of RNs felt bullied by other RNs

o 14% of LPNs felt bullied by RCWs, and 11.1% of RCWs felt bullied by other RCWs


Page 5

The vast majority of respondents felt that their work was of high quality, that their co-

workers were committed to doing quality work and that they were aware of what is expected

from them in the workplace;

Many RNs, LPNs and RCWs feel overworked – 46% felt frequently or always overworked;

Scope of practice continues to be a concern among RNs, LPNs and RCWs – 42% felt that

they never/seldom/occasionally worked to their full scope of practice;

The vast majority of respondents indicated they would be willing to take additional training

to expand their scope of practice. However, 35% indicated they are not able to attend

applicable training with the most common obstacles including finding replacement staff or

taking time off to attend;

Regular performance reviews by supervisors or managers were reported by less than 43%

of respondents and 49% had never or seldom received a performance review. Managers

and supervisors were more likely to indicate that they had received valuable feedback from

their direct supervisor (52% frequently or always);

A significant percentage of respondents were eligible to retire within the next 5 years,

including 31% of RNs, 21% of LPNs and 21% of RCWs. Slightly lower numbers were

considering retiring within the next 5 years – 29% of RNs, 18% of LPNs and 16% of RCWs;

Among those who were eligible to retire within 5 years but were not considering retiring

within that time, 64% of RNs, 46% of LPNs and 52% of RCWs indicated ―not being able to

afford retirement‖ as a reason. However, a significant percentage of respondents (31% of

RNs, 55% of LPNs and 48% of RCWs) also indicated they were not considering retirement

because they ―like their job and want to continue working.‖

The PEI health system is facing numerous human resource challenges, including an aging

workforce, shortages and recruitment concerns. This survey brings many issues affecting job

satisfaction to light—issues that can have a profound effect on recruitment and retention of RNs,

LPNs and RCWs. The survey also illustrates that individuals working in these occupations have a

genuine enthusiasm for their work. We can ensure a strong and vital health system by addressing

current and emerging job satisfaction issues with sound strategies and proactive measures.


Page 6

SURVEY METHODOLOGY

Outline

The frame work and initial questions for the survey were provided by the Health Sector Council

after a consultation process involving organizations represented on the Board, focus group

analysis, and input from Service Canada.

The survey was reviewed to ensure that questions would achieve stated objectives and some

questions were redesigned for online use. The design was modified slightly for creation of the

paper survey ensuring that all questions were covered, and comparable, between survey designs.

The paper survey was tested within focus groups (segregated by profession) for reliability and

readability and adjusted accordingly.

To allow for the shift work nature of the professions and to keep costs down, data collection was

done with a broadly promoted web-based survey and a select distribution of 1500 paper surveys.

Promotion of the survey was achieved through partner organizations and direct distribution of

promotional materials and paper surveys. Incentive draw prizes were offered to improve the

response rate.

Paper survey data was manually entered into the same database as the online survey for analysis.

As confidentiality of respondents was critical to involvement of target groups, question skipping

was permitted.

To achieve a goal of 95% confidence interval with an error rate of +/- 5% (19 times out of 20), a

response sample size of 380 was required (with key sub-groups with a minimum of 40 respondents

to ensure anonymity in smaller workplaces.)

Limitations

Preliminary work with the target groups indicated a general distrust in the confidentiality of surveys

and a pessimism regarding the release of gathered information. To ensure confidence in survey

confidentiality, online surveys were not accessed by codes (felt by target groups to be traceable)

and all questions had an opt-out function. Therefore, assurance of profession and location of

employment is based on self-reporting of respondent.

Although a multi-phase communications strategy was used to promote the survey, the lack of

direct support from one association (due to agreement with membership to eliminate the

distribution of surveys) and one union (after completing their own survey in the prior calendar year,

they were not in support of the survey) somewhat limited the comprehensiveness of the reach of

the survey. During the survey, underrepresented groups were targeted for the second wave of

communications.

As the survey was voluntary, not connected to the employer, and relatively long, there is a self-

selection bias attached to this survey. Access to paper surveys was offered compensating for

those without high speed internet access.


Page 7

The data used in the analysis are based on self-reports and were not validated against objective

criteria or by direct observation. Although self-reporting has limitations, due to the nature of this

survey responses were necessarily subjective and based on individual perception.

Participant inclusion criteria included LPNs, RNs, and RCWs (but not those participants who

identified their position as geriatric care workers), and did not include other professions.

The data reported is unweighted. The ratio of LPNs to RNs stands at 650:1500 or 1:2.3 – with the

number of RCWs estimated at about equal to LPNs, the best ratio of RCWs to LPNs to RNs would

be 1:1:2.3. The results of this survey have a ratio of 1:1:1.7.

Cells of under 40 are not reported in detail in this report. Question skipping of under 10% (50

respondents) was deemed an acceptable rate and will not be noted in the report.

Due to rounding, not all percentage breakdowns will equal 100%.

Sample

According to 2008 data gathered from the Association of Registered Nurses PEI, there are

approximately 1500 RNs on PEI. According to 2008 data gathered from the PEI Licensed Practical

Nurses Association, there are approximately 650 LPNs. Without a registration process for RCWs

on PEI, it is estimated that the number of RCW‘s today is approximately equal to that of LPNs 1(also compared to similar figures from the Canadian Institute of Health Information.)

A total of 225 e-surveys were completed as were 289 hard copies for a total of 514 submitted

surveys. Twenty-one surveys were removed from the final count as respondents did not identify as

an RCW, LPN, or RN (one Nurse Practitioner was included with the RN population.) Four more

were removed as they were undergraduates to any one group. Thirteen were removed as less

than 1/3 of the survey was completed. The final participant inclusion number was 476

respondents, representing approximately 17% of the population.

Interpretation

Interpretation of survey results is limited, in this report, to the identification of issues that might bear

further investigation. Results reported focus on areas of significance that would require further

analysis to confirm or refute statistical significance of possible relationships. The author, in

consultation with an advisory group, has recommended relationships that may make a good

starting point for future data analysis.

1 Anne Marie Atkinson and Sonya Hull. Health Human Resources Supply and Demand Analysis – Executive

Summary. DMR Consulting Inc. for the Health and Social Services System of Prince Edward Island (2001).


Page 8

RESULTS

Statistics

Of the 476 included respondents to the Job Satisfaction and Job Retention Survey, 127 were

Licensed Practical Nurses, 220 were Registered Nurses, and 129 were Resident Care Workers.

Fifty one (51) self-identified as Supervisors with 20 self-identified as Managers.

Sites Represented

Two hundred and six (206) or 43% of respondents worked in at least one of the 8 hospitals. One

hundred and sixty seven (167) or 35% worked primarily in a publicly owned nursing home or

chronic care facility. Forty two (42), or almost 9%, worked in privately owned nursing homes or

chronic care facilities. Twenty nine (29) worked in Public Health Nursing or Home Care. Twenty-

two (22) worked in clinics or private doctor‘s offices. The remaining 10 worked in a variety of other

locations, including Addictions Services, NGOs, private home care, or they preferred not to say.

Years in Practice

The years in practice represented by the respondents reflects that seen in statistics produced by

the Canadian Institute of Health Information (2006).

Work Schedule

Fifty percent (50%) of respondents worked permanent full time positions, 38% worked part-time

positions, with the remaining 12% working temporary or casual positions.

Three hundred and thirty one (331) staff reported working 8-hour shifts and 43 were working 12-

hour shifts (either regular or rotating.) Twenty-nine (29) respondents commented on a variety of

other working hours. Participants were asked about their preference of 8 hour or 12 hour shifts.

0

20

40

60

80

100

120

Less than 2 years

3 to 5 years

6 to 10 years

11 to 15 years

16 to 20 years

21 to 25 years

26 to 30 years

More than 30

years

4349

68

47

6861

35

101

# o

f re

spo

nd

en

ts

Number of Years in Practice


Page 9

Sixty percent (60%) preferred to work 8 hour shifts while 31% expressed a preference for 12-hour

shifts. Only 6 percent did not have a preference. Of significance, 78% of RCWs preferred the 8-

hour shifts over the longer shift.

Most of the 155 respondents who preferred 12 hour shifts commented on the effect of having more

straight days off as the reason for the preference. Twenty of the respondents indicated reasons

such as: I like the mix of hours; it will mean less driving or less money on gas, or more time

and better contact with patients.

Of those who preferred the 8-hour shifts, physical stress and heavy workload were the most

common reasons cited with family needs or childcare concerns as a close second most

common reason.

Of the 463 respondents who answered a question ―Are you working at any other paid, non-

healthcare jobs?‖, 8.5% were working at other non-healthcare jobs at least once in a while. Of the

19 respondents who commented on why they held other, non-healthcare job, most commented on

increasing income, with an equal number split between working as part of a family business and

due to the outside job being less stressful.

Ninety percent (90%) of respondents had some form of employer contribution to benefits such as a

health plan or retirement funding.

Work Environment

A number of questions were asked about satisfaction with communication, interaction with

colleagues, confidence in management, physical environment, and wages.

Communications

Communication with management and co-workers can have an effect on job performance as well

as job satisfaction.

Seventy three percent (73%) of respondents were slightly to very satisfied with the level of

communication with their immediate supervisors while 85% were slightly to very satisfied with the

level of communication with their co-workers. Seventy four percent (74%) felt that their supervisor

kept them informed about issues affecting their work, with 64% being slightly to very satisfied that

their supervisors were responding to issues that were most important to the respondent.

Sixty nine percent (69%) were ―slightly satisfied‖ to ―very satisfied‖ with the value of their input in

discussions and meetings about the workplace.


Page 10

Interaction with Colleagues

Positive interaction with co-workers was one of the most common responses stated when

participants were asked: If you were talking to someone about coming to PEI to work in your

profession, what would you tell them about what you LIKE MOST about your work?

Interaction with colleagues was addressed in a number of questions within the survey. The

following table shows the level of satisfaction with items of staff communication, collaboration, and

spirit. This chart does not necessarily include interactions with supervisors or management.

Respondents were much more satisfied with their interaction with their colleagues (71% slightly,

moderately, or very satisfied) and communication with co-workers (85% slightly, moderately, or

very satisfied), than their perception of the overall team spirit (59% slightly, moderately, or very

satisfied) or staff morale (54% slightly, moderately, or very satisfied).

0 50 100

The level of communication with your immediate supervisor

That your immediate supervisor keeps you informed about the issues

affecting your work

The level of communication with your co-workers

That your input in discussions/meetings about the

workplace is valued

That your supervisor is responding to the issues that are most important to

you in the workplace

8

7

2

14

13

9

11

4

8

10

10

9

9

9

13

12

16

19

22

25

30

34

39

31

25

31

24

27

16

14

Percentage

Communication

1 Very Dissatisfied

2 Moderately Dissatisfied

3 Slightly Dissatisfied

4 Slightly Satisfied

5 Moderately Satisfied

6 Very Satisfied


Page 11

Confidence in Management

Confidence in management was measured by analyzing responses to questions around

supervisors, management and some issues directly affecting the health care worker (such as

assigned workload, physical work environment and job security.)

Seventy two percent (72%) were slightly to very satisfied that their immediate supervisor cared

about their general well being, 74% were slightly to very satisfied with their supervisor, and 64%

were slightly to very satisfied that their supervisor was responding to issues that were important.

There were 13% who were very dissatisfied with how their supervisor was responding to issues

while 14% were very satisfied. Fourteen percent (14%) very dissatisfied with the decisions that

leaders were making at work, compared to 12% who were very satisfied.

Seventy percent (70%) of respondents were satisfied with the reasonableness of their work

responsibilities. Job security was not a concern for most respondents with 68% being moderately

to very satisfied with their job security.

0% 50% 100%


With the level of collaboration WITHIN your classification

The level of collaboration with OTHER classifications

With the staff morale in the workplace

2

5

6

16

4

9

9

13

9

14

13

16

19

19

28

24

39

37

33

22

27

15

11

8

Satisfaction with Interaction with Colleagues

1 Very Dissatisfied





6 Very Satisfied


Page 12

The categories where confidence was rated as lowest included decision making and physical

environment. Forty percent (40%) were dissatisfied with leaders making good decisions in the

workplace and 44% were dissatisfied with the building or physical work environment.

Physical Environment

Eighteen percent (18%) of respondents were very dissatisfied ―with your place of work (the building

or physical environment)‖, 12% were moderately dissatisfied, 14% were somewhat dissatisfied

while 15% were slightly satisfied, 26% were moderately satisfied, while 16% were very satisfied.

In another part of the survey, the question was asked: Does your employer provide any

activities/equipment/resources to relieve stress at work? Of the 80% who responded ―No‖,

60% provided suggestions of what they would like to see. Nineteen percent (19%) of the

suggestions were related to physical environment with most looking for an exercise room and/or

exercise equipment, followed very closely by a separate staff room where they could relax on

break away from patients, residents, and visitors.

0% 20% 40% 60% 80% 100%

With your overall job security

That your supervisor is responding to the issues that are most important to you in

the workplace

With your place of work (the building or physical environment)

With the reasonableness of your work responsibilities

That the leaders in your work place are making good decisions

With your direct supervisor

That your immediate supervisor cares about your general well-being

6

13

18

9

14

8

10

5

10

12

9

13

7

8

6

13

14

12

13

10

10

15

25

15

22

21

17

20

41

25

26

33

27

33

25

27

14

16

15

12

24

27

Percentage

Confidence in Management

1 Very Dissatisfied





6 Very Satisfied


Page 13

Wages

When asked about satisfaction with wages, 10% were very dissatisfied, 11% moderately

dissatisfied, 12% slightly dissatisfied, 20% slightly satisfied, 35% moderately satisfied, and 11%

were very satisfied.

When asked: If you were talking to someone about coming to PEI to work in your profession,

what would you tell them about what you LIKE LEAST about your work?- eleven percent

(11%) commented on poor wages and/or benefits.

Respect

In this survey, there was an attempt to determine how perception of ―respect‖ contributes to

satisfaction in the workplace. The level of regard that participants perceived their colleagues to

have toward them is subjective. Perceptions of respect of colleagues encountered daily were

contrasted with perceptions of other health care professionals (who may have fewer contacts) for

comparison purposes.

Participants were asked to indicate whether they felt that their opinion or work was respected by

different health care groups. Participants were asked to consider the groups that they work with

regularly, so not all professions are commented upon equally.

Four hundred and seventy eight (478) respondents answered the question. While only 16

respondents skipped this question, professions where no relationship exists or where the

respondent chose not to comment were left blank. As a result, the numbers of respondents

commenting on the respect relationship with the different professions varied from 186 to 416 and

are noted below.

Two hundred and forty nine (249) participants noted the respect they felt was given by RCWs to

their opinion and work. Seventy seven percent (77%) felt that their opinion was respected by

RCWs. Sixty seven percent (67%) felt that their work was respected by RCWs.

Three hundred and fifty eight (338) responded to the section on LPNs. Eighty one percent (81%)

of all respondents felt that their opinion was respected by LPNs. Seventy percent (70%) felt that

their work was respected by LPNs.

Four hundred and sixteen (416) responded to the section on RNs. Seventy three percent (73%) of

all respondents felt that their opinion was respected by RNs. Seventy five percent (65%) felt that

their work was respected by RNs.

For comparison purposes, respondents were also asked to comment on the respect they felt came

from other health care professionals that they dealt with regularly. Two hundred and seventy one

(271) responded to the section on Physicians. Seventy one percent (71%) felt that their opinion

was respected by Physicians. Fifty eight percent (58%) felt that their work was respected by

Physicians.

One hundred and eighty six (186) responded to the section on Pharmacists – this group had the

least contact with the health care professionals in our survey. Seventy one percent (71%) of


Page 14

respondents who had regular contact with Pharmacists felt that their opinion was respected by

Pharmacists. Fifty seven percent (57%) felt that their work was respected by Pharmacists.

Two hundred and fifty (250) responded to the section on Other Health Care Professionals.

Seventy four percent (74%) felt that their opinion was respected by Other Health Care

Professionals. Sixty two percent (62%) felt that their work was respected by Other Health Care

Professionals.

During the focus group testing of the draft survey, comments and discussion arose spontaneously

in 2 separate groups around the stresses created by the participants‘ perceptions of ―bullying‖ and

excessive pressure by some of their work colleagues. To test the extent of this perception in the

larger population, this question was added to the chart on Respect and is separated out in the

chart below for clarity of impact on the survey participant groups.

Participants were asked to comment on those groups that they ―worked with regularly‖. Actual

number of responses is noted in the chart in brackets. A breakdown by respondent‘s profession is

also shown to attempt to partially account for perceptions that might be attributed to positions of

power (for example, LPNs could feel more pressured by RNs as they may be supervisors

compared to LPNs who feel pressured by RCWs who would not be in a position of power;

additionally, RNs may feel more pressured by Physicians who are in positions of power over the

RNs they deal with regularly.)

Workplace bullying is defined by the Canadian Centre for Occupational Health and Safety

(CCOHS) as ―acts or verbal comments that could ‗mentally‘ hurt or isolate a person in the

workplace.... Bullying usually involves repeated incidents or a pattern of behaviour that is intended

to intimidate, offend, degrade or humiliate a particular person or group of people.‖2 Bullying in the

workplace may also include negative physical contact. Research into workplace bullying is still

2 Canadian Centre for Occupational Health and Safety (2005), ―Bullying in the Workplace.‖ 12 December 2008

<www.ccohs.ca/oshanswers/psychosocial/bullying.html>

RCWs LPNs RNs Physicians Pharmacists Other Health Care

Professionals

191

293 306

192

133

185

21 3066

4523 32

166

252 267

154

105

155

23 2041 31 17 17

# o

f re

spo

nd

en

ts

Respect

Opinion respected by Opinion NOT respected by Work respected by Work NOT respected by


Page 15

very much in its infancy and there are few statistics regarding its prevalence. The Public Service

Alliance of Canada suggests that workplace bullying is far more common than sexual harassment

and racial discrimination. Unlike those destructive behaviours, however, there is very little

legislation in Canada to deal with workplace bullying.

A small but growing amount of research suggests that workplace bullying is particularly prevalent

in the health sector. An Australian study of health workers indicates that 50% of those surveyed

had been exposed to bullying within a 12-month period, with fellow colleagues reporting the

highest incidence of bullying.3 A smaller survey of 1100 employees in one United Kingdom health

facility revealed 38% experienced bullying,4 while a nursing-specific study in the UK suggested 1 in

6 nurses have experienced bullying at the hands of a colleague.5 That figure rises to 3 in 10 for

nurses from an ethnic minority. Studies from other countries show similarly alarming results.

Thirty eight percent (38%) of nurses in Bulgaria and 22% in Lebanon, for instance, experienced

bullying.6,7

Question: Of those health care professionals that I work with regularly, I feel that in MOST

cases I feel bullied or unduly pressured:

Differences not tested for statistical significance.

3 Alison Rutherford and Chris Rissel, ―A survey of workplace bullying in a health sector organization‖, Australian

Health Review, Vol 28:1 (2004): 65-72. 4 L. Quinn (1999), cited in Jon Richards, Management of Workplace Victims, ILO/INC/WHO/PSI Joint Programme

on Workplace Violence in the Health Sector (2003). 5 Royal College of Nursing (2002), Working Well: A Call to Employers. 12 December 2008

<www.rcn.org.uk/__data/assets/pdf_file/0011/78527/001595.pdf> 6 ILO/INC/WHO/PSI Joint Programme on Workplace Violence in the Health Sector (2003), Bulgaria Case Study.

7 ILO/INC/WHO/PSI Joint Programme on Workplace Violence in the Health Sector (2003), Lebanon Case Study.

(Total #) responding

either positively or

negatively to this group:

Grouped by all

health care

workers together –

(# who felt bullied or

pressured) % of total

number of respondents

Grouped by

“as an RN, I

feel …‖(#) % of

total RN group who

feel bullied or unduly

pressured

Grouped by “as

an LPN, I feel

…‖(#) % of total

LPN group who feel

bullied or unduly

pressured

Grouped by “as

an RCW, I feel

…‖(#)

% of total RCW

group who feel bullied

or unduly pressured

by RCWs (249) (26) 10.4% (5) 6.8% (8) 14.0% (13) 11.1%

by LPNs (358) (21) 5.9% (6) 4.1% (5) 4.4% (10) 10.3%

by RNs (416) (62) 14.9% (24) 11.8% (18) 17.0% (20) 19.0%

by Physicians (271) (26) 9.6% (22) 12.8% (4) 6.3% (0) 0.0%

by Pharmacists

(186)

(4) 2.2% (3) 2.4% (0) 0.0% (1) 4.8%

by Other Health

Care Professionals

(250)

(23) 9.2% (14) 9.7% (2) 3.2% (7) 12.7%


Page 16

Actual numbers of individuals who feel bullied or unduly pressured are low compared to the

Australian and UK studies, but do vary by profession. Numbers exceeding 10% of the population

bear further investigation.

Quality in the Workplace

Quality in the workplace can be measured on a number of levels. Direct questions were asked on

the participants‘ perspectives on quality issues. In addition, information was gathered on continuing

education and performance reviews.

Ninety three percent (93%) of respondents frequently or always knew what was expected of them

at work.

Ninety seven percent (97%) of the respondents who answered the Quality in the Workplace

questions felt that their work was of high quality frequently or always. In their opinion, they felt that

their coworkers were ―committed to doing quality work‖ frequently or always in 76% of the cases.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

I have witnessed staff (not formally trained) performing health care

I have opportunities to do what I do best

I have the time to do quality work

I am under worked

I am over worked

I have the tools/equipment that I need to do my work properly

I am allowed to use the skills I am trained to do during every shift or workplace

I have opportunities to increase my skills (learn new skills)

I know what is expected of me at work

My co-workers are committed to doing quality work

My work is of high quality

55

2

2

56

3

1

6

3

0

0

0

18

7

10

29

15

6

13

19

1

4

0

15

29

30

12

37

21

18

33

6

20

4

7

44

46

2

31

52

34

29

46

54

47

4

18

13

1

15

20

28

16

47

22

50

Quality Never Seldom Occasionally Frequently Always


Page 17

Of note, 11% frequently or always ―witnessed staff performing health care duties when they have

not graduated from a recognized training program (not including students).‖ Among RNs, the rate

was 6%, among LPNs – 11%, and among RCWs – 22%.

Sixty two percent (62%) stated that they were frequently or always ―allowed to use all the skills

they were trained for during all shifts or workplaces.‖ Having opportunity to ―do what I do best‖

occurred frequently or always for 63% of the respondents. Being able to use most of the skills for

which they were trained occurred frequently or always for 54% of the population. Seventy three

percent (73%) frequently or always had the tools to do their work properly.

Fifty-five percent (55%) never/seldom/occasionally had the opportunity to increase their skills

leaving 45% who felt that they frequently or always had that opportunity.

While 97% never/seldom/occasionally felt they were underworked, 45% felt they were frequently or

always over-worked. When asked if they had the time to do quality work, 40% reported that they

never/seldom/occasionally had enough time, while 60% felt they frequently or always had enough

time (ranging from 53% of RCWs to 62% of RNs).

Continuing Education

When asked: In the last two years, has your employer offered regular in-services training to

keep staff up-to-date on current best practice? – seventy one percent (71%) said yes and

described a broad range of training. Twenty nine percent (29%) said that their employer did not

offer regular in-service training. In addition, 35% are not able to attend training that they are

interested in with the most common obstacle being replacement staff or time off of work to attend.

Performance Reviews

Regular reviews completed by supervisors or managers were reported by less than 43% of the

respondents. Forty nine percent (49%) had never or seldom received a performance review.

Direct supervisors were perceived to give useful feedback in 43% of the responses.

0%10%20%30%40%50%60%70%80%

I receive useful feedback from my immediate

supervisor

My manager reviews my progress

I receive performance reviews with my

supervisor or manager

54%

66%74%

43%34%

26%

% o

f re

spo

nd

en

ts

Reviews

Never/Seldom/Occasionally Frequently or Always


Page 18

Scope of Practice

Scope of practice encompasses all of the actions and procedures one is trained and educated to

perform as a member of a particular occupational group. Each occupational group has its own

scope of practice which is defined through a combination of education and legislation. Scope of

practice is distinct from scope of employment, which encompasses the activities an individual is

authorized to perform by an employer. Ideally, scope of practice and scope of employment match,

meaning an individual‘s actual duties equate with what they have been trained to do.

The PEIHSC identified scope of practice as an area of concern in the PEI health sector

(particularly among RNs, LPNs and RCWs) during its first year of operation and carried out a

number of initiatives to address the issue further, including a Scope of Practice Forum in early

2007 and a series of focus groups later that year. These initiatives helped define many of the

issues around scope of practice and identified several barriers limiting employees from working to

full scope of practice, including inconsistent or outdated policies and job descriptions, legislation

and regulation incongruent with training and education, management style and resistance to

change.8,9

Job satisfaction is something that was raised during focus groups as closely tied to scope of

practice. The survey indicates that it remains an area of concern for RNs, LPNs and RCWs.

Ninety-nine percent (99%) of RNs, LPNs, and RCWs think that all groups should be working to

their full scope of practice.

Forty two percent (42%) never/seldom/occasionally work to their full scope of practice. While 58%

frequently or always work to their full scope.

Forty six percent (46%) never/seldom/occasionally use the skills for which they were trained. While

54% frequently or always use the skills for which they were trained.

Thirty eight percent (38%) never/seldom/occasionally use the skills for which they were trained.

While 62.4% frequently or always use the skills for which they were trained.

Most are willing to take on additional training to expand their scope of practice: ranging from 91%

of RNs to 95% of LPNs.

The Corpus Sanchez report, a comprehensive review of PEI‘s health system, makes note of scope

of practice, particularly in relation to improving efficiencies in home-based care (including manors

and nursing homes).10

In response to the recommended strategic directions outlined within the

Corpus Sanchez report, the provincial government has included scope of practice as a priority and

has promised to maximize the capacity for RNs, LPNs and RCWs to work to full scope of practice.

8 Betty Bailey and Jennifer Ghiz, Scope of Practice Forum 2007 Summary Report, PEI Health Sector Council

(2007). 9 MacPherson Roche Smith & Associates, Prince Edward Island Health Sector Council Focus Group Report, PEI

Health Sector Council (2008). 10

Prince Edward Island, Department of Health (2008), An Integrated Health System Review in PEI – A Call to Action: A Plan for Change.


Page 19

This is a positive development that could have a profound effect on job satisfaction among RNs,

LPNs and RCWs.

Retirement

Participants were asked about their eligibility to retire within the next five years, whether or not they

were considering retirement in the next five years (despite eligibility), what would make them

reconsider retirement (they could choose more than one reason), and if they are eligible to retire

but not considering it – what was their ―main‖ reason for not retiring.

Thirty-one percent (31%) of RNs reported being eligible to retire within the next 5 years. Twenty-

nine percent (29%) of respondents were considering retirement in the next 5 years. When asked

what would make them reconsider retirement, 4% would not reconsider, 74% would reconsider if

they could maintain benefits while reducing work hours, 55% would reconsider if they could work

(without an income penalty) even after taking an early retirement package, 43% would reconsider if

their workload was not as heavy, 40% would reconsider if they didn‘t have to work evenings or

weekends, 36% would like more flexibility in their work schedule, 30% were interested in staying if

they could expand their role (examples: mentoring, teaching, or focus on news skills) and 30%

were interested in dropping to part-time work. When asked what the main reason for not retiring

would be, 64% noted not being able to afford retirement while 31% said they like their job and want

to continue working.

Twenty-one percent (21%) of LPNs reported being eligible to retire within the next 5 years.

Eighteen percent (18%) of respondents were considering retirement in the next 5 years. When

asked what would make them reconsider retirement, 25% would not reconsider, 50% would

reconsider if they could work (without an income penalty) even after taking an early retirement

package, 45% would reconsider if their workload was not as heavy, 40% would reconsider if they

could maintain benefits while reducing work hours, and 30% were interested in dropping to part-

time work. When asked what the main reason for not retiring would be, 55% said they like their job

and want to continue working while 46% noted not being able to afford retirement.

Twenty-one percent (21%) of RCWs reported being eligible to retire within the next 5 years.

Sixteen percent (16%) of respondents were considering retirement in the next 5 years. When

asked what would make them reconsider retirement, 17% would not reconsider, 56% would

reconsider if they could work (without an income penalty) even after taking an early retirement

package, 39% would reconsider if their workload was not as heavy, and 33% would reconsider if

they didn‘t have to work evenings or weekends. When asked what the main reason for not retiring

would be, 52% noted not being able to afford retirement, while 48% said they like their job and

want to continue working.

DISCUSSION

Supervisors/Management vs. Staff

Fifty-nine (59) respondents indicated that they were supervisors or managers. Ninety percent

(90%) of those reporting were RNs. Seventy two percent (72%) of the supervisors or managers,

had been in practice for more than 20 years.


Page 20

Thirty nine (39) of the respondents worked in long-term care facilities (public and private) with the

remain 11 working in a variety of acute care settings, and 9 working in home care, clinics, addiction

services, or non-government organizations.

Managers and supervisors scored about the same as the larger population on almost all areas.

The one area where there was a significant difference was in the value of feedback from direct

supervisors – managers and supervisors felt that they received valuable feedback 52% frequently

or always (compared to 43% in the staff group.)

Acute Care vs. Long-term Care

The survey gathered responses from acute care facilities (Hillsborough Hospital, Kings County,

Memorial Hospital, O‘Leary Community Hospital, Prince County Hospital, Queen Elizabeth

Hospital, Souris Hospital, Stewart Memorial Hospital, and Western Hospital) as well as public

chronic care (Colville Manor, Riverview Manor, Prince Edward Home, Beach Grove Home,

Summerset Manor, Wedgewood Manor, Stewart Memorial Hospital - Margaret Stewart Ellis Wing,

Maplewood Manor) and private chronic care facilities (Garden Home, MacMillan Lodge, PEI

Atlantic Baptist Nursing Home, Park West Lodge, Whisperwood Villas, Clintonview Lodge, South

Shore Villa).

Two hundred and twelve (212) respondents worked in acute care facilities. Of the 211

respondents working in long-term care facilities, 170 worked in publicly owned facilities while 41

0

10

20

30

40

50

60

1 1 27 6

127

23

59

# o

f re

spo

nd

en

ts

Supervisors and ManagersYears in Practice


Page 21

worked in privately owned facilities. It should be noted that no RCWs worked in acute care

settings.

Significant differences between workplace settings were noted but when RCWs were removed

from the data set (as RCWs do not work in acute care settings) this significance disappeared.

Adding RCWs into the data set creates four areas of difference that are statistically significant.

The areas of significant difference were in satisfaction with job issues such as wages, quality of

your work, staff morale and overall job security. On all other measures, there was no significance

in the difference between acute care settings and chronic care facilities.

That your immediate supervisor keeps you informed about the issues affecting your work

That your supervisor is responding to the issues that are most important to you in the workplace

That you receive adequate recognition from your supervisor when you do a good job



That your input in discussions/meetings about the workplace is valued


With the level of collaboration within your classification in your work place



With your ability to maintain a good balance between family life and work life



Your wages

The quality of your work

That your work gives you a feeling of personal accomplishment

18%

29%

30%

20%

33%

25%

11%

27%

37%

26%

22%

32%

16%

37%

9%

17%

82%

71%

70%

80%

67%

75%

89%

73%

64%

74%

78%

68%

84%

63%

91%

83%

37%

49%

43%

41%

54%

46%

22%

38%

61%

40%

34%

59%

21%

36%

9%

13%

63%

51%

57%

59%

46%

54%

78%

63%

39%

61%

66%

41%

79%

64%

91%

87%

Acute Care Facilities vs Chronic Care Facilities

Comparison on Satisfaction with Workplace Issues

Slightly/Moderately/Very Dissatisfied Slightly/Moderately/Very Satisfied

(including RCWs)


Page 22

In addition to these satisfaction issues, those survey participants working in chronic care facilities

are more likely to report being able to attend most of the training programs that they are interested

in. Those working in long-term care facilities are more likely to have been scheduled to work a

double shift. The most common reason given for needing to work a double shift is that they were

short staffed.

In all settings RNs reported never being scheduled to work a double shift in 89% of the cases,

LPNs reported never being scheduled to work a double shift in 82% of the cases. RCWs reported

never being scheduled to work a double shift in 64% of the cases.

Computer Use

As the province‘s health system began the rollout of a new electronic health records system into

acute care institutions this year, comfort levels with computer use were addressed by the survey.

More health care workers working in acute care settings have a computer at home than do those

working in long-term care facilities. Acute care health care workers also use their home computers

more frequently and they express more comfort in using computers.

The majority of respondents (84%) have frequent or daily use of a computer at home with 74%

reporting being comfortable using a computer frequently or daily. Twelve percent (12%) reported

never or seldom having access to a computer at home and 13% reported never or seldom being

comfortable with using a computer.

Of those using electronic health records, 54% were comfortable using it frequently or daily.

Thirteen percent (13%) reported never or seldom being comfortable with using electronic health

records.

0%

20%

40%

60%

80%

Pe

rce

nt

of

Re

spo

nd

en

ts

Frequency

Computer Usage and Comfort Level

I have access to a computer at home

I use a computer at home

I have access to a computer at work

I use a computer at work

I am comfortable using a computer


Page 23

Generational Differences

Within many healthcare workplaces today, we can find 4 distinct generations of workers, each

influenced by the era in which they were born and raised. Since approximately 1980, the newest

generation (popularly named Millenials) is now within, or just entering, the health care work place.

Within this survey, Millenials were represented by 52 of the 476 respondents.

Comparing the Millennial group against the group aged 30+ years (which includes the generations

popularly named: Gen X, Baby Boomers, and Matures) uncovers some interesting distinctions.

Within this survey, the mix of RCWs to LPNs to RNs was similar in both generations‘ groups. Forty

one percent (41%) of the Millenials had been in the workforce for 2 years or less with another 39%

working 3-5 years. Within the older group, 31% had been in the workforce for 16-25 years while

the next largest group, 23%, had been working in healthcare for more than 30 years.

The spread of those working in long-term care vs. acute care settings was similar. The older group

was more heavily represented in privately owned facilities and Home Care or Public Health

Nursing.

Forty percent (40%) of Millenials and 51% of the older group report permanent, full-time

employment. Not surprisingly, the older group was less likely to be working temporary or casual

positions (3% and 4% respectively) while Millenials were 19% temporary and 10% casual

positions.

When asked if they would prefer to work 8-hour or 12-hour shifts, Millenials were more likely to

choose 12-hour shifts (at 61%) while the older group preferred 8-hour shifts (at 69%).

Staying in Healthcare and Staying in PEI

Respondents were asked how frequently they think about leaving health care as a profession and

how frequently they think of leaving PEI to work in healthcare in another province or country.

Thirty eight percent (38%) never think of leaving healthcare as a profession and 58% never think of

leaving PEI. Twenty two percent (22%) frequently or always think about leaving healthcare and

13% frequently or always think about leaving PEI.

When asked: If you were talking to someone about coming to PEI to work in your profession,

what would you tell them about what you LIKE MOST about your work?- 405 responded with

comments. Of the 405 comments returned, 111 included comments identifying their co-workers as

a primary reason for liking the work on PEI. Eleven respondents (11) commented on wages or

salary being a positive thing on PEI with just as many commenting on working opportunities being

abundant. Most of the remaining comments focused on the joy of the type of work (working with

sick people, working with the elderly, dealing with families.) In another portion of the survey, the

majority of respondents (65%) reported feeling I am engaged in meaningful work frequently or

always.


Page 24

All respondents were asked about reasons they might leave PEI; 346 returned comments. Sixty

three respondents (63) would consider leaving for financial considerations. Forty four (44) would

consider leaving due to health concerns, sickness, or injury. Thirty four (34) commented on

retirement related issues. Twenty five (25) commented on workload issues. Nineteen (19)

respondents commented on moving due to issues around their scope of practice. Nineteen (19)

would consider leaving due to stress. Another thirteen respondents (13) used the term burn-out in

their comments.

When all respondents were asked to reflect on why they stay on PEI, 84 people used the word

―love‖ in their comments with 23 saying they loved their job. Eighty eight (88) commented that they

stay on PEI due to it being their home. Thirty eight (38) commented that pay or salary kept them on

PEI.

Suggestions for Future Data Analysis

The data collected in this survey has a vast amount of information yet to be mined. As the timing

and scope of this survey contract limited the analysis done, the author has defined areas that might

yet yield valuable information to policy makers, facility owners/managers, unions, professional

associations, researchers, and the healthcare work force.

Subpopulations

Subgroups of RNs, LPNs, and RCWs are large enough that more analysis can occur connected

specifically to each health care group.

With 29% of respondents indicating 25 or more years of practice, there is a wealth of experienced

opinion to be investigated in this dataset. Analysis of the views and opinions of other age brackets

should also be considered for further investigation.

0%

10%

20%

30%

40%

50%

60%

I think about leaving my job in health care but staying in PEI

I think about leaving PEI to work in health care in another province or

country

38%

58%

17%14%

23%

15%15%10%

7%3%%

of

Re

spo

nd

en

ts

Leaving Healthcare or Leaving PEI

Never

Seldom

Occasionally

Frequently

Always


Page 25

Subsets of the acute care and publicly owned chronic care facility group have detailed information

to share with certain facilities where response rates where over 40 responses. Others with over 20

respondents may also contain valuable information depending upon the size of staff in each facility.

Although there was a disappointing response rate from privately owned long-term care facilities,

one facility is represented by 22 respondents and facility owners may benefit from a further

analysis of this information (although statistical significance may not be reached on some

questions depending up on the size of the staff population working in this facility.)

Public home care and public health nursing had 29 respondents and there may be some value to

stratifying data for this group.

In all cases, comparing the data to other subgroups may turn up significant differences or insights

that might be carried over from one setting to another (example: what may be making certain

health care groups more satisfied in their workplace carried over to another setting.)

Hours of Work

With a definite split in preference for 8 hour vs. 12 hour shifts, more research could be done to

define what groups could work on their preferred shifts. (At the time of this survey, the cost of gas

had doubled in price from the previous year which may have affected comments on fewer shifts

saving on travel costs – now with the price of gas back down considerably, this group may have

changed their opinions somewhat).

Forty five percent (45%) of workers were designated to work 80% or less, yet 71% of respondents

were working more than 80% time. The benefits of a lower designation with full-time hours worked

was not investigated in this survey. Comments would indicate that some respondents are willing to

give up the security of guaranteed hours in favour of more control over working hours and time off

– this would need to be statistically proven or disproven with deeper analysis.

Work Environment

On most measures of work environment, respondents were moderately to very satisfied. More

investigation could be done in areas where satisfaction was only slightly to very dissatisfied

including: that your supervisor is responding to the issues that are most important to you in

the workplace and team spirit or staff morale.

Respect

Although the vast majority of respondents felt that their opinions and work are respected by their

direct colleagues and other health care workers, opinions and work were not perceived as being

held in equal esteem – the data could be investigated to look for significance in this area.

With those who feel bullied in low numbers, policy makers and facility managers may easily

overlook this area, but without comparison to healthcare facilities in other provinces or other

professions, we do not know if these low numbers are acceptably low.


Page 26

Quality in the Workplace

With 54% of respondents stating that they only receive useful feedback from their supervisors

occasionally and a third of that group feeling that the feedback is seldom or never useful the data

could be further mined for evidence of similar levels of dissatisfaction in this subgroup. More

importantly, the group who frequently or always find the feedback useful may also have similarities

or situations that may be applied to the other group.

Forty six percent (46%) of the survey group feel that they are frequently or always overworked

(have too much work to do in the time available). How does this compare to healthcare workers

in other provinces and how does it compare to other trades and professions?

Is it acceptable that 28% of the reporting workforce never to only occasionally feel positive when

they are at work? Is this subgroup located in certain areas, is there something unique in their

worksites or in their supervision or management? The data may be able to give some of the

answers.

Sixty six percent (66%) of the respondents reported at the end of each work day I have the

energy to engage in personal interests never-seldom-occasionally, is this comparable to other

jobs or healthcare workers in other provinces?

Ninety seven percent (97%) of respondents report that their work is frequently or always of high

quality. Fifty eight percent (58%) work to their full scope of practice frequently or always –

leaving 21% only occasionally, 14% seldom, and 8% never working to their full scope. With 50%

reporting that they seldom or never receive performance reviews with their supervisor or manager,

should we be concerned about performance issues in healthcare facilities and how does this rate

compare to other provinces? And finally, with 59% of the respondents saying that they frequently

or always have time to do quality work, what kind of a total picture does this paint about the

overall quality of work being done in our health care system?

Should I Stay or Should I Go?

More research can be done with this data set to find ways of comparing what is keeping workers

on PEI to those who are thinking about leaving.

In addition, there is a wealth of feedback on workplace efficiencies, supports to relieve stress,

and requested activities/program/services that health care workers are looking for. In a brief

investigation, this data contains many reasonable suggestions that may be easily implemented in a

number of situations. Given the levels of stress and dissatisfaction noted in certain groups, there

may be ―easy wins‖ to be gained from responding to this information.

Scope of Practice

Having trained and skilled people prevented from performing essential tasks where they are

needed does not make sense when there is a documented demand.


Page 27

With 99% of respondents wanting to see all health care workers working to their full scope of

practice and 93% willing to take more training to expand their scope of practice, the desire to work

to full scope is evident.

The data yet to be mined also includes over 130 recommendations for changes to everything from

local procedures and policies to necessary legislative initiatives. The responses also identify

concerns about ―attitudes‖ that would need further investigation outside the capacity of this data.

The Burden of Working in Health Care

There are a number of areas within this survey that speak to the burden on the healthcare worker.

More work can be done with this data to further define where that burden is most intense (where

workers do not get their earned time off, where double shifts are to be expected, where the

pressure to put in more time is excessive). The data can also be mined for information on where

the burden is not so oppressive and lessons learned for transfer to other areas.

Sixteen percent of respondents reported that their employer expects them to take on additional

duties for which they have not been trained. Forty one percent (41%) report performing duties that

were not included in their job description, including a considerable amount of custodial and food

service tasks. With concerns around contagious infections in healthcare settings, the potential for

cross contamination needs to be investigated.

What is missing from this data is the measure of workers who have not been refused earned time

off because they have learned not to ask. This information came out in some of the comments

within the survey where respondents identified issues around seniority, time of year, and lack of

request lead time as barriers to getting time off.


Page 28

Appendix A - Job Satisfaction and Retention Survey - Overview

Overview A profession-based survey (of RNs, LPNs, and RCWs on PEI) will be used to

determine population job satisfaction and personnel retention issues based on

collection and interpretation of quantitative and qualitative data.

Data collection will be done with a select distribution of 1500 paper-based and

broadly promoted web-based survey to allow for the shift work nature of the

professions as well as to keep costs down

As the opinions of all professionals are sought, the mailing target will encompass

all working members of the population; a minimum response sample of 380 is

required for detailed analysis with no subgroups with fewer than 40 respondents

Target population: Registered Nurses, Licensed Practical Nurses, and Resident Care

Workers working on PEI

Sampling/Sampling

Details

Details related to target population:

o employed in public and private facilities as well as private homes

o approximately 2300 individuals with targeted subgroups based on profession

and private/public sector employers

Sample frame:

o the sample source will be accessed through project partners (including

professional associations and union)

o sampling procedures – mailings will be forwarded through partner

organizations; returns will be collected by the Health Sector Council

- web-based survey site will be promoted through communications plan

o sampling limitations and low response rates may affect the subgroup analysis

promotions through partner bodies and the media will be used to encourage

survey participation

Response Rate/Error Rate Anticipated response rate to achieve a minimum sample size of 380 with key sub-

groups with a minimum of 40 respondents

Goal of 95% confidence interval with an error rate of +/- 5% (19 times out of 20)

Indicate any other potential source of error based on the study design that might

affect the accuracy of the data.

Description of Data

Collection

Method of data collection: paper-based surveys (partner distributed) surveys and

web-based survey

Incentives for early returns of surveys is recommended to encourage returns on a

time restricted project

Respondent anonymity and confidentiality will be protected

Questionnaire Design The questionnaire design will be provided by the Health Sector Council

The questionnaire will be pre-tested using focus groups to ensure that the


Page 29

Appendix A - Job Satisfaction and Retention Survey - Overview

readability and completion times are acceptable

o Subgroups will be represented

o Results will be used to make final adjustments to the questionnaire

Description of Data

Processing/Data

Management

The data for quantitative analysis will be exported as Excel files to the client to

allow for import into SPSS

During the project data will be backed up to an external hard drive daily and kept

in a secured location; following completion of the project, stripped data will be

provided in an electronic form to the Health Sector Council

Data Analysis/ Reporting Basic statistical analysis of the data will be performed related to the

objectives/research questions, including any special analyses (e.g., segmentation).

Report format will be determined by an advisory team

Deliverables Questionnaire(s), including pre-test

Data in SPSS readable format for further tabulation/processing

Electronic copy of the report and promotional material

PowerPoint presentation (electronic file)

Project Schedule Work plan with dates and responsibilities under separate cover


30 PEI Health Sector Council – Job Satisfaction & Job Retention Survey

PEI HEALTH SECTOR COUNCIL

Comprehensive Job-satisfaction and Retention Survey

Dear Participant,

The PEI Health Sector Council (PEIHSC) is a non-government organization dedicated to understanding issues related to supply and demand of

health human resources. Retention of our health care workers is very important and we are trying to gain your insight regarding your work

environment.

This survey is unique in that we are asking for input from RCWs, LPNs, and RNs. The final report will be available to you on the PEIHSC

website (www.peihsc.ca) or by contacting the PEIHSC office at (902) 367-4460.

All reports created from this survey will be available to you.

The survey is anonymous. To ensure confidentiality only group data will be reported, that is, no individual information will be included in any

reports and no reports will make it possible to identify individuals in a workplace. Please note that:

• your participation is entirely voluntary,

• you are free to refuse to respond to any of the survey questions,

• you are free to withdraw at any time.

Thank you for your time and interest.

As a bonus for participation, we are offering Draw Prizes to participants. You could win:

* a new computer

* a $200 gift certificate for a fitness centre of your choice

* a $100 gift certificate for Future Shop

Once you have completed the survey, simply call (902) 367-4460 or email [email protected] to have your name entered in the draw. We

will not be able to connect Draw Prize forms to completed surveys – your confidentiality will be protected and respected. Draws will be

completed on October 10, 2008 at the PEIHSC office.

Winners will be contacted and their names will be posted on the PEI HSC website. There are 6 parts to this survey: Please complete all

pages



PART 1 - YOU AND YOUR WORKPLACE

1. I am currently employed as a (please

choose one):

LPN (Licensed Practical Nurse)

RN (Registered Nurse)

RCW (Resident Care Worker)

Other (please specify):

2. Number of years in practice:

Less than 2 years

3 to 5 years

6 to 10 years

11 to 15 years

16 to 20 years

21 to 25 years

26 to 30 years

More than 30 years

3. I am a supervisor?

Yes

No

4. I am a manager?

Yes

No

5. I work primarily at: (please choose one)

Hospitals

Hillsborough Hospital

Kings County Memorial Hospital

O’Leary Community Hospital

Prince County Hospital

Queen Elizabeth Hospital

Souris Hospital

Stewart Memorial Hospital

Western Hospital

Health Care Clinic

Private doctors office

Non-government organization

I prefer not to say

Publically owned long term care

facility

Colville Manor

Riverview Manor

Prince Edward Home

Beach Grove Home

Summerset Manor

Wedgewood Manor

Stewart Memorial Hospital

Margaret Stewart Ellis Wing

Maplewood Manor

Privately owned long term care facility

Dr. John Gillis Memorial Lodge

Garden Home

MacMillan Lodge

PEI Atlantic Baptist Nursing Home

Park West Lodge

Whisperwood Villa:

Clintonview Lodge

South Shore Villa

Other

Other Publically owned Community

Care/Nursing Home

Other Privately owned Community Care/

Nursing Home

Public Home Care or Public Health Nursing

Private Home Care

Addictions Services



6. Currently, I am hired to work/ or I am

designated as:

Permanent full time

Permanent part time at one location

Permanent part time at more than one

location

Temporary

Casual at one location

Casual at more than one location

7. I have a Line Sharing Agreement on

my position:

Yes

No

8. Compared to a full-time position, I am hired

to work/or I am designated to work:

Less than 40 percent

More than 40 but less than 60 percent

60 percent to 80 percent

More than 80 percent but less than 100

percent

100 percent or more

9. Compared to a full-time position, I am actually working :




More than 80 percent but less than 100 percent

100 percent or more

10. I would prefer to work:




More than 80 percent but less than 100 percent

100 percent or more

11. Are you working at any other paid, non-healthcare jobs? (please choose one)

Yes, once in a while

Yes, sometimes

Yes, often

No

12. I prefer to work:

8-hour shifts

12-hour shifts

- Please explain why:

____________________________________________________________________________________________________



13. For each place you work as a health care worker, what are your usual hours of work. (Mark location #1 as where you spend most of your

time, #2 as the next largest amount of time, etc.) Only mark the 1 (one) shift per location that represents most of your work.

Regular 8-hour Shifts Rotating 8-hour Shifts Regular 12-hour

Shifts

Rotating 12-hour

Shifts

Other (please

describe:)

Location

#1 Days

Evenings

Nights

Days & Evenings

Days & Nights

Days, Evenings & Nights

Days

Evenings

Nights

Days & Evenings

Days & Nights


Days

Nights

Days & Nights

Days

Nights

Days & Nights

Location

#2 Days

Evenings

Nights

Days & Evenings

Days & Nights


Days

Evenings

Nights

Days & Evenings

Days & Nights


Days

Nights

Days & Nights

Days

Nights

Days & Nights

Location

#3 Days

Evenings

Nights

Days & Evenings

Days & Nights


Days

Evenings

Nights

Days & Evenings

Days & Nights


Days

Nights

Days & Nights

Days

Nights

Days & Nights

Location

#4 Days

Evenings

Nights

Days & Evenings

Days & Nights


Days

Evenings

Nights

Days & Evenings

Days & Nights


Days

Nights

Days & Nights

Days

Nights

Days & Nights

14. Does your employer contribute to “benefits” for you such as a health plan or retirement funding?

Yes

No



Part 2 Your Work Environment and the People You Work With

15. In the following table please use the 6 point scale to rate your level of satisfaction with each of the items listed on the left. The scale

progresses from 1 to 6 where 1 indicates that you are Very Dissatisfied and 6 indicates that you are Very Satisfied. Please read each item

carefully.

How satisfied are you with the following: Very

Dissatisfied

1

Moderately

Dissatisfied

2

Slightly

Dissatisfied

3

Slightly

Satisfied

4

Moderately

Satisfied

5

Very

Satisfied

6

The level of communication with your immediate supervisor

That your immediate supervisor keeps you informed about the issues

affecting your work

Your job (what you were hired to do)

That you receive adequate recognition from your supervisor when you do a good

job



That your input in discussions/meetings about the workplace is valued


With the level of collaboration within your classification in your work place

The level of collaboration with other classifications in your work place

That your supervisor is responding to the issues that are most important to

you in the workplace

With the team spirit in your workplace



With your ability to maintain a good balance between family life and work life

The quality of your work


Your wages



That your work gives you a feeling of personal accomplishment

With your direct supervisor


16. Of those health care professionals that I work with regularly, I feel that:

(Only mark the situations that

apply to you)

My opinion is

respected by

most:

My opinion is NOT

respected by most:

My work is

respected by

most:

My work is NOT

respected by most:

I feel bullied or

pressured by some:

RNs

RCWs

LPNs

Physicians

Pharmacists

Other Health Care

Professionals

PART 3 QUALITY IN THE WORKPLACE

17. In the following table, please use the 5 point scale to respond to the items listed on the left. Place a mark in the box that best indicates your

experience with each item. The scale progresses from 1 to 5 where 1 indicates NEVER and 5 indicates ALWAYS. Please read each item

carefully.

Never

1

Seldom

2

Occasionally

3

Frequently

4

Always

5

My work is of high quality

I have good friends at work

I receive useful feedback from my immediate supervisor.

The people I work with are positive about their work.

I am over worked (Have too much work to do in the time available)

I am under worked (Do not have enough work to do in the time available)



I am able to use most of the skills for which I have been trained.

I feel positive when I am at work

I feel that I have opportunities to provide input into decisions that affect my

work

At the end of each work day, I have the energy to attend to the people I care

about

At the end of each work day I have the energy to engage in personal interests

I am engaged in meaningful work

I have confidence in our leadership team

I receive the training I need to do a good job

I have opportunities to increase my skills (learn new skills)

I know what is expected of me at work

I have the tools/equipment that I need to do my work properly

At work my opinions are taken into account in decisions that affect the

workplace

My co-workers are committed to doing quality work.

I have the time to do quality work

I work to my full scope of practise

My manager reviews my progress

When I have a stressful day, I get support from my co-workers

I have opportunities to do what I do best (within my classification) at work

I think about leaving my job in health care but staying in PEI

I think about leaving PEI to work in health care in another province or country

I have witnessed staff performing health care duties when they have not

graduated from a recognized training program (not including students)

I am allowed to use the skills I am trained to do during every shift or workplace

I receive performance reviews with my supervisor or manager



PART 4 In Your Opinion In this section, the detail you provide can help create a better picture of the problem areas and areas of success

within the current health care system.

18. Would you like all nursing groups (RNs, LPNs, RCWs) to work to their full scope of practise?

Yes Comments:

No

19. Do you think that your workplace could run more efficiently?

Yes How? ______________________________________________________________________________________________

No

Not sure

20. In the last two years, my employer offered regular in-services training to keep staff up-to-date on current best practices.

Yes - If yes, please list training:

No

21. Are you able to attend most of the training programs you are interested in?

Yes

No – why not?

22. Are you willing to take additional training to work to expand your scope of practice.

Yes

No - If no, why not? _________________________

23. Are there any regulations or legislation that you would like to see changed so that you can work to your full scope of practise? (If yes, what

would need to change?)

24. Does your employer provide any activities/equipment/resources to relieve stress at work?

Yes - please list: __________________________________________________

No - What would you like to have your employer provide? – please list: ______________________________________



25. Are there any other activities/programs/services you would like your employer to provide?

Yes - please list: __________________________________________________

No

26. If you were talking to someone about coming to PEI to work in your profession, what would you tell them about what you like most about

your work?

27. If you were talking to someone about coming to PEI to work in your profession, what would you tell them about what you like least about your

work?

28. The main reason(s) I might leave my job in health care in PEI is/are:

29. The main reason(s) I stay in my job in health care in PEI is/are:

30. In the past 12 months, have you ever been denied a vacation request for vacation time you had earned?

No

Yes - How many times?

Once

More than once but less than 3 times

More than 3 times

- What was the reason(s) given?

- Was your denied vacation request given in writing?

Yes – always

Yes – sometimes

No

31. In the past 12 months, have you ever been denied a request for time in lieu for statutory holidays?

No

Yes - How many times?

Once


More than 3 times



- What was the reason(s) given?

- Was your denied vacation request given in writing?

Yes – always

Yes – sometimes

No

32. In the past 12 months, have you been scheduled to work a double shift?

No

Yes - How many times? ____________

Once


More than 3 times

- What was the reason given?

33. In the past 12 months, I have worked double shifts:

Never

On occasion when asked by my employer on

Regularly when asked by my employer

Only at my request

34. In the past 12 months, have you ever felt pressured to work a double

shift?

Yes - How many times? ____________

Once


More than 3 times

No

35. I am required to perform duties that were not part of my original

job description.

Yes - If yes, are they?

Nursing duties ☐ Non-nursing duties

- Please describe:

No

36. My employer provided formal training for additional duties not included in my job description.

Yes - If yes, please describe training:

No



37. My employer expects me to take on additional duties without providing proper training.

Yes - If yes, please describe duties:

No

38. I would be more satisfied at work if I could work to my full scope of practice.

Yes

No

Comments:

PART 5 COMPUTERS

39. Please mark the areas in the following table that apply to you:

Never Seldom Occasionally Frequently Always Not Applicable

I have access to a computer at

home

I use a computer at home

I have access to a computer at work

I use a computer at work

I am comfortable using a computer

I am comfortable using the

electronic health record in my

workplace



PART 6 THINKING ABOUT THE FUTURE

40. Are you considering retirement in the next 5

years?

Yes - please go to Question 41.

No - please go to Question 42.

41. If yes, what would have to happen for you to consider delaying retirement?

Nothing, I would not consider delaying retirement

More flexibility in time scheduling

Dropping to part-time work

Maintaining benefits while reducing work hours

Line sharing (designated full time but able to arrange to give some of my time to

another worker)

Not have to work nights/weekends after certain number of years of service

Increase my scope of employment

Decrease my scope of employment

If the workload was not as physically heavy

Taking on a new role: ie – mentoring, teaching, focus on new skills {explanation

required}

Being able to work even if I take an early retirement package

Other (please describe): _____________________________

42. Are you eligible to retire in the next 5 years?

Yes - please go to Question 43.

No - please go to PART 6

43. What best describes why you are not considering retirement? (Please choose

only one.)

I cannot afford to retire just yet

I know I will be needed and can stay on the job

I enjoy my work and want to continue

None of the above (please specify):

_______________________________



PART 6 DEMOGRAPHICS

44. Home Postal Code: __________

46. Number of adults living in your home (including you):

0

1

2

3

4 or more

45. Number of dependents living in your home:

0

1

2

3

4 or more

47. My age (in years) is:

Less than 21

21 – 30

31 – 40

41 – 50

51 – 55

56 – 60

61 – 64

65 +

49. Gender: Male ☐ Female ☐

50. I moved to PEI within the last 10 years:

Yes

No

48. Total family income

Under $10,000

$ 10,000 - $19,999

$ 20,000 - $29,999

$ 30,000 - $39,999

$ 40,000 - $49,999

$ 50,000 - $59,999

$ 60,000 - $69,999

$ 70,000 - $79,999

$ 80,000 - $89,999

$ 90,000 - $99,999

$100,000 and over

Documents

Job_Satisfaction_Survey_2008_Report