FEBRUARY 1988, VOL. 47, NO 2 AORN J O U R N A L

Job Satisfaction and Personalitv d

ARE THEY RELATED?

A. Louise Hart, RN

he purpose of this research project was to investigate the possible relationship T between selected personality characteristics

of operating room nurses and their job satisfaction. The relationship may be important because (1) operating room nurse turnover rates are a major hospital problem contributing to the increased cost of nursing care,' (2) authors have suggested that dissatisfaction with the work area is an important element in the turnover rate,2 and (3) the personality of nurses employed in operating rooms may be a factor that contributes to their job satifaction? The literature suggests that nursing specialty areas need to be studied to determine the relationship among employment situations, an individual's personality, and job satisfaction! If the attributes that produce a satisfactory job-person match could be identified, some of the benefits could include a lower nursing turnover rate,

improved working conditions, and greater job satisfaction.

Operating room nurse turnover is costly because the specialty requires a lengthy orientation beyond the basic RN ed~ca t ion .~ The educational development costs for a competent OR nurse range between $8,000 and $10,000.6 Authors also have suggested that the necessity for extensive OR orientation of an inexperienced RN is due, in part, to the lack of OR experience in nursing school curricula?

Several authors have expressed the opinion that OR nurses must have particular types of personalities to be satisfied with their jobs, and that not every nurse can function in an OR setting because certain innate characteristics are needed.* Other researchers have reported a significant correlation between job satisfaction and the job rate turnover?

professor at the DePauw University School of Nursing Indianapolis. She received her bachelor of science degree in nursing from the University of Missouri, Columbia, and her masters of nursing science degree and doctorate of nursing science from Indiana Universiv, Indianapolis.

The author acknowledges AORN for its jhancial support of thk project, and ackno wledges Carol Deets, RN, E D , professor at Indiana University School of Nursing, and Juanita Keck, RN, DNSc, assistant professor, Indiana University School of Nursing, Indianapolis, for their

A. Louise Hart, RN, DNSc, ir an assfitant assistance.

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Theory Base

he Person-Environment Fit Theory (PEFT) provided the theoretical frame- T work to explore the relationship between

job environments, job satisfaction, and personal- ity.I0 The theory was developed to address mental and physical health in industry, and the role the fit between the person and the job has upon health. Two personality characteristics derived from PEFT-anxiety and locus of control-are explored in relation to OR job satisfaction.

Anxiety was chosen because the OR is considered to be a stressful environment; however, the interpretation of the OR as an anxiety- producing environment varies among individu- als.'' Theoretically, when there is a poor fit between the characteristics of the person and the job, employee satisfaction is reduced.12 If a poor fit between person and environment occurs, job dissatisfaction should result; if a good fit exists, job satisfaction is predicted.

An internal locus of control is associated with the belief that events, positive or negative, are the result of one's own behavior, and they are potentially under the personal control of the indi~idual.'~ Internally controlled individuals are described as assertive, independent, and possessing the ability to appreciate internal rewards. An internal locus of control may be a salient personality characteristic for OR nurses. They are described as individuals who need the ability to derive rewards and satisfactions from a job well done based on their own appraisal because

they often cannot depend upon others for rewards.14 Person-Environment Fit Theory also proposes that age, education, and tenure are important to job satisfaction.

Literature Review

o studies were identified whose specific purpose was to study the personality N characteristics of OR nurses as they

related to the OR environment and OR job satisfaction. Thus, studies of other nursing specialty areas were assumed to be similar to the OR specialty and were reviewed. The suggestion was made that the similar specialty characteristics of the intensive care unit (ICU) nurse and the OR nurse make a comparison valid.15

In one study, the relationship between anxiety as a trait and job satisfaction among ICU nurses and non-intensive care nurses was investigated.16 For ICU nurses, low anxiety scores were associated with greater job satisfaction.

Another researcher also used trait anxiety scales to study ICU and non-ICU nurses' job satisfac- tion." The researcher was interested in determin- ing if ICU nurses have personality characteristics that allowed them to cope better with the higher level of stress assumed to be a component of their environment. Both groups of nurses indicated satisfaction with their jobs; however, non-ICU nurses expressed higher trait anxiety than the ICU nurses. The study concluded that the lower anxiety scores of the ICU nurses may enable them to tolerate high levels of stress.

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Researchers investigating the locus of control of nurses in relation to job satisfaction hypothe- sized that an internally oriented person would perceive his or her job differently than an externally oriented person.’8 Their results indicated that the RNs who expressed a tendency toward internal control had higher job satisfaction scores.

Variables extracted from previous studies and incorporated into this study included the person’s previous OR educational experience; the variables of education, age, and tenure; and the number of operating rooms in the hospital. It was thought that nurses with O R experience in their basic nursing education would have a more realistic expectation of the O R environment and the requirements involved in operating room nursing than those who did not have such a backgr0~nd.I~ If expectations and job satisfaction are related positively, then it is assumed that OR nurses with specific O R education are more likely to express job satisfaction.

The variables of education, age, and tenure in relation to job satisfaction were investigated in a 1978 study focusing on 55 general-duty nurses.2O Diploma-prepared nurses were found to be more satisfied than nurses with associate degrees or baccalaureates. Those over 40 years of age were more satisfied, and job satisfaction increased with tenure both in relation to time at the same hospital and time in the specific job.

Another study involving 757 O R nurses in-

used. The sample was limited to RNs who had completed an operating room orientation period, and who were currently employed in their present positions for one year or more. The sample also was limited to nonsupervisory staff nurses to ensure that the subjects’ main responsibilities were identifiable as hands-on operating room practice.

After obtaining permission from hospital research departments, operating room managers were contacted. Possible sample members were approached when OR nurses gathered for O R staff meetings immediately before the workday began. All supervisory personnel were asked to leave the data collection area. The letter of consent and data collection instruments were explained and questions answered. The potential subjects were informed of their rights and advised that their participation was voluntary.

Data Collection

our instruments were used to measure the variables. Included were the Spielberger F State-Trait Anxiety Inventory, a modifica-

tion of the Rotter Internal-External Locus of Control General Expectancy Scale, an operating room specific expectancy locus of control scale, and a semantic differential measurement of job satisfaction. All of the instruments used were

tionship to nurses’ job satisfaction. The results showed no differ- ences in job satisfaction be- tween nurses working in hos- pitals with a large number of ORs and nurses working in hospitals with fewer ORs.

Ihe study sample consisted of 138 fe- male RNs between 22 and 58 years of age employed full-time in hospital oper-

ating rooms. Eleven hospitals, all located within or in the vicinity of a large midwestern city, were

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reviewed for validity and reliability. Demographic data also were collected.

The Spielberger State-Trait Anxiety Inventory consists of two separate self-report scales for measuring two distinct anxiety concepts: state and trait.Z2 State anxiety is characterized as a transitory emotional condition that is influenced by unique factors associated with specific situations. Trait anxiety, on the other hand, is conceptualized as relatively stable anxiety proneness (ie, the tendency to respond to situations perceived as threatening with elevated state intensity)J3

The Internal-External Locus of Control instruments were both a general and an OR- specific to01.2~ The locus of control tools were modifications of the original Rotter Internal- External Locus of Control instrument. The items of the instrument do not directly address the preference for internal or external control; however, they were designed to ascertain the subject’s expectations of how reinforcement is controlled. A high score on the scales indicated an externally controlled individual, while a low score was representative of an internally oriented person.

An Osgood sematic differential scale was developed to measure the dependent variable, job satisfaction.25 Because the purpose of this study was to investigate the relationship between selected personality characteristics of OR nurses and their

expression of general job satisfaction, a general assessment of OR job satisfaction was deemed appropriate. The assumption was the higher the score on the differential scale, the greater the job satisfaction.

Subjects also were asked to complete a demographic data sheet that included age, education, tenure as a nurse, and length of time at the present hospital and in the present operating room. Subjects also were asked to indicate if they had OR experience in their basic nursing education program.

Findings

he findings proved to be mixed. They indicated support for some traditional T assumptions, and departures from other

assumptions. The following highlights the data collected in this study.

The results of the statistical analyses indicated a relationship between personality and job satisfaction. Alpha reliability coeffi- cients were obtained for the four measures of personality and the job satisfaction scale. Although all nurses reported job satisfaction, the OR nurses with the lowest level of expressed anxiety indicated the highest levels of job satisfaction. Those OR nurses who expressed the greater degree of internal locus of control expressed higher job satisfaction.

AORN JOURNAL FEBRUARY 1988, VOL. 47, NO 2

Nurses employed in hospitals with a small number of operating rooms expressed higher job satisfaction than nurses

working in hospitals with a large number of ORs.

An additional finding garnered from nurses in postcollection conversations cited that the “need for order” and “liking a challenge” were important attributes for OR job satisfaction.

Job satisfaction was not related to the demographic data analyzed. A Chi-square analysis was done for the three levels of nursing education. A Pearson Product Moment Correla- tion coefficient was calculated to analyze the three variables of tenure, years in nursing, and months at present hospital or years in the OR. The subjects ranged in age from 22 to 58 years with an average age of 33. Tenure in the OR was from one year to 26 years with a mean of 6.6 years. Twenty- five percent of the subjects had a diploma, 36% had an associate degree in nursing, and 38% had a bachelor of science degree in nursing. Fifty-six percent of the nurses reported they had operating room experience in their basic nursing education.

Contrary to the literature, this study did not show a relationship between certain demographic data and job satisfaction. Older nurses were not more satisfied in their job than younger nurses. An increase in any of the three variables designed to reflect tenure, years in nursing, months at present hospital, or years in the OR were not associated with a corresponding increase in job satisfaction. In addition, there was no difference in expressed job satisfaction based on the level of the nurse’s education.

Nurses who had OR experience in their basic education reported higher job satisfac- tion. This study found that nurses with OR experience in their basic education expressed a mean job satisfaction score of 72.7, while those without previous OR experience scored a lower 67.5. The difference in these two scores was statistically significant.

Nurses employed in hospitals with a small number of ORs showed significantly more job satisfaction than those employed in hospitals with a large number of ORs. A serendipitous

finding revealed that there was a significant difference in job satisfaction based on the number of ORs in the hospital. Eleven hospitals were included in the study, with OR capacities ranging from four to 28. Hospitals categorized as small contained four to eight operating rooms, and hospitals with 20 or more ORs were considered large. This finding contradicts the results of previous studies where number of operating rooms was used as a variable.

Discussion

basic proposition of PEFT is that employee well-being is, in part, a function A of the fit between characteristics of the

person and characteristics of the job. If there is a poor fit, employee well-being will be lessened, resulting in job dissatisfaction. A previous study suggested that persons with high levels of trait anxiety may be less able to cope with stress than those with low levels of trait anxiety.26

It would be expected that persons who are satisfied with their jobs in the OR, which is considered a stressful environment, would exhibit low levels of trait anxiety. The low state and trait anxiety expressed by the OR nurses in this study indicated that the nurses were not anxious in what has been suggested as a high-stress environment. Their moderately high job satisfaction suggested a good fit between themselves and their envir- onment. These findings were in agreement with previous studies2’

The OR nurses in this study expressed a high tendency toward internal locus of control and moderately high job satisfaction. This can be seen as support for the Person-Environment Fit Theory because there was a fit between the internally locused nurses and an environment lacking external rewards. This corresponds with a previous study that reported similar negative relationships between locus of control and job satisfaction

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among operating room nurses.28 This study suggested that certain personality

variables may be successfully utilized to select nurses in specialty areas, and can be the basis for continued research. Such selection has been indicated as a way that the turnover rates within specialty areas of nursing may be decreased and hospital costs contained.

An additional finding was that nurses employed in hospitals with a small number of operating rooms expressed significantly higher job satisfac- tion than nurses working in hospitals with a large number of ORs. The finding was in disagreement with a previous study that reported no significant differences in job satisfaction based on number of ORs.Z9 This study may indicate that OR nurses prefer to be part of a relatively small group where individuals know their coworkers and their responsibilities.

Recommendations

he variable, number of OR rooms, needs to be investigated further to better T understand the relationship between it and

job satisfaction. The findings concerning the variable of exposure to OR in the basic education curriculum support the value of providing OR experience to students. Such an experience would give students the opportunity to develop realistic expectations of OR nursing and an opportunity to decide whether or not it is the type of nursing they wish to pursue.

Finally, it is recommended that the study be replicated to determine if the results can be duplicated by other researchers. If personality variables prove to be important for OR personnel selection, the reduction of turnover could be influenced. 0

Notes 1. F L Ulschak, J K Hixon, “Coming on board

and staying,” AORN Journal 38 (July 1983) 5 1-56. 2. A Harvey, “Finders keepers, or weathering the

nursing shortage,” Today’s OR Nurse 4 (February 1983)

3. C Joiner et al, “The motivating potential in nursing specialties,” Journal of Nursing Administration 12 (February 1982) 26-30.

15-17.

4. M R MacDonald, “Matching personalities with position: A study of job satisfaction,” Supervisor Nurse 6 (April 1975) 43-50.

5. Ulschak, Hixon, “Coming on board and staying,”

6. B Trimiglozzi, K Cooke, “Meeting demands for qualified OR nurses,” Today’s OR Nurse 7 (July 1985)

7. Harvey, “Finders keepers, or weathering the nursing shortage,” 15-17; B J Gruendemann, “Analysis of the role of the professional staff nurse in the operating room,” Nursing Research 19 (July/August 1970) 349- 353; C Mailhot, J L Binger, “The operating room: A complex challenge for the nursing administrator,” Journal of Nursing Administration 14 (April 1984) 1 1 - 16.

8. “An interview with Cynthia Porter Hartman,” Today’s OR Nurse 4 (December 1982) 32-36; Gruendemann, “Analysis of the role of the professional staff nurse in the operating room,” 349-353; C A Lindeman, S L Stetzer, “Effect of preoperative visits by operating room nurses,” Nursing Research 22 (January/February 1973) 4-16; E S Schrader, “As she puts on her mask,” AORN Journal 21 (February 1975)

9. Harvey, “Finders keepers, or weathering the nursing shortage,” 15-17; J L Price, C W Mueller, Professional Turnover: The Case of Nurses (New York S P Medical & Scientific Books, 1981).

10. J R P French, R L Kahn, “A programmatic approach to studying the industrial environment and mental health,” Journal of Social Issues 18 (1 962) 1 - 48.

11. C A Preston, J M Ivancevich, M T Matteson, “Stress and the OR nurse,’’ AORN Journal 33 (March

12. French, Kahn, “A programmatic approach to studying the industrial environment and mental health,”

13. J B Rotter, Social Learning and Clinical Psychologv (Englewood Cliffs, NJ: Prentice-Hall, 1954).

14. M R Parker, “The nurse as a leader,” Today’s OR Nurse (March 1983) 8.

15. C Joiner et al, “The motivating potential in nursing specialties,” 26-30; J A Uebele, Job Satirfaction and Dissatisfaction Among Operating Room Nurses, (PhD dissertation, Ann Arbor, Mich: University Microfilms International, 1979) 11-104.

16. G L Wallace-Barnhill, Comparison of Intensive Care Unit Nurses, Non-intensive Care Unit Nurses and Non-nursing Personnel Personalio, (PhD dissertation, Ann Arbor, Mich: University Microfilms International, 1981) 94.

17. J P Maloney, “Job stress and its consequences on a group of intensive care and non-intensive care nurses,” Advances in Nursing Science 4 (January 1982)

51-56.

32-34.

222-229.

198 1) 662-67 1.

1-48.

31-42.

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18. T F Frost, H G Wilson, “Effects of locus of control and A-B personality type on job satisfaction within the health care field,” Psychological Repons 53 (October 1983) 339-405.

19. J P Wanous, “Organizational entry: From naive expectations to realistic beliefs,” Journal of Applied

20. D B Slavitt et al, “‘Measuring nurses’ job satisfaction,” Hospital & Health Services Administration

21. Uebele, “Job satisfaction and dissatisfaction among operating room nurses,” 82.

22. C D Spielberger, R L Gorsuch, R E Lushene, ST4I manual for the Stait-Trait Anxiety Invenloiy (Palo Alto, Calif: Consulting Psychologist Press, 1983) 1-35.

23. Ibid, 1. 24. B S Nichols, A n Expansion of RotterS Social

Ps~choZO~ 61 (1976) 22-29.

24 ( 1979) 62-76

Learning Theory in Terms of Locus of Control, (PhD dissertation, Ann Arbor, Mich: University Microfilms International,l983) 1-1 35.

25. D F Polit, B P Hungler, Nursing Research: Principles and Methods, 2nd ed (Philadelphia: Lippincott, 1983) 331.

26. French, “A programmatic approach to studying the industrial environment and mental health,” 1-48.

27. Maloney, “Job stress and its consequences on a group of intensive care and non-intensive care nurses,” 3 1-42; Wallace-Barnhill, Comparison of Intensive Care Unit Nurses, Non-intensive Care Unit Nurses and Non- nursing Personnel Personality.

28. Preston, “Stress and the OR nurse,” 662-671. 29. Uebele, “Job satisfaction and dissatisfaction

among operating room nurses.”

Vitamin A Improves Newborn Lung Function After 10 years of research, physicians at Vander- bilt University (VU), Nashville, Tenn, concluded that vitamin A deficiency may stunt lung devel- opment in premature infants. They found that premature babies have low levels of vitamin A and that children who die from bronchopulmo- nary dysplasia generally have impaired lung function and low levels of vitamin A in their livers.

The physicians studied 40 infants weighing between 700 and 1300 g. The infants were divided into two groups. One received standard treatment, the other received 1000-unit doses of vitamin A every other day for 28 days. The vitamin was given in intramuscular injections to avoid possible toxicity from direct injection to the bloodstream. The dose was based on the National Research Council’s recommended daily allowance.

Infants who received vitamin A showed signif- icant improvement in lung function compared to the other infants, and morbidity dropped approx- imately 5056, according to a news release from VU Medical Center. These infants also required less supplemental oxygen and experienced less airway infection and eye disease.

that will determine whether a child requires Physicians at VIJ are developing a blood test

vitamin A therapy, and they will continue their study with a larger population of premature infants.

Fibrinogen Studied as Cardiovascular Risk An elevated level of fibrinogen, a protein involved in blood clotting and blood flow, is an important predictor of cardiovascular disease and should be added to the cardiovascular risk factor profile, according to the Sept 4 issue of Journal of the American Medical Association.

Researchers at the Boston University Medical Center studied fibrinogen levels from 1,3 15 peo- ple enrolled in the Framingham Study, a 12-year study of cardiovascular disease risk factors.

Overall, elevated levels were found to be sig- nificant predictors of cardiovascular disease in men, and marginally significant predictors in women. As a predisposing factor for coronary heart disease, fibrinogen was comparable to the major accepted risk factors, such as cigarette smoking, high serum cholesterol, and hyperten- sion, according to the article. Elevated fibrinogen levels are also thought to be a strong risk factor of stroke.

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