Nursing as a Profession

Nursing as a profession has been reported to be stressful. The profession is known to be  associated with high prevalence of job dissatisfaction, emotional disturbances and psychological distress universally (Coker A. et al. 2014). Socioeconomic factors, type and nature of occupation, daily schedule, competitive workload and emotional disturbances have led to increased stress levels in the modern lifestyle especially among those who work in rotating shift as nurses (Kshetrimayum N. et al. 2019). On the other hand, nursing job satisfaction is one indicator of the quality of health care provided in the hospitals. Nurses’ satisfaction is an emotional response and behavioral reflexion which reflects individual evaluation of his or her own performance, working life, and working environment ( Rizany I. et al. 2019)
     Health-care providers work with patients who are suffering from life-threatening trauma or facing death and dying. Working in such conditions is stressful and may result in  psychonxious among health-care providers (AlMutair A. et al 2017). From another point of view, management usually increases the workload in nursing care and does not provide sufficient staff which results in a high operating speed as well as varied workload in units. Overload reduces the ability of nursing staff in solving emotional distress in patients, coping with death and communication with family members which in turn adds another load for psychological status of nurses and more distress (Dobnik M. et al. 2018)
Problem statement
The relationship between nurses’ job satisfaction and psychological distress

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To assess nurses’ job satisfaction in King Khalid Hospital in Hael
To assess psychological distress among nurses in King Khalid Hospital, Hael

Literature review
     Adopted articles are retrieved from data bases Springer, Pubmid, CINHAL and Google scholar using the key words: nurses’ job satisfaction, psychological distress, emotional disturbances, workload and burnout. Eight articles were chosen out of eighteen based on being quantitative or literature review and published between 2019 and 2016.
     Different studies were done to assess the association between nurses’ job satisfaction and psychological distress. Khamisa N. et al. (2017) concluded in their cross sectional study that staffing issues and coping strategies need to be evaluated in South Africa because of their great effect on nurses’ health and burnout. Koutsimani P. et al. (2019) opposed the previous study using systematic review to assess the relationship between anxiety and burnout among nurses in Greece and ended up with the result that no conclusive overlap between anxiety and burnout and further studies are suggested for more association proof.
     Another study investigated this problem form a different point of view; Godwin A. et al. (2016) studied the identification of causes of occupational stress and their effective management and its effect on stress and anxiety among nurses in Ghana. They concluded that effective management polices to overcome nursing occupational problems has a positive effect in minimizing stress. Almutair A. et al. (2019) conducted a cross-sectional study to assess the overall emotional function of health care providers in Saudi Arabia and resulted in a conclusion of that psychological distress may result from stressors associated with high work demands, high workload, nursing staff shortage, fear of infection, fear of losing job, fear of reaction from leaders, peers and patients and their families. They recommended organizational supportive programs to decrease the previously mentioned stressors.
     Another important factor in increasing psychological distress among nurses is scheduling management and its effect on job satisfaction; that was the aim of Rizany I. et al. (2019) in their study to investigate using a cross sectional study in Jakarta and concluded that the effective management of nurse scheduling is statistically correlated with increased nurse job satisfaction level which in turn decreases their stress since this allow them to be involved in their social life.
     Dobnik M. et al. (2018) investigated work related stress factors among nurses in Slovenia using a cross sectional study to end up with the result that stress rate and stress factors are influenced by variables reflecting work organization, competences, qualifications and skills of healthcare management to work with other people. Recommendations for the need for nursing management and policy makers to set policies to ensure adequate staffing, effective organization and motivating work environment.
     Kshetrimayum N. et al (2019) defined stress as a dynamic and reciprocal relationship between the person and the surrounding environment. From this definition it is clear that nurses’ stress is related to occupational conditions. A descriptive cross sectional study was done in India and concluded that nurses had a moderate level of occupational and perceived stress which need an effective management to overcome occupational stressors.
    From the above literature we can conclude that most studies’ results agree with the hypothesis that nursing psychological distress is greatly associated with job satisfaction which is controlled primarily by nursing management.

A. Design
Quantitative, descriptive cross-sectional study

B. Setting of the study
King Khalid Hospital in Hael

C. Population
      All nurses in King Khalid Hospital in Hael

D. Sample
Nurses who meet the inclusion criteria in King Khalid Hospital will be the sample of this study.
E. Sample size and sampling technique
One hundred nurses will be selected to be the sample using non-random convenient sampling technique

F. Inclusion criteria
Nurses with BSc certificate, passed the SCHS exam, Saudi  and non-Saudi nationality and willing to participate in this study.

G. Exclusion criteria
Nurses who don’t have BSc certificate in nursing, failed the SCHS exam and not willing to participate in the study will be excluded from this study.

H. Ethical consideration
Approval from IRB will be obtained as well as the Saudi Ministry of Health and the manager of King Khalid Hospital. Informed consent from the participants also will be obtained. Ensuring participants’ privacy, confidentiality and anonymity. Participants will be informed that they have the freedom to withdraw anytime from the study without any coercion.  

I. Time frame
The study will be done over a period of four months.

J. Tool and data collection procedures
Part one: demographic data of the participants including age, sex, ethnicity, area of experience, years of experience, area of experience and marital status.
Part two: a questionnaire is developed to assess nursing job satisfaction composed of four parts; the first one regarding enjoying the job of three questions with five choices for answers, the second one regarding doing the job of five questions of five answer choices, the third one regarding colleagues of three questions of five answer choices and the last one regarding administrative issues of seven questions of five answer choices.
Part three: Kessler stress scale will be used to assess level of psychological distress of nurses (Kessler et al. 2002)
Data will be collected over four months on different rotating nursing shifts. Pilot test will be done to determine content validity and reliability of the questionnaire

K. Plan for statistical analysis
Data will be analyzed using SPSS and factor analysis test will be used.


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