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INTRODUCTION

Two years after the outbreak of COVID-19, the world has changed and

had a significant impact on people's daily lives. The outbreak has increased

public awareness of the health care system, and the health workforce has been

disproportionately exposed to the virus. Throughout those two years, nurses

demonstrated their willingness and flexibility in adapting to new ways of working,

which has continued to the present. Since the start of the COVID-19 pandemic,

there have been millions of COVID-19 infections reported among healthcare

professionals worldwide, tragically.

In comparison to before the pandemic, nurses reported higher levels of

stress, fewer flow events, and much worse levels of satisfaction with their jobs,

personal lives, work performance, and general well-being. Additionally, nurses

reported feeling less gratitude from their patients but more from society.

There is a substantial need for registered nurses, but not enough capable

people to meet the need. This indicates that we are short on qualified nurses who

can provide essential and required care for patients in need.

Background of the Study

In today’s present generation, COVID-19 still affecting our daily lives.

Many have lost love ones, many suffered ill-health. In instance, nurses, who

account for more than 50% of the current deficit of health workers, are in short

supply, according to the World Health Organization. The provision of primary and
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community healthcare, the promotion of health, and the prevention of disease all

depend on nurses. They provide care in urgent situations and are essential for

achieving of universal health coverage. The central of Primary Health Care are

the nurses and who are frequently the first and sometimes the only medical

provider that people encounter. The quality of their initial evaluation or

assessment, care and treatment is vital. Nurses can develop and implement

successful treatments to suit the needs of patients, families, and communities

since they are also a member of the local community, sharing its culture,

strengths, and weaknesses. (The State of the World’s Nursing 2020). According

to the National Nurses Association (NNA), nurses in various nations throughout

the world state that they are concerned about rising health dangers, a persistent

risk of COVID-19 infection at work, and significant work expectations because of

the rise in patients with urgent needs and insufficient nursing staff workforce

levels to address the situation safely and effectively. They also state that nurses'

work is still emotionally and physically exhausting in many hospital settings.

It is important to think about the issue of mental health and how to help

nurses in the context of the present coronavirus pandemic and against a

background of a pre-existing understaffing of nurses. (Scott, J. 2020). Nursing

shortages clearly increased the risk for the health workforce, including a negative

impact on patient care quality. Researchers believe that one of the main causes

of emergency department overcrowding is a shortage of nurses, which can result

in an extension of hospitalization, the need for further surgeries, permanent

injury, or even death. However, the shortage of staffing is not enough because it
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is a long-term issue in the nursing profession, with the safety outcome of

understaffing likely being worsened by the COVID-19 outbreak. (Andel, Shen,

Arvan, & Maryana. (2021). The experience was new and challenging, and the

nurses has a contribute enormously to the management of COVID-19. Positive

and negative emotions of front-line nurses intertwined and coexisted during this

COVID-19 outbreak. (Konwar, Kakati, & Sarma,(2022). In addition, overcrowding

also increases the risk of physicians committing more errors. Lack of nurses is

leading to issues like patients waiting for hours for their first consultation with the

doctor in the emergency room.

The COVID-19 pandemic resulted in numerous hospitals being challenge

to accommodate the daily, quickly increasing number of infected patients

requiring critical care while maintaining the standard of care and safe practice in

critical care units. One of the major effects and most challenging issues to deal

with is the shortage of nursing staff in the critical care unit. (Mhawish, & Rasheed

(2021). Nurses are the heart of health care because caring is the essence of

nursing and their workload is multifaceted and very complex. Therefore, prior to

the pandemic, there was a well-known problem with the global nursing shortage.

The World Health Organization (WHO) published the first State of the World's

Nursing (SOWN)2 report in 2020. It is having a harmful effect around the world.

The nursing shortage can lead to medical errors, a lack of patient engagement,

and missed nursing care (PRS Global). However, in general, it indicates that the

growing COVID-19 effect, which considers that the nursing workforce has been

traumatized or may result in global nurse shortages.

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There are a lot of factors that have contributed to the shortage of qualified

employees, which also includes: increase demand to provide care for an aging

population. older nursing staff are getting ready to retire. understaffing of trained

nurse educators and faculty. The degree to which individuals feel positive or

negative about their jobs Therefore, the response people may experience when

presented with work demands and stresses that are out of proportion to their

knowledge and skills and that test their capacity for adjustment also a person's

capacity to comprehend and affect their own emotions as well as those of those

around them. The perspectives of the head nurses and their staff can be seen

within these themes, as evidenced by the primary problems that the nurses face

when recording data: Inadequate supervision for nurses on nursing

documentation, Competency issues in documentation, Because of the shortage

of staff, they sometimes encountered failures to date, time, and sign a medical

entry.

In addition, shortage of nurses is generally affected not only individual’s

health but also their way of living. However, without more nurses being trained by

higher education institutions, the nursing shortage cannot be resolved. What we

all need is focus more on maintaining the satisfaction of the patients through

giving holistic care and the quality of services that they deserve.

This study aims to determine the impacts of nursing shortage in patients

care amidst the COVID 19 pandemic in Southern Isabela Medical Center,

Santiago City.

Research Questions
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This study aims to answer the following questions:

1. What is the demographic profile of the respondents in terms of:

1.1 Age

1.2 Gender

1.3 Civil Status

1.4 Work status in term of

1.4.1 Department

1.4.2 Work Tenure

2. What is the impacts of nursing shortage significantly relate to quality of patient

care during pandemic in terms of:

2.1 Job satisfaction

2.2 Work stress

2.3 Work load

3. Is there any significant difference of nursing shortage in patients care before

and during pandemic?

Significance of the study

This study will be beneficial to the following:

Nurses. This study helps them advance their field, stay updated and offer

better patient care.

Teachers. This study will help the teachers to boost morale and they will

focus more on helping the students to enhance the capacity to learn and
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motivate them as well to finish the study of the students till they graduated and

be one of the staff nurses who will serve our country.

Students. With the school administration and teacher’s effort to inculcate

spiritual values and develop strong commitment to future workplaces, they will be

central recipients of the programs, projects and activities of the school on

development spiritual and workplace values aside from providing them physical

and emotional support to enhance their academic performance.

Future Researchers. This will serve as a springboard for prospective

researchers, the benefit of this study, is they will be awakening and motivated to

study harder and be one of the nurses that will serve our country. To help a lot of

people in need medically and morally. Being them also as a future researcher, it

will serve as their basis and also guide for them to create a good study like this.

Theoretical background

Nursing theory is "an organized framework of concepts and aims

designed to guide the practice of nursing,"  The purpose of developing nursing

theories is to explain and define nursing care, to guide nursing practice, and to

establish a foundation for clinical decision making (Petipen, 2016).

According to Watson (1997), the core of the Theory of Caring is that

"humans cannot be treated as objects and that humans cannot be separated

from themselves, others, nature, or the larger workforce." Her theory

encompasses the entire field of nursing, with a focus on the interpersonal

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relationship between the caregiver and the care recipient. "the importance of

human caring and on the caring-to-caring transpersonal interaction and its

healing potential for both the one who is caring for and the one who is being

cared for," as stated in the theory, is the main focus (Watson, 1996).

The application of Watson's theory is carried out using what are known as

carative factors or caratas processes. There are ten reasons that contributed to

this result, and they are as follows: In a nutshell, the application of the theory is

demonstrated as the practice of loving-kindness, equanimity, authenticity,

enabling, cultivating a spiritual practice, developing a relationship that is helping-

trusting, enabling the expression of both positive and negative feelings, having a

caring-healing practice, having a willingness to learn for the caring experience,

being able to engage in a teaching-learning experience that is genuine, enabling

and creating environments that are enabling and creating environments that

(Watson, 2017). In reality, this implies that a nurse practitioner engages his or

her own emotions in the caring relationship, and does not close  to new spiritual

and emotional experiences while attending to the patient's physical and health-

related requirements.

Nursing is a physically, emotionally, spiritually demanding and stressful

job.  It would be beneficial to make use of Jean Watson's grand theory of human

caring in order to investigate methods in which a more supportive working

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atmosphere might be created for nurses. Watson's theory was her attempt to

give meaning and focus to nursing as an emerging discipline and distinct health

profession that had its own distinct values, knowledge, and practices, as well as

its own ethic and mission to society. Watson's theory was a result of her attempt

to bring meaning and focus to nursing as an emerging discipline and distinct

health profession (Smith & Parker, 2015, p. 322). Watson developed the caritas,

which derives its meaning from the Latin phrase "to cherish and love, give special

attention to, or love," as a framework for nursing that provides a format and focus

for the profession (Smith & Parker, 2015, p. 323). The ten Caritas processes

(Watson, 2008), along with some instances of how leaders might use these

processes as a guide towards reducing the nursing shortage, are described in

this article.

Staff members should be encouraged to engage in activities that promote

self-care and to demonstrate loving kindness for both themselves and their fellow

staff members. Encourage people to keep their faith and optimism alive. Instill a

spirit of faith and hope in the workforce by granting days off for the staff's

religious holidays and other important celebrations. Promote an individual's

unique set of beliefs and practices, as well as those of others. Recognize the

differences in staff members and promote their potential and talents. Promote

helping and trusting relationships. Use effective communication skills and be

accepting and sensitive to the feelings of the staff. acceptance of positive and

negative feelings. Let staff give their ideas, positive or negative, without

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judgment. without passing judgment on their opinions.Creative solution-seeking

using scientific methods and all ways of knowing. Encourage the staff assist in

problem solving when issues arise.Genuine teaching and learning that supports

individual needs.  Support a working environment that provides chances for

continuing nursing education and design work schedules that allow individuals to

seek higher education while still fulfilling their obligations at their place of

employment. Creation of a healing environment.  Give the staff a supportive and

nurturing place to work, no matter what pressures may be coming from inside or

outside. Provide acts of healing by attending to basic human needs. Make sure

the staff has adequate time for breaks, lunch, and bathroom visits. Remain open

to mystery and the unknowns of existence. Be open and accepting of the

diversity of the staff and their spiritual and religious beliefs.

Jean Watson's caring theory is the philosophical foundation of the discipline of

nursing. Care theory is the belief that all of humanity's needs must be met.

Watson's theory of human caring begins with love, and this is how we are

connected to all mankind. Watson's caring theory encompasses three

components, the caritas process, the transpersonal caring relationship, and the

caring moment or occasion. In contrast to the curative elements of medicine,

the caritas processes, also known as the carative factors, were developed as

nursing guidelines. Loving-kindness, faith-hope, transpersonal, relationship,

forgiveness, creative self, learning, caritas field, humanity, and infinity are the

10 caritas processes.
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According to the loving-kindness aspect of the process, nurses must prioritize

self-care in order to be altruistic toward others. It is considered his step of the

procedure crucial to the treatment of patients during the COVID-19 pandemic.

In his explanation of the Caritas process, Watson describes it as the

cultivation of a spirit of loving-kindness and equanimity, which is a condition of

mental composure, inside oneself and others in order to serve as our first

conscious act of caring for others. The mental health of nurses is just as

important as their physical health, and they should be gentle to themselves.

When people make an effort to love ourselves, it can serve as a source of

motivation for everything else we accomplish.

Once a nurse is able to stimulate loving kindness, their hearts are

overjoyed with compassion and this spreads to their life experiences. Young

(2006) emphasizes that the first caritas would not work if loving kindness is

used as a facade to conceal one's feelings of frustration, hurt, anger, worry,

and despair. The nurse must be able to navigate through this pain, and allow it

to be released and absorbed by the space of energy. Once these emotions

have dissipated and been carried by the flow, a deeper true charity, or caritas,

radiates from within to others. In addition, the theory of caring proposed by Jean

Watson upholds the time-honored principles of empathy and caring, as well as

supports a more sentimental and open approach to the treatment of patients

within the context of a healthcare setting. In order to provide a healthier and more

pleasant atmosphere for everyone involved, nurses are strongly urged to interact

with their patients and the relatives of their patients in a sincere and spiritual
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manner. This helps to ensure that everyone benefits from the healthcare setting.

According to the findings of several studies, when patients are involved in this

way, both the nurses and the patients benefit from the experience that they have

in common.

When the caring theory is integrated into the nursing curriculum, nursing

students learn early on in their profession to include the theory in their own

practice, which enables a more authentic experience of nursing for both the

students and the patients who are cared for by them.

Conceptual Framework

INPUT PROCESS OUTPUT

 Age The tool was structured Determined the impacts

 Gender questionnaire to assess the of nursing shortage
 Civil Status impact of nursing shortage significantly relate to
 Work status in on nurse’s workload, stress, quality of patient care
term of satisfaction, and patient during pandemic in
care. This questionnaire was terms of:
o Depart
ment basically divided into four  Job
o Work sections by considering the satisfaction
Tenure following objectives:  Work stress
 Workload
o collect demographic
information about Identified significant
the respondent. difference of nursing
o to determine the job shortage in patients care
satisfaction level of before and during
nurses. pandemic.
o about the work stress
level of nurses
o to determine the
workload level of
nurses
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Figure 1. Conceptual Framework

The following conceptual framework was developed to identify the relationship, if

any, and the impact among the related variables of the study. The following

operational definitions of the study variables were developed by the researcher

and used in this study.

Variables Definition
Nursing shortage The number of nurses is not enough to provide
high quality of the care as compared to the
professional standard
Job satisfactions The degree to which individual feel positive or
negative about their jobs
Work stress The response people may experience when
presented with work demands and pressure that
are not matched to their knowledge and abilities
and which challenge their ability to cope.
Patients care The service offers by health professionals in
promoting health and preventing illnesses of the
patients.

Above the conceptual framework (Figure 1). The conceptual framework

inputs demographic data of respondents to determine other factors that

influences the process where the process indicates objective is to identify

whether shortage of nurses influence the Job satisfaction, work stress, and

workload. The process was basically divided into four sections by considering the

following objectives: Section 1: designed to collect demographic information

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about the respondent. The first section, comprising of questions 1 to 5 required

personal information with regards to current position, number of service years,

age, gender, and marital status. Section 2: Questions 1 to 15 were included to

determine the job satisfaction level of nurses. Respondents were required to

make a choice from the job satisfaction elements listed. Response alternatives of

very dissatisfied, dissatisfied, neutral, satisfied and very satisfied were applicable

to all these 15 questions. Section 3: Questions 1 to 15 were about the work

stress level of nurses. Respondents were requested to select one choice by

checking the number on the scale. The Likert scale with five response

alternatives of no pressure, some pressure, and moderate pressure, more than

average and extreme pressure was used to measure opinion, reaction, and

attitude in relation to the statement given. Section 4: Questions 1 to 8 attempted

to determine the workload level of nurses. Respondents were requested to make

a choice. Likert scale was used to measure workload level of nurses. The scale

consisted with five response alternatives of strongly disagree, disagree,

uncertain, agree and strongly agree for all question items. By the process that

will be done the expected output is to determine the impacts of nursing shortage

significantly relate to quality of patient care during pandemic in terms of job

satisfaction, work stress, and workload. Identified significant difference of nursing

shortage in patients care before and during pandemic.

Literature Review

COVID-19 is a lethal respiratory virus that has rapidly spread throughout

the world. The infection causes serious respiratory problems such as pneumonia
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and acute respiratory distress syndrome. It is especially harmful for children

under the age of five, because it can cause irreversible lung damage. Covid-19 is

not like the seasonal flu or other common respiratory viruses. In contrast to

seasonal flu, which spreads more slowly in large groups of people, it spreads

quickly in small groups of people. People around you may be infected with

COVID-19 if they are coughing or sneezing or have symptoms such as fever,

cough, and shortness of breath. The pandemic has also had a significant impact

on our daily lives, altering how we communicate and travel and how we care for

our loved ones.

The Covid19 pandemic has been examined the strength of the healthcare

system worldwide. Hospital nurses are one group that has been severely

impacted by this high case rate. Furthermore, to shortages of personal protective

equipment (PPE), one of the most pressing occupational stressors faced by

these nurses during the pandemic is inadequate staffing (American Nurses

Association, 2020), also known to have a negative impact to nurses and patient’s

safety and well‐being outcomes, such as nurse exhaustion, (Lasater et al., 2020),

adverse patient outcomes (Shang et al., 2019) and patient satisfaction (Aiken et

al., 2018; Vahey et al., 2004). Also, The Covid-19 pandemic has intensified many

chronic problems that go along to an ongoing nursing shortage. Deficient staffing

is a persistent issue within the nursing profession, with the safety result of

understaffing likely being worsen by the COVID‐19 pandemic. Hospitals all

around the country continue to be affected by the nursing shortage. The

worldwide nursing shortage is impacted by a number of important variables, such

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as emotional exhaustion, staff turnover, a shortfall in staff and resources, and a

lack of qualified and experienced nurses.

One of the most serious challenges facing hospitals, nursing homes, and

other healthcare organizations is the lack of nurses. The effects of this scarcity

can be observed not only in the quantity of nurses that are available globally but

also in employee morale and job satisfaction. Many factors influence job

satisfaction among nurses, including compensation, working hours, work

environment, and duties, among others. The lack of nurses has made it

challenging for hospitals to hire new employees and hold on to those who have

been with them for a while. Forbes claims that some hospitals have turned to

hiring contract employees, who are paid less than their permanent colleagues

and do not have access to benefits like vacation pay or health insurance.

Numerous studies conducted throughout the world (including India) have

emphasized the impact of low nurse pay on job satisfaction, showing that

workers are dissatisfied with their careers if they are not paid enough for them.

Opatha (2020) revealed in his research report that from February 2020, a

horrible disease known as COVID-19 or Corona has been attacking people all

around the world. Coronavirus is the most recent problem for businesses fir in

terms of human resource management. In fact, it is not an exaggeration to say

that Coronavirus is the most hazardous tragedy we have ever witnessed. From

the standpoint of human resource management, this is the most serious health

risk that the organization must address while managing its employees. As a

result, it is evident that health-care personnel are at risk of a disease pandemic

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under the current situation. For nurses, emotional problems are the biggest

cause of stress. The hospital turned the ward into a staff dormitory to prevent the

spread of disease among the medical personnel, which is the cause of the

intense emotional pressure. During the anti-epidemic period, the medical staff

could only rest in the staff dormitory and could not go home, so they could not

reunite with their families. As a result, they were unable to reunite with their

families. Family members of nurses also get information over the Internet, which

is complex and makes it challenging to discriminate between real and incorrect

information. Family members' anxiety as a result of this will further develop into

concern for nurses. However, the nurses must stay in close contact with the

confirmed patients and separate from their family members in order to

continuously monitor the patient's vital signs and condition changes. Nurse

weariness and burnout have gotten worse as a result of the epidemic conditions.

Nurse burnout The pandemic conditions have worsened fatigue and burnout in

healthcare. Nurses are more likely to experience stress, exhaustion, and injury

since they work longer shifts with more patients. Also, they are exhausted, both

physically and mentally, by the pandemic. As a result of the continually high

demands placed on them at work to care for patients with critical requirements

and insufficient staffing, they are worried about dangers to their health and the

health of their families.

Nursing instructors are impacted by aging, retirement, and a lack of

motivation in instructing. Moreover, due to the educational challenges

encountered during the pandemic, some nurse programs excluded a whole class
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of students. In addition, front-line nurses fear that they will worry too much about

themselves and their family members, This will undoubtedly cause problems.

Increase the psychological pressure of nurses. All these measures increase

nursing workload (Giuliani et al., 2018), not only because of the time needed for

their implementation but also because of how they are organized and managed.

The sudden lack of ICU beds and mechanical ventilators has led to an

increasing number of conversions of recovery and operating rooms into new

COVID-19 areas. (Bambi et al., 2020, Lucchini et al., 2020). New ICU beds were

designated and critical care nurses were needed to manage patients who were

dependent on high tech organ and system support (including extracorporeal

membrane oxygenation) (Bambi et al., 2020, Lucchini et al., 2020). Some

preliminary reports identify the nursing workload is dramatically high in COVID-19

patients (Lucchini et al., 2020, Reper et al., 2020). In addition to the severity of

illness, the nursing workload increased because of the need to provide

humanistic care in the absence of family. Mobile phone calls were introduced,

which made patients feel less alone and kept them and their loved ones informed

about events both inside and beyond "the hospital walls" (Negro et al., 2020).

When people affected by COVID-19 enter the hospital, they literally disappear

from their love ones lives.

The COVID-19 era is therefore driving the need to improve nursing

workload scores with new issues, such as the time for donning and doffing

personal protective equipment (PPE), the additional time taken to provide care

while wearing PPE, the need for distanced communication between patient and
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relatives, and the need to manage the increasing incidence and severity of

agitation and delirium due to the isolated environment (Kotfis et al., 2020).

The effects of the nursing shortage are far-reaching. But perhaps the

biggest impact is on patient outcomes. A shortage of nurses’ impacts outcomes,

but the mix of staff skill sets and skill levels also play a factor. During staffing

mixes, the ratio of seasoned nurses to new graduates must be considered.

Ensuring staffing mixes that balance novice and expert nurses is essential. Many

studies have supported improved outcomes when a higher percentage of nurses

have a baccalaureate degree, but the optimal ratio of graduate to expert nurses

has not been determined. Retaining expert nurses to mentor new graduates is a

high priority in ensuring an adequately trained nursing workforce (Watt et

al., 2022)

COVID’S IMPACT ON THE NURSING SHORTAGE

Family obligations: The nursing profession is predominately held by women. If

a woman is trapped in the sandwich generation or is already raising a family, she

may leave the profession or scale back if there are no benefits for family care.

Nurse burnout: Medical fatigue and burnout have gotten worse as a result of the

pandemic conditions. Nurses work longer shifts with more patients, increasing

their risk of stress, exhaustion, and injury. The pandemic has also worn them out

mentally and physically. As a result of the consistently high demands placed on

them at work to care for patients with critical needs and insufficient staffing, they

are worried about risks to their health and the health of their families.
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Shortage of nursing educators: Lack of nursing faculty restricts the amount of

students a program can enroll. Aging and retirement, as well as a lack of interest

in teaching, have an impact on nursing educators. Moreover, some nurse

programs skipped an entire group of students because of educational difficulties

faced during the pandemic.

The truth is that this shortage could have negative effects on healthcare

providers as well as patients because of the skilled nursing staff's alarmingly high

rates of burnout brought on by a combination of inadequate staffing levels and

long hours on the job. Mortality rates are affected when there is a significant

disparity between patients and nurses, according to research from Edith Cowan

University. Patients take longer to recover and heal when there are fewer nurses

available to care for them. The potential number of complications that are unique

to a given unit, like bleeding, infection, and others, is influenced by the number of

nurses on staff. Patient safety issues can arise as a result of nurse burnout.

Additionally, the shortage of nurses has put health care organizations in a dire

financial situation. In order to recruit nurses, healthcare facilities are required to

offer bonuses and improved benefits in addition to higher salaries. Additionally,

paying overtime is necessary when nurses work longer shifts. The profit margin

is influenced by each of these factors. One of our top public policy concerns

continues to be the critical role that nursing staffing plays in patient safety.

Nurses are the best candidates to take the initiative to lower adverse events and

poor patient outcomes.

Understaffing can lead to:

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Decreased quality of care: An Eastern Michigan University study found that

when there aren't enough nurses in a healthcare facility, the current workforce

must take on the same amount of work. These nurses inevitably work longer

hours, which is not surprising. Longer shift nurses run the risk of making more

errors that lower the quality of care.

Higher risk of failing to prevent negative outcomes: Similar research from

Eastern Michigan University found that understaffed facilities had a higher risk of

infection, an increase in post-operative complications, and a higher number of

falls in addition to a higher in-hospital death rate.

Overworked nurses experience fatigue or stress, which can impair their ability to

conduct swift and precise medical assessments. This may lead to medication

administration errors, a lack of patient involvement, and subpar nursing care.

Overcrowded emergency departments: When there are not enough nurses to

provide care and handle administrative tasks, patients who need serious

attention must wait. It is well known that crowding patients together and

postponing care can result in cross-transmission of diseases and pollution,

according to a report from the National Center for Biotechnology Information of

the National Library of Medicine

Additional medication administration errors: Nurses are prone to serious

errors when dispensing prescription medications due to the overwhelming

number of tasks they must complete each day. This is easily preventable in

hospitals with a balanced nurse-to-patient ratio.

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Hospitals are struggling to keep safe staffing levels in place, which results in

avoidable injury. This problem could have terrible effects on patients who are

already dealing with serious illnesses or injuries, and hospitals could end up

paying out a lot of money in lawsuits as a result. According to PRS Global and

the National Association for Health Care Recruitment, 2022.

THE IMPACT OF NURSING SHORTAGE IN PATIENT’S CARE AMIDST THE

COVID-19 PANDEMIC.

Sample Questionnaire

Adapted from “The nursing shortage impact on job outcome (the case in Sri

Lanka) Questionnaire”

SECTION 1

Please answer for all questions.

1. Your Age:

Your Gender: Male Female

2. Civil Status: Married Single Divorced Widow

3. What is the unit you normally work on?

(e.g., medical, surgical, pediatric etc.)

4. How long have you been at this hospital? Years: Months:

SECTION 2

The following conditions describe your Job Satisfaction level at work. Please
indicate how strongly you satisfied or dissatisfied with each condition by checking
the number on the scale where 1 is very dissatisfied, and 5 is very satisfied.
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Very Dissatisfie Neutr Satisfie Very

Dissatisfie d al d Satisfie
d d
1 2 3 4 5
1. The physical
condition in
which you work
2. Concern for
nurses’ well-
being
3. The amount of
responsibility
you are given

4. Interpersonal
relationship
with
management
and other staff
5. Pay for the
work
6. The hours of
work
7. Working with
new technology
8. The way of
hospital
managed
9. Freedom to
choose your
own working
methods
10. Future chance
for promotions
11. Special training
for present
work
12. Your fellow
workers
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13. The recognition

you get for
good work
14. Your
immediate
boss
15. Ability to
participate in
planning/decisi
on making

SECTION 3
The following conditions describe your work stress level. Please indicate how
strongly you agree or disagree with each condition by checking the table on the
scale where 1 is no pressure, and 5 is extreme pressure
No Some Moderat More Extrem
pressur pressur e than e
e e pressur averag pressur
e e e
pressur
1 2 e
3 5
4
1. Time pressure
and deadlines
2. Work amount and
number of
assignments
3. Unrealistically
high expectations
by others of my
role
4. Exposure to
death situations
5. Conflict with
medical and other
staff
6. Uncertainty about
the degree or
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area of my
responsibility
7. Coping with new
technology
8. Staff shortage
9. Lack of support
from senior staff
10. Shortage of
essential
resources/equipm
ent
11. Lack of special
training for
present work
12. Poor quality of
supporting staff
13. Difficult patients
14. Poor physical
working condition
15. Unpreparedness
for my duty.
.
SECTION 4
The following conditions describe your workload level. Please indicate how
strongly you agree or disagree with each condition by checking the table on the
scale where 1 is strongly disagree, and 5 is strongly agree.
Strongly Disagree Uncertain Agree Strongly
disagre agree
e
2 3 4 5
1
1. In last month,
often my shift
was extended
(e.g., from days
to evenings,
evenings to
nights, nights to
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days, etc.
2. I had to do more
mandatory
overtime in this
month
3. I have done
more voluntary
overtime in this
month
4. Comparing to
the last month,
the amount of
overtime done
by me has been
increased
5. I have seen
multiple delays
experienced on
the ward in
many times
6. In my one shift,
often I engage
with non-patient
activities (e.g.
dietary, nursing
administration,
housekeeping,
statistics
preparing)
7. There is a
greater demand
for psychological
support for
patients and
their family
members
8. During last
month, several
times I had to
work on another
ward or unit
rather than
 26

where I usually
attached.