Registered nurses’ (RNS) perception of the nursing profession and health care work environment in tertiary and secondary health facilities in Calabar, Nigeria

Abstract

Background A healthy work environment has tremendous benefits on organizational performance, health service delivery, health worker performance and patient outcome. In 2009, International Council of Nurses (ICN) undertook a global survey which sought for nurses’ opinion on the nursing profession and their work environment in 11 countries, excluding Nigeria. Little is known about how Nigerian nurses, particularly nurses in Cross River state perceive their work environment. This study explores registered nurses’ perceptions and experiences with selected features of a positive practice environment, as a basis for developing an intervention strategy for improving nurses’ work
environment in Calabar, Cross River state.
Methods This study was a descriptive survey by design. Perceptions of features of positive practice environment were explored among Registered Nurses in full time employment at tertiary and secondary health facilities in Calabar using a modified 51-item standard structured questionnaire originally developed by Pfizer to measure Nurses expectations and needs in a 2009 ICN Quadrennial Study. The questionnaire was adapted with the permission of Pfizer. Data werecomputer analyzed using SPSS for Windows version 15. Interrelationships between variables were tested using Chi- Square analysis.
Results The mean (SD) age of the respondents was 37.4 ± 8.3 years while respondents’ mean (SD) working experience was 15.8 ± 8.7 years. The respondents were predominantly female 149(90.3%) while 109 (66.1%) were married. The level of education indicated that most 110(66.7%) had diploma in Nursing, 43(26.1%) had first degree, and 12(7.3%) had post-graduate qualification. Most 86(52.1%) of the nurses had heard just a little some about positive practice environment (PPE), 30(18.2%) had heard nothing at all while only 49(29.7%) were quite knowledgeable. The features of PPE rated highly by the participants were clear and comprehensive description of their job responsibility 75(45.5%) and an environment of team work and collegiality 71(43.0%). Similarly, in their practice experience, the very positive feature in their work environment was an environment of open communication, teamwork and collegiality 60(36.4); clear and comprehensive description of their job responsibility 53(32.1%). Most favorable aspect of nursing identified by the nurses was helping patients/patient contact 75 (45.5%) while the most unfavourable aspect of nursing identified were risk of contracting infections 61(37.0%). Although 96(58.2%) of the participants opined that nursing is better today than 5 years ago, only 50(30.3%) were very satisfied with nursing while 103(61.8%) of the nurses expressed the desire to remain in the nursing profession in the next 5 years.
Discussion The findings have established the need for making information on PPE widely available to practicing Registered Nurses in Calabar. Employers of nurses should take urgent steps to improve health and safety policies and procedures at the work place to create a more positive practice environment for nurses to perform their duties and improve patient outcome. More efforts are required by the professional association to negotiate better pay packages, benefits and incentives for nurses in order to guarantee nurses wellbeing and retention in the profession.

KEYWORDS: Positive Practice Environment, HealthCare, Registered Nurses, Satisfaction, Nigeria