Work-life balance, job satisfaction and nurses retention

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Int. J. Business Excellence, Vol. 10, No. 4, 2016

Work-life balance, job satisfaction and nurses retention: moderating role of work volition Alamzeb Aamir* Department of Management, University Technology Malaysia (UTM), Johor, Malaysia Email: [email protected] *Corresponding author

Abu Bakar Abdul Hamid Faculty of Management (FM), Department of Business Administration, Universiti Teknologi Malaysia (UTM), 813100 Johor Bahru, Johor, Malaysia Email: [email protected]

Maqsood Haider and Chaudhry Shoaib Akhtar Department of Management, University Technology Malaysia (UTM), Johor, Malaysia Email: [email protected] Email: [email protected] Abstract: Retention of competent employees is becoming a huge challenge for organisations and more so for healthcare institutions. The growing shortage of nursing staff and its potential effect on the healthcare industry is of paramount importance. To retain the existing staff and to attract potential new entrants, healthcare organisations have to adopt strategies that would help them in retention. So, creating a balance between work-life is found as one of the suitable practices that when adopted can reduce work related stresses, increase satisfaction and performance. This study investigated the influence of work-life balance on job satisfaction leading to retention. Further, work volition was tested as a moderator between work-life balance and job satisfaction. The study results indicate significant influence of all work volition as a moderator. The study found that job satisfaction had a partial mediation effect on the relationship of work-life balance and retention. Keywords: work-life balance; job satisfaction; work volition; hospitals; nursing staff. Reference to this paper should be made as follows: Aamir, A., Hamid, A.B.A., Haider, M. and Akhtar, C.S. (2016) ‘Work-life balance, job satisfaction and nurses retention: moderating role of work volition’, Int. J. Business Excellence, Vol. 10, No. 4, pp.488–501.

Copyright © 2016 Inderscience Enterprises Ltd.

Work-life balance, job satisfaction and nurses retention

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Biographical notes: Alamzeb Aamir is a PhD scholar at the Department of Management University Technology Malaysia (UTM) Malaysia. His area of study is compensation and rewards management and its role in employee’s behaviour. He received his MPhil in HRM from Pakistan. He has numerous publications in refereed journals. He has also rich experience with multinational organisations in the field of human resource management. Abu Bakar Abdul Hamid obtained his doctoral degree from Derby University UK in 2003. He is a Professor of Marketing and Supply Chain Management, at the Department of Management Universiti Teknologi Malaysia Johor Bahru Malaysia. He has published many research papers in refereed journals, covering a wide range of areas in management and marketing. Maqsood Haider is a PhD scholar at the Department of Management – University Technology Malaysia (UTM). His area of study in his PhD degree is crises management. He received his Master in Business Administration and Economics from Pakistan. He has rich academic and professional experience with multinational organisations. Chaudhry Shoaib Akhtar is a PhD scholar at the Faculty of Management Universiti Teknologi Malaysia Johor Bahru, Johor, Malaysia. He received his Master degree from Australia. He has more than 15 years teaching experience. He has also published many articles in reputed journals mostly in the field of SMEs.

1

Introduction

In today’s knowledge economy, retaining the competitive employees and maintain their competitive advantages is one of the major challenges for organisations (Camuffo and Comacchio, 2005). Particularly sustaining the workforce in healthcare organisations to fulfil the growing demands is a serious challenge in health services (Skinner and Chapman, 2013). The human population ratio in the world is on increasing trend, so the increase in of the population and labour force mean that there will be increasing demand of the healthcare system will remain into the predictable future (Ollier-Malaterre, 2010). According to the global nursing literature the shortage of nursing for next two decade has been well documented (Gambino, 2010; Numminen et al., 2014). Cottingham et al. (2011) added that the nursing shortage issue in many countries is severe due to its prospective outcome on health services if the problem is not tackled because healthcare workforce in common and nurses in particular are vital importance to healthcare sector. Therefore, to retain the nurses different strategies have been adopted and are reinforced with approval presented by researchers in the overall nursing literature (Gambino, 2010; Erenstein and McCaffrey, 2007). Like other countries Saudi Arabia is also facing the nursing retention issue in private and public sector hospitals which present serious challenges at all levels of healthcare (Alonazi and Omar, 2013). Similarly, over the previous decade the concept of work-life balance and its importance in employee’s retention has been extensively studied across a number of fields (e.g. Lewis and Campbell, 2008; Mescher et al., 2010). However, it is still a new research area in social work, let alone in hospitals the importance of work-life balance in nurses’ retention. Some of research studies have found the positive relationship between

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work-life balance and nurses’ job retention in hospitals (Eley et al., 2014), however different job-related links of work-life balance have been under-reviewed to date. Though prior research declared the positive or negative effects of work-life balance on social work and human service employees’ job satisfaction (Mescher et al., 2010), but the moderating effect of work volition is still an untouched issue among the nurses in hospitals. This paper is an attempt to examine the role of nursing staff work-life balance in their retention in hospitals. In addition the paper also checks the role of work volition as a moderator.

2

Review of literature

2.1 Work-life balance In literature, the word ‘balance’ was both distinctive from and interrelated with enrichment and conflict at job and personal life domains. So, different research on the balance between employee’s jobs, family, and other phases of life has developed over time (Ferguson et al., 2012). In the beginning most of the studies highlighted the work-family balance and later on moved to work-life balance (Lewis and Campbell, 2008). In general, the work-life balance is the degree to which a person is equally involved and satisfied with their work and family role (Cascio, 2000). Similarly, Kelly et al. (2008) have categorised the work-life balance into time, involvement and satisfaction balance that refers to a particular balance in each factor both in work and family roles. So, all of the previous discussions is around a person subjective opinion that both job and family make real demands which are not possible to effectively fulfilled with available resources (Moen et al., 2011). Hence as a result, the perception of work-life imbalance causes tension escalation within the person as either work or family demands become unsatisfied. These unsatisfied interferences and demands potentially affect employees’ work and social life and become a serious cause of psychological discomfort for organisations and families (Greenhaus and Beutell, 1985). Thus, to avoid the negative results of conflict between employee’s work and family, organisations can introduce WLB policies and practices. Cascio (2000) define WLB as “any employer sponsored benefit or working condition that helps an employee to balance work and non-work demands”. The objective of WLB policies should be to permit employees to increase their quality of life by giving more time to different activities such as leisure, family care duties, training courses, resting or social life (Hughes and Bozionelos, 2007). The personal management practices that organisations can apply to boost WLB among their employees we can find various methods i.e. practices the comfort and flexible use of time, offer spatial flexibility to employees, time reduction such as shared work and part-time work, employee assistance and advisory programmes and work leave for example paternity and maternity leave in excess of the official amount and career breaks (Carnicer et al., 2004). Current studies from diverse professions have shown the positive and negative results of work-life balance and imbalance. The work-life balance positive result is related to employee’s job satisfaction, commitment to the organisation, retention and family functioning. Whereas, the negative imbalance results in work-life is correlated to


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employees’ stress, lower commitment with organisation, job dissatisfaction, turnover, domestic violence and lower productivity (Ollier-Malaterre, 2010).

2.2 Job satisfaction Numerous attempts in the past were made to discuss employees’ job satisfaction (Parvin and Kabir, 2011). Few notable efforts in this regard are that of Locke (1976), Armstrong (2003) and Odom et al. (1990). The earliest attempt to define job satisfaction was made by Hoppock (1935), who mentioned job satisfaction as being any number of psychological, physiological and environmental circumstances which lead an individual to express his/her satisfaction with their work. Similarly, Ranft and Ranft (1999) added to the debate by mentioning that the employee’s job satisfaction is the combination of his/her attitude toward or about the job. This attitude is at times referred to as a ‘positive element’ (Sweeney et al., 2002) which leads to effective employee’s performance, and minimise the chances to quit the organisation (Chen et al., 2011). Research conducted by Tourangeau and Cranley (2006) confirmed the importance of job satisfaction, and its relationship with employee’s retention within organisation. Review of previous studies highlighted that employees’ job satisfaction and plan to leave the organisation depends upon various factors which include pay, work schedule, promotional opportunities, co-workers support, and supervision (Robbins and Judge, 2009). However, Kavanaugh et al. (2006) highlighted that while these factors are linked, but satisfaction with one element does not assurance of overall satisfaction or with other elements. Similarly, the previous meta-analytic studies focusing job satisfaction showed that personal variables generally had low correlation with job satisfaction (Rajesh and Suganthi, 2014; Rindell et al., 2014); whereas, job-related perceptions, such as task identity, importance and autonomy, had positive correlations with job satisfaction (Spector, 1997). Employees’ lack of satisfaction not only had a negative impact on job performance and success, but also resulted in an increase in absenteeism, productivity and separation from the job (Allen et al., 2010). Numerous studies that investigate the relationship between job satisfaction and turnover has found negative relationship (Chen et al., 2011), which means that when employees level of dissatisfied in their job are high, ultimately the turnover will be high and they are likely to leave the organisation. In healthcare perspective, various research have been conducted to represent the link between job satisfaction and value of care and maximum of studies recommend that nurses’ job satisfaction effects quality of patient care and satisfaction, reduce morality and better organisational setting (West et al., 2006). In healthcare research the studies on job satisfaction has been done mostly accordingly to diverse jobs for example studying doctors, nurses, therapists, etc. in developed countries. Therefore, there seems to lack a global approach to healthcare, namely nurses at hospitals, predicting them as an essential part of the healthcare service. According to Veld et al. (2010), the healthcare profession is a service industry where the whole service practice is important for patient satisfaction and standard of care. Hence, the literature has been discussing the correctness of such a universal methodology, so this study was directed within this perspective.

2.3 Work volition Duffy et al. (2012a) based on the previous literature highlighted the predictors of job satisfaction that include personality, goal behaviour, self-efficacy, organisational support,

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person environment fit, and core self-evaluations. Similarly they further added that although previous studies were able to highlight various variables but still the studies only focused on one segment of population who are financially sounds and with availability of high level opportunities. These studies ignored population with limited opportunities and who are financially not sound. The present study is attempting to answer the call of Duffy et al. (2012b) to examine “what makes people more happy at work” i.e. satisfied at job and how exactly can ‘work volition’ can play role in this scenario. The decision of an individual about jobs depends on various factors, one such factor relates to their ability to make decisions. Researchers for instance Haggard and Lau (2013) revealed that such decision making, which basis on ‘internal motivation’ is known as volition. Similarly when decision making about job is concerned it lies within the domain of work volition. Duffy et al. (2012a) describe work volition as “the perceived capacity to make occupational choices despite constraints”. They described work volition by using two lenses that is high work volition and low work volition. Review of recent literature however shows the focus of researchers to use concept of volition to judge the level of employee’s satisfaction. Numerous researcher although showed their concern about limited or low work volition and low job satisfaction (Cuyper and Witte, 2008). Leading researchers on work volition agree on the notion that individual decision about job is based on their ‘skills, values, and interest’ (Blustein, 2006). Duffy et al. (2013) in a recent work although raised the question about the scope of the above argument. They argued that the existence of constraints limits the ability of individuals to be volitional in their decision making. The constraints they mentioned ranged from financial limitations to physical and cognitive to social limitations. Similarly, Jadidian and Duffy (2011) pointed towards the limited research conducted in the area of work volition. They mentioned that although research was conducted in the past that were limited to only those variables that were similar to work volition.

2.4 Retention The employees’ retention is a process by an organisation to create an environment which involves employees’ within their jobs for longer period of time (Chaminade, 2007). A more comprehensive definition of retention is “to prevent the loss of proficient employees from leaving productivity and profitability” (Chiboiwa et al., 2010). Most authors agree that employee retention strategies cannot be over-emphasised because a well-trained and experienced work-force is crucial for achieving the goals of the organisation. The human capital theory one of the basic perspectives is that like any business investment skill development would be more cost-effective and more likely to be assumed the longer period over which the investment return can increase (Yawson, 2012). Employee’s retention is a dilemma that most of the organisations are facing; identifying the root cause of the reason employee are leaving the job is a good approach. However, organisations have to be proactive and do not wait until employees’ leaves the company and only then start to analyse. Dibble (1999, p.3) supports this by stating that “If you think that it is hard to retain your employees now, is aware that in the future it will be worse”. There is an intense competition among organisations to retain their competent and skilled human resource because it relates to the cost associated with recruiting new employee, training and development and performance difference also the


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expense of severance packages or removal if the organisation employed the wrong candidate in the first place (Askary and Kukunuru, 2014). Fitz-enz (1997) estimated that on average the organisations lose about $1 million with every ten specialised and white-collar employees who leave the organisation. The cumulative cost of total turnover budget allied with one employee’s ranges from at least one year’s pay and benefits of two years pay and benefits. Hence, there is major economic influence when the employee leaves the organisation particularly given the knowledge that is lost with the employee departure because knowledge and abilities are vital to an organisation’s ability to be economically reasonable (Allen et al., 2010).

3

Model of the study

The model of the study after extensive review is shown in Figure 1. Figure 1

4

Research framework

Methodology

4.1 Study design and population For this study the target population are the clinical nurses at public sector hospitals in Saudi Arabia. The sample size for the study was 357 nurses from patient direct care and patient care support staff in hospitals. Completely filled and useable questionnaire were 191, indicating a response rate of 53.5%.

4.2 Instrumentation A quantitative methodology was used for this study. Participants’ attitudes about their work-life balance, job satisfaction, work volition and retention were assessed through the existing questionnaires in the literature. 1

Demographic information In demographic information section the respondent’s details i.e. age, gender, total years of experience, experience with current organisation, qualification, marital status, number of kids, nature of job and basic responsibility has been gathered.

2

Work-life balance The work-life balance has been measured using seven-item scale, developed using existing tools as a template (Fields, 2002). Responses were based on five-point Likert scale (1 – strongly disagree and 5 – strongly agree).

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A. Aamir et al. Job satisfaction The nurse’s job satisfaction level is measured using the scale developed by Brayfield and Rothe (1951). The eight items ask the employees about the satisfaction with present job related factors. The respondents’ opinion was based on a five-point Likert scale (1 – strongly disagree, and 5 – strongly agree).

4

Work volition The work volition is measured by means of 13-item scale developed by Duffy et al. (2012c). The work volition items capture the perceptions of individual’s decision about job and is based on their skills, values, and interest. These items were based on five-point Likert scale (1 – strongly disagree, and 5 – strongly agree).

5

Retention The last part of the questionnaire comprised of four items regarding the intention of the participant to remain associated with their respective organisations. The items are adapted from Mobley et al. (1978). The items were based on five-point Likert scale (1 – strongly disagree, and 5 – strongly agree).

4.3 Data analysis The data for this paper is analysed using descriptive statistics using frequency tests for demographic items. Pearson correlation for establishing the association between the variables and regression analysis for examining the effect of independent variable on the dependent variable as well as testing the influence of moderating variable on the relationship between nurses’ work-life balance and their job satisfaction. The alpha reliability using Cronbach alpha test indicated that the instrument was reliable. The alpha values were found to be within 0.72–0.87.

5

Results and discussion

The descriptive statistics of demographic items using frequency test is shown in Table 1. In the gender category, majority of the nurses were females (77.4%). Regarding age, it was found that maximum of the respondents belonged to age group of 31–40 years (45.2%) and only 3.2% respondents were above 50 years of age. The respondents were asked to indicate whether they were married or single and also if they were married their spouses were working or not. The responses indicate that 74.2% were married and 69.5% indicated that their spouse was also employed. In the children category, 47.8% respondents were having three or more than three children. 25.8% of respondents were responsible for child care, 12.9% were appointed for elderly dependents care while 58.1% of the respondents indicated others category which included emergency and general ward duties. In the experience category it was found that the professional experience of 46.6% respondents was less than ten years while 20% were having more than 20 years of experience in same profession.

Work-life balance, job satisfaction and nurses retention Table 1

Demographic analysis (N = 191)

Item

Percent

Gender Age

Marital status Spouse employed No. of children

Nature of Job Responsibility

Experience

495

Male

51.6

Female

48.4

< 30 years

25.8

31–40 years

45.2

41–50 years

22.6

> 50 years

3.2

Married

74.2

Single

25.8

Yes

69.5

No

30.5

None

34.8

1 child

4.3

2 children

13.0

3 and more

47.8

Managerial

51.6

Non-managerial

48.4

Elderly dependents

12.9

Child care

25.8

Children with disability

3.2

Others

58.1

< 5 years

23.3

5–10 years

23.3

11–15 years

16.7

16–20 years

16.7

> 20 years

20.0

To establish the association between the variables of the study Pearson correlation matrix was generated for the work-life balance, job satisfaction, work volition and retention. Table 2 shows the results. Table 2

Correlation matrix WLB

WV

JS

WLB

1

WV

.509**

JS

.246**

.273**

1

Retention

.228**

.346**

.393**

Retention

1

Note: **Correlation is significant at the 0.01 level (two-tailed).

1

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Table 2 outcomes indicate that the work-life balance is having a moderate correlation with retention (r = 0.251, p < 0.01) and with work volition (r = 0.291, p < 0.01). There is a strong link between work-life balance and job satisfaction (r = 0.543, p < 0.01). While moderate correlation is found between work volition and job satisfaction (r = 0.346, p < 0.01). The study investigated the moderating role of work volition on work-life balance and job satisfaction relationship. To test moderation three steps were followed as highlighted by Baron and Kenny (1986). The first and second steps were associated to the testing of influence of work-life balance and work volition on job satisfaction while third step checked the influence of interaction term of work-life balance and work volition on nurse’s job satisfaction. The results indicate that work volition when acting as a moderator significantly influences the work-life balance and job satisfaction relationship. Table 3

Moderation test

Model WLB

β .157

t 5.163

p .000

Summary 2

R .246, R .060 F 26.659, P < 0.05

WV

.300

5.777

.000

R .273, R2 .074 F 33.376, P < 0.05

WLB * WV

.031

5.958

.000

R .281, R2 .079 F 35.503, P < 0.05

The results of work volition as a moderator indicate that work volition is an important contributor towards satisfaction. According to Duffy et al.’s (2012b) work, volition is the perceived capacity of individual to make occupational choices keeping in view the limitations they face. If an individual is able to get a job that matches with the skills and capabilities of an individual, the satisfaction level will be higher, as the individual will feel at home and will be more creative and innovative as well. Various researchers use volition as part of measuring satisfaction level of individuals in their existing jobs (Holtom et al., 2002). Individuals who chose their employment relationship voluntarily are found more committed and satisfied (McLean Parks et al. 1998). Similarly, Krausz et al. (1995) also found in their study that working by choice as opposed to not leads to higher satisfaction levels. In past different research studies have found that work-life balance has a positive and significant link with job satisfaction. Work life balance reduces work burden and make employees more effective in dealing with work related pressures (Shujat et al., 2011). Work volition and work life balance both show a positive and significant relationship with job satisfaction. This has been evidenced from the results of the present study. Further, the results indicate that work volition as a moderator has a significant influence of job satisfaction. We were also intent to find the mediation effect of job satisfaction between work life balance and retention. The result of mediation is shown in Table 4. The results reveal that the relationship between WLB and JS is partially mediated by job satisfaction, indicating presence of other variables as well that mediate the relationship between work-life balance and retention.

Work-life balance, job satisfaction and nurses retention Table 4

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Test of mediation WLB-JS-R model

Model

β

t

p

WLB

.172

4.772

.000

Summary R .228, R2 .052 F 22.771, P < 0.05 Dependent: retention

WLB

.157

5.163

.000

R .246, R2 .060 F 26.659, P < 0.05 Dependent: job satisfaction

JS

.464

8.713

.000

R .393, R2 .155 F 75.913, P < 0.05 Dependent: retention

WLB

.105

3.034

.003

R .416, R2 .173

JS

.424

7.783

.000

F 43.311, P < 0.05 Dependent: retention

Earlier studies have indicated that employee’s job satisfaction is one of the important predictors of their retention (Ambrose et al., 2005). However, Ambrose et al. (2005) have suggested that employee’s job satisfaction as a predictor of retention should be used with caution as not every employee with low satisfaction would leave nor every employee with high satisfaction would stay with the organisation. This indicates that employee retention is affected by many other variables as well such as culture, leadership, HR policies, commitment etc. The results of the present also indicate that the nurses’ job satisfaction has a partial mediation effect on their retention. The researchers have highlighted that work life balance practices adopted by organisations help increase the job satisfaction and reduced turnover among employees (Halpern, 2005; Gajendran and Harrison, 2007). Kofodimos (1993) suggests that work-life imbalances results in high levels of anxiety, depression, low quality of life and reduced work effectiveness. Creating a balance between family and work life could result in greater satisfaction at home and at work, which results in greater employee performance and reduced turnover. Konrad and Mangel (2000) have highlighted that the organisations work-life balance policies can decrease the work and family conflict which resultantly increase job satisfaction; a satisfied employee is found to be more committed and has a lower intention to leave and show high performance (Pryce et al., 2006) that can consequently affect the bottom line (Comfort et al., 2003). Thus, work-life balance practices not only increases job satisfaction but can reduce the overall turnover intention of the employee.

6

Conclusions

Organisations all over the world try to retain competent and knowledgeable employees as the exit of these employees leads to the loss of competitive advantage that is there in the form of tacit knowledge. This tacit knowledge is of utmost importance in medical profession especially in the nursing field, where experienced and competent employees are much needed for effective working of the medical institutions. In Saudi Arabia,

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maximum of the labour force is involved in nursing profession which is mostly based on expatriates. Thus, providing policies such as work-life balance practices are needed to retain this workforce. The cost of turnover has become a huge issue for organisations and especially in Saudi Arabia, where female workforce is found to be reluctant in indulging in nursing profession especially due to socio-cultural factors. Thus medical institutions are in process of developing policies that would help retain the existing employees but would also attract new entrants in the field. Though the study did not specifically focus on gender of employees in the study, but the fact remains that there are fewer nurses per 1,000 Saudi persons. The main reason is the lack of work-life policies in the Saudi medical institutions and also due to heavy workload. Thus, the path of work life balance, employees’ job satisfaction and retention is most appropriate to better understand the employee retention and organisational linkages. The present study is significant for medical institutions as it indicates that work-life balances would not only increase the job satisfaction but would increase employee retention. In addition the study also signifies that employees who voluntary opt for a profession are not only satisfied but can be retained. This is important in the context of Saudi medical institutions and nursing profession where females hesitate to join the profession due to cultural factors and if they do are victimised due to lower status of the profession. Also this research has opened a new direction for future research scholars, academicians, managers and policy developers to further analyse the role and importance of rarely used psychological variable (work volition) in relation with other variables. The results of the study show a strong and influential role of nurses’ work-life balance, work volition, and job satisfaction on employees’ retention. As well as the results also point out that there may be other variables such as organisational culture and climate, commitment, leadership etc., which could be studied to better understand the relationships portrayed in the study.

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