Job Satisfaction and Retention Survey Insights

JOB SATISFACTION
AND JOB RETENTION
ISSUES

A Survey of RNs, LPNs, and RCWs on
2009
Prince Edward Island

Job Satisfaction and Job Retention Issues

Table of Contents
ACKNOWLEDGEMENTS ............................................................................................................... 2

BACKGROUND .............................................................................................................................. 3

EXECUTIVE SUMMARY ................................................................................................................. 4

SURVEY METHODOLOGY ............................................................................................................ 6
Outline ........................................................................................................................................... 6
Limitations ..................................................................................................................................... 6
Sample .......................................................................................................................................... 7
Interpretation ................................................................................................................................. 7

RESULTS ........................................................................................................................................ 8
Statistics ........................................................................................................................................ 8
Sites Represented ...................................................................................................................... 8
Years in Practice ........................................................................................................................ 8
Work Schedule ........................................................................................................................... 8
Work Environment......................................................................................................................... 9
Communications ......................................................................................................................... 9
Interaction with Colleagues ...................................................................................................... 10
Confidence in Management ..................................................................................................... 11
Physical Environment ............................................................................................................... 12
Wages ...................................................................................................................................... 13
Respect ....................................................................................................................................... 13
Quality in the Workplace ............................................................................................................. 16
Continuing Education ............................................................................................................... 17
Performance Reviews .............................................................................................................. 17
Scope of Practice ........................................................................................................................ 18
Retirement ................................................................................................................................... 19

DISCUSSION ................................................................................................................................ 19
Supervisors/Management vs. Staff ............................................................................................. 19
Acute Care vs. Long-term Care .................................................................................................. 20
Computer Use ............................................................................................................................. 22
Generational Differences ............................................................................................................ 23
Staying in Healthcare and Staying in PEI ................................................................................... 23
Suggestions for Future Data Analysis......................................................................................... 24
Subpopulations ......................................................................................................................... 24
Hours of Work........................................................................................................................... 25
Work Environment .................................................................................................................... 25
Respect .................................................................................................................................... 25
Quality in the Workplace .......................................................................................................... 26
Should I Stay or Should I Go? .................................................................................................. 26
Scope of Practice ..................................................................................................................... 26
The Burden of Working in Health Care .................................................................................... 27
Appendix A - Job Satisfaction and Retention Survey - Overview ............................................... 28
Comprehensive Job-satisfaction and Retention Survey ............................................................. 30

Page 1


Job Satisfaction and Job
Retention Issues
A Survey of RNs, LPNs, and RCWs on Prince Edward
Island

ACKNOWLEDGEMENTS
The conclusion of the survey questionnaire development, the focus testing of and the design for
the web and paper-based versions of the survey were done by Consultant, Vicki Bryanton in
conjunction with an Advisory Committee consisting of Betty Bailey (former Executive Director of the
PEI Health Sector Council - PEIHSC), Mark DeMone (Human Resource Advisor), and James
McClean (current Executive Director of the PEI Health Sector Council). Additional input and
support was received from the PEIHSC Board Members.

Special thanks go to the RNs, LPNs, and RCWs who participated with enthusiasm and candor in
the focus group sessions. Successful distribution of the promotional materials and paper surveys
was made possible through the efforts of Muriel Steele (LPN), Anne Dunphy (LPN), Lynn Parker
(RCW) and Sheila Gallant (RN). Thanks also goes out to Julie Murphy, Administrative Assistant
for the PEIHSC, who made special rounds to low responding areas to ensure good distribution of
the surveys.

The PEI Health Sector Council is funded by the Canada / Prince Edward Island Labour Market
Development Agreement (www.lmda.pe.ca). The opinions and interpretations presented in this
report are those of the authors and do not necessarily reflect those of the Government of Canada
or the Government of Prince Edward Island.

Page 2


BACKGROUND
The PEI Health Sector Council Inc. (PEIHSC) is an independent organization which has been
developed to provide a neutral and sector-wide forum for the discussion, identification, validation
and resolution of health human resource issues. In fulfilling its role as a sector-wide representative
organization, the PEIHSC Board of Directors is composed of individuals from the public, private
and charitable/not-for-profit arms of the sector. The resolution of health human resource issues
also requires that the PEIHSC establishes open and ongoing dialogue with relevant educational
institutions, government departments and community organizations.

The Job Satisfaction & Job Retention Survey was developed to acquire information from a wide
range of Prince Edward Island Registered Nurses, Licensed Practical Nurses and Resident Care
Workers on their perspectives on issues of job satisfaction and retention.

Survey data will be used to establish baseline measures for other project objectives or other key
desired results, and/or to better understand the socio-demographic and work-related factors
associated with different aspects of job satisfaction and retention issues.

Page 3


EXECUTIVE SUMMARY
This report provides an analysis of job satisfaction and retention issues among the Registered
Nurse (RN), Licensed Practical Nurse (LPN) and Resident Care Worker (RCW) occupational
groups on Prince Edward Island. The frame work and initial questions for the survey were
provided by the Health Sector Council in consultation with organizations represented on the Board,
focus group analysis and input from Service Canada. The survey was conducted online and in
paper format. It was promoted through partner organizations and direct distribution of promotional
materials and paper surveys.

Four hundred and seventy six (476) people responded to the survey, including 220 RNs, 127 LPNs
and 129 RCWs. The survey asked questions regarding place of work, years in practice, work
schedule, work environment including communication and interaction with co-workers, supervisors
and managers, quality of the physical work environment, wages, feelings of respect among
colleagues and other health workers, scope of practice, performance review and retirement.

The research draws attention to a number of points.

 The survey supports national statistics indicating an aging workforce of RNs, LPNs and
RCWs – 41% of respondents have been in practice for over 20 years and 21% have been in
practice for over 30 years. Only 19% of respondents have been in practice for less than 5
years;
 Much of the workforce is employed part-time – only 50% of the respondents reported full-
time employment;
 The majority of respondents were satisfied regarding interaction and level of communication
with both colleagues and supervisors;
 Staff morale seems to be an issue requiring attention with 45% of respondents indicating
some level of dissatisfaction with staff morale. Perhaps linked to staff morale, 40% of
respondents were not satisfied that leaders in the workplace were making good decisions
and 44% were dissatisfied with the physical environment at their place of work;
 The majority of respondents were satisfied with overall job security and wage levels;
 Respondents working in acute care settings (versus those working in long-term care
facilities) were more satisfied regarding most workplace issues, including communications
with supervisors, staff morale and job security;
 When questioned about ‗respect‘, the majority of respondents felt that both their opinion and
work was respected by all occupational groups identified, although there was some
variation between occupational groups;
 Bullying in the workplace is an emerging health and safety issue that is becoming more
widely recognized as a form of workplace violence. Respondents to this survey reported
low incidences of workplace bullying overall, but perceptions of bullying did vary according
to occupational group. The following results have not been tested for statistical significance
(refer to pages 13-15 for a discussion on workplace bullying):
o 19% of RCWs and 17% of LPNs felt bullied by RNs
o 12.8% of RNs felt bullied by Physicians, and 11.8% of RNs felt bullied by other RNs
o 14% of LPNs felt bullied by RCWs, and 11.1% of RCWs felt bullied by other RCWs

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 The vast majority of respondents felt that their work was of high quality, that their co-
workers were committed to doing quality work and that they were aware of what is expected
from them in the workplace;
 Many RNs, LPNs and RCWs feel overworked – 46% felt frequently or always overworked;
 Scope of practice continues to be a concern among RNs, LPNs and RCWs – 42% felt that
they never/seldom/occasionally worked to their full scope of practice;
 The vast majority of respondents indicated they would be willing to take additional training
to expand their scope of practice. However, 35% indicated they are not able to attend
applicable training with the most common obstacles including finding replacement staff or
taking time off to attend;
 Regular performance reviews by supervisors or managers were reported by less than 43%
of respondents and 49% had never or seldom received a performance review. Managers
and supervisors were more likely to indicate that they had received valuable feedback from
their direct supervisor (52% frequently or always);
 A significant percentage of respondents were eligible to retire within the next 5 years,
including 31% of RNs, 21% of LPNs and 21% of RCWs. Slightly lower numbers were
considering retiring within the next 5 years – 29% of RNs, 18% of LPNs and 16% of RCWs;
 Among those who were eligible to retire within 5 years but were not considering retiring
within that time, 64% of RNs, 46% of LPNs and 52% of RCWs indicated ―not being able to
afford retirement‖ as a reason. However, a significant percentage of respondents (31% of
RNs, 55% of LPNs and 48% of RCWs) also indicated they were not considering retirement
because they ―like their job and want to continue working.‖

The PEI health system is facing numerous human resource challenges, including an aging
workforce, shortages and recruitment concerns. This survey brings many issues affecting job
satisfaction to light—issues that can have a profound effect on recruitment and retention of RNs,
LPNs and RCWs. The survey also illustrates that individuals working in these occupations have a
genuine enthusiasm for their work. We can ensure a strong and vital health system by addressing
current and emerging job satisfaction issues with sound strategies and proactive measures.

Page 5


SURVEY METHODOLOGY
Outline
The frame work and initial questions for the survey were provided by the Health Sector Council
after a consultation process involving organizations represented on the Board, focus group
analysis, and input from Service Canada.

The survey was reviewed to ensure that questions would achieve stated objectives and some
questions were redesigned for online use. The design was modified slightly for creation of the
paper survey ensuring that all questions were covered, and comparable, between survey designs.
The paper survey was tested within focus groups (segregated by profession) for reliability and
readability and adjusted accordingly.

To allow for the shift work nature of the professions and to keep costs down, data collection was
done with a broadly promoted web-based survey and a select distribution of 1500 paper surveys.

Promotion of the survey was achieved through partner organizations and direct distribution of
promotional materials and paper surveys. Incentive draw prizes were offered to improve the
response rate.

Paper survey data was manually entered into the same database as the online survey for analysis.

As confidentiality of respondents was critical to involvement of target groups, question skipping
was permitted.

To achieve a goal of 95% confidence interval with an error rate of +/- 5% (19 times out of 20), a
response sample size of 380 was required (with key sub-groups with a minimum of 40 respondents
to ensure anonymity in smaller workplaces.)

Limitations
Preliminary work with the target groups indicated a general distrust in the confidentiality of surveys
and a pessimism regarding the release of gathered information. To ensure confidence in survey
confidentiality, online surveys were not accessed by codes (felt by target groups to be traceable)
and all questions had an opt-out function. Therefore, assurance of profession and location of
employment is based on self-reporting of respondent.

Although a multi-phase communications strategy was used to promote the survey, the lack of
direct support from one association (due to agreement with membership to eliminate the
distribution of surveys) and one union (after completing their own survey in the prior calendar year,
they were not in support of the survey) somewhat limited the comprehensiveness of the reach of
the survey. During the survey, underrepresented groups were targeted for the second wave of
communications.

As the survey was voluntary, not connected to the employer, and relatively long, there is a self-
selection bias attached to this survey. Access to paper surveys was offered compensating for
those without high speed internet access.

Page 6


The data used in the analysis are based on self-reports and were not validated against objective
criteria or by direct observation. Although self-reporting has limitations, due to the nature of this
survey responses were necessarily subjective and based on individual perception.

Participant inclusion criteria included LPNs, RNs, and RCWs (but not those participants who
identified their position as geriatric care workers), and did not include other professions.

The data reported is unweighted. The ratio of LPNs to RNs stands at 650:1500 or 1:2.3 – with the
number of RCWs estimated at about equal to LPNs, the best ratio of RCWs to LPNs to RNs would
be 1:1:2.3. The results of this survey have a ratio of 1:1:1.7.

Cells of under 40 are not reported in detail in this report. Question skipping of under 10% (50
respondents) was deemed an acceptable rate and will not be noted in the report.

Due to rounding, not all percentage breakdowns will equal 100%.

Sample
According to 2008 data gathered from the Association of Registered Nurses PEI, there are
approximately 1500 RNs on PEI. According to 2008 data gathered from the PEI Licensed Practical
Nurses Association, there are approximately 650 LPNs. Without a registration process for RCWs
on PEI, it is estimated that the number of RCW‘s today is approximately equal to that of LPNs
1
(also compared to similar figures from the Canadian Institute of Health Information.)

A total of 225 e-surveys were completed as were 289 hard copies for a total of 514 submitted
surveys. Twenty-one surveys were removed from the final count as respondents did not identify as
an RCW, LPN, or RN (one Nurse Practitioner was included with the RN population.) Four more
were removed as they were undergraduates to any one group. Thirteen were removed as less
than 1/3 of the survey was completed. The final participant inclusion number was 476
respondents, representing approximately 17% of the population.

Interpretation
Interpretation of survey results is limited, in this report, to the identification of issues that might bear
further investigation. Results reported focus on areas of significance that would require further
analysis to confirm or refute statistical significance of possible relationships. The author, in
consultation with an advisory group, has recommended relationships that may make a good
starting point for future data analysis.

1
Anne Marie Atkinson and Sonya Hull. Health Human Resources Supply and Demand Analysis – Executive
Summary. DMR Consulting Inc. for the Health and Social Services System of Prince Edward Island (2001).
Page 7


RESULTS
Statistics
Of the 476 included respondents to the Job Satisfaction and Job Retention Survey, 127 were
Licensed Practical Nurses, 220 were Registered Nurses, and 129 were Resident Care Workers.
Fifty one (51) self-identified as Supervisors with 20 self-identified as Managers.

Sites Represented
Two hundred and six (206) or 43% of respondents worked in at least one of the 8 hospitals. One
hundred and sixty seven (167) or 35% worked primarily in a publicly owned nursing home or
chronic care facility. Forty two (42), or almost 9%, worked in privately owned nursing homes or
chronic care facilities. Twenty nine (29) worked in Public Health Nursing or Home Care. Twenty-
two (22) worked in clinics or private doctor‘s offices. The remaining 10 worked in a variety of other
locations, including Addictions Services, NGOs, private home care, or they preferred not to say.

Years in Practice
The years in practice represented by the respondents reflects that seen in statistics produced by
the Canadian Institute of Health Information (2006).

Number of Years in Practice
120 101
# of respondents

100
80 68 68
61
60 49 47
43
35
40
20
0
Less 3 to 5 6 to 10 11 to 15 16 to 20 21 to 25 26 to 30 More
than 2 years years years years years years than 30
years years

Work Schedule
Fifty percent (50%) of respondents worked permanent full time positions, 38% worked part-time
positions, with the remaining 12% working temporary or casual positions.

Three hundred and thirty one (331) staff reported working 8-hour shifts and 43 were working 12-
hour shifts (either regular or rotating.) Twenty-nine (29) respondents commented on a variety of
other working hours. Participants were asked about their preference of 8 hour or 12 hour shifts.

Page 8


Sixty percent (60%) preferred to work 8 hour shifts while 31% expressed a preference for 12-hour
shifts. Only 6 percent did not have a preference. Of significance, 78% of RCWs preferred the 8-
hour shifts over the longer shift.

Most of the 155 respondents who preferred 12 hour shifts commented on the effect of having more
straight days off as the reason for the preference. Twenty of the respondents indicated reasons
such as: I like the mix of hours; it will mean less driving or less money on gas, or more time
and better contact with patients.

Of those who preferred the 8-hour shifts, physical stress and heavy workload were the most
common reasons cited with family needs or childcare concerns as a close second most
common reason.

Of the 463 respondents who answered a question ―Are you working at any other paid, non-
healthcare jobs?‖, 8.5% were working at other non-healthcare jobs at least once in a while. Of the
19 respondents who commented on why they held other, non-healthcare job, most commented on
increasing income, with an equal number split between working as part of a family business and
due to the outside job being less stressful.

Ninety percent (90%) of respondents had some form of employer contribution to benefits such as a
health plan or retirement funding.

Work Environment
A number of questions were asked about satisfaction with communication, interaction with
colleagues, confidence in management, physical environment, and wages.

Communications
Communication with management and co-workers can have an effect on job performance as well
as job satisfaction.

Seventy three percent (73%) of respondents were slightly to very satisfied with the level of
communication with their immediate supervisors while 85% were slightly to very satisfied with the
level of communication with their co-workers. Seventy four percent (74%) felt that their supervisor
kept them informed about issues affecting their work, with 64% being slightly to very satisfied that
their supervisors were responding to issues that were most important to the respondent.

Sixty nine percent (69%) were ―slightly satisfied‖ to ―very satisfied‖ with the value of their input in
discussions and meetings about the workplace.

Page 9


Communication
That your supervisor is responding to
the issues that are most important to 13 10 13 25 25 14
you in the workplace

That your input in 1 Very
discussions/meetings about the 14 8 9 22 31 16 Dissatisfied
workplace is valued 2 Moderately
Dissatisfied
The level of communication with your 24 9 19 39 27 3 Slightly
co-workers Dissatisfied
4 Slightly
That your immediate supervisor keeps Satisfied
you informed about the issues 7 11 9 16 34 24
5 Moderately
affecting your work
Satisfied
6 Very
The level of communication with your 8 9 10 12 30 31 Satisfied
immediate supervisor

0 50 100
Percentage

Interaction with Colleagues
Positive interaction with co-workers was one of the most common responses stated when
participants were asked: If you were talking to someone about coming to PEI to work in your
profession, what would you tell them about what you LIKE MOST about your work?

Interaction with colleagues was addressed in a number of questions within the survey. The
following table shows the level of satisfaction with items of staff communication, collaboration, and
spirit. This chart does not necessarily include interactions with supervisors or management.

Respondents were much more satisfied with their interaction with their colleagues (71% slightly,
moderately, or very satisfied) and communication with co-workers (85% slightly, moderately, or
very satisfied), than their perception of the overall team spirit (59% slightly, moderately, or very
satisfied) or staff morale (54% slightly, moderately, or very satisfied).

Page 10


Satisfaction with Interaction with Colleagues

With the staff morale in the 16 13 16 24 22 8
workplace
1 Very Dissatisfied

The level of collaboration with 6 9 13 28 33 11 2 Moderately
OTHER classifications Dissatisfied
3 Slightly
Dissatisfied
With the level of collaboration 5 9 14 19 37 15
WITHIN your classification 4 Slightly Satisfied

5 Moderately
The level of communication with 24 9 19 39 27 Satisfied
your co-workers 6 Very Satisfied

0% 50% 100%

Confidence in Management
Confidence in management was measured by analyzing responses to questions around
supervisors, management and some issues directly affecting the health care worker (such as
assigned workload, physical work environment and job security.)

Seventy two percent (72%) were slightly to very satisfied that their immediate supervisor cared
about their general well being, 74% were slightly to very satisfied with their supervisor, and 64%
were slightly to very satisfied that their supervisor was responding to issues that were important.

There were 13% who were very dissatisfied with how their supervisor was responding to issues
while 14% were very satisfied. Fourteen percent (14%) very dissatisfied with the decisions that
leaders were making at work, compared to 12% who were very satisfied.

Seventy percent (70%) of respondents were satisfied with the reasonableness of their work
responsibilities. Job security was not a concern for most respondents with 68% being moderately
to very satisfied with their job security.

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Confidence in Management

That your immediate supervisor cares 10 8 10 20 25 27 1 Very
about your general well-being Dissatisfied

2 Moderately
With your direct supervisor 8 7 10 17 33 24
Dissatisfied

3 Slightly
That the leaders in your work place are 14 13 13 21 27 12 Dissatisfied
making good decisions
4 Slightly
With the reasonableness of your work Satisfied
9 9 12 22 33 15
responsibilities
5 Moderately
Satisfied
With your place of work (the building or 18 12 14 15 26 16
physical environment) 6 Very Satisfied

That your supervisor is responding to the
issues that are most important to you in 13 10 13 25 25 14
the workplace

With your overall job security 6 5 6 15 41 27

0% 20% 40% 60% 80% 100%
Percentage

The categories where confidence was rated as lowest included decision making and physical
environment. Forty percent (40%) were dissatisfied with leaders making good decisions in the
workplace and 44% were dissatisfied with the building or physical work environment.

Physical Environment
Eighteen percent (18%) of respondents were very dissatisfied ―with your place of work (the building
or physical environment)‖, 12% were moderately dissatisfied, 14% were somewhat dissatisfied
while 15% were slightly satisfied, 26% were moderately satisfied, while 16% were very satisfied.

In another part of the survey, the question was asked: Does your employer provide any
activities/equipment/resources to relieve stress at work? Of the 80% who responded ―No‖,
60% provided suggestions of what they would like to see. Nineteen percent (19%) of the
suggestions were related to physical environment with most looking for an exercise room and/or
exercise equipment, followed very closely by a separate staff room where they could relax on
break away from patients, residents, and visitors.

Page 12


Wages
When asked about satisfaction with wages, 10% were very dissatisfied, 11% moderately
dissatisfied, 12% slightly dissatisfied, 20% slightly satisfied, 35% moderately satisfied, and 11%
were very satisfied.

When asked: If you were talking to someone about coming to PEI to work in your profession,
what would you tell them about what you LIKE LEAST about your work?- eleven percent
(11%) commented on poor wages and/or benefits.

Respect
In this survey, there was an attempt to determine how perception of ―respect‖ contributes to
satisfaction in the workplace. The level of regard that participants perceived their colleagues to
have toward them is subjective. Perceptions of respect of colleagues encountered daily were
contrasted with perceptions of other health care professionals (who may have fewer contacts) for
comparison purposes.

Participants were asked to indicate whether they felt that their opinion or work was respected by
different health care groups. Participants were asked to consider the groups that they work with
regularly, so not all professions are commented upon equally.

Four hundred and seventy eight (478) respondents answered the question. While only 16
respondents skipped this question, professions where no relationship exists or where the
respondent chose not to comment were left blank. As a result, the numbers of respondents
commenting on the respect relationship with the different professions varied from 186 to 416 and
are noted below.

Two hundred and forty nine (249) participants noted the respect they felt was given by RCWs to
their opinion and work. Seventy seven percent (77%) felt that their opinion was respected by
RCWs. Sixty seven percent (67%) felt that their work was respected by RCWs.

Three hundred and fifty eight (338) responded to the section on LPNs. Eighty one percent (81%)
of all respondents felt that their opinion was respected by LPNs. Seventy percent (70%) felt that
their work was respected by LPNs.

Four hundred and sixteen (416) responded to the section on RNs. Seventy three percent (73%) of
all respondents felt that their opinion was respected by RNs. Seventy five percent (65%) felt that
their work was respected by RNs.

For comparison purposes, respondents were also asked to comment on the respect they felt came
from other health care professionals that they dealt with regularly. Two hundred and seventy one
(271) responded to the section on Physicians. Seventy one percent (71%) felt that their opinion
was respected by Physicians. Fifty eight percent (58%) felt that their work was respected by
Physicians.

One hundred and eighty six (186) responded to the section on Pharmacists – this group had the
least contact with the health care professionals in our survey. Seventy one percent (71%) of

Page 13


respondents who had regular contact with Pharmacists felt that their opinion was respected by
Pharmacists. Fifty seven percent (57%) felt that their work was respected by Pharmacists.

Two hundred and fifty (250) responded to the section on Other Health Care Professionals.
Seventy four percent (74%) felt that their opinion was respected by Other Health Care
Professionals. Sixty two percent (62%) felt that their work was respected by Other Health Care
Professionals.

Respect
Opinion respected by Opinion NOT respected by Work respected by Work NOT respected by
# of respondents

293 306
252 267

191 192 185
166 154 155
133
105
66
30 41 45 31 32
21 23 20 23 17 17

RCWs LPNs RNs Physicians Pharmacists Other Health
Care
Professionals

During the focus group testing of the draft survey, comments and discussion arose spontaneously
in 2 separate groups around the stresses created by the participants‘ perceptions of ―bullying‖ and
excessive pressure by some of their work colleagues. To test the extent of this perception in the
larger population, this question was added to the chart on Respect and is separated out in the
chart below for clarity of impact on the survey participant groups.

Participants were asked to comment on those groups that they ―worked with regularly‖. Actual
number of responses is noted in the chart in brackets. A breakdown by respondent‘s profession is
also shown to attempt to partially account for perceptions that might be attributed to positions of
power (for example, LPNs could feel more pressured by RNs as they may be supervisors
compared to LPNs who feel pressured by RCWs who would not be in a position of power;
additionally, RNs may feel more pressured by Physicians who are in positions of power over the
RNs they deal with regularly.)

Workplace bullying is defined by the Canadian Centre for Occupational Health and Safety
(CCOHS) as ―acts or verbal comments that could ‗mentally‘ hurt or isolate a person in the
workplace.... Bullying usually involves repeated incidents or a pattern of behaviour that is intended
to intimidate, offend, degrade or humiliate a particular person or group of people.‖ 2 Bullying in the
workplace may also include negative physical contact. Research into workplace bullying is still

2
Canadian Centre for Occupational Health and Safety (2005), ―Bullying in the Workplace.‖ 12 December 2008
<www.ccohs.ca/oshanswers/psychosocial/bullying.html>
Page 14


very much in its infancy and there are few statistics regarding its prevalence. The Public Service
Alliance of Canada suggests that workplace bullying is far more common than sexual harassment
and racial discrimination. Unlike those destructive behaviours, however, there is very little
legislation in Canada to deal with workplace bullying.

A small but growing amount of research suggests that workplace bullying is particularly prevalent
in the health sector. An Australian study of health workers indicates that 50% of those surveyed
had been exposed to bullying within a 12-month period, with fellow colleagues reporting the
highest incidence of bullying.3 A smaller survey of 1100 employees in one United Kingdom health
facility revealed 38% experienced bullying,4 while a nursing-specific study in the UK suggested 1 in
6 nurses have experienced bullying at the hands of a colleague.5 That figure rises to 3 in 10 for
nurses from an ethnic minority. Studies from other countries show similarly alarming results.
Thirty eight percent (38%) of nurses in Bulgaria and 22% in Lebanon, for instance, experienced
bullying.6,7

Question: Of those health care professionals that I work with regularly, I feel that in MOST
cases I feel bullied or unduly pressured:

(Total #) responding Grouped by all Grouped by Grouped by “as Grouped by “as
either positively or health care “as an RN, I an LPN, I feel an RCW, I feel
negatively to this group: workers together – feel …‖(#) % of …‖(#) % of total …‖(#)
(# who felt bullied or total RN group who LPN group who feel % of total RCW
pressured) % of total feel bullied or unduly bullied or unduly group who feel bullied
number of respondents pressured pressured or unduly pressured
by RCWs (249) (26) 10.4% (5) 6.8% (8) 14.0% (13) 11.1%

by LPNs (358) (21) 5.9% (6) 4.1% (5) 4.4% (10) 10.3%

by RNs (416) (62) 14.9% (24) 11.8% (18) 17.0% (20) 19.0%

by Physicians (271) (26) 9.6% (22) 12.8% (4) 6.3% (0) 0.0%

by Pharmacists (4) 2.2% (3) 2.4% (0) 0.0% (1) 4.8%
(186)

by Other Health (23) 9.2% (14) 9.7% (2) 3.2% (7) 12.7%
Care Professionals
(250)
Differences not tested for statistical significance.

3
Alison Rutherford and Chris Rissel, ―A survey of workplace bullying in a health sector organization‖, Australian
Health Review, Vol 28:1 (2004): 65-72.
4
L. Quinn (1999), cited in Jon Richards, Management of Workplace Victims, ILO/INC/WHO/PSI Joint Programme
on Workplace Violence in the Health Sector (2003).
5
Royal College of Nursing (2002), Working Well: A Call to Employers. 12 December 2008
<www.rcn.org.uk/__data/assets/pdf_file/0011/78527/001595.pdf>
6
ILO/INC/WHO/PSI Joint Programme on Workplace Violence in the Health Sector (2003), Bulgaria Case Study.
7
ILO/INC/WHO/PSI Joint Programme on Workplace Violence in the Health Sector (2003), Lebanon Case Study.
Page 15


Actual numbers of individuals who feel bullied or unduly pressured are low compared to the
Australian and UK studies, but do vary by profession. Numbers exceeding 10% of the population
bear further investigation.

Quality in the Workplace
Quality in the workplace can be measured on a number of levels. Direct questions were asked on
the participants‘ perspectives on quality issues. In addition, information was gathered on continuing
education and performance reviews.

Never Seldom Occasionally Frequently Always
Quality
My work is of high quality 04 47 50

My co-workers are committed to doing quality work 04 20 54 22

I know what is expected of me at work 0 6
1 46 47

I have opportunities to increase my skills (learn new skills) 3 19 33 29 16

I am allowed to use the skills I am trained to do during every 6 13 18 34 28
shift or workplace
I have the tools/equipment that I need to do my work properly 16 21 52 20

I am over worked 3 15 37 31 15

I am under worked 56 29 12 21

I have the time to do quality work 2 10 30 46 13

I have opportunities to do what I do best 2 7 29 44 18

I have witnessed staff (not formally trained) performing health 55 18 15 7 4
care

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Ninety three percent (93%) of respondents frequently or always knew what was expected of them
at work.

Ninety seven percent (97%) of the respondents who answered the Quality in the Workplace
questions felt that their work was of high quality frequently or always. In their opinion, they felt that
their coworkers were ―committed to doing quality work‖ frequently or always in 76% of the cases.

Page 16


Of note, 11% frequently or always ―witnessed staff performing health care duties when they have
not graduated from a recognized training program (not including students).‖ Among RNs, the rate
was 6%, among LPNs – 11%, and among RCWs – 22%.

Sixty two percent (62%) stated that they were frequently or always ―allowed to use all the skills
they were trained for during all shifts or workplaces.‖ Having opportunity to ―do what I do best‖
occurred frequently or always for 63% of the respondents. Being able to use most of the skills for
which they were trained occurred frequently or always for 54% of the population. Seventy three
percent (73%) frequently or always had the tools to do their work properly.

Fifty-five percent (55%) never/seldom/occasionally had the opportunity to increase their skills
leaving 45% who felt that they frequently or always had that opportunity.

While 97% never/seldom/occasionally felt they were underworked, 45% felt they were frequently or
always over-worked. When asked if they had the time to do quality work, 40% reported that they
never/seldom/occasionally had enough time, while 60% felt they frequently or always had enough
time (ranging from 53% of RCWs to 62% of RNs).

Continuing Education
When asked: In the last two years, has your employer offered regular in-services training to
keep staff up-to-date on current best practice? – seventy one percent (71%) said yes and
described a broad range of training. Twenty nine percent (29%) said that their employer did not
offer regular in-service training. In addition, 35% are not able to attend training that they are
interested in with the most common obstacle being replacement staff or time off of work to attend.

Performance Reviews
Regular reviews completed by supervisors or managers were reported by less than 43% of the
respondents. Forty nine percent (49%) had never or seldom received a performance review.
Direct supervisors were perceived to give useful feedback in 43% of the responses.

80% 74%
66%
% of respondents

70%
60% 54%
50% 43%
40% 34%
26%
30%
20%
10%
0%
I receive useful feedback My manager reviews my I receive performance
from my immediate progress reviews with my
supervisor supervisor or manager
Reviews
Never/Seldom/Occasionally Frequently or Always

Page 17


Scope of Practice
Scope of practice encompasses all of the actions and procedures one is trained and educated to
perform as a member of a particular occupational group. Each occupational group has its own
scope of practice which is defined through a combination of education and legislation. Scope of
practice is distinct from scope of employment, which encompasses the activities an individual is
authorized to perform by an employer. Ideally, scope of practice and scope of employment match,
meaning an individual‘s actual duties equate with what they have been trained to do.

The PEIHSC identified scope of practice as an area of concern in the PEI health sector
(particularly among RNs, LPNs and RCWs) during its first year of operation and carried out a
number of initiatives to address the issue further, including a Scope of Practice Forum in early
2007 and a series of focus groups later that year. These initiatives helped define many of the
issues around scope of practice and identified several barriers limiting employees from working to
full scope of practice, including inconsistent or outdated policies and job descriptions, legislation
and regulation incongruent with training and education, management style and resistance to
change.8,9

Job satisfaction is something that was raised during focus groups as closely tied to scope of
practice. The survey indicates that it remains an area of concern for RNs, LPNs and RCWs.

Ninety-nine percent (99%) of RNs, LPNs, and RCWs think that all groups should be working to
their full scope of practice.

Forty two percent (42%) never/seldom/occasionally work to their full scope of practice. While 58%
frequently or always work to their full scope.

Forty six percent (46%) never/seldom/occasionally use the skills for which they were trained. While
54% frequently or always use the skills for which they were trained.

Thirty eight percent (38%) never/seldom/occasionally use the skills for which they were trained.
While 62.4% frequently or always use the skills for which they were trained.

Most are willing to take on additional training to expand their scope of practice: ranging from 91%
of RNs to 95% of LPNs.

The Corpus Sanchez report, a comprehensive review of PEI‘s health system, makes note of scope
of practice, particularly in relation to improving efficiencies in home-based care (including manors
and nursing homes).10 In response to the recommended strategic directions outlined within the
Corpus Sanchez report, the provincial government has included scope of practice as a priority and
has promised to maximize the capacity for RNs, LPNs and RCWs to work to full scope of practice.

8
Betty Bailey and Jennifer Ghiz, Scope of Practice Forum 2007 Summary Report, PEI Health Sector Council
(2007).
9
MacPherson Roche Smith & Associates, Prince Edward Island Health Sector Council Focus Group Report, PEI
Health Sector Council (2008).
10
Prince Edward Island, Department of Health (2008), An Integrated Health System Review in PEI – A Call to
Action: A Plan for Change.
Page 18


This is a positive development that could have a profound effect on job satisfaction among RNs,
LPNs and RCWs.

Retirement
Participants were asked about their eligibility to retire within the next five years, whether or not they
were considering retirement in the next five years (despite eligibility), what would make them
reconsider retirement (they could choose more than one reason), and if they are eligible to retire
but not considering it – what was their ―main‖ reason for not retiring.

Thirty-one percent (31%) of RNs reported being eligible to retire within the next 5 years. Twenty-
nine percent (29%) of respondents were considering retirement in the next 5 years. When asked
what would make them reconsider retirement, 4% would not reconsider, 74% would reconsider if
they could maintain benefits while reducing work hours, 55% would reconsider if they could work
(without an income penalty) even after taking an early retirement package, 43% would reconsider if
their workload was not as heavy, 40% would reconsider if they didn‘t have to work evenings or
weekends, 36% would like more flexibility in their work schedule, 30% were interested in staying if
they could expand their role (examples: mentoring, teaching, or focus on news skills) and 30%
were interested in dropping to part-time work. When asked what the main reason for not retiring
would be, 64% noted not being able to afford retirement while 31% said they like their job and want
to continue working.

Twenty-one percent (21%) of LPNs reported being eligible to retire within the next 5 years.
Eighteen percent (18%) of respondents were considering retirement in the next 5 years. When
asked what would make them reconsider retirement, 25% would not reconsider, 50% would
reconsider if they could work (without an income penalty) even after taking an early retirement
package, 45% would reconsider if their workload was not as heavy, 40% would reconsider if they
could maintain benefits while reducing work hours, and 30% were interested in dropping to part-
time work. When asked what the main reason for not retiring would be, 55% said they like their job
and want to continue working while 46% noted not being able to afford retirement.

Twenty-one percent (21%) of RCWs reported being eligible to retire within the next 5 years.
Sixteen percent (16%) of respondents were considering retirement in the next 5 years. When
asked what would make them reconsider retirement, 17% would not reconsider, 56% would
reconsider if they could work (without an income penalty) even after taking an early retirement
package, 39% would reconsider if their workload was not as heavy, and 33% would reconsider if
they didn‘t have to work evenings or weekends. When asked what the main reason for not retiring
would be, 52% noted not being able to afford retirement, while 48% said they like their job and
want to continue working.

DISCUSSION
Supervisors/Management vs. Staff
Fifty-nine (59) respondents indicated that they were supervisors or managers. Ninety percent
(90%) of those reporting were RNs. Seventy two percent (72%) of the supervisors or managers,
had been in practice for more than 20 years.
Page 19


Thirty nine (39) of the respondents worked in long-term care facilities (public and private) with the
remain 11 working in a variety of acute care settings, and 9 working in home care, clinics, addiction
services, or non-government organizations.

Managers and supervisors scored about the same as the larger population on almost all areas.
The one area where there was a significant difference was in the value of feedback from direct
supervisors – managers and supervisors felt that they received valuable feedback 52% frequently
or always (compared to 43% in the staff group.)

Supervisors and Managers
Years in Practice
59
60

50
# of respondents

40

30 23

20 12
7 6 7
10 2
1 1
0

Acute Care vs. Long-term Care
The survey gathered responses from acute care facilities (Hillsborough Hospital, Kings County,
Memorial Hospital, O‘Leary Community Hospital, Prince County Hospital, Queen Elizabeth
Hospital, Souris Hospital, Stewart Memorial Hospital, and Western Hospital) as well as public
chronic care (Colville Manor, Riverview Manor, Prince Edward Home, Beach Grove Home,
Summerset Manor, Wedgewood Manor, Stewart Memorial Hospital - Margaret Stewart Ellis Wing,
Maplewood Manor) and private chronic care facilities (Garden Home, MacMillan Lodge, PEI
Atlantic Baptist Nursing Home, Park West Lodge, Whisperwood Villas, Clintonview Lodge, South
Shore Villa).

Two hundred and twelve (212) respondents worked in acute care facilities. Of the 211
respondents working in long-term care facilities, 170 worked in publicly owned facilities while 41

Page 20


worked in privately owned facilities. It should be noted that no RCWs worked in acute care
settings.

Significant differences between workplace settings were noted but when RCWs were removed
from the data set (as RCWs do not work in acute care settings) this significance disappeared.

Adding RCWs into the data set creates four areas of difference that are statistically significant.
The areas of significant difference were in satisfaction with job issues such as wages, quality of
your work, staff morale and overall job security. On all other measures, there was no significance
in the difference between acute care settings and chronic care facilities.

Comparison on Satisfaction with Workplace Issues
(including RCWs)
Acute Care Facilities vs Chronic Care Facilities

That your work gives you a feeling of personal accomplishment 17% 83% 13% 87%

The quality of your work 9% 91% 9% 91%

Your wages 37% 63% 36% 64%

With your overall job security 16% 84% 21% 79%

With your place of work (the building or physical environment) 32% 68% 59% 41%

With your ability to maintain a good balance between family life 22% 78% 34% 66%
and work life

With the reasonableness of your work responsibilities 26% 74% 40% 61%

With the staff morale in the workplace 37% 64% 61% 39%

With the level of collaboration within your classification in your 27% 73% 38% 63%
work place

The level of communication with your co-workers 11% 89% 22% 78%

That your input in discussions/meetings about the workplace is 25% 75% 46% 54%
valued

That the leaders in your work place are making good decisions 33% 67% 54% 46%

That your immediate supervisor cares about your general well- 20% 80% 41% 59%
being
That you receive adequate recognition from your supervisor when 30% 70% 43% 57%
you do a good job
That your supervisor is responding to the issues that are most 29% 71% 49% 51%
important to you in the workplace
That your immediate supervisor keeps you informed about the 18% 82% 37% 63%
issues affecting your work

Slightly/Moderately/Very Dissatisfied Slightly/Moderately/Very Satisfied

Page 21


In addition to these satisfaction issues, those survey participants working in chronic care facilities
are more likely to report being able to attend most of the training programs that they are interested
in. Those working in long-term care facilities are more likely to have been scheduled to work a
double shift. The most common reason given for needing to work a double shift is that they were
short staffed.

In all settings RNs reported never being scheduled to work a double shift in 89% of the cases,
LPNs reported never being scheduled to work a double shift in 82% of the cases. RCWs reported
never being scheduled to work a double shift in 64% of the cases.

Computer Use
As the province‘s health system began the rollout of a new electronic health records system into
acute care institutions this year, comfort levels with computer use were addressed by the survey.
More health care workers working in acute care settings have a computer at home than do those
working in long-term care facilities. Acute care health care workers also use their home computers
more frequently and they express more comfort in using computers.

The majority of respondents (84%) have frequent or daily use of a computer at home with 74%
reporting being comfortable using a computer frequently or daily. Twelve percent (12%) reported
never or seldom having access to a computer at home and 13% reported never or seldom being
comfortable with using a computer.

Computer Usage and Comfort Level
Percent of Respondents

I have access to a
80% computer at home

60% I use a computer at
home
40%

20% I have access to a
computer at work
0%
I use a computer at
work

I am comfortable
using a computer

Frequency

Of those using electronic health records, 54% were comfortable using it frequently or daily.
Thirteen percent (13%) reported never or seldom being comfortable with using electronic health
records.

Page 22


Generational Differences
Within many healthcare workplaces today, we can find 4 distinct generations of workers, each
influenced by the era in which they were born and raised. Since approximately 1980, the newest
generation (popularly named Millenials) is now within, or just entering, the health care work place.
Within this survey, Millenials were represented by 52 of the 476 respondents.

Comparing the Millennial group against the group aged 30+ years (which includes the generations
popularly named: Gen X, Baby Boomers, and Matures) uncovers some interesting distinctions.

Within this survey, the mix of RCWs to LPNs to RNs was similar in both generations‘ groups. Forty
one percent (41%) of the Millenials had been in the workforce for 2 years or less with another 39%
working 3-5 years. Within the older group, 31% had been in the workforce for 16-25 years while
the next largest group, 23%, had been working in healthcare for more than 30 years.

The spread of those working in long-term care vs. acute care settings was similar. The older group
was more heavily represented in privately owned facilities and Home Care or Public Health
Nursing.

Forty percent (40%) of Millenials and 51% of the older group report permanent, full-time
employment. Not surprisingly, the older group was less likely to be working temporary or casual
positions (3% and 4% respectively) while Millenials were 19% temporary and 10% casual
positions.

When asked if they would prefer to work 8-hour or 12-hour shifts, Millenials were more likely to
choose 12-hour shifts (at 61%) while the older group preferred 8-hour shifts (at 69%).

Staying in Healthcare and Staying in PEI
Respondents were asked how frequently they think about leaving health care as a profession and
how frequently they think of leaving PEI to work in healthcare in another province or country.

Thirty eight percent (38%) never think of leaving healthcare as a profession and 58% never think of
leaving PEI. Twenty two percent (22%) frequently or always think about leaving healthcare and
13% frequently or always think about leaving PEI.

When asked: If you were talking to someone about coming to PEI to work in your profession,
what would you tell them about what you LIKE MOST about your work?- 405 responded with
comments. Of the 405 comments returned, 111 included comments identifying their co-workers as
a primary reason for liking the work on PEI. Eleven respondents (11) commented on wages or
salary being a positive thing on PEI with just as many commenting on working opportunities being
abundant. Most of the remaining comments focused on the joy of the type of work (working with
sick people, working with the elderly, dealing with families.) In another portion of the survey, the
majority of respondents (65%) reported feeling I am engaged in meaningful work frequently or
always.

Page 23


All respondents were asked about reasons they might leave PEI; 346 returned comments. Sixty
three respondents (63) would consider leaving for financial considerations. Forty four (44) would
consider leaving due to health concerns, sickness, or injury. Thirty four (34) commented on
retirement related issues. Twenty five (25) commented on workload issues. Nineteen (19)
respondents commented on moving due to issues around their scope of practice. Nineteen (19)
would consider leaving due to stress. Another thirteen respondents (13) used the term burn-out in
their comments.

When all respondents were asked to reflect on why they stay on PEI, 84 people used the word
―love‖ in their comments with 23 saying they loved their job. Eighty eight (88) commented that they
stay on PEI due to it being their home. Thirty eight (38) commented that pay or salary kept them on
PEI.

Leaving Healthcare or Leaving PEI
58%
60%
50%
% of Respondents

38%
40% Never

30% 23% Seldom
17%
20%
15% 14% 15% Occasionally
10%
7% Frequently
10% 3%
Always
0%
I think about leaving my job in health I think about leaving PEI to work in
care but staying in PEI health care in another province or
country

Suggestions for Future Data Analysis
The data collected in this survey has a vast amount of information yet to be mined. As the timing
and scope of this survey contract limited the analysis done, the author has defined areas that might
yet yield valuable information to policy makers, facility owners/managers, unions, professional
associations, researchers, and the healthcare work force.

Subpopulations
Subgroups of RNs, LPNs, and RCWs are large enough that more analysis can occur connected
specifically to each health care group.

With 29% of respondents indicating 25 or more years of practice, there is a wealth of experienced
opinion to be investigated in this dataset. Analysis of the views and opinions of other age brackets
should also be considered for further investigation.

Page 24


Subsets of the acute care and publicly owned chronic care facility group have detailed information
to share with certain facilities where response rates where over 40 responses. Others with over 20
respondents may also contain valuable information depending upon the size of staff in each facility.

Although there was a disappointing response rate from privately owned long-term care facilities,
one facility is represented by 22 respondents and facility owners may benefit from a further
analysis of this information (although statistical significance may not be reached on some
questions depending up on the size of the staff population working in this facility.)

Public home care and public health nursing had 29 respondents and there may be some value to
stratifying data for this group.

In all cases, comparing the data to other subgroups may turn up significant differences or insights
that might be carried over from one setting to another (example: what may be making certain
health care groups more satisfied in their workplace carried over to another setting.)

Hours of Work
With a definite split in preference for 8 hour vs. 12 hour shifts, more research could be done to
define what groups could work on their preferred shifts. (At the time of this survey, the cost of gas
had doubled in price from the previous year which may have affected comments on fewer shifts
saving on travel costs – now with the price of gas back down considerably, this group may have
changed their opinions somewhat).

Forty five percent (45%) of workers were designated to work 80% or less, yet 71% of respondents
were working more than 80% time. The benefits of a lower designation with full-time hours worked
was not investigated in this survey. Comments would indicate that some respondents are willing to
give up the security of guaranteed hours in favour of more control over working hours and time off
– this would need to be statistically proven or disproven with deeper analysis.

Work Environment
On most measures of work environment, respondents were moderately to very satisfied. More
investigation could be done in areas where satisfaction was only slightly to very dissatisfied
including: that your supervisor is responding to the issues that are most important to you in
the workplace and team spirit or staff morale.

Respect
Although the vast majority of respondents felt that their opinions and work are respected by their
direct colleagues and other health care workers, opinions and work were not perceived as being
held in equal esteem – the data could be investigated to look for significance in this area.

With those who feel bullied in low numbers, policy makers and facility managers may easily
overlook this area, but without comparison to healthcare facilities in other provinces or other
professions, we do not know if these low numbers are acceptably low.

Page 25


Quality in the Workplace
With 54% of respondents stating that they only receive useful feedback from their supervisors
occasionally and a third of that group feeling that the feedback is seldom or never useful the data
could be further mined for evidence of similar levels of dissatisfaction in this subgroup. More
importantly, the group who frequently or always find the feedback useful may also have similarities
or situations that may be applied to the other group.

Forty six percent (46%) of the survey group feel that they are frequently or always overworked
(have too much work to do in the time available). How does this compare to healthcare workers
in other provinces and how does it compare to other trades and professions?

Is it acceptable that 28% of the reporting workforce never to only occasionally feel positive when
they are at work? Is this subgroup located in certain areas, is there something unique in their
worksites or in their supervision or management? The data may be able to give some of the
answers.

Sixty six percent (66%) of the respondents reported at the end of each work day I have the
energy to engage in personal interests never-seldom-occasionally, is this comparable to other
jobs or healthcare workers in other provinces?

Ninety seven percent (97%) of respondents report that their work is frequently or always of high
quality. Fifty eight percent (58%) work to their full scope of practice frequently or always –
leaving 21% only occasionally, 14% seldom, and 8% never working to their full scope. With 50%
reporting that they seldom or never receive performance reviews with their supervisor or manager,
should we be concerned about performance issues in healthcare facilities and how does this rate
compare to other provinces? And finally, with 59% of the respondents saying that they frequently
or always have time to do quality work, what kind of a total picture does this paint about the
overall quality of work being done in our health care system?

Should I Stay or Should I Go?
More research can be done with this data set to find ways of comparing what is keeping workers
on PEI to those who are thinking about leaving.

In addition, there is a wealth of feedback on workplace efficiencies, supports to relieve stress,
and requested activities/program/services that health care workers are looking for. In a brief
investigation, this data contains many reasonable suggestions that may be easily implemented in a
number of situations. Given the levels of stress and dissatisfaction noted in certain groups, there
may be ―easy wins‖ to be gained from responding to this information.

Scope of Practice
Having trained and skilled people prevented from performing essential tasks where they are
needed does not make sense when there is a documented demand.

Page 26


With 99% of respondents wanting to see all health care workers working to their full scope of
practice and 93% willing to take more training to expand their scope of practice, the desire to work
to full scope is evident.

The data yet to be mined also includes over 130 recommendations for changes to everything from
local procedures and policies to necessary legislative initiatives. The responses also identify
concerns about ―attitudes‖ that would need further investigation outside the capacity of this data.

The Burden of Working in Health Care
There are a number of areas within this survey that speak to the burden on the healthcare worker.
More work can be done with this data to further define where that burden is most intense (where
workers do not get their earned time off, where double shifts are to be expected, where the
pressure to put in more time is excessive). The data can also be mined for information on where
the burden is not so oppressive and lessons learned for transfer to other areas.

Sixteen percent of respondents reported that their employer expects them to take on additional
duties for which they have not been trained. Forty one percent (41%) report performing duties that
were not included in their job description, including a considerable amount of custodial and food
service tasks. With concerns around contagious infections in healthcare settings, the potential for
cross contamination needs to be investigated.

What is missing from this data is the measure of workers who have not been refused earned time
off because they have learned not to ask. This information came out in some of the comments
within the survey where respondents identified issues around seniority, time of year, and lack of
request lead time as barriers to getting time off.

Page 27


Appendix A - Job Satisfaction and Retention Survey - Overview

Overview  A profession-based survey (of RNs, LPNs, and RCWs on PEI) will be used to
determine population job satisfaction and personnel retention issues based on
collection and interpretation of quantitative and qualitative data.
 Data collection will be done with a select distribution of 1500 paper-based and
broadly promoted web-based survey to allow for the shift work nature of the
professions as well as to keep costs down
 As the opinions of all professionals are sought, the mailing target will encompass
all working members of the population; a minimum response sample of 380 is
required for detailed analysis with no subgroups with fewer than 40 respondents
 Target population: Registered Nurses, Licensed Practical Nurses, and Resident Care
Workers working on PEI

Sampling/Sampling  Details related to target population:
Details o employed in public and private facilities as well as private homes
o approximately 2300 individuals with targeted subgroups based on profession
and private/public sector employers
 Sample frame:
o the sample source will be accessed through project partners (including
professional associations and union)
o sampling procedures – mailings will be forwarded through partner
organizations; returns will be collected by the Health Sector Council
- web-based survey site will be promoted through communications plan
o sampling limitations and low response rates may affect the subgroup analysis
 promotions through partner bodies and the media will be used to encourage
survey participation

Response Rate/Error Rate  Anticipated response rate to achieve a minimum sample size of 380 with key sub-
groups with a minimum of 40 respondents
 Goal of 95% confidence interval with an error rate of +/- 5% (19 times out of 20)
 Indicate any other potential source of error based on the study design that might
affect the accuracy of the data.

Description of Data  Method of data collection: paper-based surveys (partner distributed) surveys and
Collection web-based survey
 Incentives for early returns of surveys is recommended to encourage returns on a
time restricted project
 Respondent anonymity and confidentiality will be protected

Questionnaire Design  The questionnaire design will be provided by the Health Sector Council
 The questionnaire will be pre-tested using focus groups to ensure that the

Page 28


Appendix A - Job Satisfaction and Retention Survey - Overview

readability and completion times are acceptable
o Subgroups will be represented
o Results will be used to make final adjustments to the questionnaire

Description of Data  The data for quantitative analysis will be exported as Excel files to the client to
Processing/Data allow for import into SPSS
Management  During the project data will be backed up to an external hard drive daily and kept
in a secured location; following completion of the project, stripped data will be
provided in an electronic form to the Health Sector Council

Data Analysis/ Reporting  Basic statistical analysis of the data will be performed related to the
objectives/research questions, including any special analyses (e.g., segmentation).
 Report format will be determined by an advisory team

Deliverables  Questionnaire(s), including pre-test
 Data in SPSS readable format for further tabulation/processing
 Electronic copy of the report and promotional material
 PowerPoint presentation (electronic file)

Project Schedule  Work plan with dates and responsibilities under separate cover

Page 29


PEI HEALTH SECTOR COUNCIL
Comprehensive Job-satisfaction and Retention Survey

Dear Participant,

The PEI Health Sector Council (PEIHSC) is a non-government organization dedicated to understanding issues related to supply and demand of
health human resources. Retention of our health care workers is very important and we are trying to gain your insight regarding your work
environment.

This survey is unique in that we are asking for input from RCWs, LPNs, and RNs. The final report will be available to you on the PEIHSC
website (www.peihsc.ca) or by contacting the PEIHSC office at (902) 367-4460.

All reports created from this survey will be available to you.

The survey is anonymous. To ensure confidentiality only group data will be reported, that is, no individual information will be included in any
reports and no reports will make it possible to identify individuals in a workplace. Please note that:
• your participation is entirely voluntary,
• you are free to refuse to respond to any of the survey questions,
• you are free to withdraw at any time.

Thank you for your time and interest.

As a bonus for participation, we are offering Draw Prizes to participants. You could win:
* a new computer
* a $200 gift certificate for a fitness centre of your choice
* a $100 gift certificate for Future Shop
Once you have completed the survey, simply call (902) 367-4460 or email betty.bailey@peihsc.ca to have your name entered in the draw. We
will not be able to connect Draw Prize forms to completed surveys – your confidentiality will be protected and respected. Draws will be
completed on October 10, 2008 at the PEIHSC office.
Winners will be contacted and their names will be posted on the PEI HSC website. There are 6 parts to this survey: Please complete all
pages

30 PEI Health Sector Council – Job Satisfaction & Job Retention Survey


PART 1 - YOU AND YOUR WORKPLACE

1. I am currently employed as a (please 2. Number of years in practice: 3. I am a supervisor?
choose one):  Less than 2 years  Yes
LPN (Licensed Practical Nurse)  3 to 5 years  No
RN (Registered Nurse)  6 to 10 years
RCW (Resident Care Worker)  11 to 15 years 4. I am a manager?
Other (please specify):  16 to 20 years  Yes
 21 to 25 years  No
 26 to 30 years
 More than 30 years

5. I work primarily at: (please choose one)

Hospitals Publically owned long term care Privately owned long term care facility
 Hillsborough Hospital facility  Dr. John Gillis Memorial Lodge
 Kings County Memorial Hospital  Colville Manor  Garden Home
 O’Leary Community Hospital  Riverview Manor  MacMillan Lodge
 Prince County Hospital  Prince Edward Home  PEI Atlantic Baptist Nursing Home
 Queen Elizabeth Hospital  Beach Grove Home  Park West Lodge
 Souris Hospital  Summerset Manor  Whisperwood Villa:
 Stewart Memorial Hospital  Wedgewood Manor  Clintonview Lodge
 Western Hospital  Stewart Memorial Hospital  South Shore Villa
 Margaret Stewart Ellis Wing
 Health Care Clinic  Maplewood Manor Other
 Private doctors office  Other Publically owned Community
 Non-government organization Care/Nursing Home
 Other Privately owned Community Care/
 I prefer not to say Nursing Home
 Public Home Care or Public Health Nursing
 Private Home Care
 Addictions Services



6. Currently, I am hired to work/ or I am 7. I have a Line Sharing Agreement on 8. Compared to a full-time position, I am hired
designated as: my position: to work/or I am designated to work:
 Permanent full time  Yes  Less than 40 percent
 Permanent part time at one location  No  More than 40 but less than 60 percent
 Permanent part time at more than one  60 percent to 80 percent
location  More than 80 percent but less than 100
 Temporary percent
 Casual at one location  100 percent or more
 Casual at more than one location

9. Compared to a full-time position, I am actually working : 10. I would prefer to work:
 Less than 40 percent  Less than 40 percent
 More than 40 but less than 60 percent  More than 40 but less than 60 percent
 60 percent to 80 percent  60 percent to 80 percent
 More than 80 percent but less than 100 percent  More than 80 percent but less than 100 percent
 100 percent or more  100 percent or more

11. Are you working at any other paid, non-healthcare jobs? (please choose one)
 Yes, once in a while
 Yes, sometimes
 Yes, often
 No

12. I prefer to work:
 8-hour shifts
 12-hour shifts

- Please explain why:

____________________________________________________________________________________________________



13. For each place you work as a health care worker, what are your usual hours of work. (Mark location #1 as where you spend most of your
time, #2 as the next largest amount of time, etc.) Only mark the 1 (one) shift per location that represents most of your work.

Regular 8-hour Shifts Rotating 8-hour Shifts Regular 12-hour Rotating 12-hour Other (please
Shifts Shifts describe:)
Location  Days  Days  Days  Days
#1  Evenings  Evenings  Nights  Nights
 Nights  Nights  Days & Nights  Days & Nights
 Days & Evenings  Days & Evenings
 Days & Nights  Days & Nights
 Days, Evenings & Nights  Days, Evenings & Nights
14. Does your employer contribute to “benefits” for you such as a health plan or retirement funding?
 Yes
 No

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