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The Relationship of Educational Preparation,

Autonomy, and Critical Thinking to Nursing


Job Satisfaction
Joyce Zurmehly, PhD, RN

directly related to turnover rates (Gary, 2002; Watson).


abstract Thus, why some nurses leave the profession while others
remain committed is a topic of much discussion. Perhaps
Background: This descriptive correlational study ex- part of the explanation can be found by examining the re-
plored factors influencing job satisfaction in nursing. Rela- lationships between autonomy, educational preparation,
tionships between educational preparation, autonomy, and and critical thinking and job satisfaction. Strengthening
critical thinking and job satisfaction were examined. these attributes is believed to positively affect job satis-
Method: A convenience sample of 140 registered nurses faction (Gary; Watson) and may help mediate the high
was drawn from medical-surgical, management, and home attrition rate of 33% among employed nurses (American
health nursing specialties. The nurses were asked to com- Association of Colleges of Nursing, 2002).
plete the Watson-Glaser Critical Thinking Appraisal and Min- It has been established in the nursing literature that
nesota Satisfaction Questionnaire. Relationships between higher levels of job autonomy can lead to higher levels of
variables were analyzed to determine which explained the job satisfaction (Gary, 2002; Laschinger, 2003). A review
most variance in job satisfaction. of nursing literature on job satisfaction and its correla-
Results: Results indicated significant positive correla- tion with autonomy indicates that when nurses perceive
tions between total job satisfaction and perceived autonomy, they have little control within the work setting, frustra-
critical thinking, educational preparation, and job satisfiers. tion and dissatisfaction result. It is also true that auton-
Significant negative correlations between job dissatisfiers omy most greatly affects satisfaction when employees
and total job satisfaction were also found. have a strong need for independence.
Conclusions: Understanding nursing job satisfaction Efforts by nursing leaders to address the changing
through critical thinking, educational level, and autonomy is health care system and increase nursing autonomy in-
the key to staff retention. Further research focusing on in- clude calling for a minimum of a baccalaureate degree to
creasing these satisfiers is needed. practice nursing and encouraging complex professional
J Contin Educ Nurs 2008;39(10):453-460. decision making (Bartels & Bednash, 2005; Goodhue,
2005). These efforts have resulted in more pressure for
lengthened nursing educational preparation at a time

A ccording to the U.S. Department of Health and


Human Services (2002), the demand for registered
nurses (RNs) is expected to grow to 2.8 million by 2020
when the nursing shortage is growing more critical.
Thus, retaining nurses now in practice, rather than fo-
cusing simply on educating new nurses, is important if
from 2 million in 2000, which is a 29% increase in the the nursing shortage is to be controlled.
number of nurses needed. Retaining nurses who are Numerous researchers have attempted to increase
leaving the profession is one possible means of decreas-
ing the demand (Watson, 2002). Job satisfaction among
Dr. Zurmehly is Assistant Professor, Wright State University, Day-
nurses has long been recognized as a critical indicator ton, Ohio.
of their performance and quality of patient care (Aiken, Address correspondence to Joyce Zurmehly, PhD, RN, Wright State
Clarke, Sloane, Sochalski, & Silber, 2002) and has been University, 3640 Colonel Glenn Highway, Dayton, OH 45435.

The Journal of Continuing Education in Nursing · October 2008 · Vol 39, No 10 453
awareness of factors affecting nursing job satisfaction of the scores between groups on the California Criti-
(Hoffman & Scott, 2003; Larrabee et al., 2003; Ram- cal Thinking Skills Test, bachelor of science in nursing
bur, McIntosh, Palumbo, & Reiner, 2005). Several stud- (BSN) RNs scored significantly higher than associate de-
ies have examined the relationship between educational gree in nursing (ADN) nurses on critical thinking abili-
level and job satisfaction in nursing (Blegen & Mueller, ties (analysis of variance: F = 3.03, p = .03).
1987; Ingersoll, Olsan, Drew-Cates, DeVinney, & Da- The concept of job satisfaction has been studied ex-
vies, 2002; Rambur et al.). By investigating variables that tensively, but limited research has been conducted on the
influence the delivery of quality patient care and rela- correlation between educational preparation, autonomy,
tionships between nursing work conditions and autono- and critical thinking and job satisfaction. However, it has
my and job satisfaction in Magnet hospitals, Laschinger, been demonstrated that autonomy and critical thinking
Shamian, and Thompson (2001) found that several fac- are considered essential components of professionalism
tors contributed to job satisfaction. The findings, based (Brunt, 2005; Kovner, Brewer, Wu, Cheng, & Suzuki,
on the Nursing Work Index, suggested that high levels 2006). Therefore, this research was designed to investigate
of autonomy, control, and collaboration were associated relationships that may exist between levels of job satisfac-
with high levels of trust in management, which in turn tion among nurses now in practice and educational level,
were associated with higher job satisfaction. perceptions of autonomy, and critical thinking skills.
Chen-Chung, Samules, and Alexander (2003) com-
pared nurses from hospital and non-hospital settings Methodology
regarding job satisfaction and found that autonomy was Design and Sample
the second most significant predictor of job satisfaction A correlational research design was used with a pur-
for hospital nurses. Aiken, Havens, and Sloane (2000) posive sample consisting of RNs. Inclusion criteria were
reported that job satisfaction increased in Magnet hospi- current RN licensure; graduation from an accredited
tals and contributing factors included staffing patterns, nursing program with a diploma or associate, baccalau-
support, responsibility, decentralized management, and reate, or master’s degree in nursing; employment in a
quality. health care facility; and job of floor nurse, supervisor,
The literature is devoid of studies investigating criti- director, or manager. The sample was drawn from staff
cal thinking and job satisfaction, with most of the re- nurses employed in four different types of health care
search focused on critical thinking in nursing educa- organizations: urban and rural hospitals, community
tion and a few studies on nursing practice. In an early health agencies, and home health agencies. After institu-
descriptive study, Ketefian (1981) sampled 79 practic- tional review board and study site approval, eligible RNs
ing nurses to determine the relationship between criti- were recruited and informed consent was obtained prior
cal thinking and educational preparation and level of to data collection. Two hundred packets were distribut-
moral judgment. There was a statistically significant ed and 146 were returned, with 6 unusable, representing
difference in critical thinking and educational prepara- a response rate of 73%.
tion predicting greater variance in moral judgment than
either variable alone. Instrumentation
Maynard (1996) examined the relationship between A demographic survey was administered to gain in-
critical thinking ability and professional nursing com- formation about gender, marital status, age, ethnicity,
petence from beginning nursing students to practicing level of nursing education, area of practice, years of ex-
professionals. Relationships were investigated between perience, and work status. Two standardized measures
measures of critical thinking and professional competen- were used with permission to assess levels of critical
cies. Findings indicated critical thinking ability did not thinking, autonomy, and job satisfaction. The first tool,
change significantly during the educational experience the Watson-Glaser Critical Thinking Appraisal (WGC-
(sophomore to senior); however, a significant increase TA) (Watson & Glaser, 1980), measures critical think-
was found from senior year to practicing nurses. No re- ing gains resulting from instructional programs, predicts
lationship was demonstrated between critical thinking success in certain types of occupations or programs
ability and professional competence. where critical thinking is known to play an important
Beeken (1997) investigated relationships among criti- role, and determines the relationship between critical
cal thinking abilities and self-concept in practicing staff thinking and other abilities or traits. The WGCTA is a
nurses. When comparing critical thinking and self-con- 40-item test, with a possible score ranging from 0 to 40.
cept, correlations showed no statistically significant re- This tool requires responses to two types of items: those
lationship (r = .1097, p > .05). However, on comparison having neutral content and those having controversial

454 The Journal of Continuing Education in Nursing · October 2008 · Vol 39, No 10
content. The WGCTA seeks to provide an estimate of The independent variables of educational prepara-
an individual’s standing in a composite of abilities by tion, critical thinking (total score on the WGCTA), and
means of five subtests, each designed to investigate a dif- autonomy (subcomponents on the MSQ) of practicing
ferent aspect of the composite: inference, recognition or RNs and the dependent variable of total job satisfaction
assumptions, deduction, interpretation, and evaluation were examined. A standard multiple regression analysis
of arguments. The inference subtest consists of 16 state- was performed, measuring the relationship among the
ments with five possible options. Each of the remaining one internal level dependent variable and three inde-
four subtests contains 16 statements with two possible pendent variables. Stepwise forward multiple regression
options. Reliability was determined by the test’s internal was used to determine if the independent variables in
consistency, stability of test scores over time, and corre- combination explained the variance in job satisfaction.
lation between scores on alternative forms. Coefficients The correlation of total job satisfaction on the MSQ and
ranged from .69 to .85. scores on the subscales were examined. The mean scores
The Minnesota Satisfaction Questionnaire (MSQ) on the MSQ and the mean scores of the subscales were
Short Form was used to measure autonomy as well as compared.
job satisfaction (Weiss, Davis, England, & Lofquist,
1967). It is a 20-facet tool on job satisfaction. Some of Results
the more pertinent areas covered in the 20 subscales in- Demographics
cluded achievement (the feeling of accomplishment one Respondent employment areas were 34% medical-
gets from a job), advancement (the chance for advance- surgical, 34% community care, 17% management, and
ment in a job), compensation, creativity, independence, 15% home health, closely reflecting national averages.
recognition, and work conditions. Each of these facets Respondent age range was 20 to older than 50 years. The
was measured by the sum of five items rated on a 5-point greatest frequency was at 41 to 50 years (43%), followed
Likert scale (1 = very dissatisfied to 5 = very satisfied). by 31 to 40 years (29.2%), closely matching national mean
Participants indicated being very dissatisfied with an RN ages (Spratley, Johnson, Sochalski, Fritz, & Spencer,
item if that job aspect provided much less than expected 2000). Regarding marital status, 81.4% were married
results. On the other hand, if an element of the job pro- and 18.6% were widowed, divorced, or never married.
vided much more than expected, a participant indicated The majority of the sample was female (95%), reflecting
being very satisfied with the item (Weiss et al.). the national trend of 94.6% (Spratley et al.). Most of the
The highest documented median Hoyt reliability co- respondents indicated race as White (88.6%), with 6%
efficient was .93 for advancement and recognition and reporting Black, 3% American Native, and 2% Asian or
the lowest median was .78 for responsibility. The Hoyt Pacific Islander, again reflective of RNs nationally (U.S.
reliability coefficient ranged from a high of .97 on the Department of Health and Human Services, 2002).
ability utilization scale to a low of .59 on the variety Respondents had a variety of educational levels, from
scale. The test-retest correlation of general satisfaction diploma to master’s degree. Almost half had an ADN
scale scores produced coefficients of .89 over a 1-week (43%), consistent with national trends in ADN educa-
period for 75 employees attending night school and .70 tion (43%; Spratley et al., 2000). A diploma in nursing
for 115 employees over a 1-year period. was the basic preparation for 16% of respondents and a
BSN was the basic preparation for 30%. A master’s de-
Data Analysis gree in nursing was held by 12%, compared to a national
Data were analyzed according to the appropriate sta- average of 9.6% (U.S. Department of Health and Hu-
tistical technique determined by the level of measurement. man Services, 2002). This difference may be accounted
The relationships between the job satisfaction score on the for by the specific practice areas that were surveyed ne-
MSQ and the subcomponents of ability, achievement, au- cessitating an advanced degree (i.e., management, home
thority, independence, responsibility, and working condi- health, and community care). Full-time employment
tions were examined. A Pearson moment correlation was was held by 89% with 11% reporting part-time employ-
performed to investigate the degree of the relationship be- ment, somewhat higher than the national full-time em-
tween autonomy and job satisfaction. A correlation coef- ployment rate of 80% (U.S. Department of Health and
ficient and coefficient of determination (r) were computed Human Services).
to determine the degree of the linear relationship between The post-hoc Bonferroni correlation indicated
job satisfaction and autonomy. Pearson’s r correlation there was a significant difference among groups on age
coefficient was used to examine the relationship between [F(3, 136) = 2.887, p = .034]. Medical-surgical nurses
critical thinking and job satisfaction. (M = 30.51, SD = 5.33) were younger than home health

The Journal of Continuing Education in Nursing · October 2008 · Vol 39, No 10 455
(M = 31.51, SD = 6.23), community care (M = 33.10, ceived autonomy of practicing RNs increased, total job
SD = 5.65), and management (M = 33.65, SD = 6.00) satisfaction also increased.
nurses. When mean years of working as an RN were
compared among the four groups, significant differences Critical Thinking and Job Satisfaction
were noted [F(3, 136) = .552, p = .896]. The overall scores on the WGCTA ranged from 12
There was no difference noted between groups on to 38 (M = 19) and scores on the subscales ranged from
level of education [2 (3, N = 140) = 3.252, p = .088]. 0 to 9. The WGCTA mean composite score was 18.13
The groups did not differ on marital status [2 (3, N = (SD = 6.57). Subjects were divided into four groups ac-
140) = .877, p = .655], gender [2 (1, N = 140) = 1.506, cording to their work environment. There was a signif-
p = .471], employment status (2 (1, N = 140) = 2.835, icant difference in critical thinking scores for the four
p = .242], or ethnicity [2 (3, N = 140) = 2.938, p = .230]. groups [F(3,136) = 4.62, p = .01]. Post-hoc Bonferroni
Although there was no significant difference between comparisons indicated that the mean score for the man-
groups on education, more ADN nurses (42.8%, n = agement nurses demonstrated higher critical thinking
60) participated than did BSN nurses (29.2%, n = 41), skills (M = 20.25, SD = 7.22) compared to the commu-
diploma nurses (15.7%, n = 22), or master’s-prepared nity care (M = 17.95, SD = 4.64), medical-surgical (M =
nurses (12.3%, n = 17). 17.43, SD = 5.63), or home health (M = 15.71, SD = 6.69)
In summary, the four groups surveyed were similar in nurses. Management nurses ranked the highest in all
all demographics except age. Significant differences were categories: inference (M = 3.91, SD = 1.83), recognition
revealed between the medical-surgical nursing group’s (M = 4.16, SD = 2.23), deduction (M = 4.41, SD = 1.55),
age and the community care, home health, and man- interpretation (M = 4.04, SD = 2.15), and evaluation
agement groups’ ages, with the medical-surgical group (M = 3.91, SD = 1.76).
reporting the youngest ages, which is supported by the Relationships between critical thinking of practic-
literature (Spratley et al., 2000). Data for age, years of ing RNs and total job satisfaction were analyzed using
experience, gender, marital status, ethnicity, education, Pearson correlations. A one-way analysis of variance
area of practice, work experience, and employment sta- was used to analyze mean differences between groups
tus were analyzed using the chi-square test and analysis based on total MSQ and WGCTA scores. Analysis dem-
of variance. No differences were noted between groups onstrated a significant positive correlation (r = .442, p <
in demographics other than age. .05) between WGCTA total score and the MSQ. Inter-
estingly, when these factors were explored from the per-
Autonomy and Job Satisfaction spective of the subgroups with Bonferroni comparisons,
The MSQ was used to elicit factors that contrib- the results were different: community health (r = -.411,
uted to job satisfaction and autonomy. An analysis n = 47, p < .01) and management (r = -.572, n = 24, p <
of variance was conducted to explore job satisfaction .01) nurses demonstrated a negative significant correla-
overall scores. There was a significant difference be- tion. The medical-surgical (r = .441, n = 48, p < .01) and
tween group scores on overall satisfaction [F(3,136) = home health (r = .398, n = 21, p < .01) nurses demon-
8.44, p = .000]. The community care nurses were the strated a positive significant correlation between total
most satisfied group (M = 76.35, SD = 8.73), followed job satisfaction and critical thinking.
by management (M = 75.30, SD = 8.32), home health
(M = 66.57, SD = 7.99), and medical-surgical (M = 65.27, Educational Preparation and Job Satisfaction
SD = 11.59) nurses. The autonomy items that partici- A multiple regression analysis was conducted to ex-
pants were least satisfied with were ability and working amine educational preparation and critical thinking (total
conditions. Autonomy variables were rank ordered by score on the WGCTA) of practicing RNs and total job
total sample means (Table). The relationship between satisfaction with two predictors of total job satisfaction.
job satisfaction (as measured by the MSQ) and per- Results demonstrated a significant positive correlation
ceived autonomy (as measured by the MSQ subcompo- (r = .896) among educational level, WGCTA total score,
nents of ability, achievement, authority, independence, and total job satisfaction of practicing RNs. Linear com-
responsibility, and working conditions) was investi- bination scores of the WGCTA total score and educa-
gated using the Pearson product moment correlation tion revealed a strong positive association with total job
coefficient. There was a statistically significant posi- satisfaction [R2 = .651, adjusted R2 = .647; F(1,138) =
tive correlation between job satisfaction and perceived 52.49, p = .008], suggesting job satisfaction was related to
autonomy (r = .538, p < .05). The Pearson correlation some combination of the variables. The regression equa-
between MSQ and autonomy revealed that as the per- tion with educational level was significant [R2 = .082, ad-

456 The Journal of Continuing Education in Nursing · October 2008 · Vol 39, No 10
Table
Means (Standard Deviations) of the Nurses’ Scores on the Minnesota Satisfaction
Questionnaire Autonomy Variables by Employment Area (n = 140)
Medical- Home Community Total
Rank Minnesota Satisfaction Questionnaire Surgical Management Health Care Sample
Order Questiona (n = 48) (n = 24) (n = 21) (n = 47) (N = 140)
1. The chance to work alone on the job 3.81 3.87 3.71 4.14 3.92
(0.86) (0.61) (0.84) (0.65) (0.77)
2. The feeling of accomplishment I get from 3.37 4.16 4.33 4.14 3.91
the job
(0.96) (0.70) (0.66) (0.64) (0.87)
3. The freedom to use my own judgment 3.79 3.65 3.95 3.91 3.82
(0.87) (0.87) (0.86) (0.94) (0.89)
4. The chance to tell people what to do 3.56 4.08 3.71 3.81 3.75
(1.12) (0.65) (0.78) (0.67) (0.87)
5. The chance to do something that makes use 2.66 2.91 2.00 2.13 2.42
of my abilities
(0.70) (0.71) (0.70) (0.65) (0.73)
6. The working conditions 2.43 2.50 2.19 2.10 2.30
(0.92) (0.66) (1.03) (0.78) (0.93)
a
Rated on a 5-point Likert scale (1 = very dissatisfied, 2 = dissatisfied, 3 = neither dissatisfied nor satisfied, 4 = satisfied, and 5 = very satisfied).

justed R2 = .075; F(2,137) = 263.78, p = .007]. Total criti- tion, and responsibility. Although the home health and
cal thinking was also significant [R2 = .684, adjusted R2 = community care nurses rank ordered the same top four
.672; F(3, 136) = 52.49, p < .01]. Standardized regression satisfying factors, they differed on the fifth factor. Both
coefficients (beta) for each variable suggested that educa- groups identified independence, responsibility, security,
tional level (.34) and critical thinking (.79) did contribute and ability as the top four variables with which they were
to greater total job satisfaction. most satisfied. However, the home health nurses valued
Interestingly, when the factors of educational prepa- ability, whereas the community care nurses valued com-
ration were explored from the perspective of educational munity service as the fifth factor. The medical-surgical
subgroups, the results were different, with a significant nurses identified the same five items as the management
difference between group scores on overall satisfaction nurses with a slightly different rank order (social service,
[F(3,136) = 7.33, p = .000]. The BSNs were the most moral values, security, ability, and responsibility). Both
satisfied group (M = 66.25), followed by the master’s groups identified security as being the third top satisfac-
(M = 63.30), ADN (M = 56.57), and diploma (M = 44.26) tion variable.
nurses. These results suggest that educational prepara- A review of the five variables that these nurses were
tion and critical thinking have an important role in total least satisfied with revealed a similar trend. The medical-
RN job satisfaction. surgical, management, and home health nurses ranked
Study findings indicated that education, autonomy, recognition 20th. The medical-surgical, management,
and critical thinking significantly relate to overall nurse community care, and home health nurses were least
job satisfaction. Testing the job satisfaction model with satisfied with the same items (coworkers, compensa-
multiple regression analysis of all variables on job satis- tion, supervision, recognition, and achievement), but the
faction showed that critical thinking accounted for the rank order differed. The participants all listed indepen-
largest contribution to job satisfaction, followed by au- dence, recognition, responsibility, and authority as the
tonomy and educational level. autonomy attributes that most affected job satisfaction.
Medical-surgical and community health nurses reported
Discussion that independence most affected their level of job satis-
The RNs in this study were generally satisfied with faction. Management and home health nurses designated
their jobs. The top five overall satisfaction factors were recognition as the most important variable influencing
social service, moral values, independence, recogni- satisfaction. Although all participants identified the same

The Journal of Continuing Education in Nursing · October 2008 · Vol 39, No 10 457
top variables as most satisfying, they prioritized these tion. It is also unknown how variables such as age, mo-
variables differently. The variables all participants iden- tivation, or time of day in relation to other life events
tified being the most dissatisfied with were ability and could have impacted results.
compensation. The rankings by group varied slightly,
but it was clear that these nurses were least satisfied with Recommendations for Practice
ability and working conditions. In the past few years, hospitals have begun to lose
These findings suggest that critical thinking plays an nurses to other health care settings where they have
important role in total RN job satisfaction. As critical more independence in making decisions (Finn, 2001).
thinking increased, nurses’ total job satisfaction also in- Many administrators have begun to address job satisfac-
creased. Overall, management nurses scored the highest tion factors in hopes of retaining nurses. Besides provid-
on the WGCTA. Management nurses also scored the ing an opportunity for nurses to apply their professional
highest on all subscales, with community care, medi- skills, health care organizations need to contribute to
cal-surgical, and home health nurses closely following. their overall professional development by identifying or-
Scores on the WGCTA subscales between groups were ganizational activities that have the potential to increase
consistent except on the subscale of deduction. Medical- job satisfaction and retention.
surgical nurses scored higher on deduction than commu-
nity and home health nurses did. Administrators
The predictor variable of age contributed to higher- Job advancement opportunities were one of the
order critical thinking attributes. Management nurses top dissatisfiers among the nurses in this study. Cre-
were the oldest group and demonstrated the highest criti- ating opportunities for career advancement and rec-
cal thinking attributes on the WGCTA. Medical-surgical ognition for RNs may increase their job satisfaction.
nurses were the youngest group and demonstrated lower Career advancement and recognition in the current
critical thinking levels on the WGCTA. As the com- health care environment may be facilitated by such
munity health and management nurses’ critical think- actions as implementation of career ladders. A model
ing scores increased, their total job satisfaction scores that supports advancement should be designed that
decreased. On the other hand, as medical-surgical and promotes organization, education, and improvement
home health nurses’ critical thinking scores increased, of working conditions. This research suggests that
their job satisfaction scores also increased. when the autonomous variables of independence, rec-
Educational level, autonomy, and critical thinking ognition, responsibility, authority, ability, and work
were strong antecedents of job satisfaction. The esti- conditions are addressed, the level of job satisfaction
mated regression provided an adequate explanation of increases.
the overall deviations of job satisfaction from its mean The nurses in this study were not satisfied with the
and the overall fit of the equation was statistically ac- amount of recognition they received from their supe-
ceptable. This indicated that autonomy, critical think- riors. Health care facilities need to educate leaders to
ing, and educational preparation were predicators of support the value of positive feedback. Job redesign is
RNs’ job satisfaction. needed and should include a reward system that sup-
ports and appreciates appropriate employee efforts. It
Limitations is imperative that nursing leaders evaluate RN job de-
This study used a convenience sample of RNs, scriptions and expectations to incorporate job satisfac-
which may limit the ability to generalize the findings. tion variables of achievement, authority, independence,
This sample was composed of unique individuals with recognition, responsibility, and positive working con-
diverse lifestyles and backgrounds, and it is unclear ditions.
how some of these individual variables affected the re- The job dissatisfiers identified in this study can serve
sults. Voluntary participation meant it was possible that as an impetus for health care facilities to implement
nurses who did not choose to participate differed from models that allow nurses active input in decision mak-
those who did participate. The quality of research is af- ing. These efforts would lead to shared governance and
fected by the appropriateness of a researcher’s choice decreased job dissatisfaction. Promoting and providing
of instruments. The use of self-reporting instruments positive working environments is imperative. A men-
may have decreased the reliability of the responses due toring program for new or entry-level managers could
to misinterpretation of some of the items. Influencing provide for advancement and variety within the orga-
variables, such as organizational climate or personality nization.
factors, were not controlled for related to job satisfac- This study found that compensation was the major

458 The Journal of Continuing Education in Nursing · October 2008 · Vol 39, No 10
variable of job dissatisfaction, and the literature sup-
ports the importance of monetary incentives for job key points
satisfaction. Improved pay should lead to increased
Job Satisfaction
nurse retention (Chen-Chung et al., 2003). Compen- Zurmehly, J. (2008). The Relationship of Educational Prepara-
sation should be awarded for excellence in client care tion, Autonomy, and Critical Thinking to Nursing Job Satis-
services. faction. The Journal of Continuing Education in Nursing, 39(10),
453-460.
Educators
Mentoring programs for new graduates as well as
novice nurses have proven to be effective retention strat- 1 Educational level, autonomy, and critical thinking skills play an
important role in nurses’ total job satisfaction. Critical thinking
is a facilitator to potential advancement of competency, which
egies and lead to increased job satisfaction (Buerhaus,
affects job satisfaction.
Donelan, Ulrich, Norman, & Dittus, 2005). Through
mentoring relationships, nurses can begin to conceptu-
alize and examine concepts, arguments, situations, or
positions to produce a positive outcome or decision in
2 Mentoring for experienced as well as novice nurses reduces
feelings of isolation and increases opportunities to share
ideas and ask questions, resulting in higher satisfaction in the
their practice. Learning activities designed for nurses workplace.
at advanced levels should also be implemented. Gain-

3
ing further insight and awareness of how others think, Nursing job satisfaction continues to be a significant work-
through feedback and practice, are important and lead to place issue and one that employers can positively impact with
improved critical thinking. advancement and recognition programs. These efforts would
lead to autonomy and decreased job dissatisfaction.
Researchers
This study found that critical thinking skills con-
tributed to job satisfaction and were a facilitator to the Trossman, 2002). As this isolation increases, novice
potential advancement of competency, which affects job nurses are required to make decisions without input
satisfaction. This investigation also found that job satis- from peers. Often, this leads to feelings of discontent-
faction among nurses was interrelated to autonomy and ment and job dissatisfaction. It is apparent that initial
critical thinking. Therefore, further research focusing on job expectations are not congruent with reality (Kovner
how to increase autonomy and critical thinking of prac- et al., 2006).
ticing RNs is needed.
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