Perceived job stress and job satisfaction among intensive care nurses in the Kingdom of Saudi Arabia

Background: This thesis explores the phenomena of job stress and job satisfaction among Intensive Care Unit (ICU) nurses in a multicultural nursing workforce at two main hospitals in the Kingdom of Saudi Arabia. Aim: To explore sources of perceived job stress and satisfaction among expatriate ICU nurses in a multicultural nursing workforce in two hospitals in Riyadh, Kingdom of Saudi Arabia. Methods: The research applied a mixed-methods design. Stage 1 (quantitative) distributed a survey to all expatriate ICU nurses employed by the hospitals; 421 (60%) responded. Participants completed the Critical Care Nursing Stress Scale (CCNSS), the McCloskey/Mueller Satisfaction Scale (MMSS), and demographic questionnaires. Stage 2 (qualitative) consisted of semi-structured interviews with 19 intensive care nurses recruited from stage 1 respondents. Findings: Overall, the CCNSS identified a moderate level of work-related stress. Closer analysis however identified workload factors, lack of appreciation/respect /support from managers, and negative interprofessional factors, especially with physicians, as being strong sources of stress. Nurses with a Bachelor's degree had highest stress scores suggesting an educational influence. Overall, the MMSS identified a moderate level of job satisfaction but closer analysis identified specific strong sources of dissatisfaction related to ‘Extrinsic rewards’ in particular ‘Salary’, ‘Vacation’ and ‘Maternity leave’. Married nurses scored lower on job satisfaction suggesting a need for further work on personal/social factors. Qualitative findings corroborated quantitative outcomes but also extended insights by identifying adverse nurse/patient ratios, expectations around meal times, and cleaning beds, floors and equipment, as important sources of stress and dissatisfaction. Additional sources were cultural; expatriate nurses reported discrimination of salaries and benefit packages based on nationality and gender. Female nurses felt discriminated against by KSA society inside and outside the hospitals. Conclusions: The study makes a valuable contribution to understanding job stress and dissatisfaction among migrant ICU nurses in the Kingdom of Saudi Arabia. This mixed methods design identified strong sources related to work demands, lack of appreciation, recognition of their skills, and respect from managers and physicians, and salary/benefit differentials according to nationality and gender. Regarding the latter, it is of note that since completing this study the regime has introduced unprecedented societal changes, particularly freedom and fairness, which make it important for future work to re-examine present findings in that context.