Review of workplace characteristics and Self-motivation as Indicators of nurses' Job satisfaction

Nursing staff turnover and absenteeism are reduced thanks to job satisfaction, which also enhances performance and productivity. Further research is required to determine how the interaction of these factors is impacted by individual initiative. This study's goal was to look into the relationships between nurses' personal initiative, work environment, and job satisfaction. According to the findings, high levels of individual initiative and favorable opinions of the nursing workplace were major factors in explaining job satisfaction. The working environment needs to be improved, the initiative needs to be encouraged, and nurses need to be encouraged to be active, share their knowledge, and foster innovation.


Introduction
Many studies have shown that people who are happier with their jobs are generally happier, so those who spend a significant portion of their lives at work shouldn't be surprised by this finding. Both happier and healthier. As well as having a favorable impact on health, happiness, subjective well-being, and self-esteem, job satisfaction also lowers the risk of depression, anxiety, and stress in employees. There are significant connections between job satisfaction and mental and physical health, according to a meta-analysis of nearly 500 studies. Organizations benefit from job satisfaction because it improves work performance and results, boosts productivity, and reduces turnover and absenteeism. According to nursing studies, a sizable portion of resignations are brought on by a lack of satisfaction with one's job [1].
The phenomena of job satisfaction have been attempted to be explained by several ideas. According to Frederick Herzberg's two-factor hypothesis, job satisfaction is influenced by two different categories of elements. Job stability, pay, perks, working environment, etc., are examples of hygiene considerations (extrinsic or maintenance factors). The second element category is motivators, which include tasks demanding high expertise, praise for superior performance, accountability, autonomy, significance, participation in decision-making, organizational dedication, etc. These elements contribute to high job satisfaction since they are inherent job requirements, such as achievement, acknowledgment, and personal development. A study that looked into this matter showed that external factors prevent work unhappiness when they are there [2]. The only way to encourage employees' internal growth and development and to improve output, performance, and job satisfaction is to incorporate intrinsic elements. Various intrinsic and extrinsic factors can influence a nurse's level of job satisfaction. Unlike the work environment, the personal initiative can be an intrapersonal (intrinsic) characteristic, a well-known extrinsic factor that predicts nurses' job satisfaction. A proactive, independent behavioral approach that overcomes obstacles is a personal initiative. This trait is crucial for innovation because creative and innovative people must be proactive. Innovation is a requirement for a productive work environment. The definition of healthcare innovation is the "introduction of a new concept, idea, service, process, or product aimed at improving treatment, diagnosis, education, outreach, prevention, and research, with the long-term goals of improving quality, safety, outcomes, efficiency, and costs." The American Nurses Association's recently revised scope and standards of practice encourage all nurses to take the initiative, participate in policy practice, and promote innovation. Systems for providing healthcare are currently developing quickly. This is characterized by developing innovative methods and technologies to extend life expectancy, improve quality of life, and expand diagnostic and therapeutic options while considering the healthcare system's efficacy and efficiency. The modern workplace has become increasingly dependent on innovation, and nurses are at the forefront of this development. Personal initiative is a behavioral phenomenon that entails being proactive and creating a more comprehensive set of goals that are strictly necessary for the position [3]. Nurses' level of initiative varies depending on their personal traits and working conditions. A review paper examines the connections between individual initiative, workplace traits, and job satisfaction [4]. In this Review article, workplace traits and intrinsic motivation are discussed as markers of job satisfaction in nurses.

Methodology
Dr. Dobbin's evidence-informed decision-making (EIDM) process, which consists of the following steps, is recommended by the Rapid Review Guidebook. The framework was "Steps for Conducting a Rapid Review." We located and accessed relevant research evidence, evaluated its methodological quality, and synthesized it using the Health EvidenceTM tool.

Search Strategies
These key search terms were developed after quickly going over the research questions: "personal initiative," "work environment," and "job satisfaction."

The final search string is as below:
"Personal initiative", "work environment" and "job satisfaction".
Scopus, Google Scholar, PubMed, and the Cochrane Library are the four databases used to conduct in-depth searches for publications. Due to the abundance of publications in the work environment and job satisfaction fields, Google Scholar has been added to help spread awareness of the gray literature. Scopus, PubMed, and the Cochrane Library superbly provided peer-reviewed article coverage.

Eligibility criteria
All work environment-related articles, theses, and review papers released before February 2023 were included in the literature search.

Data Extraction
Two objective medical reviewers examined the articles to ensure the selection's objectivity. On the final list of articles to be used for additional data extraction, the two reviewers agreed with 80%.

Results of the literature search
The initial screening process reduced a total of 98 articles to articles that might be relevant. Relevant articles were eliminated because of their titles, abstracts, and book chapters in languages other than English. Based on the inclusion criteria, sixteen studies were discovered (Figure 1: Preferred Reporting Items for Reviews; Health EvidenceTM tool).
The Preferred Reporting Items for Reviews (PRISMA) were followed in this review.

Results and discussion
The current study examined the connections between hospital nurses' job satisfaction, individual initiative, and workplace features. The findings revealed higher levels of personal initiative and workplace satisfaction. A higher job is independently linked to the score. Satisfaction after accounting for the traits of other nurses [6]. These results support Herzberg's two-factor hypothesis, which holds that external and intrinsic elements are interrelated. On the other hand, extrinsic variables, in Herzberg's theory, do not increase employee satisfaction but keep employees from becoming dissatisfied. Higher job satisfaction was associated in our study with both the work environment and personal initiative, with the work environment score contributing most significantly to the variation in job satisfaction. This result may be explained by the fact that the questionnaire's assessment of workplace factors included nurse autonomy, control over nursing practice, nurse-physician relationships, and a collaborative environment. These elements thus primarily represent intrinsic aspects rather than extrinsic ones like working circumstances, pay, status, etc. [7].
Our study's results align with a meta-analysis of 16 studies on nurses' job satisfaction, which found that higher degrees of autonomy, high levels of collaboration between nurses and physicians, and lower workplace stress are all essential for reasonable job satisfaction. Our research suggests that personal initiative partially mediates the relationship between job satisfaction and the work environment. The workplace setting may encourage initiative, linked to greater job satisfaction. According to prior studies into the factors influencing nursing leadership and personal initiative, a work environment that fosters initiative is a crucial factor affecting actual inventive behavior at work [8]. Individual initiative is heavily influenced by the workplace culture and the nurse's personality traits. The organizational culture, traits, resource allocations, and organizational structures of specific workplaces may impact the learning settings. A positive environment supporting education and creativity fosters personal development and raises job satisfaction through individual initiative [9].
Regarding the variations between wards, some clinical departments (pediatric and ER) were directly connected with better job satisfaction, independent of other nurses' characteristics, work environment, and personal initiative scores. Working in the emergency room and pediatrics was related to the highest chances for high and very high job satisfaction when the oncology department was used as a reference group (the odds for high and very high job satisfaction were lowest in the oncology section). These results can be explained by the diverse traumatic situations these nurses have been exposed to and their emotional weight. Oncology nurses frequently deal with high patient mortality rates [10]. They are exposed to several stressors, which may help to explain why this specialty experiences high levels of stress and burnout. Our findings regarding the highest probabilities for high and very high work satisfaction in the ER conflict with some prior studies but agree with others, even though it is difficult to compare studies because different methods were used to gauge job satisfaction [11]. A literature survey on the variations in job satisfaction by ward produced a few contradictory results. According to a study from Greece, ER, and ICU nurses expressed high levels of job satisfaction. However, a Brazilian study found that ER staff were more satisfied with their jobs than ICU staff. According to a US survey, pediatric unit employees were the most satisfied, whereas another study found that nurses in medical/surgical units were the most content. The rapid effect of nursing involvement may have a greater favorable effect on job satisfaction in a ward serving patients with acute illnesses. In the current study, increased education was found to be strongly associated with increased job satisfaction, but this impact vanished when personal initiative was taken into consideration. According to a prior study, educational interventions may greatly help nurses acquire leadership behaviors [12]. The removal of the link between education and job satisfaction with the inclusion of personal initiative in the model may help to explain our findings about the mediating influence of personal initiative. Finally, in our review study, women were more likely than men to report high or very high levels of job satisfaction greater evidence of job satisfaction. The fact that males are more impacted by extrinsic rewards like pay is one reason for this finding. Another factor might be connected to research showing that male nurses encounter higher aggressiveness and workplace prejudice. In addition, they may feel as though they are "taking a step down" in terms of social standing due to the role pressure that comes with being a man in a field that is dominated by women. Due to the study's cross-sectional nature, we can only make inferences about the relationships between the variables rather than their causality [13]. Another drawback is that this study did not analyze the evaluation of external variables of the work environment, such as income, workload, staffing levels, and professional status. Participant traits and workplace factors not investigated in this review study may also be influenced by job satisfaction, as the final model explained nearly a third of the variance [14].

Conclusion
The review's findings indicate that a high level of individual initiative and favorable opinions of the nursing workplace were crucial elements in determining job satisfaction. The workplace needs to be made better, the initiative needs to be rewarded, and nurses need to be motivated to participate in activities, share their knowledge, and support innovation.

Compliance with ethical standards
Acknowledgments I am grateful to God for making it possible for me to carry out and finish this research project to improve my grade point average. I was appreciative of my mentor's suggestions and assistance as I was writing this post. I sincerely appreciate my friends' unwavering support and help in getting this study done. They committed valuable time to assisting me on the journey, either directly or indirectly.

Disclosure of conflict of interest
There are no conflicts of interest, according to the authors.