Relationship between job satisfaction and organisational commitment among nurses Author:LINU LUKE JOSEPH

INTRODUCTION In this systematic review, the author focuses to identify the relationship between the job satisfaction and organisational commitment among nurses. As the health care system is facing nursing staff shortage all over the world, this study aims to find out the nature of the relationship between the organisational commitment and job satisfaction. This study also focuses on the role of both these variables has on nurses turnover rate. The relationship between the job satisfaction and the organisational commitment has been an area of choice for many researchers. Therefore, many researches are available on this topic. However, all those studies have not gone deeply to identify the kind of relationship between these two variables. The methodology that is used in this study is a systematic review. A systematic review is a study in which the primary article about the selected relevant study question, combine together to find an answer to the research question. According to Saltikov (2010), systematic review is a particular type of study, which is otherwise called a summary of the relevant researches to answer to a single question. In a systematic review, the primary articles about the researchers area of interest is to take a process of critical analysis and combine the information gathered from the study together. The systematic literature review comprised of four different steps. In each of these steps, the selected primary studies undergo a series of process. The steps involved in the systematic literature review are in identifying the primary researches to the research question, and then selecting the relevant researches. The next two steps are appraisal and synthesis of data. (Saltikov, 2010). The systematic review is focussed on synthesising high quality research evidences through a series of processes. The primary article used in systematic review should be of high quality. This indicates that the findings and methods used in that research can be easily questioned by the secondary researcher. In this systematic review, the selected researches are in high quality and, the findings and methods used in these studies are clear and specific, which allows the researcher to get a high quality result. This systematic review is based on peer review protocol. Indeed, the job satisfactions among nurses are so important for the organisation in the perspective of the quality of care provided. Job satisfaction is a broad term that is influenced by several factors. According to Saiyadain (2009), job satisfaction is a psychological state in which an individual tend to say that I am satisfied with my job. In other words, it can be explain that it is a persons positive feeling when a given task has been achieved. Job satisfaction is a personal feeling which is correlated by so many factors such as a work climate, nature of the work, persons
1

emotional status, peer pressure etc. Job satisfaction can also be described as the general attitude of a person towards their work. Job satisfaction has a particular importance in terms of an organisational perspective. Studies suggest that the job satisfaction has been related to the turnover rate and absenteeism in an organisation. Moreover, it has a definite role in the productivity of an organisation. Several studies suggest that when the employees become more satisfied with their work, the productivity improves. Therefore, in the perspective of an organisation in health care industry, the job satisfaction is a significant factor because, if the workers in the health care organisation are not productive, then the quality of care provided by the organisation will be compromised and this will affect the name and productivity of the organisation badly. Obviously, the commitment to the organisation is as important as the job satisfaction. Nurses who shows high levels of job satisfaction also have high levels of organisational commitment.(Doran & Almost,2003). Job satisfaction only focuses on job, whereas the organisational commitment focuses on the commitment of the individual towards the entire system of organisation. Organisational commitment comes when the individuals in the organisation strongly identifies the organisational values and goals (Mckenna,2000).There are two types of commitment which can be seen in an organisation. Affective and Continuance commitment. These two types of commitments differ from each other. However, both these commitments are necessary for the organisational perspective. Aim of this study This study mainly focuses on the recent primary researches dealt with the relationship between nurses organisational commitment and job satisfaction. In addition to this, the study also analyses the factors influencing the job satisfaction and organisational commitment .The focus of this study is extended to the influence on nurses turnover by these two variables. Objectives of this study *To critically review and explore the most recent primary research literatures about the relationship between the job satisfaction and organisational commitment. *Discuss the relevant themes that are formulated by the critical review of the literature. *To provide a better management views for the authorities of health care organisation. *To provide a platform for the further research studies.

Nursing shortage
A nurse has a pivotal role in health care sector and he or she is committed to protect the public by providing comprehensive quality care. As they coordinate the activities of different sectors of the health care system, maintain the quantity and quality of health center, their care is very vital to the human society. Adequate number of nursing staff are important to render quality nursing care. A shortage is the term used where there is a disparity between the supply and demand. In other words, when the demand exceeds the supply, then there is a shortage happening. There are many reports saying that the world is facing a nursing shortage.(reference) Therefore, it is important to check whether a real shortage exists or not. A nursing shortage can be described as a condition where the nurses supply and demand is not at an equilibrium (Huber,2006).This circumstance can be viewed in two aspects. This can be either due to a decrease in supply of the nurses all over the world or an increase in demand which exceeds the current supply of the nursing resources. The WHO(World Health Organisation) statement in 2006 clearly estimates a 4.3 million nursing staff shortage across the countries (WHO,2006).In addition, it also indicates that the shortage is severe in poorest countries of Africa. These data put forward some serious concerns in the mind of the author. According to WHO, the nursing personnel distribution in developed countries such as United States of America, United Kingdom and Canada is around 10 per 1000 population (WHO, 2006).Even in this condition, these countries are facing severe nursing shortage. Indeed, there are nursing shortages existing in some developed countries. As per the Bureau of Labour Statistics of United States of America, projected employment in the nursing sector in 2018 is 3,200,200(BLS,2011).Whereas, the supply of working force will be around 1,808,000( Bureau of Health Professions,2004).It is sure that the overall figure of 1,808,000 future nursing work force is not going to fill the 3,200,200 vacancies. This disparity in the data from the two American health departments clearly shows that the current US nursing work force is not enough to meet the health care needs of the American society. In order to meet the exceeding demands for the nursing workforce, the country has to depend on other countries such as India, South Africa, and Philippines etc. Obviously, nurses from these countries will get attracted by the better living conditions and opportunities in the developed countries and, these migrations will cause a shortage in the developing countries. For example, the data from the Nursing Midwifery Council, UK, shows that 1020 Indian nurses were registered in the council in the year 2008(NMC,2008). Although it looks like a negligible number, the importance can been seen when we compare the nurse population ratio of both these countries. The nurse density per 1000 population in United Kingdom is 12.12, whereas in India, it is 0.80 (WHO, 2006).This data shows that there is a large scale of difference in nurse-population ratio in these countries. Even in this condition, a number of nurses keep migrating from India to United Kingdom.
3

Apparently, having such nursing shortage in the developed countries, nurses from developing countries are attracted to migrate for better living condition and working atmosphere rather than working in an environment with no job satisfaction. This migration will be an extra burden for the health care sector in the developing countries, which is already suffering from the lack of resources. For instance, almost 28% of the nurses in Jamaica are migrating to the developed countries each year (WHO, 2010) which accounts for the countrys serious problems in terms of nursing human resource. So, it would be beneficial if we look into the major factors behind the existing nursing shortage across the world. Nursing shortage in the past seemed to be the disproportion of the need of the health care sector and the difficulties faced by the health care organisations in raising wages of the nurses and the willingness of the nurses to work with the less wages they offered( Berliner & ginzberg;Goodin,2003). During the post world war era, the Western countries especially USA, had to open more community health centres, in order to meet the growing health care needs of the baby boom generations. This was the main reason for the nursing shortage during the early periods of the post World War years. In 70s and 80s,this shortage was fuelled by nurses unwillingness to work with less pay and other working conditions Goodin (2003).The current nursing shortage seems to be a combined effect of all these factors rather than being aggravated by a single factor. It would be beneficial, if we link the theme chosen by the International Council for nurses day 2007 with the current nursing shortage. The theme for the 2007 nurses day was Positive practice environment: Quality work places= Quality care (ICN,2007).This gives us an indication that the nurses are not satisfied with their work atmosphere. Many studies suggests that the job satisfaction and organisational commitment are most influential factors in working environment(*references******).This finding tends the author to think that if the organisations take measures to improve job satisfaction and organisational commitment among their nursing staff, they could retain the existing staff in the profession and attracts more people in to the profession. Authors also think, this could be a better approach rather than looking for a quick fix solution by importing nursing work force from abroad.
NURSES JOB SATISFACTION

Job satisfaction is a broadly defined term that has been subjected to several studies. Hoppock defined job satisfaction as a physiological, psychological and environmental circumstances that tend the person to feel satisfaction in his job.(Saiyadain,2009).Job satisfaction has been subjected to many studies and it is an area of interest for people who study about the organisational activities. Job satisfaction among nurses is a very important element in retaining nursing workforce as well as in resolving nursing shortage (Albaugh, 2005). There are many factors that affect the job satisfaction among nurses. Herzberg distinguished the factors affecting job satisfaction as intrinsic factors and extrinsic
4

factors. The intrinsic factors can be called as job satisfaction and extrinsic factors are called job dissatisfaction. Intrinsic factors are linked with the experience and nature of the persons way of doing work. It is termed as the motivators. It may include age, gender, length of employment etc. (Wyatt &Harrison, 2010).These factors are clear predictors of job satisfaction, so it is termed as motivators. On the other hand, the extrinsic factors are related to the job dissatisfaction. Extrinsic factors also called hygienic factors. It may include the leadership style, manager employee relationship, employee organisation relationship, pay, promotion etc. (Wyatt &Harrison, 2010). According to Woodside, the factors determining the job satisfaction can be allocated in to two groups; internal factors and external factors. Internal factors are within the individuals environment. These factors include feeling of appreciation, perception towards the job, sense of achievement etc. External factors are those influencing the job satisfaction from individuals external environment. This tends to be more related to the organization where the individual works. This factors include work place setting, interpersonal relationship, career advancement, organisational policy, leadership etc. The factors belongs to both these group are significantly affect the individuals job satisfaction. Factors affecting nurses job satisfaction are mainly related to individual and work related environment .In a meta analysis conducted by Zangaro & Soeken, they found a number of factors that affect the nurses job satisfaction. This study found autonomy, job stress and nurse-physician collaboration are the common variables associated with the job satisfaction. It suggests that better autonomy, good relationship with the physician together with less stress in the work place make the nurses more satisfied with their job (Zangaro & Soeken, 2007). In another study conducted by Gormley suggests that, the factors such as organisational characteristics and organisational climate have minimal effect on nurses job satisfaction .This study stress that professional autonomy has a major role in enhancing the job satisfaction level of a nurse (Gormley,2003). Job satisfactions among nurses have a significant contribution in the current nursing shortage. A survey conducted among nurses in two states of America suggests that poor working condition, low pay and inadequate staff are the main reasons for the staff shortage in these two states(Massachusetts nurse,2002).As we discussed earlier, these factors are associated with the individuals job satisfaction. Therefore, we can assume that the lack of job satisfaction or the factors promoting job satisfaction could be the nursing shortage in these areas. The staff shortage may stretch the extra work load on nursess shoulders leaving with frustration and job dissatisfaction which may in turn compromise the quality of care. Unable to finish the given task in the time limit period due to lack of staff may invite stress and dissatisfaction. The more nurses are satisfied in their job, the more chances to retain them in the profession. Since the nursing turnover has a considerable role in the nursing shortage, it is beneficial to make them stay in the profession. According to Wieck Et Al, the job satisfaction is a good indicator of nurses turnover (Wieck Et
5

Al,2009). Nurses with low job satisfaction are more prone to leave the organisation. Internal factors and external factors of job satisfaction have a greater role in the employee turnover and retention rate. When an individual feels anxious, hostility, frustration and exhaustion, they leave the organisation. When people feels strong level of autonomy and control, sense of growth and development, they tends to remain in the profession (West,2005).Therefore, in order to tackle the current nursing shortage, organisations should give attention to raise the level of nurses job satisfaction. The term organizational commitment has wide variety of meaning. In simple way it can be say that the loyalty of the employee towards the organization. Jackson and Mathis defined the organizational commitment as the extent of employees believe and acceptance about the organizational goals and values and his desire to be with the organization.(Jackson & Mathis,2007).According to Robbins, organizational commitment is a state in which the employee identifies with a particular organisation and its objectives and wishes to continue his membership in the same organisation.(Robbins,2009). The most accepted concept about the organizational commitment was made by midway Et Al. According to this concept, the individuals identification with and involvement in the organization is characterized by individuals strong belief and acceptance of the organisational goals and values, desire to put considerable effort for the organisation, strong willingness to remain in the organisation.( Zangaro,2001). Organisational commitment can be explained in many dimensions. Penley &Gould describes organisational commitment in two dimensions. They are instrumental and affective. The concept of instrumental commitment is related to the rewards and system of compensation received by the individual for his achievement in the organization. Whereas the affective view is quite different from the instrumental view as it deals with the personnel aspect of the individual. Affective view relates to the individuals emotional attachment towards the organisation and personnel commitment to do his duty within the institution.( Zangaro,2001).Robbins put forward three separate dimensions for the organisational commitment. According to Robbins, the three dimensions such as affective, continuance and normative are the significant dimensions for organizational commitment. In his view, the affective dimension is the emotional attachment to the organization and trust in its value and beliefs. Continuance commitment is the economic value for remaining in the organisation and normative commitment is the moral or ethical commitment towards the organisation.

One major thing that author found interesting in this research is the correlation among the job satisfaction, organisational commitment and turnover rate in nursing field. The year of experience a person have can be consider as a reflection of individuals organisational commitment.(Chan et al 2008).At the same time,
6

experience is consider as an intrinsic factor in job satisfaction.(Wyatt & Harrison,2010).A theoretical approach to explain the effect of experience on job satisfaction put forwarded by Weiss & Cropanzano(1996).This theory is called as work events theory.(Grube Et Al,2008).According to this theory the work environment characteristics like autonomy and participation courses specific events. These specific events combined with affective disposition of the person lead to positive or negative affect at work. This experience directly or indirectly affects the work and attitude towards the work by the employee. (Grube et al,2008). In a study to analyse the effectiveness of the spirit at work programme Kinjersky & Skrypnek (, 2008) found that the job satisfaction and organisational commitment of nurses raised after the implementation of the particular programme. The pre-test mean of job satisfaction was 69.7% and after test it was 76.4%.Pre test mean of organisational commitment was 47.2% and later it became 49.7%.(Kinjersky & Skrypnek,2008).This finding put forward some questions in authors mind that whether the predictors of job satisfaction and organisational commitment are same? Are they lead by the same factors? The focus of this chapter is on the methods used in conducting systematic review of literature. The methodology used here is systematic review of literature which is a type of secondary study. A systematic review can be described as a route of discovering, knowing and evaluating the existing research to a particular area of interest or a question. The studies used here are primary. This systematic review aims to answer the formulated research question.This study is a systematic review to evaluate the effectiveness of nurses job satisfaction over organizational commitment. A systematic review appraise, summarise and synthesise the large number of research findings (Mc Innes,2009).The systematic review process involves identifying, selecting, appraising and synthesising the high quality evidences in an attempt to seek answer to the research question. As it combines the various research findings together on a same topic, it has got a particular attention in the health care sector. The synthesis of the significant evidences from the relevant primary researches enable the reader to get a cumulative view of the issue that reader looking for(Houde,2009). There are several background factors to choose systematic review as the mode of study in this research. One of the reason is it allows checking of consistency (torgerson, 2003).This enable the researcher to provide a most reliable result about the research issue. It is necessary to have reliability and consistency in studies in the medical field.Becouse it deals with human beings. The inconsistent and less reliable result may lead to wrong practices. Systematic review can be replicate easily (Saltikov, 2010).In addition to that, it is easy to scrutinize those studies using systematic review as their method. In this subject, the author has another choice as well. The author can be use literature review as a method of study. As this research subject deals with a sensitive issue, it should be free from bias. A literature review is conducted of a researchers area of choice and preference. Therefore; it is
7

vulnerable to the potential bias. For example, if a researcher believes regular intake of aspirin can reduce the risk of myocardial infarction, he prefers to choose the studies that share his view. This could result in personnel bias in the study. In addition to this, literature reviews do not set search criteria and there is no specific questions for this type of studiesSaltikov,2010).On the other hand, systematic review follows a rigorous search strategy ,in order to avoid bias(Saltikov,2010).So that the researcher could get a more valid and reliable result. STAGES OF SYSTEMATIC REVIEW A systematic review process includes many steps. The process is structurally similar to the primary research. Systematic review adopts five steps in the research process. The first step in the systematic review is the formation of the research question. The review question formed on the basis of the PICO elements (Saltikov, 2010). This includes Population, Intervention, Comparative intervention and Outcome. PICO has a major role in conducting systematic review. The significance of the PICO is that it determines the nature of the article included in the study.(Saltikov,2010).Moreover, it can guide the researcher through each and every phase of the research. It aides from the selection of the article till the interpretation of the results. The search of literature starts with hundreds of literature, the PICO strategy helps the researcher to carry out his literature search in an organized manner. In this study, the PICO criteria helped the author to retrieve and scrutinize only the relevant literatures. The second stage in systematic review is the finding of the research studies. This face includes the collection of best available information from various data sources (Glasziou et al, 2001).In order to maintain a uniform quality of the research studies, the systematic review needs a quality appraisal of the studies. This is the third phase of the study. This phase helps to avoid potential bias in the study. Quality of the selected studies will determine the outcome of the systematic review. Checking the validity and reliability is an important part in the systematic review studies. It is important in the context that the systematic review is based on the peer review protocoal.Peer reviews does not assure the validity of the selected studies (Saltikov, 2010). The critical appraisal has to do with the standard and scientific appraisal tool. Systematic review chooses variety of tools in examining the primary study and to check the reliability and validity. The selected tools are How to read a paper: papers that summarize other papers(Greenhalgs, 1997), National Health Service in UK 10 questions to help you make sense of review (Jadad, Mohar et al, 1998). It is obvious that the tools used for this study is insufficient and did not measure the reliability and validity (Pearson, 2004). Systematic review has three different stages for vital analysis. The importance of the topic must be clearly specified in order to recognize the issues and for a valuable search to the selected topic. The next stage involves the summary and synthesis of the selected data. This stage is useful to make quality decisions on the basis of high quality evidences. The final stage is meant to assess the applicability of the

research. This stage ensure that whether the synthesised result is applicable or not (Glasziou et al, 2001). ADVANTAGES OF SYSTEMATIC REVIEW There are many advantages for systematic review. Some primary researches include very small sample population, therefore, they may lack generalisability and it is very difficult to find modest effect from these studies. Systematic review combines all these studies and gets a cumulative result. As it combine many studies together, systematic review assures more statistical power. So that it can assess even the least significant variable as well.Also,it make sure the consistency of the result(Glasziou et al,2001).Analysing the same effect in various settings allows transferability and robustness .This is another significant advantage of systematic review(Glasziou et al,2001). DISADVANTAGES OF SYSTEMATIC REVIEW Systematic review has disadvantages too. Even the small bias in the primary research can be magnified by systematic review (Glasziou et al, 2001).This can influence the research outcome adversely. In addition to this, there is a risk of bias. The authors tendency to accept positive and interesting result can lead to bias in systematic review. As a result the study may lose the generalisability over the subject(Hoffmann et al,2009).Moreover, if the quality appraisal is not done in a proper manner, it can lead to the inclusion of the poor quality of researches in the study and cause subsequent bias in the study(Hoffmann et al,2009). SEARCH METHODS The selection of literature was through the electronic database of the Bedfordshire University which includes MEDLINE, CINHAL, AMED, Psych Info, Pub Med, Embase, and Cochrane library. Many keywords were used to filter the electronic journals for example, job satisfaction, organizational commitment, nurses etc. These key words were used in a variety of settings and contexts. Efficient use of such terms resulted in identifying suitable materials. The help from the librarian was unforgettable; he showed the route for getting relevant database. During the review process, a huge number of articles were found. Only those studies from the year 2000 to 2010 were included in order to get recent update. The search found literature from various countries around the globe. Setting inclusion / exclusion criteria The scope of the review is mainly determined by the available resources and formulated question. So it is necessary to set the inclusion and exclusion criteria to identify the terms of boundaries of the review. The setting of inclusive and exclusive criteria also accounts for the wide usage of the findings, so it should be clearly specified.
9

Inclusive criteria The research studies which dealt with nurses job satisfaction and organizational commitment were included. While selecting review of literature only primary studies conducted worldwide were taken. Primary source of chosen was English. It was then processed by filtering the titles and abstracts and removing the irrelevant and inappropriate ones. All the studies related with the topic were taken if suitable including randomized controlled trials, non randomized controlled trials, and other study designs: qualitative and quantitative studies investigating nurses job satisfaction and organizational commitment. Exclusive criteria All the secondary researches were eliminated from the study. Apart from that the studies which are not specifying the study design were excluded. Articles published before the year 2000 also excluded from the study. Editorials, reviews also eliminated from this study. The available resources were properly utilized including websites which provide valuable data from recent conferences. A vast area of search was undertaken using search engines, seeking advices from colleagues with experience in the nursing field and analyzing the reference list from selected research studies. The aim was to identify relevant research work that finds papers reporting expert opinion and to avoid accidental omission suitable studies. The study that was obtained was a result of vigorous effort and critically analyzing the available literature that dealt with job satisfaction and organizational commitment of nurses. After that all the significant research studies and guidance papers were then interpret in full and analyzed / appraised as apt for the study. There were many studies and reviews which cover o huge range of research questions and issues regarding job satisfaction and organizational commitment, in particular randomized controlled trials which aim to illustrate the experience of job satisfaction in respect to organizational commitment of nurses working in a variety of settings. Only studies that had direct relation with the selected topic were included and others were excluded from the review. Finally ten studies were taken that directly suite to the topic. Quality Appraisal: The research study was analyzed from different angles and checked under different headings such as authors name, year of publication, where the research was conducted. Independent review of the research articles was done and the outcome was evaluated. The qualitative studies were evaluated to check the strength and weakness using the question devised by Schneider (2004).The quantitative study was evaluated by Schneiders ten questions. Some shortcomings were observed in a few studies. Researches with inadequate information were discarded. Only those studies which meet two out of three
10

criteria according to Schneiders (2004) questions were included and all others were excluded. After doing all the filtration process 10 studies were selected. Quality appraisal questions (Schneider, 2004) Questions for qualitative study were Whether the aim and objective were clearly explained in the study? Was the strategies and data collection tool used suite to the research question? Was the confidentiality of the information provided maintained? Which methods were employed in choosing samples for the study? Did the researcher demonstrate the method chosen for data analysis? Did the researcher recognize the limitations of the study? Has the researcher properly described the bias like participant number, discrimination and impartiality? Questions for the quantitative studies were What were the methods chosen by the research to find the sample size? Did the aim and objectives related to the study clearly explained? Whether the sample size was appropriate for the study? What method was used for the study analysis? How was the statistical data analyzed? Were the results of the study completely understood and clearly stated? Did the researcher identify the limitations of the study? Were the available data useful for further studies? ANALYSIS OF THE STUDY

STUDY 1 This study was conducted by Medley and Larochelle. The main objective of this study is to find out the relationship between the head nurses leadership style and staff nurses job satisfaction .More specifically, this study is to identify the effectiveness of the transactional and transformational leadership styles among staff nurse. This study is in the context of a growing nursing shortage in the health care system. The main research question addressed in this study were, 1)the extent of which the nurse distinguish the transactional and transformational leadership behaviours in the head nurse,2)The relationship of nurses job satisfaction and leadership style. This study is a primary research. The samples used in this study are nurses from four different hospitals. The samples were taken by using random sampling method. The samples included in this study were taken after being met certain set criteria. Criteria used in this study to include the samples were, staff nurse in a clinical unit , working under a head nurse. In order to collect the data, questionnaires were used. The knowledge of the staff nurse 11

about the type of leadership style possessed by their head nurse is determined by using a 70 item multifactor leadership questionnaire (MLQ).Leadership behaviour of the head nurse perceived by the staff nurse is assessed by using a 4 point linker scale. Indeed, not all research issues can be dealt with the experimental designs. The studies involving human characteristics are not subjected to experimental manipulation (Polit &Beck, 2004).This study are about the effect of leadership characteristics and its relationship with the job satisfaction. As these variables cannot be measured by an experimental design, a non experimental approach was the suitable design for this type of study. This study used a non experimental design. By considering the above mentioned facts, it was fine to conduct a non experimental study in this kind of topic. Self assessed questionnaires are used in this study to collect data. Questionnaires are widely used data collection method. Questionnaires enable the researcher to conduct study in a large group within a short period (Mitchell& jolly, 2009).This data collection method is suits for this kind of study. The reason is that the research questions posed in this study were dealing with the knowledge and attitudes of the staff nurse about the leadership style of their head nurse, it also dealt with the relationship of job satisfaction and leadership style. According to Polit & Beck, the survey is designed to gain information about the distribution, prevalence and interrelations of variables within the population (Polit & Beck, 2004). Therefore, in this study, the questionnaire survey is the most reliable data collection method, which can bring the accurate result. In addition to this, sensitive nature of the data required for this study need to maintain anonymity. Self administered questionnaire survey often allows anonymity (Mitchell& jolly, 2009).This may also tends the authors of this study to choose questionnaire survey as their method of data collection. However, some disadvantages of questionnaire survey are also evident in this study. According to Mitchell & Jolly, one of the main drawbacks of questionnaire survey is its low return rate because, a number of people may not be typical for the study, this will ultimately results in a biased sample (Mitchell&jolly,2009;baraceros,2000) .This finding is true in this study. Among the 278 people in the sample, only 122 were returned the questionnaire completed. Although it seems a low return rate, those who returned the questionnaire might be interested to participate in the study. They are more likely to be good informant for the study. However, a small sample size is not healthy for a descriptive study like this. The reason is, it is dealing with multiple variables. The subject response to the main variables in the study can significantly influenced by the extraneous variables. In addition, it will not be possible to carry out a statistical comparison between the sub group, if the sample size is small (Grove & Burns, 2005). These drawbacks prevent this study to look in to the study more specifically. STUDY 2 This study was conducted by Cummings Et Al. Main objective behind this study is to find out the relationship between the nursing leadership and job satisfaction in the Canadian oncology work environment. This study is in the background of increasing sick leaves and work related stress among the nurses working in the oncology ward. The area of focus of this study is to find out the work environmental factors that affect the job satisfaction of the oncology nurse. This study used a descriptive, prospective research design to survey the Canadian nurses working in the oncology ward. As this is descriptive study, it examines the features of the work environment on job satisfaction. Many of the descriptive studies uses 12

survey as their method of design (Houser, 2007).This study also followed the same process. The survey conducted twice in a two year period. The sample group is selected from the registered nurses those providing direct care to the cancer patient in clinical setting as well as in the ambulatory clinical service. The data collected through mailing self reported questionnaire. The questionnaire consist of three different sections. Questions regarding the demography, work environment characteristics, job satisfaction, and intent to leave were allocated separately in these sections. A four point linker scale is used to gather data regarding the work environment characteristics. Although it is a useful tool in situations need comparison, there are some limitations too. This tool fails to find the depth of the respondents opinion(Kothari,2008).For example, a question about how nurses view autonomy in the work place, the linker scale can only describe whether they are more or less favourable to that particular issue. This tool has a limitation to find out how much less or favour nurses to this issue. This will prevent the researcher to look in to the depth of the issue more specifically. The major finding of this study is that there is a significant relationship between the leadership and nurses job satisfaction. According to this study, nurses job satisfaction is directly related to the positive physician relationship, clear organisational philosophy, adequate staffing, nursing autonomy in important care decisions. However, this findings cannot be consider as a overall reflection from the nurse because, this study was conducted only among nurses in Oncology speciality. Their perception about autonomy in ward may be different from the nurses in other sectors of the health care field .It would have been better, if this study focuses on the nurses from a particular region, rather than looking in to the nurses in a particular speciality. So that, we can get an overall view of nurses perception towards the work environment characteristics and job satisfaction. Study 3 This study was conducted by Carol S Wiesman, Cheryl S Alexander and Gary S Chase. The main objective of this study was to find out the job satisfaction and independent variables that determines the job satisfaction among the nurses in two different hospitals. This study found that the autonomy and task delegation predicts job satisfaction strongly. This study also suggests that the nurses own characteristics can predict job satisfaction more specifically than the structural characteristics of the nursing unit and the job characteristics. This study was conducted among the hospital staff nurses at two university hospital in a metropolitan area. The samples were taken from 105 different areas of the hospitals including all major area. The data were taken from three different ways. Some data, such as daily activity reports collected from the hospital documents. While the data about the nursing care policy of the organisation and structural features of the organisation were obtained from the head nurses report. Nurses perception towards the job satisfaction elements, job, work environment and nurses demographic features were collected using interview method. This study used two different hospitals. This approach enables the researchers to carry out the study in a large population. As this study dealing with several variables, it is feasible to have a large sample. This view is supported by Rubin & Babbie. According to them it is essential to have a large sample, whenever the variables analysed simultaneously (Rubin & Babbie, 2009).Data collection through documents has many advantages. The first and most important advantage is it is economical. Hospital documents gives us information over the periods (Polit & Beck,2004).However, 13

there is a need to look in to the disadvantages too. It is necessary to verify the authorship, accuracy of such document .It will be difficult if the studies are old.( Polit & Beck,2004).However, in this study, the researchers did not mentioned about the reliability of the data collected through hospital documents. This may affect the result negatively. While comparing the data from the two hospitals, autonomy is evolved as the strongest predictor of job satisfaction in one hospital and second in other hospital. This may be due to the difference in the organisational policy. Nurses in the hospital, where the autonomy is the second most predictor of job satisfaction may get more freedom in clinical decision making than the other. Internal characteristics of the individual are ranked second most predictor in one hospital and third in the other. Although there is a marginal difference in the priority of the variables that predict job satisfaction between these two hospitals, the study re instate the importance of these variables in predicting job satisfaction. Study 4 This study was conducted by Ahamed .S. Al Ameri. The main intention of this study was to examine the extent to which the nurses in the public health sector are satisfied with their profession and their level of commitment to the organisation. In addition to this, the study also examines the relationship between the job satisfaction and organisational commitment. The samples were taken from different hospitals in the public sector across the country. Two hundred and ninety nursing staffs were participated in the study. Questionnaire was used to collect data from these samples. Off the 400 questionnaire sent for this study, 290 only returned. This low return rate is common in survey method. Mitchell & jolly consider the low return rate is one of the main drawbacks of the survey method. However, in this case, the sample response is considerably good. The researchers got almost 70% responses. It can be consider as good response. It has to be clarify that the sample is free from bias. When the sample size is too homogeneous, sampling bias can be occur(Houser,2007).In this study, among the 290 sample size,220 are females, of that 150 married,84 singles,26 divorced and 25 widowed. Though the sample looks like a homogeneous sample in terms of large female participants that was not a significant issue in this study. Considering the fact that nursing is a female dominant profession, the over participants from the female population is not a significant problem. The study found that the mean of job satisfaction among the nurses in the public hospital is 3.67, which is reasonable well score. It suggests that the majority of the nurses are satisfied with their job. The mean of organisational commitment is 4.87; also indicate the nurses are strongly committed to the organisation. This study also found that the correlation coefficient between job satisfaction and organisational commitment is 0.59.A number which indicates the strength of relationship between two variable is called the correlation coefficient (Plotnik & Kougoumdjian, 2010).The study found no significant relationship between the job satisfaction and other demographic variables. All together, this study conducted in a reasonable well manner by using appropriate methods for data collection and analysis. The study findings were in line with the findings of other studies conducted in the same area. Study 5 14

This study was conducted by Hsien Ho Et Al .The main purpose of this study was to identify the impact of role stress on job satisfaction and organisational commitment among nurses. It also focuses on whether the job rotation system helps the staff nurse to get more information regarding the organisational policy and views, thereby increasing the job satisfaction and organisational commitment consequently encourage them to stay in the organisation. This study was conducted in Taiwan. The method used to collect data in this study is a questionnaire. Since the main purpose of this study was to examine the effect of job stress, questionnaire is the most suitable method for this study. According to Parahoo, questionnaires are often used to examine the attributes, relationships, patterns, trends, between the variables (Parahoo,).The samples were selected from two large hospitals in southern Taiwan. One of the main demerit of the questionnaire survey is it often get low response rate. However, this study has got a good response rate from the samples. Among the 650 questionnaires sent, 532 valid copes were returned, which shows a return rate of more than 80%.In this study, data analysis was done by using SPSS 11.0 and LISREL 8.54.These types of data analysis methods are a kind of structural equation modelling techniques (Smart, 1997).Though the study has got so many advantages like this, the selection of the sample is a noticeable deficit of this study. Although the sample size was considerably good, the selection was homogeneous. The sample were selected from only a particular region of Taiwan. This can lead to sample errors. Sample errors happens when the sample not representing the entire study population(Andrew,2011).The sample selected in this study does not represent the entire study population, therefore it will not reflect the nature of the entire population. The study findings suggests that the job satisfaction and organisational commitment positively influenced by the job rotation. The correlation variance is 0.51 and 0.46 respectively. In addition to this, study found that the job satisfaction and organisational commitment are significantly related to each other (0.63).On the other hand, the job stress has a negative influence on the job satisfaction and organisational commitment (-0.79 & -0.52).

On the basis of statistical findings researchers could explore the correlation of job rotation among staff nurses with job satisfaction and organisational commitment. Here researchers also explore the positive influence of job satisfaction on organisational commitment. However the main limitations noticed here are the sample selection, here researchers select nurses from a single country, the data collection tool was questionnaire it have its own validity and reliability. Also the study carried out in a one time period. STUDY 6 This study was conducted by Ru Liu & Yu Cheng. The main aim of this study was to find out the relationship between the three variables such as intention to leave, organisational climate and organisational commitment. This study also looks in to the demographic differences among these variables and mediating role of organisational commitment between the organisational commitment and organisational climate. This study is a cross sectional study and used a descriptive design.

15

The samples were taken from the eight hospitals across southern Taiwan. Questionnaires were used to collect the data. Questionnaires were distributed among 612 participants and 486 valid returns were taken for the study. This study opted for a strong valid method for the study design and data collection. A descriptive design is useful to study the things happening in the real life situations (Drummond & Campling, 1998).According to the nature of the study, a descriptive design is very much suitable for this study. In addition, the questionnaire used in this study is suits with both the study type and in terms of the sample size. Questionnaire are often used to collect datas for descriptive studies (Wood &Kerr,2010).The reason is not just because of the cost effectiveness of the questionnaires, more, it provides a wide range of coverage, so that the researcher can conduct study in a large population(Singh,2007).This study dealing with multiple variables. The studies include multiple variables requires large sample (Burns & Grove, 2005).Therefore, it is feasible to use questionnaire survey in this kind of study. Moreover, this study overcame the major drawback of questionnaire survey in the form of good response from the participants. This is also an advantage of this study. However, there are some limitations too. The participants were taken from a southern region of Taiwan, therefore; this study could not include the nursing population across the country. So that it lacks generic ability. It could also lead to sampling errors and bias. This would have been a better study, if the sample includes populations from other parts of the country. This study found that the organisational climate is significantly related to the organisational commitment .The mean between these two variables are 0.57.There is a negative association between the organisational climate and intention to leave. The mean between these is -0.40.This finding is important in an organisational perspective, where the nursing turnover is at high. All together, this study is conducted in a well manner, using appropriate design and data collection instrument. Though, the study lack generic ability, the findings of the study can applicable to health care organisations in the other parts of the world. Study 7 This study was conducted by Ahmed& Oranye. The main objective of this study is to assess the relationship between the nurses job satisfaction, empowerment and organisational commitment among the nurses in two different societies. The method used in this study is a descriptive correlation survey. The samples were 556 registered nurses from two teaching hospitals in these two countries. The world has now facing nursing shortage. There are many study suggesting that, in order to retain nurses, the job satisfaction and organisational commitment must be improved.(REFERENCES******)Therefore the intention of this study is significant in the
16

current situation of the nursing field. As the studys main aim is to examine the relationship between the job satisfaction, organisational commitment and nurses empowerment, the method used in this study is well fit to the objective. The descriptive correlation studies are used when the situation needs to describe the relationship between the variables (Polit &Beck, 2004).Simple random sampling method was used to select the participants in this study. Although, this method brings a good result for the study, the suitability of this sampling method has to analyse. Though the samples selected in this study are from the same professional background, culturally and geographically, they are different. This makes this sample more homogenous than heterogeneous. When an individual or group is different from each other in a significant aspect, then it can be consider as a heterogeneous sample. Simple random sampling may not be a suitable method, when the sample is heterogeneous in nature(Antonysamy Et Al,2010).In addition ,in this study, the samples were from geographically different are, which might made the data collection hard. The questionnaire in this study constituted four scales. The structural empowerment scale was used to measure the nurses structural empowerment .Five point linker scale were used to rate the item. Psychological empowerment scale used to measure the nurses view towards the psychological empowerment in their work place. Seven point linker scales was used to rate items in this situation. The researchers justified the usage of these scales satisfactorily. The study has got ethical approval from the university of Sheffield ethical committee, directors of the two hospitals and NHS. The collected data were analysed by using SPSS software. The study shows a significant similarity in the demographic features of the two groups. Even though, the job satisfaction, commitment and empowerment are different in both the group. The study suggests that the demographic features such as age, experience, education are associated with the job satisfaction, commitment and organisational commitment. Despite some drawbacks of sample selection, this study conducted in a well manner. The researcher could give some more attention while selecting samples and sampling method. However, this study has some positive finding which helps the profession to develop further. Study 8 This study was conducted by Ching Sheng Chang and Hsin Hsin Chang. The main purpose of this study is to examine the nurses view towards the internal marketing, job satisfaction and organisational commitment. This study was conducted in southern Taiwan .The samples selected in this study were taken from the two medical centres in southern Taiwan. In this study, questionnaires were used to collect data from the samples. The questionnaires formulated after a detailed review of literature and discussion with the experts. This can be considering as one of the main advantage of this study. This approach will ensure the validity of the questionnaire. A pilot study also conducted to avoid invalid items from the
17

questionnaire. This approach would help the researchers to measure the correlations effectively. It is useful to conduct a pilot study before the intervention. Small scale study before the actual intervention helps the researcher to measure the feasibility of the proposed study and to make sure that the research approach is well enough to bring the desired outcome (Polit &Beck, 2004).Among the 450 questionnaires distributed, 318 were completed and returned, and of that 18 were incomplete, therefore excluded from the study. Even then, the study had 300 questionnaires, which is a reasonable well response. The data analysis was done by using analysis software SPSS11.0 and LISREL8.50.Structural equation model was used to analyse the relationship between the three variables, job satisfaction, internal marketing and organisational commitment. Though the study has got many advantages, it could not maintain the general ability of the sample. The samples were taken from a particular region of the Taiwan so that, it could not bring the overall reflection of the nursing population in Taiwan. Demographical characteristics, such as culture, education may be different in this region compared to other parts of the Taiwan. So, nurses from that area may have different opinion about the issues handled in this study. Researchers in this study could participate with the nurses from the other region as well so that; they could ascertain the general ability of the sample. The data analysis reveals that the path coefficient between the variables job satisfaction and organisational commitment is 0.56, which suggests a significant relationship. The study findings also support the positive relationship of internal marketing with the organisational commitment and that of the job satisfaction .However, this findings not reflecting the entire nursing population as it contain samples from a particular region only. In general, this study adopted a proper design and instruments to carry out the research. However, the limitations of selecting a suitable sample prevent this study to draw a general reflection. Study 10 This study was conducted by Al Hussami. In this study, the researcher intent to examine the multiple correlation between the job satisfaction, transformational leadership behaviour, perceived organisational support and the level of education on organisational commitment. The study was conducted in four nursing homes in the south eastern USA. The study population includes a vast number of white Hispanic, black non Hispanic and Hispanic. The method used in this study was multiple regression analysis. According to the nature of the study, the selected study design is a suitable one. This study examine the correlation between the job satisfaction, level of education, transformational leadership and perceived organisational support on organisational commitment. When the correlation between the two variables are not clearly perfect, the researchers attempt to enhance the prediction by adding more than one independent variable. Multiple regression is applied in these
18

circumstances(Polit &Beck,2004).This study attempts to find the correlation between one dependant variable with four dependant variable. Therefore, the selected study method is appropriate to the aim of the study. By adopting this method, the researcher do not need to apply separate analysis for the each independent variable(Andrew et al,2009).The participants in the study were taken randomly from the four nursing homes. The researcher chooses simple random sampling for the sample selection.15 participants were taken from each nursing home. Although the sample has taken in a systematic manner, there is a concern about the sample size. Number of participants in this study is 60. Though, it looks like a low number of participants, it is sufficient enough for the study. In multiple regression studies, the sample size is calculated according to the number of predictors(Andrew et al,2011).The ratio for the sample size in multiple regression study is 15 :1,that is,15 samples for 1 predictor(Andrew et al,2011).This study has got four predictors. So, the required sample size is 60.The number of participants in this study also 60.Therefor,the study has got sufficient sample size to conduct a multiple regression analysis. It is evident from the research that the researcher gave special care to maintain the anonymity of the participants in the study. So that we can assume that the researcher had been taken the ethical issues in to consideration. However, a descriptive research method would be more suitable for the study population. Since the most of the studies in nursing uses descriptive method(Polit & Beck,2004),it would be better to reflect the relationship among the variables in this study by using descriptive research. Moreover, a descriptive method allows the researcher to include more participants, so that the study could get a general ability of the matter. Pearsons product moment coefficients were used in this study to measure the relationship between the dependant and independent variables. A multiple regression analysis also used to measure the predictive values of job satisfaction, level of education, perceived organisational behaviour on organisational commitment. The study found that the perceived organisational support and transformational leadership is associated with the organisational commitment. The high scores of these two independent variables related to the dependant variable, organisational commitment. Study also found that the correlation between the level of education and organisational commitment is positive. Multiple regression analysis also reveals that the four independent variables are strongly related to the organisational commitment. These findings are very significant in an organisational perspective. Overall, this study has met all the criterias in the quality appraisal tool .It has got a good design, and data collection and analysis methods were well fit for the study design and the objectives of the study. The findings of the study are useful in the organisational and professional perspective of the nursing. STUDY 11

19

This study was conducted by Mcneese smith in the year 2001.This study was conducted in the context of the nursing shortage.The main purpose of this study was to find out the determinant factors of the nurses commitment and non commitment to the organisation they are working.Semi structured interviews were used as the method of data collection for this study. The samples of this study was taken from the los angelos county hospital.Thirty nurses were selected for this study from various departments such as obstetrics,paediatrics,medical , surgical and intensive care unit.Of the 30 participants,28 were females.Almost 60 percent of the participants were Filipinos,20 percent were Asians and the rest shared between coucassians,afro Americans.The over representation of Filipino nurses can lead to sample bias. In this 60 % of the participants are Filipino nurses. These nurses from different educational, cultural, and geographical area can have a different perception towards the issue that the study deals. So, this over representation can have a negative impact on the study result. Systematic over representation of the one segment of the sample refers to sample bias (Polit & Beck, 2004).The interview questions were formed on the basis of the previous research and expert suggestions. This study found nine factors that affect the organisational commitment. This study identified personal factors, job satisfaction, opportunities for learning, monetary benefits, co workers, patient care, job security as the factors that affect the organisational commitment of the nurses. Despite the limitations of sample bias and sample size, this study organised reasonably well manner. The aim and objectives of the study is well stated and proper data collection methods and design is used. STUDY 12 This study was conducted by Morgan & Lynn in the year 2009.This study was in the context of nursing shortage that US face at present. The main purpose of the study was to determine how nurses are satisfying at their workplace. Semi structured interviews are used to collect data from the participants. Data were collected from 20 nurses and each interview was recorded. The interview took about 25 to 60 minutes. The study method selected in this research is well suits with the aims and objectives of the study. Semi structured interviews are very useful for the exploratory type research (Bless et al, 2006).As the main aim of this study is to determine the nurses perception about the satisfying work atmosphere, semi structured interview enable the researcher to explore more effectively and to get a detailed view from the respondents (Bless et al, 2006).Content analysis was used to identify and relate themes from the participants response. A content analysis means coding and ordering the textual

20

data Newell &Burnard, 2006).The data analysis was done by using NUD*IST 0.4 software. The data coded according to the themes. The study found that the nurses attitude towards the satisfiers of job has changed over the years. The factor that was considered the job satisfiers such as pay and benefits are not bothering the current nurses. They consider autonomy as the major job satisfier. Prior to the data collection process, the researchers ensured to get the informed consent from the participants and they protected the anonymity of the participants. In general, the study could bring some valuable points to the nurses job satisfiers at their work place. These findings will be valuable from the nurse managers point of view. The data collection method and study design is used according to the aims and objectives of the study. STUDY 13 This study was conducted by Peter loke and John Crawford in the year 1999.The main purpose of this study is to assess the dynamics of the relationship between the organisational culuture, organisational sub culture and organisational commitment. This study also assesses the relationship of these variables with the leadership style, job satisfaction and individual characteristics such as level of education, age etc. The samples in this study were taken from 7 large hospitals in Sydney. The hospitals include general, private and psychiatric specialities. A questionnaire survey was used to obtain the datas from the participants. Four established scales were used in this study as survey instrument. Wallachs organisational cultural index, stogdills leader behaviour description questionnaire, mowday et al job commitment survey, Mueller and Mcloskys job satisfaction scale were the instrument scales. One of the main advantages of this study was the sample selection .The samples were selected from seven different hospitals of various specialities. This enables the researcher to get a broad view of different hospital environment. This approach gave the researcher to ensure the heterogenesity of the sample. The studies include survey questionnaire requires large sample size.Becouse these studies often need comparison between multiple variables. In addition, it requires comparison of various sub groups in the sample (Burns & Grove,2005).Therefore a large sample will give more opportunity for the researcher to bring the desired outcome. This study has got a large sample size, and the researchers tried to maintain the heterogeneous nature of the sample by opting different hospitals. Among the 398 samples distributed, 258 were completed and returned. This is a good response rate. DISCUSSION Theme 1 There is a positive relationship between job satisfaction and organisational commitment
21

Most of the study selected in this systematic review suggests that there is a relationship between the job satisfaction and organisational commitment. Here, author trying to identify whether it is a positive or negative relationship between these two variables. Majority of the studies scrutinized here clearly define that there is a positive relationship between the job satisfaction and organisational commitment. This indicate that when the individual feels satisfaction in his job, that will ultimately lead to the improvement in organisational commitment. Study about the effectiveness of internal marketing on job satisfaction and organisational commitment could explain more authoritatively about the positive relationship between job satisfaction and organisational commitment. This study conducted in southern Taiwan in the year of 2007.This study conducted by Chingsheng chang & Hsin-Hsin chang.This study conducted among the nurses in medical centres in southern Thaiwan.One of the hypotheses of this research is that the job satisfaction has a positive influence on organisational commitment. The datas of this study suggest that the path coefficient from the job satisfaction to organisational commitment is 0.56.Path coefficient of 0.56 indicates that a strong positive relationship between the variables, that is job satisfaction and organisational commitment.Indeed,this research suggest a strong positive relationship between job satisfaction and organisational commitment. Organisational commitment enhances according to the job satisfaction.(Sheng chang &Hsin chang,2007).This can be explain in other way like whenever the nurse feels better level of job satisfaction, nurse tend to respect the organisational values and believes, and shows more dedication to the work. This study also states that the employee tends to remain with the organisation. This study also suggests that the job satisfaction is an intervening variable which can have an indirect effect on the organisational commitment. Hsien Ho et al (2009) conducted a study about the effect of job rotation and role stress on job satisfaction and organisational commitment found that the influence on organisational commitment by job satisfaction is positive. This study was conducted among nurses in Taiwan. This study reveals that the nurses job satisfaction has a positive influence over organisational commitment.(Hsien Ho et al,2009).In addition to that, this study also suggests both the job satisfaction and organisational commitment negatively influenced by the role stress. It has shown by the parameter measures that the negative influence of role stress on organisational commitment is greater than that on the job satisfaction. According to this study, variables such as role stress and job rotation has an influence on job satisfaction. The mean between the job satisfaction and organisational commitment is 0.63.That indicates a positive strong influence. Combining all these evidences together reveals that the job satisfaction is an antecedent to the organisational commitment. Positive relationship by the job satisfaction and organisational commitment clearly explained by Mahmoud Al Hussami in his study about the nurses job satisfaction and its relationship with the organisational commitment. This study took place around the nursing homes in the south-eastern part of United States. This study
22

conducted in the year 2008.In this study, the job satisfaction is considered as the dependant variable and organisational commitment and organisational support is considered as the independent variable. The findings of the study indicated that the correlation between the dependant variable job satisfaction and independent variable organisational commitment is strong.(0.93) (Al Hussami,2008).This score indicate that 80% of the variance in job satisfaction is accounted for the independent variable organisational commitment.(Al Hussami,2008).Job satisfaction and organisational commitment are strongly related to the all 20 correlation items in the study. Strong attitude of the nurses towards the organisational commitment and job satisfaction evidenced from the findings of this study is a clear indication of the nurses loyalty towards the organisation and their job satisfaction.(Al Hussami,2008).In addition to that, the multiple regression performed in this study suggest that the 92 % of the variance of job satisfaction is accounted for the linear combinations of the independent variables like organisational support ,organisational commitment etc.This study proposes that the job satisfaction is a significant predictor of organisational commitment. All studies that are discussed above strongly suggest that there is a positive relation between the organisational commitment and job satisfaction. Both these variables are inter related .This suggestion is evident in all the studies. The relationship between these variables is strongly correlated. Greater job satisfaction will lead to a raise in organisational commitment of nurses. Theme 2 INTERNAL FACTORS COMMITMENT
Age Age is an important factor ,that influence the job satisfaction and organisational commitment. It has been pointed out in many studies such as Lok & Crawford,1999;Wiesman et al, Al ameri, in his study found that the aged nurses are more satisfied than the young nurses(Al ameri,2000).In this study,the correlation of age and job satisfaction is 0.23,and correlation between age and organisational commitment is 0.15.This can be viewed in the context that the young nurses are at their beginning of the career,and they may face many obstacles during the early stage of the career.That may affect their level of job satisfaction and organisational commitment.Moreover,most of the aged nurses might be experienced people,they may familiar with the working condition and climate.,which makes their work easier than the young people.Experience too has a significant correlation with the job satisfaction and organisational commitment(Al ameri,2000).Therefor ,the combined effect of both these factors make the older people more committed and satisfied than the young people. However, age is not a significant factor of job satisfaction in situations ,where professional characteristics have priority than the work environmental characteristics.A study about job satisfaction of Canadian nurses ,working in oncology department ,conducted by cummings 23

OF

JOB

SATISFACTION

AND

ORGANISATIONAL

et al,found that age has no significant relationship with the job satisfaction(Cummings et al,2008).This result may be due to the different environment where the study conducted.Becouse,oncology is a speciality area,therefor we can assume that ,those who working there is interested in that speciality.So,their job satisfactory drive may be different from others.However,majority of the study conducted in different environment found that age has a specific role in promoting organisational commitment and job satisfaction. CULTURE There are cultural difference in the perspective of job satisfaction and organisational commitment.The nurses view towards job satisfaction and organisational commitment is vary across the societies.Study conducted between the nurses in England and Malaysia reveals the cultural difference in the nurses perspective towards the job satisfaction and organisational commitment(Ahmad &Oranye,2010).In this study,the author found that the organisational commitment of English nurses were comparatively less than their Malaysian counterpart.However,they shows high job satisfaction.The possible reason for this difference is due to the difference in culture.In another study conducted by Al ameri,found that there is difference in organisational commitment across the countries.This study found that arab nurses are more committed to the organisation than the nurses from the other countries(Al ameri,2000).In this study,the European nurses were the less committed people.If we taking consideration of the environment where the study conducted,we can assume that the cultural difference has taken part of these difference on organisational commitment.This study was conducted in public hospital in Riyadh,which is a middle east city.The lifestyle in these region is entirely different from the European countries.So,the difference in culture may tends the European nurses to show less commitment to the organisation.However,studies such as Al hussami,MCneese-smith,where the participants from various cultural and ethnic background does not find any influence on job satisfaction and organisational commitment by culture,it is difficult to predict that the culture has a significant influence on these variables.Therefor ,we can say that cultural factors have a minimal effect on job satisfaction and organisational commitment. AUTONOMY Autonomy has been recognised as one of the strongest factor influencing the organisational commitment and job satisfaction.Many studies suggest that the autonomy of the nurse positively influence the organisational commitment and job satisfaction.The study conducted among hospital nurses between two hospital, by wiesmann et al,found that the professional autonomy is the strongest predictor of job satisfaction.Cummings et al ,2008 also support this view.Autonomy gives a good working environment and feeling of reward( liu&Cheng,2010). This may cause them to feel a high level of job satisfaction.According to cumming et al,autonomy is one of the work environment factor which has a strong correlation with the job satisfaction.Nurses want more freedom in their work environ ment ,so that they can control their work environment.This view can be linked with Cummings et al,2008 view of nurse physician relationship.According to cummings et al,2008,a good nurse- physician relationship also a factor that contributes job satisfaction.An environment where the nurse maintain a good positive relationship,the nurse get more freedom and control over the area.Moreover,nurse may also participate in decision making process.That also triggers the job satisfaction element.Autonomy enable the nurses to have control over work environment through making work related decision.Organisational 24

commitment,however,not a direct beneficiary of autonomy,eventually it increases when the individual starts to participate in decision making.So,it can be say that the professional autonomy is a strong factor behind the job satisfaction and a contributor to the organisational commitment. EDUCATION Education seems to be an important factor behind the nurses job satisfaction and organisational commitment.The study conducted by (weisman et al)found a significant correlation between the education and job satisfaction.The study found that the nurses job satisfaction level was high in an area where the most nurses have a degree qualification.This finding may be in the background of a different organisation,where the policy allows more opportunity for the degree holders to work freely in their clinical area.However,(Al ameri,2000) suggests only a minimal effect on job satisfaction by education.(Al hussami,2009) found that the correlation between the education and organisational commitment.The correlation between these two variable is .30,that means p less than .05,which suggests a strong relation.This can be attributed to the career opportunity they get from the organisation.The more educated staff members get more higher positions in the organisation,and get more involvement in the decision making process(Al hussami,2009).This perception may tends the nurses to show more commitment to the organisation.However,( Ahmad & Oranye,2010) found a difference in organisational commitment between the nurses share similar educational qualification.In this study, though they have got the similar educational qualification,the nurses from England shows less commitment than the Malaysian nurses.On the other hand English nurses has more job satisfaction than the Malaysian nurses.This difference can be attributed to the difference in culture,organisational policy.Becouse we already discussed the influence of culture in organisational commitment and job satisfaction.By analysing all these factors ,we can conclude that,though the education has a positive influence on organisational commitment and job satisfaction,it varies according to the situation. Marital status Marital status can be a factor constitutes the job satisfaction and organisational commitment.(Al ameri,2000) found that there are significant difference in the job satisfaction and organisational commitment among nurses in four different catagories of marital status.Liou & Chamg,2010) also supported this view.The study shows that ,the widowed nurses are less satisfied with their work,whereas the most satisfied group is the divorced one.In case of organisational commitment,married group shows more commitment than the widowed group(Al ameri,2000).This finding might be due to the psychological condition in which the widowed people are undergoing. THEME 4:EXTERNAL FACTORS AFFECTING ORGANISATIONAL COMMITMENT Leadership & job satisfaction There have been a number of investigations conducted to analyse the impact of leadership on job satisfaction.many studies suggests that the leadership and the type of leadership have significant role on job satisfaction.The study conducted by Lok & Crawford found a strong correlation between the job satisfaction and leadership.Similar result can be seen in studies such as medley & Larochelle,1995;cummings eta l,2008;Al Hussami,2009. 25

The impact of leadership on job satisfaction of nurses has got many dimensions.Not every leadership style can raise the level of job satisfaction.This view is supported by Medley &Larochelle,1995.I n their study ,they found that the staff nurses job satisfaction positively correlated with the head nurses transformational leadership style(Medley& Larochelle,1995).That means ,if the head nurse has a transformational leadership style,that will enhance the level of the job satisfaction of the staff nurse. Al hussami and Hall also states that the transformational leadership has a significant correlation with the job satisfaction(Alhussami,2009;Hall,2005).In the study of Medley and Larochelle,the correlation between the transformational leadership style and job satisfaction is r = 0.4010 ,whereas the correlation between the transactional leadership and job satisfaction of nurse is r=0.0469(Medley &Larochelle,1995).Moreover,the study also found that the job satisfaction components such as professional status,autonomy,interaction,organisational policy,pay are significantly correlated with the transformational leadership factors.While,none of the transactional leadership factors were significantly correlated with the job satisfaction components.Among these variables,interaction and autonomy were the most correlated job satisfaction component with the transformational leadership factor.This indicte that the nurses would like to work under a leader who shows transformational leadership characteristics.This could be due to various reasons.A transformational leadership enable the nurses to work more freely in their work environment.As nurses prefer autonomy in their work(Cummings et al,2008),this approach may raise their level of job satisfaction.Moreover,working in a conducive environment helps to reduce the role stress,which has a significant negative correlation with the job satisfaction(Hsien ho et al,2009).An employee oriented leadership also positively influence the job satisfaction of nurse.Lok & Crawford found in their study that the consideration dimension of the leadership has a strong positive influence on job satisfaction(Lok & Crawford,1999). In general,the nurses job satisfaction is very much related to the leadership quality.Nurses prefers a transformational leadership rather than transactional leader. Leadership & organisational commitment Many studies investigated about the influence of leadership on organisational commitment of the nurse.In his study,Al hussami found that the nurses organisational commitment is positively related to the leadership behaviour(Al hussami,2009) .The correlation between the considerational leadership and organisational commitment was found very high in the study of Lok &Crawford,1999). The correlation coefficient between organisational commitment and transformational leadership is 1(Al hussami,2009),which indicate a positive relation.According to this study,the transformational leadership was the strong predictor of the organisational commitment.This finding can be viewed in the context of organisational policy.Tranformational leadership allow the nurse to take part in the organisational policy making and important decision making.This tends the nurses to think that they are the part of the organisation.Further ,leads to a strong organisational commitment.

STAFFING

26

Adequate staffing is an important factor in promoting job satisfaction and organisational commitment.Studies such as( cummings et al,2008;Wiesmann et al,1995;Ho et al,2009) are suggesting that the adequate number of staff is a significant factor to promote a healthy work environment.Nurses feel that they require adequate number of staff to provide quality care,that will enhance their job satisfaction(Cummings et al,2008).This can be due to two factors.providing quality care itself a job satisfaction component,in addition to that,number of staff reduce the work load of the staff and thereby reduce the stress,which has negative influence on job satisfaction (Ho,et al,2009).Staffing ,however,does not seems to be directly linked with the organisational commitment.

PAY Many studies suggest that pay has not much influence on job satisfaction and organisational commitment.(Morgan & Lynn,2008) found in their study that,although money is an important factor,it does not contribute to their job satisfaction.(Wiesman et al) also found pay has a very little influence on job satisfaction and organisational commitment.Although,(Mcneesesmith,2001) identified an association between the pay and organisational commitment,it is in a different circumstances .Therefor we can say that the pay has a minimal effect on job satisfaction and organisational commitment. CAREER OPPORTUNITY Career opportunity tends to be a significant factor influencing the job satisfactionand organisational commitment.(Morgan & Lynn,2008) identified in their study that career opportunity as a significant external factor of job satisfaction.

Theme 4 Job satisfaction is an antecedent to organisational commitment. Indeed, it has been clear that there is a relationship between the job satisfaction and the organisational commitment. The studies discussed above all suggested that the relationship between the organisation and job satisfaction positive and strong. However, there are some studies discussed in the background suggest that the job satisfaction is a preceding circumstance to organisational commitment. In this section, the author tries to find out through the selected articles whether the job satisfaction is an antecedent top organisational commitment or not. Al Hussami (2008) in his study to find out the predictors of nurses commitment to health care organisation analyse the predictive value of the job satisfaction. In this study the correlation coefficient between the job satisfaction and organisational commitment r= 0.93 which means P<0.5.This indicates a very high relation. The correlation coefficient in this study indicates that the high value of the job satisfaction related to the high value of organisational commitment. (AlHussami,2008).The co efficient correlation0.93 emphasise that the majority of the variance in organisational commitment are accounted for job satisfaction.(Al Hussami,2008).This finding stresses the theme that the job satisfaction is an antecedent to organisational
27

commitment. According to Al Hussami (2008) the job satisfaction is the strongest predictor of the organisational commitment. By analysing all these factors, the author tend to feel that the study strongly support the theme that job satisfaction is an antecedent to the organisational commitment. Obviously, job satisfaction has a positive role in nurses organisational commitment, says Shen chang &Hsin chang (2007).organisational commitment increases in accordance with the job satisfaction.Shen chang &Hsin chang found in their study that nurses at a higher level of job satisfaction are willing to dedicate more for the organisation.Inaddition to that, they will put more effort to attain their goals within the organisation. More importantly, they tend to recognise the organisational goals and values. This finding suggests that organisational commitment is driven by the job satisfaction. In other words, the job satisfaction is predicting event to organisational commitment. According to this study, the higher job satisfaction among nurses helps to raise the level of their organisational commitment. This finding is especially important in the nursing administrative field.Becouse, higher organisational commitment and job satisfaction will lead to a higher productivity. (Foong Loke, 2001). Hsien Ho et al( 2009) suggest that when a medical organisation trying to elevate the organisational commitment of their employees, reduce the role uncertainty in role stress is effective than improving the factors that influences the job satisfaction.Although,this finding directly supporting the theme that the job satisfaction is an antecedent to the organisational commitment, indirectly it admit the theme. The data and information from all these studies clearly indicate that the job satisfaction is an antecedent to the organisational commitment. The studies strongly suggest that the job satisfaction is an important predictor of the organisational commitment. Whenever the nurses feel satisfaction in their work, they will be more committed to the organisation. OUTCOME OF THE DISCUSSION The findings from the thematic review suggest that there is a significant positive relationship between the nurses job satisfaction and organisational commitment.The reviewed articles in this study shows that there are some factors commonly affecting the job satisfaction and organisational commitment.Inaddition to this,the studies also indicates that the job satisfaction is an antecedent to the organisational commitment.One of the major finding in the study is that the organisational commitment improves according to the job satisfaction.This factor is significant in an organisational perspective.Moreover,when a nurse getting more job satisfaction,that helps the nurse to give more respect to the organisational policy and values.This attachment to the organisation tends the nurse to show more commitment to the organisation.One of the interesting finding is that both the job satisfaction and
28

organisational commitment are negatively related to the role stress(Ho et al,2009).The factors affecting job satisfaction and organisational commitment are identified and analysed separately as individual factors and external factors.Age ,one of the individual factor influences the organisational commitment positively.This study found that the job satisfaction and organisational commitment increases with the age.The cultural aspect of the organisational commitment also discussed in this study.It is evident from the studies that the job satisfaction and organisational commitment is influenced by various cultural factors.One major thing that can be very effective in the organisational point of view is the nurses preferences to the professional autonomy.This study found that the nurses likes to be more free in their work place, and would like to have professional autonomy.So,according to this study,nurses will be more satisfied with their job and committed to their organisation,when they feel more freedom at their work.Though,there are many studies suggests the influence of education in job satisfaction and organisational commitment,this study found the impact of education vary according to the situation.Becouse ,this study found that education can contribute to nurses job satisfaction and organisational commitment only in certain circumstances.The thematic analysis of external factors reveals that the leadership has a significant role in nurses job satisfaction and organisational commitment.Nurses would like to work under a transformational leader rather than a transactional leader.The study suggests that the nurse leaders should be more interactive with the nurses who working under them.This approach will help to develop more satisfied and more commited nurses in the unit.In addition to the leadership characteristics,other factors which influence job satisfaction and organisational commitment are staffing,organisational culture and career opportunities.Interestingly,this study found that the pay has a minimal effect on job satisfaction and organisational commitment.This study also suggests that the job satisfaction is an antecedent to the organisational commitment. STRENGTH AND WEAKNESS OF THE STUDY The result of this study indicates that the job satisfaction and organisational commitment positively correlated.The author think ,one of the main advantage of this study is the chosen topic.The topic ,which the study dealt with ,is essential for the current circumstances.Many data shows that the world is now facing a shortage of nursing work force.Increasing nurses turnover rate is one of the significant contributor to this crisis.In addition to that,the nursing turnover costs a serious economic troubles in the organisation(Jones & Gates,2007).Studies such as (stordeur et al,2006;sourdif,2004) suggests a link between the nurses turnover and their job satisfaction and organisational commitment.In this context,this study will helps to promote the job satisfaction and build organisational commitment among nurses.Another advantage of this study is that this study could look in to the nurses work related issues and problems to an extent.This can be used as a platform for further studies.The selected articles were reviewed critically and themes were
29

formulated on the basis of this evidences.The findings and the methods of the selected literatures can be questioned.This would enable to criticise the findings of the study.The study uses a simple language,so that any persons can understand and carry out further studies. Weakness This study has limitations too.The selected literatures were not uniform in quality.Some of the studies used in the review has a low sample size.This would be a drawback of this study.Becouse,limited sample size may reduce the generalisability of the subject and cause sample bias.The review articles selected in the study is published between the year 1995 to 2011.This is a limitation to this study.The author could have focus on much more recent studies. SUGGESTIONS AND RECOMMENDATIONS World has been facing a nursing shortage over the years. There are many factors associated with the present nursing shortage.The nursing shortage in the developed countries couses an increased migration of nurse to this places from developing countries(WHO,2008).This turnover creates a nursing shortage in developing countries too.On this context,this study focus to retain nurses through developing job satisfaction and organisational commitment. The reviewed studies suggests that the job satisfaction and organisational commitment are closely associated.Therefor the measures that intended to improve any of these variable will eventually raise the level of other factor as well.We know from this study that the nurses wants more professional autonomy in their work place.This is one of the factor that contributes to the job satisfaction and organisational commitment of a nurse.Therefor,an organisation which enable the nurses to maintain professional autonomy ,can retain their staff through enhancing the job satisfaction and organisational commitment.Another finding from the study is that the leadership quality and style have an impact on job satisfaction and organisational commitment.It is evident from the study that the transformational leadership can raise the level of job satisfaction and organisational commitment among nurses.Therfore,it should be beneficial for hospital authorities to poses the transformational leadership characteristics.Maintain adequate staff ratio also a factor ,that helps to develop job satisfaction and subsequent organisational commitment.Therefor ,the organisations should be careful to maintain adequate prescribed staff ratio in each area.The study found pay has only a minimal impact over job satisfaction and organisational commitment.In light of these finding,the author recommends the organisations should focus to provide a healthy environment for work rather than focusing on economic aspect of the issue. The review gives contradictory findings about certain factors such as education and staffing.Therefor,further research is needed in these area.

30

FUNDING This is a self funding study.The author met all the expenses.The literature search were carried out through university website. DISSEMINATION: The manner by which data is received and shared to the desired people and target group can be called as the dissemination of findings. Literature dissemination widens the after effect of the research project or literature review and fortifies the research capability (Woodfield, 2002). There has been a wide acceptance of dissemination process in the last two decades along with high profile in the UK (Mulhall et al, 1999). The findings of the research should be made available to the audience after the work is completed. In order to get wide dissemination of findings, a variety of methods can be used. Dissemination aims to increase awareness and take measures through effective techniques (Crosswite & Curtice, 1994).A huge audience is necessary for creating a desired impact on healthcare (Hughes, 2003). Publication in medical journals and electronic means with the entire article instead of just printing the abstract should be there for getting proper dissemination (Mann, 2002). On completion of the final report the reviewer send it through e-mail to the colleague and it is also made available in the local Learning Resource Centre. If the reviewer is skilled in presentation and visual aid preparation such as overhead projector slides and power-point, he can conduct presentations or seminar to a group. This is an excellent method for dissemination of findings. The findings can be summarized and displayed as a poster in places where people gather. News letters can be circulated which contain the major findings. The visual impact of the poster should be taken into consideration while preparing the poster. If needed contact details can be given for extra information. Awareness can be created though journals and magazines and by uploading the result on the internet. Method of dissemination is applied to draw them to the internet so that they know where the information is available (Hughes, 2003). The advantages of disseminating the findings are that it promotes the healthcare and ensures wellbeing, initial start for a change, informing policies and practices, responding to policy changes, demanding quality as well as audit (Shober & Farrington, 1998).

CONCLUSION

31

The review assessed the relationship of job satisfaction and organisational commitment.From the review ,it is clear that there is a positive relationship existing in between these two variables.The study also assessed certain work environment factors which affect the job satisfaction and organisational commitment.This study also found that the job satisfaction is an antecedent to the organisational commitment.

DESCRIPTION OF THE EVENT This project work is the last face of the Msc in advance nursing studies in University of Bedfordshire. The past 12 months the lecture seminars brought to the modern health care field as a part of the nursing studies. It gives me immense pleasure to experience the new approach of the nursing studies in the United Kingdom. The study approach is entirely different as compared to what I studied in my under graduation. So I decided here for my project I choose the subject that has a correlation with the nursing field. When the topic suggested by my tutor I was very happy that the topic is the same what I was wish to study and understand more. The topic Does job satisfaction plays a role in organizational commitment among nurses is very important for the modern nursing studies. As a topic this given a challenging face to the author, But the research work given confidence and the communication with the business administration students helped in making all the part of these research work. The study given an idea how the human resource and the nursing profession connected each other. Apart from caring a patient the profession demands more from the modern nurses who works in the new modern hospitals. Now the nursing jobs demand more on the organizational commitment. Hospitals are considered to be non profitable organization still the competition among the industry is very high. So it is very easy for a healthcare professional to change the job. As an organization is considered the retention rate is not good. So now in the hospital field it is the duty of the nurses who is working or interacting with all the staff at all the time to avoid this retention. The studies helped me to find out the different strategically methods in order to avoid the retention. The important factor of this project work is that how the nursing job is related to the management side. The

32

studies shown that the modern nurse is more or less doing the job of a human recourse manager as well. AUTHORS FEELINGS The author was very much concern about this project work as it is considered as the last phase of the master program. It given a confidence to the author in his field. The project work was not new for the author. As a part of the undergraduate program the author did a project work back in the home country. The approach was very different in back home country. There the project work was about the nursing job and its challenges. So the work was more related or bound with the studies. But the project work that the part of the Masters program given an open topic to the author. So the author got really a good space to do the research work. There were no boundary for the research, all field were important so far consider the topic does job satisfaction plays a role in organisational commitment. There was a planning even while the author joined the masters course in University Of Bedfordshire. The senior students given a clear picture about what is happening in the course and how effectively the study process as well the research process can do. Those advices helped the author to finish all the stages of studies. When the topic allocated to the author that was a bit confused one because the exposure that the author was not much related to the organization. But as a part of the part time job the author was noticing or watching closely the organizational procedure. The advice given by the managers who were working as a senior consultant of the author helped the author to go deeply to the organization. The author planned very well about the time allocation for all the fields. For all the assignment the time allocation is very important that the author were well aware about that. The timing is very important because rush in the last minutes will not give a good result. The dissertation is the core subject for the author to fulfil his masters course so the author was planning very advance to do a best project work. The author is planning more to study some subject that is correlated to the hospital management. In that concern the topic does job satisfaction plays a role in organizational commitment was very much interesting for the author. Not only interesting the author is hoping this project work is his first stage of his further education. RECOLLECTION OF THE EXPERIENCE
33

In this section the author recollecting all of my experience that I gone through the dissertation process. I myself assigned to do the dissertation report about the managerial side of the hospital and the role of a nurse on those issues facing by the hospital. Basically the topic was Does the job satisfaction plays an important role in the organizational commitment. This project work is for the successful completion of the authors masters course in the University Of Bedfordshire. There were an induction class was there in the university and the lecture given by out unit coordinator Mrs. Rosie Preston. In this section the all of the lectures taught us about the importance of the dissertation in the masters level and how effectively approach to the dissertation. Those all section were very much helpful to really understand the process of dissertation. There were several workshops that undergone to the plagiarism, reference, and other important aspects of the several section. The author got a personal feeling as well in this section because that was the last class for the author in the University Of Bedfordshire. So all the colleges were in good interest to attend the class and that classes brought us to a new field or it given a new approach level in my life. At last there was a distribution of the topic among the

groups. Once the author received the topic regarding the job satisfaction as a part of the project work. There were clear pictures drawn in the authors mind about the topic and the project work because the induction class was absolutely useful in all sense. PERSONAL FEELINGS AND LEARNING The above paragraph was saying about all my personal feelings that I had from my dissertation work. The lesson that I acquired from this dissertation report is more valuable than any other studies. Because of my time management after the project report I had more than enough time to review all the field that and I gone through during the work. The experience i gained was absolutely Interesting. For each decision taken in any organizations will reflect all the employees who works in that organization in all the sense. In the normal world we cannot identify why the organizations are changing their rules or how job satisfaction will happen. Normally that is indigestible for common man. Once we gone through all this the job satisfaction is the main attractive area in the organization. The job satisfaction is a very complex thigh and has a huge impact on all the area of the organization. The satisfied employees are the main born of any organization but how to satisfy an employee is another topic because the satisfaction level is different for each
34

individual. So as a whole it is not been assessed by a common criteria or we cannot see it in the same platform. The project work really given me an experience that how an organization will run and how important is the decision process.

Evaluation

In this part of the reflective report it is saying about the bad and good things that gone through during this project work. At the first phase of this process I have been in to gathering information regarding the subject. When it comes to the selection of the subject my co-ordinator suggested me to take some topic that is related to the job satisfaction. I was little confused because the topic is more related to the business aspect. As a nursing student the author was not that much confident about that side. But in the last phase of the course i realized that the nursing studies here is United Kingdom is entirely different from my bachelor nursing studies back in India. Once I finished all modules of my masters I am in a position to understand more about the organizational functioning. There is some problems I faces during the project work helped me to understand and realize the real world situation. What we are studying in theory and what experience we are gaining from the real world situation have some difference. That difference we are overcome through this type of project work in our curriculum. So the author is really appreciating the curriculum of United Kingdom known as one of the best curriculum in the world. The university granted an extension for the submission of this project work that helped the author to take a very good time to complete this work. The author tried the level best to avoid mistakes in this project. GROUP DYNAMIC AND LEARNING FROM IUTCOMES Group work is an essential factor in all project work. Even though it was a individual project there was a scope for the group work in the beginning. In the first stage of this project we formed a group of five self motivated and enthusiastic students.. For me as an individual it was an interesting experience. All the group mates who works together to gather material that are useful for the project work. We have a discussion section in each week end that helped as to gather all the information that we
35

collected during week days. This discussion section was very much useful in the process of the project. In that one we used to be a moderator to monitor the arguments. In the last session of the group meeting we used to conclude with the common points that we gained through the discussion. The group meeting was really so helpful in all the sense. Later stage while working in any organization those group works will really help to co operate with co workers and work toward the organizational goal. We as a diversified group did not had any international exposure because every group mates are from the same country. Apart from that everything was perfect and all group mates are co operative in nature. We passed our email id and the telephone numbers that will help us to contact each other in our future life. This project work gave me a good exposure in my last phase of study. So all group mates really enjoyed those all group work and all will remember each other in future as well. Conclusion During the process of this reflective section of dissertation, author would focus more on the work done during gathering study materials that are useful for the project work. The use of university library helped to do the project work much easier. The proper usage of university library database and university electronic library have effectively enhanced in collecting the necessary articles for the research work Although the university has provided ample of time to complete the project on time, the author took it as a challenge by racing against the time inorder to finsh the committed task. The author is satisfied in completing the project on time. Action Plan Author would prefer to choose the same methods and technique for his further research. Managing time in any profession and organisation is crucial, especially in Nursing, an individual is recognized by his or her professional commitment and attitude by keeping time.The author believes that the key to success is based on how one plans, times and act appropriately with broad outlook .

36

37