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IOSR Journal of Nursing and Health Science (IOSR-JNHS
e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 6, Issue 3 Ver. IV (Mar. - Apr. 2017), PP 13-23
www.iosrjournals.org
DOI: 10.9790/1959-0602041323 www.iosrjournals.org 13 | Page
Nurses’ Perceptions of Nursing as a Profession and Its Impact on
Their Intention to Leave Their Career: Staff
Nurses in Jeddah City
Shafeah Makdour Aljedaani1
1(Nursing Specialist, Supervisor of Nursing Research and Development in Nursing Administration in Jeddah
Province, Kingdom of Saudi Arabia)
Abstract: Nurses play a vital role in the healthcare system, providing continuous 24-hour care to hospitalized
patients. Nurses have also established themselves as an essential element of other disciplines within the
hospitals. Despite the significant role of the nursing staff, there is a shortage of nurses worldwide
.
Hospitals in
the Ministry of Health in Saudi Arabia are facing notable deficiencies in staffing. The present quantitative study
assessed Saudi nurses’ perceptions of nursing as a profession to determine the reasons that may lead to nursing
staff turnover. A questionnaire consisting of two parts was administered, with the first part eliciting
demographic information and the second asking questions related to the nurse’s perceptions, the reasons that
may lead to nursing turnover and factors to improve the retention of nurses, their point of view, and
suggestions
.
The sample comprised 350 nurses of both genders, selected randomly. The study was conducted at
three Saudi Arabian government hospitals (King Fahd Hospital, King Abdulaziz Hospital, and Althager
Hospital). The results show that most participants perceived nursing positively, as most (59.1%) felt proud to be
a nurse. However, 55.5% believed that the nursing profession would be not suitable for their children.
Additionally, 76.0% of them confirmed that they were not satisfied with their career ladder or the financial
benefits of a nursing career
.
The results of this study illustrate statistically significant variations among the
responses regarding nurses’ satisfaction with their career ladder and the financial benefits of the nursing
profession related to employment systems. This study found that nurses in autonomously operated health
facilities had a higher satisfaction related to their career ladder and the financial benefits in comparison with
the nurses on civil service system. The main recommendation is to improve the physical and psychological
aspects of nurses’ work environment.
Keywords: Perceptions, Nursing Profession, Retention, Shortage, Turnover.
I. Introduction
Nurses represent the largest proportion of workers in the healthcare sector. They provide continuous,
direct nursing care to hospitalized patients around the clock. Their main focus is the patient’s condition, and it is
generally accepted that nurses play a significant role in the hospital setting. Nevertheless, the shortage of nurses
is a global issue. Therefore, the nursing shortage is a major challenge facing the healthcare sector [1].There has
been an increase in the number of Saudi nurses working in the Ministry of Health in the Kingdom of Saudi
Arabia in both employment systems. The civil service system which the nurses are employed by ministry of
civil service and the autonomously operated health facilities which the nurses employed by the health facilities
itself and renewing their contract on annual basis. In 2015 the rate of Saudi nurses in ministry of health it was
60.14 % [2]. Yet the nursing shortage continues to be a problem.
According to the World Health Organization, healthcare sectors worldwide are facing nursing
shortages [3]. In line with this, [4] reported that Saudi Arabia loses 50% of its nursing graduates annually due to
social and professional factors. Thus, the shortage of nurses in general, and those working in hospitals in
particular, is a growing concern. In 2015, 101 nurses from hospitals in Jeddah Province requested to transfer
their services, with 84 of them wanting to move to public health centers [5].
Hospitals in Saudi Arabia are currently facing a significant problem, as they employ a considerable
number of new nurses, in place of experienced non-Saudi nurses, in order to achieve their Saudization targets
[5]. This prioritization of Saudis is the result of the second Gulf War (1990), when a large number of
experienced non-Saudi nurses left the country proving suddenly, which had disastrous consequences.
Nevertheless, achieving the Saudization of the profession is to be a long process [6]. Moreover, newly qualified
nurses are not selecting the nursing profession as a potential career path, and many experienced nurses are
leaving the field [1]. Every nurse in every setting has the opportunity to make a positive impact on the
profession by advocating daily for nurses and the nursing profession [7]. Therefore, nurses’ perceptions of their
profession have an important value in creating a clear framework for the nursing profession.
Nurses’ Perceptions of Nursing as a Profession and Its Impact on Their Intention to Leave Their Career
DOI: 10.9790/1959-0602041323 www.iosrjournals.org 14 | Page
[8] defined perception as “The ability to see, hear, or become aware of something through the senses.”
Nurses’ satisfaction with the benefits and advantages of their career, and respect and appreciation from their
employer, have a role in shaping their perceptions of the nursing profession and have a profound impact on
nurse retention and turnover. There are many factors that may affect the nurses’ perceptions of their profession
and their decision to leave the profession. Studies have shown that 39.7% of nurses left their work due to family
reasons and 37.3% for other reasons, and one of the main reasons for the current shortage of nurses is the
community’s perception of nurses [9, 10].
According to [11], when nurses perceived their public image to be poor, in addition to a lack of
professional recognition at work, their intention to leave their job tended to increase. Evidently, to enhance
nurses’ job performance and reduce their turnover intention, it is important to improve both the perception in the
community and nurses’ self-perception. The nursing profession needs to be clarified to the community in order
for the latter to understand nurses’ roles and the vital tasks that they perform.
Nurses in particular, and health workers in general, have always been under observation by patients, members of
the community, and the media, because they are involved with a most valuable factor—namely, human health.
“Although nurses comprise the majority of healthcare professionals, they are largely invisible. Their
competence, skill, knowledge, and judgment are as the word ‘image’ suggests—only a reflection, not reality”
[12]. The nursing profession does not receive appreciation or support from Saudi tribal families, as they believe
that the profession brings shame to the family and the tribe. Therefore, they direct their children to other
professions, such as medicine and education. In addition, they consider the profession unsuitable for women, as
it exposes them to interactions with men and working long hours and night shifts[13].
Accordingly, the work environment is another important reason for the nursing turnover rate. [14]
found that nurses’ intention to leave their profession increased when they lacked support in the work
environment and when the demands of the profession overlapped with their family life. Moreover, [15] stated
that nurses’ intention to leave the profession or change their career was caused by dissatisfaction with salaries
and shift work. They found it taxing to reconcile their work schedule and personal life. The work environment
comprises the psychological and physical environments, established through the interactions of the staff with the
organization [16]. A good workplace is characterized by low levels of stress and employees feeling appreciated
by management and not feeling threatened at work [17]. A study conducted in the Makkah region, which
includes the cities of Makkah, Jeddah, and Taif, uncovered that nurses who work in general hospitals were
dissatisfied with their work [18]. The importance of the relationships within the nursing team, when nurses
experience high-quality exchanges with their fellow team members. As these relationships solidify, nurses
become more satisfied with their job and feel a greater sense of belonging to the hospital, and this minimizes the
nursing staff’s intention to leave [19]. There are a number of nurses who believe that the image of the nursing
profession is affected by many factors, such as what is displayed and published about nursing in the media and
advertising, and each individual’s level of education. Nurses can also have a significant effect on the nursing
image in how they present themselves every day during daily nursing care. However, the greatest influence on
the image of nursing comes from the personal interactions between nurses, patients, and those participating in
other disciplines in the workplace, from family and relatives’ encouragement, and the presence of a family
member working in the same hospital [20, 21, 22]. The positive perceptions of nurses regarding the nursing
profession result from their job satisfaction and sense of belonging to their profession. Nurses can promote a
positive image of their profession through adopting a caring and constructive approach both in the hospital and
in the community . [21] reported that nurses play a major role in building a good image of their profession during
the daily interactions, communications, appearance, and behaviors of nurses when they perform their tasks and
provide nursing care. Nurses also represent their profession outside the work environment and in their personal
lives because, as soon as they say that they are a nurse, people perceive them differently and most likely have
specific expectations.
[23] found a significant direct relationship between nurses’ caring behaviors and patient satisfaction.
Nurses’ communication while providing care is the most important behavior in caring for hospitalized patients.
In addition, the relationship between the caring practices and patient satisfaction shows that positive nurses’
behaviors lead to the improvement of patients’ perceptions of healthcare and increased satisfaction with it. In
this study, the researcher aimed to uncover nurses’ perceptions of their profession and also identify the reasons
why nurses may choose to leave the nursing profession. The study was undertaken in the three largest general
hospitals in the Jeddah region, which have been experiencing nursing shortages and high staff turnover. Most
studies have focused on the perceptions of patients and community members regarding the nursing profession
and have paid less attention to the nurses’ own perceptions of their profession.In fact, nurses are the ones who
are best able to determine the causes of staff turnover and who can suggest appropriate retention strategies. The
objective of this study was to give nursing administrators and organizations a clear indication of how nurses
perceive their profession and the factors that may lead to these perceptions. The findings of the study have
produced recommendations for enhancing the positive view of nurses toward the profession and for determining
how to retain staff in the nursing profession.
Nurses’ Perceptions of Nursing as a Profession and Its Impact on Their Intention to Leave Their Career
DOI: 10.9790/1959-0602041323 www.iosrjournals.org 15 | Page
Research Question:
How do professional nurses in government hospitals (King Fahd Hospital, King Abdulaziz Hospital
and Althager Hospital) in the Jeddah city perceive their profession and its impact on their intention to leave the
nursing career?
Research Aim:
To assess how professional nurses in government hospitals (King Fahd Hospital, King Abdulaziz
Hospital, and Althager Hospital) in the Jeddah city perceive their profession and its impact on their intention to
leave the nursing career.
Research Objectives:
1. To assess how professional nurses perceive their profession.
2. To determine the reasons that may lead to nurses’ turnover.
3. To identify the factors that may improve the retention of nurses and thereby prevent nursing turnover.
II. Material and Methods
This paper presents a cross-sectional descriptive study using a quantitative approach. The study was
conducted in three Saudi Arabian government hospitals under the Ministry of Health in the city of Jeddah. The
Jeddah city was chosen because the researcher works in nursing administration, which is responsible for the
nurses who work in these hospitals. The target of the study was Saudi nurses working in King Fahd Hospital,
King Abdulaziz Hospital, and Althager Hospital. These specific hospitals were selected because they are the
largest general hospitals in Jeddah, with each reporting frequent nurse turnover and staff expressing the
intention to leave the job after complaining of a shortage of nurses for many years.
Research Methodology
The research methodology is a broader concept than the research method. The research methodology
entails the discussion of how the survey will be carried out through determining the population and sample of
the study, the methods used in the administration of the survey, and the suitable statistical techniques and
models used to analyze the collected data. As stated by [24], the research methodology is a way to
systematically solve the research problem; it may also be understood as a science of studying how research is
done scientifically and the logic behind it.
As [25] argued, the research methodology is intended to describe how to translate the research
perspective on the way of studying the world. The research methodology may be implemented through several
different research designs, such as the plan for conducting the study, through translating the research
methodology into specific research methods and the techniques used to collect and analyze the data [25]. Hence,
this study involved the use of a descriptive method in the presentation of information that has been collected
through a primary data source.
Research Methods
As [24] described, research methods may be understood as all those methods or techniques that are used to
conduct research. The research methods have been classified into three groups: [25]
1. The first group includes methods that are concerned with data collection. These methods are used when the
data are insufficient to arrive at a conclusion.
2. The second group consists of those statistical techniques that are used for establishing relationships between
the data and the unknowns.
3. The third group consists of those methods that are used to evaluate the accuracy of the results obtained.
The last two groups are generally regarded as the analytical tools of research.
Based on the above, the researcher constructed a questionnaire as an instrument to collect quantitative data in
order to answer the research question. The designed questionnaire method consisted of information regarding
the selected sample of the study, known as demographic factors, and the other components of the questionnaire
that were aimed at measuring nurses’ perceptions regarding the nursing profession.
Sampling
The sample size was 350 nurses of both genders (99 male, 251 female), selected randomly. The sample
only included Saudi nurses because there is a shortage of Saudi nurses in the hospitals. Besides the frequent
turnover of nursing staff, Saudi Arabia seeks to “Saudize” the nursing profession, as the practice of contracting
non-Saudi nurses to cover this shortage in nursing is common. For this reason, non- Saudi nurses were excluded
from this study. The Sample Size Calculator Program was used to distribute the samples among the intended
hospitals [26].
Nurses’ Perceptions of Nursing as a Profession and Its Impact on Their Intention to Leave Their Career
DOI: 10.9790/1959-0602041323 www.iosrjournals.org 16 | Page
Setting This study was conducted at the three largest general hospitals in Jeddah city This study was carried
out during the 2016: King Fahd Hospital, King Abdulaziz Hospital, and Althager Hospital. Accordingly,
subjects were recruited from these hospitals to participate in the study. King Fahd Hospital, the oldest and
largest hospital of the three, is located in the northern part of Jeddah city and has a capacity of 727 beds and
1500 staff nurses. King Abdulaziz Hospital, the second largest hospital, is located in the southern part of Jeddah
city and has a capacity of 576 beds and 919 staff nurses. Lastly, Althager Hospital is located in the far southern
region of Jeddah city and has a capacity of 150 beds and 230 staff nurses.
Measures/Instruments
Using the findings from the literature review, the researcher developed the questionnaire. It comprised
three parts: Part I contained sociodemographic data, including gender, age, marital status, and level of
education; Part II focused on the perceptions of nurses regarding the nursing profession; and Part III included
nurses’ perceptions regarding other issues related to the nursing profession. A focus group was used to establish
tool validity. The pilot study involving 22 nurses was undertaken to evaluate the questionnaire and to report the
nurses’ comments and any difficulties they may have had with the questionnaire. The questionnaire was
modified according to their answers and distributed in its final form among a large random sample.
Statistical Techniques for the Data Analysis
The data collected were entered and processed using the Statistical Package for Social Sciences (SPSS)
version 20. Descriptive and inferential statistical techniques have been used to analyze the collected data. These
techniques include frequencies, percentages, mean average, standard deviations, in addition to T-Test and
ANOVA.
Ethical Considerations
Research ethics approval was obtained from the research ethics committee of the Directorate of Health Affairs
in Jeddah Province. In addition, approval was obtained from the hospitals where the research was carried out.
˗ Fully informed participants freely consented to participate in the research.
˗ All the processes of this research were carried out within the ethical and legal frameworks.
III. Data Analysis
Data were collected through a questionnaire administered to a sample of nurses selected randomly from
the three hospitals.
The detailed data analysis was conducted as follows:
1) Demographic characteristics of the sample
2) Nurses’ perceptions of the nursing profession
3) Comparisons between nurses’ perceptions to measure significant variations attributed to gender, marital
status, education level, graduation, and years of experience
Analysis of demographic characteristics
Figure 1.Sample distribution according to the hospital
32.9%
36.9%
30.2%
0.0%
10.0%
20.0%
30.0%
40.0%
Al-thager hospitalKing Fahd
Hospital
King Abdulaziz
hospital
The statistics in the above figure show participants distribution according to hospital; it can be seen that the
participants were quite evenly distributed between the three hospitals.
Nurses’ Perceptions of Nursing as a Profession and Its Impact on Their Intention to Leave Their Career
DOI: 10.9790/1959-0602041323 www.iosrjournals.org 17 | Page
Figure (2) the sample subject of the study distribution according to gender
71.7%
28.3%
0.0%
20.0%
40.0%
60.0%
80.0%
MaleFemale
From the above figure, it is clear that female nurses comprised the majority of the participants with 71.7%, with
male nurses representing only 28.3%.
Figure (3) Sample distribution according to age classes
From the statistics in the above figure, indicate that the majority of sample were in the younger age.
Figure (4) the nurses sample distribution according to marital status
The above figure illustrates that the married and never married nurses represented the majority of participants in
the study, which indicted different views might be reflected in the study due to differences in personal life
experiences regarding the nursing profession.
Figure (5) the nurses sample of the study distribution according to employment systems
The statistics in the above figure showed the participants distribution according to employment systems and it is
clearly indicated that the majority are employed in the civil service (65.7%), whereas those employed on
operational programs represented about 34.3%.
Nurses’ Perceptions of Nursing as a Profession and Its Impact on Their Intention to Leave Their Career
DOI: 10.9790/1959-0602041323 www.iosrjournals.org 18 | Page
Figure (6) the nurses sample distribution according to educational level
Figure (6) shows that holders of nursing diplomas represent the majority of participants in the study with 83.5%
percent of the total sample.
Figure (7) the nurses sample of the study distribution according to graduation
The statistics in figure (7) above show the participant's distribution according to graduation institutions,
and it can be seen that the majority graduated from government institutions, with 63.1%, whereas those
graduated from private institutions represented about 36.9%.
Figure (8) the nurses sample of the study distribution according to years of experience
From the statistics in figure (8) it is evident that the majority of the sample have working experience between
(1-5) years.
Nurses’ Perceptions of Nursing as a Profession and Its Impact on Their Intention to Leave Their Career
DOI: 10.9790/1959-0602041323 www.iosrjournals.org 19 | Page
Table 1. Perceptions of the nursing profession
The statistics in the above table show the nurses’ perceptions of the nursing profession. In general, it
can be seen that nurses’ perceptions of the nursing profession tend to vary with the mean value reaching 3.38,
with a standard deviation of 0.42. The elements that the participants perceived with a high and positive rating
included the following: nursing is a humanitarian profession, is an indispensable profession in any society, is an
admirable job, and plays an important role in patient care. In addition, they perceived the nursing profession as
helpful in providing effective education and promoting health.
Furthermore, nurses had negative perceptions of various elements of their profession, such as nurses
following doctors’ orders without questioning them, the suitability of the nursing profession for their children,
that the nursing profession is equal to other professions, that nursing does not have eligibility criteria (i.e.,
anyone can be a nurse), satisfaction with the career ladder and financial benefits of nursing, and nurses devoting
most of their time to non-nursing care. In particular, they were never satisfied with the career ladder and
financial benefits of nursing.
Perceptions of other issues related to the nursing profession
Table 2. Perceptions of nurses’ feelings about their profession
Variables
Frequency
Percentage
Proud
207
59.1
Shy
24
6.9
Frustrated
39
11.1
Happy
41
11.8
Satisfied
39
11.1
Total
350
100.0
As Table 2 indicates, when the participants were asked to express their feelings about being nurses, 59.1% felt
proud, 11.8% felt happy, 11.1% expressed frustration about nursing, 11.1% considered themselves satisfied, and
only 6.9% felt shy. Table3. Perceptions regarding intention to leave the nursing profession
Items
Sample responses in percentages (n =
350)
Average mean
Level of response
Strongly
agree
Agree
Don't know
Disagree
Strongly
disagree
Humanitarian profession
79.2
17.4
2.3
1.1
0.0
4.75
SA
Indispensable profession
72.9
21.7
2.9
2.3
0.3
4.65
SA
Admirable job
62.9
29.4
3.4
2.9
1.4
4.49
SA
Plays an important role in patient care
59.3
31.2
6.6
2.6
0.3
4.47
SA
Contributes to effective health education
57.1
33.2
5.7
1.7
2.3
4.41
SA
Supporting self-realization
37.4
28.9
22.3
5.4
6.0
3.86
SA
Predominantly female profession
33.7
27.7
7.7
20.0
10.9
3.53
SA
Caring profession in which ethical standards
of care are maintained
38.9
43.7
7.4
4.9
5.1
4.06
Agree
Hard profession that does not receive enough
appreciation
38.0
39.4
9.1
8.9
4.6
3.97
Agree
Opportunity to get personal growth
27.4
41.4
10.9
9.4
10.9
3.65
Agree
Receives recognition from the community
22.3
35.1
12.0
20.3
10.3
3.39
Agree
Allows nurses to make positive changes
16.9
22.6
20.0
23.7
16.9
2.99
Disagree
Nurses make decisions about nursing care
16.9
22.6
16.0
29.1
15.4
2.96
Disagree
Nurses follow doctors’ orders without question
10.0
15.1
14.0
39.1
21.7
2.53
Disagree
Does not require eligibility criteria
6.0
13.4
14.6
41.1
24.9
2.35
Disagree
Equal to other disciplines
11.1
16.6
8.9
28.9
34.5
2.41
Strongly
disagree
Nurses spend most of their time in non-nursing
care
5.4
8.9
10.3
22.0
53.4
1.91
Strongly
disagree
I am satisfied with the career ladder and
financial benefits of nursing
5.7
13.7
4.6
27.7
48.3
2.01
Strongly
disagree
I think nursing would be a great profession for
my children
12.3
15.4
16.9
16.6
38.9
2.46
Strongly
disagree
Similar to the servants’ job
16.6
22.9
12.6
18.0
30.0
2.78
Strongly
disagree
The grand mean
3.38
Responses
Frequency
Percentage
Yes
212
60.6
No
138
39.4
Total
350
100.0
Nurses’ Perceptions of Nursing as a Profession and Its Impact on Their Intention to Leave Their Career
DOI: 10.9790/1959-0602041323 www.iosrjournals.org 20 | Page
The results in Table 3 clearly indicate that 60.6% of nurses intend to leave the nursing profession, suggesting
that there are serious influential factors underpinning this trend. Therefore, recognizing these factors is critical
for the Ministry of Health, as there is already a continuous shortage of nursing staff in the government hospitals.
Table 4. Perceptions regarding where nurses would like to be transferred
Responses
Frequency
Percentage
Another hospital
42
12.0
Public health center
98
28.0
Outside the ministry of health
72
20.6
Total
212
60. 6
From the results in Table 4, it can be seen that 28% of the nurses would transfer to a public health center,
whereas 20.6% would transfer completely outside the Ministry of Health, and 12% would transfer to another
hospital. Table 5. Perceptions regarding the reasons why they intend to leave the profession
The results in Table 5 above show the most important reasons causing nurses to leave the nursing profession,
and it is evident that the work environment is the most important one, with 24.5% confirming this, followed by
the low salary and allowances, with 22.2%. The third reason is rewards and incentives, with 17.5%. This is
followed by the nurses’ practical development, with 16.0% and the public perception of the nursing profession,
at 11.3%, and lastly, relationship with other disciplines, at 8.5%.
Table 6. Perceptions of the factors that can prevent nursing staff turnover
The results in Table 6 above show that the most important factors for retaining nurses, in order, are the work
environment (40.9%), increase in salary and allowances (19.1%), rewards and incentives (15.7%), practical
development (14.0%), public perceptions of the nursing profession (5.4%), and the relationship with other
disciplines (4.9%).
Testing significant differences
Table (7) shows the results of T-Test statistics to measure the variations between nurses satisfaction with career
ladder and financial benefits of nursing profession related to employment systems.
Employment systems
N
Mean average
Stdv.
Df
T-Test
P-value.
Civil service
230
1.87
1.20
348
-2.79
0.006
Autonomously operated health facilities,
120
2.27
1.35
The tabulated T-test value is calculated at the significant level (0.05) and is equal to (1.645).
From the above table, the study found that there are significant variations in nurses’ levels of satisfaction with
their career ladder and the financial benefits of the nursing profession related to employment systems. we
noticed that, the value of T-test statistics is equal to (-2.79) which is statistically significant as the P-value is less
than (0.01). It is obvious that the variations are owing to the nurses employed in autonomously operated health
facilities, which indicates that those nurses feel more satisfied than those employed in the civil service system.
The results do not show any statistically significant differences between sample responses regarding satisfaction
with the career ladder and financial benefits of the nursing profession related to gender, age classification,
educational level, marital status, or years of experience. In addition, there are no statistically significant
variations between male and female nurses regarding their perceptions in relation to nursing being a respectable
profession, suggesting that the gender difference should not be regarded as causing any variations between
nurses.
Reasons
Frequency
Percentage
Work environment
52
24.5
Low salary and allowances
47
22.2
Rewards and incentives
37
17.5
Practical development
34
16.0
Public perceptions of the nursing profession
24
11.3
relationship with other disciplines
18
8.5
Total
212
100.0
Factors
Frequency
Percentage
Work environment
143
40.9
Increase salary and allowances
67
19.1
Rewards and incentives
55
15.7
Practical development
49
14.0
Public perceptions of the nursing profession
19
5.4
Relationship with other disciplines
17
4.9
Total
350
100.0
Nurses’ Perceptions of Nursing as a Profession and Its Impact on Their Intention to Leave Their Career
DOI: 10.9790/1959-0602041323 www.iosrjournals.org 21 | Page
Table 8. Suggestions regarding improving nurses’ perceptions of nursing as a profession
(Open ended question)
IV. Discussion
The main purpose of this research was to evaluate how professional nurses perceive their profession in
the three largest government hospitals in Jeddah province, and to investigate the reasons why nurses leave the
profession. Most of the participants in this study (38.3%) were in the youngest age group of 26–30 years,
indicating that the nursing staff working in the government hospitals could contribute effectively to the
improvement of the services introduced to patients, if they were fully trained and qualified, and being respected
both inside and outside the hospital.
The results of this study reveal that the majority of the sample perceived nursing positively. Indeed,
96.6% of participants viewed the nursing profession as a humanitarian career based on a set of core values and
principles, 94.6% considered it an indispensable and essential career, 92.3% stated that the community considers
it to be a respectable and admirable career, 90.5% believed it to be important for providing care to the patients,
and 90.3 % thought it had a key role in improving health through health education. These results are consistent
with the findings of [27] that 99.1% of the sample perceived the nursing profession positively and as giving
them a chance to serve humanity. In addition, [27] found 69.6% of the participants considered the nursing
profession as a source of attaining recognition within the community, while another 69.4% perceived nursing as
a dignified and respectful profession. [28] obtained a similar result—namely, that 56% of nurses had a positive
perception of nursing.
The sample in this study believed that nurses take advantage of their time in delivering nursing care,
and they declared that the nursing profession is not an easy profession, and thus should require the fulfillment of
certain criteria. Most participants (59.1%) felt pleased and proud when they were talking about the nursing
profession. This finding is similar to that of [29] that 80.9% of participants expressed pride when talking to
others about their career. Although the nurses in this study perceived the nursing profession positively and
discussed it proudly, 76.0% confirmed that they were not satisfied with the career ladder and financial benefits
of the career. Therefore, there are statistically significant variations in the sample’s responses regarding their
satisfaction with their career ladder and financial benefits of the profession related to employment status. The
researcher could attribute the variations to the nurses employed in an autonomously operated health facilities, as
the career ladder in the operational program rises higher than that in the civil service. In addition, the nurses in
this study connected the desire to leave their work to the low salaries and lack of incentives. These results
correspond to those of [22], where 77.6% of the sample believed that nursing was not a profession with high
financial rewards. This result confirmed by [18], who found that in general, nurses were dissatisfied with the
nursing work.
Suggestions of Nurses
Frequency
Percent
1
Improvement of working conditions Improving the career ladder, increasing salaries, incentives, and morale for nurses, and
providing special allowances, such as infection, scarcity allowances, and transportation
allowances
89
24
2
Reducing the work hours to six hours; implementing four or six shifts in the day
45
12%
3
Providing daycare for nurses’ children
26
7.1%
4
Giving nursing staff the rights and advantages that contribute to the improvement of job
performance and job ethics, as nursing is a humanitarian profession
25
6.9%
5
Increasing the number of nurses to decrease work pressure and load
24
6.6%
6
Respect for the nursing profession and dealing with nurses as human beings (especially on
the part of physicians)
24
6.3%
7
Replacing the current nursing administration with one that is responsible; applying justice
to improve nursing management
23
6.3%
8
Increase the society and cultural recognition of the importance of the nursing profession
20
5.4%
9
Give educational opportunities for nurses to complete their university education and
higher studies
18
4.9%
10
Equalization of nursing staff with staff in other professions
17
4.6%
11
Nurses should contribute to change by showcasing their abilities and imposing respect for
the profession on the society, patients and medical staff.
15
4.0%
12
Caring for the families of nursing staff
14
3.7%
13
Allow the nurses their right to child care or increase the days of rest from six days a
month
11
2.9%
14
Punishment for irresponsible staff and appreciation for active staff
9
2.3%
15
Workshops to improve nurses’ performance.
8
2.0%
Nurses’ Perceptions of Nursing as a Profession and Its Impact on Their Intention to Leave Their Career
DOI: 10.9790/1959-0602041323 www.iosrjournals.org 22 | Page
Furthermore, the participants in the present study indicated that a nursing career was not appropriate
for their children. This indicates that they were not sufficiently satisfied with the profession to believe that their
children should pursue nursing career. A South African study found a similar result, where just 43.6% of the
participants wanted their children to become nurses, with the remainder of the sample disagreeing [10[. In
addition, [10[ reported that nursing is still viewed as a female oriented profession, which is consistent with the
present study, where 61.4% of the sample saw a nursing career as a feminine profession. Although most of the
participants in the study perceived the nursing profession positively, the results reveal that 60.6% of the nurses
intend to leave the nursing profession, whereas 39.4% intend to remain in the profession, 28% plan to transfer
their services to public health centers, 20.6% intend to transfer outside the Ministry of Health, and 12.0% intend
to transfer to another hospital.
The finding of this study do not align with those of a similar study conducted by [27], who stated that
the majority of the nurses showed no interest in changing their profession. Similar findings were reported by
[22], who found that 80% of nurses had a positive image of the profession and had not thought about leaving
their job, and only 29.4% held a negative view and expressed the intention to leave the job. According to the
results of this study, the working environment was the most important reason for leaving the nursing profession
and also the most important factor in retaining nurses. These results are in agreement with the conclusion
reached by [30 [ in her research on the “Effects of Work Environments on Nursing and Patient Outcomes,”
which showed that a work environment characterized by structural and psychological empowerment factors may
enhance the quality of patient care, reduce patient risk, and increase nurses’ job satisfaction. [31[ found a
relationship between work environment and nurses’ stress and burnout.
However, regarding those who want to leave the nursing profession, the results may indicate that the
nurses in the sample were not satisfied with the working conditions of the nursing career, rather than the nursing
practice itself. In their investigation into the link between the shortage of Saudi nurses and socio-cultural factor
within Saudi literature [32 [ found that these factors influenced the prevailing negative images and perceived low
status of nursing. [32 [ also, shows that the community’s perceptions, family disagreements, cultural and
communal values, long working hours, mixing with members of the opposite gender, and worries about not
being “marriageable” are the main reasons why Saudis do not choose nursing as a career. Hospitals face a
significant challenge in their ability to find and keep highly qualified and experienced nurses; therefore, each
hospital should prepare a retention plan to prevent or reduce the turnover rate of their nurses, taking into account
the provision of a suitable work environment for the staff.
IV. Conclusion
In conclusion, this research was conducted essentially to study professional nurses’ perceptions of the
nursing profession in the three largest government hospitals in Jeddah province. The main objective of this study
was to assess the reasons why nurses would leave the nursing profession and determine the factors that can help
to retain them. The study followed a quantitative approach, using a survey method. The sample consisted of 350
nurses. Most participants perceived nursing positively, with 59.1% feeling proud to be part of the nursing
profession. However, 76.0% confirmed that they were not satisfied with the career ladder or with the financial
benefits of nursing. Moreover, 55.5% believed that the nursing profession would not be suitable for their
children. The participants in this study reported that the work environment was the most important reason
behind nurses’ decision to leave the profession and therefore in retaining them.
V. Recommendations
The researcher recommends the following:
1. Improve the working conditions by focusing on improving the psychological and physical environment.
2. Provide emotional support to nurses by enhancing the community’s perceptions of the importance of the
nursing profession, because if this changes, nurses will encourage their children to pursue a career in the
same field and remain in the field, thus increasing the number of nurses and reducing the workload .
3. To retain nurses, it is necessary to improve their perceptions of their profession and ensure that others
respect the nursing profession and deal with nurses as human beings. Moreover, nursing staff should be
given rights and advantages that contribute to the development of their job performance and enable them to
make changes on their own.
4. It is essential to develop strategies to improve the leadership in nursing. It is very important for new nurses
to have the opportunity to progress into leadership and management positions after undergoing training and
preparation.
5. Nurses should have the opportunity to continue their studies to attain bachelor’s, master’s, and doctoral
degrees in nursing, and nursing education and training should be developed according to the needs of the
nurses.
Nurses’ Perceptions of Nursing as a Profession and Its Impact on Their Intention to Leave Their Career
DOI: 10.9790/1959-0602041323 www.iosrjournals.org 23 | Page
6. Create incentive programs for nurses who are working in hospitals to increase their loyalty to the nursing
profession and prevent staff turnover. In addition, hospitals should take disciplinary action against
irresponsible staff members and show more appreciation for the deserving ones.
7. Improve the financial benefits of the nursing career by developing the career ladder for nurses and
providing allowances for nurses working in critical care departments. In addition, provide general
allowances for all nurses working in hospitals, such as an accommodation allowance, infection control
allowance, shifts allowance, and an increased transportation allowance.
Acknowledgement
I would like to thank Mrs. Eman Saeed Badokhon Director of Nursing Administration in Jeddah
Provence for her unstinting support. My genuine appreciation for nursing administration and nursing staff in
King Fahd Hospital, King Abdulaziz Hospital and Althager Hospital for their participation in distribution,
completion and collection of questionnaires. Finally, my special appreciation to my family, my husband and my
children for their help and encouragement. References
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