AN ANALYSIS OF JOB SATISFACTION OF NURSES IN HANDLING COVID-19

PATIENTS IN THE COVID-19 ISOLATION ROOMS, INDONESIA

ABSTRACT
Objective: To describe the job satisfaction of nurses in handling Covid-19 patients in
the Covid-19 Isolation Rooms, Menur Mental Hospital, East Java Province.
Methods: This research is a descriptive study with a cross-sectional design. The
samples in the study were 78 nurses in the Covid-19 isolation rooms at Menur
Mental Hospital. Samples were taken by total sampling. Research variables include
demographics and nurse satisfaction in handling Covid-19 patients. The data
collection used was the Minnesota Satisfaction Questionnaire (MSQ). The study was
conducted in April 2021.
Results: Male nurses are more satisfied than female nurses. The percentage of
nurses who said they were satisfied is mostly those who are over 40 years old, which
is 23.1%. Nurses with bachelor’s degrees express more satisfaction than nurses with
diploma course III level. The volunteer nurses express the most satisfaction
compared to nurses whose status as contract employees and civil servants, namely
25%. Nurses who have worked more than 12 years express the most satisfaction,
namely 19.0%. The number of unmarried nurses who stated that they were most
satisfied is 13.3%.
Conclusion: Most of the nurses in the COVID-19 isolation rooms have moderate job
satisfaction.
Keywords: Job Satisfaction of Nurses, Covid-19

INTRODUCTION
The current Covid-19 pandemic is a global health disaster. Coronavirus
Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute
Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). SARS-CoV-2 is a new type of
coronavirus that has never been previously identified in humans. At least two types
of coronavirus are known to cause diseases that can cause severe symptoms such
as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory
Syndrome (SARS) 1.
Indonesia reported its first case of COVID-19 on March 2, 2020, and the
number continues to grow until now. As of January 2, 2021, the Ministry of Health
reported 758,473 cases of confirmed positive COVID-19 patients with 22,555 cases
of death (CFR 2.97%) spread across 34 provinces 2. Efforts made by the
government in the context of preventing and controlling the spread of Covid-19 are
by setting up several special Covid-19 referral hospitals.
The government has designated 835 hospitals as referrals for handling
COVID-19, with details of 132 national referral hospitals designated by the Ministry
of Health and 703 Provincial/District/City referral hospitals designated by Governor 3.
One of the hospitals designated for Covid-19 referrals is the Menur Mental Hospital
in East Java Province. Menur Mental Hospital in addition to treating patients with
mental disorders/ mental illness also provides a Covid-19 isolation room.
The changes in circumstances that occur rapidly during the Covid-19
pandemic require medical personnel, especially nurses, to be ready to be on the
front line. Nurses are a vital profession in care during the Covid-19 pandemic.
Nurses carry out their duties directly caring for patients who are confirmed positive
for Covid-19 at a close distance and have a high risk of contracting it 4. In addition to
their duties as professional nurses during the pandemic, many nurses are worried
that they will contract the SARS-Cov2 virus and transmit it to their family members.
This can affect job satisfaction of nurses in hospitals in handling Covid-19 5.
Job satisfaction is an evaluation that describes a person's satisfaction or
dissatisfaction with the work he/she does. Job satisfaction is individual. The higher
the assessment of the work that is felt following the wishes of the individual, the
higher the satisfaction with the job 6. Some indicators that can affect a person's job
satisfaction include the type of work itself, the level of wages or salaries, promotions,
supervision from superiors, and communication with colleagues 7. According to
Xiaoyan et al (2020) research, the average job satisfaction score of participants is
82.58 ± 11.11. In the study, the job satisfaction of frontline medical staff was at a
relatively decent level 8. This study aims to describe the job satisfaction of nurses in
handling Covid-19 patients in the Covid-19 Isolation Rooms at the Menur Mental
Hospital, East Java Province.
MATERIAL AND METHODS
The study was conducted at the Menur Mental Hospital in Surabaya which
was held in April 2021. This research is a quantitative study. The type of this
research is descriptive research. The research design used was cross-sectional.The
population of this study was nurses who work in the Covid-19 isolation room s at the
Menur Mental Hospital. The samples used were 78 nurses who work in the Covid-19
isolation rooms at the Menur Mental Hospital. Samples were taken by total sampling.
Research variables included demographic characteristics and job satisfaction
of nurses. The demographic variables of nurses include age, gender, education
level, length of service, employment status, and marital status. The job satisfaction
questionnaire used was the customized Minnesota Satisfaction Questionnaire
(MSQ). The questionnaire has been tested for validity and reliability with the validity
test value of each question item > 0.329 and Cronbach's Alpha value = 0.848. The
questionnaire consists of 10 aspects of satisfaction. These aspects include the
amount of salary/ wages, job promotion, workload, working conditions, job security,
relationship with colleagues, hospital policy, support from superiors, superiors’
competence in making decisions, and satisfaction feeling in completing work. The
satisfaction score refers to a Likert scale of 1-5. Score 1 “Very Unsatisfied”, 2
“Unsatisfied”, 3 “Neutral”, 4 “Satisfied” and 5 “Very Satisfied”. Respondents filled out
the questionnaire in the Google form.
The data were presented descriptively by making a frequency distribution
table. The satisfaction data for each aspect was presented into three categories,
namely "not satisfied" if the score is less than 2, "neutral" if the score is 3, and
"satisfied" if the score is more than 4. Total job satisfaction was described according
to the research of Xiaoyan et al (2020) 8. Job satisfaction was categorized into three
categories, namely: a score of 10 - 30 "Not satisfied", a score of 31 - 40 "Moderate",
and a score of 41-50 "Satisfied".
 The study has received approval from the Health Research Ethics Committee
(KEPK) Menur Mental Hospital Surabaya; East Java Province with number
070/1350/305/2021 dated March 15, 2021.
RESULTS
Menur Mental Hospital is a special hospital with Class A classification. Menur
Mental Hospital is one of the Covid-19 referral hospitals based on the Decree of East
Java Governor No.188/138/KPTS/013/2020 regarding the determination of the
Coronavirus Disease 2019 referral hospital (COVID-19).
Demographic Characteristics of Nurses in Covid-19 Isolation Rooms at Menur
Hospital Surabaya
The characteristics of nurses in the Covid-19 isolation rooms at the Menur
Hospital in Surabaya are described based on demographics. The characteristics of
nurses are shown in table 1. Demographic characteristics include gender, age,
marital status, education level, employment status, and length of service.
Table.1 Demographic Characteristic of Nurses in the Covid-19 Isolation Rooms at
Menur Mental Hospital Surabaya (n=78)
Variables N %
Gender
Male 55 70.5
Female 23 29.5
Age (years)
<30 28 35.9
30-40 37 47.4
>40 12 16.7
Marital Status
Unmarried 15 19.2
Married 61 78.2
Others 2 2.6
Education Level
D3 Nursing 51 65.4
Nursing Bachelor’s Degree 27 34.6
Employment status
Contract Employee 33 42.3
Civil servant 33 42.3
Volunteer 12 15.4
Length of Service (years)
<6 34 43.6
6 – 12 23 29.5
> 12 21 26.9
Source: Primary Data
Based on Table 1, it can be seen that the demographic characteristics of
nurses in the Covid-19 isolation rooms at the Menur Mental Hospital Surabaya are
mostly male nurses, namely 70.5%, aged between 30 - 40 years, namely 47.4%, and
married, namely 78.2%. The placement of nurses in the Covid-19 isolation room s at
the Menur Mental Hospital in Surabaya was following the Decree of the Director of
the Menur Mental Hospital No. 188.4/2377/305/2020 dated April 9, 2020, regarding
the Covid-19 patient service team at the Menur Mental Hospital Surabaya 9.
Nurse Satisfaction during the COVID-19 Pandemic
Job satisfaction of nurses consists of 10 variables, namely the amount of
salary, job promotion, workload, working conditions, job security, relationship with
colleagues, hospital policy, support from superior, superiors’ competence in making
decisions, and satisfaction feelings in completing work. Job satisfaction of nurses
during the COVID-19 pandemic is shown in Tables 2 and 3.
Table 2. Nurses Satisfaction by Aspect in the Covid-19 Isolation Rooms of the Menur
Mental Hospital, East Java Province during the Covid-19 Pandemic (n=78).
Aspects Satisfaction Level
Not Satisfied Moderate Satisfied Total
N % N % N % N %
Salary 4 5,1 32 41,1 42 53,8 78 100
Job promotion 11 14,1 40 51,3 27 34,6 78 100
Workload 17 21,8 38 48,7 23 29,5 78 100
Working conditions 17 21,8 36 46,2 25 32,0 78 100
Job security 19 24,4 31 39,7 28 35,9 78 100
Relationship with 4 5,1 25 32,1 49 62,8 78 100
colleagues
Hospital policy 22 28,2 31 39,7 25 32,1 78 100
Support from superiors 7 9,0 34 43,6 37 47,4 78 100
Superiors’ competence 9 11,6 38 48,7 31 39,7 78 100
in making decisions
Satisfaction feeling in 3 3,8 26 33,4 49 62,8 78 100
completing work
Source: Primary Data
Table 3. Nurses Satisfaction with All Aspects in the Covid-19 Isolation Rooms at
Menur Mental Hospital (n=78)
Satisfaction Level N %
Not satisfied 25 32,1
Moderate 45 57,7
Satisfied 8 10,2
Total 78 100
Source: Primary Data
Table 2 shows that during the COVID-19 pandemic, most of the nurses
namely 53.8% are satisfied with the salaries they received. Based on the Decree of
the Ministry of Health of the Republic of Indonesia Number
Hk.01.07/Menkes/278/2020 concerning the Provision of Incentives and Death
Compensation for Health Workers Handling Coronavirus Disease 2019 (Covid-19),
including nursing personnel at the Menur Mental Hospital in Surabaya 10. Based on
the decree of the Ministry of Health, financially, the nurse's income from the salary
received has increased. Research by Shar and Novrianda (2017) and Setiawan
(2018) found that the level of salary will affect self-esteem and will ultimately affect
employee satisfaction and performance 11,12. Similarly, research at the Mental
Hospital in Sulaimani, found that low salaries and salary delays are the main factors
in decreasing job satisfaction 13 .
Table 2 shows that the majority, namely 51.3% of nurses feel neutral
satisfaction with the job promotion. This is in accordance with the results of Yuanita's
research (2018) on job satisfaction of inpatient nurses at Tgk Hospital, Chik Ditiro
Sigli. Satisfaction is not only influenced by the amount of salary, but also influenced
by supervision, working conditions, career development, awards, and workgroups 14 .
Table 2 shows that most of the nurses, namely 48.7%, feel neutral with their
workload. In the aspect of working conditions, 46.2% of nurses feel that their
satisfaction is neutral. Furthermore, 39.7% of nurses feel satisfied with security
during regular work. Research at the UPT of the Pesawaran Regency Inpatient
Health Center found that there is a decrease in workload satisfaction during covid-19
which is related to the application of patient safety during the covid-19 pandemic 15.
Based on the research of Savitsky et al (2021), it was found that nurses who care for
patients who are positive for Covid-19 have much lower job satisfaction than others.
Most nurses have to increase their workload as a result of the shortage of nurses.
This results in a lower level of job satisfaction 16. Quality in service including
satisfaction in carrying out the work of nurses and doctors will have an impact on
service quality. This will provide patient and family satisfaction which in turn
improves the image of the hospital 17. The procedure for handling COVID-19 patients
at the Menur Mental Hospital, East Java Province, is following the standards. This
procedure is regulated in the decree of the Director of the Menur Mental Hospital of
East Java Province Number 188.4/2213/305/2020 dated April 20, 2020, regarding
guidelines for medical clinical practice at the Menur Mental Hospital, East Java
Province 18.
Based on Table 2, it can be seen that in the aspect of relationship with
colleagues, most of the nurses are satisfied, namely 62.8%. The COVID-19
pandemic has prompted a new policy in the non-physical work environment, namely
the relationship among colleagues is more limited by the necessity to keep a
distance, and there are more work standards and procedures related to the
implementation of the covid-19 prevention protocol. This new policy does not have a
negative impact on relationship satisfaction with colleagues for nurses in the covid-
19 isolation rooms. Nurses are aware of the importance of this policy for the common
good 19.
Based on Table 2, it can be seen that most of the nurses namely 39.7% are
neutral with the hospital policy aspect. 48.7% of nurses are satisfied with the
competence of their superiors in making ordinary decisions. Organizational policies
such as hospital policies in creating a conducive working environment for nurses can
support the feelings of pleasure and satisfaction for employees at work. In certain
situations, unfavorable working conditions can lead to conflict among nurses which
causes dissatisfaction at work. Ideally, working conditions that can accommodate all
interests as part of the organizational policy will improve nurse performance 20.
Based on Table 2, it can be seen that most of the nurses, namely 47.4%, said
they were satisfied with the aspect of support from their superiors. This is in line with
the research by Sirajuddin and Permana (2017) which found that social support
including superiors’ support has a significant positive contribution to job satisfaction
of nurses 21. According to Pohl and Galletta (2017), superior support is important and
has an impact on the affective reactions of team members and employee
satisfaction. The results of the study effectively show that evaluation of superiors’
support is an important determinant of job satisfaction of nurses 22.
Based on Table 2, it can be seen that most of the nurses namely 62.8% are
satisfied with the completion of their work. Efforts to achieve satisfaction at work are
very important for individuals. Doing fun work results in feelings of satisfaction at
work. Feeling satisfied in work brings happiness and health. Employee job
satisfaction in the institution is related to positive work behavior, resulting in
increased productivity, controlling turnover, and good performance 23. Issues of
management justice are also not uncommon to color the journey of the organization
that causes conflict, causing employee dissatisfaction at work 24. Based on the
theoretical and empirical literature on job satisfaction, both the Expectation Theory
and Equity Theory approaches can be influenced by the understanding of working in
the transactional (Transactional Theory) and relational (Social Exchange Theory)
approaches as well as the quality of life of workers 25, work is not only a return of
income, namely a pleasant, good, and meaningful work atmosphere 26,27.
Based on Table 3, it can be seen that most of the nurses, namely 57.7% who
feel satisfied in the COVID-19 isolation rooms, are in the moderate category. During
this COVID-19 period, nurses feel that their security and safety needs are disrupted
which resulted in stress. Based on the results of the study, it is found that the stress
of the nurses working in the COVID-19 isolation rooms. Signs of stress include
anxiety, nervousness, frequent crying, indigestion, the difficulty of sleeping, and lack
of appetite. Nurses, as health workers, have a high risk of transmission. This
requires psychological support in carrying out their duties, including support among
fellow health teams and families in providing services to Covid-19 patients 28,29.
DISCUSSION
The Relationship between Demographic Characteristics and Job Satisfaction
of Nurses during the COVID-19 Pandemic
The factors that can affect job satisfaction can be divided into two groups;
namely intrinsic factors and extrinsic factors. According to Mangkunegara (2016),
intrinsic factors are factors within workers which include: intelligence (IQ), age,
gender, education, length of service, emotions, and perceptions 30. The relationship
between the demographic characteristics of nurses and the level of job satisfaction is
shown in Table 4.
Table 4. The Relationship between Demographic Characteristics and Job
Satisfaction of Nurses in the Covid-19 Isolation Rooms at Menur Mental Hospital
(n=78)
Satisfaction Level
Demographic
Not Satisfied Moderate Satisfied Total
Characteristics
N % N % N % N %
Gender
Male 15 27.3 33 60.0 7 12.7 55 100
Female 10 43.5 12 52.2 1 4.3 23 100
Age(years)
< 30 7 25 17 60.7 4 14.3 28 100
30 – 40 15 40.5 21 56.8 1 2.7 37 100
> 40 3 23.1 7 53.8 3 23.1 13 100
Education Level
D3 Nursing 15 29.4 33 64.7 3 5.9 51 100
Nursing Bachelor’s Degree 10 37.0 12 44.4 5 18.6 27 100
Employment Status
Contract employee 12 36.4 20 60.6 1 3.0 33 100
Civil servant 10 30.3 19 57.6 4 12.1 33 100
Volunteer 3 25.0 6 50.0 3 25.0 12 100
Length of Service (years)
<6 10 29.4 21 61.8 3 8.8 34 100
6 – 12 7 30.4 15 65.2 1 4.4 23 100
> 12 8 38.1 9 42.9 4 19.0 21 100
Marital status
Unmarried 2 13.3 11 73.4 2 13.3 15 100
Married 22 36.1 33 54.1 6 9.8 61 100
Others 1 50.0 1 50.0 0 0 2 100
Source: Primary Data
Based on Table 4, it can be seen that both male and female nurses are
mostly in the moderate category, namely 60% and 52.2%. The results of this study
indicate that male nurses tend to be satisfied compared to female nurses. The
results of this study are different from the results of research by Sari et al (2018) that
there are differences in job satisfaction between male and female nurses. The mean
of female nurses is 14.37, which is greater than male nurses, namely 14.07. Job
satisfaction of female nurses is higher than male nurses. Female nurses have higher
satisfaction which has been measured by indicators of Salary Payment, Work itself,
Colleagues, Promotion, and Superiors. Gender is one of the factors that influence
job satisfaction because both have different emotional burdens and conditions. A
very significant difference between male and female job satisfaction of nurses is
related to the reward/compensation factor. Female nurses are more satisfied than
male nurses. This dissatisfaction occurs in male nurses who have worked for more
than 3 years. The difference in job satisfaction between male and female nurses is
mainly due to economic-dependent factors. Male nurses have larger family economic
demands, especially those who are married, while female nurses, work just to earn
extra income. It is in contrast to male nurses who act as heads of families who have
to earn a larger living than female nurses 31.
Based on Table 4, it can be seen that nurses aged over 40 years who express
satisfaction are the most, namely 23.1%. Nurses aged over 40 years tend to be
satisfied compared to those aged below. A cross-sectional study conducted on 382
nurses at a large general hospital in Dammam, Saudi Arabia found that job
satisfaction of nurses is positively correlated with age, the older a nurse the better
the level of satisfaction. The study also found that older nurses tend to report greater
job satisfaction. The results of the regression analysis show that age in addition to
monthly salary is the only demographic characteristics that can significantly predict
job satisfaction 32 .
Based on Table 4, it can be seen that nurses with D3 education level whose
job satisfaction is included in the satisfied category are only 5.9% but for nurses with
bachelor’s degree education level, it is 18.5%. This shows that nurses with
bachelor’s degree education level stated that they were more satisfied than D3
nurses. Kitajima et al.'s (2020) cross-sectional study consisted of 200 certified
specialist nurses and 1,472 certified nurses who work in Japanese cancer care. The
study found that the job satisfaction of certified nurses and certified specialist nurses
are 38.45% and 49.00%, respectively. The difference in the satisfaction of certified
nurses and certified specialist nurses is related to work activities, supporting
facilities, and the care team 33.
Based on Table 4, it can be seen that volunteer nurses who express
satisfaction are the most satisfied compared to civil servants and contract nurses.
Status as an employee, both civil servants and non-civil servants who work in
government agencies will be at risk of experiencing discomfort at work so that it can
affect job satisfaction 34.
Based on Table 4, it can be seen that nurses with a length of service of fewer
than 6 years whose job satisfaction is in the satisfied category are 8.8%, nurses with
a length of service of 6 to 12 years are 4.3% while nurses with a length of service of
more than 12 years are 19%. This shows that the percentage of nurses with a length
of service of more than 12 years who stated they were satisfied is the highest.
Someone who has worked for a long time can make adjustments to the work
environment. Employees who have worked for a long time tend to be more satisfied
than employees who have not worked for a long time 19.
Based on Table 4, it can be seen that unmarried nurses who express
satisfaction are more than those who are married, namely 13.3% and 9.8%,
respectively. Marital status and having children are some of the factors that affect
nurse stress. Having children causes stress for nurses because children need care
and are at high risk of transmitting COVID-19 from nursing parents to their children
35
. The study of Yildirim et al (2020) found that there is a significant relationship
between marital status and nurse stress 36.
CONCLUSION
Male nurses whose job satisfaction is included in the satisfied category are
12.7% and female nurses are 4.3%. Nurses who are over 40 years old have the
highest percentage of satisfaction, which is 23.1%. Nurses with bachelor’s degree
are more satisfied than those with D3 education level, namely 18.5% and 5.9%,
respectively. Volunteer nurses who express satisfaction are the most compared to
contract employees and civil servants, namely 25%. Nurses who have worked more
than 12 years who express satisfaction are the most, namely 19.0%. The unmarried
nurses who express satisfaction are the most, namely 13.3%. Most of the nurses in
the COVID-19 isolation rooms have moderate job satisfaction, namely 57.7%.
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