공공병원 간호사의 직장에 대한 인식과 직무만족에 관한 연구

Abstract

본 연구는 공공병원에 근무하는 간호사의 직장에 대한 인식 및 직무만족을 파악하여 간호조직의 효율적인 인적자원관리가 이루어지는데 기여하고자 하는 서술적 조사연구이다. 본 연구는 2015년 10월 23일부터 2015년 11월 20일까지 경기도 의료원 6개 병원(의정부, 수원, 파주, 포천, 안성, 이천) 간호사를 대상으로 자료를 수집하였으며 참여자는 총 404명이었다. 연구도구는 공공병원 직장에 대한 인식 관련 문항은 본 연구자가 작성하여 간호학과 교수 1인과 공공병원 근무 임상경력 10년 이상 간호사 5인에게 검토 받아 사용하였고, 직무만족도는 미네소타 산업관계연구소에서 개발한 MSQ(Minnesota Satisfaction Questionnaire)의 short form으로 측정하였다. 수집된 자료는 SPSS Window version 21.0 프로그램을 이용하여 각 변수의 실수와 백분율, 평균과 표준편차, 기술통계와 빈도분석, t-test, ANOVA로 분석하였고, 사후검정은 scheffe test로 분석하였으며 대상자의 직무만족에 영향을 미치는 요인은 다중선형회귀분석(Multiple Linear Regression)을 이용하여 분석하였다. 본 연구의 결과는 다음과 같다. 1. 대상자의 평균 연령은 34.5세였고, 기혼이 56.4%, 미혼이 42.8%였으며 공공병원에 입사 당시 경력직 53%, 신규 47%였다. 총 임상경력은 평균 11.0년이었고, 공공병원 근무경력은 평균 9.3년이었으며 공공병원에 10년 이상 근무한 간호사는 전체 간호사의 38.9%이었다. 2. 대상자의 공공병원 선택 동기는 신규와 경력직 간호사 모두 ‘준공무원 대우로 직원 복지가 좋음’ 37.1%, ‘근무지가 집과 가까워 출퇴근이 편리’ 25.5%로 높게 나타났고, 경력직 간호사가 공공병원으로 이직한 이유는 ‘업무량 과다’가 27.6%로 가장 많았고 ‘직원복지혜택이 적음’ 19.6%, ‘결혼 및 출산, 육아, 이사 등의 개인적인 사유’ 17.8%순으로 나타났다. 3. 대상자의 공공병원의 역할에 대한 인식은 ‘경제적 이익보다 공공성이 우선되어야 한다’ 37.6%, ‘투명한 정보공개와 취약계층을 위한 보건의료사업에 더욱 앞장서야 한다’ 25.5%, ‘양질의 적정진료 수행을 통해 민간영역을 선도해야 한다’ 19.1%순으로 나타났으며 공공병원 간호사들은 직업적 사명감을 가지고 민간병원에서 수행하기 어려운 공익적 보건의료의 중심적인 역할을 수행해야 한다고 생각하고 있었다. 4. 대상자의 공공병원 근무환경에 대해서는 근무환경의 장점으로 ‘정년 보장이 되어 안정적(고용안정성)’이 66.3%로 가장 많았고, 단점으로는 ‘업무량에 비해 낮은 보수’ 34.4%, ‘공공병원 특성상 난폭한 환자의 난동 등 환자의 무리한 요구로 스트레스가 많음’ 27.7%로 높았다. 5. 대상자의 직무만족도 전체 평균 점수는 5점 만점에 3.29.48점으로 나타났다. 신규간호사는 3.26.50점이었고, 경력간호사는 3.31.44점으로 경력간호사의 직무만족 점수가 높았으나 통계적으로 유의한 차이는 없었다. 공공병원으로 이직한 경력직 간호사의 84.1%가 전직병원과 비교하여 만족한다고 하였고, 이직 후 좋은 점으로는 ‘직원복지(분만휴가, 육아휴직, 직장어린이집 등)’ 47.2%, ‘고용안정성(정년보장)’ 25.0%, ‘편안한 분위기’ 15.6%순으로 나타났다. 6. 대상자의 일반적 특성에 따른 직무만족 차이 분석에서는 연령이 높을수록, 기혼여성일수록, 자녀수 2명, 상근직의 직무형태, 외래 근무자, 근무경력이 길수록, 직무위치가 올라갈수록, 월 평균급여가 높을수록 통계적으로 유의한 정도(<.05)로 직무만족이 높게 나타났다. 7. 대상자의 직무만족에 영향을 미치는 요인을 파악하기 위해 다중선형회귀분석을 실시한 결과, 회귀식은 (R2 = .325, F = 19.720, <.001)로 32.5%의 설명력을 가지며 월평균급여(=.384, <.001), 상근직 직무형태(=.220, <.001), 공공병원 근무경력(=.125, <.001)이 직무만족과 통계적으로 유의한 영향을 미치고 있었다. 본 연구는 공공병원 간호사들의 직장에 대한 인식 및 직무만족에 대한 간호사들의 의견을 파악하는 연구가 국한되어 있는 실정에서 실제 임상에 있는 간호사를 대상으로 직접적인 의견을 수렴하여 직장을 선택하는 동기와 간호근무환경의 장·단점 및 간호사의 직무만족에 영향을 미치는 변수를 실증으로 분석하였다. 연구결과 공공병원 간호사들은 안정적이고 복지혜택이 좋으며 편안한 분위기의 근무환경에 만족하며, 간호사들은 공공보건의료사업과 민간의료영역의 선도가 공공병원의 역할임을 인식하고 있음을 확인할 수 있었다. 하지만 공공병원이 업무량에 비해 급여가 낮으며 낮은 급여는 직무만족 저하로 이어져 공공병원 간호사의 급여수준 개선과 간호 인력 확대, 업무량 조절의 필요성을 보여주었다.;This study is a descriptive research study that aims to contribute in efficient human resource management of nursing organizations by investigating Job Cognition and Satisfaction of Nurses Working in Public Hospitals. In this study, data was collected subject to nurses from 6 hospitals in Gyeonggi-do (Uijeongbu, Suwon, Paju, Pocheon, Anseong, Icheon) from October 23, 2015 to November 20, 2015 in which there were a total of 404 participants. Regarding research tools, items related to cognition on public hospital workplace were written by the researcher, received reviews from 1 nurse department professor and 5 nurses with clinical career of 10 years or longer at public hospitals, and items related to job satisfaction were measured in a short form of MSQ(Minnesota Satisfaction Questionnaire) developed from the Minnesota Industrial Relation Institute. SPSS Window version 21.0 program was used on collected data for analysis with real numbers, percentage, mean value, standard deviation, descriptive statistics, frequency analysis, t-test and ANOVA on each variable, scheffe test was used for post-test, and multiple linear regression was used to analyze the factors that influence job satisfaction of the subjects. The results of this study are as follow. 1. The average age of the subjects was 34.5 years old, 56.4% were married, 42.8% were single, 53% were had experience when entering public hospitals, and 47% were new workers. The total average of clinical career was 11.0 years, average working career in public hospitals was 9.3 years, and nurses who worked 10 or more years in public hospitals occupied 38.9% of the total subjects. 2. Motives of selecting public hospital among new workers and experienced nurses were shown high in ‘great employee welfare due to treatment as semi-civil servants’ as 37.1%, ‘commuting is convenient because workplace is close to home’ as 25.5%, and the reasons of transfer to public hospital for experienced nurses were shown in ‘excessive work’ as 27.6%, ‘less employee welfare’ as 19.6% and ‘personal reasons such as marriage, birth, child care, and moving’ as 17.8% in order. 3. cognition on role of public hospitals was shown as ‘publicity should be considered before economic profit’ as 37.6%, ‘health medical business should lead vulnerable social groups and transparent information release’ as 25.5%, and ‘private sector should be led through high quality optimal care performance’ as 19.1% in which public hospital nurses thought that core role of public interest health care which is difficult to perform in private hospitals must be performed as a professional sense of duty. 4. For advantages of public hospital working environment of the subjects, ‘stable because of guaranteed retirement age(stability of employment)’ was most common with 66.3% and disadvantages were high for ‘low remuneration compared to amount of work’ with 34.4% and ‘high stress due to impractical demands of patients such as violent behavior of patients in public hospitals’ with 27.7%. 5. The total average score of job satisfaction of the subjects was shown to be 3.29.48 points out of 5 points. New nurses showed 3.26.50 points and experienced nurses showed 3.31.44 points in which only job satisfaction of experienced nurses was high, but there was no statistically significant difference. 84.1% of experienced nurses who have transferred to public hospitals said that they were satisfied compared to the previous hospital and advantages after turnover were ‘employee welfare(maternity leave, chid care leave, work daycare center, etc.) with 47.2%, ’employment stability(guaranteed retirement age) with 25.0%, and ‘comfortable ambience’ with 15.6% were shown in order. 6. In the analysis on job satisfaction difference according to general characteristics of the subjects, older age, married female, 2 children, full-time work form, foreign service worker, longer work career, higher job position, and higher monthly salary showed statistically significant level(<.05) of high job satisfaction. 7. As result of performing multiple linear regression analysis to investigate the factors that influence job satisfaction of the subjects, the regression equation (R2 = .325, F = 19.720, <.001) had explanation power of 32.5% and monthly average salary(=.384, <.001), full-time work form(=.220, <.001), and work career in public hospital(=.125, <.001) had statistically significant influence on job satisfaction. In this study, direct opinions subject to nurses in actual clinical scenes were collected to practically analyze variables that influence the motive of selecting workplace, pros·cons of nurse working environment, and job satisfaction of nurses in the status of limited research investigating opinion of nurses on job satisfaction and cognition on workplace of public hospital nurses. As result of the research, public hospital nurses were satisfied to work environment with stable, great welfare benefits, comfortable ambience and it was known that nurses were recognizing that leading public health care business and private health care fields were the role of public hospitals. However, public hospitals have low salaries compared to the amount of work and is connected to lowered job satisfaction that the necessity of improving salary level, expanding nursing manpower, and controlling amount of work of public hospital nurses was needed.