Front-line registered nurses (RNs) make up the workforce that directly affect the care of patients in a variety of different healthcare settings. RN job satisfaction is important because it is tied to retention, organizational commitment, workforce safety, patient safety, and cost savings. The strongest predictors have been difficult to determine because workplaces differ, numerous tools to measure satisfaction exist, the workforce is diversified by generations and work positions, and ongoing policy changes directly impact the work of the front-line RN. The strength and stability of the workforce depends on an accurate understanding of the predictors of job satisfaction for the front-line RN. The purpose of this study was to comprehensively, quantitatively examine predictors of front-line RN job satisfaction from 1980-2009 to provide overarching conclusions based on empirical evidence. Of interest was: the (1) estimation of large, moderate, and small predictor summary effect sizes; (2) assessment of predictor differences among decades (i.e., 1980s, 1990s, and 2000s); (3) identification of causes for predictor differences among studies (i.e., moderators); and (4) investigation of predictor differences between generations (i.e., Baby Boomers, Generation X, and Millennials). A non-a priori meta-analysis approach was guided by inclusion and exclusion criteria to review published and unpublished studies from 1980–2009. The search process identified 48 published and 14 unpublished studies used for analysis. Within the studies that met inclusion criteria, 27 job satisfaction predictors met inclusion for analysis. Studies were coded for Study Characteristics (e.g., Year of Publication, Country of Study) that were needed for moderator analysis. Predictors were coded for data that were necessary to calculate predictor summary effect sizes (i.e., r, n). Coding quality was maximized with a coding reliability scheme that included the primary investigator (PI) and secondary coder. A random-effects model was used iv to guide the calculation of summary effect sizes for each job satisfaction predictor. Publication bias was examined using funnel plots and Rosenthal’s Fail-safe N. An analysis of variance (ANOVA) was used to evaluate predictor differences among decades (i.e., 1980s, 1990s, and 2000s). Heterogeneity among studies was calculated (i.e., Q-statistic, I-squared, and Tausquared) to guide the need for moderator analysis. Moderator analyses were conducted to evaluate Study Characteristics as sources of predictor differences among studies, and to investigate the influence of Age (i.e., generation) on predictor effect sizes. The largest effect sizes were found for three predictors: Task Significance (r=.61), Empowerment (r=.55), and Control (r=.52). Moderate effect sizes were found for 10 predictors (e.g., Autonomy: r=.44; Stress: r=-.43), and small effect sizes were found for nine predictors (e.g., Wages: r=.23; Staffing Adequacy: r=.19). Significant heterogeneity between studies was present in all of the 27 predictor analyses. Effect size differences were not found between decades or generations. Moderator analysis found that the sources of the difference between studies remain unexplained indicating that unknown moderators are present. Findings from this study indicate that the largest predictors of job satisfaction for the front-line RN may be different than previously thought. Heterogeneity between studies and unidentified moderators indicate that there are significant differences among studies and more research is needed to identify the source(s) of these differences. The findings from this study can be used at the organizational, state, and national level to guide leaders to focus efforts of workplace improvements that are based on predictors that are most meaningful to front-line RNs (i.e., Task Requirements, Empowerment, and Control). Future research is needed to determine contemporary predictors of job satisfaction for the front-line RN, and the causes of heterogeneity between studies. The findings from the current study provide the critical synthesis needed to v guide educational and practice recommendations aimed at supporting job satisfaction of frontline RNs, thereby, maintaining this integral component of the healthcare workforce.

As the nation’s healthcare system moves through the 21st century, unprecedented changes are occurring on both a local and global stage. Healthcare organizations are faced with creating and implementing leadership strategies to enhance the overall patient experience. When coupled with the need to ensure increased nurse job satisfaction, improved cost-effectiveness and healthy organizational cultures with fiscally sound budgets, improvement work has led efforts to ensure effective leadership techniques are used across an agency. This task may be viewed as commonplace for some organizations, while others may perceive this process as a complete paradigm shift from historical practices related to leadership style, behaviors and performance. A successful transition during this time of unprecedented change may depend on an organization’s ability to accept and implement the tenets of transformational leadership. Empirical research illustrates that transformational leadership empowers staff, increases job satisfaction and facilitates cost-effectiveness while constructing an environment conducive to the development of a supportive organizational culture. In an effort to ascertain the current state of leadership at a southeastern Veterans Affair Medical Center, this research study explored the self-reporting leadership practices of all supervisory staff employed at the facility. As a means of measurement, the Leadership Practices Inventory (LPI) was coupled by demographic questionnaire developed by the researcher. Both measurement tools were used to collect the data.

Job dissatisfaction among nurses may contribute to disengagement and withdrawal from the profession. The degree of leadership support in the workplace influences job satisfaction, and when nurses are satisfied with their job, they provide better patient care. Guided by the social cognitive theory, which asserts a relationship between behavior change and one's surroundings, this quantitative, exploratory project sought to determine the type of nursing leadership practiced in the facility where the project took place, whether nurses were satisfied with their job, and if patients were satisfied with their care. Participants in the project included 55 registered nurses and 5 nurse managers. Three surveys of demographics, job satisfaction, and leadership styles were administered to 60 RN participants; patient satisfaction data were obtained from the hospital's last reported Hospital Consumer Assessment of Healthcare Providers and Systems survey. Descriptive statistics from the nurse surveys showed 75% were female, 56.7% had a bachelor's degree, and, most were under the age of 50 years. Results showed that 90.8% of nurses enjoyed working for the hospital, leaders primarily used transformational leadership styles, and 80.2 to 89.7% of patients were satisfied with their care. This project has implications for positive social change because healthy, transformative leadership leads to staff satisfaction and improved patient satisfaction.