Journal of Nursing Management, 2015, 23, 974–982

Communication satisfaction of professional nurses working in public hospitals J.-D. WAGNER 1

MA

1

, M.C. BEZUIDENHOUT

DLitt et Phil

2

and J.H. ROOS

DLitt et Phil

3

Student, 2Emeritus Professor and 3Professor, Department of Health Studies, Unisa, Pretoria, South Africa

Correspondence J.H. Roos Department of Health Studies PO Box 392 Unisa 0003 Pretoria South Africa E-mail: [email protected]

WAGNER J.-D., BEZUIDENHOUT M.C. & ROOS J.H.

(2015) Journal of Nursing Management 23, 974–982. Communication satisfaction of professional nurses working in public hospitals Aim This study aimed to establish and describe the level of communication satisfaction that professional nurses experience in selected public hospitals in the City of Johannesburg, South Africa. Background The success of any organisation depends on the effectiveness of its communication systems and the interaction between staff members. Method Data were collected by means of questionnaires, based on the Communication Satisfaction Questionnaire (CSQ), from a sample of 265 professional nurses from different categories, chosen using a disproportionate random stratified sampling method. Results The results indicated poor personal feedback between nurse managers (operational managers) and professional nurses, as well as dissatisfaction among nurse managers and professional nurses with regard to informal communication channels. A lack of information pertaining to policies, change, financial standing and achievements of hospitals was identified. Conclusion Nurse managers should play a leadership role in bringing staff of different departments together by creating interactive communication forums for the sharing of ideas. Implications for nursing management The results emphasise the need for nurse managers to improve communication satisfaction at all levels of the hospital services in order to enhance staff satisfaction and create a positive working environment for staff members.

Keywords: communication satisfaction, nurse manager, operational manager, personal feedback, professional nurses Accepted for publication: 14 April 2014

Introduction Communication is an essential element in the success of any organisation. For an organisation to perceive itself as effective, it must have a thorough understanding and in-depth knowledge of its communication system (Muller et al. 2006, Trenholm 2011). Hospitals function as organisations and therefore need to assess their communication systems from time to time in order to assess the effectiveness of these systems and 974

to change existing communication structures. This could be done by means of communication audits. According to figures released by the South African Nursing Council (SANC) in 2012 for 2011, professional nurses (PNs) and registered midwives numbered 30 770 in Gauteng. Of these, the largest number is employed by hospitals in the public health sector (South African Nursing Council 2012). Poor communication by professional nurses was noted as one of the reasons for their intention to leave their organisations

DOI: 10.1111/jonm.12243 ª 2014 The Authors. Journal of Nursing Management Published by John wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Communication satisfaction

(Mokoka et al. 2011). Professional nurses spend, on average, approximately 40 hours per week at work, where they are required to communicate effectively on an on-going basis. These nurses want to experience a high level of communication satisfaction, which could enhance their job satisfaction.

Related research A study conducted by Kekana et al. (2007) on job satisfaction at a community hospital in Limpopo, indicated poor interpersonal relationships between supervisors and employees as a reason for job dissatisfaction. The respondents in this study indicated their dissatisfaction with the amount of guidance provided by their supervisors and the lack of performance appraisals. However, they were satisfied with the opportunity to get to know other people at work and the chance to socialise and communicate with colleagues. Communication is identified as one of the most important problems in the National Department of Health (NDOH). This lack of communication efficacy seems to have an impact on a wide spectrum within health care delivery institutions. ‘There is no effective communication on interdepartmental level and communication is only one-directional’ (Enslin 2005). An example of a negative practice environment is evident from an ethics audit, completed by the Ethics Institute of South Africa in 2001, in one of the largest health care facilities in the City of Johannesburg, namely the Chris Hani Baragwanath Hospital (Landman et al. 2001). This audit included communication as one of its major ethical pillars.

After analysing the data on management and communication contained in the audit, Landman et al. (2001) are of the opinion that an organisation will be unsuccessful if it does not value participation and consultation in decision making, if the views of ordinary staff members do not matter and if opportunities for constructive communication are limited or non-existent. A follow-up study at the Chris Hani Baragwanath Hospital, conducted by Von Holdt and Maseramule (2005), reported that this hospital still had no internal communication capacity, implying that it did not make provision for either formal or informal communication channels. This constituted one of the hospital’s many managerial problems, creating justifiable frustration and disempowerment among staff (Von Holdt & Maseramule 2005).

Theoretical framework The theoretical framework that served as the basis for this study, was the Downs and Hazen Communication Satisfaction Model (Downs & Hazen 1977), as shown in Figure 1. This multidimensional model postulates that communication satisfaction depends on three satisfaction contexts, namely the interpersonal, group and organisational communication contexts. Each context is subdivided into dimensions. Interpersonal communication includes personal feedback, as well as communication between supervisor and subordinate. Group communication entails horizontal communication and organisational integration, while organisational communication encompasses corporate information, the communication climate and media quality dimensions.

COMMUNICATION SATISFACTION

• -



Personal Feedback Dimension

-

-

Figure 1 Based on the Downs and Hazen Communication Satisfaction Framework. Adapted by Downs and Adrian (2004) from the Downs and Hazen (1977) model.

Supervisory Communication Dimension

• -

-

Subordinate Communication Dimension Responsiveness to downward communication Initiating upward communication

ª 2014 The Authors. Journal of Nursing Management Published by John wiley & Sons Ltd. Journal of Nursing Management, 2015, 23, 974–982

Accuracy of co-worker communication Activeness of grapevine

-

Openness Attention Trust Guidance •

-

Horizontal (Co-worker) Communication Dimension

Job performance Recognition of efforts •

Organisational Communication Context

Group Communication Context

Interpersonal Communication Context

-

Organisational Integration Dimension Departmental policies and goals Job requirements Personnel news

• -

Organisational change Profits/ financial standing Achievements/failures •

-

Communication Climate Dimension Motivation in the organisation Identification with organisation Attitude towards communication

• -

Corporate Information Dimension

Media Quality Dimension Meetings Written directives Amount of information

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For this study the dimensions of this theory were used to design the data collection instrument and to analyse and discuss the results of the study.

Table 1 Reliability coefficient of the communication satisfaction dimensions (n = 130) Factor/Dimension

Aim The purpose of this study was to establish and describe the extent of communication satisfaction among professional nurses, including the nurse managers and operational managers, in selected public hospitals in the City of Johannesburg.

0.9020 0.8758 0.8523 0.8274 0.8177 0.8071 0.7996 0.7467

Sampling and sampling method

Methods Study design A quantitative and descriptive survey study was undertaken, whereby structured questionnaires were used to collect data in three public hospitals in the City of Johannesburg, South Africa, during March 2012. The hospitals were general hospitals comprising medical, surgical, intensive care and casualty units. The bed occupancy of the three hospitals was 500–800 patients.

Data collection instrument A questionnaire, adapted from the Communication Satisfaction Questionnaire (CSQ), comprising 40 closed-ended Likert scale questions (ranging from 1, ‘very dissatisfied’, to 5, ‘very satisfied’) was used (Downs & Adrian 2004). All responses were coded, analysed and interpreted accordingly. The response alternatives of ‘very satisfied’ and ‘satisfied’ were grouped together as ‘satisfied’, while the response alternatives of ‘very dissatisfied’ and ‘dissatisfied’ were grouped together as ‘dissatisfied’; the indifferent responses stayed as supplied.

Cronbach’s alpha internal consistency analysis Item analysis was done to assess the reliability of the different dimensions or constructs in the questionnaire via Cronbach’s alpha values. A Cronbach’s alpha value above 0.8 indicates good reliability, a value between 0.6 and 0.8 indicates acceptable reliability and a value below 0.6 indicates unacceptable reliability. The results of this internal reliability coefficient of the communication satisfaction dimensions are displayed in Table 1. From the findings it is evident that all of the constructs were measured with good reliability. Therefore, it can be accepted that the reliability of the data collection instrument is also good. 976

Subordinate communication Supervisor communication Communication climate Media quality Personal feedback Corporate information Horizontal communication Organisational integration

Cronbach’s alpha

A disproportionate stratified random sample of 265 PNs was drawn from a total of 1001 PNs working in various wards/departments in three selected public hospitals. A simple formula was initially used to determine the sample size. A sampling proportion of 25% was taken from the total population of each of the three strata, which delivered a sample ratio of 5 : 75 : 170 for the three categories of professional nurses, giving a rounded total of 250 respondents in the sample. The three strata were, however, greatly unequal in size. The nurse manager stratum was very small in this study and therefore the sampling proportion of this group was altered to include 100% of the nurse managers. Twenty respondents were NMs, inter alia, deputy directors (DDs) and assistant directors (ADs) in nursing, 75 were operational managers (OMs) in a chief professional nurse (CPN) capacity and 170 were operational PNs.

Data analysis The data analysis of this study was done with the assistance of a statistician, utilising the Statistical Analysis System (SAS JMP version 10.0; SAS Institute, Cary, NC, USA) statistical software. Descriptive analysis was done and a Cronbach alpha test was performed to determine the internal reliability of the questionnaire. A one-way analysis of variance (ANOVA) test was performed to determine statistically significant differences between the three strata.

Results Respondents’ background The results displayed in Table 2 indicate that of the three respondent strata, 80 (88.9%) of the professional nurses were aged between 21 years and

ª 2014 The Authors. Journal of Nursing Management Published by John wiley & Sons Ltd. Journal of Nursing Management, 2015, 23, 974–982

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Table 2 Age distribution of respondents (n = 130) Number of responses NM (n = 18) Age in years 21–29 30–39 40–49 50–59 60+ Total

OM (n = 22)

PN (n = 90)

Total (n = 130)

f

%

f

%

F

%

F

%

0 2 6 6 4 18

0.0 11.2 33.3 33.3 22.2 100

0 1 14 7 0 22

0.0 4.6 63.6 31.8 0.0 100

19 35 26 9 1 90

21.1 38.9 28.9 10.0 1.1 100

19 38 46 22 5 130

14.6 29.3 35.4 16.9 3.8 100

NM, nursing manager; OM, operational manager; PN, professional nurse.

49 years, falling into the younger age groups, whereas 21 (95.4%) of the operational managers ranged between 40 years and 59 years of age, and 16 (88.8%) of the nurse managers were aged between 40 years and 60 years or more. The gender mix of the respondents indicated that 119 (91.5%) of the respondents were female and 11 (8.5%) were male. All of the male respondents were professional nurses, thus indicating that none of the male respondents held a managerial position.

Results regarding communication satisfaction The study revealed that the PNs and OMs experienced personal feedback and the flow of communication between managers and PNs was inadequate. The operational manager stratum, in particular, experienced dissatisfaction with this dimension. Thirteen (59.1%) of the OMs expressed dissatisfaction with the extent to which problems in their jobs were being handled. In contrast to the low number of NMs (n = 4; 22.2%) who indicated their dissatisfaction with the recognition of their efforts, 13 (59.1%) OMs and 41 (45.5%) PNs were dissatisfied with the lack of acknowledgment they received for their work efforts (see the Supporting Information, Table S1.) The supervisor communication dimension pertains to the way in which PNs perceive communication from their supervisors. Seventy-six (58.4%) of all the respondents were satisfied with the trust placed in them by their supervisors and 77 (58.2%) were satisfied with the amount of supervision they received. The professional nurse stratum, in particular, indicated their satisfaction with their supervisors’ openness to ideas (n = 51; 56.7%), although transparency was indicated as posing a challenge to hospitals (see the Supporting Information, Table S2). The findings indicate that 11 (61.1%) NMs were dissatisfied with the extent to which their supervisors (managerial commit-

tees and the central office) listened and paid attention to them. In contrast, 50 (55.5%) of PNs and nine (40.9%) of OMs, indicated their satisfaction with the extent to which their supervisors (NMs) listened and paid attention to them. Respondents in the OM group found themselves in two minds about the extent to which their supervisors offered guidance with a view to solving job-related problems as nine (40.9%) of the OMs were dissatisfied, four (18.2%) were indifferent and nine (40.9%) were satisfied. A large percentage (n = 13; 72.2%) of NMs were satisfied with the amount of supervision they received. For obvious reasons, in the subordinate communication dimension section, only the PNs and OMs were required to answer questions. The findings revealed a positive tendency towards organisational effectiveness in terms of communication, as it seems that communication does travel from one level to the next. However, there are also strong indications that information is not travelling through the hierarchical structure correctly, especially when the OM is not present in the ward/unit. This was also evident in the number of all NMs (n = 17; 42.5%) who indicated indifference towards the degree to which they can avoid communication overload. Managers often become overloaded with unnecessary information and precious time is consumed sifting through irrelevant information. The NMs and OMs were positive with regard to subordinates’ responsiveness to evaluations, suggestions and criticism (n = 22; 55.0%). The NMs (n = 10; 55.6%) were more satisfied with the extent to which subordinates feel responsible for initiating accurate upward communication than were the OMs (n = 7; 31.8%). This could possibly be attributed to the direct feedback they receive from OMs (see the supporting information, Table S3.) Horizontal communication satisfaction includes all informal communication aspects in an organisation such as informal communication networks (‘grape-

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vine’), communication with same-level employees, adaptability of communication practices in emergencies, compatibility of work groups and accuracy levels of informal communication. The findings indicate that respondents perceive the ‘grapevine’ as not being sufficiently active and not meeting their information needs, as the total satisfaction level in this regard was 23.8% (n = 31). The NMs experienced a low level of satisfaction (n = 7; 38.9%) with the extent to which their working group members were compatible in comparison with the PNs, who indicated a higher level of satisfaction (n = 53; 58.9%) with the same item. The OMs (n = 11; 50%) and PNs (n = 50; 55.6%) appeared to be more satisfied with their communication with other employees at the same level than were the NMs (n = 7; 38.9%). The majority of operational nurses (n = 12; 54.6%) and PNs (n = 49; 54.4%) were satisfied with the adaptability of communication with regard to emergencies in their hospitals (see the Supporting Information, Table S4.) In the organisational integration dimension, the professional nurse stratum indicated a lower level of satisfaction (n = 44; 48.9%) with the information they received on progress in their jobs, compared with both NMs and OMs. Although most of the NMs (n = 16; 88.9%) were satisfied with the news they receive regarding staff matters, the OMs (n = 5; 22.7%) and PNs (n = 32; 35.6%) were less satisfied. Eighty-five (65.4%) respondents were satisfied with the information they received regarding their job requirements, but 62 (47.7%) indicated dissatisfaction with information on their benefits and pay (see the Supporting Information, Table S5.) Regarding corporate information, the study revealed that the majority of those reflected in the three respondent strata (n = 84; 64.4%) were satisfied with the information they received on hospital policies and goals, but 78 (60.0%) were dissatisfied with the information they received on their hospitals’ finances. Compared with the NMs, who indicated satisfaction (n = 16; 88.9%) with the information on governing regulations affecting hospitals, PNs indicated dissatisfaction with information on change in the hospitals (n = 11; 61.1%), as well as on the achievements/failures of hospitals (n = 9; 50.0%) (see the Supporting Information, Table S6). Pertaining to the communication climate, only 42 (32.3%) of all respondents were satisfied with the extent to which the communication at their hospitals motivates them to meet its goals. Forty-seven (36.2%) of all respondents indicated their indifference towards the extent to which hospital employees (nurses) have 978

communication skills, while 53 (40.8%) indicated indifference towards the extent to which communication in the hospital motivates them to identify with the hospital, or make them feel as though they were a vital part of the hospital. Only 51 (39.2%) of all respondents indicated satisfaction with the extent to which conflict was handled appropriately, using communication channels (see the Supporting Information, Table S7). However, a more positive aspect seems to be the fact that 73 (56.1%) out of all the respondents indicated their satisfaction with the extent to which they receive information in good time to enable them to do their job. Media quality refers to important communication methods, formats and channels, such as meetings and directives. Seventy-five (57.7%) respondents from all three strata indicated satisfaction with the extent to which written directives and reports are clear and concise. Overall, the three strata indicated their dissatisfaction (n = 54; 41.5%) with just how helpful and interesting the hospital’s communication was, as well as their dissatisfaction with the staff’s attitude towards communication (n = 53; 40.8%) (see the Supporting Information, Table S8).

One-way

ANOVA

A one-way ANOVA test was performed to identify statistically significant differences between the communication satisfaction dimension mean scores of the three strata of respondents at a level of P < 0.05 (Burns & Grove 2009). The analysis of variance in statistics refers to a collection of statistical models and their associated procedures whereby the observed variances are partitioned into components according to variables. Thus ANOVA refers to a parametric statistical technique that assists with inferring whether there are real differences between the means of three or more groups responses to one or more factors (Plichta & Garzon 2009:408). The results revealed statistically significant differences between the different strata of NMs and OMs in two of the communication satisfaction dimensions tested namely the organisational integration and corporate information dimensions. These differences are displayed in Tables 3 and 4, respectively: The P-value of 0.0079 (F2,129  5.03), which is smaller than 0.05, indicates that there is a significant difference between the mean organisational integration scores of the different management levels in the hospitals at a 95% level of confidence. The P-value of 0.0129 (F2,129  4.50), which is smaller than 0.05, indicates that there is a significant

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Table 3 One-way analysis of variance (ANOVA) test for the organisational integration communication satisfaction dimension Organisational integration Between the NM and OM categories Error Total

Sum of squares

df

Mean squares

F-ratio

F

5.0341

0.0079

2

4.914076

2.45704

127 129

61.985616 66.899692

0.48808

NM, nursing manager; OM, operational manager.

Table 4 One-way analysis of variance (ANOVA) test for the corporate information communication satisfaction dimension Corporate information Between the NM and OM categories Error Total

Sum of squares

df

Mean squares

F-ratio

F

5.0341

0.0129

2

4.792963

2.39608

127 129

67.611960 72.404923

0.53238

NM, nursing manager; OM, operational manager.

difference between the mean corporate information scores of the different management levels in the hospitals at a 95% level of confidence. The NMs reported a higher level of satisfaction with both the organisational integration (average mean score of 3.66) and corporate information (average mean score of 3.39) dimensions than the OMs in both dimensions (see the Supporting Information, Table S9). This phenomenon could result from the high level of exposure the NMs enjoy and their direct contact with these dimensions due to their post status in the health service. There were no other significant differences between the strata of respondents.

Discussion This study was undertaken to establish the extent of communication satisfaction among PNs in selected hospitals in the City of Johannesburg. Both NMs and OMs experienced personal feedback from PNs as being unsatisfactory, indicating that the feedback received from PNs was incomplete or inaccurate. Muller et al. (2006) regard feedback as the completion of the communication cycle and in cases of problems sufficient feedback is essential to improve productivity and performance. Information regarding performance management received by the professional nurse stratum was insufficient, while OMs and PNs

felt that their efforts were not suitably recognised. The PNs felt that NMs did not seem to understand the job-related problems of subordinates and appeared to lack effective problem-solving skills. Supervisory communication refers to both upward and downward communication that subordinates experience with their supervisors. Nurses view their relationship with their managers as an important factor in their overall sense of job satisfaction and their intention to remain in their hospitals (Dhlamini 2012). The PNs indicated satisfaction with the openness of supervisors to their ideas and the extent to which their supervisors listened to them and paid attention to them. Only the NM strata indicated dissatisfaction with the latter aspect. According to Muller et al. (2006), open communication is the sharing of all types of information throughout the organisation, across functional and hierarchical levels. In other words, in a situation of mutual trust and open communication, the supervisor can confidently be susceptible to new ideas coming from colleagues and subordinates. The PNs were satisfied with the guidance that their direct supervisors (OMs) offered with regard to solving job-related problems and the extent to which their direct supervisors trusted them. Jooste (2009) stated that managers who supply their subordinates with appropriate information that will simplify their work and which is readily available, reflect an open climate of trust in nurses to make their own decisions. Regarding subordinate communication, OMs indicated satisfaction with the extent to which their staff members were responsive to downwardly directed communication, but felt that PNs’ initiating of communication with NMs was lacking. The NMs and OMs remarked that staff members were not all that receptive to evaluation, suggestions and criticism, while OMs indicated information overload as a problem. Communication overload could also indicate a communication chain that functions too slowly (Van Staden et al. 2002): i.e. communication is not dealt with in an efficient and timely manner. Horizontal communication refers to employees’ level of comfort with regard to using informal communication channels (the ‘grapevine’) to discuss issues with co-workers and pertains to the accuracy and activeness thereof (Muller et al. 2006). The NMs and the PNs were dissatisfied with the extent to which the ‘grapevine’ and informal communication channels and processes were active in their hospitals. The OMs experienced dissatisfaction with the level of activity and accuracy of these informal communication

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networks in their hospitals – if they were actually functioning at all. The NMs indicated their dissatisfaction with the extent to which their working group members were compatible. Regarding organisational integration, both NMs and PNs were satisfied with the information received on departmental policies and goals, as well as on the requirements of their jobs, but only the NMs were satisfied with the information received on progress in their jobs. According to Meyer et al. (2009), policies and procedures are guidelines for enhancing the standard of nursing care in the nursing unit, while departmental goals are broad statements, used to formulate departmental objectives that need to be achieved by members of the health care team (Jooste 2010). In relation to corporate information, PNs were dissatisfied with the amount, availability and accuracy of the information on governing regulations affecting the hospitals where they were employed. In addition, PNs also indicated their dissatisfaction with the amount and quality of information on change, profits and financial standing, as well as the achievements and failures of their hospitals. Jooste (2009) stated that effective communication is essential if effective change is to take place in the organisation. Employees must be informed about the reasons for change, but circulating this information only by e-mail is not good enough. It will require a lot of face-to-face communication to get employees involved in the change process. Elements inherent in an ideal communication climate include supportiveness, participative decisionmaking, trust, confidence and credibility, openness and high performance goals (Meintjes & Steyn 2006). The NMs reported apparent poor communication ability among PNs in the communication climate. The majority of the respondents indicated their dissatisfaction with the extent to which conflict was handled appropriately via the hospital’s proper communication channels. Media quality is also an area of concern, as most of the respondents in all three strata indicated their dissatisfaction with the extent to which the hospital’s communication was interesting and helpful, the attitude of staff regarding communication and the amount of information they received in their hospitals. Most of the respondents in all three strata indicated satisfaction with the organisation of meetings and with the extent to which written directives and reports were clear and concise. The value and importance of meetings are supported by Jooste (2010), who stated 980

that meetings are ‘one of the most effective communication tools of the work environment’ where ideas can be stimulated, plans of action generated, teamwork encouraged, guidance provided, employees empowered and productivity improved. She elaborated on this statement by mentioning that ‘effective meetings also ensure the continuous flow of information to all levels and between all health care professionals’ in the organisation (Jooste 2009).

Limitations When analysing the results, some limiting aspects should be taken into account. First, the questionnaire was only available in English as the official language medium, while the majority of respondents did not use English as their first language. Using ‘indifferent’ as a response alternative appears to have been an unsuitable term in the questionnaire, affecting the response by respondents, as well as the interpretation of data. The term, ‘uncertain’ could have facilitated a better understanding of what was required and would therefore have provided data that would be more valid in this sense.

Conclusion This study was conducted to determine what constitutes effective organisational communication and to establish the extent of communication satisfaction among PNs in selected public hospitals in the City of Johannesburg. From the analysis of the findings, it was established that PNs are experiencing dissatisfaction with a number of communication factors, and that the most noteworthy indicator of communication satisfaction is the organisational integration abilities of NMs and OMs. Recommendations were formulated to address the communication dimensions that had been rated as unsatisfactory.

Implications for nursing management In view of the findings of this study, it is recommended that NMs and OMs should schedule and adhere to fixed performance management reviews for their staff members during the year, and acknowledge nurses who deliver quality work and excellent work input not only by means of material rewards but also by means of personal feedback in the form of verbal and/or written recognition. The PNs have to be guided by managers in workrelated problem-solving by means of encouragement,

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providing direction and mentorship. It is recommended that, should problems persist, managers take a constructive leadership role in bringing all the relevant parties together, using techniques such as brainstorming as well as the nominal group technique to find possible solutions. Thereafter, they should be instrumental in applying/implementing the most feasible solution and in monitoring progress. Supervisory communication requires NMs and OMs to observe and listen to staff members and pay attention to staff needs and ideas. This could be enhanced by creating staff forums for sharing ideas and information between different categories of staff. It is suggested that NMs avoid downwardly directed subordinate communication by utilising formal communication structures to allow interactive communication (i.e. meetings or forums). Furthermore, they can maintain an open climate that is conducive to the initiation of upward communication by using face-toface communication, presenting the manager to staff as a person who understands their needs and the challenges they face. The NMs could keep OMs informed about relevant matters and the latter should then prioritise information and assignments into high, medium and low priority categories in order to effectively manage the demands facing them. By providing feedback in a tactful, supportive and one-on-one manner that is focused on developmental needs, NMs could reduce staff members’ sensitivity with regard to evaluation, suggestions and criticism. Managers and all staff members who deal with the distribution of information in the hospital, should preferably provide staff with accurate information, especially on issues that might cause anxiety and result in discontent, such as change, major problems and work security, in order to avoid the distortion of information by hearsay and gossip. Relating to organisational integration, managers are required to update individual staff members on their job progress (how well they are developing in their jobs), by providing them with feedback and guidance on career planning. All managers who develop and distribute policies to staff members should ensure that such policies are written in a simple, clear and concise way, thereby enabling easy comprehension. All new and key concepts should be defined and explained and a list of abbreviations should be included. The NMs need to update nurses on corporate information, such as policies affecting the hospital and nursing practice per se, and make regulations accessible to staff members by maintaining a file for such

documents in the offices of OMs. Top management should implement a corporate communication channel that would inform all employees, via the electronic media, about impending change, financial standing and achievements/failures by the hospital. For example, start a newsletter, highlighting events in the hospital, by allocating the task to creative staff members who are interested in compiling such newsletter and include this responsibility in their Key Performance Areas (KPAs). Regarding the communication climate, managers could establish a team of different role-players, both from inside the hospital and from the community, to encourage organisational identification, which should be evident in the conduct and behaviour of all staff members. They could involve staff members in activities to improve the hospital’s professional image and probe staff members by means of a needs analysis survey on possible improvements. Following a needs analysis, and based on the outcomes of such need analysis, NMs could schedule workshops on communication skills to address the needs of staff at different levels of proficiency, in order to enhance their communication skills. Media quality is important and top management, NMs and OMs should distribute important information in a formal, written format (i.e. memorandums, policy statements and procedures) and follow up verbal messages with written messages for verification purposes. Messages could also be distributed via the electronic media (i.e. via e-mail or as text messages). Space should be provided on relevant documents where staff can sign after reading the information, to ensure that they have received the information.

Acknowledgement The authors wish to thank Dr CW Downs for permission to use and adapt the ComSat (CSQ) for this study. J.-D.W. gratefully acknowledges a bursary received from Unisa in his final study year.

Source of funding The authors did not receive any funding for this paper.

Ethical approval Before conducting the study, permission was obtained from the Higher Degrees Committee of the Department of Health Studies at Unisa (HSHDC57/2011),

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from the Gauteng Department of Health and Social Development and from the chief executive officers (CEOs) and nursing managers (NMs) of all three hospitals. Both verbal and written informed letters of consent were obtained from the respondents, which included the pre-test respondents. In the letter seeking permission from respondents the purpose of the study was explained and the respondents’ right to voluntary participation, anonymity and confidentiality was assured.

Trenholm S. (2011) Thinking Through Communication: An Introduction to the Study of Human Communication, 6th edn. Pearson Education, Upper Saddle River, NJ. Van Staden E., Marx S. & Erasmus-Kritzinger L. (2002) Corporate Communication: Getting the Message Across in Business. Van Schaik, Pretoria. Von Holdt K. & Maseramule B. (2005) After apartheid: decay or reconstruction in a public hospital? In Beyond the Apartheid Workplace: Studies in Transition (E Webster & K von Holdt eds), pp. 435–460. University of KwaZulu-Natal Press, Scottsville.

Supporting information References Burns N. & Grove S.K. (2009) The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence, 6th edn. Saunders, Philadelphia, PA. Dhlamini S. (2012) Job satisfaction. Nursing Update 37 (7), 62–63. Downs C.W. & Adrian A.D. (2004) Assessing Organizational Communication: Strategic Communication Audits. Guilford Press, New York, NY. Downs C.W. & Hazen M.D. (1977) A factor analytic study of communication satisfaction. Journal of Business Communication 14 (3), 63–73. Enslin P. (2005) Problems in the nursing world. Nursing Update 29 (4), 31. Jooste K. ed. (2009) Leadership in Health Services Management, 2nd edn. Juta, Cape Town. Jooste K. (2010) The Principles and Practice of Nursing and Health Care. Van Schaik Publishers, Pretoria. Kekana H.P.P., Du Rand E.A. & Van Wyk N.C. (2007) Job satisfaction of registered nurses in a community hospital in the Limpopo Province South Africa. Curationis 30 (2), 24– 35. Landman W.A., Mouton J. & Nevhutalu K.H. (2001) Chris Hani Baragwanath Hospital Ethics Audit: Research Report No. 2. Ethics Institute of South Africa, Pretoria. Meintjes C. & Steyn B. (2006) A critical evaluation of the Downs-Hazen instrument (CSQ) by measuring employee communication satisfaction at a private higher education institution in South Africa. Communication: South African Journal for Communication Theory and Research 32 (1), 152–188. Meyer S.M., Naude M., Shangase N.C. & Van Niekerk S.E. (2009) The Nursing Unit Manager: A Comprehensive Guide, 3rd edn. Heinemann Publishers, Sandton. Mokoka K.E., Ehlers V.J. & Oosthuizen M.J. (2011) Factors influencing the retention of registered nurses in the Gauteng Province of South Africa. Curationis 34 (1), Art. 16. Available at: http://dx.doi.org/10.4102/curationis.v34i1.16, accessed 10 March 2013. Muller M.E., Bezuidenhout M.C. & Jooste K. (2006) Healthcare Service Management. Juta, Cape Town. Plichta S.B. & Garzon L.S. (2009) Statistics for Nursing and Allied Health. Wolters Kluwer Health/ Lippincott Williams & Wilkins, Philadelphia, PA. South African Nursing Council (2012) Statistics for 2011. Available at: http://www.sanc.co.za/ ©2011, accessed 29 May 2012.

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Additional Supporting Information may be found in the online version of this article: Table S1. Level of satisfaction with personal feedback in an interpersonal communication context. Table S2. Level of satisfaction with supervisor communication in an interpersonal communication context. Table S3. Managers’ level of satisfaction with subordinate communication in an interpersonal communication context. Table S4. Level of satisfaction with the horizontal (co-worker) dimension in group communication channels. Table S5. Level of satisfaction with the organisational integration in a group communication context. Table S6. Level of satisfaction with corporate information flowing through formal communication channels. Table S7. Level of satisfaction with the communication climate in an organisational communication context. Table S8. Level of satisfaction with the media quality in formal communication channels. Table S9. Rank order of means on a 1–5 scale.

ª 2014 The Authors. Journal of Nursing Management Published by John wiley & Sons Ltd. Journal of Nursing Management, 2015, 23, 974–982

Communication satisfaction of professional nurses working in public hospitals.

This study aimed to establish and describe the level of communication satisfaction that professional nurses experience in selected public hospitals in...
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