Pensar Enfermagem / v.29 n.01 / february 2025
DOI: 10.71861/pensarenf.v29i1.342 / e00342
Qualitative Original Article
Como citar este artigo: Villagran CA, Lanes TC, Dalmolin GL. Job satisfaction and intent to leave among
obstetric nurses. Pensar Enf [Internet]. 2025 Feb; 29(1): e00342. Available from:
https://doi.org/10.71861/pensarenf.v29i1.342
Job satisfaction and intent to leave among obstetric
nurses
Abstract
Introduction
The sustainability of the nursing workforce depends on the effective management of
occupational stress and job satisfaction. Factors such as workload, organizational support
and work environment influence the intention of nurses to stay or leave their jobs.
Dissatisfaction, especially in obstetric contexts, can lead to increased turnover, affecting
both mental health and organizational commitment of professionals.
Objective
To analyze the job satisfaction and intent to leave among obstetric nurses.
Methods
Qualitative, descriptive and exploratory study carried out with seven obstetric nurses from
a university hospital in southern Brazil. The collection took place through a semi-structured
interview and the data were submitted to Discursive Textual Analysis. The research
respected the ethical precepts established in Resolution 466/2012 of the National Health
Council. Participants were identified with pseudonyms.
Results
Two categories emerged: “Job satisfaction among obstetric nurses”, showing the suffering
and psychological exhaustion lead nurses to dissatisfaction to work in the obstetric center
and, “Intent to leave among obstetric nurses” bringing disappointment in working in the
unit.
Conclusion
It is clear that obstetric nurses are dissatisfied with their work and they express an intention
to leave.
Keywords
Nurse Midwives; Personnel Turnover; Psychological Distress; Job Satisfaction.
Camila Antunez Villagran1
https://orcid.org/0000-0002-9498-3049
Tais Carpes Lanes2
https://orcid.org/0000-0001-9337-7875
Graziele de Lima Dalmolin3
https://orcid.org/0000-0003-0985-5788
1 Master in Nursing, University of Rio Verde, College
of Nursing,
2 PhD in Nursing, Federal University of Santa Maria,
Department of Nursing, Santa Maria, RS, Brazil.
3 PhD in Nursing, Federal University of Santa Maria,
Department of Nursing, Santa Maria, RS, Brazil.
Corresponding author
Camila Antunez Villagran
E-mail: camilaantunezvillagran@gmail.com
Recebido: Sep 03 2024
Aceite: Feb 05 2025
Editor
Pedro Bernardes Lucas
Villagran, C.
Qualitative Original Article
Introduction
The sustainability of the nursing workforce is intrinsically
linked to the effective approach to human resources issues
related to stress in the workplace and job satisfaction. The
literature shows that the challenges inherent in the
provision of health care, which initially attract nurses, can
become sources of occupational stress, job dissatisfaction,
reduced prospects for work capacity, increased absenteeism
and the intention to leave employment. 1
By fostering job satisfaction, work ability and a safe
environment, it is possible to decrease the intention of
workers to leave their jobs. Therefore, nursing managers
need to understand these factors to develop strategies that
keep nursing professionals in the work process, aligned
with the institution's objectives. 2 The nurse's intention to
remain or leave their job is associated with factors such as
self-assessment of health, monthly income, working hours,
violence originating from the patients, perception of
respect for the patients, coordination between physicians
and nurses, and job satisfaction. 3 There are often related to
various manifestations of adverse reactions and
abandonment of employment. This includes low
engagement with the organization, frequent absences, and
intention to leave the job, high turnover, and job
dissatisfaction. 4
Organizational factors, such as adequate staff and a positive
work environment, significantly influence nurses' decisions
to remain in their positions. When these factors are absent,
nurses are more likely to express intentions to leave. 5
The work context in obstetric centers has a significant
influence on the intention of health professionals to leave
their jobs. Factors such as job satisfaction, organizational
commitment and the quality of the work environment are
crucial in this decision. Dissatisfaction at work, usually
resulting from overload, lack of organizational support and
difficulties in reconciling work and personal life, can
increase the intention of professionals to leave the
profession. Studies indicate that both obstetric nurses are
directly impacted by these factors, which can lead to an
increase in turnover. 6-7
Research indicates that obstetric nurses experience
significant dissatisfaction in their functions, which
correlates with the intention to give up. One study
highlighted that factors such as high workload, emotional
stress and inadequate support contribute to job
dissatisfaction among these nurses. In addition, a survey
revealed that many obstetric nurses feel undervalued and
overwhelmed, which not only affects their job satisfaction,
but also their mental health, leading them to think about
leaving the profession. 5, 8
Thus, the following research question was outlined: What
is the relationship between job satisfaction and the
intention to leave the job among obstetric nurses? The
objective was to analyze job satisfaction and the intention
to leave the job among obstetric nurses.
Methods
This is a qualitative, descriptive and exploratory study
carried out in a university hospital in southern Brazil. The
study was conducted with obstetric nurses, where the
selection of participants was intentional, according to the
inclusion criteria: obstetric nurses working for at least one
month in the obstetric center and excluding those who
were on sick leave or away from work for any reason during
data collection. Of the 11 professionals invited, 01 refused
to answer and 3 did not answer, totaling 7 participants.
The data were collected in August to October 2021, and
initially the head of the sector was contacted in order to
explain the objectives of the research. The head of the
nurses' telephone contact was requested, which was passed
on to send the invitation, via text message via WhatsApp,
to participate in the research.
Nurses were invited to participate in data collection,
explaining the objectives, risks and benefits of the research.
Due to the health panorama related to the Covid-19
Pandemic, data collection took place online, through the
Google meet platform, according to convenience and
availability, without interfering with the progress of the
professionals' activities.
The interviews were conducted individually by the
researchers. The semi-structured interview guide included
characterization questions, and then open questions that
discuss the experiences and manifestations of
dissatisfaction with work and the intention to leave the job,
consisting of the following questions: “How do you feel
about this routine?", "How do you evaluate the working
conditions in this sector?", "Do you believe that conflicts
or the way you face situations that occur in the workplace
affect your health?", "How is care provided to the patients
in this sector?". The interviews were recorded for later
transcription with the authorization of the interviewee, with
a mean duration of approximately 42 minutes per interview.
The confidentiality agreement and the informed consent
form were signed via form. The sample size was due to data
saturation, that is, when it is observed that the participants'
responses become repeated and redundant, so that the
collection of a greater amount of data does not generate
new information. 9
The speeches were transcribed by a qualified scholarship
holder from the research group together with the
researcher. The information was organized in the Microsoft
Word software and submitted to discursive textual analysis,
which aims to deconstruct and reconstruct the researcher's
understanding, so that new understandings emerge from
the investigated phenomena.
This analysis went through three stages: 1) unitarization
that consists of the deconstruction of the texts of the
Pensar Enfermagem / v.29 n.01 / february 2025
DOI: 10.71861/pensarenf.v29i1.342 / e00342
Qualitative Original Article
corpus; 2) categorization that establishes relationships
between the unitary elements; and 3) capture of the new
and the emerging understanding is communicated and
validated. 10 In the first stage of unitarization, the interviews
were examined in detail in order to identify constituent
units of the studied phenomenon. This stage, in turn, also
followed three steps: 1) fragmentation of texts and coding
of each unit; 2) rewriting of each unit in order to recognize
a meaning in it; and 3) assigning a title to each unit (Moraes;
Galiazzi, 2016).
In the second stage of categorization, the units of analysis
were organized and grouped in order to compose
categories that established relationships between the
elements. In the third stage, related to a new understanding
of the phenomenon studied, meta-texts were produced
based on the units of analysis and categories (Moraes;
Galiazzi, 2016). The research respected the ethical precepts
established in Resolution 466/2012 of the National Health
Council. 11 The participants were identified with
pseudonyms formed by the acronym “Nurse 01, Nurse
02...”, followed by the order number of the interviews. The
data were saved on an external hard drive, and deleted from
the cloud and will be kept for a period of five years
according to the confidentiality agreement, approved by the
Research Ethics Committee with opinion 4,847,212, July
14, 2021.
The emergence of only two main categories is due to the
saturation of information related to the objectives of the
study. During the process of discursive textual analysis, it
was observed that the participants' answers converged to
two major thematic axes that encompass multiple aspects
of their experiences: "Satisfaction with work" and
"Intention to leave work". Despite the breadth of the
question script, the reports showed greater intensity and
relevance in these two domains, justified by the specific
working conditions reported by the participants.
Results
Seven obstetric nurses participated in the research, of which 100% (n=7) were female. Regarding the age group, 42.8% (n=03)
of the participants were aged between 28-39 years and 57.2% (n=04) were aged between 40-61 years and had worked for more
than 6 years in the obstetric center; the reports were divided into two categories, as shown in the following box:
Box 1: Categories
Subcategory
Suffering and psychological exhaustion
Demotivation.
Source: Authors
Job satisfaction among obstetric nurses
As a result of suffering and psychological exhaustion, it is
clear that obstetric nurses are dissatisfied with working in
the obstetric center. Job dissatisfaction is reported by the
nurses' awareness of suffering constraints that prevent
them from fulfilling the proposed work.
““A little frustrated! Because, in fact, the work I set out to do, for
which I came, was boycotted” (NURO6)
"But it's a very slow change and, until it happens, I already had
several colleagues who have already left the obstetric center, who are
obstetric nurses too, because they couldn't stand to see what was
happening [...]” (NUR03)
“So, we can't do a complete job, as an obstetric nurse, you know? This
is something that bothers me.” (NUR04)
Intent to leave among obstetric nurses
The intention to leave the job was verified by the
disappointment in working in the obstetric center.
“I used to feel better. It was once my dream to work there. I'm currently
looking at strategies to feel better or maybe even get another job.”
(NURO5)
"[...] you can't work like this; you end up isolating yourself from...
In a painful way, but you end up moving away from patients and
you want to give up on everything [...]”(NUR06)
Discussion
Job satisfaction and the intention to leave the job among
obstetric nurses are linked to factors that reflect an
organizational and systemic scenario. Dissatisfaction, often
manifested by challenges such as excessive workload, lack
of recognition and barriers to the implementation of
humanized practices, generates a negative impact on both
the well-being of professionals and the quality of care
provided. Dissatisfaction in the work environment is
associated with excessive workload, where the volume of
activities exceeds the operational capacity of nurses,
generating physical and mental exhaustion.12 The difficulty
in implementing humanized practices, especially in
contexts that prioritize the biomedical model, leads to
misalignment with the ethical and professional principles of
nurses. 13 The little appreciation of the specialized learning
of obstetric nurses by the medical team, as in the case of
the management of vaginal delivery, accentuates the feeling
of demotivation. 7 Difficult interpersonal relationships and
the absence of institutional support also aggravate
discontent.14 The illness of obstetric nursing professionals
emerges as a threat to the continuity of quality care. Factors
such as emotional exhaustion and the feeling of
powerlessness in the face of decisions unrelated to good
practices contribute to situations of stress, burnout and
Villagran, C.
Qualitative Original Article
absence from work.5 Dissatisfaction, combined with
emotional exhaustion, significantly influences the intention
of turnover, especially when nurses perceive that their
professional competencies and values are not recognized.15
Studies show that favorable environments, with
psychological support and recognition of individual
contributions, are essential to reverse this scenario.16 To
mitigate these challenges, actions such as the revision of
institutional policies are necessary to promote fairer
working conditions, with adequate teams and reduction of
overload.17 Offering opportunities for professional
development and updating that value the specialized
performance of obstetric nurses is also fundamental.7 In
addition, it is necessary to implement psychological support
programs that take care of the mental health of
professionals and strengthen interprofessional dialogue,
promoting the inclusion of nurses in care decisions. 15 The
interaction between job satisfaction and intention to leave
reflects the need for a holistic look at working conditions
and institutional factors that impact the practice of
obstetric nurses. Valuing these professionals is essential to
ensure retention and continuous improvement in obstetric
care. 14
Conclusion
The results show that obstetric nurses are dissatisfied with
their work and intend to leave their jobs. This study
contributes to both practice and theory by highlighting the
complex dynamics that influence job satisfaction and
intention to leave employment among obstetric nurses. In
the practical sphere, the results highlight the need to
reassess the work environment and management practices
in health institutions, proposing greater appreciation and
recognition of the specialized knowledge of these
professionals. The lack of autonomy and underutilization
of obstetric skills emerge as critical factors that directly
impact the motivation and retention of these professionals,
suggesting the urgency of strategies that promote
autonomy in decision-making and collaborative integration
in the care of parturients.
From a theoretical point of view, the study reinforces the
importance of investigating the relationship between job
satisfaction, professional appreciation and intention to
abandon in specific groups of nurses, contributing to a
growing body of literature on well-being and management
in the field of nursing.
The implications for nursing management and work
policies are clear: it is essential to implement organizational
practices that value the technical knowledge of obstetric
nurses, promote inclusive work environments and
encourage a culture of recognition and autonomy. In
addition, retention policies should prioritize evidence-
based interventions that address the factors of
dissatisfaction highlighted, also considering the specificities
of public and private institutions.
Future research can expand on these findings, investigating
how the characteristics of different health institutions
influence levels of dissatisfaction and abandonment, as well
as exploring concrete interventions that can increase job
satisfaction and strengthen the permanence of obstetric
nurses in the labor market.
Study limitations
As a limitation of the Dar study, the study was carried out
in a single university hospital in southern Brazil, which may
not reflect the realities of other places or health institutions
and data collection occurred during the COVID-19
pandemic, which may have influenced the participants'
responses due to increased stress and changes in working
conditions.
Authorship and Contributions
Villagran CA: Data collection; Writing the manuscript;
Critical revision of the manuscript; Approval of the final
version of the manuscript;
Lanes TC: Data collection; Writing the manuscript; Critical
revision of the manuscript;
Dalmolin GL: Conception and design of the study; Data
collection; Writing the manuscript; Critical revision of the
manuscript; Approval of the final version of the manuscript.
Conflicts of interest and funding
No conflicts of interest have been declared by the authors.
Sources of support/ Funding
The study was not funded.
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