Job satisfaction of the nursing team in intensive care units

Objective: to evaluate job satisfaction and its relationship with the personal and professional characteristics of the nursing team. Method: a descriptive and cross-sectional study with 163 nursing workers from the intensive care units of a teaching hospital. For data collection, the Brazilian version of the Job Satisfaction Survey and a personal and professional characterization form were used. Data were analyzed using descriptive statistics, comparisons and correlations. Results: the professionals demonstrated ambivalence for job satisfaction in a global way and concerning the communication domain. They were satisfied with the supervision, co-workers, and nature of work, while dissatisfied with other domains. There was a correlation between the intention to stay in the job and the majority of the Job Satisfaction Survey domains, except for co-workers and operating procedures, and a correlation between time working at the unit and at the institution with the domains pay, contingent rewards, and supervision. Conclusion: there was an ambivalence regarding job satisfaction and the variables intention of stay in the job and time working at the unit and at the institution were correlated with job satisfaction concerning the domains pay, contingent rewards, and supervision.


Introduction
Job satisfaction is a complex phenomenon with multiple causal factors related to the work environment, supervision, and management. It is defined as the positive response of professionals to working conditions that meet their needs, as a result of their assessment of the value or fairness of their professional experience (1) .
Benefits and salary compensations are the factors that most influence the satisfaction of nursing professionals (2) , followed by workload, recognition, institutional incentive (3)(4) , autonomy, and respect of the colleagues (5) . On the other hand, job satisfaction influences the intention to stay in the job (6) and in the institution (7) , as well as reflects on the quality and safety of nursing care (8) .
In a critical care environment, the continuous presence of suffering and death, highly complex care, and the use of advanced technologies, among other elements, may lead to professional dissatisfaction and hinder the quality of life at work of nursing professionals (9) . The practice of leadership and organizational commitment were predictors for job satisfaction of nurses in critical care units (10) , as well as workload (11) , relationship with the work team, autonomy, compensation, and recognition (12)(13) .
It is an environment that needs constant updating of professionals concerning technological innovations and complexity of patient care, as well as management support to deal with conflicts and develop interdisciplinary actions in the health context, thus promoting safe care. In addition, nursing is the largest category of health professionals, responsible for continuous care to patients, which reinforces the need to value an environment in which professionals may be satisfied with their work, exercising their activities with quality and ensuring the safety of patients. Therefore, this study aimed to evaluate job satisfaction and its relationship with the personal and professional characteristics of the nursing team. Thus, the participants filled a personal and professional characterization form and answered the Brazilian version of the Job Satisfaction Survey (JSS) (14) .

Method
The personal and professional characterization form  (14) .
It should be mentioned that, in the data analysis, for the domains benefits, promotion, nature of work, and operating procedures, we considered as job satisfaction mean values between 12 and 18 points; dissatisfaction for means between three and nine points; and for values between 10 and 11, www.eerp.usp.br/rlae 3 Teruya KY, Costa ACS, Guirardello EB.
it was considered that they were neither satisfied or dissatisfied with the job, which is called ambivalence.
For the domains pay, contingent rewards, supervision, and communication, mean values between 16 and 24 points indicated satisfaction; between four and 12 points, dissatisfaction; and means between 13 and 15 points represented ambivalence (14).

Results
The study included 163 nursing professionals, with a mean age of 38.7 years (± 8.6), and a response rate of 93.34%. The sample characterization data are presented in Table 1.
The mean time of professional experience was 14.9 years (±7.6), the mean time working at the unit was seven years (±5.5) and the mean time working at the institution was 9.6 years (±7.1). As for the intention to stay in the current job in the next year, the mean  difference between the three periods concerning pay (p=0.0186), benefits (p=0.0187), and contingent rewards (p=0.0220), with the afternoon period obtaining higher means of job satisfaction, followed by the night and morning shifts. However, for these three subscales, the comparison was statistically significant only between the morning and afternoon shifts. The evaluation of the existence of a correlation between the JSS domains and other personal and professional variables is presented in Table 3.  to act in such complex units, as is the case of intensive care units. As in another study on the subject, the mean value for the variable intention to stay in the job was high, indicating that the professionals intend to continue in the current job (16) .
JSS enables the assessment of satisfaction in a general way, considering the total number of items, as well as separately, by the domains. In the analysis, considering the total score, the professionals were not satisfied or dissatisfied with their jobs, which can be understood as a perception of ambivalence for job satisfaction. However, these findings cannot be www.eerp.usp.br/rlae 5 Teruya KY, Costa ACS, Guirardello EB.
compared with other studies in Brazil, since this is the first study that evaluated the job satisfaction of the nursing team using the Brazilian version of the JSS.

However, in a study carried out with nurses in Saudi
Arabia, ambivalence was also reported regarding job satisfaction (17) .
However, when assessing satisfaction by the JSS domains, satisfaction was found with supervision, coworkers, and the nature of work, which was also identified in other international studies (18)(19) . On the other hand, the professionals showed dissatisfaction with most JSS domains, which were: contingent rewards, pay, benefits, operating procedures, and promotion. The perception of dissatisfaction expressed in the contingent rewards and operating procedures domains was also reported by nurses in Saudi Arabia (17) , while for nurses in Turkey dissatisfaction was attributed to contingent rewards, pay, and benefits (19) .
Some studies that evaluated job satisfaction using other instruments, other than JSS, also evidenced that benefits (4) and pay (20) negatively influenced the perception of job satisfaction. It is important to highlight that, in this study, the professionals reported ambivalence only for the communication domain, which differs from the Saudi nurses, for whom most domains were perceived as ambivalent (17) .
As for sex, men were more satisfied than women, regarding the domain nature of work, corroborating data from the national literature in which men presented higher rates of job satisfaction (21) . In international research, women presented higher levels of job satisfaction than men (22) .
Nursing professionals also differed among categories regarding job satisfaction, with nursing technicians being more satisfied than nurses in the domains: contingent rewards, nature of work, operating procedures, and communication. Similar data were found in a study that used the Index of Work Satisfaction and revealed that nursing technicians were more satisfied than nurses (23) .
The professionals of the Transplants ICU were more

Conclusion
The nursing professionals, in general, reported ambivalence regarding job satisfaction. In the analysis by domains, they were satisfied with supervision, coworkers, and nature of work, and dissatisfied with contingent rewards, pay, benefits, operating procedures, and promotion. Moreover, the shorter the time of experience in the unit and the institution and the greater the intention to stay in the job, the greater the job satisfaction.