Job satisfaction encapsulates the degree to which employees perceive fulfilment in various facets of their work, including the stability of their position, opportunities for professional development and confidence in their capability to execute tasks successfully. In Namibia, a decline in job satisfaction has been observed with nurses leaving hospitals at alarming rates, yet limited research exists on the factors influencing their job satisfaction. This study was conducted at Rundu Intermediate Hospital between June 2024 and September 2024.
The study explored factors affecting job satisfaction among nurses at Rundu Intermediate Hospital in the Kavango East Region, Namibia.
A qualitative, exploratory, descriptive and contextual design was used. Fifteen nurses from various departments were selected through non-probability convenience sampling. Data were collected via semi-structured interviews, audio-recorded, transcribed verbatim and analysed thematically.
Nurses’ job satisfaction is closely linked to personal fulfilment, professional growth and contributions to patient care. Objective factors such as promotion, pay and recognition further shape satisfaction levels. Major challenges include staff shortages, resource constraints and lack of support.
Hospital management should implement strategies that reduce workload, enhance recognition and create opportunities for professional development to improve job satisfaction and retention.
The study provides context-specific insights into factors influencing nurses’ job satisfaction in Namibia and proposes management interventions to strengthen morale, support professional growth and improve the quality-of-patient care.
Globally, job satisfaction has been a critical issue for healthcare organisations in recent years, particularly in nursing (Lucas et al.
Poor job satisfaction among nurses is not a new phenomenon (Mere et al.
This study investigated the factors influencing job satisfaction at Rundu Intermediate Hospital in the Kavango East Region of Namibia, as there has been limited research in the Namibian context. The 2013 Presidential Commission of Enquiry by the Ministry of Health and Social Services (MoHSS) highlighted growing concerns about the high rate of nurse attrition in public hospitals, which threatens healthcare delivery (MoHSS
The purpose of this study was to explore and describe the factors affecting nurses’ job satisfaction at Rundu Intermediate Hospital in the Kavango East Region of Namibia. The findings are expected to guide the MoHSS in developing evidence-based strategies to enhance job satisfaction, strengthen retention and promote a healthier work environment for nurses. In addition, the results will assist healthcare human resource managers (HRMs) across Namibia to design and implement practical strategies to better support nurses, improve morale and reduce turnover.
A qualitative study with an exploratory, descriptive and contextual design was employed to answer the research questions. The exploratory approach enabled a deep understanding of nurses’ experiences regarding job satisfaction; the descriptive design facilitated the clear presentation of findings through coding and theming of the participants’ perspectives (Rutberg & Bouikidis
The study was conducted at Rundu Intermediate Hospital in Rundu town, Kavango East Region, Namibia. The hospital has 167 registered nurses and 157 enrolled nurses, who work 12-h shifts on a rotating schedule. With a total bed capacity of 519, the hospital includes units such as casualty, high care, paediatrics, maternity, surgical, prem, tuberculosis and male and female wards. The hospital serves patients from the Zambezi, Kavango East and Kavango West regions. Fifteen nurses who met the inclusion criteria from various units participated in the study.
The population of this study consisted of all nurses employed at Rundu Intermediate Hospital in the Kavango East Region, Namibia. At the time of the study, 324 nurses registered and enrolled nurses were responsible for providing direct patient care. The target population included nurses who were available and willing to participate in the study. A non-probability, snowball recruitment strategy was employed to select 15 nurses for the interviews. Access to participants was facilitated through the Nursing Department supervisors, who informed eligible nurses about the study and provided their contact details. Appointments were then scheduled with each participant.
Data were collected through semi-structured interviews between June 2024 and September 2024. An interview guide was developed based on the study objectives and existing literature, which was used to explore factors affecting nurses’ job satisfaction among nurses at Rundu Intermediate Hospital, Kavango East, Namibia. English was used as all participants were proficient due to their academic and professional backgrounds, ensuring clarity and authenticity of the data collected. The researcher obtained permission to conduct the study from the HRM of Rundu Intermediate Hospital, who also granted access to the hospital and assisted in facilitating contact with participants. The researcher had no prior personal relationships with the participants that could influence their responses. To prevent coercion, participants were fully informed about the purpose of the study, the voluntary nature of participation and their right to withdraw or decline to answer any questions at any time. Written informed consent was obtained from all participants prior to the interviews, and confidentiality and anonymity were emphasised, with assurances that all information would be securely stored and used solely for research purposes.
Interviews were conducted at times and locations selected by the participants, typically within hospital offices or quiet areas near their departments, providing a conducive environment for open discussion without interruptions. Field notes were taken to capture non-verbal cues and relevant environmental observations, and the interviews were audio-recorded with the participants’ permission. Each interview lasted approximately 30 min – 45 min.
The researcher posed the following core open-ended questions, with follow-up probes based on the participants’ responses: (1)
Data saturation was reached by the 15th participant, indicating that no new information would emerge from additional interviews. Raw data from the audio-recordings were transcribed verbatim before they were analysed using Braun and Clarke (
The four principles framework of Lincoln and Guba (
Prior to data collection, ethical approval for the study was obtained from the School of Nursing Research and Ethics Committee (SoNREC) at the University of Namibia (SoNREC 99/2023). Permission to conduct the study was also granted by the Ministry of Health and Social Services Institutional Research Review Board (Reference number: 22/7/7/2). Confidentiality and anonymity were strictly maintained throughout the study. Participants’ names were replaced with codes, and all information was securely stored on a password-protected computer accessible only to the researcher and study supervisors. Participants were informed that they would not receive direct personal benefits, but that the findings of the study were intended to inform strategies to enhance nurses’ job satisfaction, which could positively impact the work environment at Rundu Intermediate Hospital. The study adhered to the principle of non-maleficence, as no interventions were conducted that could potentially harm participants.
The study included 15 nurses (
Demographic characteristics of participants.
| Participant codes | Age (years) | Gender | Nursing qualification | Working experience (years) |
|---|---|---|---|---|
| P1 | 36 | Female | Registered | 8 |
| P2 | 32 | Female | Registered | 5 |
| P3 | 32 | Female | Enrolled | 6 |
| P4 | 33 | Male | Enrolled | 11 |
| P5 | 30 | Male | Enrolled | 7 |
| P6 | 30 | Male | Registered | 3 |
| P7 | 26 | Male | Registered | 3 |
| P8 | 52 | Female | Registered | 25 |
| P9 | 26 | Male | Registered | 2 |
| P10 | 26 | Female | Registered | 3 |
| P11 | 25 | Female | Enrolled | 3 |
| P12 | 37 | Female | Registered | 10 |
| P13 | 39 | Female | Registered | 14 |
| P14 | 32 | Female | Registered | 3 |
| P15 | 36 | Male | Registered | 5 |
P, participant.
Themes and subthemes that emerged from analysis.
| Themes | Subthemes |
|---|---|
| 1. Understanding of job satisfaction | Personal fulfilment |
| 2. Factors affecting job satisfaction | Opportunities for career advancement Team work Better wages Coworker relationships |
| 3. Factors contributing to job dissatisfaction | Heavy workload Shortage of resources Lack of recognition Lack of opportunities for continuous professional development |
| 4. Recommendations to improve job satisfaction among nurses | Review nurses’ salary grading Training and development opportunities Ensure availability of equipment and supplies Management support |
This theme captures the participants’ perceptions regarding job satisfaction; they described it as a sense of personal fulfilment, emotional well-being and accomplishment in their work. They emphasised that job satisfaction goes beyond salary or career advancement to include feeling valued, supported and able to perform their duties effectively.
This subtheme comprises participants understanding concept definition of job satisfaction. Numerous participants understood the term ‘job satisfaction’ as meaning an individual’s positive or negative emotional response towards their job role and level of happiness derived from the job:
‘When an employee feels good or stable about their job and they also feel they can also grow in their job or career; also, this relates to personal life.’ (P4, 33 years, male)
This theme relates to which factors contribute to participants’ job satisfaction and their effect on patient care, with the following subthemes: Opportunities for career advancement, team work, better wages and coworker relationships.
Participants highlighted that opportunities for career advancement are a contributing factor to nurses’ job satisfaction. Participants also stated that they are able to sharpen their skills and knowledge in nursing at their jobs as the hospital is a training hospital.
Participants emphasised that collaboration with other health workers promotes patient-centred care and reduces stress among nurses, leading to increased job satisfaction. They highlighted that effective teamwork fosters mutual support, improves efficiency and creates a positive work environment:
‘We share the information on how to treat the patient and how to maintain the well-being of the patient as a teamwork.’ (P8, 52 years, female)
Participants highlighted that fair salaries enable them to support their families, reduce financial stress and remain motivated to provide quality patient care. They emphasised that adequate pay not only meets their basic needs but also serves as recognition of their hard work, which fosters loyalty, commitment and overall job satisfaction:
‘A good salary makes me satisfied as a nurse as it boosts my work morale and life, because if I am paid a salary that can cater for my basic needs it boosts my energy and confidence and at the end the day, I will even give proper nursing care since I do not have worry when it comes to finances.’ (P7, 30 years, male)
Participants highlighted that inter-professional respect improves job satisfaction and well-being. Positive relationships and teamwork foster trust, reduce stress and enhance patient care. Participants added that mutual support among colleagues creates a healthy work environment, while poor relationships are demotivating and affect overall performance:
‘The staff relationships whereby there is mutual respect and dignity and as well me providing nursing care and my patients gets well afterwards it really makes me feel satisfied.’ (P7, 26 years, male)
This theme explores the various factors participants have experienced that limit their job satisfaction. The key aspects discussed under this theme include heavy workload, shortage of equipment, lack of recognition and limited opportunities for continuous professional development.
Participants mentioned that despite satisfying aspects of their workplace, an imbalanced nurse-to-patient ratio significantly increases their work burden. This heavy workload leads to fatigue, stress and burnout, making the profession less appealing and reducing interest in pursuing a long-term nursing career. Nurses reported that excessive responsibilities often limit their ability to provide quality patient care, which further impacts their job satisfaction and overall well-being:
‘I want to render that proper care but then I cannot give to all of them because there are a lot of patients, so I have to do here and there so thus I am not satisfied.’ (P10, 26 years, female)
Nurses reported that a shortage of medical equipment frustrates them by limiting their ability to provide quality care. This shortage complicates achieving work goals and negatively impacts job satisfaction due to compromised service delivery. Participants further noted that a lack of essential tools not only affects their efficiency but can also delay treatment, increase patient risks and create additional stress in the workplace:
‘If we do not have the necessary resources or for us to progress to the next level it makes me feel unsatisfied because one would not achieve their goals and the work becomes complicated.’ (P4, 33 years, female)
The nurses commented that they are the beating heart of medical teams, delivering care on regular basis, making judgements and providing comfort during times of crisis. However, many times their efforts are ignored, and achievements may go unnoticed or unacknowledged by supervisors, and the nurses are not aware of the method that was utilised to promote those that are recognised:
‘We are not appraised in areas that we did well, and those that are recognised we do not know how they were selected by the management that they are hard workers, for him or her to deserve to be recognised.’ (P14, 32 years, female)
Nurses stated that in-service training is a major concern in the hospital, as nurses are not frequently given opportunities for further training and not everyone has an equal chance to attend. They emphasised that limited access to continuous professional development hinders skill improvement, reduces confidence and affects the quality of care delivered. Some participants expressed frustration, noting that unequal opportunities create feelings of neglect and demotivation among staff:
‘At the clinic I was working I got exposed to a lot of programmes whereby here in the hospital it is limited and not everybody has access to such programmes; so to say programmes for training for TB, IMCI [
This theme provides suggestions for promoting job satisfaction among nurses at Rundu Intermediate Hospital. The subthemes include the need to recruit more nurses to reduce workload, to review and improve nurses’ salaries to enhance motivation and to increase opportunities for in-service training in various aspects of nursing care to strengthen skills and confidence.
Participants stated that although they are being paid, there is a need to review and increase their salaries to boost morale and motivation in the workplace. Participants emphasised that better compensation would help retain staff, reduce financial stress and enhance commitment to providing quality patient care:
‘Government should review the salary grading of enrolled nurses at least to push it to grade 9 not grade 10; like that is too little for us.’ (P5, 30 years, male)
Participants suggested further training on patient care and current nursing guidelines through in-service programmes to enhance their skills and knowledge. They also emphasised that regular training would improve confidence, ensure up-to-date practices and lead to better quality care for patients:
‘We need proper and fresh in-service training on the latest update information about how to take care of the patient so that we can provide proper nursing care based on the guidelines and policies.’ (P8, 52 years, female)
Participants proposed that hospital management should procure quality equipment and necessary supplies to support patient care and ensure accurate results. In addition, they emphasised that having the right tools reduces frustration, improves efficiency and enhances their ability to provide safe and effective care, which in turn promotes morale and overall job satisfaction:
‘We need equipment which we can use to monitor patients for the services to improve and nurses will even be happy because they are not going to struggle.’ (P1, 36 years, female)
‘We need good quality instruments that can give proper results so that we do not end up losing our patients as result of equipment.’ (P8, 52 years, female)
Participants suggested that hospital management should regularly visit units to identify issues affecting nurses and address them promptly. They emphasised that active management support would improve nurses’ job satisfaction, foster a supportive work environment and ensure the delivery of high-quality patient care:
‘The management should come on the ground to see how we are working, ask challenges we are facing and familiarise themselves with daily operations.’ (P6, 30 years, male)
‘I think the management should not only be in the offices; they should come and do daily inspections because sometimes even if we raise a complaint that there are too few staff in the unit, they just say a shortage of nurses is everywhere.’ (P2, 32 years, female)
The participants comprised nine females and six males, reflecting a slightly higher representation of females. This gender disparity between males and females can be attributes to the fact that the nursing profession is viewed as a female profession. In terms of qualifications, most were registered nurses, while a smaller group were enrolled nurses. Their years of working experience ranged from 2 years to 25 years, indicating a mix of junior, mid-level and highly experienced nurses. This diversity in age, gender, qualification and professional experience provided a broad perspective on the study topic.
This study explored and described the factors that affect job satisfaction among nurses at Rundu Intermediate Hospital in Kavango East Region, Namibia and provided recommendations to improve satisfaction, promote nurse retention and enhance the quality of nursing care. The participants demonstrated an acceptable understanding of the concept of job satisfaction, defining it as feelings of stability in one’s role and the ability of the job to fulfil personal needs. This aligns with Tomaszewska et al. (
Several factors were described as contributing to nurses’ satisfaction, including opportunities for career advancement, adequate remuneration, teamwork and positive relationships with coworkers. These findings are consistent with Bragadóttir et al. (
Moreover, participants reported that excessive workloads, often due to a high nurse-to-patient ratio, negatively affects their job satisfaction and interest in the profession. These findings are in line with those of Garcia (
Participants further indicated that inadequate medical equipment, such as blood pressure machines and thermometers, hinders the provision of quality care. This correlates with a study by Moyimane, Matlala and Kekana (
The participants strongly recommended several measures to enhance job satisfaction and the work environment, including hiring additional staff to reduce workload, improving patient care and ensuring adequate staffing to meet unit goals. These results corroborate with a study conducted by Albashayreh et al. (
The findings of this study provide valuable insights for hospital management and HRMs at Rundu Intermediate Hospital and other hospitals in Namibia. To improve nurses’ job satisfaction, hospital management should enhance recognition and professional development by providing opportunities for promotion, career growth and continuous training. Moreover, remuneration and benefits should be reviewed to ensure they are fair and comparable to similar positions in other healthcare settings. Reducing nurses’ workloads through adequate staffing and optimised shift schedules can help prevent burnout and improve their work–life balance. In addition, strengthening leadership and management support through training in transformational and supportive leadership can foster positive communication, trust and morale among staff. Promoting teamwork and a positive organisational culture through team-building initiatives and peer support programmes can further enhance job satisfaction. Additionally, implementing employee well-being programmes to address stress, burnout and occupational health risks will support nurses’ mental health and overall well-being. Collectively, these interventions could increase staff retention, boost motivation and improve the quality of patient care while creating a more supportive and positive work environment for nurses.
The findings are limited to nurses working at the Rundu Intermediate Hospital, however, and may not reflect experiences in other healthcare settings with different contexts. The use of convenience sampling may also have influenced the range of perspectives captured, as not all nurses may have been represented. Nevertheless, the study revealed important areas for further exploration, including how nurse-to-patient ratios affect job satisfaction and how experiences of job satisfaction may differ across nursing departments.
Based on the findings of this study, the following recommendations are made:
Management should prioritise creating a supportive and conducive working environment to ensure that nurses feel happy, fulfilled and engaged in their roles. A positive work environment reduces stress, enhances motivation and promotes overall job satisfaction. This can be achieved by promoting mutual respect, open communication and collaborative teamwork, which will foster a sense of belonging and professional pride among nurses.
Ensuring adequate nurse-to-patient ratios in all units and on each shift is essential to prevent excessive workload and burnout. Overburdened nurses may experience fatigue, reduced performance and decreased satisfaction. Proper staffing allows nurses to provide high-quality care, meet patient needs efficiently and maintain a balanced work–life schedule, which directly influences retention and satisfaction.
Maintaining sufficient medical equipment and supplies, such as blood pressure machines, thermometers and other essential tools, will support nurses in performing their duties effectively. Shortages of equipment increase stress, compromise patient care and diminish job satisfaction. Ensuring that a hospital is consistently stocked with functional and high-quality resources will enable nurses to work efficiently and safely.
A clear system of recognising high-performing nurses should be established through awards, salary increases and promotional opportunities. Recognition fosters a sense of value, motivates staff and encourages professional growth. Reward systems not only increase individual satisfaction but also promote a healthy competitive spirit within nursing units, enhancing overall morale and engagement.
Supporting nurses’ professional growth through opportunities for further studies, in-service training, workshops and clinical skill development is vital. Continuous learning improves competence, confidence and job satisfaction. Additionally, structured pathways for career advancement, promotions and leadership development empower nurses to achieve personal and professional goals.
Allowing nurses to contribute ideas to hospital unit policies and protocols will empower them and foster a sense of ownership and appreciation. Participation in decision-making strengthens engagement, ensures that policies are practical and relevant and enhances job satisfaction by making nurses feel heard and valued within the organisation.
Encouraging strong teamwork, collaboration and peer support within nursing units will enhance trust, communication and cooperation. Mentorship programmes for junior or less experienced nurses can provide guidance, reduce stress and improve confidence. Positive interactions among colleagues are closely linked to higher job satisfaction and improved patient care outcomes.
Timely payment of salaries, competitive wages and additional incentives are crucial for nurse motivation and job satisfaction. Financial recognition reinforces the value of nurses’ work and encourages commitment to the organisation. Policies addressing fair remuneration contribute to retention and reduce turnover intention.
Hospital management should establish systems to identify workplace challenges, gather feedback and implement interventions to address occupational stress, professional recognition, workload issues and opportunities for career growth. Active management of these factors will ensure that nurses remain satisfied, motivated and capable of delivering high-quality care to patients.
The study revealed multiple factors affecting job satisfaction among nurses at Rundu Intermediate Hospital, including workload, lack of recognition, insufficient resources, limited career advancement opportunities, inadequate professional development and the need for supportive management and teamwork. Nurses reported that excessive patient loads, shortages of essential medical equipment and minimal acknowledgement of their efforts hinder their motivation and satisfaction, while positive relationships with colleagues, opportunities for skill development and supportive leadership enhance their engagement. It is imperative that hospital management and relevant stakeholders address these factors to improve nurses’ job satisfaction, promote staff retention and enhance the quality of patient care. The findings of this study may contribute to the development of policies and interventions that foster a supportive work environment, provide adequate resources and encourage professional growth, ultimately strengthening nursing practice and improving health outcomes in the region. By addressing these factors, healthcare leaders can ensure a motivated, competent and satisfied nursing workforce capable of delivering high-quality and safe patient care.
The authors wish to thank the research participants who agreed to be part of this research endeavour. Without their participation, this study would not have been possible. The authors also wish to thank the University of Namibia Ethics Review Committee and the Ministry of Health and Social Services research unit for granting permission to conduct this study.
This article is based on research originally conducted as part of Matias Mekondjo Kalomo’s Bachelor of Nursing Science (Clinical) Honours thesis titled ‘Factors affecting job satisfaction of nurses at Rundu Intermediate Hospital in Kavango East Region, Namibia’, submitted to the Faculty of Health Sciences and Veterinary Medicine in the School of Nursing and Public Health, at the University of Namibia in 2024. The thesis is currently unpublished and not publicly available. The thesis was supervised by Dr Daniel O. Ashipala. The thesis was reworked, revised and adapted into a journal article for publication. The authors confirm that the content has not been previously published or disseminated and complies with ethical standards for original publication.
The authors, Daniel O. Ashipala, Matias M. Kalomo, Alice Lifalaza, Epafras Anyolo and Julia Amadhila, declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
Matias M. Kalomo: Conceptualisation, Formal Analysis, Investigation, Methodology. Daniel O. Ashipala: Conceptualisation, Data curation, Formal Analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Visualisation, Writing - original draft, Writing - review & editing. Alice Lifalaza: Resources, Writing – original draft, Writing – review & editing, Epafras Anyolo: Resources, Writing – original draft, Writing – review & editing, Julia Amadhila: Resources, Writing – original draft, Writing – review & editing. All authors reviewed the article, contributed to the discussion of results, approved the final version for submission and publication and take responsibility for the integrity of its findings.
The data that support the findings of this study are not openly available, Daniel O. Ashipala, upon reasonable request.
The views and opinions expressed in this article are those of the authors and are the product of professional research. They do not necessarily reflect the official policy or position of any affiliated institution, funder, agency or that of the publisher. The authors are responsible for this article’s results, findings, and content.