AN INVESTIGATION INTO THE IMPACT OF PSYCHOLOGICAL SAFETY ON HEALTHCARE WORKERS' JOB SATISFACTION IN NIGERIAN HOSPITALS. A CASE STUDY OF MOTHER AND CHILD HOSPITAL AKURE, ONDO STATE

CHAPTER ONE

INTRODUCTION

1. Background of the study

Employee satisfaction are notoriously poor in the healthcare sector. According to a 2021 National Institute for Health Care Management research, in September 2020, 79% of doctors and 76% of healthcare workers reported feeling burned out (National Institute for Health Care Management, 2021). 93% of healthcare workers felt they were "stretched too thin," 82% were physically and emotionally exhausted, 39% felt they were not receiving enough emotional support, and 32% of registered nurses were thinking about quitting their current patient-facing position, according to other studies (Berlin et al., 2022; Mental Health America, 2020). The health and job happiness of healthcare professionals are critical in the high-stakes world of healthcare because they are directly related to the standard of patient treatment. Heavy workloads, long hours, and the emotional toll of patient care put healthcare workers under constant stress and strain, which can result in a variety of problems like burnout and turnover (Maslach & Leiter, 2016). Because it influences not only the quality of patient outcomes but also the general stability and efficiency of healthcare organisations, job satisfaction in the industry has therefore become a crucial subject of emphasis (Roberts et al., 2022).

Psychological safety is a notion that is becoming more and more linked to job satisfaction in the healthcare industry. Edmondson (1999) first used the term "psychological safety" to describe an environment in which staff members feel free to voice their opinions, ask questions, own up to their mistakes, and voice concerns without worrying about criticism or repercussions. Numerous sectors have investigated this idea extensively, and it has been discovered to promote employee engagement, creativity, and innovation (Clark, 2020). However, because patient care carries a high risk and communication failures can have serious repercussions, the requirement for psychological safety in the healthcare industry is even more critical (Edmondson & Lei, 2014). Healthcare professionals may rectify mistakes and speak honestly in a psychologically secure workplace, which eventually improves patient safety and job satisfaction (Brown et al., 2021). According to research, healthcare professionals who feel psychologically safe are more likely to disclose mistakes or close calls, which promotes organisational learning and better patient care (Reason, 2020). On the other hand, workers are more likely to conceal information or refrain from talking about errors in settings where they fear punishment or embarrassment, which might jeopardise patient safety and raise job discontent (Lee et al., 2023). Thus, psychological safety promotes team cohesiveness and care quality in addition to improving individual well-being (Salas et al., 2015). Despite these advantages, creating and sustaining psychologically secure settings remains a challenge for many healthcare organisations. According to studies, hospitals' strict rules, hierarchical structures, and high performance expectations can stifle free speech and foster a culture of fear (Roberts et al., 2022). A lack of psychological safety is also a result of management strategies that prioritise harsh punishment for mistakes, which makes staff members less inclined to voice concerns, mistakes, or the need for changes in patient care procedures (Edmondson & Lei, 2016). Another important factor in this situation is job satisfaction, which affects the dedication, output, and mental health of healthcare professionals. Workload, autonomy, management support, and interpersonal interactions within teams are some of the elements that affect job satisfaction in the healthcare industry (Spector, 2017). By creating a healthy work environment where staff members feel appreciated and respected, psychological safety has a beneficial impact on these variables. Therefore, psychologically secure healthcare personnel are more likely to be more committed to their organisations and have greater job satisfaction, which lowers turnover and improves organisational performance (Brown et al., 2021).In healthcare settings, high turnover rates pose serious problems. In addition to interfering with the continuity of service, the loss of qualified healthcare personnel results in significant expenses for hiring and training new employees (Roberts et al., 2022). Healthcare organisations may address the underlying reasons of employee turnover by enhancing job satisfaction and lowering employee fatigue by fostering psychological safety. This strategy is in line with an expanding corpus of research that emphasises the significance of social and psychological elements in affecting employee retention and job satisfaction. Therefore, the researcher sought to investigate the impact of psychological safety on healthcare workers' job satisfaction in Nigerian hospitals. A case study of Mother and child hospital Akure, Ondo State.

1.2 Statement of the problem

Healthcare professionals frequently deal with emotional, physical, and cognitive demands that might jeopardise their well-being when working in high-stress environments (Edmondson & Lei, 2016). The idea of psychological safety, which is characterised as the common conviction that team members won't face consequences or humiliation for voicing their opinions, queries, worries, or errors, has become acknowledged as a crucial component in improving work satisfaction and team performance in this setting. Healthcare professionals may engage in open communication and active decision-making without worrying about unfavourable outcomes when they are in psychological safety, which may improve job satisfaction and lower burnout (Clark, 2020). High levels of stress, job dissatisfaction, and turnover among healthcare workers are the result of many hospitals' failure to establish an atmosphere where psychological safety is valued (Brown et al., 2021). These difficulties may result in serious workforce instability and lower the standard of care given to patients (Roberts et al., 2022). Improving working conditions and patient outcomes in the healthcare industry requires an understanding of how psychological safety affects job satisfaction; yet, there is currently little empirical study on this topic. Therefore, the study investigate the impact of psychological safety on healthcare workers' job satisfaction in Nigerian hospitals. A case study of Mother and child hospital Akure, Ondo State.

1.3 Objective of the study

The broad objective of the study is to investigate the impact of psychological safety on healthcare workers' job satisfaction in Nigerian hospitals. A case study of Mother and child hospital Akure, Ondo State. The specific objectives is as follows

1. To examine the level of psychological safety perceived by healthcare workers in hospital settings.

2. To identify factors within hospital environments that enhance psychological safety among healthcare workers.

3. To identify factors within hospital environments that hinder psychological safety among healthcare workers.

4. To provide recommendations for hospital management on strategies to improve psychological safety and job satisfaction among healthcare workers.

1.4 Research questions

The following questions have been prepared to guide the study

1. What is the level of psychological safety perceived by healthcare workers in Nigerian hospital settings?

2. What are the factors within hospital environments that enhance psychological safety among healthcare workers?

3. What are the factors within hospital environments that hinder psychological safety among healthcare workers?

4. What are the recommendations for hospital management on strategies to improve psychological safety and job satisfaction among healthcare workers?

1.5 Significance of the study

This study holds substantial practical significance, as it addresses the critical role of psychological safety in promoting job satisfaction and well-being among healthcare workers. By investigating how psychological safety impacts healthcare workers' satisfaction and performance, the findings of this research can provide hospital administrators and policymakers with actionable insights to foster a supportive work environment.

Findings of the study will also be significant to the academic community as it will contribute to existing literature, add to library resources and serve as a guide to future researchers.

1.6 Scope of the study

The study focus on the impact of psychological safet on healthcare workers' job satisfaction in Nigerian hospitals. A case study of Mother and child hospital Akure, Ondo State. Empirically, the study will examine the level of psychological safety perceived by healthcare workers in hospital settings, identify factors within hospital environments that enhance psychological safety among healthcare workers, identify factors within hospital environments that hinder psychological safety among healthcare workers and provide recommendations for hospital management on strategies to improve psychological safety and job satisfaction among healthcare workers.

Geographically, the study will be delimited to Mother and child hospital Akure, Ondo State.

1.7 Limitation of the study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint are:

Time: The researcher encountered time constraint as the researcher had to carry out this research along side other academic activities such as attending lectures and other educational activities required of her.

Finance: The researcher incurred more financial expenses in carrying out this study such as typesetting, printing, sourcing for relevant materials, literature, or information and in the data collection process.

Availability of Materials: The researcher encountered challenges in sourcing for literature in this study. The scarcity of literature on the subject due to the nature of the discourse was a limitation to this study.

1.8 Definition of terms

Psychological Safety: Psychological safety is a shared belief within a team or organization that members can express ideas, concerns, and mistakes without fear of negative consequences, such as ridicule, punishment, or reprisal (Edmondson, 1999). It fosters open communication and supports collaborative work environments, especially in high-stakes settings like healthcare.

Job Satisfaction: Job satisfaction refers to the level of contentment and fulfillment employees feel toward their work. In healthcare, it includes factors such as workload, organizational support, professional autonomy, and interpersonal relationships, which collectively influence a healthcare worker's morale and commitment to their role.

Healthcare Workers: Healthcare workers are professionals involved in the delivery of health services to patients, including doctors, nurses, technicians, administrative staff, and other allied health personnel who support patient care within hospitals and healthcare facilities.

Workplace Environment: The workplace environment encompasses the physical, social, and psychological conditions in which healthcare professionals operate. It includes factors such as work conditions, management style, team dynamics, and safety protocols, which collectively affect employees' well-being and performance.

Team Cohesion: Team cohesion is the degree to which healthcare team members work collaboratively and maintain a unified approach to patient care. High team cohesion often leads to better communication, support, and trust, which are critical in high-pressure environments like hospitals.

Burnout: Burnout is a state of chronic physical and emotional exhaustion often caused by prolonged exposure to workplace stress. In healthcare, burnout is linked to emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, which negatively impact both employee well-being and patient care.

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