A descriptive cross sectional study of job satisfaction among pharmacists in a clinical setting

Background : Job satisfaction has been linked to improved job performance. Pharmacists as key healthcare providers with the ultimate duty of improving and maintaining the quality of life through the responsible provision of drug therapy, are expected to be highly productive. Low performance by Pharmacists can result to loss of lives especially through undetected actual and potential drug therapy problems which have been documented to be associated with high mortality and high rate of hospital admissions. Job satisfaction is the feeling of fulfilment that employees derive from their job which has a significant deal on their productivity. Assessing Pharmacists’ job satisfaction is therefore very paramount. Objective : This study accessed job satisfaction among Pharmacists


Introduction
Job satisfaction, also known as employee satisfaction, has become an important and extensively researched subject.It is considered an indicator of working-life quality and therefore, has become a crucial variable used to determine the quality of healthcare systems.Employee satisfaction is beneficial to the progress of any organization.The more satisfied employees are with their job, the more attached they are to the job, their coworkers and the organization, and the lower the tendencies to leave the organization.A positive workplace culture that nurtures purpose in an organization's vision, will most likely have workers who feel connected to their job and coworkers reducing migration from one organization to another.Employee who are satisfied with their job tend to have a sense of dedication that drives them to be more productive at work and less at absenteeism [1].Employee satisfaction translates to a positive customer experience which pays off [2].Satisfied employees are more motivated, engaged and committed.A 2016 Gallup report found that actively engaged employees showed 10%, 70%, 17% and 21% higher customer rating, fewer safety incidents, higher productivity and greater profitability respectively [3].
Job satisfaction is a term used to describe employees' level of satisfaction or fulfillment with their job or certain elements of their job.Thompson and Phua, opined that job satisfaction vary in the extent to which they measure feelings about the job (Affective job satisfaction) [4].It is an important indicator of how employees feel about their job and is necessary to promote functional employee behavior in an organization [5].According to Deborah et al., job satisfaction refers to an individual's perception and evaluation of his job.However, this perception is influenced by the person's unique circumstances such as needs, values, and expectations [6].Thus, individuals will evaluate their jobs on the basis of factors which they consider to be important to them.Consequently, job satisfaction and job dissatisfaction can occur in any given work situation [7].All aspects of a particular job, positive and negative can contribute to the development of feelings of satisfaction or dissatisfaction.
Services provided by Pharmacists as healthcare professionals are essential to enhancing patient care and promoting wellness [6].In fact, they are the health professionals with the best potential to effectively coordinate medication use across the continuum of care [8].Although their professional responsibilities vary across the diverse areas of pharmacy practice, it is important to note that Pharmacists roles are crucial to improving the general well-being of patients.How committed and effective they are in the discharge of their duties is commensurate with how satisfied they are with their job.
The professional commitment of a pharmacist is the provision of pharmaceutical care to patients with the principal goal of achieving definite outcomes that improves patients' quality of life with no or minimum risk.The quality of performance of this task to a large extent depends on whether the health professionals are job satisfied or dissatisfied [9].
Job satisfaction among healthcare professionals acquire significance for the purpose of maximization of human resource potential [10].In contrast, job dissatisfaction has a negative impact on the structure and workflow of organizations such as non-conformity with procedures and policies, increase in work accidents and organizational conflicts that may increase the rate of medical error [9].This has the tendency to jeopardize the safety of the patients and increase cost of employment due to increased turn-over rate.The effectiveness and efficiency of organizations depend to some extent on the level of satisfaction of employees and the extent to which employees are motivated.
According to the Society for Human Resource Management (SHRM), the top three drivers of job satisfaction were respectful treatment of employees, compensation/pay and benefits [11].Other factors that affect job satisfaction are work environment and work relationship, recognition, equity etc. Job satisfaction among pharmacists working in the hospital setting is vital because given the shortage of pharmacists in general and the extended time necessary to fill a pharmacist vacancy, job turnover resulting from a dissatisfied pharmacist can result in a significant financial loss to the hospital [12].Also, job turnover can result in the loss of a pharmacist who possesses special skills and knowledge, which may be expensive to replace.According to Gallup surveys, the average cost of an individual employee turnover is between one-half to two times an employee's annual salary for each you lose [13].Thus, it is necessary for Pharmacists' wellbeing to be adequately attended to in order to ensure that they are satisfied with their jobs.It is, also, imperative to understand what motivates Pharmacists and to what extent they are satisfied with the organization.This study, therefore, assessed Pharmacists' job satisfaction, identified factors affecting job satisfaction and the relationship between job satisfaction and demographic characteristics of the participants.

Study Area
The study was carried out at the pharmacy department of Federal Medical Center, Makurdi, Benue State, North Central Nigeria.Federal Medical Center Makurdi is a more than 400 bedded tertiary health institutions that serves as a referral facility.However, it also renders secondary and primary care.

Study Design
A descriptive, cross sectional study done to access Pharmacists job satisfaction.The study used structured questionnaire to obtain information from the study participants.The researchers used a model which compared the current work situation, feelings and expectations of the pharmacists with what they perceived to be an ideal work situation.The main outcome measures of the study were pharmacists' satisfaction statements and indicators of job satisfaction.The study duration was 1month (1 st October, 2022 to 30 th October, 2022)

Study Population
The researchers recruited all resident Pharmacists working in Federal Medical Center, Makurdi, Benue State, North Central Nigeria.

Sample size determinations and Sample Technique
Considering the small size of the population, total population sampling technique was used.However, only persons who consented were enrolled.Of the 36 full-time Residents Pharmacists on the employment of FMC, as at the time of the study, only 30 consented and participated in the study.

Data Collection/Analysis
Structured questionnaires were distributed to participants.The data collected included socio-demographic data such as sex, religion, marital status and highest educational qualification.Pharmacist job satisfaction with hospital practice was assessed as humanistic outcomes.The Pharmacist job satisfaction questionnaire anchored on a four likert scale: Very satisfied=4, Satisfied=3, Some-what satisfied=2 Dissatisfied=1.

Data Analysis
Simple percentages were used to analyse participants' demographic characteristics, level of satisfaction.Chi square was used to analyse the association between variables.Level of significance was measured at 95% confidence interval (p=0.05)

Ethical Approval
Approval for the study was obtained from the hospital research ethical committee (HERC).Respondents were assured of confidentiality of information provided and names were not included in the questionnaire.Also, informed consent was sought.

Results
Table 1 below shows the social demographic characteristics of the respondents.76.7% of the participants were males.56.7% had between 11-20 years of practice.63.3% had Masters Degrees, 93.3% were Christians and 80% married.Overall, Hospital culture (76.7%), work environment (60%), reward system (60%) and remuneration (53.4%) were found to be factors recorded with the highest level of dissatisfaction.The Pharmacists were some-what satisfied with how their contribution were valued and the value placed on them by management (53.3%each).However, they were satisfied with their position in the organisation.See table2.Over all job satisfaction was documented by only one third (33.3%) of the respondent as seen in table 3 below.Table 4 below reports significant correlation between job satisfaction and gender (p = 0.038) as well as educational qualification (p = 0.03).However, no significant relationship between job satisfaction and marital status (p = 0.306), religion (p = 0.103) and length of experience (p = 0.690) were reported.Level of significance tested at 95% confidence interval with P= 0.05

Discussion
Job satisfaction has been described as the way employees feel about their job or different aspects of their job.It is also considered to be the overall perceptions and feelings employees have about their work.Job satisfaction is an important attitudinal variable in organizational behavior therefore, managers are expected to direct attention to it for maximum organizational success.This study assessed job satisfaction among Pharmacists in Federal Medical Center, Makurdi, Benue State, Nigeria.
The result showed that the respondent were generally dissatisfied with their work; Job satisfaction was documented only by about one-third of the respondents.The highest level of dissatisfaction was with hospital work culture.It is paramount that a follow up research be done to identify the specific aspects of the organizational culture that are responsible for dissatisfaction.Overall, two-third of respondents were dissatisfied with their working environment and the reward system.Remuneration was also a strong dissatisfaction factor.More than half of the respondents expressed dissatisfaction with their salary.A similar study by Muliwork S.B et al 2021 revealed that near half of the pharmacists were poorly satisfied with their job [14].In their study, high workload, inadequate salary, low respect and treatment from hospital management, uncomfortable work environment and insufficient promotion were mentioned as major reasons for poor job satisfaction.They opined that improving work environment, professional management, income and organizational loyalty was necessary to enhance Pharmacists' job satisfaction.Similarly, salary was found to have influence on Job satisfaction according to Chinonyerem O. Iheanacho and Valentine U. Odili (2021).In Arabic countries, it was discovered that Pharmacists' satisfaction was average.In their study using the general Pharmacists population in 18 Arabic countries, Pharmacists had the lowest satisfaction averages with income and job expectations [15]15].In Abia state, Nigeria, Khamlub et al., 2013 showed that majority of the workers were not satisfied with how prompt salaries were paid [16].The findings of our current study is not consistent with the study among hospital pharmacists in China, where about 70% were satisfied with their salary.In our study, Job position was not a serious dissatisfaction factor though they were not very satisfied with it.The findings of Deborah Obehi Onwusah and Emmanuel Omuarore 2017 in Delta State showed that two third of the respondents were satisfied with their positions [6].It can be deduced from these studies that although pharmacists in Nigeria are not very satisfied with their position, it is not a major factor affecting job satisfaction.However, poor remuneration is a key factor affecting Pharmacists job satisfaction.It is advisable that the salaries of Pharmacists be enhanced so as to boost their satisfaction with resultant maximum productivity.
In our study, the strongest satisfaction indicator was the Pharmacists being valued for the contributions they make followed by their position and value placed on them by management.
Chi square tests of the relationship between variables showed no significant relationship between job satisfaction and demographic parameters except with gender and educational qualification.Gender has been associated with job-related experience, including job satisfaction and work-life balance [17].Our study revealed that female Pharmacists were significantly more dissatisfied than male Pharmacists.This is in line with Ali Azeez et al. who reported significant higher job satisfaction among male Pharmacists compared with their female counterparts [15].Considering the two studies above, it can be deduced that female Pharmacists are generally less satisfied with their job.This may be attributed to the gender responsibilities placed on them by the society which tend to be more cumbersome.A study by Dan Liu et al aimed to identify gender differences in job satisfaction and work life balance among Chinese Physicians found no significant gender differences in job satisfaction [17].Another study in Sweden among men and women working in five different occupations reported a higher level of job satisfaction among females than men.In their opinion, the paradox appeared to be consistent but it couldn't be attributed to work-family trade-offs [18].These variations in the results of the studies may be due to gender responsibilities, occupational tasks and gender inequality as they vary from country to country.A global gender based job satisfaction study taking into cognizance causal relationship elements may give a broader and more balanced understanding of gender-job satisfaction relationship.
Pharmacists with postgraduate degree had significantly lower satisfaction than those with bachelor's degree.This contrasts Ali Azeez et al 2022 whose study showed that Pharmacists with Bachelor's degree had significantly lower satisfaction than those with postgraduate degree [15].The dissatisfaction expressed by the Pharmacists with higher degree may be attributed to the inability of government to meet their high expectations.Majority of them graduated from the West African Postgraduate College of Pharmacists as consultants, a cadre that has been approved by the Nigerian government yet its implementation halted.While the Pharmacists expect that they should have some compensations in terms of specialty allowance, it has simply been an unmet expectation.This has the propensity to cause dissatisfaction in this group of participants.

Conclusion
Job satisfaction is the feeling of fulfilment that employees derive from their job.It is an indicator of working-life quality and an important attitudinal variable used to assess the quality of health-care systems.Poor job satisfaction may transcend to poor service quality if not timely handled.Motivators such as good reward system, good remuneration, conducive work environment, unbiased organizational culture will address this challenge.It is, however, worthy to note that the factors that may positively influence one employee might dissatisfy another.Therefore a multidimensional approach to enhancing pharmacists' satisfaction including their individual needs and practice areas of interest should be implemented.Further research to identifying these needs and practice areas of interest would help for timely intervention.

Table 2
Level of Satisfaction among the participants

Table 3
Level of Satisfaction and dissatisfaction among the participants

Table 4
Association between the level of satisfaction and demographics of the participants