Public Health Nursing Vol. 21 No. 6, pp.

564–571
0737-1209/04
# Blackwell Publishing, Inc.

Organizational Structure and

Job Satisfaction in Public Health Nursing
Sara L. Campbell, D.N.S., R.N.,
Eileen R. Fowles, Ph.D., R.N., and
B. Jan Weber, M.S.N., R.N.

public health has the capacity to provide essential public

Abstract The purpose of this descriptive study was to describe
the characteristics and relationship of organizational structure
and job satisfaction in public health nursing. A significant rela-
tionship was found between organizational structure variables
and job satisfaction for public health nurses employed in down
state Illinois local health departments. The findings of this study
suggest that work environments in which supervisors and sub-
ordinates consult together concerning job tasks and decisions,
and in which individuals are involved with peers in decision
making and task definition, are positively related to job satisfac-
tion. This information will assist nurse administrators in devel-
opment of work structures that support participative decision
making and enhance job satisfaction, critical to retaining and
attracting a well-qualified public health nurse workforce.
Key words: job satisfaction, nursing shortage, organizational
structure, public health nursing, retention.
Healthy People 2010 (U.S. Department of Health and
Human Services, 2000) outlines a comprehensive, nation-
wide health promotion and disease prevention agenda
and is a continuation of the national prevention initiative,
Healthy People 2000: National Health Promotion and
Disease Prevention (Public Health Service, 1990). Healthy
People 2010 objectives include the goal to ensure that
Sara L. Campbell is Associate Professor, Mennonite College of Nursing
at Illinois State University, Normal, Illinois. Eileen R. Fowles is Assistant
Professor, Mennonite College of Nursing at Illinois State University,
Normal, Illinois. B. Jan Weber is Supervisor, Maternal Child Health
Services at McLean County Health Department, Bloomington, Illinois.
Address correspondence to B. Jan Weber, 14648 Margo Lane,
Bloomington, IL 61704. E-mail: jan.weber@mcleancountyil.gov
health services. Public health nurses provide essential
public health services and require skills in epidemiology,
statistics, health promotion, disease surveillance, commu-
nity health assessment, and policy development, as well as
the ability to quickly respond to threats to the health of
the public. A key to carrying out essential public health
services is an adequate number of nurses with educational
preparation in public health and nursing science and a
primary focus on population-level outcomes (American
Public Health Association, Public Health Nursing Sec-
tion, 1996).
The current diminished supply of qualified nurses is
cause for concern to the public’s health as well as the
entire health care industry. Fluctuations in supply and
demand for nurses have led to periodic nurse shortages
since the 1960s (Brewer & Kovner, 2001). When demand
for nurses exceeds the supply, there is a nursing shortage.
The health care community is experiencing such a short-
age (Nevidjon & Erickson, 2001). Higher patient acuity
levels requiring ever increasing nursing care hours and the
increased need for preventive services have increased the
demand for nurses.
Currently, hospitals and other health care providers are
struggling to obtain enough nursing staff to adequately
care for their patients. In addition, hospitalized patients
are more acutely ill and tend to be older; thus, the
demand for nurses continues to increase. At the same
time as the demand for nurses increases, nursing educa-
tional programs have experienced a decrease in enroll-
ment. A 16.6% decrease in enrollment was reported
from 1996 to 2000 (Hopkins, 2001). In addition, greater
career opportunities exist for women, who in the past,
chose careers in nursing or teaching. Compounding the

564
 Campbell et al.: Job Satisfaction in Public Health Nursing 565

problem, many nurses have chosen not to work in the developing work structures that enhance job satisfaction
typical health care setting. Of 39,483 female registered (American Nurses Association, 2000b). Enhanced job
nurses in Illinois in 1996, 12.3% reported not working satisfaction will assist in retention of well-qualified staff,
as a registered nurse and 7.4% reported working outside reduce the cost of recruitment and orientation, and
of nursing altogether (Marcantonio, Young, & Howard, reduce the stress caused by turnover (Crose, 1999).
1997). The average age for a nurse in Illinois, as well as
nationwide, is increasing each year. The 1996 Biennial
Survey of Illinois Registered Nurses (Marcantonio et al., LITERATURE REVIEW
1997) reports that in 1996, 46.9% of registered nurses
Multiple variables in the literature are associated with
were 31–45 years of age and 40.3% were 46–65 years of
nurse job satisfaction such as autonomy, achievement,
age. The aging of the nursing workforce will result in a
interaction, job importance, prestige, professional status,
decreasing number of expected work years. ‘‘As those
and stress (Blegen, 1993). In addition, organizational
nurses retire, the supply of working nurses is projected
structure variables, such as vertical participation, hori-
to be 20 percent below requirements in 2020’’ (Hopkins,
zontal participation, formalization, and organic versus
2001, p. 16).
mechanistic structures, are associated with job satisfac-
The number of baccalaureate-prepared nursing appli-
tion. Acorn, Ratner, and Crawford’s (1997) causal model
cants has diminished, resulting in extended vacant pos-
of organizational commitment suggested a relationship
itions and increased workload upon staff already stressed
between environmental structure, perceived autonomy,
by staff turnover and uncertain staff replacement. Coping
and job satisfaction. Structure, perceived autonomy, and
during the current nurse shortage will require strategies to
job satisfaction resulted in greater organizational com-
reduce stress and increase job satisfaction of those nurses
mitment among front line nurse managers in acute care
taking on additional duties (Nursing Executive Center,
hospitals in this study. Decentralized or organic organ-
2000). Of particular concern is the added stress on staff
izational structures, as opposed to mechanistic or cen-
nurses who assume extra duties as a result of staff vacan-
tralized organizational structures, directly supported
cies left unfilled for long periods.
organizational commitment and indirectly affected
A shortage of qualified Master of Science in Nursing
autonomy and job satisfaction (Acorn et al., 1997). In
(MSN)- and Baccalaureate (BSN)-prepared nurse appli-
addition, Cumbey and Alexander (1998) found a positive
cants makes it necessary to ensure currently employed
relationship between organizational structure variables of
public health nurses remain in their positions, and that
vertical and horizontal participation and job satisfaction
the work structure and environment be such that growth
among public health nurses. Cumbey and Alexander
and professional practice are nurtured and supported,
(1998) and Organ and Greene (1981) examined the impact
thus retaining current staff as well as attracting new
of formalization, the extent to which standard practices,
nurses into the field. Nursing administrators (American
policies, and position responsibilities have been explicitly
Nurses Association, 2000b) have the responsibility to
formalized by the organization, finding that role clarity,
provide the necessary leadership in human resource devel-
standard practices, and rules attributed to greater job
opment and management to ensure ongoing evaluation
satisfaction.
and innovation of nursing services.
Public health nursing, ‘‘the practice of promoting and
protecting the health of populations using knowledge
CONCEPTUAL FRAMEWORK
from nursing, social, and public health sciences’’ (Amer-
ican Public Health Association, Public Health Nursing The conceptual framework for this study was based upon
Section, 1996), plays a major role in educating and pro- Maslow’s theory of human motivation (Maslow, 1943).
moting healthy behaviors. ‘‘Prevention of disease and Maslow theorizes that each individual has basic, physiolo-
disability for all people through the creation of conditions gical needs and as needs are met, the individual seeks
in which people can be healthy’’ is the goal of public to satisfy other needs. He categorizes needs into physiol-
health nursing (American Nurses Association, 1999, p. 2). ogical, safety, love, esteem, and self-actualization. He speci-
The purpose of this study was to describe the char- fies that no need is isolated and is related to satisfaction or
acteristics and relationship of organizational structure dissatisfaction of other needs and the surrounding envir-
and job satisfaction in public health nursing. Understand- onment. Maslow defines the safety need as freedom from
ing how staff nurses perceive (Ruetter & Ford, 1996) and danger and preference for a familiar environment, rather
interpret job satisfaction and how it relates to organi- than an unfamiliar environment. The love and belong-
zational structure will assist nurse administrators in ingness need is defined as ‘‘… hunger for affectionate
566 Public Health Nursing Volume 21 Number 6 November/December 2004

relations with people in general, namely a place in his TABLE 1. Primary Work Assignment
group …’’ (Maslow, 1954, p. 89). The esteem need is
Primary work assignment N %
classified into two categories: (1) the desire for strength,
achievement, adequacy, mastery, and competence and Family Case Management 39 21.4
(2) the desire for respect from other people, or reputa- Administration 22 12.1
tion and prestige. Fulfillment of esteem leads to feelings WIC 19 10.4
of self-confidence, worth, strength, and capability. Family planning 15 8.2
Dissatisfaction with lack of achievement, recognition, Adult health 14 7.7
responsibility, and growth were shown to result in high Immunization 9 4.9
Communicable disease 7 3.8
rates of turnover amongst community health nurses
School health 6 3.3
(Riordan, 1991). Public health nurses ranked achieve- Childhood Lead Poisoning Prevention 2 1.1
ment, recognition, and importance as important job satis- HIV 2 1.1
fiers (Lucas, McCreight, Watkins, & Long, 1988) and Teen parent 1 0.5
reported lack of recognition attributes to feelings of low TB 1 0.5
self-esteem. Based upon Maslow’s theory of human motiv- Other 44 24.2
ation (1954), nurses will seek to fulfill safety and esteem Total 182
needs within their work environments.
WIC, Special Supplemental Nutrition Program for Women,
Infants, and Children; HIV, human immunodeficiency virus;
METHODS TB, tuberculosis.
Research Design
Data Collection
This study used a descriptive design to examine the rela-
tionship between organizational structure and job satis- Study participants were asked to complete a survey, which
faction in public health nursing. included general demographic information, a 14-item
instrument assessing organizational structure, a 31-item
Sample job satisfaction survey, and three qualitative items regarding
intent to stay and suggestions for job improvement.
State of Illinois certified, county-based public health
departments located in central Illinois and their respective
nurse administrators, or directors of nursing, were con- Variables
tacted and asked to participate in this study. All except Demographic variables examined in this study included
one department agreed to participate (n = 20). The gender, age, category of personnel (RN/LPN), work sta-
department that declined reported recent funding issues, tus (full-time/part-time), educational level, marital status,
potential program closure, and possible staff layoffs as position classification, number of years in nursing,
reasons for not participating. Each of the participating number of years employed at the health department,
health departments varied in size, structure, number of and primary work assignment. Organizational structure
public health nurses employed, and range of public health variables examined in this study included vertical partici-
services. The services (Table 1) included population-based pation, horizontal participation, formalization, and job
services, as well as individual health services provided satisfaction.
through case management, home visiting, or clinic-based
services, in the areas of adult health, school health, mater- TABLE 2. Educational Characteristics
nal child health, child health, communicable disease, and Educational preparation N %
community health assessment, planning, and implement-
ation of health promotion and disease prevention strat- Associate degree 47 24.9
egies. The purposive sample consisted of registered nurses Diploma 45 23.8
BSN 64 33.9
and licensed practical nurses (Table 2) employed in each
BA, BS 13 6.9
of the participating health departments (n = 20). Each
MSN 16 8.5
health department distributed survey packets to department- Other 4 2.1
employed registered nurses and licensed practical nurses *
Total 189
(n = 345). Of the 345 potential participants, 192
*
(Table 3) chose to participate and returned completed Five of the participants identified themselves as nurse
surveys, for a response rate of 55%. practitioners.
 Campbell et al.: Job Satisfaction in Public Health Nursing 567

TABLE 3. Personal Characteristics and Experience

Personal characteristics N % Experience N %

Sex Number of years in nursing

Female 186 96.9 Less than 5 years 17 9.1
Male 6 3.1 5–9 years 25 13.5
Total 192 10–19 years 54 29.0
20 or more years 90 48.4
Total 186
Age Department employment
20–25 years 4 2 Less than 5 years 76 40.4
26–30 years 12 6.5 5–9 years 53 28.2
31–40 years 32 17.5 10–19 years 46 24.5
41–50 years 74 40.5 20 or more years 13 6.9
51–60 years 53 28.8 Total 188
61–65 years 8 4.2
Total 183
Marital status Category of personnel
Married 147 76.6 LPN 10 5.2
Divorced 16 8.3 RN 181 94.8
Single 8 4.2 Total 191
Widowed 5 2.6
Total 176
Work status Position classification
Full-time 158 85.9 Staff nurse 127 66.1
Part-time 26 14.1 Supervisor 31 17.9
Total 184 Director of nursing 9 5.2
Nurse administrator 6 3.5
Total 173

Qualitative items included: (1) ‘‘What would you
change in your current job to make it more satisfying?’’
(2) ‘‘What could your superior or management staff do to
make your job more satisfying?’’ and (3) ‘‘Do you plan to
continue to work in your current job? (__ yes/__ no)
Please explain: ___.’’
Instrumentation
The Alexander Structure Instrument, a 14-item, 5-point
Likert-type scale, originally developed by Leifer and
Huber (1977), adapted by Alexander (1982), and
modified by Cumbey and Alexander (1993), measured
organizational structure and the flexibility of relationships
among nursing personnel. An overall Alexander Structure
score was obtained by adding all values. The possible range
of subscale scores for this instrument are 5–25 for vertical
participation (five items), 7–35 for horizontal participation
(seven items), and 2–10 for formalization (two items).
Scores of 43–70 suggest a large degree of vertical and
horizontal participation, few rules, and a low degree of
organizational structure (organic). A score of 42 suggests
an even balance between mechanistic and organic organiza-
tional structure, and scores of 14–41 suggest low participation
with many rules and mandatory procedures, indicative of high
organizational structure (mechanistic).
In prior use of this instrument, reliability coefficients
ranged from 0.67 to 0.84 for vertical participation,
0.30–0.73 for horizontal participation, and 0.48–0.74 for
formalization (Cumbey & Alexander, 1993). For this
study, alpha reliability coefficients for the subscales were
0.84, 0.75, and 0.60, respectively.
Job satisfaction was measured using the 31-item
McCloskey/Mueller Satisfaction Survey (MMSS)
(Mueller & McCloskey, 1990). This tool measures three
dimensions of nurse job satisfaction: safety rewards,
social rewards, and psychological rewards. Eight types
of satisfaction are assessed: extrinsic rewards (three
items), scheduling (six items), balance of family and work
(three items), coworkers (two items), interaction opportun-
ities (four items), praise and recognition (four items), and
control and responsibility (five items). Scheduling, family
and work balance, control, and responsibility address
Maslow’s safety needs. Satisfaction with coworkers,
568 Public Health Nursing Volume 21 Number 6 November/December 2004
interaction, professional opportunities, praise, and
recognition address Maslow’s esteem needs. Adding the
MMSS subscale scores and dividing by the number of
subscales to obtain an individual MMSS global score
measured job satisfaction.
Established reliability coefficients for the eight sub-
scales ranged from 0.52 to 0.89 (Mueller & McCloskey,
1990). For this study, the overall MMSS alpha reliability
coefficient was 0.91. The alpha reliability coefficients for
individual subscales were 0.58 for the extrinsic rewards,
0.61 for scheduling, 0.15 for balance of family and work,
0.45 for coworkers, 0.75 for interaction opportunities,
0.85 for praise and recognition, 0.69 for professional
opportunity, and 0.89 for control and responsibility.
The Statistical Package for the Social Sciences (SPSS)
10.0 computer program was used to analyze the relation-
ships between demographic and independent variables
and job satisfaction in public health nursing.
RESULTS
The more vertical participation, or degree to which super-
visors and subordinates consult together concerning job
tasks and decisions, and the more horizontal participa-
tion, or degree to which individuals are involved with
peers in decision making and task definition, the higher
the job satisfaction among these participants. Analysis of
variance (ANOVA) revealed a significant difference in
scores by site of employment on the Alexander Vertical
Participation subscale (F = 2.06, p < 0.01). The largest
difference occurred between two counties, one experiencing
labor and union issues (t = 0.04). Table 4 is a correlational
matrix of organizational and selected demographic
variables.
Scores (n = 176) for the Alexander Structure Instru-
ment (Cumbey & Alexander, 1993) ranged from 22 to
62, with a mean score of 44.85 (SD = 7.28), and a mode
TABLE 4. Correlation Matrix of Organizational and Selected Demographic Variables
HP FORM
* *
Vertical participation (VP) 0.585 0.105
Horizontal participation (HP) 0.026
Formalization (FORM)‡
Alex instrument total (ALEX)
Nursing years (NYRS)
Health department years (HDYRS)
Job satisfaction (MMSS)
*
p < 0.01 (two-tailed).
†p < 0.05 (two-tailed).
‡Formalization was reverse-scored so that a high score indicates few rules and procedures.
of 43. 28.4% (n = 50) scored 44 or less, 8 scored 42, and
67.1% (n = 118) scored 43 or greater. Overall organiza-
tional structure scores among participants describe the
health departments in which these public health nurses
are employed as only slightly organic in structure, sug-
gesting a slightly higher degree of participation in an
informal, flexible, and decentralized environment. This
finding contradicts the belief that health departments, as
governmental agencies, are generally expected to exhibit a
mechanistic environment, characterized as bureaucratic,
inflexible, centralized, with a low degree of participation,
highly specific task descriptions and formalized procedures.
There was not enough variability to measure differ-
ences between genders, because only six of the 192 partici-
pants were male. A significant difference (t = 3.20,
p < 0.002) was noted between full-time and part-time
employees for Vertical Participation subscale scores of
the Alexander Structure Instrument. Full-time staff
reported higher levels of vertical participation (mean
score 16.72). A significant relationship was found
between job satisfaction and the organizational structure
dimensions of vertical participation and horizontal deci-
sion making. Formalization, defined as the extent to
which standard practices, policies, and position respon-
sibilities have been explicitly formalized by the organiza-
tion, was not significantly related to job satisfaction in
this study.
Significant differences were noted between the current
position classifications of administrator, director of
nurses, supervisor/manager, or staff nurse for total
Alexander score (F = 8.541, p = 0.000), Alexander Vertical
Participation subscale (F = 6.99, p = 0.000), and Alexander
Horizontal Participation subscale (F = 7.32, p = 0.00).
Post hoc tests (Tukey’s Honestly Significant Difference
[HSD]) revealed significant differences for the total
Alexander Structure Score between administrators and
staff nurses (p = 0.037), director of nurses and staff
ALEX NYRS HDYRS MMSS
*
0.787 0.113 0.155† 0.657
* *
0.836 0.095 0.084 0.529
*
0.376 0.003 0.037 0.104
*
0.132 0.121 0.530
*
0.462 0.184†
0.176†
 Campbell et al.: Job Satisfaction in Public Health Nursing 569

nurses (p = 0.004), and between supervisors and staff
nurses (p = 0.004). In addition, significant differences
were noted for the Alexander Vertical Participation
subscale scores between nurse administrators and staff
nurses (p = 0.021), director of nurses and staff nurses
(p = 0.011), and supervisors and staff nurses
(p = 0.044), as well as significant differences for the
Alexander Horizontal Participation subscale scores
between administrators and staff nurses (p = 0.037) and
director of nurses and staff nurses (p = 0.001).
Intent to Stay
Global job satisfaction scores (n = 138) ranged from 75
to 144 with a mean score of 113.04 (SD = 6.32) (Table 5).
The developers of the MMSS do not specify a total score
that indicates job satisfaction. Given that an item score of
3 indicates that the nurse is neither satisfied nor dissatis-
fied, and an item score of 4 indicates satisfaction, a global
score of 94 for all 31 items was established as the lowest
score possible to indicate job satisfaction.
Although no significant differences for job satisfaction
scores were associated with current position or primary
work assignment, educational preparation made a differ-
ence, in that MSN prepared nurses scored highest on the
MMSS. Of the participants, 98% (n = 169) planned to
remain working for their health department. When par-
ticipants were asked why they were choosing to continue
to work in their current primary work assignment, enjoy-
ment of what they do, autonomy, flexibility, scheduling,
benefits, and low stress were reported. Of those respond-
ing ‘‘yes’’ who included an explanation, 28% (n = 49)
responded that they enjoyed their work, and 6%
(n = 10) responded that they appreciated their flexible
schedules.
Participants were asked two open-ended questions: (1)
‘‘What would you change in your current job to make it
more satisfying?’’ and (2) ‘‘What could your superior or
management staff do to make your job more satisfying?’’
Of the 192 participants, 27% (n = 52) responded that
‘‘better pay’’ would make their job more satisfying, 19%
(n = 37) would increase management feedback and staff
recognition, 15% (n = 28) would like to have more input
and decision-making opportunity in their jobs, and 4%
(n = 7) would increase role clarity. In addition, one
participant requested an agency automobile to assist in
getting the job done. ‘‘Increase staff’’ and ‘‘decrease workload,
paperwork, and stress’’ were included in response to the
question ‘‘What could your superior or management
staff do to make your job more satisfying?’’
DISCUSSION
Generational differences have been suggested to play a
significant role in the expectations of American workers
(Corporate Leadership Council, 1998). In that, 73.3% of
the participants in this study were 40 years of age or
older; generational differences must be considered when
attempting to change the workplace and increase partici-
pative work environments. Public health nurses in this
study reported moderate job satisfaction. As vertical
and horizontal decision-making opportunities increased,
so did their job satisfaction. These public health nurses
requested better pay, more input, and better role clarity,
all related to establishing a ‘‘… safe, orderly, predictable,
organized world, which can be counted on and in which
unexpected, unmanageable, or other dangerous things do
not happen’’ (Maslow, 1954, p. 87). The number of years
employed at the health department was significantly cor-
related with job satisfaction (Table 4), suggesting support

TABLE 5. Job Satisfaction Scores Based on McCloskey/Mueller Job Satisfaction Scale

Current study

Subscale N Possible range Range Mean SD

Current study
Extrinsic rewards 186 3–15 3–15 10.64 2.47
Scheduling 157 6–30 15–30 25.18 3.27
Work and family life 156 3–15 3–15 9.20 1.75
Coworker satisfaction 180 2–10 3–10 8.19 1.23
Interaction opportunity 187 4–20 8–20 15.52 2.71
Professional opportunity 176 4–20 5–20 13.04 2.63
Praise and recognition 189 4–20 4–20 14.52 3.97
Control and responsibility 186 5–25 5–25 17.12 4.88
*
Global score 138 31–155 75–144 113.04 16.32
*
Global score is based upon pairwise exclusion.
570 Public Health Nursing Volume 21 Number 6 November/December 2004

of Maslow’s theory that job tenure aids in satisfying the needed in developing vertical and horizontal participative
need for safety. The added years of experience for these work environments in order to increase job satisfaction
nurses may have increased familiarity, greater compe- and insure an adequate public health workforce.
tence, as well as a greater understanding of the work
related expectations, schedules, and decreased stress Summary
within the work environment. Baby Boomers are noted
Job satisfaction is critical to retaining and attracting a
for their loyalty to their employers and often remain in
well-qualified public health nurse workforce. The findings
the same job for longer periods of time (Corporate Lead-
of this study suggest that work environments in which
ership Council, 1998). The fact that the study participants
supervisors and subordinates consult together concerning
most often voiced the desire for increased feedback may
job tasks and decisions, and in which individuals are
be a generational characteristic related to loyalty to their
involved with peers in decision making and task defini-
employers.
tion, are positively related to job satisfaction.
Participants’ request for increased management feed-
The critical role of the public health nurse continues to
back and staff recognition suggest an attempt to satisfy
grow both on a local level, as well as globally (American
the need for reputation, prestige, and respect from other
Nurses Association, 2000a). The development of antibiotic-
people, leading to increased esteem. As suggested by
resistant diseases, increased morbidity and mortality
Maslow (1954), fulfillment of the esteem need leads to
related to smoking and obesity, bioterrorism, and the
feelings of self-confidence, worth, strength, and capabil-
threat of recurrence of a formerly eradicated infectious
ity, suggesting that ‘‘… ignoring the need for esteem
disease such as smallpox require the expertise of an
brings about feelings of weakness and inferiority, giving
adequate number of public health nurses. Public health
rise to discouragement’’ (1954, p. 92). Opportunity for
organizational structures in which participative decision
workplace input and decision making enhances the fulfill-
making is encouraged will positively impact job satisfac-
ment of safety and esteem needs as described by Maslow.
tion for public health nurses. Creating a participative
Surprisingly, only one of the 192 participants
work environment, as suggested in this study, is critical
responded to the question ‘‘What could your superior
to retaining and attracting a well-qualified public health
do to make your job easier’’ with a tangible equipment
nurse workforce in this time of potential global threats
need to help get the job done. The participant suggested
to the public’s health.
an agency automobile. Among a different generational
group, the response may have been overwhelming to
provide agency-owned and -operated automobiles to ACKNOWLEDGMENTS
avoid the personal expense of wear and tear upon one’s
This research was supported in part by a grant from the
own automobile. Nor were cell phones suggested as
Mennonite College of Nursing at Illinois State Univer-
needed for ease of referral, follow-up, client scheduling,
sity, Normal, Illinois, Xi Pi Chapter of Theta Sigma Tau
or personal safety. Nor were laptop computers and sys-
International.
tems requested to more easily handle the huge amount of
paperwork so often described in the participants’ qualita-
tive responses. These are tangible pieces of equipment to REFERENCES
get the job done in the most time-efficient manner. These Acorn, S., Ratner, P. M., & Crawford, M. (1997). Decentraliza-
results may reflect the characteristics of the Baby Boomer tion as a determinant of autonomy, job satisfaction, and
generation and in contrast to those American workers organizational commitment among nurse managers. Nursing
born between 1965 and 1977, known as the Generation Research, 46(1), 52–57.
Xers. Alexander, J. W. (1982). The relationship of technology and struc-
ture to quality of care on nursing subunits. Unpublished Doc-
toral Dissertation, University of South Carolina, Columbia.
Limitations of the Study American Nurses Association. (1999). Scope and standards of
public health nursing practice. Washington, DC: American
The characteristics of these participants may be unique to
Nurses Publishing.
this group of public health nurses. It is a self-report, and
American Nurses Association. (2000a). Public health nursing: A
those agreeing to complete the survey may differ from partner for healthy populations. Washington, DC: American
those not completing the survey. In addition, the forced Nurses Publishing.
responses of the survey items may not get at the real American Nurses Association. (2000b). Scope and standards for
issues regarding job satisfaction. Bias in the results may nurse administrators. Washington, DC: American Nurses
occur due to the research design. Additional research is Publishing.

American Public Health Association, Public Health Nursing
Section. (1996). The definition and role of public health nur-
sing, a statement of the Public Health Nursing Section.
Washington, DC: Author.
Blegen, M. A. (1993). Nurses’ job satisfaction: A meta-analysis
of related variables. Nursing Research, 42(1), 36–40.
Brewer, C., & Kovner, C. T. (2001). Is there another nursing
shortage? What the data tell us. Nursing Outlook, 49(1), 20–26.
Corporate Leadership Council. (1998). Recruiting, managing and
motivating generation X. Washington, DC: The Advisory
Board Company.
Crose, P. S. (1999). Job characteristics related to job satisfaction in
rehabilitation nursing. Rehabilitation Nursing, 24(3), 95–102.
Cumbey, D. A., & Alexander, J. W. (1993). Validation of tech-
nology instrument (Leattt & Schneck, 1981) and structure
(Alexander, 1986) for use in community health clinic settings.
Presented at South Carolina Academy of Science and
Mathematics: April 13, 1993: Columbia, SC.
Cumbey, D. A., & Alexander, J. W. (1998). The relationship of
job satisfaction with organizational variables in public health
nursing. The Journal of Nursing Administration, 28(5), 39–46.
Hopkins, M. E. (2001, March). Critical condition. Nurse Week,
2, 15–19.
Leifer, R., & Huber, G. P. (1977). Relations among perceived envir-
onmental uncertainty, organization structure, and boundary
spanning behavior. Administrative Science Quarterly, 22, 235–247.
Lucas, M. D., McCreight, L. M., Watkins, J. G., & Long, S. E.
(1988). Job satisfaction assessment of public health nurses.
Public Health Nursing, 5(4), 230–234.
Marcantonio, R. J., Young, W. B., & Howard, M. J. (1997).
1996 Biennial survey of Illinois registered nurses, final report.
Chicago, IL: University of Illinois at Chicago.
Campbell et al.: Job Satisfaction in Public Health Nursing 571
Maslow, A. H. (1943). A theory of human motivation. Psycho-
logical Review, 50.
Maslow, A. H. (1954). Motivation and personality. New York:
Harper & Rowe.
Mueller, C. W., & McCloskey, J. C. (1990). Nurses’ job satis-
faction: A proposed measure. Nursing Research, 39(2),
113–117.
Nevidjon, B., & Erickson, J. (2001). The nursing shortage:
Solutions for the short and long term. Online Journal of
Issues in Nursing [Computer File], 6(1), 1–15. Retrieved
February 16, 2001, from the World Wide Web: http://
www.nursingworld.org/ojin/topic14/tpc144.htm
Nursing Executive Center. (2000). The nurse perspective, drivers
of nurse job satisfaction and turnover. Washington, DC: The
Advisory Board Company.
Organ, D. W., & Greene, C. N. (1981). The effects of formal-
ization on professional involvement: A compensatory
process approach. Administrative Science Quarterly, 26(6),
237–252.
Public Health Service. (1990). Healthy people 2000: National
health promotion and disease prevention objectives.
Washington, DC: U.S. Department of Health and
Human Services.
Riordan, J. (1991). Prestige: Key to job satisfaction for commu-
nity health nurses. Public Health Nursing, 8(1), 59–64.
Ruetter, L. I., & Ford, J. S. (1996). Perceptions of public health
nursing: Views from the field. Journal of Advanced Nursing,
24, 7–15.
U.S. Department of Health and Human Services. (2000).
Healthy People 2010 (Conference Edition, in Two Volumes).
Washington, DC: U.S. Department of Health and Human
Services.