Job Satisfaction and Turnover Intent Among Hospital Social Workers in the United States

Background & Purpose:  Job satisfaction and employee turnover among social workers is an issue across fields of practice, as they have negative economic effects and impacts on client services.  However, much of the research in this area is focused on child welfare settings, and the research lacks a theoretical frame for organizing and explaining findings.  Herzberg’s theory of work separates factors that are merely required to maintain job satisfaction (preventing job dissatisfaction) from those variables that motivate employee satisfaction.  This project looked at job satisfaction and turnover intent among hospital-based social workers in a large, nationwide, representative sample.  The purposes of the study were to (1) examine predictors of job satisfaction and turnover intent among hospital social workers, and (2) to organize and explore these relationships utilizing Herzberg’s theory. 

Methods:  Five hundred randomly selected hospitals from a list of all hospitals in the U.S. with 200 beds or more were invited to participate by phone.  A secure, web-based survey link and invitation was emailed to hospital contacts who agreed to participate.  Existing and validated single-item measures were used for job satisfaction and turnover intent.  Descriptive variables included level of education, experience, and organizational variables of particular interest for their potential to predict job satisfaction under the Herzberg framework.  These included profit status, workload, job functions, social work supervision, and social work departmental configuration.  Analyses included t-tests, ANOVA, and multiple regression modeling, with confirmatory testing and effect sizes,

Results:  The sample is 973 social workers from 290 hospitals across 40 U.S. States, a 58% hospital response rate, and a minimum 24% social worker response rate.  The sample is primarily female, Caucasian, MSWs, working full-time in non-profit hospitals in centralized social work departments.  The social workers reported high job satisfaction (83% positive, n = 969).  No demographics were predictive of job satisfaction or turnover intent.  Social workers in centralized departments and engaged in psychosocial support functions report higher job satisfaction than those in decentralized systems engaged in discharge planning functions.  As workload increases, job satisfaction decreases.  However, these variables only explain 2.7% of the variance in job satisfaction with workload as the strongest contributor.  Exploration of variables indicated by Herzberg as sources of dissatisfaction (as potential predictors for turnover intent) was not significant.

Conclusion & Implications:  The hospital social workers in this sample report generally high job satisfaction and low turnover intent, as is consistent with previous findings.  Consistent with Herzberg’s motivation factors for job satisfaction, the idea of task variety, inclusive of both psychosocial care and involvement in complex discharge planning or case management, is positively linked to job satisfaction.  The evidence supports the continuation of centralized social work departments as well.  Under the Herzberg theory, workload should be related to job dissatisfaction, and the findings of this study suggest that turnover intent is not a good substitute for dissatisfaction or that dissatisfiers are not predictive of turnover intent.  This supports Herzberg's theory that dissatisfiers are a different concept from satisfaction, while satisfaction is related to turnover intent.