Abstract
BACKGROUND: The global nursing shortage poses significant challenges to healthcare systems. In high-stakes environments such as intensive care units (ICUs), job satisfaction is a key determinant of nurse turnover. AIM: This study aimed to identify relational and organisational factors that influence job satisfaction among ICU nurses, as these factors remain underexplored in this context. STUDY DESIGN: A cross-sectional, correlational study used survey data collected from ICU nurses across 21 hospitals in Korea. Surveys on situation monitoring, collegial nurse-physician relationships and leader identification were collected as relational factors, and safety climate and workplace safety systems were investigated as organisational factors. Pearson correlations and multiple linear regression analyses were employed to investigate the relationship between the factors and job satisfaction. RESULTS: This study included 200 ICU nurses. Pearson correlation analyses showed that all relational and organisational factors were significantly positively associated with job satisfaction. In multiple regression analyses adjusting for years of experience, leader identification showed the strongest positive association with job satisfaction (β = 0.328, p < 0.001), followed by safety climate (β = 0.160, p = 0.041), workplace safety systems (β = 0.153, p = 0.023) and collegial nurse-physician relationship (β = 0.139, p = 0.033). Situation monitoring was not significantly associated with job satisfaction (β = 0.044, p = 0.554). CONCLUSIONS: Job satisfaction among ICU nurses was significantly associated with both relational and organisational factors. In particular, strong identification with nurse leaders, positive collegial relationships with physicians, a favourable safety climate and the presence of systematic workplace safety procedures were all significant factors. These findings highlight the importance of nurses' identification with their leaders, interprofessional collaboration and a supportive safety environment in enhancing job satisfaction in high-acuity care settings. RELEVANCE TO CLINICAL PRACTICE: Healthcare organisations should promote interprofessional collaboration between nurses and physicians, as well as relationships with nurse leaders and prioritise cultivating a strong safety culture and system for patients and healthcare staff.