Exploring Direct and Indirect Influences of Physical Work Environment on Job Satisfaction for Early-Career Registered Nurses Employed in Hospitals

The nurses station in the  John Theurer Cancer Center.

Nursing job satisfaction and patient outcomes improve when nurses have a say in the design of the physical work environment in hospitals.

The Issue:

Some 18 percent of new nurses leave their hospital registered nurse (RN) jobs in their first year. Nursing turnover and job dissatisfaction contributes to high health care costs and poorer patient outcomes. Since October 2013, the Centers for Medicare & Medicaid Services has reduced payments by one percent to hospitals that do not meet quality standards or make quality improvements that relate to nurse job satisfaction.

Researchers explored the relationship between the physical work environment and RN job satisfaction. The work environment was subjectively assessed in terms of architectural, interior design, and ambient features (light, temperature, and ventilation).

Key Findings

  • The physical work environment was positively related to job satisfaction in two models.

  • The physical work environment was not related to job satisfaction when job stresses such as workload, organizational constraints, and wage and promotional opportunities were considered.

  • Improving one element of the work environment had little effect on improving job satisfaction, but if all were improved, satisfaction increased.


Health care leaders could consider use of optimal physical work environment design as a viable strategy for improving RNs’ job satisfaction and therefore positive patient and financial outcomes,” the authors write.

About the Study:

A nationally representative sample of 1,141 first-time nurses were surveyed as part of a larger longitudinal study. Respondents were mostly white, married females.