A STUDY ON THE INFLUENCE OF PSYCHOLOGICAL SAFETY ON JOB SATISFACTION AMONG HEALTHCARE WORKERS IN NIGERIAN HOSPITALS: A CASE STUDY OF MOTHER AND CHILD HOSPITAL, AKURE, ONDO STATE

CHAPTER ONE INTRODUCTION 1.1 Background of the Study Employee satisfaction has long been a concern in the healthcare industry, often falling below acceptable standards. A study conducted by the National Institute for Health Care Management in 2021 revealed that by September 2020, 79% of doctors and 76% of healthcare staff were experiencing burnout (National Institute for Health Care Management, 2021). Further reports indicated that 93% of healthcare workers felt overwhelmed, 82% reported both physical and emotional exhaustion, 39% felt a lack of emotional support, and 32% of registered nurses were contemplating leaving their current patient care roles (Berlin et al., 2022; Mental Health America, 2020). Given the high-pressure nature of the healthcare sector, the well-being and job satisfaction of healthcare workers are essential, as these directly influence the quality of patient care. The industry is known for demanding workloads, extended shifts, and the emotional weight of caring for patients, all of which contribute to constant stress, ultimately leading to burnout and staff turnover (Maslach & Leiter, 2016). As a result, job satisfaction has emerged as a vital area of focus, not just for ensuring better patient outcomes but also for maintaining the operational efficiency and stability of healthcare institutions (Roberts et al., 2022). The concept of psychological safety is increasingly being recognized as closely tied to job satisfaction in healthcare settings. Originally introduced by Edmondson (1999), psychological safety refers to a workplace atmosphere where employees feel safe to express ideas, admit mistakes, ask questions, and raise concerns without fear of criticism or retaliation. While this concept has been extensively studied in various fields and linked to improved engagement, innovation, and creativity (Clark, 2020), it holds even greater significance in healthcare. The high-risk nature of patient care means that communication failures can have dire consequences, making psychological safety not just beneficial but essential (Edmondson & Lei, 2014). In environments where psychological safety is present, healthcare professionals are more likely to admit to mistakes and communicate openly, thereby enhancing patient safety and job satisfaction (Brown et al., 2021). Studies have shown that professionals who feel safe are more inclined to report near misses and actual errors, contributing to a culture of learning and improved care delivery (Reason, 2020). Conversely, fear of punishment or embarrassment discourages transparency, potentially endangering patient safety and lowering job satisfaction (Lee et al., 2023). In this sense, psychological safety not only fosters team cohesion and quality care but also supports individual well-being (Salas et al., 2015). However, achieving and maintaining psychological safety remains a persistent challenge in many healthcare institutions. Factors such as rigid policies, hierarchical systems, and high expectations can suppress open communication and breed a culture of fear (Roberts et al., 2022). In addition, punitive management approaches that respond harshly to errors often discourage staff from speaking up about mistakes or suggesting improvements in patient care procedures (Edmondson & Lei, 2016). Job satisfaction plays a significant role here, as it directly affects the commitment, productivity, and mental health of healthcare workers. Elements like workload, autonomy, team relationships, and managerial support all contribute to job satisfaction (Spector, 2017). Psychological safety positively influences these factors by fostering a respectful and supportive work culture. As a result, healthcare professionals who feel psychologically secure are more likely to remain loyal to their organizations, experience higher job satisfaction, and contribute to better overall performance (Brown et al., 2021). The issue of high turnover in healthcare is particularly concerning. Losing experienced staff disrupts service continuity and incurs significant costs in terms of recruitment and training (Roberts et al., 2022). By promoting psychological safety, organizations can improve job satisfaction and reduce burnout, ultimately addressing the root causes of turnover. This approach aligns with a growing body of research emphasizing the importance of psychological and social dynamics in employee retention and workplace satisfaction. Therefore, this study aims to explore the impact of psychological safety on job satisfaction among healthcare workers in Nigerian hospitals, focusing on Mother and Child Hospital in Akure, Ondo State. 1.2 Statement of the Problem Healthcare professionals often face emotional, physical, and cognitive challenges that may undermine their well-being, especially in high-pressure environments (Edmondson & Lei, 2016). Psychological safety—defined as a shared belief that it is safe to voice opinions, ask questions, raise concerns, and acknowledge mistakes without fear of negative consequences—has been identified as a key factor in enhancing job satisfaction and team performance. When healthcare workers operate in environments where psychological safety is present, they are more likely to communicate openly and participate in decision-making without fear of retaliation, which can increase job satisfaction and reduce burnout (Clark, 2020). Unfortunately, many healthcare settings fail to cultivate such a culture, resulting in high stress levels, low job satisfaction, and elevated staff turnover (Brown et al., 2021). These issues can seriously disrupt the workforce and reduce the quality of patient care (Roberts et al., 2022). Although there is growing recognition of the importance of psychological safety, empirical research on its effect on job satisfaction—particularly in Nigerian healthcare settings—is still limited. Consequently, this study investigates the relationship between psychological safety and job satisfaction among healthcare workers, using Mother and Child Hospital in Akure, Ondo State, as a case study. 1.3 Objectives of the Study The main objective of this study is to examine the impact of psychological safety on healthcare workers’ job satisfaction in Nigerian hospitals, using Mother and Child Hospital in Akure, Ondo State, as a case study. The specific objectives are: i. To assess the level of psychological safety experienced by healthcare workers in hospital settings. ii. To identify environmental factors in hospitals that promote psychological safety among healthcare workers. iii. To determine the factors within hospital environments that hinder psychological safety. iv. To provide practical recommendations for hospital management on how to enhance psychological safety and job satisfaction among healthcare staff. 1.4 Research Questions To guide the investigation, the following research questions have been formulated: i. What level of psychological safety is perceived by healthcare workers in Nigerian hospitals? ii. What factors within hospital settings enhance psychological safety among healthcare workers? iii. What factors within hospital environments hinder psychological safety among healthcare workers? iv. What strategies can hospital management adopt to improve psychological safety and job satisfaction among healthcare workers? 1.5 Significance of the Study This study carries significant practical value as it highlights the role of psychological safety in improving the job satisfaction and overall well-being of healthcare workers. By analyzing how psychological safety influences satisfaction and performance, the research can provide valuable insights for hospital administrators and policymakers looking to foster a more supportive and effective work environment. Additionally, this research will contribute to academic literature, expanding resources in university libraries and serving as a helpful reference for future researchers exploring similar topics. 1.6 Scope of the Study This research focuses on the impact of psychological safety on job satisfaction among healthcare workers in Nigerian hospitals, with specific reference to Mother and Child Hospital in Akure, Ondo State. Empirically, the study investigates the levels of psychological safety perceived by healthcare workers, identifies both the facilitating and hindering factors in hospital settings, and provides actionable recommendations for improving workplace culture. Geographically, the study is limited to the Mother and Child Hospital in Akure, Ondo State. 1.7 Limitations of the Study As with any academic project, this study encountered certain limitations: Time Constraints: Balancing this research with other academic responsibilities, such as attending lectures and meeting deadlines, limited the researcher’s time. Financial Constraints: The study required personal financial investment in areas like printing, typesetting, data collection, and sourcing of relevant materials. Limited Access to Materials: Finding enough relevant literature posed a challenge, as the specific topic of psychological safety in Nigerian healthcare contexts is still under-researched. 1.8 Definition of Terms Psychological Safety: A shared belief among team members that they can speak up, ask questions, or admit mistakes without fear of negative consequences such as ridicule or punishment (Edmondson, 1999). Job Satisfaction: The degree of fulfillment or contentment that employees feel about their work, influenced by workload, management support, autonomy, and interpersonal relationships. Healthcare Workers: Individuals involved in providing health-related services, including doctors, nurses, support staff, technicians, and administrators. Workplace Environment: The overall setting in which employees work, including physical conditions, managerial style, social dynamics, and safety measures. Team Cohesion: The extent to which team members collaborate effectively, communicate openly, and support one another in achieving shared goals. Burnout: A condition characterized by chronic physical and emotional exhaustion, often resulting from prolonged workplace stress. In healthcare, it includes feelings of detachment, reduced accomplishment, and fatigue.