The Impact of Job Satisfaction and Role Conflict on Turnover Intention of Bakti Timah Nurses

ABSTRACT


Introduction
The Bakti Timah Pangkalpinang Hospital is currently under PT Pertamina Bina Medika IHC where previously it was under PT Timah Medika.The change in management led to policy changes such as reducing allowances and increasing graduate standards with the goal of efficiency.This can make nurses dissatisfied with their jobs and want to change jobs.The existence of conflict between nurses, colleagues and superiors is also one of the factors that causes nurses to want to move to another organization.
Nurses as the main guard in providing care to patients need to be maintained.Nurse turnover is a major problem especially given the protracted and ongoing labor shortage [1].The high rate of turnover of nurses causes an increase in costs that must be incurred by managers in different countries [2].Workers who have a desire to change jobs tend to show low performance [3].Individual turnover intention factors consist of demographic and psychosocial factors while organizational factors consist of nursing homes, nursing staff and resident characteristics [4].
Nurse turnover is caused by factors originating from individuals and organizations and job satisfaction is the biggest cause [4].Nurses were found to be willing to change jobs within the next 1 to 5 years due to job burnout, job satisfaction, and type of hospital [5].The level of appreciation received, emotional commitment is a factor in the high and low turnover intention of nurses [6].Conflict between work and family aspects is the cause of high nurse turnover intention [7].Low possibility of promotion, work stress, burnout, emotional exhaustion, career commitment, organizational commitment, work engagement, compatibility between workers and organizations, job satisfaction are the factors that determine the level of nurse turnover intention [8].
The desire of individuals to leave the organization in the near future which can impact the efficiency of the remaining employees [9].Turnover intention is considered to be one of the best predictors of turnover behavior and may explain some of the variance in turnover behavior [10].
Job satisfaction is the level of individual satisfaction regarding certain aspects of work [11].Nurse job satisfaction is a positive feeling about working conditions according to her wishes and is based on the evaluation results of values [12].Job satisfaction has become an important issue for healthcare organizations in recent years due to potential shortages in the nursing workforce, its impact on patient care, and cost issues [13].Nurses who are satisfied with their work will have good performance and provide excellent service, as a result will increase patient satisfaction [14].
The degree to which a person experiences pressure in one role that is incompatible with the pressure that arises in another role due to a mismatch between the requirements and expectations of the roles [15].Role conflict is caused by two or more overlapping and conflicting social roles [16].Role conflict has a positive impact on job stress and the impact of role conflict on job stress is high for young employees because young employees do not have the skills or life experience needed to deal with role conflict [17].

Research Methods
This study aims to determine the influence of job satisfaction and role conflict on the turnover intention of nurses at the Bakti Timah Hospital in Pangkalpinang.A total of 91 nurses were used as respondents through accidental sampling.The causality quantitative research design was applied in this study.SEM PLS is used as a data analysis method.The research instrument was distributed online using a Google form through the hospital management.The instrument uses five answer choices "strongly agree", "agree", "undecided", "disagree", "strongly disagree".Job satisfaction instrument adapted from Griffin [18].The role conflict instrument was adapted from Shukla & Srivastava [19].The turnover intention instrument was adapted from Bothma & Roodt [20].

Result and Discussion 1. Respondent Description
Respondents consisted of 25 men (21.48%) and 66 women (72.52%).Respondents who were married were 74 people (81.32%) and the remaining 17 people (18.68%) were not married.As many as 62 nurses (68.13%) have diploma education, 29 nurses (31.87%) have bachelor education.9 nurses (9.89%) aged 18-27 years, 28-37 years old 44 nurses (48.35%), 38-47 years old 35 nurses (38.46%), 48-57 years old as many as 3 people (3.30) %.The majority of nurses are female, married, have a diploma with an age range of 38-47 years.2. contains the factor loading scores of all items from each variable.The score is obtained after getting an AVE score > 0.5.A total of 2 job satisfaction, 1 role conflict item, 3 turnover intention items were deleted because they caused the measurement to be invalid.The factor loading values of all items > 0.5 were included in the next analysis.5. contains the value of f Square where the impact of job satisfaction and role conflict each has a score of 0.143 and 0.114 (> 0.02 and <0.15).This means that both job satisfaction and role conflict have a weak effect on turnover intention.), which means it has a significant impact.Role conflict on turnover intention has a statistical T score of 3.136 (> 1.96) so it is stated to have a significant impact.

Tabel 6. Hypothesis Testing
Original Sample P Value Decision Job Satisfaction on Turnover Intention -0.335 0.002 Accepted Role Conflict on Turnover Intention 0.300 0.002 Accepted Table 6.shows that job satisfaction has a significant negative effect on turnover intention seen from the P value of 0.002 (<0.05) and the original sample value of -0.335.Table 6.also shows that role conflict has a significant positive effect on turnover intention seen from the P value of 0.002 (<0.05) and the original sample value of 0.300.
Job satisfaction was found to have a negative impact on turnover intention with a closeness level of -0.335 (Table 6).This value ignores the negative sign, then ≥ 0.2 and <0.4,then the relationship level is weak.This finding is supported by previous research that the more satisfied nurses are with their work, the lower the level of turnover intention [21].The impact of work stress on turnover intention decreases when nurses feel satisfied with their work [22].Nurses who are satisfied with aspects of their work such as career development opportunities, compensation, task clarity, organizational policies, level of supervision will reduce their intention to change jobs [23].Nurses' dissatisfaction with aspects of job autonomy and training opportunities increases the desire to change jobs [24].Violence in the workplace can increase nurse turnover intention but depends on the level of job satisfaction [25].
Role conflict was found to have a positive impact on turnover intention with a closeness level of 0.300 (Table 6).This value is ≥ 0.2 and < 0.4, so it has a weak relationship level.The results of this study are supported by previous findings where role conflict has a positive impact on turnover intention [26].Workers with high role conflict will have a high level of turnover intention [27].Increases in age, work experience, legal recruitment, and permanent morning shifts reduce the intention to switch nurses.Role conflict and role ambiguity are significantly related to the intention to change the nursing profession [28].Previous findings do not support the results of this study [29].
The weak level of relationship between exogenous variables and endogenous variables indicates that there are other factors that are stronger.Stronger factors can bridge the effect of job satisfaction and role conflict on turnover intention.Other factors such as work engagement, organizational commitment, work stress were found to have an impact on employee turnover intention ([30]- [32].

Conclusion
The findings in this study conclude that job satisfaction has a negative effect on nurse turnover intention with a weak correlation level.Role conflict has a positive effect on nurse turnover intention with a weak correlation level.
Future researchers can use variables that link the effect of job satisfaction and role conflict on turnover intention.Factors such as work engagement, stress and commitment are thought to be able to bridge the impact of job satisfaction and role conflict on nurse turnover intention.Hospital management can reduce the level of turnover intention by making nurses more satisfied with their jobs and reducing conflicts that occur between colleagues.

Table 1 .
shows the results of the validity test where the variables of job satisfaction, role conflict, and turnover intention have an AVE score > 0.5 so that all variables are declared valid.

Table 3 .
Reliability Composite Score

Table 4 .
has an R Square value of 0.236 which means job satisfaction and role conflict only contribute 23.6%.As much as 77.4% of the causes of turnover intention are outside the variables of this study.4.