Nurse Manager Competence, Work Environment, and Staff Nurse Job Satisfaction in Private Hospitals of Cagayan de Oro City
Nurse Manager Competence, Work Environment, and Staff Nurse Job Satisfaction in Private Hospitals of Cagayan de Oro City
NURSE MANAGER COMPETENCE, WORK ENVIRONMENT, AND
STAFF NURSE JOB SATISFACTION IN PRIVATE
HOSPITALS OF CAGAYAN DE ORO CITY
PSYCHOLOGY AND EDUCATION: A MULTIDISCIPLINARY JOURNAL
Volume: 46
Issue 6
Pages: 694-701
Document ID: 2025PEMJ4489
DOI: 10.70838/pemj.460603
Manuscript Accepted: 08-27-2025
Psych Educ, 2025, 46(6): 694-701, Document ID:2025PEMJ4489, doi:10.70838/pemj.460603, ISSN 2822-4353
Research Article
Nurse Manager Competence, Work Environment, and Staff Nurse Job Satisfaction in
Private Hospitals of Cagayan de Oro City
John Troy C. Gamil,* Gloria M. Cunanan
For affiliations and correspondence, see the last page.
Abstract
Nurse manager competence and the work environment are recognized as critical determinants of nurse job satisfaction,
yet limited evidence exists in Philippine private hospitals. This study examined their influence on staff nurse job
satisfaction in Cagayan de Oro City. A descriptive-correlational design was employed with 206 staff nurses selected
through proportionate stratified random sampling. Data were collected using modified versions of the Managerial
Competence Scale, the Practice Environment Scale of the Nursing Work Index (PES-NWI), and the Job Satisfaction
Survey. Findings revealed that staff nurses perceived nurse managers as highly competent in both leadership (M =
3.76, SD = 1.076) and management skills (M = 3.73, SD = 1.034). The work environment was generally favorable (M
= 3.81, SD = 0.963), with collegial relationships rated highest (M = 4.18, SD = 0.721) and staffing/resources lowest
(M = 3.37, SD = 1.142). Job satisfaction was also high (M = 3.67, SD = 1.034), with intrinsic motivation ("I like doing
the things I do at work," M = 4.06, SD = 0.909) scoring highest, while salary (M = 3.12, SD = 1.376) was lowest.
Correlation analysis revealed significant positive associations among job satisfaction, nurse manager competence, and
work environment, with the strongest correlations found in participation in hospital affairs (r = 0.886, p < 0.001) and
staffing/resources (r = 0.841, p < 0.001). Regression analysis revealed four significant predictors: participation in
hospital affairs (β = 0.552), staffing/resources (β = 0.348), leadership skills (β = 0.153), and work relationships (β =
0.097), which collectively explained 85.2% of the variance (adjusted R² = 0.852). The study emphasizes the
importance of competent leadership, participatory governance, and adequate resources to enhance nurse satisfaction
and retention in private hospitals.
Keywords: nurse manager competence, work environment, job satisfaction, staff nurses, healthcare
Introduction
Findings from this study are expected to contribute both theoretically and practically. They will enrich nursing management literature
by focusing on private healthcare settings, while also offering practical insights for hospital administrators seeking to improve nurse
retention and engagement. In a broader sense, the study highlights the importance of fostering competent nurse leaders, participatory
governance, and adequate resourcing—elements consistently identified in recent studies (Arevalo et al., 2025; de la Cruz et al., 2024;
Rezapour et al., 2024; Yasin et al., 2021). These efforts aim not only to boost job satisfaction but also to ensure the delivery of sustained,
high-quality care and a resilient nursing workforce.
This study, therefore, aims to examine the influence of nurse manager competence and the work environment on job satisfaction among
staff nurses in private hospitals in Cagayan de Oro City. Specifically, it evaluates staff perceptions of management and leadership
skills, the work environment—including foundations of care, interpersonal relationships, staffing adequacy, and governance—and their
combined impact on job satisfaction.
Private hospitals in the Philippines face unique challenges such as limited resources, high patient-to-nurse ratios, and more business-
oriented governance models. These conditions may shape how nurse managers exercise competence and how staff nurses perceive
their work environment. International evidence also reinforces this concern; for instance, an analytical cross-sectional study in Iran
found a strong positive correlation (r = 0.933, p < 0.001) between nurse manager competence and nurse job satisfaction, as well as an
inverse correlation with turnover intentions (Rezapour et al., 2024). This highlights that managerial competence and workplace support
are not just organizational issues but also determinants of workforce stability.
Extensive literature has established that positive work environments improve professional commitment and reduce turnover. For
example, a literature review confirmed that supportive environments encompassing collaboration, fair staffing, recognition, and
leadership significantly enhance satisfaction and decrease resignation rates (Yasin et al., 2021). In the Philippines, the leadership traits
of nurse managers have also been shown to influence staff commitment and satisfaction, highlighting the role of mentoring and
participatory leadership in strengthening staff loyalty and the quality of care (de la Cruz et al., 2024). Despite these findings, most
scholarship focuses on public hospitals, leaving private healthcare institutions relatively underexplored.
The effective management of nursing personnel is vital to delivering high-quality patient care, with nurse manager competence and the
work environment emerging as key determinants of staff nurse job satisfaction. Nursing is both physically and emotionally demanding,
and organizational factors such as leadership, staffing adequacy, and collaborative culture significantly influence motivation and
retention. In the Philippine context, job satisfaction among nurses remains a pressing concern due to understaffing, resource shortages,
and turnover intentions. Recent studies have emphasized that the way nurse managers exercise leadership and implement human
resource management practices directly affects nurse morale and job satisfaction (Arevalo et al., 2025).
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Research Article
Research Questions
This study aimed to investigate the impact of nurse manager proficiency and the work environment on job satisfaction among staff
nurses. Specifically, the study sought to answer the following questions:
1. What is the level of nurse manager competence in terms of:
1.1. management skills, and
1.2. leadership skills?
2. What is the level of work environment among staff nurses, in terms of:
2.1. foundations in quality care,
2.2. work relationships,
2.3. staffing and resources, and
2.4. participation in hospital affairs?
3. What is the level of job satisfaction among staff nurses?
4. Is there a significant relationship between staff nurses' job satisfaction, nurse manager competence, and work environment?
5. Which of the variables singly or in combination is the best predictor of job satisfaction among staff nurses?
Methodology
Research Design
This study employed a descriptive-correlational and causal design to investigate the impact of nurse manager competence and the work
environment on staff nurses' job satisfaction. The descriptive design helped identify existing workplace conditions (Siedlecki, 2020),
while the correlational design explored relationships among variables (Seeram, 2019). The causal design assessed direct effects between
variables to understand how changes in managerial competence and the work environment influence job satisfaction (Bloomfield &
Fisher, 2019), providing a comprehensive framework for addressing the study's objectives.
Respondents
The study included regular, full-time staff nurses employed for more than six months in the selected hospitals. Nurses on probation
(less than three months), relievers, trainees, and those with health concerns were excluded or allowed to withdraw. Out of a total
population of 440 staff nurses, a sample size of 206 was determined using the Raosoft sample size calculator.
A proportionate stratified random sampling method was employed, treating each hospital as a stratum to ensure representation based
on the population's original distribution (Rahman et al., 2022).
Table 1. Distribution of population and sample of
participants in the study
Stratum Population Sample
Hospital A 151 71
Hospital B 79 37
Hospital C 160 75
Hospital D 50 23
Total 440 206
Instrument
The study employed a structured survey comprising three parts, adapted from standardized instruments. The first part was based on the
Managerial Competence Scale by Gunawan et al. (2019), originally a 43-item tool developed in Indonesia. To ensure relevance and
brevity, items with a Cronbach's alpha above 0.650 were retained, resulting in 19 items categorized into management skills (9 items)
and leadership skills (8 items). The second part adapted the Practice Environment Scale of the Nursing Work Index (PES-NWI) by
Lake et al. (2024), which assesses nurses' perceptions of their work environment. It includes four subscales: Foundations of Quality
Care (9 items), Work Relationships (6 items), Staffing and Resources (10 items), and Participation in Hospital Affairs (8 items). The
third part fully adopted the 18-item Job Satisfaction Survey by Spector (2022), which has been widely used in various nursing studies
(Ngoc et al., 2024; Serafin et al., 2019). All sections employed a 5-point Likert-like scale, enabling respondents to express their levels
of agreement and ensuring standardized and quantifiable responses across the measured constructs. Since these tools originated from
foreign contexts, the final instrument was subjected to content validation by two study experts and a nurse administrator. Revisions
were made to enhance clarity and appropriateness. A pilot test with 30 nurses, excluded from the main sample, was conducted to assess
reliability. Cronbach's alpha values ranged from 0.907 to 0.989 across all subscales, indicating high internal consistency. Cronbach's
alpha is an appropriate reliability measure for cross-sectional studies (Park, 2021), while validity ensures that the tool accurately
measures the intended concepts (Heale & Twycross, 2015).
Procedure
Prior to data collection, the investigator obtained approval from the College Dean, the University Research Office, and the Liceo
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Research Article
Research Ethics Board (LREB). Ethical clearance ensured that all protocols complied with study standards. Approval was then secured
from the participating hospitals through formal letters of intent. Regular staff nurses, full-time employees with at least six months of
service, were included, while probationary staff, relievers, trainees, and those with health concerns were excluded.
Surveys were administered in a designated room after informed consent was obtained. A 10-minute time limit was given to complete
the survey, with the investigator present to address any queries. Completed responses were coded, secured, and submitted to the
university statistician for analysis, ensuring accuracy and adherence to ethical data handling practices.
Data Analysis
To analyze the data, both descriptive and inferential statistics were employed. For Problems 1 (assessing nurse manager competence)
and 2 (evaluating the nurses' work environment), means and standard deviations were computed to summarize the central tendency and
variability of the responses. For Problem 3 (determining the relationship between nurse manager competence, work environment, and
job satisfaction), Pearson's Product-Moment Correlation was used to assess the strength and direction of linear relationships between
variables (George & Mallery, 2018). Finally, for Problem 4 (examining the predictive effects of nurse manager competence and work
environment on job satisfaction), multiple linear regression was conducted to identify the influence of independent variables and their
sub-components on the dependent variable (Maulud & Abdulazeez, 2020).
The selection of these statistical tools is supported by existing literature. O'Hara et al. (2019) and Baek et al. (2019) employed
correlation analysis to investigate the relationship between leadership and job satisfaction among nurses. Similarly, Jankelova and
Joniakova (2021), and Akinwale and George (2020), applied multiple regression to examine how leadership styles and work
environment factors predict job satisfaction levels in healthcare settings.
Ethical Considerations
This study adhered to ethical principles safeguarding participants' rights, autonomy, and well-being. Informed consent was obtained
after the study's purpose, procedures, and voluntary nature were fully disclosed. Participants were given sufficient time to make a
decision, encouraged to seek clarification, and assured of their right to withdraw at any stage without consequence. Confidentiality and
anonymity were strictly maintained by coding responses and excluding identifying information. All data were securely stored with
restricted access and responsibly disposed of after use. Ethical clearance was secured from the Liceo Research Ethics Board (LREB).
Results and Discussion
The tables below present, analyze, and interpret the data gathered, addressing the specific problems of the study.
Level Proficiency of Nurse Managers in terms of Management Skills and Leadership Skills.
Table 2. Summary of Mean Scores for the Level of Nurse Manager
Competence
Nurse Manager Competence Mean SD Description Interpretation
Management Skills 3.73 .958 Agree High
Leadership Skills 3.76 1.076 Agree High
Overall Mean 3.75 1.017 Agree High
Legend: 5 (4.51–5.00) – Strongly Agree: Very High Work Environment | 4 (3.51–4.50) – Agree: High Work
Environment | 3 (2.51–3.50) – Neutral: Moderately High Work Environment | 2 (1.51–2.50) – Disagree: Low Work
Environment | 1 (1.00–1.50) – Strongly Disagree: Very Low Work Environment
As shown in Table 2, staff nurses perceived nurse managers as highly competent, with overall competence rated high (M = 3.75, SD =
1.017). Leadership skills (M = 3.76) scored slightly higher than management skills (M = 3.73), indicating that staff valued leaders who
could inspire, guide, and support their teams. This suggests that nurses place a strong value on leaders who are approachable, supportive,
and able to provide a vision that extends beyond administrative tasks. Competent leaders foster an environment of trust and professional
growth, which is crucial in retaining staff nurses in private hospital settings where staff turnover is common. Previous studies confirm
that transformational leadership enhances staff satisfaction by empowering nurses and reducing burnout (Labrague et al., 2020). De la
Cruz et al. (2024) further demonstrated in Philippine hospitals that nurse managers with strong leadership traits are instrumental in
improving staff commitment. This suggests that, beyond technical management, the relational aspects of leadership are crucial to
nurses' daily experiences and long-term retention.
Condition of Work Environment among Staff Nurses in terms of Foundation in Quality Care, Work Relationships, Staffing
and Resources, and Participation in Hospital Affairs.
Table 3 summarizes staff nurses' perceptions of their work environment. The work environment received an overall positive rating (M
= 3.81, SD = 0.963), with collegial relationships scoring the highest (M = 4.18, SD = 0.721). This highlights the importance of teamwork
and collaboration in ensuring a supportive culture that sustains morale, especially in high-pressure hospital environments. Foundations
of quality care (M = 3.93) and participation in governance (M = 3.75) were also viewed favorably, underscoring that nurses appreciate
when care delivery is aligned with professional standards and when they are engaged in decision-making.
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Table 3. Summary of Mean Scores for the Condition of Work Environment
among Staff Nurses
Work Environment Mean SD Description Interpretation
Foundations in Quality Care 3.93 .922 Agree High
Work Relationships 4.18 .721 Agree High
Staffing and Resources 3.37 1.142 Neutral Moderately
High
Participation in Hospital Affairs 3.75 1.068 Agree High
Overall Mean 3.81 .963 Agree High
Legend: 5 (4.51–5.00) – Strongly Agree: Very High Work Environment | 4 (3.51–4.50) – Agree: High Work Environment | 3 (2.51–
3.50) – Neutral: Moderately High Work Environment | 2 (1.51–2.50) – Disagree: Low Work Environment | 1 (1.00–1.50) – Strongly
Disagree: Very Low Work Environment
However, staffing and resources were rated lowest (M = 3.37, SD = 1.14), reflecting systemic issues with nurse–patient ratios and
limited resources. Poor staffing not only lowers satisfaction but also endangers patient safety by increasing errors and fatigue. Arevalo
et al. (2025) confirmed that staffing and HR management practices strongly predict job satisfaction in private hospitals in the
Philippines. Therefore, while nurses value collegiality, it cannot compensate for systemic deficiencies in staffing and support.
Job Satisfaction among Staff Nurses
Table 4. Level of Job Satisfaction of Staff Nurse
Indicators Mean SD Description Interpretation
1. I am satisfied with the moments of dialogue and sharing of information 3.73 1.198 Agree High
with my co-workers.
2. I am satisfied with the spirit of collaboration between me and my co- 3.69 1.173 Agree High
workers.
3. I am satisfied with the workload at my workplace. 3.50 1.229 Neutral Moderate High
4. I am satisfied with my superiors' efforts to improve better care. 3.76 1.204 Agree High
5. I am satisfied with my participation in decision-making at my workplace. 3.73 1.230 Agree High
6. I am satisfied with the nurse-to-patient ratio in a shift. 3.47 1.309 Neutral Moderate High
7. I am satisfied with the career advancement opportunities. 3.71 1.123 Agree High
8. I am satisfied with the fact that my work is rewarded and/or valued by my 3.67 1.180 Agree High
nurse managers.
9. I am satisfied with how patients and their families value my work. 3.86 1.069 Agree High
10. I am satisfied with the level of competence of colleagues in the same 3.83 1.078 Agree High
profession.
11. I am satisfied with the equipment/materials at my unit. 3.62 1.194 Agree High
12. I am satisfied with how protocols are organized and elaborated at my unit. 3.55 1.216 Agree High
13. I am satisfied with the time I have to wait to be promoted at my 3.73 1.198 Agree High
workplace.
14. I am satisfied with the salary taking into account the task I perform. 3.12 1.376 Neutral Moderate High
15. I am satisfied with the physical condition of the space where I provide 3.71 1.190 Agree High
care.
16. I like doing the things I do at work. 4.06 .909 Agree High
Overall Mean 3.67 1.034 Agree High
Legend: 5 (4.51–5.00) – Strongly Agree: Very High Work Environment | 4 (3.51–4.50) – Agree: High Work Environment | 3 (2.51–3.50) – Neutral: Moderately High Work Environment | 2 (1.51–
2.50) – Disagree: Low Work Environment | 1 (1.00–1.50) – Strongly Disagree: Very Low Work Environment
Table 4 reveals that job satisfaction was generally high (M = 3.67, SD = 1.034), reflecting that nurses derive meaning from their work.
Intrinsic motivation was a major strength, with the highest indicator being "I like doing the things I do at work" (M = 4.06, SD = 0.909).
This indicates that nurses are dedicated to their profession and derive fulfillment from their roles. They also valued patient appreciation
(M = 3.86) and peer competence (M = 3.83), indicating that recognition from patients and colleagues reinforces their professional
identity. Conversely, extrinsic factors were sources of dissatisfaction, with salary (M = 3.12) and nurse-to-patient ratios (M = 3.47)
scoring the lowest. This suggests that while nurses are intrinsically motivated, systemic issues, such as inadequate pay and
overwhelming workload, continue to undermine their satisfaction. Yasin et al. (2021) noted that job satisfaction is maximized when
both intrinsic and extrinsic needs are met. Lu et al. (2019) also emphasized that dissatisfaction with compensation is a recurring global
issue. Thus, intrinsic motivation sustains commitment, but inadequate extrinsic rewards pose long-term risks for retention.
Significant Relationship Between Staff Nurses' Job Satisfaction and Nurse Manager Competence and Work Environment
Table 5 presents the correlation analysis between staff nurses' job satisfaction and variables related to nurse manager competence and
the work environment. All variables were positively correlated with job satisfaction (p < .05). The strongest correlations were
participation in hospital affairs (r = .886) and staffing/resources (r = .841). This indicates that satisfaction is highest when nurses feel
empowered to participate in decision-making and perceive sufficient staff and resources to perform their duties effectively. Leadership
competence was also positively correlated, indicating that effective managers make a significant contribution to employee satisfaction.
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Table 5. Correlation Analysis between Staff Nurses' Job Satisfaction and Nurse Manager Competence
and Work Environment
Job Satisfaction
Variables Remarks
R-value P-value
Nurse Manager Competence
Management Skills .734** .000 Significant
Leadership Skills .777** .000 Significant
Work Environment
Foundations in Quality Care .752** .000 Significant
Work Relationships .666** .000 Significant
Staffing and Resources .841** .000 Significant
Participation in Hospital Affairs .886** .000 Significant
**. Correlation is significant at the 0.01 level (2-tailed).
Rezapour et al. (2024) similarly found strong correlations between managerial competence and satisfaction, while also demonstrating
its inverse relationship with turnover. These findings suggest that satisfaction encompasses not only interpersonal relationships but
also structural empowerment and organizational inclusivity. When nurses feel their voices matter and resources are adequate, their
satisfaction and loyalty increase.
Predictor of Job Satisfaction among Staff Nurses
Table 6. Multiple Regression Analysis of Predicting Job Satisfaction among Staff Nurses by Nurse Manager
Competence and Work Environment
Unstandardized Coefficients
Predictors B Std. Error Stand. Coeff. t-value P-value Remarks
(Constant) .130 .173 -- .750 .454 Not Significant
Management Skills -.035 .064 -.033 -.553 .581 Not Significant
Leadership Skills .147 .073 .153 2.000 .047 Significant
Foundations in Quality Care -.133 .083 -.118 -1.607 .110 Not Significant
Work Relationships .139 .060 .097 2.307 .022 Significant
Staffing and Resources .315 .041 .348 7.590 .000 Significant
Participation in Hospital Affairs .535 .053 .552 10.111 .000 Significant
Note: R = .923; Adjusted R2=.852; ANOVA for Regression: F=190.75, P=.000
Dependent Variable: Job Satisfaction
Table 6 presents the multiple regression analysis (Predictors of Job Satisfaction). The regression model explained 85.2% of the variance
in job satisfaction (Adj. R² = .852), indicating that the chosen variables strongly predict satisfaction. Four predictors were significant:
participation in hospital affairs (β = .552, p < .001), staffing/resources (β = .348, p < .001), leadership skills (β = .153, p = .047), and
work relationships (β = .097, p = .022). Among these, participation in governance emerged as the strongest predictor, underscoring the
value of shared decision-making in enhancing satisfaction.
This confirms that when nurses are given a voice in organizational policies and processes, they are more motivated and engaged.
Staffing and resources also emerged as critical, highlighting the importance of adequate support systems in sustaining employee
satisfaction. Leadership skills and work relationships, although less influential, still made significant contributions.
On the other hand, management skills and foundations of quality care were not significant predictors in the final model. This suggests
that while these factors are valued by nurses and scored positively at the descriptive level, their unique influence on satisfaction
diminishes when other stronger predictors, such as governance and staffing, are considered.
These findings validate international literature and resonate with Philippine studies (Arevalo et al., 2025; de la Cruz et al., 2024). The
implication is clear: participatory governance, supported by adequate staffing and strong leadership, forms the foundation of nurse job
satisfaction.
Conclusions
Statistical analysis confirmed that nurse manager competence and work environment significantly influenced job satisfaction. Among
the predictors, participation in hospital affairs (β = .552) emerged as the strongest driver of satisfaction, followed by staffing/resources,
leadership skills, and work relationships. These findings emphasize the importance of inclusive decision-making, adequate resourcing,
and supportive leadership in sustaining nurse satisfaction. This aligns with both Philippine (Arevalo et al., 2025; de la Cruz et al., 2024)
and international evidence (Rezapour et al., 2024; Yasin et al., 2021), which consistently demonstrate that empowering nurse managers
and ensuring organizational support enhances staff morale and reduces turnover.
Staff nurses perceived nurse manager competence as high, particularly in leadership and management skills, reflecting confidence in
their nurse managers' ability to guide effectively. The work environment was also viewed positively, with strong interpersonal
relationships emerging as a key strength. However, concerns were evident regarding staffing shortages, resource limitations, and
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dissatisfaction with compensation. Item-level analysis revealed that while intrinsic motivation was strong—nurses enjoyed their work
(M = 4.06) and felt valued by patients (M = 3.86)—extrinsic factors such as salary (M = 3.12) and nurse-to-patient ratios (M = 3.47)
were the lowest-rated indicators, highlighting areas requiring urgent organizational attention.
Based on these findings, hospital administrators are encouraged to address staffing and resource gaps, review compensation packages,
promote participatory governance, and invest in leadership development. Human resource departments and nursing service departments
may prioritize nurse involvement in decision-making, ensure adequate support and resources, enhance compensation, and foster team
cohesion. Communities may support healthcare institutions by advocating for improved infrastructure, raising public awareness of
nurses' roles, and encouraging community engagement in health programs. Families play a vital role by providing emotional support
and promoting open communication and self-care. Nurse managers are encouraged to continue fostering collaborative teams,
supporting staff development, and mentoring emerging leaders. Staff nurses are also encouraged to participate in governance actively,
contribute to team efforts, and pursue professional growth. Colleges of nursing can strengthen leadership training and better align their
curricula with clinical demands by forming partnerships with healthcare providers. Ultimately, future studies may delve deeper into
the relationship between compensation and job satisfaction, employ longitudinal and mixed-methods designs, and broaden their scope
to diverse healthcare settings. Collectively, these efforts aim to enhance nurse satisfaction, strengthen leadership, and improve the
healthcare work environment, ultimately benefiting patient care and sustaining the nursing workforce.
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Gamil & Cunanan 700/701
Psych Educ, 2025, 46(6): 694-701, Document ID:2025PEMJ4489, doi:10.70838/pemj.460603, ISSN 2822-4353
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Affiliations and Corresponding Information
John Troy C. Gamil
Liceo de Cagayan University – Philippines
Gloria M. Cunanan
Liceo de Cagayan University – Philippines
