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Job Satisfaction of Dietitians with Management Responsibilities: An Exploratory Study Supporting ADA's Research Priorities
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TOPICS OF PROFESSIONAL INTEREST
Job Satisfaction of Dietitians with Management Responsibilities: An Exploratory Study Supporting ADA’s Research Priorities
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n 2007, the American Dietetic Association (ADA) prioritized six research needs for the profession which included “research examining the best methods for attracting, educating and retaining competent ADA members and credentialed Registered Dietitians and Dietetic Technicians, Registered will be critical to the future of the dietetics profession” (1). Inclusive of this priority is the need to examine employment trends and factors that affect the careers of dietitians (1). To support these objectives, there remains a need for current information about how registered dietitians (RDs) feel about their jobs, in particular, attitudes and perceptions about multiple factors of their jobs and desires to remain or leave. Unfortunately, current research in this area is limited in scope and lacking in frequency. Research conducted more than 20 years ago indicated that job satisfaction for dietitians was associated with nature of the work (2,3), the job in general (4), and coworkers (2). Nearly 10 years ago, greater job satisfaction was correlated with professional involvement (5). This article was written by Kevin Sauer, PhD, RD, LD, assistant professor, Department of Hospitality Management and Dietetics, Kansas State University, Manhattan; Deborah Canter, PhD, RD, LD, professor and head, Department of Hospitality Management and Dietetics, Kansas State University, Manhattan; and Carol Shanklin, PhD, RD, dean, Graduate School, Kansas State University, Manhattan. doi: 10.1016/j.jada.2010.08.024
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Unfortunately, job satisfaction research continues to evolve across numerous occupations with little current insight available about dietitians. Even less is known about dietitians’ intent to leave their jobs and possible relationships with job satisfaction or dissatisfaction. Ultimately, ADA’s priority to attract and retain RDs is significantly limited without this information. Pay and compensation have been a repeatedly noted source of job dissatisfaction for dietitians (3,4,6). In 2007, RDs with management responsibility, defined as those who manage other employees or financial resources, reported higher incomes compared to RDs without these responsibilities (7). More precisely, RDs who supervised 100 or more employees had a median salary nearly 50% greater than other RDs (7). In addition, managing financial resources correlated with higher salaries for RDs; those responsible for budgets of $1 million or more earned a median wage approximately 50% greater than those with no budget responsibility (7). Unfortunately, it is left to speculation whether simply earning a higher salary also correlates with higher satisfaction with pay for RDs in management roles. Equally important, there is little currently known about factors other than pay that impact job satisfaction or dissatisfaction for RDs who have management oversight. Undoubtedly, there are numerous obligations that managers in all professions confront daily: personnel issues with employees and other professionals, administration of finances, and responding to varying customers’ and organizational needs. RDs in management positions face similar challenges and high expectations in the workplace (8). Some management dietitians have even expanded their
Journal of the AMERICAN DIETETIC ASSOCIATION
oversight to include multiple departments such environmental and other services, at times with little to no increase in pay or training and development (9). There are numerous reasons that management dietitians may or may not be satisfied with their jobs or specific facets of their jobs. It is also plausible that negative feelings could impact recruitment and retention of RDs in these roles. This research explored sources and relationships of job satisfaction and intent to leave among dietitians with management responsibilities. Management dietitians, defined in this study as RDs who manage personnel or financial resources, provide key oversight and leadership across the continuum of dietetics practice, often under challenging and stressful circumstances. Unfortunately, little is known about whether these professionals are satisfied with their jobs or various factors of their jobs. The lack of current information such as this brings with it significant vulnerabilities. For example, it could be that management dietitians are overstressed, unhappy, and essentially dissatisfied, perhaps to the extent that they might leave their jobs. Conversely, management dietitians could find specific elements of their jobs highly satisfying, yielding useful information for the ADA and other stakeholders, particularly those interested in the sustainability of RDs and their career development. The purpose of this exploratory research was to examine multiple facets of job satisfaction and intent to leave among RDs with management responsibilities, defined as RDs who, at minimum, manage personnel or financial resources. Specifically, nine facets of job satisfaction were assessed using the Job Satisfaction Survey (JSS). Key limitations included
© 2010 by the American Dietetic Association
TOPICS OF PROFESSIONAL INTEREST the use of Dietetic Practice Group (DPG) members for the sample and generalized use of job titles for variable comparisons. This research narrows the existing gap in the literature and informs the dietetics profession and others about this important topic. METHODOLOGY Three DPGs were used for the population of RDs with management responsibilities, including the Management of Food and Nutrition Systems (MFNS), Clinical Nutrition Management (CNM), and the School Nutrition Services (SNS). Of these DPGs, 3,783 members were available for the final sample. The total excluded those without e-mail addresses and rejected or undeliverable addresses upon initial delivery of the online survey. An online survey pilot test was conducted among 200 randomly chosen e-mail addresses and resulted in 133 responses. Only a few minor changes to the final survey instrument were made based on the pilot study. The final survey instrument included three sections: job satisfaction (36 items), intent to leave (2 items), and demographic information (21 items). The survey was distributed with three reminders to nonresponders over a 3-week period. The research protocol was approved by the Institutional Review Board of the university employing the researchers and ADA’s Practice, Member Interest, and Affiliate Relations Department per ADA Policy C-17. Given the numerous factors impacting today’s RDs along with the lack of current knowledge about job satisfaction, a multidimensional evaluation of job satisfaction was necessary to provide a more detailed baseline from which to understand the current state and to facilitate future research. Paul Spector identified a gap in the literature pertaining to multi-trait–multi-method instruments of job satisfaction devoted specifically to those working in the human services sector (10). Thus, the JSS was originally designed from the analysis of pilot data derived from 19 studies involving 3,148 participants, including those from the human services, public, and nonprofit sectors such as hospitals, nursing homes, and social service agencies (10). In this study, the JSS was used to assess job
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satisfaction and included the original 36 questions to measure nine facets (four questions each): pay, promotion, supervision, fringe benefits, contingent rewards, operating conditions, coworkers, nature of the work, and communication. The original 6-point Likert scale was used with the anchors of 1⫽disagree very much to 6⫽agree very much. A well-established correlate to job satisfaction/dissatisfaction is intent to leave, yet this construct has not been published in recent dietetics-related research. Two intent to leave measures were adapted from Mobley and colleauges (11), including, “How likely is it that you will look for another job during the next six months?” and “How likely is it that you will quit your job during the next six months?” The original 5-point Likert scale anchored from 1⫽not at all likely to 5⫽extremely likely (11) was used to measure intent to leave. Three additional measures were used to more precisely identify RDs with management responsibilities. After the introductory cover letter, the initial question was, “Are you currently employed as a dietitian with supervisory responsibilities?” Those who selected “yes” were invited to continue with the survey, while those who selected “no” were excused and thanked for their time. RDs who indicated “yes” and continued were later asked, “How many employees report directly to you?” and “What is your level of budget responsibility?” Respondents could select from predetermined categories for each item. All responses were then screened for those who reported, at minimum, managing personnel or financial resources. Those who reported no management responsibility for both criteria were excluded from the data analysis. The review of literature suggested a number of traditional demographic variables that may be associated with satisfaction, such as age (12,13), sex (13,14), pay (15), and level of education (16,17). All of these variables were also included in this study. In addition, demographic information gathered assisted in evaluating variables specific to dietetics practice that may play a role in satisfaction for managers. Other variables assessed were place/type of employment (eg, schools, health care, long-term care,
self-op/contract), level of budget responsibility, number of RDs worked with on a routine basis, number of direct reports, and hours worked per week. Given the exploratory nature of the study, job titles were gathered and categorized for further comparison of satisfaction variables. Although specific job tasks and associated job titles for dietitians in management roles are diverse, in particular between different work environments such as schools, colleges, long-term care, government, or health care organizations, the core set of management-related responsibilities for dietitians were not considered uniquely different for this phase of the research. Job titles were also obtained to examine possible differences in satisfaction variables at the level of hierarchical or departmental structure (eg, directors vs supervisors). Similar job titles were categorized into groups of 20 or more. Job titles with 20 or fewer responses were not used in the data analysis. Finally, a data file of responses was created using the Statistical Package for the Social Sciences (SPSS) (version 11.5, 2002, SPSS, Inc, Chicago, IL). Statistics were calculated for demographic, operational, satisfaction, and intent to leave variables including means, frequencies, Pearson correlation, cross tabulations, and analysis of variance (ANOVA) procedures. Cronbach’s ␣ was used to measure internal consistency of measurement items. Significance for statistical tests was set at Pⱕ.05 unless otherwise indicated. RESULTS Of the 3,783 surveys delivered, 1,200 responses were collected, for a response rate of 31.7%. After screening for management responsibility, the final usable sample included 851 RDs, of whom 96% were female, 55% had a graduate degree, and 9% indicated a race other than white. Approximately one half (51%) of the RDs were 50 years or older and 43% had 25 years of dietetics-related experience or more. More than half (57%) reported more than 10 years of experience of dietetics-related management experience, while a majority (63%) had been in their present job for less than 10 years.
TOPICS OF PROFESSIONAL INTEREST Table 1. Comparison of Job Satisfaction Survey (JSS) subscales of management dietitians with normative values for multiple occupations MeanⴞStandard Deviation Subscale
Management dietitians (nⴝ851)a
JSS overallb
Nature of work Supervision Coworkers Fringe benefits Communication Contingent rewards Pay Promotion Operating conditions Overall satisfaction
20.0⫾3.4 19.4⫾4.5 18.6⫾3.6 18.2⫾4.3 17.3⫾4.2 16.4⫾4.9 16.3⫾5.0 14.7⫾4.7 12.9⫾3.9 153.8⫾26.7c
18.9⫾1.8 18.8⫾1.7 17.9⫾1.4 14.6⫾2.1 14.5⫾1.9 13.8⫾1.8 12.3⫾2.4 12.1⫾1.8 13.5⫾2.0 138⫾21.6
a
Possible range 4 to 24. JSS standardized observations for multiple occupations (18). Overall satisfaction score was determined by summing composite scores for nine subscales. Possible range 36 to 216.
b c
Job titles were categorized and included 318 (32%) clinical nutrition managers or chief clinical dietitians, 287 (29%) directors, 61 (7%) assistant directors, 106 (11%) managers, and 33 (4%) supervisors. The titles district or regional managers were cited by 26 RDs while 20 RDs were general managers. Almost half (49%) of the RDs earned $70,000 or more per year, and 97% worked full time. No clinical managers, district managers, or general managers earned less than $40,000, while the majority (66%) of clinical managers earned more than $60,000 annually. More than half of the clinical nutrition managers (51%) and supervisors (55%) had no budget responsibility, while 42% of clinical managers and 46% of supervisors reported having nine or fewer employees reporting to them. Reliability indices for overall job satisfaction and intent to leave measures were 0.93 and 0.80 respectively, which indicated strong internal consistency and reliability. Satisfaction subscale scores were calculated from the accumulated values for each of four measurement items for each job satisfaction subscale (Table 1). The possible range for each subscale score was 4 to 24. The highest composite subscale score was nature of the work (M⫽20.0⫾3.4). Other subscales with higher scores included supervision (M⫽19.4⫾4.5), coworkers (M⫽18.6⫾ 3.6), and fringe benefits (M⫽18.2⫾4.3). The lowest composite subscale was operating conditions (M⫽12.9⫾3.9).
Overall job satisfaction was determined by summing the nine subscale scores. Management dietitians in this study had an overall satisfaction score of 153.75⫾26.68, which is a higher value than reported by Spector (18) for multiple occupations of both private and public employers in the United States. Spector (18) reported an overall satisfaction value of 138.00⫾21.60 based on results of 132 studies with 36,380 respondents. Spector (18) also reported an overall satisfaction score value of 134.3⫾14.8 for those in the medical field. One-way ANOVA analysis was conducted and revealed that overall job satisfaction scores differed significantly across the seven job titles for management dietitians, F (6, 844)⫽4.41, P⬍0.001. Tukey post hoc analysis showed that clinical nutrition managers had significantly lower overall satisfaction scores when compared to district managers and directors (Table 2). Additional one-way ANOVA procedures were used to examine differences among satisfaction subscales. Significant differences were not found for supervision, fringe benefits, communication, or operating conditions. However, significant differences were found between job titles and satisfaction with nature of the work F (6, 844)⫽6.14, P⬍0.000, coworkers F (6, 844)⫽2.97, P⫽0.007, rewards F (6, 844)⫽5.22, P⬍0.001, pay F (6, 844)⫽3.55, P⫽0.002, and promotion F (6, 844)⫽2.80, P⫽0.010 (Table 2). Specifically, clinical nutrition
managers had significantly lower satisfaction scores for pay, contingent rewards, and nature of the work with at least one other manager type. Those who had the job title of manager reported significantly lower scores with pay, promotion, and nature of the work compared to directors. Mean overall job satisfaction scores were also compared across various levels of demographic and operational variables of management dietitians. Initial one-way ANOVA models indicated significant differences in mean overall satisfaction scores across levels of income F (6, 825)⫽5.16, P⬍0.001, level of budget responsibility F (6, 836)⫽4.81, P⬍0.001, and number of RDs worked with on a routine basis F (6, 837)⫽3.18, P⬍0.001. More specifically, overall job satisfaction scores were significantly different between $70,000/higher and $60,000 to $69,000 income levels (158.39⫾26.63 vs 149.48⫾26.54). Dietitians with a budget responsibility of $100,000 to $499,000 and those with no budget responsibility were significantly less satisfied compared to those who were responsible for $1 million or more of budget responsibility (150.74⫾25.28, 149.18⫾26.29, and 158.71⫾26.61). Finally, management dietitians who worked with one to three and no RDs on a routine basis were significantly less satisfied overall than those who worked with 25 or more RDs routinely (151.48⫾27.21, 149.38⫾28.49, and 164.40⫾24.82). Overall, intent to leave was not observed. Mean score for the item, “likelihood to look for another job in the next six months,” was 2.02⫾1.28, while the mean score for the item, “likelihood to quit their current job during the next six months,” was 1.54⫾0.94. ANOVA procedures did not indicate significant differences in mean scores of intent to leave across those with different job titles. Pearson correlation was used to examine relationships between job satisfaction subscale scores and overall intent to leave score. Strong negative correlations (P⬍ 0.001) existed between all job satisfaction subscales and overall intent to leave. The strongest significant correlations with intent to leave were with contingent rewards (r⫽⫺0.444), nature of the work (r⫽⫺0.444), and overall satisfaction (r⫽⫺0.477).
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TOPICS OF PROFESSIONAL INTEREST Table 2. Comparison of Job Satisfaction Survey (JSS) subscales and overall satisfaction of management dietitians with different position titles MeanⴞStandard Deviationa
Subscale
District manager (nⴝ26)
General manager (nⴝ20)
Director (nⴝ287)
Assistant director (nⴝ61)
Manager (nⴝ106)
Supervisor (nⴝ33)
Clinical manager (nⴝ318)
Nature of work Supervision Fringe benefits Coworkers Rewards Pay Communication Promotion Operating conditions Overall satisfactionb
21.7⫾2.0y 20.5⫾4.7 19.9⫾3.6 19.6⫾3.4y 18.7⫾3.8y 17.9⫾3.6y,z 17.8⫾3.7 17.4⫾4.3y 13.5⫾3.7 167.1⫾19.7y
20.8⫾4.5y,z 19.9⫾4.1 18.0⫾4.8 18.4⫾3.4y,z 16.5⫾4.9y,z 16.1⫾5.8y,z 16.3⫾4.3 14.7⫾5.8y,z 12.4⫾5.0 152.9⫾28.5y,z
20.8⫾3.1y 19.9⫾4.2 18.5⫾4.5 19.2⫾3.3y 17.4⫾5.0y 17.2⫾5.3y 17.9⫾4.1 15.0⫾4.8y,z 13.1⫾4.2 158.9⫾27.5y
19.7⫾3.3y,z 18.9⫾4.6 18.6⫾4.0 17.8⫾3.5y,z 15.6⫾4.9y,z 15.7⫾5.0y,z 17.0⫾3.9 15.3⫾4.6y,z 11.9⫾3.5 150.4⫾24.7y,z
19.6⫾3.5y,z 19.3⫾4.7 18.2⫾4.3 18.00⫾3.9z 16.2⫾5.0y,z 15.5⫾4.9z 17.0⫾4.7 13.9⫾4.5z 12.9⫾3.8 150.5⫾28.0y,z
20.4⫾2.8y,z 18.1⫾5.3 18.2⫾4.2 17.8⫾3.7y,z 16.9⫾4.8y,z 16.24⫾5.3y,z 16.5⫾4.9 14.2⫾4.5y,z 12.7⫾3.9 151.0⫾28.9y,z
19.4⫾3.8z 19.2⫾4.7 17.74⫾4.1 18.5⫾3.7y,z 15.5⫾4.7z 15.6⫾4.6z 17.1⫾4.1 14.3⫾4.5z 12.8⫾3.6 150.1⫾25.1z
a
Possible range 4 to 24. Possible range 36 to 216. y,z Means in the same row with different superscripts (y,z) differ significantly by Tukey’s post hoc test (Pⱖ0.05). b
DISCUSSION Spector (18) recommends that overall satisfaction scores over 144 generally indicate job satisfaction. Accordingly, management dietitians expressed overall satisfaction with their jobs as measured by the JSS (153.75⫾26.68) and compared to national normative values across multiple occupations (138.00⫾21.60) (18). Cross tabulations also indicated that only 4.7% (40) were considered dissatisfied, 31.8% (271) were neither satisfied nor dissatisfied, while 63.5% (540) were satisfied. The highest overall satisfaction score for managers was 213 cited by one person, while the lowest overall satisfaction score was 76 reported by two respondents. According to Spector’s (18) guidelines, composite satisfaction scores for subscales below 12 indicated dissatisfaction, while scores greater than 16 suggested satisfaction. RDs appeared to be satisfied with most facets of their jobs except for operating conditions. The top three sources of job satisfaction were nature of the work, supervision, and coworkers. Furthermore, when contrasted against national accumulative values, management dietitians were also more satisfied in all facets of job satisfaction except for operating conditions. It has been reported that RDs with management responsibilities are among the highest paid in the profession (7), but it was unknown if management dietitians were also satisfied
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with their level of compensation. According to this research, RDs in management roles were satisfied with pay. However, differences in pay satisfaction across all job titles was somewhat elusive, as the only significant differences in total job satisfaction scores at the level of pay were with those earning $70,000 compared to those earning just below that level at $60,000 to $69,000. Level of income may not explain differences in satisfaction with pay for all management dietitians. For example, clinical nutrition managers were found to be significantly less satisfied with pay as compared to directors. However, similar numbers of both clinical managers (91%) and directors (92%) reported incomes greater than $50,000. These findings reiterate the need to explore differences among specific types of management dietitians with different job titles and responsibilities and associated feelings of inequity towards pay. Some management dietitians, such as clinical nutrition managers, may share unique reference groups when it comes to satisfaction with pay or other elements of satisfaction. As such, management dietitians are often categorized into one of many roles related to foodservice management, while clinical managers may perform management duties that are very different from those in the hierarchy of providing foodservices. Approximately 94% of the clinical
nutrition managers in this study worked in hospitals. Therefore, it is possible that clinical managers compare their level of compensation, and thus form their perception of pay equity, with non-RD management professionals in health care settings. These professionals could include nurses, pharmacists, radiologists, or others. On the other hand, it seems logical that other management dietitians without clinical oversight might compare themselves to managers within similar areas such as foodservice management. Future research should identify referent groups for RDs and compare satisfaction variables with those groups. Previous research has reported that dietitians are less satisfied with promotional opportunities (2-4). Similarly, satisfaction with promotion was one of the lowest subscales for management dietitians, but still considered satisfying according to the JSS interpretation. District managers were the most satisfied with promotion, but clinical managers and managers were significantly (P⬍0.05) less satisfied with promotion. For some management dietitians, a variety of elements could affect the perceptions of the likelihood to be promoted, such as size of the facility, the economy, or even internal politics. In addition, the lack of turnover among the existing management team could reduce the chances for promotion and thus cause dissatisfaction. In other
TOPICS OF PROFESSIONAL INTEREST cases, some RDs may feel that fewer opportunities exist to promote beyond food and nutrition services due the specialization of being an RD or that the necessary skill set is deficient in order to promote beyond nutrition services within specific environments. Operating conditions, which included satisfaction or dissatisfaction with policies, procedures, rules, and perceived red tape, was a possible source of dissatisfaction. Among specific manager types, assistant directors were considered dissatisfied while general managers, managers, supervisors, and clinical nutrition managers scored only slightly above dissatisfaction. RDs appeared to be pleased with the supervision they receive. However, it is not clear whether having an RD as a supervisor moderated satisfaction levels. For example, only 26% of the RDs reported having an RD as his or her supervisor. Assistant directors and supervisors had the highest frequency of supervisors who were RDs, 55.7% and 51.5%, respectively, but only 34.6% of clinical managers reported the same. District managers reported the highest satisfaction with supervision, but only seven out of 26 district managers reported having a supervisor who was an RD. Management dietitians were very satisfied with their coworkers. Given that satisfaction with supervision was rated high among the majority of RDs in this study, it is possible that RDs were thinking of their supervisor(s) as a coworker. Furthermore, RDs who worked with more than 25 RDs on a regular basis had significantly higher levels of overall job satisfaction compared to those who worked with less than three RDs. Nature of work revealed the greatest source of job satisfaction. Although not a specific subscale of the JSS, important operational factors such as level of budget authority and number of employees supervised are theoretically aligned with nature of the work for managers. One study indicated that satisfaction with pay increased for dietitians as the number of employees they supervised increased (3). Interestingly, no significant (P⬍0.05) differences in overall job satisfaction were found across number of employees supervised in this study. However, those who managed a budget greater than $1 million
were significantly (P⬍0.05) more satisfied compared to those who managed $100,000 to $499,000 and those with no budget responsibility. Results also indicated that approximately 51% of clinical nutrition managers had no budget authority, which is similar to previous findings (19). In contrast, only 62 (7%) of all other management dietitians in this study reported no budget authority. When controlled for respondents considering retirement, 133 (16%) management dietitians indicated that it was likely or extremely likely they would look for another job in the next 6 months. Also, 42 (5%) indicated it was likely or extremely likely they would quit their current job in the next 6 months. The reasons RDs might quit their jobs could be numerous and/or due to reasons that have little to do with job satisfaction. These could include relocation, workplace restructuring, challenges with childrearing, return to school, or a change in career. Overall, the results of this study are consistent with the literature among other occupations; as overall satisfaction or facets of job satisfaction among RDs increased, the likelihood of voluntary leave decreased. Correlation analyses support the assertion in that overall satisfaction had a strong significant negative relationship with intent to leave for RDs. More specifically, cross tabulations found only 23 of the management dietitians who were considered dissatisfied overall indicated that it was likely or very likely they would look for another job in the next 6 months. Comparatively, only seven of the RDs who were dissatisfied also indicated that it was likely or extremely likely they would actually quit their current jobs. LIMITATIONS Limitations were present with this research and pertained mostly to the methods used. For example, the use of DPGs for the sample limits the ability to generalize the findings due to the lack of information gathered from those who are not members of ADA or certain DPGs. Since both ADA and DPG membership is voluntary, it is possible that a heightened sense of job satisfaction exists specifically
among these members compared to those who are not ADA/DPG members. Gathering information about job satisfaction could be sensitive to some participants. Although the methods used to distribute the survey instrument and to collect data maintained confidentiality and anonymity, requests for sensitive job-related information such as perceptions about pay, coworkers, and supervisors, could have inhibited or altered some responses. The measures used to maintain confidentiality and anonymity were reiterated to the participants throughout the data collection process. Using job titles is limiting since variance likely exists between the tasks performed by management dietitians with similar and/or different job titles. In addition, very specific roles and responsibilities within work environments such as schools, longterm care, universities, corrections, and medical centers were not ascertained. However, given the exploratory nature of this study and need for renewed baseline of information, the core responsibilities (managing people and/or financial resources) was not considered uniquely different for management dietitians. It is advised that future studies more precisely examine satisfaction or dissatisfaction with the specific roles and responsibilities of management dietitians in different environments. Finally, due to the current economic recession and historic unemployment rates reported across several occupations, caution is necessary with regards to the measurement and interpretation of intent to leave scores. RDs are not immune to the effects of the recession, which limits the current interpretation. However, there is also no current baseline from which to compare intent to leave among RDs involved in any line of work and the numerous variables that may or may not have contributed to the phenomena within the dietetics profession. Intent to leave obviously fulfills the desire to understand the retention of RDs. This research promotes a new starting point from which to compare with future studies. CONCLUSIONS This study provided current insight about job satisfaction among RDs with management responsibilities.
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TOPICS OF PROFESSIONAL INTEREST Among 851 RDs who were members of selected DPGs and held supervisory responsibilities, overall job satisfaction was observed. Generally, management dietitians were more satisfied when compared to national indices. However, levels of overall satisfaction and facets were significantly (P⬍0.05) different among management dietitians with different job titles. The need for additional study is particularly intriguing, especially among clinical nutrition managers, who were not classified as dissatisfied, but expressed significantly lower satisfaction in a variety of areas when compared to other types of managers. Important questions and new research needs also surface from this study. For example, nature of the work was a strong source of satisfaction for the majority of RDs in this study, making clear the need for a new baseline of knowledge that illustrates more specifically which elements of the work for different groups of management dietitians in different work environments are particularly satisfying or dissatisfying and why. Furthermore, the large number of RDs who fell into the neutral category for satisfaction in different areas of their jobs reinforces the reason to continue research in this area. Future work should focus on the underlying factors that may cause these practitioners to feel more or less satisfied in regards to their job. Qualitative data that provide a more precise voice on satisfying and dissatisfying elements of work for RDs would be most insightful in addition to quantitative comparisons. Finally, this study sought to determine whether RDs belonging to certain DPGs with management responsibility intended to leave their current jobs. This was not the case for the majority of respondents in this study. Most elements of job satisfaction had significantly negative relationships with intent to leave, yet predicting intent to leave is left with unanswered questions. The implications of this research are significant. Current insight about job and career satisfaction aligns the ADA and other organizations in a position to better support job and career development of RDs. If management dietitians are satisfied with certain aspects of their jobs, then those facets can be further examined and encour-
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aged to others, in particular to those looking toward job or career promotion, new or different opportunities, or income enhancement. Job dissatisfaction with work, in particular among RDs in management roles, can negatively impact productivity and services, other managers and employees, organizations, and customers. Negative perceptions about the services and expertise provided by RDs, particularly those in key departmental leadership roles, are very threatening to the entire dietetics profession. With perceptions of negativity, some may question hiring or promoting RDs into management positions, paving the way for others without the appropriate qualifications or backgrounds in food and nutrition to provide the leadership for nutritional care and services. Finally, the initial hiring process for entry-level RDs often initiates within the academic setting and, therefore, is further enhanced by current knowledge about RDs’ level of satisfaction in different work areas. Educators, advisors, and mentors of RDs gain substantially from understanding the satisfying and dissatisfying elements that surround the jobs of RDs, particularly those that manage and lead other RDs. Accordingly, educators and other stakeholders can better guide and prepare graduates for the realities and challenges that lie ahead for graduates when factors about jobs are better understood. References 1. American Dietetic Association. Priorities for research: Agenda to support the future of dietetics. http://www.adaevidencelibrary.com/ files/file/ADA_Priority%20for%20Research. 2007.pdf. Published 2007. Accessed July 21, 2010. 2. Calbeck DC, Vaden AG, Vaden RE. Workrelated values and satisfactions. J Am Diet Assoc. 1979;75:434-440. 3. Sims LS, Khan J. Job satisfaction among public health nutrition personnel. J Am Diet Assoc. 1986;86:334-338. 4. Rehn BL, Stallings SF, Wolman PG, Cullen RW. Job satisfaction of South Carolina dietitians. J Am Diet Assoc. 1989;89:979-981. 5. Mortensen JK, Nyland NK, Fullmer S, Eggnett DL. Professional involvement is associated with increased job satisfaction among dietitians. J Am Diet Assoc. 2002;102:14521454. 6. Dalton S, Gilbride JA, Russo L, Vergis L. Job satisfaction of clinical, community, and longterm care dietitians in New York City. J Am Diet Assoc. 1993;93:184-186. 7. Rogers D. Compensation & benefits survey 2007: Above-average pay gains seen for reg-
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19.
istered dietitians. J Am Diet Assoc. 2008; 108:416-427. Silverman MR, Gregoire MB, Lafferty LJ, Dowling RA. Current and future practices in hospital foodservice. J Am Diet Assoc. 2000; 100:76-80. Canter DD, Nettles MF. Dietitians as multidepartment managers in health care settings. J Am Diet Assoc. 2003;103:237-240. Spector PE. Measurement of human service staff satisfaction: Development of the Job Satisfaction Survey. Am J Community Psychol. 1985;13:693-713. Mobley WH, Horner SO, Hollingsworth AT. An evaluation of precursors of hospital turnover. J Appl Psycho. 1978;63:408-414. Birdi K, Warr P, Oswald A. Age differences in three components of employee well-being. Applied Psychology: An International Review. 1995;44:345-373. Spector PE. Job Satisfaction: Application, Assessment, Causes, and Consequences. Thousand Oaks, CA: Sage; 1997. Brush DH, Moch MK, Pooyan A. Individual demographic differences and job satisfaction. J Occup Behav. 1987;8:139-155. Rice RW, Philips SM, McFarlin DB. Multiple discrepancies and pay satisfaction. J Appl Psychol. 1990;75:386-393. Gordon ME, Avery RD. The relationship between education and satisfaction with job content. Acad Manage J. 1975;18:888-892. Florit EF, Lladosa LE. Evaluation of the effects of education on job satisfaction: Independent single-equation vs. structural equation models. Int Adv Econ Res. 2007;13:157170. Spector P. Job satisfaction survey Web site. http://chuma.cas.usf.edu/⬃spector/scales/ jsspag.html. Published 1994. Updated December 5, 2009. Accessed March 1, 2010. Witte SS, Messersmith AM. Clinical nutrition management position: Responsibilities and skill development strategies. J Am Diet Assoc. 1995;95:1113-1120.
TOPICS OF PROFESSIONAL INTEREST
Job Satisfaction of Dietitians with Management Responsibilities: An Exploratory Study Supporting ADA’s Research Priorities
I
n 2007, the American Dietetic Association (ADA) prioritized six research needs for the profession which included “research examining the best methods for attracting, educating and retaining competent ADA members and credentialed Registered Dietitians and Dietetic Technicians, Registered will be critical to the future of the dietetics profession” (1). Inclusive of this priority is the need to examine employment trends and factors that affect the careers of dietitians (1). To support these objectives, there remains a need for current information about how registered dietitians (RDs) feel about their jobs, in particular, attitudes and perceptions about multiple factors of their jobs and desires to remain or leave. Unfortunately, current research in this area is limited in scope and lacking in frequency. Research conducted more than 20 years ago indicated that job satisfaction for dietitians was associated with nature of the work (2,3), the job in general (4), and coworkers (2). Nearly 10 years ago, greater job satisfaction was correlated with professional involvement (5). This article was written by Kevin Sauer, PhD, RD, LD, assistant professor, Department of Hospitality Management and Dietetics, Kansas State University, Manhattan; Deborah Canter, PhD, RD, LD, professor and head, Department of Hospitality Management and Dietetics, Kansas State University, Manhattan; and Carol Shanklin, PhD, RD, dean, Graduate School, Kansas State University, Manhattan. doi: 10.1016/j.jada.2010.08.024
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Unfortunately, job satisfaction research continues to evolve across numerous occupations with little current insight available about dietitians. Even less is known about dietitians’ intent to leave their jobs and possible relationships with job satisfaction or dissatisfaction. Ultimately, ADA’s priority to attract and retain RDs is significantly limited without this information. Pay and compensation have been a repeatedly noted source of job dissatisfaction for dietitians (3,4,6). In 2007, RDs with management responsibility, defined as those who manage other employees or financial resources, reported higher incomes compared to RDs without these responsibilities (7). More precisely, RDs who supervised 100 or more employees had a median salary nearly 50% greater than other RDs (7). In addition, managing financial resources correlated with higher salaries for RDs; those responsible for budgets of $1 million or more earned a median wage approximately 50% greater than those with no budget responsibility (7). Unfortunately, it is left to speculation whether simply earning a higher salary also correlates with higher satisfaction with pay for RDs in management roles. Equally important, there is little currently known about factors other than pay that impact job satisfaction or dissatisfaction for RDs who have management oversight. Undoubtedly, there are numerous obligations that managers in all professions confront daily: personnel issues with employees and other professionals, administration of finances, and responding to varying customers’ and organizational needs. RDs in management positions face similar challenges and high expectations in the workplace (8). Some management dietitians have even expanded their
Journal of the AMERICAN DIETETIC ASSOCIATION
oversight to include multiple departments such environmental and other services, at times with little to no increase in pay or training and development (9). There are numerous reasons that management dietitians may or may not be satisfied with their jobs or specific facets of their jobs. It is also plausible that negative feelings could impact recruitment and retention of RDs in these roles. This research explored sources and relationships of job satisfaction and intent to leave among dietitians with management responsibilities. Management dietitians, defined in this study as RDs who manage personnel or financial resources, provide key oversight and leadership across the continuum of dietetics practice, often under challenging and stressful circumstances. Unfortunately, little is known about whether these professionals are satisfied with their jobs or various factors of their jobs. The lack of current information such as this brings with it significant vulnerabilities. For example, it could be that management dietitians are overstressed, unhappy, and essentially dissatisfied, perhaps to the extent that they might leave their jobs. Conversely, management dietitians could find specific elements of their jobs highly satisfying, yielding useful information for the ADA and other stakeholders, particularly those interested in the sustainability of RDs and their career development. The purpose of this exploratory research was to examine multiple facets of job satisfaction and intent to leave among RDs with management responsibilities, defined as RDs who, at minimum, manage personnel or financial resources. Specifically, nine facets of job satisfaction were assessed using the Job Satisfaction Survey (JSS). Key limitations included
© 2010 by the American Dietetic Association
TOPICS OF PROFESSIONAL INTEREST the use of Dietetic Practice Group (DPG) members for the sample and generalized use of job titles for variable comparisons. This research narrows the existing gap in the literature and informs the dietetics profession and others about this important topic. METHODOLOGY Three DPGs were used for the population of RDs with management responsibilities, including the Management of Food and Nutrition Systems (MFNS), Clinical Nutrition Management (CNM), and the School Nutrition Services (SNS). Of these DPGs, 3,783 members were available for the final sample. The total excluded those without e-mail addresses and rejected or undeliverable addresses upon initial delivery of the online survey. An online survey pilot test was conducted among 200 randomly chosen e-mail addresses and resulted in 133 responses. Only a few minor changes to the final survey instrument were made based on the pilot study. The final survey instrument included three sections: job satisfaction (36 items), intent to leave (2 items), and demographic information (21 items). The survey was distributed with three reminders to nonresponders over a 3-week period. The research protocol was approved by the Institutional Review Board of the university employing the researchers and ADA’s Practice, Member Interest, and Affiliate Relations Department per ADA Policy C-17. Given the numerous factors impacting today’s RDs along with the lack of current knowledge about job satisfaction, a multidimensional evaluation of job satisfaction was necessary to provide a more detailed baseline from which to understand the current state and to facilitate future research. Paul Spector identified a gap in the literature pertaining to multi-trait–multi-method instruments of job satisfaction devoted specifically to those working in the human services sector (10). Thus, the JSS was originally designed from the analysis of pilot data derived from 19 studies involving 3,148 participants, including those from the human services, public, and nonprofit sectors such as hospitals, nursing homes, and social service agencies (10). In this study, the JSS was used to assess job
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satisfaction and included the original 36 questions to measure nine facets (four questions each): pay, promotion, supervision, fringe benefits, contingent rewards, operating conditions, coworkers, nature of the work, and communication. The original 6-point Likert scale was used with the anchors of 1⫽disagree very much to 6⫽agree very much. A well-established correlate to job satisfaction/dissatisfaction is intent to leave, yet this construct has not been published in recent dietetics-related research. Two intent to leave measures were adapted from Mobley and colleauges (11), including, “How likely is it that you will look for another job during the next six months?” and “How likely is it that you will quit your job during the next six months?” The original 5-point Likert scale anchored from 1⫽not at all likely to 5⫽extremely likely (11) was used to measure intent to leave. Three additional measures were used to more precisely identify RDs with management responsibilities. After the introductory cover letter, the initial question was, “Are you currently employed as a dietitian with supervisory responsibilities?” Those who selected “yes” were invited to continue with the survey, while those who selected “no” were excused and thanked for their time. RDs who indicated “yes” and continued were later asked, “How many employees report directly to you?” and “What is your level of budget responsibility?” Respondents could select from predetermined categories for each item. All responses were then screened for those who reported, at minimum, managing personnel or financial resources. Those who reported no management responsibility for both criteria were excluded from the data analysis. The review of literature suggested a number of traditional demographic variables that may be associated with satisfaction, such as age (12,13), sex (13,14), pay (15), and level of education (16,17). All of these variables were also included in this study. In addition, demographic information gathered assisted in evaluating variables specific to dietetics practice that may play a role in satisfaction for managers. Other variables assessed were place/type of employment (eg, schools, health care, long-term care,
self-op/contract), level of budget responsibility, number of RDs worked with on a routine basis, number of direct reports, and hours worked per week. Given the exploratory nature of the study, job titles were gathered and categorized for further comparison of satisfaction variables. Although specific job tasks and associated job titles for dietitians in management roles are diverse, in particular between different work environments such as schools, colleges, long-term care, government, or health care organizations, the core set of management-related responsibilities for dietitians were not considered uniquely different for this phase of the research. Job titles were also obtained to examine possible differences in satisfaction variables at the level of hierarchical or departmental structure (eg, directors vs supervisors). Similar job titles were categorized into groups of 20 or more. Job titles with 20 or fewer responses were not used in the data analysis. Finally, a data file of responses was created using the Statistical Package for the Social Sciences (SPSS) (version 11.5, 2002, SPSS, Inc, Chicago, IL). Statistics were calculated for demographic, operational, satisfaction, and intent to leave variables including means, frequencies, Pearson correlation, cross tabulations, and analysis of variance (ANOVA) procedures. Cronbach’s ␣ was used to measure internal consistency of measurement items. Significance for statistical tests was set at Pⱕ.05 unless otherwise indicated. RESULTS Of the 3,783 surveys delivered, 1,200 responses were collected, for a response rate of 31.7%. After screening for management responsibility, the final usable sample included 851 RDs, of whom 96% were female, 55% had a graduate degree, and 9% indicated a race other than white. Approximately one half (51%) of the RDs were 50 years or older and 43% had 25 years of dietetics-related experience or more. More than half (57%) reported more than 10 years of experience of dietetics-related management experience, while a majority (63%) had been in their present job for less than 10 years.
TOPICS OF PROFESSIONAL INTEREST Table 1. Comparison of Job Satisfaction Survey (JSS) subscales of management dietitians with normative values for multiple occupations MeanⴞStandard Deviation Subscale
Management dietitians (nⴝ851)a
JSS overallb
Nature of work Supervision Coworkers Fringe benefits Communication Contingent rewards Pay Promotion Operating conditions Overall satisfaction
20.0⫾3.4 19.4⫾4.5 18.6⫾3.6 18.2⫾4.3 17.3⫾4.2 16.4⫾4.9 16.3⫾5.0 14.7⫾4.7 12.9⫾3.9 153.8⫾26.7c
18.9⫾1.8 18.8⫾1.7 17.9⫾1.4 14.6⫾2.1 14.5⫾1.9 13.8⫾1.8 12.3⫾2.4 12.1⫾1.8 13.5⫾2.0 138⫾21.6
a
Possible range 4 to 24. JSS standardized observations for multiple occupations (18). Overall satisfaction score was determined by summing composite scores for nine subscales. Possible range 36 to 216.
b c
Job titles were categorized and included 318 (32%) clinical nutrition managers or chief clinical dietitians, 287 (29%) directors, 61 (7%) assistant directors, 106 (11%) managers, and 33 (4%) supervisors. The titles district or regional managers were cited by 26 RDs while 20 RDs were general managers. Almost half (49%) of the RDs earned $70,000 or more per year, and 97% worked full time. No clinical managers, district managers, or general managers earned less than $40,000, while the majority (66%) of clinical managers earned more than $60,000 annually. More than half of the clinical nutrition managers (51%) and supervisors (55%) had no budget responsibility, while 42% of clinical managers and 46% of supervisors reported having nine or fewer employees reporting to them. Reliability indices for overall job satisfaction and intent to leave measures were 0.93 and 0.80 respectively, which indicated strong internal consistency and reliability. Satisfaction subscale scores were calculated from the accumulated values for each of four measurement items for each job satisfaction subscale (Table 1). The possible range for each subscale score was 4 to 24. The highest composite subscale score was nature of the work (M⫽20.0⫾3.4). Other subscales with higher scores included supervision (M⫽19.4⫾4.5), coworkers (M⫽18.6⫾ 3.6), and fringe benefits (M⫽18.2⫾4.3). The lowest composite subscale was operating conditions (M⫽12.9⫾3.9).
Overall job satisfaction was determined by summing the nine subscale scores. Management dietitians in this study had an overall satisfaction score of 153.75⫾26.68, which is a higher value than reported by Spector (18) for multiple occupations of both private and public employers in the United States. Spector (18) reported an overall satisfaction value of 138.00⫾21.60 based on results of 132 studies with 36,380 respondents. Spector (18) also reported an overall satisfaction score value of 134.3⫾14.8 for those in the medical field. One-way ANOVA analysis was conducted and revealed that overall job satisfaction scores differed significantly across the seven job titles for management dietitians, F (6, 844)⫽4.41, P⬍0.001. Tukey post hoc analysis showed that clinical nutrition managers had significantly lower overall satisfaction scores when compared to district managers and directors (Table 2). Additional one-way ANOVA procedures were used to examine differences among satisfaction subscales. Significant differences were not found for supervision, fringe benefits, communication, or operating conditions. However, significant differences were found between job titles and satisfaction with nature of the work F (6, 844)⫽6.14, P⬍0.000, coworkers F (6, 844)⫽2.97, P⫽0.007, rewards F (6, 844)⫽5.22, P⬍0.001, pay F (6, 844)⫽3.55, P⫽0.002, and promotion F (6, 844)⫽2.80, P⫽0.010 (Table 2). Specifically, clinical nutrition
managers had significantly lower satisfaction scores for pay, contingent rewards, and nature of the work with at least one other manager type. Those who had the job title of manager reported significantly lower scores with pay, promotion, and nature of the work compared to directors. Mean overall job satisfaction scores were also compared across various levels of demographic and operational variables of management dietitians. Initial one-way ANOVA models indicated significant differences in mean overall satisfaction scores across levels of income F (6, 825)⫽5.16, P⬍0.001, level of budget responsibility F (6, 836)⫽4.81, P⬍0.001, and number of RDs worked with on a routine basis F (6, 837)⫽3.18, P⬍0.001. More specifically, overall job satisfaction scores were significantly different between $70,000/higher and $60,000 to $69,000 income levels (158.39⫾26.63 vs 149.48⫾26.54). Dietitians with a budget responsibility of $100,000 to $499,000 and those with no budget responsibility were significantly less satisfied compared to those who were responsible for $1 million or more of budget responsibility (150.74⫾25.28, 149.18⫾26.29, and 158.71⫾26.61). Finally, management dietitians who worked with one to three and no RDs on a routine basis were significantly less satisfied overall than those who worked with 25 or more RDs routinely (151.48⫾27.21, 149.38⫾28.49, and 164.40⫾24.82). Overall, intent to leave was not observed. Mean score for the item, “likelihood to look for another job in the next six months,” was 2.02⫾1.28, while the mean score for the item, “likelihood to quit their current job during the next six months,” was 1.54⫾0.94. ANOVA procedures did not indicate significant differences in mean scores of intent to leave across those with different job titles. Pearson correlation was used to examine relationships between job satisfaction subscale scores and overall intent to leave score. Strong negative correlations (P⬍ 0.001) existed between all job satisfaction subscales and overall intent to leave. The strongest significant correlations with intent to leave were with contingent rewards (r⫽⫺0.444), nature of the work (r⫽⫺0.444), and overall satisfaction (r⫽⫺0.477).
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TOPICS OF PROFESSIONAL INTEREST Table 2. Comparison of Job Satisfaction Survey (JSS) subscales and overall satisfaction of management dietitians with different position titles MeanⴞStandard Deviationa
Subscale
District manager (nⴝ26)
General manager (nⴝ20)
Director (nⴝ287)
Assistant director (nⴝ61)
Manager (nⴝ106)
Supervisor (nⴝ33)
Clinical manager (nⴝ318)
Nature of work Supervision Fringe benefits Coworkers Rewards Pay Communication Promotion Operating conditions Overall satisfactionb
21.7⫾2.0y 20.5⫾4.7 19.9⫾3.6 19.6⫾3.4y 18.7⫾3.8y 17.9⫾3.6y,z 17.8⫾3.7 17.4⫾4.3y 13.5⫾3.7 167.1⫾19.7y
20.8⫾4.5y,z 19.9⫾4.1 18.0⫾4.8 18.4⫾3.4y,z 16.5⫾4.9y,z 16.1⫾5.8y,z 16.3⫾4.3 14.7⫾5.8y,z 12.4⫾5.0 152.9⫾28.5y,z
20.8⫾3.1y 19.9⫾4.2 18.5⫾4.5 19.2⫾3.3y 17.4⫾5.0y 17.2⫾5.3y 17.9⫾4.1 15.0⫾4.8y,z 13.1⫾4.2 158.9⫾27.5y
19.7⫾3.3y,z 18.9⫾4.6 18.6⫾4.0 17.8⫾3.5y,z 15.6⫾4.9y,z 15.7⫾5.0y,z 17.0⫾3.9 15.3⫾4.6y,z 11.9⫾3.5 150.4⫾24.7y,z
19.6⫾3.5y,z 19.3⫾4.7 18.2⫾4.3 18.00⫾3.9z 16.2⫾5.0y,z 15.5⫾4.9z 17.0⫾4.7 13.9⫾4.5z 12.9⫾3.8 150.5⫾28.0y,z
20.4⫾2.8y,z 18.1⫾5.3 18.2⫾4.2 17.8⫾3.7y,z 16.9⫾4.8y,z 16.24⫾5.3y,z 16.5⫾4.9 14.2⫾4.5y,z 12.7⫾3.9 151.0⫾28.9y,z
19.4⫾3.8z 19.2⫾4.7 17.74⫾4.1 18.5⫾3.7y,z 15.5⫾4.7z 15.6⫾4.6z 17.1⫾4.1 14.3⫾4.5z 12.8⫾3.6 150.1⫾25.1z
a
Possible range 4 to 24. Possible range 36 to 216. y,z Means in the same row with different superscripts (y,z) differ significantly by Tukey’s post hoc test (Pⱖ0.05). b
DISCUSSION Spector (18) recommends that overall satisfaction scores over 144 generally indicate job satisfaction. Accordingly, management dietitians expressed overall satisfaction with their jobs as measured by the JSS (153.75⫾26.68) and compared to national normative values across multiple occupations (138.00⫾21.60) (18). Cross tabulations also indicated that only 4.7% (40) were considered dissatisfied, 31.8% (271) were neither satisfied nor dissatisfied, while 63.5% (540) were satisfied. The highest overall satisfaction score for managers was 213 cited by one person, while the lowest overall satisfaction score was 76 reported by two respondents. According to Spector’s (18) guidelines, composite satisfaction scores for subscales below 12 indicated dissatisfaction, while scores greater than 16 suggested satisfaction. RDs appeared to be satisfied with most facets of their jobs except for operating conditions. The top three sources of job satisfaction were nature of the work, supervision, and coworkers. Furthermore, when contrasted against national accumulative values, management dietitians were also more satisfied in all facets of job satisfaction except for operating conditions. It has been reported that RDs with management responsibilities are among the highest paid in the profession (7), but it was unknown if management dietitians were also satisfied
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with their level of compensation. According to this research, RDs in management roles were satisfied with pay. However, differences in pay satisfaction across all job titles was somewhat elusive, as the only significant differences in total job satisfaction scores at the level of pay were with those earning $70,000 compared to those earning just below that level at $60,000 to $69,000. Level of income may not explain differences in satisfaction with pay for all management dietitians. For example, clinical nutrition managers were found to be significantly less satisfied with pay as compared to directors. However, similar numbers of both clinical managers (91%) and directors (92%) reported incomes greater than $50,000. These findings reiterate the need to explore differences among specific types of management dietitians with different job titles and responsibilities and associated feelings of inequity towards pay. Some management dietitians, such as clinical nutrition managers, may share unique reference groups when it comes to satisfaction with pay or other elements of satisfaction. As such, management dietitians are often categorized into one of many roles related to foodservice management, while clinical managers may perform management duties that are very different from those in the hierarchy of providing foodservices. Approximately 94% of the clinical
nutrition managers in this study worked in hospitals. Therefore, it is possible that clinical managers compare their level of compensation, and thus form their perception of pay equity, with non-RD management professionals in health care settings. These professionals could include nurses, pharmacists, radiologists, or others. On the other hand, it seems logical that other management dietitians without clinical oversight might compare themselves to managers within similar areas such as foodservice management. Future research should identify referent groups for RDs and compare satisfaction variables with those groups. Previous research has reported that dietitians are less satisfied with promotional opportunities (2-4). Similarly, satisfaction with promotion was one of the lowest subscales for management dietitians, but still considered satisfying according to the JSS interpretation. District managers were the most satisfied with promotion, but clinical managers and managers were significantly (P⬍0.05) less satisfied with promotion. For some management dietitians, a variety of elements could affect the perceptions of the likelihood to be promoted, such as size of the facility, the economy, or even internal politics. In addition, the lack of turnover among the existing management team could reduce the chances for promotion and thus cause dissatisfaction. In other
TOPICS OF PROFESSIONAL INTEREST cases, some RDs may feel that fewer opportunities exist to promote beyond food and nutrition services due the specialization of being an RD or that the necessary skill set is deficient in order to promote beyond nutrition services within specific environments. Operating conditions, which included satisfaction or dissatisfaction with policies, procedures, rules, and perceived red tape, was a possible source of dissatisfaction. Among specific manager types, assistant directors were considered dissatisfied while general managers, managers, supervisors, and clinical nutrition managers scored only slightly above dissatisfaction. RDs appeared to be pleased with the supervision they receive. However, it is not clear whether having an RD as a supervisor moderated satisfaction levels. For example, only 26% of the RDs reported having an RD as his or her supervisor. Assistant directors and supervisors had the highest frequency of supervisors who were RDs, 55.7% and 51.5%, respectively, but only 34.6% of clinical managers reported the same. District managers reported the highest satisfaction with supervision, but only seven out of 26 district managers reported having a supervisor who was an RD. Management dietitians were very satisfied with their coworkers. Given that satisfaction with supervision was rated high among the majority of RDs in this study, it is possible that RDs were thinking of their supervisor(s) as a coworker. Furthermore, RDs who worked with more than 25 RDs on a regular basis had significantly higher levels of overall job satisfaction compared to those who worked with less than three RDs. Nature of work revealed the greatest source of job satisfaction. Although not a specific subscale of the JSS, important operational factors such as level of budget authority and number of employees supervised are theoretically aligned with nature of the work for managers. One study indicated that satisfaction with pay increased for dietitians as the number of employees they supervised increased (3). Interestingly, no significant (P⬍0.05) differences in overall job satisfaction were found across number of employees supervised in this study. However, those who managed a budget greater than $1 million
were significantly (P⬍0.05) more satisfied compared to those who managed $100,000 to $499,000 and those with no budget responsibility. Results also indicated that approximately 51% of clinical nutrition managers had no budget authority, which is similar to previous findings (19). In contrast, only 62 (7%) of all other management dietitians in this study reported no budget authority. When controlled for respondents considering retirement, 133 (16%) management dietitians indicated that it was likely or extremely likely they would look for another job in the next 6 months. Also, 42 (5%) indicated it was likely or extremely likely they would quit their current job in the next 6 months. The reasons RDs might quit their jobs could be numerous and/or due to reasons that have little to do with job satisfaction. These could include relocation, workplace restructuring, challenges with childrearing, return to school, or a change in career. Overall, the results of this study are consistent with the literature among other occupations; as overall satisfaction or facets of job satisfaction among RDs increased, the likelihood of voluntary leave decreased. Correlation analyses support the assertion in that overall satisfaction had a strong significant negative relationship with intent to leave for RDs. More specifically, cross tabulations found only 23 of the management dietitians who were considered dissatisfied overall indicated that it was likely or very likely they would look for another job in the next 6 months. Comparatively, only seven of the RDs who were dissatisfied also indicated that it was likely or extremely likely they would actually quit their current jobs. LIMITATIONS Limitations were present with this research and pertained mostly to the methods used. For example, the use of DPGs for the sample limits the ability to generalize the findings due to the lack of information gathered from those who are not members of ADA or certain DPGs. Since both ADA and DPG membership is voluntary, it is possible that a heightened sense of job satisfaction exists specifically
among these members compared to those who are not ADA/DPG members. Gathering information about job satisfaction could be sensitive to some participants. Although the methods used to distribute the survey instrument and to collect data maintained confidentiality and anonymity, requests for sensitive job-related information such as perceptions about pay, coworkers, and supervisors, could have inhibited or altered some responses. The measures used to maintain confidentiality and anonymity were reiterated to the participants throughout the data collection process. Using job titles is limiting since variance likely exists between the tasks performed by management dietitians with similar and/or different job titles. In addition, very specific roles and responsibilities within work environments such as schools, longterm care, universities, corrections, and medical centers were not ascertained. However, given the exploratory nature of this study and need for renewed baseline of information, the core responsibilities (managing people and/or financial resources) was not considered uniquely different for management dietitians. It is advised that future studies more precisely examine satisfaction or dissatisfaction with the specific roles and responsibilities of management dietitians in different environments. Finally, due to the current economic recession and historic unemployment rates reported across several occupations, caution is necessary with regards to the measurement and interpretation of intent to leave scores. RDs are not immune to the effects of the recession, which limits the current interpretation. However, there is also no current baseline from which to compare intent to leave among RDs involved in any line of work and the numerous variables that may or may not have contributed to the phenomena within the dietetics profession. Intent to leave obviously fulfills the desire to understand the retention of RDs. This research promotes a new starting point from which to compare with future studies. CONCLUSIONS This study provided current insight about job satisfaction among RDs with management responsibilities.
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TOPICS OF PROFESSIONAL INTEREST Among 851 RDs who were members of selected DPGs and held supervisory responsibilities, overall job satisfaction was observed. Generally, management dietitians were more satisfied when compared to national indices. However, levels of overall satisfaction and facets were significantly (P⬍0.05) different among management dietitians with different job titles. The need for additional study is particularly intriguing, especially among clinical nutrition managers, who were not classified as dissatisfied, but expressed significantly lower satisfaction in a variety of areas when compared to other types of managers. Important questions and new research needs also surface from this study. For example, nature of the work was a strong source of satisfaction for the majority of RDs in this study, making clear the need for a new baseline of knowledge that illustrates more specifically which elements of the work for different groups of management dietitians in different work environments are particularly satisfying or dissatisfying and why. Furthermore, the large number of RDs who fell into the neutral category for satisfaction in different areas of their jobs reinforces the reason to continue research in this area. Future work should focus on the underlying factors that may cause these practitioners to feel more or less satisfied in regards to their job. Qualitative data that provide a more precise voice on satisfying and dissatisfying elements of work for RDs would be most insightful in addition to quantitative comparisons. Finally, this study sought to determine whether RDs belonging to certain DPGs with management responsibility intended to leave their current jobs. This was not the case for the majority of respondents in this study. Most elements of job satisfaction had significantly negative relationships with intent to leave, yet predicting intent to leave is left with unanswered questions. The implications of this research are significant. Current insight about job and career satisfaction aligns the ADA and other organizations in a position to better support job and career development of RDs. If management dietitians are satisfied with certain aspects of their jobs, then those facets can be further examined and encour-
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aged to others, in particular to those looking toward job or career promotion, new or different opportunities, or income enhancement. Job dissatisfaction with work, in particular among RDs in management roles, can negatively impact productivity and services, other managers and employees, organizations, and customers. Negative perceptions about the services and expertise provided by RDs, particularly those in key departmental leadership roles, are very threatening to the entire dietetics profession. With perceptions of negativity, some may question hiring or promoting RDs into management positions, paving the way for others without the appropriate qualifications or backgrounds in food and nutrition to provide the leadership for nutritional care and services. Finally, the initial hiring process for entry-level RDs often initiates within the academic setting and, therefore, is further enhanced by current knowledge about RDs’ level of satisfaction in different work areas. Educators, advisors, and mentors of RDs gain substantially from understanding the satisfying and dissatisfying elements that surround the jobs of RDs, particularly those that manage and lead other RDs. Accordingly, educators and other stakeholders can better guide and prepare graduates for the realities and challenges that lie ahead for graduates when factors about jobs are better understood. References 1. American Dietetic Association. Priorities for research: Agenda to support the future of dietetics. http://www.adaevidencelibrary.com/ files/file/ADA_Priority%20for%20Research. 2007.pdf. Published 2007. Accessed July 21, 2010. 2. Calbeck DC, Vaden AG, Vaden RE. Workrelated values and satisfactions. J Am Diet Assoc. 1979;75:434-440. 3. Sims LS, Khan J. Job satisfaction among public health nutrition personnel. J Am Diet Assoc. 1986;86:334-338. 4. Rehn BL, Stallings SF, Wolman PG, Cullen RW. Job satisfaction of South Carolina dietitians. J Am Diet Assoc. 1989;89:979-981. 5. Mortensen JK, Nyland NK, Fullmer S, Eggnett DL. Professional involvement is associated with increased job satisfaction among dietitians. J Am Diet Assoc. 2002;102:14521454. 6. Dalton S, Gilbride JA, Russo L, Vergis L. Job satisfaction of clinical, community, and longterm care dietitians in New York City. J Am Diet Assoc. 1993;93:184-186. 7. Rogers D. Compensation & benefits survey 2007: Above-average pay gains seen for reg-
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