Jennifer Ruiz holds her patient's trembling hand as she presses a stethoscope to the frail woman's chest and belly. She compliments the woman on her recently painted fingernails. She cheerfully asks how she's feeling, knowing she'll get no answer from the little curled body in the big hospital bed but for a penetrating stare.

Ruiz, a hospice nurse, finds her work deeply meaningful, in part for reasons that are obvious: "We get to be there for people during some of the most tragic and tough times in their lives," she said.

But even those who shepherd the dying and their families through the fear, heartbreak, and mystery of the end of life can lose sight of a job's meaning in the stress of the day to day, if their employer doesn't foster it.

"You have to fan that flame," said Brenda McGarvey, corporate director of program development at Skokie, Ill.-based Unity Hospice, where Ruiz works. "It's your responsibility."

A job's meaningfulness — a sense that the work has a broader purpose — is consistently and overwhelmingly ranked by employees as one of the most important factors driving job satisfaction. It's the linchpin of qualities that make a valuable employee: motivation, job performance, and a desire to show up and stay.

Meaningful work needn't be lofty. People find meaning picking up garbage, installing windows, and selling electronics — if they connect with why it matters.

But many employers seem to be missing an opportunity to tap this critical vein.

In a survey conducted by Energage for the Chicago Tribune's 2017 Top Workplaces magazine, local employees regarded their employers more positively than the national average on nearly all measures, but companies fell significantly short in response to this statement: "My job makes me feel like I am part of something meaningful."

The survey results, based on responses from more than 67,000 local employees across 219 companies, suggest there is room for employers to more effectively encourage a sense of meaning at work, or at least not erode it. That in turn could improve retention, which is on the minds of many employers as unemployment stays near historic lows and employees look for better opportunities. The process required to replace an employee costs about 70 percent of that person's annual salary, and up to twice the salary when it involves a senior leader, according to Energage, the Exton-based consultancy formerly known as WorkplaceDynamics.

Finding meaning in work is important to everyone, but employers should keep in mind that millennial employees are particularly keen on understanding a company's social impact, due perhaps to social media that have let them feel connected to the world.

"I think it's hypersensitivity to understanding the world in a real-time basis, and they can see the immediate impact of that engagement," said Jon Shanahan, CEO of Businessolver, a benefits-technology company based in Des Moines, Iowa.

More meaning also could cut down on absenteeism. In a study published in 2012 in the Journal of Career Assessment, researchers found that people skip work not because they're dissatisfied, uncommitted, or even intend to quit, but rather because they find the work meaningless.

So what makes a job meaningful? And how do you achieve it?

A line of work doesn't have to feel like a calling to feel meaningful, said Jaclyn Jensen, associate professor in the department of management and entrepreneurship at DePaul University.

Rather, Jensen said, citing research on the topic dating back 40 years, a job's meaningfulness is driven by five factors, the three most important being that it allows you to use a variety of skills, that it has an impact on other people's lives, and that you are able see the product of your work from beginning to end. The other factors are having autonomy to do your best work and receiving feedback about your performance.

Organizations can design jobs to maximize those features, such as highlighting how the job helps other people, Jensen said. That impact can often be lost on employees who don't get to connect directly with the beneficiaries of their work.

As important as encouraging meaning is refraining from snuffing it out.

"Employers are really good at killing people's sense of inherent meaningfulness in what they are doing," said Amy Wrzesniewski, a professor of organizational behavior at Yale University's School of Management. That can happen when a job is made so fast-paced and overloaded that people feel they can't do it well, or when overly controlling bosses micromanage the sense of ownership out of a job.

Often the best thing employers can do to encourage meaningfulness is to give employees autonomy to incorporate meaning themselves, Wrzesniewski said.