Paramedics, especially nurses, are the most dominant workforce in carrying out tasks in the management of hospital organizations. Therefore, it is very necessary to pay attention to the level of satisfaction and comfort of the nurses in working, in order to be able to do their work optimally. This study aims to analyze the influence of intrinsic and extrinsic motivation on nurse job satisfaction. This type of research is quantitative non-experimental with a descriptive approach (cross-sectional survey) and associative analysis. The research was conducted at RSU Royal Prima Medan, in March 2022. The population is 377 people, the technique of determining the number of samples using Structural Equation Modeling (SEM) with the approach used is purposive sampling, a criterion for the inclusion of nurses who want to be respondents. Data analysis uses univariate, bivariate (Chi-Square), and Multivariate (Multiple Linear Regression). The results of the partial analysis, the variables of Award (X1), Achievement (X2), Supervision (X3), Responsibility (X4), have an influence on the variable of job satisfaction with a p-value < 0.05. While the variables of Wages (X5), Work Environment (X6), Status (X7), with a p-value of > 0.05, have no influence on the variable of job satisfaction of implementing nurses at Royal Prima Hospital Medan. The results of the multivariate analysis, that from independent variables, namely Awards, Achievements, Supervision, Responsibilities, which are suspected to affect job satisfaction, the most influential is the responsibility variable with a p-value of 0.002 < 0.05. The OR value obtained is 8,522, meaning a high sense of responsibility, has an 8,522 times chance of affecting the level of job satisfaction of nurses at Royal Prima Hospital Medan.