Tillot et al. (2013) identifies that nursing shortage is a result of an aging workforce, aging population, job dissatisfaction, shortage within the nursing faculty and the lack of an engaging and collaborative environment is care settings. Tillot et al. (2013) utilized a systematic review of past literature aimed at assessing the factors that deny the workers an opportunity to engage their colleagues constructively in practice. The study notes that the management should focus on developing an environment where communication and staff collaboration and engagement is considered a primary element of the organizational culture. The study is highly applicable in nursing practice since it identifies the major issues that have held back nurses or at other times motivated them to engage with colleagues in making decisions pertaining care. This information can then be utilized to develop policies that can significantly help retain nurses in the workforce.
Duffield et al. (2011) examine the impact of nurse managers and their relationship with the other staff in the delivery of quality and timely care. The study used a secondary analysis if 94 randomly selected wards from a total of 21 public hospitals. The data was collected for a period of two years upon which this information was subjected to a logical and mathematical analysis using SPSS version 16 software. All nurses (n=2488 with 80% turnover rate) within the selected wards were presented with a survey that they were required to complete. The survey included a 49-item Nursing Work Index-Revised [NWI-R] which also included other job satisfaction measures such as satisfaction with nursing as well as intention to quit the career. The subscales of the survey were then calculated with leadership that formed the domain of interest having a total of 12 times. The subdivision of wards was based on those that reported positive or negative leadership. The results indicated that the positivity or negativity of the ward was solely based on the nurse manager leadership skills. A good leader was described as visible, consultative, can work with flexible work schedules and was able to recognize and praise the role played by others. Combining leadership with practice has been proved to be a key aspect of encouraging and keeping the workforce motivated. The study advocates for the open management systems in nursing that essentially form the core concept nurturing and encouraging nurses in practice.
Wieck et al. (2010) is a literature review based on the analysis of online survey of staff from 22 hospital settings in which job satisfaction and perceptions of safety using the Nurse Manager Desired Traits survey/tool and the Nursing Work Index-Revised tool. The results indicated that satisfaction levels were high with the nurse/physician relationship abut lower for the nurse control of practice. On the other hand, younger nurses were said to have less satisfaction in practice as compared to older nurses beyond the age of 40 years. Wieck et al. (2010) helps in identifying nurturing as a critical aspect of retaining and encouraging the young nurses. On the other hand, the need for a stable staff, revamped incentives for motivation, nurses’ safety and empowerment of the nurse councils are identified as playing a significant role in retention and keeping the staff motivated. The recommendations can be helpful in drawing up policies that can ultimately help in ensuring a better environment that serves the interest of the nurses to the fullest.
In a similar study to Wieck et al. (2010), the study by Twigg & McCullough (2014) employed a systematic review of 41 articles all relating to nurse retention. Thirty-nine of the sources revealed that Nurse Managers play a key role in adopting strategies that can ably create a positive working environment for the nurses. The recommendation provided here can be adopted to develop policies at organizational level that can aid in nurturing skill of the young nurses and motivating them to remain in the service.
Renter et al. (2014) identifies the work environment and nurse satisfaction as a key to improving the nurse retention rates. Renter et al. (2014) is a literature review of related sources collected from renowned medical and clinical databases. The study was based on a PICO question “How does nurse retention in acute-care hospitals with Magnet designation compare to nurse retention in non-Magnet hospitals?” The results indicated that Magnet designation provides a positive environment as compared to non-magnet acute care settings. Magnet designed organization have programs that facilitate career development for the nurses, funding continuing education for their workforce and promotion of employee education. Renter et al. (2014) establish that as long the bets solution is to make all possible costs to retain current workforce since the costs of hiring a new workforce highly overwhelm the costs of retaining. On the other hand, loss of current workforce is accompanied by loss of experience and expertise coupled with an unstable organizational culture.
Dr. Wang in his many years in the health care professionals has observed that many nurses and doctors are becoming specialized in their area of expertise such as urology, hematology, and pulmonary disease among others. Although this meets the doctors’ expectations of efficiency, professionalism and quality care, it’s a divergent from the core function of a nurse which is providing care to all the patients irrespective of the disease or illness the patient is suffering from. Additionally, due to poor numeration packages, nurses have resulted to take administration position is various healthcare facilities to gain more allowances. Thus, due to these scenarios many health facilities are facing a shortage of nurses. Therefore, although specialization is an excellent idea move in the nursing professional, Dr. Wang proposes for review of policies which govern the nursing professional so that the they can make sure nurses are paid according to their experience and the kind of specialization they are engage in. Furthermore, the hospital administration should be able to design work schedule that accommodate nurses social life. As such, nurses should be given ample time to be with their loved ones at home not confined to the hospital all their life. Additionally the hospital administration should work out mechanism and working ethics which will make sure the nurses and doctors work in harmony. In the case of a conflict there should be guidelines on how to solve the disputes so as the patient is given the best treatment from professionals.
Dunn (2012) looks at the positive side of nursing professional that keeps nurses in the professional despite wide negativity about nurses as has been portrayed by previous research. Moreover, it also looks at the impact nurses have on the patient as they administer health care to the patient. On the hand, previous research have shown nurse leave the professional due to job dissatisfaction, getting opportunities elsewhere, retirement, fatigue and psychological stress. The research employed Schoenhofer and Boyking nursing theory as the framework for this research. Thus, this theory asserts that nurses are supposed to have an attribute of a caring and nurturing relationship. These are the core values which should drive nurses. Hence, nurse should be looking forward to alleviating the suffering of the patient by forming a good relation with the patient. The research found out that the nurses do their job simply because they believe it is the right thing to do. Additionally some see it as a way of giving back to the society since it was ethically correct.
The research by SPENCE LASCHINGER et al. (2009) sought to establish how an environment that is conducive at the workplace plays a role in retaining the nurses in the professional. As such, research was hesitated by previous research that has indicated poor working environment and job dissatisfaction as the major contributor which forces the nurse to leave the professional. Hence, 612 respondents were used through questionnaires in this research to get the data on the impact of the workplace environment on the nurses in general and how it contributes in the retentions of nurse. The authors observe that there are many nurses who are near to retire, and a small number of new nurse are join the professional. Thus, there is a need to restructure the nursing professional in that it will be attractive to new nurses and encourage the existing nurses to remain in the professional. Additionally, many studies have shown there is an acute shortage of nurses and the major contributor to this is unsatisfying workplaces. Therefore, this research found out that many nurses opt to leave nursing professional due to exhaustion and poor incivility behavior. Thus, this research recommends professionalism standards, working structures and ethics of the nursing professional should be maintained at all times. This will eliminate the incivility behavior and protect the workers from burnout.
This article by Lambrou et al. (2014) asserts that by providing productivity and quality environment many nurses will opt to remain working than leaving the professional since it motivates the workers to continue working. As such hospitals with poor staffing conditions, depilated resources offer a job dissatisfaction environment to nurses hence prompting their decision to leave the professional. This research was conducted between 2000 and 2012 to examine the working environment to job satisfaction. Furthermore, the research concentrated with the data from Pubmed, Embase, Google scholar and CINAHL. Thus, the finding of the research from various authors suggested that job satisfaction and retention of nurses indirectly linked to the good working environment where nurses feels they are not strained psychologically and physically. Hence, this kind of environment motivates them to work even harder to meets patient's needs.
Friedrich (2011) is qualitative research aimed at finding what inspires the seasoned nurses to continue working despite reaching the retirement age. Additionally, the research was geared towards finding out which rewards and practices keep the nurses in the professional. Thus, a grounded theory offered a great foundation for this research. As such, 25 nurses of age 55-62, years were interview to provide the data for this research. This research was necessitated by the fact that there is aging in the nursing workforce. As such, many health professional are employing the services of season nurses. However, the research found out many season nurses remain in the professional due to the attitude and the experience they have in the professional. Hence, many remain practicing because they love the professional, they identify with the culture of the workplace, and they don’t want their experience and knowledge to go to waste when they can still help. Additionally, the health facility where they were working provides an environment which is conducive the aged nurses to work in terms of work schedules, finances and work pressure. Thus, due to these conditions the seasoned nurses have result to continue working.
The study by Stassen et al. (2014) sought to determine the factors that could help retain nurses. The study also sought to identify the differences in perceptions between nurse managers and their staff in terms of human resource practices that are tailored to suit the needs of the nurses. A random sample of 45 seasoned nurses aged beyond 45 years was used. Questionnaires were mailed to the nurses with a cover letter, a questionnaire booklet, and a letter of information for consent. A response rate of 38% (n=1133) was achieved. The nurses were categories into subgroups, depending on their role as either nurse managers or staff within direct care settings. Nurses were supposed to indicate how well the needs of the nurses were net in their current institution of service. Data analysis of the collected data was done using SPSS and significant differences between the two groups were analyzed using MANCOVA/ANCOVA. Confirmatory factor analysis was done suing LISREL 8.54 statistical package to ascertain the unique characteristics of the five HR practice measures seasoned nurses have their unique factors of motivation and their experience, skill and expertise is extraordinary. Any healthcare organization should seek to retain this cream of the workforce as they do not only help in care provision but also nurturing the incoming nurses hence facilitating quicker integration into practice. Nurse Managers should thus seek to create an environment that accommodates the seasoned nurses and more so by specifically looking at the differences in perceptions between seasoned nurses and the nurse managers in regard to satisfactory work environments. This report opens up the costs and benefits of retaining the seasoned nurse against the cost of employing new nurses to replace the seasoned. Essentially, in terms of numbers it would be possible to replace the seasoned nurses but the loss of experience and expertise would be a big blow to the nurse manager and the healthcare institution in general.
The article by Brown et al. (2013) discusses the various factors that influence the quitting of nurse managers as well as their retention. The results of the research depicted that the shortage of nurse is a global problem due to retirements as well as quitting. Thus, various measures need to be undertaken to eradicate the shortage of nurses so as to ensure quality health care. Various factors are highlighted as the major contributing factors of the nursing manager’s intentions to quit or stay. These factors are categorized as personal, organizational or role factors. Qualitative, as well as quantitative analysis, were to obtain data used in the analysis of the results. However, the response rate of the interviewees and focus groups was the main weakness of the study.
The article by Van den Heede et al. (2013) analyses the relationship between nurse’s intention to quit or stay and workplace environment. Research was carried out in fifty-six Belgian acute hospitals where three thousand one hundred and eighty-six bedside nurses were interviewed in two hundred and seventy-two nursing units. Results obtained from the study indicated that the workplace environment such as managerial support and excellent relations between nurses and doctors greatly influence the nurse’s intentions to quit. This shows that various strategies need to be undertaken to improve the workplace environment of nurses so as to improve the provision of quality health care to patients.
Wallis and Kennedy (2013) analyze the measure that can be undertaken so as to improve the retention of nurse. These measures include nursing leadership and team approaches. Training programs on leadership were carried out in Colorado involving various organizations to develop efficient teams to tackle the nurse’s retention issue. Evaluation was carried out after one year to ascertain the effectiveness of the training program towards addressing the retention of nurse’s problem. Result obtained indicated that collaboration of the team members led to efficient problem-solving teams. Thus, organizations should aim at improving nursing leadership and ensure collaboration so as to ensure the delivery of quality health care.
The article by Brunetto et al. (2013) explores the impact of staff relationships towards the turnover of nurses and provision of quality health care based on social exchange theory. The study was based on cross-sectional design whereby seven hundred and thirty completed surveys were used to depict how staff relationships affect the working environment of nurses. Results obtained from the study showed that satisfying supervisor-nurse relationships positively influence the nurse’s intention to stay. Thus, health care organizations should aim at improving workplace relationships to ensure satisfying relationships for better delivery of services.
References
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