Causative factors of turnover among public sector registered nurses

Manona, Wellman Wela (2000-12)

Thesis (MPA)--Stellenbosch University, 2000.

Thesis

ENGLISH ABSTRACT: Managing human resources is crucial to the efficient and effective delivery of quality health care. However, turnover of nurses constitutes a major factor in the shortages of staff which are being experienced by the nursing profession in the Republic of South Africa. Shortages of trained nurses with experience, particularly in public sector hospitals, have adverse effects on the provision of efficient and effective quality health care to the consumers of this service. The aim of the study was to provide an understanding of and insight into those inherent problems in the health sector that propel nurses to leave public sector institutions. The overall objective was to investigate and identify some of the factors which exercised an influence on the turnover of registered nurses in public sector hospitals, so as to be able to provide suggestions to hospital managers on the more effective management of human resources, in order to retain nursing personnel. Theresearch was based on a model of nursing turnover which regarded voluntary withdrawal as a process in which feelings of satisfaction with pay, on the one hand, and the opportunity of obtaining alternative jobs in the labour market, on the other, were proposed as the primary causative factors of turnover behaviour. In addition the propositions, made in literature reviewed, that age, tenure, kinship responsibility, general training, education, professionalism, marital status, lintent to stay', job satisfaction, routinization, job autonomy and responsibility, instrumental communication, promotional opportunity, integration, supervisory relationships, distributive justice, work-load, and local kin acted as predictors of turnover, were also investigated. The research was conducted with a sample of 123 nurses in one hospital, Groote Schuur, situated in the Western Cape Province of the Republic of South Africa. The sample included registered nurses, senior professional (registered) nurses, and chief professional (registered) nurses. The data was gathered from respondents by means of a selfadministered questionnaire. In addition, data was gathered by means of semi-structured, open-ended discussions with nursing management. The hypothesised interactions between variables influencing nursing turnover were explored by means of basic statistics, which made it possible to assess the effects of both independent and dependent variables. The results of data analysis provided some support for the proposition contained in the hypothesis. The determinants whose increase produced a greater degree of turnover were firstly, the many jobs available outside the hospital and secondly, professionalism. The determinants whose increase resulted in reductions in turnover were "intent to stay" (which the researcher views as a dimension of commitment), the existence of local kin (kinship responsibilities), participation in making job-related decisions (job autonomy), the receipt of sufficient work-related information (instrumental communication and good supervisory relationships), and tenure. The determinants whose decreaseresulted in increased turnover werepromotional opportunities, distributive justice, pay satisfaction, job satisfaction, integration, opportunity for self-development,age and tenure. Turnover of nurses has serious ramifications for employers, patients, and the nursing profession itself. Effective management of employee turnover is of critical importance to health care providers, employees, and patients. Better control of turnover can improve the quality of patient care, reduce labour costs, and improve employee morale.

AFRIKAANSE OPSOMMING: Die bestuur van menslike hulpbronne is die deurslaggewende omstandigheid ten einde die lewering van effektiewe en doeltreffende gesondheidsorg van gehalte. Nietemin, dra die omset van verpleegkundiges grotendeels by tot die personeeltekort wat tans deur die verpleegprofessie in Suid-Afrika ondervind word. Die tekort aan ervare, opgeleide verpleegkundiges, veral in die openbare sektor staatshospitale, het 'n nadelige uitwerking op die voorsiening van effektiewe en doeltreffende gesondheidsorg van gehalte aan die verbruikers van hierdie diens. Die doelwit van die studie was om 'n begrip te ontwikkel vir, en 'n insig te probeer kry in, daardie inherente probleme binne die gesondheidsektor wat verpleegkundiges dryf om die staatsinstellings te verlaat. Die oorkoepelende doel was die ondersoek en identifikasie van sommige faktore wat die omset van geregistreerde verpleegkundiges in staatshospitale beïnvloed. Die doel hiervan was om voorstelle aan hospitaal bestuurders te kan voorsien ten opsigte van die meer doeltreffende bestuur van menslike hulpbronne, in die strewe na behoud van verpleegpersoneel. Die navorsing is gebaseer op 'n model van verpleegomset wat vrywillige onttrekking as 'n proses beskou het waar gevoelens van salaristevredenheid, aan die een kant, en geleentheid tot alternatiewe betrekkings in die arbeidsmark, aan die ander, as die primêre veroorsakende faktore van omset-gedrag voorgestel is. Daarbenewens is die stellings vanuit die literatuurstudie dat die volgende dien as voorspellers van omset ook ondersoek: ouderdom, ampstermyn of dienstyd, verantwoordelikheid teenoor familie, algemene opleiding, opvoeding, professionalisme, huwelikstatus, 'voorneme om te bly', werksbevrediging, roetine, selfbestuur en verantwoordelikheid in die werksomgewing, bevorderlike kommunikasie, bevorderingsgeleenthede, integrasie, toesighoudende verhoudings, toedelende gereg, werkslading en plaaslike naasbestaandes. Die navorsing is uitgevoer met gebruik van 'n monster van 123 verpleegkundiges van een hospital, die Groote Schuur Hospital, geleë in die Wes-KaapProvinsie van die Republiek van Suid Afrika. Die monster het geregistreerde verpleegkundiges, senior geregistreerde verpleegkundiges en hoof geregistreerde verpleegkundiges ingesluit. Die data is verkry van respondente deur middel van 'n self-toegediende vraelys. Daarbenewens is data versamel deur half-gestruktureerde, niegeslote besprekings met van die verpleegbestuur. Die interaksie tussen veranderlikes ten opsigte van verpleegomset wat veronderstel is, is ondersoek deur middel van basiese statistiek, dus kon die uitwerking van afhanklike en onafhanklike veranderlikes bepaal word. Die uitslae van data-ontleding het wel ondersteuning verleen aan die voorstelling soos uiteengesit in die hipotese. Die determinante wie se toename 'n toename in die omsetkoers tot gevolg gehad het was, eerstens, meer werksgeleenthede buite die hospitaal en, tweedens, professionalisme. Die determinante wie se toename tot 'n vermindering in omset bygedra het was 'voorneme om te bly' (wat die navorser as binne die omvang van toewyding beskou), deelname aan werksverwante besluitneming (werks outonomie), die ontvangs van genoegsame werksverwante inligting (bevorderlike kommunikasie en goeie toesighoudende verhoudings), en ampsduur (dienstyd). Die determinante wat tot 'n vermindering in omset lei is bevorderingsgeleenthede, toedelende gereg, salaris bevrediging, geleenthede tot self-ontwikkeling, ouderdom en ampsduur. Die omset van verpleegkundiges het verreikende gevolge vir werkgewers, pasiënte en die verpleegsberoep self. Doeltreffende bestuur van werknemer-omsetis van kritiese belang vir gesondheidsorg voorsieners, werknemers en pasiënte. Die meer effektiewe beheer van omset kan die kwaliteit van pasiëntesorg verbeter, arbeidsonkoste verminder en die moraal van werknemers verbeter.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/51645
This item appears in the following collections: