ORIGINAL RESEARCH

 

Retaining professional nurses in South Africa: Nurse managers' perspectives

 

 

Elizabeth Mokoka; Martha J. Oosthuizen; Valerie J. Ehlers

Department of Health Studies, University of South Africa, South Africa

Correspondence

 

 

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ABSTRACT

South Africa is experiencing a serious shortage of nurses, which has to be addressed to prevent crises in health care services. Previous studies (Fletcher 2001:324; Oosthuizen 2005:117) found that nurses change their work environment due to dissatisfaction with their job situations. This implies that creating a favourable environment in the workplace situation could help retain professional nurses in their posts, implying that retention strategies should be effective.
An exploratory, descriptive, contextual and qualitative design was used to describe nurse managers' views on factors which could influence professional nurse retention, as well as their views regarding attributes that were required to enable them to contribute towards enhancing professional nurse retention. A purposive sample of nurse managers employed in public and private hospitals in the Gauteng province was selected. Semi-structured interviews were conducted with 21 nurse managers. The results were analysed qualitatively and contextualised within Vogt, Cox, Velthouse and Thames's Cork-Top (Bottleneck) Theory of Nurse Retention (1983) and Lewin's Force-Field Analysis Theory (1952).
Factors pertaining to individual nurses, the organisation and nurse managers could influence the retention of professional nurses. Poor working conditions, long and inconvenient working hours, uncompetitive salaries and professional development of nurses have to be addressed to enhance professional nurses' retention. Unsafe working environments and a lack of resources threaten the safety and well-being of nurses and patients and contribute to high turnover rates. Nurse managers have to address shortcomings in their managerial and leadership skills and implement changes within a multigenerational nursing workforce and challenging working environments.

Keywords: baby boomers; generation X; generation Y; nurse retention; silent generation

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OPSOMMING

Suid-Afrika ervaar 'n ernstige tekort aan verpleegkundiges wat aangespreek moet word ten einde krisisse in gesondheidsorgdienste te voorkom. Vorige studies (Fletcher 2001:324; Oosthuizen 2005:117) het bevind dat verpleegkundiges hulle werksomgewing verander as gevolg van ontevredenheid met hulle werksituasies. Dit impliseer dat die daarstelling van 'n gunstige omgewing in die werkpleksituasie, kan help om professionele verpleegkundiges in hulle poste te behou, wat beteken dat retensiestrategieë doeltreffend moet wees.
'n Verkennende, beskrywende, kontekstuele, kwalitatiewe ontwerp was gebruik om verpleegbestuurders se sienings te bekom, oor faktore wat professionele verpleegkundiges se retensie kan beïnvloed, asook hulle sienings omtrent vereiste hoedanighede wat hulle in staat sou stel om professionele verpleegkundiges se retensie te bevorder. 'n Doelgerigte steekproef van verpleegbestuurders in openbare en private hospitale in die Gauteng provinsie is gekies. Semi-gestruktureerde onderhoude is met 21 verpleegbestuurders gevoer. Die resultate is kwalitatief ontleed en gekontekstualiseer volgens Vogt, Cox, Velthouse en Thames se Kurkprop Bottelnek (Cork-Top Bottleneck) Teorie van Verpleegretensie (1983) en Lewin se Kragveld Analise Teorie (1952).
Faktore met betrekking tot individuele verpleegkundiges, die organisasie en verpleegbestuurders kan die retensie van professionele verpleegkundiges beïnvloed. Swak werksomstandighede, lang en ongerieflike werksure, nie-mededingende salarisse en professionele ontwikkeling van verpleegkundiges moet aangespreek word om professionele verpleegkundiges se retensie te bevorder. Onveilige werksomgewings en 'n gebrek aan hulpbronne bedreig die veiligheid en die welsyn van verpleegkundiges en pasiënte en dra by tot hoë omsetsyfers. Verpleegbestuurders moet die tekortkominge in hulle bestuurs- en leierskapsvaardighede aanspreek en veranderinge implementeer binne 'n multigenerasie verpleegwerkkrag en uitdagende werksomgewings.

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REFERENCES

Aiken, L.H., Smith, H.L. & Clarke, E.T., 1994, 'Lower medicare mortality among a set of hospitals known for good nursing care', Medical Care 32(8), 771-785.         [ Links ]

American Nurses' Association, 2001, Code of ethics for nurses with interpretive statements, American Nurses' Association, Washington.         [ Links ]

Barney, S.M., 2002, 'The nursing shortage: why is it happening?' Journal of Health Management 47(3), 153-155.         [ Links ]

Bethune, G., Sherrod, D. & Youngblood, L., 2005, 'Tips to retain a happy, healthy staff', Nursing Management 36(4), 24-30.         [ Links ]

Bliss-Holtz, J., Winter, N. & Scherer, E.M., 2004, 'An invitation to magnet accreditation', Nursing Management 35(9), 36-42.         [ Links ]

Booyens, S.W. (ed), 1998, Dimensions of nursing management, 2nd edn., Juta, Kenwyn.         [ Links ]

Butler, A.S., 2000, 'Best place to work', Executive Excellence 17(11), 4-5.         [ Links ]

Cameron, S. & Armstrong-Stassen, M., 2005, 'Retention of community nurses: strategies for success. Innovations in retention of nurses', viewed 03 May 2006, from http://stti.confex.com/stti/inrc16/techprogram/paper_21876.htm        [ Links ]

Cook, A., Hiroz, J. & Mildow B., 2006, Strategies and outcomes associated with magnet hospitals, Nursing Health Services Research Unit, Toronto.         [ Links ]

Creswell, J.W., 2003, Qualitative, quantitative and mixed methods approaches, 2nd edn., Sage, Thousand Oaks.         [ Links ]

De Vos, A.S., Strydom, H., Fouché, C.B. & Delport, C.S.L., 2005, Research at grass roots for the social sciences and human service professions, 3rd edn., Van Schaik, Pretoria.         [ Links ]

Donnelly, M.C., 2003, 'Why leadership is important to nursing', in N.H. Holmes (ed.), Five keys to successful nursing management, n.p., Lippincott Williams & Wilkins, Philadelphia.         [ Links ]

Duchscher, J.E. & Cowin, L., 2004, 'Multigenerational nurses in the workplace', Journal of Nursing Administration 34(11), 493-501.         [ Links ]

Ehlers, V.J., 2003, 'Professional nurses' requests to remove their names from the South African Nursing Council's register. Part 1: Introduction and literature review', Health SA Gesondheid 8(2), 63-69.         [ Links ]

El-Jardali, F., Jamal, D., Abdallah, A. & Kassak, K., 2007, 'Human resources for health planning and management in the Eastern Mediterranean region: Facts, gaps and forward thinking for research and policy', Human Resources for Health 5(9), 1-12.         [ Links ]

Fitzpatrick, M.A., 2003, 'Getting your team together', in N.H. Holmes (ed.), Five keys to successful nursing management, n.p., Lippincott Williams & Wilkins, Philadelphia.         [ Links ]

Fletcher, C.E., 2001, 'Hospital RN's job satisfaction and dissatisfactions', Journal of Nursing Administration 31(6), 324-331.         [ Links ]

Force, M.V., 2005, 'The relationship between effective nurse managers and nursing retention', Journal of Nursing Administration 35(7/8), 336-341.         [ Links ]

Furnham, A., 1997, The psychology of behaviour at work: The motivation in the organization, Psychology Press, Hove.         [ Links ]

Gopwani, J., 2004, 'Boomer bust: New opportunities for generation X and Y', Business news, viewed 01 July 2005, from http://www.freep.com/money/business/genxy27e20041227.htm        [ Links ]

Gurney, G.A., 1990, Determinants of intent to leave among nurses with doctoral degrees, UMI Dissertation Services, Chicago.         [ Links ]

Hall, E.J., 2004, 'Nursing attrition and the work environment in South African health facilities', Curationis 27(4), 28-36.         [ Links ]

Hammill, G., 2005, 'Mixing and managing four generations of employees', FDU Magazine, viewed 27 August 2005, from http://www.fdu.edu/newspubs/magazine/OSWS/generations.htm        [ Links ]

Hart, S.M., 2006, 'Generational diversity: Impact on recruitment and retention of nurses', Journal of Nursing Administration 36(1), 10-12.         [ Links ]

Health Systems Trust (HST), 2008, 'Percentage of professional nurse posts vacant', viewed 14 April 2008, from www.hst.org.za/healthstats/140/data        [ Links ]

Jooste, K (ed.), 2003a, Leadership in health services management, Juta Academic, Lansdowne.         [ Links ]

Jooste, K., 2003b, 'Essential Managerial attributes of the nowadays nursing service manager in the South African context', Curationis 26(2), 19-29.         [ Links ]

Kaestner, R., 2005, 'An overview of public policy and the nursing shortage', Journal of Nursing Administration 35(1), 8-9.         [ Links ]

Lewin, K., 1952, Field theory in social science: Selected theoretical papers, Tavistock, London.         [ Links ]

Marshall, C. & Rossman, G.B., 1995, Designing qualitative research, 2nd edn., Sage, Thousand Oaks.         [ Links ]

Maxwell, M., 2004, 'Recruitment realities: Building a HR/ nursing partnership', Nursing Economics 22(2), 86-87.         [ Links ]

Moore, D.P., 2002, 'Workplace generational differences noteworthy', Business Major 20 (May), 1.         [ Links ]

Naude, M. & McCabe, R., 2005, 'Increasing retention of nursing staff at hospitals: Aspects of management and leadership', WISER Working Paper no 43, viewed 12 March 2007, from http://www.cbs.curtain.edu.au/wiser        [ Links ]

Neuhauser, P.C., 2002, 'Building a high retention culture in healthcare', Journal of Nursing Administration 32(9), 470-477.         [ Links ]

Oosthuizen, M.J., 2005, 'An analysis of the factors contributing to the emigration of South African nurses', unpublished D Litt et Phil thesis, Department of Health Studies, University of South Africa.         [ Links ]

Pullan, S.E. & Lorbergs, K.A., 2001, 'Recruitment and retention. A successful model in forensic psychiatric nursing', Journal of Psychosocial Nursing 39(9), 18-25.         [ Links ]

Rhule, K.J., 2004., 'The effects of the managers' behaviour on the retention of high potential employees from different generations', unpublished D Ed Thesis, Duquesne University.         [ Links ]

Runy, LA., 2006, 'Cultural transformation', Hospital and Health Networks 18(April), 1-4.         [ Links ]

Rosebrough, C., 1999, 'Retaining "Me Generation" nurses: Management strikes back', Managerial Thought Shots 1(3), 1-3.         [ Links ]

Schwering, R.E., 2003, 'Focusing leadership through force field analysis: New variations on a venerable planning tool', Leadership and Organization Development Journal 24(7), 361-370.         [ Links ]

Sellgren, S., Ekvall, G. & Tomson, G., 2006, 'Leadership styles in nursing management: Preferred and perceived', Journal of Nursing Management 14(5), 348-355.         [ Links ]

Shaffer, F.A., 2003, 'Stepping outside of yesterday's thinking: Preparing nurse managers for a new world order', Nurse Leader 1(4), 33-37.         [ Links ]

Sherman, R., 2006, 'Leading a multigenerational workforce: Issues, challenges and strategies', The Online Journal of Issues in Nursing 11(2), manuscript 2, viewed 20 May 2006, from http://www.nursingworld.org/ojin/topic30/tpc30_2htm        [ Links ]

South African Nursing Council (SANC), 2005, 'Output of 4yr program from South African nurse training institutions', viewed 12 April 2006, from: http//:www.sanc.co.za        [ Links ]

Statistics South Africa, 2006, 'Population of South Africa, 1996-2006', viewed 02 November 2006, from http://www.sanc.co.za        [ Links ]

Strachota, E., Normandin, P., O'Brien, N., Clary, M. & Krukow, B., 2003, 'Reasons registered nurses leave or change employment status', Journal of Nursing Administration 33(2), 111-117.         [ Links ]

Stuenkel, D., Cohen, J. & De La Cuesta, K., 2005, 'The multigenerational nursing workforce: Essential differenes in preceptors of work environment', Journal of Nursing Administration 35(6), 283-285.         [ Links ]

Sullivan, E.J. & Decker, P.J.C., 2001, Effective leadership and management in nursing, 6th edn., Jones & Bartlett, Upper Saddle River, NJ.         [ Links ]

Tappen, R.M., 2001, Nursing leadership and management: Concepts and practice, 4th edn., FA Davis, Philadelphia.         [ Links ]

Tappen, R.M., Weiss, S.A. & Whitehead, D.K., 2004, Essentials of nursing leadership and management, F.A. Davis, Philadelphia.         [ Links ]

Upenieks, V.V., 2003, 'Assessing differences in job satisfaction of nurses in magnet and non-magnet hospitals', Journal of Nursing Administration 32(11), 564-576.         [ Links ]

Vogt, J.F., Cox, J.L., Velthouse, B.A. & Thames, B.H., 1983, Retaining professional nurses: A planned process, Mosby, London.         [ Links ]

Williams, K.A., Stotts, R.C., Jacob, S.R., Stegbauer, C., Roussel, P. & Carter, D. 2006, 'Inactive nurses: A source for alleviating the nursing shortage?' Journal of Nursing Administration 36(4), 205-210.         [ Links ]

Wilson, A.A., 2005, 'Impact of management development on nurse retention', Nursing Administration Quarterly 29(2), 137-145.         [ Links ]

Xaba, J. & Phillips, G., 2001, 'Understanding nurse emigration: Final report. Pretoria: Trade Union Research Project (TURP)', Denosa, Pretoria.         [ Links ]

 

 

Correspondence:
Martha Oosthuizen
University of South Africa
Department of Health Studies
PO Box 392
UNISA 0003
South Africa
email: oosthmj@unisa.ac.za

Received: 04 Aug. 2009
Accepted: 26 July 2010
Published: 03 Nov. 2010