Introduction
The problem of high turnover of nurses in the general surgical floor of hospitals has remained a thorn in the flesh of many hospital management teams and the entire medical practice (Al-Aameri, 2000).
This is because all the deliberate efforts to reduce the turnover has always born no fruits and proved to be futile. The rate of turnover has continued to increase in an alarming rate and as such the nursing profession has been termed as a disguised profession.
The turnover rate has led to numerous problems in the hospital and this has caused the service delivery quality to deteriorate over time. Lack of adequate nurses has caused such problems as stress on the available few nurses (Jones & Gates, 2007).
This has significantly reduced the quality of service delivery by these nurses. Patients have experienced dissonance as a result of this poor quality and the whole profession has plunged in chaos (Kristin, 2010).
Freund (2005) found out that the nurses’ turnover rate happens in periods. The newly hired nurses soon leave their profession after realized that the stress levels at the workplace are unmanageable. This has caused the problem of general surgical floor nurses turnover to be perennial.
As such both proactive and reactive measures ought to be taken to ensure that a durable and sustainable solution to this problem is reached (Elloy, 2005). Previous efforts to solve this problem have proved unsuccessful as the turnover rate has continued despite the efforts by the hospital management.
The measures taken should not only be aimed at reducing the turnover but also coming up with means and ways of ensuring that there is retention of the existing workers (Jones & Gates, 2007). This will ensure proper staffing and reduce the turnover costs that hospitals have experienced for a long time.
A careful study of the causes of this problem can go a long way in ensuring that the root cause of this problem is identified. The results that can be achieved can be far and wide in solving the problem that has for a long time lacked a practical solution.
Abstract
A study carried out on 800 nurses on their work places welfare indicated that the major area in the profession where the nurses experience dissatisfaction is their working conditions; 80% (American Psychological Association, 2010). Although most nurses confess loving their profession, majority of them indicate that they would easily change their jobs whenever an opportunity arises.
The main cause of dissatisfaction among many nurses is their working conditions (Fletcher, 2001). Some nurses claim to have irregular working patterns and this destabilizes their personal programs and other schedules.
Lack of a clear working time table for nurses in many hospitals has often caused nurses to work for over 10 hours a day. This has often caused fatigue and a gradual fade in the productivity. In a short time, the nurses experience situations of work dissatisfaction and they hence move to other jobs where the conditions are seemingly conducive (Best & Thurston, 2004).
Of the potential causes of turnover, work related stress and dissatisfaction has topped the list of the causes (Mahmoud AL-Hussami, 2008). This has been followed by such other causes as poor remuneration, and lack of career growth prospects.
Purpose Statement
The problem statement in this study is what are qualitative factors that can be enhanced to ensure a reduction of in the turnover rate and increase the nurses’ retention in general surgical floor of Hospitals? The study will also quantify the costs of turnover and how it affects the hospitals’ budget and budgetary processes.
This is because it is widely known that hospitals experience and incur high turnover costs. These costs can be controlled if a durable solution on the high turnover rate of nurses is sought.
Problem statement and the study objectives and the hypothesis
There are several research problems in this study. These include: Are nurse regarded as a resource in the hospitals or they are considered to be cost centers? Is there a quantitative measure that can indicate the economic values of the nurses?
Do hospitals have sufficient economic knowledge on the cost of nurses’ turnover? Is the root cause of nurses turnover related to the working conditions or are there other quantifiable factors that contribute to the turnover.
For the above research study the following key objectives of the research are discussed:
- To determine the impact of nurses’ turnover on the economic state of the hospital
- To identify where nurses are regarded as resources in the hospitals or they are mere cost centers.
- To identify the cost of nurses turnover
- To establish the strategies that the hospital can employ to ensure a reduction of the nurses turnover and increase their retention
- To establish any other factor that is relevant to the job satisfaction that can be successfully employed to ensure nurses are retained in their work place.
The hypothesis of the study is, “There is a direct relationship between the nurses’ job dissatisfaction and the turnover ratio, and a relationship exists between the working environment and the nurses’ retention in the general surgical floor of the hospital.”
Research design
In this study, various qualitative and quantitative research methods will be employed. This seeks to elucidate the qualitative and the quantitative factors that lead to nurses’ turnover. The study then proposes the possible means of containing these problems.
The importance of carrying out a quantitative research is that quantifiable aspects are presented (Creswell, 2008). In this case the hospital’s management is able to ascertain the costs in incurs from turnover of nurses.
With the understanding of the turnover costs the management can then explore all the available option to ensure that the rate of turnover is brought down as well as the nurses’ retention is fostered.
The main problem will be determining the economic value of nursing. This will help the hospital’s management change their view on nursing from what has been held for so long as cost centers to realizing that nurses are revenue streams to the hospital.
To fully understand and articulate the economic value of nurses, the quantitative information relating to attitude, behavior, and performance instruments will be sought.
Some sources of this information will include the recorded materials such as the attendance sheet, the appraisal forms and the checklists found in the hospitals’ operational and procedures manual. This data once obtained will be statistically analyzes to come up with a more clear report and recommendation on the possible ways of improving on the areas that are found out to contain errors.
The qualitative aspects of the study will provide the reasons behind the turnover as relates to the job satisfaction. This report will then recommend the possible solutions to these qualitative problems. A good qualitative report ensures that all the factors are explored and understood.
Open ended questions are formulated and this is majorly done so as to give the research participants a chance to express the views that are not available in the information gotten from the quantitative reports (Creswell, 2008).
This data can also be obtained from subjective observation of participants or research sites, or obtaining information from private sources. This type of research technique usually uses aggregation since most of the information is subjective (Creswell, 2008). It also acts as a boost to the already available quantitative information and helps cement the finding s as well as the recommendations.
Both the qualitative and quantitative techniques will be used together so as to obtain more comprehensive report and a more accurate research findings. The purpose of the study will be to provide strategies for reducing the turnover rate of nurses as well as increasing the retention in the general surgical floor of hospitals.
The study will provide the cost benefits of retention highlight the economic losses incurred during turnover as well as develop policies that can be useful in promoting employees retention.
The participants in this research will be gotten from the various hospitals, both public and private. Research participants will not be limited to nurses but instead they will also include such other persons as hospital managers and doctors. when obtaining information from nurses.
Registered nurses who have managed to remain in one employment for a long time will be interviewed. Others who have changed jobs more than once will also be interviewed.
The reason rationale behind interviewing these various groups is to obtain a wide perspective on the causes of the turnover. These participants will also give more insight on the work related factors that contribute to the satisfaction of the employees. This will ensure a holistic approach is sought and obtained incoming out with research findings.
The results of this study will be of great use to organizations which seek to know understand the cost of turnover. It will also provide useful insight on the benefits of employees’ retention. The study will focus on the strategic actions that a firm can employ to ensure a short term and a long-term success in the area of employees’ retention.
Many organizations fails realize the economic impacts of losing critical employees (American Psychological Association, 2010). Organizations should always endeavor to retain such employees since a loss in the results in negative innovation as well as consistency in providing services to the clients. This often results is dissatisfaction among the customers and becomes the root source of dissonance (Freund, 2005).
Once clients have expressed dissatisfaction, the loyalty is lost and this has a negative effect on the workers. Their productivity goes down and if the management fails to intervene, this ultimately leads to employees’ turnover.
Conclusion
An increase in the number of nurses in the hospital has a direct relationship to reduced deaths of patients. This clearly indicates that the matter of nurses’ retention and turnover has a life or death effects.
The nurses’ turnover not only results in poor medical care quality but also leaves the remaining nurses with more work stresses since they have to increase their productivity so as to attend to more patients and work for longer hours. As such extensive research is needed that will address this problem in a comprehensive manner.
References
Al-Aameri, A. S. (2000). Job satisfaction and organizational commitment for nurses. Saudi Medical Journal , 231-235.
American Psychological Association. (2010). Publication Manual of the American Psychological Association. Washington DC: American Psychological Association.
Best, M., & Thurston, N. (2004). Measuring nurse job satisfaction. Journal of Nursing Administration , 283-290.
Creswell, J. W. (2008). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. CA: Thousand Oaks.
Elloy, D. F. (2005). The influence of super-leader behaviors on organization commitment, job satisfaction and organization self-esteem in a self-managed work team. Leadership and Organizational Development Journal , 120-127.
Fletcher, C. E. (2001). Hospital RNs’ job satisfactions and dissatisfactions. Journal of Nursing Administration , 324-331.
Freund, A. (2005). Commitment and job satisfaction as predictors of turnover intentions among welfare workers. Administration in Social Work , 5-21.
Jones, C., & Gates, M. (2007). The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention. The Online Journal of Issues in Nursing , 4.
Kristin, V. (2010). Increasing New Graduate Nurse Retention from a Student Nurse Perspective. Journal of Nursing , 12-23.
Mahmoud AL-Hussami, R. N. (2008). A Study of Nurses’ Job Satisfaction: The Relationship to Organizational Commitment, Perceived OrganizationalSupport, Transactional Leadership, Transformational Leadership, and Level of Education. European Journal of Scientific Research , 5.