Retaining professional nurses in South Africa: Nurse managers’ perspectives

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.OpsommingSuid-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. Semigestruktureerde 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.

Job satisfaction and attitudes towards nursing care among nurses working at Mzuzu Central Hospital in Mzuzu, Malawi

“…34 Extrinsic rewards and professional opportunities were the aspects of the job that were most commonly found to be dissatisfying by particpants in this study; other studies from Malawi and South Africa also found nurses to be dissatisfied with these particular subscales. [22][23][24] The findings in several of the previous studies reviewed 3,33,34,35 suggest moderate satisfaction among nurses, which is consistent with the findings of this study. These studies further suggest some satisfying and dissatisfying elements of the nursing profession across various cadres of nurses and cultures.…”

“…8,20,21 Such behaviours are associated with job dissatisfaction among nurses. [22][23][24] Patient and public complaints about the quality of nursing care in Malawi may be related to negative attitudes among nurses who are dissatisfied with their jobs. This study was conducted to investigate the relationship between nurses' job satisfaction and attitudes towards nursing care at Mzuzu Central Hospital in Malawi.…”

Nurses Intent to Leave and Job Satisfaction in Hematology/Oncology Areas: Implications for Policy and Practice

“…Nurses' plans to stay or leave were correlated to their control on work environment and availability of resources and equipment as the latter wasted their time and burned them out [27]. Multiple studies have shown correlation with control and responsibilities and job satisfaction, Mokoka et al [28] found a strong correlation with job satisfaction and intent to leave and unfair opportunities to job development [29,30] and noted a control over work included involvement in decision making and competency of work place and Takase et al [31] found that nurses were more satisfied and intended to stay when they were involved in the decision making to establish policies and patient education. These findings are in congruence with the finding of this study and support the strong correlation between job satisfaction and satisfaction with control and responsibilities.…”

A creative analysis of the role of practice development facilitators in a critical care environment

“…The quality of care in the critical care units has also been affected. Nursing in South Africa finds itself in a crisis because of the impact of globalisation and increasingly porous country borders facilitating an increase in the exodus of skilled professional nurses, leading to a shortage of critical care nurses (De Beer, Brysiewicz, & Bhengu, 2011;Department of Health, 2012) and as nurse leaders, managers and the public opinion reveal poor standards of nursing care (Mokoka, Oosthuizen, & Ehlers, 2010;News24, 2013;Oosthuizen, 2012). Examples of concerns expressed by the Critical Care Nurses Forum (2013) and medical doctors include poor adherence to routine and evidence-based nursing care of critically ill patients and decreased accountability and responsibility as critical care nurses are not involved in monitoring and evaluating patient care.…”