Turnover among Filipino nurses in Ministry of Health hospitals in Saudi Arabia: causes and recommendations for improvement

Abstract

BACKGROUNDNurse turnover is a critical challenge for healthcare organizations as it results in a decreasing nurse/patient ratio and increasing costs.AIMIdentify factors influencing the termination of Filipino nurses in Ministry of Health (MOH) hospitals and record nurse recommendations to improve retention.DESIGNCross-sectional.METHODSData was gathered from a convenience sample of Filipino nurses with previous experience in MOH hospitals in Saudi Arabia who attended recruitment interviews at the Saudi employment office in Manila.RESULTSThe sample included 124 nurses. Major turnover factors included low salary (18.3%), low nurse/patient ratio (15%), end of contract (14.5%), discrimination (13.5%), and bad accommodations (9%). Suggested areas of improvement included financial motivations (34%), administration support (25%), quality of life (25%), and work environment (16%).CONCLUSIONManaging nurse turnover can be implemented on the organizational as well as at MOH levels. The recommendations given by the participants provide direct targets to improve retention.LIMITATIONSWith convenience sampling, the sample is probably not representative of the Filipino nursing population.

Turnover among Foreign Nurses in Saudi Arabia

“…17,18 Many studies have identified the intention to quit nursing as a predictor of the ultimate decision. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The Nurses' Early Exit Study (NEXT), 20 found that ultimately, the decision to leave nursing is mostly taken within 6 months of actually doing so. It also been reported by Hasselhorn et al 20 that about 80% of nurses who left the profession began seriously considering the move within the previous year.…”

“…Nurses are a very diverse group of professionals, culture and alternative employment opportunities can have an impact on their intention to leave , the mindset that strengthened the idea, was "intention to leave" has often been probed, particularly using quantitative methods to determine associations with many variables that can influence nursing resolution to leave. 8,7,21 Occupational factors related to the "intention to leave" change the profession include hospital work environment, poor support from supervisors, lack of importance of the work, conflicting roles, and lack thereof in development opportunities. [14][15][16][17][18][19][20][21][22] Nurses' "intention to leave" in the professional capacity has been ascribed to psychosocial job strain ascertained by "demandcontrol-support" (DCS) 23 and "effort-reward imbalance" (ERI) 24 models.…”

“…In the last five years, only two relevant research articles, 7,8 have been found related to foreign nurses' turnover in Saudi. Aljohani et al indicated that the common cause of turnover for Filipino nurses in the Saudi Arabian Ministry of Health (MOH) hospitals to be related to low salary, 7 18.3% of the recruited participate indicate the low salary and low nursing patient ratio to be the most significant factor in Filipino nursing turnover in Saudi Arabian hospitals, until now the sample not representative the Filipino nurses population. 7 Findings indicated that financial incentives, indeed are a primary driving force for those working internationally in healthcare organizations.…”

“…Aljohani et al indicated that the common cause of turnover for Filipino nurses in the Saudi Arabian Ministry of Health (MOH) hospitals to be related to low salary, 7 18.3% of the recruited participate indicate the low salary and low nursing patient ratio to be the most significant factor in Filipino nursing turnover in Saudi Arabian hospitals, until now the sample not representative the Filipino nurses population. 7 Findings indicated that financial incentives, indeed are a primary driving force for those working internationally in healthcare organizations. 9 The second study ended in low tertiary care sites in Saudi Arabia randomly selected with a representative sample of 364 nurses, the majority of foreigners at a rate of 97%; the study indicated the low satisfaction of nurses of their quality of nursing work life and high turnover intention.…”

Nursing Education in Saudi Arabia: History and Development

“…Therefore, to reach the recommended ratio of one nurse for every 200 Saudi citizens, KSA must recruit 185,722 expatriate nurses [2]. The recruitment of expatriate nurses throws up several challenges, including a competitive market, high turnover, financial costs, healthcare instability, and concerns regarding patient safety [3]. Therefore, establishing and enhancing domestic nursing education programs to meet the needs of the nursing workforce will be a key strategic requirement for the Saudi government.…”