Collective Behaviour & Social Movements Precipitating Conditions.
By Abby L. Bacon. At the time of hiring a new employee, it is unknown whether precipitating factors...
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Transcript of By Abby L. Bacon. At the time of hiring a new employee, it is unknown whether precipitating factors...
Nurse Hiring & Retention Issues
By Abby L. Bacon
At the time of hiring a new employee, it is unknown whether precipitating factors are present that may contribute to the departure of the registered nurse within one year from the date of hire.
Statement of the problem
The purpose of this study is to explore possible precipitating factors before employment that may lead to the departure of a registered nurse from a critical access hospital (CAH) in South Dakota within one year from the nurse’s original hire date.
Purpose of the study
What are the precipitating factors present at the time of hire that may contribute to the registered nurse departing a CAH of South Dakota within one year of the original date of hire?
Research Question
SignificanceAffects of high turnover among nurses
• Cost is considerably high
• Outcomes of a facility decline
• People (staff and patients) are directly and negatively affected
• Productivity decreases
• Staff can become more negative leading to an increased turnover
Critical access hospital (CAH) ◦ a hospital certified to receive reimbursement from Medicare
Precipitating factor ◦ element that causes or contributes to the occurrence of a disorder or problem
Registered Nurse ◦ Approved/accredited school of nursing, passed NCLEX, active license
Definitions
Factors relating to increased turnover Job Satisfaction
◦ (Parry, 2008) (Ma, Lee, Yang, & Chang, 2009) (Lai et al., 2008) (Klug, 2009)
Poor management ◦ (Morgan & Lynn, 2009) (Tourangeau, Cummings, Cranley, Ferron, & Harvey, 2010)
Decreased salary/benefits ◦ (Tourangeau, Cummings, Cranley, Ferron, & Harvey, 2010) (Chan and Morrison, 2000)
Review of the Literature
Factors relating to increased turnover Intent to stay or leave
◦ (McCarthy, Tyrell, & Lehane, 2007) (Klug, 2009)
Job embeddedness ◦ (Mitchell, Holtom, Lee, Sablynski, & Erez, 2001) (Holtom & O’Niell, 2004)
Nurse’s health & the physical workload ◦ (Lai et al., 2008) (Atencio, Cohen, & Gorenberg, 2003)
Review of the Literature
Factors relating to increased turnover Nurses’ attitudes, dedication, and perception of work
◦ (Lu, While, & Barriball, 2007) (Chan & Morrison, 2000)
Work environment ◦ (Tourangeau, Cummings, Cranley, Ferron, & Harvey, 2010) (Chan & Morrison, 2000)
Other External Factors◦ (Tourangeau, Cummings, Cranley, Ferron, & Harvey, 2010)
Review of the Literature
Theory of planned behavior The factors include behavioral attitude, subjective norms,
& perceived behavioral control
Describes the relationship between attitudes and behavior
The best predictor of behavior is one’s intent to behave
These factors influence intention and thus behavior.
Conceptual framework
Model
Based on the Theory of Planned Behavior
Behavior : factors may be present at the time of hire affecting the intent of the nurse that result in voluntary departure
Attitudes: positive and negative beliefs about the behavior
Subjective norms: perception of social pressure
Behavioral control: Perceived ability to control the behavior.
Conceptual Frameworkrelated to this study
A typical descriptive study design will be used for this qualitative study
A descriptive design is ideal for discovering areas of concern within a current practice where little information is known
Research Design
Registered nurses included in the sample must have the following
Be previously employed by CAH in South Dakota
Worked less than one year before voluntarily leaving the facility
Completed a course of study at an approved/accredited school of nursing
Passed the National Council of Licensure Examination.
Have an active license at the time of the study.
Sample
Facility is critical access hospital of South Dakota
The location is where each of the subjects were employed prior to departure
The survey includes the number of beds, the number of registered nurses employed by the facility, and the number of open positions for registered nurses.
Study Setting
Approval from Human Subjects Committee at SDSU and the internal review board of the participating CAHs.
A survey will be mailed to HR dept. of the CAHs of SD
Each department will forward the questionnaire to 10 RNs
◦ RN voluntarily stopped working, employed for less than one year
Include letter about the study, the confidentiality, and return steps
Include a stamped, return envelope for convenience of returning survey
Study Procedure
A self-reported questionnaire
1. Demographics of nurses (age, gender, years of nursing experience)
Information of their hospitals (# of beds, # of RNs, # of open positions)
2. Statements to be answered with a likert scale response◦ 1 meaning strongly agree to 5 meaning strongly disagree.
3. Fill-in-the-blank statement, ◦ Labeled as internal or external & if it was present at the time of hire.
Instrument
Demographics: Gender: Male or Female; Age: ____; Number of years as a nurse? _____
Hospital: beds _____, RN’s employed _____; open RN positions _____
Answer the following with the number 1 through 5
1 – Strongly Agree, 2 – Agree, 3 – Undecided, 4 – Disagree, 5 – Strongly Disagree
1 2 3 4 5 The factor that lead me to leave my position was present at the time I was hired
1 2 3 4 5 My perception of rural health nurse requirements affected me leaving
1 2 3 4 5 When I was hired, I understood the position required knowledge of multiple areas
1 2 3 4 5 Only work related factors lead me to leave my position
1 2 3 4 5 Only personal related factors lead me to leave my position
Complete the following of as many that apply to you
Name a factor for you leaving your current position in the CAH.
____________________________________________________
Was the factor external (personal related) or internal (work related)
Was this factor present at the time you were hired? Y N
(Last section is repeated three more times on actual survey)
Sample of the Survey
Demographic data will be analyzed using frequencies and percentages.
Statement answers will be analyzed using frequencies and percentages.
Fill-in-the-blank statements categorized into themes or patterns.
Categorized factors into internal/external & if present at the time of hire.
The researcher will focus on factors that were present when the nurse was hired.
Present all of the data in narrative and graph form
Projected Analysis
ReferencesAnderson, K.N. (Eds.). (2009). Mosby’s Medical, Nursing, and Allied Health Dictionary (5th ed.). St. Louis, MO: Mosby-Year Book, Inc.
Andrews, D. R. & Dziegielewski, S. F. (2005). The nurse manager: Job satisfaction, the nursing shortage and retention. Journal of Nursing Management, 13 (4), 286-295. doi: 10.1111/j.1365-2934.2005.00567.x
Atencio, B.L., Cohen, J., & Gorenberg, B. (2003). Nurse retention: Is it worth it? Nursing Economics, 21 (6), 262-299.
Blegen, M.A., Vaughn, T., & Vojir, C.P. (2008). Nurse staffing levels: impact of organizational characteristics and registered nurse supply. HSR: Health Services Research, 43 (1), 154-173. doi: 10.1111/j.1475-6773.2007.00749.x
Burns, N. & Grove, S. (2005). The practice of nursing research: Conduct, critique and utilization (5thed.). St. Louis, Mo: Elsevier Saunders.
Chan, E.Y. & Morrison, P. (2000). Factors influencing the retention and turnover intentions of registered nurses in a Singapore hospital. Nursing and Health Sciences, 2 (2), 113-121. dio: 10.1046/j.1442-2018.2000.00046.x
Critical Access Hospital. http://www.raconline.org/info_guides/hospitals/cahfaq.php#whatis
Holtom, B.C. & O’Niell, B.S. (2004). Job embeddedness: a theoretical foundation for developing a comprehensive nurse retention plan. Journal of Nursing Administration, 34 (5), 216-227. doi:10.1097/00005110-200405000-00005
Lai, H-L., Lin, Y-P., Chang, H-K., Wang, S-C., Liu, Y-L., Lee, H-C.,… Chang, F-M. (2008) Intensive care unit staff nurses: predicting factors for career decisions. Journal of Clinical Nursing, 17 (14), 1886–1896. doi: 10.1111/j.1365-2702.2007.02180.x
Lu H., While, A.E., & Barriball, K.L. (2007). A model of job satisfaction of nurses: a reflection of nurses’ working lives in Mainland China. Journal of Advanced Nursing, 58 (5), 468–479. doi: 10.1111/j.1365-2648.2007.04233.x
Ma, J-C., Lee, P-H., Yang, Y-C., & Chang, W-Y. (2009). Predicting factors related to nurses’ intention to leave, job satisfaction, and perception of quality of care in acute care hospitals. Nursing Economics, 27 (3), 178-202. Retrieved from http://findarticles.com/p/articles/mi_m0FSW/is_3_27/ai_n31974418/pg_4/?tag=content;col1
McCarthy, G., Tyrrell, M.P. & Lehane, E. (2007). Intention to 'leave' or 'stay' in nursing. Journal of Nursing Management, 15 (3), 248–255. doi: 10.1111/j.1365-2834.2007.00648.x
Mitchell, T.R., Holtom, B.C., Lee, T.W., Sablynski, C.J. & Erez, M. (2001). Why people stay: Using job embeddedness to predict voluntary turnover. Academy of Management Journal, 44 (6), 1102-1121. doi: 10.2307/3069391
Morgan, J.C. & Lynn, M.R. (2009). Satisfaction in nursing in the context of shortage. Journal of Nursing Management, 17 (3), 401-410. doi: doi:10.1111/j.1365-2834.2007.00842.x
O’Brien-Pallas, L., Duffield, C., & Hayes, L. (2006). Do we really understand how to retain nurses? Journal of Nursing Management, 14 (4), 262-270. doi: 10.1111/j.1365-2934.2006.00611.x
Parry, J. (2008). Intention to leave the profession: antecedents and role in nurse turnover. Journal of Advanced Nursing, 64 (2), 157–167. doi: 10.1111/j.1365-2648.2008.04771.x
Puffer, S. & Rashidiam, A. (2004). Practice nurses’ intentions to use clinical guidelines. Journal of Advanced Nursing, 47(5), 500-509. doi:10.1111/j.1365-2648.2004.03129.x
Registered Nurse. (2008). South Dakota Department of Health. Retrieved January 20, 2010, from http://doh.sd.gov/RuralHealth/Documents/RN.pdf
Shoham, S & Gonen A. (2008). Intentions of hospital nurses to work with computers: based on the theory of planned behavior. CIN: Computers, Informatics, Nursing, 26(2), 106-116. doi:10.1097/01.NCN.0000304777.48155.e3
Taylor-Powell, E. & Renner, M. (2003). Analyzing qualitative data. Program Development and Evaluation, Madison, WI: Cooperative Extension Publishing Operations.
Tourangeau, A.E., Cummings, G., Cranley, L.A., Ferron, E. M., & Harvey, S. (2009). Determinants of hospital nurse intention to remain employed: Broadening our understanding. Journal of Advanced Nursing, 66 (1), 22-32. doi: 10.1111/j.1365-2648.2009.05190.x
Wenzlow, L. (2009). What is a Critical Access Hospital? Rural Assistance Center Online. Retrieved from http://www.raconline.org/info_guides/hospitals/cahfaq.php#whatis
Westphal, J. (2009). The effect of workforce shortages on nurse leader turnover and succession in U.S. hospitals. Western Journal of Nursing Research, 31 (8), 1084-1085. doi: 10.1177/0193945909342528