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NURS 236A Nursing Shortage Interview Dr. Jayne Cohen, Director, School of Nursing, SJSU. Phyllis M. Connolly, Ph.D., APRN, BC, CS Interviewer. Retention & Shortage. RN Turnover in US approx. 21.3% in 2000 Loss compromises patient care Increases cost of health care
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NURS 236A Nursing ShortageInterview Dr. Jayne Cohen, Director, School of Nursing, SJSU Phyllis M. Connolly, Ph.D., APRN, BC, CS Interviewer
Retention & Shortage • RN Turnover in US approx. 21.3% in 2000 • Loss compromises patient care • Increases cost of health care • Minimum cost to replace 1 RN nurse $45,000 • Job dissatisfaction predictor of intent to leave • As School of Nursing we can educate a limited number of RNs • HCOs need to retain new hires
Factors Influence Retention • Job satisfaction • Supervisor Support • Work Environment • Personal Factors
Methodology • Longitudinal, descriptive at 3 sites • Initial survey Insel & Moos Work Environment Scale (WES) Form R • Dimensions: Relationship, Personal Growth or Goal Orientation, & System Maintenance & Change • Demographic tool • Data collected Q 6 months for 2 years
First Setting & Sample • Acute care RN staff nurses on all 3 shifts large government hospital in Northern California • Clinical levels 1 – III and charge nurses and assistant head nurses • 692 surveys were distributed • N = 272, 39% Response Rate
Relationship Dimensions • Involvement – employees are concerned about and committed to their jobs • Peer Cohesion – employees are friendly and supportive of one another • Supervisor Support – management is supportive of employees and encourages them to be supportive of one another
Autonomy – “employees are encouraged to be self-sufficient; make their own decisions” Task Orientation – “emphasis is on good planning, efficiency, and getting the job done” Work Pressure – “the degree to which the pressure of work and time urgency dominate the job milieu” Personal Growth or Goal Orientation Dimensions
System Maintenance and System Change Dimensions • Clarity – “employees know what to expect in their daily routine” • Control – “extent to which management uses rules and pressures to keep employees under control” • Innovation – “degree of emphasis on variety, change, and new approaches” • Physical comfort – “extent to which the physical surrounding contribute to a pleasant work environment”
Results • Supervisor Support, 4.5 mean score below normed average (5.5-6.0) • Goal Orientation & Efficiency mean score 6.67 (5.5.-6.0) • Work and Time Pressure 5.85 (4.0-5.0) • Organizational Control 5.08 (4.5-5.0) • Physical Comfort 5.08(4.5-5.0) • Clarity of Expectations 5.33 (5.5-6.0) • Innovative Environment 3.27 ( 4.0-5.0)
Conclusions • Nurses Perceived a lack of supervisor support • Were unsure of their job roles • Felt that new ideas or techniques were not valued • High degree of task orientation & work pressure, rules, regulations, & management control were perceived as high • Physical work environment was satisfactory
Retention Strategies • Improve supervisor support • Clarify expectations • Reduce organizational control • Reduce work and time pressure