Recruitment and retention of nurses: challenges facing hospital and community employers.
ABSTRACT Understanding nurses' perceptions of their workplaces underpins successful recruitment and retention initiatives, particularly in this time of global nursing shortage. The American Nurses Association and the American Academy of Nursing have identified "magnet characteristics"--organizational factors that support excellent practice and working conditions in hospital settings. Using selected magnet characteristics, this exploratory study examined nurses' perceptions of their work experiences in both hospital and community settings. Mail surveys were completed by community and hospital nurses (n = 1248) selected randomly from a provincial registry in Ontario, Canada. Scales measured organizational factors (organizational and immediate supervisor support, decentralized decision-making, nurse-physician relationships and work-group cohesiveness) and job-related factors (autonomy, job challenge, work demands, fair treatment, work-status congruence; satisfaction with career, salary, working conditions) of nurses' experiences in their work settings. Nurses in both sectors wanted more opportunities to participate in decision-making and recognition for their contributions to their organizations. In the hospital sector, nurses reported significantly lower levels of perceived organizational and supervisory support and autonomy, and were less satisfied with working conditions and scheduling. Nurses in the community sector were most dissatisfied with salary. No cross-sector differences were reported on nurse-physician relationships, degree of job challenge or career satisfaction. Successful recruitment and retention initiatives hinge on the ability (and willingness) of healthcare organizations to attend to the concerns expressed by nurses and create work settings that are attractive to both new recruits and nurses currently in their employ.
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ABSTRACT: Economic downturns and recession lead to budget cuts and service reductions in the healthcare sector which often precipitate layoffs and hiring freezes. Nurses, being the largest professional group in healthcare, are strongly affected by cost reductions. Economic downturns destabilize the nursing labour market with potential negative outcomes, including serious shortages, extending beyond the recessionary period. The objectives of this manuscript are to provide an overview of the potential short- and long-run impact of economic downturns on the supply and demand of nurses, and present healthcare decision makers with a framework to enhance their ability to strategically manage their human resources through economic cycles.A narrative review of the literature on the effects of economic downturns on the nursing labour market in developed countries was carried out with a special focus on studies offering a longitudinal examination of labour force trends. Analysis indicates that economic downturns limit the ability of public payers and institutions to finance their existing health workforce. As salaried healthcare workers, nurses are especially susceptible to institutional budget cuts. In the short run, economic downturns may temporarily reduce the demand for and increase the supply of nurses, thereby influencing nursing wages and turnover rates. These effects may destabilise the nursing labour market in the long run. After economic downturns, the market would quickly display the pre-recessionary trends and there may be serious demand-supply imbalances resulting in severe shortages. Potential long-term effects of recession on the nursing labour market may include a downsized active workforce, difficulty in retaining younger nurses, a decreased supply of nurses and workforce casualisation.Lack of understanding of labour market dynamics and trends might mislead policy makers into making misinformed workforce downsizing decisions that are often difficult and expensive to reverse. In the aftermath of an economic downturn, the costs of attracting nurses back often outweigh the short term cost savings. Effective management should support the nursing workforce by creating attractive and stable work environments to retain nurses at a manageable cost.Human Resources for Health 08/2012; 10(1):23. · 1.83 Impact Factor
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ABSTRACT: To assess Malaysian nurses' perceived job satisfaction and to determine whether any association exists between job satisfaction and intention to leave current employment. There is currently a shortage of qualified nurses, and healthcare organisations often face challenges in retaining trained nurses. Job satisfaction has been identified as a factor that influences nurse turnover. However, this has not been widely explored in Malaysia. Cross-sectional survey. Registered nurses in a teaching hospital in Malaysia completed a self-administered questionnaire. Of the 150 questionnaires distributed, 141 were returned (response rate = 94%). Overall, nurses had a moderate level of job satisfaction, with higher satisfaction for motivational factors. Significant effects were observed between job satisfaction and demographic variables. About 40% of the nurses intended to leave their current employment. Furthermore, age, work experience and nursing education had significant associations with intention to leave. Logistic regression analysis revealed that job satisfaction was a significant and independent predictor of nurses' intention to leave after controlling for demographic variables. The results suggest that there is a significant association between job satisfaction and nurses' intention to leave their current employment. It adds to the existing literature on the relationship between nurses' job satisfaction and intention to leave. Methods for enhancing nurses' job satisfaction are vital to promote the long-term retention of nurses within organisations. Attention must be paid to the needs of younger nurses, as they represent the majority of the nursing workforce and often have lower satisfaction and greater intention to leave than older nurses do. Strategies to nurture younger nurses, such as providing opportunities for further education, greater management decision-making capabilities and flexible working environment, are essential.Journal of Clinical Nursing 11/2013; 22(21-22):3141-3152. · 1.32 Impact Factor
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ABSTRACT: Abstract Purpose - The purpose of the paper is to describe the processes and results of implementing and evaluating the Releasing Time to Care™ (RTC™) model in a 45 bed Neurosciences unit in a tertiary care hospital in Saskatchewan province of western Canada. Design/methodology/approach – Organizational restructuring in healthcare systems has impacted the ability of CRNs in participation and in influencing the decision making that affect the delivery and outcomes of patient-centered care. At the same time, Clinical Registered Nurses (CRNs) work has intensified because of increases in patient acuity, technological advances, complexity of care provided to patient families and communities, in addition to the intensifying demands put on by aging population and dwindling resources. The work reported in this paper shows that significant improvements have been made based on the current needs and the change is forever imminent. Establishing solid people connections and networking opportunities proved valuable for current and future exchange of information and knowledge translation. Findings – Model implementation resulted in positive narrative and empirical data including: improved patient safety, staff engagement, leadership opportunities and an affirmative shift in organizational culture. Improved patient safety was evidenced by a reduction in falls and decreased medication errors. Originality/value – The paper focuses on including the clinical nurse in organizational and system change towards improving patient-centered quality care. Neurosciences 6300 at Royal University Hospital (RUH) in Saskatoon, was viewed as an RTC™ champion and one of the first to implement and complete the eleven module toolkit. Keywords – Patient-centered quality care, Clinical registered nurse (CRN), Lean, Quality improvement. Paper type – Case studyLeadership in Health Services. 04/2013; 26(3):220-231.