Empowerment as a Nurse Retention Tool Essay
A sense of empowerment, according to Kanter’s theoretical framework, provides nurses with access to information, support, opportunity, and resources. Based on Kanter’s theory of organizational empowerment, secondary literature and primary survey as a background, a policy has been developed for retaining higher number of nurses (Kanter, 1977). This model considered the opinion of respondents through primary survey and specific concepts of Kanter like negative work place behavior and impact of power and opportunity on retaining rate of nurses. This policy would facilitate transform care at bed site (TCAB) through empowerment, which in turn would result in higher satisfaction at work where care quality may improve immensely and also leads to higher nurse retention. Empowerment as a Nurse Retention Tool Essay. This would also lead to safe and reliable care, where a patient-centred approach may be utilized to lead to value-added care processes through empowerment, satisfaction, teamwork, and involvement.
Staff retention has become major threat and concern for hospitals nationwide. Retaining nurses once they enter the organization is significant as the cost of orienting a new nurse may exceed the cost of an annual salary; that is, cost to replace a registered nurse begins at $42,000 for a medical/surgical nurse and $64,000 for an intensive care unit nurse (Kerfoot, 2000). Along with the excessive financial cost of losing staff nurses, hospitals suffer long-term negative effects on the quality of patient care. It has been estimated that the shortage of nurses will rise to 800,000 by 2020 (Spetz & Given, 2003). Multiple search studies have shown that job satisfaction is one of the key factors that determine nurses’ intent to stay or leave (Nedd, 2006; Lacey, Teasley, & Cox, 2009).Job satisfaction is often enhanced when organizational factors, such as opportunity, information, support, and resources are an inherent part of organizational functioning. Empowerment as a Nurse Retention Tool Essay.
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Staff retention is one of the strategies nurse administrators employs in preventing high rates of nurse turnover. Currently, the rate of nurse turnover is quite high, and this problem is more common in nurses at the entry level. The high rate of nurse turnover is one the major contributors of the shortage of nurses experienced throughout the country (Brunetto, 2012). Apart from prevention of nurse turnover, retention of nurses has a lot of benefits accrued to it. The strategy is useful in keeping nurses in a particular organization, and this helps to retain the skills and knowledge accrued in the process of serving at the organization. Other benefits associated with nurse retention include a reduced number of new nurses or “rookies,” thus reducing cost of training, fewer terminations that lead to reduced termination cost and increased productivity. However, the retention of nurses also comes along with increased cost. Some of the nurse retention costs include salary increases, rewards, bonus programs, ongoing “education and promotion,” among others (Ley, 2007). Therefore, as a nurse manager, it is essential to devise ways of dealing with challenges that arise as a result of nurse retention. Possessing the knowledge on nurse retention is vital for career development as a nurse manager. Hence, this paper provides an analysis of research articles regarding the issue of nurse retention.
Staff Retention in Nursing
Part A: – Summary of Each Study
Article 1: Retention Priorities for the Intergenerational Nurse Workforce by Wieck et al., 2010
The researchers in this particular study focused on the retention priorities for nurses belonging to different generations. The purpose of the study was “to conduct an assessment on the environment, job satisfaction, and desired traits of managers in a bid to improve nurse retention” (Wieck et al., 2010). As mentioned earlier, nurses’ retention is important in any organization since it helps reduce the problem of nurses’ shortages that is felt across the whole country. Empowerment as a Nurse Retention Tool Essay. Work environment, job satisfaction, and qualities portrayed by nurse managers have direct impacts on nurse retention.
As part of the methodology, this study was purely quantitative and entailed collection of data from 1,773 nurses from 22 hospitals. The survey was conducted online and included aspects such as “nurse manager desired traits, safety perceptions, nursing work index and job satisfaction” (Wieck et al., 2010).
The findings of this research indicate that the satisfaction with work environment were high among all the participants. The satisfaction was highest where there existed nurse-physician relationship, and lowest where there was nurse control of practice, and younger nurses were less satisfied compared to nurses aged over 40 years. 40% of nurses involved in the sample expressed safety concerns. Additionally, 61% of all the participants indicated that they were planning to leave their jobs within the next ten years (Wieck et al., 2010).Empowerment as a Nurse Retention Tool Essay.
In order to halt the alarming findings contained in this research, the researchers assert that health organizations should create model managers since the characteristics of the manager are among the major factors influencing nurse retention. Hence, it important for nurse managers to possess qualities that promote a good working relationship with the nursing staff. The nurse managers should empower the staff nurse councils, which are very useful in advancing the grievances raised by nurses, hence improving job satisfaction. The other recommendations are revamping of the incentives, stabilizing staffing, and focusing on their safety during service delivery (Wieck et al., 2010).
Article 2: Study on Nurse Retention by Brunetto
The study aimed at improving the rates of nurse retention by focusing on the factors that make nurses stick into their professions (Brunetto, 2012). The study took three years, and it sought to determine nurses’ satisfaction levels concerning the relationship with supervisors, ability to solve problems during service delivery, and communication structures (Brunetto, 2012).
The findings of the study show that nurses leave their jobs due to lack of autonomy. 20% of the nurses involved in the study felt that they did not possess the relevant skills to solve the problems they were facing, thereby forced to consult from their superior. This practice leads to erosion of the autonomy in nursing. Other findings indicate that younger nurses are faced with the greatest challenges of retention. Another factor that contributes to nurses leaving their job is random changes in the hospital management that complicate the work relationships between the nurses and supervisors. Well-organized structures in the hospital have the potential to reduce the number of nurses leaving their jobs (Brunetto, 2012).
The insights contained in this study can be very beneficial if they are applied in a hospital. First of all, increasing the autonomy of nurses can help lower nurses turnover and retain more nurses in the hospital. In the cases where nurses lack autonomy due to lack of knowledge on how to deal with certain situations can undergo further in training to increase their knowledge (Brunetto, 2012). The supervisors should create proper working relationships with nurses. Good relations between the nurses and their supervisors will help reduce the rate of nurse turnover. Empowerment as a Nurse Retention Tool Essay.
Article 3: “Keeping Nurses on the Job: Retention is part of the Answer to the Nursing Shortage” (New York University, 2009).
The purpose of this study was to “establish the factors that can help keep new nurses from leaving their jobs” (New York University, 2009). The topic of study was important because nurses turnover not only results in a shortage of nursing staff in the hospital, but also results increased hospital budget as the hospitals tries to cater for turnover costs (New York University, 2009). This study was funded by the Robert Wood Foundation, and it incorporated a sample size of 1,933 newly licensed nurses that were sampled from various hospitals across 34 states in the USA” (New York University, 2009).
The results of the study showed that nurses stayed on their jobs based on factors that included perceptions of the working conditions, job opportunities available, personal characteristics and specific workplace attributes. According to the researchers, nurse retention can be useful in cutting the costs of running the hospitals. Nurse retention is also useful in improving patients’ outcomes since it increases the staff stability. Whenever the nurses are satisfied with their jobs, bear the organizational commitment, possess autonomy, and have opportunities for promotion, such nurses have minimal chances of leaving their job (New York University, 2009).
The knowledge contained in this research article is applicable in addressing problems with nurses’ retention. Health organizations should try to create equal chances for promotion for the nurses. Some nurses should not feel sidelined for promotions whereas others are favored. As the results of the study show, the hospitals can reduce high workload for nurses in a bid to increase job satisfaction. Increasing job satisfaction can result in the high rate of nurses’ retention. The nurse managers should provide supervisory support in the efforts to increase the organizational commitment among younger nurses. Nurse Managers should also avoid some practices such as mandatory overtime since they lead to reduced organizational commitment (New York University, 2009).
Article 4: “Effective Strategies for Nurse Retention in Acute Hospitals; A mixed Method Study” by Koen et al., 2013
Nurse retention is one of the best strategies in countering the problem nurse shortage within the organization. Therefore, “the purpose of this study was to examine the impact of nurse education, nurse staffing and nursing practice environment on the nurse reported intention to leave the hospital” (Koen et al., 2013). The study also sought to “provide best practices in the nursing care that can lead to a sound practice environment and thereby improving nurse retention rates” (Koen et al., 2013). The study involved 3186 bedside nurses drawn from 56 Belgian acute hospitals.
The results show that 29.5% of the participants were planning to leave the hospital. Empowerment as a Nurse Retention Tool Essay. “Two factors, namely, nurse work environment and patient-to-nurse ratio were among the leading reasons for the intentions of nurses to leave” (Koen et al., 2013). Further results indicate, “high performing hospitals with high rates of nurse retention had a participative management style, structured education programs, and career opportunities for nurses” (Koen et al., 2013). However, the study contains several limitations. The RN4CAST nurse survey conducted did not cover all the components. Important elements like magnetic force 11 were locked out of the study. The qualitative data was collected from six Flemish hospitals and thus it hard to make generalizations of the findings.
Therefore, the knowledge contained in this research article is applicable in addressing problems with nurses’ retention, and this can be achieved by mentoring nurses and addressing their dissatisfactions in a timely manner (Koen et al., 2013).
Article 5: “Exploring the Key Predictors of Retention in Emergency Nurses” by Sawatzky & Enns, 2012
The objective of this study was specifically “to explore and describe the influencing and intermediary factors that predict the retention of nurses working in the emergency departments” (Sawatzky, & Enns, 2012). The researchers employed cross-sectional survey designed in the collection of the data (Sawatzky & Enns, 2012).
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The results indicate, “Engagement emerged as the most convincing predictor for intermediary factors” (Sawatzky & Enns, 2012).The intermediary factors use in this case included job satisfaction, fatigue, and burnout. An inverse relationship was evident between “engagement and influencing factors such as nursing management, collaboration with nurses, available resources, and shift work” (Sawatzky & Enns, 2012).There are limitations contained in this work. The purposive sampling method used can elicit biased findings. The other limitation is that the despite the fact that framework used in the research was “based on scientific evidence,” it had not been tested (Sawatzky & Enns, 2012).Empowerment as a Nurse Retention Tool Essay. In addition, since the subjects used in the study were drawn from the nurses operating in the emergency departments, the findings of the study cannot be applied in the entire nursing population. According to the findings of this study, engagement is a key factor in retaining nurses working in the emergency departments. Hence, nurse managers should work on factors that increase engagements. Some of these factors include engaging the nursing management in providing guidance, collaboration with physicians, and shift work.
Article 6: “The Mediating Role of Organizational Subcultures in Health Care Organizations” by Lok et al., 2011
The objective of this study was “to investigate the mediating role of the organizational subculture between job satisfaction, organizational commitment and leadership culture in health care organizations” (Lok et al., 2011). The study used nurses drawn from 26 wards in indifferent hospitals (Lok et al., 2011).
The results obtained “shows that in the innovative ward, subculture was found to bear greater impact on nurses’ commitment and retention. In the bureaucratic ward, “subculture had a significant negative direct relationship with commitment” (Lok et al., 2011). On the supportive ward, “subculture had small but positive indirect relationship with job commitment, and this was achieved through job satisfaction” (Lok et al., 2011). Some limitations contained in this research calls for further research. In the first instance, this research is only applicable in Australia due to differences in culture across the different countries of the world. Another limitation is that the study was conducted in a hospital in which nurses spend long periods in the ward. Hence, in organizations where nurses move more frequently, they may not have adequate time to form subcultures that influence commitment (Lok et al., 2011). Empowerment as a Nurse Retention Tool Essay.