Careers in the health care field can be physically,mentally and emotionally demanding
Executive Summary
According to (2008) careers in the health care field can be physically, mentally, and emotionally demanding. This is especially evident in a professional nursing career where a staggering number of registered nurses are leaving the profession due to feeling of stress, inadequacy. Anxiety, oppression and disempowerment, often the result of lateral violence.
Because many nurses are choosing to leave their works due to different reasons, employee retention is now an important consideration for every organizations.
Company Background
(2002) conducted a research focusing on the reasons why employees consider leaving their organizations. His research revealed that there are six (6) major factors that affect employees’ intention to leave their jobs. In his research 71 percent of the respondents cited pay as an important factor while 33 percent said that the lack of promotional opportunities affects their intention to quit. There were also 26 percent who said that the lack of work-life balance programs (26 percent) and the stress (24 percent) that they get from the job make them want to leave their jobs. 24 percent of the respondents sited the lack of career development programs and inadequate health care packages that force them to look for other jobs.
Hospital X (real name of the facility withheld) is a public funded acute care hospital. The hospital is a teaching facility that is affiliated with the university. The facility provides 24-hour preoperative care, which requires nurses and other staff to work one of four possible shifts. The average age of the nurses in the operating room is 46 years.
The preoperative care department of the facility experience difficulty in retaining nurses. Younger and new graduate nurses are difficult to recruit and once they are selected and employed, they are difficult to retain. In a study conducted by (2008), she presented data and statistics surrounding the issue of new graduate nurses high turnover and their decision to leave their employment within the first year of working. According the her findings 35 percent to 69 percent of newly hired graduate nurses leave their place of employment within the first year. In Canada as a whole, it has been recorded that the turnover rate reaches 55 percent to 61 percent.
Reporting and Analysis of Primary Research
Research Objectives
The case study aims to investigate on the different issues in Retaining New Graduate Nurses at Hospital X. More specifically it seeks to:
1. To determine the different factors that affect retention of new graduate nurses in preoperative setting.
2. To determine the main reasons why nurses in preoperative setting leave their work.
3. To identify different strategies to make employee retention more effective and to decrease employee turnover in general.
Related Literature
Employee Retention
Employee retention can be defined as the effort by an employer to keep desirable workers in order to meet business objectives. This term is connected with the term turnover, which is most often describe as the unplanned loss of workers who voluntarily leave and whom employers would prefer to keep ( 2004).
Employee retention is now a major concern in every organization. The time, effort, and resources that are wasted on recruiting, placing and training new employees led companies to come up with strategies to retain their valued employees. Also, the scarcity of skilled and competent workers gave way to more intense competition between companies to attract and retain workers.
Retaining a good employee is one of the most cost-efficient practices a company can employ. The cost of replacing an employee is always more than the cost of recruitment. Oftentimes, by the time an employee leaves his/her job, hundreds or thousands of dollars and hours have been invested into that employee. When an organization retain, it removes many unforeseen costs, including the cost of recruitment, cost of training, the loss of productivity and the cost of replacement materials.
Reasons Why Employees Leave
(2002) in her book entitled ‘The Employee Recruitment and Retention Handbook’ presented some of the top reasons for high turnover. According to her these are the most frequent reasons that were cited by employees for leaving their work:
1. Incompatible corporate culture – Employees need to feel that their interests, goals, work styles, and experiences are valued and supported by the organization for which they work. Employees who find that their differences are just tolerated rather than embraced are likely to leave.
2. Feelings of not being appreciated or valued – Most employees genuinely want to do a good job. It follows, then, that they want to know that their work is appreciated. Some employees require almost constant feedback on how they are doing, while others are content with an occasional encouragement. Even the most experienced employee needs to feel appreciated and recognized.
3. Not feeling part of the company – Employees need to sense that what they do fits in with the company overall. While new employees, in particular, are anxious to understand the impact of their work on achieving organizational goals, the same is true of workers at all levels.
4. Not knowing how they are doing – During a tight labor market, when employees know they can leave tomorrow and land another job in a week, few workers are willing to wait a year for their performance review to find out how they are doing. Day-to-day coaching is needed to acknowledge accomplishments and point out areas requiring improvement.
5. Inadequate supervision – while not every worker requires close supervision, all employees need a sense of direction and guidance. They also need to know that the person they report to is available and responsive to their questions or concerns.
6. Lack of opportunity for growth – Finding out that they have been hired into a dead-end job can make employees feel deceived; that alone can make a person quit his/her job.
7. Lack of training – People want to strengthen their knowledge, skills and abilities to maintain a high level of marketability in an ever changing employment market.
8. Unequal salaries and benefits – Employees talk to one another and if they find out that some are earning more in the way of pay or benefits, other earning less for comparable work, their reaction could include resignation and possibly legal action.
9. Lack of flexible schedules – There are still many companies that adhere to a strict 9 to 5, Monday to Friday work mentality. With so many alternative work arrangements available, employees with other-than-work interests and commitments are likely to leave an inflexible environment for a company that acknowledges life outside of work.
10. Unsatisfactory relationship at work – Employees today expect a more collaborative work environment among themselves, coworkers, and supervisors. The are more discriminating about whom they spend time with during work hours, and they are likely to leave if they do not have high comfort level.
11. Inadequate or substandard equipment, tools, or facilities – Employees mat not be willing to stay in an environment with poor working conditions, a workplace that lacks important facilities such as proper lighting and furniture, or outdated computers and other equipment. The environment in which a person works directly impacts his/her level of productivity, and in some instances, may be all that is needed to cause valuable employees to quit.
As I further investigate the issue of employee retention, using secondary sources such as published materials, I discovered that employee retention is deeply connected with recruitment. Recruitment is the process of finding and attracting individuals to fill actual or anticipated job vacancies ( 2002). The recruitment process provides the organization with a pool of potentially qualified job candidates. Recruitment covers all activities that aim to create a candidate base for the organization’s open positions. In recruitment the organization:
o Search for potential employees
o Find methods of communicating with the potential employees
o Tell them about the position and the organization
o Determine whether they possess the necessary skills
o Describe how their career interests will be met (1999)
Research Methodology
In order to investigate the issue further, the researcher employed a descriptive type of research. The researcher used a survey questionnaire in order to find out the issues in retaining new graduate nurses in Hospital X. The survey presented useful information from the respondents regarding the topic. The responses of the subjects were summarized, analyzed, and reported in order to make a general finding about the topic.
The survey was distributed to fifty (50) nurses working in the
preoperative setting of Hospital X. The nurses were asked to complete the
questionnaire within a two-week period and submit them anonymously to the
receptacle for collection.
Aside from primary research, the researcher also employed secondary research. The researcher consulted different publications such as journals and books in order to guide the investigation and to substantiate the findings of the research. Moreover, published materials were also consulted in presenting different strategies to improve employee retention at Hospital X. The data collected through secondary research will be compared with the results of the primary research and will be presented in the Gap Analysis.
Gap Analysis
The paper is based on a research conducted by (2008) entitled “Mentoring the New Graduate Preoperative Nurse: A valuable Retention Strategy”. In her paper, (2008) discusses the importance of mentoring relationships in retaining new graduate preoperative nurses. The current paper deals with the different issues in employee retention in the preoperative environment.
In this section selected literature regarding employee retention will be analyzed and compared against the results of the survey. There is a shortage of literature that focuses on the experiences of new graduate nurses in the preoperative setting.
Factors affecting Recruitment/Retention
The survey pointed to the changes in the demographics that lead to labor shortage as the top reason why nurses are not attracted or why nurses leave their jobs. A research conducted by (2004) also pointed to demographic changes that lead to labor shortage as one of the reasons why employee retention is much more difficult to achieve today. A major reason is that the big baby-boom generation is starting to retire. There are not enough workers behind the baby boomers in the labor supply pipeline to fill their jobs.
Workplace Environment
Workplace environment plays an important part in employee retention. Employees want a feeling of belonging and security. Their decision to stay or leave may depend on working conditions, the characteristics of the employer and the degree of stress they get from work ( 2000). The research conducted at Hospital X also revealed that the new graduate preoperative nurses are affected by the stress in the workplace, the load of works, and most especially with their relationship with colleague and superiors.
Pay/Salary/Incentive
Pay is also a major consideration for nurses in the preoperative setting of Hospital X. Many of the respondents revealed that they think the Hospital’s pay system is unsatisfactory and that the management must develop its pay schemes.
Recommendations
Based on the result of the survey, and from the secondary research materials that I consulted there are implications that Employee Retention is connected and related to Employee Recruitment and that the HRM department is highly responsible for employee retention.
1. Pay
2. Development and Career Opportunities
3. Work Environment
4. Performance Management
Performance appraisal is the process by which an employee’s contribution to the organization during a specified period of tine is assessed ( 2002). Performance appraisal is integral to the successful operation of most organizations. During this process, employees are evaluated formally and informally to determine the nature of their contributions to the organization. Appraisal occurs during time periods and in meetings that are scheduled to produce reasoned consideration of contributions, but it also occurs informally as employee contributions are observed, or when an evaluation is brought to the attention of others (1993).
5. Work-Family Balance (Flexible Working)
Appendix A
Survey Questionnaire
Objective: This questionnaire aims to determine the issues surrounding the retention of new graduate nurses. This is a short survey consisting of 10 questions to be distributed to the preoperative nurses in an attempt to determine what can be done to assist with the retention of new graduate nurses. The responses will be collated and considered within the development of strategic plan for retention of new graduates. This survey will not be limited to stag nurses but will also clinical leaders/charge nurses. The responses will be held confidential and will be used for the sole purpose of creating an overview of the group’s sentiments surrounding this topic.
Direction: Please read the questions and respond accordingly. Choose only one answer.
1. What do you think is the single most important factor that affects your performance and job satisfaction as a nurse in preoperative setting?
a. Good Leadership and Direction
b. Clear Policies and Procedures
c. Strong Mentoring and Presenting Program for new Nurses
d. Educational Opportunities
e. Good Communication that is Consistent
f. Staff Scheduling that is Fair and Equitable
g. others, please specify:______________________________
2. What strategies can Hospital X employ to encourage new graduate nurses to stay in the organization?
a. Develop the pay and incentive policy
b. Provide mentoring/preceptoring programs
c. Develop the performance appraisal system
d. Promote good communication
e. Provide learning and development opportunities
f. Provide flexible working arrangements
g. others, please specify:______________________________
3. What do you think are the reasons behind the shortage of preoperative nurses?
a. Demographic changes that lead to labor shortage
b. Nurses exploring other career opportunities
c. Nurses are not satisfied with pay and incentives
d. Nurses cannot handle stress and other demands of the job
e. Nurses attend to family duties and obligations
4. It is said that older operating room nurses put undue stress on younger and new nurses. To what extent do you believe that this statement is true?
a. Very True
b. Party True
c. False
Please explain your answer:
5. If you were given the responsibility for developing a recruitment program for hiring new graduates what aspect will you focus on that you think will attract new graduates?
a. Pay and Incentives
b. Mentoring and Presenting Programs
c. Good Communication in the workplace
d. Reasonable Scheduling Practices
e. others, please specify: __________________________
6. What do you think is the most important responsibility of the HRM department in encouraging employees to stay in the organization?
a. Clear Recruitment, Selection and Placement Policies and Practices
b. Effective Orientation of new nurses and Training and Development Programs
c. Effective Performance Appraisal System
d. Clear outline of expectations of both Employee and Employer
e. Effective Pay and Incentive Programs
f. others, please specify: ____________________________________
7. If someone at a social function asked you to describe the value you receive from working at Hospital X, what would be your response?
a. Educational and Career Opportunities
b. Exposure to an Academic Environment
c. Pay, Incentive and Health Benefits
8. Please describe the quality of communication that you experience with your managers/supervisors.
a. Very satisfactory
b. Satisfactory
c. Unsatisfactory
9. Please describe the quality of communication that you experience with other staff nurses.
a. Very satisfactory
b. Satisfactory
c. Unsatisfactory
10. If you were asked to consider becoming a manager at this hospital, what changes would you make to improve management?
a. Work with HRM department and develop and improve mentoring/presenting process
b. Develop training and development programs
c. Develop performance appraisal
d. Meet with the staff regularly
e. Communicate all organizational information
f. Demonstrate a willingness to listen to staff concerns
g. Develop a committee to work to improve the relationship between staff
h. others, please specify: ________________________
11. The work environment influences how you feel about your work, those who you work with and how you feel about yourself. Assume you were asked to suggest changes to improve the hospital’s work environment. What improvements would you suggest?
a. Work with HRM department to develop a work environment that is positive
b. Ask the staff for teams to create a supportive environment for learning
c. Work with HRM department and staff to develop mentors and preceptors for new staff
d. Provide remuneration for assisting with presenting and mentoring
e. others, please specify: ___________________________________
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