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• 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

Personal Growth or Goal Orientation

Dimensions• 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”

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”

50-5926.1%

40-4943.8%

20-2910.3%

30-3915.8%

AGE CATEGORIESN=272

GENDERN=272

Hospital I, 2002

Male4.4%

Female95.6%

³603.7%

Other &Missing4.8%

American Indian/Alaskan Native

0.4%

Hispanic4.4%

Caucasian43.4%

Filipino24.3%

Asian - Non Filipino20.6%

African American2.2%

ETHNICITYN=272

Hospital I, 2002

Doctorate0.4%

Other Masters1.9%

MSN0.8%

Other Baccalaureate8.0%

BSN54.2%

Other Associate Degree1.5%

Associate Degree in Nursing23.9%

Diploma9.5%

HIGHEST DEGREE COMPLETEDN= 272

21 Years and Above35.6%

16-20 Years18.1%

11-15 Years12.6%

6-10 Years13.0%

4-5 Years7.4%

2-3 Years6.6%

Less Than 2 Years6.7%

SENIORITYN= 272

Hospital I, 2002

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

The End