Nurse Retention: A Case Study

Thesis: Nurse Turnover is a challenge for both hospital administration and the quality of the health care service which is being provided. As a result, it is necessary to implement strategies which increase nurse retention in health care settings.

That situation affected the organization to the insufficient of excellent nurses available to care for patients and have an effect on those who continued working in a troubling work environment. Granstra (2015) researched that “Bullying results in increased turnover when nurses choose to leave the organization instead of remaining in a workplace where they are unhappy” (p.

Incivility Workplace incivility affects our everyday interactions, professional nursing relationships and our organizations. It is important to be aware of incivility to address it. Incivility in the workplace doesn’t have to be a major event, but it may be little things daily that can make a huge impact. This affects the employee which impacts productivity and patient care. Employee turnover rates, job dissatisfaction, and poor workplace environments can be attributed to incivility.

The first step in Kotter’s change process is establishing the sense of urgency (Gaudine & Lamb,2015). In this stage, a leader informs the group or employees about the need for the change in an organization. To address the issue of workplace bullying, a transformational leader should be able to envision the effect of bullying in the workplace. The nurse leader should identify the current work environment, the relationship among the employees, and should communicate the existing issues and the negative consequence of workplace bullying (Mbamalu & Whiteman, 2014). The nurse leaders can spread awareness about the consequences of the bullying by providing the research evidence (Small, et al., 2016).

What is a solution for nurse burnout? Nowadays a great of organizations are finding that the engagement and commitment of nurses coincide with good quality patient care. When nurses are better engaged and committed you’ll find that you’ll notice that they work harder and perform better in their job. You may also find less absenteeism and less turnover.

According to the data from Health Resources and Services Administration Bureau of Health Professions (2013), there were 2.8 million Registered Nurses (RNs) and 690,000 Licensed Practice Nurses (LPNs) were working in the period from 2008-2010, in the United States. The nursing workforce grew substantially in 2000s, by RNs growing by more than 24.1 percent and LPNs by more than 15.5 percent. The population of nurses are facing multiple challenges at the workplace, such as shortage in staffing, nurse turnover, increased workload, long working hours, poor relationship with co-workers, lack of support from the management, and eventually these challenges create high level of nurse burnout. It is estimated that job- related burnout measure using the Maslach Burnout inventory – Human Services Survey, 36.5 % of nurses having high level of burnout. The researchers at the Center for Health Outcomes and Policy Research at the University Of Pennsylvania School Of Nursing, estimates if nurse burnout reduces by 10 %, could prevent thousands of hospital acquired infections and reduce the health care expense (Potera, 2012).

The display of lateral violence in nursing is an issue that is hurting the profession as a whole. Lateral violence is an unprofessional display of behavior from one nurse to another that is meant to intimidate. According to Tina Dimarino “researchers have found that the most common forms of lateral violence in nursing include nonverbal innuendo, verbal insults, gossiping, undermining, withholding information, sabotage, infighting, scapegoating, backstabbing, failure to respect privacy, and broken confidences.” This type of behavior is also termed horizontal violence, nurse to nurse, incivility or bullying (Dimarino, 2011).

Information regarding the reports such as research limitations, level of evidence, research method and design are included in the discussion and implications of nursing. The literature review found that nurse on nurse bullying does indeed effect nurses in a physical and emotional way as well as effecting the adequacy of patient care. Effects of Horizontal Violence in the Workplace on Nurses and Patient Care Introduction Nurses spend approximately 12 hours a day 3-4 times a week working in either a hospital, clinic, or some sort

Conflicts within the nursing profession may be seen among the different age generations, with senior nurses holding different values than new graduates. For example, there are many cases where horizontal violence and bullying occurs between senior nurses and new nurses. However, in most cases, nurse bullying results from ineffective communication (Sauer, 2012). Interprofessional conflict may occur due to the medical hierarchy and existing profession stereotypes. According to Whitehead (2007), a barrier to physician collaboration is the vision of a ‘flattened hierarchy’ where a physician’s traditional power, decision-making responsibility, and status is reduced.

Violence against healthcare providers is a significant problem that has been receiving growing attention. Incidents of workplace violence are experienced by nurses and physicians on a day-to-day basis, especially in emergency departments. The corollary of this phenomenon has become a significant matter due to the psychological stress it is placing on healthcare providers, hence affecting their efficiency and productivity. We may often undermine the consequences of workplace violence, but studies show that it may cause distress, apathy, rage, disappointment, helplessness, anxiety, self-doubt, and insecurity of healthcare workers. (Öztunç 360-365)Hence, their entire job performance is decreased and absenteeism is increased.

Whether another nurse or higher medical provider it isn’t right and is a major concern in healthcare. ANA recognizes that incivility, bullying, and violence in the workplace are serious issues in nursing. Currently, there is no federal standard that requires workplace violence protections, but several states have enacted legislation

There are different types of violence that an individual may encounter at some point in their lives due to conflicting values, experiences and knowledge. In a clinical health care setting, newly registered nurses may encounter horizontal violence, while nursing students may experience vertical violence. The term horizontal is used to illustrate violence between two individuals who are either of the same or unequal status, while the term vertical is used specifically to nursing students (Thomas & Burk, 2009). In my opinion, many nursing students, such as myself, we are unaware of these terms because they are not frequently addressed. However, it is certain that it happened, and it will continue to occur if there is no appropriate action is taken to prevent this violence.

Martin et al. (2006) in their study noted that some personal factors that reduced confidence in clinicians were due to inexperience with physical restraint, and a lack of knowledge of aggression. Nurses require good assessment skill to manage or prevent aggression and this skill can be acquired by having hands on training by experienced specialist. The nurse has to be aware of the triggers of aggression and moreover be able to recognise early signs of aggression. Of equal importance, developing a better understanding of the causes of aggression might lead to more effective treatment and preventive strategies (Shub, Ball, Abbas, Gottumukkala & Kunik, 2010).

Due to the absence of a standard definition for nurse turnover within most studies, the descriptions for nursing turnover vary. According to O’Brien-Pallas et al. (2006), “the most frequently used definition of turnover in a literature review was the process whereby nursing staff leave or transfer within the hospital environment” (page number goes here for direct quote). However, there are several types of nurse turnover found in the literature Professional turnover is not the same as organizational turnover. Professional turnover is when nurses do not renew licenses, do not work, or find another job outside of the medical field (One in five, 2014). Sometimes an employee will simply stay at the same hospital but will transfer to a different

Low job satisfaction can result to intention to leave, burnout, and other losses such as early transfer or retirement (Duffield, Roche, Blay, & Stasa, 2010). Various managers should focus on making the working environment for nurses better so as to avoid high turnover because the loss of employees is costly. I believe nursing leadership is another crucial