Relationship Dimensions

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NURS 236A Nursing ShortageInterview Dr. Jayne
Cohen, Director, School of Nursing, SJSU
Phyllis M. Connolly, Ph.D., APRN, BC,
CS Interviewer
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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

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Factors Influence Retention

• Job satisfaction
• Supervisor Support
• Work Environment
• Personal Factors

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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

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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

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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

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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

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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

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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)

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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

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Retention Strategies

• Improve supervisor support
• Clarify expectations
• Reduce organizational control
• Reduce work and time pressure

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The End