The purpose of the study was to explore the lived experiences of nurses on the implementation of occupational specific dispensation (OSD). Qualitative research using hermeneutic phenomenology was conducted in the three selected public hospitals in the Umgungundlovu district in KwaZulu-Natal (KZN). Data was collected by means of in-depth interviews with professional nurses, enrolled nurses and nursing assistants and focus group discussions with nurse managers purposively selected at the public hospitals in the Umgungundlovu district. Parse’s extraction synthesis analysis of data was done and seven (7) themes emerged from the participants’ dialogical conversation exploring the experiences of the implementation of OSD. The findings suggested that nurses viewed OSD as unfair labour practice because it divided nurses; there are those who grossly benefitted and those who benefitted less. The researcher concluded that the study will assist the authorities in the department of health both nationally and provincially to review OSD for nurses and close the gaps identified during the implementation as they were the pilot group. / Health Studies / M.A. (Health Studies)

Thesis (MBA)--University of Stellenbosch, 2011. / Healthcare systems of the world’s poorer nations have been heavily impacted by economic globalisation. This has resulted in a steady deterioration of working conditions, resulted in less job security and has led to an increase in the spread of communicable diseases in developing countries such as South Africa. It is factors such as these, against the backdrop of a global recession, that have contributed to the escalation in global healthcare costs which has itself augmented the strain on already strained hospital resources in developing economies (Issues paper: Economic Globalisation, 2009). The current workplace faces complicated challenges which extend beyond the effects of the global recession. One of these challenges is the task of managing the diversity of the modern day workforce. This includes differences in gender, race, religion, culture, language, physical and mental ability, sexual orientation as well as generational differences. As a result, organisations that choose to exploit these differences are able to leverage a competitive advantage from them. This ability is however determined by the flexibility of organisations’ policies and practices. Furthermore, adapting an organisation’s human resource policies and practices pertaining to attracting, retaining, developing, promoting and managing a generational diverse workforce is only possible once these cohorts have been clearly identified, analysed and understood (Manion, 2009). Nurses are the pillar of healthcare systems throughout the world. In South Africa, however, the high staff turnover of nurses compared to the relatively small number of new recruits is of great concern due to its impact on the South African government’s capacity to provide a healthcare model of sustainable service delivery (Mokoka, 2007). The reality of the decline in the number of newly qualified nurses was clearly evident in the results of this study. Twenty-eight percent of the current community service nurses had previously considered leaving the profession, eight percent reported that they were considering leaving the profession within the next year and 20 percent intended leaving the public health sector after completing community service. The purpose of this qualitative study was to determine factors that preclude better remuneration that would influence community service nurses’ decision to remain employed in the public health sector. According to the Western Cape Nursing directorate, 270 nurses were registered to complete community service in the Western Cape in 2010. The 25 registered nurses who were scheduled to complete community service at Groote Schuur Hospital at the end of 2010 constituted the study sample. A self-administered questionnaire was used as the instrument for data collection from this fixed, convenient sample. Confidentiality of the participants was assured throughout the study and findings were reported as combined facts and figures using histograms. The majority of the participants were between the age of 20 and 25 years (48%). Furthermore, 88 percent of the participants were below the age of 35 years, largely representative of Generation X and the Millennials, Generation Y. The results of this study suggested an extremely complex interplay between intrinsic and extrinsic motivators, in influencing the decision of whether or not to remain employed in the public health sector. It was further evident that most of the factors that were rated to be of high importance were strongly self-centred, largely geared at personal reward and recognition. This finding is in clear agreement with literature published by Manion (2009) who supports the thinking that generations representative of Generation X and Y have a strong need for personal achievement and reward. Eighty percent of participants indicated a dire need for hospital management to recognise and manage generational diversity in the current workforce as this presented a daily challenge in the workplace. It was perceived that fundamental differences in needs, work ethic and values exist between Generations X and Y, compared to those of nurse and hospital managers who were representative of Baby Boomers. Consequently, there appeared to be a mismatch in the expectations and opportunities presented in the current workplace among the three generations. These findings merit further discussion on whether the permanent multi-disciplinary team at hospitals understand the influential role that they have on the complex task of retaining community service nurses in the public health service. Furthermore, 92 percent of community service nurses highlighted the need for mandatory orientation and induction programmes in each ward prior to commencing duty. This in itself was identified as a huge cause for anxiety and discord. In conclusion, even though this study was designed to establish factors that preclude better remuneration which could influence the decision of community service nurses to remain employed in the public health sector, it found that more than half the participants of this study recommended that receiving a more competitive salary was still an important issue for government to prioritise. However, it did not appear to be the overshadowing theme of dissatisfaction amongst community service nurses.

The purpose of the study was to explore the lived experiences of nurses on the implementation of occupational specific dispensation (OSD). Qualitative research using hermeneutic phenomenology was conducted in the three selected public hospitals in the Umgungundlovu district in KwaZulu-Natal (KZN). Data was collected by means of in-depth interviews with professional nurses, enrolled nurses and nursing assistants and focus group discussions with nurse managers purposively selected at the public hospitals in the Umgungundlovu district. Parse’s extraction synthesis analysis of data was done and seven (7) themes emerged from the participants’ dialogical conversation exploring the experiences of the implementation of OSD. The findings suggested that nurses viewed OSD as unfair labour practice because it divided nurses; there are those who grossly benefitted and those who benefitted less. The researcher concluded that the study will assist the authorities in the department of health both nationally and provincially to review OSD for nurses and close the gaps identified during the implementation as they were the pilot group. / Health Studies / M. A. (Health Studies)

Thesis (MTech (Public Administration)--Cape Peninsula University of Technology, 2018. / Organisations spend large sums of money on staff after they have been recruited in order to make them proficient in their jobs. It is therefore important to ensure that staff remain with the organisation for as long as possible, allowing the organisation to reap the benefit from its investment in the form of good performance by staff. Work performance can however, be affected negatively when labour turnover is high. This research project reflects on staff turnover amongst professional nurses, posing the question, “What can be done to alleviate high staff turnover?” A quantitative approach to research was followed within a Western Cape Metropolitan Municipality. The significance of the research is reflected in the recommendations made to the management of the municipality to address staff turnover in the specified category of employees.

The United States is in the middle of a gripping nursing shortage; a shortage that is putting patients' lives in danger. This study determined the impact community and tribal colleges in severely economically distressed counties of the United States have on the nursing shortage faced by health care facilities serving these areas. The initial sample of 24 institutions selected in the Ford Foundation's Rural Community College Initiative (RCCI) (1995-2000). Data were collected from the Fall 1998 National Study of Post Secondary Faculty to obtain characteristics of faculty and from the 2003 Integrated Postsecondary Education Data System (IPEDS) to obtain characteristics of students, both at all publicly-controlled community colleges, all tribal colleges, and the 24 RCCI colleges that included 18 community and six tribal colleges. A survey was sent to the directors/deans/chairs of the nursing programs to ascertain issues related to the nursing program, nursing faculty, and nursing students. Respondents were asked to identify the healthcare facilities used for students' clinical experiences. A survey was then sent to each of these facilities asking about rural health, and source of nursing staff. Findings: 1) 87% of these these rural healthcare facilities are experiencing a significant shortage of nurses, and they are challenged to recruit and retain nursing staff; 2) Nursing programs, including both Licensed Practical Nursing and Associate's Degree Nursing are important to these rural community and tribal colleges, have seen growth over the past 5 years and expect to continue growth (86%); 3) Financial aid for nursing students is critically important; 4) Students are predominantly white and female; minorities are significantly under-represented; 5) Lack of subsidized public transportation and child care for nursing students even at tribal colleges are barriers that impact program completion; and 6) A shortage of nursing faculty exists at rural community and tribal colleges that negatively impacts student enrollment in these programs, thus reducing the rural nursing workforce pipeline. It is the rural community and tribal college nursing programs help provide severely economically distressed counties of the United States with the nursing workforce needed to decrease the nurse to patient ratio.

Indiana University-Purdue University Indianapolis (IUPUI) / National calls for a better-educated nursing workforce are proliferating. The Institute of Medicine (IOM) challenged the nursing profession by setting the goal of having 80% of the nation's nurses prepared at the baccalaureate level (BSN) or higher by 2020. This is an ambitious goal given that, nationally, only 50% of nurses have a BSN. In fact, only 40% of nurses in Michigan have a BSN, and in the rural North-Central Region of this state, only 29% (the lowest in the state) of the nurses have a BSN. The purpose of this hermeneutic phenomenological study was to understand and interpret the meaning of being an associate degree (AD) nurse, the meaning attaining a BSN has for rural registered nurses who currently have an AD, and the barriers they experience that inform their decisions to return to school (or not). The investigator interviewed 11 AD nurses from rural North-Central Michigan and analyzed interview transcripts to identify common experiences and shared meanings using methods identified by Diekelmann, Allen, and Tanner (1989). Two themes were explicated in this study: "Getting in and Getting out" and "What Difference Does it Make?" The findings in this study challenge many of the common assumptions about academic progression in nursing and provide educators, administrators, and legislators with insight about the strategies that may be most helpful for achieving the IOM goal in rural Michigan.

Professional nurses comprise the largest number of health care professionals in South Africa. High turnover rates contribute to shortages of nurses in South Africa, aggravated by the emigration of nurses, inadequate recruitment of student nurses, and the expected retirement of many baby boomer nurses by 2016. This study addressed factors influencing the retention of professional nurses in the Gauteng Province of South Africa. In phase 1, postal questionnaires were completed by 101 registered nurses while semi-structured interviews were conducted with 21 nurse managers in phase 2. Personal, organisational and managerial factors influenced the retention potential of the professional nurses. In terms of Maslow' Hierarchy of Needs Theory, most factors influencing nurses' retention operated on the lowest (physiological) level and concerned remuneration. Safety needs were compromised by the lack of equipment and supplies, the shortage of nurses and unsafe working places. Esteem needs included respect from doctors, managers and colleagues as well as recognition for outstanding performance. In terms of Vogt et al's Theory of Nurse Retention Theory, the constrictions caused by inadequate remuneration and safety aspects should be addressed. Lewin's Force-Field Analysis Theory recommends that the factors that influence nurses' retention negatively should be unfrozen, changed and refrozen, including communication. Based on these results guidelines were compiled for enhancing the retention rates of professional nurses (Annexure G). / Health Studies / D.Litt. et Phil. (Health Studies)

Nurses constitute the largest professional group in South Africa's health care services. Factors contributing to South African nurses' emigration were studied qualitatively by analysing expatriate nurses' responses to open-ended questions, and quantitatively by analysing newly registered nurses' responses to structured questionnaires. These results were contextualised within Maslow's Hierarchy of Needs Theory, revealing that nurses' inability to meet their physiological needs, due to inadequate remuneration, was the major factor contributing to nurses' emigration potential. While improved salaries might enable more nurses to remain in South Africa, expatriate nurses would not return to South Africa unless certain esteem and self-actualisation needs could also be satisfied. Improving nurses' salaries is essential to address South African nurses' emigration potential. However, improved working conditions, enhanced workplace security, improved levels of job satisfaction and the appointment of nurses into currently frozen posts are also necessary, as is governmental and public recognition of the value of the profession. The South African nursing profession, health care services, Government and society should urgently address factors contributing to South African nurses' emigration potential; otherwise a serious shortage of nurses could cause the collapse of this country's health care services. / Health Studies / DLITT ET PHIL (HEALTH ST)

The National Health Act aims to protect the health care users and workers by ensuring that their work environments are protected against injuries. Practice environment is described as a physical, social and psychological characteristic of a work setting in which policies, procedures and systems are designed so that employees can meet the organisational objectives and achieve personal satisfaction in their work environment. The aim of the study was to describe and analyze characteristics of the practice environment of nurses. A quantitative descriptive study was conducted in a public hospital in Gauteng Province. Practice Environment Scale-Nursing Working Index (PES-NWI) questionnaires were distributed to 207 nurses who were proportionately stratified. Data was analysed using the SPSS version 25. Findings identified gaps of the current characteristics of the practice environment and developed strategies that will assist managers to enhance practice environment. There was alignment and correlation between the means, standard deviation and the frequencies which were drawn from the findings. The overall Cronbach’s alpha was 89% which confirmed the internal consistency of the instrument. The majority of the variables demonstrated statistical significance which had a p value of 0.001. In conclusion, practice environment affects all health care professionals although the study only analyzed the practice environment of nurses. / Health Studies / M. P. H.

Professional nurses comprise the largest number of health care professionals in South Africa. High turnover rates contribute to shortages of nurses in South Africa, aggravated by the emigration of nurses, inadequate recruitment of student nurses, and the expected retirement of many baby boomer nurses by 2016. This study addressed factors influencing the retention of professional nurses in the Gauteng Province of South Africa. In phase 1, postal questionnaires were completed by 101 registered nurses while semi-structured interviews were conducted with 21 nurse managers in phase 2. Personal, organisational and managerial factors influenced the retention potential of the professional nurses. In terms of Maslow' Hierarchy of Needs Theory, most factors influencing nurses' retention operated on the lowest (physiological) level and concerned remuneration. Safety needs were compromised by the lack of equipment and supplies, the shortage of nurses and unsafe working places. Esteem needs included respect from doctors, managers and colleagues as well as recognition for outstanding performance. In terms of Vogt et al's Theory of Nurse Retention Theory, the constrictions caused by inadequate remuneration and safety aspects should be addressed. Lewin's Force-Field Analysis Theory recommends that the factors that influence nurses' retention negatively should be unfrozen, changed and refrozen, including communication. Based on these results guidelines were compiled for enhancing the retention rates of professional nurses (Annexure G). / Health Studies / D.Litt. et Phil. (Health Studies)