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The observed high turnover of nursing staff in some public hospitals in Luanda was assumed to give rise to staff shortages, resulting in work overload for the remaining nurses and poor service delivery. The aim of this study was to determine the reasons for the high turnover of nurses in public hospitals in the city of Luanda, and to determine the actual turnover over a two-year period. The researcher adopted a quantitative approach with an exploratory and descriptive design, using a questionnaire for data collection from a sample of 100 respondents consisting of the Directors of Nursing, Directors of Human Resources and Heads of Departments (ward/units) in seven public hospitals. The study found that the most common reasons for the resignation of nurses were retirement, ill health, and better remuneration and working conditions elsewhere. Lack of motivation could be ascribed to the perceived low remuneration, insufficient supplies and equipment, being overworked due to staff shortages, unsafe working environment and poor conditions of service. Recommendations were made to tackle these issues. It was however not possible to determine the actual extent of nurses resigning from the public hospitals. / Health Studies / M.A. (Health Studies)

Job redesign could significantly impact the efficiency was obtained. This survey was comprised of nineteen scales with of the organization. The purpose of this descriptive, comparative study was to describe and compare job characteristics, general job satisfaction, and motivation potential of the job in order to diagnose the job profile of registered nurses, licensed practical nurses, and nursing assistants.The convenience sample consisted of all staff nurses, licensed practical nurses, and nursing assistants working at a 515 bed Department of Veterans Affairs Medical Center in the midwest who voluntarily agreed to complete the Job Diagnostic Survey. A response rate of 36.8% (n = 118) to measure the degree of job characteristics, motivating potential of the job, psychological states, growth need strength, general job satisfaction, and satisfaction context factors present in the current job.Mean scores were computed to measure each variable. All means for each job category were found to be over the midpoint (3.5). Growth need strength was significantly lower than the normative data for RN's and LPN's. Task identity and experienced responsibility for work outcomes were significantly lower than the norm for LPN's assigned to the acute medical area. Motivating potential was significantly lower for nursing assistants assigned to the acute medical and the long term psychiatric area.Adjusting staff assignments to encourage continuity and observation of patient outcomes, and providing direct feedback regarding performance to staff members from nurse managers were implications. Implications include combining tasks to provide a more identifiable job and enable the worker to visualize patient outcomes to a greater degree. Recommendations included further research utilizing the JDS, including comparison of various types of nurse jobs. Statistical analysis in future studies should include comparisons of these different groups. / School of Nursing

The purpose of this study was to determine the extent to which Neonatal Intensive Care Unit (NICU) nurses participate in ethical decision making, and to describe the role NICU nurses have in the ethical decision making process.This study replicated a 1991 study conducted by Elizondo. According to Lowe, 1991, replication research is the repeating of a study for the purposes of validating the findings of the original investigation. The traditional theory of utilitarianism provides the theoretical framework for this study, a goal-based approach to ethical decison making that focuses on consequences of actions. Findings provide information about satisfaction and conflicts related to nurse participation in ethical deecision making in the NICU.The Nurse Participation in Ethical Decision Making (NPEDM) questionnaire (Elizondo, 1991) was used for data collection. Of fifty NICU nurses, seventeen (34%) of the sample completed the questionnaire. Confidentiality was maintained. Results showed that all respondents were able to identify methods that are used for participation in ethical decision making. Informal conversations with physicians was identified as the primary method of participation. Forty-one percent of respondents were satisfied with the nurse's role in ethical decision making. Forty-seven percent were only somewhat satisfied.An indication of satisfaction demonstrated by 100% of the study sample was that nurses' ideas are respected by other health care professionals.Findings indicated that a significant positive relationship exists between role satisfaction and study variables. Eighty-eight percent of respondents stated that conflicts related to participation were experienced. Overwhelmingly, respondents felt that the primary source of conflicts were with physicians. These findings are consistent with results reported in the original study.When asked what factors impact on how decisions are made, 40% of respondents indicated that ethical decisions are often impacted by generalized decisions based on viability of the neonate as determined by the gestational age, and "quality of life."Seventy-six percent of respondents believed nurses should be more involved in the ethical decision making. Conferences with physicians and parents was identified by 69% of the study sample. This study found that the older the nurse, the more satisfied with role in the ethical decison making process. Length of employment also contributed positively to satisfaction in ethical decision making. The more educated the nurse, the more satisfied with role in the ethical decision making process. Nurses were less satisfied if conflicts were experienced or identified.Findings suggest that collaborative relationships exist between nurses and other health team members and that nurses feel some sense of fulfillment with their role in the ethical decision making process. It was concluded that many issues were unsolved and need to be discussed. / School of Nursing

The literature is replete with studies and information about registered nurse burnout, compassion fatigue, and turnover rates. Registered nurses enhance and bring benefits to the health care system, but stressful health care environments may contribute to their self-neglect and may adversely affect their decision to remain working at the bedside. Retention of registered nurses is necessary for the delivery of patient care. An investigation of self-compassion among registered nurses in the clinical workplace may help to understand how registered nurses deal with the pressures of the health care setting. In addition, there is a need for research to clarify what self-compassion looks like among nurses and how it may foster caring for themselves, nurse retention, and the delivery of quality patient care. This qualitative study used a phenomenological method designed to illuminate registered nurses’ experiences of self-compassion in clinical practice. Also, findings from this study will contribute to the body of knowledge of self-compassion in the context of registered nurses. Van Manen’s phenomenological research method of the six activities were used to guide the study. Nine registered nurses were interviewed about their experiences of being kind and compassionate toward oneself in the clinical work setting. Transcripts of the study participants’ interviews were analyzed and four essential themes emerged that shed light on these nurses’ experiences of self-compassion: (1) Transforming Time Famine; (2) Authentic Communication and Presence, (3) Collegial Cohesion, and (4) Evolution Toward an Ideal Registered Nurse. Most of the participants in this study shared stressful situations in the clinical workplace along with encouraging learning points through their stories of being kind to themselves in the workplace while caring for others.

published_or_final_version / Public Health / Master / Master of Public Health

South African nurses are emigrating for greater prospects abroad – a weakening of the healthcare system. Nurses play a critical role in health care globally as well as in South Africa. Work engagement or lack thereof may be the reason why so many nurses decide to emigrate. This study aimed to get a better understanding of whether nurses working more specifically with mentally and physically challenged ‘children’ experience work engagement. The focus will be on the resources and demands that nurse’s face in their work environment and whether these contribute to feelings of work engagement. A qualitative research design was used to collect data in this study. The study took the form of a cross sectional survey design with a sample of 8 nurses from a home for physically and mentally challenged individual’s in the Durban, KwaZulu-Natal region. The data was collected with the use of a biographical questionnaire and an interview schedule. The resulting data was analysed using thematic content analysis with the aid of NVIVO 9. The study found that the nurse’s do experience work engagement despite the circumstances they are exposed to. The study also found the resources the nurses were presented with aided in them experiencing work engagement. A love for their job contributed to feelings of work engagement. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2012.

BACKGROUND : Many professional nurses have left the employment to work in developed countries. Quality patient care is declining because the few PNs that are rendering care have limited expertise. Literature review showed that nurse managers have a role to play in retention of staff. PURPOSE : The study aims to analyze the leadership styles and organizational factors toward the retention of professional nurses working in public health facilities. POPULATION : Professional nurses in four public hospitals, four union managers, twelve professional nurses working abroad and representative from SANe. A total of 188 participated in the study which formed part of the 70% of the sample. DESIGN : A Case study design which included both quantitative and qualitative approaches. Observations in the wards and document analysis were done guided by a case protocol. INSTRUMENTS : Revised Nursing Work Index and Revised Conditions of work effectiveness was administered among the professional nurse and chief professional nurses. Chief nursing service managers and union managers were interviewed using interview guides. Focus groups among professional nurses who had overseas experiences were conducted. Reliability was maintained by having a Cronbachs alpha of above 0.70 in all variables except leadership. RESULTS : Cases presented differently in all aspects, except Case C who was consistent in all the variables. The professional nurses in Case C viewed their CNSM as being visible and accessible. Case A and B were similar in terms of the organizational factors. All CNSM verbalized that they were willing to send PNs for educational programmes but the DOH policy was allowing nurses to work anywhere in the province. PNs had little access to resources on time to do tasks and paperwork as compared to access to support and opportunity.CONCLUSION : PNs are willing to stay in their organizations provided they will be given educational and promotional opportunities. There was a relationship between organizational factors and retention. Leadership factors showed a weak negative relationship with other variables. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2009.

Stress among nurses is still perceived as a challenge experienced by the nursing profession. Several studies have shown the negative impact of stress on both nurses and patients. However, little is known about the factors influencing stress among nurses in Rwanda. Aim: The overall aim of the study was to explore the factors contributing to nurses’ stress and related coping strategies used by nurses in the University Teaching Hospital of Butare (UTHB), Rwanda. Methods: The researcher used a non-experimental, descriptive study to explore the factors contributing to nurses’ stress and related coping strategies used by nurses in the University Teaching Hospital of Butare, Rwanda. This study was informed by a stress and coping theoretical framework. A questionnaire was used to collect the demographic characteristics of participants, while nurses’ stressors were assessed using the questionnaire of nurse’s stressors previously developed by Bianchi. The ways of coping were evaluated using the ways of coping elaborated by Folkman & Lazarus. A convenient sampling of 85 registered nurses, working at UTHB, participated in this study. Permission to conduct the study was requested and obtained from the University of KwaZulu-Natal Ethics Committee, the Kigali Health Institute -Institutional Review Board and the management of UTHB. The data was analysed using the Statistical Package for Social Sciences (SPSS), version 15, and was summarized using descriptive statistics. The results were presented in tables and graphs. Results: The findings of the study revealed that registered nurses at UTHB face a variety of stressors such as shortages of staff and materials, facing death and dying, dissatisfaction with the work environment, work overload and time spent on bureaucratic activities. It was shown that consequences of stress vis-à-vis registered nurses could be low quality of care, job dissatisfaction and burnout syndrome. Among the major strategies of coping with stress, registered nurses have indicated problem solving, social support and accepting responsibility. This study indicates that stress can be prevented and managed by using vi nursing strategies such as team work, effective communication improving work conditions and fostering the managerial nursing strategies in working unit. Conclusion: Drawing from these findings, it can be inferred that nurses’ stressors need to be addressed in order to create a working environment conducive to high quality of care and also to enhance nursing staff morale, satisfaction, motivation and retention. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

America's health care industry is in a state of crisis. Nursing administrators are in the position to facilitate change in institutions. One aspect of nursing which has remained constant is high turnover rates. The high turnover rates have been linked to job dissatisfaction. One method of reducing turnover is to provide greater job satisfaction to staff nurses. Job satisfaction has been connected with management style (Lucas, 1991; Price & Mueller, 1981; Volk & Lucas, 1991).This study described the impact of head nurse management style on staff nurse job satisfaction. Likert's (1967) System 4 management theory was utilized as the framework in the study. All staff nurses and head nurses from three Central Indiana hospitals were given the opportunity to participate in the study. Participants completed two questionnaires, one from Price and Mueller's (1981) work on turnover to determine job satisfaction and one from Likert and Likert's (1976) work to determine management style.Data analysis was conducted to describe any variations between staff nurse experience of head nurse management style and staff nurse job satisfaction. Differences between head nurse and staff nurse description of management style were also examined. There were no identified risks as participation was voluntary and did not affect the employment status of any individual.Results of the study demonstrated agreement with previous research findings. When management style is closer to participative (system 4), greater job satisfaction is expressed. Recommendations are to provide management training and training in communication and self-awareness for head nurses, and to form unit based committees designed to achieve greater staff input in decisions affecting the unit functioning.Benefits of the study include identification of the management style which leads to improved staff nurse job satisfaction. Equipping nurse administrators with information regarding desirable management style to employ for staff nurses to experience greater job satisfaction, and training present managers in that management style are also possible benefits from the study. / School of Nursing