Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: In view of the escalating shortage of nurses, attention is focused on the emerging workforce and efforts to retain new nurse graduates. The aim of this study was to investigate possible factors that could influence the retention of new nurse graduates currently employed within the public sector in the Cape Winelands District of the Western Cape. The objectives of the study were to determine whether the retention of new nurse graduates is influenced by: • the mentoring programme • leadership in the workplace • workload pressure and stress • complexity of care • staff shortages A quantitative approach with a descriptive design was applied. The total population (N=73) consisted of all new nurse graduates who had registered with the South African Nursing Council within the last three years, and who were employed at one of the 6 provincial hospitals included in the study. Since the total population was relatively small, no specific sampling method was employed but the whole population served as the sample. A self-administered questionnaire was used for data collection. Ethical approval to conduct the study was obtained from the Health Research Ethical Committee at Stellenbosch University. Permission to conduct the study at the specific hospitals was obtained from the provincial government of the Western Cape. Informed consent was obtained from all the respondents. A pilot test was completed, prior to the initiation of the main study, during which the questionnaire was issued to n=7 respondents who were not part of the total population utilized in the actual study. Data was presented in the form of tables, histograms and frequencies. The results revealed diminished implementation of mentoring and orientation programmes for new graduates. Most respondents, however, indicated that they had received appropriate day to day guidance in the workplace. Unit managers had provided guidance relating to the development of leadership, problem-solving and conflict management skills. The new graduate nurses had not been sufficiently exposed to managerial duties such as supervising the budget and scheduling of off-duties. Most respondents reported that they had experienced work-related stress due to work overload associated with shortage of staff. Furthermore, respondents reported that they would be likely to resign due to issues that relate to complexities in patient care; for example, limited numbers of trained staff in specialization units, too little support and direction and the presence of low levels of motivation and burnout among staff. Recommendations: • Mentoring and orientation programmes for new nurse graduates should be reviewed or initiated. • New nurse graduates should be exposed to all leadership activities. • Staffing management issues should be reviewed to address issues such as work overload, burnout and unrealistic nurse-patient ratios. • Managers should focus on the strengths of new nurse graduates and structure a workforce that will support the new graduate with professional duties in order to reduce complexities of care. In conclusion, implementation of the transformational leadership approach and Herzberg’s Two-Factor Theory are proposed to ensure motivation, productivity and job satisfaction, which will ultimately improve the retention of new nurse graduates in the public sector. / AFRIKAANSE OPSOMMING: In die lig van die toenemende tekort aan verpleegsters, word die aandag gevestig op die ontluikende werksmag en pogings om nuutgegradueerde verpleegsters te behou. Die doel van die studie was om moontlike faktore te ondersoek wat die behoud van nuutgegradueerde verpleegsters wat tans in die diens van die openbare sektor in die Kaapse Wynland-distrik van die Wes-Kaap staan, te ondersoek. Die doelwitte van hierdie studie was om vas te stel of die behoud van nuutgegradueerde verpleegsters beïnvloed word deur • die mentorprogram • leierskap binne die werksplek • werksdruk en stres • die kompleksiteit van pasiëntsorg • personeeltekorte. ’n Kwantitatiewe benadering met ’n beskrywende ontwerp was toegepas. Die totale teikengroep (N=73) het bestaan uit alle nuutgegradueerde verpleegsters wat by die Suid- Afrikaanse Raad van Verpleging binne die afgelope drie jaar geregistreer is en wat in diens was by een van die ses provinsiale hospitale wat in hierdie studie ingesluit is. Aangesien die totale teikengroep relatief klein is, is geen spesifieke steekproefmetode toegepas nie, maar die hele teikengroep het as steekproef gedien. ’n Selfgeadministreerde vraelys was vir data-insameling gebruik. Etiese goedkeuring om die navorsing te doen is van die Gesondheidsnavorsing se Etiese Komitee aan die Universiteit van Stellenbosch verkry. Toestemming om die studie by die spesifieke hospitale te doen, is van die Provinsiale Regering van die Wes-Kaap verkry. Ingeligte toestemming is van al die deelnemers verkry. ’n Loodsstudie is voor die aanvang van die hoofstudie voltooi waartydens die vraelys uitgereik is aan n=7 deelnemers wat nie deelgevorm het van die totale teikengroep wat in die eintlike studie gebruik is nie. Data is aangebied in die vorm van tabelle, histogramme en frekwensies. Die resultate het verminderde implementering van mentorskap en oriënteringsprogramme vir nuutgegradueerdes getoon. Die meeste deelnemers het nietemin saamgestem dat hulle gepaste leiding daagliks binne die werksplek ontvang. Eenheidsbestuurders het leiding verskaf wat te make het met die ontwikkeling van leierskap, probleemoplossing en konflikbestuursvaardighede. Die nuutgegradueerde verpleegsters was nie genoegsaam blootgestel aan bestuurspligte soos die begroting en skedulering van afdienste/diensroosters nie. Die meeste deelnemers het rapporteer dat hulle werksverwante stres ervaar weens werksoorlading wat met personeeltekorte geassosieer word. Voorts het deelnemers rapporteer dat hulle sal bedank as gevolg van aangeleenthede wat met kompleksiteit van siekeversorging verband hou.Dit is,beperkte hoeveelhede van opgeleide personeel veral in gespesialiseerde eenhede, te min ondersteuning en leiding, asook die aanwesigheid van uitputting en lae vlakke van motivering onder personeel. Aanbevelings: • Mentorskap en oriënteringsprogramme vir nuutgegradueerdes moet hersien of ingestel word. • Nuutgegradueerde verpleegsters moet blootgestel word aan alle leierskap aktiwiteite. • Personeelbestuur kwessies moet hersien word om die faktore soos werksoorlading, ooreising en onrealistiese verpleeg-pasiënt ratio’s te adresseer. • Bestuurders moet fokus op die sterk punte van nuutgegradueerdes en ’n werksmag struktureer wat die nuutgegradueerdes met professionele pligte sal ondersteun ten einde die kompleksiteit van siekeversorging te verminder. Ten slotte, die transformasie leierskap benadering en Herzberg se Twee-Faktor Teorie word voorgestel om motivering, produktiwiteit en werksbevrediging wat uiteindelik die behoud van nuutgegradueerdes binne die openbare sektor sal verbeter, te verseker.

Philosophiae Doctor - PhD / Curriculum review can ensure that nurses develop appropriate competencies to respond to market demand. Regular revision and updating of curricula are in line with recommendations of the WHO to scale-up health professionals' education and training. Introducing transformative changes in education provides an opportunity to review the strengths and weaknesses of the current systems. The nursing profession was the first of the health professions in South Africa to transform its legislative framework, which led to the development of new qualifications.

<p><strong>Background.</strong> The nursing profession has a long tradition of migration. The migration of nurses from Canada has received little attention.</p> <p><strong>Objective.</strong> The purpose of this sandwich thesis was to understand the migration intentions of nurse graduates in a Canadian border city, their intention to become commuter migrants, and to explore the factors influencing these intentions.</p> <p><strong>Methods.</strong> Two qualitative studies of the migration literature included an analysis of the concept of migration and an integrative review of case study methodology in the study of nurse migration. A mixed methods study, guided by the Value-Expectancy framework, explored the migration intentions of nurse graduates in a Canadian border city and the factors influencing these intentions.</p> <p><strong>Results.</strong> The concept of nurse migration was found to be multifaceted. Its attributes, antecedents and consequences were defined. The mixed methods study provided insights into the migration intentions of recently graduated Canadian nurses. The majority preferred to work in Canada, but because of a perceived absence of valued jobs factors, were willing to migrate. Two thirds considered migrating and sixteen percent were interested in becoming commuter migrants. The findings supported the hypothesis that nurses weigh employment values (goals) against the expectation of achieving them, thus influencing intentions to migrate or stay.</p> <p><strong>Conclusion.</strong> The value-expectancy framework offered a novel approach for identifying the job factors that were driving migration intentions. There is a need for more primary research employing different methodologies to explore the characteristics, causes, and consequences of nurse migration that were identified through this research.</p> / Doctor of Philosophy (PhD)