For almost fifteen years, South Africa has been a target for developed countries' active recruitment of nurses and other healthcare professionals to their healthcare systems. South Africa is now a leading source of nurses for the UK, the USA, Canada, Australia, and New Zealand. This study investigates the underlying factors behind nurse emigration from South Africa by examining the differences in the economic job factors between South Africa and the UK, the US, and Australia, the three countries where the highest percentage of South African nurses are emigrating to. The economic factors investigated include wages, salary advancement for experience and length of service, hours worked, and employment-based benefits such as pension benefits, medical aid/health insurance benefits, and paid leave. Although not a focus of the empirical work, other job factors, such as poor working conditions in South African hospitals, as well as broader societal factors influencing nurse emigration, are discussed. The study was motivated by the fact that although the underlying factors that are causing South African nurses to leave for greener pastures have been identified, there exists limited empirical literature on the shortcomings of working conditions. As emigration of nurses are driven by forces present in both sending and receiving countries, a cross-country comparison of these factors leads to a greater understanding of nurse emigration from South Africa. In turn, a greater understanding can lead to effective policies improving the working conditions for South African nurses and thus improving retention. By using comparative secondary data from 2006, the findings reveal that the main difference in economic job factors lie in wages, both average wages and the possibility for salary advancement over the lifetime, and working hours. The differences in access to employment-based benefits were less significant, as benefits in South Africa tend to be high among nurses as in the comparison countries. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

published_or_final_version / Community Medicine / Master / Master of Public Health

South African nursing profession is in a crisis as professional nurses leave the country in search of lucrative work overseas. This exodus will have a catastrophic effect on the delivery of health care over the next decade. It is also clear that the shortages of staff due to the turnover problems in hospitals are also creating various other problems such as enormous pressure on existing employees, job stress and job dissatisfaction. Financial constraints to compete with international competitors, exchange rates, tax-free foreign money, the existence of many job opportunities overseas and the tendency that a person’s career is enriched with overseas experience, makes the retention of professional nurses almost uncontrollable for nursing employers in South Africa. The question was therefore asked whether employers should not rather focus their retention strategies on things they can control internally to retain their employees. An alternative approach, to build strategies around the needs and work circumstances of professional nurses, was therefore proposed. The focus of this study was to develop a predictive model with organisational culture and the selected mediating variables, namely knowledge sharing, organisational commitment, organisational citizenship and job satisfaction, as well as various demographic variables (sub-cultures, tenure, age, level of education, gender, race, home language, level of seniority, marital status, number of dependents) of turnover intentions. A General Linear Model approach was adopted to answer the research question. The relationship between organisational culture and turnover intentions was determined, followed by the independent and/or interdependent role of the demographic variables in predicting firstly, organisational culture and secondly, turnover intentions on a bivariate and a multivariate level. Thereafter, the objective was to determine the independent and/or interactive role of the independent variable (organisational culture) and the selected mediating variables (knowledge sharing, organisational commitment, organisational citizenship behaviour, job satisfaction) in explaining turnover intentions. The next objective was to determine whether knowledge sharing, organisational commitment, organisational citizenship behaviour and job satisfaction mediates the relationship between organisational culture and turnover intentions. The final objective was to determine a most parsimonious model by entering all demographic variables, the independent variable and the mediating variables simultaneously into an equation to determine which variables independently and/or interactively emerged to predict turnover intentions. The most important finding was that 49% of the variance in turnover intentions was explained by the proposed model when all the variables were simultaneously entered into the equation. Organisational commitment emerged as the only independent predictor in the final most parsimonious model of turnover intentions. This result support theoretical evidence of the importance of organisational commitment as predictor of turnover intentions. Organisational culture, in interaction with knowledge sharing and job satisfaction, emerged as predictors in the final model decreasing turnover intentions, while organisational culture in interaction with organisational citizenship behaviour increases turnover intentions of professional nurses. Organisational culture also emerged in interaction with white professional nurses, as demographic variable, decreasing turnover intentions. Organisational culture is therefore an important concept in determining turnover intentions, clearly emphasising the responsibility of nursing employers to seriously embark on internal strategies to prevent turnover amongst professional nurses. Various other demographic variables also emerged in interaction to determine turnover intentions in the final model. They are professional nurses in ICU/casualties and 50 years and older, 1-5 years in unit and an incumbent of a chief professional nurse position, 11 years and more in the current hospital and no dependents above 18, being married/co-habitating and no dependents above 18, 50 years and older and no dependents under 18 and working in ICU/Casualties and in possession of a degree. Finally, knowledge sharing, organisational commitment and job satisfaction mediated the relationship between organisational culture and turnover intentions, although only partially, while OCB’s did not mediated this relationship. Various conclusions and recommendations, theoretically, methodologically and empirically, were made as a result of this study. Further theoretical development of the concepts, especially knowledge sharing, the value of General Linear Modelling and further development of turnover models amongst professional nurses and other health professional alike, were recommended. / Prof. Gert Roodt

There is alleged to be a severe nursing shortage in Canada. While the shortage is attributed in large part to fiscal restraint in the hospital sector in the early 1990s, there are competing claims addressing why nursing employment levels changed over this period. Supply-side proponents argue that deteriorating working conditions and stagnant wages led nurses to voluntarily leave the profession, province, or country for better employment prospects. Demand-side proponents argue that hospitals reduced staff levels in response to a decline in inpatient utilization. There is also considerable disagreement on what impact, if any, reduced nursing employment levels had on access to hospital care. However, while there is no shortage of anecdotal evidence and plausible rhetoric, the debate is being carried out in a largely data-free environment. This thesis attempts partially to fill this void. Part I of this thesis examines trends in the nursing employment level in Canada over the hospital restructuring period. Results indicate that the number of nurses employed in hospitals decreased significantly during the cut-backs period and that the decrease was particularly severe among young nurses. The employment level is decomposed into three separate components for each age group: the change in the potential supply of nurses, the change in the employment rate of this group and the change in the likelihood that an individual will work in the nursing profession conditional on being employed. Results indicate that the third factor is most important. To determine whether the observed shift toward non-nursing employment was voluntary, an occupational sector choice model is developed and the pattern of nursing wages, non-nursing wages, and hospital expenditure (a proxy for demand) is examined. The evidence strongly suggests that the reduction in the nursing employment level in hospitals during the downsizing period was a result of a decrease in the demand for nursing labour and did not represent voluntary movement out of the nursing sector. That the decrease in demand primarily affected young nurses appears to reflect the influence of seniority in the highly unionized nursing sector.

There is alleged to be a severe nursing shortage in Canada. While the shortage is attributed in large part to fiscal restraint in the hospital sector in the early 1990s, there are competing claims addressing why nursing employment levels changed over this period. Supply-side proponents argue that deteriorating working conditions and stagnant wages led nurses to voluntarily leave the profession, province, or country for better employment prospects. Demand-side proponents argue that hospitals reduced staff levels in response to a decline in inpatient utilization. There is also considerable disagreement on what impact, if any, reduced nursing employment levels had on access to hospital care. However, while there is no shortage of anecdotal evidence and plausible rhetoric, the debate is being carried out in a largely data-free environment. This thesis attempts partially to fill this void. Part I of this thesis examines trends in the nursing employment level in Canada over the hospital restructuring period. Results indicate that the number of nurses employed in hospitals decreased significantly during the cut-backs period and that the decrease was particularly severe among young nurses. The employment level is decomposed into three separate components for each age group: the change in the potential supply of nurses, the change in the employment rate of this group and the change in the likelihood that an individual will work in the nursing profession conditional on being employed. Results indicate that the third factor is most important. To determine whether the observed shift toward non-nursing employment was voluntary, an occupational sector choice model is developed and the pattern of nursing wages, non-nursing wages, and hospital expenditure (a proxy for demand) is examined. The evidence strongly suggests that the reduction in the nursing employment level in hospitals during the downsizing period was a result of a decrease in the demand for nursing labour and did not represent voluntary movement out of the nursing sector. That the decrease in demand primarily affected young nurses appears to reflect the influence of seniority in the highly unionized nursing sector. / Arts, Faculty of / Vancouver School of Economics / Graduate

Thesis (M. A.(Nursing Science)) -- University of Limpopo, 2021 / In this study, the working conditions of nurses in the public clinics are assessed as the nurses are not satisfied with their working conditions. The dissatisfaction on nurses working conditions by nurses was identified and observed by the researcher at certain clinics in the Sekhukhune District. Strategies are suggested to improve nurses’ working conditions in the selected public clinics of the Limpopo Province, South Africa. The study aims to develop strategies to improve nurses’ working conditions in selected public clinics of Limpopo Province, South Africa. A qualitative exploratory and descriptive research approach, using a phenomenological design has been used. Data were collected from professional nurses from the selected public clinics, using semi-structured interviews. Data were audiotaped and field notes were taken. The eight Steps of Tesch’s inductive, descriptive open coding technique, described by Creswell was used, followed by independent coding. Purposive sampling recruited 20 professional nurses from seven selected clinics in the Limpopo Province. The Turfloop Research Ethics Committee gave ethical clearance. The Department of Health gave permission for the study to be conducted in the selected clinics. Ethical considerations and measures to ensure trustworthiness have been observed. The results show that nurses’ working conditions are affected by the shortage of human and material resources, poor health clinic structures, unacceptable duty schedules, large numbers of clients which to lead to nurses’ burnout. In addition, there is the challenge of the different roles played by nurses, which impede the provision of quality patients’ care. The nurses suggested that the Department of Health should be transparent regarding any information regarding issues of the health system. Furthermore, strategies to improve patients’ awareness regarding the nurses’ working conditions have been developed from the themes that emerge from this study. The findings of the study cannot be generalized to other clinics of the Limpopo province and of other provinces.

It is estimated that by 2018, workers age 55 or older will compose nearly a quarter of the labor force (Tossi, 2009). The aging workforce is dramatically affecting the nursing workforce. Indeed, the nursing workforce is expected to face staffing shortages of epidemic proportions because of the impending retirement of nurses who are Baby Boomers (Buerhaus, et al., 2006). Moreover, the nursing shortage is exacerbated by younger nurses' greater willingness to turn over (Aiken et al., 2001). Consequently, investigating how the workplace context affects retention of nurses is important. The present study sought to address the nursing shortage concern through examining how the workplace climate associated with age-related worker treatment and individual characteristics affect nurse retention. In this study, I developed and validated new ageism climate measures, which include younger worker, older worker, and general ageism climates. I examined how ageism climates affect people's job withdrawal intentions, organizational commitment, and work engagement. Additionally, I investigated whether Core Self-Evaluation (CSE; Judge, Locke, Durham, 1998) moderates the ageism climates relationships with the outcome variables. During the scale development and validation process, I found that assessments of younger and older worker ageism climates depend on the age of the respondent, whereas general ageism climate did not have this dependency. Because younger and older ageism climates displayed measurement non-equivalence across age groups, I tested each of my hypotheses using three sample variations (under 40, 40 and older, and combined sample). In the under 40 sample, CSE buffered the negative effects of negative older and younger worker ageism climates, and CSE enhanced the positive effects of a positive general age climate on turnover intentions and organizational commitment. In the 40 and older sample, I found that less ageist younger and older worker climates were associated with decreased turnover intentions and increased affective commitment. Finally, in the combined sample, I observed that a less ageist general ageism climate was associated with lower turnover intentions and greater affective commitment. The results contribute to our understanding of how perceptions of age-related treatment affect important workplace outcomes. The findings also support ageism climates as separate measures. However, additional measure development and validation is needed because this was the initial study to investigate ageism climate. This study has implications for the relational demography paradigm (Tsui & O'Reilly, 1989) in that people's age group identification may affect their ageism climate perceptions. This potentially explains the differential relationships among the ageism climates on the outcomes between the under 40 and 40 and older age groups. From a practical perspective, improving ageism climates in the workplace could positively affect nurse retention, which could alleviate some of the nursing shortage concerns.

Thesis (MTech (Public Management))--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.

Globally, there is a shortage of professional nurses, which compromises the rendering of Health Care performance worldwide. South Africa has the added challenge of a dual Health Care system where there is a large disparity in financial resources, service levels and workload between private and public hospitals, which leads to public hospitals in rural areas failing to attract and retain professional nurses. The purpose of this study is to determine the relationships between three variables from the Positive Organisational Scholarship paradigm namely Workplace Trust, Organisational Citizenship Behaviour and Workplace Well-being which is researched amongst professional nurses in the private and public sectors in both the rural and urban areas in two districts in the Eastern Cape Province. The ultimate aim of the study is to propose interventions of how hospitals can improve the work environment in order to attract and to retain professional nurses. It is also anticipated that the results of the research will contribute to the body of research about Positive Organisational Scholarship (POS). The Workplace Trust Survey (WTS), Organisational Citizenship Level Scale (OCLS) and the Workplace Well-being Questionnaire (WWQ) were integrated into a single selfadministered questionnaire to measure the existence of the variables. The questionnaire also included questions relating to demographic factors. In order to confirm the reliability of the measuring instruments, an Exploratory Analysis was done, a Scree test was applied and a Principal Axis Factor Analysis was conducted. Finally, an Item-reliability Analysis on each factor was administered. The WTS and WWQ revealed sound factorial validity and was considered to be compatible with a South African sample, but the OCLS indicated poor construct validity. Relationships between the variables were analysed by applying a Pearson Productmoment Correlation Analysis in SPSS. T-tests, Analysis of Variance (ANOVA) and the Tukey HSD test was utilized to determine the potential influence of demographic characteristics on the variables. Several interesting relationships between variables and sub-variables were identified. The study concludes with proposed interventions needed to retain professional nurses in hospitals. The limitations of the study as well as recommendations for further research is briefly noted.

The last decade has seen an exodus of South African nurses migrating to "greener pastures". As a result of this migration, the South African Healthcare Service has been drained of one of its most essential resources – nurses. Subsequently, the crippling flight of nurses has thrown the nursing profession into a state of crisis. The Kingdom of Saudi Arabia is one of the more popular destinations for South African nurses, the main reason being the attractive financial rewards. One agency reports that they send an average of thirty nurses a month to various hospitals within the Kingdom of Saudi Arabia. Saudi Arabia is an Islamic country. Due to the uniqueness of the enforcement of the Islamic faith and the Saudi culture, many restrictions are imposed, particularly on women. The challenges and problems facing the South African nurses were, therefore, unique compared to elsewhere in the world. This research study had a primary and a secondary objective: The primary objective of this study was to explore and describe the lived experiences of South African nurses related to living and working in Saudi Arabia; The secondary objective of this study was to develop orientation guidelines to support South African nurses working and living in Saudi Arabia. The researcher utilized a qualitative, explorative, descriptive and contextual design based on a phenomenological approach to inquiry, in an attempt to answer the question: "What are the professional and personal experiences of the South African registered nurses working and living in Saudi Arabia?" Eleven registered nurses were selected to participate by means of purposive sampling. These nurses had been living in Saudi Arabia between three and six months. Consent was obtained from participants and the ethics committee of both the Nelson Mandela Metropolitan University and King Faisal Specialist Hospital and Research Centre. The central theme emanating from the study was recognized as being 'Cultural Diversity'. The sub-themes identified related to the registered nurses’: - Religious/spiritual adaptation - Environmental adaptation - Emotional/psychological adaptation - Professional adaptation Based on the identified themes, guidelines were formulated to assist South African registered nurses when migrating to Saudi Arabia. Utilization of these should assist the South African registered nurse in assimilating into both the cultural and working environment. However, in reality, the outcome showed that no one can be prepared fully for what awaits them in Saudi Arabia.