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Retaining community service nurses in the Western Cape public health sector

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.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/8515
Date03 1900
CreatorsKruse, Beverley-Ann
ContributorsVan Dyk, L., University of Stellenbosch. Faculty of Economic and Management Sciences. Graduate School of Business.
PublisherStellenbosch : University of Stellenbosch
Source SetsSouth African National ETD Portal
Languageen_ZA
Detected LanguageEnglish
TypeThesis
RightsUniversity of Stellenbosch

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