| Summary: | Thesis (MPA)--Stellenbosch University, 2000. === Full text to be digitised and attached to bibliographic record. === ENGLISH ABSTRACT: Managing human resources is crucial to the efficient and effective
delivery of quality health care. However, turnover of nurses constitutes
a major factor in the shortages of staff which are being experienced by
the nursing profession in the Republic of South Africa. Shortages of
trained nurses with experience, particularly in public sector hospitals,
have adverse effects on the provision of efficient and effective quality
health care to the consumers of this service.
The aim of the study was to provide an understanding of and insight
into those inherent problems in the health sector that propel nurses to
leave public sector institutions. The overall objective was to investigate
and identify some of the factors which exercised an influence on the
turnover of registered nurses in public sector hospitals, so as to be able
to provide suggestions to hospital managers on the more effective
management of human resources, in order to retain nursing personnel.
Theresearch was based on a model of nursing turnover which regarded
voluntary withdrawal as a process in which feelings of satisfaction with
pay, on the one hand, and the opportunity of obtaining alternative jobs
in the labour market, on the other, were proposed as the primary
causative factors of turnover behaviour. In addition the propositions,
made in literature reviewed, that age, tenure, kinship responsibility,
general training, education, professionalism, marital status, lintent to
stay', job satisfaction, routinization, job autonomy and responsibility,
instrumental communication, promotional opportunity, integration,
supervisory relationships, distributive justice, work-load, and local kin
acted as predictors of turnover, were also investigated.
The research was conducted with a sample of 123 nurses in one
hospital, Groote Schuur, situated in the Western Cape Province of the
Republic of South Africa. The sample included registered nurses, senior professional (registered) nurses, and chief professional (registered)
nurses. The data was gathered from respondents by means of a selfadministered
questionnaire. In addition, data was gathered by means of
semi-structured, open-ended discussions with nursing management.
The hypothesised interactions between variables influencing nursing
turnover were explored by means of basic statistics, which made it
possible to assess the effects of both independent and dependent
variables.
The results of data analysis provided some support for the proposition
contained in the hypothesis. The determinants whose increase
produced a greater degree of turnover were firstly, the many jobs
available outside the hospital and secondly, professionalism. The
determinants whose increase resulted in reductions in turnover were
"intent to stay" (which the researcher views as a dimension of
commitment), the existence of local kin (kinship responsibilities),
participation in making job-related decisions (job autonomy), the receipt
of sufficient work-related information (instrumental communication and
good supervisory relationships), and tenure. The determinants whose
decreaseresulted in increased turnover werepromotional opportunities,
distributive justice, pay satisfaction, job satisfaction, integration,
opportunity for self-development,age and tenure.
Turnover of nurses has serious ramifications for employers, patients,
and the nursing profession itself. Effective management of employee
turnover is of critical importance to health care providers, employees,
and patients. Better control of turnover can improve the quality of
patient care, reduce labour costs, and improve employee morale. === AFRIKAANSE OPSOMMING: Die bestuur van menslike hulpbronne is die deurslaggewende
omstandigheid ten einde die lewering van effektiewe en doeltreffende
gesondheidsorg van gehalte. Nietemin, dra die omset van
verpleegkundiges grotendeels by tot die personeeltekort wat tans deur
die verpleegprofessie in Suid-Afrika ondervind word. Die tekort aan
ervare, opgeleide verpleegkundiges, veral in die openbare sektor
staatshospitale, het 'n nadelige uitwerking op die voorsiening van
effektiewe en doeltreffende gesondheidsorg van gehalte aan die
verbruikers van hierdie diens.
Die doelwit van die studie was om 'n begrip te ontwikkel vir, en 'n insig
te probeer kry in, daardie inherente probleme binne die
gesondheidsektor wat verpleegkundiges dryf om die staatsinstellings te
verlaat. Die oorkoepelende doel was die ondersoek en identifikasie van
sommige faktore wat die omset van geregistreerde verpleegkundiges in
staatshospitale beïnvloed. Die doel hiervan was om voorstelle aan
hospitaal bestuurders te kan voorsien ten opsigte van die meer
doeltreffende bestuur van menslike hulpbronne, in die strewe na behoud
van verpleegpersoneel.
Die navorsing is gebaseer op 'n model van verpleegomset wat vrywillige
onttrekking as 'n proses beskou het waar gevoelens van salaristevredenheid,
aan die een kant, en geleentheid tot alternatiewe
betrekkings in die arbeidsmark, aan die ander, as die primêre
veroorsakende faktore van omset-gedrag voorgestel is. Daarbenewens
is die stellings vanuit die literatuurstudie dat die volgende dien as
voorspellers van omset ook ondersoek: ouderdom, ampstermyn of
dienstyd, verantwoordelikheid teenoor familie, algemene opleiding,
opvoeding, professionalisme, huwelikstatus, 'voorneme om te bly',
werksbevrediging, roetine, selfbestuur en verantwoordelikheid in die
werksomgewing, bevorderlike kommunikasie, bevorderingsgeleenthede, integrasie, toesighoudende verhoudings, toedelende gereg, werkslading
en plaaslike naasbestaandes.
Die navorsing is uitgevoer met gebruik van 'n monster van 123
verpleegkundiges van een hospital, die Groote Schuur Hospital, geleë in
die Wes-KaapProvinsie van die Republiek van Suid Afrika. Die monster
het geregistreerde verpleegkundiges, senior geregistreerde
verpleegkundiges en hoof geregistreerde verpleegkundiges ingesluit.
Die data is verkry van respondente deur middel van 'n self-toegediende
vraelys. Daarbenewens is data versamel deur half-gestruktureerde, niegeslote
besprekings met van die verpleegbestuur. Die interaksie tussen
veranderlikes ten opsigte van verpleegomset wat veronderstel is, is
ondersoek deur middel van basiese statistiek, dus kon die uitwerking
van afhanklike en onafhanklike veranderlikes bepaal word.
Die uitslae van data-ontleding het wel ondersteuning verleen aan die
voorstelling soos uiteengesit in die hipotese. Die determinante wie se
toename 'n toename in die omsetkoers tot gevolg gehad het was,
eerstens, meer werksgeleenthede buite die hospitaal en, tweedens,
professionalisme. Die determinante wie se toename tot 'n vermindering
in omset bygedra het was 'voorneme om te bly' (wat die navorser as
binne die omvang van toewyding beskou), deelname aan werksverwante
besluitneming (werks outonomie), die ontvangs van genoegsame
werksverwante inligting (bevorderlike kommunikasie en goeie
toesighoudende verhoudings), en ampsduur (dienstyd). Die
determinante wat tot 'n vermindering in omset lei is
bevorderingsgeleenthede, toedelende gereg, salaris bevrediging,
geleenthede tot self-ontwikkeling, ouderdom en ampsduur.
Die omset van verpleegkundiges het verreikende gevolge vir
werkgewers, pasiënte en die verpleegsberoep self. Doeltreffende
bestuur van werknemer-omsetis van kritiese belang vir gesondheidsorg
voorsieners, werknemers en pasiënte. Die meer effektiewe beheer van
omset kan die kwaliteit van pasiëntesorg verbeter, arbeidsonkoste
verminder en die moraal van werknemers verbeter.
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