Introduction
Background
The Kingdom of Saudi Arabia has committed vast resources by allocating more than 13 percent of its annual budget in improving the Kingdom's medical care system, with the ultimate goal of providing free medical care for everyone. This commitment has been translated to more than 330 hospitals operated by the government and the private sector, with a capacity of more than 50,000 beds. Of these hospitals, 184 are run by the government, with more than 16 thousand doctors, 40 thousand nurses, and more than 25 thousand assistant nurses according to the Ministry of Health (2003). Based on these figures and the Saudi population of 20 million people, to satisfy and maintain the current health care standard, one out of every
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Work overload due to nurse shortage, low salaries and additional factors as expected nurse conduct and behavior standards, in addition of competition with other recruitment countries have made recruitment and marinating the right nurse with the right qualification harder every year. Therefore, within this review we would examine causes that lead to this high turnover and try to provide effective solution for each cause.
Variables of Concern:
Through this review we will examine some of the variables that lead to the high rate of turnover in the King Abdulaziz University Hospital and how this number can be reduced significantly with few marginal adjustments to the recruiting policy:
Behavior & Conduct Standers
As most foreign nurses come to Saudi Arabia from countries like the Philippines and India, living the Saudi different culture and tradition becomes a daily ritual of these nurses' lives. Due to its pride in the Arabic and Islamic heritage, the Saudi Arabian customs and traditions sometime impose stricter rules and specific behaviors other than nurses have been accustomed to. Due to these differences in customs, imported nurses have a hard time to adjusting with Islamic & Arabian customs and traditions. Life luxuries substance as alcohol, sexually suggestive magazines, and narcotics among other things including any and all additives are not available in Saudi. Plus, the separation in the Saudi life between
According to Suzanne Gordon “ whether young or old, nurses are disillusioned because they believe that health care systems guided by bottom-line concerns simply don’t recognize the specificity of their work” (234). Nursing is more demanding than many other professions or occupations, due to the combination of difficult patients, exhausting schedules and arduous physical work (Gordon 235). It can take a significant emotional toll on many, hence the higher levels of burnout. Job dissatisfaction as a result of increased workloads and unreasonable demands, such as inappropriate nurse staffing levels, was cited as the number one reason that drives many experienced nurses to leave the profession (Sanford 38+). Studies have shown that such working conditions also affected the retention of new graduate nurses by leaving their first hospital jobs within two years of graduating (Sanford 38+).
Nursing shortage has been a global problem that need to be eradicated in order to promote patient care and improve care outcomes. Nursing shortage in America has caused a lot of negative impact on the nurses, patients and nursing profession. It has caused a lot of dissatisfaction on the part of the nurses and the patients (Nardi & Gyurko, 2013). Nurses are prone to injuries, stress and burn-out as a result of nursing shortages. They engaged in working long hours to compensate their coworkers and ensure completion of assigned jobs. They end up breaking down emotionally, physically and psychologically due to poor work-environment and
Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).
Nurse-to-patient ratios is not a new topic of debate for all of us who deliver care to patients every day. Only lately it has been a big issue that have caught the attention of many. Demands by the medical community for changes concerning staffing, asking for the government interventions in minimum staffing laws. Registered nurses have long acknowledged and continue to emphasize that staffing issues are an ongoing concern, one that influences the safety of both the patient and the nurse. (ANA, 2015) .nowadays hospitals are running for profit and the emphasis is not put on job burnout, stress, and endangerment of patients. Nursing shortages is a very pertinent problem, it will be optimum to have laws in place to help with the issue, however meanwhile leadership and management methods to the matter can help to mend the nursing situation and avoid many of the damaging effects of unfitting nurse-to-patient ratios.
There are many major challenges facing the nursing shortage environment today. One of those challenges includes the facility recruitment of registered nurses and then the facility retention of the registered nurses that they have recruited. Factors to consider would be as to why a registered nurse chose to accept a particular job and will they choose to stay at the facility after being given an employment opportunity. A facility’s reputation, union status, autonomy and salary are among some of the factors that influence recruitment. Factors that influence retention includes the inclusion in decision making, practice
The nursing shortage in healthcare has been a highlighted issue for many years. With the ever-growing health care system, hospitals and healthcare facilities often find themselves searching for ways to acquire new nurses and retain their very own. Throughout the years, the number one solution to this problem remains the same: decreasing nurse turnover, and increasing nurse retention. This paper discusses the causes of high nurse turnover rate, the negative effects on health care, and ways to improve the turnover rate.
Retaining a stable and sufficient supply of nurses is an important hospital and nationwide concern. Numerous factors affecting retention of registered nurses comprises of practice autonomy, managerial respect, workload, and inclusion in decision making, flexible schedules, education, and pay (“Recruitment”, 2013). Hospitals not capable of retaining qualified registered nurses may result in the loss of experienced and knowledgeable staff. Additionally this will lower hospital productivity during this transition. High turnover rates for registered nursing staff may also impact job fulfillment and nursing moral altogether. Retaining qualified registered nurses will enhance patient care quality and satisfaction.
We hear nurse’s talk about how rewarding their profession is but what they seldom talk about is how it can be very challenging as well. There seems to be many issues existing in the nursing profession. One of the most affective issues in nursing is the decreasing number of staff nurses. With inadequate staffing, nurses are demanded to have more responsibilities thus causing more stress on the nurse. This increase in responsibility causes nurses to neglect many aspects of their patients’ care. Patient care is suffering from the shortage of nurses as there is an increase in adverse patient outcomes due to the shortage. Also, there is evidence that there is a positive relationship between the number of staff and the effectiveness of their teamwork. The more staff available the more likely nurses will work together as a team. A new act is being implemented to help with the nursing shortage. This act is called the National Nursing Shortage Reform and Patient Advocacy Act. The purpose of this paper is to discuss the issue of nursing shortage and how the National Nursing Shortage Reform and Patient Advocacy Act is an example of evidence-based practice.
With the ongoing changes in the healthcare field, nursing workforce retention presents itself as one of the greatest challenges facing healthcare systems today. According to the American Nursing Association, nursing turnover is a multi-faceted issue which impacts the financial stability of the facility, the quality of patient care and has a direct affect on the other members of the nursing staff (ANA, 2014). The cost to replace a nurse in a healthcare facility ranges between $62,100 to $67,100 (ANA, 2014). The rising problem with nursing retention will intensify the nursing shortage, which has been projected to affect the entire nation, not just isolated areas of the country, gradually increasing in its scope from 2009 to 2030 (Rosseter,
The nursing shortage is no longer a projected problem in the healthcare industry in the United States, this problem is present and is not phasing out anytime soon. Addressing this challenge would improve job satisfaction, reduce burnout in the profession and ultimately improve retention.
Nurse turnover is defined as “the number of nurses changing jobs within an organization or leaving an organization within a given year” (Baumann 2010). Retaining nurses is one of the most important issues in health care as its effects range from challenges in human resource planning, to high costs in financial and organizational productivity (Beecroft et al, 2008), to workgroup processes and morale, to patient safety and quality of care (i.e. patient satisfaction, length of patient stay, patient falls, and medication errors) (Bae et al, 2010). Nursing Solutions Inc (NSI) reported the national average turnover rate for hospitals increased from 13.5% in 2012 to 14.7% last year. Nurses working in Med/Surg had more turnover
The nursing occupation is facing tough working conditions as a result of a nurse shortage in the industry. (Bowles & Candela, 2005). Due to this, hours are prolonged to unhealthy lengths and increase in patient – nurse ratio means that nurses are being stretched to their maximum productivity to provide extensive care for everyone. This essay examines the reasons behind why nurses are choosing to leave the occupational field and the consequences of these working conditions on both nurses and patients. Secondly, it’ll look at how improvements can be made to in order to lower stress levels aswell as retain existing and attract new nurses to the occupation.
According to Paller (2012), the nursing shortage in different countries for example the United States tends not to be the only growing problem, but has also become a complex one. Nursing shortage and nurse's turnover has become the worsening predicament in the health care industry in the United
The global nursing shortage is resulting in the need to find multiple solutions to providing adequate numbers of nursing personnel. The shortage is exacerbated by nurses leaving the profession and their current positions. Globally, nursing turnover rates range from 10–21% per year, with countries such as the USA and Australia reporting turnover rates of over 20% per year. Retaining nurses in their current positions will reduce the magnitude of consequences associated with the nursing shortage (Cowden and Cummings, 2012).
The Kingdom of Saudi Arabia has committed vast resources by allocating more than 13 percent of its annual budget in improving the Kingdom’s medical care system, with the ultimate goal of providing free medical care for everyone. This commitment has been translated to more than 330 hospitals operated by the government and the private sector, with a capacity of more than 50,000 beds. Of these hospitals, 184 are run by the government, with more than 16 thousand doctors, 40 thousand nurses, and more than 25 thousand assistant nurses according to the Ministry of Health (2003). Based on these figures and the Saudi population of 20 million people, to satisfy and maintain the current health care standard, one out of every