Implementation of Magnet Environment in Riyadh Military Hospital ICU Unit to Reduce Nurses Attrition - Literature review Example

Topic:  Implementation of Magnet Environment in Riyadh Military Hospital ICU Unit to Reduce Nurses Attrition and Increase Nursing Retention Introduction Nurse turnover is becoming a global concern in the hospital industry. And, this turnover must be taken as a health human resource issue where nursing attrition is becoming visible, creating nursing shortages in the health workplaces (O’Brien Pallas, 2006). Growing trend of attrition in the nurses calls for effective recruitment and retention strategies (Stone,& Gershon 2006). In addition, turnover has become a significant challenge for human resource departments in the health industry globally. This attrition is not only a problem for hospitals but also for the managers, health policy makers, and managers relevant to the field of nursing. Besides increasing cost burden over the hospital management to renew the hiring process in order to fill the gap created by attrition of nurses. Interestingly, not only in the developed countries, where the health industry is considerably advanced and stable than health industry operating in the developing countries. In this regard, Hughes, Finlayson , & Firkin (2005) contend that in smaller countries, inability to retain nurses has become one of the critical issues, impacting negatively the viability of the health industry. Various causes, such as general perception about nursing as profession, other employment opportunities, insufficient workplace facilities, increased demand, and less wages are those factors that heavily put pressure over the participants entering to the field of nursing. And, the effective retention strategies would be to take these factors into account and put in place such measures that ensure the minimum exposure of such circumstances to the nurses in the health industry. In the subsequent parts of this literature review, first, magnet environment is appropriately defined along with different types of nurses currently serving globally in the health industry; it is followed by the causes, creating nurse attrition. Before summing up, effective strategies are incorporated in a way to reduce attrition and increase retention of nurses in the health industry. Magnet Environment and types of nurses Magnet hospitals are defined as those hospitals having a good reputation for recruitment and retention of registered nurse (Buchan, 1999). The process of magnet environment in magnet hospitals begins from the process of recruitment and continues with the process of retention. In the process of recruitment, a considerable number of measures are put in place and taken into account in order to ensure the attainment of recruitment objectives. In which candidates current and future expectations are taken into account. After recruiting, many efforts are consumed to retain the hired nurses. Needless to say, it is the ultimate objective of the recruitment of nurses to ensure their continual nursing services with a quite foreseeable future with the management of hospital. More significantly, numerous factors are taken into that require their attainment at recruitment and retention of nurses. However, Shortell & Kaluzny (2006) provide some fundamental elements essential to magnet environment within hospitals; they include, quality of nursing and leadership, organisational performance, motivation and worker autonomy, work design, effective groups and teams, coordination and communication, participative or decentralized management, and organizational change and organizational innovation. The nursing profession consists of three types of workers: registered nurses, nurse aides, and licensed practical nurses (General Accounting Office, 2001). Registered nurses, who are state-licensed and possess associate degrees (two-year community colleges), diplomas (three-year hospital programs), or baccalaureate degrees (four-year colleges), provide direct patient care besides managing nursing care (Keenan, & Kennedy, 2003). Nurse aides may provide their health care services in hospitals and home care settings as well, but commonly they work in nursing homes. Additionally, they assist in the routine works in the hospitals such as dressing, bathing, providing food to the patients. On the other hand, licensed practical nurses, who are also state-licensed and they are required to complete 12 to 18 months of nursing training, provide patient care services under the direct supervision of a registered nurse of physician. Causes of nurse attrition The general perception of nurse is less positive. There are many authors on the topic who do not disagree with this fact; in many societies including in the Kingdom of Saudi Arabia, people do not see this profession with a positive impression. Being a male dominated society, many cultures do not consider it appropriate for a female to performing nursing services. In addition, other than nursing, a sufficient amount of candidates heads towards other employment sectors as globally economy is growing with a diverse range of employments are being offered. And, due to the less social and cultural recognition, the field of nursing finds fourth or fifth choice for a candidate deciding about career. This trend negatively impacts over the demand and supply curve of nurses. The expected demand of nurses is unable to meet with the provided quantity of supply of nurses with the new entrants entering into the field of nursing. Furthermore, insufficient workplace facilities cause nurses to increase the graph of nursing attrition. In many hospitals, the nurses do not avail nor are they given the required workplace facilities such as resting time, appropriate level of behaviour and etc. These factors de-motivate nurses and they find it difficult to stay employed within that environment. Further, globally the nursing profession is considerably growing. And this growth is mostly fuelled by the growing population globally. And, the same is applicable to the environment of the Kingdom of Saudi Arabia, where local population has observed a significant increase in the recent history. However, this increased demand is unable to attract the required number of nurses to fulfil the nursing requirements in the global health industry. Last but in the least, unattractive and insufficient wages offered to nurses cause nurses attrition. Globally, this looks a trend to pay a minimum sum of amount to nurses. More importantly, their wages in comparison with other professions tend to be incomparable. Although they work as required of them, but the amount of wages they receive remains insufficient particularly in the privately owned hospitals. Effective strategies to increase nurse retention Increasing funding for nursing education towards faculty of nursing and students might be helpful in discouraging attrition and in encouraging retention of nurses (Nevidjon & Erickson, 2001). This would significantly reduce the current attrition rate existing in the health industry. In addition, increasing wages to nurses would also be a helpful way to retain nurses. This has been identified as a major cause of nurse attrition in the hospitals, by appropriately increasing the wages, and the same time, if nurses are provided with other advantages, which are currently not availed by them, the objective of retention would considerably be covered up. At the same time, nurse training and professional advancement must be pursued by the management of hospitals. In addition, the experts on this issue suggest that hiring foreign nurses would be another way to fulfil the shortage in the health industry. Additionally, policies improving a hospital’s work environment are of paramount importance; in this regard, the American Nursing Credentialing Centre highlights those hospitals having successful recruitment and retention nursing policies as magnet facilities (Scott et al., 2002). In addition to that, work environment involve reorganising nursing care to diminish paperwork and modify the types of work performed by nurses with an aim of increasing the proportion of nurse time spent on patient care (Buerhaus, 2002). Additionally, policies rebuilding the roles of nursing leadership are of key importance for the purpose of nurse retention (JCAHO, 2002). And, redesigning the workplace in accordance with the standards of ergonomics may become highly significant to reduce and prevent workplace injuries in the health industry (Buerhaus, Staiger & Auerbach, 2000). Boyle et al., (1999) hypothesized that perceptions of nurse-manager’s leadership style, job stress, work autonomy, job satisfaction, and cohesion of groups directly impact over the nurse intent to remain employed. And, Sourdif (2004) contends that the nurse intent to remain employed is also attached with organizational commitment and administrative policies. Conclusion Magnet environment holds a key to retain nurses. And, the magnet environment occurs when all the elements inside an organisation work in the required way; In which, organisational commitment, nurse leadership, recruitment policies and procedures, and enablement of nurses in the required level of decision making. These factors aggregately construct and develop the essentials for magnet hospitals. However, in the recent history, the events of nurse attrition have considerably been increased. And, this increase in the nurse attrition is mostly caused by the existing perception of nursing profession in many societies, insufficient wages being offered to nurses, less compliance with the standards of ergonomics, the presence of other employment sectors globally are those major factors causing attrition. However, these causes can be dealt with in a way to reduce attrition and increase retention in the health industry by working over the positive perception development of nursing profession. And, at the same time, putting more funds in the nursing education, training and development not only to practising nurses but also to the students as well; this would ensure the retention of nurses. in addition to that, by offering attractive wages to nurses, and providing required level of work environment would greatly encourage retention of nurses. References 1. Buchan J. (1999). “ Still attractive after all these years? Magnet hospitals in a chaing health care environment, Journal of Advanced Nursing 30 (1), 100-108, Blackwell Science 2. Stone, P.W. & Gershon, R.R.M., 2006. Nurse Work Environments and Occupational Safety in Intensive Care Units. Policy, Politics, & Nursing Practice, 7(4), p.240-247. Available at: [Accessed July 20, 2011]. 3. Hughes, F., Finlayson, M., & Firkin, P. (2005). Situational analysis of 19 island countries in relation to mental health capability and capacity. Geneva, Switzerland: World Health Organization 4. Keenan, P., Kennedy, J.F, (2003). “ The Nursing Workforce shortage: Causes, Consequences, Proposed Solutions,” The common Wealth Fund 5. Shortell SM, Kaluzny AD. 2006. Health care management: organization design and behavior. 5th ed. Clifton Park, NY: Thomson Delmar Learning; 6. O’Brien-Pallas, L. et al., 2006. The Impact of Nurse Turnover on Patient, Nurse, and System Outcomes: A Pilot Study and Focus for a Multicenter International Study. Policy, Politics, & Nursing Practice, 7(3), p.169-179. Available at: [Accessed July 20, 2011]. 7. General Accounting Office. 2001. “Nursing Workforce: Recruitment and Retention of Nurses and Nurse Aides Is a Growing Concern.” Statement of William J. Scanlon before the Committee on Health, Education, Labor and Pensions, U.S. Senate. 8. B. Nevidjon and J. Erickson, 2001,“The Nursing Shortage: Solutions for the Short and Long Term,” Online Journal of Issues in Nursing 6 (2001): Manuscript 4. 9. Scott, J. Sochalski, J. and Aiken, L. 2002 “Review of Magnet Hospital Research: Findings and Implications for Professional Nursing Practice,” Journal of Nursing Administration 29 (1999): 9–19;Ward,“Arching the Flood,” 10. Buerhaus,(2002)“Strengthening Hospital Nursing,” JCAHO, (2002) Health Care at the Crossroads, 2002;AAHC, Nursing Shortage and AHCs, 11. Buerhaus, P. Staiger, D. and Auerbach, D. (2000) “Policy Responses to an Aging Registered Nurse Workforce,” Nursing Economics 18 (2000): 278–303. 12. Boyle D.K., Bott M.J., Hansen H.E., Woods C.Q. & Taunton R.L. (1999) Managers’ leadership and critical care nurses’ intent to stay, American Journal of Critical Care 8(6), 361–371. 13. Sourdif J. (2004) Predictors of nurses’ intent to stay at work in a university health center. Nursing and Health Sciences 6, 59–68. Read More