In any profession, a person training has a different feeling of the profession while still on training and a real-life situation at the place of work. Naivety is sometimes nominated as a course in the differences in the mentioned feelings. Consequently, the first impression or experience that confronts an employee who has just come out of college challenges the job satisfaction level expected. Therefore, if this impression turns out in favor of an employee, the employer won’t have a difficult time worrying about how to retain skilled employees who could otherwise leave. In clinical nursing, employee turnover especially Registered Nurses is one problem that many healthcare institutions have failed to address. Questions that remain unanswered are those that try to probe into the reasons that a leaving clinical nurse gives out to justify departure. To resolve retaining nurses, three parties must be involved: the administration of a hospital, the nurses, and the nursing environment.
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Nursing and the nurse
Nursing and the nurse may look like ambiguous words imposed against each other but with a critical examination, they represent a common thing. Why, therefore, should the two be looked at as a single entity? The answer is that an absence of one disqualifies the practice of the other. As result, nursing is a profession that a nurse pursues (Auerbach, Buerhaus & Staiger, 2007). If the word is given a further critical extension in its meaning, the word patient comes in as well. Besides existing in a two-fold setting patients are the ones that give meaning and the true existence of either a nurse or nursing. What then could be reasons genuine enough to make someone who chose nursing as a profession quit the profession? Some of the reasons from research work are discussed as follows.
The work environment has been singled out as one of the reasons that registered nurses leave their work. In the matter of environment” unfriendly” is the keyword. It has been suggested that unfriendly work is a combination of factors such as sexual and physical harassment of RNs by either coworkers or physicians. Managers in the workplace are also included on the list. For a worker to derive satisfaction from the work done, acceptance should come right from the top management flowing down to the Nurse. An immediate supervisor to the nurse should be there always to act and listen to the problems arising at the place of work (Gutierrez, 2005). By way of fact, an affected nurse can easily tolerate harassment incidences if they come from an RN at the same level. This coupled with a lack of support from other RNs aggravates the lack of morale for the nurse, even causing feelings like ‘I am on my own with the patients’ from the RNs affected. The end effect is a nurse will leave surrounded with choking dissatisfaction.
It looks like there is a close connection between an RN and patients that a nurse gives direct care. At face value, this statement may be neglected. At times incidences related to patients’ care not being taken keenly by physicians may draw high emotions from an RN. They may go to an extent of causing conflicts between a nurse administering bedside care to a patient and a physician. Everyone likes to have his/her opinion taken seriously (Longo & Sherman, 2007). Signs that show a lack of concern are not taken well and they may strain relationships. Furthermore, patients that are viewed as neglected or family members’ wishes about the patient sidestepped by doctors, cause emotional distress to the nurses. Repeated encounters of this nature may result in an RN quitting a working environment or completely leaving a profession because a patient matters most to an RN than anything else.
Fatigue and exhaustion
Fatigue and exhaustion are also cited as some of the reasons that may cause an RN to leave. The mention of this reason is related to situations involving nurses who would be on-off being recalled to work. It is normal to encounter or have fatigue exhaustion and sometimes burnouts in the course of one’s work. However, the prospect of being recalled to work when one is on a formal rest was the very fact that led to many nurses feeling overworked. The call back to duty more often than not implied that other nurses had reported on duty. Another reason was an increase in patient census. The latter reason is genuine. The former has an edge of suspicion to whomever absentees themself from work because he knows there is a new member on staff that requires ‘toughing up”. This can be of more use when there is a consensus between an RN and any other nurse excusing himself from work. A consultation of this nature builds confidence in RNs resulting in their retention (Young, Stuenkel & Bawel-Brinkley, 2008).
Conclusion and Recommendations
The study presents three main factors that are identified as possible courses of RNs leaving nursing as a profession. The reasons given suggest that a nurse is very unlikely to leave because of reasons initiated by him. Identified courses are related to management culture at the place of work, which is given no attention by the administration in a nursing environment. Since nurses do not contribute a lot to their departure from the profession, the recommendation is made that strategies of retaining RNs should target majorly vertical indifference in a nursing environment. What they call toughing up a new RN is not in the actual sense. This is bullying. As a consequence, strategies aimed at retaining nurses should also address this bullying activity. A nurse should also be called back only in emergencies but not because another one has not reported to duty.
Auerbach, D.I., Buerhaus, P.I., & Staiger, D.O. (2007). Better late than never: Workforce supply implications of later entry into nursing. Health Affairs, 26(1), 178-185.
as little as 3 hours
Gutierrez, K.M. (2005). Critical care nurses’ perceptions of and response to moral distress. Dimensions in critical care nursing, 24 (5)229-241.
Longo, J., & Sherman, R.O. (2007). Leveling horizontal violence. Nursing Management, 38(3), 34-37, 50-51
Young, M., Stuenkel, D.L., & Bawel-Brinkley, K. (2008). Strategies for easing the role transformation of graduate nurses. Journal for nurses in staff development, 24(3), 105-110.