1. NURS 236A Nursing Shortage Interview Dr. Jayne Cohen, Director, School of Nursing, SJSU Phyllis M. Connolly, Ph.D., APRN, BC, CS Interviewer

2. Retention & Shortage RN Turnover in US approx. 21.3% in 2000 Loss compromises patient care Increases cost of health care Minimum cost to replace 1 RN nurse $45,000 Job dissatisfaction predictor of intent to leave As School of Nursing we can educate a limited number of RNs HCOs need to retain new hires

3. Factors Influence Retention Job satisfaction Supervisor Support Work Environment Personal Factors

4. Methodology Longitudinal, descriptive at 3 sites Initial survey Insel & Moos Work Environment Scale (WES) Form R Dimensions: Relationship, Personal Growth or Goal Orientation, & System Maintenance & Change Demographic tool Data collected Q 6 months for 2 years

5. First Setting & Sample Acute care RN staff nurses on all 3 shifts large government hospital in Northern California Clinical levels 1 – III and charge nurses and assistant head nurses 692 surveys were distributed N = 272, 39% Response Rate

6. Relationship Dimensions Involvement – employees are concerned about and committed to their jobs Peer Cohesion – employees are friendly and supportive of one another Supervisor Support – management is supportive of employees and encourages them to be supportive of one another

7. Personal Growth or Goal Orientation Dimensions Autonomy – “employees are encouraged to be self-sufficient; make their own decisions” Task Orientation – “emphasis is on good planning, efficiency, and getting the job done” Work Pressure – “the degree to which the pressure of work and time urgency dominate the job milieu”

8. System Maintenance and System Change Dimensions Clarity – “employees know what to expect in their daily routine” Control – “extent to which management uses rules and pressures to keep employees under control” Innovation – “degree of emphasis on variety, change, and new approaches” Physical comfort – “extent to which the physical surrounding contribute to a pleasant work environment”

12. Results Supervisor Support, 4.5 mean score below normed average (5.5-6.0) Goal Orientation & Efficiency mean score 6.67 (5.5.-6.0) Work and Time Pressure 5.85 (4.0-5.0) Organizational Control 5.08 (4.5-5.0) Physical Comfort 5.08(4.5-5.0) Clarity of Expectations 5.33 (5.5-6.0) Innovative Environment 3.27 ( 4.0-5.0)

13. Conclusions Nurses Perceived a lack of supervisor support Were unsure of their job roles Felt that new ideas or techniques were not valued High degree of task orientation & work pressure, rules, regulations, & management control were perceived as high Physical work environment was satisfactory

14. Retention Strategies Improve supervisor support Clarify expectations Reduce organizational control Reduce work and time pressure

15. The End