İşten Ayrılma (Turnover)
Özet
Hemşire yetersizliği tüm dünyada pandemi ile önemi daha da artmış güncel bir sorundur. Dünyada 2030 yılına kadar 13 milyon ek hemşire insan gücüne gereksinim vardır. Bununla birlikte çalışma koşulları nedeniyle hemşirelerin kurumdan ve meslekten ayrılma oranları yüksektir.
Hemşirelerin kurumdan ayrılma nedenlerinin başında çalışma ortamı gelmektedir. Çalışma ortamında fazla iş yükü, rol karmaşası, düzensiz vardiyalar ve kariyer fırsatlarının yetersiz olması ayrılma için önemli faktörlerdir. Ayrıca yönetici özellikleri, desteği ve yönetici-çalışan ilişkisi de belirleyicidir. Bunun yanı sıra stres, iş doyumsuzluğu, tükenmişlik ve kuruma bağlılığın düşük olması gibi bireysel nedenler öne çıkmaktadır. Hemşirelerin kurumdan ve meslekten ayrılmaları hasta, hemşire ve kurum sonuçlarını da olumsuz etkilemektedir.
Sağlık sistemlerinin ve yönetici hemşirelerin gündemindeki en önemli sorun hemşire yetersizliğidir. Bu sorunun şiddetini artıran en önemli faktör ise mevcut işgücündeki hemşirelerin kurumdan ve meslekten ayrılmalarıdır. Özellikle yeni kuşak hemşirelerin farklılıkları iyi anlaşılmalı ve çalışma ortamında buna uygun düzenlemeler yapılmalıdır.
The global nursing shortage has become an increasingly critical issue, particularly in the context of the ongoing pandemic. It is predicted that an additional 13 million nurses will be needed by 2030 to meet the global demand for healthcare workers. However, the high turnover of nurses due to working conditions is a major challenge.
One of the main reasons nurses leave their institutions is the working environment. Factors such as excessive workload, role ambiguity, irregular shifts and limited career opportunities contribute significantly to nurses' decisions to leave. In addition, the quality of leadership, support and the manager-employee relationship play a crucial role. Individual factors such as stress, job dissatisfaction, burnout and low organisational commitment also contribute to nurses leaving the profession. It is important to note that when nurses leave their institutions and the profession, this has a negative impact on patients, nurses and healthcare organisations.
The shortage of nurses remains one of the most pressing challenges on the agenda of healthcare systems and nurse managers. The most significant factor exacerbating this problem is nurses leaving their current positions. Understanding the unique characteristics of the new generation of nurses and making appropriate adjustments to the work environment are particularly important steps in addressing this issue effectively.
Referanslar
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Koehler T, & Olds D. Generational Differences in Nurses’ Intention to Leave. Western Journal of Nursing Research;2022;44(5): 446-455. doi: 10.1177/0193945921999608
Kovner CT, Brewer CS, Fatehi F, & Jun J. What does nurse turnover rate mean and what is the rate? Policy, Politics, & Nursing Practice;2014;15(3-4): 64-71. doi: 10.1177/1527154414547953
Duffield CM, Roche MA, Homer C, Buchan J, & Dimitrelis S. A comparative review of nurse turnover rates and costs across countries. Journal of Advanced Nursing;2014;70(12): 2703-2712. doi: 10.1111/jan.12483
Halter M, Boiko O, Pelone F, Beighton C, Harris R, Gale J, ... & Drennan V. The determinants and consequences of adult nursing staff turnover: a systematic review of systematic reviews. BMC Health Services Research;2017a; 17(1): 1-20. doi: 10.1186/s12913-017-2707-0
Buchan J. Reviewing the benefits of health workforce stability. Human Resources for Health;2010;8(1): 1-5. doi: 10.1186/1478-4491-8-29
Takase M. A concept analysis of turnover intention: Implications for nursing management. Collegian;2010;17(1): 3-12. doi: 10.1016/j.colegn.2009.05.001
Duffield CM, Roche MA, Homer C, Buchan J, & Dimitrelis S. A comparative review of nurse turnover rates and costs across countries. Journal of Advanced Nursing;2014;70(12): 2703-2712. doi: 10.1111/jan.12483
Nursing Solutions, Inc. NSI National Health Care Retention & RN Staffing Report, 2023. (21.12.2023 tarihinde https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf adresinden ulaşılmıştır).
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Kocaman G, Seren S, Kurt S, Danis B, & Erer T. Turnover among nurses at three university hospitals. Journal of Education and Research in Nursing;2010;7(1): 34-39.
Arslan Yürümezoğlu H, Kocaman, G, & Mert Haydari S. Predicting nurses’ organizational and professional turnover intentions. Japan Journal of Nursing Science; 2019;16(3): 274-285. doi: 10.1111/jjns.12236
Arslan Yurumezoglu H, & Kocaman G. Predictors of nurses’ intentions to leave the organisation and the profession in Turkey. Journal of Nursing Management; 2016;24(2): 235-243. doi: 10.1111/jonm.12305
Hallaran AJ, Edge DS, Almost J, Tregunno D. New Registered Nurse Transition to the Workforce and Intention to Leave: Testing a Theoretical Model. Canadian Journal of Nursing Research;2021;53(4): 384-396. doi:10.1177/0844562120957845
Sasso L, Bagnasco A, Catania G, Zanini M, Aleo G, Watson R, & RN4CAST@ IT Working Group. Push and pull factors of nurses' intention to leave. Journal of Nursing Management;2019;27(5): 946-954. doi: 10.1111/jonm.12745
Cao T, Huang X, Wang L, Li B, Dong X, Lu H, ... & Shang S. Effects of organisational justice, work engagement and nurses' perception of care quality on turnover intention among newly licensed registered nurses: A structural equation modelling approach. Journal of Clinical Nursing;2020;29(13-14): 2626-2637. doi: 10.1111/jocn.15285
Aiken LH, Sloane DM, Bruyneel L, Van den Heede K, Sermeus W, & Rn4cast Consortium. Nurses’ reports of working conditions and hospital quality of care in 12 countries in europe. International Journal of Nursing Studies; 2013;50(2): 143-153. doi: 10.1016/j.ijnurstu.2012.11.009
Burmeister EA, Kalisch BJ, Xie B, Doumit MA, Lee E, Ferraresion A, ... & Bragadóttir H. Determinants of nurse absenteeism and intent to leave: An international study. Journal of Nursing Management;2019;27(1): 143-153. doi: 10.1111/jonm.12659
Oyeleye O, Hanson P, O’Connor N, & Dunn D. Relationship of workplace incivility, stress, and burnout on nurses’ turnover intentions and psychological empowerment. The Journal of Nursing Administration;2013;43(10): 536-542. doi: 10.1097/NNA.0b013e3182a3e8c9
Halpin Y, Terry LM, & Curzio J. A longitudinal, mixed methods investigation of newly qualified nurses’ workplace stressors and stress experiences during transition. Journal of Advanced Nursing;2017;73(11): 2577-2586. doi: 10.1111/jan.13344
Hayward D, Bungay V, Wolff AC, & MacDonald V. A qualitative study of experienced nurses' voluntary turnover: learning from their perspectives. Journal of Clinical Nursing;2016;25(9-10): 1336-1345. doi: 10.1111/jocn.13210
MacKusick CI, & Minick P. Why are nurses leaving? Findings from an initial qualitative study on nursing attrition. Medsurg Nursing;2010;19(6).
Çamveren H, Arslan Yürümezoğlu H, & Kocaman G. Why do young nurses leave their organization? A qualitative descriptive study. International Nursing Review;2020;67(4): 519-528. doi: 10.1111/inr.12633
Hawkins N, Jeong S, & Smith T. New graduate registered nurses’ exposure to negative workplace behaviour in the acute care setting: An integrative review. International Journal of Nursing Studies;2019;93: 41-54. doi: 10.1016/j.ijnurstu.2018.09.020
Al Zamel LG, Lim Abdullah K, Chan CM, & Piaw CY. Factors influencing nurses’ intention to leave and intention to stay: An integrative review. Home Health Care Management & Practice; 2020;32(4): 218-228. doi:10.1177/1084822320931363
Li X, Zhang Y, Yan D, Wen F, & Zhang Y. Nurses' intention to stay: The impact of perceived organizational support, job control and job satisfaction. Journal of Advanced Nursing;2020;76(5): 1141-1150. doi: 10.1111/jan.14305
Bell M, & Sheridan A. How organisational commitment influences nurses’ intention to stay in nursing throughout their career. International Journal of Nursing Studies Advances;2020;2. doi: 10.1016/j.ijnsa.2020.100007
Satoh M, Watanabe I, & Asakura K. Determinants Strengthening Japanese Nurses’ Intention to Stay at Their Current Hospital. The Tohoku Journal of Experimental Medicine;2018;246(3): 175-182. doi: 10.1620/tjem.246.175
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Referanslar
Nursing Solutions Inc. 2021 NSI National Health Care Retention & RN Staffing Report, (2021a). (21.12.2023 tarihinde https://nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf adresinden ulaşılmıştır).
Nursing Solutions Inc. 2021 Hospital Executive Level Priorities-CNE, (2021b). (21.12.2023 tarihinde https://nsinursingsolutions.com/Documents/Library/HELP-CNE.pdf adresinden ulaşılmıştır).
World of Health Organization. State of the world's nursing 2020: investing in education, jobs and leadership. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO. (23.12.2023 tarihinde https://apps.who.int/iris/bitstream/handle/10665/331677/9789240004863-ara.pdf adresinden ulaşılmıştır).
International Council of Nurses. Policy Brief - The Global Nursing Shortage and Nurse Retention, 2021. (21.12.2023 tarihinde https://www.icn.ch/system/files/2021-07/ICN%20Policy%20Brief_Nurse%20Shortage%20and%20Retention.pdf adresinden ulaşılmıştır).
Ohue T, Aryamuang S, Bourdeanu L, Church JN, Hassan H, Kownaklai J, Pericak A, Suwannimitr A. Cross-national comparison of factors related to stressors, burnout and turnover among nurses in developed and developing countries. Nurs Open;2021;8(5): 2439-2451. doi: 10.1002/nop2.1002
Koehler T, & Olds D. Generational Differences in Nurses’ Intention to Leave. Western Journal of Nursing Research;2022;44(5): 446-455. doi: 10.1177/0193945921999608
Kovner CT, Brewer CS, Fatehi F, & Jun J. What does nurse turnover rate mean and what is the rate? Policy, Politics, & Nursing Practice;2014;15(3-4): 64-71. doi: 10.1177/1527154414547953
Duffield CM, Roche MA, Homer C, Buchan J, & Dimitrelis S. A comparative review of nurse turnover rates and costs across countries. Journal of Advanced Nursing;2014;70(12): 2703-2712. doi: 10.1111/jan.12483
Halter M, Boiko O, Pelone F, Beighton C, Harris R, Gale J, ... & Drennan V. The determinants and consequences of adult nursing staff turnover: a systematic review of systematic reviews. BMC Health Services Research;2017a; 17(1): 1-20. doi: 10.1186/s12913-017-2707-0
Buchan J. Reviewing the benefits of health workforce stability. Human Resources for Health;2010;8(1): 1-5. doi: 10.1186/1478-4491-8-29
Takase M. A concept analysis of turnover intention: Implications for nursing management. Collegian;2010;17(1): 3-12. doi: 10.1016/j.colegn.2009.05.001
Duffield CM, Roche MA, Homer C, Buchan J, & Dimitrelis S. A comparative review of nurse turnover rates and costs across countries. Journal of Advanced Nursing;2014;70(12): 2703-2712. doi: 10.1111/jan.12483
Nursing Solutions, Inc. NSI National Health Care Retention & RN Staffing Report, 2023. (21.12.2023 tarihinde https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf adresinden ulaşılmıştır).
National Health Service. Workforce Statistics - September 2022 (Including selected provisional statistics for October 2022). (23.12.2023 tarihinde https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/september-2022 adresinden ulaşılmıştır).
Mannix K. The future of Australia’s nursing workforce: COVID-19 and burnout among nurses. Melbourne: University of Melbourn, 2021. (21.12.2023 tarihinde https://www.unimelb.edu.au/__data/assets/pdf_file/0004/4085194/katelyn_mannix_report.pdf adresinden ulaşılmıştır).
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Registered Nurses’ Association of Ontario (RNAO). Work and Wellbeing Survey Results, 2021. (28.12.2023 tarihinde https://rnao.ca/sites/rnao-ca/files/Work-and-Wellbeing-Survey-Results-2021.pdf adresinden ulaşılmıştır).
Kocaman G, Seren S, Kurt S, Danis B, & Erer T. Turnover among nurses at three university hospitals. Journal of Education and Research in Nursing;2010;7(1): 34-39.
Arslan Yürümezoğlu H, Kocaman, G, & Mert Haydari S. Predicting nurses’ organizational and professional turnover intentions. Japan Journal of Nursing Science; 2019;16(3): 274-285. doi: 10.1111/jjns.12236
Arslan Yurumezoglu H, & Kocaman G. Predictors of nurses’ intentions to leave the organisation and the profession in Turkey. Journal of Nursing Management; 2016;24(2): 235-243. doi: 10.1111/jonm.12305
Hallaran AJ, Edge DS, Almost J, Tregunno D. New Registered Nurse Transition to the Workforce and Intention to Leave: Testing a Theoretical Model. Canadian Journal of Nursing Research;2021;53(4): 384-396. doi:10.1177/0844562120957845
Sasso L, Bagnasco A, Catania G, Zanini M, Aleo G, Watson R, & RN4CAST@ IT Working Group. Push and pull factors of nurses' intention to leave. Journal of Nursing Management;2019;27(5): 946-954. doi: 10.1111/jonm.12745
Cao T, Huang X, Wang L, Li B, Dong X, Lu H, ... & Shang S. Effects of organisational justice, work engagement and nurses' perception of care quality on turnover intention among newly licensed registered nurses: A structural equation modelling approach. Journal of Clinical Nursing;2020;29(13-14): 2626-2637. doi: 10.1111/jocn.15285
Aiken LH, Sloane DM, Bruyneel L, Van den Heede K, Sermeus W, & Rn4cast Consortium. Nurses’ reports of working conditions and hospital quality of care in 12 countries in europe. International Journal of Nursing Studies; 2013;50(2): 143-153. doi: 10.1016/j.ijnurstu.2012.11.009
Burmeister EA, Kalisch BJ, Xie B, Doumit MA, Lee E, Ferraresion A, ... & Bragadóttir H. Determinants of nurse absenteeism and intent to leave: An international study. Journal of Nursing Management;2019;27(1): 143-153. doi: 10.1111/jonm.12659
Oyeleye O, Hanson P, O’Connor N, & Dunn D. Relationship of workplace incivility, stress, and burnout on nurses’ turnover intentions and psychological empowerment. The Journal of Nursing Administration;2013;43(10): 536-542. doi: 10.1097/NNA.0b013e3182a3e8c9
Halpin Y, Terry LM, & Curzio J. A longitudinal, mixed methods investigation of newly qualified nurses’ workplace stressors and stress experiences during transition. Journal of Advanced Nursing;2017;73(11): 2577-2586. doi: 10.1111/jan.13344
Hayward D, Bungay V, Wolff AC, & MacDonald V. A qualitative study of experienced nurses' voluntary turnover: learning from their perspectives. Journal of Clinical Nursing;2016;25(9-10): 1336-1345. doi: 10.1111/jocn.13210
MacKusick CI, & Minick P. Why are nurses leaving? Findings from an initial qualitative study on nursing attrition. Medsurg Nursing;2010;19(6).
Çamveren H, Arslan Yürümezoğlu H, & Kocaman G. Why do young nurses leave their organization? A qualitative descriptive study. International Nursing Review;2020;67(4): 519-528. doi: 10.1111/inr.12633
Hawkins N, Jeong S, & Smith T. New graduate registered nurses’ exposure to negative workplace behaviour in the acute care setting: An integrative review. International Journal of Nursing Studies;2019;93: 41-54. doi: 10.1016/j.ijnurstu.2018.09.020
Al Zamel LG, Lim Abdullah K, Chan CM, & Piaw CY. Factors influencing nurses’ intention to leave and intention to stay: An integrative review. Home Health Care Management & Practice; 2020;32(4): 218-228. doi:10.1177/1084822320931363
Li X, Zhang Y, Yan D, Wen F, & Zhang Y. Nurses' intention to stay: The impact of perceived organizational support, job control and job satisfaction. Journal of Advanced Nursing;2020;76(5): 1141-1150. doi: 10.1111/jan.14305
Bell M, & Sheridan A. How organisational commitment influences nurses’ intention to stay in nursing throughout their career. International Journal of Nursing Studies Advances;2020;2. doi: 10.1016/j.ijnsa.2020.100007
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