The Causes of Nursing Attrition

"The study was conducted by Carol Isaac MacKusick and Ptlene Minickto to determine the causes of nursing attrition. According to MacKusick and Minickto, the academia researching on this aspect has ignored nurses who are no longer in clinical practice. However, the researchers in this study feel that nurses who have left clinical practice have vital first-hand information that can help stakeholders in understanding the important factors behind nursing attrition.

Research Methodology

Descriptive Framework

The researchers in this study employ a descriptive framework. Descriptive research is employed in scenarios where the researcher seeks to determine the prevalence of phenomena among the subjects or participants. The characteristics that describe the sample or situations are usually considered a categorical scheme. In the case of this research, the respondents put themselves and their situations in certain descriptive categories and went ahead to give more explanations on what they feel was unique in their departure from clinical practice.

Phenomenological Design

The researchers employed a phenomenological design. The choice of this design was informed by the complexity of phenomena that influence clinical nurses into abandoning practice. It is likely that there may be as many phenomena to study as the number of respondents chosen. Some of the nurses’ decisions to leave active practice may have been informed by more than one reason, this means that the phenomena may exceed the number of nurses.

Data Collection and Analysis

Geographical Setting

The study was conducted in the United States. The initial content analysis and literature review involved a scrutiny of data and information relevant to nursing practice in the US. The researchers coordinated the processes of preliminary studies, data collection and analysis from Georgia State University. The data was collected from nurses who had initially served in hospitals in the Southeastern United States.

Institutional Approval and Sampling Method

The authors state that they sent their request to the Georgia State University explaining the purpose and procedure of the research. The process of collecting and analyzing data only commenced after the institutional review board approved the application by the researchers. This research involved nurses who had left practice but were still registered. This means that despite being out of clinical practice, these individuals still considered themselves nurses. Such individuals are few and cannot be contacted through any specific organization. The researchers used snowball sampling to overcome these two challenges. This type of sampling involves identifying a few study respondents then recruiting others among their acquaintances. The assumption was that the RNs who were initially recruited were likely to be in contact with others who had quirt clinical practice.

Interview Process and Consent

The initial stages of the study involved analysis of existing data and information on the subject of nursing attrition in the US. This stage was important in identifying pertinent issues and phenomena that should form the center of discussion in the process of data collection and analysis. Nurses serving in various hospitals in the Southeastern United States were contacted and asked if they could link the investigator with their colleagues who were no longer in practice. The researcher provided a brief explanation on the research over the telephone and gave the respondents an opportunity to decide on whether they would like to participate. The telephone conversations were also used to set the appropriate time and date for the interviews. A written consent was sought from the prospective respondents. This consent was sought through forms that assured the nurses that their participation was voluntary and their privacy would be respected. Semi-structured interviews were conducted on the respondents in 2007. The researcher audiotaped them and took short notes while using pseudonyms to ensure that privacy of the nurses was respected. The participants received transcripts of their interviews and were given a chance to meet the researcher and clarify on issues that either party felt that was not satisfactorily responded to.

Data Analysis

The researcher does not clearly define the data analysis procedure. However, from their explanation of the data analysis process, it is likely that grounded analysis was applied in this research. This procedure involves a technique of coding where discussions and conversations are based on themes that emerge in the data. However, it is likely that the researchers had some ideas about various hypotheses. This means that content analysis may as well have been applied in the study.

Joint Analysis by Researchers

Two different researchers were involved in this study. However, the data was analyzed jointly by the two researchers. Interpretation of the data started early in the process of collection. This was done jointly by the researchers and the respondents in order to identify gaps and seek clarifications. Hermeneutics were used to help the researcher decode the contextual meanings in the interviews. Identification of new themes led to rereading of previous themes to determine whether they had been identified before.

Research Findings

Unfriendly workplace was an aspect that was reported by all the respondents. This refers to a hostile work environment that is difficult or uncomfortable for the nurses thus making them less productive. Emotional distress related to patient care was described by the respondents as a result of lack of collaboration and respect from colleagues and the employer, and overly aggressive treatment by individuals within the working environment. Fatigue and exhaustion were described as the two major effects of an unfriendly workplace on the physical wellbeing of the respondents (MacKusick and Minick, 2010). There were no other findings outside the three major themes. The findings were placed in the context of what was known about the situation previously in the discussion section.

Critique of the Study

From the above summary, the findings of the study by MacKusick and Minick (2010) appears credible and is likely to offer valid insights that can lead to solutions on the issue of nursing attrition in the US. Phenomenological research design effectively dealt with the issue of multiplicity of phenomena arising from the open-ended nature of questions asked during the interviews. This designed enabled the researcher to incorporate respondents’ insights in what had already been collected on topic.

Classification of the Study

Using the Hopkins Scale, this study can be categorized as IIIB. It is a qualitative study without systematic review. It offers fairly consistent description of the study process, results, sample size and comprehensive conclusions. There is a connection between the preliminary content analysis and the primary data collected through interviews.

Relevance and Coherence

Nurses who had left practice were appropriate for this study since they provided first-hand information on what had led to their departure. Ideas presented in this paper are coherent and flow smoothly, giving the reader an easy time to follow the research process. The reader can thus understand the essence of the experience by these nurses at the workplace.

Limitations and Saturation

Though this research included only 10 respondents, the interviews and follow-up questions gave the researcher an opportunity to describe their experiences at the workplace effectively. The researcher did not mention saturation. However, they came up with transcripts and went back to the respondents for clarifications on what had been recorded earlier. The three themes that emerged from data are well described in the results and discussion sections. There was no apparent bias in the process of data analysis.

Threats to Internal Validity

One threat to internal validity is the use of snowball sampling. This sampling design means that most of the nurses who acted as respondents know each other. Therefore, their quitting may have been as a result of influencing each other based on a limited number of factors. It is likely that if another sampling design was used, more phenomena would come out. Cultural factors and differences and differences in nursing practice are likely to affect nursing attrition. Therefore, these findings may not be applicable if transferred in a place with a different culture. I may transfer these findings to my practice. However, I have to do with caution due to differences in culture.

Implications for Practice

The implementation of the findings is of great importance to both the patients and nurses. If the issues discussed are addressed, nurses will find the workplace more comfortable thus reducing stress, burnout and the turnover rate. A conducive working environment for nurses will improve patient outcomes and increase safety in hospitals. Unlike in previous studies on nurse, MacKusick and Minick, (2010) collected data from nurses with a first-hand experience thus making their findings more relevant for solving the issue.

Conclusion

The study findings can be categorized as phenomenological. They can also be described as a survey because they show a general description of the issues around nurse attrition. They may also be described as descriptive.

References

MacKusick, C. I., & Minick, P. (2010). Why are nurses leaving? Findings from an initial qualitative study on nursing attrition. Medsurg Nursing, 19(6), 335.