Retaining Professional Nurses in South Africa: Nurse Managers' Perspectives

South Africa is experiencing a serious shortage of nurses; which has to be addressed to prevent crises in health care services. Previous studies (Fletcher 2001:324; Oosthuizen 2005:117) found that nurses change their work environment due to dissatisfaction with their job situations. This implies that creating a favourable environment in the workplace situation could help retain professional nurses in their posts; implying that retention strategies should be effective. An exploratory; descriptive; contextual and qualitative design was used to describe nurse managers' views on factors which could influence professional nurse retention; as well as their views regarding attributes that were required to enable them to contribute towards enhancing professional nurse retention. A purposive sample of nurse managers employed in public and private hospitals in the Gauteng province was selected. Semi-structured interviews were conducted with 21 nurse managers. The results were analysed qualitatively and contextualised within Vogt; Cox; Velthouse and Thames's Cork-Top (Bottleneck) Theory of Nurse Retention (1983) and Lewin's Force-Field Analysis Theory (1952). Factors pertaining to individual nurses; the organisation and nurse managers could influence the retention of professional nurses. Poor working conditions; long and inconvenient working hours; uncompetitive salaries and professional development of nurses have to be addressed to enhance professional nurses' retention. Unsafe working environments and a lack of resources threaten the safety and well-being of nurses and patients and contribute to high turnover rates. Nurse managers have to address shortcomings in their managerial and leadership skills and implement changes within a multigenerational nursing workforce and challenging working environments

Factors that May Influence South African Nurses' Decisions to Emigrate

Although no accurate statistics about the number of South African nurses working in other countries are available; the Organisation of Economic Cooperation and Development estimated that 35 000 South African nurses were working outside South Africa and/or outside the health care system (Horning; 2005:58). The global shortage of nurses; creating opportunities for South African nurses to work in foreign countries; as well as a variety of factors related to nursing; health care and the general living conditions in South Africa influence nurses' decisions to emigrate. The purpose of this study was to explore and describe the factors that influence nurses' decisions to emigrate. Maslow's Hierarchy of Needs Theory was used as a point of departure to establish what motivates the behaviour of nurses to emigrate from South Africa. A quantitative approach was used. The target population comprised all the nurses (n=3 331) on the registers of the South African Nursing Council (SANC) who completed their basic training during 2002. A random sample of 15 (n=501) of the total population of nurses who completed their basic training during 2002 was selected. Data were collected by structured questionnaires. The analysis of the data indicated that nurses' inadequate remuneration; poor working conditions; excessive workloads; lack of personal growth and career advancement possibilities and inability to meet their safety and security needs were major factors that influenced nurses' decisions to emigrate. The recommendations include improved remuneration for nurses; enhanced working conditions with adequate supplies and equipment; reduced workloads by employing more nurses; expanded career prospects and improved safety

The Role Played by Recruitment Agencies in the Emigration of South African Nurses

Active recruitment of foreign nurses might offer solutions to many countries' nursing shortages. During 1999; the International Council of Nurses (ICN) expressed concerns regarding the aggressive international recruitment of nurses.The ICN maintained that internationally recruited nurses might be particularly at risk of exploitation or abuse. The ICN denounced unethical recruitment practices that might exploit nurses (ICN; 1999a:1-6). Many nurses who leave the Republic of South Africa might use recruitment agencies' assistance. These concerns raised by the ICN indicated the need for obtaining information about the emigration of South African nurses and the role played by recruitment agencies. The purpose of this study was to explore and describe how recruitment agencies contributed to the emigration of South African nurses. Both qualitative and quantitative approaches were used. A purposive sample of recruitment agencies that recruited South African nurses to practise in foreign countries (N=4) was drawn. The second sample; a purposive sample selected through snowball sampling consisted of South African registered nurses who were practising in foreign countries (N=27). The findings obtained from structured interviews conducted with recruitment agencies were supported by findings from e-mail responses from nurses working in foreign countries. These research results indicated that recruitment agencies in South Africa provided professional services to nurses who wanted to work in foreign countries. Contrary to research reports published in other countries; no evidence was found of nurses being exploited by recruitment agencies in South Africa