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 influencing nurses' job satisfaction in selected private hospitals in England.

The quantitative descriptive survey used self-completion questionnaires to study factors influencing nurses' job satisfaction in selected private hospitals in England. Herzberg's Theory of Motivation was used to contextualise the results obtained from 85 completed questionnaires. In terms of Herzberg's Theory of Motivation, the most important extrinsic (hygiene) factor was no satisfaction with their salaries compared to nurses' salaries in other private hospitals in England, in the NHS and even at their own hospitals. However, most nurses were satisfied with the other extrinsic factors (organisation and administration policies, supervision and interpersonal relations). The most important intrinsic factors (motivators), influencing nurses' job satisfaction was their lack of satisfaction with promotions (including the fact that their qualifications were reportedly not considered for promotions), lack of advancement opportunities and being in dead-end jobs, and lack of involvement in decision- and policy-making activities. Nurses' levels of job satisfaction might be enhanced if promotion policies could be consistent, advancement opportunities implemented, qualifications considered for promotions, salary issues clarified, and if nurses could be involved in decision- and policy-making. Enhanced levels of job satisfaction could help to reduce turnover rates among registered nurses at the private hospitals in England that participated in this study.

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

The well-being of gays, lesbians and bisexuals in Botswana.

AIMS: To investigate the level of well-being of gays, lesbians and bisexuals (GLBs) in Botswana, how this level of well-being could be promoted and whether their health care needs were met by health care professionals. RATIONALE: It is illegal to engage in same-sex activities in Botswana, punishable by imprisonment. Although Botswana's citizens have one of Africa's best health care systems, little is known about the health status, health care needs and general well-being of Botswana's GLBs. This survey attempted to uncover some of these potential health care needs, impacting on the GLBs' well-being. DESIGN/METHODS: The research framework adopted was the health and human rights approach, placing dignity before rights. A survey design, with structured questionnaires, was used. Snow-ball sampling techniques were used. RESULTS: Results indicated that varying degrees of distress were experienced by 64% of the GLBs in this study. The GLBs identified a need for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) education and had concerns about their general health, discrimination against them and vulnerability to violence including sexual assaults. CONCLUSIONS: The well-being of the GLBs in Botswana was influenced by both positive internal acceptance of their sexual orientation and negative external acceptance by society. Health care professionals played insignificant roles in the promotion of GLBs' well-being, and could make greater inputs into health education efforts, and more significant contributions towards enhancing the GLBs' levels of well-being. Enhanced collaboration between health professionals and human rights activists are recommended to reduce violations of Botswana's GLBs' dignity and to improve their quality of life, including enhanced access to and utilization of health care services.

[Can we intervene in child abuse?]. / Kan ons toetree by kindermishandeling?

An alarming increase in cases of child abuse compels the nurse to become an active participant in the prevention and early detection of cases of child abuse. Although the Child Care Act, 74 of 1983, imposes a legal duty on nurses to give notification of suspected cases of child abuse, the nurse can play an even greater role by anticipating problems and assisting families to avoid or minimize them. The increased opportunities for nurses to share the responsibility for the prevention of child abuse are challenging.

Production of arachidonic and linoleic acid metabolites by guinea pig tracheal epithelial cells.

Pulmonary epithelial cells may be responsible for regulating airway smooth muscle function, in part by release of fatty acid-derived mediators. Incubation of isolated guinea pig tracheal epithelial cells with radiolabeled arachidonic acid (AA) leads to the production of 5- and 15-hydroxyeicosatetraenoic acid (5- and 15-HETE) and smaller amounts of leukotriene (LT) B4 and C4 and 12-hydroxyheptadecatrienoic acid (HHT). Epithelial cells also are able to release linoleic acid (LA) metabolites. Incubation with radiolabeled linoleic acid leads to the formation of 9- and 13-hydroxyoctadecadienoic acid (9- and 13-HODE). The biological significance of these mediators produced by epithelial cells is discussed.

Epithelium-derived linoleic acid metabolites modulate airway smooth muscle function.

Cultured epithelial cells obtained from guinea pig tracheal preparations metabolized arachidonic acid into 5- and 15-hydroxy-eicosatetraenoic acid and into the prostaglandins E2 and F2 alpha. Linoleic acid was converted by the epithelial cells into 9-hydroxy-octadecadienoic acid (9-HODE) and smaller amounts of 13-HODE. It was further investigated whether linoleic acid metabolites are of importance for the regulation of airway smooth muscle function. 13-HODE caused an increase of maximal contraction of tracheal rings to histamine, while 9-HODE had no effect.