Qualitative Study of Experienced Nurses' Voluntary Turnover

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5th Sep 2017 Health Reference this

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Title

Hayward,D., Bungay,V., Wolff,A.C. & Macdonald,V. (2016). A qualitative study of experienced nurses’ voluntary turnover: learning from their perspectives. Journal of Clinical Nursing, 25, 1336-1345. doi: 10.1111/jocn.13210

Introduction

Issues of nursing turnover has been a perpetual challenge for healthcare industry. Furthermore, resignation of experienced nurses causes critical declination in standard of care and reduces desirable nursing outcome. In fact, crisis of staffing shortages often occur during the transitional period while an experienced nurse left while at that same time a newly recruited staff is undergoing orientation and training. In the first place, employment of new staff incurs significant high cost to the society and health care organization. The aim of this qualitative, interpretive descriptive study is to explore the reasons that caused resignation of experienced nurses. In this cross sectional qualitative study, 12 purposive selected participants took part in individual face to face interview. The sample included 8 full time and 4 part time nurses. Thorne’s (2009) interpretative descriptive design was used for data collection and analysis. Hayward et al found that work environment and personal reason caused nurses to leave. Sample will be the element chosen for discussion.

The sample

Purposive sampling method is employed for the specific information that one has to offer due to the personal experience (Patton, 2005). This method of sampling is deployed deliberately to recruit the particular individuals because of the crucial information they can give (Carpenter & Suto, 2008). Guarte et al. (2007) stated that purposive sampling is the selection of population that provides most information on the subject of interest. Similarly, Liamputtong (2013) believes that qualitative study depends on information rich individuals who have in-depth understanding of the discussed topic due to their experiences. Selecting members of the participants with a purpose enable researchers to focus on the issues that need to be explored extensively. Furthermore, qualitative research is mainly about the lived experiences of people, owing to this phenomena researcher sample for meaning and not frequency. Since qualitative study aims to explore meanings that an individual experience, the finding is not general (Hesse-Biber & Leavy, 2011). Likewise, in the research that examines how nurses cope with nursing workload nursing critically ill patients, researchers will recruit nurses with experiences working in intensive care unit. Alternatively, qualitative researchers may use convenience and snowball sample which is efficient but does not necessary provide most information rich sources (Polit & Beck, 2014). On the other hand, Jansses et al. (2015) stated that some studies concluded that purposive sample may develop representative samples whereas a random sample avoid biases. Even so, purposive sampling seems as the main approach in qualitative study as the criterion based participants has the characteristics enabling exploration of their experience related to the study (Ritchie et al., 2014).

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In this study, there were 12 participants recruited while a smaller sample size can be considered since this is a qualitative study. Sandelowski (1995) maintained that qualitative sample of 10 may be a sufficient number for sampling among the homogeneous population. In fact, qualitative research focuses on the importance of breadth and depth to thoroughly address the relevant research questions. Hence, the approach centered around meaning and feeling of the studies thus not intended to create a representative samples. In the year 2012, Dworkin stated that qualitative research requires in-depth understanding of phenomenon, concentrate on the meaning and reasons behind the stories pertaining to social issues. On the contrary, Polit and Beck (2014) commented that qualitative research sample size is guided by principle of data saturation and may need a larger sample. Research conducted by Bertrand (2012) was an example used to explain this situation where the interview continued while sample size was thought to have achieved data saturation, a participant told the story that was never been shared before. Theoretically, careful and meaningful selection of participants in small number is appropriate for qualitative study. Ideally, the participants will provide details and range of information that answer the questions probe by researcher. Hence, it is possible for a sample size of less than 10 participants to achieve data saturation. Interestingly, Morse (2008) pointed out that quality of data is influenced by the skill of interviewer and affect the required sample size in achieving saturation. Mason (2010) added that 10 interviews conducted by an experienced interviewer can obtain more information than an inexperienced interviewer who have more interviews. Having one single case as sample can be meaningful and extremely informative as seen in the studies from management and medical research (Boddy, 2016).

Since the selection of sample is vital to the outcome of qualitative study, the sample inclusion of part time nurses and nurses who worked in different role and position will likely to have opinions highly objective to their varied work situation. For instance, nurses’ employment decisions are contributed by work hour, job function and salary. Full time employees are perceived to shoulder on extra responsibilities due to their participation in the other improvement plan of the organization. In addition to that, full time workers remain busy performing routine nursing duty as their part time counterpart (Janssona & Engstromb, 2017). Commitment and job satisfactions are major predictor of staff turnover (Satoh et al. 2016) Generally, part time nurses are perceived to be less committed due to shorter work hour as compare to full time nurses (Katz & Kahn, 1979). In year 2009, Han et al. reported that full time nurses attained more job satisfaction, commitment and empowerment than part time nurses. Having said that, there were many studies (e.g. Eberhardt et al. 1984; Jackofsky et al. 1987; Logan et al. 1973; McGinnis et al. 1990; Miller et al. 1979; Shockey et al. 1994; Sinclair et al. 1999; Steffy et al. 1990; Still, 1983; Vecchio, 1984; Wetzel, Soloshy et al. 1990; Wotruba, 1990) which examined the variance of work attitudes, commitment, job satisfaction and turnover intention between part time and full time employee throughout two decades but the outcomes were inconclusive and inconsistent. Similar levels of job satisfaction and organizational commitment were reported among part time and full time employees (Thorsteinson, 2003).

Conclusion

In qualitative research, the sampling plan must achieve its mean to be adequate and appropriate. In order to achieve the goal, selected individual must have total understanding of the subject under study and in return supply full information. In brief, the study can be effective using smaller number of participants if researcher can apply good skill with the right inclusion and exclusion criteria.

References

Boddy, C.R. (2016). Sample size for qualitative research. Qualitative Market Research: An International Journal, 19(4), 426-432. Retrieved from http://dx.doi.org/10.1108/QMR-06-2016-0053

Dworkin,S.L. (2012). Sample size policy for qualitative studies using in-depth interviews. Archives of Sexual Behavior, 41(6), 1319-1320. doi: 10.1007/s10508-012-0016-6

Eberhardt, B. J. & Shani, A. B. (1984). The effects of full-time versus part-time employment status on attitudes toward specific organizational characteristics and overall job satisfaction. Academy of Management Journal, 27, 893-900.

Guarte, J.M. & Barrios,E.B. (2007). Estimation under purposive sampling. Communications in Statistics-Simulation and Computation, 35(2), 277-284. Retrieved from http://dx.doi.org/10.1080/03610910600591610

Hammell, K.W. & Carpenter, C. (2004). Qualitative research in evidence-based rehabilitation. Edinburgh: Churchill Livingstone.

Han, S.H., Moon, S.J. & Yun, E.K. (2009). Empowerment, job satisfaction and organizational commitment: comparison of permanent and temporary nurses in Korea. Applied Nursing Research, 22, 15-20.

Hesse-Biber, S.N. & Leavy, P. (2010). The practice of qualitative research. (2nd ed.). Edinburgh: Churchill Livingstone.

Jackofsky, E. F. & Peters, L. H. (1987). Part-time and full-time employment status differences: A replication and extension. Journal of Occupational Behavior, 8, 1-9.

Janssona, A.B. & Engstromb, A. (2017). Working together: critical care nurses experiences of temporary staffing within Swedish health care: a qualitative study. Intensive and Critical Care Nursing. Retrieved from http://dx.doi.org/10.1016/j.iccn.2016.08.010

Katz, D. & Kahn, R. L. (1979). The social psychology of organizations. New York: Wiley.

Liamputtong, P. (2013). The science of words and the science of numbers: research methods as foundations for evidence-based practice in health. In P. Liamputtong (Ed.), Research Methods in Health: Foundations for Evidence-Based Practice. (pp. 3-23). Melbourne: Oxford University Press Australia and New Zealand.

Logan, N.O’Reilly, C.A. & Roberts, K.H. (1973). Job satisfaction among part-time and full-time employees. Journal of Vocational Behavior, 3, 33-41.

Mason, M. (2010). Sample size and saturation in PhD studies using qualitative interviews. Forum: Qualitative Social Research, 11(3), Article 8. Retrieved from http://nbn-resolving.de/urn:nbn:de:0114-fqs100387

McGinnis, S.K. & Morrow, P.C. (1990). Job attitudes among full- and part-time employees. Journal of Vocational Behavior, 36, 82-96.

Miller, H.E. & Terborg, J.R. (1979). Job attitudes of part-time and full-time employees. Journal of Applied Psychology, 64, 380-386.

Morse, J.M. (2008). Styles of collaboration in qualitative inquiry. Qualitative Health Research, 18(1), 3-4.

Patton, M.Q. (1990). Qualitative evaluation and research methods. (2nd ed.). California: SAGE.

Polit, D.F. & Beck C.T. (2014). Essentials of nursing research: appraising evidence for nursing practice. (8nd ed.). Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins.

Ritchie, J., Lewis, J., Elam, G., Tennant, R. & Rahim, N. (2014). Designing and selecting samples. In Ritchie, J, Lewis, J., Nicholls, C.M. & Ormston, R. (Eds.), Qualitative research practice: A guide for social science students and researchers. (pp.113). Los Angeles: SAGE.

Sandelowski, M. (1995). Sample size in qualitative research. Research in Nursing & Health, 18(2), 179-183.

Satoh, M., Watanabe, I. & Asakura, K. (2016). Occupational commitment and job satisfaction mediate effort-reward imbalance and the intention to continue nursing. Japan Journal of Nursing Science, 14(1), 49-60. doi: 10.1111/jjns.12135

Shockey, M.L. & Mueller, C.W. (1994). At-entry differences in part-time and full-time employees. Journal of Business and Psychology, 8, 355-364.

Sinclair, R.R., Martin, J.E. & Michel, R.P. (1999). Full-time and part-time subgroup differences in job attitudes and demographic characteristics. Journal of Vocational Behavior, 55, 337-357.

Steffy, B.D., & Jones, J.W. (1990). Differences between full-time and part-time employees in perceived role strain and work satisfaction. Journal of Organizational Behavior, 11, 321-329.

Still, L.V. (1983). Part-time versus full-time salespeople: Individual attributes, organizational commitment and work attitudes. Journal of Retailing, 59, 55-79.

Thorsteinson, T.J. (2003) Job attitudes of part-time vs. full-time workers: A meta-analytic review. Journal of Occupational and Organizational Psychology, 76, 151-177.

Van Hoeven, L.R., Janssen, M.P., Roes, K.C.B. & Koffijberg, H. (2015). Aiming for a representative sample: Simulating random versus purposive strategies for hospital selection. Biomed Central Medical Research Methodology, 15(90), 1-9. Retrieved from https://dx.doi.org/10.1186%2Fs12874-015-0089-8

Vecchio, R.P. (1984). Demographic and attitudinal differences between part-time and full-time employees. Journal of Occupational Behaviour, 5, 213-218.

Wetzel, K., Soloshy, D.E. & Gallagher, D.G. (1990). The work attitudes of full-time and part-time registered nurses. Health Care Management Review, 15, 79-85.

Wotruba, T.R. (1990). Full-time versus part-time salespeople: A comparison on job satisfaction, performance, and turnover in direct selling. International Journal of Research in Marketing, 7, 97-108.

Title

Hayward,D., Bungay,V., Wolff,A.C. & Macdonald,V. (2016). A qualitative study of experienced nurses’ voluntary turnover: learning from their perspectives. Journal of Clinical Nursing, 25, 1336-1345. doi: 10.1111/jocn.13210

Introduction

Issues of nursing turnover has been a perpetual challenge for healthcare industry. Furthermore, resignation of experienced nurses causes critical declination in standard of care and reduces desirable nursing outcome. In fact, crisis of staffing shortages often occur during the transitional period while an experienced nurse left while at that same time a newly recruited staff is undergoing orientation and training. In the first place, employment of new staff incurs significant high cost to the society and health care organization. The aim of this qualitative, interpretive descriptive study is to explore the reasons that caused resignation of experienced nurses. In this cross sectional qualitative study, 12 purposive selected participants took part in individual face to face interview. The sample included 8 full time and 4 part time nurses. Thorne’s (2009) interpretative descriptive design was used for data collection and analysis. Hayward et al found that work environment and personal reason caused nurses to leave. Sample will be the element chosen for discussion.

The sample

Purposive sampling method is employed for the specific information that one has to offer due to the personal experience (Patton, 2005). This method of sampling is deployed deliberately to recruit the particular individuals because of the crucial information they can give (Carpenter & Suto, 2008). Guarte et al. (2007) stated that purposive sampling is the selection of population that provides most information on the subject of interest. Similarly, Liamputtong (2013) believes that qualitative study depends on information rich individuals who have in-depth understanding of the discussed topic due to their experiences. Selecting members of the participants with a purpose enable researchers to focus on the issues that need to be explored extensively. Furthermore, qualitative research is mainly about the lived experiences of people, owing to this phenomena researcher sample for meaning and not frequency. Since qualitative study aims to explore meanings that an individual experience, the finding is not general (Hesse-Biber & Leavy, 2011). Likewise, in the research that examines how nurses cope with nursing workload nursing critically ill patients, researchers will recruit nurses with experiences working in intensive care unit. Alternatively, qualitative researchers may use convenience and snowball sample which is efficient but does not necessary provide most information rich sources (Polit & Beck, 2014). On the other hand, Jansses et al. (2015) stated that some studies concluded that purposive sample may develop representative samples whereas a random sample avoid biases. Even so, purposive sampling seems as the main approach in qualitative study as the criterion based participants has the characteristics enabling exploration of their experience related to the study (Ritchie et al., 2014).

In this study, there were 12 participants recruited while a smaller sample size can be considered since this is a qualitative study. Sandelowski (1995) maintained that qualitative sample of 10 may be a sufficient number for sampling among the homogeneous population. In fact, qualitative research focuses on the importance of breadth and depth to thoroughly address the relevant research questions. Hence, the approach centered around meaning and feeling of the studies thus not intended to create a representative samples. In the year 2012, Dworkin stated that qualitative research requires in-depth understanding of phenomenon, concentrate on the meaning and reasons behind the stories pertaining to social issues. On the contrary, Polit and Beck (2014) commented that qualitative research sample size is guided by principle of data saturation and may need a larger sample. Research conducted by Bertrand (2012) was an example used to explain this situation where the interview continued while sample size was thought to have achieved data saturation, a participant told the story that was never been shared before. Theoretically, careful and meaningful selection of participants in small number is appropriate for qualitative study. Ideally, the participants will provide details and range of information that answer the questions probe by researcher. Hence, it is possible for a sample size of less than 10 participants to achieve data saturation. Interestingly, Morse (2008) pointed out that quality of data is influenced by the skill of interviewer and affect the required sample size in achieving saturation. Mason (2010) added that 10 interviews conducted by an experienced interviewer can obtain more information than an inexperienced interviewer who have more interviews. Having one single case as sample can be meaningful and extremely informative as seen in the studies from management and medical research (Boddy, 2016).

Since the selection of sample is vital to the outcome of qualitative study, the sample inclusion of part time nurses and nurses who worked in different role and position will likely to have opinions highly objective to their varied work situation. For instance, nurses’ employment decisions are contributed by work hour, job function and salary. Full time employees are perceived to shoulder on extra responsibilities due to their participation in the other improvement plan of the organization. In addition to that, full time workers remain busy performing routine nursing duty as their part time counterpart (Janssona & Engstromb, 2017). Commitment and job satisfactions are major predictor of staff turnover (Satoh et al. 2016) Generally, part time nurses are perceived to be less committed due to shorter work hour as compare to full time nurses (Katz & Kahn, 1979). In year 2009, Han et al. reported that full time nurses attained more job satisfaction, commitment and empowerment than part time nurses. Having said that, there were many studies (e.g. Eberhardt et al. 1984; Jackofsky et al. 1987; Logan et al. 1973; McGinnis et al. 1990; Miller et al. 1979; Shockey et al. 1994; Sinclair et al. 1999; Steffy et al. 1990; Still, 1983; Vecchio, 1984; Wetzel, Soloshy et al. 1990; Wotruba, 1990) which examined the variance of work attitudes, commitment, job satisfaction and turnover intention between part time and full time employee throughout two decades but the outcomes were inconclusive and inconsistent. Similar levels of job satisfaction and organizational commitment were reported among part time and full time employees (Thorsteinson, 2003).

Conclusion

In qualitative research, the sampling plan must achieve its mean to be adequate and appropriate. In order to achieve the goal, selected individual must have total understanding of the subject under study and in return supply full information. In brief, the study can be effective using smaller number of participants if researcher can apply good skill with the right inclusion and exclusion criteria.

References

Boddy, C.R. (2016). Sample size for qualitative research. Qualitative Market Research: An International Journal, 19(4), 426-432. Retrieved from http://dx.doi.org/10.1108/QMR-06-2016-0053

Dworkin,S.L. (2012). Sample size policy for qualitative studies using in-depth interviews. Archives of Sexual Behavior, 41(6), 1319-1320. doi: 10.1007/s10508-012-0016-6

Eberhardt, B. J. & Shani, A. B. (1984). The effects of full-time versus part-time employment status on attitudes toward specific organizational characteristics and overall job satisfaction. Academy of Management Journal, 27, 893-900.

Guarte, J.M. & Barrios,E.B. (2007). Estimation under purposive sampling. Communications in Statistics-Simulation and Computation, 35(2), 277-284. Retrieved from http://dx.doi.org/10.1080/03610910600591610

Hammell, K.W. & Carpenter, C. (2004). Qualitative research in evidence-based rehabilitation. Edinburgh: Churchill Livingstone.

Han, S.H., Moon, S.J. & Yun, E.K. (2009). Empowerment, job satisfaction and organizational commitment: comparison of permanent and temporary nurses in Korea. Applied Nursing Research, 22, 15-20.

Hesse-Biber, S.N. & Leavy, P. (2010). The practice of qualitative research. (2nd ed.). Edinburgh: Churchill Livingstone.

Jackofsky, E. F. & Peters, L. H. (1987). Part-time and full-time employment status differences: A replication and extension. Journal of Occupational Behavior, 8, 1-9.

Janssona, A.B. & Engstromb, A. (2017). Working together: critical care nurses experiences of temporary staffing within Swedish health care: a qualitative study. Intensive and Critical Care Nursing. Retrieved from http://dx.doi.org/10.1016/j.iccn.2016.08.010

Katz, D. & Kahn, R. L. (1979). The social psychology of organizations. New York: Wiley.

Liamputtong, P. (2013). The science of words and the science of numbers: research methods as foundations for evidence-based practice in health. In P. Liamputtong (Ed.), Research Methods in Health: Foundations for Evidence-Based Practice. (pp. 3-23). Melbourne: Oxford University Press Australia and New Zealand.

Logan, N.O’Reilly, C.A. & Roberts, K.H. (1973). Job satisfaction among part-time and full-time employees. Journal of Vocational Behavior, 3, 33-41.

Mason, M. (2010). Sample size and saturation in PhD studies using qualitative interviews. Forum: Qualitative Social Research, 11(3), Article 8. Retrieved from http://nbn-resolving.de/urn:nbn:de:0114-fqs100387

McGinnis, S.K. & Morrow, P.C. (1990). Job attitudes among full- and part-time employees. Journal of Vocational Behavior, 36, 82-96.

Miller, H.E. & Terborg, J.R. (1979). Job attitudes of part-time and full-time employees. Journal of Applied Psychology, 64, 380-386.

Morse, J.M. (2008). Styles of collaboration in qualitative inquiry. Qualitative Health Research, 18(1), 3-4.

Patton, M.Q. (1990). Qualitative evaluation and research methods. (2nd ed.). California: SAGE.

Polit, D.F. & Beck C.T. (2014). Essentials of nursing research: appraising evidence for nursing practice. (8nd ed.). Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins.

Ritchie, J., Lewis, J., Elam, G., Tennant, R. & Rahim, N. (2014). Designing and selecting samples. In Ritchie, J, Lewis, J., Nicholls, C.M. & Ormston, R. (Eds.), Qualitative research practice: A guide for social science students and researchers. (pp.113). Los Angeles: SAGE.

Sandelowski, M. (1995). Sample size in qualitative research. Research in Nursing & Health, 18(2), 179-183.

Satoh, M., Watanabe, I. & Asakura, K. (2016). Occupational commitment and job satisfaction mediate effort-reward imbalance and the intention to continue nursing. Japan Journal of Nursing Science, 14(1), 49-60. doi: 10.1111/jjns.12135

Shockey, M.L. & Mueller, C.W. (1994). At-entry differences in part-time and full-time employees. Journal of Business and Psychology, 8, 355-364.

Sinclair, R.R., Martin, J.E. & Michel, R.P. (1999). Full-time and part-time subgroup differences in job attitudes and demographic characteristics. Journal of Vocational Behavior, 55, 337-357.

Steffy, B.D., & Jones, J.W. (1990). Differences between full-time and part-time employees in perceived role strain and work satisfaction. Journal of Organizational Behavior, 11, 321-329.

Still, L.V. (1983). Part-time versus full-time salespeople: Individual attributes, organizational commitment and work attitudes. Journal of Retailing, 59, 55-79.

Thorsteinson, T.J. (2003) Job attitudes of part-time vs. full-time workers: A meta-analytic review. Journal of Occupational and Organizational Psychology, 76, 151-177.

Van Hoeven, L.R., Janssen, M.P., Roes, K.C.B. & Koffijberg, H. (2015). Aiming for a representative sample: Simulating random versus purposive strategies for hospital selection. Biomed Central Medical Research Methodology, 15(90), 1-9. Retrieved from https://dx.doi.org/10.1186%2Fs12874-015-0089-8

Vecchio, R.P. (1984). Demographic and attitudinal differences between part-time and full-time employees. Journal of Occupational Behaviour, 5, 213-218.

Wetzel, K., Soloshy, D.E. & Gallagher, D.G. (1990). The work attitudes of full-time and part-time registered nurses. Health Care Management Review, 15, 79-85.

Wotruba, T.R. (1990). Full-time versus part-time salespeople: A comparison on job satisfaction, performance, and turnover in direct selling. International Journal of Research in Marketing, 7, 97-108.

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