Nursing staff who assist patients at healthcare facilities and/or in local communities play an important role to provide patients safe and high quality nursing care. At present, however, the demand for nurses exceeds the supply, and Japan is facing the problem of a nursing shortage as seen in other countries in the world. Nursing professionals develop their abilities and skills mainly through years of clinical experience to become nursing experts. Preventing experienced nurses from leaving their profession, and retaining them at medical facilities for as long as possible can prove to be highly effective and important measures to ensure the number of quality nurses. Many previous studies on the nurse turnover in Japan have focused on newly qualified nurses’ intentions to leave, and do not properly investigate the factors involved in leaving, which might concern the work environment, including psychosocial factors, such as life events of giving birth to a new baby and raising a child, and/or the factors involved in continuing work, which would include job satisfaction and the charm of nursing. In addition, only a small number of studies analyze these points by examining individual nurses’ situations.
Therefore, this study was intended to clarify the factors involved in Healthy Work Environments (HWE) for retention of hospital nurses in Japan. This study is important for hospital nurses who wants to know what is Healthy Work Environments (HWE),and they keep work healthy.
Methodology:
The nursing directors of 525 hospitals with 200 or more beds for acute care that are located in core cities, government ordinance cities or special wards of Tokyo in Japan were asked to cooperate with the survey, and seven directors showed willingness to cooperate. Written requests for a personal interview were sent to members of the nursing staff at these seven hospitals, and18 interviewees were randomly selected from the 100 nurses who responded positively. Interviews were conducted with the 11 nurses who were actually able to arrange an interview with the researcher. Interview questions included, why they were continuing to work at their current workplace, and what they considered necessary for HWE, which would allow them to continue working. The interview survey was carried out after obtaining approval from the Medical Research Ethics Committee of Tokyo Medical and Dental University.
Results:
The research subjects were two male and nine female nursing professionals. The mean age was 39.3 years (SD ± 7.3), the mean number of years of experience was 14 years and nine months (SD ± nine years and seven months), and the mean years of service at their current workplace was 11 years and five months (SD ± eight years and eight months).
Eight out of 11 interviewees gave economic reasons as the main reason for them to continue working. Some answered that there was no specific reason to leave their job. The following reasons were given as reasons why some of their colleagues had left the profession: long overtime, difficulties with balancing work and private life, negative impact on their children, being bothered by phone calls from the workplace while they were off duty, having to attend meetings when off duty. It was found that they wanted support and strong leadership from their superiors.
Discussion:
Economic reasons were given by most of the subjects as the reason for continuing to work. The lack of reason that would make them quit has also been mentioned. However, if nursing staff work only or mostly for economic reasons, they may keep changing their workplace in search of better remuneration, which would be an obstacle to effective career development. For nursing professionals to work healthily and enthusiastically, and to provide quality nursing care, it is necessary to enhance the positive factors why they remain in their profession, including a higher level of job satisfaction, and to improve their working conditions, such as reducing overtime and providing better work-life balance. It has also been suggested that the managerial capability of a nurse’s superior is a key factor to the nurse’s HWE.
Conclusion:
1. Economic reasons are the most common reasons why the 8 interviewees continue their careers.
2. Long overtime, not being able to establish a good work-life balance, having to attend meetings or perform other duties on a holiday are some reasons why their colleagues had quit their jobs.
3. Support and strong leadership are expected of superiors.
Based on the above findings, it has been suggested that the management skills of Nursing manager, who are in a position of managing the nursing staff, are key to the creation of nursing professionals’ HWE.