Realities of Nursing Turnover: Ecuador, South America

Monday, 22 July 2013: 2:10 PM

Sheri P. Palmer, DNP, RN
College of Nursing, 554 SWKT, Brigham Young University, Provo, UT

Learning Objective 1: The learner will be able to identify factors associated with nursing dissatisfaction within a large hospital in Ecuador

Learning Objective 2: The learner will be able to discuss possible methods to implement to increase nursing retention within a large hospital in Ecuador

Realities of nursing turnover: Ecuador, South America


Nursing turnover is a challenge internationally. Research shows patient care is compromised due to high turnover among nurses.  Turnover increases the nurse to patient ratio which negatively affects patient health outcomes.  The overall shortage of nurses globally is a considerable problem and the International Council of Nurses views the retention of nurses as a major factor in this shortage (ICN, 2012). It is imperative to increase the positive work environment to retain nurses; this may be especially true in developing nations.  This paper presents a descriptive study at a large welfare hospital in Ecuador.


A survey of 88 nurses from all areas of the hospital was conducted.  Quantitative results were identified from an adapted version of the Nurse Work Index (Aiken, 2010).  Qualitative data was also gathered from open-ended questions.


Factors identified affecting turnover  were:  not satisfied with pay, not enough nurses to provide care, under appreciation of nursing, unable to advance in work, lack of supervisors, lack of autonomy,  inflexibility in schedule, and lack of teamwork between physicians and nurses.


Knowledge of why nurses leave their current positions can help various nursing administrations globally in affecting policy changes, benefits, and pay.  Some of the recommendations for this particular administration in Ecuador were: increase nurses pay according to merit, implement clinical ladders for advancement, and implement clinical protocols to enhance autonomy.  These factors may increase retention among the nursing staff.  Improved quality and safety in patient care will be the ultimate benefit from increased nurse retention.