Perceived Strategies to Decrease Attrition Rates Among Nurses Practicing at Healthcare Institutions in India

Sunday, 30 July 2017: 11:35 AM

Llewellyn Prater, PhD, RN1
Shelby L. Garner, PhD, RN, CNE1
Leena Raj, MSN, MPhil2
(1)Louise Herrington School of Nursing, Baylor University, Dallas, TX, USA
(2)Nursing Institute, Bangalore Baptist Hospital, Bengaluru, India

Background: A profound nursing shortage exists in India, where nurses are increasingly out-migrating to practice nursing abroad. A robust nursing workforce is needed to improve health outcomes in India. Until recently, nursing was not considered a profession in India and research suggests nurses historically experienced marginalization and oppression (Johnson, Green, & Maben, 2014). A recent positive shift in the perception of nurses as professionals in India creates a timely milieu in which to give nurses a voice so that they may express their ideas and perceptions (Walton-Roberts, 2015). Strategies to decrease attrition rates among nurses in India could also shape health policy in other countries that may be facing similar shortages.

Purpose:  To explore a subset of nurses’ perceived strategies to decrease attrition rates among nurses practicing at healthcare institutions in India.

Methods:  A qualitative descriptive approach was used. Purposive sampling resulted in 10 participants. First, participants were asked to complete a short written questionnaire to provide information on socio demographics and nursing experience. Participants were then interviewed using face-to-face semi structured, in depth, individual interviews. The interviews started with open-ended questions related to each participant’s lived experience as a nurse in India and moved into open-ended questions to solicit their ideas on strategies to decrease attrition rates among nurses in India. Data were collected from November 2014 to March 2015. Interviews were audio recorded and transcribed. A directed content analysis approach was used to derive codes, themes, and subthemes.

Results:  Coding and thematic interpretation resulted in three themes and multiple subthemes. Perceived strategies to decrease attrition rates included the need to: 1) implement reasonable remuneration through establishing equitable and aligned salary scales, 2) provide safe and effective environments by standardizing nursing workforce policies, ensuring equipment availability, and offering transportation services for nurses, and 3) recognize nursing as a profession by offering increased opportunities for nurses to become leaders and providing opportunities to recognize the value of nurses in the healthcare workforce.

Conclusion: Participants in this study advocated for change in nursing and workforce policy to start from within the nursing profession towards positive practice environments to increase nursing capacity in India and globally.