Background
Recent studies have revealed that Turnover of Nurses is huge problem in every health care system that put major impact on organizational structure and it is highly associated with workplace stress. The concept of home health care nursing is relatively new in Pakistan. Nurses working in home health care setting are faced with great difficulties due to dealing with palliative care patients. Hence, it is imperative to work on shortage of nurses in home health care services to decrease the ratio of turnover and improve nurses’ satisfaction level. This study aimed to determine the factors associated with satisfaction and turnover among nurses in home health care setting. Based on the findings, we implemented Variable payment model in collaboration of finance department to increase incentives and monetary benefits of nurses to promote their work satisfaction level.
Method
This study was a mixed methods design. At phase 1, we employed an analytical cross-sectional survey. Eighty nursing staff i.e. qualified nurses and health care assistant were interviewed with the help of a structured questionnaire in a tertiary care hospital, Karachi Pakistan. Based on the findings of phase 1, we implemented Variable Payment Model (VPM) with the coordination of finance department. We allowed staff to do 107 nursing procedures per month; if staff exceed the procedure then they were rewarded special allowance. In addition, sever other coping strategies were reinforced by management like: work friendly environment, introduction of special relaxation activities on weekly basis and encouraging staff to visit sports center.
Results
The turnover rate of nurses in Home health care setting was 40% due to low job salary. Around 55% were dissatisfied with their work environment. The potential reasons were low incentive, managerial style and increased workload. After the implementation of VPM and other coping strategies, staff reported a significant increased job satisfaction. Furthermore, nursing staff reported a positive environment change after introduction of the afore-mentioned strategies.
Conclusion
Variable Payment Model along with other stress relieving strategies had a positive impact upon job satisfaction and turnover rate of nurses in home health care setting. The implication of these findings will help managers and researchers to explore the effectiveness of VPM in other settings.