Técnicas e instrumentos

The following emerged from the findings, discussion and recommendations. The theory suggesting the severity of staff shortages was conclusively proven. These staff shortages have also affected the Cape Town hospital in which much of the research was conducted. Enough evidence was gathered from the nurses to justify the need for more nursing staff.

The data from the research inquiry into causes, which affect the nurses was examined and commented upon. In order to draw an accurate conclusion, the researcher had to weigh and balance the facts in perspective so that an accurate result could be achieved.

The nurses’ responses to the questionnaires could be concluded as honest responses, as they could answer them anonymously. The interview-related responses could also be interpreted in the same manner, as the nurses were opinionated about the matter in their replies and spoke openly about how staff shortages affected them.

Finding – There is a shortage of nurses.

Recommendation

It is recommended that the hospital should apply to the provincial Department of Health for more qualified nurses and urge the Department to release a bigger budget for training and development purposes so that nurses can be recruited and selected for the desired posts at the hospital. The hospital should inform the Department where the most critical shortages are such as the intensive care unit or general wards, where there is a greater need for nurses.

6.2.1.1 Staff shortages as the main cause of nursing challenges

The researcher outlined factors that govern staff shortages from the perspective of the nurses and found that the causes for concern were that some of the nurses’ behaviour, as evidenced in some of the literature documentation, lead to absenteeism, stress, conflict with other staff members and burnout. Staff shortages was still critical and caused the greatest stress for currently-employed nursing staff.

Finding – Staff shortages lead to absenteeism among nursing staff.

Recommendation

It is recommended that the hospital management should conduct an urgent investigation into levels of absenteeism amongst the nurses. The outcomes of the said investigation should establish, which of the 3 groups of nurses, namely the professional nurses, the enrolled nursing assistants, and the staff nurses are mostly affected by absenteeism. Absenteeism impacts directly on staff shortages, and should be addressed by the hospital leadership as a matter of urgency.

6.2.1.2 Stress resulting from staff shortages

Stress was identified as a primary indicator of nursing behaviour when they were forced to face challenges that were caused by the absence of staff from the hospital. It could be seen from the comments that were made in the discussion and recommendations that there was an urgent need for more state nurses to assist their heavily-burdened colleagues, who were strained by patients’ demands.

There is also an urgency to train the nurses more often so that they can cope with stress and other barriers that hinder them in performing their duties towards their patients more effectively. This will result in the nurses being more multi-skilled and motivated.

Recommendation

It is suggested that the nurses should attend stress management training courses. A further recommendation is that these nurses should be empowered. If the nurses were placed in delegated positions in which they can make decisions, it will increase their confidence, lower their levels of stress, and reverse the decisions by many of them to leave the nursing profession.

It is recommended that there is a need for the nurses to be shown how to combat occupational challenges more effectively, not as individuals, but as a group or team. This can be achieved by reducing the isolation of some nurses in some wards, and having them work with patients in groups of two or more for short periods at a time so as not to disrupt working operations in terms of patient service delivery at the hospital.

6.2.1.3 Staff shortages during training and development

There was a desire for more trained and qualified staff to use their skills in the practical nursing environment. It was identified in the findings that absenteeism and operational requirements were the main causes of staff shortages during training and development sessions.

Other causes for the below-par attendance of nurses at courses, seminars and workshops is that some of their training needs may not be properly addressed, whereas too much emphasis may have been placed on a few aspects of development, while completely ignoring others.

Finding – Absenteeism and operational requirements cause staff shortages during training and development.

Recommendation

It is suggested that the nurses should be made aware of what their needs for training are, so that a plan can be devised to ensure that their training needs are aptly met. Further suggestions are that their line supervisors should monitor where lower level nurses’ shortcomings are in certain skills and take the necessary steps to communicate with hospital

It is, therefore, recommended that the nursing leaders should hold sessions with groups of nurses at a time so that the required skills needs can be identified and the appropriate courses, workshops or seminars can be chosen for the relevant nurses to attend.

6.2.1.4 The lack of work satisfaction as a factor that determines staff shortages

The nurses will choose to leave the state nursing profession for a private institution or leave nursing completely if not enough attention is given to their needs. Another motivating factor for nursing turnover is the inability for organisation growth, which means that there is a lack of promotion or job stagnation owing to performing the same daily work routine. The desire to leave nursing will be reduced if nurses also understand their jobs and working conditions better. Nurses have complained that they are frustrated.

Finding – Staff shortages occur owing to the lack of work satisfaction.

Recommendation

It is suggested that the work satisfaction model that was previously mentioned in the research should be implemented at the hospital under review. Further suggestions are that there should be input sourced from the nurses to create a more effective and realistic model. It is, therefore, recommended that these nurses should be made aware of the advantages of the model so that there can be less staff turnover, and other qualified state nurses can be attracted to seek employment at the hospital. The hospital should also consider redesigning the jobs, as it is important to add varying skills to the jobs, so that the tasks of the nurses do not have a lack of variation and become merely routine.

There is a need for hospital managers to encourage their staff to complete the provincial Department of Health’s Staff Satisfaction Survey 2013 questionnaire that has been recommended for them to complete. This is necessary so that the reasons for the levels of job dissatisfaction can be properly assessed by the hospital leaders.

6.2.1.5 The non-filling of vacant nursing posts

This sensitive topic was discussed with the nurses during the interviews, where they voiced their dissatisfaction with nursing posts that remained vacant for lengthy periods of time. The desire for job creation should be of paramount importance to the hospital.

If the posts are not filled in a reasonable space of time, this unfortunate problem will result in an increase in unnecessary challenges for the currently-employed nurses in the wards at the hospital and the delays in patients being properly attended to by the nurses.

Finding – The non-filling of posts on time cause staff shortages.

Recommendation

It is suggested that the hospital should review all posts under its control on a monthly basis and advertise the vacant posts as soon as possible.

It is, therefore, recommended that the Human Resource Department should take responsibility for advertising posts at the hospital. They must be supported by the heads of each section in the hospital in respect of the correct advertising of the relevant posts for consideration.

It is further suggested that nursing should be advertised as a desirable career, which will instill a sense of pride amongst existing nursing employees, and attract those persons who wish to qualify, and be more driven and determined to do so.