The Process of Nurse Turnover a Grounded Theory Study

Abstract

Abstract: Introduction: Turnover and shortage of nurses is causing problems for the health care system in terms of cost, ability to care for patients and quality of care, then the aim of this study was to explore the process of nurse’s turnover. Method: This study is a qualitative design based on grounded theory approach that conducted in 2013-2015. The main participants in this study were nurses with different clinical experiences and clinical degrees. Selection of participants was initiated using purposive sampling and continued by theoretical sampling until saturation was achieved. Data was collected using unstructured interviews. A total of 26 interviews were performed with 23 participants. Data were analyzed based on Corbin and Strauss (2008) approach. Findings: Based on the experiences of participants, three main categories: "Selected routes into Nursing", "Social prestige of the nursing profession" and "culture and structure of the bedside" formed the contextual factors that influences on turnover of nurses. "Limited opportunities for advancement and promotion" was the psychosocial concern for the participants. "Self-help" and "passivity", the strategies that taken by the participants in the process of dealing with tendency to leave the bedside, the outcomes of these strategies were "lack of professional commitment" and "adherence". "Mismatched individual expectations with the expectations of the organization: empowerment for liberation" was the core category. Conclusion: With respect to routes to nursing, social prestige and culture and structure of bedside the nurse's turnover process was the result of mismatched expectations of individual versus corporate expectations and The use of passivity saving strategies and self-help. The identification of this process, influencing factors and outcomes in identifying problems and strategies for solving them will be helpful. Nursing managers can on the one hand by improving the working conditions of nursing and culture and introduce this sacred profession in society and the other hand with empowering and supportive behaviors and create opportunities for growth and professional development has helped to achieve lasting nurses and to improve quality of care.