Recruitment and retention in nursing is a recurring issue within the current political health workforce climate. Discuss your thoughts on how the micro politics of health enables or disables effective recruitment and retention.
Some ideas of micro political issues are: (but are not limited to)
The requirement for healthcare services and community services is rapidly increasing among the individuals who are suffering from any ailment or any illness. But there are many challenges faced by the nurses or other clinicians in healthcare, which are long-working hours, fatigue, etc. But the greatest and the predominant challenge or the problem that is faced by the individuals in nursing are recruitment and retention. These challenges thus, affect the qualitative care that is provided to the patients or the clients.
Recruitment and retention of competent qualified people are crucial challenges not only for the coming decades for the nursing staff of Australia but also for the provision of healthcare services. Both challenges while recruiting the nurses and the retention in the nursing leads to the problem of the shortage of nurses or other clinicians in the hospitals and this shortage of the nurses leads to many other problems occur, as it becomes difficult to handle the patients by the limited staff and due to this there are a high number of chances of committing errors by the nurses because the burden on the limited staff leads to the other challenges in nursing such as increased fatigue, short-term engagement, etc. And the increased errors and short-term engagement further lead to the increase in the morbidity as well as the mortality rate among the patients. As it has been studied that the high engagement ratio of the patients to the nurses leads to dissatisfaction among the clients and burnouts and other injuries among the nurses whereas the low engagement ratio leads to morbidity and mortality in the patients (Aph.gov.au, 2022).
The primary goal of recruitment is to inspire current health professionals and students to open jobs or future positions. In nursing, recruitment is considered as the main problem that leads to issues like nurse shortage, as it has been estimated by Health workforce Australia that by 2050, there will be a shortage of 100,000 nurses while 123,000 shortage of nurses will be by 2030.
There are many reasons behind the shortage of nurses and the recruitment of nurses in the healthcare center. As nursing is a profession in which adequate skills and qualities are required to help the patient to improve his or her health outcomes. And it is difficult to find nurses with adequate skills in problem-solving and critical thinking, so it becomes difficult to recruit the nursing staff. Mainly rural and remote areas found difficulty with finding the talented and skilled nursing workforce. Besides, another issue is that most of the experienced nurses are aged or have reached the age of retirement due to which it becomes hard to recruit them because those clinicians have reached that age where they are having certain physical or mental requirements for themselves (Marufu et al., 2021).
Further, the other issue that has been found out behind the recruitment in nursing in Australia is that many of the nurses who are skilled by nature are not themselves interested in applying for the nurse post because of the low pay which is offered to them, so to prevent this issue or to eliminate this problem the proper funding is required by the government. As the proper funding by the government increases the pay in the nursing occupation which is enough to attract the participants towards nursing. Besides, through many studies, it has been found that the budget for hiring the new nursing staff is also one of the problems, as the low budget for the recruitment of the nurses can thus result in the loss of the talented and skilled nursing staff. The main reason behind this inadequate budget for recruiting the nursing staff is the high salaries that are being offered to other staff members (Broyles et al., 2011).
Apart from all of these reasons, the most important reason behind the issue with recruiting nursing is found as the poor process of recruitment. As, the recruitment process in nursing starts with the collection of data of applicants and the written exam of the nursing applicants, which is then followed by the process of the interview in which the questionnaire session is being conducted for the nursing applicants to assess their theoretical as well as practical knowledge, critical thinking as well as the problem-solving skills, etc. And based on this, the recruitment decisions are taken.
So, if the process of recruitment in nursing is poor then it may result in poor skilled nurses and clinicians which may directly affect the health outcomes of the patients, as it can enhance the rate of morbidity and mortality among the patients (Broyles et al., 2011).
The primary goal of the retention is to keep the healthcare professionals or the clinicians employed in the healthcare centers or to keep them in their job roles. In nursing, retention is another challenge or issue which is faced by the healthcare centers in the present scenario. According to certain reports, the current nurse turnover rate is 8.8 percent to 37 percent, this turnover varies and depends upon regions as well as the specialty that nurses have. And upon the survey of 1000 nurses, it has been found that around one-third of the registered nurses are thinking about leaving their job, the high turnover rates can directly impact the economic status of the healthcare centers and increase the health issue rate in patients. There are many reasons behind quitting the nursing occupation or their job. Besides, one of the reasons behind quitting the nursing occupation is related to the issues in recruitment. As, it has been found that the limited staff is the result of the lack of recruitment, which further put pressure on the other staff in the healthcare centers and due to this there are the chances of committing a high number of the medical errors which can lead to morbidity and mortality in the patients. Besides, the errors in the performance of the staff also increase the range of burnouts, cuts, and other injuries to the nursing staff, which becomes the predominant problem behind quitting the profession of nursing (Marufu et al., 2021).
Furthermore, another reason that has been found behind quitting up the nursing profession is the stress which is present in the nursing position, as it has been reported by many of the nurses that they are unable to maintain mental as well as physical health along with the profession of nursing because the nursing profession makes the entire day hectic due to which nurses and other clinicians unable to fulfill their health requirements and also unable to schedule their life properly. Along with this, the lower pay scale in nursing occupation is also one of the reasons raised by the nurses behind quitting the job and some nurses are under financial crisis, so to prevent that they quit their job and grab some other opportunity in which they receive the reasonable or higher pay in comparison to their nursing profession (Seifi, Heidari and Gharebagh, 2017).
Furthermore, another reason behind quitting the job that has been found is that nurses above 60 years of age have reached the age of retirement, due to which they have to quit their profession of nursing, is the major drawback because in such cases there is the loss of the highly skilled and talented nurses and this loss becomes major when there is the lack of recruitment of nurses. Apart from these, the strained relationship between the nurses and the managers is also one of the reasons behind quitting up the nursing occupation by the nurses and can also reason behind firing the nurse, as in the strained relation the two individuals lack trust and also dislikes each other, which results in the frustration and also unable to provide qualitative services to the patients (Seifi, Heidari and Gharebagh, 2017).
Micropolitics is the political dynamic that majorly focuses upon certain aspects, which includes decision-making, formulation of the rules, allocation of the tasks, provision of adequate and proper instructions, and the creation of the proper structure system of the organization. All of these aspects are of the utmost in healthcare centers. Micropolitics leads to political behavior in the organization or in the healthcare centers which further promotes as well as safeguard the interests and the power of every individual and staff member in the healthcare centers. Due to this, it has been interpreted that micropolitics enables effective recruitment and retention in the healthcare centers of nursing staff. As the implementation of proper decision-making in healthcare helps to build the proper strategy which further supports in undertaking the proper and effective recruitment process in nursing and also able to make decisions and the strategies that lower the quitting of nursing professions among the nursing staff. Similarly, the formulation of the proper rules affects the formulation of the effective process of recruitment and this proper rule formulation also helps to maintain the proper budget which is the main issue while recruiting the nursing staff (Franco, Soares and Gazzinelli, 2020).
Besides, adequate allocation of the task helps to prevent the issue of stress and overburden of work on the nurses due to which the nurses quit the nursing profession. As the proper allocation of tasks results in less burden on nurses due to which there are fewer chances of committing medical errors and also results in preventing burnouts and other injuries while performing their duty (Franco, Soares and Gazzinelli, 2020).
Similarly, the provision of adequate and proper instructions enables effective recruitment and retention in nursing, as adequate instructions help to implement the effective process of recruitment. Besides, this also helps in avoiding burnouts and committing medical errors in nursing staff, which is the main cause behind quitting the nursing occupation by nurses. In the same way, the proper structure system enables effective recruitment and retention in nursing by preventing the issues that are in the way.
Besides, it is also has been interpreted that if all the aspects of the micropolitics are not implemented properly and adequately then the political behavior unable to safeguard the interests, rights, and power of the individuals in the healthcare centers. Due to this, micropolitics can lead to micropolitical issues and the challenges that the nursing staff is facing in the healthcare center, even the issue of recruitment and retention in nursing also. So, through this, it can be said that micropolitics also disables effective recruitment and retention in nursing (Franco, Soares and Gazzinelli, 2020).
Micropolitical issues are the problems that result from the ineffectiveness in bringing the political behavior in the healthcare center, which leads to the issue in enabling effective recruitment and retention in nursing. Micropolitical issues are the problems that only impact the nurses and other clinicians in the healthcare center. Many micropolitical issues or problems make recruitment and retention a challenge in nursing. The first micropolitical issue is horizontal violence, as this violence is considered as bullying or violence harassment or abuse in the healthcare centers, which creates a negative workplace environment. All of this horizontal violence is mainly faced by female nursing staff, as there is around 61.9 percent of the nurses who have experienced horizontal violence in the healthcare center, this further affects their physical as well as mental health conditions due to which nurses show their disinterest in acquiring the occupation of the nursing and they often quit their nursing job. Besides, the words, comments, or actions which demotivate or belittle the individuals are also considered as horizontal violence, which is also faced by the staff in nursing (Bloom, 2018).
Further, autonomy is also analyzed as the micropolitical issue which disables recruitment and retention of nursing. Autonomy is the power or the right that is provided to the nursing staff and the other members in the healthcare center, the rights which are provided to the staff members are the right to make a decision, freedom to act in accordance with their base knowledge, maintenance of the personal care, organization of the workday, etc. if the nurses are not allowed to make their own decisions or the strained relation of manager and the nurse does not provide freedom to the nurses to work according to their knowledge, then it may lead to frustration among the nursing staff and they quit their nursing job (Oshodi et al., 2019).
Besides, it also has been viewed that the inadequate funding of the equipment, dressing materials, and medications raise the issues of the recruitment and retention in nursing, as nurses or clinicians shows disinterest to those healthcare centers in which there is inadequate funding of the equipment and medications, due to which the problem in the recruitment of nurses arise. Besides, the nursing staff who is already working in such healthcare centers which lack the basic equipment or medications thinks to quit the job because without the proper instruments and medications it becomes difficult for the clinicians to provide proper services to the patients and to take proper care of them (Rogers et al., 2020).
Discrimination is one of the leading micropolitical issues that the nurses and other staff members are facing in healthcare centers. There are many forms of discrimination that are faced by the nurses and other clinicians in the healthcare center, like they face discrimination based on gender, race, religion, etc. The most common form of discrimination is racial discrimination, as it has been estimated in Australia that one in every four nurses faced or experienced racial discrimination in the healthcare centers. This discrimination faced by individual further deteriorates the mental health condition of nurses, which thus restrict them to join the nursing occupation and compels them to quit their nursing job (Rogers et al., 2020).
It has been concluded that nurses are the backbone of the healthcare centers, as the critical thinking and problem-solving skills help to improve the health outcomes of the patients but in nursing, the biggest challenge or the recurring issue is recruitment and retention. Many reasons lead to the problem or the issue of recruitment and retention in nursing. Some of the reasons behind the recruitment of nurses are the poor recruitment process, low pay provided to the nurses, difficulty in finding talented and skilled nurses, etc. Besides, the reasons behind the issue in retention of nurses are the increased burden or workload on the nurses, which increases the burnouts and other injuries in nurses, low pay scale, hectic schedule, etc.
Furthermore, it also has been concluded that micropolitics is the political dynamic that enables as well as disables the effective recruitment and retention in nursing means micropolitics works both positively as well as negatively in nursing or healthcare. As, there are certain aspects like proper structure system, provision of the adequate instructions, formulation of the rules and decision-making, etc., which creates the political behavior and thus protects the interests and rights of the individuals in the healthcare center, which enables the effective recruitment and retention in nursing. Besides, if the political behavior is not created properly then, it may give rise to micropolitical issues like horizontal violence, staffing issues, oppressive groups at workplace, discrimination, lack of autonomy, inadequate funding of the proper dressing materials, medical equipment, and medications, etc., disables the effective recruitment and retention in nursing.
Aph.gov.au, 2022. Chapter 6 - Recruitment, retention and return to nursing. [online] Aph.gov.au. Available at: <https://www.aph.gov.au/parliamentary_business/committees/senate/community_affairs/completed_inquiries/2002-04/nursing/report/c06> [Accessed 10 March 2022].
Bloom, E., 2018. Horizontal violence among nurses: Experiences, responses, and job performance. Nursing Forum, [online] 54(1), pp.77-83. Available at: <https://pubmed.ncbi.nlm.nih.gov/30332520/> [Accessed 10 March 2022].
Broyles, L., Rodriguez, K., Price, P., Bayliss, N. and Sevick, M., 2011. Overcoming Barriers to the Recruitment of Nurses as Participants in Health Care Research. [online] Available at: <https://www.researchgate.net/publication/51574000_Overcoming_Barriers_to_the_Recruitment_of_Nurses_as_Participants_in_Health_Care_Research> [Accessed 10 March 2022].
Franco, E., Soares, A. and Gazzinelli, M., 2020. Macro and micropolitics recontextualization of an integrated curriculum: experienced itinerary in nursing undergraduate. [online] Available at: <https://www.scielo.br/j/ean/a/9HrFwnPJmCsfNNCgR7fKCrR/?format=pdf&lang=en> [Accessed 10 March 2022].
Marufu, T., Collins, A., Vargas, L., Gillespie, L. and Almghairbi, D., 2021. Factors influencing retention among hospital nurses: systematic review. British Journal of Nursing, [online] 30(5), pp.302-308. Available at: <https://pubmed.ncbi.nlm.nih.gov/33733849/> [Accessed 10 March 2022].
Oshodi, T., Bruneau, B., Crockett, R., Kinchington, F., Nayar, S. and West, E., 2019. Registered nurses’ perceptions and experiences of autonomy: a descriptive phenomenological study. BMC Nursing, [online] 18(1). Available at: <https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-019-0378-3> [Accessed 10 March 2022].
Rogers, L., De Brún, A., Birken, S., Davies, C. and McAuliffe, E., 2020. The micropolitics of implementation; a qualitative study exploring the impact of power, authority, and influence when implementing change in healthcare teams. BMC Health Services Research, [online] 20(1). Available at: <https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05905-z> [Accessed 10 March 2022].
Seifi, B., Heidari, M. and Gharebagh, Z., 2017. Nursing staff retention: Effective factors. [online] Available at: <https://www.researchgate.net/publication/322394239_Nursing_staff_retention_Effective_factors> [Accessed 10 March 2022].
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