Factors That Contribute to Nurse Manager Retention
Mickey L. Parsons, Jana Stonestreet
Nurs Econ. 2003;21(3)
The purpose of this study was to describe factors that contribute to a health system's successful retention of nurse managers. This study is the first of a series that will provide the foundation for developing the nursing organization as a "health-promoting organization." The background and significance, theoretical framework, study findings, and executive strategies are discussed. The results and implications are intended to guide executive strategies, including organizational interventions, to build the nursing organization for ...view middle of the document...
Vacancy rates for nurse managers were the highest in the West (8.5%) and South (8.2%) in a recent study sponsored by the American Organization of Nurse Executives (HSM Group, 2002). Reports documenting the shortage of nurse managers and challenges for the chief nurse executive to maintain clinical services are emerging. In a management case study, Silvetti, Rudan, Frederickson, and Sullivan (2000) articulated concern with the development of nurse managers and the decreasing numbers of qualified managers to handle the expanded and multifaceted responsibilities.
With the plethora of health system problems affecting patient care and nursing, today's nurse manager is on the front line, the firing line. As the department manager, the expectation of the nurse manager is to sustain a viable, productive workforce to provide quality, cost-effective patient care. For executives to provide leadership and direction for nursing unit managers, it is essential to learn about factors that support nurse manager retention.
Due to the complexity of issues in the nursing and nurse manager shortage, a comprehensive theoretical framework is required. An ecological framework was used to develop a Health Promoting Organizations Model (Parsons, 1999). A health promoting organization is "defined as a community that designs activities and programs, to improve social and environmental living conditions, that enable people to increase control over and improve their health. Organizations, everywhere, may conceive 'Health Promoting' as an integrative strategy to promote the wellbeing of each and every person"(Parsons, 1999, p. 84). Health is defined holistically, as mind, body, and spirit. The goal of this study was to begin building the foundation for developing the nursing organization as a health-promoting organization. Creating positive work environments, healthy workplaces, where the nursing leaders and staff design activities and programs for their own and their patients' well-being is the long-term goal.
The study design was qualitative, using open-ended data-generating questions, guided by interview by comment (Snow, Zurcher, & Sjoberg, 1982). The interviewees were nurse managers who had been in their roles at least 2 years, employed in one of the health system's five hospitals, with a capacity of 1,562 licensed beds within a large metropolitan city in the Southwest. All nurse managers who met these criteria were invited to be interviewed.
A Participant Informed Consent form was prepared and completed prior to the interview. Any and all questions each participant had were immediately answered. The confidentiality of specific nurse manager interviews was assured. A leadership book was given to each participant as an honorarium at the end of the interview. The interviews were held in a conference room in the hospital where the nurse manager was employed and they were conducted on paid work time. Each interview was tape-recorded...