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Sharon Callister is a Clinical Nurse Specialist in the Operating Theatre at St. Vincent's Hospital, Sydney. |
High staff turnover is a problem common to many hospitals. The purpose of this study was to examine and profile nurses in the specialised unit of the Operating Theatre St. Vincent's Hospital. An attempt was made to provide information that would allow Nurse Managers to meet challenges of periodic staff shortages and high turnover rates. A questionnaire survey of 55 registered nurses in the Operating Theatre was conducted. Results of the study indicated that most of the OR nurses enjoy their work and a large proportion (49%) travel a considerable distance i.e. greater than 10 kms. to work at St. Vincent's Hospital, frequently bypassing similar hospitals.
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Australia's health services are in a state of rapid change. Hospitals are faced with ever constricting budgets and managers of all disciplines must focus tremendous amounts of time and energy on maintaining staff satisfaction and thus performance.
High staff turnover is a problem common to hospitals in Australia, Europe, the United Kingdom and North America. In the financial year 1990-1991 St. Vincent's Hospital had a staff turnover of between 20%-50%. Since nurses represented 40% of staff, the estimated cost to the hospital was $160,00 (St. Vincent's Hospital, 1991: 15).
Whilst the specific figures for Operating Room nurses was not defined it is reasonable to expect that all areas of nursing contributed to the cost of staff turnover.
Research into general nursing satisfaction is abundant, yet papers devoted to specialised units such as the Operating Rooms are scarce. The purpose of this research was to examine and profile Operating Room nurses at St. Vincent's Hospital, Sydney. By determining the profile of nurses in specialised units, Nurse Managers are better able to meet challenges of periodic staff shortages and high turnover rates, and perhaps even reduce them.
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The Operating Suite at St. Vincent's is comprised of nine Theatres, eight of which are commissioned for use. Each theatre has an Anaesthetic Bay, a Recovery Room and a Theatre Sterile Supply Unit. Approximately 65 registered nurses work in the department and seven enrolled nurses. The majority of nurses work a rotating roster of morning and evening duties. Night duty is largely covered by permanent staff.
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A survey was conducted using a structured questionnaire (see Appendix 1). Questions pertained to participants age, sex, marital status, type of employment, distance travelled to work, educational status (current and predicted), length of employment, and also level of work enjoyment.
The researcher distributed 55 questionnaires to registered nurses. Of the questionnaires distributed, 45 were returned (ten nurses on leave or days off) hence a response rate of 82%. All returned questionnaires were fully completed.
| AGEGROUP | FREQUENCY | |
| 20 - 24 years | 5 | (11.1%) |
| 25 - 29 years | 13 | (28.9%) |
| 30 - 34 years | 15 | (33.3%) |
| 35 - 39 years | 6 | (13.3%) |
| 40 - 44 years | 2 | (4%) |
| 45 - 49 years | 4 | (8.9%) |
Table 1. Age Differences of Staff
Eighty four percent of respondents were female. Ages ranged from 22 to 49 years (mean 32 years). The males were slightly older, mean age 33 years. Table 1 indicates age differences.
Only 13% of nurses were married and had children living with them; an overwhelming 87% were either married or single with no children.
Of the group 29% smoked, this figure was lower than expected, yet is higher than the estimated national average of 19% (Australian Bureau of Statistics, 1990).
The survey attempted to identify the distance from the nurses' place of residence to St. Vincent's Hospital and whether nurses travelled past similar institutions to work at the hospital. Twenty-two nurses travelled more than 10 kilometres (kms) to work; all these nurses journeyed past similar hospitals to work at St. Vincent's Hospital. Of the 23 nurses who travelled less than 10 kms. to work, 11 bypassed similar institutions.
The education level of registered nurses working in the Operating Rooms was generally high with 78% of respondents completing more than the registration minimum, almost one third (31%) had achieved tertiary qualifications of Diploma of higher level. Currently 36% are studying for higher qualifications in Nursing or Allied Health, see Figure 1.
Figure 1: Profile of Operating Room nurses' education levels
Most nurses (91%) have indicated they enjoyed work most of the time. An analysis of variance indicated that level of work enjoyment was not influenced by type of employment (i.e. that is full-time nor part-time work).
Of the nurses in the Operating Rooms 71% had worked at St. Vincent's Hospital for more than two years (mean three years). When questioned about future career aspirations 73% indicated they would be continuing to work at St. Vincent's Hospital in the future. However, 6% indicated they would be resigning within 12 months for various reasons that this survey did not delve into. Figure 2 illustrates the nurses' length of service in St. Vincent's Hospital Operating Rooms.
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Howery (1990: 488) found that "...the dissatisfiers (in Operating Room Nursing) outnumber the satisfiers". Of the nurses surveyed by Howery, 42% were dissatisfied enough to leave the profession. However, at St. Vincent's Hospital this was not the case; 91% found the work enjoyable. This result was encouraging and challenged popular belief regarding worker satisfaction levels. According to Howery the reasons some nurses were satisfied with their work varied, i.e. the joy of nursing stems from the flexible hours, enjoyment of co-workers, special relationships with medical staff and supervisors. Other salient factors included individual growth opportunities, continual challenges and being in a setting that provides outstanding nursing care. St. Vincent's Hospital is well regarded for providing excellent nursing care. The researcher believes this contributes enormously to the positive findings.
It was interesting that 71% of the nurses surveyed worked at St. Vincent's Hospital for more than two years, considering the relatively young age of the sample and the problems the hospital had identified in 1991 with high staff turnover rates. Possible reasons for greater length of service include, high unemployment caused by the recession and, or, the (conditional) availability of study leave offered by the hospital for nurses currently studying.
Figure 2: Nurses' length of service at St Vincent's Hospital Operating Theatre
The number of nurses working in the Operating Rooms with children was surprisingly low. On interview, the nurses in the department who had children, indicated the following as possible reasons for the low number: that the number of child minding positions available at St. Vincent's Hospital Child Care Centre is limited; there are limited numbers of part time positions offered in the department; and that most mothers want to, or have to work part-time. A survey reported in the American Operating Room Nurses' journal identified raising children as the primary reason for nurses leaving their jobs (Howery, 1990: 488). The data collected in this survey appears to support the American findings.
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This survey has led to the belief that Operating Room nurses at St. Vincent's Hospital can deal with the changing role of nursing today. A relatively young, well educated group, they appear to be comfortable meeting the continual challenges of surgery in the 1990's. Testimony to this is the number of nurses in the department currently studying, the distances they travel to work, frequently bypassing similar institutions, and importantly, the high rating of work enjoyment they have indicated.
Nursing today is changing, many of these changes are positive and attitudes in the Operating Rooms appear to confirm this. By profiling the Operating Room nurses at St. Vincent's Hospital the researcher has attempted to identify those nurses who chose to work in a specialised unit and why. This information would be beneficial for numerous reasons, including staff recruitment and in some instances for staff retention.
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