Research On Nurses Of Job Rotation To Community Health Centers In Hospital Alliance System

In Chinese medical system,there is an imbalance development between big hospitals and grass-roots level health institutions.It is an important measure to perform "Healthy China" strategy to develop "hospital alliance",ensuring the hospital’s high quality resources sink into the grass-roots level health institutions.In the view of lacking human resources of general practitioners(GPs)at the grass-roots level and the attempt to carry out tiered health service,it is an useful exploration to transfer the nurses from large hospitals to the community health service centers,who can directly and accurately sink the high-quality medical resources of the hospital to the community health service centers.Since the nurses generally have solid medical knowledge and rich clinical experience,they can play a great role of replacing community GPs on common diseases diagnosis and treatment as well as chronic disease management.At the same time,nurses,as the link and liaison of medical organizations,connect hospitals and communities.However,in the practice of"hospital alliance" construction,the intention of job rotation of nurses generally is not high.At present,the research on job rotation of nurses in the field of medical management is only limited to its preliminary exploration,and has not yet been carried out in depth and lacks theoretical guidance.Therefore,this paper focuses on the empirical study,on the influencing factors and the mechanism of the intention of job rotation of nurses,so as to provide a theoretical basis for relevant practice.Based on the conservation of resource theory(COR),this study explores the mechanism of the impact on community nurses job rotation intention from the perspective of challenge-hindrance stress,LMX,TMX and various capitals respectively.Specifically,it includes three aspects listed as follows:(1)Study the mechanism of different types of stresses on the community job rotation of nurses,that is the effects of challenge stress and hindrance stress on the community job rotation of nurses,the mediating effect of work engagement,and the moderating effect of personal initiative were studied respectively.(2)The mechanism of TMX and TMX on the nurses transfer to the community,and the effects of LMX,TMX and LMX*TMX interaction on their community job rotation intention and the mediating effect of self-efficacy.(3)The interaction mechanism of human capital,psychological capital and social capital of nurses on their community job rotation intention,the mediating effect of job competence and the moderating effect of perceived organizational support and directive leadership.After literature and theoretical review,the research hypothesis is put forward,and 508 valid questionnaires are collected with the method of questionnaire survey.The research data are processed with SPSS 19.0,Lisrel 8.70 and other tools.The following conclusions are obtained through data analysis:(1)The positive impact of challenge stress on the intention of job rotation is significant,and the negative impact of hindrance stress on which is significant.Work engagement plays a mediating role between two types of stresses and nurses’ community job rotation intention.Personal initiative plays a positive role in the relationship between challenge stress and community job rotation intention.(2)The interaction between LMX and TMX affects the intention of community job rotation of nurses.Self-efficacy plays a mediating role between LMX＊TMX and community job rotation intention.(3)The positive effect of psychological capital and social capital on the community job rotation intention of nurses is significant.Job competence mediated psychological capital-community job rotation intention,as well as social capital-community job rotation intention.Directive leadership positively moderated the relationship between job competency and community job rotation intention.Whereas,the effect of human capital and community job rotation intention is not significant.The moderating effect of perceived organizational support between human capital and community job rotation intention is not significant.The theoretical contributions of this study include:(1)From COR theory,study the mechanism of stresses,the interaction of LMX&TMX,and various capitals on community job rotation of nurses,enriches the contents of the study on community job rotation of nurses.(2)The study of stresses related to nursing has been expanded.It clarifies the relationship between challenge-hindrance stress and community job rotation of nurses,enriching the related researches on the relationship between stresses and job performance,as well as the application of COR theory,and deepening the understanding of stresses and the responses of stress in the field of nursing.(3)Introduce COR theory to explain the community job rotation of nurses in the construction of hospital alliance.(4)On the basis of the "relationship" of leadership-individual,and the "relationship" of team members,the research model has made up for the lack of "relationship" of nurses.(5)Increased the related empirical research of human capital,psychological capital and social capital in the field of health care on the issue of nurses’ community job rotation.The practical significance of this study lies in:on one hand,the leaders and colleagues of the hospital should focus on the career and development of nurses,giving support to provide them with abundant resources,thus promoting their intention of community job rotation.On the other hand,the nurses should strengthen their own skills and get access to related training,giving full play to its personal initiative and enhancing its confidence in meeting the challenges of community job rotation.