Strategic Study On Protection Of Nursing Human Resources In Chongqing Area

Part One: Survey of Nurse Job Satisfaction【Objective】To understand the job satisfaction of nursing staff in various levels of medical units in Chongqing area in order to find ways to improve it , and to know their motivation needs in order to explore the strategic management of nursing development.【Methods】Nurse Job Satisfaction Questionnaire (NJSQ) was structured on the basis of Job Satisfaction Survey Sample from Human Resources internet, in combination with characteristics of nursing professional. Some basic theories were used in this model, such as Maslow's hierarchy of human needs, two factors theory of Herzberg and McClelland's achievement motivation theory. From April to June 2006, the job satisfaction survey was conducted among 1,128 nurses from 23 hospitals at random. The nurse's motivation needs was also collected. The reliability and validity met the criteria requirements.【Results】1. The content and structure validity of NJSQ is satisfying, with Cronbach'sαcoefficient of 0.9411, and split-half coefficient of 0.8806, test-retest reliability coefficient of 0.9040.2. In NJSQ, the highest score of each item was 5, while the lowest was 1. The total score, composed of 50 items, was 250, with an average of 50.614±23.276, minimum score of 82, maximum of 232, among which the factor of welfare &income was the lowest, with an average of 2.310±0.710, followed by the aspect of hospital management. The excellent rating went to the factors of family support & colleague relationship, which was 3.8510±0.439.3 Significant differences were found in the total NJSQ's score assessment according to related factors, such as employment contracts, practicing years, post and rank, night shift, average income, and so on.4 Permanent contract nurses were less satisfied than the temporary one in the aspects of practicing agreement, hospital management, family support, and personal development, while in some other aspects, such as income and welfare, temporary nurses were more satisfied. The difference was significant.5 Significant differences in the factor of turnover intention were found among nurses of different levels of age, practicing years, post and rank, average income, employment contracts, and night shift.6 The top five stimulating factors selected by nurses were:①Improving nurse's social status;②Harmonious relationship between colleagues;③Perfect welfare benefits;④Sufficient salary & bonus;⑤Ideal management style of direct supervisor.【Conclusions】1There was no formal evaluation of nurse job satisfaction in Chongqing area nowadays, no regular judgment and no enough emphasis to be attached.2 Nurse Job Satisfaction Questionnaire (NJSQ) was testified, with a good reliability and validity, which put a good foundation to establish further questionnaires for Chinese nurse.3 The total degree of job satisfaction was at the medium level. To improve the nurse job satisfaction, the most important measure was to improve their welfare and income, increase their social status, and strengthen humanity management.。Part Two: Interview to Nursing Directors and Turnover Nurses【Objective】Firstly to know the current policies and measures about nurse excitation, and to collect the countermeasures of the nursing directors; then to understand the real reasons for nurse's turnover by exploring their deep hearts; finally to provide suggestions of improving nurse job satisfaction in order to cut down the turnover rate in the coming five years.【Methods】Qualitative research methods were introduced during the interview of the directors/general-head-nurses from 21 chosen hospitals in the survey. The present stimulating policies and the future working plans for the coming five years were collected. Then by convenience sampling, six nurses from different hospitals with different personal background were invited to join the depth- interview, in which the original reasons of their loss had been explored.【Results】1 Lack of specifics and fairness, the motivation measures for nurses in Chongqing area have not been updated for many years.2 The reasons for nurse's turnover were various, mainly concentrated on overload, insufficient payment, and lower social status.3 The fundamental reasons for nurse's loss were lack of professional agreement and sense of pride.【Conclusions】1 It becomes urgent to establish an updating motivation system to improve nurse job satisfaction.2 The public health administrative departments should do more positive propaganda to increase nurse's social status and to enhance their sense of professional pride.Part Three: Conclusions and Suggestion Through the research, conclusions and suggestion have been reached as below:1 Establish a comprehensive evaluation system for nurse job satisfaction as soon as possibleIt is very important for nursing officers to assess nurse's job satisfaction. To improve general nursing service quality, hospitals should assign special personnel to evaluate nurse job satisfaction, open files for NJS, and establish a comprehensive evaluation system. 2 Strengthen humanity in management.Strengthening humanity in nursing management is the key factor to improve NJS and to develop nursing quality. It is also an important measure to release nurse's stress, keeping them in good health condition. Furthermore, by improving nurse job satisfaction, strengthening humanity in nursing management can eliminate factors of nurse's turnover, thus reduce loss of nurses.3 Satisfy hygiene factors, reduce unsatisfied emotions Nurses can work better with less unsatisfactory emotions through improving working condition, providing better welfare benefits, improving their food and transportation, and guaranteeing their safety, et al.4. Establish prolonged prompting system to fully motivate nurse.(1)Stimulate sense of job achievement.Through allocating challenging tasks, giving chances to show competence, and providing chances to promote, sense of achievement may be aroused.( 2 ) Stimulate desire for study& upgrade Through arranging well-designed training courses, nurse's desire for studying & upgrading may be stimulated.(3)Stimulate honor sense of collectism Through setting up the nurse's image as saint angel, their love for the profession and the circle that they belong to may be boosted; through nursing skills show and technical innovation, spirit of teamwork may be prompted; through personal motivation combined with group motivation, spirit of collectivism and collective honor may be enhanced.(4)Stimulate sense of professional prideBy means of more positive propaganda, people may understand nurse, respect nurse, and support nurse more, thus nurse's sense of professional pride may be aroused.In the practice process, the superintendents should provide fair promoting opportunity to each nurse, assign them properly according to a well understanding of their ability, and fully unearth their potential talents. Meanwhile nurse's reasonable needs should also be cared, their reality problem should be solved properly, so their job satisfaction may be improved further with less professional tiredness.5 Seek the efforts of hospitals and the administration departments of public health to reduce nurse's loss and keep the nurse group stable(1)Enlarge the investment to public health, improve working conditions, raise the average salary, and purchase the medical insurance, pension, unemployment insurance, housing common reserve fund and so on. All these done nurse's worries may be reduced, and their working enthusiasm may be enhanced.(2)Bring the nursing manpower equipment into consideration of the evaluation items for goal management, stipulate the minimum ratio of nurse to bed. Subsidize nurse's salary, cut down its relationship with hospital's cost.(3)Construct nurse resources reservoir to manage their employment. Set up nurse association to effectively protect their legal rights.6 Innovations and gains(1)According to Maslow's Hierarchy of Human Needs, Two Factors Theory of Herzberg and McClelland's Achievement Motivation Theory, We constructed Nurse Job Satisfaction Questionnaire (NJSQ). With a good reliability and validity, it can be formally used to test the job satisfaction of clinical nurse.(2) It is the first time to carry out such a wide range of formal evaluation for nurse job satisfaction in Chongqing area. Through the survey, we understood the nurse's job satisfaction, in which the most unsatisfying factor is income& welfare, followed by the factor of hospital management and policies. We also collected nurse's motivation needs. All these findings would provide authority of administration departments of public health a basis to make the relevant policies, as well as provide hospital managers an accordance to make innovation plans in practical process.(3)Qualitative methods were initiated into quantitative methods to the strategic study on protection of nurse. In part one, data of NJS was mainly analyzed in a statistic way, while in part two, the interview information of nursing directors and nurses of turnover was dealt with content analysis methods, a kind of qualitative methods, to code and classify. There was a large number of data to be input, coded, triangulated and analyzed, which provided us with valuable opportunity to increase our research ability greatly.