Discussion Reponse Module 5
Assignment:
Respond to 3 postings from other class members, please be positive in responses. Respond to each
post separate usings at least 2 references for each response.
***Please refer to reading assignments as given in order number 81709233**
*** Please follow APA format as instructed in American Psychological Association (2010). Publican
manual of the American psychological association (6th ed.). Washington, D.C.
*Please ensure the use of grammar properly.
POST 1:
Author's name is Monica
Turnover is defined as an occurrence where an employee leaves an organization and must be replaced
(Flynn, Jackson, Mathis, & Valentine, 2016). There are two types of turnovers: Voluntary and
Involuntary. Involuntary is usually due to termination for poor performance or through lay offs and
voluntary is when an employee leaves by choice. There are a variety of reasons why employees choose
to leave an organization. According to Roussel, Thomas & Harris (2016), about 2% of turnover is due
to relocations, promotions, retirements and family reasons. However, turnover is also caused by job
dissatisfaction, pay and benefits levels, and poor leadership. Turnover is very costly to an
organization. It is estimated that it takes $75,000 to replace a nurse (Roussel et al., 2016).
Turnover also affects the remaining staff members by having to pick up heavier assignments or
working overtime to cover the vacancy which may lead to burnout. If turnover levels/vacancies
remain high, it can result in more turnover (Roussel et al., 2016).
There are several retention factors that affect employee/employer relations. Supervisors must
provide clear performance expectations, ensure a safe, clean work environment, value employees?
contribution, listen and respond to employees? concerns and offer performance management coaching.
Employees must feel that they are being treated fairly and receiving nondiscriminatory treatment
(Flynn et al., 2016). Coworker relationships can also affect retention. If coworkers do not get
along it may result in turnover, however, if there is a good relationship between coworkers this
will result in retention. Most employees state a good supervisor is one who communicates, listens
and responds to employee concerns (Flynn et al., 2016).
Employees that receive regular training are better prepared for the changes and challenges in
health care. Human resource and training professionals must first identify training needs,
objectives and criteria. Training design must address the specific objectives by selecting training
methods and planning the training content. Through monitoring, scheduling or conducting, training
is delivered. Training must then be evaluated to measure outcomes and compare objectives and
criteria (Flynn et al., 2016). The Joint Commission (TJC) standards focus on staff orientation,
training and development to assure staff competence. Ensuring staff competence requires initial job
training and orientation, encouragement of self-development, ensuring ongoing training to maintain
and improve competence, and monitoring data to identify and respond to employee learning needs
(Flynn et al., 2016). According to the American Nurses Association (2016), the nurse administrator
assists employees in developing and maintaining competence in identifying problems, issues and
trends. Both TJC and ANA standards influence training and development, as well as, organizational
success.
Performance appraisals measure how well an employee is doing in their jobs, therefore they must
reflect the nature of the work performed (Flynn et al., 2016). Some managers may feel conflicted
about judging performance, as well as, encouraging and coaching employees to improve performance,
especially if they perform the same functions and work along side their employees. However, giving
an employee a false appraisal, to avoid animosity, does not help the employee or the organization
(Flynn et al., 2016).
Employees may see appraisals as a threat and may not agree with the manager. However, if an
appraisal is done well, it may be seen as constructive feedback (Flynn et al., 2016). One thing to
consider is employee perceptions of manager behaviors during the performance appraisal process.
Research has shown that manager behaviors affect employee perceptions. Behaviors such as respect,
feedback, voice, consistency and bias suppression influence employee perception. Managers should be
aware that employees not only judge the performance appraisal procedure, but also how it is
implemented (Farndale & Kelliher, 2013). ?If a performance appraisal is implemented fairly in the
eyes of the employee, managers may be motivated to be more effective in their implementation.?
(Farndale & Kelliher, 2013, p. 891)
References
American Nurses Association (2016). Nursing Administration: Scope and Standards of Practice (2nd
ed.). Silver Spring, MD: American Nurses Association.
Farndale, E., & Kelliher, C. (2013, Nov/Dec 2013). Implementing performance appraisal: Exploring
the employee experience. Human Resource Management, 52, 879-897.
https://dx.doi.org/10.1002/hrm.21575
Flynn, W. J., Jackson, J. H., Mathis, R. L., & Valentine, S. R. (2016). Healthcare human resource
management (3rd ed.). Boston, MA: Cengage Learning.
Roussel, L., Thomas, P. L., & Harris, J. L. (2016). Management and Leadership for Nurse
Administrators (7th ed.). Burlington, MA.: Jones and Bartlett Learning.
Post 2:
Author's name is Moises
The impact of staff turnover is detrimental to the overall functionality of health care
organizations. The most direct impact with staff turnover is financial performance. Costs of
turnover include direct financial costs, such as costs of recruiting a new employee to fill the
vacant position, as well as more indirect costs, such as the possible effect employee turnover can
have on morale of those still employed. Other indirect costs include increased workloads on
coworkers who must make up for those vacant positions (Flynn, 2016). Other effects of staff
turnover include organizational performance, safety, and productivity. Research also shows that job
satisfaction, the labor market, and intention to quit have major impacts on voluntary employee
resignations. One of the primary predictors of turnover and turnover intention is the extent to
which employees are engaged with their work. There is a need to better understand additional
organizational factors that may affect both turnover and engagement, and to better understand the
form of these relationships (Collini, 2015).
Indicators of successful retention plans include the recruiting process, selection process,
compensation, career development, and employee relations. During the recruiting process, the job
should be outlined and clearly defined, so that the expectation of the job is met by the employee.
By ensuring that the expectations of the potential employee match the organization may reduce
voluntary turnover. By having a successful selection process and hiring individuals that will not
have disciplinary or performance issues or whose work histories suggest high turnover, may reduce
turnover. Compensation is another factor because a competitive, fair, and equitable pay system can
also help reduce turnover. Career development can help health care organizations retain employees.
If employees believe they have few opportunities for career advancement, their turnover rates are
likely to increase and will most likely leave the organization. Employee relations including
fair/nondiscriminatory treatment and enforcement can also help retention rates (Flynn, 2016).
Leadership is another retention plan that can be successful in retaining engaged and satisfied
employees. Specifically, nurse managers have a direct influence on the work environment of their
staff, work processes and work rewards such as praise and recognition. All of these factors
influence staff nurse?s intention to remain employed. The importance of social support,
particularly from nursing leadership, is consistent with links reported between social support and
job satisfaction which are associated with turnover rates (Carter, 2012).
Training and development issues in HR, nursing management, and staff all impact the TJC and
administrative nursing standards. Joint commission standards have a significant focus on staff
orientation, training, and development. These standards require a process for the continuous and
ongoing efforts of assuring staff competency through orientation, training, development, and
through encouraging self-development. In addition, the TJC standards are the basis of an objective
evaluation process that can help health care organizations measure, assess, and improve
performance. These standards set expectations for organizational performance that are reasonable,
achievable, and surveyable (The Joint Commission, 2016). For example, a health care organization
can evaluate the number of incidents of inadvertent needle sticks on a patient care unit or out-
patient clinic. This evaluation can determine if any special safety training would be required on a
particular unit or clinic to remedy competency issues and to meet the important TJC HR standards.
Monitoring these trends and training efforts should be well documented for availability during TJC
on-site inspection (Flynn, 2016)
Performance appraisal is one of the most important managerial duties in health care organizations.
The evaluation of an employee?s job performance and meeting their job standards are essential
measurable factors of determining how well an employee is doing. The perception of these
evaluations vary from the employee perspective and from the administrative/leadership perspective.
Some leaders who must complete the evaluations of their employees often resist the appraisal
process. Many leaders think that their primary role requires them to assist, encourage, and coach
employees and not appraise their performance. Other leaders are concerned that their appraisals
will affect an employees? future careers, which may cause them to alter or bias their ratings on
performance. Most importantly, avoidance of appraisals helps no one. The role of an effective
leader owes an employee a well-done appraisal, no matter how difficult the conversation about the
performance might be (Flynn, 2016). On a different perspective, employees may see the appraisal
process as a threat or feel that the only way for them to get a higher rating is for someone else
to receive a low rating. Emphasis on self-improvement and development aspects of appraisal may be
the most effective way to reduce this perception. Another common perception on appraisals from
employees is that they are not in agreement with a particular manager performing the appraisal. In
most cases, employees will view appraisals done well as constructive and meaningful feedback. There
is demonstrated significance in the importance of managers enacting performance appraisal practices
to influence employee commitment (Farndale, 2013).
References
(2016, September 21). Retrieved from The Joint Commission: www.jointcommission.org
Carter, M. T. (2012). Staying in nursing: what factors determine whether nurses intend to remain
employed? Journal of Advanced Nursing, 1589-1600.
Collini, S. G. (2015). Turnover in health care: the mediating effects of employee engagement.
Journal of Nursing Management, 169-178.
Farndale, E. K. (2013). Implementing performance appraisal: exploring the employee experience.
Human Resource Management, 879-897.
Flynn, W. J. (2016). Healthcare Human Resource Management. Boston: Cengage Learning.
Post 3:
Author's name is Jose
Nursing staffing it is a very important to topic for health care organization. Nurses are the
primary source of work force among hospitals, as well as being the major work force to delivery
care to the patients, in other words, if there is a lack of nursing personnel, the health care
deliver will be deficient, Cavanagh (1990). Nursing staff turnover remains a financial concern to
public as well as private institutions, and it has an impact on staff morale and working practices.
Numerous studies have examined the reasons why staff leaves their jobs, some have found that job
satisfaction and participation at work to be important variables in the turnover process, Cavanagh
and Coffin (1992). In addition to this, we can also mention that many researchers have identified
other factors that influenced voluntary turnover among nurses. These factors included job stress as
a result of job burnout and job dissatisfaction, Dworkin (2002). Other factors may included
dissatisfaction with salary or benefits and organizational climate of the hospital, Gormley (2003).
Finally, some researchers have identified poor nurse?physician relationships, workplace bullying
and unsuitable work schedule as other voluntary turnover factors, Hamilton and Pearce (2013).
Another major reason for nurses? turnover is the perception of a lack of professional respect and
recognition by hospital administrators, doctors and the broader community Alotaibi (2007).
The retention of personnel is important for every single health care organization, for that reason,
human resources departments have to have strategies for staff retention. Regardless of the setting,
the more employees were satisfied with their job, the more likely they remained in that job, Kocher
and Thomas (1994). Evidence shows that an effective retention strategy is having managers to
communicate directly, frequently, and respectfully with their nursing staff. Studies have found
that nurse administrator relationships were embodied by a lack of trust and poor communication
Cline, Reilly, and Moore (2003). In addition, administrators need to understand that nurses are
valuable professionals and they expect to be provided with autonomy and the opportunity to suggest
and recommend strategies to improve their work setting Lacey (2003). Researchers argue that nurses
are more likely to stay in a hospital when they perceive that there is a positive relationship with
doctors, this positive collegial relationship is an important component of nursing retention
strategies (Lacey, 2003). Failure of hospital administrators to help in creating this relationship
would result in high levels of voluntary nurse turnover, for that reason another retention strategy
is to focus on the development of orientation or induction training programs helpful in preventing
nurse turnover. Those programs should provide newly hired nurses with the needed information to
adapt to the new job environment, Waters (2003). According to Khowaja, Merchant, and Hirani (2005)
reducing workload by adequate nurse patient ratios, promoting respect of nurses in front of
patients and other staff, using rewards and recognition of nurses, simplifying nursing
documentation, increasing recreational activities for nurses and empowering nurses and Nursing
Management group were some strategies to reduce nurse turnover as well.
Training it is an important aspect on every organization. The specific training and development
departments of every company must look for the sources needed in order to implement the appropriate
workshops for their personnel in order to meet the government standards and other regulatory
organizations such as the Joint Commission. It is important to understand as explained before, that
an appropriate training before the personnel start working in an institution, and continue training
on ongoing basis are important for the optimal employee success within the company (Waters, 2003).
On the other hand, not everything is about the administration side, it is also important for the
institutions to measure their staff performance in order to identify break points to resolve. A
very important tool used to measure personnel performance is based on the performance appraisal. A
performance appraisal can be viewed as the process of assessing and recording staff performance for
the purpose of making judgments about staff that lead to decisions. Performance appraisal should
also be viewed as a system of highly interactive processes which involve personnel at all levels in
differing degrees in determining job expectations, writing job descriptions, selecting relevant
appraisal criteria, developing assessment tools and procedures, and collecting interpreting, and
reporting results. Performance appraisal is an organizational system comprising deliberate
processes for determining staff accomplishments to improve staff effectiveness, Massachusetts
Institute of Technology (2016).
As we can see, there are some strategies that companies need to identify in order for the proper
staff retention. If there is an existence of a high nurses turnover, the care delivery will be
poor, and the economic losses by this issues will be of significant considerations for the medical
institutions, that is why it is important to have a clear understanding of this topics.
References
Alotaibi, M. (2007). Factors affecting nurses? decisions to join their professional association.
International Nursing Review, 54, 160-165. Retrieved from
https://onlinelibrary.wiley.com/doi/10.1111/j.1466-7657.2007.00555.x/epdf
Cavanagh, S. J. (1990). Predictors of nursing staff turnover. Journal of Advanced Nursing, 15, 373
-380. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/2332561
Cline, D., Reilly, C., & Moore, J. (2003). What?s behind RN turnover? Nursing Management, 34(10),
50-50. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/14557783
Dworkin, R. W. (2002). Where have all the nurses gone? Public Interest, 148, 23-37. Retrieved from
https://www.nationalaffairs.com/doclib/20080710_20021482wherehaveallthenursesgoneronaldwdworkin
Cavanagh, S. J., & Coffin, D. A. (1992). Staff turnover among hospital nurses. Journal of Advanced
Nursing, 17, 1369-1376. Retrieved from https://0-
web.a.ebscohost.com.lib.utep.edu/ehost/pdfviewer/pdfviewer?sid=88de913a-9fe7-4ef9-9c78-
6188fed976cc%40sessionmgr4006&vid=4&hid=4101
Gormley, D. K. (2003). Factors affecting job satisfaction in nurse faculty: A meta-analysis.
Journal of Nursing Education, 42(4), 174-178. Retrieved from
https://www.researchgate.net/profile/Denise_Gormley/publication/10790740_Factors_affecting_job_sati
sfaction_in_nurse_faculty_a_meta-analysis/links/0fcfd5134a0648d8cf000000.pdf
Hamilton, N., & Pearce, L. (2013). A question of respect. Nursing Standard, 45, 14-16. Retrieved
from
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Khowaja, K., Merchant, R., & Hirani, D. (2005). Registered nurses perception of work satisfaction
at tertiary care university hospital. Journal of Nursing Management, 13(1), 32-39. Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/15613092
Lacey, L. M. (2003). Called into question: what nurses want? Nursing Management, 34(2), 25-26.
Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12576778
Massachusetts Institute of Technology. (2016). Human Resources. Retrieved from
https://hrweb.mit.edu/
Waters, L. (2003). Overcome hidden expenses, migrating staff. Nursing Management, 34(5), 20-20.
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&S=JAOFFPGEHBDDNBJGNCIKPHJCJNCIAA00&C=_main&tab=search&Main+Search+Page=1
Kocher, K. M., & Thomas, G. W. (1994). Retaining army nurses: A longitudinal model. Research in
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