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Nursing Recruitment and Retention - Havelock's Theory of Change

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Daniel Tan

on 15 March 2013

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Transcript of Nursing Recruitment and Retention - Havelock's Theory of Change

Transformational Leadership & Recruitment and Retention By: Ummara Jabir, Jessica Mac, Janet Nguyen, Christine Ates, Zahra Keshavjee, Daryl Manankil, Daniel Tan, & William Lay Nursing Recruitment
and Retention HAVELOCK’S THEORY OF CHANGE Recommendations - Nursing Policies and Strategies to Promote Recruitment and Retention Conclusion 1. Building Relationships
2. Diagnosis
3. Acquiring Resources
4. Choosing a Solution
5. Gaining Acceptance
6. Implementation & Stabilization Provincial Initiatives - Ministry of Health and Long-Term Care
HealthForceOntario - The Nursing Strategy
• A comprehensive strategy aimed at addressing the primary reasons for instability in the nursing workforce
• Focuses On:
Full employment of Nurses
Recruitment and Retention
Creating Positive and Rewarding Work Environments

Full Employment of Nurses
The Ontario government is aiming to have 70% of Ontario nurses employed full time
Recruitment and Retention
The Ontario government is focusing on improving recruitment and retention of nurses to address nursing supply challenges
Creating Positive and Rewarding Work Environments
The Ontario government is investing funds to improve work environments and make them safer (HealthforceOntario, 2013a). 1990s Reduction
of nurses Hiring freezes and early retirement packages Unsafe conditions
due to under staffing
and heavy workload A growing and aging population
A multicultural society
Vulnerable groups susceptible to marginalization http://www2.cna-aiic.ca/CNA/documents/pdf/publications/2010_RN_Snapshot_e.pdf Brief analysis of the Issue During the previous two decades, the nursing profession experienced funding cuts leading to a major cause of turnover among nurses. This has been linked to unsatisfying and stressful work conditions related to incivility. Incivility refers to deviant actions (ie. lack of respect towards colleagues) (Spence Laschinger, Leiter, Day, & Gilin, 2009). Moreover, the funding cuts cause poor staffing. Discussion Agenda 1. Brief Introduction of Havelock’s Theory

2. Transformational Leadership

3. Application of Change Theory Framework

4. Recommendations of How to Proceed Toward Change

5. Provincial Initiatives/ Strategies to Target Recruitment & Retention

6. Conclusion 1. Building Relationships
Change agents (staff) should be identified
Create a positive environment and positive working relationships
Change agents should be friendly, familiar, responsive, and open
2. Diagnosis:
Poor nursing management
Stressful working environment
3. Acquiring Resources:
Gather research using literature searches
Collaborate with RNs and other staff to brainstorm solutions 6 Aspects of Havelock's Theory 1. Nursing Graduate Guarantee (NGG)
Initiative to provide full time work opportunities for new nursing graduates
(HealthforceOntario, 2013b)
2. Development of Innovative Nursing Roles
NP – Nurse Practitionero
RNFS – Registered Nurse Performed Flexible Sigmoidoscopy
RN-SFA – Surgical First Assist (HealthforceOntario, 2013c) 4. Choosing a Solution:
Nursing Management:
Staff nurses should confront the nursing manager and state their concerns directly
If ineffective, higher management should be contacted
Lobby for more unit funding
Address causes behind increased absenteeism like fatigue/burnout
Select solution based on the objective of change
5. Gaining Acceptance:
Communicate solution
Generate interest
Adapt solution to response
Encourage feedback before and after
Share results with staff
6. Implementation & Stabilization:
Planned change is made permanent
Change should allow similar responses to future needs
Follow-up through regular meetings Additional Programs 3. Included in the table: QUESTIONS? Nursing Retention Fund - Provides funds to hospitals in Ontario for education/training and retention initiatives where changes in hospital services may result in layoffs for nurses

- Purpose is to secure nursing jobs in situations where a service change may cause layoffs/reduction in hours.

- NRF provides hospitals funding for salaries, wage, plus a percentage in lieu of benefits, and education/training costs required to retain nurses (Nursing Retention Fund, 2013). What are the Variables? The variables of recruitment and retention include:
Undesirable work conditions, unhealthy work environments
Poor staffing, burnout, which led to heavy workloads
Emotional and physical exhaustion (Registered Nurses of Ontario, 2000) An Introduction •Studies have continued to demonstrate that leadership styles correlate with nurse job satisfaction (Gardner, 2010)
•Poor leadership within healthcare systems can result in toxic symptoms that negatively impact organizational work cultures, staff satisfaction and lead to staff burnout (Weberg, 2010)
•Nursing managers should be actively challenged to improve their skills and become transformational leaders (Gardner, 2010)
•Designing interventions that directly impact leadership styles of first-level managers will have greater effect on staff attitudes and RN retention (Gardner, 2010) What is Transformational Leadership? Transformational Leadership Sub-styles: • Leads to:
o Positive sense of self-worth and value in employees (McGuire & Kennerly, 2006)

o Increased job satisfaction, job performance, and organizational commitment (McGuire & Kennerly, 2006)

o Increased well-being, and a decline in exhaustion and burnout factors in staff (Weberg, 2010)

• More self-confident and involved followers have a sense of belonging and share a sense of direction (McGuire & Kennerly, 2006)
• Followers emerge as committed and loyal employees with a desire to remain a member of the organization (McGuire & Kennerly, 2006) Impact of Transformational Leadership • Promotion of leadership skills through content presentation, dissemination of reading material, role-playing activities, round-table discussions, leadership support groups and continuous 360 degrees evaluation (Kleinman, 2010)

• Implementation of an organizational strategy to re-evaluate the nursing management structure and identify how leadership can be shared among nursing staff (Klienman, 2004)

• Engaging nurses in degree-based educational programs, continuing education, in-service instruction, and mentoring experiences (Kleinman, 2004). Strategies to Improve R&R: •Transformational nurse leaders promote a greater sense of commitment in nursing staff (McGuire & Kennerly, 2006)
•Transformational leadership enhances staff retention and empowers nursing professionals (Weberg, 2010).
•Recruiting and retaining a committed workforce leads to a competitive advantage to the organization, fosters a healthier work environment, and allows for staff to gain a sense of accomplishment and success (McGuire & Kennerly, 2006)
•Transformational leadership can potentially transform healthcare from the bedside up (Weberg, 2010) Summary of Transformational Leadership •Incorporating Transformational nursing leadership

•Implement Havelock’s Theory of Change

•Embody a strong culture to safety to retain nurses

•Improve patient outcomes

•Achieve the best possible financial outcomes for recruiting nurses

•Increase job satisfaction, job security, and quality of patient care Questions? Poor Nursing Management Wage Disparity Fear in the Workplace References
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