Abstract
South African nursing profession is in a crisis as professional nurses leave the country in
search of lucrative work overseas. This exodus will have a catastrophic effect on the
delivery of health care over the next decade. It is also clear that the shortages of staff
due to the turnover problems in hospitals are also creating various other problems such
as enormous pressure on existing employees, job stress and job dissatisfaction.
Financial constraints to compete with international competitors, exchange rates, tax-free
foreign money, the existence of many job opportunities overseas and the tendency that
a person’s career is enriched with overseas experience, makes the retention of
professional nurses almost uncontrollable for nursing employers in South Africa. The
question was therefore asked whether employers should not rather focus their retention
strategies on things they can control internally to retain their employees. An alternative
approach, to build strategies around the needs and work circumstances of professional
nurses, was therefore proposed.
The focus of this study was to develop a predictive model with organisational culture and
the selected mediating variables, namely knowledge sharing, organisational
commitment, organisational citizenship and job satisfaction, as well as various
demographic variables (sub-cultures, tenure, age, level of education, gender, race,
home language, level of seniority, marital status, number of dependents) of turnover
intentions.
A General Linear Model approach was adopted to answer the research question. The
relationship between organisational culture and turnover intentions was determined,
followed by the independent and/or interdependent role of the demographic variables in
predicting firstly, organisational culture and secondly, turnover intentions on a bivariate
and a multivariate level. Thereafter, the objective was to determine the independent
and/or interactive role of the independent variable (organisational culture) and the
selected mediating variables (knowledge sharing, organisational commitment,
organisational citizenship behaviour, job satisfaction) in explaining turnover intentions.
The next objective was to determine whether knowledge sharing, organisational
commitment, organisational citizenship behaviour and job satisfaction mediates the
relationship between organisational culture and turnover intentions. The final objective
was to determine a most parsimonious model by entering all demographic variables, the
independent variable and the mediating variables simultaneously into an equation to
determine which variables independently and/or interactively emerged to predict
turnover intentions.
The most important finding was that 49% of the variance in turnover intentions was
explained by the proposed model when all the variables were simultaneously entered
into the equation. Organisational commitment emerged as the only independent
predictor in the final most parsimonious model of turnover intentions. This result support
theoretical evidence of the importance of organisational commitment as predictor of
turnover intentions. Organisational culture, in interaction with knowledge sharing and job
satisfaction, emerged as predictors in the final model decreasing turnover intentions,
while organisational culture in interaction with organisational citizenship behaviour
increases turnover intentions of professional nurses. Organisational culture also
emerged in interaction with white professional nurses, as demographic variable,
decreasing turnover intentions. Organisational culture is therefore an important concept
in determining turnover intentions, clearly emphasising the responsibility of nursing
employers to seriously embark on internal strategies to prevent turnover amongst
professional nurses. Various other demographic variables also emerged in interaction to
determine turnover intentions in the final model. They are professional nurses in
ICU/casualties and 50 years and older, 1-5 years in unit and an incumbent of a chief
professional nurse position, 11 years and more in the current hospital and no
dependents above 18, being married/co-habitating and no dependents above 18, 50
years and older and no dependents under 18 and working in ICU/Casualties and in
possession of a degree. Finally, knowledge sharing, organisational commitment and job
satisfaction mediated the relationship between organisational culture and turnover
intentions, although only partially, while OCB’s did not mediated this relationship.
Various conclusions and recommendations, theoretically, methodologically and
empirically, were made as a result of this study. Further theoretical development of the
concepts, especially knowledge sharing, the value of General Linear Modelling and
further development of turnover models amongst professional nurses and other health
professional alike, were recommended.
Prof. Gert Roodt