Case Study Staff Retention

8/3/2019 Case Study Staff Retention

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Holy Angel University

Graduate School of Nursing

Masters of Science in Nursing

School Year 2011-2012

Human Resource Management in Health Services

Increasing Retention of Nursing Staff at Hospitals:

Aspects of Management and Leadership

A Case Study Presentation

Presented By:

Jessa N. Guanzon R.N.

Presented To:

Jay Manuel T. Galeon, R.N., M.S.N., M.A.N


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Increasing retention of nursing staff at hospitals: aspects of

management and leadership

by Marita Naude, Rebecca McCabe

Abstract

In a previous study by Naude and McCabe, the factors that

motivate nurses to remain working in a specific hospital were explored and

described. From that research it was evident that there are factors related to

leadership, management and interpersonal issues that will motivate nurses to

remain working at a hospital and therefore increase the nursing staff retention

rate of the hospital. This article will focus on the factors that were among the top

four mentioned in that study; these include friendly and supportive staff

supportive and effective management, job satisfaction, and staff development

including opportunities for new challenges. The aim of this article is to discuss

leadership and management strategies to support the four most mentioned

factors that will motivate nurses to remain at a specific hospital and therefore

increase the retention rate at that hospital.

Introduction

Excessive staff turnover is costly for any organization (North, Rasmussen,

Hughes, and Finlayson 2005). Its impact goes beyond the financial costs

inherent in recruitment, selection and (new employee) training. When a staff
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member leaves an organization, the knowledge, skill and experience that the

person has brought to, and gained at, the organization is lost. It takes

newcomers to the organization some time to become fully functional; depending

on the complexity of the position, this can take as long as six months. This is

costly to any organization. Waldman, Kelly, Arora and Smith (2004) found that in

a specific medical centre case study the turnover costs represent an expenditure

of about five per cent of the annual operating budget. Larsen (2000) found that

when the employees are highly satisfied, they will remain in the organization,

thus increasing the retention rate for that organization.

Retention of nurses is a recognized issue for the health industry, as

evidenced by the many studies undertaken on the reasons why nurses leave

nursing (BIZTRAC 1998; Nowak 1998, 2000; Health Department of Western

Australia 1997, Senate Community Affairs Committee 2002). There are,

however, hospitals where nurses seem to be satisfied with their jobs, the

turnover rates are lower than average and the quality of nursing care provided is

higher than average. In the United States, the concept of'Magnet Hospitals'

reflects hospitals that attract and hold quality-nursing staff. These hospitals were

considered by the nurses to be good places to work and places where consistent

good quality nursing care was rendered (Bednash 2000; Buchan 1999). This

prompted the following research questions:

Why do nurses in a selected sample of Western Australian hospitals remain

working at that hospital?

What, from the nurses' perspective, increases the retention rate at hospitals?


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In 2002 the researchers, with the assistance of three Western Australian

hospitals, explored and described the nurses' perceptions of the factors that

attract them to a specific hospital and motivate them to remain working at that

hospital. Although this study was prompted by the idea of a Magnet hospital, it

was very different from the original Magnet hospital research, as it focused on

the retention issues as perceived by the nurses and not on the presence of key

characteristics such as professional practice, professional development, and

administration (Buchan 1999) in the original Magnet hospital research.

It was very clear from the Western Australian study that there are many

factors that have an effect on the retention of staff. But the four most often

mentioned factors are: friendly and supportive staff; supportive and effective

management; job satisfaction; staff development and opportunities for new

challenges. On closer analysis it was evident that effective leadership and

management strategies underpin all these factors. The aim of this article is to

discuss the management and leadership strategies related to those four most

important factors stated by the nurses in the study to influence their decision to

remain with the organization.

For the Western Australian study, three metropolitan based hospitals were

selected where the average annual turnover rate was lower than 20 per cent and

the hospital was identified, through feedback/discussions with Western Australian

nursing opinion leaders, as a place with a reputation for being where nurses

seem to enjoy working. The hospitals included in the study comprised one large

teaching hospital, one private corporate run hospital and one private church


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controlled hospital. The two non-public hospitals cater for a reasonably

comprehensive range of hospital based services. The nurses in the sample

surveyed were registered professional nurses, directors of nursing/nurse

managers, clinical nurses and enrolled nurses registered with the Western

Australian (WA) Nurses Board who had been working in the specific hospital for

more than two years.

The researchers used a qualitative methodology to explore, capture and

represent the multiple realities inherent in the study. This methodology is

consistent with the knowledge claims associated with social constructivism,

whereby individuals develop subjective meanings of their experiences and these

experiences are varied and multiple (Creswell 2003). (1) That is, all participants

would have their own perceptions and indeed, reality, in relation to the factors

that motivate them to choose a place of work and to remain there. The question

'Please describe the factors (aspects, things) that are motivating you to remain

working at the hospital' was posed as an open question as part of a

questionnaire.

Leadership and Management Strategies to Increase Retention

1. Friendly and Supportive Staff as a Factor to Increase Retention

Where staff feels that they are supported by co-workers, retention

rates are usually higher as job satisfaction is increased. Weinberg and Creed

(2000) concluded, from a study of health care professionals and hospital staff,

that positive support from supervisors and colleagues at work reduced
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absenteeism. Weinberg and Creed also argue that changing the psychosocial

environment at work is a way of reducing sick leave. This is also applicable to

the retention of staff. Butler (2000) stated that the best places to work have a

sense of community where staff experience belonging to a team. Staff feel

that they fit in and know each other, and people can be human and still focus

on action. Butler added that fun is encouraged, all levels and positions are

respected and staff treat each other with respect and know each other's

passions.

Meyer, Naude and Van Niekerk (2004) argue that support is developed

when positive relationships are built. This means that mutual respect, trust

and integrity need to be created and maintained. Staff should be treated as

unique individuals who can make unique contributions, and there should be

effective interpersonal relationships and conflict management.

From the negative perspective, Hemingway and Smith (1999) note that

specific factors such as work pressure, supervisor support, poor cohesion and

autonomy may affect withdrawal behaviours (turnover and absenteeism)

among.nurses, both directly and indirectly. Fagin (1992) reported that poor

morale was one of the main reasons leading to an increase in absence in

mental health nurses.

The comments from the nurses in this study supported the importance

of this emphasis on a supportive and friendly working environment. The most

important factor reported by participants in the research study related to


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support from staff and a welcoming atmosphere in the workplace. Participants

contributed statements such as:

My colleagues are a big factor as I enjoy the people I work with and

have made some good friends. I work with other hard working staff who try to

support one another. I find that the staff as a whole are very encouraging and

caring people. I enjoy the friendliness in the hospital/workplace.

A study by Lacey (2003) found that nurses rated the nature of

professional relationships with doctors as one of the top five reasons for

staying in a health care setting. Morrison and Chan (2000), as well as

Friedrich (2001), also found that nurses would remain in a hospital where

there are positive relationships. Friedrich (2001) added that bullying and

disrespectful behaviour should not be tolerated and that it is the responsibility

of the manager to put strategies in place to change such behaviours.

Good relationships among health professionals also supported the

atmosphere of friendly, supportive staff. It was evident from the participants'

responses that good relationships among health professionals are a major

reason why nurses remain at a given hospital. This is evident from the

following statements:

All the doctors (including the consultants) are great to work with. Have

respect from colleagues and doctors (long time worker)

In a study including health care professionals, Weinberg and Creed

(2000) found that positive support from supervisors reduced sick leave and


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absenteeism. This may have the added effect of increasing the retention rates

long-term. Upenieks (2003a) argues that nurses do not experience as much

stress from a long day of work if the job is fulfilling or if they receive positive

feedback and support for the work done. A study by Centrella (2004) found

that by providing a supportive environment to nurses, the retention rate was

increased dramatically.

To be effective, the 'nurse manager' must act as a leader as well as a

manager. Table l, derived from Waddell, Cummings and Worley (2004), very

briefly summarises the differences between leaders and managers. There is a

clear interaction and interrelationship between leadership andmanagement,

and the effective nurse manager needs to be able to integrate leadership and

management in his or her role.

It is extremely important that the followers are motivated to follow the

leader. Franklin D. Roosevelt remarked that it is a terrible thing to look over

your shoulder when you are trying to lead and find no one there. Butler (2000)

argues that effective workplaces have leaders that the followers can trust and

respect. The followers need to believe that the leaders are able to lead the

team and the organization into the future. Leaders who value and recognise

contributions of others are more effective.

Effective leadership has a considerable impact on staff empowerment

and the realisation of the goals in the nursing unit. As individuals and teams

are unique, the exciting and interesting challenge for the leader is to select

the correct leadership style to implement for each individual, team and
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situation. The same leadership style will not be most effective in all situations

and with all followers.

The leadership style of the managerwill influence all the activities in

the nursing unit. It is vital to select and implement the most appropriate

leadership style for each situation.

For example, the transactional leader focuses on the day-to-day

aspects and planning and the leadership actions are task oriented (Waddell et

al. 2004). When the developmental levels (maturity levels) of the followers are

different, the situational leadership model (Hersey and Blanchard 1972;

Robbins et al 2001) may be most effective. During the implementation of

change, transformational leadership (Bass 1995; Eisenbach, and Kotter 1995;

Waddell et al 2004) will be most appropriate.

Upenieks (2003a) pointed out that hospitals would attract and retain

more qualified nurses if they provided the nurses with open communication

channels to nurse leaders and if the hospital made sure that there were

enough nurse leaders present. In return, nurses will accomplish their jobs

more successfully and obtain greater job satisfaction. Upenieks (2003b)

stated that decentralised decision making and shared governance increase

nurses' control over their work environment, as it supports autonomy and

decision making and also improves relationships. Upenieks (2003a) argued

that aspects such as empowerment and the opportunity to function

autonomously add to job satisfaction.
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In the authors' study, supportive and effective management was

frequently reported as a motivating factor in remaining at a hospital. It is

interesting to note that the behaviours which the nurses draw on in their

comments are a mix of management and leadership behaviours. The nature

of supportive and effective management described by participants included

management implementing new initiatives, effectively working with nurses

and engaging them in participative decision-making. Also mentioned were

comments regarding management's good problem solving strategies. The

following comments from participants denote this:

Manager of the ward is understanding and pleasant. Makes working

conditions pleasant and this encourages staff to remain committed long term.

Clinical nurse manager working along side staff promotes staff

appreciation so staff doesn't feel isolated from the management.

The manager has been fair and flexible.

Successful business people running the establishment.

I have the support of management.

An understanding and supportive Director of Clinical Services

In the study, there was a strong suggestion that nurses appreciate a

manager who is both willing and able to work alongside staff and prepared to

'roll up the sleeves'. The importance of this seems to be twofold: firstly, in

facilitating a team situation rather than a manager/staff relationship and,

secondly, in establishing a sense among nurses that their manager


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understands the role and workload of his/her nurses, who thus have greater

confidence in the actions taken by managers. It is important that the manager

encourages and implements innovative ideas and practices and engages the

staff in participative decision-making. While staff cannot be involved in all

decision-making all the time, it is advisable that they be involved in the

aspects that will impact directly on their practice or in the area where they

have a lot of knowledge and experience.

The nurses in the study highlighted the importance of a manager's

personal touch. This can be as simple as acknowledging a staff member on

his/her birthday by a phone call or card or personal good wishes or a phone

call or card to congratulate a staff member after a specific accomplishment,

for example promotion, support and follow-up on a staff member who has

been on sick leave. Other strategies that the nurses regarded as important

were informal get-togethers, for example a morning tea in a nursing unit. This

should not be to 'check up' but just to spend time together to get to know the

staff. Points of particular note were the introduction of social programs and

the encouragement of social events by the management, the personal

touches and 'little things' (i.e. cards and gifts, free meals, cakes on special

days) that were valued and appreciated. Ross (2001) added that two-way

communication, feedback, management that keeps staff informed and in the

big picture, participation, consultation, decentralisation and empowerment

are important aspects of the supportive workplace.
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2. Job Satisfaction

Increased job satisfaction leads to increased retention rates (Ross

2001; Larsen 2000). As seen from the earlier discussion, by the

implementation of effective leadership and management strategies, job

satisfaction may be enhanced greatly. Moss and Rowles (1997) found that a

participative management style improved job satisfaction. In a study in Hong

Kong, Sui and Donald (1995) found that 'relationships to superiors' was a

strong indicator of the incidence of health complaints and job satisfaction.

In recent years, organizational culture and climate has been found to

be a potential source of job stress or job satisfaction (Adams and Bond 2000;

Fagin 1992; Hemingway and Smith 1999). Jain et al (1996) stated that it is

possible for work-related stress to result in physical, mental, emotional and

depressive symptoms that contribute to job dissatisfaction. They make the

case for workplace counselling services for distressed nursing staff in order to

enhance their job satisfaction.

Upenieks (2003a) stated that aspects such as empowerment and the

opportunity to function autonomously add to job satisfaction. Meyer et al

(2004) are of the opinion that specific management strategies can enhance

job satisfaction. These strategies include participative management, problem

solving and decision making. This means that the staff must be totally

involved in the processes, rather than being consulted but with their input not

having a bearing on the final decision made by the manager. They argue that

managers should show respect for the input, ideas and uniqueness of staff


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members and provide clear, realistic and practical goals, objectives and

expected outcomes for individuals and fornursing units. Goals and objectives

should be challenging but attainable. They also argue that managers can

motivate their staff by supporting them in their push for better conditions such

as creches, safe parking areas, tearooms, adequate equipment and supplies.

Saltzstein, Ting and Saltzstein, (2001) found that flexible scheduling

has positive links to job satisfaction. They also found that part-time

employment has no direct effect on job satisfaction but has a positive effect

on work/family balance. It was evident that flexible scheduling increases

productivity. A perceived lack of work/family balance, and the reduction in job

satisfaction linked to it, also produce other negative job behaviours such as

increased absenteeism, impaired performance and increased turnover.

Upenieks (2003a) concurs on this point, noting that when it comes to job

choice, the majority of nurses would rather select a hospital that provides

flexible hours than one that does not. Ross (2001) added that there is a range

of financial and lifestyle services that will lead to job satisfaction. Included in

these are aspects such as flexible work hours.

Since flexible rostering allows nurses to attend to family and personal

needs, the nurses' productivity and commitment will also improve because

they are allowed to work the hours that they feel comfortable with. The

challenge to the manager is to allow for flexibility to staff but also to ensure

that quality nursing care is provided to the patients.


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Much of the feedback found by the authors correlated with the

discussed literature regarding job satisfaction of nurses as indicated by the

following statements:

Have worked and been happy here for the whole of the past 26 years.

I am thoroughly enjoying my work.

The nursing skill/patient care provides me a sense of satisfaction and

hopefully my role makes a difference.

I'm in my comfort zone.

I love midwifery; I enjoy and delight in every delivery.

Love the job. Love the people.

According to Centrella (2004), it was found at the Oklahoma Heart

Hospital that nurses felt a lot of frustration because they have to do more

with less and were sometimes unable to provide the level and type of

nursing care that they want. By introducing a mostly paperless system, the

hospital was able to save a lot of time, allowing nurses to focus on nursing

care and to do the part of their job that they loved and really wanted to do.

This increased the job satisfaction for the nurses and therefore increased

the retention rate at the hospital.

Barbian (2001) stated that a very important factor in job satisfaction

is to achieve a work/life balance. It seems that this is extremely difficult to


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do, but management which is open-minded to each individual, and tries to

accommodate his or her needs, is valued.

3. Staff Development and Opportunities for New Challenges Increase

Retention Rates

Upenieks (2003b) argues that improved opportunity, information

and resources will empower staff and also create an improved job

satisfaction among nurses. Butler (2000) adds that the best places to work

are where staff are provided with the needed training to succeed in the

market place and where there are plans to build capacity. Growth is

encouraged by doing exciting and leading-edge work and by challenging

the old ways of working. Staff" prefer to learn and grow. Ross (2001) adds

that staff need to be challenged and stretched, but within their capability.

Curran (2003) stated that one of the key reasons that employees

leave hospitals is a perceived lack of career development. Curran (2003)

added that it seems that baby boomers often stay with an organization out

of loyalty while members of Generation X report opportunities for skill

building and learning as key motivators in the decision to stay or to leave

an organization, reflecting their perceived commitment to continuing

development and learning. Investment in mentoring programs and training

and development programs can be an effective response to these needs.

Participants in the authors' study identified opportunities for new

challenges and additional experiences through skill variety and task


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significance as motivating factors to remain at their hospital. This is

evident by the following statements from the participants:

Opportunity to move within the hospital while remaining attached to

a clinical area. That is jobs within the hospital are being created to allow

nurses to work 50 per cent clinical in their area of speciality and 50 per

cent within other area of healthy care system i.e. research and

management, education and development and temporary project

positions.

Opportunities given to challenge myself professionally.

Opportunities available for those who seek them. Opportunity to develop a

position over time

Participants also mentioned that they were attracted by the fact that

the hospital offered a career path and not just a job. Very good support in

terms of staff development. As a new graduate, the program I am in is

very supportive.

The unit gives the opportunity for study and encourages you to

study.

Barbian (2001) noted that many companies found that offering

training and development courses allowed staff to deal better with change.

These courses include leadership, management, time management and

public speaking. By training the staff, companies also had more

confidence to decentralise decision making, and this in turn provided


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motivation for staff. It is important that creativity and innovation are

encouraged.

Conclusion

Many of the factors cited as influencing nurses to remain at their

hospitals relate to interpersonal relations, and leadership and

management style and action. It can be seen also that action to improve

job satisfaction, to provide challenges and to create opportunities for staff

development are ultimately the responsibility of managers and leaders in

the organization Therefore, it is possible for the organization to attract and

retain nurses by strengthening the interpersonal leadership and

management skills within the hospital. This is supported by other studies

which found that, although nurses' pay is important, it is not as critical in

enhancing retention of nurses as a positive work place or a culture that

promotes teamwork and encourages continuous learning, trust, respect

and flexible scheduling (Chan et al. 2004).

It must always be remembered that nursingretention is the result of

a combination of factors. There is no easy solution and managers and

leaders should select the combination of factors that will be effective in

their specific hospital as there is also no one range or combination of

strategies that will fit all hospitals.
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Supportive conclusions:

When a business loses employees, it loses skills, experience and

corporate memory whether in healthcare, and business management. The

magnitude and nature of these losses is a critical management issue, affecting

productivity, profitability, and product and service quality. For employees, high

turnover can negatively affect employment relationships, morale and workplace

safety. The cost of replacing workers can be high, the problems associated with

finding and training new employees can be considerable, and the specific

workplace-acquired skills and knowledge people walk away with can take years

to replace.

The problem of turnover can be addressed through a variety of pro-active

retention strategies: workplace policies and practices which increase employee

commitment and loyalty. Knowledge transfer initiatives on the other hand, ensure

that the knowledge and expertise of a companys employeesits 'corporate

memory'are systematically and effectively shared among employees. They can

offset the negative impact of turnover, but can also work pro-actively to reduce

turnover by providing learning and skills development opportunities to employees

- factors known to reduce turnover.

Employee retention and knowledge transfer are two elements of a more

general concern that might be best termed skills management,i.e., everything

that has to do with recruiting, maintaining and developing the necessary mix and

levels of skill required to achieve organizational and business objectives.


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Best Practices in Retention and Knowledge Transfer

1. Competitive and Fair Compensation is a fundamental starting point in

most strategies to attract and retain employees. However, there is general

agreement that compensation levels do not single-handedly guarantee employee

retention. Common best practices include the use of industry surveys to

benchmark and position wage and salary structures to be fair and competitive.

2. Adequate and Flexible Benefits can demonstrate to employees that a

company is supportive and fair, and there is evidence to suggest that benefits are

at the top of the list of reasons why employees choose to stay with their employer

or to join the company in the first place. Many companies are responding to the

increasingly diverse needs of their employees by introducing a greater element of

choice in the range of benefits from which their workers can choose. Flexibility in

benefits packages can enhance retention, as it creates responsiveness to the

specific needs and circumstances of individual employees.

3. Innovative Compensation Systems and practices can have a positive

impact on employee retention by motivating membership-oriented behaviour

(commitment). Pay systems may also affect knowledge sharing and transfer if

sharing, teamwork, suggestions, etc. are rewarded or recognized. Innovative

compensation systems include gain sharing, skill-based pay and various types of

bonus plans.


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4. Recognition and Rewards include a diverse range of formal and

informal, financial and non-financial, incentives given to individual employees,

groups of employees or to an entire staff. They include such things as employee

of the month awards, company- sponsored sports teams and social events,

prizes, clothing, and so on. Recognition and rewards can contribute to a

workplace culture of respect and appreciation for employees and work well done,

and thereby reinforce employee commitment to the firm.

5. Training, Professional Development, and Career Planning are effective

ways to enhance employee retention. Training constitutes a visible investment

that the company makes in the worker, providing him or her with new skills, and

greater competencies and confidence. Training often leads to work that is more

intrinsically rewarding. Combined with effective communication about how an

employees efforts at developing skills will lead him or her to more challenging

and meaningful positions within the company, training encourages workers to

make longer term commitments to their workplace: it permits them to see a future

with the company. All of the companies we interviewed were very active in the

area of skills training and professional development. Many have put in place

effective internal promotion programs that allow even their unskilled and

semiskilled workforce to move towards positions of greater responsibility and

remuneration within the company.

6. Recruitment & Orientation practices can be of crucial importance to

keeping workers over the longer term. Employee retention is enhanced by


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ensuring a good fit between a companys workplace cultureits way of doing

business and the qualities that it espouses as valuableand the interests,

character, and motivations of the individuals that exist within it. Recruitment

practices that emphasize not only formal qualifications (job relevant technical

ability) but also more general types of qualifications and dispositions on the part

of the recruit can be part of an effective retention strategy. Our own case based

study revealed that employees in some workplaces, particularly the smaller ones,

do more than merely work together: they often share similar interests and have a

very strong inter-personal rapport, and these in turn help to bind them together

as a cohesive whole. Indeed, the quality of interpersonal relations may contribute

significantly to retention in its own right. Good initial orientation to the newly-hired

employee can not only help to effectively integrate that person into the workplace

but can also help to make the new person feel welcome and provide him or her

information about how to cope with the demands of the workplace, and any

possible problems that may arise.

7. Healthy Workplace or Wellness Initiatives take on a variety of forms,

including those directed at the physical work environment (cleanliness, safety,

ergonomics, etc.); health practices (supporting healthy lifestyles, fitness, diet,

etc.); and social environment and personal resources (organizational culture, a

sense of control over ones work, employee assistance programs, etc.). Healthy

workplace initiatives not only improve the health and well-being of individual

employees, but contribute to business performance objectives including

employee retention.


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8. Work-Life Balance programs recognize that employees have important

family and extra professional obligations that compete with their workplace

commitments. Practices such as dependent care leave, childcare subsidies,

eldercare programs, counseling and referral, and flexible working hours allow

people to strike a more meaningful and potentially less stressful balance between

obligations at the workplace and obligations at home. Firms that operate on the

basis of shift work may have employees who find it particularly difficult to balance

family and work obligations. Flexibility and responsiveness on the part of

employers can go a long way in helping employees to resolve such conflicts and

be more productive at work. Policies that prove to be effective in helping

employees to manage work-life balance in a shift work setting include (i) limiting

split shifts, (ii) providing advanced notice of shift changes, (iii) permitting

employees to trade shifts amongst themselves and, most importantly, consulting

with employees about their work-life balance needs while planning shifts.

9. Job Design & Work Teams can enhance the intrinsic rewards of the job,

making work more fulfilling, challenging, interesting, and stimulating. Practices

such as autonomous or semi-autonomous work teams, self-scheduling, and job

rotation can not only improve retention but have also been shown to improve a

number of other important indicators such as productivity, accidents and injuries

and product quality.

10. Employee Participation & Communication. Open, responsive, two-way

communications are vital to good employee retention, and should be considered


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as the basic building blocks of any effective retention practice. Most, if not all, of

the retention strategies and practices fundamentally depend on a sound

approach to communicating with employees. Without communications, many of

these practices would be impossible to implement in any effective way. The case

studies we conducted revealed considerable efforts to communicate with

employees, through a variety of vehicles including employee surveys, regularly

scheduled committee meetings, formal postings and newsletters, and personal

discussions. Several companies keep their employees regularly up to date on the

companys financial performance, and maintain open-door communication

policies.

11. Performance Appraisal practices that provide good feedback to

employees and give them a view of their longer-term progress within the

company particularly in terms of training and career development

opportunities are important ways of enhancing employee commitment.

12. Knowledge Transfer cross-training, coaching and mentoring, phased

in retirement. While employee retention practices seek to retain workers,

knowledge transfer practices seek to retain skills, through both formal and

informal exercises in information sharing and the building of collective

knowledge. Mentoring and coaching, phased-in retirements, and cross-training

and job rotation, are types of knowledge transfer that overlap with training.

Knowledge transfer also includes the use of technology-based toolsdatabases,

intranets, groupwareaimed to support knowledge sharing among individuals,


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and to permanently document and keep knowledge that is vital to business

performance.


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References

Adams, A. and Bond, S. (2000), 'HospitalNurses' Job Satisfaction, Individual and

Organizational Characteristics', Journal of Advanced Nursing, vol. 32, pp. 536-

543.

Barbian, J. (2001), 'C'mon, Get Happy', Training, vol. 38, pp. 92-96.

Bass, B.M. (1995), 'Transformational Leadership Redux', Leadership Quarterly,

vol. 6, pp 463-478.

Bednash, G. (2000), 'Decreasing Supply of Registered Nurses: Inevitable Future

or Call to Action?', Journal of American Medical Association, vol. 283, p. 2985-

2987.

BIZTRAC (1998), Junior Registered Nurses Labour Force Survey." Research

Report Prepared for the Health Department of Western Australia, Faculty of

Business and Public Management, Edith Cowan University.

Buchan, J. (1999), 'Still Attractive after All These Years? Magnet Hospitals in a

Changing Health Care Environment', Journal of Advanced Nursing, vol. 30, pp.

100-108.

Butler, A.S. (2000), 'Best Place to Work', Executive Excellence, vol. 17, pp. 4-5.

Centrella, H. (2004), 'Oklahoma Heart Hospital Maintains 98 Percent Retention

Rate', TheJournal Record, Oct 11, pp. 12-15. Retrieved from : http://www.

journalrecord.com/

Creswell, J.W. (2003), Research Design: Qualitative, Quantitative and Mixed

Methods Approaches, Sage Publications, Thousand Oaks, CA.
http://findarticles.com/p/articles/mi_qa3689/is_200204/ai_n9020765/?lc=int_mb_1001http://findarticles.com/p/articles/mi_qn4182/is_20020827/ai_n10156056/?lc=int_mb_1001http://www/http://findarticles.com/p/articles/mi_qa3689/is_200204/ai_n9020765/?lc=int_mb_1001http://findarticles.com/p/articles/mi_qn4182/is_20020827/ai_n10156056/?lc=int_mb_1001http://www/


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Weinberg, A. and Creed, F. (2000), 'Stress and Psychiatric Disorder in Health

Care Professionals and Hospital Staff', Lancet, no. 355, pp. 533-537.

* The authors wish to acknowledge: Margaret Nowak for her continuous support

and encouragement of the WA Magnet Hospital project; Curtin Business School

for the Tier One research grant which partially funded the WA Magnet Hospital

project; and Diederick Naude for his research assistance in compiling reports on

the Magnet Hospital Project. and his contribution to the literature searches.

Endnotes

(1) The term 'knowledge claims' reflects the assumptions that researchers hold

about what will be learned and how during the research process, and therefore

how the research should be designed. These knowledge claims encompass:

what is knowledge (ontology); how we can know about it (epistemology); how it

can be written about (rhetoric); what values are within that knowledge (axiology);

and the process for studying it (methodology) (Creswell 2003:6).

Marita Naude and Rebecca McCabe, Graduate School of Business, Curtin

University

Table 1: Comparison of managers and leaders

Aspect Managers Leaders

Motivation Use extrinsic motivation

and reward systems

Enhance intrinsic

motivation ame try tocreate purpose andhope throughinvolvement,participation and sharing

Empower the followers
http://findarticles.com/p/articles/mi_hb4839/is_5_9/ai_n29060316/?lc=int_mb_1001http://findarticles.com/p/articles/mi_hb4839/is_5_9/ai_n29060316/?lc=int_mb_1001


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Approach Focus on policies andprocedures and ask howand when; mostly workwith what is by thinking

logitally and sequentially

Seek standardisationand uniformity; seekstability; re-organise andrefine

Focus on motives antiask what and whythrough thinking laterallyand non-sequentially

Challenge the statusquo; seek unity andempowerment;redevelop andrevolutionise

Characteristics Usually analyticalstructured, controlled,deliberate and orderly,think rivals as wellas competition and usethe power of logical andthinking

Focus on practicalissues

Leaders usually areexperimental, visionary,flexible, unfettered andcreative, think partnersas well as collaborationuse the power ofintuitive thinking

Focus on possibleissues and questionassumptions

Relationship withfollowers

Relate to followers

according to their rolesand jobs

Compensate followersaccording to thesystems in theorganization

Relate to followers on apersonal level andaccording to sharedvalues and the strengthof the follower and try toenhance job satisfaction

Planning Focus on the presentand operational/day-to-dayplanning; reactivethinking and short-termresults.

Focus on the futureplanning or strategicplanning; proactivethinking and long-termresults


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Aim to do things right

Acts as the"Dressmaker' whofollows the patternand implements ideas toturn ideas into reality

Interested in exploringnew ideas and takecalculated risksregarding a future vision

Aim to do the right

things

Act as the "designer'who designs the patternothers follow and guidesfollowers towards newideas

Organisation andallocation of staff

Plan and organize staffbased on organizationalneeds.

Control, solve problems

Allocate staff to enhancetheir maximum potential.

Inspire and motivate--keep followers moving inthe correct direction

This table was adapted from Waddell et al. (2004)

COPYRIGHT 2005 National Institute of Labour Studies Inc.COPYRIGHT 2008 Gale, Cengage Learning

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