Coping Strategies Employed by the Lung Center of the Philippines in Dealing with the High Turnover and Shortage of Nurses

Abstract

The health care system of the Philippines is experiencing different crises. The most pressing of these is the exodus of a large number of nurses to other countries creating shortages in the hospitals. In the last 10 years, the Philippines has exported almost 90,000 nurses to foreign countries. Hospitals, then, are left with an inadequate number of nurses. Those who leave are replaced by newly-graduated nursing students. Due to the demand for nurses abroad, however, most of these new nurses likewise leave the hospital after working for a few months. It is the job of management to find ways to deal with the problem. To date, however, no studies have been done regarding the way the present problem of high turnover and shortage of nurses is addressed. The available studies were made to find out the causes and effects of the exodus of nurses to other countries; the types of job stressors, job stress levels, and types of coping responses of employees in a hospital; and perceived effects of nursing management on nurses. Given the gap in information on this aspect, this study focuses on this question: “What coping strategies are being employed by the Lung Center of the Philippines in dealing with the high turnover and shortage of nurses?” This study is descriptive in nature. While it is rooted mainly on the discipline of management, it also touches other disciplines, which are, economics, sociology, psychology, and the art of nursing. In order to perform the descriptive study, the researcher employed a qualitative technique in data collection. Selected respondents were the chief nurse, some head nurses, some staff nurses, some patients, and the deputy director for hospital support services of the Lung Center of the Philippines. An interview schedule was the tool used to gather data from all the respondents. The interview schedule for the deputy director and the chief nurse consisted of questions regarding the hospital’s profile and how they deal with the high turnover and shortage of nurses. The interview schedule for the head nurses consisted of questions regarding the causes and effects of the high turnover and shortage of nurses on their units and the ways on how they cope with it. The questions for the staff nurses were about the causes and effects of the high turnover and shortage of nurses on them and on their work. On the other hand, the questions for the patients were about the effects of the shortage of nurses on them. A qualitative thematic analysis was made by the researcher followed by an integration of the information and interpretation based on the model of the study. The researcher found out that the Lung Center of the Philippines is a government- owned tertiary specialty hospital created to provide health care to Filipinos with respiratory ailments. The causes of shortage of nurses in the hospital are the demand for nurses abroad, the long employment process, and the limited budget allocation from the government resulting to an increase in the workload of the nurses who are left, and inadequate bedside care for the patients. The cause of high turnover of nurses is the rapid replacement of nurses by the new graduates of nursing who, likewise, leave the hospital after a few months of working; this in turn results to high potential for nursing care errors and a need for old nurses to train new ones again and again. The senior nurses of the Nursing Service Department, especially the chief nurse and the head nurses, deal with the crisis by modifying the staffing methods in terms of recruitment (e.g., scheduling of the Basic Skills training from irregular to every two months and making it a pre-employment requirement; upgrading the qualifications for nursing aide applicants to being midwives, caregivers, or undergraduates of nursing); retention through employee development (e.g., more frequent nurse orientations and progressive rotations than before); and retention through employee maintenance (e.g., higher salary of government hospital nurses than that of private hospital nurses). Some staffing methods retained were in terms of retention (e.g., trainings and refresher courses for nurse promotion; and discounts in hospital services). New staffing methods have been added (e g., the Values Reorientation program; reporting every unit meeting; standardization of nurses’ stations; two-year contract for nurses; and ethical communication from senior nurses to the new nurses). Other methods that are not classified as staffing methods include changing the 8-hour shift of nurses to 12-hour shifts, the watchers class, and the use of student affiliates. All in all, and in order to cope with the high turnover and shortage of nurses, it is concluded that the usual staffing methods are enriched with the new staffing methods, while retaining some old and traditional ones while other methods aside from staffing are also being used by the hospital.