A COMMUNITY PSYCHOLOGY-INTERACTIONIST APPROACH TO NURSING ATTRITION (BURNOUT, JOB DISSATISFACTION, PROFESSIONAL POWER).
Contributors: California School of Professional Psychology (Los Angeles, Calif.)
Published: 1986
Number of pages: 282
Subjects: Psychology, Clinical.
Description: This study was undertaken in order to examine the utility of a Community Psychology-Interactionist model of intervention when applied to an analysis of nursing attrition.

The dropout rate among registered nurses is considered excessively high by industrial standards and is believed to be the primary cause of a critical shortage of nurses to meet patient care needs within our hospital system.

It was proposed that the inability of the system to affect nursing attrition rates is a result of the inherent values of the system that have directed the problem-solving process toward the selection, definition, and formulation of the "wrong" problem.

A procedure was applied to an analysis of the problem-solving process utilizing the tactics of reframing and negation suggested by Seidman (1983, Chap. 3). Those conceptual models that have dominated the literature as explanations for the high rate of attrition among nurses, yet have failed to solve the difficulty, were reframed within the context of alternative conceptual models that ascribed a different meaning to the same "facts." After applying this procedure at multiple levels of analysis and intervention, it was concluded that nursing attrition is a consequence of the socio-political-economic-cultural values that govern relationships within the health care system. Interventions that have not explicitly addressed these values as the appropriate target of change have failed to affect attrition rates among nurses, and have created a more difficult problem in the process.

The reframing process allowed for the negation of a nursing "shortage" as the appropriate problem to be solved. In direct opposition to the logical choice of committing system resources to solving a "shortage" of nurses, the evidence suggested that promoting the ideal of a nursing "shortage" has allowed the system to deal with its nursing personnel needs in a way that does not threaten its status quo values, goals, operating procedures, or role relationships. The implementation of interventions whose goals have been to fill existing vacancies has served to direct attention away from systems problems that have given rise to professional dissatisfaction among nurses, thus perpetuating attrition.

As a consequence of the relationship that has evolved between the nursing education system and the hospital system in response to a nursing "shortage," a problem of retention has been created as a result of actions applied to a problem of production, a definition of the problem based upon a false premise regarding the true nature of nursing attrition.

It was suggested that a permanent solution will require that future research and intervention be directed toward changing the rules that govern the relationship between the nursing education and hospital systems that have developed in response to the "wrong" problem.
Notes: Source: Dissertation Abstracts International, Volume: 47-05, Section: B, page: 2149.

Thesis (PH.D.)--CALIFORNIA SCHOOL OF PROFESSIONAL PSYCHOLOGY - LOS ANGELES, 1986.

School code: 0068.