Does nurse turnover mean nurse wastage in intensive care units

Factors influencing the turnover of intensive care nurses

Access to the intensive care unit (ICU) is often tortuous as there is a high incidence of bed closure due to staff shortage, a problem exacerbated by a high rate of turnover. It is proposed that the first step in addressing the problem is to explore the reasons why people leave, illuminating areas of policy and practice that would benefit from amendment. Given that the issues concerned are complex and contextual in nature, an open exploratory approach was adopted, whereby respondents were interviewed using open questions and given the freedom to shape their responses according to their perceptions of the problem. The transcripts of eleven interviews were analysed, with four themes emerging which represent the most dominant factors influencing the respondents' decision to leave. These included stresses related to the work; inadequate opportunity for professional development; recognition and respect of others and the implications of shift-work. It was concluded that there needs to be a greater awareness of the potential for nurses to become excessively stressed in the ICU environment; that a decentralized management style may help maintain motivation; that rostering systems need to retain flexibility; and that there is a requirement for greater incentives to pursue a career in intensive care.

Workforce dilemmas: a comparison of staffing in a generalist and a specialist intensive care unit

Intensive care units are arguably one of the most costly resources a hospital has to maintain in terms of nursing staff, skills and technology. Given that the Government's agenda on quality remains one of obtaining cost-effective healthcare, it is imperative that nursing managers consider the implications of the new policy shift for how they currently provide services. The purpose in this paper is to compare the different staffing levels adopted by managers in generalized and neurosurgical intensive care in an acute hospital trust. The dilemmas facing managers making staffing decisions without any definitive guidelines for resourcing these specialized units are examined.

The evolution and nursing history of a general intensive care unit (1962-1983)

In this paper we have reviewed the origin and evolution of Whiston Hospital's General Intensive Care Unit (ICU) from its humble beginnings as an offshoot of a general ward in the early 1960s. The length of service of the senior nursing staff over a period of 21 years was also calculated. The average duration of service was 16.5 years--a figure which significantly surpassed those quoted in the literature. In addition, we have outlined the development of nurse training in intensive care as well as the role of the nurses in research in the ICU. The question as to whether later college-based training was superior to the previous hospital-based course remained unanswered.

Responsibility in intensive care: a critical analysis

Nursing has undergone numerous aspects of change within the last 10 years, resulting in a blurring of roles and thus responsibilities. Responsibility in nursing is an enormous, vitally important and pertinent concept. In this paper the term 'responsibility' will be described, discussed and critiqued within the context of the management of care, research and education for nurses working in an intensive care environment.