Factors enhancing nursing student retention in aged care employment

Student Training in Aged Care

What Factors in Students Training Enhance Retention

Post Placement in the Aged Care Sector?

What Factors in Students Training Enhance Retention

Post Placement in the Aged Care Sector?

Thanks to medical research, better provision of medical assistance and increased lifestyle options, individuals are living longer and in better health than previous generations; however, the Australian population continues to age, largely due to decreasing birth rates and increased life expectancy. Not surprisingly, this will have an impact on the health care system. Specifically, the aged care sector of healthcare requires committed and competent workers to meet workplace needs. Unfortunately, Fagerberg & Ekman's (1997) study (as cited in Abbey et al., 2006) shows that the number of nursing graduates willing to assume employment in the aged care sector is alarmingly low. For one or more reasons, it appears that many students are either unwilling to enter this sector or are unlikely to continue in this sector over time. Studies conducted by Marsland & Hickey (2003), Moyle, (2003), Happel (2002), and The Australian Department of Health and Aging (2002) have already demonstrated some of the contributing factors of this phenomenon, to include insufficient geriatric content, discouraging quality of clinical placement, and inadequately competent teachers in nursing education programs (as cited in Abbey et al., 2006 ). The proposed research study will attempt to gain the viewpoints of nursing trainees and their supervisors regarding the influence of their teachers, the education process, and the placement experience as it relates to enhancing or diminishing post placement retention within the aged care sector. The study will seek to identify similarities in experience suggestive of what elements dissuade a student from employment in an age care facility, as well as what can be done to reverse or compensate for these elements. Towards this purpose, the study will ask several questions regarding perceived stressors, needs and expectations of students during training, and how trainers can better address these needs. In order to meet the persistent need of nurses willing and able to specialize in aged care, a quick address of this issue is required.

Aims and Objectives

Nursing undergraduates typically view aged care as an unsatisfactory specialty option, resulting in their dissuasion from seeking employment in the aged care sector. The proposed research study will explore the various factors contributing to this dissuasion, toward the purpose of discovering ways in which to prevent dissuasion and encourage nursing graduates to pursue a career in aged care.

A Brief Overview of the Relevant Literature in This Field

Every experience and student-educator interaction has a marked impact -- either positive or negative -- on the student's comprehensive learning experience, and henceforth upon his or her decisions for future involvement in the medical field. In recent years, numerous articles have discussed what factors influence students' decisions to withdraw from or avoid nursing in the aged care sector, to include a lack of sufficient geriatric content, incompetent instruction regarding geriatric care, and poor quality clinical placements within nursing education programs (Abbey et al., 2006; The Australian Department of Health and Aging, 2002; Happel, 2002; Marsland & Hickey, 2003; & Moyle, 2003).

A recent article by Abby et al. (2006) discusses how many nursing students are reluctant to work in an aged care facility, for numerous reasons. These reasons include -- but are not limited to -- erroneous assumptions about their underlying skills, a lack of orientation prior to placement, lower levels of compensation, compromised autonomy, and a lack of opportunity for career advancement. It is worth noting, however, that the sample group for this particular study -- 14 nursing students and registered nurses -- was relatively small. In order to determine the legitimacy of the study's results, and also to address potential gaps in the research, a much larger sample is required.

Literature by the Australian Department of Health and Ageing (2002) examines the contributing factors of students' dissatisfaction with aged care placements, in addition to potential incentives for graduates to pursue a career in aged care. In a government survey of 300 healthcare professionals, the following factors were cited as discouraging involvement in the aged care sector:

Low wages.

An absence of current specialists.

A lack of educational support for nurses interested in aged care.

A lack of literature/documentation regarding the aged care specialty.

Similarly, Happell (2002) discusses a survey of 793 students aimed at determining what factors contribute to their negative perception of the aged care sector. These factors include -- but are not limited to -- the abundance of part-time employees in aged care, insufficient program coordination, and limited opportunities for career advancement in the aged care sector.

In addition to corroborating the contributing factors already discussed, the proposed research will attempt to address such specific sub-questions as:

Do you perceive your trainer(s) to be knowledgeable and experienced in their fields?

What other -- if any -- influences or stressors are currently impacting your training/placement experience?

Narrowing the research focus to address such specific concerns as previously determined to dissuade students from the aged care sector will allow for a better understanding of potential ways to encourage aged care placement.

According to Rowland & Shoemake (1995), nurses are happier working in aged care facilities that consider the nurses' needs as on par with the patients' needs, offer several types of placement options, and allow for nurses to work with a variety of patient-care levels. Such findings suggest that initial interest in aged care can be optimized by presenting students with program placements in facilities with high worker-satisfaction rates, as this will help to dispel the negative perception of aged care as a 'dead-end' career sector. The proposed research study will attempt to identify additional workplace components of importance to student nurses, towards the purpose of determining how aged care facilities might better attract recent graduates.

Marsland (2003) discusses yet another contributing factor to the aged care dilemma; namely that many students feel insufficiently prepared for the chronic stresses of aged care. This coincides with the Australian Department of Health & Ageing survey (2002), in which students cited insufficient geriatric content in nursing training programs as informing their reluctance to seek placement in the aged care sector. Simply put, nursing instruction and/or literature regarding aged care is not currently sufficient to prepare students for employment in the aged care sector.

In conclusion, the literature review provided several insights as to what discourages students from seeking aged care placement; however, the question of what can be done to encourage placement has yet to be examined in full. It is the purpose of the proposed research study to a) consider the findings of previous research, b) address the gaps in previous research, and c) determine specific ways in which to enhance retention in the aged care sector.

Methodology

A qualitative, phenomenology-based research approach is proposed for this study. Such an approach typically employs interview and/or survey techniques toward the purpose of discovering the causes of a particular phenomenon and the various human interactions that contribute to it (Babbie, 2007).

Participants

Two sample cohorts will be recruited for the study, to include a) nursing students who have successfully finished the entire clinical placement, and b) registered nurses (RNs) who have participated as educators and/or supervisors in an academic setting. No fewer than 200 students/RNs will be invited to participate in the study, towards the purpose of securing a sample cohort of no less than 100 participants. All participants will be between the ages of 21-60, with a subdivision of male and female participants that accurately reflects gender divisions in the field.

Ethical Issues

Any research that uses qualitative and/or quantitative methodology must ensure the confidentiality of all parties involved. Prior to administering the survey, survey participants will be presented with a document ensuring that collected information will not be used for any other purpose outside of the study; participants will be asked to sign the agreement as documentation that they have received it. They will also be asked to sign a consent form documented their consent to study participation.

The interview format allows for the possibility of relationship development between researchers and participants; all parties involved should endeavour to restrict this relationship to a professional, clinical nature. As the survey requires participants to reflect on personal, potentially troubling experiences in the academic and placement settings, post participation counselling resources will be made available for interested parties.

Prior to the study beginning, a formal letter informing the training colleges of the content and purpose of the study will be dispensed; this letter will also inquire if specific approval from college ethics boards and/or officials is needed to conduct the study. Should a college require further approval, it will be attained.

Contribution of the Proposed Study to the Field

This study will disclose and explain the characteristics and origin of pessimistic perceptions of the aged care sector and/or experiences in aged care placement as contributes to students' dissuasion from the aged care specialty. As this dissuasion has obvious implications for higher education training programs, further research is required to fully address the issues surrounding students' reluctance to engage in aged care. After determining what aspects of training programs influence students' decisions regarding post graduate placements, the study will provide suggestions as to how training programs can better prepare students for aged care placements and encourage students to seek these placements.

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