This paper critically evaluates the Hayhurst et al. (2005) study on work environmental factors and nurse retention. The critique examines the adequacy of the study's literature review, the representativeness of its convenience sample drawn from a single Northern California hospital, and the appropriateness of its data collection procedures. The paper argues that the literature review offers little more than a tautology, that the volunteer-based sample lacks generalizability, and that the survey data collection process raised unresolved concerns about anonymity and subject rights. Supporting evidence from AbuAlRub (2004), Erenstein and McCaffrey (2007), and McCauley (2005) is used to contextualize the study's shortcomings.
The purpose of a literature review, as Tebeaux (2010) observes, is to provide a summary of the relevant research in a given area. This allows researchers not only the ability to identify what gaps may exist in the scholarly literature on a given topic, but also to understand how proposed research fits into or fills those gaps. In an effort to support the need for the study, Hayhurst et al. (2005) provides a literature review that focuses on the positive and negative factors influencing nurse retention efforts. However, the literature review offered by Hayhurst et al. (2005) is marginal at best; it serves only to remind readers that nurses are unhappy when job satisfaction is low, when management style and supervisory support are lacking, and when work-related pressures and personal or peer-conflict issues are present.
In contrast, Hayhurst et al. (2005) notes that nurse retention is correlated with higher favorable perceptions of the work environment. For example, when nurses feel they "belong" to the organization, or feel a strong sense of peer connection, they tend to remain in their current jobs. Runy (2006) notes that retaining older nurses is an imperative for healthcare organizations in an effort to curb relatively high turnover and attrition rates. While nurse retention and job satisfaction may be related, and the need for the study may exist, Hayhurst et al. (2005) offers little to support the need for a study on factors associated with nurse retention in conjunction with workplace conditions.
The literature review provided does little more than offer a tautology of nurse retention causes and cures. Furthermore, it provides minimal substantive content; it only marginally addresses concerns related to job satisfaction and reasons for job dissatisfaction, and offers as evidence of the study's necessity only data collected from prior survey administrations in other research studies. Erenstein and McCaffrey (2007) note that among the many reasons for the current nursing shortage in the United States is dissatisfaction with the work environment. McCauley (2005) further elaborates on how a lack of satisfaction among nursing practitioners in hospital settings can have serious and harmful consequences for patient safety, noting that significant evidence suggests unsupportive and un-nurturing environments can result in poor healthcare quality due to medical errors.
AbuAlRub (2004) found that social support and peer approval were both highly correlated with job-related satisfaction markers in the nursing field. Furthermore, upon administering a job-stress scale, AbuAlRub (2004) found that even slight indications of job stressors carry significant negative consequences, including increased staff attrition and turnover rates, absenteeism, and an overall decline in the quality of care provided by hospital staff. Unfortunately, the Hayhurst et al. (2005) study did not meaningfully detail either the positive or negative consequences of nurse-related job dissatisfaction as documented in the scholarly literature.
The Hayhurst et al. (2005) study utilized a convenience sample of volunteer research participants consisting of registered nurses (RNs) working at one hospital in Northern California. While this sample population may be representative of the hospital under investigation — as it purports to encompass nurses from "all shifts" and the return rate of the survey packets is reasonable — the sample fails to account for nurses in other hospital settings, under other working conditions, or in specialized roles such as "staff development nurses" and "clinical nurse specialists" (Hayhurst et al., 2005, p. 284). Furthermore, participation was based on voluntary survey completion rather than a random sampling technique; those who either did not volunteer or did not return their surveys were not considered in the data analysis.
"Why the sample lacks broader generalizability"
The data collection procedures for this study involved distributing and collecting voluntary responses to a survey packet sent to nearly 700 nurse practitioners at one hospital. The research did not involve cross-sectional analysis or provide a means to achieve random sampling. The use of non-probability sampling means that results are not generalizable because they are not representative of other populations.
The data collection methods were appropriate given the study's limitations and its goal of simply analyzing how nurses feel about their jobs at one Northern California hospital. However, the procedures did not specifically detail how anonymity would be guaranteed, nor did they provide for alternative methods of data collection. The nurses were simply given a survey packet, asked to complete the instrument, and instructed to return it via postal mail. A particular concern, therefore, is how the researchers could determine that the survey responses actually came from the intended recipients.
"IRB adherence and ethical issues with incentives and confidential HR data"
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