Nurse Absenteeism in Public Hospitals: A Study of Factors and Solutions, Lecture notes of Management Theory

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TABLE OF CONTENT

SL.NO. TITLE^ PAGE NO.

ABSTRACT

1. INTRODUCTION

2. LITERATURE REVIEW

3. RESEARCH METHODOLOGY

4. RESULTS

5. DISCUSSION

6. CONCLUSION

7. BIBLIOGRAPHY

ABSTRACT

Nursing is the greatest occupation in hospitals. Absenteeism may be closely correlated with working circumstances, impacting performance and productivity as well as the personal lives of nurses. This study will determine the degree of nurse absenteeism, reasons that affect it, and suggest methods nurse administrators might address these issues in order to reduce absenteeism rates among licensed professional nurses working in public hospitals. This research is exploratory, descriptive, quantitative, and qualitative. According to information provided by the Hospital Management, the yearly average and total absence rates among nurses from five public hospitals in Mumbai were measured at the qualitative stage throughout a 12-month period. Five nurse managers from five institutions were interviewed during the qualitative stage. The quantitative stage indicated significant variations within and across institutions, with a range of monthly rates above the monthly average of 6.7%. In the qualitative stage, actions made by these institutions that had a beneficial impact were analyzed. Relationships with management, dialogue, and supporting the physical and emotional needs of professionals were all key considerations. In the day-to-day administration of the nursing workforce, absenteeism is a fact. It varied depending on the month of the year and the hospital, and it might be categorized based on the severity of the issue. Additionally, the findings demonstrated that staff illness, in-law illness, and other social aspects were important variables, permitting management options depending on each hospital's actual situation. Key Words: Absenteeism; Human Resources in Hospitals; Human Resource Management in Hospitals; Nursing Supervision; Nursing administration.

study, the Municipal Corporation of Delhi's public hospitals would be able to better understand the reasons that affect absenteeism and make recommendations for nurse administrators on how to resolve them. Nursing absenteeism is a problem because it throws off the daily schedule, makes the remaining staff unhappy, and overburdens them, all of which degrade the standard of patient care. In Delhi's public hospitals, the already small quantity of nursing personnel is frequently strained by nurse absenteeism. This has an impact on the organization's capacity to successfully address the problems posed by its surroundings and disrupts the way the organization operates. The provision of high-quality nursing care in medical facilities depends on having enough nurses. The backbone of the global health care delivery system is the nurse, and this nation's community's healthcare needs also require a sufficient number of nurses on staff. Nurse absenteeism has been a major concern for healthcare organizations. The upshot of this absenteeism is a growing worker shortage. Regardless of staff shortages, nurses who are on duty are expected by both nurse administrators and patients to do all assigned responsibilities on time and provide patients with the necessary medical care. To maintain the continuity of patient care in the unit, nurse administrators sometimes struggle to change work schedules and transfer nursing responsibilities from absent nurses to those present. When filling in for missing colleagues, nurses are frequently overworked. Overwork and a high nurse to patient ratio are frequently the results, which impair patient outcomes and raise death rates. There are two types of nurse absences: planned and unplanned. Planned absences, such as upcoming vacations, classes for continuing education, and training, are simpler to handle since a nurse manager is aware of the possible staffing shortages they may generate. Unplanned absences, on the other hand, are expensive and can jeopardize both patient safety and the standard of care since it can be difficult and expensive to recruit appropriate substitutes quickly. For these reasons, unscheduled absence is the topic of this essay. This study will determine the degree of nurse absenteeism, variables that affect it, and provide solutions.

The variables that contribute to the absence rates of professional nurses working in public hospitals should be addressed by nurse administrators. 1.2. Purpose of the Study More than merely the problem's nature is conveyed in the study purpose statement. The goal of the study is to evaluate the level of nurse absenteeism, identify factors that affect nurse absenteeism among professionals, and suggest solutions to the issue of nurse absenteeism at a particular public hospital. 1.3 Researchers' goals A general explanation of the study's goal is a research objective. The thesis statement is divided into particular goals to be attained or research topics to be investigated (Cormack 2003:18) The purpose of this study was to evaluate the level of nurse absenteeism and to pinpoint factors that affect it among professional nurses working in Delhi's public hospitals. 1.4 Objectives  To determine the degree of nurse absenteeism at work.  To evaluate the sorts of allowed leave that the nurses have taken.  To pinpoint factors that affect the absence of nurses. 1.5. Understanding of Concepts Definitions for Operations Absenteeism: What it implies for nurses in this research Absenteeism is the term used to describe an employee's absence from work. The weekly time off, casual leave, yearly earned leave, and sick leave are all permitted for staff nurses to use. Here, the total number of days of personal leave is only regarded to be 50 days in order to maintain the hospital's efficiency and improve patient care. The staff nurse is gone for a total of 50 days, which includes 35 days of absence without pay, 15 days of casual leave, and 35 days of annual leave, half pay, leave without pay, and annual absence. The three main factors that affect a nurse's absence from work are their personal characteristics, the characteristics of their own illness, that of their husband, children, or in-laws,

2. LITERATURE REVIEW

In this research study, absenteeism rates among nurses were discussed. A literature review entails finding and analyzing pertinent articles that provide data related to the study topic, claims (Fain 2004: 50). The literature review fulfils a number of crucial purposes, making the time and effort invested in it worthwhile. The purpose of the literature search, according to Cormack (2003:22), is to provide the groundwork for future study by conducting a critical assessment of prior literature on the subject at hand. Literature review can serve a few significant capabilities in the examination cycle. A writing survey gives a direction regarding what is known and about an area of request, to determine what sort of examination can best make a further commitment to the current base of proof about the subject being explored. Fain (2004:51) states that the writing survey figures out what is known and what isn't been aware of a subject, idea, or issue. The motivation behind the writing audit in this study was to acquire data on factors affecting attendants' truancy and prescribe methodologies to resolve the issues of non-attendance. Davey et al. (2009) detailed that work disposition included normal topics like work fulfillment, authoritative responsibility, and occupation association. One component that could impact work demeanor is bothersome work conditions (for example outrageous temperatures, work environment stress and ongoing business related states of being) and another is boss help (for example mindful, preparing, make up for additional time and work modification). Bamberger and Biron (2012) in a cross-sectional review, inspected whether unfortunate work conditions added to non-attendance while thinking about peer referent gatherings (i.e., peers in the work environment whose sentiments impacted an individual) and boss help. They proposed that laborers might try not to come to work when that work implies dangers (for example outrageous temperatures, and working environment stress) or unfortunate working circumstances In 2012, Bamberger and Biron added that boss help could likewise impact non-appearance. On the off chance that the laborer's boss was steady and encouraged a collaboration, the specialist ought to find it more challenging to miss work.

Work demeanor could likewise be impacted by responsibility or a laborer's apparent responsibility. Rauhala et al. (2007) analyzed the impact of responsibility on non-appearance in an observational partner study. Their review included 877 enrolled nurture and enlisted viable medical caretakers in 31 wards from five public clinics in Finland in 2004. Nurture chiefs experience challenges in changing plans for getting work done and redistributing the nursing errands of the people who are missing from work to the attendants who are available, to guarantee the congruity of patient consideration in the unit (Taunton, Perkins, Oetker-Black and Heaton 1995:82). Non-attendance and the resultant expanded responsibility for the medical attendants compromises the nature of patient consideration. The leftover medical caretakers experience business related pressure, which unfavorably influences their confidence. This may thus cause non-attendance. Haccoun and Jeanrie found that singular nonappearance designs rely upon the individual mentalities of the medical attendant towards their work. Medical caretakers with a negative work disposition add to a higher pace of non-appearance in the working environment than those with a positive work demeanor. Mohamed Baydoun et al in his "What really do nurture supervisors say regarding medical attendants' disorder non-appearance? "Another point of view uncovered that information investigation yielded three spaces as follows: business related, individual and hierarchical variables that lead to attendants' ailment non-appearance. Schreuder JA, Roelen CA et al: In their "Initiative viability and recorded disorder nonattendance among nursing staff": a cross-sectional pilot concentrate on expressed that the administration style utilized in wellbeing offices can impact the nonappearance patterns of wellbeing laborers. In the Netherlands, administrators' authority adequacy was contrarily connected with the quantity of nonappearance days and transient shortfall of medical attendants despite the fact that there was no relationship to long haul nonattendance. In any case, in work likewise embraced in the Netherlands examining the impacts of two authority styles neither affected nonappearance recurrence, in spite of the fact that it was suggested that a blend of various styles could bring down nonattendance recurrence.

additionally builds the responsibility for the medical caretakers who are normal in their obligations.

3. RESEARCH METHODOLOGY 3.1 Research Approach Descriptive, explorative, and quantitative research methods were employed. Non-probability purposive sampling was used to choose the sample, and power analysis was used to determine its size. The samples were chosen from a list of public hospitals where the patients met the inclusion requirements for sample selection. For collecting demographic information and for other purposes, semi-structured questionnaires were used as the instruments. Specialists in a variety of sectors, including general education, administration, nursing education, nursing administration and management, statisticians, and English and Marathi language experts, validated the tool. After speaking with the guide, the thoughts and recommendations provided by these specialists were taken into consideration to alter the instruments. The tools underwent feasibility and reliability testing in an Indian setting. 3.2 Procedure for Data Collection and Protocol  Institutional approval from the ethical committee.  Permission to conduct the research project was acquired from the relevant authorities at each institution.  Presented the research study to the staff nurses, including the nursing management (Matron), and asked for their consent to participate in the study.  Obtained the willing individuals' informed consent before starting the study.  Assured them that their name would remain anonymous and that only research purposes would be served by using the results. The staff nurses must have at least one year of professional experience and must not have taken an unapproved leave or taken more time off than allowed during the predefined year, from January 2021 to December 2021. i.e., 15 days of casual leave; 50 days total, made up of [Half Pay Leave, Annual Leave, Leave Without Pay, and Absent Without Leave = 35] days.

Staff nurses working in primary level care peripheral institutions, such as health posts, who were on extended leaves without notification and so unavailable for the research are omitted from it. 3.3. Principal justifications for absence Personal traits, traits related to illness in themselves, in their husbands, children, or in-laws, and societal traits related to festival celebration, child exams, transportation, absence of creche, etc.

The table portrays that the segment profile of the missing staff attendants of foreordained public clinics of the Municipal Corporation of Delhi (M.C.G.M.). The missing staff medical caretakers according to the comprehensive and restrictive models were H1 =350, H2 = 75, H3 = 60, H4 = 120 and H5 = 40. Age of the missing staff medical attendants was conveyed in four gatherings 21yrs. to 30 yrs, 31yrs to40yrs ,41yrs to 50yrs or more 50yrs. Greatest missing staff medical attendants were of H3 - 10(16.66%), 50(15.28%) in H1 , 8 (6.67%) in H4 and 2(2.67%) in H emergency clinics in the age gathering of 21 to 30 yrs. 50(66.67%) in H2 medical clinic, 24

(60%) in H5, 185(52.86%) in H1 medical clinic, 25 (41.67%) in H 3 and 45 (37.5%) in the H clinic in the age gathering of 31 to 40 yrs. In age gathering of 41 to 50 yrs, there were 65 (54.16%) in the H 4, 22 (36.67%) in H 3 medical clinic, 14(35%) in H 5 clinic, 105 (30%) in H 1 clinic and 21 (28%) in H 2 clinic staff attendants were missing. Over 50 yrs there were most extreme staff medical attendants missing in 3 (5%) in H 3 emergency clinic, 10 (2.86%) in H 1 clinic, 2 (2.66%) in H2 emergency clinic, 1 (2.5%) in H 5 and 2 (1.67%) in H 4 medical clinic. The table portrays that the segment profile of the missing staff medical attendants of foreordained public emergency clinics of the Municipal Corporation of Greater Mumbai (M.C.G.M.). The missing staff medical attendants according to the comprehensive and selective measures were H1 =350, H2 = 75, H3 = 60, H4 = 120 and H5 = 40. Experience of the missing staff medical caretakers was appropriated in four gatherings < 10 yrs., < 15 yrs, < 20 yrs and > 20 yrs. Most extreme missing staff attendants were of H3 - 10 (16.66%), 50 ( 14.29%)in H1 , 10 (8.33%) in H4 and 2 (2.67%) in H2 medical clinics in the experience of < 10 yrs. 50 (66.67%) in H2 medical clinic, 24 ( 60%) in H5 , 200 (57.14%) in H1 clinic , 25 (41.67%) in H 3 and 43 ( 35.83%) in the H4 emergency clinic in the experience of < 15 yrs. In the experience of < 20 yrs. there were 65 (54.17%) in the H 4 , 22 (36.67%) in H 3 clinic, 14(35%) in H 5 medical clinic, 21 (28%) in H 2 emergency clinic and 90 (25.71%) in H 1 medical clinic staff attendants

The table portrays that the segment profile of the missing staff medical attendants of foreordained public clinics of the Municipal Corporation of Greater Mumbai (M.C.G.M.). The missing staff medical caretakers according to the comprehensive and restrictive rules were H =350, H2 = 75, H3 = 60, H4 = 120 and H5 = 40. Family Structure of the missing staff medical caretakers was appropriated in two gatherings single/Nuclear and Joint family. Most extreme missing staff medical caretakers were of H1 - 300 (85.71%) 45 (75%) in H 3 , emergency clinic ,52 (69.33%) in H2 , 25 (62.50%) in H5 and 70 (58.33%) in H4 medical clinic having solitary or family unit structure. Though 50 (41.67%)in H4 medical clinic, 15(37.50%) in H medical clinic ,23 (30.67%) in H 2 medical clinic 15 (25%) in H3 medical clinic , 50 (14.29%) in H 1 clinic having joint family structure. It shows that solitary or family unit size influences the straightforwardly the minding of kid/youngsters and consequently by implication influences the non-attendance of staff attendants from the work place.

The table portrays the appraisal of the degree of truancy of medical caretakers at work place, in foreordained public clinics of the Municipal Corporation of Greater Mumbai (M.C.G.M.). The missing staff medical attendants according to the comprehensive and elite standards were H =350, H2 = 75, H3 = 60, H4 = 120 and H5 = 40. Number of long periods of truancy of the missing staff medical caretakers was disseminated in three classifications 51 to 180 days, 181 to 365 days and over 365 days. Greatest missing staff attendants of 51 to 180 days were in 86 (71.67%) in H 4 emergency clinic, 235 (67.14%) in H 1 clinic, 38 (63.33%) in H 3 , 24 (60%) in H5 and 39 (52%) in H 2 emergency clinic.. In 181 to 365 days classification of non-attendance of staff medical caretakers were 13 (32.50%) in H5 clinic, 23 ((30.67%) in H2, 100 (28.57%) in H1 , 28 (23.33%) in H4 and 10 (16.67%) in H3 emergency clinic. Over 365 days class there were 12 (20%) in H3, 13 (17.33%) in H2, 3 (7.50%) in H5, 6 (5%) in H4 and 15 (4.29%) in H

The table portrays the evaluation of the reasons of truancy of medical caretakers at work place, in foreordained public emergency clinics of the Municipal Corporation of Greater Mumbai.

(M.C.G.M.).. The missing staff medical caretakers according to the comprehensive and selective rules were H1 =350, H2 = 75, H3 = 60, H4 = 120 and H5 = 40. Reasons of non-appearance of staff medical attendants were sorted in three classes. Individual, Social and Sickness reasons The first is Personal Reasons in this class there were Fluctuating movements at work environment ,Heavy Workload at working environment ,Carrier Development Unfair/Inadequate therapy of staff at working environment and Unfair discipline forced on the staff nurture at working environment reasons considered for assortment of information reason. H1 95(27.14%) was showing greatest individual purposes behind truancy, H2 25(25.33%) ,H4 26(21.67%) , H 10(16.67%) and H5 7(17.50) of individual reasons of non-attendance among the staff attendants. Social Reasons in this classification there were Lack of Child care offices, Transport issue at working environment, Celebration of celebrations like Ganeshyotsav, Diwali, Christmas and so on, Children's Examinations reasons included for assortment of information reason. H 35(58.33%) and H4 70(58.33%) non-appearance of staff medical attendants in friendly reasons, H2 40(53.33%), H5 18(45%), and H1 155(44.28%) recorded. The third explanation was Sickness Reasons, in this class there were Self, Husband, Child/Children, parents in law disorder reasons were thought of. Greatest in 15 (37.50%) in H5, 100 (28.57%) in H1 H3 15(25%), H 16(21.33%) and 24(20%) in H4 kept in ailment class. Section V Semi structured Questionnaires to the Nurse Administrator The nurse administrators from all five hospitals were asked the following semi structured open questionnaires face to face and summarized as followed: Is medical caretakers' non-appearance a typical issue in your unit? If it's not too much trouble, make sense of. All the five medical caretaker overseers saw that attendants' non-appearance is a significant issue in their particular clinic. The truancy of medical caretakers affects the patient consideration particularly toward the beginning of the day hours when the patient consideration is at the ideal level. ,likewise, does it acquire the trouble dealing with the other two movements evening and night where number of permitted nursing force is less. Simultaneously this spontaneous ailment leave non-attendance causes the directors trouble in overseeing nursing force nonstop for the better consideration. Some of them replied "Nonappearances at last take a charge in care and the entire group (H5). "Non-attendance illustrates nature of work and principally how the staff part is