Addressing High Nursing Turnover: Analysis of Theoretical Concepts and Case Study.

The article contains a systematic review of the scientific literature on the nurse turnover problem. It is analysed from two perspectives. Firstly, the topic of employees is discussed (increased workload, inconsistency of salary with the amount of work performed, standards for the number of patients assigned to one nurse, job dissatisfaction, limited opportunities for career growth and professional development, professional burnout, unregulated rest time between shifts, etc.). Secondly, medical institution is described (shortage of medical staff leads to a decrease in patient satisfaction, loss of care quality, increased waiting time for services, review of safety and patient care protocols, reduction in the number of patients who can receive medical care or consultation, which causes a decrease in hospital revenue, hinders organisational growth, raises the cost of additional recruitment, leads to medical errors that turn into lawsuits in future, etc.). In addition to personal and financial reasons, the medical staff turnover is often caused by purely organisational imbalances (in particular, the lack of a teamwork atmosphere in the hospital, an ineffective leadership model, an imperfect and stressful working environment, poor working conditions, poor relations between doctors and nurses, etc.). The article represents mechanisms for applying provisions of a number of theories and models to address the nurse turnover problem. Among examples, there are leadership models -- the contingency theory (concepts of adaptation, equivalence, effectiveness and congruence), the organisational culture theory like Hofstede's corporate culture theory (concepts of power distance, uncertainty avoidance, male / female values, collectivism / individualism, long-term / short-term orientation, indulgence / restraint), the change management theory like the Plan-Do-Study-Act cycle theory. Tenet Healthcare, Inc. was selected as a case study. One of the well-known and largest healthcare organisations in the United States, it has been experiencing significant problems with the nurse turnover since 2006, which is currently over 50% and higher than the industry average. Given the size of this organisation and its leading position in the US healthcare market, this problem poses a significant threat to the market as a whole, and Tenet Healthcare, Inc. is in immediate need of a comprehensive plan to address [ABSTRACT FROM AUTHOR]