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Absenteeism in Nursing: A Longitudinal StudyAbsence from work is a costly and disruptive p
Absenteeism in Nursing: A Longitudinal Study
Absence from work is a costly and disruptive problem for any organization. The cost of absenteeism in Australia has been put at 1.8 million hours per day or $1400 million annually. The study reported here was conducted in the Prince William Hospital in Brisbane, Australia, where, prior to this time, few active steps had been taken to measure, understand or manage the occurrence of absenteeism.
Nursing Absenteeism
A prevalent(普遍的)attitude amongst many nurses in the group selected for study was that there was no reward or recognition for not utilizing the paid sick leave entitlement allowed them in their employment conditions. Therefore, they believed they may as well take the days off sick or otherwise. Similar attitudes have been noted by James(1989), who noted that sick leave is seen by many workers as a right, like annual holiday leave.
Miller and Norton(1986), in their survey of 865 nursing personnel, found that 73 percent felt they should be rewarded for not taking sick leave, because some employees always used their sick leave. Further, 67 percent of nurses felt that administration was not sympathetic to the problems shift work causes to employees' personal and social lives. Only 53 percent of the respondents felt that every effort was made to schedule staff fairly.
In another longitudinal study of nurses working in two Canadian hospitals, Hackett, Bycio and Guion(1989) examined the reasons why nurses took absence from work. The most frequent reason stated for absence was minor illness to self. Other causes, in decreasing order of frequency, were illness in family, family social function, work to do at home and bereavement.
Method
In an attempt to reduce the level of absenteeism amongst the 250 registered and enrolled nurses in the present study, the Prince William management introduced three different, yet potentially complementary, strategies over 18 months.
Strategy 1: Non-financial incentives(刺激)
Within the established wage and salary system it was not possible to use hospital funds to support this strategy. However, it was possible to secure incentives from local businesses, including free passes to entertainment parks, theatres, restaurants, etc. At the end of each roster period, the ward(病房) with the lowest absence rate would win the prize.
Strategy 2: Flexible fair rostering
Where possible, staff were given the opportunity to determine their working schedule within the limits of clinical needs.
Strategy 3: Individual absenteeism and counseling
Each month, managers would analyze the pattern of absence of staff with excessive sick leave(greater than ten days per year for full-time employees). Characteristic patterns of potential 'voluntary absenteeism' such as absence before and after days off, excessive weekend and night duty absence and multiple single days off were communicated to all ward nurses and then, as necessary, followed up by action.
Results
Absence rates for the six months prior to the incentive scheme ranged from 3.69 percent to 4.32 per cent. In the following six months they ranged between 2.87 percent and 3.96 per cent. This represents a 20 percent improvement. However, analyzing the absence rates on a year-to-year basis, the overall absence rate was 3.60 percent in the first year and 3.43 percent in the following year. This represents a 5 percent decrease from the first to the second year of the study. A significant decrease in absence over the two-year period could not be demonstrated.
Discussion
The non-financial incentive scheme did appear to assist in controlling absenteeism in the short term. As the scheme progressed it became harder to secure prizes and this contributed to the program's losing momentum and finally ceasing. There were mixed results across wards as well. For example,
A．Y
B．N
C．NG
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