Factors influencing the retention of registered nurses in the Gauteng Province of South Africa

BACKGROUND: South Africa is a source country for many destination countries that recruit registered nurses who emigrate for personal and/or professional reasons. A large number of South African nurses belong to the baby boomer generation (born between 1943 and 1964) who will retire within the foreseeable future. Statistics from the South African Nursing Council show a decline of 42.0% in the number of nurses who completed their training in South Africa from 1996 to 2005. These aspects combine to predict a potential dire shortage of nurses in South Africa within the foreseeable future. OBJECTIVES: Retention of registered nurses should be the focus of health-care planners to avoid crises in South Africa's health-care services. This study attempted to identify factors that would influence registered nurses' decisions to stay with their current employers in the Gauteng Province of South Africa. METHODS: An exploratory descriptive quantitative design was adopted and questionnaires were sent to a sample of nurses, registered with the South African Nursing Council (SANC), with addresses in the Gauteng Province. A total of 108 nurses completed and returned questionnaires, of whom 77 (73.1%) had considered leaving their current employers. RESULTS: The most important factors that would influence more than 90.0% of these nurses' decisions to stay with their current employers related to finances, safety and security, equipment and/or supplies, management, staff and patients. CONCLUSIONS: In terms of Maslow's Hierarchy of Needs Theory, deficiency needs (physiological, safety and social needs) should be met by improved salaries revised on an annual basis, paying long-service and outstanding-service bonuses, and improving the safety and security, as well the available equipment and supplies, at institutions. Sufficient numbers of nurses should be employed and vacancies should be filled rapidly. However, not all changes required to enhance nurses' retention rates involve increased costs. Managers should lead by example and respect nurses, and encourage doctors as well as patients to do so, to meet nurses' self-esteem needs. Recognising and rewarding outstanding service would meet nurses' self-actualisation needs, as well as opportunities to further their education.