Abstract: The Prevailing Nursing Culture in Private Hospitals in Kenya and its Role in Registered Nurses’ Turnover

Abstract

Background and Aim of the study: Registered nurse (RN) turnover is a global phenomenon affecting both low and high income countries over the last 10 years (Kelly and Ahern 2008). A plethora of literature exists on causes of registered nurse turnover in high income countries but little is known on Africa countries and Kenya in particular. Therefore, the purpose of this study was to explore the organizational culture prevalent in private hospitals in Kenya and describe factors that are hitherto unknown on nurses’ turnover. The results have the potential to both enhance the work environment of nurses and the quality of patient care

Methods: A phenomenological approach was used to explore the situation. The study setting was in Nairobi and it involved eight nurses who had resigned from any of the private hospitals in Nairobi within one year. The research was approved by the Kenyan National Commission of Science, Technology and Innovation. A sample of eight nurses was selected using snowball sampling technique. Data were collected through individual interviews and field notes, and analyzed using N-Vivo.

Results: The findings indicated that the culture of private hospitals in Kenya is characterized by negative organizational and environmental factors which were: restricted working practices, limited opportunity for decision making and professional development, tendency towards autocratic leadership, bullying and lack of professional support. Tendency towards autocratic leadership involved receiving orders, adopting unquestioning attitude and unwritten rules that had to be learnt. Nursing leadership was one of the key factors that influenced these relationships.

Conclusions: Nursing culture in private hospitals in Nairobi was characterized by negative sub-cultures. The study utilized a small sample, hence, the results of this study cannot be generalized to all private hospitals in Kenya.

Keywords: nursing culture, nursing turnover, nursing retention, organizational culture