to study and understand the gap between pre & post

Jour of Adv Research in Dynamical & Control Systems, 06-Special Issue, July 2017

TO STUDY AND UNDERSTAND THE GAP BETWEEN PRE & POST SOFT SKILL TRAINING AMONG NURSES, A STUDY ON STAFF NURSES IN CHENNAI 1

2

S. Balachandar, Research Scholar, St.Peters University, senior trainer, Saveetha engineering college, Chennai

Dr. R. Jayam, Prof.department of Management Studies, Dr. MGR Educational & Research Institute University, Chennai.

ABSTRACT Human resource in health care is elementary to its functioning. They assume a significant part in deciding the health status of the populace as they contribute distinctive abilities and attempt different errands in the health framework. The shortage of health specialists contrarily influences the quality and proficiency of administrations gave by a nation's health framework. The objective of this study is to evaluate the difference in the performances on some of the job enhancement factors influenced by soft skill training amongst staff nurses from Chennai city, India, the changes before and after such soft skill training programs, purely of nontechnical in nature and content. Findings show significant differences between pre and post evaluations, suggesting that they have a positive impact on such training program. The inferences helps to draw conclusions that the clinics ought to consider the rate and variety of such engagements like soft skill training initiatives and inspire employers to lessen the turnover goal among nurses and it will positively affect their representative responsibility and occupation fulfillment in their healing facilities. Keywords: Training Evaluation, Nurses, Chennai.

INTRODUCTION Today the health care sector is viewed as one of the biggest service industry all through the world. It incorporates a great many healing centers, facilities and different sorts of offices which give essential, auxiliary and tertiary levels of care. Passing on this care requires healthcare professionals, including doctors, nurses and other associated health experts, and also group-based health specialists particularly to give benefits in the restoratively underserved range. There is expanding acknowledgment of the possibility that ISSN 1943-023X

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esteem is the mean to accomplish all associations, including health care. Promising quality is the obsession that pulls in clients, here patients and attending relatives and handing over worth is the thing that holds them returning to the health care institution. The conveyance of important health care relies on upon an extending interdisciplinary group of prepared health care experts.

I. NEED FOR STUDY A.

Present scenerio in heath care

The human resource management in healthcare, like in any other service industry is vital to its functioning, assume a significant part in deciding the health status of the populace as they contribute characteristic abilities and attempt different errands in the health framework. The shortage of healthcare specialists contrarily influences the quality and proficiency of administrations gave by a nation's health framework. Nurses and other health care pofessionals, are incorporated in the direct delivery of health care to the community and in this forms a key part of the health and its care framework. To overcome staff deficiencies, the urbanized nations have endeavor adequate enrollment of foreign nursing care professionals. This problem has been noted in healthcare in particular because the loss of healthcare professionals in poorer countries leaves already struggling healthcare systems in an even more desperate state. For its World Health Report 2006,[1] the World Health Organization (WHO) noted that there is a global shortage of 4.3 million doctors, midwives, nurses, and support workers. Furthermore, these [shortfalls] often coexist in a country with large numbers of unemployed health professionals. India is one of the significant source nations giving nurses to those developed countries. The resource nation's health structure, particularly the creating ones, like India, meet head-on a serious loss of prepared staff as the nurses relocate from both people in general and the private division. A nation with a pre existing unfavorable healthcare framework suffers increasingly when nurses relocate to different nations. There is firm evidence that the even the USA reports nursing shortage. Much is known about the many contributing factors but now employers of nurses need to become proactive to help secure the future of their workforce Janiszewski Goodin, H. (2003) [2] By forming partnerships within the profession and with other influential persons, nurses can be in the forefront of resolving their workforce issues.

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This study attempts to understand the explanations behind nursing their wearing down. Addressing the question of how to manage nurses and to retaining them, reduce their turnover intentions is related to their increased job satisfaction levels furthermore, meta analytic review of research demonstrates that those employees committed to the organization are less likely to leave, With the going up interest for improved effectiveness and nature of administration in associations, newer behavioral soft skill training methodologies for enhancing the work execution of staff have turned out to be progressively imperative. The requirement for enhanced profitability has turned out to be generally acknowledged and that it relies on upon proficient and powerful training is not less obvious. As a rule, before training or advancement projects are sorted out, endeavors ought to be made to people and hierarchical examinations to recognize the training needs. The training needs evaluations is a basic movement for the training and improvement work. It is against this scenery the study is tended to study training needs recognizable proof of nursing staff and responsibility, work fulfillment and aim to continue and grow in a healthcare association B.

Statement of problem

The health care division, particularly the doctor's facility industry is developing at a fast pace in the century. One of the primary difficulties confronted and acted like a risk to the healing center is the steady loss rate of nurses which in the present situation is around 30% - 35%. In the healthcare business, the wearing down rate of nurses is the most elevated among all representative classes. Healthcare facilities are beleaguered by a nursing deficiency of pestilence extents, might concentrate a lot on enlistment and insufficient on maintenance, noted as a slip by that has added to aggravating rates of wearing down. Kane, P. P. (2009)[3] The consistent beat in nursing staff definitely implies a colossal financial deplete for healing facilities which need to always furrow in more supports for training. Enlisting and holding nurses is quick turning into a state of sympathy toward Indian clinics. They are somewhere around 28% and 35 % when contrasted with the normal 10.1% healthcare division whittle down rate. India’s population constitutes 17 per cent of the world population, whereas it accounts for 20 per cent of global disease burden (Govt. of India 2007). The differences in health status reflect in part the disparities in terms of the availability and accessibility of health services. The nurses are considered to be secondary in position as compared to other health professionals in India. There is a vast difference in the stature and respect accorded to doctors as compared to nurses (Gill 2009)[4]. The nursing profession continues to be neglected in

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India. Some of the causes behind this neglect are more emphasis on medical education, political influence by the medical community and less allocation of financial resources on health by the Indian government (Rao, Rao, Kumar, Chatterjee, & Sundararaman 2011). Industry specialists call attention to this is because of two components. To start with, the Indian healthcare part is developing at a rate of 30%, and thus the segment is ready for an ability war, as per the roundtable discussions with minority healthcare consumers and advocates at one of two large national conferences (the Asian American and Pacific Islander Health Forum conference and the Indian Health Service Research Conference, both held in April, 2001); and Bandman, E. & Bandman, B. (2002). Nursing Ethics through the Life Span. (4th Ed.). Upper Saddle River, NJ: Prentice Hall The eminent dwindling levels are additionally on the grounds that there is a constrained upside to nursing as a career. While specialists are paid well in private healing facilities, then in a Government foundation, the case is turned around for nurses, who are better cared for openly clinics. The present lack may not yet be devastating huge clinics in enormous urban communities yet is felt in residential communities or provincial zones. On account of the intense deficiency, numerous doctors’ facilities are today employing unregistered nurses to adapt to their essential needs. Likewise, poaching of staff from different healing centers has gone uncontrolled. The steady disquiet in nursing staff definitely implies tremendous money related deplete for clinics which need to always furrow in more subsidizes for training. Each such healing center has its own altered training conventions. A long way from tolerating whittle down rates as a component of the cost of working together, it is without a doubt something that all associations ought to address, and similarly unquestionably it is a territory in which HR can lead the pack to measure steady loss, look for its causes, set out arrangements and target execution. To sum up, the commonly encountered problems by hospitals or employers of nurses, may include  High turnover of hospital nurses , as it may result in soaring cost to the hospital administration  The commitment and involvement of nursing staff , since it may influence the quality of services provided by the hospital, these issues may possibly lead to the following tight situations a. Large attrition of nursing staff b. Retention of quality staff

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c. Increased turnover intentions , due to various influencing factors Hence, this study was done as an endeavor to quantify the association between training needs, training on soft skills and its impact on job responsibility, work fulfillment and expectations.

II. REVIEW OF LITEATURE El-Salam et al., (2008) conducted a study on Egyptian nurses emphasized on the fact that it is important to involve employees in decision-making and empower them. So, the participation of employees in decision making enables to increase the employees’ commitment towards the organization. Khan et al., (2009) conducted a study recommends that organizational commitment guides to lesser degrees of both absenteeism and turnover. Nurse’s job satisfaction and commitment are considered to influence hospital output and the performance, as research has generally clarified that satisfied personnel are more dynamic and committed to their occupations, whereas non-committed ones face turnover and absenteeism. Altinoz et al., (2012) recognized that the continuing commitment is linked to the factors of age, the tenure of office, promotion chances; satisfaction earned from the payment extracted and wishes to leave the organization, business cycle, and marital status. “Normative commitment reflects a feeling of obligation to continue employment. Employees with a high level of normative commitment feel that they ought to remain with the organization Butt et al., (2012) state that nurses commitment towards the job is important for researchers and academicians in healthcare organizations due to nurses play the central role in their organizational performance. Hamdi & Rajablu (2012) have stated that organizational commitment is a significant idea in the discussion of behavioral elements, which upset high effectiveness and performance. These parts are also connected to the job satisfaction of nursing staff. Workers who were more satisfied with their occupations were also more devoted and committed to their paying organizations.

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Veldhuizen (2012) observed that the impact of autonomy is especially important in extramural care. In extramural settings, care takes place at the patients’ homes. Nurses often work alone when providing services. In fact, autonomy is often a main factor in their job choice decision. To quote Bandhanpreet Kaur et al., (2013) “Turnover intention is a very complex phenomenon and there are various factors that contribute to it. Many studies on intention to leave have been conducted to examine intention to leave and factors relating to intention to leave in various fields“. Khan et al., (2013) suggested that organizational commitment as theorized in the three forms identified in the literature, as affective, continuance, and normative commitment. Organizational commitment is a condition in which an employee recognizes himself/herself with a particular organization and its objectives, and wants to remain its participant. Ghasemi and Keshavarzi, (2014) had conducted a study among nurses and managers of hospitals in Iran suggested that mutual respect, promoting a culture of creativity, innovation, engaging employees in the decision, and problem resolutions enhance employees’ commitment towards the organization. As a result, these actions encourage and enhance the employees’ performance and capabilities within the organization. A.

Objectives of the study

The confined objectives of the present study are: 

To understand the staff nurses perception towards training program, soft skills development organized, by the organization, in order to reduce their turnover intentions.



To find the difference between the performances of the respondents, namely the identified nursing staff before and after such training programs.

 B.

To suggest best practices improve such training initiatives and performances

Methodology

A Total of 536 staff nurses from Chennai based hospitals were randomly selected for the study, falling between the experience groups between 0-2, 3-5, & more than 5 years of experience and used a well-structured questionnaire to collect the data from the respondents.

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The questionnaire included two parts, like demographic profile of the respondents and questions related to pre and post-perception towards such training programs, non technical, soft skill training program, with no technical content in it. The Cronbach's alpha values of questionnaires were most fell within the range of 0.75 to 0.89. Used multiple regression analysis to identify the impact on perception on training on soft skills, IBM SPSS 22 version was used for statistical purpose. A training schedule, was developed based on the inferences derived from the questionnaire, spread over one month, to start with, at a frequency 2 hours every alternate day, 6 hours a week, making it to 24 hours of soft skill development training program , addressing the majority of soft skill training which are expected to influence their communication skills, team and interpersonal skills, peer management skills, competency enhancement modules, like the swot analysis, role plays to realize the work values and ethics. Used pair t-test to compare the difference between before and after training perception of the nurses, to study the differences between before and after training on soft skills, non clinical in content and nature. Out of the many soft skill training modules available for training staff nurses, it was decided to go as per the McCloskey-Mueller Satisfaction Scale (1990) for identifying select factors out of the many factors involved in job satisfaction, leading to reduction in attrition rates, the below mentioned 20 factors perceived to the nursing staff with relevance to Indian context were used, namely from Induction of nursing staff, Training on communication, Interpersonal training, Peer group management skill development, Period of training, Amount spent, Motivation, Conscientious and seriousness, Skill development, Individual need fulfillment, Team need fulfillment, Organizational need fulfillment, Internal training, External training, Values and ethics, Relationship with all, Competency mapping, Infrastructure and working conditions, Understanding technical training and Methodology of training. These were also checked with the findings from the affective commitment scale of the revised three component model employee commitment survey scale, (1993), and Group commitment from the Heuvel et al;1995 and the turnover intention factors adopted from Shore and Martin(1989).The post training analysis of the short soft skill training schedule had given us insights on the factors like availability of such soft skill trainings use of the acquired skills leading to better performance, swiftly acting in critical circumstances, as some of the perceived benefits post training, with expertise when caring for their patients coupled with supervisor support for such soft skills training initiatives, was recognized more important to many nurses. It revealed that job satisfaction is different for each one, the perception is positive, when such training initiatives are included while the students pursue their education. ISSN 1943-023X

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It also suggests that the leadership support is positively related to job satisfaction among staff nurses, which has been identified important finding, as it supports the view what kind of an influential role the nursing manager and can play, which the nursing students pursuing nursing education would become in the future. Consequently, it was observed that motivation to learn improved and enhanced preparation for their profession reduced the withdrawal or turnover intention among nurses and it will have a positive impact in building up their career. The table below shows the mean, Standard Deviation and ‘t’ values for before and after training. The findings - Null hypothesis: There is no significant difference between before and after training. Table 1: Difference between before and after soft skills training Factors perceived

Before

After

Paired

t value

p-value

19.55

0.000*

Differences Mea

SD

n Induction

3.67

Mea

SD

n 0.57

2.71

Mea

SD

n 0.82

0.96

1.14

* Communication

3.7

0.55

2.85

0.88

0.85

1.12

17.63

skill Interpersonal

* 3.71

0.57

2.74

0.88

0.98

1.17

19.41

training Peer group

0.000* *

3.71

0.59

3.13

0.92

0.59

1.08

12.6

management Period of training

0.000*

0.000* *

3.74

0.57

2.98

0.93

0.75

1.11

15.67

0.000* *

Amount Spent

3.78

0.56

3.03

0.95

0.75

1.11

15.54

0.000* *

Motivation

3.68

0.59

2.9

0.9

0.78

1.13

16.04

0.000* *

Conscientious and

3.83

0.59

2.66

0.96

1.17

1.28

21.24

Seriousness Skill Development

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0.000* *

3.82

0.58

3.18

0.99

0.63

1.1

13.28

0.000*

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* Individual need

3.85

0.64

2.56

0.97

1.29

1.36

22.01

fulfillment

0.000* *

Team need

3.89

0.59

2.68

1.02

1.21

1.31

21.36

fulfillment

0.000* *

Organizational

3.81

0.59

2.6

0.92

1.2

1.27

21.96

need fulfillment

0.000* *

Internal Training

3.84

0.58

2.66

0.97

1.18

1.29

21.18

0.000* *

External Training

3.83

0.62

2.51

0.91

1.32

1.32

23.19

0.000* *

Value and Ethics

3.86

0.62

2.73

1.02

1.13

1.36

19.23

0.000* *

Relationship with

3.87

0.58

2.69

1

1.18

1.32

20.73

all

0.000* *

Competency

4.83

0.38

4.64

0.89

0.19

0.84

5.12

mapping

0.000* *

Infrastructure and

4.75

0.43

4.57

0.89

0.18

0.83

5.01

Working conditions Understanding

* 4.79

0.41

4.64

0.84

0.16

0.78

4.67

technical training Methodology of

0.000* 0.000* *

4.67

0.47

4.46

Training

0.94

0.21

0.89

5.43

0.000* *

** denotes significant at 1% level. * denotes significant at 5% level. Inferences from the above hypothesis are We found that P value is less than 0.01, hence null hypothesis is rejected at 1% level with regard to the identified 20 perceived factors of Soft skill training starting from Induction, Communication, Interpersonal training, Peer group management, Period of training, Amount spent, Motivation, Conscientious and seriousness, Skill development, Individual need fulfillment, Team need fulfillment, Organizational need fulfillment, Internal training, External training,

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Infrastructure and working conditions, Understanding technical training and Methodology of training. Hence there is significance difference between before and after training with regard to the 20 perceived factors starting from Induction, Communication, and all others to Methodology of training, given above. The above post training analysis of the short soft skill training schedule had given us insights on the fact that availability of such soft skill trainings use and scope to use those acquired skills lead the staff nurses deliver better performance, also swiftly acting in critical circumstances, as some of the perceived benefits post training, with expertise when caring for their patients coupled with supervisor support for such soft skills training initiatives, was recognized more important to many nurses.

SUGGESTIONS AND CONCLUSION It revealed that job satisfaction is different for each one, the perception is positive, when such training initiatives are included while working. It also suggests that the employer support, in form of training and other engagements is positively related to job satisfaction among staff nurses, which has been identified as an important finding, as it supports the view of the kind of influential role the nursing manager and can play, if retained and inspired to stay. Consequently, it was observed that motivation to learn improved and enhanced preparation for their profession reduced the withdrawal or turnover intention among nurses and it will have a positive impact in building up their career. Implementation of such consistent assignment of the seen initiatives to those caregivers of nursing staff belonging to nursing homes or hospitals to may lead to them abandon the practice of seeking job assignments elsewhere. Such consistent projects and efforts of the employers allow the staff to form close relationships with the residents. Making sure all staff clearly understand goal to keep everyone safe and regular discussions on workplace safety at every general staff meeting, it was observed that it would probably potentiate them to infer how much the hospital or the employer cares about the staff’s well being. Study also suggests establishing an active and involved Safety Committee, including all disciplines and levels of nursing staff , from different age groups as members of the committee (Coyle et al., 2015), regularly conduct of root-cause analysis of every incident including every near miss, or an almost failure avoided and allow those affected participate in the root-cause analysis. It also suggests to have

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employees of the Safety Committee participate in safety rounds and help them to learn to identify and report unsafe practices and unsafe working conditions. (De Silva et al., 2015).These efforts may lead to a better interpersonal skill development and may as well influence their commitment to the health care institution. HR unit rate soft skills, such as interpersonal skills, communication skills and management skills, as some of the most valuable skills they look for when selecting new employees. However employees with well-developed soft skills are hard to find, and once people have joined the organization, employers struggle to provide training in these areas. This may suggest us that there exists a real gap between the soft skills the organization needs, and the skills employees have. Looked at positively, establishing the fact that there’s a huge opportunity for organizations to improve productivity and profitability by bridging this gap. Hence, it is inferred that the clinics and nursing homes engaging for their clinical support and expertise staff nurses ought to consider the rate and kind of usage of different training projects including soft skills and inspire to lessen the turnover desire among nurses and it will positively affect their representative responsibility and occupation fulfillment in the healing facilities, which is primarily the purpose of appointment.

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