The employment and psychological contract in the Department of Health in the Vaal Triangle : a case study
Mosoetsa, Serame Ephraim
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Internationally and nationally a global shortage of nurses exists as a result of a variety of reasons such as emigration, failure of younger individuals to enter and to stay in this profession and the ageing of those in practice. A productive and stable health service is fundamental to any country and nurses are one of the essential mechanisms of the health service. Nurses experience various problems on a daily basis in South Africa. These problems include, among others, high patient load, shortage of staff, inadequate equipment, negligible disposal methods and exposure to viruses, bacteria and needle-prick injuries. The ongoing shortage of nurses in South Africa and the growing number of nurses leaving the profession raise the question about the impact of nurse intention to quit as a result of their psychological contract, job satisfaction and organisational commitment. Lack of an adequate amount of resources leave nurses with a feeling of dissatisfaction, as it makes it difficult for them to do their nursing work as expected (Pillay, 2009). The career of a nurse is stressful and this leads to dissatisfaction. The dissatisfaction experienced by nurses in this regard include a poor working environment, low salaries, a high nurse-patient ratio, long working hours and inadequate nurse care. The primary objective of this research was to investigate the employment relations and the psychological contract of nurses in the Vaal Triangle’s Department of Health. The measuring instruments, namely employer’s obligations, employee’s obligations, state of psychological contract, job satisfaction, organisational commitment, as well as intention to quit questionnaires were used in the empirical study. The research method for both research articles comprised of a brief literature review and an empirical study. A simple principal component analysis was utilised to assess the construct validity of measuring instruments, while Cronbach alpha coefficients were used to assess the internal consistency of the scales of the measuring instruments. Descriptive statistics were utilised to analyse data and the Pearson product-moment correlation coefficients, as well as regression analyses were utilised v to examine the relationships between the constructs used in this study. A cross-sectional survey design was conducted among 300 nurses in the Vaal Triangle hospitals and primary health care centres. A response rate of 73 percent from 220 respondents was obtained. This study comprises two research articles. The first article investigates the relationship between the employer’s obligations, employee’s obligations and the intention to quit of nurses in the Vaal Triangle’s Department of Health, focusing on specific hospitals and primary health care centers. Obligations are perceived by the employee as having an important role in determining the behaviour of employees in an organisation and if these are unmet or unfulfilled, could result in counter-productive behaviour from the employees. The second article focuses on the relationship between job satisfaction, organisational commitment, and intention to quit on the psychological contract of nurses in the Vaal Triangle. Employees who are not satisfied with their jobs are likely not to be committed to an organisation and, consequently, have a higher intention to leave their employer than satisfied employees. The results indicated a practically significant correlation coefficient of a medium effect between the employer’s obligations and the employee’s obligations, a negative correlation of medium effect between the employer’s obligations and an intention to quit, and no practically significant relationship between the employee’s obligations and an intention to quit. Furthermore, a practically significant correlation coefficient of a medium effect was obtained between job satisfaction and an intention to quit, no practically significant relationship could be found between job satisfaction and organisational commitment. Lastly, a practically significant negative correlation of a medium effect was obtained between organisational commitment and an intention to quit. Multiple regression analysis indicated that 21 percent of the variance in intention to quit was predicted by both employer’s obligations and employee’s obligations. Organisational commitment and job satisfaction predicted 33 percent of the total variance. Thus, all the constructs held a predictive value for an intention to quit. Conclusions as well as limitations of this study are discussed. Lastly, the recommendations for the Department of Health and future research are provided.