Study on the requirements and scope for involvement in the Re Care project of active and inactive nursing staff
Studies and research conducted in recent years indicate that there will be a significant shortage of nursing staff in most industrialised countries, including Switzerland, over the coming years. This is due to the increase in demand for healthcare services, especially in the areas of long-term care and chronic illnesses owing to demographic, environmental and cultural changes as well as factors concerning working environments for both the existing workforce and potential new recruits.
The study, which was part of the Re Care cantonal project (resilience and reintegration of nursing staff in long-term care), aims to contribute to the retention and reintegration of nursing staff in long-term care adopting an integral approach on management, on existing staff (in the various professional roles) and on qualified staff who have left the sector but wish to return under sustainable conditions. Re Care aimed to design and test a targeted and innovative continuing education offer, organised on the basis of several initiatives, addressed to either existing staff or those wishing to return to the sector.
The Re Care project included three pilot activities:
- Workshop-on-future proposals in six long-term care services. These interprofessional workshops aimed to encourage reflection, exchange and planning in relation to care requirements and changes in progress.
- Preparation and evaluative support of a modular professional development programme on the issue of long-term care.
- Preparation of a pilot training initiative entitled “wellbeing in care work” aimed at the management staff in the various services involved and drawn up with partners from the organisations and cantonal institutions involved in the project.
The study described here is part of action plan B and, in particular, aimed to enable studies to be carried out for the design of continuing education and training concerning long-term care, which took account of the requirements and needs of active and inactive care staff, and to provide useful context data for the implementation of action plan C.
The general methodology of the Re Care project was based on an Action research theoretical frameworkwith a participatory approach and a recursive trend. Instead, the investigations of action plan B were based on a Mixed-method research approach, aimed at answering the following questions:
- Which factors contribute to the retention or loss of nursing staff at the healthcare establishments in canton Ticino?
- In relation to this topic, what measures can be used in the basic and continuing training of nursing staff?
- What measures can be implemented to enable the healthcare establishments to promote the retention or reintegration of nursing staff at their own facilities?
Two types of investigations were carried out based on these questions:
- Documentary exploration: current and statistical national and international studies relevant to the Re Care project as well as projects and good practices in the sector (of which there were 15) concerning both the resilience and reintegration of nursing staff.
- Field research involving semi-structured interviews (20 participants), distribution of an online questionnaire (100 respondents) surveying career paths and requirements, and three focus groups which discussed the results of the interviews and questionnaire (24 participants).
The documentary analysis enabled the problem to be clearly defined, the factors causing the shortage of nursing staff to be identified and proposals addressing it to be set out based on the analysis of the projects, recent studies, and good practices. The field study recorded the experiences of a group of actors involved in our region (practising and non-practising nursing staff, experts in the sector). We have set out a summary of the results below based on the research questions initially set.
- Which factors contribute to the retention or loss of nursing staff at the healthcare establishments in canton Ticino?
The results of the documentary analysis and field research indicate that the factors contributing to the retention of staff are the same as those concerning staff leaving the profession if these conditions are not met. The comparison of the results highlighted the importance of investing in the psychosocial aspects of wellbeing and, especialy in four priority areas of intervention: professional growth and development of staff, health and safety, positive social relationships and good work-life balance. The joint action in these four areas of intervention represents an effective approach at cantonal level to retain nursing staff and to keep them satisfied, thereby reducing the phenomenon of staff turnover.
- In relation to this topic, what measures can be used in the basic and continuing training of nursing staff?
In view of the findings on the conditions required to increase the resilience of practising nursing staff and effective reintegration practices for non-practising staff, proposals were outlined on approaches that could be pursued in the field of training. They concern two main areas. The first is the growth and development of staff as continual investment in all professional career stages (basic training, professional socialisation, deployment in new healthcare services due to organisational turnover, reintegration, and continuing training courses). The second concerns health and safety using training programmes to promote the development of a resilient attitude to strengthen protective health factors and to counteract risk factors. In particular, the importance of support with stress management was highlighted by survey participants on the ground.
- What measures can be implemented to enable the healthcare establishments to promote the retention or re-entry of nursing staff at their own facilities?
In relation to this question, the results allowed us to underline the importance of support systems providing counselling courses, supervised placements, and paid leave. These aspects also include the dimension of staff growth and development which is becoming of fundamental relevance in this sector. The respondents also attach great importance to work-life balance with more flexible arrangement of shifts. This does not just concern staff with children but is becoming an increasingly widespread issue related to the protection of privacy and recuperation.
These considerations formed the basis of the training course on the reintegration of nursing staff designed and implemented by the ‘Centro professionale sociosanitario e infermieristico CPSI’ (Sociomedical and Nursing Professional Centre) of Bellinzona and Manno in the 2022–23 academic year. They also form the basis of the third action plan of the Re Care project, known as ‘Wellbeing in Care Professions’, which is currently being implemented.