Sharifa Alsayed

PhD candidate

Intending to stay – Retaining Saudi Arabian nurses: A grounded theory study

Supervisors: Associate Professor Sandra West and Dr Virginia Mapedzahama

Health care in Saudi Arabia has developed rapidly since the early 1950s and the rapid population growth along with the significant expansion of health care services have made great demands for an adequate supply of nurses to meet the staffing needs in hospitals in Saudi Arabia. More recently the need to develop an adequate Saudi nursing workforce rather than continuing to employ large numbers of international nurses has been identified. The most recent (2010) report from the Saudi Ministry of Health stated that there were only 43.7 Saudi nurses per 10,000 and 23.5 nursing assistants per 10,000 people (Abu-Zinadah 2010; Health 2010). [WHO report (2004) indicates as many as 100 nurses per 10,000 people]. Despite increasing interest in enrolment in various nursing education programs from both genders, with current workforce retention rates it is estimated that a further 25 years would be needed to prepare an adequate number of Saudi nurses to satisfy 30% of the Saudi Arabian nursing workforce requirements (Abu-Zinadah 2006).

Recent assessments of the development in nursing education by the Ministry of Health in Saudi Arabia report an incredible increase in the number of female nursing graduates from different Saudi universities and health colleges: 46% of the Saudi Nursing workforce is now bachelor degree prepared and 38% are Diploma prepared (Abu-Zinadah 2010). These nurses are distributed throughout the Kingdom and are working in all healthcare settings. Saudi female nurses are therefore considered to be the backbone of the national nursing workforce.

Despite the increase in graduate nurses there remains a significant nursing shortage in Saudi hospitals. One of the main reasons for this is believed to be nursing turnover in general and the early career attrition rate for well qualified Saudi female staff nurses, especially bachelor degree nurses in particular. Published turnover studies elsewhere, predominantly focus on measuring the turnover rate, job satisfaction and reasons for leaving positions (O’Brien-Pallas, Duffield et al. 2006). To date, there are no Saudi Arabian studies exploring Saudi nurses intentions to leave or remain in employment.

My thesis therefore aims to develop an insightful perspective on retention of Saudi registered nurses, through qualitatively exploring how Saudi female nurses fit themselves in clinical nursing role besides other social role that help them maintain their job as nurses.

A grounded theory approach as described by Charmaz (2006) has been selected for this study as it will facilitate a qualitative exploration of the ways Saudi female RNs are fitting together their social roles in Saudi society and their clinical nursing role to enable them to stay employed in health care settings. Symbolic interactionism will be used as the theoretical framework for this study as it will support and inform contextual analysis of the social interactions and behaviours of the Saudi nurse participants. It is anticipated that the researcher will be able to conceptualise the process of work and life integration in order to uncover its meanings within the Saudi context and that the outcome of this study will contribute to finding useful ways to address the retention of Saudi nurses within a Saudi context.