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Chapter 7 Discussion
reduces stress on remaining staff, thus reducing the turnover cycle. The concept
analysis of resident autonomy indicates that staff retention is a consequence of an
environment that encourages resident autonomy. Retaining staff is also suggested
to improve standards of care and reduce mortality (Moseley and Paterson, 2008;
Lovgren, Rasmussen, and Engstrom, 2002). Hertzberg and Ekman (2000)
reported that a consequence of high staff turnover is a feeling of exhaustion for
relatives of residents. Relatives struggled with finding the energy to start yet
another relationship with new staff members. The retention rates in this study
were not an issue as the majority of staff had worked in the case study site for a
number of years. However, it was observed that not all opportunities to engage
with residents’ families were maximised. Phase two of this research therefore
focused on building upon those relationships in order to include family members
in enhancing the residents’ autonomy.
Moseley and Paterson (2008) state that in addition to staff personality and a
desire to work with older people, retention factors include the need for respect
and recognition of achievements, empowerment, valuing expertise, providing
challenges, creating a sense of community within the organisation, providing
education and peer development, and offering flexible shift patterns. The
interviews revealed that the majority of staff felt satisfied working with older
people but they also felt that at times it was difficult to maintain morale during
difficult budgetary constraints in the health service and against negative
perceptions from colleagues who worked elsewhere. Similar sentiments have
been found in the literature (The RCN for Age Concern UK, 2008). Mann’s
(1986) power theory suggests that budgets and resources are important for
sharing power, for those who possess the organisational advantage will always
succeed in overcoming those who lack organisational resources. Despite these
challenges families in this study spoke highly of staff commitment and of their
fun and lively personalities. However this research also reported that some of the
staff participants felt frustrated with their managers and at times they did not feel
supported. Transformational leadership has been recognised as an appropriate
leadership method for health care (Sofarelli and Brown 1998; Kouzes and Posner
1995; Demings 1987). It can potentially inspire and motivate staff. Its principles
include; vision, trust, participation, learning, diversity, creativity, integrity and