Turnover intention and its related factors of clinical research coordinator in Hunan, China: a cross-sectional study.

To explore the related factors of turnover intention in clinical research coordinators (CRCs) and assess the mediating effects of professional identity on the association between job burnout and turnover intention. In China, CRC has become increasingly common among clinical trial teams in recent years. However, limited published research focused on the status of turnover intention in CRCs. We invited all the 220 CRCs currently working at Hunan Cancer Hospital located in Changsha city in the central south of China from March to June 2018. Participants were asked to complete structured questionnaires regarding basic demographic information, job burnout, professional identity and turnover intention. A total of 202 participants were included in this study, with a response rate of 91.82%. The main reason for turnover intention among CRCs was human resources, followed by communications, management and material resources (per item score in each dimension: 2.14 vs. 2.43 vs. 2.65 vs. 2.83). All the correlations among job burnout, professional identity and turnover intention were statistically significant, with coefficients ranging from -0.197 to 0.615. Multiple liner regression analysis showed that older age, longer workhours per week, and lower level of professional identity were associated with the prevalence of turnover intention among CRCs. Besides, the association between job burnout and turnover intention was fully mediated by professional identity. This study revealed the status and causes of turnover intention among Chinese CRCs. Effective measures on decreasing working time and improving professional identity should be taken in order to reduce CRCs' turnover intention.

Change in Patient Enrollment After Site Principal Investigator Turnover in Surgical Clinical Trials.

This cohort study examines the association of principal investigator (PI) turnover with patient enrollment in surgical clinical trials.

Bridging the Gap: Standardizing Orientation to Improve Vacancy and Turnover Rates of Ambulatory Oncology Nurses.

This article describes standardizing ambulatory oncology nursing orientation within an academic comprehensive cancer center to reduce turnover rates. The nursing professional development specialist created a standardized orie.

Oncology Nursing for the Future: Multisector Planning Is Needed.

Assessing the landscape for oncology nursing of the future, the biggest problem that faces the specialty is that of workforce shortages. On the practice side, nursing turnover, resignations, and early retirements have contrib.

Importance of doctor-initiated management of the balance between work and treatment for lung cancer patients: Results of a nationwide survey by the Japan Lung Cancer Society.

BACKGROUNDS: Since the recent development of molecular targeted drugs and immune checkpoint inhibitors has improved lung cancer treatment options and outcomes, supporting patients in balancing work and pharmacotherapy have become even more important in the field of lung cancer treatment. This study sought to identify the current status and roles of doctors in balancing work and treatment for lung cancer patients. METHODS: Patients and doctors were recruited to complete a web-based questionnaire survey by the Japan Lung Cancer Society. RESULTS: About 287 lung cancer patients and 381 doctors were included in the analysis. About 42.9% of patients responded that "there was no discussion" about their working conditions or work before the initiation of pharmacotherapy, while 22.6% responded that "there was an inquiry from a doctor/health care provider and a discussion that included the doctor was held." About 45.3% of patients took leave or resigned from work at the time of diagnosis. The most common reasons for patients to resign before or during pharmacotherapy were "poor physical condition due to side effects of treatment or illness" and "concern about causing problems in the workplace." To assist in balancing work and pharmacotherapy, patients desired "increased opportunities to consult about work" (36.9%) and "provision of treatment options with few adverse events" (28.9%). CONCLUSION: This study highlights the importance of doctor-initiated management of the balance between work and treatment for lung cancer patients. An important first step is for doctors themselves to take an interest in their patients' professions and initiate discussions of work-related topics with their patients.

Diet, physical activity, and emotional health: what works, what doesn't, and why we need integrated solutions for total worker health.

BACKGROUND: Current research advocates lifestyle factors to manage workers' health issues, such as obesity, metabolic syndrome, and type II diabetes mellitus, among other things (World Health Organization (WHO) Obesity: preventing and managing the global epidemic, 2000; World Health Organization (WHO) Obesity and overweight, 2016), though little is known about employees' lifestyle factors in high-stress, high turnover environments, such as in the long term care (LTC) sector. METHODS: Drawing on qualitative single-case study in Ontario, Canada, this paper investigates an under-researched area consisting of the health practices of health care workers from high-stress, high turnover environments. In particular, it identifies LTC worker's mechanisms for maintaining physical, emotional, and social wellbeing. RESULTS: The findings suggest that while particular mechanisms were prevalent, such as through diet and exercise, they were often conducted in group settings or tied to emotional health, suggesting important social and mental health contexts to these behaviors. Furthermore, there were financial barriers that prevented workers from participating in these activities and achieving health benefits, suggesting that structurally, social determinants of health (SDoH), such as income and income distribution, are contextually important. CONCLUSIONS: Accordingly, given that workplace health promotion and protection must be addressed at the individual, organizational, and structural levels, this study advocates integrated, total worker health (TWH) initiatives that consider social determinants of health approaches, recognizing the wider socio-economic impacts of workers' health and wellbeing.

Survey of the US Surgeon Workforce: Practice Characteristics, Job Satisfaction, and Reasons for Leaving Surgery.

BACKGROUND: An impending surgeon shortage looms in the US due to increasing demand and a stagnant number of surgeons entering practice. We sought to evaluate the state of our surgical workforce by exploring current practice patterns, job satisfaction, and reasons why surgeons consider leaving surgery. STUDY DESIGN: In 2018, a link to a detailed survey was distributed by email to Fellows of the American College of Surgeons (ACS) who actively practice in the US and have completed a general surgery residency or integrated cardiothoracic, vascular, or plastic surgery fellowship. Detailed questions regarding practice attributes, surgical training, professional choices, and career satisfaction were included. Nonresponse weights were adjusted for respondent sex, age, and presence of subspecialty training between respondents and the total surveyed ACS population. All estimates and analyses were weighted to account for potential nonresponse bias. RESULTS: There were 3,807 surgeons who responded (15% response rate). Overall, 81% reported career satisfaction and 80% would choose surgery over again. Twenty-six percent were considering leaving surgery within the next 2 years. Stratified by age groups 40 to 49, 50 to 59, and 60 to 69 years, the survey found that 9%, 17%, and 45% of respondents were considering leaving surgery within the next 2 years, respectively. Thirteen percent of surgeons less than 60 years old were considering leaving surgery, and only 49% of these surgeons reported career satisfaction. Among surgeons less than 60 years old who were considering leaving surgery, the top 3 reasons rated as very important were overall stress (79%), work time demands (77%), and personal time requirements (73%). CONCLUSIONS: Reported surgeon job satisfaction was high, but a surprising number of surgeons reported that they were considering leaving surgery. Work time requirements and lack of personal time are leading factors contributing to surgeons leaving practice.

Why don't young doctors want to be surgeons?

<b>Aim:</b> The increasing staff shortages in Polish surgery incline towards posing the following questions: What are the reasons for the reluctance of Polish doctors in training and residents to specialize in this field of medicine? What measures could be pursued to raise the interest of students and trainees in specializing in general surgery? The aim of this paper is to attempt to answer these questions. <br><b>Material and methods:</b> From August 5 to December 30, 2019, an online survey of doctors in training and resident doctors was conducted. The study covered 2,498 people. <br><b>Results:</b> The key reason indicated by young doctors of both sexes was the disproportion between the level of remuneration and professional responsibility. Other most commonly reported reasons include: high overtime, physical and mental strain at work, and fear of not being allowed by senior colleagues to perform surgery. <br><b>Conclusions:</b> In view of the aging Polish surgical staff and a decreasing number of young doctors interested in this field of medicine, it is necessary to introduce changes into their mode of education.

Laboratory Staff Turnover: A College of American Pathologists Q-Probes Study of 23 Clinical Laboratories.

CONTEXT.­: Knowledge of laboratory staff turnover rates are important to laboratory medical directors and hospital administrators who are responsible for ensuring adequate staffing of their clinical laboratories. The current turnover rates for laboratory employees are unknown. OBJECTIVE.­: To determine the 3-year average employee turnover rates for clinical laboratory staff and to survey the types of institutional human resource practices that may be associated with lower turnover rates. DESIGN.­: We collected data from participating laboratories spanning a 3-year period of 2015-2017, which included the number of full-time equivalent (FTE) staff members that their laboratories employed in several personnel and departmental categories, and the number of laboratory staff FTEs who vacated each of those categories that institutions intended to refill. We calculated the 3-year average turnover rates for all laboratory employees, for several personnel categories, and for major laboratory departmental categories, and assessed the potential associations between 3-year average all laboratory staff turnover rates with institutional human resource practices. RESULTS.­: A total of 23 (20 US and 3 international) participating institutions were included in the analysis. Among the 21 participants providing adequate turnover data, the median of the 3-year average turnover rate for all laboratory staff was 16.2%. Among personnel categories, ancillary staff had the lowest median (11.1% among 21 institutions) and phlebotomist staff had the highest median (24.9% among 20 institutions) of the 3-year average turnover rates. Among laboratory departments, microbiology had the lowest median (7.8% among 18 institutions) and anatomic pathology had the highest median (14.3% among 14 institutions) of the 3-year average turnover rates. Laboratories that developed and communicated clear career paths to their employees and that funded external laboratory continuing education activities had significantly lower 3-year average turnover rates than laboratories that did not implement these strategies. CONCLUSIONS.­: Laboratory staff turnover rates among institutions varied widely. Two human resource practices were associated with lower laboratory staff turnover rates.

Permanence of professionals who work in the Tuberculosis Control Program / Permanencia de profesionales que actúan en el Programa de Control de la Tuberculosis / Permanência de profissionais que atuam no programa de controle da tuberculose

ABSTRACT Objective: To analyze the length of stay of the professionals who work in the Tuberculosis Control Program in Basic Health Units of the city of Rio de Janeiro/RJ. Method: Sectional study, developed in eight Health Units of the Maré Complex/RJ. Physicians, nurses, nursing technicians and Community Health Agents of the Family Health Teams were interviewed. The Kruskal-Wallis test was used to verify the existence of groups with the same distribution, and Dunn's multiple comparison test with Bonferroni correction, to identify which group presented a difference. Results: Among Health Units, a significant difference was observed in the length of work (p-value = 0.0005909) and in the dwell time (p-value = 0.0003598). Conclusion: It was observed low length of stay of the professionals that work in the Basic Health Units. This result points to challenges inherent in the control of tuberculosis at the local level.

RESUMEN Objetivo: Analizar el tiempo de permanencia de los profesionales que actúan en el Programa de Control de la Tuberculosis en Unidades Básicas de Salud del municipio de Río de Janeiro/RJ. Método: Estudio seccional, desarrollado en ocho Unidades de Salud del Complejo de la Maré/RJ. Entrevistaron médicos, enfermeros, técnicos de enfermería y Agentes Comunitarios de Salud de los Equipos de Salud de la Familia. Se optó por la prueba de Kruskal-Wallis para verificar la existencia de grupos con la misma distribución, y prueba de comparaciones múltiples de Dunn, con corrección de Bonferroni, para identificar qué grupo presentaba diferencia. Resultados: Entre las Unidades de Salud, se comprueba diferencia significativa en el tiempo de ejercicio de la función (p-value = 0,0005909) y en el tiempo de permanencia (p-value = 0,0003598). Conclusión: Se constató bajo tiempo de permanencia de los profesionales que actúan en las Unidades Básicas de Salud. Este resultado apunta a desafíos inherentes al control de la tuberculosis a nivel local.

RESUMO Objetivo: Analisar o tempo de permanência dos profissionais que atuam no Programa de Controle da Tuberculose em Unidades Básicas de Saúde do município do Rio de Janeiro/RJ. Método: Estudo seccional, desenvolvido em oito Unidades de Saúde do Complexo da Maré/RJ. Entrevistaram-se médicos, enfermeiros, técnicos de enfermagem e Agentes Comunitários de Saúde das Equipes de Saúde da Família. Optou-se pelo teste de Kruskal-Wallis para verificar a existência de grupos com a mesma distribuição, e teste de comparações múltiplas de Dunn, com correção de Bonferroni, para identificar qual grupo apresentava diferença. Resultados: Entre as Unidades de Saúde, comprova-se diferença significativa no tempo de exercício da função (p-value = 0,0005909) e no tempo de permanência (p-value = 0,0003598). Conclusão: Constatou-se baixo tempo de permanência dos profissionais que atuam nas Unidades Básicas de Saúde. Esse resultado aponta para desafios inerentes ao controle da tuberculose em nível local.

From organisational support to second victim-related distress: Role of patient safety culture.

AIM: This cross-sectional correlation study aimed to explore the associations among patient safety culture, organisational support, second victim-related distress, absenteeism and turnover intentions in the registered nurses (RNs) by using structural equation modelling. BACKGROUND: Medical errors could cause RNs' second victim-related distress, which may either positively or negatively impact patient safety culture. METHOD: The Hospital Survey on Patient Safety Culture (HSOPSC) and Second Victim Experience and Support Tool (SVEST) were used to investigate 267 RNs who were involved in direct patient care and medical errors within the previous year in China. RESULTS: About half (45.3%) of nurses experienced psychological distress, and 26.6% of the nurses intended to leave. The model showed that 6 dimensions of patient safety culture have contributed to decreasing absenteeism and turnover intention via increased organisational supports and decreased second victim-related distress. CONCLUSION: The second victim-related distress may be relieved, and organisational support may be enhanced through improvements in patient safety culture. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies are needed to establish an environment where cooperation/cooperative relationships between the supervisor and the staff nurse can be ensured.

Impact of a chemotherapy workload and productivity dashboard on pharmacy technician turnover.

PURPOSE: To describe the methods used in the development of an intravenous chemotherapy workload and productivity dashboard and its impact on symptoms of burnout and technician turnover. SUMMARY: In February 2017, chemotherapy sterile preparation pharmacy technicians reported symptoms of burnout as a result of perceived increase in workload. In response, an i.v. chemotherapy workload and productivity dashboard was developed at an academic medical center to validate workload in comparison to the reported job stress of pharmacy technicians. The dashboard provided pharmacy leadership objective data to validate staff concerns and leveraged lean principles to level-load the work prior to requesting additional full-time equivalents (FTEs) to senior leadership. The rate of turnover of i.v. chemotherapy technicians was assessed before (December 2016-June 2017) and after (July 2017-January 2018) dashboard implementation and approval of an additional i.v. chemotherapy technician FTE. The addition of the new FTE resulted in a decrease in productivity from an average of 106% (range 67%-151%) to 84% (range 65%-110%). The interventions allowed for the ability to leverage a staffing-to-demand model, resulting in the observed improvement in technician symptoms of burnout and a notable decrease in the overall turnover rate of i.v. chemotherapy technicians. CONCLUSION: The i.v. chemotherapy workload and productivity dashboard confirmed frontline staff perception and provided data to support the addition of labor resource and an opportunity to leverage a staffing-to-demand model to decrease symptoms of burnout and technician turnover.

Workplace injury rates and firm-level turnover in Montana's oil and gas industry.

BACKGROUND: Do workers follow their self-interest by minimizing injury risk in their employment decision? If so, employers could use injury reduction as a recruitment and retention strategy. This study explores whether injury incidence is associated with turnover in Montana's Oil and Gas industry. METHODS: A panel data set of Unemployment Insurance and Workers' Compensation administrative records from 2010 to 2015 was used to model the relationship between turnover and injury claim rates at the firm level. RESULTS: Total turnover and injury rates were found to be positively related while injury rates and separation rates had no such association. Quarters in which the employer experienced a severe injury had a 3.3 percentage point increase in separation rates. DISCUSSION: The findings suggest that injured workers contribute to increased turnover, but coworker turnover does not increase with increased injury rates in the firm. Secondary findings suggest a relationship between recent hires and increased injury rates, although further investigation is required.

[Turn-over of non-tenured public health research personnel in an Italian public research institute (IRCCS).] / Il turn-over del personale con contratti di lavoro flessibili o borse di studio dedicato alla ricerca sanitaria in un IRCCS pubblico italiano.

BACKGROUND: The objective is to show variations in the number of non-tenured personnel (NTP) in a public health research centre (IRCCS) between 30th June 2016 and 31st December 2017. In this time interval, the issue of NTP was at the centre of governmental discussions. METHODS: Data collection was performed from CVs and scientific publications of NTP working at the Fondazione IRCCS Istituto Nazionale dei Tumori (INT). We compared the characteristics of NTP entering or leaving INT and those of NTP who remained in the considered time interval. RESULTS: NTP in INT counted 465 members of staff at 30th June 2016 and 472 at 31st December 2017. 75% of these works in the research. 26% of NTP left INT and their position resulted entirely substituted by other NTP. NTP staff who left are mainly aged under 40 and show fewer publications than those who stayed. Newly acquired NTP are younger and show a fewer number of publications compared to the personnel who left. CONCLUSIONS: 1 out of 4 NTP members of staff moved to a new job during a period in which the uncertain future of NTP research staff was under the spotlight. It appears that IRCCS are progressively being identified as suitable for hands-on, post university internships from which researchers would then choose to move, in search of a new job in public or private centres, with a consequent decline of IRCCS' role in health research.

What causes patients with breast cancer to change employment?: evidence from the health insurance data in a medical facility.

This study aims to make clear the following aspects of breast cancer patients and their occupation. 1. What percentage of patients have changed their working status around surgery? 2. When did patients change their employment? 3. What is the cause of the employment change? We investigated 269 patients who underwent curative surgery for primary breast cancer at one university hospital in Tokyo. Patients who were under the age of 58 at the time of surgery and had the experience of being a company or government employee during a year prior to the surgery were used as sample for analysis. To determine factors related to the employment change, multiple logistic regression analysis was performed. Nineteen percent patients changed the employment status before and after surgery. Of those, 19% changed the employment by the end of surgery month while 42% did by the fourth month after surgery. Treatment-related factors such as mastectomy and the combination of chemotherapy and hormone therapy affected changes in employment. We believe that the validity of our study can be confirmed by comparing with the previous study results. We show the potential large effects of cancer treatment on patients' daily lives.

Rodízio de postos em abate de bovinos: para além das dimensões físicas do trabalho / Job rotation in beef packing operations: beyond the physical dimensions of work / Rotación de puestos en el sacrificio de bovinos: más allá de las dimensiones físicas del trabajo

Resumo: A norma brasileira NR-36, específica para indústrias de abate e processamento de carnes, indica a necessidade de implantação de rodízios de postos para reduzir a exposição dos trabalhadores a constrangimentos físicos repetitivos e controlados por máquinas. Porém, estudos demonstram que os efeitos alcançados com essa implantação são geralmente inferiores ao esperado e que a rotação sozinha não seria a solução para os problemas de saúde no trabalho. Por meio de uma pesquisa empírica em um frigorífico de abate de bovinos, o objetivo deste artigo é apresentar e discutir dimensões do trabalho real consideradas relevantes para a saúde e segurança dos trabalhadores. Tais dimensões constituem elementos importantes a serem considerados em projetos de implantação de rodízio de postos. A metodologia compreende entrevistas coletivas com 16 trabalhadores voluntários divididos em 4 grupos. As técnicas de grupo focal e de confrontação coletiva valendo-se de filmes da atividade foram utilizadas. Os resultados evidenciam dimensões já conhecidas na literatura relacionadas aos constrangimentos físicos, competências necessárias, ritmo de trabalho e falta de tempo para realizar um trabalho de qualidade. Dados novos aparecem quanto às prescrições heterogêneas do trabalho que representam uma fonte de pressão psíquica em zonas do abate. Essas dimensões organizacionais impactam a atividade individual e coletiva dos trabalhadores, assim como a saúde no trabalho. Do nosso ponto de vista, e corroborando estudos internacionais, além das dimensões físicas do trabalho, aspetos organizacionais, humanos, estratégicos e pedagógicos devem ser considerados em projetos de implantação do rodízio de postos.

Abstract: Brazilian Regulation NR-36, specific to the slaughterhouse and meat packing industries, emphasizes the implementation of job turnover to reduce workers' exposure to repetitive and machine-controlled physical strain. However, studies have shown that the effects of such measures are generally less than expected, and that rotation alone is not the solution to work-related health problems. Based on a study performed in a beef packing plant, the article aims to present and discuss real work dimensions that are considered relevant to the plant workers' health and safety. Knowledge of such dimensions is important for the implementation of job rotation projects. The methodology included interviews with 16 volunteers divided into four groups. The focus group and collective confrontation techniques were used, drawing on videos of the work. The results pointed to dimensions already known in the literature, related to physical strain, the required skills, work pace, and insufficient time to perform quality work. New data appeared in relation to the work's heterogeneous specifications, representing a source of psychological pressure during work in the cattle slaughtering areas. These organizational dimensions impact workers' individual and collective activity as well as workplace health. In our view, and corroborating international studies, in addition to the work's physical dimensions, organizational, human, strategic, and pedagogical aspects should be considered in projects involving the implementation of job rotation.

Resumen: La norma brasileña NR-36, específica para industrias de sacrificio y procesamiento de carnes, indica la necesidad de la implantación de rotación de puestos para reducir la exposición de los trabajadores a presiones físicas repetitivas y controladas por máquinas. No obstante, algunos estudios demuestran que los efectos alcanzados con esa implantación son generalmente inferiores a lo esperado, y que sólo la rotación no sería la solución para los problemas de salud en el trabajo. Mediante una investigación empírica en un frigorífico de sacrificio de bovinos, el objetivo de este artículo es presentar y discutir las dimensiones del trabajo real, consideradas relevantes para la salud y seguridad de los trabajadores. Tales dimensiones constituyen elementos importantes que deben ser consideradas en proyectos de implantación de rotación de puestos. La metodología comprende entrevistas colectivas con 16 trabajadores voluntarios divididos en 4 grupos. Se utilizaron técnicas de grupos focales y confrontación colectiva, valiéndose de grabaciones de la actividad. Los resultados evidencian dimensiones ya conocidas en la literatura, relacionadas con presiones físicas, competencias necesarias, ritmo de trabajo y falta de tiempo para realizar un trabajo de calidad. Aparecen nuevos datos en relación con las prescripciones heterogéneas del trabajo que representan una fuente de presión psíquica en zonas de sacrificio. Estas dimensiones organizativas impactan en la actividad individual y colectiva de los trabajadores, así como la salud en el trabajo. Desde nuestro punto de vista, y corroborando estudios internacionales, además de las dimensiones físicas del trabajo, se deben considerar aspectos organizativos, humanos, estratégicos y pedagógicos en proyectos de implantación de rotación de puestos.

Rotatividade de profissionais da Estratégia Saúde da Família no município de Montes Claros, Minas Gerais, Brasil / Personnel turnover of the Family Health Strategy in Montes Claros, Minas Gerais, Brazil

Objetivo: analisar a rotatividade dos profissionais de saúde vinculados às Equipes de Saúde da Família (ESFs) de Montes Claros, MG. Sujeitos e método: trata-se de um estudo transversal de natureza quantitativa do tipo exploratório e descritivo. Os dados foram extraídos do Relatório de Profissionais Desligados no Estabelecimento do Cadastro Nacional de Estabelecimentos de Saúde (CNES), no período de fevereiro de 2001 a agosto de 2016. Resultados: foram avaliados 811 profissionais, dos gêneros feminino (n=599) e masculino (n=212), em 93 ESFs. Estiveram cadastrados 283 médicos, 264 enfermeiros, 50 técnicos de enfermagem, 75 auxiliares de enfermagem, 78 dentistas, 56 auxiliares de saúde bucal e 5 técnicos de saúde bucal. A média do tempo de permanência (TP) dos profissionais nas ESFs foi de 20 meses, sendo que o tempo mais frequente foi menor que 1 mês (6,2%), seguido pelos tempos de 1 (5,9%) e 2 (4,3%) meses; 48,82% dos profissionais (n=396) permaneceram por tempo menor que 12 meses. Os cirurgiões-dentistas foram os profissionais que tiveram maior TP dentre os profissionais de nível superior, e profissionais de nível médio apresentaram TP significativamente maior. Conclusão: pôde-se observar uma alta taxa de rotatividade profissional nas ESFs no município avaliado. (AU)

Objective: to analyze the turnover of health professionals linked to the Family Health Teams (FHT) of Montes Claros, MG, Brazil. Subjects and method: it is a cross- -sectional, quantitative, exploratory, and descriptive study. The data were extracted from the Report of Professionals Dismissed from the Establishment available at the Brazilian Registry of Health Establishments (CNES), from February 2001 to August 2016. Results: a total of 811 professionals were evaluated, both women (n=599) and men (n=212) in 93 FHT. Moreover, 283 physicians, 264 nurses, 50 nursing technicians, 75 nursing assistants, 78 dentists, 56 oral health assistants, and five oral health technicians were registered. The average length of stay (LS) of the professionals in FHT was 20 months, and most often, it was less than 1 month (6.2%), followed by 1 (5.9%) and 2 (4.3%) months. Additionally, 48.82% of the professionals (n=396) stayed for less than 12 months. Dentists were the professionals with the highest LS among higher-level professionals, while medium- level professionals presented significantly higher LS. Conclusion: a high rate of personnel turnover was observed in the FHT in the city analyzed. (AU)

The Social Determinants of Nursing Retention in a Pediatric Hematology/Oncology Unit.

Pediatric hematology/oncology units (PHOUs) are highly paced, stressful environments and can be difficult areas to work. Thus, these units can present issues when it comes to both recruiting and retaining health care professionals (HCPs). There is scant research addressing how the environment of a PHOU contribute to a HCP's desire to stay or leave this environment. To conduct this project, a critical ethnographic approach was used. The researcher conducted semistructured interviews ( n = 29), which included nurses ( n = 21), physicians ( n = 4), and allied health care staff ( n = 4). This sample represented approximately one third of staff in each category. Participants identified that their ability to develop long-term relationships with children and families as a significant source of satisfaction. Belonging to the oncology team was seen as extraordinarily important to all the participants. The majority of the participants also felt that working in this ever-evolving dynamic medical field afforded them with ongoing learning opportunities. The main frustration described by participants pertained to administrative involvement in the everyday workings of the PHOU, potentially leading to attrition. It is important to note that there was also diversity among and between the categories of HCPs when describing the work environment and the issues that most influence them. While similarities among participants were found between satisfaction and dissatisfaction, significant differences between them led us to believe it would be unreasonable to attempt to compare the three groups here. Thus, in this article the author focused primarily on nursing while noting related observations from physicians and allied health professions.

Racial and ethnic disparities in promotion and retention of academic surgeons.

BACKGROUND: Racial/ethnic diversity remains poor in academic surgery. However, no study has quantified differences in the rates of retention and promotion of underrepresented minority (URM) academic surgeons. METHODS: The American Association of Medical Colleges Faculty Roster was used to track all first-time assistant and associate professors appointed between 1/1/2003 and 12/31/2006. Primary endpoints were percent promotion and retention at ten-year follow-up. RESULTS: Initially, the majority of assistant and associate professors of surgery were White (62%; 75%). Black assistant professors had lower 10-year promotion rates across all specialties (p < 0.01). There were no race/ethnicity-based differences in promotion for associate professors. Retention rates were higher for White assistant professors than Asian or Black/Hispanic/Other minority faculty (61.3% vs 52.8% vs. 50.8% respectively; p < 0.01). There was no difference in 10-year retention rates among associate professors based on race/ethnicity. CONCLUSIONS: Underrepresented minority surgeons are less likely to remain in academia and Black assistant professors have the lowest rates of promotion. These findings highlight the need to develop institutional programs to better support and develop minority faculty members in academic medicine.

Accounting for early job turnover in recent pediatric surgery fellowship graduates: An American Pediatric Surgical Association Membership and Credentials Committee study.

PURPOSE: Employment opportunities for graduating pediatric surgeons vary from year to year. Significant turnover among new employees indicates fellowship graduates may be unsophisticated in choosing job opportunities which will ultimately be satisfactory for themselves and their families. The purpose of this study was to assess what career, life, and social factors contributed to the turnover rates among pediatric surgeons in their first employment position. METHODS: American Pediatric Surgical Association members who completed fellowship training between 2011 and 2016 were surveyed voluntarily. Only those who completed training in a pediatric surgery fellowship sanctioned by the American Board of Surgery and whose first employment involved the direct surgical care of patients were included. The survey was completed electronically and the results were evaluated using chi-squared analysis to determine which independent variables contributed to a dependent outcome of changing place of employment. RESULTS: 110 surveys were returned with respondents meeting inclusion criteria. 13 (11.8%) of the respondents changed jobs within the study period and 97 (88.2%) did not change jobs. Factors identified that likely contributed to changing jobs included a perceived lack of opportunity for career [p = <0.001] advancement and the desire to no longer work at an academic or teaching facility [p = 0.013]. Others factors included excessive case load [p = 0.006]; personal conflict with partners or staff [p = 0.007]; career goals unfulfilled by practice [p = 0.011]; lack of mentorship in partners [p = 0.026]; and desire to be closer to the surgeon's or their spouse's family [p = 0.002]. CONCLUSIONS: Several factors appear to play a role in motivating young pediatric surgeons to change jobs early in their careers. These factors should be taken into account by senior pediatric fellows and their advisors when considering job opportunities. TYPE OF STUDY: Survey. LEVEL OF EVIDENCE: IV.