Theme 1: Negative Staff Attitude towards the Implementation of Staff

The word negative refers to consisting of negation, refusal or denial (The Free Dictionary, www.thefreedictionary.com) and attitude refers to a settled way of thinking or feeling about something (Swanepoel, Erasmus & Schenk, 2008:24). In addition, attitude refers to a predisposition or tendency to respond positively or negatively towards a certain idea, object (www.businessdictionary.com). Consequently, a negative staff attitude refers to a degree of negative feeling that a person possesses towards a particular object or another person (Swanepoel et al., 2008:19).

In this study participants experienced negative staff attitude as a factor that affects the implementation of staff development programmes in the hospital. These factors were perceived as reluctance and uncooperativeness. Negative attitudes were identified by participants who said:

“Did we talk about attitude because communication goes with attitude? If somebody wants to share the knowledge and some are making noise during the discussion answering negatively, against what one is saying. I mean we are adults it has to be done professionally. The manner of approach prevents the implementation of programme you have attended.”

“Like even if there is something that you are lacking, your senior must call you and correct you properly than saying you don’t know what you are saying or doing with a loud voice in front of everybody. That is demotivating and preventing the implementation of programmes.”

Lee (2005:41) claims that the effect of negative attitude in the workplace impedes the implementation of programmes. It is true that top-down approach or down top that does not recognise professionalism and prevents the effectiveness of learning programmes.

Negative perceptions experienced by nurses regarding staff development delays their opportunity to implement ideas, knowledge and skills, gained from educational programmes (Hughes, 2005:47). A negative attitude affects feelings of empowerment to implement new ideas from study activities attained from SDPs that were attended.

From the above discussion, participants reported that they had experienced negative attitudes from nurses towards the implementation of staff development programmes.

59

They mentioned a lack of professionalism in the manner in which the staff is approached which demotivates and inhibits the implementation of SD programmes.

When the participants were asked what can be done to facilitate the implementation of staff development programmes in this hospital the following response was received:

“Attitude will improve if we are working together as a team. We must be approached in a proper manner to be motivated and implement what we have learned.”

Nurses should have a positive attitude towards their work and other people because a negative attitude affects the implementation of knowledge acquired (Swanepoel et al., 2008:19). There is a need to have a positive attitude and to implement staff development programmes. Additionally, and most importantly, it is the responsibility of staff to be positive towards their own learning in order to facilitate the implementation of knowledge to benefit the individual and the organisation (Jones & Jenkins, 2006:9).

From the above mentioned participant’s remarks it may be inferred that staff is experiencing negative attitudes towards the implementation the SD programmes because of the manner in which they are approached which is demotivating and hinders the implementation of knowledge acquired from the programmes. Staff believes that they should be approached in an inviting manner that will facilitate the implementation of staff developmental programmes. Emanating from the analysis was the sub-theme reluctance and an uncooperative attitude, which is examined next.

3.2.2.1 Sub-Theme 2.1: Reluctance and uncooperative attitude

Reluctance refers to a feeling or showing doubt about something, not willing or eager to do something (Merriam- Webster, www.merriam-webster.com). [Assessed 12 June 2016] well as unwillingness, lack of eagerness, enthusiasm to do something (New Oxford American Dictionary, www.oxforddictionaries.com) [Accessed 22 June 2016].

Participants mentioned that staff is sometimes reluctant when an individual try to implement what she has learned from staff development programmes.

“Sometimes when one tries to implement what one has learned; staff is reluctant to show interest in what you say. They say we have been doing it this way now you coming with your new things.”

60

“To add on, one goes for neonatal resuscitation and when you try to implement, someone will say that it is the incorrect way to do it, which will discourage the person doing it. This also has an underlying message of us regressing.”

It is important to be committed to continuous learning and implementing knowledge gained as people’s knowledge becomes less relevant because of skills gained early in a career are insufficient to avoid costly mistakes made through negligence and ignorance (Tlholoe, 2006:5 as cited in Richards & Potgieter 2010:41). Continuing formal education in nursing is a key element to the maintenance of quality in health care delivery.

“Yes, it is because sometimes we lack enthusiasm to go and attend the in-service because we do not know why we must attend the in-service.”

Richards and Potgieter (2010:44) pointed out that organisations which do not invest in the development of their employees may discover that their organisation is characterised by reluctant employees who are not interested in implementing current knowledge and skills acquired from SDPs. My personal belief is congruent with participant’s statements that reluctance of staff is related to a negative attitude towards the implementation of SDPs in the hospital. Implementation of SDPs is impeded by some of the staff members who do not show an interest in learning and implementing the programmes for their own personal growth and the benefit of the institution.

When participants were asked what can be done to facilitate the implementation of staff development programmes they were adamant that:

“We must change.’’

“People must change we all need to change and stop being reluctant staff development is for our own growth.’’

“I think people are stuck in doing things the old way rather than moving with the current age. People must change for their own benefit and that could help to implement the knowledge they have acquired.”

Nurses must take responsibility for their own development and not be reluctant in order to be empowered (McGillis Hall, Waddell, Donner & Wheeler, 2004:232). Staff development fosters the development of skills that are necessary for nurses to become active participants in implementing what they have learnt form the programmes that they have attended. Employees who are committed to the idea of continuous learning, and to implementing what has been learned and who are prepared to reinvest themselves to

61

keep abreast with change and take responsibility for their own development and are committed to the organisation’s success, are employees who will progress.

A positive attitude towards nursing practice is associated with job satisfaction (McGillis Hall et al., 2004:232). Individuals who exert more control over their work by implementing knowledge gained from what they have learned are likely to be more satisfied with their jobs and are more competent, effective and committed to the organisation. The researcher concurs with the participant’s statements that nurses who have the ability to engage in their educational practices always have the interest to implement new innovations to improve quality of care. Reluctance is perceived as an impediment to the implementation of SDPs.

While it is evident that the implementation of SD programmes is an important aspect of nursing work roles today, to enhance competency, self-efficiency and effectiveness, it is imperative that nurses realise this and become more amenable to the implementation of these programmes. Staff must be encouraged to embrace change and foster innovations.

New skills are essential to professional and organisational success and are requisite to adapt to these changes (Richards & Potgieter, 2010:42). Next the aspect of uncooperative attitudes to SDPs is discussed.

b) Uncooperative attitude towards SDPs

Uncooperative refers to being unwilling to help others or do what they ask (New Oxford American Dictionary, www.oxforddictionaries.com) [Accessed 22 June 2016] as well as unwilling to work with others, help others, or do what they ask (Cambridge English Dictionary, www.dictionary.cambridge.org)[Accessed 22 June 2016].

Participants mentioned that in most instances, staff becomes uncooperative because they are not recognised and are overlooked.

“I am a junior sister in this hospital. You will find that if there is a new community service sister in the unit, some staff members will start treating her unfairly because they feel she is of their age and cannot delegate them to carry out their duties. That is very much sad.”

62

“I think people must go and attend the courses learn in order to get the opportunity to be cooperative to implement and not to have attitude to staff development.’’

The researcher believes that it appears as if insufficient knowledge predisposes nurses to have negative attitudes towards the implementation of SDPs. Undeveloped staff cannot render optimum quality care which is demotivating and causes staff to become uncooperative (Yfantis, Tiniakou & Yfanti, 2010:193). Patients’ expectations of quality health care service require health professionals to improve the educational status of nurses in order to meet these expectations.

Jooste (2013:249) emphasise that it is imperative to encourage nurses to realise the need to improve their own and others’ performance by implementing what they have learnt from SDPs to enhance the provision of quality care.

“Just to support your statement, you will find that you attend courses and do not give feedback and implement because others or nobody listens when you give feedback for everybody to learn and benefit.’’

Dickerson (2010:100), encourages a lifelong process of active participation of nurses to give feedback and implement what they have learned from SDPs. This will assist with developing nurses continuing competence and enhance their professional practice.

“To add on that, you will be an honest worker always on duty trying to be noted, doing your work effectively, but when wanting to apply for training you will not be accepted to go study. They will send someone who is a delinquent and uncooperative to do her work.

When she comes back then she resigns and that is a loss to the institution. I don’t know it is like they are doing you a favour when they send you for training to be developed.”

CPD is a systemic learning experience that must be promoted and is designed for nurses to be developed, to be confident, effective, efficient and assist in implementing programmes that they had attended (Tame, 2009:6). It enriches their contribution to quality of healthcare and to the promotion of personal growth.

Based upon the above, participants’ assertions regarding the uncooperative attitudes of nurses to SDPs it is evident that that this hampers the implementation of SDPs. Some staff members are not considered for attending SDPs, they subsequently become uncooperative to attend in service programmes when they are chosen. These SDPs are intended to help nurses to learn and extend their knowledge, be productive and

63

implement what they have learned as required by the Continuous professional development and the National core standards.

When participants were asked what can be done to facilitate the implementation of staff development programmes in this hospital they replied as follows.

“We need to be trained and all to take part in our wards.’’

“Training must be given to all staff members in order to be developed.”

‘’All staff that has attended must implement what they have attended.’’

Effective continuing education will facilitate the implementation of SDPs (Richards &

Potgieter 2010:43). It is linked to raised staff morale, increased motivation staff satisfaction as well as the enhancement of professional knowledge, advancing professionally and the provision of quality care.

The South African National Quality Policy acknowledges the need for the development of nurses (Mseleku, 2007:14). Nurses must cooperate and need to implement programmes that they have attended to keep up to date and equip themselves with knowledge skills and a positive attitude in order to keep pace with rapidly changing healthcare settings.

The policy also recommends the use of evidence based practice in decision making and service delivery. McGillis Hall et al. (2004:233) emphasise the fact that SDPs assist nurses to develop and implement knowledge gained from programmes and it is necessary for each to create a work environment that is meaningful, productive and satisfying.

Healthcare organisations are committed to ensuring a quality of opportunities in the development of all its healthcare professionals (Jooste, 2013:250). In this regard, the researcher is of the opinion that staff needs to be trained in order to be knowledgeable.

The reader is introduced to the summary of recommendations that emerged from participants and literature in Table 3.3. Details will be described in Chapter 4.

TABLE 3.2: Summary of themes with recommendations

THEMES AND SUB-THEMES RECOMMENDATIONS

3.3.1 Ineffective Management Practices

64

 Implement effective management practices

3.3.1.1 Bureaucratic Management  Ensure active participation of all staff to facilitate implementation of SDPs

3.3.1.2 Poor Planning of Staff Development Programmes

 Plan SDPs adequately

3.3.1.3 Poor Implementation of Staff Development Programmes

 Improve on the Implementation of Staff Development Programmes

3.3.1.4 Lack of support for staff  Formulate and promote a managerial support system to facilitate the

implementation of SDPs.

3.3.2 Negative staff attitudes towards the implementation of Staff Development Programme

 Improve nurse’s attitudes towards the implementation of Staff

Development Programmes.

3.4 CONCLUSION

In chapter three the findings from the focus group interviews were presented in table 3.1.

Themes and sub-themes were based upon the perceptions of professional nurse’s regarding the implementation of staff development programmes in a public hospital in Gauteng which revealed the negative staff attitudes towards the implementation of staff development programmes.

The findings from the study revealed that nurses had the following perceptions regarding the implementation of SDPs in the public hospital in Gauteng; ineffective management practices, bureaucratic management, poor planning of SDPs, poor implementation of SDPs, lack of support of staff, negative staff attitude towards the implementation of staff development programmes, reluctance and uncooperative attitude towards SDPs.

Literature was integrated into the findings which provided support and meaning to the findings, from which the recommendations to facilitate the implementation of SDPs in the public hospital emerged.

65

Recommendations will be discussed in detail in Chapter Four which will also describe the review of the research, recommendations for nursing practice, nursing education, limitations of the research and the conclusion of the study.

66 CHAPTER 4

RECOMMENDATIONS, LIMITATIONS, RECOMMENDATIONS FOR NURSING PRACTICE, NURSING EDUCATION, RESEARCH AND CONCLUSION OF THE

STUDY

4.1 INTRODUCTION

In Chapter Three, the findings of the focus group interviews on participants’ perceptions regarding the implementation of staff development programmes in a public hospital were discussed and integrated into literature. Chapter Four focuses on the recommendations for the implementation of staff development programmes in the public hospital where this study was conducted. These recommendations were based on the themes and sub-themes identified in Chapter Three. This chapter also addresses the summary of the findings of this study, the recommendations for nursing practice, nursing education and future research, limitations and conclusion of the study. The recommendations pertaining to the implementation of SDPs in the hospital under study is presented next.

4.2 PHASE TWO: RECOMMENDATIONS REGARDING IMPLEMENTATION OF