Journal of Nursing Management, 2015, 23, 623–631

Factors influencing nurse absenteeism in a general hospital in

Durban, South Africa
1 2
P. MUDALY Hons Nurs Ed, MCUR, BCUR and Z. Z. NKOSI PhD, MCUR, BCUR

1
Academic Development Officer, School of Nursing, University of KwaZulu-Natal, Howard College Campus,
Durban, and 2Associate Professor, Department of Health Studies, University of South Africa, Theo van Wyk
Building, Pretoria, South Africa

Correspondence (2015) Journal of Nursing Management 23, 623–631.

P. Mudaly
School of Nursing
University of KwaZulu-Natal
Howard College Campus
Durban 4001
South Africa
E-mail: mudalyp@ukzn.ac.za
MUDALY P. & NKOSI Z.Z.
Factors influencing nurse absenteeism in a general hospital in Durban,
South Africa
Aim To establish reasons for absenteeism amongst professional nurses, enrolled
nurses and enrolled nurse auxiliaries in a general hospital in Durban, in order to
recommend strategies that could decrease absenteeism.
Background Nurses endure increased workload, resulting in burnout and
absenteeism in workplace environments that already suffer staff shortages.
Method This study was a quantitative, non-experimental survey. The study
population consisted of 60 nurses, including professional and enrolled nurses and
enrolled nurse auxiliaries. The survey consisted of closed-ended questions to
options of ‘agree’ and ‘disagree’ and an open-ended section.
Result Family matters, lack of motivation to attend work, illness, finance,
favouritism, unfriendly nurse managers, long work hours, increased workload,
unsatisfactory work conditions, lack of equipment, unfair promotions and
selection of nurses for training, staff shortages, lack of a reward system and
incoherent decision-making caused nurse absenteeism.
Conclusion Personal, professional and organisational factors may cause nurse
absenteeism, crippling the health sector further against the backdrop of human
and mechanical resource shortage.
Implications for nursing management Nurse managers have an important role in
reducing absenteeism by addressing the employees’ concerns, which can lead to
productivity, increased staff morale, decreased medical hazards and satisfied patients.
Keywords: absenteeism, nurse, nurse manager, organisation, work environment

Accepted for publication: 6 September 2013

on the employer, organisation and society being

Introduction
Absenteeism, as defined by Martocchio and Jimeno
(2003), is a single day of missed work. Josias (2005)
defines absenteeism as a failure of an employee to
report to work, despite the reason. Globally, absentee-
ism is a serious occurrence. Workplace data records in
Britain in 2006 highlighted that 420 000 employees
were absent from work due to stress, depression and
anxiety due to work, which has a rebounding effect
DOI: 10.1111/jonm.12189
ª 2013 John Wiley & Sons Ltd
served by absent employees (Cooper & Dewe 2008).
As a result, sessional staff are needed and they need to
be retrained, educated and skilled for the temporary
work to be done to reduce turnover and increase pro-
ductivity, which is a doubly costly exercise to employ-
ers (Cooper & Dewe 2008).
In South Africa, investigations were led by The
Commission of Enquiry (2005) at a provincial psychi-
atric hospital in response to allegations of abuse of
623
Factors influencing nurse absenteeism in South Africa
human rights of psychiatric patients. The findings
revealed that there were high rates of absenteeism
amongst staff at the hospital, especially on paydays on
the 15th and 30th of each month. Staff were also
absent from work due to abuse of alcohol and poor
working conditions (The Commission of Enquiry
2005).
Problem statement
Booyens (1998) states that absenteeism is disruptive
to patient care and the work environment. Absentee-
ism of nurses entails patients being cared for by fewer
qualified caregivers, which compromises effective care
and treatment delivery (Booyens 1998). Health Can-
ada (2004) highlights that the absenteeism rate of reg-
istered nurses (RNs) in Canada is steadily increasing.
Full-time employed RNs had absenteeism rates due to
illness and injury which was 83% higher than other
full-time employees for the year 2002. Canada faces
severe nurse shortages, causing existing nurses to have
an increased workload coupled with increased work
hours. All nurses, full- or part-time, suffered high
rates of strain due to increased work responsibilities,
leading to absenteeism. In South Africa, Takaki et al.
(2006) stated that nurse absenteeism is a widespread
phenomenon. Causal factors for staff absenteeism
could be attributed to increased workloads, worsened
due to hospitals being inundated with patients
infected with HIV/AIDS-related illnesses. The purpose
of this study was to establish reasons for nurse absen-
teeism amongst the nurse categories of professional
nurses (PNs), enrolled nurses (ENs) and enrolled
nurse auxiliaries (ENAs) from day and night duty in
medical, surgical, maternity and trauma units of a
hospital.
Conducting this study was an inherent interest
towards studying reasons for absence behaviour
amongst nurses. This study was conducted in a gen-
eral hospital located in Chatsworth in the city of the
eThekwini City District, South Africa, which primarily
serves the population of Chatsworth and the sur-
rounding area (R.K. Khan Hospital 2012). The hospi-
tal is a regional and district hospital with 543 beds.
At the outset of the study, the researcher was
informed by the nurse managers and staff that there
was a high absenteeism rate of nurses coupled with
severe staff shortages. A report published by Govender
(2009) emphasised the problem of nurse absenteeism,
highlighting that the general hospital is a busy and a
short-staffed one; the report also mentioned that there
was already a need for staff, with 128 vacant posts
624
for specialists, 91 for professional nurses, 20 for medi-
cal specialists and 17 for pharmacists.
Conceptual framework
The conceptual framework of Taunton et al. (1995),
adapted by Nyathi (2005), underpinned this study.
The independent variables of the nurse, nurse man-
ager, work and organisation, the variables-associated
characteristics and dependent variables of nurse absen-
teeism, guided this study. Nurse characteristics consist
of: age and gender of nurses, qualifications, health
status, family responsibility, transport problems, work
commitment, opportunities outside the workplace and
income. With regard to age, Josias (2005) states that
younger employees take shorter periods of sick leave
than older employees. Alternatively, older workers are
more prone to sickness absence than younger workers,
possibly due to health deterioration and prolonged
periods of recovery. With regard to gender, women
display increased rates of absenteeism compared with
men, due to being the primary caregiver in most
homesteads (Josias 2005). Cullinan (2006) explains
that nurses are stressed at work as others are absent
from work to ‘moonlight’ for extra income, supple-
menting their smaller salaries. The nurses remaining at
work are burnt out due to the increased workloads.
Nurse manager characteristics consist of the leader-
ship styles of the nurse manager. Hayes et al. (2006)
claimed that nurse managers’ use of position, power
and influence over work coordination had a direct link
to employees’ satisfaction in their jobs. Work charac-
teristics consist of autonomy, routine work and group
cohesion. Ose (2004) states that if there is work group
cohesion in an environment, there is low absenteeism
due to high job satisfaction. Regarding performing a
job task, Becker and de Oliveira (2008) state that
nursing professionals face long working hours and do
multiple job functions, which is also intensive and at
times physically challenging, subjecting the nurse to
accidents and illness, leading to absenteeism.
Organisational characteristics consist of facilities,
manpower, career development, absence policy, pro-
motion opportunities, incentives and decentralisation.
Academic Writing Tips (2012) states that absenteeism
from work indicates work dissatisfaction; job satisfac-
tion is how happy or content the individual is with his
or her job. Nyathi (2005) highlights that lack of rec-
ognition towards employees in terms of promotional
opportunities in the workplace can lead to dissatisfac-
tion among employees, also possibly leading to absen-
teeism.
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Journal of Nursing Management, 2015, 23, 623–631

Methods
Research design
This study was a quantitative, non-experimental design.
Cooper and Schindler (2006) assert that a quantitative
design allows the researcher to use techniques that
measure precisely the variable under study. Participants
completed a survey questionnaire. According to Brink
et al. (2000), a questionnaire allows participants to
describe accurately the characteristics of a particular
subject so that data collection and information gathering
can be elicited.
Research methods
These included collecting data by a survey question-
naire that consisted of closed and open-ended ques-
tions and were handed to the participants for
completion. The questionnaire consisted of six sec-
tions: A, biographic data – age and professional
details of the participant; B, C, D and E covered sepa-
rate aspects of the independent variables and their
associated characteristics, these being the nurse (seven
questions), nurse manager (seven questions), work
(eight questions) and organisation (nine questions),
totalling 31 closed-ended questions, with options of
‘agree’ and ‘disagree’; F consisted of four open-ended
questions about nurse, nurse manager, work and orga-
nisation characteristics, aimed to derive additional
reasons for absenteeism.
Sample frame
There were 233 professional nurses (PNs); 142
enrolled nurses (ENs) and 121 enrolled auxillary
nurses (ENAs) employed at the hospital. The
researcher was unfortunate in that data was collected
during massive strike action in the province and a sec-
ond data collection phase was done, as the initial data
collection produced only few respondents. Hence, the
study sample population included only 20 PNs, 20
ENs and 20 ENAs in the study; this constituted 10
PNs, 10 ENs and 10 ENAs on each of the day and
night shifts. The sampling technique included stratified
and convenience samples. Stratified sampling, accord-
ing to Brink et al. (2000), is when the population is
divided into subgroups according to some variable.
The sample size for each category of nurse was chosen
on the highest possible availability at the time and
their consensus to take part in the study, contributing
to the convenience sample. Due to the strike, not
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Journal of Nursing Management, 2015, 23, 623–631
P. Mudaly and Z. Z. Nkosi
many nurses were on duty, and in order to have a
representative sample size, for reasons of nurse absen-
teeism the researcher sought 20 nurses/nurse category
– this was also in aid of establishing uniformity
amongst the sample population. In this study, the
nurse categories of ENs, ENAs and PNs were stratified
to unique nursing groups. Brink et al. (2000) further
state that convenience sampling is the selection of the
most readily available people or objects for a study.
Data collection
This research study took place in a selected general
hospital in Durban, KwaZulu-Natal. Data were col-
lected by distributing the questionnaires to the
research participants once they had signed to consent
for participation in the study. Participants completed
the questionnaires at a time convenient to them. The
questionnaire was first distributed on 29 May 2007 to
30 nurses. Data were collected from five PNs, ENs
and ENAs each on day and night duty. Due to poor
response rates for the open-ended section, the ques-
tionnaire was resampled to four PNs, ENs and ENAs
each on day and night duty on 14 June 2007. On 17
June 2007, one PN, EN and ENA each on day and
night duty were approached to complete the question-
naire. Altogether, 60 nurses were approached to com-
plete the questionnaire for the study. The researcher
manually sorted the questionnaires into separate piles
of PNs, ENs and ENAs, including night and day duty
staff. Each questionnaire was numbered as Participant
1, Participant 2, etc. per nurse category until all 60
participants were accounted for. The collected data
were arranged into separate piles for PNs, ENs and
ENAs and specifically further into participants from
day and night duty.
Data analysis
Closed-ended data analysis
The researcher utilized quantitative methods of the
exact binomial test of significance with P = 5% for
the closed-ended data. This was to establish a rela-
tionship between nursing absenteeism and each factor
of the closed-ended questions, statistically and accu-
rately. Bain and Engelhardt (1992) explain that the
exact binomial test is an appropriate test for analysing
the dichotomous response variable, which is whether
an individual agrees or disagrees with the question.
The exact binomial test of significance was performed
for each question under each factor to determine
whether there was, according to the test itself, a
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Factors influencing nurse absenteeism in South Africa

significantly high proportion of ‘agrees’ for that partic- Combining the closed and open-ended results indi-
ular factor, in which case that factor could be consid- cates the following reasons for nurse absenteeism.
ered as a cause of nursing absenteeism.
Nurse characteristics
Open-ended data analysis
Nurses have family responsibilities to attend to. Fif-
The qualitative software package Nvivo v. 9 was used
teen ENs (72%), 19 ENAs (95%) and 16 PNs
to perform content analysis, code and analyse qualita-
(80%) agreed that this factor causes nurse absentee-
tive data of the open-ended survey by the researcher
ism. Josias (2005) indicates absenteeism due to per-
University of Technology, Sydney (2012). Content
sonal or family-related issues where child, eldercare
analysis of the data entails little interpretation but
and single-parent families have a profound impact
attributes a class of phenomena to a portion of the
on organisational absenteeism.
text. In this study, key words were identified and an
Nurses lack motivation to work due to stress. Fifteen
overall concept was formulated symbolizing a cause
ENs (72%), 15 ENAs (72%) and 20 PNs (100%)
for absenteeism. The codes were represented in a tab-
agreed that this factor causes nurse absenteeism.
ulated format under a specific theme, which allowed
Bakker et al. (2005) state that a job where there is a
for frequency distribution and simple descriptive sta-
high job demand and low resources results in burn-
tistics counts. Newly founded codes outside the coding
out, due to exhaustion, and absenteeism.
source-coding scheme were also listed in tabulated
Nurses have financial problems. Three ENs (25%),
form. Comparisons concerning the relative frequency
three PNs (20%) and three ENAs (25%) agreed that
of scores falling into specific coded categories were
this theme causes nurse absenteeism. Excerpts by
done and highlighted the number of participants
participants include one EN having stated that:
agreed on a code (Brink et al. 2000).
‘Nurses are moonlighting and therefore they can-
not work in the hospital that they are registered to’,
Results
For purposes towards understanding the commonality whilst one ENA stated that there is
of reasons for nurse absenteeism, the results in the
closed and open-ended section only highlight which ‘Unsatisfying salary given to nurses’
factors caused nurse absenteeism agreed by PNs, ENs and, similarly, one PN stated that:
and ENs indicating statistical significance towards
nurse absenteeism. Additionally, responses by partici- ‘Nurses are suffering from burnout due to the
pants which were 75% and above are considered sta- increase in turnover of patients. Other staff
tistically significant towards nurse absenteeism for the members are moonlighting while their colleagues
closed-ended results. have to double up their workload’.

Davey et al. (2009) state that less pay is a definitive

Closed-ended and open-ended results
Results for the closed-ended section are presented as
commonly agreed-upon reasons for nurse absenteeism
amongst PNs, ENs and ENAs of the nurse, nurse
manager, work and organisation characteristic ques-
tions. Results for the open-ended section are high-
lighted in terms of nurse, nurse manager, work and
organisation characteristics which were commonly
agreed by ENs, ENAs and PNs. A select few responses
by participants are indicated by each professional
nurse category. Responses by participants who had
more than one theme are highlighted. The percentages
were calculated against the total number of partici-
pants who answered under a specific open-ended ques-
tion. For example, 13 participants answered the nurse
manager open-ended question.
determinant leading to absenteeism.
Nurse manager characteristics
Nurse managers are unfriendly. Three ENs (23%),
two PNs (17%) and two ENAs (20%) agreed that
this theme causes nurse absenteeism. An excerpts
from one EN stated that:
‘Some of them are unfriendly and nurses feel out
of place’,
while one ENA stated that:
‘Approaching nurses is important should a nurse
be wrong in certain action. Treat all fairly, don’t
pick and choose’,

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626 Journal of Nursing Management, 2015, 23, 623–631
 P. Mudaly and Z. Z. Nkosi

‘Heavy work load because of short staff, result-

while one PN stated that:
‘Some nurse managers are unapproachable and
not empathetic enough to their staff’.
Favouritism. Three ENs (23%), three ENAs (30%)
and three PNs (25%) stated that favouritism causes
nurse absenteeism. Excerpts by participants include
one EN stating that the nurse managers
‘… pick and choose, they are racists. They can
make you feel pressure on you because they pick
and choose’.
One ENA stated that:
‘Approaching nurses is important should a nurse
be wrong in certain action. Treat all fairly. Don’t
pick and choose’,
while one PN stated:
ing that after doing your work on your ward,
you also have to cover another ward in one day’.
Furthermore, one PN responded there are:
‘Too few staff for large number of patients,
unable to cope with work load’.
Becker and de Oliveira (2008) state that organisa-
tion-related absenteeism occurs due to poor supervi-
sion, task monotony, lack of motivation, poor
environmental and working conditions and a non-
autonomous environment for the employee in the
organisation.
Shortage of staff. Five ENs (40%), four ENAs
(25%) and two PNs (17%) agreed that this theme
causes nurse absenteeism. Excerpts from participants
include one EN stating that there is:
‘Too much work and less staff’.

‘Favouritism – gang up with colleagues – show- Similarly, one ENA stated that there is an:
ing favouritism with colleagues for extra breaks’.
‘Overload of work and shortage of staff’,
Hayes et al. (2006) claimed that nurse managers’
use of position, power and influence over work whereas one PN emphasised that there are:
coordination had a direct link to employees’ job sat-
isfaction and absenteeism. ‘Too few staff for large number of patients
which makes us unable to cope with workload’.
Work characteristics
Unruh and Strickland (2007) emphasise that absen-
Nurses are overworked on a ward. All ENs (100%),
teeism from the workplace contributes to an ongo-
20 ENAs (85%) and 19 PNs (95%) agreed that this
ing negative effect of causing increased absenteeism
factor causes nurse absenteeism. According to Dale
by other exhausted employees.
(2006), reports from Canada highlight that nurses
have the highest absenteeism rates of all health care No equipment. Two ENs (17%), four ENAs (17%)
professionals due to work pressure and stress, lead- and two PNs (17%) stated that there is a:
ing to missing working days due to illness and
‘Lack of resources, gloves, aprons, daily towels
injury. Dale (2006) emphasises that recruiting nurses
open to infection due to lack of resources’.
in place of the absent staff leads to the newly
recruited nurses being overburdened by work duties
Excerpts include one EN stating that there is a:
due to a short-staffed workforce, causing fatigue and
absenteeism.
‘Poor working environment, lack of skilled
An increase of workload. Six ENs (50%), two PNs
workers and lack of equipment’.
(17%) and four ENAs (40%) agreed that this
theme causes nurse absenteeism. Excerpts by partici-
Stressing the same, one ENA stated that:
pants include one EN stating:
‘Shortage of staff, this causes overload of work ‘Sometimes there is not enough equipment to do
which exhausts nurses’. their work’.

In addition, one ENA also stated there is a Similarly one PN stated that there is a:

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Journal of Nursing Management, 2015, 23, 623–631 627
Factors influencing nurse absenteeism in South Africa
‘Shortage of equipment’.
Hobfoll (2001) states that burnout and absenteeism
are related to insufficient resources. Becker and de
Oliveira (2008) state that absenteeism is related to
the work conditions, reflecting on quality and pro-
ductivity and on the personal life of the nursing pro-
fessional. In this regard, hospitals provide their
employees with work conditions that are far worse
than other healthcare services. Becker and de Olive-
ira (2008) highlight previous studies on absenteeism
in hospitals, where a lack of resources (human and
equipment) leads to individual physical and emo-
tional stress, leading to absenteeism.
Organisation characteristics
Organisation is short-staffed and there is an
increased workload for nurses. Nineteen ENs (95%),
19 ENAs (95%) and 20 PNs (100%) agreed that this
factor causes nurse absenteeism. In the South African
context, Cullinan (2006) states that hospitals in
KwaZulu-Natal face a huge strain because of the
HIV/AIDS epidemic, with very sick people needing
specialised treatment and care. Cullinan (2006)
further emphasises that an already short-staffed
environment means that existing nurses face huge
workloads, resulting in tremendous stress, leading to
absenteeism.
The organisation has no equipment to provide qual-
ity patient care. Seventeen ENs (85%), 15 ENAs
(75%) and 18 PNs (90%) agreed that this factor
causes nurse absenteeism.
The organisation has no reward system for nurses.
Seventeen ENs (85%), 17 ENAs (85%) and 18 PNs
(90%) agreed that this factor causes nurse absentee-
ism. Nyathi (2005) highlights that a lack of recogni-
tion towards employees in terms of promotional
opportunities in the workplace can lead to dissatis-
faction and possibly absenteeism among employees.
Similarly, Takaki et al. (2006) state that when
employees perceive that the effort they make to
perform their jobs gets little reward, this leads to
emotional distress and absenteeism.
Ethical considerations
Permission to conduct the study was granted by the
ethics committee at the selected University (at which
the researcher studied towards the Master’s degree),
the Department of Health and the selected general
hospital in Durban, KwaZulu-Natal. Participants in
628
this study provided written consent on a consent form,
once the research had been explained to them verbally
and via an information sheet by the researcher. The
study information sheet and consent form were avail-
able in isiZulu and English for participants. Partici-
pants had a right not to divulge personal details, such
as their name and to remain anonymous, which is fur-
ther supported by Bislimi et al. (2009). Furthermore,
in undertaking research, the participant’s well-being
must be ensured by avoiding harm and also maximis-
ing the possible benefits (Bislimi et al. 2009). Partici-
pants in this study were not harmed, neither was any
experimentation on their emotional and physical well-
being done.
Reliability and validity in the research study
Validity is the degree to which an instrument mea-
sures what it is intended to measure (Phelan &
Wren 2005–2006). Content validity was ensured by
the instrument representing all the different compo-
nents of the variables to be measured as debated in
the literature review, according to Brink et al.
(2000). The questionnaire of this study was guided
by the conceptual framework of Taunton et al.
(1995), encompassing all the independent variables
from the nurse, nurse manager, work and organisa-
tion factors as possible causal factors of nurse
absenteeism.
The questionnaire was also tested for reliability
and, specifically, for internal consistency. The guide-
line of 0.70 was followed as the cut-off point for
acceptable Cronbach alpha coefficients by the
research. The reliability of the questionnaire was
achieved by conducting a pilot study. Prior to the
study, the researcher distributed 10 questionnaires
with a marking scheme to the pilot study partici-
pants. Five questionnaires were given to nurse profes-
sionals who were studying at the selected university
and five lecturers at the university where the
researcher was studying. All participants agreed that
the questions met the objectives of understanding,
ability, neatness, relevance, sensitivity, satisfaction
and length.
Discussion
New-found reasons from the open-ended data analysis
revealed reasons for nurse absenteeism, which were
listed as associated characteristics according to the
conceptual framework of Taunton et al. (1995). Com-
mon findings amongst the closed and open-ended sec-
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Journal of Nursing Management, 2015, 23, 623–631

tions from multiple groups of PNs, ENs and ENAs
formed the basis of highlighting the results for this
paper. Findings in the nurse characteristics section
highlighted that nurses were absent due to family
responsibilities, lacked motivation as they felt tired
and stressed, and inadequate remuneration. With
regard to the nurses who stated that being tired and
stressed led to absenteeism, Eriksen et al. (2002) state
that work factors such as job stress, psychological
stress, job strain and physical workload are associated
with high rates of sickness absenteeism. Similarly, Sa-
very and Luks (2001) agree that stress manifests in the
form of low morale, high turnover of employees and
absenteeism. In addition, Bennett (2002) states that
additional job demands, difficult work environment,
and poor social relationships between management
and employees coupled with low morale contributed
to employees’ stress, directly or indirectly contributing
to a high level of absenteeism. Equally as stressful to
nurses is inadequate remuneration for work done.
Findings from the nurse manager characteristics data
indicated that unfriendly nurse managers and favourit-
ism caused absenteeism. Munro (2007) found that
under-trained and less experienced supervisors cause
stress to employees, resulting in absenteeism. In this
regard the stress incurred due to the supervisor is due
to performing monotonous work as allocated, low job
satisfaction and unfair treatment by the supervisor.
Munro (2007) deemed poor leadership as the root
cause for job dissatisfaction, leading to stress and
absenteeism.
Work characteristics results highlighted staff agree-
ing that they are moved to a new ward every day to
cover staff shortages, overworked on a ward, work
long hours, face unsatisfactory work conditions and
have insufficient equipment to do work, causing nurse
absenteeism.
Sekhukhune (2005) also states that nurses’ stressors
are due to the work environment. There was not
enough suitable equipment to deal with patient needs,
frustrating nurses as they still had to do patient care
with or without equipment. As a result, nurses felt
stressed and were absent from work, owing to sickness
or frustration. Priest (2006) reiterated that nursing as a
profession is faced with a serious understaffing crisis.
Nurses are therefore forced to cope with inadequate
support from management and the situation at work is
worsened, causing absenteeism.
In addition to job strain are the long work hours.
Chauke (2007) found that an organisational contribu-
tor to absence from work was the long shifts. Basu
and Gupta (2007) also state that poor working condi-
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Journal of Nursing Management, 2015, 23, 623–631
P. Mudaly and Z. Z. Nkosi
tions affect staff shortages, as remaining staff burnout
further and absent themselves from work.
Organisation characteristics results due to nurse
absenteeism included that unfair promotions, unfair
selection of nurses for training, short-staffed work-
force causing a heavy workload for nurses, no equip-
ment to carry out work, no reward system and
incoherent decision-making practices for nurses were
also reasons to absenteeism.
Dieleman and Harnmeijer (2006) highlight that con-
tinuous career development, an applicable reward sys-
tem, satisfactory working conditions, teamwork and
management support results in reduced employee
absenteeism as job satisfaction and motivation of staff
are enhanced. Reward systems also include non-mone-
tary elements, such as appreciation and recognition, as
Dieleman and Harnmeijer (2006) highlight.
Becker and de Oliveira (2008) state that in a hospital
work environment, nurses are susceptible to inappropri-
ate work conditions, affecting their psychological and
physical well-being. Work tasks may include long
working hours, physical and mental work that may be
unbearable, poor interpersonal relations, pressurising
time schedules and absence of a career ascension plan
for the individual.
Limitations of the study
The response rate of the first group of research partici-
pants was poor due to the national strike at the time,
which also affected all public health care workers.
During this time, there was an additional staff short-
age and nurses could not afford the time to complete
the questionnaires. As a result, a second group of
nurses was resampled. It is suggestive that if further
studies are done in a hospital setting, the researcher
should approach study participants at a time equally
conducive to both the researcher and research partici-
pant. Study participants, as assumed, will not scuttle
through the questionnaire without giving due consid-
eration to their responses, if an appropriate time
decided by themselves is chosen. Factors such as
strikes, violence and unrest are all limitations in a
study and can affect the response rate by study partici-
pants and the quality of data produced.
Recommendations
The findings suggested that recording absenteeism of
each employee throughout the year assists in monitor-
ing absenteeism. This includes recording the duration
and reason for an employee’s absenteeism. An organi-
629
Factors influencing nurse absenteeism in South Africa
sation needs to produce policies to address the under-
lying causes of absenteeism.
With regard to findings of lack of recognition and
rewards, a career ladder for demonstration of compe-
tency, professional recognition and introduction of
monetary incentives should be introduced in the hospi-
tal. Rewards could be in the form of training pro-
grammes or monetary incentives.
Conclusion and implications for nursing
management
The inclusion of open-ended questions allowing par-
ticipants to freely express what they thought could
have also caused absenteeism. This new information is
very useful in understanding the factors of absenteeism
which may have missed as questions on the closed-
ended survey questionnaire. A few recommendations
have been provided, so that management could apply
some of these techniques to reduce absenteeism.
Essentially, what can be deduced is that most causes
of absenteeism arise from the nature of the organisa-
tion. A person working in a better working environ-
ment is more likely not to absent him- or herself from
work than a person working in a physically exhaust-
ing and psychologically depressing environment.
Nurse managers employed in the hospital can play
an important role in reducing absenteeism by address-
ing all the factors that were identified by the nurses.
Source of funding
The authors did not receive any funding for this
paper.
Ethical approval
Ethical approval was obtained from UKZN EXPO
18/06.
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