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Williams James has recently been hired as the Director of Human Resources for an academic medical center located in the Northeast.

Mr. Williams James has recently been hired as the Director of Human Resources for an academic medical center located in the Northeast. While he was interviewing for the position, several administrators and physicians told him there was a severe employee morale problem, particularly among registered nurses. Mr. James later learned that the average annual turnover rate of nurses at this facility has averaged 18.4 percent as compared to 11.6 percent in the metropolitan area of the past three years.Mr. James was aware that all exiting employees are required to complete an exit interview questionnaire and interview prior to receiving their final pay check. He asked his assistant to pull the files for all exit interviews of departing nurses and prepare a summary of the major reasons for leaving and specific suggestions for how the facility could increase retention.When the results were compiled, Mr. James was disappointed. The utility of these data was very low. Most of the respondents indicated they were leaving for “personal reasons,” “family responsibilities,” or “job offer.” Very few volunteered recommendations for how the facility could improve nurse retention even when asked directly on both the questionnaire and during the interview. The recommendation mentioned most frequently was “better parking.”The prevailing opinion of individuals with whom Mr. James spoke was that departing employees are reluctant to discuss any “sensitive” issues or concerns for fear of alienating the interviewer or supervisor. He was told no one wanted to possibly jeopardize their recommendation to other employers due to anything they might say during the exit interview. Through his informal conversations with nurses and nurse supervisors he knew there were many problems and concerns shared by many nurses including inadequate staffing, lack of respect and support from supervisors and top management, favoritism in salary increases and promotions, and high stress levels due to all of the above. Yet he was unable to document these problems and others with the current exit interview data.Mr. James is now attempting to determine the best methods of identifying employee problems and assessing employee reaction to the organization, its various components, and various human resource policies and programs. He is also interested in determining factors that cause many of the long-tenured nurses to stay.Questions1.

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