Article Critique: Turnover rate among registered nurses in Jordanian hospitals: an exploratory study

The title provides an accurate outline of the research focus being turnover rate in registered nurses with Jordan hospitals acting as the study context. The abstract captures a representative picture, brief yet exhaust content. The abstract summarizes the article in brief with clear indication of the aim in the phenomenon studied. It sets clear the focus of the research as turnover rate and its subjects being registered nurses working in Jordan hospitals. The abstract illustrates finer details of the study context, data collection method, and sample design while acknowledging the research findings as supporting the hypothesized phenomenon as a complex problem in Jordan hospitals.

The article features a clear introductory of the employee turnover using the specific illustrations drawn from the mainstream human resource concept, where the authors cast the mainframe of the research focus. The purpose of this research features clearly in the introduction as determining the size of turnover challenge amongst registered nurses (RNs) in Jordan hospitals deriving a multi-factor comparison including national, geographic, inter-gender and hospital contexts (Hayajneh, AbuAlRub, Athamneh, & Almakhzoomy, 2009).  Although acknowledge using a structured interview approach, the article barely draws the research questions guiding the data collection. However, the article features a descriptive theoretical framework and application of a cross-sectional retrospective survey oriented to RNs in Jordanian hospitals.

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The authors adopt a case-building approach in the literature review preceded by outlining the factors behind employee turnover. A reflection of cause-factors is provided exhaustively derived from findings of past researches.  The review captures a rich outline of American context with specific illustrations from similar studies discussed at length. Although drifting scantly to other regionalized studies, the literature successfully builds a case supporting the need for the study. Importantly, the inclusion of recent studies in Australia, America, and the UK bridges a critical reflection gap, fitted further through the Jordan study investigating factors influencing Jordanian nurses’ job dissatisfaction from random sample of 250 RNs. The consistency in the findings of the reviewed studies builds a need to study turnover rates in Jordan RNs.

Being a both a descriptive and exploratory, the authors were right to base the population for this study as all Jordan hospitals. The inclusion of public, private and university-owned hospitals in the study fulfilled the external validity for generalizability for this study. The authors utilized cluster random sampling upon the conclusive list of 99 hospitals; 33 public, 64 private and 2 university hospitals obtained from the ministry of health website (Hayajneh, et al. 2009). Three clusters were then developed representing the northern, middle and southern regions. Owing to the expansive nature of this study, the having a proportional sample of 25% of Jordan hospitals drew a representative sample. This saw 24 hospitals selected in the study sample; 5 for northern region, 16 middle region and 3 from the southern region (Hayajneh, et al. 2009). Besides getting approval from the MOH, the participation of hospitals was voluntary with all cooperating hospitals remaining anonymous. Besides, collected data was limited to scientific and statistical purposes that saw raw data destroyed after the analysis process. All cooperating hospitals remained anonymous in the study.

The use of descriptive and exploratory approach suited this study particularly facilitating use of the cross-sectional survey design. While the article lacks an adequate description of the design, the sample design and instrument were appropriate to the study. The exclusion of military hospitals does not signal bias since turnover rates in such facilities are obviously lower. Although the authors do not explain the regional imbalance in the sample, using 25% of Jordan hospitals was a representative. The simplicity in the method, sample design and research framework makes it possible to redo the research.

High quality data was collected from 21 hospitals out of the sampled 24. The collection was reliable with 2126 RNs participating from a national 9,000. Besides, 36.6% – 779 RNs quit from their position during the study period, highest in private and urban hospitals (Hayajneh, et al. 2009). The high turnover rates noted in the middle region corresponded to the higher number of hospitals in the sample. This shows accurate reflection of phenomenon studied explained in the discussion as caused by high remuneration variances and desire for improved working conditions.  A consistent analytical approach is applied to the research questions based on gender differences, location, type and ownership of the facilities. The discussion offers a pinpoint explanation of the variations and results obtained. Nevertheless, the reliability and validity of the results is missing despite the explanation of seasonal variation.

The study suffers from scarcity of literature on turnover in Arab healthcare systems, therefore serves a preliminary role. This occurrence barely prevented the study from supporting the hypothesis of turnover rate challenges in Jordan hospital.  The study applies descriptive information to front the implications and applicability of results obtained to health planners, policy-makers, academic institutions and larger nursing practice community.  Lastly, it presents a foundation for future research studies on associated factors causing the problem and variations in turnover rates amongst the study variables such as health sector, residential places, and geographical location.



Hayajneh, Y. A., AbuAlRub, R. F., Athamneh, A. Z., & Almakhzoomy, I. K. (2009). Turnover rate among registered nurses in Jordanian hospitals: an exploratory study. International journal of nursing practice15(4), 303-310.