Editorial Board

A Refereed Monthly International Journal of Management

The Need of Rotational Duties in SMS Hospital, Jaipur (Rajasthan)

Author

Dr. Sher Singh Morodiya Faculty College of Nursing & Nursing Superintendent S.M.S. Hospital, (SMS Medical College) Jaipur (Rajasthan)

Abstract

Sawai Man Singh Hospital, Jaipur (Rajasthan) is one the largest hospital of country, is staffed with 700 doctors and 1770 nurses with 2282 beds in 72 wards. It has many specialty and super-specialty departments with many ICU, semi-ICU and OTs. It is most populated hospital of the country with 575 average patients in IPD per day, 7780 average patients in OPD per day and 854 average patients in accident/ emergency per day. During the round of hospital by author, it was found that there was no certain policy of rotation of nursing staff in different places of the hospital. The nursing staff posted in 1980 in a ward is working without any interruption in same ward till date. It was felt that there is need of implementation of rotational duties of nursing staff in different places in SMS Hospital; Jaipur (Rajasthan).The aim of the study was to assess the need and describe the probable benefits of implementation of rotational duties of nursing staff at different places in SMS Hospital, Jaipur (Rajasthan). It was a descriptive survey research. The population of the study were Administrative Officer/ Nursing Superintendent, Head of department/ Unit Head/ Other faculty/ resident Doctors, Nursing In charge/ Nurse Grade I/ Nursing Grade II working in S.M.S. Hospital, Jaipur (Rajasthan). Sample size was 1039, sampling technique was purposive sampling. The research tool was the structured opinionnaire. The analysis of the study proves that there is need of implementation of rotational duties of nursing staff in hospitals. It also proved that there are many probable benefits of implementation of rotational duties of nursing staff at different places in the hospitals. The research report was submitted to the Medical Superintendent of the Hospital. Based on the research study, some recommendations were also made for implementation. The Medical Superintendent of the Hospital appreciated the research work and realized the need of a certain rotational policies.

Keywords – S.M.S. Hospital, Rotational Duties, Need of Policy, Nursing Staff, Benefits of Rotation.

Introduction

Sawai Man Singh Hospital, Jaipur is one the largest hospital of country. This government hospital is staffed with 700 doctors, 1770 nurses, paramedical and technical staff with 2282 beds in 72 wards. The construction of the hospital building began in 1934¹ and opened in 1936² as city dispensary. The hospital is named after Sawai Man Singh II, then King of Jaipur. It has many speciality and super-speciality department. The hospital is parental Hospital for Sawai Man Singh Medical College, School of Nursing and College of Nursing. It provides practical training to the students of these institutes.

During the round of hospital by author, it was found that there was no certain rotation policy of nursing staff in different places of the hospital. The nursing staff posted in 1980 in a ward is working continuously in same ward and getting retirement from government job in next month due to supernation age.

Job rotation is considered as an effective tool for successful implementation of human resources. It is useful for posting employees at the right place where they can deliver the optimum results. Finding the most suitable people and shifting them to take on the responsibilities of a higher level is a tough task. Job rotation helps Human Resource Managers determine who can be replaced by whom and create a suitable and beneficial fit.

A properly planned and carried job rotation process plays an essential role in strengthening the position of an organization and helps it deal with uncertain and tentative outer environment.

Review of Literature

An-Ten Hsieh & Hui-Yu Chao,⁴ describes that this study applies the concept of job specialization and job rotation. In past management systems of traditional industries, job rotation was adopted to address employees' feelings of monotony, boredom and fatigue as a result of job simplification and specialization. However, with the advancement of technology, shortening of technical life cycles and changes in job characteristics, the relationship between job rotation, job specialization and job burnout is now different from in the past. The results from 304 valid samples collected from employees of Taiwan's high-technology industry reveal that the adoption of job specialization in high-tech industry in fact raises professsional efficacy and reduces employees' feeling of job burnout, which is opposed to the benefits of job design purported in past management systems. Therefore, this paper seeks to re-examine the relationship between the three variables. By implementing job rotation or job specialization systems as means to address issues related to employees' job burnout, organizations should not only consider the benefits to job management, but also adjust according to technology and environmental changes. Only by doing so could organizations release the maximum potential from human resources management systems.

Patrick Kampkotter, Christine Harbring & Dirk Sliwka,⁵ investigated the determinants and performance effects of job rotation empirically by analyzing a large panel data-set covering the German banking and financial services sector. In particular, they study (i) how prior individual performance affects the propensity to rotate and (ii) how performance changes after the rotation. They find that while both, low- and high-performers rotate, lateral moves are more frequent among low performers. However, those having been rotated between jobs achieve a higher performance in subsequent years as compared to other non-rotating employees in a comparable position. Interestingly, this effect is driven by high performers, whereas for low performers, they find no significant relationship between job rotation and future performance. The results thus suggest that firms should focus their job rotation programs on high performers and should not expect that low performers achieve performance gains when being rotated to a different function.

Ho WH , Chang CS , Shih YL , Liang RD .⁶ investigated how role stress among nurses could affect their job satisfaction and organizational commitment, and whether the job rotation system might encourage nurses to understand, relate to and share the vision of the organization, consequently increasing their job satisfaction and stimulating them to willingly remain in their jobs and commit themselves to the organization. According to the nurses' views, the findings are as follows: (1) job rotation among nurses could have an effect on their job satisfaction; (2) job rotation could have an effect on organizational commitment; (3) job satisfaction could have a positive effect on organizational commitment; (4) role stress among nurses could have a negative effect on their job satisfaction; and (5) role stress could have a negative effect on their organizational commitment.

As a practical and excellent strategy for manpower utilization, a hospital could promote the benefits of job rotation to both individuals and the hospital while implementing job rotation periodically and fairly. And when a medical organization attempts to enhance nurses' commitment to the organization, the findings suggest that reduction of role ambiguity in role stress has the best effect on enhancing nurses' organizational commitment. The ultimate goal is to increase nurses' job satisfaction and encourage them to stay in their career. This would avoid the vicious circle of high turnover, which is wasteful of the organization's valuable human resources.

Evelin Daiane Gabriel Pinhatti^, Marli Terezinha Oliveira Vannuchi, Denise da Silva Scaneiro Sardinha and Maria do Carmo Lourenço Haddad⁷ found the rotation process between hospital sectors was positive regarding factors that help resolve conflicts, such as in increasing knowledge and skills, recognizing activities performed by peers, improving interpersonal relationships, and reducing resistance to work in another sector. However, the tool aroused diverse feelings of anxiety, anger, fear, frustration, sadness, anguish and insecurity. In this sense, it should be considered that the way individuals react to change derives both from individual perceptions and from the context. Thus, some weaknesses of the context pointed out by the nursing team may have contributed to the emergence of these feelings, namely ineffective communication and the lack of participation of the team in elaborating the strategy. In this way, it becomes clear that managers should address some aspects for the reducing resistance before implementing strategies, aiming to increase team performance and reduce the negative feelings that accompany it. It is therefore essential to clarify the purpose and advantages of cross-sectoral rotation, to ensure that the strategy is transparent and that the nursing team has the opportunity to participate in administrating the rotation and offering suggestions for improvement, thus granting them co-responsibility for the process. The time elapsed between the rotation and the data collection was considered as a limitation of this study, since the collection occurred in the year following the rotation, which may have interfered in the participants' perception. However, it is believed that the findings of this study may not only contribute to researchers, but also to managers in the health area, as knowing the performance of this tool allows for using and optimizing the strategy, considering the benefits for both parties. For the professional, this tool allows them to acquire new skills and expand their knowledge in their profession. It also promotes flexibility in the management of human resources in the work community.

Gap between the available literature and existing problem and Need of the Study

Since year 2002, OPD, I.P.D., accident/ emergency patients is increasing continuously. SMS Hospital, Jaipur (Rajasthan) is most populated hospital of the country with 575 average patients in IPD per day, 7780 average patients in OPD per day and 854 average patients in accident/ emergency per day.³

Researcher is working in the above said hospital as Nursing Superintendent. Gap between the available literature and existing problem is present. No study is found related to assess the need of implementation of rotational duties of nursing staff at different places in SMS Hospital, Jaipur (Rajasthan). During the round of hospital, it was felt that there is need of such study, so this study is done.

Research Methodology

Objectives of the study

(1) To assess the need of implementation of rotational duties of nursing staff at different places in SMS Hospital, Jaipur (Rajasthan)

(2) To describe the probable benefits of implementation of rotational duties of nursing staff at different places in SMS Hospital, Jaipur (Rajasthan)

Research approach- Survey approach

Research design - Descriptive

Research Tool- Structured opinionnaire, Paper and pencil method

Population- Administrative Officer/ Nursing Superintendent, HOD/ Unit Head/ Other faculty/ resident Doctors, Nursing In charge/ Nurse Grade I/ Nursing Grade II working in S.M.S. Hospital, Jaipur (Rajasthan)

Setting of study- S.M.S. Hospital, Jaipur (Rajasthan)

Sample Size- 1039

Sampling Technique- Purposive sampling

ANALYSIS

Objective – 1

To assess the need of implementation of rotational duties of nursing staff at different places in SMS Hospital, Jaipur (Rajasthan)

Section- A

Table – 1: Characteristics of sample

N = 1039

S.No.	Age of Respondent		Frequency	Percentage
1.
	1.1	Up to -30 Yrs.	357	34.36
	1.2	31-40 Yrs.	359	34.55
	1.3	41-50 Yrs.	171	16.46
	1.4	More than 50Yrs.	152	14.63
2.		Gender
	2.1	Male	634	61.02
	2.2	Female	405	38.98
3.		Designation
	3.1	Administrative Officer/ Nursing Superintendent	9	0.87
	3.2	HOD/ Unit Head/ other Faculty/ Resident Doctor	39	3.66
	3.3	Nursing In charge/ Nurse Grade I	195	18.77
	3.4	Nurse Grade II	797	76.70
4.		Qualification (Only for Nursing Personnel)
	4.1	General Nursing/ General Nursing & Midwifery	899	86.53
	4.2	B.Sc. Nursing/ Post Basic Nursing	93	8.95
	4.3	M.Sc. Nursing	5	0.48
	4.4	Any other (Specify)	42	4.04
5.		Work Experience in SMS Hospital
	5.1	01-10 Years.	774	74.45
	5.2	11-20 Years.	112	10.78
	5.3	21-30 Years.	131	13.38
	5.4	More than 30 Years.	22	2.18
6.		Work Experience in present ward/ ICU/ OT/ OPD/ Specialized unit
	6.1	01-10 Years.	928	89.32
	6.2	11-20 Years.	51	4.91
	6.3	21-30 Years.	52	5.00
	6.4	More than 30 Years.	8	0.77

Table – 1: Reveals that –

1. Majority of the respondents are in age group 31-40 years with the 359 (34.55%).

2. Majority of the respondents are male 634 (61.02%).

3. Majority of the respondents are from designation Nurse Grade II 797(76.70%).

4. Majority of the respondents are from Qualification General Nursing/ General Nursing & Midwifery 899(86.53%).

5. Majority of the respondents are fromWork Experience in SMS Hospital 0-10 years with 774 (74.45%).

6. Majority of the respondents are from Work Experience in present ward/ ICU/ OT/ OPD/ Specialized unit 0-10 Years with 928 (89.32 %).

Table – 2: Characteristics of Opinion

N=1039

S.No	Opinions	A	B	C	D
1.	Duration of Nursing In-charge of General Ward at one place should be	5 Yrs. F (%)	4 Yrs. F (%)	3 Yrs. F (%)	2 Yrs. F (%)
		607 (58.42)	69 (6.64)	138 (13.28)	225 (21.65)
2.	Duration of Nursing In-charge of OT/ ICU/ Specialized Unit at one place should be	5 Yrs.	4 Yrs.	3 Yrs.	2 Yrs.
		741 (71.32)	68 (6.54)	79 (7.60)	151 (14.53)
3.	Duration of Nursing In-charge of OPD at one place should be	5 Yrs.	4 Yrs.	3 Yrs.	2 Yrs.
		369 (35.51)	52 (5.00)	154 (14.82)	464 (44.66)
4.	Duration of Nurse Grade I of General Ward at one place should be	4 Yrs	3 Yrs.	2 Yrs.	1 Yrs.
		541 (52.07)	167 (16.07)	171 (16.46)	160 (15.4)
5	Duration of Nurse Grade I of OT/ICU/ Specialized Units at one place should be	4 Yrs.	3 Yrs.	2 Yrs.	1 Yrs.
		662 (63.71)	145 (13.96)	141 (13.57)	91 (8.75)
6.	Duration of Nurse Grade I of OPD at one place should be	4 Yrs.	3 Yrs.	2 Yrs.	1 Yrs.
		336 (32.34)	143 (13.76)	264 (25.40)	296 (28.49)
7.	Duration of Nurse Grade II of General Ward at one place should be	2 Yrs.	1.5 Yrs.	1 Yrs.	0.5 Yr.
		734 (70.64)	27 (2.60)	162 (15.60)	116 (11.16)
8.	Duration of Nurse Grade II of OT/ICU/ Specialized Units at one place should be	4 Yrs.	3 Yrs.	2 Yrs.	1 Yrs.
		538 (51.78)	158 (15.30)	225 (21.65)	118 (11.35)
9.	Duration of Nurse Grade II of OPD at one place should be	2 Yrs.	1.5 Yrs.	1 Yrs.	6 Months
		489 (47.06)	25 (2.41)	293 (28.20)	232 (22.33)
10.	Night duty of female nursing personnel after maternity leaves should be started after-	Just after joining	2 Months	4 Months	0.5 Yr.
		52 (5.00)	59 (5.68)	58 (5.58)	870 (83.73)
11.	Interference of HOD/Unit Head should be considered in rotation of duties-	Yes		No
		175 (16.84)		864 (83.16)
12.	Interference of Political Leaders should be considered in rotation of duties-	Yes		No
		53 (5.10)		986 (94.90)
13	Interference of nursing union/ association leaders should be considered in rotation of duties-	Yes		No
		153 (14.73)		886 (85.27)
14.	Interference of Ward –In Charge should be considered in rotation of duties-	Yes		No
		863 (83.06)		176 (16.94)
15.	Preference of specialized education/ training according to speciality should be considered in rotation of duties-	Yes		No
		972 (93.55)		67 (6.45)

Table 2: Reveals that-

1. Majority of the respondents i.e. 607(58.42%) replied that duration of Nursing In-charge in General Ward at one place should be 5 years.

2. Majority of the respondents i.e. 741(71.32%) replied that duration of Nursing In-charge in OT/ ICU/ Specialized Unit at one place should be 5 years.

3. Majority of the respondents i.e. 464 (44.66%) replied that duration of Nursing In-charge of OPD at one place should be 2 years.

4. Majority of the respondents i.e. 541 (52.07%) replied that duration of Nurse Grade I of General Ward at one place should be 4 years.

5. Majority of the respondents i.e. 662 (63.727%) replied that duration of Nurse Grade I of OT/ICU/ Specialized Units at one place should be 4 years.

6. Majority of the respondents i.e. 336 (32.44%) replied that duration of Nurse Grade I of OPD at one place should be 4 years.

7. Majority of the respondents i.e. 734 (70.64%) replied that duration of Nurse Grade II of General Ward at one place should be 2 years.

8. Majority of the respondents i.e. 538 (51.78 %) replied that duration of Nurse Grade II of OT/ICU/ Specialized Units at one place should be 4 years.

9. Majority of the respondents i.e. 489 (47.06 %) replied that duration of Nurse Grade II of OPD at one place should be 2 years.

10. Majority of the respondents i.e. 870 (83.73%) replied that Night duty of female nursing personnel after maternity leaves should be started after 6 months.

11. Majority of the respondents replied i.e. 864(83.16%) that Interference of HOD/Unit Head should not be considered in rotation of duties.

12. Majority of the respondents i.e. 986 (94.90%) replied that Interference of Political Leaders should not be considered in rotation of duties.

13. Majority of the respondents i.e. 886 (85.27%) replied that Interference of nursing union/ association leaders should not be considered in rotation of duties.

14. Majority of the respondents i.e. 863 (83.06%) replied that Interference of Ward –In Charge should be considered in rotation of duties.

15. Majority of the respondents i.e. 972 (93.55%) replied that Preference of specialized education/ training according to specialty should be considered in rotation of duties.

Objective- 2

To describe the probable benefits of implementation of rotational duties of nursing staff at different places in SMS Hospital, Jaipur (Rajasthan)

It may be beneficial as follows-

1. To develop new skills and competencies among nursing personnel.

2. To transfer fresh ideas from one area to another area.

3. To break monotony and monopoly of staff.

4. To strengthen the staff to deal with emergency situations.

5. To avoid potential corruption in patient care.

6. To provide opportunity for professional development.

7. To identify employee for rewards and reinforcement.

8. To promote decision making.

9. To motivate self development.

10. Helps managers to explore the hidden talent.

11. Helps individuals to explore their interests.

12. Identifies knowledge, skills and attitudes.

13. Motivates employees to deal with new challenges.

14. Increases satisfaction and decreases attrition rate.

15. Helps align competencies with requirements.

16. Reduced physiological stress, strain, and fatigue to muscle group used for one job.

17. Reduces employee exposure to high-risk job demands.

18. Reduced Musculo-Skeletal Disorder incidents and severity.

19. Increased innovation and improved work process efficiency.

20. Improves employee skill base and increases job assignment flexibility over time.

21. Increased productivity & quality.

22. Reduced absenteeism & turnover.

23. Consider these benefits of job rotation programs for both employees and employers.

24. Gives a backup plan if an employee leaves Gives you a backup plan if an employee leaves

CONCLUSION

The analysis of the study proves that there is need of implementation of rotational duties of nursing staff in hospitals. It also proved that there are many probable benefits of implementation of rotational duties of nursing staff at different places in the hospitals. The research report was submitted to the Medical Superintendent of Hospital. Based on the research study, some recommendations are also made for implementation.

RECOMMENDATIONS BASED ON RESEARCH STUDY

1. Duration of Nursing In-charge in General Ward at one place should be 5 years.

2. Duration of Nursing In-charge in OT/ ICU/ Specialized Unit at one place should be 5 years.

3. Duration of Nursing In-charge of OPD at one place should be 2 years.

4. Duration of Nurse Grade I of General Ward at one place should be 4 years.

5. Duration of Nurse Grade I of OT/ICU/ Specialized Units at one place should be 4 years.

6. Duration of Nurse Grade I of OPD at one place should be 2 years.

7. Duration of Nurse Grade II of General Ward at one place should be 2 years.

8. Duration of Nurse Grade II of OT/ICU/ Specialized Units at one place should be 4 years.

9. Duration of Nurse Grade II of OPD at one place should be 2 years.

10. Night duty of female nursing personnel after maternity leaves should be started after 6 months.

11. Interference of HOD/Unit Head should not be considered in rotation of duties.

12. Interference of Political Leaders should not be considered in rotation of duties.

13. Interference of nursing union/ association leaders should not be considered in rotation of duties.

14. Interference of Ward –In Charge should be considered in rotation of duties.

15. Preference of specialized education/ training according to specialty should be considered in rotation of duties.

ACKNOWLEDGEMENT

v First of all my deepest gratitude to our Medical Superintendent, Dr.(Prof.) D.S.Meena for inspiring and permitting the study.

v My heartfelt gratitude to our Medical Officer In-Charge (Nursing) Dr.(Prof.) Manish Agrawal for permitting and full support in the study.

v I am extremely thankful to those who take part in this study.

v I am grateful to Sh. Gauri Shankar Sharma, Sh. Bhanwar Singh, Sh. Gulab Chand Kuldeep, Sh. Radhey Shyam Dayama, Sh. Ram Chandra Verma, Sh. Sh.Ishwar Khinchi and all who co-operated me in this study.

References:

1. Foundation stone of hospital

2. Opening stone of hospital

3. Medical Record Office, S.M.S. Hospital, Jaipur (Rajasthan)

4. An-Tien Hsieh & Hui-Yu Chao (2004). A reassessment of the relationship between job specialization, job rotation and job burnout: example of Taiwan's high-technology industry. The International journal of Human Resource Management, 15(6), 1108-1123 https://doi.org/10.1080/09585190410001677331

5. Patrick Kampkotter, Christine Harbring & Dirk Sliwka.(2016). Job rotation and employee performance – evidence from a longitudinal study in the financial services industry. https://doi.org/10.1080/09585192.2016.1209227

6. Ho WH ¹ , Chang CS , Shih YL , Liang RD . Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment. BMC Health Serv Res. 2009 Jan 12;9:8. doi: 10.1186/1472-6963-9-8.

7. Evelin Daiane Gabriel Pinhatti^, Marli Terezinha Oliveira Vannuchi, Denise da Silva Scaneiro Sardinha and Maria do Carmo Lourenço Haddad^. (2017). Job Rotation of Nursing Professionals among the Sectors of a Hospital: A Management Tool in Conflict Resolution, Texto context. 26(2). Florianópolis 2017. Epub June 26, 2017