SCHOOL PERFORMANCE AND STABILITY OF STUDENT NURSES

Die keuring van studentverpleegsters skep spesifieke probleme vir verpleegadministrateurs en skoolprestasie skyn een van die min objektiewe keurmiddels te wees. Die resultate van hierdie studie toon dat daar wel beduidende verskille bestaan met betrekking tot prestasie in skoolvakke tussen studente wat hul opleiding voltooi het en die wat hul opieiding gestaak het. Kosteimplikasies van kortdienstermynstudente wat die beroep verlaat, word bespreek.

O W ING to a num ber o f factors the selection of student nurses in hospitals appears to present specific problem s for the nursing adm inistrator.In the first place, nursing applicants are, with few exceptions, recruited straight from school.C onsequently very little in fo rm atio n is available in order to assess the suitability o f the applicant to nursing.F urtherm ore, at the tim e of her application, the interests, am bitions and career aspirations o f the scholar are still in a process o f being shaped.T herefore the applicant herself is probably not in a position to m ake a com m ited career decision at this stage.M oreover, the selection ratio (i.e. the num ber of applicants in relation to the num ber o f posts) is usually not very favourable.This has the result th at nursing ad m inistrators cannot screen applicants effectivelym ost o f those who apply are accepted for training owing to the shortage o f staff.
W ithin these constraints the ad m in istrato r has only a few guidelines in order to m ake a selection decision, nam ely, the medical exam ination, character references, selection interview and the ap p lican t's school leaving certificate.
R egarding these aids, the medical exam ination can screen out those applicants w ho are obviously not suitable from a medical point o f view.C haracter references are generally regarded as being o f very little value in im proving the predictive efficiency o f selection decisions (Flippo, 1976).T he selection interview, especially interviews which are unstructured, can be very subjective, with resultant loss o f validity of assessm ents.It appears, therefore, that one o f the few objective aids at the disposal o f nursing adm inistrators to evaluate the suitability o f nursing applicants, is the school perform ance o f the individual as reflected by the sym bols achieved for subjects studied.
A lthough there is a fairly widely held belief that suc cessful perform ance at school is usually a good pre dictor o f success in later w ork life, organisations in most cases never attem pt to m atch these tw o sets o f variables.Such an exercise w ould seem particularly desirable in the nursing profession as far as student nurses are con cerned.Firsly, the difficulty level o f the nursing cur riculum has increased over time.T herefore it can be hypothesised that school achievement could be pre dictive o f successful com pletion o f nursing training.F urtherm ore, the rate o f attrition o f student nurses is com paratively high.Consequently, m ore effective screening o f applicants on the basis o f their school per form ance could result in m ore effective utilisation o f personnel and reduction o f costs.
In view o f the foregoing, the present study was con ducted with two aims in mind: In the first place, to establish the nature o f the relation ship between school perform ance o f student nurses and their later stability during training.Secondly, to gain insight into the nature o f attrition am ong student nurses with specific regard to the length of time students spent in training before term inating.

Samples
The total sample consisted o f 244 student nurses o f whom 91 had com pleted their training (stayers) and 153 failed to com plete the course (leavers).The leavers' group constituted persons who left nursing owing to reasons such as dissatisfaction with nursing, failing n u r sing exam inations, or m arriage.Persons who left because o f medical reasons or pregnancies were not in cluded in the study.

Procedure
All the d ata were gathered from school leaving cer tificates o f students which gave the symbols achieved by the persons on the various subjects studied.W ith this in form ation it could be determ ined how well stayers and leavers perform ed at school.F or the purpose of this study, individuals who achieved A, B or C symbols were considered to be " b etter" school perform ers while those who received D, E or F symbols were classified as " poorer" perform ers.
The frequencies o f the data recorded were converted to percentages order to m ake com parisons between the groups o f stayers and leavers.In order to assess the significances o f the percentage differences between the two groups, use was m ade o f a nom ograph developed by Lawshe and Baker (1950).This nom ograph is used to calculate an om ega value (w) which, when substituted in the ap p ropriate form ula, gives t-values, which indicate the significance o f the differences between percentages.
are not reported here.Also, in some cases, sam ple sizes on certain school subjects were regarded as being too small to allow m eaningful interpretation.F or example, sym bols for Science were only available for 7 stayers and 24 leavers.C onsequently these results are also not reported here.F rom the inform ation presented in the table it is ap-

Results
Analysis o f school perform ance.The findings o f the study are sum m arised in Table 1.The table shows school sym bols achieved by percentages and actual num bers o f stayers and leavers as well as the percentage difference between the tw o groups.The last colum gives om ega (w) values to assess the significance o f differences between the groups.
F or the sake o f brevity, school subjects which did not yield differences o f m ore than 10% between the groups parent th at student nurses who com pleted their training generally achieved higher school sym bols than students who failed to com plete their training.This is true for all the school subjects listed except one, nam ely, S h o rth an d /S n elsk rif.In the latter case leavers per form ed better than stayers in that 60% o f leavers achieved either A, B or C sym bols com pared to 47% o f the stayers.A lthough the sam ple size here is too small to m ake reliable deductions (it will be noted that the om ega value is not significant), it m ay be argued that persons who have done well on these subjects m ay find it relatively easy to obtain better-paying jobs in com m erce or industry, for exam ple as secretaries.A lthough this conclusion may be tenable, this logic does not apply to Typing or Bookkeeping which are also valued in the private sector.On both these subjects stayers achieved higher symbols than leavers.
T he subject which produced the greatest difference between the two groups (30% ) was Biology which is not unexpected.It can be argued th at students who did well in this subject at school are probably in a better position to cope with the subjects in the nursing curriculum than students who achieved lower symbols.
O ther subjects where statistically significant dif ferences occured are for English and the D om estic Science group o f subjects.A lthough a relationship be tween high achievem ent on D om estic Science and com pletion o f nursing training can be envisaged, the case o f English is less clear.A pparently this result is som ewhat contingent on hom e language in th at 58% o f the stayers were English-speaking and 42% were A frikaans speaking.F or the leavers group 40% were English and 60% were A frikaans.This gives a difference o f 18% (w = 0,26, p 0,5).These results show that, for the group studied, English-speaking students had a greater tendency to com plete their training than A frikaans speaking students.The n ature o f the d ata does not allow the draw ings o f any firm conclusions but it does point to possible biographical factors linked in hom e language which should be explored further.

Length of service o f leavers
The second aim o f the study was to establish the length o f time student nurses stayed in nursing before they left.For this purpose the m edian length o f service was calculated for a sam ple o f 212 students who dis continued their training.T he m edian length o f service for this group was 6 m onths.This m eans that half o f the students who left nursing dropped out o f the course before they had com pleted 6 m onths o f their training.This finding has a num ber o f serious cost implications.
As nursing is a highly skilled profession it is unlikely th at students in the firt 6 m onths o f their training could have contributed a great deal as far as proficient nursing care is concerned.At best, such persons can be regarded as having been an " extra pair o f h an d s" to perform relatively routine tasks only.B alanced against this are a num ber o f costs which are incurred by hospitals to em ploy these persons.C onsider, for example, the following costs in term s o f adm inistration and time: recruitm ent, selection (eg, interview , medical exam ina tion), o rentation, training, salaries, accom m odation, meals and usual overheads.In addition to these, there are often " invisible" costs associated with staff tu rn over, such as lowered m orale am ong persons who re main behind.
In total, it would appear th at hospitals are gaining very few benefits from short tenure nurses but, indeed, are subject to a large num ber o f expenditures which could potentially have been allocated to other m ore essential items.

Discussion and Conclusions
The results o f this study have dem onstrated that stu dent nurses who com pleted their training generally per form ed better at school than nurses who did not com plete the course.A lthough the differences between the two groups were not all statistically significant the results have nevertheless highlighted this trend.
It should be borne in m ind, however, that the findings o f the study refer to certain general trends.Therefore, no categorical statem ents can be m ade here regarding the qualities o f students who should be accepted for training.F o r exam ple, there are nurses who perform relatively poorly at school but who nevertheless become successful students.The contrary is also true.It is therefore advisable th at nursing adm inistrators in in dividual hospitals record and m onitor base data such as school symbols for students.Over time a profile of students who leave nursing could be built up which could be contrasted to a profile o f successful students.In this m anner criteria for acceptance o f nursing applicants could be developed by each hospital which could im prove selection and have a substantial bearing on cost reduction and im proving operational efficiency.
Finally, it should be noted that the results pertaining to this study m ay only be specific to the hospital in which the investigation was carried out.Therefore, fu r ther research on these variables in other hospital settings are necessary so as to broaden our knowledge of the fac tors leading to stability o f students in the nursing p ro fession.