ANNOTATED BIBLIOGRAPHY 2

Annotated Bibliography

Hayward, D., Bungay, V., Wolff, A. C., & MacDonald, V. (2016). A qualitative study of
experienced nurses’ voluntary turnover: learning from their perspectives. Journal of
clinical nursing, 25(9-10), 1336-1345.
Hayward et al.’s article looks at one of the major issues affecting nursing practice-
relatively high turnover of experienced nurses which results in a dearth of nursing care
quality, fewer nurses to mentor incoming ones, and general rise in recruitment costs. The
authors take a qualitative approach in the study with their data found through interviews
with nurses who have already left their previous working places. The paper finds that
poor working relations with colleagues and physicians, high work load, patient acuity,
and unsupportive leadership are the main causes of turnover of experienced nurses.
Compared to other research papers on the subject, this article takes a different approach
of interviewing nurses who have already left their previous employer instead of those
who are planning to leave. Theoretically such an approach should be able to produce
more reliable results because it provides reasons why a nurse left rather than why they
may leave. However, the research’s sample is small and the geographic spread of the
sample is also small as all interviews were for nurses in the same region. The results
obtained may not, therefore, be universal. Its small sample also means that it has a very
high margin of era which casts doubt on the reliability of the findings. Despite these
weaknesses, the research is able to arrive at very helpful conclusions that every nursing
employer should take seriously if they are to retain their most experienced nurses and
reduce the disruptions caused by the high nurse turnover.

ANNOTATED BIBLIOGRAPHY 3
Vryonides, S., Papastavrou, E., Charalambous, A., Andreou, P., & Merkouris, A. (2015). The
ethical dimension of nursing care rationing: A thematic synthesis of qualitative
studies. Nursing ethics, 22(8), 881-900.
The article by Vryonides et al. looks at ethical dilemmas that nurses face when, due to
scarcity, they are forced to either delay or altogether omit some interventions and
prioritize others. While it is clear that such actions increase risk of poor health outcomes
for patients, ethical elements to such actions are less clear. Even less clear are feelings of
nurses towards such decisions from an ethical perspective and how those feelings affect
their work.
The study used a qualitative approach. The authors conducted a systematic review of
various peer reviewed articles on the subject. Many of the reviewed works revealed that
the decision to omit or delay certain interventions because of scarcity often left nurses
facing moral challenges. They feel their decisions compromise their professional values
and are, therefore, left feeling distressed and guilty. Other works, however, were
ambiguous about the feelings of nurses to such decisions. Thus, the authors conclude that
more research needs to be done in the area in order to get clearer findings.
While the study used only high quality articles for its review, it still glaring weaknesses.
Chief among them is that all the reviewed articles are in English or Greek. This limitation
means that high quality studies published in languages other than those two were not
included in the review. Thus, it fairly poorly when compared with similar studies that
have employed articles from different linguistic and geographical backgrounds. Another
weakness is that many of the articles used in the review did not specifically deal with the
topic the research sought to address. The authors, thus, did not always the specific

ANNOTATED BIBLIOGRAPHY 4
information that they were looking for. This again weakens their findings. Overall,
however, the study sheds valuable light on an area that is important yet has very little
research conducted on it.

ANNOTATED BIBLIOGRAPHY 5

References

Hayward, D., Bungay, V., Wolff, A. C., & MacDonald, V. (2016). A qualitative study of
experienced nurses’ voluntary turnover: learning from their perspectives. Journal of
clinical nursing, 25(9-10), 1336-1345.
Vryonides, S., Papastavrou, E., Charalambous, A., Andreou, P., & Merkouris, A. (2015). The
ethical dimension of nursing care rationing: A thematic synthesis of qualitative
studies. Nursing ethics, 22(8), 881-900.