ANALYSIS OF INFLUENCING FACTORS HIGH TURNOVER RATE OF NURSES AT RSU ANWAR MEDIKA SIDOARJO

ABSTRACT


Introduction
RSU Anwar Medika Sidoarjo is a private hospital in the west Sidoarjo area.This hospital started from an individual practice of Doctor H (Muharni & Wardhani, 2020).Agus Fachrudin Farid in 1992.Then, in 1996, it developed into a Medical Center and Maternity Home, "Anwar Medika."Because the health services provided by the Medical Center and Maternity Home "Anwar Medika" are increasingly in demand by the wider community, motivating the Hospital Foundation "Anwar Medika" and Doctor H. Agus Fachrudin Farid as the Head of the Medical Center and Maternity Home "Anwar Medika" at that time, to improve the status of BP/RB services to become a General Hospital.Alhamdulillah, thanks to the Mercy of Allah SWT.BP and RB "Anwar Medika" changed their function and service status to become "Anwar Medika" General Hospital on April 12, 2001(Putra & Putra, 2019).
Along with the growing organization, Anwar Medika General Hospital has become the most significant Type C General Hospital in Sidoarjo, with a capacity of 356 beds.This condition requires optimal human resource support from quantity and quality (Mariani & Gorda, 2019).
The problem of employee turnover, including that of nurses, is a classic problem that has occurred in organizations for a long time, as well as in hospitals.According to Azijah (2018), the annual turnover rate in the health industry is 23% of the overall employee turnover rate, and 50% are nurses.Based on a survey by the American Organization of Nurse Executives, the national average turnover rate for registered nurses (RN) in 2000 was 21.3%.Based on a national survey of 138 recruiters in the health sector, the average RN turnover rate is 13.9%, and the vacancy rate in hospitals is 16.1% (Suryani, Windiyaningsih, & Rahardjo, 2020).
RSU Anwar Medika Sidoarjo experienced a labour turnover or nurse turnover rate of 25.2% from December 2021 to November 2022.From the results of identifying the causes of employees leaving the hospital, various reasons emerged: contracts were not renewed, getting jobs elsewhere, living too far away, personal problems, and others.A high enough number hurts hospitals (Al Mamun & Hasan, 2017).Therefore, hospital management needs a strategy to reduce the turnover rate of nurses at Anwar Medika Hospital.The objectives of this study are: 1. Knowing the types of turnover at RSU Anwar Medika 2. Know how to calculate the turnover rate 3. Knowing the causes of nurse turnover at RSU Anwar Medika 4. Knowing the impact of high turnover for Anwar Medika General Hospital

Research Methods
The type of research used in this study is descriptive research using qualitative approach methods.The focus of her research is the analysis of factors affecting high nurse turnover.In this study, researchers used the location, RSU Anwar Medika Sidoarjo, to conduct research.Data analysis, as revealed by Miles and Huberman in Sugiyono (2009, p.246), is data reduction, data presentation, and conclusion drawing or verification.Analysis of employee turnover data at RSU Anwar Medika Sidoarjo during 2021-January 2022 from the point of view of turnover theory, according to Gary Dessler, can be concluded as follows:

Results and Discussion
1.The turnover ratio in December 2021 -November 2022 is: Number of employees leaving or not continuing to work x 100% ½ x (Number of employees at the beginning of the year + at the end of the year) = 75 x 100% = 25,2 % ½ x (294+299) 1.Of the total 75 people who left, 22 people (39%) left because their contracts were not renewed, and two (3%) left because they were mutated into subsidiaries.This is included in the category of involuntary turnover.2. While the remaining 53 people belong to the voluntary turnover category.From there, it can be sorted again based on the reasons as follows: 3.Then, from the reasons that fall into the category of controllable turnover, the percentage is calculated to find out the main problem that causes turnover, which the company should control.Based on the analysis above, it can be concluded that most nurses leave RSU Anwar Medika Sidoarjo because they get jobs in other places that are considered more attractive (Jehan, 2016).Then the following reasons are related to management policies in appointment to permanent employees who are considered too long, the reason for being accepted as an ASN, and the feeling of less income.
Therefore, it is necessary to improve six factors that affect employee retention (Nasir, 2022), especially on factors directly related to why most employees leave RSAM.Some of these factors include: 1. Organizational and Management Factors The organisational structure of RSAM quite often changes both in its form and officials in the structure.This change occurs on average once a year.According to Armstrong, the average executive takes 12.5 months to get comfortable in a new position.Changes in structure and officials are undoubtedly different in management and leadership patterns, causing discomfort for employees under them because they must adapt to new leadership patterns again.

Work Relationship
Changes in organisational structure and employee rotation often occur in RSAM and affect the relationship between employees and managers (Nurul, 2022).Establishing positive relationships and teamwork certainly takes a long time, and structural changes that are too frequent cause these relationships not to be formed optimally.However, the excellent relationship of employees with their superiors and coworkers significantly affects employee retention.

Job and Work Life
Many employees are interested in becoming civil servants, considering that civil servants have high job security.For example, because civil servants are less likely to be fired, there are pension benefits and health insurance until after retirement, and workload and working hours are considered lighter than private employees.In order to adjust the workload of employees, Management should recalculate HR needs.

Reward: compensation, benefits and performance
While increasing employee workload and not balancing the number of human resources with the number of patients treated, Management does not yet have a policy that regulates overtime pay compensation for employees.

Career Training and Development
The opportunity for employees to get training, especially new employees, is uneven.This condition certainly causes dissatisfaction for new employees.

Employer Policies and Practices
A policy states that for husband and wife who work at Anwar Medika Hospital, only one can be appointed as a permanent employee, and they should be evaluated.This policy is felt not to bring a sense of justice to employees, prompting several married couples to resign.The policy of proposed appointment to a permanent employee after an employee has served a contract period of 3 years is considered too long, so it should be reviewed.

Conclusion
The employee turnover rate at RSU Anwar Medika Sidoarjo in December 2021 -November 2022 was 25.2%.Of the 75 nurses who left, 42% were in the involuntary turnover category.Moreover, the remaining 58% is voluntary turnover.From the voluntary turnover, it was sorted again, and 38 people were found to be controllable turnovers.The most important reason for the controllable turnover category is that you get another, more exciting job.