p–ISSN: 2723 - 6609 e-ISSN: 2745-5254
Vol. 5, No. 1 January 2024 http://jist.publikasiindonesia.id/

Doi: 10.59141/jist.v5i01.862 226

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

SIDOARJO

Sri Wahyuni
Universitas Airlangga Surabaya, Indonesia

*Correspondence
ABSTRACT

Keywords: Turnover; Nurse;
Welfare.

This study aims to analyse the factors causing the high turnover of nurses
at Anwar Medika Sidoarjo Hospital and compile steps to reduce the
nurse turnover ratio at Anwar Medika Hospital. This research was
conducted using a descriptive method to make an objective picture of a
situation with hindsight. The nurse turnover ratio at RSU Anwar Medika
Sidoarjo for December 2021-November 2022 was 25.2%. As much as
42% is involuntary turnover. Moreover, the remaining 58% is voluntary
turnover. The voluntary turnover was further sorted, and 38 people were
included in the controlled turnover. Most nurses leave RSU Anwar
Medika Sidoarjo because they get jobs in places considered more
attractive, both in private companies and as civil servants. Then, the
following most common reason relates to management policies in
appointing permanent employees who are considered too long and
policies regarding income.

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 organisation, 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 organisations 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

Analysis of Influencing Factors High Turnover Rate of Nurses At Rsu Anwar Medika Sidoarjo

Jurnal Indonesia Sosial Teknologi, Vol. 5, No. 01, January 2024 227

(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.

Results and Discussion

Table 1
Number of Nurses discharged during December 2021–November 2022

NO. MOON
NUMBER OF

NURSES (PEOPLE)
OUTGOING NURSE
(person)

1 December 2021 294 8
2 January 296 6
3 February 295 7
4 Maret 310 5
5 April 294 6
6 From 289 5
7 June 280 9
8 July 285 6
9 Agustus 295 7
10 September 290 5
11 October 295 6
12 November 299 5

Total Turnover December 2021–November 2022 75

Table 2

Sri Wahyuni

Jurnal Indonesia Sosial Teknologi, Vol. 5, No. 1, January 2024 228

Why nurses leave RSU Anwar Medika Sidoarjo in December 2021 – November 2022

REASONS EMPLOYEES LEAVE
NUMBER
(PEOPLE)

PERCENTAGE
%)

Contract not renewed 20 39
Getting a job elsewhere 15 17
Appointment to permanent employees for too long 10 11
Continuing higher education 9 8
Accepted as ASN 9 8
Feeling underearning 4 6
Husband moves errands out of town 3 4
Mutation to child branches 2 3
Married and no longer working 2 2
Have a disease that does not allow you to work 1 2
TOTAL 75 100%

Analysis of employee turnover data at RSU Anwar Medika Sidoarjo during December

2021–January 2022 from the point of view of turnover theory, according to Gary Dessler, can be
concluded as follows:
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:

Table 3
The reason why nurses leave in December 2021–January 2022, which is included in the

voluntary turnover category

REASONS EMPLOYEES LEAVE INFORMATION

Getting a job elsewhere controllable turnover
Appointment to permanent employees for too long controllable turnover
Continuing higher education uncontrollable turnover
Accepted as ASN controllable turnover
Feeling underearning controllable turnover
Husband moves errands out of town uncontrollable turnover
Married and no longer working uncontrollable turnover
Diseases that do not allow to work uncontrollable turnover

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Jurnal Indonesia Sosial Teknologi, Vol. 5, No. 01, January 2024 229

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.

Table 4
Reasons for employee exits that include controllable turnover

REASONS FOR EMPLOYEE EXITS THAT
INCLUDE CONTROLLABLE TURNOVER

NUMBE
R

(PEOPL
E)

PERCENT
AGE

Getting a job elsewhere 15 41%
Appointment to permanent employees for too long 10 25%
Accepted as ASN 9 17%
Feeling underearning 4 17%
SUM 38 100%

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.
2. 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.
3. 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.

Sri Wahyuni

Jurnal Indonesia Sosial Teknologi, Vol. 5, No. 1, January 2024 230

4. 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.
5. Career Training and Development

The opportunity for employees to get training, especially new employees, is
uneven. This condition certainly causes dissatisfaction for new employees.
6. 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.

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Jurnal Indonesia Sosial Teknologi, Vol. 5, No. 01, January 2024 231

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