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Research Proposal Example: The Malaysian Nursing Industry

7 pages
1826 words
Harvey Mudd College
Type of paper: 
Research paper
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Malaysia is considered to be a rapidly developing country that has a population of approximately 27 million people. The country has an aging population, as its proportion of the population of people who are aged 65 years and older is expected to double by the year 2030. It is also important to point out that the life expectancy in the country is above 70 years for both the male and female population in the country.

In the country, the nurses comprise approximately 2-3% of the female workforce in the country. It has been determined that approximately 66% of the nurses have been employed to work in the public sector healthcare facilities (Abdullah, 2016). In this case, they are expected to work fulltime and are required to retire upon reaching the age of about 55 or 56 years. It is also important to point out that due to various cultural and historical reasons, there are few male nurses in the country.

As has been stated out before, the proportion of people who are aged over 65 years is expected to double by 2030. However, the country is facing a crucial challenge and subsequent shortage in the nursing industry due to a slowdown of students undertaking a certain nursing course in the institutions of higher learning. There is also the issue of nurses migrating to other countries both in the United States and Europe due to both the financial and non-financial incentives that they are offered (Armstrong & Brown, 2009). In addition to that, most nurses are switching to work in more lucrative carriers such as pharmacists and laboratory assistants due to the financial incentives, shorter working hours as compared to the nursing schedule, the appreciation and value that is accorded to such careers in relation to nursing.

The World Health Organizations (WHO) recommended nurse-to-population ratio is 1:200. In this case, Malaysia needs approximately 174,000 nurses to be employed to fulfill this nurse-to-population ratio by 2020. The shortage of the nurses means that the doctors have to spend more time attending to their patients, and this will lead them to be less effective as they will not be able to treat as many patients as they could. WHO also recommends that a doctor should be assisted by approximately 2.5 nurses at all times. However, in Malaysia, the doctor-to-nurse ratio is approximately 1.2:10.

According to Ng Kok Toh, the head of nursing programs at the International Medical College in Subang Jaya, there are less than 3,000 nurses that are graduating on a yearly basis in the country (Ng et al., 2012). This has pushed the government to seek temporary solutions to address the nursing shortage issue in Malaysia (BROWN et al., 2012). One of the solutions has been to employ qualified nurses from countries such as India, Philippines, Pakistan, Albania, and Myanmar. The problem with such a solution is that, even though the foreign nurses quota has been filled, there is still staff shortage in the country. Both the government and private health institutions need to come up with various measures that will help them increase the employee engagement, and organization commitment levels of the nurses in the country.

Preliminary Literature Review

The Malaysian nursing industry is considered to be at a crisis level at the moment. The countrys health care expects to employ a total of 174,000 Registered Nurses (RN) by 2020, to achieve the 1:200 nurse-patient population ratio. According to the Malaysian Human Resources for Health Country Profiles, in 2014, the total number of nurses in the country was 92,681(Christmas, 2008). Therefore, nurse retention is now considered to be a top agenda in the healthcare industry, particularly, if the country wants to reach the WHO recommended nurse-patient population ratio.

One of the reasons why the nursing shortage issue is becoming a challenge in Malaysia stems from the significant drop in the number of nurses graduating on a yearly basis from the nursing institutions (Neog & Barua, 2015). Between 2005 and 2010, it was estimated that approximately 10,000 nursing students graduated on a yearly basis (Ministry of Health Malaysia, 2012). However, in 2010, the Malaysian Nursing Board introduced new entry requirements to students who wanted to enroll in the nursing schools or colleges. Previously, an aspiring nursing student required only three credits to enroll in a nursing school (Ministry of Health Malaysia, 2012). However, the number of credits was increased from three to five, and it led to a subsequent drop in both the intakes and number of nursing graduates in the country. Currently, there are less than 3,000 nursing graduates on a yearly basis. In addition to that, most of the students who may want to undertake a nursing course are unable to do so because they cannot afford the fees (Ministry of Health Malaysia, 2012). The average total fees for a Diploma in Nursing is between RM45, 000 to RM60, 000. The maximum loan that students are provided by the National Higher Education Fund Corporation is RM 38,000 for the Bantuan Rakyat 1 Malaysia (BR1M) recipients. For the students who do not fall into this category, they only receive a loan of between RM20, 000 to RM24, 000(Ministry of Health Malaysia, 2012).

In a country such as Malaysia, the shortage of nurses is highly likely to worsen. This is because most of its registered nurses are either leaving the country to go and work in the same capacity in developed countries due to the better financial compensations that they will receive or are changing their careers for more lucrative ones such as being a pharmacist or a medical laboratory assistant (The Ministry of International Trade & Industry (MITI), 2012). The nursing industry can, therefore, be regarded as facing employee retention issues, which if not addressed will lead to catastrophic effects in the country. There are various factors such as low organization commitment level, job burnout, and human resource practices that have a negative effect on the nursing retention rates in most of the health care institutions in the country. The high employee turnover in both the public and the private hospitals will have a negative effect on the performance capability of these institutions (Roslan et al., 2014). The remaining nurses will have to attend to more patients and work for longer hours. This will eventually increase their likelihood of experiencing job burnout, and overall making them be more prone to conducting medical errors.

One of the short-term measures that, the healthcare sector of Malaysia has undertaken is to increase its efforts of hiring nurses-including filling up their foreign quota. However, this can only be considered to be a temporary solution for addressing the nursing shortage in the country (Siew et al., 2011). This is because the countrys nursing education institutions produce less than 3,000 nursing graduates on an annual basis (The Ministry of International Trade & Industry (MITI), 2012). Therefore, the only viable solution is through ensuring that the health care institutions in this country, have the right strategies implemented, to retain the nurses who are working in these firms.

To address the nursing shortage issue, and ensure that they can employ the required number of nurses while maintaining a sufficient number of the current registered nurses in the country to achieve the nurse-to-patient population ratio, there is the need to find long-term measures(TOURANGEAU et al., 2010). One of the long-term measures that the management of these healthcare organizations will have to look into is to ensure that they achieve high nursing retention rates in their healthcare facilities. This will be achieved by the management or leadership examining the factors that are influencing the registered nurses employed in their firms wanting to leave or leaving these organizations to work in other firms or changing the career (Tummers et al., 2013). By addressing these factors, they will then be able to come up with stringent measures, which will eventually reduce the likelihood of employees wanting to quit working in their firms or changing their careers.

Goal Statement

To determine the effect of organizational commitment to employee retention.

To determine the effect of various aspects of job burnout on the employee retention rate in the Malaysian nursing industry.

To determine the significant effect of various human resources practices such as training and development of employees, compensation and rewards for high performing employees, and an ideal working environment on the employees retention rate in the Malaysian health care industry.

Research Questions

The researcher will use the following research questions as a guide to this study:

How does the level of organizational commitment by nurses towards the health institutions that they work for affect their employee retention level in the nursing industry?

Can job burnout be considered to be an important factor in determining the employee retention rate in the nursing industry?

How do different aspects such as emotional exhaustion, and reduced personal accomplishments affect the employee retention rate in the nursing industry?

How does various human resource practices such as training and development, rewards and compensation, and an adequate working environment affect the employee retention rate in the nursing industry?


The methodology that will be undertaken in this research is the quantitative approach. Data collection will be conducted through the use of questionnaires, which will be distributed to the target population, and they will act as a means of collecting evidence for this study. The target population of this study will be all the Registered Nurses, who are currently working in the healthcare institutions of Malaysia (Zikmund, 2003). The researcher will use the non-probability sampling design to select the appropriate respondents that will be included in this study. Non-probability sampling is ideal for this research because of its ability to minimize the costs and also required time for conducting the research (Zikmund, 2003). The sample size for this research was determined through the use of the Krejcie and Morgan sample size table for a decision model that was considered to be correct and adequate. In accordance to this table, since the nursing population of Malaysia is approximately comprised of 100,000 people, it requires a sample size of 384 respondents.


Activity Timeline

Conduct a thorough literature review on the Malaysian Nursing Industry in order to identify the gaps in Knowledge January 5th to March 12th 2018

Identify specific objectives for the research based on the research vision, plan and literature review results March 13th to March 20th 2018

Identify the healthcare institutions where you will find the appropriate research participants March 21st to April 15th 2018

Develop the questionnaire for this research April 16th to April 20th 2018

Conduct a pilot study April 21st to May 17th 2018

Correct the errors identified in the pilot study May 18th to June 13th 2018

Conduct the non-probability sampling method on the target population

June 14th to October 30th 2018

Distribute the questionnaire to the research participants October 31st to December 12th 2018

Collect the Questionnaire January 19th to February 13th 2019

Conduct Data Analysis February 14th to April 13th 2019

Organize ideas for the main paper April 14th to April 30th 2019

Draft the research paper May 1st to May 15th 2019

Revise and fill the gaps May 16th to May 30th 2019

Edit the paper June 1st to September 18th 2019

Submit the Final paper October 25th 2019


Abdullah, A. G., Ling, Y., Ping, C. S., & Yusoff, Z. B. (2016). T...

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