The experience of thriving at work in rotational physiotherapists in Aotearoa New Zealand

Abstract

Aim: This thesis aims to identify what contributes to thriving at work by rotational physiotherapists employed at national public hospitals in Aotearoa New Zealand. It will do this by exploring what enables individuals to thrive at work and what organisations can do to better support their rotational therapy staff to thrive, recommendations will be created to promote thriving at work to better support the retention and recruitment of staff in both a local and national workforce. Background: Workforce retention and attrition is a major concern for all health professions, including physiotherapy. A workforce analysis undertaken for the New Zealand physiotherapy workforce highlights that whilst there are no issues with the supply of physiotherapists for graduate positions, the supply of experienced physiotherapists, i.e. over five years work experience, is less than demand. This study builds on the literature using the thriving at work model in the nursing workforce. Research has highlighted the lack of a perceived career pathway as a major concern for physiotherapists and a contributing factor to the number of physiotherapists who leave the profession before the seven-year mark. Recommendations to date have emphasised consideration be given to the implications regarding the quality of leadership support and positive workplace practices on job satisfaction and turnover intention in the profession. Design: An exploratory sequential mixed methods design. Method: Data were collected in 2021 via face to face focus groups at one hospital location in Aotearoa New Zealand with rotational physiotherapists. The focus groups data was coded using Nvivo and then used to generate a nation-wide survey for rotational physiotherapists using Qualtrics. Survey data was analysed using thematic analysis. Results: The survey respondents had low intention to leave the profession, and agreed they found themselves learning often in their roles. Seven themes were generated from the qualitative data; 1) professional support; 2) culture of well-being; 3) supported learning activities; 4) workload; 5) engaged leaders; 6) rotations which align to career aspirations; 7) culture of Aotearoa. The recommendations include: 1) senior staff need to be available to provide regular clinical support and coaching; 2) mentorship by physiotherapists working outside of the hospital environment who also have previous experience within the environment; 3) provide access to cultural supervision for staff of Māori ethnicity; 4) explore the nationwide use of clinical coaches with rotational physiotherapists as they would be additional resource that would free-up current senior staff to provide workload support to the rotational staff; 5) replication for Allied Health of the funding models that exist for ongoing learning for other health professionals ; 6) increase connectivity by senior management in the organisation as well as line managers; 7) implement forums for rotational therapist nationwide to provide opportunity for two-way communication without senior clinicians present to provide safe space for open discussion; 8) rotation allocation processes need to include regional and cross-district placements; 9) Develop an allied health specific wellness group to promote wellbeing in the workplace with provision to implement the Good4work model within Allied Health. Conclusion: Professional support, culture of wellbeing and supported learning activities play an important role in supporting early career physiotherapists to thrive at work. Being engaged in work that aligns with career aspirations also help rotational physiotherapist to thrive. The unique culture of Aotearoa New Zealand should be reflected in future health workforce research to embody the spirit of Te Tiriti o Waitangi.