READING COMPREHENSION
PASSAGE 1
ABSENTEEISM IN NURSING: A LONGITUDINAL STUDY
Absence from work is a costly and disruptive problem for any organisation. The cost of absenteeism in
Australia has been put at 1.8 million hours per day or $1400 million annually. The study reported here was
conducted in the Prince William Hospital in Brisbane, Australia, where, prior to this time, few active steps
had been taken to measure, understand or manage the occurrence of absenteeism.
Nursing Absenteeism
A prevalent attitude amongst many nurses in the group selected for study was that there was no reward or
recognition for not utilising the paid sick leave entitlement allowed them in their employment conditions.
Therefore, they believed they may as well take the days off — sick or otherwise. Similar attitudes have been
noted by James (1989), who noted that sick leave is seen by many workers as a right, like annual holiday
leave.
Miller and Norton (1986), in their survey of 865 nursing personnel, found that 73 percent felt they should be
rewarded for not taking sick leave because some employees always used their sick leave. Further, 67 per cent
of nurses felt that administration was not sympathetic to the problems shift work causes to employees'
personal and social lives. Only 53 percent of the respondents felt that every effort was made to schedule staff
fairly.
In another longitudinal study of nurses working in two Canadian hospitals, Hacket Bycio and Guion
(1989) examined the reasons why nurses took absence from work. The most frequent reason stated for
absence was minor illness to self. Other causes, in decreasing order of frequency, were illness in family,
family social function, work to do at home and bereavement.
Method
In an attempt to reduce the level of absenteeism amongst the 250 Registered an Enrolled Nurses in the
present study, the Prince William management introduced three different, yet potentially complementary,
strategies over 18 months. Strategy 1: Non-financial (material) incentives : Within the established wage and
salary system it was not possible to use hospital funds to support this strategy. However, it was possible to
secure incentives from local businesses, including free passes to entertainment parks, theatres, restaurants,
etc. At the end of each roster period, the ward with the lowest absence rate would win the prize. Strategy
2 Flexible fair rostering: Where possible, staff were given the opportunity to determine their working
schedule within the limits of clinical needs. Strategy 3: Individual absenteeism : and Each month, managers
would analyse the pattern of absence of staff with excessive sick leave (greater than ten days per year for full-
time employees). Characteristic patterns of potential 'voluntary absenteeism' such as absence before and
after days off, excessive weekend and night duty absence and multiple single days off were communicated to
all ward nurses and then, as necessary, followed up by action.
Results
Absence rates for the six months prior to the Incentive scheme ranged from 3.69 per cent to 4.32 per cent. In
the following six months, they ranged between 2.87 percent and 3.96 percent. This represents a 20 percent
improvement. However, analysing the absence rates on a year-to-year basis, the overall absence rate was
3.60 percent in the first year and 3.43 percent in the following year. This represents a 5 percent decrease
from the first to the second year of the study. A significant decrease in absence over the two-year period
could not be demonstrated.
Discussion
The non-financial incentive scheme did appear to assist in controlling absenteeism in the short term. As the
scheme progressed it became harder to secure prizes and this contributed to the program's losing
momentum and finally ceasing. There were mixed results across wards as well. For example, in wards with
staff members who had a long-term genuine illness, there was little chance of winning, and to some extent,
the staffs on those wards were disempowered. Our experience would suggest that the long-term effects of
incentive awards on absenteeism are questionable.
Over the time of the study, staff were given a larger degree of control in their rosters. This led to significant
improvements in communication between managers and staff. A similar effect was found from the
implementation of the third strategy. Many of the nurses had not realised the impact their behaviour was
having on the organisation and their colleagues but there were also staff members who felt that talking to
them about their absenteeism was 'picking' on them and this usually had a negative effect on management—
employee relationships.
Conclusion
Although there has been some decrease in absence rates, no single strategy or combination of strategies has
had a significant impact on absenteeism per se. Notwithstanding the disappointing results, it is our
contention that the strategies were not in vain. A shared ownership of absenteeism and a collaborative
approach to problem solving has facilitated improved cooperation and communication between management
and staff. It is our belief that this improvement alone, while not tangibly measurable, has increased the ability
of management to manage the effects of absenteeism more effectively since this study.
[" This article has been adapted and condensed from the article by G. William and K. Slater (1996), 'Absenteeism
in nursing: A longitudinal study', Asia Pacific Journal of Human Resources, 34(1): 111-21. Names and other
details have been changed and report findings may have been given a different emphasis from the original. We
are grateful to the authors and Asia Pacific Journal of Human Resources for allowing us to use the material in
this way. " ]
Questions 1-7
Do the following statements agree with the information given in Reading Passage.
In boxes 1-7 on your answer sheet write:
YES if the statement agrees with the information
NO if the statement contradicts the information
NOT GIVEN if there is no information on this in the passage
1. The Prince William Hospital has been trying to reduce absenteeism amongst nurses for many years.
2. Nurses in the Prince William Hospital study believed that there were benefits in taking as little sick leave
as possible.
3. Just over half the nurses in the 1986 study believed that management understood the effects that shift
work had on them.
4. The Canadian study found that 'illness in the family' was a greater cause of absenteeism than 'work to do at
home'.
5. In relation to management attitude to absenteeism the study at the Prince William Hospital found similar
results to the two 1989 studies.
6. The study at the Prince William Hospital aimed to find out the causes of absenteeism amongst 250 nurses.
7. The study at the Prince William Hospital involved changes in management practices.
Questions 8-13
Complete the notes below.
Choose ONE OR TWO WORDS from the passage, for each answer.
Write your answers in boxes 8-13 on your answer sheet.
In the first strategy, wards with the lowest absenteeism in different periods would win prizes donated by .......
(8) .......
In the second strategy, staff were given more control over their ......(9 )........
In the third strategy, nurses who appeared to be taking ...... (10)...... sick leave or ...... (11) ...... were identified
and counselled.
Initially, there was a ...... (12)...... per cent decrease in absenteeism.
The first strategy was considered ineffective and stopped.
The second and third strategies generally resulted in better ...... (13) ...... among staff.
PASSAGE 2
A There are now over 700 million motor vehicles in the world - and the number is rising by more than 40
million each year. The average distance driven by car users is growing too - from 8 km a day per person in
western Europe in 1965 to 25 km a day in 1995. This dependence on motor vehicles has given rise to major
problems, including environmental pollution, depletion of oil resources, traffic congestion and safety.
B While emissions from new cars are far less harmful than they used to be, city streets and motorways are
becoming more crowded than ever, often with older trucks, buses and taxis, which emit excessive levels of
smoke and fumes. This concentration of vehicles makes air quality in urban areas unpleasant and sometimes
dangerous to breathe. Even Moscow has joined the list of capitals afflicted by congestion and traffic fumes. In
Mexico City, vehicle pollution is a major health hazard.
C Until a hundred years ago, most journeys were in the 20 km range, the distance conveniently accessible
by horse. Heavy freight could only be carried by water or rail. The invention of the motor vehicle brought
personal mobility to the masses and made rapid freight delivery possible over a much wider area. Today
about 90 percent of inland freight in the United Kingdom is carried by road. Clearly, the world cannot revert
to the horse-drawn wagon. Can it avoid being locked into congested and polluting ways of transporting
people and goods?
D In Europe, most cities are still designed for the old modes of transport. Adaptation to the motor car has
involved adding ring roads, one-way systems and parking lots. In the United States, more land is assigned to
car use than to housing. Urban sprawl means that life without a car is next to impossible. Mass use of motor
vehicles has also killed or injured millions of people. Other social effects have been blamed on the car such as
alienation and aggressive human behaviour.
E A 1993 study by the European Federation for Transport and Environment found that car transport is
seven times as costly as rail travel in terms of the external social costs it entails such as congestion, accidents,
pollution, loss of cropland and natural habitats, depletion of oil resources, and so on. Yet cars easily surpass
trains or buses as a flexible and convenient mode of personal transport. It is unrealistic to expect people to
give up private cars in favour of mass transit.
F Technical solutions can reduce the pollution problem and increase the fuel efficiency of engines. But fuel
consumption and exhaust emissions depend on which cars are preferred by customers and how they are
driven. Many people buy larger cars than they need for daily purposes or waste fuel by driving aggressively.
Besides, global car use is increasing at a faster rate than the improvement in emissions and fuel efficiency
which technology is now making possible.
G One solution that has been put forward is the long-term solution of designing cities and neighbourhoods
so that car journeys are not necessary - all essential services being located within walking distance or easily
accessible by public transport. Not only would this save energy and cut carbon dioxide emissions, it would
also enhance the quality of community life, putting the emphasis on people instead of cars. Good local
government is already bringing this about in some places. But few democratic communities are blessed with
the vision - and the capital - to make such profound changes in modern lifestyles.
H A more likely scenario seems to be a combination of mass transit systems for travel into and around
cities, with small 'low emission' cars for urban use and larger hybrid or lean burn cars for use elsewhere.
Electronically tolled highways might be used to ensure that drivers pay charges geared to actual road use.
Better integration of transport systems is also highly desirable - and made more feasible by modern
computers. But these are solutions for countries which can afford them. In most developing countries, old
cars and old technologies continue to predominate.
Questions 14-19
Reading Passage 39 has eight paragraphs (A-H). Which paragraphs concentrate on the following
information? Write the appropriate letters (A-H) in boxes 14-19 on your answer sheet.
NB You need only write ONE letter for each answer.
14 a comparison of past and present transportation methods
15 how driving habits contribute to road problems
16 the relative merits of cars and public transport
17 the writer's own prediction of future solutions
18 the increasing use of motor vehicles
19 the impact of the car on city development
Questions 20-26
Do the following statements agree with the information given in Reading Passage 2? In boxes 20-26
on your answer sheet write
YES if the statement agrees with the information
NO if the statement contradicts the information
NOT GIVEN if there is no information on this in the passage
20 Vehicle pollution is worse in European cities than anywhere else.
21 Transport by horse would be a useful alternative to motor vehicles.
22 Nowadays freight is not carried by water in the United Kingdom.
23 Most European cities were not designed for motor vehicles.
24 Technology alone cannot solve the problem of vehicle pollution.
25 People's choice of car and attitude to driving is a factor in the pollution problem.
26 Redesigning cities would be a short-term solution.
