The Determinants of Nursing Turnover: A Multi-Year Analysis
Main Article Content
Abstract
Using cross section random surveys (2008, 2010, 2012, 2014, and 2016) of 7,000 nurses in California, we examine the influence of nursing demographics and four groups of self-reported determinants of nursing career-choice decisions: FAMILY CONCERNS (childcare, other family concerns, moving, and non-job illness), ECON (salary and benefits), STRESS (job stress, job illness, other job dissatisfaction, nurse job dissatisfaction, and lay off concerns), and OTHER group (travel, another occupation, and school).
For nurses leaving for at least one year of absence and then returning to nursing, the FAMILY CONCERNS were consistently rated most important by nurses, followed by a distant second by the equivalent STRESS and OTHER group influencers. The ECON group rated least important.
The nurses permanently leaving the health care profession, FAMILY CONCERNS were once again rated most important during the first three years of our sample (2008, 2010, 2012), but then faded as STRESS and OTHER factors took over in relative importance.
Keywords:
nursing attrition, job stress, job burnout, family, concerns, child care
Article Details
How to Cite
BUTLER, Richard J.; JOHNSON, William G..
The Determinants of Nursing Turnover: A Multi-Year Analysis.
Medical Research Archives, [S.l.], v. 8, n. 6, june 2020.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2144>. Date accessed: 24 nov. 2024.
doi: https://doi.org/10.18103/mra.v8i6.2144.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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17. Flinkman, M., Laine, M., Leino-Kilpi, H., Hasselhorn, H. M., & Salantera, S. (2008). Explaining young registered Finnish nurses’ intention to leave the profession: a questionnaire survey. International Journal of Nursing Studies 45(5), 727–739.
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20. Gormley, D.K. (2011). Are we on the same page? Staff nurse and manager perceptions of work environment, quality of care and anticipated nurse turnover. Journal of Nursing Management, 19(1), 33–40.
21. Han, G., & Jekel, M. (2011). The mediating role of job satisfaction between leader-member exchange and turnover intentions. Journal of Nursing Management, 19(1), 41–49.
22. Kelly, L, Gee, P., & Butler, R (2019). Nursing Experiences, Nurse Burnout and Nursing Turnover. Arizona State University, College of Health Care, working paper.
23. Lavoie-Tremblay, M., O’Brien-Pallas, L., Gelinas, C., Desforges, N., Marchionni, C. (2008). Addressing the turnover issue among new nurses from a generational viewpoint. Journal of Nursing Management, 16(6), 724–733.
24. Leiter, M. P., & Maslach, C. (2009). Nurse turnover: the mediating role of burnout. Journal of Nursing Management, 17(3), 331–339.
25. Leiter, M. P., Price, S. L., & Spence-Laschinger, H. K. (2010). Generational differences in distress, attitudes and incivility among nurses. Journal of Nursing Management, 18(8), 970–980.
26. Li, J., Fu, H., Hu,Y., Shang, L., Wu, Y., Kristensen, T.S., HansMueller, B., & Hasselhorn, H.M. (2010). Psychosocial work environment and intention to leave the nursing profession: results from the longitudinal Chinese NEXT-study. Scandinavian Journal of Public Health, 38 (Suppl.3), 69–80.
27. Ma, J. C., Lee, P. H., Yang, Y. C., & Chang, W.Y. (2009). Predicting factors related to nurses’ intention to leave,job satisfaction, and perception of quality of care in acute care hospitals. Nursing Economics, 27(3), 178–184.
28. McCarthy, V.J., Power, S. and Greiner, B.A., 2010. Perceived occupational stress in nurses working in Ireland. Occupational medicine, 60(8), pp.604-610.
29. Meeusen, V. C., VanDam, K., Brown-Mahoney, C., Van Zundert, A. A., & Knape, H. T. (2011). Understanding nurse anesthetists’ intention to leave their job: how burnout and job satisfaction mediate the impact of person-ality and workplace characteristics. Health Care Management Review 36(2), 155–163.
30. Nasabi, N. A., & Bastani, P. (2018). The effect of quality of work life and job control on organizational indifference and turnover intention of nurses: A cross-sectional questionnaire survey. Central European Journal of Nursing and Midwifery 9(4), 915-923.
31. Rajapaksa, S., & Rothstein, W. (2009). Factors that influence the decisions of men and women nurses to leave nursing. Nursing Forum 44(3), 195–206.
32. Sellgren, S., Ekvall, G., & Tomson, G. (2007). Nursing staff turnover: does leadership matter? Leadership in Health Services 20(3), 169–183.
33. Smokrović, E., Žvanut, M. F., Bajan, A., Radić, R., & Žvanutb, B. (2019). The effect of job satisfaction, absenteeism, and personal motivation on job quitting: A survey of Croatian nurses. Journal of East European Management Studies, 24(3), 398-422.
33. Skillman, S. M., Palazzo, L., Hart, L. G., & Keepnews, D. (2010). The Characteristics of Registered Nurses whose Licenses Expire: Why They Leave Nursing and Implications For Retention and Re-Entry,
Nursing Economics, 28(3), 181-189.
34. Stewart, N. J., D’Arcy, C., Kosteniuk, J., Andrews, M. E., Morgan, D., Forbes, D., MacLeod, M. L. P., Kulig, J. C., & Pitblado, J. R. (2011). Moving on? Predictors of intent to leave among rural and remote RNs in Canada. Journal of Rural Health, 27(1), 103–113.
35. Stone, P. W., Larson, E. L., Mooney-Kane, C., Smolowitz, J., Lin, S. X., & Dick, A.W. (2006). Organizational climate and intensive care unit nurses’ intention to leave. Critical Care Medicine, 34(7), 1907–1912.
36. Takase, M., Maude, P., & Manias, E. (2006). The impact of role discrepancy on nurses’ intention to quit their jobs. Journal of Clinical Nursing, 15(9), 1071–1080.
37. Tei-Tominaga, M., & Miki, A. (2010). A longitudinal study of factors associated with intentions to leave among newly graduated nurses in eight advanced treatment hospitals in Japan. Industrial Health, 48(3), 305–316.
38. Tschannen, D., Kalisch, B.J., & Lee, K.H. (2010). Missed nursing care: the impact on intention to leave and turnover. Canadian Journal of Nursing Research, 42(4), 22–39.
39. Zeytinoglu, I. U., Denton, M., Davies, S., Baumann, A., Blythe, J., & Boos, L. (2006). Retaining nurses in their employing hospitals and in the profession: effects of job preference, unpaid overtime, importance of earnings and stress. Health Policy 79(1), 57–72.
40. Zeytinoglu, I. U., Denton, M., Davies, S., Baumann, A., Blythe, J., & Boos, L. (2007). Deteriorated external work environment, heavy work load and nurses’ job satisfaction and turnover intention. Canadian Public Policy, 33 (Suppl.1), S31–S47.
41. Barron, D. & West, E. (2005), Leaving nursing: an event-history analysis of nurses' careers,
Journal of Health Services Research & Policy, 10(3), 150-157.
42. Borkowski, N., Amann, R., Song, S. H., & Weiss, C. (2007). Nurses’ intent to leave the profession: issues related to gender, ethnicity, and educational level. Health Care Management Review, 32(2), 160–167.
43. Takase, M., Oba, K., & Yamashita, N. (2009). Generational differences in factors influencing job turnover among Japanese nurses: an exploratory comparative design. International Journal of Nursing Studies, 46(7), 957–967.
44. McCarthy, G., Tyrrell, M. P., & Lehane, E. (2007). Intention to’leave’or’stay’in nursing. Journal of nursing management, 15(3), 248-255.
45. Hayes, L. J., O’Brien-Pallasa, L., Duffield, C., Shamianc, J., Buchan, J., Hughes, F., Spence L., Heather K., & North, N. (2012). Nurse turnover: A literature review – An update, International Journal of Nursing Studies, 49(7), 887-905.
46. Spetz J., Chu L., Levin Z., Muench U., & Keane, D. (2015). California Board of Registered Nursing: 2014 Survey of Registered Nurses, www.rn.ca.gov
2. Jones, C.B. (2004). The Costs of Nursing Turnover, part 1 [and 2]. Journal of Nursing Administration, 34(12) [35(1)], 562-570 [41-49].
3. Waldman, J. D., Kelly, F., Sanjeev, A., & Smith, H. L. (2004). The Shocking Cost of Turnover in Health Care. Health Care Management Review, 29(1), 2-7.
4. O’Brien-Pallas, L., Duffield, C., & Hayes, L. (2006). Do we really understand how to retain nurses? Journal of Nursing Management 14(4), 262–270.
5. Jones, C.B., & Gates, M. (2007). The Costs and Benefits of Nursing Turnover: A Business Case for Nurse Retention. Online Journal of Issues in Nursing, 12 (3).
6. Bae, S. H., Mark, B. & Fried, B. (2010). Impact of nursing unit turnover on patient outcomes in hospitals Journal of Nursing Scholarship, 42(1), 40-49.
7. Li, Y. & Jones, C. B.( 2013). A literature review of nursing turnover costs, Journal of Nursing Management, 21(3), 405-418
8. Applebaum, D., Fowler, S., Fiedler, N., Osinubi,O., & Robson,M. (2010). The impact of environmental factors on nursing stress, job satisfaction, and turnover intention. Journal of Nursing Administration 40(7–8), 323–328.
9. Baernholdt, M., & Mark, B. A. (2009). The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. Journal of Nursing Management 17(8), 994–1001.
10. Brewer, C. S., Kovner, C. T., Greene, W., & Cheng, Y. (2009). Predictors of RNs’ intent to work and work decisions 1 year later in a U.S. national sample. International Journal of Nursing Studies, 46(7), 940–956.
11. Castle, N. G., & Engberg, J. (2006). Organizational characteristics associated with staff turnover in nursing homes. The Gerontologist, 46(1), 62–73.
12. Chan, M. F., Luk, A. L., Leong, S. M., Yeung, S. M., & Van, I. K. (2009). Factors influencing Macao nurses’ intention to leave current employment. Journal of Clinical Nursing, 18(6), 893–901.
13. Chiu, Y. L., Chung, R. G., Wu, C. S., & Ho, C. H. (2009). The effects of job demands, control, and social support on hospital clinical nurses’ intention to turnover. Applied Nursing Research, 22(4), 258–263.
14. Delobelle, P., Rawlinson, J. L., Ntuli, S., Malatsi, I., Decock, R., & Depoorter, A.M. (2011). Job satisfaction and turnover intent of primary health care nurses in rural South Africa: a questionnaire survey. Journal of Advanced Nursing, 67 (2), 371–383.
15. Duffield, C., Roche, M., O’Brien-Pallas, L., Catling-Paull, C., & King, M. (2009). Staff satisfaction and retention and the role of the Nursing Unit Manager. Collegian, 16, 11–17.
16. Estryn-Behar, M., VanderHeijden, B., Oginska, H., Camerino, D., LeNezet, O., Conway, P.M., Fry, C., & Hasselhorn, H.M., The NEXT-Study Group. (2007). The Impact of social work environment, team work characteristics, burnout, and personal factors upon intent to leave among European nurses. Medical Care, 45 (10), 939–950.
17. Flinkman, M., Laine, M., Leino-Kilpi, H., Hasselhorn, H. M., & Salantera, S. (2008). Explaining young registered Finnish nurses’ intention to leave the profession: a questionnaire survey. International Journal of Nursing Studies 45(5), 727–739.
18. Frijters, P., Shields, M. A., & WheatleyPrice, S. (2007). Investigating the quitting decisions of nurses: panel data evidence from the British National HealthService. Health Economics 16(1), 57–73.
19. Gardner, J. K., Thomas-Hawkins, C., Fogg, L., & Latham, C. E. (2007). The relationships between nurses’ perceptions of the hemodialysis unit work environment and nurse turn over, patient satisfaction, and hospitalizations. Nephrology Nursing Journal, 34(3), 271–282.
20. Gormley, D.K. (2011). Are we on the same page? Staff nurse and manager perceptions of work environment, quality of care and anticipated nurse turnover. Journal of Nursing Management, 19(1), 33–40.
21. Han, G., & Jekel, M. (2011). The mediating role of job satisfaction between leader-member exchange and turnover intentions. Journal of Nursing Management, 19(1), 41–49.
22. Kelly, L, Gee, P., & Butler, R (2019). Nursing Experiences, Nurse Burnout and Nursing Turnover. Arizona State University, College of Health Care, working paper.
23. Lavoie-Tremblay, M., O’Brien-Pallas, L., Gelinas, C., Desforges, N., Marchionni, C. (2008). Addressing the turnover issue among new nurses from a generational viewpoint. Journal of Nursing Management, 16(6), 724–733.
24. Leiter, M. P., & Maslach, C. (2009). Nurse turnover: the mediating role of burnout. Journal of Nursing Management, 17(3), 331–339.
25. Leiter, M. P., Price, S. L., & Spence-Laschinger, H. K. (2010). Generational differences in distress, attitudes and incivility among nurses. Journal of Nursing Management, 18(8), 970–980.
26. Li, J., Fu, H., Hu,Y., Shang, L., Wu, Y., Kristensen, T.S., HansMueller, B., & Hasselhorn, H.M. (2010). Psychosocial work environment and intention to leave the nursing profession: results from the longitudinal Chinese NEXT-study. Scandinavian Journal of Public Health, 38 (Suppl.3), 69–80.
27. Ma, J. C., Lee, P. H., Yang, Y. C., & Chang, W.Y. (2009). Predicting factors related to nurses’ intention to leave,job satisfaction, and perception of quality of care in acute care hospitals. Nursing Economics, 27(3), 178–184.
28. McCarthy, V.J., Power, S. and Greiner, B.A., 2010. Perceived occupational stress in nurses working in Ireland. Occupational medicine, 60(8), pp.604-610.
29. Meeusen, V. C., VanDam, K., Brown-Mahoney, C., Van Zundert, A. A., & Knape, H. T. (2011). Understanding nurse anesthetists’ intention to leave their job: how burnout and job satisfaction mediate the impact of person-ality and workplace characteristics. Health Care Management Review 36(2), 155–163.
30. Nasabi, N. A., & Bastani, P. (2018). The effect of quality of work life and job control on organizational indifference and turnover intention of nurses: A cross-sectional questionnaire survey. Central European Journal of Nursing and Midwifery 9(4), 915-923.
31. Rajapaksa, S., & Rothstein, W. (2009). Factors that influence the decisions of men and women nurses to leave nursing. Nursing Forum 44(3), 195–206.
32. Sellgren, S., Ekvall, G., & Tomson, G. (2007). Nursing staff turnover: does leadership matter? Leadership in Health Services 20(3), 169–183.
33. Smokrović, E., Žvanut, M. F., Bajan, A., Radić, R., & Žvanutb, B. (2019). The effect of job satisfaction, absenteeism, and personal motivation on job quitting: A survey of Croatian nurses. Journal of East European Management Studies, 24(3), 398-422.
33. Skillman, S. M., Palazzo, L., Hart, L. G., & Keepnews, D. (2010). The Characteristics of Registered Nurses whose Licenses Expire: Why They Leave Nursing and Implications For Retention and Re-Entry,
Nursing Economics, 28(3), 181-189.
34. Stewart, N. J., D’Arcy, C., Kosteniuk, J., Andrews, M. E., Morgan, D., Forbes, D., MacLeod, M. L. P., Kulig, J. C., & Pitblado, J. R. (2011). Moving on? Predictors of intent to leave among rural and remote RNs in Canada. Journal of Rural Health, 27(1), 103–113.
35. Stone, P. W., Larson, E. L., Mooney-Kane, C., Smolowitz, J., Lin, S. X., & Dick, A.W. (2006). Organizational climate and intensive care unit nurses’ intention to leave. Critical Care Medicine, 34(7), 1907–1912.
36. Takase, M., Maude, P., & Manias, E. (2006). The impact of role discrepancy on nurses’ intention to quit their jobs. Journal of Clinical Nursing, 15(9), 1071–1080.
37. Tei-Tominaga, M., & Miki, A. (2010). A longitudinal study of factors associated with intentions to leave among newly graduated nurses in eight advanced treatment hospitals in Japan. Industrial Health, 48(3), 305–316.
38. Tschannen, D., Kalisch, B.J., & Lee, K.H. (2010). Missed nursing care: the impact on intention to leave and turnover. Canadian Journal of Nursing Research, 42(4), 22–39.
39. Zeytinoglu, I. U., Denton, M., Davies, S., Baumann, A., Blythe, J., & Boos, L. (2006). Retaining nurses in their employing hospitals and in the profession: effects of job preference, unpaid overtime, importance of earnings and stress. Health Policy 79(1), 57–72.
40. Zeytinoglu, I. U., Denton, M., Davies, S., Baumann, A., Blythe, J., & Boos, L. (2007). Deteriorated external work environment, heavy work load and nurses’ job satisfaction and turnover intention. Canadian Public Policy, 33 (Suppl.1), S31–S47.
41. Barron, D. & West, E. (2005), Leaving nursing: an event-history analysis of nurses' careers,
Journal of Health Services Research & Policy, 10(3), 150-157.
42. Borkowski, N., Amann, R., Song, S. H., & Weiss, C. (2007). Nurses’ intent to leave the profession: issues related to gender, ethnicity, and educational level. Health Care Management Review, 32(2), 160–167.
43. Takase, M., Oba, K., & Yamashita, N. (2009). Generational differences in factors influencing job turnover among Japanese nurses: an exploratory comparative design. International Journal of Nursing Studies, 46(7), 957–967.
44. McCarthy, G., Tyrrell, M. P., & Lehane, E. (2007). Intention to’leave’or’stay’in nursing. Journal of nursing management, 15(3), 248-255.
45. Hayes, L. J., O’Brien-Pallasa, L., Duffield, C., Shamianc, J., Buchan, J., Hughes, F., Spence L., Heather K., & North, N. (2012). Nurse turnover: A literature review – An update, International Journal of Nursing Studies, 49(7), 887-905.
46. Spetz J., Chu L., Levin Z., Muench U., & Keane, D. (2015). California Board of Registered Nursing: 2014 Survey of Registered Nurses, www.rn.ca.gov