Reasons Registered Nurses Leave Essay

Abstract

The article explored the reasons why registered nurses choose to voluntarily leave their nursing positions or change their employment status to PRN or as needed in a Midwestern healthcare system. The researchers employed a survey design administered by phone call to 84 out of the identified 183 nurses who left their positions. Results showed that the nurse working in the specialty areas had the highest turnover rate and the most common reason why the nurses interviewed left their workplace was due to the number of hours worked and the schedule that were given to them. The nurses were also concerned about the quality of care that they give to their patients because being understaffed is related to perceptions of error commitments and a decline in the quality of nursing care given. The authors concluded that to be able to retain nurses the institutions have to address the aforementioned issues by increasing job stability and flexibility and provide predictable work schedules through flexible scheduling, adequate staffing levels, and appropriate rewards and recognition (Stracbota et al, 2003).

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Introduction

There are an estimated 60% of the registered and active nurses in Iowa that are entering the age of 50 and may hence retire this year (Stracbota et al, 2003). Moreover, a declining interest in the nursing career is evident by a decrease of 40% in the number of admissions to nursing schools and a 27% dwindle in the graduates (Stracbota et al, 2003). These, plus the current turnover rate of 6.8%, will prod the immense call for new nurses. The cost for the nurse turnover is estimated to be around $22,000 to $64,000 per nurse turnover (Jones & Gates, 2007). This is because the finances needs to cover for the advertising and recruitment, vacancy costs, hiring, orientation and training, decrease in productivity, termination, potential patient errors and compromised quality of care, poor work environment, culture, dissatisfaction, and distrust, loss of organizational knowledge, and additional turnover (Jones & Gates, 2007).

Problem

The need to retain nurses because of the nurse shortage experienced prompted the researchers to explore the reasons why the nurses choose to leave their current employment status. This is important because the interventions and strategies on how to manage this issue can be planned only when the cause is known.

Purpose

The researcher’s purpose is to find out why the registered nurses voluntarily left their nursing positions or changed their employment status to as needed.

Literature review

The review of the literature of the article asserted that there are complicated reasons as to why an employee leaves his or her job. There are four pinpointed reasons that were gathered in the literature, namely, job satisfaction, supervision, work environment, and personal reasons (Stracbota et al, 2003). The authors explored each aspect and gave examples and statistics that were taken from previous studies that were conducted in the same field.

Independent & dependent variables

The independent variables are the reasons why the nurses leave and the dependent variable is the nurse turnover rate.

Description of the sample

The sample population targeted 183 nurses who left their nursing positions within the last 9 months in the three Midwestern institutions involved. However, the researchers were only able to survey 84, hence a 46% rate of return. Verbal consent for participation was obtained at the beginning of the interview. This is a very low number of subjects for the research, considering the 6.8% nurse turnover rate in the locality.

Data collection procedures

The authors categorized the respondents as full-time, part-time or PRN employment and by the department they worked in. The nurses were anonymously coded with numbers. The phone interviews were said to last for an average of 25 minutes with some exceeding an hour.

Statistical analyses

The authors independently analyzed the results by finding common themes and categories and listed all the identified themes and then collapsed into major ones. The authors employed a frequency distribution table for the responses that were created for each question. The frequency distributions were compared and matched with a 54% to 99% agreement, according to the authors; most questions had an agreement rate greater than 75%.

Strength and weaknesses of the study

The strength of the study is the rich literature that the authors can utilize because this has been researched in different areas and at different times already. However, since the research had a 46% response rate, it is very difficult to generalize their results, but the authors addressed this in the limitations of their study. Moreover, the telephone interviews were not recorded and the interviewer was just jotting down the responses to their questions; hence, the interviewer might be slightly biased in selecting which answers to write down during the conversation, and thus, might also affect the results of the research. This was also addressed in the limitations of the study. Also, the research did not mention about the possible benefits of the turnovers which are reported by Jones and Gates (2007) as reduction in benefits and salaries, savings from bonuses not paid to outgoing nurses, replacement nurses bringing new ideas, creativity, innovations, and knowledge from the competitor institution, and elimination of poor performances.

Findings

Results showed that 50% of the respondents blame the work hours, working on majority of the holidays, having the night shift schedule with no possibility of day time schedule, and no flexibility in the working hours as the main reason why they left their jobs. 31% asserted that there are other positions that offer better job opportunities for more money and better hours, while 19% stressed that their family is their priority and they had to stay at home with children or elderly parents. 15% said that pay and benefits were unsatisfactory, another 15% mentioned poor staffing and the inability to deliver quality patient care, and also 15% avowed that their management was not supportive with expectations that the staff will go the extra mile while the management did not. The work environment was unacceptable and the people were unhappy according to 14%, while 12% said that the stress of working with too little staff and heavy patient load of sick patients were too much to handle. Eight percent said that their careers had no opportunity for job advancement and another 8% had to return to school. Lastly, 7% had personal health problems and 5% had relocated. The findings are consistent with a study conducted by Cline et al (2004) that claimed management and staffing concerns are the main reasons for nurse turnover. The lack of management support, ineffective measures and failure to listen or respond to concerns were the reasons why management led to nurse turnover (Cline et al, 2004). Staffing shortage which leads to compromised patient care was also one of the reasons that nurse turnover was attributed to (Cline et al, 2004). This needs to be mentioned and included in the questionnaire so that the opinion of the nurses who left may be checked regarding these aforementioned benefits.

Recommendations for future research

Since there are already a number of researches done regarding this aspect of nursing, a research that is to be done on a national level is recommended. Also, the benefits of the nurse turnover could also be studied.

Conclusion

The research was able to answer the problem that it presented at the beginning of the article. However, the only concern that might render this research as void is that of its small number of subjects and the way the data was collected which was only through jotting down notes and not recording the conversation. It could be suggested that the research be conducted by interviewing more number of samples with at least an 85% response rate and the interviews be recorded. This is to meet the sample size criteria and to eliminate biases and ensure the correctness of the data collected. The topic that was chosen is timely because of the apparent nursing shortage and high turnover rates that are rendering the healthcare field rather limp from the costs and the declining and compromised quality of care. The impact of this research to the nursing practice is very important because this might be able to guide the healthcare institutions on how to handle their nurse turnover problems. However, each institution is different and the results might not be the same for all institutions but at least this might be able to provide an idea on what the nurses do not like in their respective jobs. Retaining is very important for the institution because not only will they be able to produce nurses with more experience and who are experts in their respective fields, but will ensure that the patients are in the good hands of nurses who prioritize giving quality care and nurses who do not want to commit errors.

References:

Cline, D., Reilly, C., & Moore, J. (2003). What’s behind the RN turnover? Holistic Nursing Practice. 34(10): 50-53.

Jones, C. & Gates, M. (2007). The costs and benefits of nurse turnover: A business case for nurse retention. The Online Journal of Issues in Nursing. 12(3): 1-12.

Stracbota, E., Normandin, P., O’Brien, N., Clary, M., & Krukow, B. (2003). Reasons registered nurses leave or change employment status. The Journal of Nursing Administration. 33(2), 111-117.

 

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