There are several current concerns about the healthcare workforce that promise to affect the future of the industry. The first is the shortage of nurses. According to the American Association of Colleges of Nursing (2008), if there is no change in current practices, there could be a shortage of one million nurses by 2020.
According to several researches conducted on the premise of nurses leaving the profession, it was discovered that nurses are leaving the profession because of low job satisfaction, high stress, and increased job availability in nonclinical sectors.
The purpose of this essay is to explain the reasons behind the decision of nurses to leave nursing profession.
Causes of nursing turnover
The determination of RN to leave job is either avoidable or unavoidable. Unavoidable circumstances are associated with marriage, pregnancy, and transfer of the husband (in the case of female RNs). According to Carol Isaac MacKusick and Ptlene Minick (2010) avoidable reasons results from failure of the job to keep the employee in the organization’s service, inhospitable workplace, “emotional suffering related to patient care, and tiredness and exhaustion.
According to Gillies (1994, 293), it is estimated that 36% of turnover can be associated with unavoidable causes, while approximately 64% of the nursing turnover is of the avoidable type. Although nursing service managers often cite pay and family responsibilities as the outstanding factors leading to RNs decision to leave job, research has shown that the characteristics of the job itself are usually accountable for turnover.
Regarding pay and family responsibilities, Murrells, Robinson, & Griffiths, (2008) makes the following observations, among others, concerning turnover among nurses.
- If money is highly valued, and the worker itself does not give the nurse satisfaction, then dissatisfaction with pay occurs. This dissatisfaction leads to turnover.
- If a nurse experiences strong feelings of responsibility towards her family and derives no satisfaction from her work, she will serve her family instead of staying at the hospital. This leads to turnover.
Though, reasons for turnover among nurses are not easy to identify; they vary from individual to individual and may also depend on the differences in organizational structures and the management of the different institutions.
Job satisfaction is an important variable to take into account when explaining reasons why nursing practitioners leave their job, but ‘intent to stay’ or an individual’s commitment to her present job is more important in terms of leaving or staying in a particular workplace. It points out that although the person might experience a high degree of job satisfaction and a commitment to her current work, it is the attraction of outside opportunities which may offer more, which will ultimately determine whether she will stay in her job or leave (Cipriano, 2006).
The aspects which underlie job satisfaction according to Cipriano (2006) are the following:
- The degree to which a job is repetitive;
- The degree of power or influence one has over the speed at which one works, how one performs one’s job activities, the sequence of job activities, and the changes one would like to make in one’s job;
- The degree to which employees are informed about the priority of work to be done, technical knowledge, and the nature of equipment to be used (Murrells, Robinson, & Griffiths, 2008);
- Whether one has close friends among the other employees;
- The total yearly income from the job;
- An employee’s feeling regarding the pay received in relation to the effort that is put into the job;
- The employee’s perception of the potential for movement from lower positions to higher positions in the organization.
Another viewpoint regarding the causes of turnover focuses not only on the job and its characteristics but on the work environment of the employee. Thus factors such as the following appear to be important for employees at different stages of their work life:
- The overall environment-whether the employee perceives it to be hostile, stressful, and full of conflicts, or calm and rewarding;
- Sexual harassment- whether the employee are being sexually harassed by coworkers, managers and supervisors.
- Frequent feedback- i.e. how often and in how much detail the employee obtains feedback on the jobs performed;
- The type of interaction the employee has with his/her supervisor;
- The number of co-workers an employee has;
- Opportunities to learn new things while doing the job;
- Opportunities to make independent decisions while doing the job
Lastly, Carol Isaac MacKusick and Ptlene Minick (2010) noted that “RNs leave their job due to emotional distress related to patient’s care, excessive aggressive treatment from coworkers and patient, lack of teamwork between RNs and staff, and lack of value for patient and personal wishes which creates persistent emotional pain”.
American Association of Colleges of Nursing (AACN). (2010). Nursing shortage fact sheet. Web.
Cipriano, P.F. (2006). Retaining our talent. American Nurse Today, 1(2), 10.
Gillies, D. (1994). Nursing Management: A Systems Approach. Saunders (W.B.) Co Ltd.
MacKusick, C. I., & Minick, P. (2010). Why Are Nurses Leaving? Findings
From an Initial Qualitative Study on Nursing Attrition. MEDSURG Nursing, Vol. 19/No. 6.
Murrells, T., Robinson, S., & Griffiths, P. (2008). Job satisfaction trends during nurses’ early career. Web.