Academic journal article Research and Theory for Nursing Practice

Understanding the Factors That Determine Registered Nurses' Turnover Intentions

Academic journal article Research and Theory for Nursing Practice

Understanding the Factors That Determine Registered Nurses' Turnover Intentions

Article excerpt

Turnover among registered nurses (RNs) produces a negative impact on the health outcomes of any health care organization. It is also recognized universally as a problem in the nursing profession. Little is known about the turnover intentions and career orientations of RNs working in Calgary, Alberta, Canada. The aim of this study is to contribute to the knowledge of and to advance the discussion on the turnover of nursing professionals. The study population consisted of RNs employed in the five major hospitals in Calgary. There were 193 surveys returned, representing a response rate of 77.2%. The results show that age and education have a negative effect on turnover intention. Education was found to have a significant negative effect on career satisfaction but not on job satisfaction and organizational com- mitment. Length of service has a significant negative effect on turnover intention. Role ambiguity has significant highly negative effect on career satisfaction. Growth opportunity and supervisor support have a very significant positive effect on job satisfaction, career satisfaction, and organizational commitment. External career opportunities and organizational commitment do not seem to have a significant effect on turnover intention. Career satisfaction, on the other hand, had negative significant effects on turnover intention.

Keywords: turnover; health outcomes; education; job satisfaction; commitment; health care organizations

There is a clearly identified demand for registered nurses (RNs) worldwide, and this is projected to increase sharply over the next decade (Goodin, 2003; Hassmiller & Cozine, 2006; Seago et al., 2006). In the Canadian context, it is estimated that the shortage of RNs will reach approximately 60,000 by year 2022 (Canadian Nurses Association [CNA], 2013). Registered nursing personnel and the nursing workforce are acknowledged to be the heart and soul of the health care delivery system. It is projected that at current levels of turnover and attrition in nursing professionals, the number of retiring RNs may in the near future outnum- ber those coming into the profession (CNA, 2013; Oulton, 2006). This staggering projection is made worse by the effect of economic realities that necessitate adjust- ments being made on staffing levels and the work environment, thus leading to an uncertain environment and increasing work pressures on practicing nurses in Canada and across the globe.

To manage the expected shortage of RNs, health care organizations are proactively developing and implementing workforce-planning strategies aimed at the identifica- tion of appropriate workload staffing levels as well as justifying budget allocations to meet their objectives. Over the past decade, these strategies have involved the alteration of the staff mix among other initiatives, leading to the reduction of RNs and an increase in auxiliary staff and nursing aides in the units (Heitlinger, 2002). This reduction in the number of RNs has had the unexpected effect of decreasing the level of care and overstretching the existing staff, thus further exacerbating the nursing shortage (Hassmiller & Cozine, 2006; Jackson, 2000; Needleman, Buerhaus, Mattke, Stewart, & Zelevinsky, 2002; Oulton, 2006; Satryan, 2007). Heitlinger (2002) argues that the main outcome of reductions in the Canadian health care industry has been a severe shortage of RNs in hospitals because the "mindset that leads to a reduction of nursing staff along with increasing delegation of tasks to less skilled personnel has only resulted in a boomerang effect-a shortage of nurses without the supply or interest to fill demand" (p. 42).

The scarcity of RNs has been highlighted as one of the principal obstacles to achiev- ing health system effectiveness. Buchan and Aiken (2008) argue that the "shortage of nurses is not necessarily a shortage of individuals with nursing qualifications; it is a shortage of nurses willing to work in the present conditions" (p. …

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