Academic journal article Australian Health Review

The Decision Process of Leaving Nursing

Academic journal article Australian Health Review

The Decision Process of Leaving Nursing

Article excerpt


This article reports the findings of a research study investigating the decision process of former division one nurses in deciding to leave the profession. Semi-structured interviews were conducted with 29 participants. For many participants, leaving nursing was not an easy decision. This article outlines the decision processes of five of the study participants to illustrate the complex psychological process associated with quitting. The insight gained may shed light on how to entice back nurses who have left the profession and address the needs of those thinking of leaving.

Aust Health Rev 2004: 28(3): 340-348

THE FEDERAL AND STATE governments have made combating the nursing shortage crisis one of their priorities. Inquiries, surveys and reviews have been commissioned to investigate nursing recruitment and retention strategies (DHS 2001), to review nursing and nursing education (Heath 2002; Senate Community Affairs References Committee 2002) and to improve nurses' working conditions (Australian Nursing Federation 1999; DHS 2001). Despite these efforts, the system continues to lose nurses. Unless urgent measures are taken, by 2006 Australia's health care system may have only 60% of the nurses it requires - a national shortfall of over 4000 graduates (Preston 2002).

Burn out, poor working conditions, poor remuneration, lack of career structure, and family unfriendly working hours have been identified as contributing to many nurses leaving the profession (Irvine & Evans 1995; Yodcr 1995; Bucrhaus 1998; Prothero et al. 2000; DHS 2001; Buchanan & Considine 2002). The role of nurses is becoming increasingly complex and demanding because of downsizing, outsourcing and cost containment efforts (Seifert 2000; DHS 2001; Buchanan & Considine 2002), with the result that many have difficulty in maintaining appropriate standards of care (Wolfe 1999; Kersbergen 2000; DHS 2001; Buchanan & Considine 2002). Shortened hospital stays and a faster turnover of patients mean that nurses are caring for a higher volume of acute care patients requiring more complex technology. The demands on nurses within the increasingly complex health care system require that they possess exceptional coping skills (DHS 2001; Buchanan & Considine 2002).

A research study was conducted in 2002 to examine the decision process used by those who have left the nursing profession. This article reports the findings of the study, which focus on the complex decision processes identified by departing nurses. An understanding of the psychological process they have gone through in deciding to leave the profession could provide some insights in developing retention strategies to stem the exodus of nurses.


Aim, framework and research design

This study aimed to understand nurses' decision-making when leaving their profession; specifically, to explore what triggered them to consider leaving, the process of leaving, and what might have changed their decision.

The theoretical framework for this study was based on Lee and Mitchell's Employee Turnover Model (Lee & Mitchell 1994; Lee et al. 1996) using Beach's image theory which argues that screening is an important mechanism for understanding decisions (Beach 1990). In a job turnover situation, screening is a process departing employees may use to ascertain fit or misfit of three domains: value, trajectory and strategic images in personal and organisational contexts. The value image is a set of general values, standards or principles important to a person. The trajectory image is the set of goals that motivates and directs their behaviour. The strategic image is the set of behavioural tactics and strategies an individual employs to attain his or her goals. The major components of Lee and Mitchell's model include: a 'shock' to the employee; the psychological analysis that precedes a decision to quit; and the act of quitting (Lee &r Mitchell 1994). …

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