Christine T Kovner

Abstract

The purpose of this study was to describe the differences between traditional-baccalaureate graduates (TBGs) who had a baccalaureate degree in nursing and no other academic degree or diploma and second-degree baccalaureate graduates (SDGs) who had both a baccalaureate degree in nursing and a baccalaureate or higher degree in a field other than nursing. Using a sample of 953 newly licensed registered nurses (NLRNs), we compared SDGs and TBGs on demographic and work characteristics, including attitudes toward work, intent to stay in their current job, and whether they are searching for a job. TBGs worked slightly more hours per week and were more likely to provide direct care. SDGs were more likely to plan to stay indefinitely in their first job and were less uncertain of plans to stay. SDGs experienced higher family-work conflict and lower workgroup cohesion. Full-time SDGs earn over $2,700 more income per year. Potential explanations for the salary difference are the greater human capital that SDGs bring to the job and their older age. Understanding the workforce productivity of these two groups is important for both organizational planning and policy for recruitment and retention.

Abstract

The purpose of this analysis is to describe the attrition process from application to associate and baccalaureate basic RN programs through the first 2 years of work using estimates from best available nationally representative data. Results of the analysis show that although about 41,000 qualified applicants are not admitted to basic RN programs, most students (76.2%) who enroll in basic RN programs graduate, and most RN graduates who pass the National Council Licensure Examination stay in their first nursing job (73.8%) and nursing (97.9%) for at least 2 years. The results suggest that room for improvement exists for retention across educational and work settings, but the system appears to be most leaky at the point of admitting qualified applicants. Precise data about attrition from educational and employment settings are essential for resolving educational capacity and workforce retention issues, but precise data are difficult to obtain. A solution may be to assign each applicant a unique identifier.

Abstract

Objective To examine the relationships between nursing staffing levels and nursing home deficiencies.MethodsThis panel data analysis employed random-effect models that adjusted for unobserved, nursing home-specific heterogeneity over time. Data were obtained from California's long-term care annual cost report data and the Automated Certification and Licensing Administrative Information and Management Systems data from 1999 to 2003, linked with other secondary data sources.ResultsBoth total nursing staffing and registered nurse (RN) staffing levels were negatively related to total deficiencies, quality of care deficiencies, and serious deficiencies that may cause harm or jeopardy to nursing home residents. Nursing homes that met the state staffing standard received fewer total deficiencies and quality of care deficiencies than nursing homes that failed to meet the standard. Meeting the state staffing standard was not related to receiving serious deficiencies.ConclusionsTotal nursing staffing and RN staffing levels were predictors of nursing home quality. Further research is needed on the effectiveness of state minimum staffing standards.

Abstract

Background: Many studies have examined predictors of nurses' intention to work in their job, including desire to quit. Intent has been a good predictor of actual turnover. Few longitudinal studies exist that consider regional variables. Objectives: To extend the conceptual framework of turnover research to the whole nursing workforce and determine: (1) how do demographics, region (metropolitan statistical area: MSA), movement opportunities, and work setting variables affect registered nurses' (RNs) intent to work and desire to quit; and (2) how do demographics, MSA variables, movement opportunities, and work setting variables affect RNs' work behavior at time 2? Design: Panel study using Dillman's design method. Settings and participants: Randomly selected national cluster sample from 40 urban geographic regions (MSAs) in 29 states of the United States. Methods: Four thousand surveys were sent. There were 1907 female RNs under 65 (48% response rate) from year 1 of which 1348 responded at year 2 (70% response rate). Results: The first analyses used desire to quit (explained 65% of the variance) and intent to work from year 1 as dependent variables. Satisfaction and organizational commitment were significant negative predictors of desire to quit. In the logistic regression on intent to work, the work motivation and work-family conflict were positive and significant as well as wages (negative) and three benefit variables. In year 2, the dependent variable was working or not and if working, full-time or not. For this bivariate probit regression no attitudes influenced the work/not work decision, but MSA level variables, wages (positive) and benefits (positive) did. Organizational commitment and higher workload increased the probability of working FT. Conclusions: Regional differences across markets need to be controlled and their influence investigated. In addition, attitudes as well as wages and benefits were important in certain decisions: these factors are clearly under the influence of employers.

Abstract

▶ Nursing turnover is costly for health care organizations. ▶ Newly licensed registered nurses work behavior is a complex process, influenced by their attitudes toward their work, personal characteristics, job opportunities, and workplace attributes. ▶ Several characteristics are significant in predicting satisfaction (ethnicity, gender) and organizational commitment (patient load, mandatory overtime, shift, and unit type) and intent to stay (income, age) over and above work attitudes. ▶ Among the most important implications are how the findings can inform management and policy. ▶ Findings from this study provide information that may be useful for those organizations that want to decrease their turnover rates.

Abstract

To understand factors that promote retention of Newly Licensed Registered Nurses (NLRNs) and those that contribute to turnover, a survey of a national sample of NLRNs was conducted. This article describes the content analysis of 612 NLRN comments about their work life. Using Krippendorff's1 technique, 5 themes were discovered. Colliding expectations describes conflicts between nurses' personal view of nursing and their lived experience. The need for speed describes the pressure related to a variety of temporal issues. You want too much expresses the pressure and stress NLRNs feel personally and professionally. How dare you describes unacceptable communication patterns between providers. Change is on the horizon suggests optimism for the future as NLRNs speak of transforming the systems where care is provided. This content analysis reveals that the working environment where NLRNs begin their career is in need of reform. Suggestions are offered from the nurses themselves.

Abstract

The purpose of this paper was to give voice to the concerns of registered nurses (RNs) who wrote comments on a survey about RNs' intent to work. Each comment (n = 472) was analyzed using thematic analysis. Four themes describe RNs' reflections on working: (a) competing priorities, (b) balancing priorities, (c) practice deterrents, and (d) collegial support encourages nurses to stay in practice. Understanding these reflections gives insight into the complexity of decisions to work and the RNs' struggle to practice. With this insight, RNs may consider decisions about their work throughout their job trajectories that may foster a more fulfilling nursing career.