Retention study identifies key factors affecting three generations of nurses

Australian researchers surveyed 900 nurses from seven private hospitals in four states, breaking them down into Baby Boomers (44 to 46 years), Generation X (29 to 43 years) and Generation Y (under 29).

The sample was representative of the nursing population in Australia. Most were women (96%), over 42 years of age, working as Registered Nurses (RNs) and doing between five and eight shifts a week.

"Our findings, which we believe may be applicable to many international hospitals, show that there is no single driver behind nurse retention" says co-author Dr Kate Shacklock, Senior Lecturer in Employment Relations and Human Resources at Griffith University, Queensland.

"Older nurses were more likely to be influenced by a larger number of factors than younger nurses and flexible working arrangements, which have been suggested by some as a possible solution to retention issues, were not deemed significant by any of the three age groups.

"However, one clear message emerged, that nurses feel a strong attachment to healing and to working in the nursing profession. This was the only variable identified by all three age groups. We believe that strategies that build on this and the other variables identified in our study may improve hospital retention rates."

Developed countries around the globe are currently suffering nurse shortages. For example, latest figures show that of the qualified nurses currently working in Australia, only 73% were employed in nursing. The Canadian Nurses Association has predicted a shortfall of 60,000 RNs by 2022 and the American Nurses Association reports that only 80% of those educated and licensed to practice are working as RNs, meaning that 480,000 are not.

"These well documented shortages are due to fewer people entering and staying in the profession and the increase in demand for nurses as health services expand to meet the needs of an ageing population" says Dr Shacklock.

Key findings of the survey include:

• Six independent variables had an important influence on the nurses' intentions to continue nursing and between them these accounted for 21% of the variations in these intentions.
• Being committed to healing and nursing was the only independent variable identified in the youngest Generation Y age group.
• Two independent variables were identified in the Generation X nurses: being committed to healing and nursing and the quality of their relationship with their supervisor.
• Five independent variables were identified in the oldest Baby Boomer group: being committed to healing and nursing, work-family conflict, being allowed to decide how and when to carry out tasks, how well they got on with colleagues and the importance of working.
• The only factor tested that did not prove a significant influence in any of the age groups was flexible working arrangements.

The data was collected from anonymous surveys sent to the seven hospitals and the 900 completed surveys represented a response rate of 36%.

Over half of the respondents (54%) were Baby Boomers, 38% were Generation X and 8% were Generation Y. Seven out of ten (69%) were RNs and the sample also included nurse unit managers, enrolled nurses and endorsed enrolled nurses. A third (33%) had worked at their hospital for more than 15 years and 59% had worked at their hospital for more than five years. More than half (58%) worked part time, 28% full time and the rest on a casual basis.

"The results of our study provide compelling arguments for changes to how Governments and healthcare providers tackle the growing challenges posed by the global nursing shortage" concludes co-author Dr Yvonne Brunetto, Associate Professor in the School of Commerce and Management at Southern Cross University, New South Wales.

"Our findings confirm that there is no single driver behind nurse retention and that further research is necessary. However, one clear message emerges – that nurses feel a strong attachment to healing and to the nursing profession and this is a key factor influencing their intention to continue nursing.

"We believe that the secret to improving hospital nurse retention rates is to build on this commitment to the nursing profession and to tackle the specific variables identified by our study for the three generations of nurses. Trying to tackle retention using a one-size-fits-all policy is clearly not the way forward."

More information: The intention to continue nursing: work variables affecting three nurse generations in Australia. Shacklock K and Brunetto Y. Journal of Advanced Nursing. 68.1, pp36-46. (2012) doi: 10.1111/j.1365-2648.2011.05709.x

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