Nurses' intentions to quit increased during the pandemic despite their high resilience: Study

Nurses' intentions to leave nursing increased during the COVID-19 pandemic, a recent study from the University of Eastern Finland shows. Yet, nurses estimated their resilience to be high.

The COVID-19 pandemic caused stress everywhere in the world, and especially for health care professionals. Coping with a pandemic calls for an ability to respond to challenging and difficult situations. It also requires crisis management, good leadership and faith in the future, all of which are linked to experienced resilience.

"Resilience refers to a person recognizing and being able to utilize their individual resources and, when necessary, turning to support available from, e.g., family and friends, colleagues, managers and other professionals, in a way that helps them to cope with a challenging situation," Doctoral Researcher Saija Sihvola of the University of Eastern Finland says. The study was published in the BMC Health Services Research journal.

Nurses' work demands, including staffing levels and appropriate compensation, have sparked discussion everywhere in the world, Finland included.

According to previous studies, work demands, such as excessive workloads, and weaker resilience, may affect nurses' intentions to leave nursing. Previous studies have also shown that resilience is associated with job satisfaction, professional commitment and quality of life, and it protects against anxiety and burnout.

The survey was conducted in Finland in spring 2021, i.e., during the third wave of the COVID-19 pandemic, and it examined nurses' assessments of their resilience, job satisfaction, quality of care and intentions to leave, and structural equation modeling was used to explore the relationships between these. A total of 437 Finnish registered nurses responded to an electronic survey. Their age ranged between 21 and 69 years, and 87% respondents were female.

The findings indicate that nurses had good resilience, but a significant proportion considered their work demands to be high, and their job satisfaction to be relatively low (5.8 out of 10). The quality of care in their own working unit as regarded as moderate (7.46 out of 10). During the pandemic, 16% of nurses had considered leaving nursing, compared to only 2% before the pandemic.

The results showed that nurses working in outpatient clinics and other units had higher resilience than nurses working in urgent care, acute wards, intensive care, or anesthesia and operative units.

Older nurses estimated their job satisfaction to be better and had fewer intentions to leave both during and after the pandemic than younger nurses. Besides job satisfaction, intentions to leave nursing were also influenced by work demands, with lower demands associated with fewer intentions to leave. For instance, 72% of nurses estimated that their salary in relation to the demands of their work was not appropriate, and 28% felt that their work unit was generally understaffed.

The findings indicate that high resilience among nurses was associated with better quality of care, and contributed to job satisfaction. Better job satisfaction, on the other hand, reduced intentions to leave nursing. However, no direct association was found between the level of resilience and intentions to leave.

According to the researchers, the results highlight the importance of nurses' high resilience during a pandemic, when work demands may increase and job satisfaction may decrease.

"A number of nurses participating in our study had considered leaving nursing, which highlights a clear need to develop effective strategies to maintain quality health care while also supporting nurses' resilience and professional commitment in times of crisis," Saija Sihvola concludes.