Nurse turnover: A literature review - An update

Nurses' intention to leave their profession: a cross sectional observational study in 10 European countries

flinkman m., leino-kilpi h. & salantera s. (2010) Nurses’ intention to leave the profession: integrative review. Journal of Advanced Nursing 66(7), 1422–1434.

Abstract
Title. Nurses’ intention to leave the profession: integrative review.

Aim.  This paper is a report of a study conducted to (1) review and critique the published empirical research on nurses’ intention to leave the profession and (2) synthesize the findings across studies.

Background.  Lack of nurses and nurse turnover represent problems for the healthcare system in terms of cost, the ability to care for patients and the quality of care. At a time of current nursing shortage, it is important to understand the reasons why nurses intend to leave the profession.

Data sources.  A review was conducted through an initial search of MEDLINE, CINAHL and PsycINFO computerized databases for the period from 1995 to July 2009. The keywords for the search were: Nurs* AND (Personnel turnover OR Career Mobility). Research on nurses’ organizational turnover was excluded.

Review methods.  An integrative literature review was carried out using Cooper’s five-stage methodology provided a framework for data collection, analysis and synthesis.

Results.  A total of 31 studies matching the inclusion criteria were identified. Variety in samples, measurement instruments and measures of intention to leave led to difficulties when attempting to compare or generalize study findings. A number of variables influencing nurses’ intention to leave the profession were identified, including demographic, work-related and individual-related variables.

Conclusions.  Further research is needed using sound measurement instruments, consistent measures of leaving intention and more rigorous sampling. More in-depth research is needed to give nurses opportunities to explain in their own words the reasons for their intentions to leave.

Nurses' intention to leave the profession: integrative review.

chan z.c.y., tam w.s., lung m.k.y., wong w.y. & chau c.w. (2013) Journal of Nursing Management 21, 605–613

A systematic literature review of nurse shortage and the intention to leave

Aim  To present the findings of a literature review regarding nurses’ intention to leave their employment or the profession.

Background  The nursing shortage is a problem that is being experienced worldwide. It is a problem that, left unresolved, could have a serious impact on the provision of quality health care. Understanding the reasons why nurses leave their employment or the profession is imperative if efforts to increase retention are to be successful.

Evaluation  Electronic databases were systematically searched to identify English research reports about nurses’ intention to leave their employment or the profession. Key results concerning the issue were extracted and synthesized.

Key issues  The diversified measurement instruments, samples and levels of intention to leave caused difficulties in the attempt to compare or synthesize findings. The factors influencing nurses’ intention to leave were identified and categorized into organizational and individual factors.

Conclusions  The reasons that trigger nurses’ intention to leave are complex and are influenced by organizational and individual factors. Further studies should be conducted to investigate how external factors such as job opportunities correlate with nurses’ intention to leave.

Implications for nursing management  The review provides insight that can be useful in designing and implementing strategies to maintain a sustainable workforce in nursing.

A systematic literature review of nurse shortage and the intention to leave.

Aims. The aim of this study is to examine the relationship between a hospital’s social capital, individual decision latitude, workload and emotional exhaustion in nurses, controlling for age, sex, years of professional experience and job tenure.

Background.  In western countries between 15–45% of nurses working in hospitals suffer from burnout, characterised by emotional exhaustion, depersonalisation and decreased personal performance. The prevention of burnout constitutes a great challenge to those responsible for the health care system, not least because burnout may cause increasing turnover rates in nurses and lead to medical mistakes.

Design.  Survey.

Method.  A questionnaire was mailed to 1325 nurses working at four hospitals in east and west Germany in 2002. Nine hundred and fifty nine nurses responded (response rate: 72·4%).

Results.  Logistic regression identified three significant predictors of emotional exhaustion in nurses: workload (OR: 4·523, CI: 3·230–6·333) was positively associated with emotional exhaustion. Decision latitude (OR: 0·376, CI: 0·254–0·557) and social capital in the hospitals (OR: 0·549, CI: 0·403–0·746) were negatively associated with emotional exhaustion. Emotional exhaustion was not affected by age, sex, years of professional experience and job tenure. Nagelkerke′s Pseudo R2 was 0·225.

Conclusions.  The findings underline the importance of social capital and organisational development in hospital management.

Relevance to clinical practice.  Efforts to create a good working atmosphere with readiness to provide mutual support and the pursuit of joint values in a hospital, the reduction of workload and increased decision latitude may prevent the development of emotional exhaustion in nurses.

M. Laine

Papers

Explaining young registered Finnish nurses' intention to leave the profession: a questionnaire survey.