Nursing News

Why Have Nurses Left the Profession?

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By Debra Wood, RN, contributor

More than 120,000 nurses are working outside of the profession in a diverse range of jobs, according to a new study, which also discovered that dissatisfaction with the nursing workplace is a key reason for RNs leaving their chosen field.

“We really need to address workplace issues so we can retain [nurses] after we recruit them to the profession,” said lead author Lisa Black, Ph.D., RN, an assistant professor in the Orvis School of Nursing at the University of Nevada, Reno.

Lisa Black
Lisa Black, Ph.D., RN, found that more than 27 percent of nurses working outside the profession cited burnout or stressful work environments as a reason for leaving the profession.

Black and colleagues sought to learn more about U.S. nurses who are active in the labor market but working outside of the nursing profession. While talking with legislators, hospital leaders and others to shape health policy, Black found the policy makers appreciated the anecdotal stories she relayed, but asked for data. Black hopes her recent research and data will provide answers and encourage changes to the environment.

“Frustration with the workplace shows there is room for policy work,” added Joanne Spetz, Ph.D., associate professor in the Department of Community Health Systems at the University of California, San Francisco School of Nursing, a co-author of the paper. She hopes the paper provides evidence that chief nursing officers can use to convince financial and administrative officials to improve the work environment, which would boost retention and save on recruitment costs.

The team used data from the 2004 National Sample Surveys of Registered Nurses, a sample of 35,635 registered nurses from all 50 states and the District of Columbia.

The researchers found 4.2 percent of the 2.9 million registered nurses licensed to practice in the United States were working in non-nursing employment and 12.1 percent were not working at all.

Joanne Spetz
Joanne Spetz, Ph.D., hopes the research she conducted helps provide CNOs with data to convince administrators of the need to improve work environments for nurses.

Nurses not working cited retirement (44.6 percent) and home and family obligations (38.4 percent) as the reason for their not participating in the labor market. More than 27 percent cited burnout or stressful work environments, 23.4 percent the physical demands, 20 percent inadequate staffing, and 20 percent said inconvenient scheduling were reasons for not working.

The authors found that nurses state retirement as a reason for not working at younger ages than other female-dominated professions, such as teaching or secretarial work. Nearly half of the respondents, between the age of 45 and 64 years, who are not working in nursing (44.7 percent) indicated they were retired.

Of the nurses employed in positions other than nursing, 15.8 percent were working for a health-related service provider and 4.2 percent were working in pharmaceutical sales. Another 15.4 percent said they held administrative or management positions, and 3.4 were working in a faculty or instructor role.

“Not all of those nurses working outside the nursing profession are doing something that isn’t valuable to the health care system,” Spetz said. “Their nursing experience has been very important.”

Nurses also might be working as legal nurse consultants, teaching health education courses or collaborating with software developers on information technology solutions for health care. Many of the nurses who stated they work in government may be in regulatory roles. Spetz expects half of the nurses who reported that they are working outside of nursing are still doing something related to health care.

The paper states that nurses who worked outside of nursing predominantly cited career change (65.8 percent), burnout/stressful work environment (41.3 percent), scheduling challenges or working too many hours (38.7 percent), better pay in non-nursing employment (31.4 percent), inadequate staffing (30.8 percent) and the physical demands of working in nursing (25.8 percent) as reasons for seeking employment outside of the nursing workforce.

According to the survey, younger nurses were more likely to cite workplace concerns than older nurses, 91 percent for nurses younger than age 30 vs. 63.8 percent for nurses age 45 years to 64 years. Nurses who had been out of school the least amount of time were the most likely to be working outside of nursing due to concerns with the nursing workplace.

The authors urge nursing leaders and decision makers to develop strategies that will retain nurses and offer incentives for those who have left to return to the nursing workforce. Black said nurses have the power to make those changes, if they come together.

“Only through decided efforts to address these continued gaps in existing health policy will nursing, the health care industry, and policy makers be able to meet the nursing needs of future generations,” the authors concluded.

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