University at Buffalo - The State University of New York

Published: September 6, 2007

By LOIS BAKER
Contributing Editor

What keeps a newly licensed nurse on the job? Answers to that question are important to hospitals across the U.S., many of which are confronting serious nursing shortages.

A study by Carol Brewer has found that lowering stress and improving management were key to keeping nurses on the job.

Based on results of a study to be published this month in the American Journal of Nursing, the top two priorities for hospitals to address the retention issue are improving nursing management and taking steps to reduce on-the-job stress.

The study surveyed the work experience of nurses from 35 states who obtained their first license between Aug. 1, 2004, and July 31, 2005, and had been employed for up to 18 months. Of the 3,226 respondents, 610 already had left their first job—41.8 percent due to poor management and 37.2 percent because of stressful work conditions. Another 34 percent changed jobs because they wanted to get experience in a different clinical area.

Carol S. Brewer, associate professor in the School of Nursing, was co-principal investigator on the study. Christine T. Kovner, professor at New York University's College of Nursing and senior fellow at the Hartford Institute for Geriatric Nursing, was first author and principal investigator.

"This study helps to establish baseline data about a population that is particularly important, both to the nursing profession and our health care system," said Brewer. "There is much conventional wisdom about the experiences of newly licensed nurses, but little fact. This study helps to fill that void and provide insight into their career choices."

The nurses who responded will be followed for three more years to collect more information on conditions responsible for turnover.

"This study provides invaluable insight into the challenges health care organizations must address to correct working conditions that undermine patient care and cause nurses to leave their jobs—and sometimes leave the profession," said Susan Hassmiller, leader of the team that focuses on health care workforce issues at the Robert Wood Johnson Foundation in Princeton, N.J., which funded the study.

"We are committed to ensuring the highest quality of care for people in this country, and nurses are critical to achieving that goal."

Results showed that the nurse-respondents generally were pleased with their jobs, and reported positive work-group cohesion. They reported not having enough support from their supervisors, however. More than one-third indicated they intended to search for a new position in one year, but not necessarily outside of nursing.

Newly licensed nurses considered their jobs difficult, and they worked long hours: 51 percent worked voluntary overtime, 13 percent mandatory overtime. Sixty-one percent were assigned to nights, evenings or rotating shifts. Nearly two-thirds—62.78 percent—said their work interfered with family life on at least four days a month, according to the results.

Survey participants also reported a somewhat hazardous working environment: A quarter of respondents sustained at least one needle-stick in a year, 39 percent at least one strain or sprain, 21 percent a cut or laceration, 46 percent a bruise or contusion and 62 percent reported experiencing verbal abuse on the job. A quarter found it "difficult or impossible" to do their jobs at least once a week due to inadequate supplies, the study showed.

"Findings have shown that the work environment for newly licensed RNs has both positive and negative aspects," said Brewer. "Future analyses will focus on evaluating these factors' contributions to the new RNs' longevity in their workplace and nursing."

Additional contributors to the study were Susan Fairchild, project director in the NYU College of Nursing; Shakthi Poornima, doctoral student in the UB Department of Linguistics; Hongsoo Kim, assistant professor, and Maja Djukic, research assistant, both at NYU's College of Nursing.