AN EXPLORATION OF REGISTERED NURSES’ INTENTIONS TO LEAVE THE PROFESSION

Stacy Lutter, D.Ed., MSN, RN-BC

Assistant Professor of Nursing

York College of Pennsylvania

slutter@ycp.edu

BACKGROUND

What is the current shortage of registered nurses? Shortage predictions Impact on healthcare Complicating factors

What is the current composition of the nursing workforce?

What are the reasons nurses leave nursing?

STATEMENT OF THE PROBLEM

“It is not a matter of looking harder or more closely, but of seeing what frames our seeing—spaces of constructed visibility and incitements to see which constitute power/knowledge.”

(Lather, 1993)

STUDY PURPOSE

To explore the perceptions of female registered nurses who have intentions to leave the profession.

RESEARCH QUESTIONS What factors have influenced a female registered

nurse’s intentions to leave the profession?

How do female registered nurses who have intentions to leave the profession perceive their practice in a female dominated profession?

How do female registered nurses who have intentions to leave the profession perceive the influence of gender on their decision?

STUDY DESIGN Basic interpretive

Semi-structured interviews

Participant criteria: have a serious intention to leave the

profession. have actively searched for other jobs or have

taken steps to prepare for another career that does not require a nursing qualification.

are not looking to exit the workforce completely.

are currently working in a patient care position. have at least 3 years of experience in nursing.

Participant’s Name

Age Race Years in Nursing

Current work setting

Career Plans

Genevieve 29 White 6 Emergency Department

Expanding home based beauty business

Betsy 59 White 29 Orthopedic unit Position in healthcare outside of nursing

Millie 42 Black 14 Maternity unit Teacher

Rose 38 White 15 Cardiac unit Real estate

Flash 55 White 33 Home care Position in healthcare outside of nursing

Ebony/Ivory 30’s Black 3 Medical surgical unit

Teaching or language interpretation

Deedee 49 White 27 Neonatal intensive care

Pet-sitting business or teaching management in an academic setting

Mary 57 White 36 Pediatric home care

Secretarial work or healthcare administration

Nanny 54 White 29 Patient and employee education

Episcopalian priest

Jewelrylady 32 White 6 Home care (recently resigned)

Expanding home based jewelry business

Moon 54 White 31 Home care Writer

FINDINGS

Five Major Themes:Feelings of duty and obligationThe power distribution in the hierarchyGrowing incongruity between working

conditions and patient care Interpersonal communicationShifting perspectives on work and self

FINDINGS

Feelings of duty and obligation In relation to family In relation to others

FINDINGS

Power dynamics of the hierarchy Positionality in the Hierarchy Lack of Compensation (The Catch 22) Lack of Opportunities (Feeling stuck) Inaccessibility to Power structures (Lack of voice)

FINDINGS

Growing incongruity between working conditions and patient care Workload Physical environment Technology

FINDINGS

Interpersonal communicationCommunication between nurses

Negative behaviors related to stress “cattiness” “eating their young”

Approach to Diversity

FINDINGS

Shifting perspectives on work and selfSeparating work from selfFinding PassionConcerns about economic

reality of leaving

DISCUSSION

Factors in the work environment influenced the decision to leave nursing.

Receiving mixed messages regarding patient care is a source of dissatisfaction.

Incidents of ineffective communication were not typically reported.

Not all reasons for leaving nursing are negative.

SIGNIFICANCE OF THE STUDY

Recommendations for Nursing Education: Increase dialogue in the classroom to encourage

the development of voice Discuss organizational structures present in the

healthcare workplace Teach techniques of self-nurturance Provide opportunities for debriefing and self-

reflection

SIGNIFICANCE OF STUDY

Recommendations for Workplace Education: Create an environment that values participation

in decision-making Provide opportunities for professional

development Facilitate a collaborative approach to patient

care among healthcare providers Provide opportunities for debriefing