Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia.
The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.
JAMA Netw Open. 2024 Apr 1;7(4):e244121. doi: 10.1001/jamanetworkopen.2024.4121.
The increase in new registered nurses is expected to outpace retirements, yet health care systems continue to struggle with recruiting and retaining nurses.
To examine the top contributing factors to nurses ending health care employment between 2018 and 2021 in New York and Illinois.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study analyzed survey data (RN4CAST-NY/IL) from registered nurses in New York and Illinois from April 13 to June 22, 2021. Differences in contributing factors to ending health care employment are described by nurses' age, employment status, and prior setting of employment and through exemplar nurse quotes.
Nurses were asked to select all that apply from a list of contributing factors for ending health care employment, and the percentage of nurse respondents per contributing factor were reported.
A total of 7887 nurses (mean [SD] age, 60.1 [12.9] years; 7372 [93%] female) who recently ended health care employment after a mean (SD) of 30.8 (15.1) years of experience were included in the study. Although planned retirement was the leading factor (3047 [39%]), nurses also cited burnout or emotional exhaustion (2039 [26%]), insufficient staffing (1687 [21%]), and family obligations (1456 [18%]) as other top contributing factors. Among retired nurses, 2022 (41%) ended health care employment for reasons other than planned retirement, including burnout or emotional exhaustion (1099 [22%]) and insufficient staffing (888 [18%]). The age distribution of nurses not employed in health care was similar to that of nurses currently employed in health care, suggesting that a demographically similar, already existing supply of nurses could be attracted back into health care employment.
In this cross-sectional study, nurses primarily ended health care employment due to systemic features of their employer. Reducing and preventing burnout, improving nurse staffing levels, and supporting nurses' work-life balance (eg, childcare needs, weekday schedules, and shorter shift lengths) are within the scope of employers and may improve nurse retention.
预计新增注册护士人数将超过退休人数，但医疗保健系统仍在继续努力招聘和留住护士。
在 2018 年至 2021 年期间，研究纽约州和伊利诺伊州的护士离职的主要原因。
设计、地点和参与者：本横断面研究分析了 2021 年 4 月 13 日至 6 月 22 日期间来自纽约州和伊利诺伊州注册护士的 RN4CAST-NY/IL 调查数据。通过护士的年龄、就业状况和先前的就业环境，以及具有代表性的护士引语，描述了导致离职的因素的差异。
护士被要求从离职的原因列表中选择所有适用的原因，按护士比例报告每个原因的百分比。
共有 7887 名护士（平均[标准差]年龄为 60.1[12.9]岁，7372[93%]为女性）在平均（标准差）30.8（15.1）年的工作经验后最近结束了医疗保健工作，包括计划退休（3047[39%]）、 burnout 或情绪疲惫（2039[26%]）、人手不足（1687[21%]）和家庭责任（1456[18%]）等其他主要离职原因。在退休护士中，2022 年（41%）因非计划退休以外的原因结束医疗保健工作，包括 burnout 或情绪疲惫（1099[22%]）和人手不足（888[18%]）。不在医疗保健领域工作的护士的年龄分布与目前在医疗保健领域工作的护士相似，这表明已经存在的、在人口统计学上相似的护士可以被吸引回医疗保健工作。
在这项横断面研究中，护士主要是由于雇主的系统特征而离职。减少和预防 burnout，提高护士的人员配备水平，以及支持护士的工作-生活平衡（例如，儿童保育需求、工作日程和更短的轮班时间）都在雇主的范围内，可能会提高护士的留任率。
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