Analyzing U.S. nurse turnover: Are nurses leaving their jobs or the profession itself?

Objective: To examine and compare factors associated with making the decision to vacate a job (organizational turnover) versus leaving the profession (professional turnover) among registered nurses (RN) in the United States (U.S.). Methods: Nationally representative data from the 2008 National Sample Survey of Registered Nurses was used. The sample consisted of 8,796 RNs who held an active RN license as of March 10, 2008, but changed a place of work or left the profession entirely. The analysis has been performed using SAS, version 9.3. Results: The results of binary logistic regression revealed that RNs who reported work-related disability (OR = 14.51; p -value: < .001), illness (OR = 3.32; p -value: < .001), experienced high physical demands (OR = 1.57; p -value: < .001) or burnout (OR = 1.39; p -value: < .001), were unsatisfied with their schedule (OR = 2.16; p -value: < .001), or staffing arrangements (OR = 1.41; p -value: < .001) were more likely to leave the profession. Whereas RNs who reported high levels of stress (OR = 0.59; p -value: < .001) were unsatisfied with the organization’s leadership (OR = 0.22; p -value: < .001), unsatisfied with their opportunity to advance their career (OR = 0.56; p -value: < .001), or were not adequately compensated (OR = 0.63; p -value: < .001), were more likely to leave the organization. Conclusions: Policy makers and health care managers should be aware of the different factors that are associated with RNs’ decision to leave the profession or an organization. Health care managers involved in the development of nurse retention strategies should address organizational leadership and consider development of comprehensive career development programs. Policy makers should consider allocating additional resources to ensure that RN workforce is of adequate size, is qualified, and is able to provide high quality care in the U.S..