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Background
Retention of current staff and recruitment of new staff is a primary concern for nurse executives throughout the country. A review of the recent literature reveals several articles on workforce trends, but few research articles related to recruitment and retention. Trending of nursing workforce data indicates a pending nursing shortage that will result in a deficit of nursing personnel twenty percent below the predicted need by the year 2020 (Buerhaus, Staiger & Auerbach, 2000). This shortage is believed to be different from previous nursing shortages because of the driving forces: an aging workforce, an aging population, a decrease in cohort size, and a decrease in nursing school enrollment.
Workforce Trends
- Two-thirds of the RN workforce are over 40 years old
- Nurses have migrated from acute care settings into the community (Health Care Advisory Board, 2000)
- The acuity level of patients in acute care settings has increased
- RN employment growth has declined from 3-4% annually to 1-2% annually (Buerhaus & Staiger, 1999)
- RN employment is expected to steadily decline after 2007 (Buerhaus, Staiger & Auerbach, 2000)
- Inflation-adjusted RN wages changed very little between 1983-1997 (Buerhaus & Staiger, 1999)
- There is an increased demand for unlicensed assistive personnel, advanced practice nurses, BSN prepared nurses, and master’s prepared managers (Cleary, Lacey, & Beck-Warden, 1998)
Recruitment
- Most efforts are focused on recruitment rather than retention (Advisory Board, 2000)
- Non-financial factors are important including professional interaction, direct praise, flexible work schedules, and supportive environments (Burns, 1999)
- Recruitment in long-term care continues to be problematic (Robertson & Cummings, 1996)
- Recruitment efforts should include encouragement of students to enter nursing as a career
Retention
- Intent to stay and job satisfaction are related to effective leadership, autonomy, and collaborative relationships (Fisher, Hinson & Deets, 1994; Mills & Blaesing, 2000)
- Professional status, patient care rewards, and pride in the profession are variables associated with career satisfaction (Mills & Blaesing, 2000)
- Self-esteem, a need to be needed, and the ability to recognize one’s limitations relate to retention (Muncey, 1998)
- Level of commitment is predictive of turnover
- Recognition of nurses from clients and the public influences retention (Becherer, 1999)
Implications
- Action to address the pending shortage is imperative
- Further research is needed regarding regional workforce issues, successful retention/recruitment efforts, influencing student career choice, and providing inviting work environments without sacrificing patient care
- Front-line managers are key players in staff retention
- The Tri-Council Policy Statement (AACN, ANA, AONE, NLN) recommendations include:
- Developing career progression initiatives to move nursing students through graduate school more rapidly;
- Instituting systems to promote more equitable compensation with a better understanding of the educational preparation required for different roles;
- Supporting staff development and life-long learning;
- Promoting recruitment of youth from diverse populations into nursing;
- Implementing specific retention strategies such as flexibility in work environment and scheduling, rewarding experienced nurses who serve as mentors to novice nurses, and implementing appropriate salary and benefit programs;
- Creating a partnership environment by establishing appropriate management structures, ensuring adequate staffing, and providing autonomous work environments;
- Designing ergonomically sensitive work environments for older nurses;
- Advocating for increased federal and other funding for nursing education;
- Advocating for better identification and recognition of nursing services within reimbursement systems;
- Investigating the potential for technological advances to enhance the capacity of a reduced nursing workforce;
- Developing models for health workforce planning;
- Promoting consistent data collection to enable appropriate workforce planning.
Prepared by:
Ann Moore, MSN, RN
RPMoore@prodigy.net
University of Tennessee
March 2001Ms. Moore completed the above work in partial fulfillment of course requirements for N582, Scholarly Inquiry for Advanced Practice Nursing. Ms. Moore has prepared a review of the research literature on the topic of recruitment and retention of nurses in the work place. She is also participating in a statewide nurse staffing survey of hospitals that is sponsored by the Tennessee Center for Nursing, Inc. Requests for information should be directed to Nancy B. Moody at Nmoody@lmunet.edu.
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