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Overview

Across a wide variety of surveys and studies, both nurses on the job and those who have left the profession focus on a few central factors as the key to recruitment and retention. Topping every list are pay and staffing levels, including myriad issues, such as reasonable scheduling options or having enough time with patients, that stem from staffing levels. The Nursing Executive Center, for instance, asked RNs to rank job attributes on a scale of 1 to 100, to identify those factors that matter the most to nurses when deciding to take, continue or leave a job.97 The highest-ranking factors were reported as follows:


  • Compensation: 31.7
  • Scheduling options: 24.3
  • Intensity of work: 14.6
  • Competence of clinical staff: 7.4
  • Growth opportunities: 7.3
  • Support services: 5.9
  • Effectiveness of direct manager: 4.7
  • Participation in decision making: 2.4
  • Recognition: 1.8

These attributes were ranked in the same order by all subgroups, including age, specialty, years since obtaining the RN degree, tenure at current hospital, union status, level of job satisfaction, expected tenure in job, or income.98

One of the most comprehensive recent survey was conducted in New Hampshire, drawing on focus groups and random surveys of both practicing and non-practicing licensed nurses. Both groups identified the same improvements as critical to enabling them to continue working in nursing: a raise in pay, more time for patient care, and more understanding from administration and supervisors regarding burnout issues.99 More specifically, practicing nurses (in hospitals and other health care settings) identified the following issues as the greatest sources of stress on the job: staff shortages, lack of time to take care of patients,unrealistic workloads, inadequate pay, lack of promotional opportunities, lack of understanding from administration about the demands of the job, a perceived lack of respect, poor relationships with doctors and co-workers, and a poor work environment in general.100 When nurses were asked what would help retention, their responses focused on these same critical issues:

  • More than 80 percent stated that a raise in pay would help retention; only 36 percent felt they were being paid a fair wage.
  • More than one-third cited the need for support and understanding about burnout.
  • More than 40 percent cited the need for more time with patients.
  • More than 20 percent responded that more time off would help.
  • More than 20 percent cited a need for better or different benefits.
  • Almost 20 percent reported that flex time would help.
  • About 8 percent reported that training opportunities would help.101


Among licensed nurses who are choosing to work in other occupations, 45.7 percent cite more convenient hours as one of their reasons for leaving nursing, 35.4 percent cite better salaries, 19.7 percent cite concerns over workplace safety, and 44.9 percent said their new job is "more professionally rewarding."102

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