A Logit Analysis of the Likelihood of Leaving Rural Settings for Registered Nurses

Abstract

This study examined the net effects of individual and community factors on the likelihood of registered nurses leaving current jobs using a logit analysis. Based on data from a survey of 2,509 rural nurses, four separate models were estimated and compared: one for nurses in rural settings as a whole and the other three for nurses in hospitals, skilled nursing facilities, and community/public health agencies. Results of the general model indicated that nurses' marital status, age, position, income, job satisfaction, and satisfaction with the community were significant determinants of the likelihood of leaving current jobs. Job satisfaction was the most significant factor, followed by satisfaction with the community. Findings from the models for three different employment settings were similar to those of the general model. However, the significance of factors and their strength of effect on nurses' decisions to leave or stay in their current jobs differed across the three types of facilities. Based on these findings rural nursing administrators and policy-makers should give priority to retention strategies that focus on improving the job environment. The development of different strategies for different groups of nurses (i.e., by age or marital status) and different types of facilities should increase the benefit/cost ratio. In addition, programs that involve rural health care agencies in community and economic development should be further explored as an avenue to increased nurse retention in rural areas.

Factors Affecting Rapid Turnover of Novice Nurses in University Hospitals

“…Regarding factors related to nurse turnover, age, job title, nursing experience, community satisfaction 2) , marital status 2,11,12) , living together with a child 11) , moving 12) , salary [11][12][13] , burnout 10,23) , job satisfaction 2,4,13,32) , hardness 4) , interpersonal relationships with doctors, senior nursing staff and patients 12,13) , organization commitment 32) , and lumbar pain 33) have been reported. These factors differed from those affecting the rapid turnover of novice nurses in university hospitals.…”

“…Consequently, it is hard to expect that enough nurses with the skills needed to meet today's highly advanced medical standards will be educated. While the turnover of nurses with long careers 1) and the factors affecting it have been investigated [2][3][4] , only a few studies on novice nurses have been conducted 5) . It has been reported that novice nurses find it hard to form an accurate perspective of their profession and to obtain job satisfaction [6][7][8] .…”

“…2,4,[11][12][13] , (3) factors related to their life cycles 2,11,12) , and (4) factors related to their individual characteristics 4) . However, (2), (3), and (4) are assumed to be causes of burnout [14][15][16][17] . It is supposed that these factors form a complex and influence each other.…”

The Use of Contract Licensed Nursing Staff in U.S. Nursing Homes

“…More importantly, job satisfaction among those working as staff nurses in nursing homes was lowest of all work settings. Lower levels of job satisfaction have been linked with increased likelihood of turnover (Pan et al 1995). A recent survey reported annualized turnover rates for nursing home staff RNs and LPNs at 56.2% and 53.6%, respectively (American Health Care Association 2002).…”

The Changing Nature of Rural Health Care

“…The issues that apply to rural primary-care clinicians also apply, although in a more local sense, to nurses. Recent studies find significant nonwage influences on the decision by nurses to enter or remain in a rural setting (64,65).…”