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Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

Medscape invited practicing licensed practical nurses (LPNs), registered nurses (RNs), and advanced practice registered nurses (APRNs), which included nurse practitioners (NPs), nurse midwives (NMs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs) from the United States, to participate in an online survey about earnings and career satisfaction. The following slides report the opinions of the entire sample of 10,523 nurses on issues ranging from best and worst aspects of the profession, to whether they would choose nursing again if given the chance to start over. This year, we also focused on some issues specific to early-career nurses (how long it took to find their first job, residency program participation) and later-career nurses (when they expect to retire, retirement preparation).

If you'd like to comment on any of the findings in this report, go to slide 18.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

Many nurses told us that it was tough to pick just one aspect of nursing as the "most rewarding." This slide shows the chief sources of professional gratification for RNs and LPNs, selected from the choices given, in descending order. Like last year, the most frequently chosen factor for both RNs and LPNs was "helping people/making a difference in peoples' lives."

Some choices (not shown on this slide) were selected by ≤ 5% respondents; these included "opportunity to work in a variety of settings" (5% of RNs and 3% of LPNs) and "being respected by nursing colleagues" (3% of RNs and 2% of LPNs). "The amount of money I make" was the top reward for only 2% of RNs and 1% of LPNs.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

Despite significant differences in practice, most APRNs (except CRNAs) identified "helping people/making a difference in peoples' lives" as most rewarding. CRNAs most often cited "working at a job I like," followed closely by "being very good at what I do." NPs and NMs were more likely than either CNSs or CRNAs to select "gratitude/relationships with patients" as most rewarding.

Of interest, among all APRNs, the choice of "gratitude/relationships with patients" was selected more often by early-career (18%) versus later-career (10%) APRNs. Few APRNs overall (1%-4%) identified pay as the most rewarding aspect of their jobs (data not shown).

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

This year, we received a higher volume of comments related to work-life balance. Nurses are increasingly looking for positions with flexible work hours, the ability to work from home, and a Monday-to-Friday workweek, without nights, weekends, or holidays. Clearly, these factors are becoming more important to nurses, and many nurses find them most rewarding. But what respondents are also indirectly praising is the diversity of the nursing profession, allowing them to spend all or part of their careers still as nurses but in positions that are conducive to their lives outside of the work setting. No longer do nurses want to spend 40 years working 12-hour shifts, nights, and weekends on a busy inpatient unit.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

RNs and LPNs most dislike their interactions with "administration" and could do without the workplace politics. The amount of documentation required was in second place for "least satisfying" among RNs, but among LPNs, it was their pay. Small proportions (1%-3%) of nurses selected (as least satisfying) working nights, weekends and holidays, the emotional demands of the job, a lack of gratitude from patients, long shifts, physical job demands, and fear of violence.

Some findings correlated to years in practice. Early-career RNs, with 1-5 years in practice, were more likely than RNs in practice longer than 20 years to choose the high patient load (high patient-to-nurse ratios) as the least satisfying aspect of nursing. Among LPNs, citing "a lack of respect from physicians, managers, or peers" as least satisfying rose with increasing years of practice.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

Among APRNs, some of the differences in what is viewed as "least satisfying" seemed to be related to the type of advanced practice. For example, although the leading complaint for most APRNs was interactions with administration and workplace politics, one group—NPs—believe that "the amount of documentation" is most burdensome, at 27%, whereas only 7% of CRNAs agree. CRNAs were more likely than other APRNs to cite "lack of respect from physicians, managers, and colleagues," and less likely to be bothered by the patient load. NPs who worked in lower-pay settings (academic positions or public health) were more likely to say that their pay is the least satisfying aspect. Working nights, holidays, and weekends was cited more often by CRNAs and NMs than by other groups. NPs in practice for 5 years or less were more likely than those in practice longer than 20 years to believe that insufficient time to support and teach patients was most problematic.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

Respect, it seems, is still the holy grail of workplace interactions. A perceived lack of respect from managers, supervisors, colleagues, and physicians was a conspicuous theme in comments about the least satisfying aspects of nursing jobs, regardless of role. Dealing with insurance companies that dictate patient care or deny reimbursement is a thorn in the side of many NPs. Many respondents believe that their employers aren't flexible, their commutes are too long, their workloads are too heavy, and that they are burdened with too much mandatory overtime and call time. And the lack of autonomy, support, resources, educational or promotion opportunities, benefits, recognition, and competent leadership were all represented in the "other" category of least satisfying aspects of the profession. Once again, the theme of insufficient work-life balance in the nursing professions came through loud and clear.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

We ask this question every year and hear the same answer. Regardless of specialty area, gender, age, and role (LPN, RN, or APRN), the overwhelming majority of nurses say they are glad that they chose the nursing profession. This is good news for patients and healthcare. But when asked whether they would choose nursing again, given the opportunity, a sizable proportion of nurses were not so sure (next slide).

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

At first glance, these findings don't quite square with the 95%-98% of nurses claiming to be glad they became nurses. After all, it's a bit like saying that you are glad you married your spouse, but if you could do it over again, you'd pick someone else. Still, although most nurses would choose nursing again, 15%-21% of nurses said they would, indeed, pursue a different career if they had the chance. Among RNs, men were somewhat more likely than women to assert their preference for a different career (27% versus 21%).

We asked nurses who said they didn't regret becoming nurses whether they wish they'd chosen a different practice setting or a different educational route to reach their current professional role. Nurses are relatively satisfied with their education choices but are less happy with their current practice settings, an interesting finding. Is it a "grass is greener" phenomenon, or does it reflect more awareness of the broad range of options now open to nurses? It's possible that, despite being less than thrilled with where they ended up, nurses like some aspects of their jobs (coworkers, location, hours, or pay) well enough to stick with them, or perhaps they hesitate to relinquish their hard-earned seniority.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

Overall, pursuing a new path and early retirement are the most popular alternatives for those who are dissatisfied with nursing and are planning to take action. LPNs were the most likely of all groups to say that they plan to pursue education or training outside of nursing or to leave nursing entirely for other employment. CRNAs were more likely than other groups to plan to reduce their working hours as a method of coping with job stress, but were least likely to plan to pursue a new path within nursing.

By gender, male RNs were more likely than females to plan to pursue education or training to start a new career, or to leave the nursing profession entirely. Among NPs, women were more likely to plan to retire early. And like last year, APRNs were generally less likely than RNs or LPNs to have a plan to change their current position or job setting.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

What other directions do dissatisfied nurses plan to take? Among respondents who weren't glad that they became nurses (or wouldn't choose nursing again if they had the chance), many simply want to retire. But others expressed a desire for a career change. Finishing or pursuing a higher degree in nursing, enabling them to assume a different professional role, was a frequent answer. Like last year, some want to stay in healthcare but in a different role, such as physician, physician assistant, physical therapist, or even acupuncturist. Many voiced a desire to become a nursing educator or an advanced practice nurse.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

The aging population in the United States, mirrored by the aging population of the country's nurses, is a source of concern to many in the healthcare industry. It's well known that nursing is a demanding profession, and many older nurses are looking forward to a well-deserved retirement, exacerbating the nursing shortage.

Like most professions, nursing has no standard retirement age. So we asked respondents to this year's survey to tell us how long they expected to work. We saw an interesting trend based on age, shown on this slide. Younger nurses expected to retire at a younger age than older nurses. Older nurses who are still practicing expect to be retiring later. This could be a consequence of nurses finding that they aren't as financially ready to retire as they thought they might be early in their careers; or it could be that the most recent generation of nurses simply doesn't plan to work as long as their older nurse peers.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

Wanting to retire and being ready to retire are two different things. We wondered whether nurses' employers were offering any assistance in retirement planning to help nurses be ready when they reach a typical age for retirement. General guidance on retirement planning was the most frequent retirement benefit reported, by 25%-50% of all nurses. Another 15%-36% of nurses are offered reduced hours or part-time work as a transition to full retirement. Few nurses, however, are able to switch to less physically demanding jobs as they approach retirement. But 39%-61% of all respondents report that they receive none of these benefits or accommodations to assist in their retirement from nursing.

Almost half get no assistance with retirement planning. Less than one third of nurses overall are able to reduce their working hours as a transition to retirement. Few nurses are offered less physically demanding work as they approach retirement, suggesting that as they age, they are expected to work at the same pace and the same workload expected of younger nurses.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

Except in cases of disability, financial readiness is often the major factor in the decision about when to retire. Being unprepared financially induces many nurses to continue to work longer than they really want to. We asked older nurses (those who were less than 10 years from retirement) whether they were financially prepared. Even in this group of late-career nurses, we were surprised at the high proportions of nurses who said they weren't financially prepared for retirement.

Financial readiness to retire correlates roughly with the nurses' level of income. CRNAs (who earn the most) are most often (77%) financially prepared to retire, whereas LPNs (who earn the least) are least often (27%) prepared. Only 46% of the largest group of nurses–RNs—say they are financially prepared for retirement.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

On the other end of the career scale, we explored some facts about the early careers of new graduate nurses. We asked those who had been working 5 years or less how long it took to find their first full-time nursing job. How much did it pay? And did new grads have the benefit of a nursing residency program to smooth their transition to professional practice? It seems that the average nurse, whether RN, LPN, or NP, is finding his or her first job relatively quickly, in about 2 months. Starting pay correlates with position. And we found that residency programs are still relatively uncommon. Only 27% of RNs and 13% of NPs participated in these transitional programs when they were first hired.

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

Medscape Nurse Career Satisfaction Report 2017

Laura A. Stokowski, RN, MS; Susan B. Yox, RN, EdD; Mary McBride; Emily Berry | December 13, 2017 | Contributor Information

Tell us what you think.

Do you agree with what your nursing peers find most and least rewarding about nursing? Are you happy with your career choice or would you switch if given the chance? How soon do you expect to retire, and are you financially ready?

Please add your comments at Voice Your Opinion: Medscape Nurse Career Satisfaction Report 2017.

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