Nursing Career Fulfillment: Statistics and Statements From Registered Nurses

Carol Reineck; Antonio Furino

Disclosures

Nurs Econ. 2005;23(1):25-30. 

In This Article

Executive Summary and Introduction

Executive Summary

  • While numerous studies have quantified the challenging aspects of the nursing profession today in terms such as vacancy and turnover rates, fewer have truly "qualified" the personal aspects of being a nurse in verbatim terms such as "unmanageable" and "impossible."

  • This study attempts to complement existing data with deeper meaning about the complexity and intensity of the nursing experience.

  • The survey of nurses (N=801) from Texas addressed issues such as compensation, personal health, and work environment.

  • Several themes emerged from the survey including a clear statement that nurses love the "intrinsic rewards of nursing" with equally clear statements about negative aspects of their career.

  • Compensation was frequently cited as a dissatisfier with respect to issues like recruitment being valued more than retention, wage compression for bed-side roles, and minimal differentiation for expertise.

  • Stressors named by nurses were multi-faceted: paperwork, patient complexity, turnover, and overtime.

  • Feedback related to workload was notably intense with comments such as "powerfully overwhelming."

Introduction

Health care organizations and communities face unprecedented challenges with regard to the supply and importance of the registered nurse (RN) workforce to promote quality patient outcomes. Important national trends form a context for these challenges. These include rapid aging and retirement of members of the RN workforce and the national mandate to reduce morbidity and mortality in hospitals. The rapid aging of the RN workforce (American Hospital Association (AHA), 2002; American Organization of Nurse Executives/NurseWeek, 2002; Auerbach, Buerhaus, & Staiger, 2000), portends the "perfect storm:" escalating nurse retirements in an era of increasing demand for nursing services. Compounding the issue is the decreased number of potential workers in the future (AHA, 2002). Clear evidence supporting the relationship between the level of staffing by nurses and the quality of care (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002; Needleman, Buerhaus, Mattke, Stewart, & Zelevinsky, 2002) reveals that a higher proportion of hours of nursing care provided by RNs and a greater number of RN care hours per day are associated with better outcomes for hospitalized patients.

Much of the evidence about the nursing shortage is quantitative in nature; that is, statistical or numerical descriptions of workforce trends and patient record reviews form the basis for much of our information about the nursing shortage. Groups or populations have been the units of analysis; that is, the element or basis for the analysis of research data. In contrast, analyses of written statements and expressions from individual RNs are missing from many of the statistical descriptions and reports. The value of such analysis at the individual level to complement numerical data is two-fold. First, the analysis of written statements confirms and amplifies the quantitative data. Second, statements written by RNs contribute to "thick description" of the quantitative data, contributing to increased understanding (Krippendorff, 1980).

The purpose of this article is to describe a regional RN workforce study which confirmed findings at the national level and raises new issues. Results center on economics, health, employment, work environment, and work satisfaction. The reader will see quantitative results on these issues as well as samples of narrative text.

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