Nurses Have High Satisfaction Rates, but Decry Lack of Respect

Alicia Ault

December 13, 2017

The vast majority of nurses — regardless of their role, age, gender, or specialty — said in the latest Medscape survey on career satisfaction that they were glad they became nurses.

The results mirrored results seen every year that Medscape has asked registered nurses (RNs), licensed practical nurses (LPNs), and advanced practice registered nurses (APRNs) the same question. Even so, some 15% to 21% of the 10,523 nurses who responded to the 2017 survey said they might choose a different career if they had to do it all over again.

Among those who were happy they chose nursing, 29% to 41% said they would have gone into a different practice setting. Clinical nurse specialists and nurse midwives were most likely to say they'd have chosen a different practice setting if they were starting over again.

Making a Difference

Survey respondents noted a variety of rewarding aspects of being a nurse, with about 40% of RNs and LPNs putting "helping people/making a difference in people's lives" at the top of the list. A slightly higher percentage of APRNs said helping people was the most rewarding part of their job, with the exception of certified registered nurse anesthetists (CRNAs), who said that being in a job they liked was number one.

A fifth of CRNAs also said that "being very good at what I do" was rewarding.

Money was about the least cited rewarding aspect — with only 1% to 4% of RNs, LPNs, and APRNs noting it as a factor.

New in 2017's survey: More respondents said that having the ability to balance work and home life was increasingly important, citing "flexibility in hours," "working from home," and "having a job that fits my lifestyle" as rewarding aspects of their job.

More nurses want to be able to work in a diversity of settings. Others cited other rewarding aspects of that new diversity: "Doing research along with my usual job to keep me growing," said one respondent.

How About a Little Respect?

The most cited downside of nursing was interactions with the administration and workplace politics, but a lack of respect was also a consistent theme.

About a quarter of LPNs and RNs and 21% to 33% of APRNs said they disliked dealing with the administration and the politics at work. "Administrative pressure to do more with less," was the source of dissatisfaction for one nurse. Others cited "constantly changing policies/regulations," and "insurance and federal regulations dictating patient care," while another decried "too many managers and not enough frontline nurses."

A third of CRNAs said workplace politics and dealing with the administration were the least rewarding aspects of their job. Meanwhile, only 7% cited dealing with paperwork as a downer on the job compared with 27% of nurse practitioners (NPs) and 12% of RNs.

A lack of respect from patients, families, managers, physicians, and peers was frequently cited by nurses as the least rewarding aspect of their job. For LPNs, the lack of respect increased with each year of practice. CRNAs were far more likely than other APRNs to cite lack of respect as a problem.

What's Next?

For nurses who expressed dissatisfaction with their career, most said they were either planning early retirement or would try a new path within nursing.

RNs in particular were most likely to say they'd try a new path within the field, with about a quarter indicating that direction, compared with only 6% of CRNAs. Hovering around 18% to 28% of clinical nurse specialists (CNS) and NPs, respondents said they would stay in nursing but find a new pathway to increase their satisfaction.

Early retirement was the choice of almost a quarter of RNs and just under a third of CNS, far outweighing other specialties.

LPNs were most likely to say they'd try education in a different field — 6% said they would take that path out of nursing compared with 2% to 9% of colleagues.

Gender made a difference when it came to contemplating the next move. Male RNs were more likely to say they'd pursue education or training to start a different career or leave nursing all together.

Only a few nurses had concrete plans for a career change. "Expand my nursing education and study astrophysics," commented one nurse. "Start my own pet-care business from home," stated another. Another respondent said they would open their own diabetes clinic and "work on my own terms."

Not Financially Ready for Retirement

Many nurses seemed to indicate that they planned to simply stay in their jobs as long as possible. Nurses aged 65 years or older said they envisioned working at least 3 more years. Those in their 60s said they might work another 6 to 7 years. 

Interestingly, nurses in their 30s said they planned to retire when they were 60.

But many nurses are not financially or otherwise prepared for retirement — and many are not getting assistance from employers to help them get there. Seventy-five percent of LPNs and CRNAs — and about half of RNs and CNS — said their employer did not give them any guidance on retirement planning.

The majority of nurses are not being offered fewer hours or reduced workloads to help them transition to retirement. And more than 90% of all nurses said they were not being offered less physically demanding work — suggesting they are expected to act in the same capacity as when they were younger.

Among nurses who said they were within 10 years of retiring, only 27% of LPNs said they were financially ready for retirement, while 43% said they were unsure. At the other end of the spectrum, 77% of CRNAs said they were ready. Neither figure is surprising, as it correlates with income, with LPNs earning the least and CRNAs earning the most.

Just under half of RN respondents — 45% of whom were aged 55 to 64 years in this survey — said they felt financially ready for retirement.

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