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Why nurses stay – and why they go

A study that takes a generational approach to exploring nurses’ attachment to the workforce has thrown up some surprising findings. 

Considering the impact of a nurse’s generation on their intent to continue in the profession may yield some effective retention strategies.

At a recent seminar, associate professor Kate Shacklock, from Griffith Business School in south-east Queensland, discussed some of her research on Generation Y, Generation X and baby boomers and the implications of understanding each group’s relationship with work.

Shacklock said considering this relationship can help keep nurses in the profession. “If we don’t have some strategies to help us keep our quality nurses, then we’re in deep trouble,” she said. “The more information we have, the better.”

By recognising differences between and similarities within each generation – while keeping in mind that there are often discrepancies – hospital management can gain a better understanding of what is crucial to staff, she said.

In a study she conducted involving 900 nurses, both full-time and part-time, one variable that was tested against the three generations was the perception of autonomy. This was significant for baby boomers (born between 1946 and 1964) who are usually well-qualified or well-practiced in the area in which they work and want to have some say on how they do their job based on their experience and skill, she found.

Baby boomers were also the only group to highlight the importance of interpersonal relationships at work and of working to them as an individual.

Gen X (born 1965 to 1979) identified satisfaction with the relationship between the supervisor and the subordinate as a focal point. Shacklock said this was perhaps because Gen X nurses might typically have young or school-aged children and their supervisors were the ones who could change their roster to allow them days off should they be needed.

In the study, flexible working conditions were not seen to be essential. Shacklock said this was a surprise and it wasn’t in keeping with a lot of the literature and even her own research. She said one explanation for this could have been that there was enough flexibility in the nurses’ rosters for it not to be a concern.

An attachment to work and passion for nursing was the only variable seen to be important for all three generations, but it was also the only one significant to Gen Y (1980 to 1994). “It’s not what we’d have expected from Gen Y,” Shacklock said. “We’d have expected flexibility to be significant as well ... and certainly autonomy because these people are coming out of university highly trained and ready to get stuck into their job.”

She said that they could still be feeling insecure and inexperienced. “They may want to follow procedure,” she said. “They want to be sure that everything is safe and correct.”

Another variable that wasn’t highlighted by Gen Y was work-family conflict. Surprisingly, it was only particularly relevant to baby boomers. “They’re heading up towards 65,” Shacklock said, “so this could well be due to having to care for grandchildren or elderly parents rather than children.”

One factor that particularly contributed to nurses leaving the profession was having children and childcare responsibilities, Shacklock said. That was why she was surprised work-family conflict was only seen to be significant by the baby boomers.

The main reasons why nurses leave the profession, she said, were typically related to health and finance, which to some extent continued down through all the generations.

When nurses left the workforce, a major negative consequence, of course, was the cost of training new nurses to replace them. Shacklock described this cost as not only being related to training but also to the less tangible loss of the implicit knowledge and experience that each nurse took with them when they left.

Knowledge about patients, about how the hospital and the wards run, about office politics and best practice can all be lost, she said.

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One comment

  1. I’m a baby boomer who came late to nursing after many years in educational research and administration. The outcomes of this survey don’t surprise me, I got that “yesssss!” feeling when I read the story above! I’d love to see more studies done on this – I have done research on retaining volunteers, and to some extent nursing as a “vocational occupation” where the work is more important than the remuneration, is rather similar. Most nurses I know don’t work full time and very few have fixed rosters, so I can understand why flexibility isn’t an issue – most common pattern I’ve found is the old “4 on 4 off”, which is about 80% full time.

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