Longevity at the Bedside: Exploring Why Nurses Stay

Registered nurses (RN) are an essential part of maintaining a stable healthcare workforce. The RN workforce assists healthcare organizations in providing safe and quality care and to remain fiscally strong (Duffield, Roche, Homer, Buchan, & Dimitrelis, 2014; Gilmartin, 2013; Lartey, Cummings, & Profetto-McGrath, 2014; Mokoka, Ehlers, & Oosthuizen, 2011). Although the RN workforce is 2.7 million strong (U.S. Bureau of Labor Statistics, 2015), the nursing shortage is not a new concept in healthcare. An abundance of research exists related to new graduate nurse turnover, however little focus has been given to why experienced nurses remain as frontline staff in acute care hospitals for periods of ten years or more. The large bodyof literature names individual and organizational reasons for nurse turn over, these are: unhealthy work environments, unit type and cohesion, and dissatisfaction in work-life quality (Djukic, Kovner, Brewer, Fatehi, & Greene, 2014; Homberg, Van Der Heijden, & Valkenburg, 2013; Klaus, Ekerdt, R Gajewski, 2012; Lachman, 2015). In the rapidly changing world of healthcare today, it is imperative to discover why experienced RNs remain as frontline staff in acute care facilities. The examination of the motives of why nurses stay, rather than why nurses leave, may have implications for nursing administration and healthcare organizations. Healthcare organizations are faced with increased acuity of patients, an aging population and an aging nursing workforce. Frontline nursing is stressful, taking place in chaotic care environments in which nurses are facing additional demands each day. Learning the motivation of the experienced nurse to remain in hectic, frenzied and difficult care environments is paramount to healthcare organizations continued struggle to provide safe, quality, fiscally responsible care. The target population is RNs currently employed and providing frontline care on inpatient units for ten years or longer. Qualitative and quantitative research, using two questionnaires and an open-ended question, was conducted to examine organizational commitment, resiliency, and motivations of RNs to stay within one organization. A convenience sample of electronic surveys were submitted via professional internet sites such as Sigma Theta Tau International, the Indiana State Nurses Association, and the American Nurses Association. The Organizational Commitment Questionnaire (OCQ) is a valid and reliable 15 item, Likert-type tool used to measure an individual’s willingness to give something of themselves to contribute to the success of an organization (Mowday, Steers, & Porter, 1979). The Connor Davidson Resiliency Scale-25 (CD-RISC-25) is a 25-item valid and reliable self-rated questionnaire measuring resiliency (Davidson & Connor, 2017). The open ended question “What has kept you at your current organization” was added to the OCQ to specifically discover why RNs remained at the current facility for ten years or more. Statistical analysis for this was done using data collected from Survey Monkey electronic services and then placed into Excel for analysis. The raw number of respondents was 230 (N=230). Respondents were from the east north central and middle Atlantic regions of the United States. Following disqualification of surveys for incompleteness (n=67), and less than ten years at current facility (n=45), inclusion surveys totaled 118 (N=118). Answers to the question of what has kept the RN at their current organization for ten years or more were listed, tallied, and divided into groups. The aspect with the largest frequency is coworkers (n=42). Flexible schedule (n=23) and patient population (n=20) were the two aspects with the next highest frequency. Other job aspects included teamwork, patient care, autonomy, position, and skill level. The Organizational Commitment Questionnaire (OCQ) and Connor-Davidson Resiliency Scale-25 (CD-RISC-25) were analyzed, the mean and median identified as well as the standard deviation (74.8, 80.6, 75, 83, 16.8, 12.9). There was a weak correlation (r=-0.0075) between the OCQ and CD-RISC-25, however the surveys were not significant with a p<0.05 and p<0.10.