Predictors of actual turnover in a national sample of newly licensed registered nurses employed in hospitals

Journal of Advanced Nursing

Volumn 68, Issue 3, 2012, Pages 521-538

  Brewer, Carol S ^a   Kovner, Christine T ^b   Greene, William ^b   Tukov Shuser, Magdalene ^a   Djukic, Maja ^b  

^a UNIVERSITY AT BUFFALO   (United States)

^b NEW YORK UNIVERSITY   (United States)

Author keywords

Hospital injury; Nurses; Nursing staff turnover; Organizational commitment; Registered nurse; Working conditions

Indexed keywords

ADOLESCENT; ADULT; AGE; AGED; ARTICLE; BEHAVIOR; DEMOGRAPHY; EMPLOYMENT; FEMALE; HEALTH PERSONNEL ATTITUDE; HUMAN; JOB SATISFACTION; LICENSING; LONGITUDINAL STUDY; MALE; MIDDLE AGED; NURSING ADMINISTRATION RESEARCH; NURSING STAFF; OCCUPATIONAL ACCIDENT; ORGANIZATION AND MANAGEMENT; PERSONNEL MANAGEMENT; REGRESSION ANALYSIS; STATISTICS; UNITED STATES;

ADOLESCENT; ADULT; AGE FACTORS; AGED; ATTITUDE OF HEALTH PERSONNEL; DEMOGRAPHY; EMPLOYMENT; FEMALE; HUMANS; INTENTION; JOB SATISFACTION; LICENSURE, NURSING; LONGITUDINAL STUDIES; MALE; MIDDLE AGED; NURSING ADMINISTRATION RESEARCH; NURSING STAFF, HOSPITAL; OCCUPATIONAL INJURIES; PERSONNEL LOYALTY; PERSONNEL TURNOVER; REGRESSION ANALYSIS; UNITED STATES; YOUNG ADULT;

EID: 84856784475     PISSN: 03092402     EISSN: 13652648     Source Type: Journal    
DOI: 10.1111/j.1365-2648.2011.05753.x     Document Type: Article

References (109)

1. Altier M.E. & Krsek C.A. (2006) Effects of a 1-year residency program on job satisfaction and retention of new graduate nurses. Journal for Nurses in Staff Development 22(2), 70-77.
2. American Association for Public Opinion Research (AAPOR) (2004) Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys, 3rd edn. American Association for Public Opinion Research (AAPOR), Lexana, KS.
3. American Association of Colleges of Nursing (AACN) and the University Health System Consortium (UHC) (2007) The UHC/AACN Nurse Residency Program. Retrieved from on 10 January 2009.
4. Anderson T., Linden L., Allen M. & Gibbs E. (2009) New graduate RN work satisfaction after completing an interactive nurse residency. Journal of Nursing Administration 39(4), 165-169.
5. Beecroft P.C., Kunzman L. & Krozek C. (2001) RN internship: outcomes of a one-year pilot program. Journal of Nursing Administration 31(12), 575-582.
6. Beecroft P.C., Dorey F. & Wenten M. (2008) Turnover intention in new graduate nurses: a multivariate analysis. Journal of Advanced Nursing 62(1), 41-52.
7. Beyea S.C., von Reyn L. & Slattery M.J. (2007) A nurse residency program for competency development using human patient simulation. Journal for Nurses in Staff Development 23(2), 77-82.
8. Bingham J.B., Boswell W.R. & Boudreau J.W. (2005) Job demands and job search among high-level managers in the United States and Europe. Group & Organization Management 30(6), 653-681.
9. Blau G. (2007) Does a corresponding set of variables for explaining voluntary organizational turnover transfer to explaining voluntary occupational turnover? Journal of Vocational Behavior 70(1), 135-148.
10. Borenstein M., Rothstein H. & Cohen J. (2001) Power and Precision. Biostat, Inc., Englewood, NJ.
11. Brewer C.S. & Kovner C.T. (2008) Work satisfaction among staff nurses in acute care hospitals. In Nursing Policy Research: Turning Evidence-Based Research into Health Policy (Dickson G.L & Flynn L.R., eds), Springer Publishing Company, New York, NY, pp. 127-142.
12. Brewer C.S., Kovner C.T., Wu Y., Greene W., Liu Y. & Reimers C.W. (2006) Factors influencing female registered nurses' work behavior. Health Services Research 41(3), 860-866.
13. Brewer C.S., Kovner C.T., Greene W. & Cheng Y. (2009) Predictors of RNs' intent to work and work decisions 1year later in a U.S. national sample. International Journal of Nursing Studies 46(7), 940-956.
14. Brooks C. & O'Neill B.S. (2004) Job embeddedness: a theoretical foundation for developing a comprehensive nurse retention plan. Journal of Nursing Administration 34(5), 216-227.
15. Camerino D., Conway P., van der Heijden B., Estryn-Béhar M., Costa G. & Hasselhorn H. (2008a) Age-dependent relationships between work ability, thinking of quitting the job, and actual leaving among Italian nurses: a longitudinal study. International Journal of Nursing Studies 45(11), 1645-1659.
16. Camerino D., Estryn-Behar M., Conway P., van Der Heijden B. & Hasselhorn H. (2008b) Work-d factors and violence among nursing staff in the European NEXT study: a longitudinal cohort study. International Journal of Nursing Studies 45(1), 35-50.
17. Cartledge S. (2001) Factors influencing the turnover of intensive care nurses. Intensive & Critical Care Nursing 17(6), 348-355.
18. Castle N.G. & Engberg J. (2006) Organizational characteristics associated with staff turnover in nursing homes. The Gerontologist 46(1), 62-73.
19. Center for Studying Health System Change (2003) Community Tracking Study Site-County Crosswalk, 2000-2001 (No. 39). Center for Studying Health System Change, Washington, DC.
20. Chen H., Chu C., Wang Y. & Lin L. (2008) Turnover factors revisited: a longitudinal study of Taiwan-based staff nurses. International Journal of Nursing Studies 45(2), 277-285.
21. Coomber B. & Barriball K.L. (2007) Impact of job satisfaction components on intent to leave and turnover for hospital-based nurses: a review of the research literature. International Journal of Nursing Studies 44(2), 297-314.
22. Crossley C.D., Bennett R.J., Jex S.M. & Burnfield J.L. (2007) Development of a global measure of job embeddedness and integration into a traditional model of voluntary turnover. Journal of Applied Psychology 92(4), 1031-1042.
23. Delfgaauw J. (2007) The effect of job satisfaction on job search: not just whether, but also where. Labour Economics 14(3), 299-317.
24. Dillman D.A. (2007) Mail and Internet Surveys: The Tailored Design Method, 2nd edn. John Wiley & Sons, Inc., New Jersey.
25. Donoghue C. & Castle N.G. (2007) Organizational and environmental effects on voluntary and involuntary turnover. Health Care Management Review 32(4), 360-369.
26. Duchscher J.B. (2008) A process of becoming: the stages of new nursing graduate professional role transition. Journal of Continuing Education in Nursing 39(10), 441-450.
27. Duchscher J.B. (2009) Transition shock: the initial stage of role adaptation for newly graduated registered nurses. Journal of Advanced Nursing 65(5), 1103-1113.
28. Finley A.P., Mueller C.W. & Gurney C.A. (2004) Organizational and professional commitment in professional and non-professional organizations: the case of nurse doctorates. In Research in Social Stratification and Mobility, Vol. 20 (Leicht K.T., ed.), JAI Press, Greenwich, CT, pp. 325-360.
29. Frone M.R., Russell M. & Cooper M.L. (1992) Antecedents and outcomes of work-family conflict: testing a model of the work-family interface. Journal of Applied Psychology 77(1), 65-78.
30. Gardner J.K., Thomas-Hawkins C., Fogg L. & Latham C.E. (2007) The relationships between nurses' perceptions of the hemodialysis unit work environment and nurse turnover, patient satisfaction, and hospitalizations. Nephrology Nursing Journal 34(3), 271-282.
31. Gibson V. (1994) Does nurse turnover mean nurse wastage in intensive care units. Intensive and Critical Care Nursing 10(1), 32-40.
32. Glor E. (2001) Codes of conduct and generations of public servants. International Review of Administrative Sciences 67(3), 525-541.
33. Greene W. (2008) Econometric Analysis, 6th edn. Prentice Hall, New Jersey.
34. Griffeth R.W., Hom P.W. & Gaertner S. (2000) A meta-analysis of antecedents and cors of employee turnover: update, moderator tests, and research implications for the next millennium. Journal of Management 26(3), 463-488.
35. Gurney C.A. (1990) Determinants of Intent to Leave among Nurses with Doctoral Degrees. University of Zinnois, Chicago.
36. Gurney C.A., Mueller C.W. & Price J.L. (1997) Job satisfaction and organizational attachment of nurses holding doctoral degrees. Nursing Research 46(3), 163-171.
37. Hare K. (2007) A Survey of Program Characteristics of New Graduate Residencies and Support Available for Underrepresented New Registered Nurses of Color in Washington State. Washington Center for Nursing, Washington, DC. Retrieved from on 5 January 2009.
38. Havener J.E. (2006) On the Job Injuries: What is the Evidence? (May 2006). New York State Nurses Association, New York. Retrieved from on 20 January 2009.
39. Hayes L.J., O'Brien-Pallas L., Duffield C., Shamian J., Buchan J., Hughes F., Laschinger H.K., North N. & Stone P.W. (2006) Nurse turnover: a literature review. International Journal of Nursing Studies 43(2), 237-263.
40. Hemingway M.A. & Smith C.S. (1999) Organizational climate and occupational stressors as predictors of withdrawal behaviours and injuries in nurses. Journal of Occupational and Organizational Psychology 72(3), 285-299.
41. Hicks R. & Hicks K. (1999) Boomers, Xers, and Other Strangers: Understanding the Generational Differences that Divide Us. Tyndale House Wheaton, IL.
42. Holmas T.H. (2002) Keeping nurses at work: a duration analysis. Health Economics 11(6), 493-503.
43. Hom P.W., Griffeth R.W. & Sellaro C.L. (1984) The validity of Mobley's (1977) model of employee turnover. Organizational Behavior & Human Performance 34(2), 141-174.
44. Hsieh F.Y., Bloch D.A. & Larsen M.D. (1998) A simple method of sample size calculation for linear and logistic regression. Statistics in Medicine 17(14), 1623-1634.
45. Irvine D.M. & Evans M.G. (1995) Job satisfaction and turnover among nurses: integrating research findings across studies. Nursing Research 44(4), 246-253.
46. Jones C.B. (2004) The costs of nurse turnover part 1: an economic perspective. Journal of Nursing Administration 34(12), 562-570.
47. Jones C.B. (2005) The costs of nurse turnover, part 2: application of the nursing turnover cost calculation methodology. Journal of Nursing Administration 35(1), 41-49.
48. Josephson M., Lindberg P., Voss M., Alfredsson L. & Vingard E. (2008) The same factors influence job turnover and long spells of sick leave-a 3-year follow-up of Swedish nurses. The European Journal of Public Health 18(4), 380-385.
49. Kash B.A., Castle N.G. & Phillips C.D. (2007) Nursing home spending, staffing, and turnover. Health Care Management Review 32(3), 253-262.
50. Keepnews D., Brewer C., Kovner C.T. & Shin J. (2010) Generational differences among newly licensed registered nurses. Nursing Outlook 58(3), 155-163.
51. Kim S., Price J.L., Mueller C.W. & Watson T.W. (1996) The determinants of career intent among physicians at a U.S. air force hospital. Human Relations 49(7), 947-976.
52. Kovner C.T., Brewer C.S., Wu Y.W., Cheng Y. & Suzuki M. (2006) Factors associated with work satisfaction of registered nurses. Journal of Nursing Scholarship 38(1), 71-79.
53. Kovner C.T., Brewer C.S., Fairchild S., Poornima S., Kim H. & Djukic M. (2007) Newly licensed RNs' characteristics, work attitudes, and intentions to work. American Journal of Nursing 107(9), 58-70.
54. Kovner C.T., Brewer C.S., Greene W. & Fairchild S. (2009) Understanding new registered nurses' intent to stay at their jobs. Nursing Economics 27(2), 81-98.
55. Kramer M., Schmalenberg C., Maguire P., Brewer B.B., Burke R., Chmielewski L., Cox K., Kishner J., Krugman M., Meeks-Sjostrom D. & Waldo M. (2008) Structures and practices enabling staff nurses to control their practice. Western Journal of Nursing Research 30(5), 539-559.
56. Lake E.T. (2002) Development of the practice environment scale of the nursing work index. Research in Nursing & Health 25(3), 176-188.
57. Letvak S. & Buck R. (2008) Factors influencing work productivity and intent to stay in nursing. Nursing Economics 26(3), 159-165.
58. LeVasseur S.A., Wang C., Mathews B. & Boland M. (2009) Generational differences in registered nurse turnover. Policy, Politics, & Nursing Practice 10(3), 212-223.
59. LoPresti L. (2009) RNs in Residence: Nurse Grads Find Support, Satisfaction in New Program at the Valley Hospital in Ridgewood, New Jersey. Retrieved from on 1 March 2009.
60. Mark B.A., Hughes L.C., Belyea M., Chang Y., Hofmann D., Jones C.B. & Bacon C.T. (2007) Does safety climate moderate the influence of staffing adequacy and work conditions on nurse injuries? Journal of Safety Research 38(4), 431-446.
61. McClure M.L. & Hinshaw A.S. (2002) Magnet Hospitals Revisited: Attraction and Retention of Professional Nurses. American Nurses Publishing, Washington, DC.
62. Mobley W.H. (1982) Employee Turnover: Causes, Consequences, and Control. Addison-Wesley, Reading, MA.
63. Mobley W.H., Griffeth R.W., Hand H.H. & Meglino B.M. (1979) Review and conceptual analysis of the employee turnover process. Psychological Bulletin 86(3), 493-522.
64. Morrell K. (2005) Towards a typology of nursing turnover: the role of shocks in nurses' decisions to leave. Nursing and Health Care Management and Policy 49(3), 315-322.
65. Morrell K., Loan-Clarke J. & Wilkinson A. (2004) The role of shocks in employee turnover. British Journal of Management 15(4), 335-349.
66. Mowday R.T., Koberg C.S. & McArthur A.W. (1984) The psychology of the withdrawal process: a cross-validational test of Mobley's intermediate linkages model of turnover in two samples. Academy of Management Journal 27(1), 79-94.
67. Murrells T., Robinson S. & Griffiths P. (2008) Is satisfaction a direct predictor of nursing turnover? Modelling the relationship between satisfaction, expressed intention and behaviour in a longitudinal cohort study. Human Resources for Health 6(1), 22-33.
68. National League for Nursing (2008) Nursing Data Review, Academic Year 2005-2006: Executive Summary. As Applications Fall off "Applicant Discouragement" is Suspected Cause. Retrieved from on 10 March 2009
69. Nelson A., Fragala G. & Menzel N. (2003a) Myths and facts about back injuries in nursing: the incidence rate of back injuries among nurses is more than double that among construction workers, perhaps because misperceptions persist about causes and solutions. The first in a two-part series. The American Journal of Nursing 103(2), 32-40.
70. Nelson A., Lloyd J., Menzel N. & Gross C. (2003b) Preventing nursing back injuries: redesigning patient handling tasks. American Association of Occupational Health Nurses Journal 51(3), 126-134.
71. Norris R. (2004) The shocking truth about verbal abuse. Nursing Times 100(31), 12-13.
72. O'Brien-Pallas L., Griffin P., Shamian J., Buchan J., Duffield C., Hughes F., Laschinger H.K., North N. & Stone P.W. (2006) The impact of nurse turnover on patient, nurse, and system outcomes: a pilot study and focus for a multicenter international study. Policy, Politics, & Nursing Practice 7(3), 169-179.
73. Oxtoby K. (2004) How to tackle verbal abuse. Nursing Times 100(43), 20-22.
74. Oztunc G. (2006) Examination of incidents of workplace verbal abuse against nurses. Journal of Nursing Care Quality 21(4), 360-365.
75. Parker C.P., Baltes B.B. & Christiansen N.D. (1997) Support for affirmative action, justice perceptions, and work attitudes: a study of gender and racial-ethnic group differences. Journal of Applied Psychology 82(3), 376-389.
76. Parsons S.K., Simmons W.P., Penn K. & Furlough M. (2003) Determinants of satisfaction and turnover among nursing assistants: the results of a statewide survey. Journal of Gerontological Nursing 29(3), 51-58.
77. Pine R. & Tart K. (2007) Return on investment: benefits and challenges of a baccalaureate nurse residency program. Nursing Economics 25(1), 13-19.
78. Price J.L. (1998) Estimation of a causal model of absenteeism. Indian Journal of Economics 41(2), 227-246.
79. Price J.L. (2001) Reflections on the determinants of voluntary turnover. International Journal of Manpower 22(7), 600-624.
80. Price J.L. (2004) The development of a causal model of voluntary turnover. In Innovative Theory and Empirical Research on Employee Turnover (Griffeth R. & Hom P.W., eds), Information Age Publishing, Greenwich, Connecticut, pp. 3-34.
81. Price J.L. & Mueller C.W. (1981) A causal model for turnover for nurses. Academy of Management Journal 24(3), 543-565.
82. Price J.L. & Mueller C. (1986a) Absenteeism and Turnover of Hospital Employees. JAI Press, Greenwich, CT.
83. Price J. L. & Mueller C. (1986b) Handbook of Organizational Measurement. Pitman Publishing Inc., Marshfield, MA.
84. Quinn R.P. & Staines G.L. (1979) The 1977 Quality of Employment Survey: Descriptive Statistics, with Comparison Data from the 1969-70 and the 1972-73 Surveys. Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI.
85. Rogers B. (1997) Health hazards in nursing and health care: an overview. American Journal of Infection Control 25(3), 248-261.
86. Romano M. (2002) War of attrition. Turnover rates for hospital jobs reaching crisis proportions, study warns. Modern Healthcare 32(32), 21-23.
87. Rondeau K.V., Williams E.S. & Wagar T.H. (2008) Turnover and vacancy rates for registered nurses: do local labor market factors matter? Health Care Management Review 33(1), 69-78.
88. Salt J., Cummings G. & Profetto-McGrath J. (2008) Increasing retention of new graduate nurses: a systematic review of interventions by healthcare organizations. Journal of Nursing Administration 38(6), 287-296.
89. Schaefer E., Potter F., Williams S., Diaz-Tena N., Reschovsky J. & Moore G. (2003) Community Tracking Study. Comparison of Selected Statistical Software Packages for Variance Estimation in the CTS Surveys. (No. 40). Center for Studying Health System Change, Washington, DC. Retrieved from on 20 March 2009.
90. Scott E.S., Keehner Engelke M. & Swanson M. (2008) New graduate nurse transitioning: necessary or nice? Applied Nursing Research 21(2), 75-83.
91. Sims H.P., Szilagyi A.D. & Keller R.T. (1976) The measurement of job characteristics. The Academy of Management Journal 19(2), 195-212.
92. Sofield L. & Salmond S.W. (2003) Workplace violence: a focus on verbal abuse and intent to leave the organization. Orthopaedic Nursing 22(4), 274-283.
93. Somers M.J. (1995) Organizational commitment, turnover and absenteeism: an examination of direct and interaction effects. Journal of Organizational Behavior 16(1), 49-58.
94. Somers M.J. (1996) Modelling employee withdrawal behaviour over time: a study of turnover using survival analysis. Journal of Occupational and Organizational Psychology 69(4), 315-326.
95. Soper D.S. (2004) Statistics Calculators version 2.0 Retrieved from on 9 March 2009.
96. Spector P.E. & Jex S.M. (1998) Development of four self-report measures of job stressors and strain: interpersonal conflict at work scale, organizational constraints scale, quantitative workload inventory, and physical symptoms inventory. Journal of occupational health psychology 3(4), 356-367.
97. Stordeur S., D'Hoore W. & the NEXT Study Group (2007) Organizational configuration of hospitals succeeding in attracting and retaining nurses. Journal of Advanced Nursing 57(1), 45-58.
98. Suzuki E., Itomine I., Saito M., Katsuki T. & Sato C. (2008) Factors affecting the turnover of novice nurses at university hospitals: a two year longitudinal study. Japan Journal of Nursing Science 5(1), 9-21.
99. Tett R.P. & Meyer J.P. (1993) Job satisfaction, organizational commitment, turnover intention, and turnover: path analyses based on meta-analytic findings. Personnel Psychology 46(2), 259-293.
100. Ulrich B.T., Buerhaus P.I., Donelan K., Norman L. & Dittus R. (2007) Magnet status and registered nurse views of the work environment and nursing as a career. Journal of Nursing Administration 37(5), 212-220.
101. US Department of Health and Human Services, Health Resources and Services Administration (2010) The Registered Nurse Population: Initial Findings from the 2008 National Sample Survey of Registered Nurses. Retrieved from on 25 March 2010.
102. Versant (n.d.) The Versant RN Residency Solution. Retrieved from on 25 January 2008.
103. Wagner C.M. (2007) Organizational commitment as a predictor variable in nursing turnover research: literature review. Journal of Advanced Nursing 60(3), 235-247.
104. Waldman J.D., Kelly F., Arora S. & Smith H.L. (2004) The shocking cost of turnover in health care. Health Care Management Review 29(1), 2-7.
105. Widger K.P., Cranley L., Wilson-Keates B., Squires M. & Tourangeau A. (2007) Generational differences in acute care nurses. Nursing Leadership 20(1), 49-61.
106. Williams C.A., Goode C.J., Krsek C., Bednash G.D. & Lynn M.R. (2007) Post baccalaureate nurse residency 1-year outcomes. Journal of Nursing Administration 37(7 8, 357-365.
107. Wood D.A. (2008). Residency Program Prepares New Texas RNs. Retrieved from on 1 July 2008.
108. Yin J.T. & Yang K.A. (2002) Nursing turnover in Taiwan: a meta-analysis of related factors. International Journal of Nursing Studies 39(6), 573-581.
109. Zimmerman S., Gruber-Baldini A.L., Hebel J.R., Sloane P.D. & Magaziner J. (2002) Nursing home facility risk factors for infection and hospitalization: importance of registered nurse turnover, administration, and social factors. Journal of the American Geriatrics Society 50(12), 1987-1995.