Other Titles
Why We Work: Examining the Relationships Between Nurse Compensation, Work-Related Burnout, and Intention to Leave the Profession [Title Slide]
Abstract
Purpose: The ongoing nursing shortage contributes to chronic nurse understaffing, which is associated with care rationing and adverse patient outcomes (Kiekkas et al., 2019 Tubbs-Cooley et al., 2019). Burnout-related attrition from the nursing profession is particularly problematic to the nursing workforce because it is both prevalent and preventable (Shah et al., 2021). Intention to leave the profession prior to anticipated retirement has been associated with burnout, however the nursing shortage has been observed to fluctuate in tandem with the availability of alternative economic opportunities (Benson, 2012). Additionally, many nurses self-report intention to stay in the profession despite burnout for financial reasons (Christianson et al., 2022). The purpose of this study is to examine the relationships between intention to leave the nursing profession, work-related burnout, and financial considerations including individual and household income, student debt burden, and pay satisfaction.
Methods: We conducted a cross-sectional digital survey on United States nurses employed in hospitals from January-March 2023. Measures collected included self-reported intention to leave the profession, the Copenhagen Burnout Inventory Work-Related Burnout scale, self-reported nursing income, nursing pay satisfaction, healthcare benefit satisfaction from one’s nursing job, personal student debt burden, household income, and housing costs. The Job Demands-Resources model and Maslow’s hierarchy of needs were used jointly as guiding frameworks for this study (Bakker & Demerouti, 2007; Maslow, 1948). Financial compensation may be a source of fulfillment for one’s base needs and may be prioritized. Therefore, we hypothesized that financial variables may have a moderator effect on the relationship between burnout and intention to leave. Data was analyzed using a series of linear regression models in IBM SPSS Statistics for Windows (IBM, 2021).
Results: A total of 843 nurses were included in this analysis. Most participants identified as female (n=608, 85.3%), white (n=599, 84.5%), practiced as registered nurses (n=640, 90.4%), and worked in direct patient care (n=575, 80.9%). The nurse’s compensation amount, household income, housing cost to income ratio, and student debt burden were not correlated with intention to leave. Pay satisfaction did not have a moderator effect on the relationship between burnout and intention to leave. However, in a post hoc analysis we found that pay satisfaction did have a mediator effect on the relationship between burnout and intention to leave, whereas greater burnout was correlated with lower pay satisfaction, and poorer pay satisfaction was correlated with greater intention to leave (work-related burnout-intention to leave the profession F=107.221, p< 0.001, adjusted R2 and R2 12.6-12.7%; work-related burnout and pay satisfaction F=115.604, p< 0.001, adjusted R2 and R2 13.6-13.8%; nursing pay satisfaction and intention to leave the profession F=32.219, p< 0.001, adjusted R2 and R2 4.2-4.3%).
Conclusions: The outcomes of this study align with previous research, indicating that pay satisfaction is correlated with intention to leave, and that nurses contextualize their pay satisfaction with the perceived burdens associated with work. Effective nurse retention strategies should take a multifaceted approach in which healthcare institutions simultaneously prioritize curation of a healthy work environment and compensate nurses satisfactorily for the burdens associated with work.
Notes
Presenter notes available in attached slide deck.
Published article by presenters:
Christianson, J., Bekhet, A., Guttormson, J., Singh, M., & Johnson, N. L. (2024). Why We Quit: Relationships Between Work-Related Burnout, Work Rewards, and Intention to Leave in Nursing. Nursing Economic$, 42(1), 7–16. https://doi.org/10.62116/NEC.2024.42.1.7
References:
Bakker, A., & Demerouti, E. (2007). The Job Demands-Resources Model: State of the art. Journal of Managerial Psychology, 22(3), 309-328. https://doi.org/10.1108/02683940710733115
Benson, A. (2012). Labor market trends among registered nurses: 2008-2011. Policy Politics and Nursing Practice, 13(4), 205-213. https://doi.org/10.1177/1527154413481810
Christianson, J., Johnson, N., Nelson, A., & Singh, M. (2022). Work-related burnout, compassion fatigue, and nurse intention to leave the profession during Covid-19. Nurse Leader, 21(2), 244-51. https://doi.org/10.1016/j.mnl.2022.06.007
Kiekkas, P., Tsekoura, V., Aretha, D., Samios, A., Konstantinou, E., Igoumenidis, M., .. & Fligou, F. (2019). Nurse understaffing is associated with adverse events in postanaesthesia care unit patients. Journal of Clinical Nursing, 28(11-12), 2245-2252. https://doi.org/10.1111/jocn.14819
IBM SPSS Statistics for Windows. (2021). (Version 28.0.0.0) IBM Corp.
Maslow, A. (1948). “Higher” and “lower” needs. The Journal of Psychology, 25, 433-436.
Shah, M., Gandrakota, N., Cimiotti, J., Ghose, N., Moore, M., & Ali, M. (2021). Prevalence and factors associated with nurse burnout in the US. JAMA Network Open, 4(2), e2036469, https://doi.org/10.1001/jamanetworkopen.2020.36469
Tubbs-Cooley, H., Mara, C., Carle, A., Mark, B., & Pickler, R. (2019). Association of nurse workload with missed nursing care in the neonatal intensive care unit. JAMA Pediatrics, 173(1), 44-51. https://doi.org/0.1001/jamapediatrics.2018.3619
Sigma Membership
Delta Gamma at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Quantitative Research
Keywords:
Professional Burnout, Reward -- Evaluation, Intention, Personal Turnover, Nurse Attitudes, Hospital Nursing Staff
Recommended Citation
Christianson, Jacqueline; Guttormson, Jill; Singh, Maharaj; Bekhet, Abir; and Johnson, Norah Louise, "Why We Work: Examining the Relationships Between Nurse Compensation, Burnout, and Intention to Leave Nursing" (2026). Creating Healthy Work Environments (CHWE). 119.
https://www.sigmarepository.org/chwe/2024/presentations_2024/119
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Washington, DC, USA
Conference Year
2024
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-03-04
Why We Work: Examining the Relationships Between Nurse Compensation, Burnout, and Intention to Leave Nursing
Washington, DC, USA
Purpose: The ongoing nursing shortage contributes to chronic nurse understaffing, which is associated with care rationing and adverse patient outcomes (Kiekkas et al., 2019 Tubbs-Cooley et al., 2019). Burnout-related attrition from the nursing profession is particularly problematic to the nursing workforce because it is both prevalent and preventable (Shah et al., 2021). Intention to leave the profession prior to anticipated retirement has been associated with burnout, however the nursing shortage has been observed to fluctuate in tandem with the availability of alternative economic opportunities (Benson, 2012). Additionally, many nurses self-report intention to stay in the profession despite burnout for financial reasons (Christianson et al., 2022). The purpose of this study is to examine the relationships between intention to leave the nursing profession, work-related burnout, and financial considerations including individual and household income, student debt burden, and pay satisfaction.
Methods: We conducted a cross-sectional digital survey on United States nurses employed in hospitals from January-March 2023. Measures collected included self-reported intention to leave the profession, the Copenhagen Burnout Inventory Work-Related Burnout scale, self-reported nursing income, nursing pay satisfaction, healthcare benefit satisfaction from one’s nursing job, personal student debt burden, household income, and housing costs. The Job Demands-Resources model and Maslow’s hierarchy of needs were used jointly as guiding frameworks for this study (Bakker & Demerouti, 2007; Maslow, 1948). Financial compensation may be a source of fulfillment for one’s base needs and may be prioritized. Therefore, we hypothesized that financial variables may have a moderator effect on the relationship between burnout and intention to leave. Data was analyzed using a series of linear regression models in IBM SPSS Statistics for Windows (IBM, 2021).
Results: A total of 843 nurses were included in this analysis. Most participants identified as female (n=608, 85.3%), white (n=599, 84.5%), practiced as registered nurses (n=640, 90.4%), and worked in direct patient care (n=575, 80.9%). The nurse’s compensation amount, household income, housing cost to income ratio, and student debt burden were not correlated with intention to leave. Pay satisfaction did not have a moderator effect on the relationship between burnout and intention to leave. However, in a post hoc analysis we found that pay satisfaction did have a mediator effect on the relationship between burnout and intention to leave, whereas greater burnout was correlated with lower pay satisfaction, and poorer pay satisfaction was correlated with greater intention to leave (work-related burnout-intention to leave the profession F=107.221, p< 0.001, adjusted R2 and R2 12.6-12.7%; work-related burnout and pay satisfaction F=115.604, p< 0.001, adjusted R2 and R2 13.6-13.8%; nursing pay satisfaction and intention to leave the profession F=32.219, p< 0.001, adjusted R2 and R2 4.2-4.3%).
Conclusions: The outcomes of this study align with previous research, indicating that pay satisfaction is correlated with intention to leave, and that nurses contextualize their pay satisfaction with the perceived burdens associated with work. Effective nurse retention strategies should take a multifaceted approach in which healthcare institutions simultaneously prioritize curation of a healthy work environment and compensate nurses satisfactorily for the burdens associated with work.
Description
This presentation will highlight the results of a study investigating the relationships between financial compensation, burnout, and intention to leave the profession for United States hospital nurses. Financial variables discussed in this study include nursing income, household income, housing costs, student debt burden, pay satisfaction, and healthcare benefit satisfaction.