Abstract

Background: Nurse staffing in the acute care setting remains turbulent and unstable, and there is increased evidence that the context within work environments may contribute to turnover. Contributing factors of this instability lead to burnout, including emotional exhaustion, depersonalization, and a decreased sense of personal accomplishment. RNs who experience burnout are twice as likely to leave their bedside nursing job in comparison with RNs who are not experiencing burnout. Significant post-COVID turnover within the acute care setting has been identified, however, current evaluation of voluntary nurse turnover is needed. This study examines exit survey data from nurses voluntarily terminating their positions at 1300-bed midwestern quaternary academic hospital. Particular attention is paid to environmental and organizational factors that may contribute to voluntary nurse turnover. Identification of these will inform future organizational-level interventions aimed at empowering nurses, reducing turnover, and creating healthy work environments.

Purpose: Aim: To explore nurse exit interviews for trends and themes related to organization departure.
Research question: What findings in the quantitative and qualitative exit survey data provide insight for institutional work environment improvements?

Methods: De-identified exit survey data with the following inclusion criteria: staff RN with voluntary organizational departure during 1/1/2023-12/31/2023. Quantitative data is descriptively examined for employer and employee-influenced reasons for departure. Qualitative data is analyzed by inductive thematic analysis.

Results: Preliminary results (N=139) suggest the top four major factors influencing voluntary turnover include compensation/reward (25%), work schedule, work hours, workload (25%), management /work relationships (24%), and career advancement or desire for a career change (15%). Qualitative data are still being analyzed but are highlighting important organizational factors not captured by the Exit Survey items.

Implications for Nursing Leadership: There are personal and organizational factors influencing voluntary nurse turnover. While it is critical to identify these from nurses voluntarily leaving an organization, it is vital to address them a priori to retain an experienced nursing workforce and to create a healthy and satisfying work environment.

Notes

References: Aiken, L. H., Sloane, D. M., McHugh, M. D., Pogue, C. A., & Lasater, K. B. (2023). A repeated cross-sectional study of nurses immediately before and during the COVID-19 pandemic: Implications for action. Nursing Outlook, 71(1), 101903. https://doi.org/10.1016/j.outlook.2022.11.007

Boudreau, C., & Rhéaume, A. (2024). Impact of the Work Environment on Nurse Outcomes: A Mediation Analysis. Western Journal of Nursing Research, 46(3), 210–218. https://doi.org/10.1177/01939459241230369

Holtz, H. K., Weissinger, G. M., Swavely, D., Lynn, L., Yoder, A., Cotton, B., Adil, T., Alderfer, M., Romig, B., Neils, K., & Rushton, C. H. (2023). The Long Tail of COVID-19: Implications for the Future of Emergency Nursing. Journal of Emergency Nursing, 49(2), 198–209. https://doi.org/10.1016/j.jen.2022.10.006

Muir, K. J., Wanchek, T. N., Lobo, J. M. (2022). Evaluating the Costs of Nurse Burnout-Attributed Turnover: A Markov Modeling Approach. Journal of Patient Safety 18(4):p 351-357. doi: 10.1097/PTS.0000000000000920

Sledge, J.A., Prentice, D., Arroyo, C. (2024). Impact of COVID-19 on Healthcare Professionals at a Midwestern Quaternary Academic Urban Health Center. Workplace Health & Safety. 2024;0(0). doi:10.1177/21650799241260604

Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. (2019). https://doi.org/10.17226/25521

Description

Acute care nurse staffing remains turbulent and unstable. This study examines 2023 RN Exit Survey data at a 1,300-bed Midwestern quaternary academic hospital. Particular attention is paid to environmental and organizational factors as they can inform future organizational-level interventions aimed at creating healthier work environments.

Author Details

Tracy A. Riley, PhD, APRN-CNS, CNE; Jennifer A. Sledge, PhD, MSW; Marilyn "Lynn" Shallom, PhD, MSN(R), RN, CCNS, CCRN, FCCM; Heidi K. Holtz, PhD, RN

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Acute care, Policy/advocacy, Workforce

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Phoenix, Arizona, USA

Conference Year

2025

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.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Factors Influencing Voluntary Nurse Turnover

Phoenix, Arizona, USA

Background: Nurse staffing in the acute care setting remains turbulent and unstable, and there is increased evidence that the context within work environments may contribute to turnover. Contributing factors of this instability lead to burnout, including emotional exhaustion, depersonalization, and a decreased sense of personal accomplishment. RNs who experience burnout are twice as likely to leave their bedside nursing job in comparison with RNs who are not experiencing burnout. Significant post-COVID turnover within the acute care setting has been identified, however, current evaluation of voluntary nurse turnover is needed. This study examines exit survey data from nurses voluntarily terminating their positions at 1300-bed midwestern quaternary academic hospital. Particular attention is paid to environmental and organizational factors that may contribute to voluntary nurse turnover. Identification of these will inform future organizational-level interventions aimed at empowering nurses, reducing turnover, and creating healthy work environments.

Purpose: Aim: To explore nurse exit interviews for trends and themes related to organization departure.
Research question: What findings in the quantitative and qualitative exit survey data provide insight for institutional work environment improvements?

Methods: De-identified exit survey data with the following inclusion criteria: staff RN with voluntary organizational departure during 1/1/2023-12/31/2023. Quantitative data is descriptively examined for employer and employee-influenced reasons for departure. Qualitative data is analyzed by inductive thematic analysis.

Results: Preliminary results (N=139) suggest the top four major factors influencing voluntary turnover include compensation/reward (25%), work schedule, work hours, workload (25%), management /work relationships (24%), and career advancement or desire for a career change (15%). Qualitative data are still being analyzed but are highlighting important organizational factors not captured by the Exit Survey items.

Implications for Nursing Leadership: There are personal and organizational factors influencing voluntary nurse turnover. While it is critical to identify these from nurses voluntarily leaving an organization, it is vital to address them a priori to retain an experienced nursing workforce and to create a healthy and satisfying work environment.