Princeton, N.J.—Compared with six years ago, newly licensed registered nurses (NLRNs) have greater job commitment, but are more likely to work part-time, and to report that they had fewer job opportunities, according to a study of newly-licensed nurses conducted by the RN Work Project, a program of the Robert Wood Johnson Foundation.
The research team compared a group of nurses licensed in 2004-2005 with a group licensed in 2010-2011 and found that those in the later cohort were less likely to work in hospitals, special care units, and direct care. They were more likely to work as managers, be enrolled in formal education programs, and have positive views of their work environments. The study is in the current issue of the American Journal of Nursing.
Investigators for the study were: Christine T. Kovner, PhD, RN, FAAN, professor at the College of Nursing, New York University; Carol Brewer, PhD, RN, FAAN, professor at the School of Nursing, University at Buffalo; Farida Fatehi, MS, BDS, data analyst at New York University; and Carina Katigbak, PhD, RN, assistant professor at the Connell School of Nursing, Boston College. Kovner and Brewer direct the RN Work Project.
While most NLRNs still begin their nursing careers in hospitals, fewer nurses in the 2010-2011 cohort (77.4%) than in the 2004-2005 cohort (88.8%) reported working in a hospital. Those in the later cohort who did were more likely to work in a Magnet hospital (13.5% of the 2010-11 cohort, compared with 10.3% of the 2004-2005 cohort). They are also less likely to work in intensive care units (18 % of those in the 2004-2005 cohort, compared with 11.6% in the 2010-2011 cohort) and more likely to be working part-time as a nurse (10.5% of the later cohort, compared with 7.8% for the earlier one).
The later cohort was more likely to be enrolled in a formal education program (16.6%, compared with 11.4% in the earlier cohort), but also report that there were fewer job opportunities. Of those who reported being unemployed, 31.1% of the 2010-2011 cohort said they could not find an entry-level RN job in their area, compared with only 11.8% reporting this in 2004-2005. Nearly one in 10 of the later cohort gave the reason for unemployment as “unable to find the type of RN job I want.” No one reported this reason in the 2004-2005 survey.
“There have been several changes in the years between when these nurses passed their licensing exams, and those changes appear to have had an important impact on nurses’ behaviors and goals,” said Kovner. “It’s possible that the increase in newly licensed RNs holding BSNs and who are enrolled in formal education programs is a function of the recommendation that 80 percent of nurses have BSNs by the year 2020 in the Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health. There is also anecdotal evidence that hospitals are preferentially hiring RNs with BSNs.”
There has been a decrease in the number of NLRNs reporting having some significant employee benefits. While the majority of 2010-11 cohort reported benefits were important to them (78.5% said it was “somewhat” or “very” important), they were less likely than the 2004-2005 cohort to report having health insurance (91.9%, compared with 97.2%) or tuition reimbursement (69.4%, compared with 86.4%).
“Given the increased emphasis on encouraging nurses to earn BSNs and the interest this later cohort of nurses expresses for ongoing formal education, employers should consider offering tuition reimbursement as a benefit,” said Brewer. “According to the American Association of Colleges of Nursing, from 2010 to 2011, enrollments in RN-to-BSN programs increased by 15.8 percent. Employers should do more to support their nurses who want to get more education and also to encourage them to do so.”
The authors also found that some problems persist with patient safety. More than one in four nurses in the 2010-2011 cohort (26.4%) disagreed with the assertion that “patient safety is never sacrificed to get more work done,” and 15.3 percent did not agree that “procedures and systems are good at preventing errors.” This is despite significant investments by the government and the health care industry in patient safety.
The RN Work Project is a 10-year study of NLRNs that began in 2006. It is the only multi-state, longitudinal study of new nurses’ turnover rates, intentions and attitudes—including intent, satisfaction, organizational commitment, and preferences about work. The study draws on data from nurses in 34 states, covering 51 metropolitan areas and nine rural areas.