RN Work Project Study Examines Recession's Impact on New Nurses
Carol S. Brewer, PhD, RN, FAAN, a professor at the University of Buffalo School of Nursing, leads the Robert Wood Johnson Foundation (RWJF)-supported RN Work Project with Christine T. Kovner, PhD, RN, FAAN. The 10-year, longitudinal study is the only one of its kind to study the careers of new nurses. Most recently, the RN Work Project released a study on the recession’s impact on new nurses.
Human Capital Blog: Your most recently-published study looked at registered nurses in the recession. Can you review the most important findings?
Carol Brewer: What we found was fairly interesting and fits with some of the other studies and data we’ve collected on new graduates in the recession. We found that the nurses’ intent to stay at their current job and their organizational commitment was higher than before the recession. We also found some indicators that the work environment was a little better. The nurses report that their relationship with physicians was better, and they had a lighter workload and fewer organizational constraints.
We can interpret this in a few different ways. One is that there has actually been a change for the better in the work environment, and stress and workload are going down a little bit. But we also found that nurses perceived fewer job opportunities, so they may feel like they can’t leave their jobs because there aren’t many other opportunities. They could be making their perceptions fit their reality, which would cause them to rate their environment higher than if they knew they had options and could afford to be pickier.
More likely, these nurses are just biding their time. We found that, despite perceiving fewer opportunities, the nurses were more likely to be searching for a job. Even though the perception is that things seem to be little better with their current employer, they’re still looking for other jobs.
HCB: So the greater intent to stay in their jobs is due to fears about not being able to find new jobs?
Brewer: That’s one interpretation, yes. When you look at workforce models of turnover that’s a fairly logical, common pathway. People assess the external environment and decide how important it is that they leave. Under a constrained environment where jobs are harder to get, that’s pretty risky. In the recession, where family members and spouses may have lost their jobs, economic security alone may indicate that they need to stay put.
HCB: Does any of your prior research suggest ways that hospitals can retain nurses?
Brewer: Our work only deals with the nurses’ side, not how hospitals can address these issues, but I think there are some obvious ways to go about fixing what nurses are not happy about. One of the things we’ve been looking at is quantitative work load, and that was one of the things that seems to have gotten a little better, based on the results of this study. Easing a nurse’s workload can have multiple impacts. Improved staffing, for instance, can reduce mandatory overtime and allows nurses more control over their schedule, which improves satisfaction and organizational commitment. Workplace supports like electronic medical records are another example.
HCB: Why do you think RWJF decided to invest in this kind of study?
Brewer: When Chris[tine] and I started this study we had just completed a similar national study of nurses over a two year period. We were using many of the same measurement instruments and were one of the few who had looked at nurse turnover through a nationally represented, randomized study. Nobody had ever extended that over a longer period of time, and we knew a longitudinal study could produce extremely rich data sets for future research.
We also wanted to find out what happens to new nurses over time. Early on we found that the turnover rate of new nurses in hospitals is actually fairly low, but each survey shows an increase of nurses leaving hospitals. The conventional wisdom is that they leave nursing, but actually they typically stay in nursing; they’re just leaving the hospital setting and their original employer.
By the time this study is over we’ll have a much better picture of a nursing career. And with the recession right in the middle of it, it’ll be a really interesting perspective.
HCB: The IOM report on the Future of Nursing includes recommendations to improve nursing workforce data collection to allow for better assessment of, and projections about, the workforce. Can you talk about how the RN Work Project advances that goal?
Brewer: Our study is not easily replicable—it takes a lot of resources to do this—but it highlights some of the areas others should be paying attention to in overall efforts to collect data on the workforce. One area where I think it’s important to have data, which we’ve provided, is being able to distinguish between leaving nursing and leaving a job. Those are often confused in the news and reporting about the nursing workforce.
I think we also contribute to other recommendations in the report. We have some unique data about mobility in nursing from our study, and we’ve found that it’s not a very mobile profession. Knowing that nurses stay close to where they’re from and where they went to school has implications for how and where we educate nurses in the future.
HCB: What other studies do you have coming out soon?
Brewer: We started this study with new nursing graduates, so now we’re following nurses who’ve been in practice for roughly five to seven years. We have a paper accepted focusing on nurse’s achievement of higher education levels. We’re also working on some papers about verbal abuse on the job.