Insufficient staffing was the most common reason that registered nurses left their work in residential and nursing homes, followed by burnout or emotional exhaustion, in a study published Tuesday in JAMA Network Open.
Thirty-seven percent of participating RNs working in residential and nursing homes cited insufficient staffing as the reason they left, whereas 32% cited burnout or emotional exhaustion.
The cross-sectional study analyzed survey data from 7,887 RNs in New York and Illinois who left healthcare employment between 2018 and 2021; 660 of the respondents worked in residential and nursing homes, and 697 worked in home care or hospice settings. Other participants worked in hospitals, primary and ambulatory care, or other settings.
“Nurses are not principally leaving for personal reasons, like going back to school or because they lack resilience. They are working in chronically poorly staffed conditions,” said senior author Karen B. Lasater, PhD, RN, an associate professor of nursing and senior fellow of the Leonard Davis Institute for Health Economics at the University of Pennsylvania.
Planned retirement was the top reason cited by participating RNs working in home care and hospice, cited by 31% of respondents working in such settings, followed by burnout or emotional exhaustion (26%).
“Prior studies evaluate nurses’ intentions to leave their job. Our study is one of the few evaluating why nurses actually left healthcare employment entirely,” said lead author K. Jane Muir, PhD, RN, a post-doctoral research fellow in the Center for Health Outcomes and Policy Research and a fellow in the National Clinician Scholars Program at the University of Pennsylvania.
Other common reasons for departure cited by participating nurses working in residential or nursing homes were concerns related to COVID-19 (25%), unsafe working conditions (24%), family obligations (23%), planned retirement (22%).
For responding RNs working in home care or hospice, other common reasons for leaving their positions were COVID concerns (21%), insufficient staffing and family obligations (20% each).
The findings suggest that “nurse retention problems do not stem from the unique exigencies of the pandemic but rather long-term problems in the workplace, including poor staffing and work environment,” according to the study authors.
Recognizing and correcting failures in working conditions could help healthcare providers retain RNs, the authors said. One of their suggestions is to support nurses’ personal/professional life balance by offering child care and flexible shifts, as well as boosting staffing ratios and offering higher pay differentials for weekend and holiday shifts.
