Nursing Career Retention

Rambur B., McIntosh B., Palumbo M.V., & Reinier K. (2005). Education as a Determinant of Career Retention and Job Satisfaction among Registered Nurses. Journal of Nursing Scholarship Vol. 37, Issue 2, 185-192.

I. Statement of the Problem

a. Research Topic

The topic is about the comparison of two groups of registered nurses, those whose highest degrees were the associate degree (AD) and those with the bachelor's degree (BS) in nursing. The authors state, "Nursing in the United States (US) is an anomaly among major professional workforces outside health care in that graduates of hospital-based diploma programs, 2-year associate degree programs, and 4-year baccalaureate degree programs are equally accepted for a single licensing exam." This leads to a more specific context for the research problem.

b. Research Problem

As the title of the article suggests, educational attainment has a role to play in the determination of career retention and job satisfaction among registered nurses. This is illustrated in the author's statement of the existing debate regarding the "continental divide" between "education and practice". More specifically, the authors note that the American debate on the preferred route to nursing practice existed for many years until now. The authors state, "The American Association of Colleges of Nursing (AACN; 2002) acknowledged years of "professional tension" regarding a preferred route to nursing practice." They go on to note that "The debate about the appropriate level of education for RNs is expected to continue to intensify at state, national, and international levels because limited educational funding is available to prepare the next generation of nurses who will be practicing in a shortage environment that extends around the globe."

c. Research Questions/Hypotheses

No specific research question is noted. However, the authors have stated two of their hypotheses – based on existing findings and inconsistencies in literature – which are: (1) "BS compared to AD-educated nurses will have different career patterns that indicate early career exploration followed by greater longevity in the workplace; this hypothesis pertains to social return on investment", and (2) "BS compared to AD-educated nurses will report higher levels of job satisfaction across a larger number of dimensions related to the job and the organization; this hypothesis pertains to private return on investment."

II. Review of the Literature

The authors begin with a brief review of literature that supports the ideas that there is an existing and growing debate about education in Nursing. They stated the past and recent discussions and surveys concerning the debate. The problem of growing tension between cohorts in this field was restated such as, "The debate about the appropriate level of education for RNs is expected to continue to intensify at state, national, and international levels".

Next, the authors review literature that elaborates the problem and results in career retention in Nursing. The authors stated that two of the retention essentials that pertain to education were: (a) "Working with other nurses who are clinically competent", and (b) "Support for education"." Furthermore, the literature states that some hospitals "preferred to employ BS nurses, but they noted that the supply is diminishing."

Lastly, the authors review literature that studied the job satisfaction of registered nurses in both educational cohorts (AD and BS). Here, literature about the relationship between job satisfaction and education have been briefly compiled. They noted both negative and positive correlation of the two such as: "In a meta-analysis,… educational level was negatively associated with satisfaction." and "that the most highly educated nurses were the most satisfied, with associate degree prepared nurses the least satisfied". Moreover, "RNs' intention to leave their current positions decreased with increasing education" and "no differences in satisfaction or turnover intent by educational level".

III. Methods

The authors stated that they used a quantitative mail survey approach in their study. The analysis used was a "part of a larger mail survey of RNs, "The RN Job Analysis and Retention Study" (JARS)." The authors used a sample randomly drawn from the roster of RN by the Vermont Board of Nursing in September 2002, which has a total population of n=7,028. However, a population of "advanced practice, inactive, out-of-state, foreign, and deceased nurses" were excluded in the sample – which gives an approximately total population of 6000.

Data analysis was performed using descriptive statistical methods. Factor analysis was done for the determination of the job satisfaction. The authors mentioned that "All data analysis was performed using SAS version 8.2 software (SAS Institute, Inc., Cary, NC)."

IV. Results and Conclusions

The author begins by stating their findings. First, result of the analysis of the respondents' personal data. Second, analysis of the educational degrees of the respondents was presented. Third, the analysis of the differences in the ages of the AD and BS nurses was presented. Lastly, the analysis of job satisfaction was stated. There were six factors being considered for the job satisfaction analysis.

The authors followed the discussions of the results of the analysis. They noted that the "data indicate that the American experiment with AD education as a more rapid entry into the profession of nursing might have unintended consequences." They also found out that in this specific sample, "currently practicing BS nurses had more long-term stability in the workforce, and the AD nurses either had dropped out of the workforce as they aged or new AD nurses entered the workforce at later ages." Furthermore, the results showed that "BS nurses were more satisfied with the opportunity for autonomy and growth in their jobs, including feelings of accomplishment and satisfaction with the people they work with."; and that the authors stated that "BS nurses reported greater satisfaction than did AD nurses concerning the level of stress and physical demands of the job, and they were more comfortable with their personal job security and their security within the organization."

Conclusion

In conclusion, the authors state that to be able to cultivate the Nursing industry, retention is necessary. For retention to take place, longevity in the workplace is extremely important. They claimed that their study proved to be helpful in providing preliminary evidence "that the additional investment in an entry-level BS degree for nurses results in higher private returns for the individual and, from a societal perspective, higher rates of return in the form of a greater proportion of experienced nurses retained." Lastly, they recommended that the "baccalaureate education provided a greater return on investment at both private individual and societal levels."