Workforce instability in the long-term care sector has raised wide attention about nursing staff turnover. Most attention has been devoted to understanding the relationship between facility’s characteristics and organizational turnover. This case-control study examined the contribution of work characteristics to individual staff turnover. Surveys were collected with nursing staff in 18 for-profit nursing homes on up to five occasions between 2006 and 2012. A list of nursing staff voluntarily terminating jobs was provided by the company. Cases and controls (628 of each) were selected from survey respondents by matching on age, job category, and survey occasion. Multiple predictor conditional logistic regression models showed that evening shift work (hazards ratio [HR] = 2.00, p < .01) and shift length > 8 hr (HR = 1.42, p < .05) were contributing factors to voluntary termination. This study provides different perspectives of nursing staff voluntary termination in nursing homes. Future qualitative research would be valuable to explore and understand nursing staff turnover in the health care industry.
AytacS.DursunS.AkalpG. (2016). Workplace violence and effects on turnover intention and job commitment: A pilot study among healthcare workers in Turkey [Special Edition]. European Scientific Journal, 458-465. Retrieved from http://eujournal.org/index.php/esj/article/view/7419/7147
3.
BannaiA.TamakoshiA. (2014). The association between long working hours and health: A systematic review of epidemiological evidence. Scandinavian Journal of Work, Environment & Health, 40, 5-18. doi:10.5271/sjweh.3388
4.
BerridgeC.TylerD. A.MillerS. C. (2016). Staff empowerment practices and CNA retention. Journal of Applied Gerontology. Advance online publication. doi:10.1177/0733464816665204
5.
BuessingA. (1996). Social tolerance of working time scheduling in nursing. Work & Stress, 10, 238-250. doi:10.1080/02678379608256803
6.
CarusoC. C. (2014). Negative impacts of shift work and long work hours. Rehabilitation Nursing, 39, 16-25. doi:10.1002/rnj.107
7.
CastleN. G. (2006). Measuring staff turnover in nursing homes. The Gerontologist, 46, 210-219. doi:10.1093/geront/46.2.210
8.
CastleN. G. (2008). State differences and facility differences in nursing home staff turnover. Journal of Applied Gerontology, 27, 609-630. doi:10.1177/0733464808319711
9.
CastleN. G.EngbergJ. (2006). Organizational characteristics associated with staff turnover in nursing homes. The Gerontologist, 46, 62-73. doi:10.1093/geront/46.1.62
10.
CastleN. G.EngbergJ.AndersonR.MenA. (2007). Job satisfaction of nursing aides in nursing homes: Intent to leave and turnover. The Gerontologist, 47, 193-204. doi:10.1093/geront/47.2.193
11.
CohenG.BlakeR. S.GoodmanD. (2015). Does turnover intention matter? Evaluating the usefulness of turnover intention rate as a predictor of actual turnover rate. Review of Public Personnel Administration, 36, 240-263. doi:10.1177/0734371X15581850
12.
Dall’OraC.GriffithsP.BallJ.SimonM.AikenL. H. (2015). Association of 12 h shifts and nurses’ job satisfaction, burnout, and intention to leave: Findings from a cross-sectional study of 12 European countries. BMJ Open, 5(9), e008331. doi:10.1136/bmjopen-2015-008331
13.
DeckerF. H.Harris-KojetinL. D.BercovitzA. B. (2009). Intrinsic job satisfaction, overall satisfaction, and intention to leave the job among nursing assistants in nursing homes. The Gerontologist, 49, 596-610. doi:10.1093/geront/gnp051
14.
DembeA. E.EricksonJ. B.DelbosR. G.BanksS. M. (2005). The impact of overtime and long work hours on occupational injuries and illnesses: New evidence from the United States. Occupational and Environmental Medicine, 62, 588-597. doi:10.1136/oem.2004.016667
15.
DonoghueC. (2010). Nursing home turnover and retention: An analysis of national level data. Journal of Applied Gerontology, 29, 89-106. doi:10.1177/0733464809334899
16.
DonoghueC.CastleN. G. (2009). Leadership styles of nursing home administrators and their association with staff turnover. The Gerontologist, 49, 166-174. doi:10.1093/geront/gnp021
17.
FlinkmanM.LaineM.Leino-KilpiH.HasselhornH.-M.SalanteraS. (2008). Explaining young registered Finnish nurses’ intention to leave the profession: A Questionnaire Survey. International Journal of Nursing Studies, 45, 727-739. doi:10.1016/j.ijnurstu.2006.12.006
18.
GreenlandS. (1989). Modeling and variable selection in epidemiologic analysis. American Journal of Public Health, 79, 340-349.
19.
GriffinM. A.NealA. (2000). Perceptions of safety at work: A framework for linking safety climate to safety performance, knowledge, and motivation. Journal of Occupational Health Psychology, 5, 347-358. doi:10.1037fl1076-8998.5.3.347
20.
GriffithsP.Dall’OraC.SimonM.BallJ.LindqvistR.RaffertyA.. . .AikenL. H. (2014). Nurses shift length and overtime working in 12 European countries: The association with perceived quality of care and patient safety. Medical Care, 52, 975-981. doi:10.1097/MLR.0000000000000233
21.
HatamN.JalaliM. T.AskarianM.KharazmiE. (2016). Relationship between family-work and work-family conflict with organizational commitment and desertion intention among nurses and paramedical staff at hospitals. International Journal of Community Based Nursing and Midwifery, 4, 107-118.
22.
HayesL. J.O’Brien-PallasL.DuffieldC.ShamianJ.BuchanJ.HughesF.. . . StoneP. W. (2006). Nurse turnover: A literature review. International Journal of Nursing Studies, 43, 237-263.
23.
Iskra-GolecA.Barnes-FarrellJ.BohleP. (2016). Social and family issues in shift work and non standard working hours. New York, NY: Springer.
24.
ItaniO.KaneitaY. (2016). The association between shift work and health: A review. Sleep and Biological Rhythms, 14, 231-239. doi:10.1007/s41105-016-0055-9
25.
JangY.LeeA. A.ZadroznyM.BaeS. H.KimM. T.MartiN. C. (2017). Determinants of job satisfaction and turnover intent in home health workers: The role of job demands and resources. Journal of Applied Gerontology, 36, 56-70. doi:10.1177/0733464815586059
26.
KankaanrantaT.RissanenP. (2008). Nurses’ intentions to leave nursing in Finland. The European Journal of Health Economics, 9, 333-342. doi:10.1007/s10198-007-0080-3
27.
KarasekR. A.BrissonC.KawakamiN.HoutmanI. L. D.BongersP. M.AmickB. C. (1998). The Job Content Questionnaire (JCQ): An instrument for internationally comparative assessments of psychosocial job characteristics. Journal of Occupational Health Psychology, 3, 322-355. doi:10.1037/1076-8998.3.4.322
28.
KashB. A.NaufalG. S.DagherR. K.JohnsonC. E. (2010). Individual factors associated with intentions to leave among directors of nursing in nursing homes. Health Care Management Review, 35, 246-255. doi:10.1097/HMR.0b013e3181dc826d
29.
KopelmanR. E.GreenhausJ. J.ConnollyT. F. (1983). A model of work, family, and interrole conflict: A construct validation study. Organizational Behavior and Human Performance, 32, 198-215. doi:10.1016/0030-5073(83)90147-2
30.
LiY.JonesC. B. (2013). A literature review of nursing turnover costs. Journal of Nursing Management, 21, 405-418. doi:10.1111/j.1365-2834.2012.01411.x
31.
MaasC. J. M.HoxJ. J. (2005). Sufficient sample sizes for multilevel modeling. Methodology, 1, 86-92. doi:10.1027/1614-1881.1.3.86
32.
MasumA. K.AzadM. A.HogueK. E.BehL. S.WankeP.ArslanÖ. (2016). Job satisfaction and intention to quit: An empirical analysis of nurses in Turkey. Peerj, 4, e1896. doi:10.7717/peerj.1896
33.
MoradiS.FarahnakiZ.AkbarzadehA.GhzragozlouF.PournajafA.AbbasiA. M.. . . KarchaniM. (2014). Relationship between shift work and job satisfaction among nurses: A cross-sectional study. International Journal of Hospital Research, 3, 63-68.
34.
MukamelD. B.SpectorW. D.LimcangoR.WangY.FengZ.MorV. (2009). The costs of turnover in nursing homes. Medical Care, 47, 1039-1045. doi:10.1097/MLR.0b013e3181a3cc62
35.
NeaF. M.KearneyJ.LivingstoneM. B.PourshahidiL. K.CorishC. A. (2015). Dietary and lifestyle habits and the associated health risks in shift workers. Nutrition Research Reviews, 28, 143-166. doi:10.1017/S095442241500013X
36.
NorthN.LeungW.AshtonT.RasmussenE.HughesF.FinlaysonM. (2013). Nurse turnover in New Zealand: Costs and relationships with staffing practises and patient outcomes. Journal of Nursing Management, 21, 419-428. doi:10.1111/j.1365-2834.2012.01371.x
37.
PodsakoffP. M.MacKenzieS. B.PodsakoffN. P. (2012). Sources of method bias in social science research and recommendations on how to control it. Annual Review of Psychology, 63, 539-569. doi:10.1146/annurev-psych-120710-100452
38.
RamooV.AbdullahK. L.PiawC. Y. (2013). The relationship between job satisfaction and intention to leave current employment among registered nurses in a teaching hospital. Journal of Clinical Nursing, 22, 3141-3152. doi:10.1111/jocn.12260
39.
RogersK. A.KellowayE. K. (1997). Violence at work: Personal and organizational outcomes. Journal of Occupational Health Psychology, 2, 63-71. doi:10.1037//1076-8998.2.1.63
40.
RosenJ.StiehlE. M.MittalV.LeanaC. R. (2011). Stayers, leavers, and switchers among certified nursing assistants in nursing homes: A longitudinal investigation of turnover intention, staff retention, and turnover. The Gerontologist, 51, 597-609. doi:10.1093/geront/gnr025
41.
StoneR.WilhelmJ.BishopC. E.BryantN. S.HermerL.SquillaceM. R. (2016). Predictors of intent to leave the job among home health workers: Analysis of the national home health aide survey. The Gerontologist. Advance online publication. doi:10.1093/geront/gnw075
42.
TrinkoffA.HanK.StorrC.LernerN.JohantgenM.GartrellK. (2013). Turnover, staffing, skill mix, and resident outcomes in a national sample of US nursing homes. Journal of Nursing Administration, 43, 630-636. doi:10.1097/NNA.0000000000000004
43.
WareJ. E.KosinskiM.KellerS. D. (1996). A 12-item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220-233.
44.
WendscheJ.HackerW.WeggeJ.RudolfM. (2016). High job demands and low job control increase nurses’ professional leaving intentions: The role of care setting and profit orientation. Research in Nursing & Health, 39(5), 353-363. doi:10.1002/nur.21729
45.
WoodheadE. L.NorthropL.EdelsteinB. (2016). Stress, social support, and burnout among long-term care nursing staff. Journal of Applied Gerontology, 35, 84-105. doi:10.1177/0733464814542465
46.
ZimmermanS.Gruber-BaldiniA. L.HebelJ. R.SloaneP. D.MagazinerJ. (2002). Nursing home facility risk factors for infection and hospitalization: Importance of registered nurse turnover, administration, and social factors. Journal of the American Geriatrics Society, 50, 1987-1995. doi:10.1046/j.1532-5415.2002.50610.x
