The nursing shortage is well documented, and government estimates indicate that shortfalls will worsen in the future. As the largest employer of registered nurses (RNs), hospitals are the most seriously affected by shortages, as they compete with other employment settings for limited nursing resources. Recruitment remains the primary avenue for ensuring staffing levels, but retention is increasingly important as applicant pools shrink because of demographic and employment trends. Effective retention strategies must address the factors that contribute to exodus of RNs from hospitals, as well as isolating the factors that enable RNs to remain in hospital employment. This secondary analysis of the 1996, 2000, and 2004 National Sample Survey of Registered Nurses examines the demographic, employment, and educational factors associated with working in hospitals, having full-time status, and holding patient care positions. The findings suggest that hospitals must address nonwork issues to retain nursing personnel. Relevant policy issues are examined and strategies for effective retention are offered.
Alfred P.Sloan Foundation. (2004). Family works. Retrieved March 2008, from http://www.sloan.org/programs/documents/Family workBrochure2004.pdf.
3.
American Association for Retired Persons. ( 2004). AARP's best employers for workers over 50. AARP Magazine. Retrieved March 2008, from http://www.aarp.org/money/work/articles/magbestchart.htm .
4.
American Association for Retired Persons. ( 2007). Will older adults be able to keep working as the employment picture changes?Washington, DC: Author.
5.
American Association of Medical Colleges. ( 2006). Council on teaching hospitals. Retrieved November 13, 2006, from http://services.aamc.org/memberlistings/index.cfm?fuseaction=home.serach&search_type=TH&state_criteria=ALL.
6.
American Hospital Association. (2001). AHA Special Workforce Survey. Retrieved November 13, 2006, from http://www.aha.org/aha/content/2001/PowerPoint/ahaspecialworkforce.ppt .
7.
Andrews, J., Manthorpe, J., & Watson, R. (2005). Employment transitions for older nurses: A qualitative study. Journal of Advanced Nursing, 51, 298-306.
8.
Auerbach, D., Buerhaus, P., & Staiger, D. (2007). Better late than never: Workforce supply implications of later entry into nursing. Health Affairs, 26, 178-185.
9.
Biles, B., & Abrams, M. (1998). The double bind: Challenges to safety net and teaching hospitals. Journal of Urban Health, 75, 17-21.
10.
Blakeley, J.A., & Ribeiro, V.E.S. (2008). Early retirement among registered nurses: Contributing factors. Journal of Nursing Management, 16, 29-37.
11.
Buerhaus, P., Staiger, D., & Auerbach, D. (2000). Implications of an aging registered nurse workforce . Journal of the American Medical Association, 283, 2948-2954.
12.
Buerhaus, P., Staiger, D., & Auerbach, D. (2003). Is the current shortage of hospitals nurses ending ? Health Affairs, 22, 191-198.
13.
Bureau of Health Professions. (2002). Projected supply, demand and shortages of registered nurses: 2000-2020. Washington, DC: United States Department of Health and Human Services.
14.
Bureau of Health Professions. (2004). What is behind HRSA's projected supply, demand and shortage of registered nurses?Washington DC: United States Department of Health and Human Services.
15.
Bureau of Health Professions. (2006a). 2004 national samples survey of registered nurses. Retrieved March 26, 2007, from ftp://ftp.hrsa.gov/bhpr/workforce.appendixc.pdf .
16.
Bureau of Health Professions. (2006b). Preliminary findings: 2004 national samples survey of registered nurses. Retrieved March 20, 2007, from www.bhpr.hrsa.gov/healthworkforce/reports/rnpopulation/preliminaryfindings.htm.
17.
Bureau of Labor Statistics. (2006-2007). Occupational outlook handbook. Retrieved November 13, 2006, from http://www.bls.gov/oco/ocos083.htm.
18.
Chen, Y.P., & Scott, J.C. (2006). Phased retirement: Who opts for it and toward what end?Washington, DC: American Association for Retired Persons.
19.
Cohen, J.D. (2006). The aging nursing workforce: How to retain experience nurses. Journal of Healthcare Management, 51, 233-245.
20.
Coleman, B., & Pandya, S. (2002). Family caregiving and long-term care: Fact sheet . Washington, DC: American Association of Retired Persons.
21.
Dentinger, E., & Clarkberg, M. (2002). Informal caregiving and retirement timing among men and women: Gender and caregiving relationships in late midlife. Journal of Family Issues, 23, 857-879.
22.
DiNatale, M. (2001). Characteristics and preferences for alternative work arrangements, 1999. Monthly Labor Review, 123, 28-49.
23.
Eschtruth, A.D., Sass, S.A., & Aubry, J. (2007). Employers lukewarm about retaining older workers . Boston: Boston College Center for Retirement Research.
24.
Feinberg, L.F., & Newman, S.L. (2004). A study of 10 states since passage of the national family caregiver support program: Policies, perceptions and program development . The Gerontologist, 44, 760-769.
25.
Feinsod, R., Davenport, T., & Arthurs, R. (2005). The business case for workers age 50+: Planning tomorrow's talent needs in today's competitive environment. Washington, DC: American Association for Retired Persons .
26.
Government Accountability Office. (2007). Engaging and retaining older workers. Washington, DC: U.S. Congress Comptroller General's Office.
27.
Ho, A., Collins, S., Davis, K., & Doty, M. (2005). A look at working-age caregiver's roles, health concerns, and need for support. Washington, DC: Commonwealth Fund.
28.
Johnson, R.W., & Lo Sasso, A.T. (2006). The impact of elder care on women's labor supply. Inquiry, 43, 195-210.
29.
Letvak, S. (2002). Retaining the older nurse. Journal of Nursing Administration, 32, 387-392.
30.
Mailey, S.S., Charles, J., Piper, S., Hunt-McCool, J., Wilborne-Davis, P., & Baigis, J. (2000). Analysis of the nursing work force compared with national trends. Journal of Nursing Administration, 30, 482-489.
31.
Martucci, W.C., & Sinatra, K.R. (2008). Caregivers in the workplace: Prohibitions against family-responsibility discrimination. Employment Relations Today, 34, 71-76.
32.
Minnick, A. (2000). Retirement, the nursing workforce, and the year 2005. Nursing Outlook, 48, 211-217.
33.
Monahan, D., & Hopkins, K. (2002). Nurses, long-term care, and eldercare: Impact on work performance. Nursing Economics, 20, 266-274.
34.
National Alliance for Caregiving. (2004). Caregiving in the U.S. Washington DC: American Association for Retired Persons.
35.
New York Academy of Medicine and Jonas Center for Nursing Excellence. (2006). Nursing retention and workforce diversity- Two key issues in New York City's nursing crisis. New York : Jonas Center for Nursing Excellence.
36.
New York State Department of Health. (2006 ). New York state nursing home profile. Retrieved November 16, 2006, from http://nursinghomes.nyhealth.gov/.
37.
Norman, L.D., Donelan, K., Buerhaus, P.I., Willis, G., Williams, M., Ulrich, B., et al. (2005). The older nurse in the workplace: Does age matter? Nursing Economics, 23, 282-289.
38.
Pandya, S. (2005). Caregiving in the United States: Research report . Washington DC: American Association for Retired Persons.
39.
Pandya, S., Wolkowitz, K., & Feinberg, L.F. (2006). Support for working family caregivers: Paid leave policies in California and beyond. San Francisco: Family Caregivers Alliance National Center on Caregiving.
40.
Pavlako, E.K., & Henderson, K.A. (2006). Combining care work and paid work: Do workplace policies make a difference? Research on Aging, 28, 359-374.
41.
Purcell, P. (2005). Older workers: Employment and retirement trends . Washington DC: Library of Congress Congressional Research Service.
42.
Rosenfeld, P. (2007). Workplace practices for retaining older hospital nurses: Implications from a study of nurses with eldercare responsibilities . Policy, Politics, & Nursing, 8, 120-129.
43.
Scanlon, W. (2001). "Nursing workforce: Recruitment and retention of nurses and nurses aides is a growing concern." Testimony before the Committee on Health, Education, Labor, and Pensions, U.S. Senate. Washington, DC: U.S. General Accounting Office. Retrieved November 19, 2006, from http://www.gao.gov/new.items./d01750t.pdf.
44.
Scharlach, A.E., & Grosswald, B. (1997). The family and medical leave act of 1993. Social Service Review, 71, 335-359.
45.
Spetz, J., & Adams, S., (2006). How can employment-based benefits help the nurse shortage? Health Affairs, 25, 212-218.
46.
Toosi, M. (2004). Labor force projections to 2012: The graying of the U.S. workforce. Monthly Labor Review, 127, 37-57.
47.
Toosi, M. (2007). Labor force projections to 2016: More workers in their golden years. Monthly Labor Reviews, 130, 33-52.
48.
Watson, R., Manthorpe, J., & Andrews, J. (2003). Older nurses and employment decisions. Nursing Standard, 18, 35-40.
49.
Williams, K.A., Stotts, R.C., Jacob, S.R., Steqbauer, C.C., Roussel, L., & Carter, D. (2006). Inactive nurses: A source for alleviating the nursing shortage? Journal of Nursing Administration, 36, 205-210.
50.
Young, L., & Newman, S. (2003). Caregiving and retirement planning: What happens to family caregivers who leave the work force?San Francisco : Family Caregiver Alliance.
