The phenomenon of career inactivity in professional nursing has been historically portrayed in the literature as a major cause of disequilibrium in the registered nurse labor market. However, there remains a general lack of understanding of the diverse forces that shape the inactive nurse pool and the likelihood that this population will return to nursing. The purpose of this study was to examine the population of registered nurses who are active in the labor market but work in nonnursing employment. Specifically, this study sought to determine the relative importance of nonworkplace- and workplace-related reasons for working outside of nursing. The results demonstrate that dissatisfaction with the nursing workplace is the key reason cited by actively licensed nurses for working outside of nursing employment. These findings suggest that policy and employer remedies are needed to improve the nursing workplace.
Aiken, L.H., Clarke, S.P., Cheung, R.B., Sloane, D.M., & Silber, J.H. (2003). Educational levels of hospital nurses and surgical patient mortality. Journal of the American Medical Association , 290, 1617-1623.
2.
Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J., & Silber, J.H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Journal of the American Medical Association, 288, 1987-1993.
3.
Anthony, A.S. (2004). Gender bias and discrimination in nursing education: Can we change it? Nurse Educator, 29(3), 121-125.
4.
Aspden, P., Wolcott, J., A., Bootman, J. L., & Cronenwett, L., R. (Eds.). (2006). Preventing medical errors: Quality chasm series. Washington, DC: National Academies Press.
Barron, D., & West, E. (2005). Leaving nursing: An event-history analysis of nurses' careers. Journal of Health Services Research and Policy , 10(3), 150-157.
7.
Berliner, H.S., & Ginzberg, E. (2002). Why this hospital nursing shortage is different . Journal of the American Medical Association, 288, 2742-2744.
8.
Berney, B., Needleman, J., & Kovner, C. (2005). Factors influencing the use of registered nurse overtime in hospitals, 1995-2000. Journal of Nursing Scholarship , 37, 165-172.
9.
Black, L.M. (2007). Sociodemographic, market, and political factors that influence nurses who do not work in nursing. Unpublished doctoral dissertation , University of CaliforniaSan Francisco .
10.
Blegen, M., Vaughn, T., & Vojir, C. (2008). Nurse staffing levels: Impact of organizational characteristics and registered nurse supply. Health Services Research, 43, 154-173.
11.
Bleich, M.R., Hewlett, P.O., Santos, S.R., Rice, R.B., Cox, K.S., & Richmeier, S. (2003). Analysis of the nursing workforce crisis: A call to action. American Journal of Nursing, 103(4), 66-74.
12.
Bowles, C., & Candela, L. (2005). First job experiences of recent RN graduates: Improving the work environment. Journal of Nursing Administration , 35, 130-137.
13.
Brewer, C.S., Kovner, C.T., Yow-Wu, W., Greene, W., Liu, Y., & Reimers, C. (2006). Factors influencing female registered nurses' work behavior. Health Services Research, 41, 860-886.
14.
Brewer, C.S., & Nauenberg, E. (2003). Future intentions of registered nurses employed in the western New York labor market: Relationships among demographic, economic, and attitudinal factors. Applied Nursing Research, 16, 144-155.
15.
Buerhaus, P., Staiger, D.O., & Auerbach, D.I. (2000). Implications of an aging registered nurse workforce. Journal of the American Medical Association, 283, 2948-2954.
16.
Buerhaus, P.I. (1999). Is a nursing shortage on the way? Nursing Management, 30(2), 54-55.
17.
Buerhaus, P.I. (2001). Aging nurses in an aging society: Long-term implications . Reflections on Nursing Leadership, 27, 35-36.
18.
Buerhaus, P.I. (2005). Six-part series on the state of the RN workforce in the United States. Nursing Economics, 23, 58-60.
19.
Buerhaus, P.I., Donelan, K., Ulrich, B.T., DesRoches, C., & Dittus, R. (2007). Trends in the experience of hospital-employed registered nurses: Results from three national surveys. Nursing Economics, 25, 69-80.
20.
Buerhaus, P.I., Donelan, K., Ulrich, B.T., Norman, L., DesRoches, C., & Dittus, R. (2007). Impact of the nurse shortage on hospital patient care: Comparative perspectives. Health Affairs, 26(3), 853-862.
21.
Bureau of Health Professions. (2006). Area resource file. Retrieved February 20, 2007, from http://www.arfsys.com
22.
Chao, E.L. (2005). Women in the labor force: A datebook. Washington, DC: U.S. Department of Labor .
23.
Chiha, Y.A., & Link, C.R. (2003). The shortage of registered nurses and some new estimates of the effects of wages on registered nurses labor supply: A look at the past and a preview of the 21st century. Health Policy , 64, 349-375.
24.
Duffield, C., Aitken, L., O'Brien-Pallas, L., & Wise, W.J. (2004). Nursing: A stepping stone to future careers. Journal of Nursing Administration, 34, 238-245.
25.
Duffield, C., Pallas, L.O., & Aitken, L.M. (2004). Nurses who work outside nursing. Journal of Advanced Nursing, 47, 664-671.
26.
Durand, M.A., & Randhawa, G. (2002). Nurses' views about returning to practice after a career break. British Journal of Nursing, 11, 477-485.
27.
Ferreira, M.M. (2007). Nurses' organizational commitment: The discriminating power of gender. Nursing Administration Quarterly, 31, 61-67.
28.
Fottler, M.D., & Widra, L.S. (1995). Intention of inactive registered nurses to return to nursing. Medical Care Research Review, 52, 492-516.
29.
Frijters, P., Shields, M.A., & Price, S.W. (2007). Investigating the quitting decision of nurses: Panel data evidence from the British National Health Service. Health Economics, 16, 57-73.
30.
Gullatte, M.M., & Jirasakhiran, E.Q. (2005). Retention and recruitment: Reversing the order. Clinical Journal of Oncology Nursing , 9, 597-604.
31.
Harrington, C., Swan, J.H., & Carillo, H. (2007). Nurse staffing levels and Medicaid reimbursement rates in nursing facilities. Health Services Research, 42, 1105-1129.
32.
Health Resources and Services Administration. ( 2006). The registered nurse population. Findings from the March 2004 National Sample Survey of Registered Nurses. Washington, DC: U.S. Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions.
33.
Hu, J., Herrick, C., & Hodgin, K.A. (2004). Managing the multigenerational nursing team. The Health Care Manager, 23, 334-340.
34.
Jackson, C. (2005). The experience of a good day: A phenomenological study to explain a good day as experienced by a newly qualified RN. Accident and Emergency Nursing, 13, 110-121.
35.
Joint Commission on Accreditation of Healthcare Organizations. (2002). Health care at the crossroads: Strategies for addressing the evolving nursing crisis. Washington, DC: Author.
36.
Keogh, B., & O'Lynn, C. (2007). Male nurses' experiences of gender barriers: Irish and American perspectives. Nurse Educator, 32(6), 256-259.
37.
Kingma, M. (2001). Nursing migration: Global treasure hunt or disaster-in-the-making ? Nursing Inquiry, 8, 205-212.
38.
Kovner, C.T., & Brewer, C.S. (2001). Research questions about the nursing labor supply: Participation, wages, and pipeline issues. Applied Nursing Research, 14(3), 117-118.
39.
Kovner, C.T., Brewer, C.S., Ying, C., & Djukic, M. (2007). Work attitudes of older RNs. Policy, Politics, & Nursing Practice, 8, 107-119.
40.
Langan, J.C., Tadych, R.A., & Kao, C.C. (2007). Exploring incentives for rns to return to practice: A partial solution to the nursing shortage. Journal of Professional Nursing, 23, 13-20.
41.
Latham, C., Hogan, M., & Ringl, K. (2008). Nurses supporting nurses: Creating a mentoring program for staff nurses to improve the workforce environment. Nursing Administration Quarterly, 32, 27-39.
42.
Link, C.R. (1992). Labor supply behavior of registered nurses: Female labor supply in the future? Research in Labor Economics, 13, 287-320.
43.
Long, K.A., & Bernier, S. (2004). RN education: A matter of degrees. Nursing, 34(3), 48-51; discussion 50-51.
44.
Lundgren, S.M., Nordholm, L., & Segesten, K. (2005). Job satisfaction in relation to change to all-RN staffing. Journal of Nursing Management, 13, 322-328.
45.
Malone, B. (2007). Testimony of Bevery Malone, Executive Director of the National League for Nursing to the House of Representatives Subcommittee on Labor, Health and Human Services, Education and Related Agencies Committee on Appropriations United States House of Representatives on Title VIII Nursing Workforce Development Programs. Retrieved June 3, 2007, from http://www.nln.org/governmentaffairs/pdf/ceo_testimony.pdf
46.
McGettrick, K.S., & O'Neill, M.A. (2006). Critical care nurses: Perceptions of 12-h shifts . Nursing in Critical Care, 11, 188-197.
47.
McIntosh, B., Rambur, B., Palumbo, M.V., & Mongeon, J. (2003). The older nurse: Clues for retention. Nursing and Health Policy Review, 2, 61-77.
48.
Moses, E.B. (1992). The registered nurse population: Findings from the National Sample Survey of Registered Nurses, March 1992. Rockville, MD: Health Resource Services Division of Nursing, Bureau of Health Professions. U.S. Government Printing Office.
49.
Moses, E.B. (1996). The registered nurse population: Findings from the National Sample Survey of Registered Nurses, March 1996. Rockville, MD: Health Resource Services Division of Nursing, Bureau of Health Professions. U.S. Government Printing Office.
50.
National Institute on Aging. (2007, July). Health and retirement survey, 2006 core (Early, version 1.0) .
51.
National Sample Survey of Registered Nurses. (2004). Retrieved April 29, 2008, from ftp://ftp.hrsa.gov/bhpr/workforce/appendixc.pdf
52.
Norman, L., Donelan, K., Buerhaus, P., Willis, G., Williams, M., Ulrich, B., et al. (2005). The older nurse in the workplace: Does age matter? Nursing Economics, 23, 282-289.
53.
O'Campo, P., Eaton, W.W., & Muntaner, C. (2004). Labor market experience, work organization, gender inequalities and health status: Results from a prospective analysis of US employed women. Social Science & Medicine, 58, 585-594.
54.
Orsolini-Hain, L., & Malone, R. (2007). Examining the impending gap in clinical nursing expertise. Policy, Politics, & Nursing Practice, 8, 158-169.
55.
Page, A. (Ed.). (2003). Keeping patients safe: Transforming the work environment of nurses. Washington, DC: National Academies Press .
56.
Richardson, A., Turnock, C., Harris, L., Finley, A., & Carson, S. (2007). A study examining the impact of 12-hour shifts on critical care staff. Journal of Nursing Management, 15, 838-846.
57.
Rivers, P.A., Fottler, M.D., & Komnenich, P. (2003). Caring for our aging population: Strategies for confronting the nursing shortage. Nursing and Health Policy Review, 2, 99-115.
58.
Rosenfeld, P. (2007). Workplace practices for retaining older hospital nurses: Implications from a study of nurses with eldercare responsibilities . Policy, Politics, & Nursing Practice, 8, 120-129.
59.
Sales, A.E., Sharp, N.D., Li, Y.F., Greiner, G.T., Lowy, E., Mitchell, P., et al. (2005). Nurse staffing and patient outcomes in Veterans Affairs hospitals. Journal of Nursing Administration , 35, 459-466.
60.
Seago, J.A., Ash, M., Spetz, J., Coffman, J., & Grumbach, K. (2001). Hospital registered nurse shortages: Environmental, patient, and institutional predictors. Health Services Research , 36, 831-852.
61.
Sochalski, J. (2002a). Nursing shortage redux: Turning the corner on an enduring problem. Health Affairs, 21(5), 157-164.
62.
Sochalski, J. (2002b). RNs not working in nursing: An analysis of trends, characteristics, and work patterns: Report to the National Advisory Council on Nursing Education and Practice, Division of Nursing, Health Resources and Services Administration, U.S. Department of Health and Human Services.
63.
Social Security Administration. (2007). Retirement benefits by year of birth [Electronic version]. Retrieved July 21, 2007, from http://www.socialsecurity.gov/retire2/agereduction.htm
64.
Spetz, J. (2000). Hospital use of nursing personnel: Holding steady through the 1990s. Journal of Nursing Administration, 30, 344-346.
65.
Spetz, J. (2004). Hospital nurse wages and staffing, 1977 to 2002: Cycles of shortage and surplus. Journal of Nursing Administration , 34, 415-422.
66.
Spetz, J., & Given, R. (2003). The future of the nurse shortage: Will wage increases close the gap? Health Affairs, 22(6), 199-206.
67.
Spetz, J.E. (1995). Wages and employment of nurses: An analysis of demand and implications for policy. Unpublished doctoral dissertation, Stanford University.
68.
Stott, A. (2007). Exploring factors affecting attrition of male students from an undergraduate nursing course: A qualitative study. Nursing Education Today, 27, 325-332.
69.
Ulrich, B.T., Buerhaus, P.I., Donelan, K., Norman, L., & Dittus, R. (2005). How RNs view the work environment: Results of a national survey of registered nurses. Journal of Nursing Administration, 35, 389-396.
70.
Ulrich, B.T., Buerhaus, P.I., Donelan, K., Norman, L., & Dittus, R. (2007). Magnet status and registered nurse views of the work environment and nursing as a career. Journal of Nursing Administration, 37, 212-220.
71.
Unruh, L.Y. (2005). Employment conditions at the bedside: A cause of and solution to the RN shortage. Journal of Nursing Administration , 35, 11-14.
72.
U.S. Department of Labor Bureau of Health Statistics. (2006). Occupational employment statistics. Retrieved April 29, 2008, from http://www.bls.gov/oes/home.htm#data
73.
Watson, R., Manthorpe, J., & Andrews, J. (2003). Older nurses and employment decisions. Nursing Standard, 18(7), 35-39.
74.
Wendt, A. (2007). 2006 job analysis of medication assistants. Chicago: National Council of State Boards of Nursing .
75.
Yang, K.P., & Huang, C.K. (2005). The effects of staff nurses' morale on patient satisfaction. Journal of Nursing Research, 13, 141-152.
