Intent to stay: a pilot study of baccalaureate nurses and hospital nursing

Hospitals want to hire baccalaureate nurses. Even if there were sufficient numbers of baccalaureate nurses to fill hospital vacancies, however, it is unclear how long these nurses stay at the "bedside." Until the profession can ascertain how many baccalaureate nurses stay in hospital nursing, simply preparing enough of them will not suffice. Because no published studies were identified that examined either how long baccalaureate nurses stay in hospital nursing or these nurses' reasons for leaving hospital nursing, we undertook a pilot study of our own baccalaureate graduates. Specifically, this comparative descriptive pilot study examined baccalaureate nurses' average number of years in hospital nursing and their reasons for leaving or intending to leave hospital nursing. Three hundred ninety graduates responded. Forty percent had left hospital nursing after an average of 6.4 years, with a median of 5 years. Just over 56% were still practicing hospital nursing, and of these, 81.8% were staff RNs, 26.9% of whom intended to leave hospital nursing in the next 3-5 years. Nurses who intended to leave were less satisfied in their jobs (P < .0001) than those who did not intend to leave. They were also more likely to disagree that RNs played a participatory role in hospital affairs (P = .048), that there were adequate staffing and resources (P = .041), and that RN-physician relationships were collegial (P = .048). The most frequent reasons for intent to leave were the following: to advance education or to take new positions (43%), stress/burnout, long hours, and lack of administrative support/respect (21%, respectively). Only 17% cited poor pay/benefits as a reason for intent to leave. Respondents who had already left hospital nursing cited similar reasons. Dissatisfaction with the practice environment results in baccalaureate nurses leaving hospital nursing at a time when there is a critical shortage of nurses in all practice settings, but especially hospitals. Considering the accumulating evidence of superior patient outcomes in hospitals well staffed by baccalaureate nurses, it is critical to identify and implement solutions to ensure that adequate numbers of experienced, baccalaureate nurses stay at the bedside.