US nurse practitioner voluntary turnover: Development of a framework for analysis

Area of Science:

• Nursing Workforce Research
• Healthcare Management
• Human Resources in Healthcare

Background:

• Annual nurse practitioner (NP) turnover rates may reach 15%, necessitating better understanding and management strategies.
• Existing literature on NP turnover lacks generalizability and conceptual clarity, highlighting the need for a structured framework.
• Operationalizing NP turnover is crucial for administrators to implement effective workplace initiatives aimed at reducing attrition.

Purpose of the Study:

• To delineate and describe four distinct voluntary nurse practitioner (NP) turnover groups: dynamic leavers, static leavers, dynamic stayers, and static stayers.
• To analyze the demographic and job characteristics associated with voluntary turnover intention and actual turnover among US NPs.
• To provide a foundation for understanding the nuances of NP voluntary movement within the nursing profession.

Main Methods:

• A secondary analysis of a large dataset comprising 86,632 nurse practitioners (NPs) from the 2018 National Sample Survey of Registered Nurses (NSSRN).
• Utilizing a cross-sectional, descriptive research design to identify and characterize different NP voluntary turnover groups.
• The methodology focused on distinguishing between intention to leave and actual departure from positions or the profession.

Main Results:

• Older NPs with extensive experience who left the nursing profession were categorized as 'static leavers'.
• Younger, less experienced NPs who changed jobs but remained in nursing ('dynamic leavers') reported lower job satisfaction.
• NPs who stayed in their positions ('stayers'), irrespective of turnover intention, exhibited higher earnings and greater job satisfaction.

Conclusions:

• Four distinct voluntary nurse practitioner (NP) turnover groups were successfully defined and described, differentiating between turnover intention and actual turnover.
• Characterizing these NP turnover groups enables administrators to better mitigate workforce losses and anticipate organizational needs.
• A framework derived from the 2018 NSSRN data can guide future research and the development of targeted initiatives to bolster the NP workforce.