Understanding what motivates job choices among registered nurses: A discrete choice experiment study

When nurses decide upon accepting a position, it is often a multifaceted decision that involves evaluating several job attributes simultaneously.

To examine the factors that motivate the job choices of registered nurses (RNs) at a large multispecialty academic medical center in the U.S. Midwest.

All direct care RNs including those working in inpatient, ambulatory, and remote settings working at our healthcare organization received an emailed survey link with an invitation to participate in the study. This study used discrete choice experiment (DCE) methods to examine RN job preferences. The DCE used six attributes to describe hypothetical nursing jobs. The attributes included appropriate nurse-to-patient ratio, salary, consistency in work schedule, work-related incentives, paid time off scheduling, and nurse manager support. A mixed logit model was used to estimate mean preference weights for the different attribute levels. A latent class analysis (LCA) was used to examine the number of preference classes in the sample.

The analysis included 1,667 respondents. The mixed logit model results showed the highest relative importance weight on the salary attribute (0.311) followed by appropriate nurse-to-patient ratio (0.202), paid time off scheduling (0.149), nurse manager support (0.140), consistency in work schedule (0.125), and work-related incentives attributes (0.073). The LCA showed that there were four preference classes.

Monetary and nonmonetary attributes were found to motivate RNs' job choices. The results from this study can be used to inform local recruitment and retention initiatives based on the average or subgroup RN preferences.