The influence of nurse employment status on market level nurse retention

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Résumé (français)

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Résumé (anglais)

Empirical nurse labour supply studies identified demographic and workplace factors impacting a nurse’s decision to exit the profession. These studies focused only on the Hospital sector and assume that part-time and casual nurses are a homogenous group. Health care decision makers applied the findings from these empirical nurse labour supply studies to generate “one-size-fits-all” cross-sectoral nurse retention strategies. This research project explores: the homogeneity assumption of part-time and casual nurses, the influence of the workplace sector, the effectiveness of a generic government retention strategy targeting nurse employment status and the relationship between nurses’ demographic and workplace characteristics on nurses’ labour supply decisions using labour economic theory. Longitudinal administrative data from the College of Nurses of Ontario (1993-2006) were analyzed using survival analysis and “stickiness” to assess full-time, part-time and casual nurses’ exit rates from Ontario’s nurse profession and their employment status changes before and after the Ministry of Health and Long-Term Care’s Full Employment of Nurses Initiative. Canadian Institute for Health Information, Statistics Canada and Health Canada survey data (2005) were analyzed using multinomial logit regression to examine the relationships between nurses’ employment status decisions and their demographic, training and workplace characteristics. Results indicate casual nurses regardless of workplace sector have the highest exit rate. After the Initiative, more casual nurses switched to PT, younger PT and CAS nurses switched to FT. Casual nurses tend to be younger, working in the community sector or dissatisfied with their job. In conclusion, variances in nurses’ labour supply decisions to exit the profession, switch employment status after the Initiative and to work full-time, part-time or casual illustrate the heterogeneity of part-time and casual nurses. Future empirical nurse turnover studies should treat part-time and casual nurses separately. Market level nurse retention strategies should target demographic differences and nurse work behaviour divergences rather than traditional “one-size-fits-all” approach.