Florida Researchers Tackle Turnover Problem Among Long-Term Care Nurses

January 6, 1997

GAINESVILLE, Fla.—High turnover among long-term care nurses is creating a shortfall in their ranks, just as demand for them is entering a decade of rapid growth, University of Florida researchers report.

The trend’s fallout — overworked, irritable nurses more prone to poor clinical judgment — is equally bad news for their elderly patients and already is showing up.

So UF experts set out to explore the heart of the problem: What makes some nurses stay and others go?

For those who remain, the answer is obvious: job satisfaction and strong ties to the community.

A recent survey of nearly 1,000 nursing homes estimated the annual turnover among nurses is almost 1 in 5, or 19 percent, according to the American Nurses’ Association. Meanwhile, the demand for nurses employed in long-term care is escalating rapidly as an increasing number of adults older than 85 enter nursing homes, health-care analysts predict.

To avoid problems, some facilities have resorted to employing temporary agency nurses to fill staff shortages. The catch? Use of agency nurses heightens the possibility of fragmenting care and significantly raises operational costs, UF researchers state in the December issue of the Journal of Applied Gerontology.

They recently surveyed 441 nurses employed in 26 urban and rural long-term care facilities throughout northern Florida. Of the 281 respondents, 147 intended to stay in their current positions. The survey outlined 20 characteristics affecting job satisfaction.

Respondents who said they intended to remain in their jobs had lived in their community longer than their counterparts. In addition, perceived supervisor interest in their career aspirations, whether they had five or more friends among fellow staffers and a shorter commute to work also proved significant.

“The inability of long-term facilities to attract and retain an adequate staff of nurses can have deleterious effects on the quality of patient care,” the UF report states. “…Long-term care facilities need to be able to attract and retain a stable staff of experienced nurses.”

Says Loree Felsen, an assistant professor in UF’s College of Nursing and a member of the research team that tackled the issue, “Clients admitted to long-term care facilities are not dynamic — instead this becomes their residence and they’re there for the duration. So turnover affects both quality and continuity of care.

“This is important because things nurses value are in the realm of control of the nursing executive or nursing home administrator. Supervisors can show an interest in their employees’ careers and help to foster positive interpersonal relationships among co-workers so people develop friendships. They also can look at relative information at the time they hire a nurse, such as their travel time. When they are deciding between two equally qualified job candidates, but one lives nearby and one has to commute a longer distance, they might want to select the former.”

Good managers and administrators have long recognized the value of making employees feel good about the work they are doing, the report states.

“The underlying thread in each of these associations may well be the importance of making employees feel they are … a valued part of the success of the organization,” researchers write.