Aims: To examine determinants of intention to leave a nursing position in rural and remote areas within the next year, for Registered Nurses or Nurse Practitioners (RNs/NPs) and Licensed Practical Nurses (LPNs).
Design: A pan-Canadian cross-sectional survey.
Methods: The Nursing Practice in Rural and Remote Canada II survey (2014-2015) used stratified, systematic sampling and obtained two samples of questionnaire responses on intent to leave from 1,932 RNs/NPs and 1,133 LPNs. Separate logistic regression analyses were conducted for RNs/NPs and LPNs.
Results: For RNs/NPs, 19.8% of the variance on intent to leave was explained by 11 variables; and for LPNs, 16.9% of the variance was explained by seven variables. Organizational commitment was the only variable associated with intent to leave for both RNs/NPs and LPNs.
Conclusions: Enhancement of organizational commitment is important in reducing intent to leave and turnover. Since most variables associated with intent to leave differ between RNs/NPs and LPNs, the distinction of nurse type is critical for the development of rural-specific turnover reduction strategies. Comparison of determinants of intent to leave in the current RNs/NPs analysis with the first pan-Canadian study of rural and remote nurses (2001-2002) showed similarity of issues for RNs/NPs over time, suggesting that some issues addressing turnover remain unresolved.
Impact: The geographic maldistribution of nurses requires focused attention on nurses' intent to leave. This research shows that healthcare organizations would do well to develop policies targeting specific variables associated with intent to leave for each type of nurse in the rural and remote context. Practical strategies could include specific continuing education initiatives, tailored mentoring programs, and the creation of career pathways for nurses in rural and remote settings. They would also include place-based actions designed to enhance nurses' integration with their communities and which would be planned together with communities and nurses themselves.
目的: 探讨注册护士或执业护士(RNs/NPs)和持证护士(LPNs)在未来一年内辞去农村和偏远地区护理职务的决定因素。 设计: 泛加拿大横断面调查。 方法: 加拿大农村和边远地区护理实践II调查(2014-2015)过程中,采用分层、系统抽样的方法,对1932名注册护士/执业护士和1133名持证护士进行问卷调查,调查样本显示,共两名有意离职。分别对注册护士/执业护士和持证护士进行逻辑回归分析。 结果: 19.8%注册护士或执业护士的离职意愿与11个变量相关,而16.9%持证护士的离职意愿与7个变量相关;组织承诺是唯一与注册护士/执业护士和持证护士离职意愿都相关的变量。 结论: 强化组织承诺可以降低离职意愿和离职率,这一点至关重要。由于注册护士/执业护士和持证护士的离职意愿相关变量大多不同,护士类型的区分对于农村地区离职率降低策略的制定至关重要。将当前注册护士/执业护士分析中的离职意愿决定因素与首次泛加拿大农村和远程护士研究(2001-2002年)进行比较,比较结果表明,随着时间的推移,注册护士/执业护士的问题趋同,表明部分离职相关问题仍未解决。 影响: 当前,护士地理分布不均,因此需要关注护士的离职意愿。研究表明,医疗单位应该针对与农村和偏远地区不同类型护士离职意愿相关的特定变量制定政策。实际策略包括制定具体的继续教育计划,因地制宜编制指导计划,以及为农村和偏远地区的护士确定职业发展道路。此外,包括地方行动,旨在加强护士与社区的融合,同时为社区和护士作出规划。.
Keywords: intent to leave; licensed practical nurses; nurse practitioners; nurses; nursing; organizational commitment; registered nurses; remote; rural; turnover.
© 2020 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.