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http://dx.doi.org/10.5807/kjohn.2022.31.4.187

The Pathways of Nurse Turnover in Long-term Care Hospitals  

Kim, Samsook (Department of Nursing, Daedong College)
Lee, Ga Eon (College of Nursing, Dong-A University)
Barbara, Bowers (School of Nursing, University of Wisconsin-Madison)
Jo, Yeonjae (Department of Nursing, Kyungil University)
Publication Information
Korean Journal of Occupational Health Nursing / v.31, no.4, 2022 , pp. 187-197 More about this Journal
Abstract
Background: This study explores the pathways of nurse turnover in long-term care hospitals (LTCHs) and its underlying conditions in Korea. Although the factors of staying or leaving of nurses in LTCHs have been reported, few studies have examined the trajectory and conditions of nurses staying in and leaving LTCHs. Methods: A qualitative study design with a grounded theory approach was conducted. Data were collected in one-to-one interviews. Purposive and theoretical sampling led to the inclusion of 20 registered nurses from 15 LTCHs in South Korea. Results: Seeking work-life balance was the core category of the nurses' turnover pathway. The consequences of the nurses' turnover pathway were categorized into three groups: thriving, surviving, and leaving. Thriving nurses found meaning in their work, fostered good relationships, and saw opportunities for growth. Surviving nurses were enduring their jobs in LTCHs, having a work-life balance, and supportive nursing leaders. Leaving group nurses wished to leave LTCHs due to a lack of professional growth, unappealing work, continued conflict, and social stigma. Conclusion: This study provided the trajectory and conditions for nurses to enter, stay, move, or leave. Understanding the pathways for staying or leaving can be used as a strategy for successful retention of registered nurses in LTCHs.
Keywords
Long-term care; Personnel turnover; Nursing staff; Reward; Qualitative research;
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1 Flinkman, M., & Salantera, S. (2015). Early career experiences and perceptions-a qualitative exploration of the turnover of young registered nurses and intention to leave the nursing profession in Finland. Journal of Nursing Management, 23(8), 1050-1057. https://doi.org/10.1111/jonm.12251   DOI
2 Flinkman, M., Laine, M., Leino-Kilp,i H., Hasselhorn, H. M., & Salantera, S. (2008). Explaining young registered Finnish nurses' intention to leave the profession: A questionnaire survey. International Journal of Nursing Studies, 45(5), 727-739. https://doi.org/10.1016/j.ijnurstu.2006.12.006   DOI
3 Hassmiller, S. B., & Cozine, M. (2006). Addressing the nurse shortage to improve the quality of patient care. Health Affairs, 25(1), 268-274. https://doi.org/10.1377/hlthaff.25.1.268   DOI
4 Hospital Nurses Association. (2016). Survey on the status of hospital nursing staff placement. Seoul: Korean Hospital Nurses Association.
5 Hwang, J. I., & Chang, H. (2009). Work climate perception and turnover intention among Korean hospital staff. International Nursing Review, 56(1), 73-80. https://doi.org/10.1111/j.1466-7657.2008.00641.x   DOI
6 Korean Statistical Office. (2020, December 31). Korean Statistical Information Service. Retrieved September 26, 2022, from https://kosis.kr/statHtml/statHtml.do?orgId=350&tblId=TX_35003_A002
7 McNeese-Smith, D. K. (1999). A content analysis of staff nurse descriptions of job satisfaction and dissatisfaction. Journal of Advanced Nursing, 29(6), 1332-1341. https://doi.org/10.1046/j.1365-2648.1999.01018.x   DOI
8 Park, J. Y. (2021). Legal regulation for quality management in long-term care hospitals. Asia Pacific Journal of Health Law & Ethics, 14(3), 25-57. https://doi.org/10.38046/apjhle.2021.14.3.002   DOI
9 Skinner, N., & Chapman, J. (2013). Work-life balance and family-friendly policies. Evidence Base, 4, 1-25. https://doi.org/10.4225/50/558217B4DE473   DOI
10 Spitzer, R. (2006, October 01). Keys to avoiding a high rate of CNO turnover. Nurse Leader, 4(5), 4-5. https://doi.org/10.1016/j.mnl.2006.07.012   DOI
11 Jones, C. B. (2008). Revisiting nurse turnover costs: Adjusting for inflation. Journal of Nursing Administration, 38(1), 11-18. https://doi.org/10.1097/01.NNA.0000295636.03216.6f   DOI
12 Estryn-Behar, M., Van Der Heijden, B. I., Fry, C., & Hasselhorn, H. M. (2010). Longitudinal analysis of personal and work-related factors associated with turnover among nurses. Nursing Research, 59(3), 166-177. https://doi.org/10.1097/NNR.0b013e3181dbb29f   DOI
13 Flinkman, M., Isopahkala-Bouret, U., & Salantera, S. (2013, July 9). Young registered nurses' intention to leave the profession and professional turnover in early career: A qualitative case study. ISRN nursing, 916061. Retrieved September 26, 2022, from https://downloads.hindawi.com/archive/2013/916061.pdf
14 Hayward, D., Bungay, V., Wolff, A. C., & MacDonald, V. (2016). A qualitative study of experienced nurses' voluntary turnover: learning from their perspectives. Journal of Clinical Nursing, 25(9-10), 1336-1345. https://doi.org/10.1111/jocn.13210   DOI
15 Chen, I. H., Brown, R., Bowers, B. J., & Chang, W. Y. (2015). Work -to-family conflict as a mediator of the relationship between job satisfaction and turnover intention. Journal of Advanced Nursing, 71(10), 2350-2363. https://doi.org/10.1111/jan.12706   DOI
16 Bogossian, F., Winters-Chang, P., & Tuckett, A. (2014). "The pure hard slog that nursing is...": a qualitative analysis of nursing work. Journal of Nursing Scholarship, 46(5), 377-388. https://doi.org/10.1111/jnu.12090   DOI
17 Brewer, C. S., Kovner, C. T., Greene, W., & Cheng, Y. (2009). Predictors of RNs' intent to work and work decisions 1 year later in a US national sample. International Journal of Nursing Studies, 46(7), 940-956. https://doi.org/10.1016/j.ijnurstu.2008.02.003   DOI
18 Castle, N. G. (2006). Measuring staff turnover in nursing homes. The Gerontologist, 46(2), 210-219. https://doi.org/10.1093/geront/46.2.210   DOI
19 Lee, Y., Kim, J., Lee, Y., Kang, D., & Park, J. (2008). A survey on the status of nursing manpower supply and nursing management fee differential system. Seoul: Korea Small & Medium Hospital Council, Korea Health Industry Development Institute.
20 Corbin, J., & Strauss, A. (2014). Basics of qualitative research: Techniques and procedures for developing grounded theory (4th ed.). California: Sage publications.
21 McGilton, K. S., Boscart, V. M., Brown, M., & Bowers, B. (2014). Making tradeoffs between the reasons to leave and reasons to stay employed in long-term care homes: Perspectives of licensed nursing staff. International Journal of Nursing Studies, 51(6), 917-926. https://doi.org/10.1016/j.ijnurstu.2013.10.015   DOI
22 McNeese-Smith, D. K., & Nazarey, M. (2001). A nursing shortage: building organizational commitment among nurses/practitioner application. Journal of Healthcare Management, 46(3), 173.   DOI
23 Montayre, J., & Montayre, J. (2017). Nursing work in long-term care: An integrative review. Journal of Gerontological Nursing, 43(11), 41-49. https://doi.org/10.3928/00989134-20170519-02   DOI
24 Park, S., & Yeom, E. Y. (2016). Experience of the role conflict of nurses in long-term care hospitals. The Journal of the Korea Contents Association, 16(7), 368-381. https://doi.org/10.5392/JKCA.2016.16.07.368   DOI
25 Sellgren, S. F., Kajermo, K. N., Ekvall, G., & Tomson, G. (2009). Nursing staff turnover at a Swedish university hospital: An exploratory study. Journal of Clinical Nursing, 18(22), 3181-3189. https://doi.org/10.1111/j.1365-2702.2008.02770.x   DOI
26 Choi, J., Flynn, L., & Aiken, L. H. (2012). Nursing practice environment and registered nurses' job satisfaction in nursing homes. The Gerontologist, 52(4), 484-492. https://doi.org/10.1093/geront/gnr101   DOI
27 Bakker, A. B., Killmer, C. H., Siegrist, J., & Schaufeli, W. B. (2000). Effort-reward imbalance and burnout among nurses. Journal of Advanced Nursing, 31(4), 884-891. https://doi.org/10.1046/j.1365-2648.2000.01361.x   DOI
28 Buerhaus, P. I., Donelan, K., Ulrich, B. T., Norman, L., & Dittus, R. (2005). Is the shortage of hospital registered nurses getting bet-ter or worse? findings from two recent national surveys of RNs. Nursing Economics, 23(2), 61-71.