Doctoral Dissertations

Date of Award

6-1981

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Economics

Major Professor

Roger Bowlby

Committee Members

H. Alan Lasater, Hans. B. Jensen

Abstract

In an effort to determine why registered nurses leave a profession which requires an extensive investment in human capital, the present study set out to examine what effect economic and non-economic factors had on the mobility decision. Since labor force participation decisions also affect the delivery of health care, a subsidiary inquiry was lodged into factors which determine the short-run nursing supply. The case study method was used.

The primary instrument for data collection was the mail questionnaire. In all there were three major sub-groups targeted for analysis: registered nurses who were working in non-nursing profession, registered nurses who were actively licensed, and registered nurses who were inactively licensed. The North Carolina Board of Nursing provided the nurses and addresses of over 4,800 registered nurses and their respective activity status. Data gathered from a sub-sample of 555 nurses was tested by a linear probability regression model.

Poor earnings potential, lack of promotion opportunities, reduced "hands-on" patient care and increased patient load are a few of the factors which emerged as instrumental in the registered nurses decision to change occupations. On the other hand, elements long believed to add significantly to job dissatisfaction failed to materialize. The negative effect of occupational stress and the irregularity of the work period did not prove to be significant factors.

The models depicting short-run labor supply contributed additional insight into market behavior. The earnings of the spouse, the wage rate facing the individual nurse and the family's monthly expenses were all found to be relevant.

In order to retain professionals in an already labor scarce occupations, several preliminary suggestions are offered. One, to encourage permanence among those feel the lack of promotion possibilities as crucial to their mobility decision, the profession could adopt a queue system within and between various job classifications. Two, every effort should be made to keep inactive personnel up to date on the latest developments in nursing techniques through constant communication and workshops. Three, team nursing in specific units, particularly in critical care assignments should be thoroughly investigated and implemented if feasible. Fourth, grievance committees should be organized and made operable through demonstrated effectiveness. In sum, the problem of retention can best be solved by recognizing that the employment package involves many aspects in the life of the professional nurse and that unmet individual needs cannot be discounted or ignored.

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