Improving Nurse Retention in the National Health Service in England: The Impact of Job Satisfaction on Intentions to Quit

In recent years the British National Health Service (NHS) has experienced an acute shortage of qualified nurses. This has placed issues of recruitment and retention in the profession high on the political agenda. In this paper, we investigate the determinants of job satisfaction for nurses and establish the importance of job satisfaction in determining nurses' intentions to quit the NHS. We find that nurses who report overall dissatisfaction with their jobs have a 65% higher probability of intending to quit than those reporting to be satisfied. However, dissatisfaction with promotion and training opportunities are found to have a stronger impact than workload or pay. Recent policies, which focus heavily on improving the pay of all NHS nurses, will have only limited success unless they are accompanied by improved promotion and training opportunities. Better retention will, in turn, lead to reduced workload.

[1]  M. Shields,et al.  Racial Harassment, Job Satisfaction and Intentions to Quit: Evidence from the British Nursing Profession , 2000, SSRN Electronic Journal.

[2]  Andrew K. Rose,et al.  Job Switching and Job Satisfaction in the U , 1988 .

[3]  A. Hagell,et al.  Nursing in a Multi-ethnic NHS , 1995 .

[4]  M. Gordon,et al.  A Re-Examination of the Relationship between Union Membership and Job Satisfaction , 1995 .

[5]  Seamus Heaney,et al.  Finders Keepers , 2002 .

[6]  A. Oswald,et al.  Satisfaction and comparison income , 1996 .

[7]  Peter Dolton,et al.  Leaving Teaching in the UK: A Duration Analysis , 1995 .

[8]  T W Tai,et al.  Review of nursing turnover research, 1977-1996. , 1998, Social science & medicine.

[9]  Peter J. Sloane,et al.  Are “Overpaid” Workers Really Unhappy? A Test of the Theory of Cognitive Dissonance , 1996 .

[10]  Stephen Pudney,et al.  Gender and Racial Discrimination in Pay and Promotion for NHS Nurses , 1999, SSRN Electronic Journal.

[11]  V. Phillips.  Nurses' labor supply: participation, hours of work, and discontinuities in the supply function. , 1995, Journal of Health Economics.

[12]  L. Allen.  I. Seccombe and G. Smith, Taking Part: Registered Nurses and the Labour Market in 1997 , Brighton: Institute for Employment Studies, 1997, £25.00, Report No. 338. , 1998 .

[13]  A. Gray,et al.  Labour turnover in the British National Health Service: a local labour market analysis. , 1996, Health policy.

[14]  D. Laband,et al.  The Effects of Sexual Harassment on Job Satisfaction, Earnings, and Turnover among Female Lawyers , 1998 .

[15]  E. J. Schumacher.  Relative wages and exit behavior among registered nurses , 1997 .

[16]  R. Ryland.  Workloads, Pay and Morale of Qualified Nurses in 1994 , 1995 .

[17]  Fanny Caranikas-Walker,et al.  A meta-analytical structural equations analysis of a model of employee turnover. , 1992 .

[18]  J. MacKinnon,et al.  Estimation and inference in econometrics , 1994 .

[19]  Andrew E. Clark,et al.  Job Satisfaction, Wage Changes, and Quits: Evidence from Germany , 1997 .

[20]  A. Clark.  Job Satisfaction in Britain , 1996 .

[21]  P. Warr.  Well-being and the workplace. , 1999 .

[22]  Orley Ashenfelter,et al.  Essays in Labor Market Analysis , 1979 .

[23]  Peter J. Sloane,et al.  Non-pecuniary Advantages Versus Pecuniary Disadvantages; Job Satisfaction Among Male And Female Academics In Scottish Universities , 2000 .

[24]  Andrew E. Clark,et al.  What really matters in a job? Hedonic measurement using quit data , 2001 .

[25]  A. Maynard.  Book Review: OHE compendium of health statistics. OHE, 12 Whitehall, London SW1A 2DY, 1997 , 1998 .

[26]  Stephen Pudney,et al.  Gender, race, pay and promotion in the British nursing profession: estimation of a generalized ordered probit model , 2000 .

[27]  A. Clark.  Job Satisfaction and Gender. Why are Women so Happy at Work , 1997 .

[28]  J. C. Gower,et al.  Factor Analysis as a Statistical Method. 2nd ed. , 1972 .

[29]  J. Hunt.  Recruiting, Retaining and Motivating Nursing Staff: The Use of Clinical Ladders by J. Buchan M. Thomson. The Institute of Employment Studies, Brighton, 74 pages, £25.00, ISBN 1 85184 267 5. , 1998 .

[30]  C. Normand,et al.  The costs of nursing turnover: evidence from the British National Health Service. , 1996, Health policy.

[31]  Nestor K. Ovalle,et al.  A review and meta-analysis of research on the relationship between behavioral intentions and employee turnover. , 1984 .

[32]  I. Seccombe,et al.  Taking Part: Registered Nurses and the Labour Market in 1997 , 1997 .