Career Motivation in Newly Licensed Registered Nurses: What Makes Them Remain.

Introduction Nurses around the globe represent the largest group of health professionals (Bureau of Labor Statistics, 2010). Nurses are described as veritable caregivers and the strength of our healthcare system (Gordon, 2005). However, the issue of recruitment and retention in nursing is a worldwide concern (Lai, Peng, & Chang, 2006). With a forecasted national nursing shortage that will intensify over the next decade, nursing leaders are looking for approaches that will attract and retain the newest generation of nurses (Halfer, 2007). Camerino, Conway and Van de Heijden (2006) suggest that new and creative ways of encouraging nurses to remain in nursing are urgently needed because of the increasing complexities of healthcare delivery, and the aging population. One of the most perplexing healthcare retention issues is keeping newly licensed nurses from leaving after just a year or two of employment in the clinical setting (Zucker, Goss, Williams, Bloodworth, Lynn, Denker, et al., 2006). Kovner, Brewer, Fairchild, Poornima, Hongsoo and Djukic (2007) presented evidence that 13% of newly licensed RNs had changed principal jobs after one year, and 37% reported that they felt ready to change jobs. Nurses leave the profession mainly because of low pay and poor job satisfaction (DiMeglio, Padula, & Piatek, 2005). Therefore, nurse leaders are faced with two challenges: to recruit sufficiently qualified nurses and to establish rewarding work cultures that promote retention. Recruiting a younger generation of nursing staff members and meeting retention demands of cross-generational nurses will be a challenge like no other previously seen in healthcare (Cordinez, 2002). Newly licensed nurses' recruitment and retention into the workplace are fundamental strategies for ensuring that healthcare systems have the continued capacity to deliver patient care (Berliner & Ginzberg, 2002). Understanding why newly licensed registered nurses choose to remain in nursing is an essential component of recruitment and retention strategies. Despite a recent four year trend of increasing nursing school enrollment and graduation of qualified nurses (American Association of Colleges of Nursing, 2005), the latest data on the shortage of RNs in the United States is estimated to reach about 500,000 by 2025 (Buerhas, Staiger, & Auerbach, 2000). Hecker (2005) predicts that more than one million new and replacement nurses will be needed by the year 2014. The problem is that many of the newly licensed nurses will not remain in nursing and will choose to leave the profession within four years of graduation from a nursing program (Sochalski, 2002). In a study by Bowles and Candela (2005), 30% of newly licensed RNs left their first nursing position within one year of employment, and 57% left their first nursing position within two years of employment. The nursing shortage and the high incidence of turnover among newly licensed nurses within the first year of employment need to be investigated. It is well documented that nurses are leaving the profession because they are dissatisfied with current working conditions and not because they are disenchanted with the ideal of nursing, which originally attracted them to the profession (Lynn & Redman, 2005; Strachota, Normandin, O'Brien, Clary, & Krukow, 2003). There is limited research that addresses newly licensed registered nurses' career choices post graduation. The future of nursing rests in the ability to recruit and retain upcoming generations to the profession. Currently, however, there is limited knowledge concerning what influences the decisions of newly licensed registered nurses to remain in nursing. Thus, the objective of this study was to identify factors that influence newly licensed registered nurses' decision to remain in nursing. Review of the Literature The shortage of people entering professional nursing, nurses' dissatisfaction, and high turnover of newly licensed registered nurses are issues of concern. …