Nursing CE Central
Nurses in Michigan have reported an improvement in working conditions, and fewer expressed interest in leaving the profession. Still — abuse, planned departure rates, and unsafe working conditions remained at high levels, according to a new study.
“Changes in Registered Nurse Employment Plans and Workplace Assessments,” published July 18 in JAMA Network Open, compared results of the 2022 and 2023 Michigan Nurses’ Study.
“Michigan nurses reported high emotional exhaustion or burnout scores, understaffed patient care areas, occurrence of abusive or violent workplace events in the past 12 months, and job dissatisfaction,” the authors stated.
These results are, in some instances, representative of nurses nationally, as discovered through a review of previous Nursing CE Central coverage.
More than 7,000 Michigan registered nurses were surveyed between May 17 and June 1, 2023, and 9,150 nurses were surveyed between Feb. 22 and March 1, 2022. In comparing the data sets, the study authors found a roughly 7% drop (39.1% in 2022 vs. 32% in 2023) in nurses who planned to leave their job within one year.
“Fewer nurses in the 2023 survey reported plans to leave their current position, reduce their clinical hours, or pursue travel nursing,” the authors stated. “These findings suggest somewhat improved working conditions and possible easing of workforce pressures.”
However, new questions posed to the 2023 cohort dug further into motivations for leaving an employer, revealing that 13% intended to leave the profession as a whole (excluding retirements). With retirements included, the number of nurses exiting the industry came in at 36%.
Christopher Friese, the study’s principal investigator and a nursing professor, said the demographics of those who plan to leave the profession are concerning because, in theory, they have “years left in their nursing careers.”
“These nurses are leaving the profession Americans have trusted the most for two decades,” Friese stated in a University of Michigan news release. “This is the group we should be listening to very carefully. And they are leaving because health care leaders are not addressing their valid concerns about their workplaces and chronic understaffing.”
The one-third of respondents who planned to leave their role were asked if experiencing abuse or a “violent workplace event,” emotional exhaustion, or poor patient safety were contributing factors in their decision.
“There may be larger societal factors associated with the high rate of planned departures observed in the present study, including general economic conditions, family factors, and alternative job opportunities,” the authors stated.
Karen Lasater, Ph.D. and RN, called the survey findings a “welcome shift” following years of reports citing burnout, turnout and vacancies. But similar to the authors, she noted in her commentary response to the University of Michigan analysis that “serious problems” persist.
“Efforts to train and recruit more nurses are akin to fueling a car with a leaking gas tank,” she wrote.
Without action from hospital or organizational leadership, Lasater argued, legislators must take the lead in addressing workforce concerns.
“Policymakers should allocate funding and regulatory efforts to evidence-based strategies that address the retention crisis at the source,” Lasater wrote. “Policymakers need not solve for a low workforce supply issue … Instead, policies are needed to address the low retention caused by employers’ chronic understaffing, rigid scheduling options, and lack of responsiveness to clinicians’ recommendations to improve care, which drives nurses to burnout and depart for better working conditions.”
Lasater named California’s registered nurse staffing standards as proof that legislative policy can help improve both patient outcomes and nurse retention. Other states have followed suit with minimum, and the American Nurses Association (ANA) endorses such policies.
Nursing CE Central has followed industry trends for several months, noting both retention and recruitment as main issues for organizations, leadership, and nurses themselves.
Data from the U.S. Bureau of Labor Statistics shows that employment of registered nurses is expected to grow 6% from 2022 to 2032, with many openings “expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.”
The U.S. Chamber of Commerce also named retention as a key factor in the nursing industry shortage.
“The turnover rate for nursing spans from 8.8% to as high as 37%, depending on the region and nursing specialty,” the report stated. “In fact, more than half of nurses leave their job within the first two years.”
Tenure is considered complex and “nuanced” when it comes to workforce dynamics and retention, according to “The American Nurses Foundation, Pulse on the Nation’s Nurses Survey Series: Multigenerational Nurse Experience Survey.”
“The early-tenure population is particularly important to retain as more experienced nurses reach retirement age,” the ANF report stated. “Supporting and retaining mid-tenure and most-tenured nurses is also crucial given the critical role they play in teaching and mentoring those newer to the profession.”
The 2024 NSI National Health Care Retention & RN Staffing Report found that healthcare leadership named recruiting and retention as top priorities.
“It is what keeps CEOs, CNOs and CHROs up at night,” the survey stated. “Since turnover has a direct correlation to staffing and is a leading indicator of future financial pressure, and patient and employee satisfaction, it is easy to understand why healthcare executives are concerned.”
As part of its advocacy efforts, particularly as it relates to retention, the ANA supports the Workplace Violence Prevention for Health Care and Social Service Workers Act and legislation that would implement nurse staffing standards.
A new study from the University of Michigan shows modest improvements in the nursing industry. However, it reiterates that retention, staffing levels, and supporting staff are still key issues that must be addressed. Based on previous NCC coverage, the study out of Michigan is indicative of the trends throughout the nation. Industry professionals suggest that if hospital and organizational leaders won’t implement changes, then legislators must take action, in part, by establishing minimum nurse staffing ratios.
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