Assessment of nursing faculty retirement projections.

BACKGROUND: Nursing faculty retirement is a critical factor contributing to the nursing faculty shortage. PURPOSE: To assess the accuracy of projections on 2016 to 2025 nursing faculty retirements made in a previous study by Fang and Kesten (2017). METHODS: The 2016 to 2022 full-time nursing faculty data collected by American Association of Colleges of Nursing were used to examine the accuracy of the retirement projections for the same years. DISCUSSION: The study found that the mean age of full-time nursing faculty decreased for the first time; the number of faculty retirees and their age distributions projected by Fang and Kesten (2017) were accurate; there was a larger loss of nursing faculty at senior ranks to retirements than was anticipated; nursing faculty aged 50 to 59 in 2015 have made significant progress in doctoral attainment, senior rank, and graduate-level teaching by 2022, but they were still underrepresented in senior ranks compared to the 2016 to 2022 retirees; and for nursing faculty with a PhD degree, their growth was slower than their loss to retirements. CONCLUSION: The findings demonstrate the usefulness of the specific methods for faculty retirement projections. The decline in the mean age of nursing faculty is a positive sign that there is an increased recruitment of younger nurses into academia. The increase in the number of younger nurses entering academia with Doctor of Nursing Practice (DNP)-degree preparation can be leveraged through PhD-DNP collaboration to prepare practice-ready nursing graduates who contribute to health care improvements. Nursing schools need to implement innovative strategies to mentor younger faculty for their successful succession.

Burnout among academic nursing faculty.

BACKGROUND: Nurse faculty burnout is a growing concern in the United States. There are limited studies exploring the level of burnout in nursing faculty. PURPOSE: To assess the prevalence of burnout among nurse faculty in undergraduate and graduate programs and its relationship with specific demographic and organizational variables. METHODS: A descriptive cross-sectional research design was employed to examine the level of burnout of nursing faculty. An internet-based survey was administered to nursing faculty in over 1000 schools of nursing in the United States. Burnout was measured using the Oldenburg Burnout Inventory. RESULTS: A total of 3556 surveys were returned. Among all participants, most of the sample exhibited moderate levels of burnout, exhaustion, and disengagement. Based on the findings from the OBI, a moderate/high exhaustion level was reported in 85.5 % of participants, while disengagement was moderate/high in 84.9 %, and overall burnout was at moderate/high levels in 85.2 % of the nursing faculty. CONCLUSIONS: The nation's nurse faculty population is experiencing a moderate to high level of burnout, exhaustion, and disengagement. Academic nursing leaders are encouraged to identify ways and take action to reduce faculty burnout and promote faculty wellness and resilience.

Systematic Review of Burnout in US Nurses.

Nurses experience high levels of burnout, and this has become a major factor in recruitment and retention of nurses. Several factors have been associated with burnout, but it is not clear which factors are the most significant predictors. Understanding the most prevalent factors that are associated with burnout will allow for the development and implementation of interventions to ameliorate and/or reduce burnout in the nursing workforce.

Comparison of Factors Associated with Physician and Nurse Burnout.

Burnout is a condition resulting from chronic workplace stress that has not been effectively managed, described in 3 dimensions: (a) feelings of energy depletion or exhaustion, (b) increased mental distance from one's job, and (c) reduced professional efficacy. Burnout is a widespread problem reaching concerning levels among health care professionals, with more than 50% of physicians and one-third as many as 80% of nurses reporting symptoms. The National Academy of Medicine (NAM) action collaborative on clinician well-being and resilience has prioritized exploring ways to enhance baseline understanding of clinician well-being and promotion of multidisciplinary solutions to burnout.

Eight Ways Nurses Can Manage a Burnt-Out Leader.

Health professionals, including nurses, are vulnerable to burnout, which occurs when chronic stress is not managed. COVID-19 led to nurses working in stressful environments, and being required to work mandatory overtime. The result was an increase in burnout. Nurses exhibited physical, psychological, emotional, and behavioral signs of burnout. There are several ways that nurses can mitigate the situation and have more control over burnout. Nurses need to work together to support each other, including supporting the leader. There are several actions, such as mindfulness activities and maintaining a healthy lifestyle that can help prevent burnout.

Completion and attrition of DNP students of the 2006-2015 matriculating cohorts.

BACKGROUND: Despite the strong support for DNP education, we have limited knowledge about completion and attrition of DNP students, which are important measures of achievement of DNP programs. PURPOSE: To examine completion and attrition of students in DNP programs. METHODS: The data were obtained from AACN's Doctoral Student Roster Survey and Annual Survey of Baccalaureate and Graduate Programs in Nursing. 31,320 students who matriculated into DNP programs between 2006 and 2015 were selected. These years were chosen to ensure accurate estimates of graduation and attrition rates. Bivariate and multivariate analyses were used to examine the associations between individual and institutional characteristics and attrition of DNP students. FINDINGS: We found that the completion rate of DNP students of the 2006-2015 matriculating cohorts was 77.3% and the attrition rate was 19.3%. On average, after matriculation, it took 3 years for the students to graduate and 1.9 years for students who left without graduating to drop out. The mean age at matriculation was 39.9 and the mean age at graduation was 42.2. Our multivariate analysis found that male students, part-time students, students who were not faculty or held a part-time faculty position, and students in DNP programs with more than 50% of courses taught online were more likely to experience attrition. DISCUSSION: The study findings provide useful information for DNP programs and nursing schools to better understand academic progression of DNP students.

Impact of the Health Resources and Services Administration's state oral health workforce grant program on dental workforce density and access to oral health care.

BACKGROUND: The Health Resources and Services Administration's Grants to States to Support Oral Health Workforce Activities, otherwise known as the State Oral Health Workforce Program (SOHWP), help states develop and implement innovations that address the workforce needs of dental Health Professional Shortage Areas in a manner appropriate to the states' individual needs. AIM: This cross-sectional study explores the broad impact of the SOHWP by comparing measures of dental workforce density and access to oral health care in states with multiple years of funding versus states with few or no years of funding. METHODS: We used data for 2006-2016 SOHWP awardees together with data from the 2016-2017 Area Health Resources Files and the 2016 Behavioral Risk Factor Surveillance System to compare numbers of dentists per 100,000 population and age-adjusted prevalence of annual dental visits among adults for long-term SOHWP-funded states versus states with few or no years of funding. RESULTS: Multi-year SOHWP funding is associated with higher workforce density and greater access to oral health care, especially in the Midwest and West. CONCLUSION: Allowing states funding utilization flexibility may result in improved outcomes. This finding can help inform planning and policy about whether and how to scale future training and workforce programs to achieve greater impact.

Practice Environment Scale of the Nursing Work Index: A Reliability Generalization Meta-Analysis.

A healthy work environment is a critical factor in nurse satisfaction, retention, and patient outcomes. The Practice Environment Scale of the Nursing Work Index (PES-NWI) is the most commonly used instrument to measure the nursing practice environment. This study uses meta-analysis to examine the reliability generalization of the PES-NWI. A meta-analysis of 51 studies representing a total of 80,563 subjects was conducted. The mean score reliability for the PES-NWI based on 38 studies (n = 68,278) was .922 (p < .05). The Mean Weighted Effect Size was stronger for studies conducted in the United States versus non-U.S. (.946 vs. .907). For studies rated high and moderate quality, the mean score reliability was .911 and .946, respectively. Scores on the PES-NWI are reliable for measuring the nursing practice environment across samples in the United States and non-U.S. countries.

Trends in racial and ethnic demographics of the nursing workforce: 2000 to 2015.

BACKGROUND: The case for a more diverse nursing workforce has never been stronger given the rapidly changing demographics of the United States (U.S.) and the underrepresentation of certain racial and ethnic groups in nursing. PURPOSE: The purpose of this paper is to examine how representation of ethnic and racial minority groups in the nursing workforce has changed over a 15-year period (2000-2015). METHODS: The American Community Survey (ACS) data files were used to examine patterns in ethnicity/race and education level in the registered nurse (RN) workforce. Data were analyzed using descriptive statistics and chi-square. FINDINGS: In the nursing workforce, minority groups are reaching higher levels of education. There has been a sharp increase in the number of baccalaureate graduates and a leveling-off of associate degree nurses. DISCUSSION: Nursing leaders are working collaboratively to increase the ethnic and racial diversity of the nursing workforce that is growing at a rate faster than that of the U.S. population as a whole.

Perspectives: Using Results from HRSA's Health Workforce Simulation Model to Examine the Geography of Primary Care.

OBJECTIVE: Inform health planning and policy discussions by describing Health Resources and Services Administration's (HRSA's) Health Workforce Simulation Model (HWSM) and examining the HWSM's 2025 supply and demand projections for primary care physicians, nurse practitioners (NPs), and physician assistants (PAs). DATA SOURCES: HRSA's recently published projections for primary care providers derive from an integrated microsimulation model that estimates health workforce supply and demand at national, regional, and state levels. PRINCIPAL FINDINGS: Thirty-seven states are projected to have shortages of primary care physicians in 2025, and nine states are projected to have shortages of both primary care physicians and PAs. While no state is projected to have a 2025 shortage of primary care NPs, many states are expected to have only a small surplus. CONCLUSIONS: Primary care physician shortages are projected for all parts of the United States, while primary care PA shortages are generally confined to Midwestern and Southern states. No state is projected to have shortages of all three provider types. Projected shortages must be considered in the context of baseline assumptions regarding current supply, demand, provider-service ratios, and other factors. Still, these findings suggest geographies with possible primary care workforce shortages in 2025 and offer opportunities for targeting efforts to enhance workforce flexibility.

Students' experiences with military nurses as faculty.

The United States Army Nurse Corps (ANC) and the University of Maryland School of Nursing (UMDSON) formed a partnership to address the nursing faculty shortage. Six ANC officers served as full-time faculty at the UMDSON for a 2-year period. Given that the student experience is central to the context of learning, the purpose of this study was to describe the experience of the students who interacted with ANC officers. Using a descriptive phenomenological approach, 14 nursing students participated in open-ended, in-depth, audiotaped interviews. Although the students had preconceived ideas about ANC officers as faculty, following engagement with the officers, the students reported many positive attributes of having ANC officers as clinical instructors and an enlightened understanding of the role of the military in today's world. The findings of this study indicate that the use of ANC officers is a plausible solution to the ongoing nursing shortage.

Meta-analysis of the reliability and validity of the Anticipated Turnover Scale across studies of registered nurses in the United States.

BACKGROUND: Globally, there are serious human and financial costs associated with registered nurse (RN) turnover. Anticipating turnover before turnover occurs is important to prevent costly and unnecessary turnover. Using a reliable and valid measure of anticipated turnover is essential to credible healthcare research on which nursing policy decisions are based. This meta-analysis provides a systematic way to determine the legitimacy of the use of the Anticipated Turnover Scale (ATS) in RN workforce research. AIMS: The aims of this meta-analysis were to determine the consistency of reliability estimates and evidence of construct validity of ATS scores across studies of RNs in the US. A secondary purpose was to evaluate variability in reliability and validity according to study quality, century within which studies were conducted and whether studies were published or unpublished. METHODS: Search strategies included accessing computerized databases, emailing researchers, consulting experts, footnote-chasing and accessing unpublished reports. Two independent reviewers examined studies according to inclusion criteria and quality. Consensus was reached on selected studies and quality ratings. RESULTS: Overall mean weighted effect size (MWES) of reliability from 12 studies was 0.89. Overall MWES of validity correlating the ATS and four job satisfaction measures for seven studies was -0.53. There was variability in reliability according to quality of studies. CONCLUSION: The ATS demonstrated excellent reliability and construct validity across studies of RNs in the US. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing management should consider the ATS in research on prevention of RN turnover.

The retention of recalled United States Navy nurse reservists.

The purpose of this study was to identify factors that contribute to the retention of United States Navy Nurse Corps reservists called to duty in 2003. Data were collected by questionnaires based on Price and Mueller's causal model of voluntary turnover and were analyzed via descriptive statistics, multiple regression analysis, exploratory factor analysis, and structural equation modeling. The data indicate that the model fits the data well, with job satisfaction having the strongest influence on one's intent to stay in the Reserve. The data analyses did not support the concern that a negative experience with a recall could make a reservist resign his/her commission. The results may prove useful to any nation that relies on a volunteer reserve force to augment its day-to-day nursing capabilities.

Job satisfaction and retention of military nurses: a review of the literature.

Job satisfaction is an extremely important concept that influences a nurse's decision to stay in an organization, as well as the cost of turnover and the nursing shortage. The purpose of this review is to identify published research studies that have assessed job satisfaction and retention (intent to stay) in military nurses serving in the Army, Navy, or Air Force. The available literature was searched from 1980 to 2010 and the review resulted in 21 studies. The majority of the studies used 2 descriptive correlational design and was specific to one particular service. The researchers reported several satisfiers such as strong sense of teamwork, favorable work environments, pay and benefits, promotional opportunities, leadership and management experiences offered to junior officers. One of the major dissatisfiers was the lack of support from leadership. Nurse researchers must expand the retention science with robust longitudinal interventional studies. Nurse researchers are well positioned to provide military nurse leaders with the best possible evidence to address issues and make decisions regarding nurse retention.

Registered nurses' job satisfaction in Navy hospitals.

Because of the increasing use of civilian registered nurses to supplement the nursing staff at U.S. Navy hospitals, it is imperative to understand the factors that influence satisfaction in both Navy and civilian nurses in military hospitals. This study sought to expand knowledge of satisfaction in hospital-based active duty Navy registered nurses and federal civilian nurses. Respondents completed a survey with a response rate of 42% (N=496). The survey was designed using well-known satisfaction models and included measures of work attitudes, work setting, and demographic characteristics. Linear regression models explained 51% of the variance in job satisfaction for Navy nurses and 55% for civilian nurses. Routinization had the strongest significant negative association with job satisfaction for Navy and civilian nurses. Supervisor support was significantly associated with satisfaction for Navy nurses although coworker support was a significant factor for civilians. These findings have implications for nurse administrators and health care executives who desire to retain nurse employees.

A meta-analysis of studies of nurses' job satisfaction.

Although several variables have been correlated with nursing job satisfaction, the findings are not uniform across studies. Three commonly noted variables from the nursing literature are: autonomy, job stress, and nurse-physician collaboration. This meta-analysis examined the strength of the relationships between job satisfaction and autonomy, job stress, and nurse-physician collaboration among registered nurses working in staff positions. A meta-analysis of 31 studies representing a total of 14,567 subjects was performed. Job satisfaction was most strongly correlated with job stress (ES = -.43), followed by nurse-physician collaboration (ES = .37), and autonomy (ES = .30). These findings have implications for the importance of improving the work environment to increase nurses' job satisfaction.

Meta-analysis of the reliability and validity of Part B of the Index of Work Satisfaction across studies.

Nurses' job satisfaction is a crucial factor in health care organizations. This study uses meta-analysis for reliability generalization and synthesis of construct validity of Part B of the Index of Work Satisfaction (IWS), a measure of job satisfaction. Meta-analysis was performed including assessments of study quality and descriptive coding of studies. Rater reliability was assessed for all coding and extraction of data. The mean reliability of Part B scores of the IWS based on 14 studies was .78 (df = 13, p < .05). The mean score reliability was .77 for university settings, .73 for community/acute care hospitals, .77 for multi-site studies, and .90 for other settings. For studies rated high and low quality, the mean score reliability was .77 and .83, respectively. Scores on Part B of the IWS correlated -.38 with turnover intent, .60 with organizational commitment, and -.53 with job stress. Scores on Part B of the IWS are reliable for measuring job satisfaction of nurses across samples. Construct validity needs additional testing.