Nurse Practitioners (NPs) are advanced Registered Nurses (RNs) with additional training and skills who diagnose and treat acute illness and chronic conditions, sometimes without the direct supervision of a doctor. The purpose of this research is to understand the determinants of NP turnover to make recommendations designed to reduce NP turnover, and thus help control costs and improve the quality of care.
Data on 7,944 NPs from the 2012 National Sample Survey of Nurse Practitioners were analyzed broken down into the four different practice settings available in the data: Primary Care (3,843), Internal Subspecialties (1,345), Surgical (724), and Other (2,032). Thirteen job dissatisfaction questions were factor analyzed to create four job dissatisfaction variables: patient workload, professional treatment, organizational administration, and pay and benefits. The four dissatisfaction variables were then included in a logistic regression model of turnover intentions that also included control variables for the NPs’ demographics and work settings.
Results of the logistic regression showed that higher NP turnover intentions were associated, in order of size of effect, with higher levels of dissatisfaction with organizational administration, professional treatment, patient workload, and pay and benefits. Some of the control variables were associated with turnover intentions in some of the different practice settings, but the effects were typically small.
The findings of this research suggest that healthcare providers can reduce NP turnover, and thus control costs and improve access and the quality of care, by focusing on reducing dissatisfaction with organizational administration, professional treatment, patient workload, and pay and benefits.
Keywords: nurse practitioner, turnover, job satisfaction, quality of care
