The Importance of Nurse Employment Categories in Determining Exit Rates from Nursing
Background: Health care is a labour-intensive industry and nursing represents a high proportion of these labour costs. In response to fiscal constraints, payers have attempted to constrain costs; in return, provider organizations have sought to reduce their labour costs by shifting from full-time (FT) to part-time (PT) or casual (CAS) workforces. In 2004, 8.6% of all working registered nurses were casual workers in Ontario, Canada. We analyzed the nursing workforce in Ontario by sub-sector, with particular attention to the structure of the casual workforce over time and its implications for nursing recruitment and retention policies. Objective: To determine whether nurses' tendency to remain in Ontario's nursing profession differs according to nurses' employment category (full-time / part-time / casual) taking into account individual and workplace covariates such as the employment setting. Data Sources: College of Nurses of Ontario (CNO) data base representing all nurses licensed to practice in the province. A longitudinal dataset for all the nurses registered with the CNO from 1993 to 2004 was created by merging on a unique registration number (N = 198, 762). Methodology: A Cox Proportional Hazard Regression Model was estimated for both Registered Nurses and Registered Practical Nurses in order to model, time to exit, from the profession for full-time, part-time and casual nurses. The panel analysis accounted for the potential left and right censoring of the data. Model covariates included employment sector (hospital, community, nursing homes, other) , age, education, training, and the number of employers. Results: We find that full-time and part-time nurses are less likely to leave nursing (FT 0.577, PT 0.506, p value <0.0001) relative to their casual counterparts. However, the exit rate differential between full-time and part-time nurses was negligible (1.03). Nurses with higher levels of formal education are more likely to leave nursing. Similarily, older nurses (i.e.50+ years of age) are more likely to leave nursing compared to a nurse who is 45 years of age. Full-time and part-time nurses in the nursing home sector are less likely to leave nursing (FT 0.598, PT 0.677) relative to a casual nurse working in the hospital sector. Conclusions: Full-time and part-time nurses appear to have similar exit rates adjusted for a range of covariates. Whereas, casual nurses experience markedly higher exit rates in comparison to full-time and part-time nurses. Employment status was found to have a greater impact than employment sector on the likelihood that a nurse will remain in the profession. In contrast to common practice in the literature, our results suggest that it is important to distinguish part-time and casual nurses in the development of labour force models
Year of publication: |
2007
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Authors: | Waisberg, Frieda ; Laporte, Audrey ; Levington, Carey ; Deber, Raisa B ; Baumann, Andrea ; O'Brien-Pallas, Linda ; Onate, Kanecy |
Publisher: |
[S.l.] : SSRN |
Description of contents: | Abstract [papers.ssrn.com] |
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