Critical Care Registered Nurse Transitions: A Life Course Perspective
Public Deposited- Creator
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Tran, Alberta
- Affiliation: School of Nursing
- Abstract
- Sufficient numbers of critical care registered nurses (CC RNs) are necessary to provide care to and improve the outcomes of critically ill patients. Unfortunately, there are challenges in maintaining a sufficient CC RN workforce, such as the fast-paced and stressful nature of the critical care (CC) environment and employers’ desire to hire experienced nurses. Little is known about nurse transitions, in general, or CC RN transitions out of the CC specialty, and the factors that influence these transitions. This dissertation addressed this knowledge gap by using life course theory (LCT) from sociology to identify factors that predict the occurrence and timing of nurse transitions out of the CC RN workforce. Individual RN licensure data from the North Carolina Board of Nursing over a 13-year period were linked at two-year intervals to create a longitudinal dataset of responses for CC RNs. Descriptive statistics, Poisson regression, logistic regression, and ordinal regression were used to examine the effects of LCT variables (e.g., economic recession, graduation cohort, age, and gender) on the occurrence and timing of CC RN transitions. This study found that, despite the relatively short observation period, the majority of CC RNs made transitions to either a non-CC specialty or inactive/non-licensed status. Working during the Great Recession (2007-2009) decreased the odds of RN transition but, for those nurses who made transitions, the odds of remaining in CC for longer times decreased. Additionally, this study found that age and gender had different effects on transition outcomes: male CC RNs were less likely to leave CC for a non-CC specialty but more likely to become inactive/non-licensed; CC RNs who were between 30 and 49 years old, relative to those 29 or younger, were less likely to transition to inactive/non-licensure status but age had no effect on transition to non-CC specialty areas. This dissertation underscores the importance of differentiating types of nurse transitions and examining nurses’ work behaviors within broader environmental contexts. Findings can help guide the development of stronger policies and employer-based strategies to bolster workforce capacity and aid in workforce planning efforts during times of need in the immediate and long-term future.
- Date of publication
- 2020
- Keyword
- DOI
- Resource type
- Advisor
- Jones, Cheryl B
- Knafl, George J
- Baernholdt, Marianne
- Fraher, Erin P
- Tonges, Mary C
- Degree
- Doctor of Philosophy
- Degree granting institution
- University of North Carolina at Chapel Hill Graduate School
- Graduation year
- 2020
- Language
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- Parents:
This work has no parents.
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