Job insecurity and intent to leave the nursing profession in Europe

To determine the occupational factors affecting nurses' decision to leave their profession before reaching retirement age, a large epidemiological study (Nurses' early exit study - NEXT)1 was carried out in ten European countries. Altogether 32,037 registered nurses answered a questionnaire, covering, for example, questions on job insecurity and intention to leave nursing work. The data were analysed statistically using Chi2 test and binary logistic regression models. Concern about becoming unemployed and difficulties to find a new job if laid off was reported by 40% of the respondents. More than half of the respondents were worried about their qualitative job security (being transferred to another job or changes in work schedule), while less than 40% had concerns about becoming unable to work. Thoughts about leaving the profession were reported by 15% of the respondents. The hypothesis, that nurses will show higher intention to leave if they experience high levels of job insecurity, was partly supported by the results of the study. The concern about the qualitative aspects of job security correlated positively with intent to leave nursing in almost all the participating countries; most strongly among the Finnish and Norwegian nurses. The relationship between the concern about employment security and intent to leave varied from country to country, probably due to differences in the labour market situation. The correlation was positive for the Dutch and British nurses while, for the Polish and German sample, nurses who reported worry about their employment security appeared to be less willing to leave the profession than those who were not too worried. The concern about being unable to work correlated positively with intent to leave in several countries, reflecting the demands of the profession. The effects of job insecurity can be reduced if nurses feel that they are important to the health care institution they work for, and that the institution cares about them, and values their opinion.