Too Few Nurses, Too Many Exits: Why are So Many Nurses Exiting the Profession?

By: Audrey Laporte

It isn’t uncommon these days to encounter anxiety among health care administrators over what appears to be an impending critical labour shortage among nurses. Some of the problem, experts contend, stems from nurses’ high rates of “exit” from the profession.

HPME faculty members Audrey Laporte and Raisa Deber, in collaboration with colleagues Andrea Baumann and Linda O'Brien-Pallas at the Nursing Effectiveness Research Unit, have recently completed research that investigates the factors that influence Ontario nurses’ exit decisions. In their study, Laporte and her fellow researchers drew on nursing licensure (registration) data to track the career paths of nurses from 1993 to 2005. They found that the Ontario nursing labour market during that period was quite heterogeneous, especially with regard to urban and rural regions, shift work, and care sectors. In particular, the community-care sector experienced greater difficulty retaining nurses than did hospitals or long-term care facilities.

Among the study’s more unexpected findings was the fact that nurses with 2 to 5 years of experience were relatively more likely to exit the profession, even after allowing for temporary (e.g., maternity) leaves of absence (that was particularly the case in non-urban regions). Given that the nursing workforce is aging in Ontario and other parts of Canada, policies that have an impact on the retention of the newest ranks of nurses may be particularly problematic. One policy lever that could help stem the tide of departures might be to allow greater flexibility in local wage setting to make wages more responsive to local demand and supply conditions, although that could give rise to other problems.