Reward frustration at work and intention to leave the nursing profession—Prospective results from the European longitudinal NEXT study

Abstract

Background Many countries are facing a serious situation of nursing shortage, and retention of nurses is a challenge. Objectives To examine whether reward frustration at work, as measured by the effort–reward imbalance model, predicts intention to leave the nursing profession, using data from the European longitudinal nurses’ early exit study. Design A prospective study with one-year follow-up. Methods 6469 registered female nurses working in hospitals in seven European countries who did not have intention to leave the nursing profession at baseline were included in our analyses by multivariate Poisson regression. Results 8.24% nurses newly developed intention to leave during follow-up. High effort–reward imbalance at baseline predicted an elevated risk of intention to leave the profession (relative risk 1.33, 95% confidence interval 1.22–1.45), and reward frustration (poor salary and promotion prospects, lack of esteem) showed the strongest explanatory power. Findings were similar in a majority of the countries. Conclusions Results suggest that improving the psychosocial work environment, and specifically occupational rewards, may be helpful in retaining nurses and consequently reducing nursing shortage in Europe.