The Nurse Work Environment and Turnover in Perinatal Hospices (S759)

Abstract

•Describe the nurse work environment in perinatal hospices.•Identify the nurse work environment characteristics related to RN turnover. Given the current healthcare reform environment, the loss of registered nurse (RN) staff to turnover is a concern in hospices, especially among those that require specialized nursing skills. Perinatal hospices provide specialized nursing care for mother and families who wish to carry out a birth even when a baby's death is imminent. Although job satisfaction and burnout have been shown to contribute to turnover, the characteristics of the nurse work environment may be important predictors of nurse turnover. Understanding the unique perinatal hospice nurse work environment and its influence on RN turnover may be essential for advancing knowledge of and compassion for families at end of life. The study examined the effect of the nurse work environment on RN turnover in perinatal hospices. This correlational design study used the 2007 National Home and Hospice Care survey. Data on fulltime RN turnover and the nurse work environment (i.e., hospice environment, nursing unit environment, nursing unit structure) were analyzed from a sample of 728 perinatal hospices. Associations were calculated using multivariate ordinary least squares regression. The fulltime RN turnover rate was 5.2%. Findings revealed that suburban perinatal hospices (β=-0.05, p<0.05) and work environments with clinical support from clinical nurse specialists and nurse practitioners (β=-0.05, p<0.01) were less likely to experience RN turnover. Other nurse work environment characteristics were not associated with RN turnover. The study provides initial insight into the role of the nurse work environment on turnover in perinatal hospices. The results suggest that work environments with greater clinical support structures and nursing expertise available through clinical nurse specialists and nurse practitioners may be critical in reducing RN turnover.