1. Johnson, Janet E. BSN, RN
  2. Buelow, Janet R. PhD, RN


In many regions of the country, hospitals are faced with increasingly serious nursing shortages. Many hospitals have developed incentive packages to recruit nurses. However, the literature clearly demonstrates that the nurses' work environments must be addressed if nurses are to be retained. The authors created a questionnaire to measure registered nurses' attitudes toward their work environments. Information from this questionnaire can provide timely feedback and enable nurse managers to identify and correct organizational factors that could lead to turnover. The questionnaire takes fewer than 10 minutes for each nurse to complete, and nurse managers can easily calculate the results. The questionnaire can be modified for use in other healthcare facilities.


Hospitals have experienced nursing shortages in the past; however, the present shortage is predicted to be one that will last well into the future, unless several changes are made. More than 40% of nurses working in hospitals report being dissatisfied with their jobs, and 1 out of every 3 hospital nurses under the age of 30 years is planning to leave his or her current job within the next year. 1 The American Hospital Association (AHA) reports that 126,000 nurses are needed to fill vacancies in our nation's hospitals. 2 Fewer students are enrolling in nursing programs, and the average age of nurses is rising. Women, who comprise the majority of the nursing workforce, are choosing careers outside nursing with better hours, less demands, and higher wages.


The estimated cost of turnover ranges from $10,000 to $60,000 per registered nurse (RN), depending on the nurse's specialty. 3 This does not include the general morale costs to an organization when nurses struggle to provide adequate care with insufficient staffing. Nor does it include the morbidity costs to individual patients who are receiving care in hospitals with low nursing ratios. It is estimated that by 2008, there will be approximately 161 million jobs for 155 million workers. With a shortage of workers, it is critical that managers do everything in their power to create a better place to work, not only to recruit but also to keep the good nurses they have recruited. 4


Administrators throughout the country are taking several measures to maintain adequate numbers of nurses. Many administrators are attracting nurses through signing bonuses, tuition reimbursement, flexible schedules, and increased compensation. Other hospital administrators are investing in international search firms recruiting and supporting new nurses from the Philippines, Canada, and Eastern Europe, but the nursing shortage is worldwide, and every nation has a problem of its own. 5


Although these measures may help bring new nurses into a facility, equal effort must be executed to retain nurses. Clearly, work environments need enhancement if healthcare organizations are to retain their nurses.