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AIMS: The paper reports a study to explore the decision process nurses go through before leaving, focusing on leaving decisions that are precipitated by a single, jarring event or shock. BACKGROUND: Nursing turnover is a significant problem. Although a range of initiatives has been adopted to improve retention, recent insights from the academic literature on labour turnover have additional implications for how this problem might be managed. METHOD: A structured questionnaire, with some open-ended items, was used to collect data. For respondents who reported a shock (n = 153), responses were cluster analysed (hierarchical, agglomerative clustering generated a solution and k-means clustering enhanced the solution). Clusters were validated using responses to open items. RESULTS: There were three broad clusters of nursing turnover: cluster 1 described nurses whose decision to leave was precipitated by a shock that was work-related, negative and unexpected; cluster 2 described those whose decision was precipitated by a shock that was personal, positive and expected; cluster 3 describes those whose decision unfolded more gradually. Cluster 3 described the conventional picture of how turnover occurs (i.e where there is no shock), whereas clusters 1 and 2 were evidence of different types, where a shock prompts the quitting. CONCLUSION: In many cases of nurse turnover, a single, jarring event, or shock, initiates thoughts of quitting. Understanding the role of shocks has implications for a range of management activities. Allocation of education, promotion and distribution of other benefits should be managed in such a way as to minimize the likelihood of shocks. Profiling of nurse leavers should be undertaken so that managers have an accurate and detailed picture of turnover.
Kevin Morrell (Wed,) studied this question.