Intention to leave nursing in a major Milano Hospital : current situation and future perspectives

BACKGROUND: European nurses manifest a significant tendency to leave nursing, with Italy in second place after the United Kingdom. It is therefore necessary to address the problem in national and local settings and to identify possible areas of intervention. OBJECTIVES: This paper discusses the results of a survey carried out in a major hospital in Milan (Italy) aimed at finding solutions to the above problem. METHODS: In 2004 a questionnaire was administered to the entire nursing staff. Associations between intention to quit, socio-demographic variables and job characteristics were verified by means of Mann-Whitneys's and Kruskall-Wallis' tests, Spearman's correlation coefficients and logistic regression. RESULTS: Nearly 60% of nurses considered leaving, at least every now and then. The tendency to quit was associated with job dissatisfaction, burnout symptoms and the job market situation. For those for whom nursing had a moral value, the tendency to quit was less marked. Characteristics such as regularity of shifts, type of ward, type of contract and number of working hours did not show any statistically significant association with tendency to quit. CONCLUSIONS: There are many organizational aspects that may be of importance in influencing nurses' intention to leave the profession. Efforts are needed to re-define the role of nurses in healthcare organization, adjusting salaries to the actual cost of living and preventing conditions that could lead to psychological exhaustion. Mentorship could also be useful for a better integration of nurses in hospital wards.