Forschungs- & Entwicklungsinformationsdienst der Gemeinschaft - CORDIS

Poland: Premature departure from nursing and 'intention to leave nursing'

The financial situation in the Polish health care system is very difficult, and many entities including large hospitals - are threatened with bankruptcy. This situation has impact on perceived employment possibilities among nurses, which are much lower in Poland than in any other country participating in the NEXT-study. The above factors seem to explain why intent to leave nursing in Poland was rather low.

The risk of premature departure from the nursing profession was estimated on the basis of the question, How often during the last year have you thought of leaving the nursing profession? Among the 4354 Polish nurses, a majority (64.4%) claimed they did not consider such decision at all; less than one-fourth (24.6%)- thought less frequently than a few times during the year; and about one in ten persons (11%) - a few times during the year, or more frequently.

The will to leave the profession was tied to age. It turned out that the persons from the two youngest groups (>30 and 31-40) think of leaving most frequently once a month or more often (15% and 11.6%, respectively)than those aged 41-50 (9.4%), and those who are above 50 years old (6.1%)- the least frequently.

The only factor tied to professional differentiation and clearly influencing the will to leave work was the type of the workplace. Most frequently, thoughts on leaving were seen among persons working in intensive care wards (15%) and medical wards (12,2%), as well as in the day clinics/outpatient clinics (12.4%). This intention was the least frequent among nurses working in pediatric wards (6.6%) and nursing homes (6.4%).

Identification of persons who left the nursing profession prematurely was made on the basis of Qex questionnaire, which covered those persons who in mid-2004 - that is, 12 months from the date of the first research (questionnaire Q0) - did not work for the same employer. In Poland, the Qexe was completed by 122 persons (98% of them were women). Among them, the most frequent formal reasons for leaving were: obtaining the retirement or disability entitlement (63.6%) and individual decision on leaving work (19.8%). Other formal reasons were: being fired by the employer (5.8%), terminating work due to other obligations (5%), expiry of the employment contract without the possibility of extending it (4.1%), or without the will to extend it (1.7%).

Among 77 persons who retired, only a small percentage (7.8% of all retiring) reached the statutory retirement age which is 60 years in the case of women. Most of them have obtained earlier retirement pensions (36.4%), or the so-called bridge pre-retirement benefits (54.5%). Only 1 person left for a disability pension.

The analysis of premature leaving the nursing profession covered two categories of persons. The first category comprised nurses who left on retirement and on other forms of benefits before reaching the retirement age. There were 71 such persons, and their average age was 53 years. Those persons, asked for the three main reasons for earlier retirement, named most frequently: job uncertainty (21%), the workplace being closed down (20%), personal financial problems resulting from financial problems of the workplace (17%), and health problems (15%).

The analyses have shown that among the persons leaving work there are no significant differences in the reasons for leaving between the persons who stay in the nursing profession and those who start new work outside that profession. It turned out that financial reasons play the most important role in the decision to leave. Other significant reasons also included the low prestige of the nursing profession, and lack of promotion opportunities as well as the lack of opportunities for professional development. Shortage of personnel was another important cause for leaving. In the social relations sphere, the most frequent reason for the decision to leave are problems with the direct supervisor. Reasons connected with the content of work are also of great importance. First of all the sense that the work offers insufficient professional challenges. Among reasons linked to the general atmosphere of work, particularly important is the belief in high turnover of nurses.

The Polish part of the NEXT-study was the first large-scale research of nursing community in Poland. Thus, the results aroused great interest among representatives of nursing profession. The results were disseminated in several ways: publications in nursing journals, in scientific journals and conferences.

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