Factors which influence pediatric intensive care unit nurses to leave their jobs
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The United States (U.S.) is in the midst of a nursing shortage that is expected to increase as ‘baby boomers’ age and the need for health care grows. Job burnout and dissatisfaction are driving forces that prompt nurses to leave the profession and their jobs. High nurse turnover and vacancy rates are affecting access to health care, and there are correlations between adequate levels of RN staffing and safe patient care. In addition to these issues, high turnover rates have sizeable financial implications. In 57% of all U.S. hospitals, critical care nurse positions are the most difficult to fill. Pediatric Intensive Care Unit (PICU) nurses, a forgotten subgroup of critical care nurses, are more vulnerable to dissatisfaction, as they face issues unique to caring for critically ill children and their families. The purpose of this qualitative study was to discover why nurses voluntarily left the PICU at Children's Medical Center (Children's) in Dallas, Texas. The specific aims of this study were to (a) determine the factors that influenced PICU nurses' decisions to leave their jobs, (b) relate these factors to the uniqueness of the PICU setting, and (c) propose an evidence-based set of strategies for retaining PICU nurses. Ten PICU nurses who voluntarily left Children's were interviewed. Critical theory provided the philosophical framework, while the methodological frameworks were action research and Heideggerian hermeneutic phenomenology. Data analysis was conducted using the circular hermeneutic process described by Heidegger and explicated by Diekelmann. From the findings of this study, I concluded that there is an inescapable and inevitable tension between the human factors and the PICU work environment. Each nurse identified the constitutive pattern of Unrelieved Job Stress as the major reason they left the PICU. The multidimensional and interactive environmental characteristics of Nature of the Job, Insufficient Resources, and Negative Perceptions of Managers/Team Leaders contributed to the development of job stress. The results of this study revealed the evidence needed to begin to focus on the interventions in the areas of nursing practice, education, and research required to reduce the likelihood of losing more PICU nurses.