PhD in Nursing Science Program

The Influence of Organizational and Personal Factors on U.S. Army Nurse Corps Officers' Intent to Leave the Army

Dissertation under the direction of Professor Ann F. Minnick

The study’s purpose was to compare organizational, personal, and economic factors in military and civilian nurses to: a) determine if differences exists between the two groups’ intent to leave (ITL), b) determine how structural empowerment, psychological empowerment, and job satisfaction factors predict ITL, and c) explore the influence of personal and economic factors on ITL. This is important because poor nurse retention in the Army Nurse Corps (ANC) at the mid-career level (losses of up to 20%) can have devastating consequences on the future of ANC leadership.

This study used a targeted comparative group design including all US Army nurses [2nd Lieutenant to Major (n=3163)] and a single hospital sample of civilian registered nurses (n=861). Too few of the civilian respondents (12.7%, n=26) reported ITL and meaningful comparative statistical analysis was not possible. The final analysis focused on the Army respondents (response rate=19.7%). The Army respondents’ were highly representative of the total ANC population. Frameworks of organizational structure and empowerment (including Kanter and Laschinger) guided survey content. The instruments used were Conditions of Work Effectiveness Questionnaire-II, Psychological Empowerment Instrument, job satisfaction scale, economic and demographic questions, and ITL items.

This study’s findings validate those of previous investigators who reported high associations between Job Satisfaction (p=<.001) (Larrabee, 2003), control over life, difficulty starting a family and ITL (Gahol, 2005). The inverse relationship with Income Contribution Percent and ITL appears to be a new finding in the ANC population. The cluster analysis revealed three clusters that defined individuals with ITL. They differed in income contribution percent, age, years with employer, rank, advanced degrees, marital status, dependents, and home ownership.

A single solution may produce little increase in retention. A three group targeted strategy may yield a greater increase in retention. The fact that only 12.7% of the civilian nurses planned to leave their Magnet hospital versus 18.5% of Army nurses, may indicate that the Army could benefit from exploring the possibility of Magnet recognition for Army hospitals.