Part 2: Nurses' career aspirations to management roles: qualitative findings from a national study of Canadian nurses.

AIM: Our aim was to investigate direct-care nurses' interests in formal management roles and factors that facilitate their decision-making. BACKGROUND: Based on a projected shortage of nurses by 2022, the profession could be short of 4200 nurse managers in Canada within the next decade. However, no data are currently available that identify nurses' interests in assuming manager roles. METHODS: Using focus group methodology, we conducted 18 focus groups with 125 staff nurses and managers in four regions across Canada. RESULTS: Major themes and subthemes influencing nurses' decisions to pursue management roles included personal demographic (education, age, clinical experience and life circumstances), personal disposition (leadership skills, intrinsic rewards and professional commitment) and situation (leadership development opportunities, manager role perceptions and presence of mentors). Although nurses see management roles as positive opportunities, they did not perceive the rewards to be great enough to outweigh their concerns. CONCLUSIONS: Findings suggested that organizations need to provide support, leadership development and succession opportunities and to redesign manager roles for optimum success. IMPLICATIONS FOR NURSING MANAGEMENT: Leaders need to ensure that they convey positive images of manager roles and actively identify and support staff nurses with leadership potential.

Part 1: The influence of personal and situational predictors on nurses' aspirations to management roles: preliminary findings of a national survey of Canadian nurses.

AIM: To examine the influence of personal and situational factors on direct-care nurses' interests in pursuing nursing management roles. BACKGROUND: Nursing managers are ageing and nurses do not appear to be interested in nursing management roles, raising concerns about a nursing leadership shortage in the next decade. Little research has focused on factors influencing nurses' career aspirations to nursing management roles. METHODS: A national survey of nurses from nine Canadian provinces was conducted (n = 1241). Multiple regression was used to test a model of personal and situational predictors of nurses' career aspirations to management roles. RESULTS: Twenty-four per cent of nurses expressed interest in pursuing nursing management roles. Personal and situational factors explained 60.2% of nurses' aspirations to management roles. Age, educational preparation, feasibility of further education, leadership self-efficacy, career motivation, and opportunity to motivate others were the strongest predictors of aspirations for management roles. CONCLUSIONS: Personal factors were more strongly associated with career aspirations than situational factors. There is a steady decline in interest in management roles with increasing age. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing leadership training to develop leadership self-efficacy (particularly for younger nurses) and organizational support for pursuing advanced education may encourage nurses to pursue nursing management roles.

The importance of employment status in determining exit rates from nursing.

To mitigate nurse shortages, health care decision makers tend to employ retention strategies that assume nurses employed in full-time, part-time, or casual positions and working in different sectors have similar preferences for work. However, this assumption has not been validated in the literature. The relationship between a nurse's propensity to exit the nurse profession in Ontario and employment status was explored by building an extended Cox Proportional Hazards Regression Model using a counting process technique. The differential exit patterns between part-time and casual nurses suggest that the common practice of treating part-time and casual nurses as equivalent is misleading. Health care decision makers should consider nurse retention strategies specifically targeting casual nurses because this segment of the profession is at the greatest risk of leaving. Nurse executives and nurse managers should investigate the different work preferences of part-time and casual nurses to devise tailored rather than "one-size fits all" nurse retention strategies to retain casual nurses.

Retaining nurses: the impact of Ontario's "70% full-time commitment".

OBJECTIVES: To evaluate the effectiveness of a nurse retention strategy, the "70% Full-Time Commitment", in retaining part-time and casual nurses in Ontario's nurse profession. METHODS: Using the College of Nurses of Ontario database, a longitudinal dataset for all nurses registered with the college from 1993 to 2006 was created (N=216,353). One-year transition probabilities of nurse employment status (full-time, part-time and casual) were conducted (1993-2009) to generate trends of nurses' likelihood to stay in, switch or leave their full-time, part-time or casual position in Ontario's nurse profession. RESULTS: After the 70% Full-Time Commitment (2004-2009) was initiated, most full-time (89.7%), part-time (76.6%) and casual (62.5%) nurses stayed in their employment position. A slightly larger proportion of part-time nurses (13.6%) switched to full-time compared to casual nurses (8.6%). However, a similar proportion of young part-time (24.5%) and casual (23.3%) nurses switched to full-time. A smaller proportion of part-time (3.2%) and casual (7.1%) nurses left the profession. CONCLUSION: Part-time and casual nurses have different employment switching patterns. The "70% Full-Time Commitment" was not an effective mechanism in retaining part-time and casual nurses. It might be more effective as a recruitment initiative for young nurses.

Where Are Ontario's Respiratory Therapists Working?

Registered respiratory therapists (RRTs) aid in the diagnosis and treatment of respiratory illness and cardiopulmonary disorders, conditions that are increasingly being managed in settings other than the hospital sector. However, analysis of a longitudinal data set of Ontario's RRTs (2,903) from 1996 to 2007 demonstrates that the majority of RRTs work full-time in the hospital sector, where retention is high. Despite a policy direction encouraging the shift of the site of care from the hospital sector to the community/home, this has had little impact on where RRTs work, raising the question of who is providing respiratory services in the community.