Nurse attrition rate a cause for concern

August 2015 Vol 15 (4)

The Nursing Council of New Zealand recently released the latest report in its Nursing Cohort longitudinal study, which includes an update on the number of nurses registered in the 2005/06 year who are still nursing in New Zealand. While the numbers, including new data on nurses first registered in 2012/13, are worryingly low, it’s not all doom and gloom. FIONA CASSIE reports.

There is bad news, and some potentially good news, about nurse retention in the update to the Nursing Cohort longitudinal study.

The initial study found a steady decline in the number of nurses registered in 2005/06 still nursing in New Zealand by 2012. This trend has continued, with only two-thirds of New Zealand-qualified (NZQN) and less than half of internationally qualified (IQN) nurses registered that year still actively practising in 2014 (see exact figures in sidebar).

This means more than 1,000 nurses (a 41 per cent attrition rate) were no longer nursing in New Zealand just eight years after registering. However, the initial study also showed a spike in 2010 of non-practising nurses renewing their annual practising certificates (APCs) as the recession hit. The update shows that in 2014 the vast majority (96 per cent of NZQN and 92.3 per cent of IQN) still had current New Zealand APCs so could nurse here if they chose to. 

In the 'May be good news’ basket are the findings from the new cohort of nurses whose careers the Nursing Council is following – those nurses who registered in 2012/13. 

This cohort includes bumper numbers of New Zealand-trained nurses (1,639 compared with 1,323 in 2005/06) and, despite the tight job market and increased demand for places, the number of new graduates still nursing a year after registering was 93 per cent, compared with 84 per cent of the smaller cohort seven years before. 

Likewise, while the number of IQN registered in 2012/13 was similar to 2005/06, the proportion of overseas-trained nurses who were actively practising in 2014 was much higher at 88.5 per cent than the 69 per cent of the earlier cohort nursing here at the same time post-registration.

Whether the higher proportion entering the nursing workforce straight after registration translates into lower overall attrition rates in the future, only time will tell. 

Valuable planning data 

In her foreword to the latest study update, Nursing Council chief executive Carolyn Reed says that the aim of this and future reports is to follow the real-time experiences of the two cohorts of new nurses as they pursue their nursing careers.  She says it is hoped the study findings (gathered from data collected when nurses renew their APCs) will provide a valuable resource for planning services, creating good workplace environments, developing policy and undertaking research. 

"Being able to follow the 2005/06 and 2012/13 populations – cohorts separated by seven years of change in the health system and our profession – will help to provide a picture of continuity and differences in the nature and practice experiences of nurses in New Zealand," she wrote. 

One trend highlighted by the study is the different make-up of the overseas-trained workforce, which has gone from predominantly ‘Other European’ to Filipino and Indian over the seven years. This has also led to a shift from the majority of IQN nurses being diploma-qualified to being degree-qualified and a shift to younger nurses and a higher proportion of males in the IQN workforce. 

The 2012/13 cohort also for the first time includes newly registered enrolled nurses (ENs) and will be following the cohort of 150 ENs who were considerably older than their RN counterparts, with a median age of 38 years compared with 26 years for the RNs. The ENs also had the lowest employment rate, with 74 per cent actively nursing.

Nursing cohort retention rates 2006–2012

2005/06 RN cohort

  • 1,323 NZ-qualified nurses (NZQN) registered in 2005/06
  • 1,273 internationally qualified nurses (IQN) registered in 2005/06
  • Average NZQN age at registration is 28 years old
  • Average IQN age at registration is 34 years old
  • Most common ethnicity for IQN nurses is Other European (62%) followed by Indian and African (both at 8%)
  • Most common ethnicity for NZQN nurses is NZ European (67%) followed by Māori (13%), Other European (7%) and Indian (5%)
  • 15% of IQN nurses are male, compared with 7% of NZQN
  • 84% of the NZQN cohort were actively practising a year after registration (i.e. 2007), compared with 72% in 2012 and 67% in 2014
  • 69% of the IQN cohort were actively practising a year after registration (2007), compared with 53% in 2012 and 47% in 2014
  • 96% of the NZQN still maintained NZ APCs in 2014 and 92.5% of the IQN had NZ APCs in 2014.

2012/13 RN cohort

  • 1,639 NZ-qualified nurses (NZQN) registered in 2012/13
  • 1,257 internationally qualified nurses (IQN) registered in 2012/13
  • Average NZQN age at registration is 26 years old
  • Average IQN age at registration is 28 years old
  • Most common ethnicity of IQN nurses is Filipino (41%) and Indian (26%) followed by Other European (19%)
  • Most common ethnicity for NZQN is NZ European (66%, which is very similar to 2005/06) followed by Māori (11%), Other European and Indian (both 6%)
  • 23% of IQN nurses are male, compared with 7.8% of NZQN cohort
  • 92% of the NZQN cohort were actively nursing one year after registration (93% of cohort had NZ APCs – nine were unemployed, 15 not currently working as nurses and six were working in other occupations)
  • 88.5% of the IQN cohort were actively nursing one year after registration (89% had NZ APCs and three were unemployed).

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