Willoughby is a third year PhD student at The University of Auckland. She has a Bachelor of Nursing degree with First Class Honors, a Bachelor of Arts degree in Film, TV and Media Studies, and is a Registered Nurse with over five years experience in accident and medical care within a primary healthcare setting. Willoughby’s PhD is funded by Health Workforce NZ’s Advanced Trainee Fellowship Scheme (ATF Scheme). This initiative is aimed at assisting exceptional advanced health professional trainees to study in a priority specialty area. The scheme bonds her to The University of Auckland as a full-time lecturer and researcher at the completion of the PhD. Willoughby has also been awarded The University of Auckland Doctoral Scholarship 2013-2016.



Background: Since the recession began in 2007 employment rates of Registered Nurses (RNs) in New Zealand (NZ) have grown. The assumption is that many increased their hours or returned to the profession to supplement their family’s income. It is predicted that as the economy continues to recover the nursing workforce will reach critically low numbers due to these same RNs reducing their hours or leaving the profession because of their family’s improved financial circumstances, at the same time as the ageing nursing workforce nears retirement, the ageing population is increasing demand and many RNs are emigrating to pursue opportunities overseas. Solutions should focus on the motivations of RNs and incentives to retain them. Objective: To provide comprehensive data on a large cohort of RNs from primary, secondary and tertiary workplace settings and from a variety of generational cohorts, in regards to their perspectives on their work conditions, how this fits in with their personal lives, and what their plans are for the future. Results will inform the development of a new model of RN intention to leave as well as provide health care planners with information for strategies that seek to motivate RNs to remain engaged in the profession despite their changing circumstances, in the hope of building a high functioning stable nursing workforce. Methods: Qualitative data were collected from 25 semi-structured interviews with RNs, nurse leaders, and key stakeholders. Results of thematic analysis informed the development of a survey that was sent to a randomized sample of RNs across NZ and was advertised in the Nursing Council of NZ newsletter. To date, over 2,500 RNs have completed the survey. Quantitative data will be analyzed using Structural Equation Modeling. Phase I Results: The literature review and thematic analysis in Phase I resulted in the development of five key themes that influence RN intention to leave. Job Demands includes the variables of role overload (quantitative demands; emotional demands; nurse-patient ratio; skill mix; task delegation; patient complexity), personal harm (physical, emotional, verbal), and returning to work. Personal demands include the variable work-life conflict. Job Resources includes variables of social support (supervisor support; colleague support), organizational support (kinship responsiveness; schedule flexibility), autonomy, professional development (training and career progression), and reward (intrinsic: respect and recognition; extrinsic: pay). Personal resources includes the variables psychological capital and value fit (value congruence; career orientation; image of nursing). Finally, Context and controls includes demographics, positive and negative affect, and economic climate.